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Sample records for total state appropriations

  1. A TOTAL MANUFACTURING SOLUTIONS TECHNIQUE TO SELECT APPROPRIATE IMPROVEMENT STRATEGY: CASE STUDY OF A FOOTWEAR FACTORY

    Directory of Open Access Journals (Sweden)

    Gezahegn Tesfaye

    2014-09-01

    Full Text Available The Government of Ethiopia is promoting the manufacturing sector to join the global market in a large scale. Due to its comparative advantages, the Ethiopian leather and leather products industry have been given due attention. To fully utilize such advantages, the country shifted its export items from hides/skins to footwear products. Nevertheless, the performance of the leather sector in general and footwear sub-sector in particular is far below the desired standards. The improvement strategies applied hitherto were mainly to tackle a small portion of their total problems. If the Ethiopian footwear companies have to become globally competitive, their entire business spectrum has to be assessed and appropriate improvement strategies must be selected. In this research, we used a Total manufacturing solutions (TMS technique to identify areas of improvement and improvement strategy of one of Ethiopian footwear companies. For this purpose, we conducted two surveys using structured questionnaire. The first survey was to test the TMS technique against the context of footwear industry. The result proved that the original TMS model can be used to measure the performance of footwear companies. The second survey was done to identify company's total problems, map its current position and select appropriate improvement strategy. The result revealed that the company has company-wide problems and its current position is a plodder. For plodders which have company-wide problems, the improvement strategy must include aggressive application of BPR; and the implementation of best practices to develop workers skills that encourages networking and promotion, a market-led manufacturing strategy, employee involvement and team work cultures. According to the findings of this research, we suggested that a BPR technique followed by a continuous improvement programme could be an appropriate improvement strategy for this company. The company requires long-term improvement

  2. State, Foreign Operations, and Related Programs: FY2008 Appropriations

    National Research Council Canada - National Science Library

    Veillette, Connie; Epstein, Susan B

    2007-01-01

    ... an unprecedented level compared with the past 40 years. Emergency supplementals enacted since the September 11, 2001, terrorist attacks to assist the front-line states in the war on terrorism, fund Afghanistan and Iraq reconstruction, and upgrade State...

  3. State, Foreign Operations, and Related Programs: FY2008 Appropriations

    Science.gov (United States)

    2007-12-14

    and social reforms. The President initially pledged $5 billion annually by FY2006, although funds requested and appropriated have never reached this...to Cuba. The BBG is planning to eliminate several VOA services including Uzbek, Greek, and Cantonese as well as the RFE/RL Macedonia service. BBG also...increased to $230.0 million. The increase of $195 million is entirely for social services to Iraqi refugees. FY2007 Supplemental Request. On April 25

  4. 42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

    Science.gov (United States)

    2010-10-01

    ... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of this...

  5. STATE BUDGET APPROPRIATION MANAGERS AS THE SUBJECTS OF BUDGET PLANNING IN THE REPUBLIC OF LITHUANIA

    Directory of Open Access Journals (Sweden)

    Bronius Sudavicius

    2017-01-01

    Full Text Available The subject. The article deals with the problem of legal status of the state budget appropriation managers in the process of budget planning in the Republic of Lithuania.The purpose of the article is evaluation of state budget appropriation managers’ role in the process of budget planning in the Republic of Lithuania.The methodology of research is the analysis of the budgetary legislation of the Republic of Lithuania and the scientific literature, using the methods of logical and systematic analysis and other methods of scientific researchMain results, and scope of it’s application. The legal definition and the system of state budget appropriation managers is analyzed in the article. Particular attention is given to the question of role of state budget appropriation managers in the process of budget framework. The role of the Government and Parliament, as well as a special body of management of public finances (in the Republic of Lithuania, the Ministry of Finance – legislative and executive authorities – is emphasized in the scientific literature. But it is often not mentioned what an important place in this process other participants of budgetary relations – state budget appropriation managers – takes. The main participation of state budget appropriation managers in the budget planning process related to the planning of the budget expenditures.Preparation of strategic plans and programmes of budgetary funds by state budget appropriation managers can be considered part of governance activities in general. For budget planning drawn up draft budgets of the programs by state budget appropriation managers is particularly important.Conclusions. The efficiency of the use of state funds depends on the spending of funds, the quality and validity of the developed programmes of activities led by their agencies. State budget appropriation managers are involved, along with other entities, on each stage of the budget planning. They provide the

  6. The Chief Financial Officer's Perception of Financial Management Response to Eroding State Appropriations

    Science.gov (United States)

    Tate, James Adam

    2012-01-01

    State fiscal support for public higher education is declining, particularly during recessionary periods. Public colleges and universities have limited channels of revenue and depend on state appropriations for current operating needs. There is an imperative now for public institutions to do more with less, be more efficient and effective in order…

  7. Flood risk management in Flanders: from flood risk objectives to appropriate measures through state assessment

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    Verbeke Sven

    2016-01-01

    Full Text Available In compliance with the EU Flood Directive to reduce flood risk, flood risk management objectives are indispensable for the delineation of necessary measures. In Flanders, flood risk management objectives are part of the environmental objectives which are judicially integrated by the Decree on Integrated Water Policy. Appropriate objectives were derived by supporting studies and extensive consultation on a local, regional and policy level. Under a general flood risk objective sub-objectives are formulated for different aspects: water management and safety, shipping, ecology, and water supply. By developing a risk matrix, it is possible to assess the current state of flood risk and to judge where action is needed to decrease the risk. Three different states of flood risk are distinguished: a acceptable risk, where no action is needed, b intermediate risk where the risk should be reduced by cost efficient actions, and c unacceptable risk, where action is necessary. For each particular aspect, the severity of the consequences of flooding is assessed by quantifiable indicators, such as economic risk, people at risk and ecological flood tolerance. The framework also allows evaluating the effects of the implemented measures and the autonomous development such as climate change and land use change. This approach gives a quantifiable assessment of state, and enables a prioritization of flood risk measures for the reduction of flood risk in a cost efficient and sustainable way.

  8. Total Factor Productivity Convergence in German States Since Reunification

    DEFF Research Database (Denmark)

    Burda, Michael C.; Severgnini, Battista

    2018-01-01

    A quarter-century after reunification, labor productivity in the states of eastern Germany continues to lag systematically behind the West. Persistent gaps in total factor productivity (TFP) are the proximate cause; conventional and capital-free measurements confirm a sharp slowdown in TFP growth...... of managers, low startup intensity and the distribution of firm size in the East rather than R&D activities....

  9. Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States

    Science.gov (United States)

    Bhadra, Arup K.; Altman, Roy; Dasa, Vinod; Myrick, Karen; Rosen, Jeffrey; Vad, Vijay; Vitanzo, Peter; Bruno, Michelle; Kleiner, Hillary; Just, Caryn

    2016-01-01

    Objective: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. Methods: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy. This workgroup utilized the results of a systematic review of evidence, expert clinical opinion, and current evidence-based clinical practice guidelines to develop appropriateness criteria for the use of intra-articular HA for knee OA in 17 real-world clinical scenarios. Results: The workgroup scored the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (7-9), uncertain (4-6), or inappropriate (1-3). Six scenarios were scored as appropriate, 10 scenarios were scored as uncertain, and 1 scenario was scored as inappropriate. Conclusion: This article can assist clinicians in shared decision-making by providing best practices in considering HA injections for knee OA treatment. Moreover, this AUC article can aid payers and policy makers in determining reimbursement and preauthorization policies and more appropriately managing health care resources. It is clear that further research is still necessary—particularly in patient populations differentiated by OA severity—that may benefit the greatest from the use of HA injections for the treatment of knee OA. PMID:28618868

  10. Cylindrical Taylor states conserving total absolute magnetic helicity

    Science.gov (United States)

    Low, B. C.; Fang, F.

    2014-09-01

    The Taylor state of a three-dimensional (3D) magnetic field in an upright cylindrical domain V is derived from first principles as an extremum of the total magnetic energy subject to a conserved, total absolute helicity Habs. This new helicity [Low, Phys. Plasmas 18, 052901 (2011)] is distinct from the well known classical total helicity and relative total helicity in common use to describe wholly-contained and anchored fields, respectively. A given field B, tangential along the cylindrical side of V, may be represented as a unique linear superposition of two flux systems, an axially extended system along V and a strictly transverse system carrying information on field-circulation. This specialized Chandrasekhar-Kendall representation defines Habs and permits a neat formulation of the boundary-value problem (BVP) for the Taylor state as a constant-α force-free field, treating 3D wholly-contained and anchored fields on the same conceptual basis. In this formulation, the governing equation is a scalar integro-partial differential equation (PDE). A family of series solutions for an anchored field is presented as an illustration of this class of BVPs. Past treatments of the constant-α field in 3D cylindrical geometry are based on a scalar Helmholtz PDE as the governing equation, with issues of inconsistency in the published field solutions discussed over time in the journal literature. The constant-α force-free equation reduces to a scalar Helmholtz PDE only as special cases of the 3D integro-PDE derived here. In contrast, the constant-α force-free equation and the scalar Helmholtz PDE are absolutely equivalent in the spherical domain as discussed in Appendix. This theoretical study is motivated by the investigation of the Sun's corona but the results are also relevant to laboratory plasmas.

  11. Optimal fetal growth for the Caucasian singleton and assessment of appropriateness of fetal growth: an analysis of a total population perinatal database

    Directory of Open Access Journals (Sweden)

    Lawrence David M

    2005-05-01

    Full Text Available Abstract Background The appropriateness of an individual's intra uterine growth is now considered an important determinant of both short and long term outcomes, yet currently used measures have several shortcomings. This study demonstrates a method of assessing appropriateness of intrauterine growth based on the estimation of each individual's optimal newborn dimensions from routinely available perinatal data. Appropriateness of growth can then be inferred from the ratio of the value of the observed dimension to that of the optimal dimension. Methods Fractional polynomial regression models including terms for non-pathological determinants of fetal size (gestational duration, fetal gender and maternal height, age and parity were used to predict birth weight, birth length and head circumference from a population without any major risk factors for sub-optimal intra-uterine growth. This population was selected from a total population of all singleton, Caucasian births in Western Australia 1998–2002. Births were excluded if the pregnancy was exposed to factors known to influence fetal growth pathologically. The values predicted by these models were treated as the optimal values, given infant gender, gestational age, maternal height, parity, and age. Results The selected sample (N = 62,746 comprised 60.5% of the total Caucasian singleton birth cohort. Equations are presented that predict optimal birth weight, birth length and head circumference given gestational duration, fetal gender, maternal height, age and parity. The best fitting models explained 40.5% of variance for birth weight, 32.2% for birth length, and 25.2% for head circumference at birth. Conclusion Proportion of optimal birth weight (length or head circumference provides a method of assessing appropriateness of intrauterine growth that is less dependent on the health of the reference population or the quality of their morphometric data than is percentile position on a birth weight

  12. Distribution (State Allotment) of Drinking Water State Revolving Fund Appropriation from the American Recovery and Reinvestment Act of 2009 (ARRA)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The ARRA appropriation for the DWSRF program is $2,000,000,000. DWSRF allotments are based on percentages derived from the 2003 Drinking Water Infrastructure Needs...

  13. Appropriate Frequency and Interval of Neck Ultrasonography Surveillance during the First 10 Years after Total Thyroidectomy in Patients with Papillary Thyroid Carcinoma

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    Yoo Jin Lee

    2018-03-01

    Full Text Available BackgroundNo previous study has employed the frequency and interval of follow-up ultrasonography (US during the first 10 years after total thyroidectomy in patients with papillary thyroid carcinoma (PTC. The aim of this study was to determine the appropriate frequency and interval of follow-up US during the first 10 years in patients who have undergone total thyroidectomy for PTC.MethodsTwo hundred seventy-two patients underwent total thyroidectomy for PTC at our institution from January 2006 to December 2007. Nineteen patients were excluded because of lack of US follow-up data for the neck. Follow-up US was performed by one of two radiologists in all patients. Tumor recurrence/persistence was confirmed by histopathology.ResultsThe mean interval between surgery and the final follow-up US examination was 79.0 months, and the mean number of follow-up US sessions was 5.9 in the 253 evaluable patients. Eleven patients (4.3% developed tumor recurrence/persistence, which was detected on follow-up US within 5 years after total thyroidectomy in all cases. T and N stages were independently associated with tumor recurrence/persistence. The interval between surgery and first suspicion of tumor recurrence/persistence on follow-up US was ≤12 months in six patients and 20, 35, 41, 53, and 60 months in the remaining five patients.ConclusionFor detection of tumor recurrence/persistence after total thyroidectomy in patients with PTC, one or two sessions of follow-up US during the first 2 years, depending on T and N stages and one session of follow-up US in every second year during the following 8 years may be appropriate.

  14. The Changing Role of State Appropriations for Higher Education: An Econometric Analysis from 1985-2008

    Science.gov (United States)

    Mushrush, Christopher E.

    2013-01-01

    Traditionally, public funding of higher education has been viewed as cyclical, where support falls during times of economic downturn and then recovers as the economy improves. This view, however, is being challenged as budgetary shortfalls are becoming more common for states, even in times of economic growth, due to structural constraints. Using…

  15. Influences on Tobacco Control Funding Decisions: Explaining State Variation in Appropriations

    Science.gov (United States)

    2003-01-01

    18 and older) in all states was 23.3%, far short of the national goal of reducing adult smoking prevalence to 15% (CDC, 2002; Mendez & Warner, 2000...Multiple levels, multiple agendas. Quorum Books: Westport CT, 1995. Mendez D, Warner K. Smoking prevalence in 2010: Why the healthy people goal is...1998. Siegel M, Carol J, Jordan J, Hobart R, Schoenmarklin S, DuMelle F, Fisher P. Preemption in tobacco control: Review of an emerging public health

  16. Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

    Science.gov (United States)

    Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

    2017-09-01

    1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

  17. A Procedure for Identification of Appropriate State Space and ARIMA Models Based on Time-Series Cross-Validation

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    Patrícia Ramos

    2016-11-01

    Full Text Available In this work, a cross-validation procedure is used to identify an appropriate Autoregressive Integrated Moving Average model and an appropriate state space model for a time series. A minimum size for the training set is specified. The procedure is based on one-step forecasts and uses different training sets, each containing one more observation than the previous one. All possible state space models and all ARIMA models where the orders are allowed to range reasonably are fitted considering raw data and log-transformed data with regular differencing (up to second order differences and, if the time series is seasonal, seasonal differencing (up to first order differences. The value of root mean squared error for each model is calculated averaging the one-step forecasts obtained. The model which has the lowest root mean squared error value and passes the Ljung–Box test using all of the available data with a reasonable significance level is selected among all the ARIMA and state space models considered. The procedure is exemplified in this paper with a case study of retail sales of different categories of women’s footwear from a Portuguese retailer, and its accuracy is compared with three reliable forecasting approaches. The results show that our procedure consistently forecasts more accurately than the other approaches and the improvements in the accuracy are significant.

  18. Activities Contributing to Total Energy Expenditure in the United States: Results from the NHAPS Study

    Directory of Open Access Journals (Sweden)

    Block Gladys

    2004-02-01

    Full Text Available Abstract Background Physical activity is increasingly recognized as an important factor influencing health and disease status. Total energy expenditure, both low-intensity and high-intensity, contributes to maintenance of healthy body weight. This paper presents the results of a quantitative approach to determining the activities that contribute to total energy expenditure in the United States. Methods Data from the National Human Activity Pattern Survey (NHAPS were used. In 1992–1994 the NHAPS sampled 4,185 females and 3,330 males, aged 18 years and over, weighted to be representative of the 48 contiguous United States. A detailed report of each activity performed in the previous 24 hours was obtained. A score was created for each activity, by multiplying duration and intensity for each individual and summing across individuals. This score was then used to rank each activity according to its contribution to total population energy expenditure, for the total sample and separately for each gender, race, age, region, and season. Results This analysis reveals our society to be primarily sedentary; leisure time physical activity contributed only approximately 5% of the population's total energy expenditure. Not counting sleeping, the largest contributor to energy expenditure was "Driving a car", followed by "Office work" and "Watching TV". Household activities accounted for 20.1% and 33.3% of energy expenditure for males and females respectively. Conclusion The information presented in this paper may be useful in identifying common activities that could be appropriate targets for behavioral interventions to increase physical activity.

  19. Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States

    International Nuclear Information System (INIS)

    Hopkins, Katharine L.; Vajtai, Petra L.; Pettersson, David R.; Spinning, Kristopher; Beckett, Brooke R.; Koudelka, Caroline W.; Bardo, Dianna M.E.

    2013-01-01

    During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI vol ). SSDE was calculated and differences among groups were compared by regression analysis. Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged. (orig.)

  20. Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, Katharine L.; Vajtai, Petra L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Pettersson, David R.; Spinning, Kristopher; Beckett, Brooke R. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Koudelka, Caroline W. [Oregon Health and Science University, Division of Biostatistics, Department of Public Health and Preventive Medicine, Portland, OR (United States); Bardo, Dianna M.E. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Cardiovascular Medicine, Portland, OR (United States)

    2013-09-15

    During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI{sub vol}). SSDE was calculated and differences among groups were compared by regression analysis. Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged. (orig.)

  1. The current state of bearing surfaces in total hip replacement.

    Science.gov (United States)

    Rajpura, A; Kendoff, D; Board, T N

    2014-02-01

    We reviewed the literature on the currently available choices of bearing surface in total hip replacement (THR). We present a detailed description of the properties of articulating surfaces review the understanding of the advantages and disadvantages of existing bearing couples. Recent technological developments in the field of polyethylene and ceramics have altered the risk of fracture and the rate of wear, although the use of metal-on-metal bearings has largely fallen out of favour, owing to concerns about reactions to metal debris. As expected, all bearing surface combinations have advantages and disadvantages. A patient-based approach is recommended, balancing the risks of different options against an individual's functional demands.

  2. A Pilot Food Bank Intervention Featuring Diabetes-Appropriate Food Improved Glycemic Control Among Clients In Three States.

    Science.gov (United States)

    Seligman, Hilary K; Lyles, Courtney; Marshall, Michelle B; Prendergast, Kimberly; Smith, Morgan C; Headings, Amy; Bradshaw, Georgiana; Rosenmoss, Sophie; Waxman, Elaine

    2015-11-01

    Food insecurity--defined as not having adequate quantity and quality of food at all times for all household members to have an active, healthy life--is a risk factor for poor diabetes control, yet few diabetes interventions address this important factor. Food pantries, which receive food from food banks and distribute it to clients in need, may be ideal sites for diabetes self-management support because they can provide free diabetes-appropriate food to people in low-income communities. Between February 2012 and March 2014, we enrolled 687 food pantry clients with diabetes in three states in a six-month pilot intervention that provided them with diabetes-appropriate food, blood sugar monitoring, primary care referral, and self-management support. Improvements were seen in pre-post analyses of glycemic control (hemoglobin A1c decreased from 8.11 percent to 7.96 percent), fruit and vegetable intake (which increased from 2.8 to 3.1 servings per day), self-efficacy, and medication adherence. Among participants with elevated HbA1c (at least 7.5 percent) at baseline, HbA1c improved from 9.52 percent to 9.04 percent. Although food pantries are nontraditional settings for diabetes support, this pilot study suggests a promising health promotion model for vulnerable populations. Policies supporting such interventions may be particularly effective because of food pantries' food access and distribution capacity. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Current Epidemiology of Revision Total Knee Arthroplasty in the United States.

    Science.gov (United States)

    Delanois, Ronald E; Mistry, Jaydev B; Gwam, Chukwuweike U; Mohamed, Nequesha S; Choksi, Ujval S; Mont, Michael A

    2017-09-01

    Revision surgery for failed total knee arthroplasty (TKA) continues to pose a substantial burden for the United States healthcare system. The predominant etiology of TKA failure has changed over time and may vary between studies. This report aims to update the current literature on this topic by using a large national database. Specifically, we analyzed: (1) etiologies for revision TKA; (2) frequencies of revision TKA procedures; (3) various demographics including payer type and region; and (4) the length of stay (LOS) and total charges based on type of revision TKA procedure. The Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database was used to identify all revision TKA procedures performed between 2009 and 2013. Clinical, economic, and demographic data were collected and analyzed for 337,597 procedures. Patients were stratified according to etiology of failure, age, sex, race, US census region, and primary payor class. The mean LOS and total charges were also calculated. Infection was the most common etiology for revision TKA (20.4%), closely followed by mechanical loosening (20.3%). The most common revision TKA procedure performed was all component revision (31.3%). Medicare was the primary payor for the greatest proportion of revisions (57.7%). The South census region performed the most revision TKAs (33.2%). The overall mean LOS was 4.5 days, with arthrotomy for removal of prosthesis without replacement procedures accounting for the longest stays (7.8 days). The mean total charge for revision TKAs was $75,028.07. Without appropriate measures in place, the burden of revision TKAs may become overwhelming and pose a strain on providers and institutions. Continued insight into the etiology and epidemiology of revision TKAs may be the principle step towards improving outcomes and mitigating the need for future revisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

    Science.gov (United States)

    AbdulAzeez, Abbas Tunde

    2016-01-01

    This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

  5. Appropriate strategies.

    Science.gov (United States)

    Halty, M

    1979-01-01

    Technology strategies are concerned with the production, distribution, and consumption of technology. Observation of less developed countries (LDCs) and international organizations shows that little attention is given to the development of a technology strategy. LDCs need to formulate a strategy of self-reliant technological development for the next decade. They should no longer be content to stand in a technologically dependent relationship to the developed countries. Such strategies must balance the ratio between investment in indigenous technologies and expenditure for foreign technology. The strategies change according to the level of industrialization achieved. The following considerations come into development of technology strategies: 1) determination of an appropriate balance among the accumulation, consumption, and distribution of technology; 2) the amount and level of government support; and 3) the balance between depth and breadth of technology to be encouraged.

  6. Appropriate Interventions on the Problems Encountered on Effective Teaching Practices in a State University External Campus in the Philippines

    Directory of Open Access Journals (Sweden)

    Nilo L. Masbaño

    2015-12-01

    Full Text Available Descriptive studies on the perception of teachers regarding effective teaching practices, problems encountered and appropriate interventions have generally supported the beliefs that the problems of education did not lie only outside the school but inside the school itself. Yet such studies neglect the primary reason through which students learn, the effective teaching practices. The current study explores the link on the perception of teachers regarding effective teaching practices, problems encountered and appropriate interventions. Data were obtained using the questionnaire that were collected from 80 respondents whom faculty members of WVSU-JC. Mean and rank were used as statistical tools. A high level of agreement among teachers on the propositions regarding effective teaching was hypothesized. However, they preferred some teaching practices to the other. Teachers' perception on effective teaching practices were, showing of mastery on the subject matter, updating of knowledge about the subject matter, utilizing an appropriate strategies and methods and observing an ethical and moral principles in teaching. Generally, the top problems perceived by teachers that hinder their effective teaching includes inadequacy of laboratory facilities and equipment, insufficient library references and classrooms which are not conducive for teaching-learning process. However, it varies according to the classification as to different categories of variables. The appropriate interventions were the upgrading of laboratory facilities and equipment, the purchasing of additional books, the giving of trainings to the teachers on the recent development on the subject that they are teaching, providing more hands on activities for students, enhancing the teaching strategies and methods, and strengthening the commitment among teachers.

  7. Change in Total Snowfall in the Contiguous 48 States, 1930-2007

    Data.gov (United States)

    U.S. Environmental Protection Agency — This map shows the average rate of change in total snowfall from 1930 to 2007 at 419 weather stations in the contiguous 48 states. Blue circles represent increased...

  8. Total hip arthroplasty in chronic dialysis patients in the United States.

    Science.gov (United States)

    Abbott, Kevin C; Bucci, Jay R; Agodoa, Lawrence Y

    2003-01-01

    The national incidence of and factors associated with total hip arthroplasty (THA) in chronic dialysis patients has never been reported. We therefore performed an historical cohort study of 375,857 chronic dialysis patients listed in the 2000 United States Renal Data System between 1 April 1995 and 31 December 1999 and followed-up until 14 May 2000. Primary outcomes were associations with hospitalizations for a primary discharge code of THA (ICD9 procedure code 81.51x) after initiation of dialysis. Dialysis patients had a cumulative incidence of THA of 35 episodes/10,000 person-years, compared to 5.3/10,000 in the general population. The leading indication for THA was osteoarthritis of the hip and pelvis (58% of cases). However, the strongest risk factor for THA in dialysis patients was end-stage renal disease (ESRD) due to systemic lupus erythematosus (SLE, adjusted rate ratio (ARR), 6.80, 95% CI 4.62-10.03, in whom avascular necrosis of the hip was the most common indication, 68.4%). The database did not include information on use of corticosteroids. Diabetic recipients were significantly less likely to receive THA, as were males, and African Americans. Mortality after THA was 0.25% at thirty days and 30% at three years, not significantly different from the expected mortality of dialysis, adjusted for comorbidity. The most common indication for THA in dialysis patients is osteoarthritis of the hip, similar to the general population. Patients with SLE are more likely to receive THA which is well tolerated and not associated with increased mortality in this population, perhaps reflecting selection bias due to appropriate screening for this elective procedure.

  9. The Total Quality Management Model Department of Personnel State of Colorado,

    Science.gov (United States)

    A panel of three members will present the Total Quality Management model recently designed for the Department of Personnel, State of Colorado. This model was selected to increase work quality and productivity of the Department and to exemplify Governor Romer’s commitment to quality work within state government.

  10. Measuring the Total Economic Value of State-Funded Higher Education in Iowa

    OpenAIRE

    Swenson, David A.

    2011-01-01

    This is an evaluation of the statewide total economic value of state-funded higher education in Iowa. The analysis is based on Fiscal Year 2010 final budgeted values for Iowa's three Board of Regents universities and their teaching hospital, as well as the state's 15 community colleges. Final budget year data were obtained from the respective state universities' web sites, from the Board of Regents, and from the Annual Condition of Iowa's Community Colleges, 2010, report published by the Iowa...

  11. Developing spatial inequalities in carbon appropriation: a sociological analysis of changing local emissions across the United States.

    Science.gov (United States)

    Elliott, James R; Clement, Matthew Thomas

    2015-05-01

    This study examines an overlooked dynamic in sociological research on greenhouse gas emissions: how local areas appropriate the global carbon cycle for use and exchange purposes as they develop. Drawing on theories of place and space, we hypothesize that development differentially drives and spatially decouples use- and exchange-oriented emissions at the local level. To test our hypotheses, we integrate longitudinal, county-level data on residential and industrial emissions from the Vulcan Project with demographic, economic and environmental data from the U.S. Census Bureau and National Land Change Database. Results from spatial regression models with two-way fixed-effects indicate that alongside innovations and efficiencies capable of reducing environmentally harmful effects of development comes a spatial disarticulation between carbon-intensive production and consumption within as well as across societies. Implications for existing theory, methods and policy are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Certification of Public Librarians in the United States. A Detailed Summary of Legally Mandated and Voluntary Certification Plans for Public Librarians Based on Information Supplied by the Various Certificating State Agencies or Other Appropriate Sources. 3rd Edition.

    Science.gov (United States)

    Coe, Mary J., Ed.

    This report contains summaries of legally mandated and voluntary certification plans for public librarians in the United States based on information supplied by the various certifying state agencies or other appropriate sources in April 1979. Each plan is identified by the descriptive terms "mandatory" (certification required by law--23 states),…

  13. Prevalence of Total Hip and Knee Replacement in the United States.

    Science.gov (United States)

    Maradit Kremers, Hilal; Larson, Dirk R; Crowson, Cynthia S; Kremers, Walter K; Washington, Raynard E; Steiner, Claudia A; Jiranek, William A; Berry, Daniel J

    2015-09-02

    Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States. Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population. The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages. Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  14. Appropriation System: water rights in the western United States; water pollution problems peculiar to the uranium industry

    International Nuclear Information System (INIS)

    Worcester, T.E.

    1976-01-01

    The legal framework surrounding water rights acquisition and usage in the western United States and the steps which should be taken in analyzing potential sources of water are dealt with. Some of the applicable water pollution control laws and regulations are discussed briefly

  15. The Determinants of State Spending on Higher Education: How Capital Project Funding Differs from General Fund Appropriations

    Science.gov (United States)

    Ness, Erik C.; Tandberg, David A.

    2013-01-01

    Our fixed-effects panel data analysis of state spending on higher education fills a near void of studies examining capital expenditures on higher education. In our study, we found that political characteristics (e.g., interest group activity, organizational structure, and formal powers) largely account for differences between general fund and…

  16. Geometric measure of quantum discord and total quantum correlations in an N-partite quantum state

    International Nuclear Information System (INIS)

    Hassan, Ali Saif M; Joag, Pramod S

    2012-01-01

    Quantum discord, as introduced by Ollivier and Zurek (2001 Phys. Rev. Lett. 88 017901), is a measure of the discrepancy between quantum versions of two classically equivalent expressions for mutual information and is found to be useful in quantification and application of quantum correlations in mixed states. It is viewed as a key resource present in certain quantum communication tasks and quantum computational models without containing much entanglement. An early step toward the quantification of quantum discord in a quantum state was by Dakic et al (2010 Phys. Rev. Lett. 105 190502) who introduced a geometric measure of quantum discord and derived an explicit formula for any two-qubit state. Recently, Luo and Fu (2010 Phys. Rev. A 82 034302) introduced a generic form of the geometric measure of quantum discord for a bipartite quantum state. We extend these results and find generic forms of the geometric measure of quantum discord and total quantum correlations in a general N-partite quantum state. Further, we obtain computable exact formulas for the geometric measure of quantum discord and total quantum correlations in an N-qubit quantum state. The exact formulas for the N-qubit quantum state can be used to get experimental estimates of the quantum discord and the total quantum correlation. (paper)

  17. Elucidation of the electronic states in polyethylene glycol by attenuated Total reflectance spectroscopy in the far-ultraviolet region

    Science.gov (United States)

    Ueno, Nami; Wakabayashi, Tomonari; Morisawa, Yusuke

    2018-05-01

    We measured the attenuated total reflectance-far ultraviolet (ATR-FUV) spectra of poly(ethylene glycol) (PEG; average molecular weights of 200, 300, and 400) and related materials in the liquid state in the 145-200-nm wavelength region. For appropriately assigning the absorption bands, we also performed theoretical simulation of the unit-number dependent electronic spectra. The FUV spectra of PEGs contain three bands, which are assigned to the transitions between n(CH2OCH2)-3s Rydberg state (176 nm), n(CH2OCH2)-3p Rydberg state (163 nm), and n(OH)-3p Rydberg state (153 nm). Since the contribution of n(OH) decreases compared to n(CH2OCH2) with increase in the number of units, the ratios of the molar absorption coefficients, ε, at 153 nm relative to 163 nm, decrease. On the other hand, the ratio of ε at 176 nm to that at 163 nm increases with increase in the number of units, because of the difference in the number of unoccupied orbitals in the transitions. The calculated results suggest that n orbitals form two electronic bands. In the upper band, the electrons expand over the ether chain, whereas in the lower band, the electrons are localized in the terminal OH in the PEGs.

  18. The total quasi-steady-state approximation for complex enzyme reactions

    DEFF Research Database (Denmark)

    Pedersen, Morten Gram; Bersani, A. M.; Bersani, E.

    2008-01-01

    ) approximation (or standard quasi-steady-state approximation (sQSSA)), which is valid when the enzyme concentration is sufficiently small. This condition is usually fulfilled for in vitro experiments, but often breaks down in vivo. The total QSSA (tQSSA), which is valid for a broader range of parameters covering...

  19. Current state of total artificial heart therapy and introduction of the most important total artificial heart systems.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Hergesell, Vera; Wasler, Andrae; Dapunt, Otto

    2018-06-14

    Due to the declining instances of organ donation, total artificial heart (TAH) therapy is of increasing importance for the management of end-stage biventricular heart failure. We introduce the currently most important established and novel TAH systems (SynCardia, CARMAT, ReinHeart, BiVACOR), report clinical outcomes and discuss technical requirements for the successful implementation of TAH therapy as an alternative to cardiac transplantation.

  20. Phase Transitions in Definite Total Spin States of Two-Component Fermi Gases.

    Science.gov (United States)

    Yurovsky, Vladimir A

    2017-05-19

    Second-order phase transitions have no latent heat and are characterized by a change in symmetry. In addition to the conventional symmetric and antisymmetric states under permutations of bosons and fermions, mathematical group-representation theory allows for non-Abelian permutation symmetry. Such symmetry can be hidden in states with defined total spins of spinor gases, which can be formed in optical cavities. The present work shows that the symmetry reveals itself in spin-independent or coordinate-independent properties of these gases, namely as non-Abelian entropy in thermodynamic properties. In weakly interacting Fermi gases, two phases appear associated with fermionic and non-Abelian symmetry under permutations of particle states, respectively. The second-order transitions between the phases are characterized by discontinuities in specific heat. Unlike other phase transitions, the present ones are not caused by interactions and can appear even in ideal gases. Similar effects in Bose gases and strong interactions are discussed.

  1. 78 FR 22501 - Designation of Areas for Air Quality Planning Purposes; State of Nevada; Total Suspended Particulate

    Science.gov (United States)

    2013-04-16

    ... Areas for Air Quality Planning Purposes; State of Nevada; Total Suspended Particulate AGENCY... designations for total suspended particulate within the State of Nevada because the designations are no longer necessary. These designations relate to the attainment or unclassifiable areas for total suspended...

  2. Development of an economical model to determine an appropriate feed-in tariff for grid-connected solar PV electricity in all states of Australia

    International Nuclear Information System (INIS)

    Zahedi, A.

    2009-01-01

    Australia is a country with a vast amount of natural resources including sun and wind. Australia lies between latitude of 10-45 S and longitude of 112-152 E, with a daily solar exposure of between less than 3 MJ/(m 2 day) in winter and more than 30 MJ/(m 2 day) in summer. Global solar radiation in Australia varies between minimum of 3285 MJ/(m 2 year) in Hobart to 8760 MJ/(m 2 year) in Northern Territory. As a result of this wide range of radiation level there will be a big difference between costs of solar PV electricity in different locations. A study we have recently conducted on the solar PV electricity price in all states of Australia. For this purpose we have developed an economical model and a computer simulation to determine the accurate unit price of grid-connected roof-top solar photovoltaic (PV) electricity in A$/kWh for all state of Australia. The benefit of this computer simulation is that we can accurately determine the most appropriate feed-in tariff of grid-connected solar PV energy system. The main objective of this paper is to present the results of this study. A further objective of this paper is to present the details of the unit price of solar PV electricity in the state of Victoria in each month and then to compare with electricity price from conventional power systems, which is currently applied to this state. The state Victoria is located south of Australia and in terms of sun radiation is second lowest compared with the other Australian states. The computer simulation developed for this study makes it possible to determine the cost of grid-connected solar PV electricity at any location in any country based on availability of average daily solar exposure of each month as well as economical factors of the country. (author)

  3. Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.

    Science.gov (United States)

    Franklin, Patricia D; Miozzari, Hermes; Christofilopoulos, Panayiotis; Hoffmeyer, Pierre; Ayers, David C; Lübbeke, Anne

    2017-01-11

    Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample. Data included age, sex, education level, BMI, diagnosis, medical co-morbidities, PROMs (WOMAC pain/function), global health (SF-12). Six thousand six hundred eighty primary TKAs (US) and 823 TKAs (Swiss) were evaluated. US vs. Switzerland TKA patients were younger (mean age 67 vs. 72 years.), more obese (BMI ≥30 55% vs. 43%), had higher levels of education, more cardiac disease. Swiss patients had lower preoperative WOMAC pain scores (41 vs. 52) but pre-operative physical disability were comparable. 4,647 primary THAs (US) and 1,023 THAs (Swiss) were evaluated. US vs. Switzerland patients were younger (65 vs. 68 years.), more obese (BMI ≥30: 38% vs. 24%), had higher levels of education, more diabetes. Swiss patients had lower preoperative WOMAC pain scores (40 vs. 48 points). Physical disability was reported comparable, but Swiss patients indicated lower mental health scores. We found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes. Reports from national registries lack detailed patient information while these data suggest the need for adequate risk adjustment of patient factors.

  4. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    Science.gov (United States)

    Jones, D. B.; da Costa, R. F.; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

    2016-04-01

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20-250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron-furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  5. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    Energy Technology Data Exchange (ETDEWEB)

    Jones, D. B. [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Costa, R. F. da [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Departamento de Física, Universidade Federal do Espírito Santo, 29075-910, Vitória, Espírito Santo (Brazil); Varella, M. T. do N. [Instituto de Física, Universidade de São Paulo, CP 66318, 05315-970 São Paulo (Brazil); Bettega, M. H. F. [Departamento de Física, Universidade Federal do Paraná, CP 19044, 81531-990 Curitiba, Paraná (Brazil); Lima, M. A. P. [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Blanco, F. [Departamento de Física Atómica, Molecular y Nuclear, Universidad Complutense de Madrid, Madrid E-28040 (Spain); García, G. [Instituto de Física Fundamental, CSIC, Serrano 113-bis, 28006 Madrid (Spain); Brunger, M. J., E-mail: Michael.Brunger@flinders.edu.au [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Institute of Mathematical Sciences, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2016-04-14

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  6. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    International Nuclear Information System (INIS)

    Jones, D. B.; Costa, R. F. da; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

    2016-01-01

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  7. Modeling networks of coupled enzymatic reactions using the total quasi-steady state approximation.

    Directory of Open Access Journals (Sweden)

    Andrea Ciliberto

    2007-03-01

    Full Text Available In metabolic networks, metabolites are usually present in great excess over the enzymes that catalyze their interconversion, and describing the rates of these reactions by using the Michaelis-Menten rate law is perfectly valid. This rate law assumes that the concentration of enzyme-substrate complex (C is much less than the free substrate concentration (S0. However, in protein interaction networks, the enzymes and substrates are all proteins in comparable concentrations, and neglecting C with respect to S0 is not valid. Borghans, DeBoer, and Segel developed an alternative description of enzyme kinetics that is valid when C is comparable to S0. We extend this description, which Borghans et al. call the total quasi-steady state approximation, to networks of coupled enzymatic reactions. First, we analyze an isolated Goldbeter-Koshland switch when enzymes and substrates are present in comparable concentrations. Then, on the basis of a real example of the molecular network governing cell cycle progression, we couple two and three Goldbeter-Koshland switches together to study the effects of feedback in networks of protein kinases and phosphatases. Our analysis shows that the total quasi-steady state approximation provides an excellent kinetic formalism for protein interaction networks, because (1 it unveils the modular structure of the enzymatic reactions, (2 it suggests a simple algorithm to formulate correct kinetic equations, and (3 contrary to classical Michaelis-Menten kinetics, it succeeds in faithfully reproducing the dynamics of the network both qualitatively and quantitatively.

  8. Total Economic Consequences of an Influenza Outbreak in the United States.

    Science.gov (United States)

    Prager, Fynnwin; Wei, Dan; Rose, Adam

    2017-01-01

    Pandemic influenza represents a serious threat not only to the population of the United States, but also to its economy. In this study, we analyze the total economic consequences of potential influenza outbreaks in the United States for four cases based on the distinctions between disease severity and the presence/absence of vaccinations. The analysis is based on data and parameters on influenza obtained from the Centers for Disease Control and the general literature. A state-of-the-art economic impact modeling approach, computable general equilibrium, is applied to analyze a wide range of potential impacts stemming from the outbreaks. This study examines the economic impacts from changes in medical expenditures and workforce participation, and also takes into consideration different types of avoidance behavior and resilience actions not previously fully studied. Our results indicate that, in the absence of avoidance and resilience effects, a pandemic influenza outbreak could result in a loss in U.S. GDP of $25.4 billion, but that vaccination could reduce the losses to $19.9 billion. When behavioral and resilience factors are taken into account, a pandemic influenza outbreak could result in GDP losses of $45.3 billion without vaccination and $34.4 billion with vaccination. These results indicate the importance of including a broader set of causal factors to achieve more accurate estimates of the total economic impacts of not just pandemic influenza but biothreats in general. The results also highlight a number of actionable items that government policymakers and public health officials can use to help reduce potential economic losses from the outbreaks. © 2016 Society for Risk Analysis.

  9. Anomalies from aerial spectrometric and total count radiometric surveys in the southeastern United States

    International Nuclear Information System (INIS)

    Lee, C.H.; Lawton, D.E.

    1978-01-01

    Aerial radiometric reconnaissance surveys are conducted because of their cost, time, and manpower savings compared to surface studies. Two types of aerial surveys are being flown in the southeastern United States: total count gamma-ray surveys for the Coastal Plains Regional Commission and the US Geological Survey, and differential gamma-ray spectrometric surveys for the US Department of Energy. Anomalous radioactivity detected during aerial surveys is related to higher concentrations of naturally occurring uranium, or to cultural activities, natural causes, or mapping errors which simulate real uranium anomalies. Each anomaly should be ground checked; however, several types of anomalies may be eliminated by evaluation of the aerial data in the office if field time is limited

  10. Renormalization of total sets of states into generalized bases with a resolution of the identity

    International Nuclear Information System (INIS)

    Vourdas, A

    2017-01-01

    A total set of states for which we have no resolution of the identity (a ‘pre-basis’), is considered in a finite dimensional Hilbert space. A dressing formalism renormalizes them into density matrices which resolve the identity, and makes them a ‘generalized basis’, which is practically useful. The dresssing mechanism is inspired by Shapley’s methodology in cooperative game theory, and it uses Möbius transforms. There is non-independence and redundancy in these generalized bases, which is quantified with a Shannon type of entropy. Due to this redundancy, calculations based on generalized bases are sensitive to physical changes and robust in the presence of noise. For example, the representation of an arbitrary vector in such generalized bases, is robust when noise is inserted in the coefficients. Also in a physical system with a ground state which changes abruptly at some value of the coupling constant, the proposed methodology detects such changes, even when noise is added to the parameters in the Hamiltonian of the system. (paper)

  11. Rovibrational bound states of SO2 isotopologues. I: Total angular momentum J = 0-10

    Science.gov (United States)

    Kumar, Praveen; Ellis, Joseph; Poirier, Bill

    2015-04-01

    Isotopic variation of the rovibrational bound states of SO2 for the four stable sulfur isotopes 32-34,36S is investigated in comprehensive detail. In a two-part series, we compute the low-lying energy levels for all values of total angular momentum in the range J = 0-20. All rovibrational levels are computed, to an extremely high level of numerical convergence. The calculations have been carried out using the ScalIT suite of parallel codes. The present study (Paper I) examines the J = 0-10 rovibrational levels, providing unambiguous symmetry and rovibrational label assignments for each computed state. The calculated vibrational energy levels exhibit very good agreement with previously reported experimental and theoretical data. Rovibrational energy levels, calculated without any Coriolis approximations, are reported here for the first time. Among other potential ramifications, this data will facilitate understanding of the origin of mass-independent fractionation of sulfur isotopes in the Archean rock record-of great relevance for understanding the "oxygen revolution".

  12. Rovibrational bound states of SO2 isotopologues. II: Total angular momentum J = 11-20

    Science.gov (United States)

    Kumar, Praveen; Poirier, Bill

    2015-11-01

    In a two-part series, the rovibrational bound states of SO2 are investigated in comprehensive detail, for all four stable sulfur isotopes 32-34,36S. All low-lying rovibrational energy levels-both permutation-symmetry-allowed and not allowed-are computed, for all values of total angular momentum in the range J = 0-20. The calculations have carried out using the ScalIT suite of parallel codes. The present study (Paper II) examines the J = 11-20 rovibrational levels, providing symmetry and rovibrational labels for every computed state, relying on a new lambda-doublet splitting technique to make completely unambiguous assignments. Isotope shifts are analyzed, as is the validity of ;J-shifting; as a predictor of rotational fine structure. Among other ramifications, this work will facilitate understanding of mass-independent fractionation of sulfur isotopes (S-MIF) observed in the Archean rock record-particularly as this may have arisen from self shielding. S-MIF, in turn is highly relevant in the broader context of understanding the ;oxygen revolution;.

  13. Solid State Sensor for Simultaneous Measurement of Total Alkalinity and pH of Seawater.

    Science.gov (United States)

    Briggs, Ellen M; Sandoval, Sergio; Erten, Ahmet; Takeshita, Yuichiro; Kummel, Andrew C; Martz, Todd R

    2017-09-22

    A novel design is demonstrated for a solid state, reagent-less sensor capable of rapid and simultaneous measurement of pH and Total Alkalinity (A T ) using ion sensitive field effect transistor (ISFET) technology to provide a simplified means of characterization of the aqueous carbon dioxide system through measurement of two "master variables": pH and A T . ISFET-based pH sensors that achieve 0.001 precision are widely used in various oceanographic applications. A modified ISFET is demonstrated to perform a nanoliter-scale acid-base titration of A T in under 40 s. This method of measuring A T , a Coulometric Diffusion Titration, involves electrolytic generation of titrant, H + , through the electrolysis of water on the surface of the chip via a microfabricated electrode eliminating the requirement of external reagents. Characterization has been performed in seawater as well as titrating individual components (i.e., OH - , HCO 3 - , CO 3 2- , B(OH) 4 - , PO 4 3- ) of seawater A T . The seawater measurements are consistent with the design in reaching the benchmark goal of 0.5% precision in A T over the range of seawater A T of ∼2200-2500 μmol kg -1 which demonstrates great potential for autonomous sensing.

  14. A Gaussian quadrature method for total energy analysis in electronic state calculations

    Science.gov (United States)

    Fukushima, Kimichika

    This article reports studies by Fukushima and coworkers since 1980 concerning their highly accurate numerical integral method using Gaussian quadratures to evaluate the total energy in electronic state calculations. Gauss-Legendre and Gauss-Laguerre quadratures were used for integrals in the finite and infinite regions, respectively. Our previous article showed that, for diatomic molecules such as CO and FeO, elliptic coordinates efficiently achieved high numerical integral accuracy even with a numerical basis set including transition metal atomic orbitals. This article will generalize straightforward details for multiatomic systems with direct integrals in each decomposed elliptic coordinate determined from the nuclear positions of picked-up atom pairs. Sample calculations were performed for the molecules O3 and H2O. This article will also try to present, in another coordinate, a numerical integral by partially using the Becke's decomposition published in 1988, but without the Becke's fuzzy cell generated by the polynomials of internuclear distance between the pair atoms. Instead, simple nuclear weights comprising exponential functions around nuclei are used. The one-center integral is performed with a Gaussian quadrature pack in a spherical coordinate, included in the author's original program in around 1980. As for this decomposition into one-center integrals, sample calculations are carried out for Li2.

  15. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

    Science.gov (United States)

    Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

    2014-04-16

    Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

  16. Association of Radon Background and Total Background Ionizing Radiation with Alzheimer's Disease Deaths in U.S. States.

    Science.gov (United States)

    Lehrer, Steven; Rheinstein, Peter H; Rosenzweig, Kenneth E

    2017-01-01

    Exposure of the brain to ionizing radiation might promote the development of Alzheimer's disease (AD). Analysis of AD death rates versus radon background radiation and total background radiation in U.S. states. Total background, radon background, cosmic and terrestrial background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States and Report No. 160 - Ionizing Radiation Exposure of the Population of the United States. 2013 AD death rates by U.S. state are from the Alzheimer's Association. Radon background ionizing radiation was significantly correlated with AD death rate in 50 states and the District of Columbia (r = 0.467, p = 0.001). Total background ionizing radiation was also significantly correlated with AD death rate in 50 states and the District of Columbia (r = 0.452, p = 0.001). Multivariate linear regression weighted by state population demonstrated that AD death rate was significantly correlated with radon background (β= 0.169, p ionizing radiation is a risk factor for AD. Intranasal inhalation of radon gas could subject the rhinencephalon and hippocampus to damaging radiation that initiates AD. The damage would accumulate over time, causing age to be a powerful risk factor.

  17. Appropriability, services and reputation

    NARCIS (Netherlands)

    Dolfsma, W.A.

    2011-01-01

    The appropriability regime (Teece 1986) that innovating service firms face is generally weaker than what firms in manufacturing sectors face. An important means to appropriate benefits from innovation that service firms can use is their reputation. This conceptual paper offers insights into how a

  18. EnviroAtlas - Total reptile species by 12-digit HUC for the conterminous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset was produced by a joint effort of New Mexico State University, US Environmental Protection Agency (US EPA,) and the U.S. Geological Survey...

  19. A Comparison of Concentrations of Sodium and Related Nutrients (Potassium, Total Dietary Fiber, Total and Saturated Fat, and Total Sugar) in Private-Label and National Brands of Popular, Sodium-Contributing, Commercially Packaged Foods in the United States.

    Science.gov (United States)

    Ahuja, Jaspreet K C; Pehrsson, Pamela R; Cogswell, Mary

    2017-05-01

    Private-label brands account for about one in four foods sold in US supermarkets. They provide value to consumers due to their low cost. We know of no US studies comparing the nutrition content of private-label products with corresponding national brand products. The objective was to compare concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) in popular sodium-contributing, commercially packaged foods by brand type (national or private-label brand). During 2010 to 2014, the Nutrient Data Laboratory of the US Department of Agriculture obtained 1,706 samples of private-label and national brand products from up to 12 locations nationwide and chemically analyzed 937 composites for sodium and related nutrients. The samples came from 61 sodium-contributing, commercially packaged food products for which both private-label and national brands were among the top 75% to 80% of brands for US unit sales. In this post hoc comparative analysis, the authors assigned a variable brand type (national or private label) to each composite and determined mean nutrient contents by brand type overall and by food product and type. The authors tested for significant differences (Pfoods sampled, differences between brand types were not statistically significant for any of the nutrients studied. However, differences in both directions exist for a few individual food products and food categories. Concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) do not differ systematically between private-label and national brands, suggesting that brand type is not a consideration for nutritional quality of foods in the United States. The study data provide public health officials with baseline nutrient content by brand type to help focus US sodium-reduction efforts. Published by Elsevier Inc.

  20. Total Quality Management in the United States Army Corps of Engineers

    Science.gov (United States)

    1993-05-01

    Office. Telephone interview with author, 20 November 1992. Ishikawa , Kaoru (1985). What is Total Quality Control? The Japanese Way. Prentice-Hall, Inc...Organizations ..... 55 Table 13. Ishikawa PDCA Cycle .......................................................... 68 Table 14. TQM Training M atrix...Standards 1008 ( Ishikawa 1985). The Japanese were aware of both the American and British work with standards. The standards were studied by

  1. Calculations of Total and Differential Solid Angles for a Proton Recoil Solid State Detector

    Energy Technology Data Exchange (ETDEWEB)

    Konijn, J; Lauber, A; Tollander, B

    1963-08-15

    The solid angles have been computed for a proton recoil counter consisting of a circular hydrogenous foil viewed by an isotropic neutron point source at different distances from the target foil. Tables are given for the total subtended solid angle as well as the differential energy distribution function of the proton recoil spectrum. The influence of finite foil thickness has also been studied.

  2. Comment on ``Steady-state properties of a totally asymmetric exclusion process with periodic structure''

    Science.gov (United States)

    Jiang, Rui; Hu, Mao-Bin; Wu, Qing-Song

    2008-07-01

    Lakatos [Phys. Rev. E 71, 011103 (2005)] have studied a totally asymmetric exclusion process that contains periodically varying movement rates. They have presented a cluster mean-field theory for the problem. We show that their cluster mean-field theory leads to redundant equations. We present a mean-field analysis in which there is no redundant equation.

  3. Entanglement between total intensity and polarization for pairs of coherent states

    Science.gov (United States)

    Sanchidrián-Vaca, Carlos; Luis, Alfredo

    2018-04-01

    We examine entanglement between number and polarization, or number and relative phase, in pair coherent states and two-mode squeezed vacuum via linear entropy and covariance criteria. We consider the embedding of the two-mode Hilbert space in a larger space to get a well-defined factorization of the number-phase variables. This can be regarded as a kind of protoentanglement that can be extracted and converted into real particle entanglement via feasible experimental procedures. In particular this reveals interesting entanglement properties of pairs of coherent states.

  4. Libertarianism and Original Appropriation

    OpenAIRE

    Dominiak, Łukasz

    2017-01-01

    The article is devoted to the problem of the structure of libertarian theory of justice. It tries to present a map of the main concepts and principles of this theory and to investigate its possible justifications. It explains such fundamental concepts as original appropriation, homesteading, labour theory of property or first possession theory of original appropriation. The article shows merits and drawbacks of alternative libertarian principles of justice in first acquisition and proposes a ...

  5. Oscillatory behaviour of Rydberg state total cross sections in the collisions Ne+-He and He+-Ne

    International Nuclear Information System (INIS)

    Andresen, B.; Jensen, K.; Veje, E.

    1976-01-01

    The Ne + -He and He + -Ne collisions have been studied by means of optical spectrometry in the projectile energy range 10-150 keV. Very similar and regular oscillations in the Rydberg state total cross sections are found for HeI in both collisions and for singlet as well as triplet excitation. These oscillations are well described by the Rosenthal model. The HeI 4d sup(1,3)D states display two superimposed oscillations for center-of-mass collision energies above 6.4 keV. This is interpreted as the opening of a third exit channel, believed to be the HeI 4f sup(1,3)F. No, or very little structure is found in the Rydberg state total cross sections for HeII, NeI, NeII and NeIII levels. (Auth.)

  6. Measurement of the total combust gases inside laser fusion pellet with corresponding state method

    International Nuclear Information System (INIS)

    Zhu Zhenghe; Wang Rong; Yang Chuanlu

    2002-01-01

    Based on the reduced parameter, the equations for equilibrium vapor pressure and density of hydrogen isotopes have been derived, which can be used below the critical point of D 2 . It is shown that the calculating results of the saturated vapor density with the corresponding state method is more accurate than that with the dew point method, and that Benedict-Webb-Robin equation is more reasonable than the ideal gas equation for calculating the filling pressure

  7. Evaluation of Productivity of Zymotis Solid-State Bioreactor Based on Total Reactor Volume

    Directory of Open Access Journals (Sweden)

    Oscar F. von Meien

    2002-01-01

    Full Text Available In this work a method of analyzing the performance of solid-state fermentation bioreactors is described. The method is used to investigate the optimal value for the spacing between the cooling plates of the Zymotis bioreactor, using simulated fermentation data supplied by a mathematical model. The Zymotis bioreactor has good potential for those solid-state fermentation processes in which the substrate bed must remain static. The current work addresses two design parameters introduced by the presence of the internal heat transfer plates: the width of the heat transfer plate, which is governed by the amount of heat to be removed and the pressure drop of the cooling water, and the spacing between these heat transfer plates. In order to analyze the performance of the bioreactor a productivity term is introduced that takes into account the volume occupied within the bioreactor by the heat transfer plates. As part of this analysis, it is shown that, for logistic growth kinetics, the time at which the biomass reaches 90 % of its maximum possible value is a good estimate of the optimum harvesting time for maximizing productivity. Application of the productivity analysis to the simulated fermentation results suggests that, with typical fast growing fungi ( = 0.324 h–1, the optimal spacing between heat transfer plates is of the order of 6 cm. The general applicability of this approach to evaluate the productivity of solid-state bioreactors is demonstrated.

  8. Is It Now Institutionally Appropriate for the Courts to Consider Whether the Assisted Dying Ban is Human Rights Compatible? Conway V Secretary of State for Justice.

    Science.gov (United States)

    Hobson, Clark

    2017-11-07

    Noel Conway has ultimately been granted permission to apply for judicial review, to seek a declaration under section 4(2) Human Rights Act 1998 that section 2(1) Suicide Act 1961 is incompatible with his right to respect for private life under Article 8(1) ECHR. Both decisions in the application process are significant. They attempt to deal with the qualitative elements in the reasoning of Lords Neuberger, Mance and Wilson, in Nicklinson v Ministry of Justice: what Parliament is required to have done to have 'satisfactorily addressed' the question of relaxing or modifying section 2(1) Suicide Act. In failing to consider the explicit use of qualitative reasoning, both courts fail to interpret Nicklinson properly-that Parliament must change the law, with a declaration of incompatibility likely if it failed to do so. The Court of Appeal was correct to overrule the High Court's unqualified approach to whether it was now institutionally appropriate for a court to consider issuing a declaration of incompatibility, for the purposes of granting permission to apply for judicial review. However, the Court of Appeal directly signals their belief that a range of primary evidence bears out a system of assisted suicide for those in Mr Conway's position could feasibly be devised. This question though, as to evidence of a feasible system in the future, is irrelevant to whether permission to apply for judicial review should be granted to argue it is institutionally appropriate to make a declaration of incompatibility regarding current legislation. This is a problem Nicklinson has made for assisted dying and incompatibility debates. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Appropriering, system, bogobjekt

    DEFF Research Database (Denmark)

    Kromann, Thomas Hvid

    og en afpersonaliseringens poetik bliver konstrueret og typologiseret ud fra et heterogent og spredt tekstmateriale. En poetik, der er kendetegnet af en vidtdreven afmytologisering og afpersonalisering af kunstnerrollen og værket. I kapitel 2, Appropriering, analyseres approprieringsteknikker som...... værker af Bjørn Nørgaard, Hans-Jørgen Nielsen, Henning Christiansen, Vagn Steen og Per Kirkeby (i kap. 2, 3 og 4) analyseres eksempler på appropriering, systemer og bogobjekter. Afpersonalisering er som strategi ikke en homogen metode, men derimod en heterogen og individuel praksis, der spænder fra...

  10. Crowding as appropriation

    DEFF Research Database (Denmark)

    Thelle, Mikkel

    2016-01-01

    This article seeks to address the relation between crowds andpublic space as a question of appropriation. With the newliberal constitutions in Europe, several phenomena of crowdingemerge in major cities, of which Copenhagen is taken as anexample. By focusing on the crowd as an agglomeration...... ofbodies, it is assessed how the agency of the crowd works on animmediate level and in its more lasting effects on urban space.The notion of appropriation is related to the crowd’s claim,formal and informal, as resulting from a negotiation of this,mostly public, space, and articulated in empirical cases...

  11. Appropriation of Information Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

    2008-01-01

    This paper explores the use of cognitive mapping for eliciting users' sensemaking during information system (IS) appropriation. Despite the potential usefulness of sensemaking, few studies in IS research use it as a theoretical lens to address IS appropriation. A possible reason for this may...... be that sensemaking does not easily lend itself to be used in practice. We introduce cognitive mapping as a way to elicit users' sensemaking and illustrate its value by reporting on findings from an empirical study of the introduction of an Electronic Patient Record (EPR) system. The contribution of the paper...

  12. Narrative self-appropriation

    DEFF Research Database (Denmark)

    Køster, Allan

    2017-01-01

    is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing...

  13. Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices.

    Science.gov (United States)

    Bleszynski, Peter A; Luc, Jessica G Y; Schade, Peter; PhilLips, Steven J; Tchantchaleishvili, Vakhtang

    There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.

  14. Total photoionization cross-sections of excited electronic states by the algebraic diagrammatic construction-Stieltjes-Lanczos method.

    Science.gov (United States)

    Ruberti, M; Yun, R; Gokhberg, K; Kopelke, S; Cederbaum, L S; Tarantelli, F; Averbukh, V

    2014-05-14

    Here, we extend the L2 ab initio method for molecular photoionization cross-sections introduced in Gokhberg et al. [J. Chem. Phys. 130, 064104 (2009)] and benchmarked in Ruberti et al. [J. Chem. Phys. 139, 144107 (2013)] to the calculation of total photoionization cross-sections of molecules in electronically excited states. The method is based on the ab initio description of molecular electronic states within the many-electron Green's function approach, known as algebraic diagrammatic construction (ADC), and on the application of Stieltjes-Chebyshev moment theory to Lanczos pseudospectra of the ADC electronic Hamiltonian. The intermediate state representation of the dipole operator in the ADC basis is used to compute the transition moments between the excited states of the molecule. We compare the results obtained using different levels of the many-body theory, i.e., ADC(1), ADC(2), and ADC(2)x for the first two excited states of CO, N2, and H2O both at the ground state and the excited state equilibrium or saddle point geometries. We find that the single excitation ADC(1) method is not adequate even at the qualitative level and that the inclusion of double electronic excitations for description of excited state photoionization is essential. Moreover, we show that the use of the extended ADC(2)x method leads to a substantial systematic difference from the strictly second-order ADC(2). Our calculations demonstrate that a theoretical modelling of photoionization of excited states requires an intrinsically double excitation theory with respect to the ground state and cannot be achieved by the standard single excitation methods with the ground state as a reference.

  15. Shapes of the $^{192,190}$Pb ground states from beta decay studies using the total absorption technique

    CERN Document Server

    Estevez Aguado, M.E.; Agramunt, J.; Rubio, B.; Tain, J.L.; Jordan, D.; Fraile, L.M.; Gelletly, W.; Frank, A.; Csatlos, M.; Csige, L.; Dombradi, Zs.; Krasznahorkay, A.; Nacher, E.; Sarriguren, P.; Borge, M.J.G.; Briz, J.A.; Tengblad, O.; Molina, F.; Moreno, O.; Kowalska, M.; Fedosseev, V.N.; Marsh, B.A.; Fedorov, D.V.; Molkanov, P.L.; Andreyev, A.N.; Seliverstov, M.D.; Burkard, K.; Huller, W.

    2015-01-01

    The beta decay of $^{192,190}$Pb has been studied using the total absorption technique at the ISOLDE(CERN) facility. The beta-decay strength deduced from the measurements, combined with QRPA theoretical calculations, allow us to infer that the ground states of the $^{192,190}$Pb isotopes are spherical. These results represent the first application of the shape determination method using the total absorption technique for heavy nuclei and in a region where there is considerable interest in nuclear shapes and shape effects.

  16. Economic impacts of the total nuclear waste management program envisioned for the United States

    International Nuclear Information System (INIS)

    Busch, L.; Zielen, A.J.; Parry, S.J.S.

    1978-01-01

    This paper presents information on the costs of nuclear waste management and on the impacts of those costs on the price of power and on the capital and labor markets. It is assumed that the LWR would be the sole commercial reactor used through the year 2000. Two fuel cycle options are considered: the throwaway mode (spent fuel is waste), and the full recycle for comparison. Total costs are calculated for all facilities needed to store, package, and reposit all the spent fuel through the lifetime of 380 GW capacity installed by 2000 and operating for 30 y. The economic impact is: the price of power produced by the reactors would be increased by 1.4%; the capital for nuclear plants would apply to waste management; the average annual labor effort needed over the next 50 to 75 years is 3000 to 5000 man years; and the unit cost of spent fuel disposal is $129/kg ($119/kg for full recycle). 7 tables

  17. Special Appropriation Act Projects

    Science.gov (United States)

    EPA is sometimes directed to provide funding to a specific entity for study, purpose, or activity.This information will be of interest to a community or other entity that has been identified in one of EPA's appropriations acts to receive such funding.

  18. Choosing Appropriate Business Models

    OpenAIRE

    UNCTAD; World Bank

    2018-01-01

    This note provides guidance on considerations in the selection of an appropriate business model through which to conduct an agricultural investment. Agricultural investments have a wide range of impacts, positive and negative. The choice of business model is one, but by no means the only, determining factor of the financial success of the investment, as well as its socioeconomic and enviro...

  19. The Discourse of Interculturality and Its Transnational Migration: Towards a Comparative Analysis of Its Appropriation by Academic and Political Actors in the State of Veracruz

    Science.gov (United States)

    Cortes, Laura Selene Mateos

    2009-01-01

    This paper analyses the ways in which social and educational networks are being configured around the actors participating in the increasingly transnational field of intercultural education both at the Universidad Veracruzana Intercultural and the Veracruz State Ministry of Education. It starts by defining the notion of discursive migration as…

  20. Patient specific instrumentation in total knee arthroplasty: a state of the art

    Science.gov (United States)

    Mattei, Lorenzo; Pellegrino, Pietro; Bistolfi, Alessandro; Castoldi, Filippo

    2016-01-01

    Patient specific instrumentation (PSI) is a modern technique in total knee arthroplasty (TKA) aiming to facilitate the implant of the prosthesis. The customized cutting blocks of the PSI are generated from pre-operative three-dimensional model, using computed tomography (CT) or magnetic resonance imaging (MRI). A correct surgical plan is mandatory for a good surgical implant. The PSI guide takes into account any slight deformities or osteophytes and applies preoperative planning for bone resection, using the pre-determined implant size, position, and rotation. The apparent benefits of this technology are that neutral postoperative alignment is more reproducible, surgical time is decreased, and the entire procedure results more efficient and cost-effective. The use of PSI is indicated when advanced osteoarthritis, severe pain, and limited function/walking ability are present, such as in a standard instrumentation TKA. In addition to that, PSI finds its indication when intra-medullary guides cannot be used. For example, when there is a post-traumatic femoral deformity. Large debates have taken place about this topic during the last years and, at the moment, there is no consensus in literature regarding the accuracy and reliability of PSI as many studies have shown controversial and inconsistent results. Literature does not suggest PSI techniques as a gold standard in TKA, and therefore it cannot be recommended as a standard technique in standard, not complicated primary TKA. Moreover, literature does not underline any improvement in components alignment, surgical time, blood loss or functional outcomes. Nevertheless, many patients who underwent TKA suffered a previous trauma. In case of deformities, like femoral or tibial fractures healed with a malalignment, preoperative planning may result difficult, and some intra-operative technical difficulties can occur, such as the use of intra-medullar rod. In these selected cases, PSIs may be very useful to avoid errors in

  1. Total and single differential cross sections for the electron impact ionization of the ground state of helium

    International Nuclear Information System (INIS)

    Singh, T.S.C.; Choudhury, K.B.; Singh, M.B.; Deb, N.C.; Mukherjee, S.C.; Mazumdar, P.S.

    1997-01-01

    Total cross sections (TCS) and single differential cross sections (SDCS) have been computed for the single ionization of the ground state of helium by electron impact in a distorted wave formalism which takes into account the effects of the initial and final channel distortions. The present TCS and SDCS results are in fair agreement with the measured values and other theoretical predictions for the incident electron energy E i > 150 eV. (orig.)

  2. Workspace appropriation and attachment

    Directory of Open Access Journals (Sweden)

    M. PAVALACHE-ILIE

    2016-11-01

    Full Text Available This literature synthesis presents a short history of the evolution of the concepts of space appropriation and place attachment, highlighting the difficulty of their operationalisation from a cultural point of view. The next subject brought into discussion is the relation between the affective dimension of the connection between a person and the work place and the behaviours which are prone to insure the proper functioning of organizations, such as the organizational civism and the organizational commitment.

  3. Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States.

    Science.gov (United States)

    Le, Margaret; Flores, David; May, Danica; Gourley, Eric; Nangia, Ajay K

    2016-05-01

    The evaluation and management of male hypogonadism should be based on symptoms and on serum testosterone levels. Diagnostically this relies on accurate testing and reference values. Our objective was to define the distribution of reference values and assays for free and total testosterone by clinical laboratories in the United States. Upper and lower reference values, assay methodology and source of published reference ranges were obtained from laboratories across the country. A standardized survey was reviewed with laboratory staff via telephone. Descriptive statistics were used to tabulate results. We surveyed a total of 120 laboratories in 47 states. Total testosterone was measured in house at 73% of laboratories. At the remaining laboratories studies were sent to larger centralized reference facilities. The mean ± SD lower reference value of total testosterone was 231 ± 46 ng/dl (range 160 to 300) and the mean upper limit was 850 ± 141 ng/dl (range 726 to 1,130). Only 9% of laboratories where in-house total testosterone testing was performed created a reference range unique to their region. Others validated the instrument recommended reference values in a small number of internal test samples. For free testosterone 82% of laboratories sent testing to larger centralized reference laboratories where equilibrium dialysis and/or liquid chromatography with mass spectrometry was done. The remaining laboratories used published algorithms to calculate serum free testosterone. Reference ranges for testosterone assays vary significantly among laboratories. The ranges are predominantly defined by limited population studies of men with unknown medical and reproductive histories. These poorly defined and variable reference values, especially the lower limit, affect how clinicians determine treatment. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Solid-State Polymerization of Poly(Ethylene Furanoate Biobased Polyester, II: An Efficient and Facile Method to Synthesize High Molecular Weight Polyester Appropriate for Food Packaging Applications

    Directory of Open Access Journals (Sweden)

    Nejib Kasmi

    2018-04-01

    Full Text Available The goal of this study was to synthesize, through a facile strategy, high molecular weight poly(ethylene furanoate (PEF, which could be applicable in food packaging applications. The efficient method to generate PEF with high molecular weight consists of carrying out a first solid-state polycondensation under vacuum for 6 h reaction time at 205 °C for the resulting polymer from two-step melt polycondensation process, which is catalyzed by tetrabutyl titanate (TBT. A remelting step was thereafter applied for 15 min at 250 °C for the obtained polyester. Thus, the PEF sample was ground into powder, and was then crystallized for 6 h at 170 °C. This polyester is then submitted to a second solid-state polycondensation (SSP carried out at different reaction times (1, 2, 3.5, and 5 h and temperatures 190, 200, and 205 °C, under vacuum. Ultimately, a significant increase in intrinsic viscosity is observed with only 5 h reaction time at 205 °C during the second SSP being needed to obtain very high molecular weight PEF polymer greater than 1 dL/g, which sufficient for manufacturing purposes. Intrinsic viscosity (IV, carboxyl end-group content (–COOH, and thermal properties, via differential scanning calorimetry (DSC, were measured for all resultant polyesters. Thanks to the post-polymerization process, DSC results showed that the melting temperatures of the prepared PEF samples were steadily enhanced in an obvious way as a function of reaction time and temperature increase. It was revealed, as was expected for all SSP samples, that the intrinsic viscosity and the average molecular weight of PEF polyester increased with increasing SSP time and temperature, whereas the number of carboxyl end-group concentration was decreased. A simple kinetic model was also developed and used to predict the time evolution of polyesters IV, as well as the carboxyl and hydroxyl end-groups of PEF during the SSP.

  5. ACR appropriateness criteria jaundice.

    Science.gov (United States)

    Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

    2013-06-01

    A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

    2014-10-01

    We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Reliability evaluation of linear multi-state consecutively-connected systems constrained by m consecutive and n total gaps

    International Nuclear Information System (INIS)

    Yu, Huan; Yang, Jun; Peng, Rui; Zhao, Yu

    2016-01-01

    This paper extends the linear multi-state consecutively-connected system (LMCCS) to the case of LMCCS-MN, where MN denotes the dual constraints of m consecutive gaps and n total gaps. All the nodes are distributed along a line and form a sequence. The distances between the adjacent nodes are usually non-uniform. The nodes except the last one can contain statistically independent multi-state connection elements (MCEs). Each MCE can provide a connection between the node at which it is located and the next nodes along the sequence. The LMCCS-MN fails if it meets either of the two constraints. The universal generating function technique is adopted to evaluate the system reliability. The optimal allocations of LMCCS-MN with two different types of failures are solved by genetic algorithm. Finally, two examples are given for the demonstration of the proposed model. - Highlights: • A new model of multi-state consecutively-connected system (LMCCS-MN) is proposed. • The non-uniform distributed nodes are involved in the proposed LMCCS-MN model. • An algorithm for system reliability evaluation is provided by the UGF method. • The computational complexity of the proposed algorithm is discussed in detail. • Optimal element allocation problem is formulated and solved.

  8. Developing an Enterprise Systems Appropriation Model in the Public Sector: A Case Study of Implementing Payroll System Replacement (PAYSERV) at the New York State Office of the State Comptroller

    Science.gov (United States)

    Kamya, Moses M.

    2009-01-01

    This dissertation examines an enterprise system appropriation process applying structuration theory and adaptive structuration theory (AST). The key research questions are: (1) what structures emerge from the implementation of enterprise information technology (EIT); (2) how do enterprise technologies and existing organization structures influence…

  9. Estimating the contribution of strong daily export events to total pollutant export from the United States in summer

    Science.gov (United States)

    Fang, Yuanyuan; Fiore, Arlene M.; Horowitz, Larry W.; Gnanadesikan, Anand; Levy, Hiram; Hu, Yongtao; Russell, Armistead G.

    2009-12-01

    While the export of pollutants from the United States exhibits notable variability from day to day and is often considered to be "episodic," the contribution of strong daily export events to total export has not been quantified. We use carbon monoxide (CO) as a tracer of anthropogenic pollutants in the Model of OZone And Related Tracers (MOZART) to estimate this contribution. We first identify the major export pathway from the United States to be through the northeast boundary (24-48°N along 67.5°W and 80-67.5°W along 48°N), and then analyze 15 summers of daily CO export fluxes through this boundary. These daily CO export fluxes have a nearly Gaussian distribution with a mean of 1100 Gg CO day-1 and a standard deviation of 490 Gg CO day-1. To focus on the synoptic variability, we define a "synoptic background" export flux equal to the 15 day moving average export flux and classify strong export days according to their fluxes relative to this background. As expected from Gaussian statistics, 16% of summer days are "strong export days," classified as those days when the CO export flux exceeds the synoptic background by one standard deviation or more. Strong export days contributes 25% to the total export, a value determined by the relative standard deviation of the CO flux distribution. Regressing the anomalies of the CO export flux through the northeast U.S. boundary relative to the synoptic background on the daily anomalies in the surface pressure field (also relative to a 15 day running mean) suggests that strong daily export fluxes are correlated with passages of midlatitude cyclones over the Gulf of Saint Lawrence. The associated cyclonic circulation and Warm Conveyor Belts (WCBs) that lift surface pollutants over the northeastern United States have been shown previously to be associated with long-range transport events. Comparison with observations from the 2004 INTEX-NA field campaign confirms that our model captures the observed enhancements in CO outflow

  10. Increase of content and bioactivity of total phenolic compounds from spent coffee grounds through solid state fermentation by Bacillus clausii.

    Science.gov (United States)

    Rochín-Medina, Jesús J; Ramírez, Karina; Rangel-Peraza, Jesús G; Bustos-Terrones, Yaneth A

    2018-03-01

    Spent coffee grounds are waste material generated during coffee beverage preparation. This by-product disposal causes a negative environmental impact, in addition to the loss of a rich source of nutrients and bioactive compounds. A rotating central composition design was used to determine the optimal conditions for the bioactivity of phenolic compounds obtained after the solid state fermentation of spent coffee grounds by Bacillus clausii . To achieve this, temperature and fermentation time were varied according to the experimental design and the total phenolic and flavonoid content, antioxidant activity and antimicrobial activity were determined. Surface response methodology showed that optimum bioprocessing conditions were a temperature of 37 °C and a fermentation time of 39 h. Under these conditions, total phenolic and flavonoid contents increased by 36 and 13%, respectively, in fermented extracts as compared to non-fermented. In addition, the antioxidant activity was increased by 15% and higher antimicrobial activity was observed against Gram positive and negative bacteria. These data demonstrated that bioprocessing optimization of spent coffee grounds using the surface response methodology was an important tool to improve phenolic extraction, which could be used as an antioxidant and antimicrobial agents incorporated into different types of food products.

  11. Characterizing the hydration state of L-threonine in solution using terahertz time-domain attenuated total reflection spectroscopy

    Science.gov (United States)

    Huang, Huachuan; Liu, Qiao; Zhu, Liguo; Li, Zeren

    2018-01-01

    The hydration of biomolecules is closely related to the dynamic process of their functional expression, therefore, characterizing hydration phenomena is a subject of keen interest. However, direct measurements on the global hydration state of biomolecules couldn't have been acquired using traditional techniques such as thermodynamics, ultrasound, microwave spectroscopy or viscosity, etc. In order to realize global hydration characterization of amino acid such as L-threonine, terahertz time-domain attenuated total reflectance spectroscopy (THz-TDS-ATR) was adopted in this paper. By measuring the complex permittivity of L-threonine solutions with various concentrations in the THz region, the hydration state and its concentration dependence were obtained, indicating that the number of hydrous water decreased with the increase of concentration. The hydration number was evaluated to be 17.8 when the molar concentration of L-threonine was 0.34 mol/L, and dropped to 13.2 when the molar concentration increased to 0.84 mol/L, when global hydration was taken into account. According to the proposed direct measurements, it is believed that the THz-TDS-ATR technique is a powerful tool for studying the picosecond molecular dynamics of amino acid solutions.

  12. Rovibrational bound states of SO{sub 2} isotopologues. I: Total angular momentum J = 0–10

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Praveen, E-mail: Praveen.Kumar@ttu.edu; Ellis, Joseph; Poirier, Bill, E-mail: Bill.Poirier@ttu.edu

    2015-04-01

    Highlights: • We report calculation of the exact rovibrational energy levels of SO{sub 2} for J = 0–10. • We report sulfur isotope shifts of the SO{sub 2} isotopologues rovibrational frequencies. • Coriolis coupling is treated exactly. • All rovibrational levels are computed to a high level of numerical convergence. • All of the rovibrational data exhibit near-perfect mass-dependent fractionation. - Abstract: Isotopic variation of the rovibrational bound states of SO{sub 2} for the four stable sulfur isotopes {sup 32–34,36}S is investigated in comprehensive detail. In a two-part series, we compute the low-lying energy levels for all values of total angular momentum in the range J = 0–20. All rovibrational levels are computed, to an extremely high level of numerical convergence. The calculations have been carried out using the ScalIT suite of parallel codes. The present study (Paper I) examines the J = 0–10 rovibrational levels, providing unambiguous symmetry and rovibrational label assignments for each computed state. The calculated vibrational energy levels exhibit very good agreement with previously reported experimental and theoretical data. Rovibrational energy levels, calculated without any Coriolis approximations, are reported here for the first time. Among other potential ramifications, this data will facilitate understanding of the origin of mass-independent fractionation of sulfur isotopes in the Archean rock record—of great relevance for understanding the “oxygen revolution”.

  13. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview.

    Science.gov (United States)

    Gademan, Maaike G J; Hofstede, Stefanie N; Vliet Vlieland, Thea P M; Nelissen, Rob G H H; Marang-van de Mheen, Perla J

    2016-11-09

    This systematic review gives an overview of guidelines and original publications as well as the evidence on which the currently proposed indication criteria are based. Until now such a state-of-the-science overview was lacking. Websites of orthopaedic and arthritis organizations (English/Dutch language) were independently searched by two authors for THA/TKA guidelines for OA. Furthermore, a systematic search strategy in several databases through August 2014 was performed. Quality of the guidelines was assessed with the AGREE II instrument, which consists of 6 domains (maximum summed score of 6 indicating high quality). Also, the level of evidence of all included studies was assessed. We found 6 guidelines and 18 papers, out of 3065 references. The quality of the guidelines summed across 6 domains ranged from 0.46 to 4.78. In total, 12 THA, 10 TKA and 2 THA/TKA indication sets were found. Four studies stated that no evidence-based indication criteria are available. Indication criteria concerning THA/TKA consisted of the following domains: pain (in respectively 11 and 10 sets), function (12 and 7 sets), radiological changes (10 and 9 sets), failed conservative therapy (8 and 4 sets) and other indications (6 and 7 sets). Specific cut-off values or ranges were often not stated and the level of evidence was low. The indication criteria for THA/TKA are based on limited evidence. Empirical research is needed, especially regarding domain specific cut-off values or ranges at which the best postoperative outcomes are achieved for patients, taking into account the limited lifespan of a prosthesis.

  14. Ways of art appropriation by the advertising

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Esteves

    2013-09-01

    Full Text Available Based on the different ways of appropriation of the artistic visualrepresentations by the advertising communication, proposed by Lucia Santaella (2005 – imitation of the ways of composing and incorporation of the artistic image – this article presents, as of the examination of advertisements broadcast in different countries, seven new categories outlined on the basis of partial or total use of the appropriated image and the interference performed in them.

  15. Certification of Public Librarians in the United States; A Detailed Summary of Legal and Voluntary Certification Plans for Public Librarians Based on Information Supplied by the Various Certificating State Agencies or other Appropriate Sources, 2nd Edition.

    Science.gov (United States)

    Frame, Ruth R.; Coyne, John R.

    Contained in this report is a detailed summary of legal and voluntary certification plans for public librarians in each of the 50 states. Descriptions of the certification plans for public librarians are based on information supplied by state agencies in September 1971. Each plan is identified by the descriptive terms--mandatory, permissive or…

  16. National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States.

    Science.gov (United States)

    Mayers, William; Schwartz, Brian; Schwartz, Aaron; Moretti, Vincent; Goldstein, Wayne; Shah, Ritesh

    2016-09-01

    While a majority of total hip arthroplasty (THA) is performed for osteoarthritis (OA), a significant portion is performed in the setting of avascular necrosis (AVN). The purpose of this study is to evaluate recent trends, patient demographics, and in hospital outcomes for primary THA in the setting of AVN in the United States. The National Hospital Discharge Survey database was searched for patients admitted to US hospitals after a primary THA for the years 2001-2010. Patients were then separated into two groups by ICD-9 diagnosis codes for OA and AVN. The rates of THA for AVN (r = 0.65) and THA for OA (r = 0.82) both demonstrated a positive correlation with time. The mean patient age of the AVN group was significantly lower (56.9 vs 65.9 years, p < 0.01). Men accounted for 51.9 % of the AVN group and 43.0 % of the OA group (p < 0.01). The AVN group had a significantly higher percentage of African Americans (11.2 % vs 5.4 %, p < 0.01) when compared to the OA group. The AVN group had a higher rate of myocardial infarction (0.3 % vs 0.07 %, p = 0.0163) and a higher average number of medical co-morbidities (5.16 vs 4.77, p < 0.01). Patients undergoing THA for AVN were more likely to be younger, male, African American, have more medical co-morbidities, and more likely to have a myocardial infarction than those with OA. While the number of primary THAs performed for AVN in the United States has increased over the past ten years, the rate of primary THA for OA increased at a much more rapid rate.

  17. Dynamic effect of total solid content, low substrate/inoculum ratio and particle size on solid-state anaerobic digestion.

    Science.gov (United States)

    Motte, J-C; Escudié, R; Bernet, N; Delgenes, J-P; Steyer, J-P; Dumas, C

    2013-09-01

    Among all the process parameters of solid-state anaerobic digestion (SS-AD), total solid content (TS), inoculation (S/X ratio) and size of the organic solid particles can be optimized to improve methane yield and process stability. To evaluate the effects of each parameter and their interactions on methane production, a three level Box-Behnken experimental design was implemented in SS-AD batch tests degrading wheat straw by adjusting: TS content from 15% to 25%, S/X ratio (in volatile solids) between 28 and 47 and particle size with a mean diameter ranging from 0.1 to 1.4mm. A dynamic analysis of the methane production indicates that the S/X ratio has only an effect during the start-up phase of the SS-AD. During the growing phase, TS content becomes the main parameter governing the methane production and its strong interaction with the particle size suggests the important role of water compartmentation on SS-AD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Unauthorized Appropriations and Expiring Authorizations

    Science.gov (United States)

    2015-01-15

    Unauthorized FY 2015 Appropriations: Not Available Organ Donation and Recovery Improvement ActP.L. 108-216 Reimbursement of travel and subsistence...FY 2013 Appropriation Authorized: Indefinite Unauthorized FY 2015 Appropriations: Not Available Capital investment grants to support intercity ...priority rail corridor projects necessary to reduce congestion or facilitate ridership growth in intercity rail passenger transportation * FY 2013

  19. Convergence of the Policies for Promoting Total Quality Management in the Public Administrations of Balkan States – European Union Member States

    Directory of Open Access Journals (Sweden)

    Ani MATEI

    2011-03-01

    Full Text Available In the past three decades, total quality management (TQM has been appreciated as “fundamental modality in view to improve the activity in the public and private sectors” (Boyne and Walker, 2002, p. 1. For the time being, in public administrations, we witness an extension of the policies for promoting TQM, although the experiences have not always been positive.The European Administrative Space (EAS incorporates TQM, in different manners at national level, taking into consideration its recognised impact on the efficiency of public administration, one of EAS fundamental principles (Zurga, 2008, pp. 39-49. In the context of analysing EAS evolution, the administrative convergence will also comprise the convergence of TQM policies. In fact, the field literature (Hackman, Wageman, 1995 reveals, in the context of national TQM policy-making, the concepts of ”Convergent validity” and ”Discriminant validity”, reflecting ”the degree to which the version of TQM promulgated by the founders and observed in organizational practice share a common set of assumptions and prescriptions” (Hackman, Wageman, 1995, pp. 318-319.By a comparative analysis on TQM policies in the national public administrations of Balkan states, EU Member States: Greece, Cyprus, Slovenia, Bulgaria and Romania, the current paper aims to reveal the level of their convergence as well as the theoretical consistency of the conceptual and practical framework for TQM assertion.The comparative analysis will be based on a comprehensive vision on TQM, provided by Dean and Bowen (1994, Boyne and Walker (2002, namely its approach should be characterised on own principles, practices and techniques, grouped on customer focus, continuous improvement and team work (Boyne and Walker, 2002, pp. 4-5.The tradition on promoting TQM in public administration in the above-mentioned states is relatively recent: since 1990s – Cyprus, since 1995 – Greece and Slovenia, since 2000 – Bulgaria and

  20. The changing demographics of total joint arthroplasty recipients in the United States and Ontario from 2001 to 2007.

    Science.gov (United States)

    Ravi, Bheeshma; Croxford, Ruth; Reichmann, William M; Losina, Elena; Katz, Jeffrey N; Hawker, Gillian A

    2012-10-01

    The rates of total joint arthroplasty (TJA) of the hip and knee have increased in North America over the last decade. While initially designed for elderly patients (>70 years of age), several reports suggest that an increasing number of younger patients are undergoing joint replacements. This suggests that more people are meeting the indication for TJA earlier in their lives. Alternatively, it might indicate a broadening of the indications for TJA. We used the administrative databases available at the Healthcare Cost and Utilization Project (HCUP) and the Institute for Clinical Evaluative Sciences (ICES) to determine the rates of TJA of the hip and knee in the United States, and Ontario, Canada, respectively. We determined the crude rates of THA and TKA in both areas for four calendar years (2001, 2003, 2005 and 2007). We also calculated the age- and sex-standardised rates of THA and TKA in both areas for each time period. We compared the age distribution of TJA recipients between the US and Ontario, and within each area over time. The crude and standardised rates of THA and TKA increased over time in both the US and Ontario. The crude rates of THA were higher in the US in 2001 and 2003, but were not significantly different from the rate in Ontario in 2005 and 2007. The crude rates of TKA were consistently higher in the US for all time periods. In addition, the US consistently had more THA and TKA recipients in 'younger' age categories (age). While the age- and sex-standardised rates of TKA were greater in the US in all time periods, the relative increase in rates from 2001 to 2007 was greater in Ontario (US - 59%, Ontario - 73%). For both the US and Ontario, there was a significant shift in the demographic of THA and TKA recipients to younger patients (p age groups in the general population, in both the US and Ontario. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Artificial neural network modelling for organic and total nitrogen removal of aerobic granulation under steady-state condition.

    Science.gov (United States)

    Gong, H; Pishgar, R; Tay, J H

    2018-04-27

    Aerobic granulation is a recent technology with high level of complexity and sensitivity to environmental and operational conditions. Artificial neural networks (ANNs), computational tools capable of describing complex non-linear systems, are the best fit to simulate aerobic granular bioreactors. In this study, two feedforward backpropagation ANN models were developed to predict chemical oxygen demand (Model I) and total nitrogen removal efficiencies (Model II) of aerobic granulation technology under steady-state condition. Fundamentals of ANN models and the steps to create them were briefly reviewed. The models were respectively fed with 205 and 136 data points collected from laboratory-, pilot-, and full-scale studies on aerobic granulation technology reported in the literature. Initially, 60%, 20%, and 20%, and 80%, 10%, and 10% of the points in the corresponding datasets were randomly chosen and used for training, testing, and validation of Model I, and Model II, respectively. Overall coefficient of determination (R 2 ) value and mean squared error (MSE) of the two models were initially 0.49 and 15.5, and 0.37 and 408, respectively. To improve the model performance, two data division methods were used. While one method is generic and potentially applicable to other fields, the other can only be applied to modelling the performance of aerobic granular reactors. R 2 value and MSE were improved to 0.90 and 2.54, and 0.81 and 121.56, respectively, after applying the new data division methods. The results demonstrated that ANN-based models were capable simulation approach to predict a complicated process like aerobic granulation.

  2. Contemporary treatment of patients with chronic total occlusion: critical appraisal of different state-of-the-art techniques and devices.

    Science.gov (United States)

    García-García, Héctor M; Kukreja, Neville; Daemen, Joost; Tanimoto, Shuzou; van Mieghem, Carlos; Gonzalo, Nieves; van Weenen, Sander; van der Ent, Martin; Sianos, Georgios; de Feyter, Pim; Serruys, Patrick W

    2007-08-01

    To describe the contemporary approach of chronic total occlusion (CTO) treatment of patients at the Thoraxcenter, Rotterdam, The Netherlands. Additionally, to make a critical appraisal of the performance of state-of-the-art CTO dedicated guidewires and devices in a prospective registry of patients. During 20 months, a total of 160 consecutive patients (165 CTOs) were enrolled. The mean age was 61.5+/-11.1 years and 83.6% were male. In 91.5% of the patients this was the first attempt to open the CTO and 93.8% were de novo. The overall success rate was 60.6%. A median of 1 guiding catheter was used per case (Range: 1 to 9) and a median of 4 guidewires (Range: 1 to 11; 13 different types). 74.5% patients required more than one guidewire/device for the treatment of the CTO. The guidewires that most frequently crossed the CTO were the following: PT Graphix intermediate 33.0%, Miracle 3 g 27.4% and Crosswire NT 25.5%. The only device tested as a first option for the treatment of the CTOs was the CROSSER. Overall, the CROSSER system was used in 23 (13.9%) patients with a success rate of 60.9%. The Point 9(R) X-80 Laser catheter was used in 10 (6.1%) patients with a success rate of 60%. Another 3 patients were treated with the Point 7(R) laser catheter. Both were used either to facilitate the crossing of the balloon, or to treat primarily in-stent restenosis occlusions. The SafeCross(R) System was used in 15 (9.1%) patients and the success rate in these patients was 46.7%. The most common strategy used in this registry was the use of an over-the-wire balloon in 81.5% of the cases. The parallel wire technique was used in 27.3% of the cases and in 12.7% was converted into a "see-saw" technique. When a large false lumen was created, re-entry into the true lumen was attempted in 21.2% of the cases, by means of IVUS guided approach and/or the use of stiffer guidewires, such as a Confianza guidewire. Retrograde recanalisation was attempted in 10 cases (6.1%), in three cases a

  3. ASP Strategies and Appropriate Antibiotic Use

    Science.gov (United States)

    Lee, Brian R; Tribble, Alison; Handy, Lori; Gerber, Jeffrey S; Hersh, Adam L; Kronman, Matthew; Terrill, Cindy; Newland, Jason

    2017-01-01

    Abstract Background The Infectious Diseases Society of America (IDSA) recommends hospitals implement antimicrobial stewardship programs (ASP) in order to decrease inappropriate antibiotic use due to the rise in antibiotic-resistant infections. Data are limited on the extent to which different ASP strategies influence appropriate antibiotic use. Methods We conducted an online survey in 2016 of U.S. Children’s Hospitals to collect hospital-level information on dedicated ASP effort, ASP monitoring activities, use of audit-feedback, formulary restrictions, rapid diagnostics, etc. During the same period the ASP teams at these hospitals completed 3 point prevalence surveys that documented details on all admitted patients 0–17 years receiving any antibiotics, determined what ASP modifications could be made, and if the antibiotic was appropriate. We employed hierarchical, multivariable logit models to examine which ASP-related, hospital-level strategies were associated with appropriate antibiotic use. Results Thirty hospitals participated. A total of 6,921 patients were included, representing 10,068 total antibiotics. Of these orders, 8,554 (85.0%) were categorized as appropriate, though this varied across sites (range: 68-92%). Additionally, 78.2% of antibiotics did not have recommended modifications. Appropriate antibiotic use was significantly higher for hospitals that relied on rapid diagnostics (aOR: 1.6; P Terrill, Merck: Grant Investigator, Research grant Allergan: Grant Investigator, Research grant. J. Newland, Merck: Grant Investigator, Research grant. Allergan: Grant Investigator, Research grant

  4. Appropriate Technology as Indian Technology.

    Science.gov (United States)

    Barry, Tom

    1979-01-01

    Describes the mounting enthusiasm of Indian communities for appropriate technology as an inexpensive means of providing much needed energy and job opportunities. Describes the development of several appropriate technology projects, and the goals and activities of groups involved in utilizing low scale solar technology for economic development on…

  5. Value Appropriation in Business Exchange

    DEFF Research Database (Denmark)

    Ellegaard, Chris; Medlin, Christopher J.; Geersbro, Jens

    2014-01-01

    value creation. Originality/value – To the authors’ knowledge, this paper represents the first attempt at reviewing the management literature on value appropriation in business exchange. The authors provide overview, details, comparisons, and frame a research agenda as a first step towards establishing......Purpose – Value appropriation is a central, yet neglected aspect in business exchange research. The purpose of the paper is to generate an overview of research on active value appropriation in business exchange and provide the foundation for further research into value appropriation, as well...... as some initial guidance for managers. Design/methodology/approach – Literatures investigating value appropriation were identified by the means of a systematic review of the overall management literature. Findings – The authors provide an overview and comparison of the literatures and find that they apply...

  6. Role of alkaline-tolerant fungal cellulases in release of total antioxidants from agro-wastes under solid state fermentation

    Digital Repository Service at National Institute of Oceanography (India)

    Ravindran, C.; Varatharajan, G. R.; Karthikeyan, A.

    -wastes and total antioxidant property. The increased antioxidant activity on free radical scavenging was also observed with the increase in pH. Thus, the present study makes it possible to produce nutraceutical ingredients cost-effectively from agricultural wastes....

  7. The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic.

    Science.gov (United States)

    Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N; Wright, John; Katz, Jeffrey N

    2012-02-01

    Total knee replacement utilization in the United States more than doubled from 1999 to 2008. Although the reasons for this increase have not been examined rigorously, some have attributed the increase to population growth and the obesity epidemic. Our goal was to investigate whether the rapid increase in total knee replacement use over the past decade can be sufficiently attributed to changes in these two factors. We used data from the Nationwide Inpatient Sample to estimate changes in total knee replacement utilization rates from 1999 to 2008, stratified by age (eighteen to forty-four years, forty-five to sixty-four years, and sixty-five years or older). We obtained data on obesity prevalence and U.S. population growth from federal sources. We compared the rate of change in total knee replacement utilization with the rates of population growth and change in obesity prevalence from 1999 to 2008. In 2008, 615,050 total knee replacements were performed in the United States adult population, 134% more than in 1999. During the same time period, the overall population size increased by 11%. While the population of forty-five to sixty-four-year-olds grew by 29%, the number of total knee replacements in this age group more than tripled. The number of obese and non-obese individuals in the United States increased by 23% and 4%, respectively. Assuming unchanged indications for total knee replacement among obese and non-obese individuals with knee osteoarthritis over the last decade, these changes fail to account for the 134% growth in total knee replacement use. Population growth and obesity cannot fully explain the rapid expansion of total knee replacements in the last decade, suggesting that other factors must also be involved. The disproportionate increase in total knee replacements among younger patients may be a result of a growing number of knee injuries and expanding indications for the procedure.

  8. Appropriate roads for rural access

    CSIR Research Space (South Africa)

    Paige-Green, P

    2006-03-01

    Full Text Available be reduced, the result remains environmentally unsustainable. Low cost but appropriate techniques for upgrading these roads cost-effectively to sealed standards have been implemented in many countries recently. These techniques optimize the use of local...

  9. Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty.

    Science.gov (United States)

    Inoue, Daisuke; Kabata, Tamon; Maeda, Toru; Kajino, Yoshitomo; Fujita, Kenji; Hasegawa, Kazuhiro; Yamamoto, Takashi; Takagi, Tomoharu; Ohmori, Takaaki; Tsuchiya, Hiroyuki

    2015-12-01

    It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant-femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem. We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping. The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state. Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

  10. Appropriate use of diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, P.E.S.; Cockshott, W.P.

    1984-11-16

    This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

  11. The moral appropriateness of shame

    Directory of Open Access Journals (Sweden)

    M. Ally

    2005-07-01

    Full Text Available In this article I explore the much neglected moral emotion of shame and consider the senses in which it may be regarded as morally appropriate. I argue that there is a connection between coming to terms with shame for those who feel ashamed, and judgments concerning its moral appropriateness. The elucidation of normative connections between shame, self-respect and autonomy implies the need to accept certain aspects of shame as regrettable yet, sometimes, as valuable.

  12. The state of the art in Japan's telecommunications energy systems - Strategy for Total Power Management -

    Energy Technology Data Exchange (ETDEWEB)

    Muroyama, Seiichi [NTT Power and Building Facilities Inc., Midori-cho, Musashino-shi, Tokyo (Japan)

    2000-07-01

    The ''strategy for total power management (STPM)'' was developed for managing problems in relation to energy for multimedia services in a comprehensive manner from the viewpoints of risk, cost, and environment. To provide integrated services based on STPM, a DC power supply system, a highly reliable UPS, and a co-generation system have been developed. (orig.)

  13. 76 FR 34270 - Federal-State Extended Benefits Program-Methodology for Calculating “on” or “off” Total...

    Science.gov (United States)

    2011-06-13

    ... requirement. The Department plans to promulgate regulations about this methodology in the near future. In the...--Methodology for Calculating ``on'' or ``off'' Total Unemployment Rate Indicators for Purposes of Determining..., Labor. ACTION: Notice. SUMMARY: UIPL 16-11 informs states of the methodology used to calculate the ``on...

  14. Landscape controls on total and methyl mercury in the upper Hudson River basin of New York State

    Science.gov (United States)

    Burns, D. A.; Murray, K. R.; Bradley, P. M.; Brigham, M. E.; Aiken, G.; Smith, M.

    2010-12-01

    High levels of mercury (Hg) in aquatic biota have been identified in surface waters of the Adirondack region of New York, and factors such as the prevalence of wetlands, extensive forest cover, and oligotrophic waters promote Hg bioaccumulation in this region. Past research in this region has focused on improved understanding of the Hg cycle in lake ecosystems. In the study described herein, the landscape controls on total Hg and methylmercury (MeHg) concentrations in riverine ecosystems were explored through synoptic surveys of 27 sites in the upper Hudson River basin of the Adirondack region. Stream samples were collected and analyzed for total Hg, MeHg, dissolved organic carbon (DOC), and ultraviolet absorbance at 254 nm (UV254) during spring and summer of 2006-08. Landscape indices including many common land cover, hydrographic, and topographic-based measures were explored as predictors of Hg through multivariate linear regression. Multivariate models that included a wetland or riparian area-based metric, an index for open water area, and in some cases a topographic metric such as the wetness index explained 55 to 65 percent of the variation in MeHg concentrations, and 55 to 80 percent of the variation in total Hg concentrations. An open water index (OWI) was developed that incorporated both the basin area drained by ponded water and the surface area of these ponds. This index was inversely related to concentrations of total Hg and MeHg. This OWI was also inversely related to specific ultra-violet absorbance, consistent with previous studies showing that open water increases the influence of algal-derived carbon on DOC, decreasing aromaticity, which should decrease the ability of the dissolved carbon pool to bind Hg. The OWI was not significant in models for total Hg that also included UV254 as a predictive variable, but the index did remain significant in similar models for MeHg suggesting that biogeochemical factors in addition to decreasing carbon

  15. Steady-state metabolite concentrations reflect a balance between maximizing enzyme efficiency and minimizing total metabolite load.

    Directory of Open Access Journals (Sweden)

    Naama Tepper

    Full Text Available Steady-state metabolite concentrations in a microorganism typically span several orders of magnitude. The underlying principles governing these concentrations remain poorly understood. Here, we hypothesize that observed variation can be explained in terms of a compromise between factors that favor minimizing metabolite pool sizes (e.g. limited solvent capacity and the need to effectively utilize existing enzymes. The latter requires adequate thermodynamic driving force in metabolic reactions so that forward flux substantially exceeds reverse flux. To test this hypothesis, we developed a method, metabolic tug-of-war (mTOW, which computes steady-state metabolite concentrations in microorganisms on a genome-scale. mTOW is shown to explain up to 55% of the observed variation in measured metabolite concentrations in E. coli and C. acetobutylicum across various growth media. Our approach, based strictly on first thermodynamic principles, is the first method that successfully predicts high-throughput metabolite concentration data in bacteria across conditions.

  16. Distribution of Total and Organic Mercury in Superficial Soils in the Upper Manzanares River Watershed, Sucre State, Venezuela

    Directory of Open Access Journals (Sweden)

    Yahsé Rojas Challa

    2008-01-01

    Full Text Available Total and organic mercury contents were determined from samples of surface soils (0-5 cm, sieved at ≤ 63µm, collected from 10 different locations in the upper Manzanares River watershed, using cold vapor atomic absorption spectroscopy. Methylmercury was determined using a HPLC-UV detector. The mean total mercury concentration was 1.3 μg.g-1, a value permitted by the Canadian environment quality guidelines for farming soils, but high for European standards. Using certified reference materials, we verified that a modification of the method described by Qian et al. (2000 was effective for organic mercury extraction, with a recovery of 92.17% for DORM-2 and 92.11% for TORT-2. This modified method was applied to soil samples, obtaining concentrations of 0.5-1.0 μg.g-1 of organic mercury. The parameters for determining methylmercury using HPLC-UV were optimized; the best results were obtained with a 4.6 mm x 25 cm Zorbax CN column, with a mobile phase of 70/30 V/V of methanol: ammonium acetate 0.05 mol.l-1, with a flow rate of 0.5 ml.min-1; the methylmercury was detected at 4.99 min retention time. Methylmercury was not found in the soil samples. Using the certified reference material we proved that the method used produced reliable results. The analysis confirmed the existence of mercury in this farming area.

  17. Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.

    Science.gov (United States)

    Ryan, Devon J; Yoshihara, Hiroyuki; Yoneoka, Daisuke; Zuckerman, Joseph D

    2015-05-01

    Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. This study used national hospital discharge data from the National Inpatient Sample between 2000 and 2009. The data were used to generate the overall blood transfusion rate, and linear regression was used to assess trends in transfusion patterns over time. Logistic regression analysis was performed to analyze which patient and hospital characteristics independently influence the likelihood that a given patient undergoes ALBT. The overall blood transfusion rate (ie, the proportion of patients who received at least 1 transfusion of any kind) was 6.7%. This rate increased over time, from 4.9% in 2000 to 7.1% in 2009 (P blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Military Construction: FY2017 Appropriations

    Science.gov (United States)

    2016-10-04

    Appropriations Act (H.R. 4974, S. 2806, H.R. 2577, H.R. 5325) Committee Markup (H.R. 4974, S. 2806) House Report H.R. 4974 House Passage H.R...List (UPL), has had the UPL extracted to indicate the budget authority not requested by the President:  Active Components (Army, Navy and Marine

  19. Total Hip Arthroplasty Bearing Surface Trends in the United States From 2007 to 2014: The Rise of Ceramic on Polyethylene.

    Science.gov (United States)

    Heckmann, Nathanael D; Sivasundaram, Lakshmanan; Stefl, Michael D; Kang, Hyunwoo Paco; Basler, Eric T; Lieberman, Jay R

    2018-06-01

    Wear of the bearing surface is a critical element in determining the longevity of a total hip arthroplasty (THA). Over the past decade, concerns related to modern metal-on-metal (MoM) bearings and corrosion at the femoral head-neck interface have influenced surgeon selection of bearing surfaces. The purpose of this study is to analyze trends in THA bearing surface selection from 2007 through 2014 using a large national database. The Nationwide Inpatient Sample database was used to extract bearing surface data from patients who underwent a primary THA between 2007 and 2014. Patients were grouped by bearing surface type: metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), MoM, and ceramic-on-ceramic (CoC) bearings. Descriptive statistics were employed to describe trends. Univariate and multivariate analyses were performed to identify differences between bearing surface groups. During the study period, 2,460,640 THA discharges were identified, of which 1,059,825 (43.1%) had bearing surface data. A total of 496,713 (46.9%) MoP, 307,907 (29.1%) CoP, 210,381 (19.9%) MoM, and 44,823 (4.2%) CoC cases were identified. MoM utilization peaked in 2008 representing 40.1% of THAs implanted that year and steadily declined to 4.0% in 2014. From 2007 to 2014, the use of CoP bearing surfaces increased from 11.1% of cases in 2007 to 50.8% of cases in 2014. In 2014, CoP utilization surpassed MoP which represented 42.1% of bearing surfaces that year. During the study period, MoM bearing surfaces decreased precipitously, while CoP surpassed MoP as the most popular bearing surface used in a THA. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Total cylindrospermopsins, microcystins/nodularins, and saxitoxins data for the 2007 United States Environmental Protection Agency National Lake Assessment

    Science.gov (United States)

    Loftin, Keith A.; Dietze, Julie E.; Meyer, Michael T.; Graham, Jennifer L.; Maksimowicz, Megan M.; Toyne, Kathryn D.

    2016-05-26

    Phytoplankton communities in freshwater lakes, ponds, and reservoirs may be dominated by cyanobacteria (also called blue-green algae) under certain environmental conditions. Cyanobacteria may cause a range of water-quality impairments, including the potential for toxin production. Cyanobacteria toxins (cyanotoxins) may adversely impact human and ecological health. Microcystins are considered to be one of the most commonly found classes of cyanotoxins in freshwater ecosystems, and as such were selected as a recreational indicator of water quality for the 2007 United States Environmental Protection Agency (EPA) National Lakes Assessment. However, much less is known about the occurrence of other classes of cyanotoxins in fresh surface water such as anatoxins, cylindrospermopsins, nodularins, and saxitoxins.

  1. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  2. Intakes and sources of total and added sugars among 4 to 13‐year‐old children in China, Mexico and the United States

    Science.gov (United States)

    Afeiche, M. C.; Koyratty, B. N. S.; Wang, D.; Jacquier, E. F.

    2017-01-01

    Summary Background Intakes of dietary sugars is a global concern, and many national and international organizations have set targets to limit consumption. However, it is unclear to what extent intakes of total and added sugars vary between geographies. Objectives The aim of this study was to assess the differences in intakes of total and added sugars in 4 to 13‐year‐old children in China, Mexico and the United States. The secondary aim was to identify main sources of total and added sugars in the diets of these children. Methods Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National Health and Nutrition Survey, and 2009–2012 US National Health and Nutrition Examination Surveys. Total and added sugar intakes were calculated using the US Food Patterns Equivalents Database. Results Mean intakes of total and added sugars were 26 and 9 g d−1 among Chinese children, 92 and 55 g d−1 among Mexican children, and 124 and 76 g d−1 among US children, respectively. The top food sources of total sugars were fruits among Chinese children, and sugar‐sweetened beverages and milk‐based beverages among Mexican and US children. Conclusions These data highlight the heterogeneity of food patterns worldwide and the need for adapted country‐specific public health recommendations on sugars. PMID:28960843

  3. Intakes and sources of total and added sugars among 4 to 13-year-old children in China, Mexico and the United States.

    Science.gov (United States)

    Afeiche, M C; Koyratty, B N S; Wang, D; Jacquier, E F; Lê, K-A

    2018-04-01

    Intakes of dietary sugars is a global concern, and many national and international organizations have set targets to limit consumption. However, it is unclear to what extent intakes of total and added sugars vary between geographies. The aim of this study was to assess the differences in intakes of total and added sugars in 4 to 13-year-old children in China, Mexico and the United States. The secondary aim was to identify main sources of total and added sugars in the diets of these children. Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National Health and Nutrition Survey, and 2009-2012 US National Health and Nutrition Examination Surveys. Total and added sugar intakes were calculated using the US Food Patterns Equivalents Database. Mean intakes of total and added sugars were 26 and 9 g d -1 among Chinese children, 92 and 55 g d -1 among Mexican children, and 124 and 76 g d -1 among US children, respectively. The top food sources of total sugars were fruits among Chinese children, and sugar-sweetened beverages and milk-based beverages among Mexican and US children. These data highlight the heterogeneity of food patterns worldwide and the need for adapted country-specific public health recommendations on sugars. © 2017 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  4. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  5. Total integrated dose testing of solid-state scientific CD4011, CD4013, and CD4060 devices by irradiation with CO-60 gamma rays

    Science.gov (United States)

    Dantas, A. R. V.; Gauthier, M. K.; Coss, J. R.

    1985-01-01

    The total integrated dose response of three CMOS devices manufactured by Solid State Scientific has been measured using CO-60 gamma rays. Key parameter measurements were made and compared for each device type. The data show that the CD4011, CD4013, and CD4060 produced by this manufacturers should not be used in any environments where radiation levels might exceed 1,000 rad(Si).

  6. Department of Defense Authorization for appropriations for fiscal years 1988 and 1989. Hearings before the Committee on Armed Services, United States Senate, One Hundredth Congress, First Session on S. 1174, Part 4, Strategic Forces and Nuclear Deterrence

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    Government, academic and military officials provided statements and documents in regard to S. 1174 authorizing appropriations for military activities of the Department of Defense and Department of Energy for defense activities. Strategic Forces and Nuclear deterrence categories include the following major topics: (1) Nuclear Testing Limitations, (2) Strategic Warning Capabilities and ICMB modernization, (3) Strategic Policy and Arms Control, and (4) Strategic Defense Initiatives

  7. Academic appropriation and Impact Indicators

    Directory of Open Access Journals (Sweden)

    Wilson López López

    2012-06-01

    Full Text Available The role of appropriation of scientific knowledge and the indicators designed to measure its impact is being hotly debated in Iberoamerica right now. I will separate what I call academic appropriation of knowledge from what many authors have called social appropriation of knowledge. The former isrelated to knowledge communication and transference practices in scientific communities, and the latter has to do with the multiple ways in which knowledge goes to society. This editorial will address academic appropriation.Academic appropriations are found in many levels: the first is that performed by colleagues (peers who use this knowledge, and citations are the indicators of usage. This is a sensitive indicator, and thus vulnerable to citation dynamics in academic communities. For example, communities with low levels of knowledge use are generally endogamic and have low international collaboration.They are also characterised by not easily modifying their citation habits. In this sense, a part of these citations generally make themselves invisible, this is, they do not acknowledge neither their own efforts, not those made by local peer groups (regional, and are negatively paradoxical, even when proclaimed in an anti-mainstream science discourse. At the same time, they downplay their own production or the regional production, and ground their work on the production that they claim to go beyond.On the other hand, research groups with an important output can improve or decrease the visibility of other groups and journals, since the amount of work ends up concentrating citations in particular works or journals, which affects themeasures derived from citation-expressed impacts. In this sense, and as a response with additional elements for assessing academic production, it is suggested that: 1. The quartile of the journal be used, since it gives a more accurate idea of its dynamics and shows the journal in relation to other journals with its variability

  8. Emerging quasi-0D states at vanishing total entropy of the 1D hard sphere system: A coarse-grained similarity to the car parking problem

    Science.gov (United States)

    Frusawa, Hiroshi

    2014-05-01

    A coarse-grained system of one-dimensional (1D) hard spheres (HSs) is created using the Delaunay tessellation, which enables one to define the quasi-0D state. It is found from comparing the quasi-0D and 1D free energy densities that a frozen state due to the emergence of quasi-0D HSs is thermodynamically more favorable than fluidity with a large-scale heterogeneity above crossover volume fraction of ϕc=e/(1+e)=0.731⋯ , at which the total entropy of the 1D state vanishes. The Delaunay-based lattice mapping further provides a similarity between the dense HS system above ϕc and the jamming limit in the car parking problem.

  9. Emerging quasi-0D states at vanishing total entropy of the 1D hard sphere system: A coarse-grained similarity to the car parking problem

    International Nuclear Information System (INIS)

    Frusawa, Hiroshi

    2014-01-01

    A coarse-grained system of one-dimensional (1D) hard spheres (HSs) is created using the Delaunay tessellation, which enables one to define the quasi-0D state. It is found from comparing the quasi-0D and 1D free energy densities that a frozen state due to the emergence of quasi-0D HSs is thermodynamically more favorable than fluidity with a large-scale heterogeneity above crossover volume fraction of ϕ c =e/(1+e)=0.731⋯ , at which the total entropy of the 1D state vanishes. The Delaunay-based lattice mapping further provides a similarity between the dense HS system above ϕ c and the jamming limit in the car parking problem.

  10. Total Mini-Mental State Examination score and regional cerebral blood flow using Z score imaging and automated ROI analysis software in subjects with memory impairment

    International Nuclear Information System (INIS)

    Ikeda, Eiji; Shiozaki, Kazumasa; Takahashi, Nobukazu; Togo, Takashi; Odawara, Toshinari; Oka, Takashi; Inoue, Tomio; Hirayasu, Yoshio

    2008-01-01

    The Mini-Mental State Examination (MMSE) is considered a useful supplementary method to diagnose dementia and evaluate the severity of cognitive disturbance. However, the region of the cerebrum that correlates with the MMSE score is not clear. Recently, a new method was developed to analyze regional cerebral blood flow (rCBF) using a Z score imaging system (eZIS). This system shows changes of rCBF when compared with a normal database. In addition, a three-dimensional stereotaxic region of interest (ROI) template (3DSRT), fully automated ROI analysis software was developed. The objective of this study was to investigate the correlation between rCBF changes and total MMSE score using these new methods. The association between total MMSE score and rCBF changes was investigated in 24 patients (mean age±standard deviation (SD) 71.5±9.2 years; 6 men and 18 women) with memory impairment using eZIS and 3DSRT. Step-wise multiple regression analysis was used for multivariate analysis, with the total MMSE score as the dependent variable and rCBF change in 24 areas as the independent variable. Total MMSE score was significantly correlated only with the reduction of left hippocampal perfusion but not with right (P<0.01). Total MMSE score is an important indicator of left hippocampal function. (author)

  11. Authorizing appropriations to the Nuclear Regulatory Commission. Hearing before the Subcommittee on Energy Research and Development of the Committee on Energy and Natural Resources, United States Senate, Ninety-Eighth Congress, Second Session on S. 2846 (Section 201), July 31, 1984

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    A hearing on S. 2846, which would amend the Nuclear Waste Policy Act of 1982 to authorize appropriations, reduces funding from $466.8 million in fiscal year 1984 to $460 million in fiscal year 1985. It also authorizes allocations. Responses to the bill noted its effect on state and federal relations and limitations on the scope of state participation. Testimony focused on the subject of States rights to reject a nuclear waste depository and other adverse effects. DOE and the nuclear industry oppose the legislation. Spokesmen for Texas felt that States rights would not suffer, but that the legislation would not be of help

  12. Wastes to Resources: Appropriate Technologies for Sewage Treatment and Conversion.

    Science.gov (United States)

    Anderson, Stephen P.

    Appropriate technology options for sewage management systems are explained in this four-chapter report. The use of appropriate technologies is advocated for its health, environmental, and economic benefits. Chapter 1 presents background information on sewage treatment in the United States and the key issues facing municipal sewage managers.…

  13. 34 CFR 300.101 - Free appropriate public education (FAPE).

    Science.gov (United States)

    2010-07-01

    ... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Fape Requirements § 300.101 Free appropriate... ensure that FAPE is available to any individual child with a disability who needs special education and... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education (FAPE). 300.101...

  14. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  15. Total Diet Study. Mg and Mn content estimation of a Market Basket of Sao Paulo state (Brazil) by Instrumental Neutron Activation

    International Nuclear Information System (INIS)

    Roseane Pagliaro Avegliano; Vera Akiko Maihara

    2014-01-01

    Total Diet Studies (TDS) have been carried out to estimate dietary intakes of the essential and toxic elements for a large-scale population over a specific period of time. In this study, the TDS was based on the evaluation of food representing a Market Basket (MB), which reflected the dietary habits of the Sao Paulo State population, corresponding to 72 % of the average food consumption for the state of Sao Paulo. In the present Total Diet Study, magnesium and manganese concentrations were determined in 30 of the most consumed food groups of a MB of Sao Paulo State, Brazil. Instrumental Neutron Activation Analysis (INAA) has been successfully used on a regularly basis in several areas of nutrition and foodstuffs. Element concentrations were determined by INAA in freeze-dried samples and ranged in mg kg -1 . Mg 41.4 (fats)-5287 (coffee) and Mn 0.12 (prime grade beef)-32.9 (coffee). The average daily Mg and Mn intake was calculated by multiplying the concentration of each element in each table-ready food group by the respective weight (g day -1 ) of the food group in the MB and adding the products from all food groups. The results of daily dietary intakes in this study were: Mg 174.8 and Mn 1.34 mg day -1 . Theses values were lower than the adequate intake (AI) proposed by the Food and Nutrition Board of the Institute of Medicine (USA National Academy) for adults. The low levels of Mg and Mn intakes presented in this TDS are probably due to the fact that MB of this study represented only 72 % of the weight of the most consumed household foods of Sao Paulo State. (author)

  16. Appropriate readiness and parenting culture

    DEFF Research Database (Denmark)

    Ellegaard, Tomas

    as supervisors for parents. Another aspect is a shared ambivalence: from the top state levels to the level of every day practice and discourse in families and day care – early childhood is (still) viewed as a period which should be more unstructured and free as the same time as there is growing anxieties about...

  17. Generating socially appropriate tutorial dialog

    NARCIS (Netherlands)

    Johnson, W. Lewis; Rizzo, Paola; Bosma, W.E.; Kole, Sander; Ghijsen, Mattijs; van Welbergen, H.; André, E.; Dybkjaer, L.; Minker, W.; Heisterkamp, P.

    Analysis of student-tutor coaching dialogs suggest that good human tutors attend to and attempt to influence the motivational state of learners. Moreover, they are sensitive to the social face of the learner, and seek to mitigate the potential face threat of their comments. This paper describes a

  18. Live Streaming of the Moon's Shadow from the Edge of Space across the United States during the August 2017 Total Solar Eclipse

    Science.gov (United States)

    Guzik, T. G.

    2017-12-01

    On August 21, 2017 approximately 55 teams across the path of totality of the eclipse across America will use sounding balloon platforms to transmit, in real-time from an altitude of 90,000 feet, HD video of the moon's shadow as it crosses the U.S. from Oregon to South Carolina. This unprecedented activity was originally organized by the Montana Space Grant Consortium in order to 1) use the rare total eclipse event to captivate the imagination of students and encourage the development of new ballooning teams across the United States, 2) provide an inexpensive high bandwidth data telemetry system for real-time video streaming, and 3) establish the basic infrastructure at multiple institutions enabling advanced "new generation" student ballooning projects following the eclipse event. A ballooning leadership group consisting of Space Grant Consortia in Montana, Colorado, Louisiana, and Minnesota was established to support further development and testing of the systems, as well as to assist in training the ballooning teams. This presentation will describe the high bandwidth telemetry system used for the never before attempted live streaming of HD video from the edge of space, the results of this highly collaborative science campaign stretching from coast-to-coast, potential uses of the data telemetry system for other student science projects, and lessons learned that can be applied to the 2024 total solar eclipse.

  19. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  20. Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State.

    Science.gov (United States)

    Ahmed, Selena; Byker Shanks, Carmen

    2017-08-17

    While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores ( p vegetable TP scores ( p vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health.

  1. Designing appropriate blended courses: a students' perspective.

    Science.gov (United States)

    Tsai, Chia-Wen

    2010-10-01

    The computing education in Taiwan's vocational schools usually focuses on how to help students enhance their professional skills and pass certified examinations. In addition, due to national education policy and universities' regulations, pure online courses are not permitted in Taiwan. In order to design appropriate blended learning (BL) courses, the author explored the effects of web-mediated self-regulated learning (SRL) with variations in online class frequency on enhancing students' computing skills and their perspective of the blended courses. A total of 172 students, divided into four groups, participated in the experiment. The results showed that students in the SRL and BL group with five online classes had the highest scores for using a database management system (DBMS), and the highest pass rate on certified examinations. Students in this group also expressed their positive perspective on the arrangement of their blended course with the intervention of web-mediated SRL.

  2. A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

    2018-07-01

    Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

  3. Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Roos, Ewa M.; Pedersen, Alma Becic

    2014-01-01

    -55% improvement from mean baseline PRO score and PASSs corresponded to absolute follow-up scores of 57-91% of the maximum score in THA patients 1 year after surgery. Interpretation - This study improves the interpretability of PRO scores. The different estimation approaches presented may serve as a guide......Background and purpose - The increased use of patient-reported outcomes (PROs) in orthopedics requires data on estimated minimal clinically important improvements (MCIIs) and patient-acceptable symptom states (PASSs). We wanted to find cut-points corresponding to minimal clinically important PRO...... change score and the acceptable postoperative PRO score, by estimating MCII and PASS 1 year after total hip arthroplasty (THA) for the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and the EQ-5D. Patients and methods - THA patients from 16 different departments received 2 PROs and additional...

  4. The Impact of Total Liberalization of Domestic Air Transport on the Social Welfare and on the Dynamic of Competition: Comparison Between the United States and the European Union

    Science.gov (United States)

    Zbidi, Karim

    2003-01-01

    Since the lst of April 1997 date of the implementation of the third package of the liberalization, air transport, within the european Union has become totally liberalized. In the United States the deregulation of domestic air traffic was earlier and faster since it took place in October 1978 after the adoption of the only act of deregulation. This paper, in its first part, deals with the liberalization of the industry of air traffic in the european union. After a comparison with US system based on market demand, fare policy and network restrictions, we present our descriptive results coming from treatments on the OAG data. These results present several aspects such as the evolution of the competitive structure of the intra-european routes, the level of airport dominance and the growth of hub structure. The second part of the paper presents models of entry in the airline industry. As profitability" of route flown explains correctly decisions taken by airlines to serve or not a route, the paper focuses on the specification and the estimation of the determinants of city, pair profitability in the european union. Treatments done on the OAG data show a rapid development of leasing space agreement (partial and total) and code sharing practices between 1995 and 2000 in Europe that's why we differentiate first between the two type of competitive strategy of entry(direct entry and leasing space agreement) and second between the competitive strategy of entry and the alliance strategy of code sharing. So the estimation of model will be able to answer the question if the european air transport market is contestable and in case not to see if the decision of entry is more directed by the level of airport dominance (as in the domestic United States market)or essentially by the competitive structure of the routes. We try to explain the nature of entry(directleasing or code sharing) by the different levels of these two determinants.

  5. Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

    Science.gov (United States)

    Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

    2018-04-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P New York hospitals (mean 179 versus 327 in Ontario hospitals; P New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P New York hospitals; P New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017, American College of Rheumatology.

  6. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety

    Science.gov (United States)

    Poeran, Jashvant; Rasul, Rehana; Suzuki, Suzuko; Danninger, Thomas; Mazumdar, Madhu; Opperer, Mathias; Boettner, Friedrich

    2014-01-01

    Objective To determine the effectiveness and safety of perioperative tranexamic acid use in patients undergoing total hip or knee arthroplasty in the United States. Design Retrospective cohort study; multilevel multivariable logistic regression models measured the association between tranexamic acid use in the perioperative period and outcomes. Setting 510 US hospitals from the claims based Premier Perspective database for 2006-12. Participants 872 416 patients who had total hip or knee arthroplasty. Intervention Perioperative intravenous tranexamic acid use by dose categories (none, ≤1000 mg, 2000 mg, and ≥3000 mg). Main outcome measures Allogeneic or autologous transfusion, thromboembolic complications (pulmonary embolism, deep venous thrombosis), acute renal failure, and combined complications (thromboembolic complications, acute renal failure, cerebrovascular events, myocardial infarction, in-hospital mortality). Results While comparable regarding average age and comorbidity index, patients receiving tranexamic acid (versus those who did not) showed lower rates of allogeneic or autologous transfusion (7.7% v 20.1%), thromboembolic complications (0.6% v 0.8%), acute renal failure (1.2% v 1.6%), and combined complications (1.9% v 2.6%); all Ptranexamic acid dose categories (versus no tranexamic acid use) were associated with significantly (PTranexamic acid was effective in reducing the need for blood transfusions while not increasing the risk of complications, including thromboembolic events and renal failure. Thus our data provide incremental evidence of the potential effectiveness and safety of tranexamic acid in patients requiring orthopedic surgery. PMID:25116268

  7. Attributes for MRB_E2RF1 Catchments by Major River Basins in the Conterminous United States: Normalized Atmospheric Deposition for 2002, Total Inorganic Nitrogen

    Science.gov (United States)

    Wieczorek, Michael; LaMotte, Andrew E.

    2010-01-01

    This tabular data set represents the average normalized atmospheric (wet) deposition, in kilograms per square kilometer multiplied by 100, of Total Inorganic Nitrogen for the year 2002 compiled for every MRB_E2RF1 catchment of selected Major River Basins (MRBs, Crawford and others, 2006). Estimates of Total Inorganic Nitrogen deposition are based on National Atmospheric Deposition Program (NADP) measurements (B. Larsen, U.S. Geological Survey, written. commun., 2007). De-trending methods applied to the year 2002 are described in Alexander and others, 2001. NADP site selection met the following criteria: stations must have records from 1995 to 2002 and have a minimum of 30 observations. The MRB_E2RF1 catchments are based on a modified version of the U.S. Environmental Protection Agency's (USEPA) ERF1_2 and include enhancements to support national and regional-scale surface-water quality modeling (Nolan and others, 2002; Brakebill and others, 2011). Data were compiled for every MRB_E2RF1 catchment for the conterminous United States covering New England and Mid-Atlantic (MRB1), South Atlantic-Gulf and Tennessee (MRB2), the Great Lakes, Ohio, Upper Mississippi, and Souris-Red-Rainy (MRB3), the Missouri (MRB4), the Lower Mississippi, Arkansas-White-Red, and Texas-Gulf (MRB5), the Rio Grande, Colorado, and the Great basin (MRB6), the Pacific Northwest (MRB7) river basins, and California (MRB8).

  8. Calibration of whole-body counters for transuranic radionuclides by using total-body donations to the United States Transuranium Registry

    International Nuclear Information System (INIS)

    Palmer, H.E.; Heid, K.R.; Breitenstein, B.D.; Durbin, P.W.; McInroy, J.F.

    1985-01-01

    One of the many benefits of the whole-body donation programme of the United States Transuranium Registry is the calibration of whole-body counters by measuring a donated body containing radioactivity before radiochemical analysis of the body occurs. These measurements have provided the best existing calibration factors for measuring 241 Am and 239 Pu in the skeleton of living people. In one case where the body contained an easily measurable quantity of 241 Am, the 241 Am content was found to be the same for identical bones on the right and left sides of the body. The bones from the right side of the body and every other vertebrae were radiochemically analysed and the bones from the left side were reserved. These latter have a known quantity of naturally distributed 241 Am based on the analysis of bones from the right side. These reserved bones are being incorporated into tissue equivalent body parts for future calibrations and interlaboratory comparisons. The measurements on the total body and the reserved bones have already been very useful in determining the contribution of skeletal activity to that of lung measurements and determining a calibration factor for measuring 239 Pu deposited in the skeleton. In the future it is planned to periodically make in vivo measurements on those people participating in the total-body donation programme so that calibration factors can be obtained for lung and liver content after subsequent analysis of these tissues. (author)

  9. Budget estimates fiscal year 1989: Appropriation, Salaries and expenses

    International Nuclear Information System (INIS)

    1988-02-01

    The budget estimates for Salaries and Expenses for FY 1989 provide for obligations of $450,000,000 to be funded in total by a new appropriation. The sum appropriated shall be reduced by the amount of revenues received during fiscal year 1989 from licensing fees, inspection services, and other services and collections, excluding those monies received for the cooperative nuclear safety research program, services rendered to foreign governments and international organizations, and the material and information access authorization programs, so as to result in a final fiscal year 1989 appropriation estimated at not more than $247,500,000

  10. Total phenolic contents, antioxidant activities, and lipid fractions from berry pomaces obtained by solid-state fermentation of two Sambucus species with Aspergillus niger.

    Science.gov (United States)

    Dulf, Francisc Vasile; Vodnar, Dan Cristian; Dulf, Eva-Henrietta; Toşa, Monica Ioana

    2015-04-08

    The aim of this study was to investigate the effect of solid-state fermentation (SSF) by Aspergillus niger on phenolic contents and antioxidant activity in Sambucus nigra L. and Sambucus ebulus L. berry pomaces. The effect of fermentation time on the total fats and major lipid classes (neutral and polar) was also investigated. During the SSF, the extractable phenolics increased with 18.82% for S. ebulus L. and 11.11% for S. nigra L. The levels of antioxidant activity of methanolic extracts were also significantly enhanced. The HPLC-MS analysis indicated that the cyanidin 3-sambubioside-5-glucoside is the major phenolic compound in both fermented Sambucus fruit residues. In the early stages of fungal growth, the extracted oils (with TAGs as major lipid fraction) increased with 12% for S. nigra L. and 10.50% for S. ebulus L. The GC-MS analysis showed that the SSF resulted in a slight increase of the linoleic and oleic acids level.

  11. Mechanism of the protective effects of the combined treatment with rhynchophylla total alkaloids and sinapine thiocyanate against a prothrombotic state caused by vascular endothelial cell inflammatory damage.

    Science.gov (United States)

    Li, Yunlun; Zhang, Xinya; Yang, Wenqing; Li, Chao; Chu, Yanjun; Jiang, Haiqiang; Shen, Zhenzhen

    2017-06-01

    The aim of the present study was to investigate the effect and the underlying mechanism of the combined treatment of rhynchophylla total alkaloids (RTA) and sinapine thiocyanate for protection against a prothrombotic state (PTS) associated with the tumor necrosis factor-alpha (TNF-α)-induced inflammatory injury of vascular endothelial cells (VECs). A TNF-α-induced VEC inflammatory injury model was established, and cell morphology of VECs was evaluated using scanning electron microscopy. In addition, reverse transcription-quantitative polymerase chain reaction and western blot analysis were performed to examine the mRNA and protein expression of coagulation-related factors, including nuclear factor-κB (NF-κB), transforming growth factor-β1 (TGF-β1), tissue factor (TF), plasminogen activator inhibitor (PAI-1), protease-activation receptors (PAR-1) and protein kinase C (PKC-α) in VECs. Combined treatment with RTA and sinapine thiocyanate was demonstrated to reduce, to a varying extent, the mRNA and protein expression of NF-κB, TGF-β1, TF, PAR-1, PKC-α and PAI-1. Furthermore, combined treatment with RTA and sinapine thiocyanate was able to downregulate the expression of coagulation-related factors in injured VECs, thereby inhibiting the PTS induced by vascular endothelial injury. The underlying mechanism is partially associated with the TF-mediated activation of the thrombin-receptor signaling pathway that suppresses coagulation during inflammation and balances fibrinolysis in order to inhibit fibrin generation and deposition.

  12. Hematologic and Total Plasma Protein Values in Free-Living Red-tailed Amazon Parrot Nestlings (Amazona brasiliensis) in Paraná State, Brazil.

    Science.gov (United States)

    Vaz, Frederico F; Locatelli-Dittrich, Rosangela; Sipinski, Elenise A B; Abbud, Maria C; Sezerban, Rafael M; Schmidt, Elizabeth M S; Dittrich, Jaqueline; Cavalheiro, Maria L

    2015-09-01

    The red-tailed Amazon parrot (Amazona brasiliensis) is an endangered psittacid species that is endemic in the south and southeast Brazilian Atlantic coastal region. Hematologic evaluation is important to monitor the health of these birds, and information about laboratory values for this species is scarce. Hematologic and total plasma protein profiles were determined for 33 free-living nestling parrots in Paraná state, Brazil. Parrots were temporarily removed from the nest and manually restrained to record body weight and collect blood samples. Mean body weight was 400 g in 20 birds (group 2). Significantly higher levels of mean corpuscular hemoglobin concentrations, white blood cell counts, monocytes, and basophils were observed in younger birds (group 1). A stress leukogram (high white blood cell and heterophil count) was found in all nestlings, suggesting stress induced by capture and restraint. Parameters obtained in this study will be essential to assess the physiologic and pathologic condition of wild parrots, to evaluate the effects of environmental changes on their health, and to contribute to conservation efforts of this endangered species.

  13. An initial SPARROW model of land use and in-stream controls on total organic carbon in streams of the conterminous United States

    Science.gov (United States)

    Shih, Jhih-Shyang; Alexander, Richard B.; Smith, Richard A.; Boyer, Elizabeth W.; Shwarz, Grogory E.; Chung, Susie

    2010-01-01

    Watersheds play many important roles in the carbon cycle: (1) they are a site for both terrestrial and aquatic carbon dioxide (CO2) removal through photosynthesis; (2) they transport living and decomposing organic carbon in streams and groundwater; and (3) they store organic carbon for widely varying lengths of time as a function of many biogeochemical factors. Using the U.S. Geological Survey (USGS) Spatially Referenced Regression on Watershed Attributes (SPARROW) model, along with long-term monitoring data on total organic carbon (TOC), this research quantitatively estimates the sources, transport, and fate of the long-term mean annual load of TOC in streams of the conterminous United States. The model simulations use surrogate measures of the major terrestrial and aquatic sources of organic carbon to estimate the long-term mean annual load of TOC in streams. The estimated carbon sources in the model are associated with four land uses (urban, cultivated, forest, and wetlands) and autochthonous fixation of carbon (stream photosynthesis). Stream photosynthesis is determined by reach-level application of an empirical model of stream chlorophyll based on total phosphorus concentration, and a mechanistic model of photosynthetic rate based on chlorophyll, average daily solar irradiance, water column light attenuation, and reach dimensions. It was found that the estimate of in-stream photosynthesis is a major contributor to the mean annual TOC load per unit of drainage area (that is, yield) in large streams, with a median share of about 60 percent of the total mean annual carbon load in streams with mean flows above 500 cubic feet per second. The interquartile range of the model predictions of TOC from in-stream photosynthesis is from 0.1 to 0.4 grams (g) carbon (C) per square meter (m-2) per day (day-1) for the approximately 62,000 stream reaches in the continental United States, which compares favorably with the reported literature range for net carbon fixation by

  14. Mercúrio total em solos de manguezais da Baixada Santista e Ilha do Cardoso, estado de São Paulo Total mercury in mangrove soils of the Baixada Santista and Cardoso Island, São Paulo state

    Directory of Open Access Journals (Sweden)

    Mara Lucia Jacinto Oliveira

    2007-06-01

    Full Text Available Total Hg content in soils of Baixada Santista, affected by different sources of pollution, and Cardoso Island, which is almost free of anthropogenic activities, were determined by CVAAS. To explain the fate of Hg in the ecosystem, pH, Eh, AVS, Stotal and Total Organic Carbon were also obtained throughout the soil profiles. With the exception of two sampling sites the average content of Hg in samples obtained for Baixada Santista was 0.34 ± 0.20 mg kg-1, which was close to the average data at Cardoso Island (0.30 ± 0.21 mg kg-1. Both of them were below the limit established by CETESB - 0.50 mg kg-1.

  15. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    OpenAIRE

    Rajesh Kumar; Vishal Dogra; Khushbu Rani; Kanti Sahu

    2017-01-01

    Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models...

  16. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  17. A measurement of ΔσL(np), the difference between neutron-proton total cross sections in pure longitudinal spin states

    International Nuclear Information System (INIS)

    Beddo, M.E.

    1990-10-01

    A measurement off Δσ L (np), the difference between neutron-proton total cross sections in pure longitudinal spin states, is described. The results will help determine the isospin-zero (I = 0) scattering amplitudes, which are not well known above laboratory energies of 500 MeV, whereas the isospin-one (I = 1) amplitudes are fairly well-determined to 1 GeV. Data points were taken at the Los Alamos Meson Physics Facility (LAMPF) at Los Alamos, New Mexico, for five neutron beam energies: 484, 568, 634,720 and 788 MeV; they are the first in this energy range. Polarized neutrons were produced by charge-exchange of polarized protons on a liquid deuterium target (LD 2 ). Large-volume neutron counters detected the neutrons that passed through a polarized proton target. The counters subtended a range of solid angles large enough to allow extrapolation of the scattered neutrons to 0 degree. Two modifications to the LAMPF accelerator system which were made for this work are described. They included a ''beam buncher,'' which modified the normal rf-time structure of the proton beam and allowed for the selection of peak-energy neutrons by time-of-flight means, and a computerized beam steering program, which reduced systematic effects due to beam motion at the LD 2 target. The experimental values of Δσ L (np) are found to be consistent with other np data, including preliminary data from SIN and Saclay, but not with some results from Argonne which used a polarized proton beam and a polarized deuteron target. The I = 0 component was extracted from Δσ L (np) using existing pp data (I = 1), with the unexpected result that Δσ L (I = 0) was found to be essentially identical in shape to Δσ L (I = 1). The significance of this is not yet understood

  18. Physical Function After Total Knee Replacement: An Observational Study Describing Outcomes in a Small Group of Women From China and the United States.

    Science.gov (United States)

    White, Daniel K; Li, Zhichang; Zhang, Yuqing; Marmon, Adam R; Master, Hiral; Zeni, Joseph; Niu, Jingbo; Jiang, Long; Zhang, Shu; Lin, Jianhao

    2018-01-01

    To describe physical function before and six months after Total Knee Replacement (TKR) in a small sample of women from China and the United States. Observational. Community environment. Both groups adhered to the Osteoarthritis Research Society International (OARSI) protocols for the 6-minute walk and 30-second chair stand. We compared physical function prior to TKR and 6 months after using linear regression adjusted for covariates. Women (N=60) after TKR. Not applicable. Age and body mass index in the China group (n=30; 66y and 27.0kg/m 2 ) were similar to those in the U.S. group (n=30; 65y and 29.6kg/m 2 ). Before surgery, the China group walked 263 (95% confidence interval [CI], -309 to -219) less meters and had 10.2 (95% CI, -11.8 to -8.5) fewer chair stands than the U.S. group. At 6 months when compared with the U.S. group, the China group walked 38 more meters, but this difference did not reach statistical significance (95% CI, -1.6 to 77.4), and had 3.1 (95% CI, -4.4 to -1.7) fewer chair stands. The China group had greater improvement in the 6-minute walk test than did the U.S. group (PChina group had greater gains in walking endurance and similar gains in repeated chair stands than did the U.S. group after surgery. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Total diet study in Sao Paulo State: estimation of dietary intakes of toxic (arsenic and cadmium) and essential elements (calcium, chromium, iron, selenium, sodium, potassium and zinc)

    International Nuclear Information System (INIS)

    Avegliano, Roseane Pagliaro

    2009-01-01

    Total Diet Study (TDS) is based on the evaluation of food samples representing a market basket, which shows dietary habits of a given population. The World Health Organization (WHO) has encouraged countries to conduct their own TDS, which is already being done in several countries, but not yet in Brazil. This study involved essential steps to establish a TDS in Sao Paulo State: a) information about food consumption (a recent national household food budget survey 'POF 2002-2003' by the Brazilian Institute for Geography and Statistics (IBGE), including 5,440 foods); b) development of a Market Basket (sampling of 71 foods consumed more than 2g/day/person, grouped into 30 food groups: cereals; leguminous; leafy, fruity and tuberous vegetables; tropical fruits; other fruits; flours; pasta; breads; biscuits; prime and standard grade beef; pork meat; sausages; poultry; milk/cream; other dairy products; sugars; sweet dishes; salts, sauces; oils, fats, alcoholic beverages; non-alcoholic beverages; coffee; ready-made dishes; seawater and freshwater fishes); c) collection and kitchen preparation in restaurants of the Food service Department of the Coordination of Social Assistance of the University of Sao Paulo (preparing ready-to- consume foods, individually and mixing foods of the same food group); d) chemical analysis (food groups were homogenized, pulverized and analyzed by Instrumental Neutron Activation and GF Atomic Absorption Spectroscopy). Element contents were determined in the 30 food groups. Average element range concentrations and daily dietary intakes were determined. The results of daily dietary intakes in this study (275±31mg Ca; 20.7±1.9μg Cr; 5.7±0.4mg Fe; 861±46mg K; 9.44±0.48μg Se; 1928±278mg Na; 4.25±0.24mg Zn; 1.53±0.43μg As and 1.31±0.16μg Cd) were lower than or similar the results of other Brazilian studies and lower than results of TDS of other countries. This is probably due to the fact that the Market Basket of this study represented

  20. State, Foreign Operations, and Related Programs: FY2009 Appropriations

    Science.gov (United States)

    2009-04-03

    resources in a few low- and low- middle income countries that have demonstrated a strong commitment to political, economic, and social reforms. The...several other areas.11 In FY2008, BBG proposed to reduce or eliminate radio broadcasting in a number of services, including Cantonese , Ukrainian

  1. Appropriate payment vehicles in stated preference studies in developing economies

    DEFF Research Database (Denmark)

    Hassan, Suziana; Olsen, Søren Bøye; Thorsen, Bo Jellesmark

    2018-01-01

    , in Malaysia as well as in many other low- to middle-income economies, large proportions of people do not pay income taxes, putting the validity of this payment vehicle into question. Instead, citizens in Malaysia and many other countries benefit from subsidies for a range of consumer goods. We find that price...

  2. State, Foreign Operations Appropriations: A Guide to Component Accounts

    Science.gov (United States)

    2009-03-30

    microcredit , water and sanitation, education, environment, democracy and governance, among others...that allow private banks to finance housing shelter projects, water and sanitation systems, and microcredit and small enterprise development programs

  3. CRS Issue Statement on State and Foreign Operations Appropriations

    Science.gov (United States)

    2010-01-12

    Moss Analyst in Global Health kmoss@crs.loc.gov, 7-7314 Melissa D. Ho Analyst in Agricultural Policy mho@crs.loc.gov, 7-5342 Kennon H. Nakamura...9525 Jim Nichol Specialist in Russian and Eurasian Affairs jnichol@crs.loc.gov, 7-2289 Charles E. Hanrahan Senior Specialist in Agricultural Policy chanrahan@crs.loc.gov, 7-7235 .

  4. The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Weiser, Mitchell C; Moucha, Calin S

    2015-09-02

    The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  5. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Consultation with appropriate officials; negotiation. 1261.403 Section 1261.403 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PROCESSING OF MONETARY CLAIMS (GENERAL) Collection of Civil Claims of the United States Arising Out of the Activities of the National Aeronautic...

  6. 34 CFR 300.17 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education. 300.17 Section 300.17 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

  7. 32 CFR 3.5 - Appropriate use.

    Science.gov (United States)

    2010-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... 32 National Defense 1 2010-07-01 2010-07-01 false Appropriate use. 3.5 Section 3.5 National... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense...

  8. Ghost-Story Telling: Keeping It Appropriate.

    Science.gov (United States)

    Weintraub, Jeff

    1996-01-01

    Guidelines for telling ghost stories at camp involve considering children's fears at different ages, telling age appropriate stories, determining appropriate times for telling ghost stories, and minimizing fear when a child becomes frightened by a ghost story. Includes tips on the selection, preparation, and presentation of ghost stories. (LP)

  9. 7 CFR 457.9 - Appropriation contingency.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Appropriation contingency. 457.9 Section 457.9 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.9 Appropriation contingency...

  10. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  11. A measurement of. Delta. sigma. sub L (np), the difference between neutron-proton total cross sections in pure longitudinal spin states

    Energy Technology Data Exchange (ETDEWEB)

    Beddo, M.E.

    1990-10-01

    A measurement off {Delta}{sigma}{sub L}(np), the difference between neutron-proton total cross sections in pure longitudinal spin states, is described. The results will help determine the isospin-zero (I = 0) scattering amplitudes, which are not well known above laboratory energies of 500 MeV, whereas the isospin-one (I = 1) amplitudes are fairly well-determined to 1 GeV. Data points were taken at the Los Alamos Meson Physics Facility (LAMPF) at Los Alamos, New Mexico, for five neutron beam energies: 484, 568, 634,720 and 788 MeV; they are the first in this energy range. Polarized neutrons were produced by charge-exchange of polarized protons on a liquid deuterium target (LD{sub 2}). Large-volume neutron counters detected the neutrons that passed through a polarized proton target. The counters subtended a range of solid angles large enough to allow extrapolation of the scattered neutrons to 0{degree}. Two modifications to the LAMPF accelerator system which were made for this work are described. They included a beam buncher,'' which modified the normal rf-time structure of the proton beam and allowed for the selection of peak-energy neutrons by time-of-flight means, and a computerized beam steering program, which reduced systematic effects due to beam motion at the LD{sub 2} target. The experimental values of {Delta}{sigma}{sub L}(np) are found to be consistent with other np data, including preliminary data from SIN and Saclay, but not with some results from Argonne which used a polarized proton beam and a polarized deuteron target. The I = 0 component was extracted from {Delta}{sigma}{sub L}(np) using existing pp data (I = 1), with the unexpected result that {Delta}{sigma}{sub L}(I = 0) was found to be essentially identical in shape to {Delta}{sigma}{sub L}(I = 1). The significance of this is not yet understood.

  12. Long-term total sleep deprivation decreases the default spontaneous activity and connectivity pattern in healthy male subjects: a resting-state fMRI study

    Directory of Open Access Journals (Sweden)

    Dai XJ

    2015-03-01

    Full Text Available Xi-Jian Dai,1,2* Chun-Lei Liu,3,4* Ren-Lai Zhou,3 Hong-Han Gong,1 Bin Wu,5 Lei Gao,1 Yi-Xiang J Wang2 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People’s Republic of China; 3Beijing Key Lab of Applied Experimental Psychology, School of Psychology, and National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People’s Republic of China; 4School of Education, Qufu Normal University, Qufu, Shandong, People’s Republic of China; 5National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing, People’s Republic of China *These authors have contributed equally to this work Objective: The aim of this study is to use resting-state functional connectivity (rsFC and amplitude of low-frequency fluctuation (ALFF methods to explore intrinsic default-mode network (DMN impairment after sleep deprivation (SD and its relationships with clinical features. Methods: Twelve healthy male subjects underwent resting-state functional magnetic resonance imaging twice: once following rested wakefulness (RW and the other following 72 hours of total SD. Before the scans, all subjects underwent the attention network test (ANT. The independent component analysis (ICA, rsFC, and ALFF methods were used to examine intrinsic DMN impairment. Receiver operating characteristic (ROC curve was used to distinguish SD status from RW status. Results: Compared with RW subjects, SD subjects showed a lower accuracy rate (RW =96.83%, SD =77.67%; P<0.001, a slower reaction time (RW =695.92 ms; SD =799.18 ms; P=0.003, a higher lapse rate (RW =0.69%, SD =19.29%; P<0.001, and a higher intraindividual coefficient of variability in reaction time (RW =0.26, SD =0

  13. 22 CFR 710.13 - Appropriate action.

    Science.gov (United States)

    2010-04-01

    ... communication to, OPIC on any matter or business for a period not to exceed five years, which may be... communication. (b) Taking other appropriate disciplinary action. [45 FR 5685, Jan. 24, 1980; 49 FR 18295, Apr...

  14. ACR Appropriateness Criteria on Resectable Rectal Cancer

    International Nuclear Information System (INIS)

    Suh, W. Warren; Blackstock, A. William; Herman, Joseph; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

    2008-01-01

    The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007

  15. Appropriate flow forecasting for reservoir operation

    NARCIS (Netherlands)

    Dong, Xiaohua

    2005-01-01

    The aim of the study presented in this thesis is to develop and apply a methodology to determine the appropriate model application by including the water management objective explicitly, and to demonstrate its benefits.

  16. Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

    African Journals Online (AJOL)

    Appropriateness of Referrals for Upper Gastrointestinal Endoscopy. ... Accra between January and December, 2008 were interviewed and evaluated for this study. ... Presentations with bleeding and suspicion of malignancy showed statistical ...

  17. Chautauqua notebook: appropriate technology on radio

    Energy Technology Data Exchange (ETDEWEB)

    Renz, B.

    1981-01-01

    Experiences in establishing and maintaining a regional call-in information-exchange radio show (Chautauqua) on energy conservation, appropriate technology, renewable energy sources, and self-reliance are discussed. Information is presented on: appropriate technology; the Chautauquaa concept; topics discussed; research performed; guests; interviewing tips; types of listeners; program features; where to find help; promotion and publicity; the technical and engineering aspects; the budget and funding; and station policies. (MCW)

  18. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar

    2017-01-01

    Full Text Available Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12 was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53% of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR = 2.7. The next left side branch was again married illiteracy with splits at 23% to determine TFR = 2.1. Conclusion: We conclude that female married illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

  19. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011-12.

    Science.gov (United States)

    Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

    2017-01-01

    District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

  20. Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

    Science.gov (United States)

    Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

    2017-01-01

    Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run. PMID:29416999

  1. Correlation between resting state fMRI total neuronal activity and PET metabolism in healthy controls and patients with disorders of consciousness.

    Science.gov (United States)

    Soddu, Andrea; Gómez, Francisco; Heine, Lizette; Di Perri, Carol; Bahri, Mohamed Ali; Voss, Henning U; Bruno, Marie-Aurélie; Vanhaudenhuyse, Audrey; Phillips, Christophe; Demertzi, Athena; Chatelle, Camille; Schrouff, Jessica; Thibaut, Aurore; Charland-Verville, Vanessa; Noirhomme, Quentin; Salmon, Eric; Tshibanda, Jean-Flory Luaba; Schiff, Nicholas D; Laureys, Steven

    2016-01-01

    The mildly invasive 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a well-established imaging technique to measure 'resting state' cerebral metabolism. This technique made it possible to assess changes in metabolic activity in clinical applications, such as the study of severe brain injury and disorders of consciousness. We assessed the possibility of creating functional MRI activity maps, which could estimate the relative levels of activity in FDG-PET cerebral metabolic maps. If no metabolic absolute measures can be extracted, our approach may still be of clinical use in centers without access to FDG-PET. It also overcomes the problem of recognizing individual networks of independent component selection in functional magnetic resonance imaging (fMRI) resting state analysis. We extracted resting state fMRI functional connectivity maps using independent component analysis and combined only components of neuronal origin. To assess neuronality of components a classification based on support vector machine (SVM) was used. We compared the generated maps with the FDG-PET maps in 16 healthy controls, 11 vegetative state/unresponsive wakefulness syndrome patients and four locked-in patients. The results show a significant similarity with ρ = 0.75 ± 0.05 for healthy controls and ρ = 0.58 ± 0.09 for vegetative state/unresponsive wakefulness syndrome patients between the FDG-PET and the fMRI based maps. FDG-PET, fMRI neuronal maps, and the conjunction analysis show decreases in frontoparietal and medial regions in vegetative patients with respect to controls. Subsequent analysis in locked-in syndrome patients produced also consistent maps with healthy controls. The constructed resting state fMRI functional connectivity map points toward the possibility for fMRI resting state to estimate relative levels of activity in a metabolic map.

  2. Leadership and Total Quality Management

    Science.gov (United States)

    1992-04-15

    leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

  3. Total Blood Mercury Levels and Depression among Adults in the United States: National Health and Nutrition Examination Survey 2005–2008

    Science.gov (United States)

    Ng, Tsz Hin H.; Mossey, Jana M.; Lee, Brian K.

    2013-01-01

    Background Mercury is a neurotoxicant linked with psychiatric symptoms at high levels of exposure. However, it is unclear whether an association is present at the low exposure levels in the US adult population. Materials and Methods Cross-sectional associations of total blood mercury and depression were assessed in 6,911 adults age ≥20 in the National Health and Nutrition Examination Survey (NHANES), 2005–2008. The Patient Health Questionnaire-9 was used to assess depression (high likelihood of a depressive spectrum disorder diagnosis; score 5–27). Results Unadjusted survey weighted logistic regression suggested that higher total blood mercury was associated with lower odds of depression (Odds Ratio  = 0.49, 95% Confidence Interval: 0.36–0.65, comparing the highest and lowest mercury quintiles). This association largely disappeared after adjustment for sociodemographic variables (income-poverty ratio, education, marital status). However, in age-stratified analyses, this inverse relationship remained in older adults (age ≥40) even after adjustment for sociodemographic variables. Simulation analyses adjusting for expected confounding effects of fish intake suggested that the inverse relationship among older adults may be plausibly attributed to residual confounding (Odds Ratio  = 0.75, 95% Confidence Interval: 0.50–1.12, comparing the highest and lowest mercury quintiles). Conclusions Higher total blood mercury was not associated with increased odds of depression. The lower odds of depression in older adults with higher total blood mercury may be due to residual confounding. PMID:24244482

  4. ACR Appropriateness Criteria® Tinnitus.

    Science.gov (United States)

    Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

    2017-11-01

    Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  5. Technological transfer. 1. Appropriateness for developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Berrie, T W

    1978-12-01

    Capital-intensive projects dominate the technology transferred to developing countries in spite of the need to serve a pool of unskilled labor and small capital reserves. Recent doubts about the appropriateness of large industrialization projects have questioned the social and economic benefits of this approach and led to an emphasis on innovative planning for the benefit of the urban and rural poor. This shift assumed that direct attacks on the roots of poverty will be more effective than the trickle-down approach, but development planners now see that technologies can be planned that are not limited to single groups. Official policies, often working against the adoption of appropriate technologies, must consider local needs and local resources. Farm equipment, for example, must minimize the need for skilled labor and maintenance. Planners for appropriate urban technology should emphasize local capability, but should also risk occasional failure in the effort to improve the efficiency of labor.

  6. An appropriate level for reactor regulatory research

    International Nuclear Information System (INIS)

    Budnitz, R.J.; Kouts, H.J.C.

    1986-01-01

    In this brief paper the appropriate role for NRC's research program is set down, based on the experience of the last decade; and the broad outlines of an appropriate research program for the next decade are discussed. The two authors bring to this topic direct personal experience: they are two of only three former directors of NRC's research program in its history (the other was the last Saul Levine). The discussion considers only reactor safety research, although NRC's research program covers several other areas as well. Safeguards, environmental and health studies, waste management, and transportation are not covered

  7. The Concept of Appropriateness in Issuing Administrative Acts

    Directory of Open Access Journals (Sweden)

    Iulian Nedelcu

    2011-05-01

    Full Text Available Administrative acts are a legal way of organizing the execution and enforcement of the law. Law can not and should not establish all cases and all the ways, by means of which public administration bodies interfere with administrative actions, therefore administrative public bodies must have some initiative and ought to be able to assess the situations in which they will issue these acts and to appreciate their appropriateness. The appropriateness principle of administrative acts must be correlated with the legality principle. It can be concluded that the appropriateness principle underscores the power conferred by public administration, permitted in accordance with which it has the right and duty to judge when issuing an administrative compliance of the state of lawand facts, an appreciation that public administration is based on a single criterion: the interests of the community that they represent. Also, the very organization of the state as a state of law leads to the conclusion that the law – which is the materialization of the idea of justice – should be the standard on which the activity of human individuals report both to the quality of beneficiaries of the provisions and benefits of public administration and on the other hand as officials, public servants or ordinary employees in public administration system.

  8. Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

    Science.gov (United States)

    Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

    2010-01-01

    Purpose: Entrepreneurship can refer to business start-up, but now sometimes has wider connotations. This paper aims to explore what entrepreneurship means for the promoters of entrepreneurship education and what might be appropriate for the students who consume it. Design/methodology/approach: The paper assesses the work of NICENT (The Northern…

  9. Desktop Publishing Choices: Making an Appropriate Decision.

    Science.gov (United States)

    Crawford, Walt

    1991-01-01

    Discusses various choices available for desktop publishing systems. Four categories of software are described, including advanced word processing, graphics software, low-end desktop publishing, and mainstream desktop publishing; appropriate hardware is considered; and selection guidelines are offered, including current and future publishing needs,…

  10. Appropriate administrative structures in harnessing water resources ...

    African Journals Online (AJOL)

    Appropriate administrative structures in harnessing water resources for sustainable growth in Nigeria. Lekan Oyebande. Abstract. No Abstract. Journal of Mining and Geology Vol. 42(1) 2006: 21-30. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  11. Audit incorporating avoidability and appropriate intervention can ...

    African Journals Online (AJOL)

    Audit incorporating avoidability and appropriate intervention can significantly decrease perinatal mortality. H. R. G. Ward, G. R. Howarth, O. J. N. Jennings,. R. C. Pattinson .... 6 months) and seven interns. The study was .... maternity care notes study: a randomized control trial to assess the effects of giving expectant mothers ...

  12. Using Appropriate Strategies to Improve Students' Comprehension ...

    African Journals Online (AJOL)

    Using Appropriate Strategies to Improve Students' Comprehension of Chemistry Texts: A Guide for Chemistry Teachers. ... African Research Review ... Unfortunately, contemporary research insight into science reading is lacking and science educators tend to focus on methods of teaching specific subject matter and ...

  13. Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

    Science.gov (United States)

    Silvério Marques, Sara; Goldfarb, Eva S.; Deardorff, Julianna; Constantine, Norman A.

    2017-01-01

    Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field.…

  14. Nationally Appropriate Mitigation Action: Understanding NAMA Cycle

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

    There is no internationally defined or agreed Nationally Appropriate Mitigation Action(NAMA) cycle, as was the case, for example, with the Clean Development Mechanisms (CDM) project cycle. However, there are some common steps that NAMA identification, formulation, and implementation will all go...

  15. Determination of ultra trace contaminants on silicon wafer surfaces using total-reflection X-ray fluorescence TXRF 'state-of-the-art'

    Science.gov (United States)

    Pahlke, S.; Fabry, L.; Kotz, L.; Mantler, C.; Ehmann, T.

    2001-11-01

    In a well balanced system of highly motivated, well trained personnel and automated equipment, pure reagents and bulk media, cleanrooms and integrated data management, total-reflection X-ray fluorescence (TXRF) can and must contribute to quality assurance and process stability, support and canalize creative engineering by continuous learning about materials and processes. TXRF has the advantage of controlled one-point calibration, a linear dynamic range of three orders of magnitude, high grade of automation in operation and data management, high up-time, and a simple control of data plausibility.

  16. Determination of total and organic mercury and evaluation of methylation and demethylation processes in sediments of the Rio Grande Reservoir, State of Sao Paulo, Brazil

    International Nuclear Information System (INIS)

    Franklin, Robson Leocadio

    2010-01-01

    The Rio Grande reservoir is located in the metropolitan area of Sao Paulo and it is a very important water supply for this region. In the present study bottom waters and sediment samples collected in this reservoir, in four sampling points, in four campaigns, from September 2008 to January 2010, were analyzed. Firstly total Hg was determined in sediment and bottom waters by cold vapor atomic absorption technique (CV AAS). Following, the analytical methodology for organic Hg was adapted from literature, where the organomercurial compounds were extracted with dichloromethane in acid medium and subsequent destruction of organic compounds by bromine chloride. The validation of this methodology, in terms of precision and accuracy, was performed by means of IAEA 405 and BCR-CRM 580 reference materials analyses. For methylation and demethylation processes evaluation in this environment, the following physical and chemical parameters were assessed, in situ: pH, water temperature, redox potential (EH), transparency and depth. For the sediment samples, granulometry, total organic carbon, sulphate-reducing bacteria, total N and P, besides the metals Co, Cu, Fe and Mn were evaluated. The selection of these parameters was related to the factors that influence the behavior of MeHg in the sediments and its transition zone. Total Hg ranging from 1.0 to 71.0 mg kg'- 1 and organic mercury from -1 in sediments and methylation rates from 0.06 to 1.4% were found, along the reservoir. Different methylation conditions along the reservoir and its influences were also discussed. As supplementary study the concentration of some metals and trace elements in the sediments by neutron activation analysis technique was determined. As, Ba, Br, Co, Cr, Cs, Hf, Fe, Na, Rb, Sb, Sc and Zn and rare earth elements Ce, Eu, La, Lu, Nd, Sm and Yb were determined. The enrichment factor in relation to earth crust values using Sc as normalizer element reached values higher than 2.0 for the elements As, Br

  17. The responses of net primary production (NPP) and total carbon storage for the continental United States to changes in atmospheric CO{sub 2}, climate, and vegetation

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, D.A. [Marine Biological Lab., Woods Hole, MA (United States)

    1995-06-01

    We extrapolated 3 biogeochemistry models (BIOME-BGC, CENTURY, and TEM) across the continental US with the vegetation distributions of 3 biogeography models (BIOME2, DOLY, and MAPSS) for contemporary climate at 355 ppmv CO{sub 2} and each of 3 GCM climate scenarios at 710 ppmv. For contemporary conditions, continental NPP ranges from 3132 to 3854 TgC/yr and total carbon storage ranges from 109 to 125 PgC. The responses of NPP range from no response (BIOME-BGC with DOLY or MAPSS vegetations for UKMO climate) to increases of 53% and 56% (TEM with BIOME2 vegetations for GFDL and OSU climates). The responses of total carbon storage vary from a decrease of 39% (BIOME-BGC with MAPSS vegetation for UKMO climate) to increases of 52% and 56% (TEM with BIOME2 vegetations for OSU and GFDL climates). The UKMO responses of BIOME-BGC with MAPSS vegetation are caused by both decreased forest area (from 44% to 38%) and photosynthetic water stress. The OSU and GFDL responses of TEM with BIOME2 vegetations are caused by forest expansion (from 46% to 67% for OSU and to 75% for GFDL) and increased nitrogen cycling.

  18. Water contents of samples from the Nevada Test Site: total, free (natural state to 1050C), and more tightly bonded (105 to 7000C)

    International Nuclear Information System (INIS)

    Pawloski, G.A.

    1981-05-01

    To help confirm correct functioning of an epithermal neutron sonde, we measured tightly bonded water content of selected Nevada Test Site (NTS) drill holes. Tuff and alluvium samples were dried overnight at 105 0 C. The samples were then heated for 45 min in a split tube furnace at 700 0 C. The water that came off due to this heating was collected and the amount recorded. The error in this procedure is +- 0.59 wt %. Total water can be calculated for samples from analyses of free and tightly bonded water contents. The maximum error in this calculation is equivalent to the error in determining the more tightly bonded water. Average total water content values have been assigned to geologic units. These values, in weight fraction, are alluvium 0.14 +- .05 and tuff 0.19 +- .04. Further division of the tuff gives values of Rainier Mesa 0.15 +- .01, Paintbrush 0.18 +- .03, Tunnel Beds 0.20 +- .04, and Grouse Canyon 0.29 +- .02. Statistically significant differences occur between the tuff and alluvium. Within the tuffs, these differences also occur between Grouse Canyon, Rainier Mesa, and Paintbrush/Tunnel Beds. Paintbrush and Tunnel Beds cannot be distinguished by this method

  19. A coleta da erva-mate pela população cabocla do Vale do Rio do Peixe e Oeste de Santa Catarina: apropriação privada da terra e rupturas (décadas de 1900 a 1940 / The harvest of erva mate (ilex paraguariensis by caboclo population in West and Peixe valley river of Santa Catarina States (Brazil: Breaks with the advancement of private appropriation (decades 1900 to 1940.

    Directory of Open Access Journals (Sweden)

    Marlon Brandt

    2014-12-01

    Full Text Available The article aims to analyze the extraction of erva-mate (Ilex paraguariensis by caboclo populations in the Western forests of Santa Catarina State, the private land appropriation processes and the disarticulation of the extractive practice of the private land appropriation processes, which becomes more intense from the First Republic decades on. In this region, a significant part of caboclo families was settled since the first decades of the nineteenth century, mostly under the ownership regime, next to the pastoral land property located in the areas of natural grassland. The primary source of income was linked to subsistence agriculture and practices related to the exploitation of forest resources, such as the extraction of erva-mate. The disintegration happens when a new social-spatial dynamics becomes present, inducing the private land appropriation, with the subsequent colonization, the fencing of land and the logging.

  20. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  1. Appropriate working hours for surgical training according to Australasian trainees.

    Science.gov (United States)

    O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

    2012-04-01

    The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  2. Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department.

    Science.gov (United States)

    Bailey, Abby M; Stephan, Maria; Weant, Kyle A; Justice, Stephanie Baker

    2015-01-01

    Emergency department (ED) providers are faced with the challenge of diagnosing and treating patients in a timely fashion given many obstacles including limited patient information, complex disease states, and high patient turnover. Time delays in administration or selection of appropriate drug therapies have been associated with negative outcomes in severe infections. This study was conducted to assess the impact of an emergency medicine pharmacist (EPh) on the selection of appropriate antibiotics and the timeliness of administration in pediatric patients in the ED. Patients younger than 18 years were evaluated who were admitted through the ED and received 1 dose of intravenous antibiotic for the following conditions: community-acquired pneumonia, complicated skin and soft tissue infection (SSTI), meningitis, and sepsis. To evaluate the impact of the presence of an EPh, patients with orders placed during the EPh's hours of 1 pm and 11 pm were compared to those with an order placed between 11 pm and 1 pm. A total of 142 patients were included in the study. Patients seen during EPh hours received an appropriate first antibiotic 93.4% of the time (p = 0.157) and second antibiotic 96.8% of the time (p = 0.023). Time from order to verification was significantly shorter for the first 2 antimicrobials in the EPh group (10.5 minutes [p = 0.003] and 11.4 minutes [p = 0.047], respectively). The days from discharge to return to readmission to the ED were also significantly different (17.5 days vs. 62.4 days, p = 0.008). The available data suggest that patients are more likely to receive appropriate doses of antimicrobials, and in a more timely fashion, whenever the EPh is present. Areas for future investigation include whether the presence of EPhs at the bedside has the potential to impact areas of patient care, including readmission rates, drug costs, and medication errors.

  3. Neural mechanism for judging the appropriateness of facial affect.

    Science.gov (United States)

    Kim, Ji-Woong; Kim, Jae-Jin; Jeong, Bum Seok; Ki, Seon Wan; Im, Dong-Mi; Lee, Soo Jung; Lee, Hong Shick

    2005-12-01

    Questions regarding the appropriateness of facial expressions in particular situations arise ubiquitously in everyday social interactions. To determine the appropriateness of facial affect, first of all, we should represent our own or the other's emotional state as induced by the social situation. Then, based on these representations, we should infer the possible affective response of the other person. In this study, we identified the brain mechanism mediating special types of social evaluative judgments of facial affect in which the internal reference is related to theory of mind (ToM) processing. Many previous ToM studies have used non-emotional stimuli, but, because so much valuable social information is conveyed through nonverbal emotional channels, this investigation used emotionally salient visual materials to tap ToM. Fourteen right-handed healthy subjects volunteered for our study. We used functional magnetic resonance imaging to examine brain activation during the judgmental task for the appropriateness of facial affects as opposed to gender matching tasks. We identified activation of a brain network, which includes both medial frontal cortex, left temporal pole, left inferior frontal gyrus, and left thalamus during the judgmental task for appropriateness of facial affect compared to the gender matching task. The results of this study suggest that the brain system involved in ToM plays a key role in judging the appropriateness of facial affect in an emotionally laden situation. In addition, our result supports that common neural substrates are involved in performing diverse kinds of ToM tasks irrespective of perceptual modalities and the emotional salience of test materials.

  4. ACR Appropriateness Criteria® Multiple Gestations.

    Science.gov (United States)

    Glanc, Phyllis; Nyberg, David A; Khati, Nadia J; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara Lynn; Poder, Liina; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M

    2017-11-01

    Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or

  5. Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods.

    Science.gov (United States)

    Luo, Gang; Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

    2016-03-07

    In young children, bronchiolitis is the most common illness resulting in hospitalization. For children less than age 2, bronchiolitis incurs an annual total inpatient cost of $1.73 billion. Each year in the United States, 287,000 emergency department (ED) visits occur because of bronchiolitis, with a hospital admission rate of 32%-40%. Due to a lack of evidence and objective criteria for managing bronchiolitis, ED disposition decisions (hospital admission or discharge to home) are often made subjectively, resulting in significant practice variation. Studies reviewing admission need suggest that up to 29% of admissions from the ED are unnecessary. About 6% of ED discharges for bronchiolitis result in ED returns with admission. These inappropriate dispositions waste limited health care resources, increase patient and parental distress, expose patients to iatrogenic risks, and worsen outcomes. Existing clinical guidelines for bronchiolitis offer limited improvement in patient outcomes. Methodological shortcomings include that the guidelines provide no specific thresholds for ED decisions to admit or to discharge, have an insufficient level of detail, and do not account for differences in patient and illness characteristics including co-morbidities. Predictive models are frequently used to complement clinical guidelines, reduce practice variation, and improve clinicians' decision making. Used in real time, predictive models can present objective criteria supported by historical data for an individualized disease management plan and guide admission decisions. However, existing predictive models for ED patients with bronchiolitis have limitations, including low accuracy and the assumption that the actual ED disposition decision was appropriate. To date, no operational definition of appropriate admission exists. No model has been built based on appropriate admissions, which include both actual admissions that were necessary and actual ED discharges that were unsafe. The

  6. Selection of appropriate greenhouse gas mitigation options

    Energy Technology Data Exchange (ETDEWEB)

    Ramanathan, R. [Indira Ghandi Institute of Development Research, Mumbai (India)

    1999-10-01

    Greenhouse gas mitigation options help in reducing greenhouse gas emissions so as to avoid the adverse environmental impacts due to global warming/climate change. They have different characteristics when evaluated using different criteria. For example, some options may be very cost effective, while some may have an additional advantage of reducing local pollution. Hence, selection of these options, for consideration by a national government or by a funding agency, has to incorporate multiple criteria. In this paper, some important criteria relevant to the selection are discussed, and a multi-criteria methodology is suggested for making appropriate selection. The methodology, called the Analytic Hierarchy Process, is described using two illustrations. (author)

  7. Budget estimates, fiscal year 1984/85. Appropriation: salaries and expenses

    International Nuclear Information System (INIS)

    1983-01-01

    This report contains the fiscal year budget justifications to Congress. The budget estimates for salaries and expenses for fiscal year 1984 to 1985 provide for obligations of $466,800,000 to be funded in total by a new appropriation

  8. ACR Appropriateness Criteria® rib fractures.

    Science.gov (United States)

    Henry, Travis S; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Parker, J Anthony; Ravenel, James G; Restrepo, Carlos Santiago; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D; Mohammed, Tan-Lucien H

    2014-11-01

    Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  9. Food appropriation through large scale land acquisitions

    International Nuclear Information System (INIS)

    Cristina Rulli, Maria; D’Odorico, Paolo

    2014-01-01

    The increasing demand for agricultural products and the uncertainty of international food markets has recently drawn the attention of governments and agribusiness firms toward investments in productive agricultural land, mostly in the developing world. The targeted countries are typically located in regions that have remained only marginally utilized because of lack of modern technology. It is expected that in the long run large scale land acquisitions (LSLAs) for commercial farming will bring the technology required to close the existing crops yield gaps. While the extent of the acquired land and the associated appropriation of freshwater resources have been investigated in detail, the amount of food this land can produce and the number of people it could feed still need to be quantified. Here we use a unique dataset of land deals to provide a global quantitative assessment of the rates of crop and food appropriation potentially associated with LSLAs. We show how up to 300–550 million people could be fed by crops grown in the acquired land, should these investments in agriculture improve crop production and close the yield gap. In contrast, about 190–370 million people could be supported by this land without closing of the yield gap. These numbers raise some concern because the food produced in the acquired land is typically exported to other regions, while the target countries exhibit high levels of malnourishment. Conversely, if used for domestic consumption, the crops harvested in the acquired land could ensure food security to the local populations. (letter)

  10. Total Petroleum Hydrocarbons (TPH): ToxFAQs

    Science.gov (United States)

    ... a state: This map displays locations where Total Petroleum Hydrocarbons (TPH) is known to be present. On ... I get more information? ToxFAQs TM for Total Petroleum Hydrocarbons (TPH) ( Hidrocarburos Totales de Petróleo (TPH) ) August ...

  11. Development and appropriation of an integration policy for sport

    DEFF Research Database (Denmark)

    Agergaard, Sine

    2011-01-01

    the history and culture of the society in which it is created. Second, policy is seen as discourses that are articulated by specific institutions, and third, the anthropological perspective focuses on the ways in which policy is a applied and interpreted in practice. The first part of this article therefore...... explores Danish immigration history and the development of an integration policy that currently focuses on adaptation of the cultural values and norms of immigrants. The second part of this article looks at current state funds that aim to promote this kind of adaptation through sports. It becomes clear......-Danish ethnic background) appropriate these political assumptions....

  12. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    1979-02-01

    The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

  13. Shoosing the appropriate size wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Lynette, R. [FloWind Corp., San Rafael, CA (United States)

    1996-12-31

    Within the past several years, wind turbines rated at 400 kW and higher have been introduced into the market, and some manufacturers are developing machines rated at 750 - 1,000+ kW. This raises the question: What is the appropriate size for utility-grade wind turbines today? The answer depends upon the site where the machines will be used and the local conditions. The issues discussed in the paper are: (1) Site-Related (a) Visual, noise, erosion, television interference, interference with aviation (b) Siting efficiency (2) Logistics (a) Adequacy of roads and bridges to accept large vehicles (b) Availability and cost of cranes for erection and maintenance (c) Capability of local repair/overhauls (3) Cost Effectiveness (a) Capital costs (1) Wind Turbine (2) Infrastructure costs (b) Maintenance costs (4) Technical/Financial Risk. 1 fig., 1 tab.

  14. Selecting appropriate cases when tracing causal mechanisms

    DEFF Research Database (Denmark)

    Beach, Derek; Pedersen, Rasmus Brun

    2016-01-01

    The last decade has witnessed resurgence in the interest in studying the causal mechanisms linking causes and outcomes in the social sciences. This article explores the overlooked implications for case selection when tracing mechanisms using in-depth case studies. Our argument is that existing case...... selection guidelines are appropriate for research aimed at making cross-case claims about causal relationships, where case selection is primarily used to control for other causes. However, existing guidelines are not in alignment with case-based research that aims to trace mechanisms, where the goal...... is to unpack the causal mechanism between X and Y, enabling causal inferences to be made because empirical evidence is provided for how the mechanism actually operated in a particular case. The in-depth, within-case tracing of how mechanisms operate in particular cases produces what can be termed mechanistic...

  15. Creating a University System for the 21st Century. Analysis of 2009-2011 Legislative Appropriation

    Science.gov (United States)

    North Dakota University System, 2009

    2009-01-01

    The 2009-11 state general fund appropriation is $597.9 million for the eleven campuses, University of North Dakota (UND) School of Medicine and Health Sciences (SMHS), Forest Service and North Dakota University System Office, which is an increase of $153.4 million over the 2007-09 adjusted appropriation, less 07-09 one-time funding. This includes…

  16. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  18. Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method

    Directory of Open Access Journals (Sweden)

    Hossein Yousefi Manesh

    2013-01-01

    Full Text Available MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM criteria. Methods This study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated. Results Of 300 cases of lumbar spine MRI prescriptions, approximately 167 (56% were considered inappropriate, 72 (24% were uncertain, and 61 (20% were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions. Conclusion In conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA and Clinical Practice Guidelines (CPGs. As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.

  19. Medicaid Financial Management Data – National Totals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...

  20. Exploring voices, exploring appropriate education. A practitioners’ discourse'

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

    My thesis describes an exploratory process into a practitioners’ discourse on appropriate education. Chapter one: Appropriate Education is about the Dutch educational policy called Passend onderwijs. The chapter positions the appropriate education in national and international educational and

  1. Criteria for Determining an Appropriate Federal Role.

    Science.gov (United States)

    Hawley, Willis D.

    1983-01-01

    Proposes a framework for determining whether federal, state, or local governments should perform certain functions in education. Applies this framework to two areas--curriculum reform and enhanced educational opportunities for children with special needs--and suggests directions for federal policy in these areas. (GC)

  2. The Appropriate Use of Student Assessments

    Science.gov (United States)

    American Federation of Teachers (NJ), 2008

    2008-01-01

    Skilled teachers who assess students using high quality, relevant and timely assessments can use the results to modify, refine and individualize instruction. Student assessments should be a reflection of what is taught in the classroom. As more accountability provisions have been implemented at the national, state and district levels, the focus on…

  3. Searching for an Appropriate Exchange Rate Regime

    Directory of Open Access Journals (Sweden)

    Yunjong Wang

    2001-06-01

    Full Text Available This paper attempts to survey current debates on the choice of exchange rate regime in emerging market economies. The issue of choosing an appropriate exchange rate regime is being actively discussed since the recent Asian crisis. As a lesson from the recent crises, one widely shared conclusion is that soft peg exchange rate regimes are extremely vulnerable in a world of volatile capital movements. Consequently, new orthodoxy based on the impossible trinity hypothesis favours two corner solutions ― greater flexibility or credible institutional assurance, like a currency board system or dollarization. Nevertheless, questions whether such corner solutions are adequate for developing countries are rising of late. "Fear of floating" is still conspicuous in many developing countries having adopted nominally a free-floating exchange rate regime. Developing countries are sensitive to exchange rate fluctuations because the cost of exchange rate volatility is greater than the benefit when compared to developed countries. Monitoring bands is a compromise solution, but it still needs further enhancement of estimation techniques for fundamental equilibrium exchange rates in order to make those estimation results more workable in practice. Other alternatives include the creation of soft peg of the G-3 currencies. Despite counterarguments, the stability of G-3 currencies could prove to be beneficial to emerging market economies.

  4. Public Library Representations and Internet Appropriations

    Directory of Open Access Journals (Sweden)

    Paula Sequeiros

    2013-11-01

    Full Text Available May the changes in the representations of the public library be propitiated by readers' appropriations of the Internet? To answer this question, a theoretically-driven and empirically-based research was developed in a public library in Portugal, combining the analysis of documents uses, the ethnography of space and Internet use, of social relations developed while reading, with the analysis of representations of the public library. No clear-cut association emerged between social-demographics or user profiles, and representations, in general. No disruptive Internet "impact" was found: Internet use may contribute to reinforce traditional representations of the library, while it may also update and democratise other representations. If the library and the Internet are represented as synonymous, the former does not make sense without the latter; but an Internet widespread and intensive use conflicts with the image of an institution dedicated to high-brow culture. Changes in uses of the public library are, instead, clearly associated with new types of readers, which in their turn reflect changes in urban social composition. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1401141

  5. Gender Inequality Index Appropriateness for Measuring Inequality.

    Science.gov (United States)

    Amin, Elham; Sabermahani, Asma

    2017-01-01

    Gender inequality means unequal distribution of wealth, power, and benefits among women and men. The gender inequality index (GII) measures the lost human development in three important dimensions: reproductive health, political empowerment, and economic status. The first purpose of this study was to calculate the index for provinces of Iran, and the second purpose was to survey the appropriateness of that, for comparing different regions, through regression estimations. In this study, GII has been calculated for Iran between the years 2006-2011 and provinces have been ranked based on it. Then, a panel composed of 30 sections was estimated for five years to determine the most important factor affecting level of index. Some changes have been made to analyze values of the index and the ranking of provinces. Based on panel model, share of parliamentary seats was the most effective factor for determination of the index. After applying adjustments, some differences were seen in the ranking of provinces and general level of index. Weighing of dimensions of the index and considering an overall variable, such as life expectancy in the field of health, will give a more accurate comparison of the GII among different regions though concurrent attention to non-discriminatory cultural dimensions of political participation of women; therefore, making more analyses possible for a more correct comparison of the extensive geographical regions, such as countries.

  6. Appropriate fluid regimens to prevent bronchopulmonary dysplasia.

    Science.gov (United States)

    Tammela, O K

    1995-01-01

    Pulmonary oedema is an important problem in premature neonates with surfactant deficiency because of fluid accumulation in the lung interstitium and reduced urine output. Some retrospective reports suggest that excessive early hydration might increase the risk of bronchopulmonary dysplasia (BPD). Only three prospective studies evaluating low or conventional fluid administration regimens to very low birth weight infants have been published. According to their results no significant differences in the incidence of BPD have been shown. However, fluid restriction seems to improve the outcome of the infants because of decreased incidence of haemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, pulmonary air leaks and decreased mortality. The appropriate amount of sodium in the intravenous fluids during the first days of life needs further evaluation. In tiny infants with birth weights from 500 to 800g intensive monitoring of fluid balance is essential to control the extremely high fluid losses due to evaporation. Undernutrition is a risk factor of BPD and therefore it is important to start parenteral nutrition early. The benefit of the use of colloids as volume expanders is controversial. According to some retrospective reports there might be an association with increased use of colloidal fluids during the first days of life and the development of BPD. Early excessive fluid administration might constitute a potential risk for low birth weight infants with hyaline membrane disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Neurophysiological appropriateness of ionizing radiation effects

    International Nuclear Information System (INIS)

    Nyagu, A.I.; Loganovsky, K.N.

    1997-01-01

    The goal of this study was to compare bioelectrical activity of the brain in remote period of acute radiation sickness (ARS), chronic and prenatal irradiation as a result of the Chernobyl disaster. Registration of computerized 19-channel EEG, visual and somato-sensory evoked potentials have been carried out for 70 patients who had a verified ARS, 100 Chernobyl disaster survivors, who have been working in the Chernobyl exclusion zone since 1986-87 during 5 and more years, 50 prenatally irradiated children, and relevant controls. The relative risks of neurophysiological abnormalities are 4.5 for the ARS-patients, 3.6 for the chronically irradiated persons and 3.7 for the prenatally irradiated children. The data obtained testify to possibility of radiation-induced neurophysiological abnormalities in examined Chernobyl accident survivors which seems to be non-stochastic effects of ionizing radiation. For all examined irradiated patients it was typically an increasing of δ- and β- powers of EEG, particularly, in the frontal lobe shifted to the left fronto-temporal region, but spectral power of both θ- and α-range was significantly depressed. Aforesaid signs together with data of evoked potentials reflect the structural and functional abnormalities of limbic system and the left hemisphere as the first revealed neurophysiological appropriateness of ionizing radiation effects. (author)

  8. Neurophysiological appropriateness of ionizing radiation effects

    Energy Technology Data Exchange (ETDEWEB)

    Nyagu, A I; Loganovsky, K N [Department of Neurology, Inst. of Clinical Radiology, Scientific Centre for Radiation Medicine of Academy of Medical Sciences of Ukraine, Kiev (Ukraine)

    1997-11-01

    The goal of this study was to compare bioelectrical activity of the brain in remote period of acute radiation sickness (ARS), chronic and prenatal irradiation as a result of the Chernobyl disaster. Registration of computerized 19-channel EEG, visual and somato-sensory evoked potentials have been carried out for 70 patients who had a verified ARS, 100 Chernobyl disaster survivors, who have been working in the Chernobyl exclusion zone since 1986-87 during 5 and more years, 50 prenatally irradiated children, and relevant controls. The relative risks of neurophysiological abnormalities are 4.5 for the ARS-patients, 3.6 for the chronically irradiated persons and 3.7 for the prenatally irradiated children. The data obtained testify to possibility of radiation-induced neurophysiological abnormalities in examined Chernobyl accident survivors which seems to be non-stochastic effects of ionizing radiation. For all examined irradiated patients it was typically an increasing of {delta}- and {beta}- powers of EEG, particularly, in the frontal lobe shifted to the left fronto-temporal region, but spectral power of both {theta}- and {alpha}-range was significantly depressed. Aforesaid signs together with data of evoked potentials reflect the structural and functional abnormalities of limbic system and the left hemisphere as the first revealed neurophysiological appropriateness of ionizing radiation effects. (author). 25 refs.

  9. Financial Audit and Spending of Appropriations

    Directory of Open Access Journals (Sweden)

    Ivo Mijoč

    2013-07-01

    Full Text Available Local and district (regional governments receive various forms of revenue. The entitlement to and purpose of this income is determined by law. Likewise for companies owned by local government there are revenues with allocated use, which are also associated with the budget of the local unit. The importance of proper recording of the revenue collected, as well as claims for different types of income is significant because it affects the proper presentation of the financial statements. The presented data are the basis for making decisions, which result in opportunities to meet the needs of local communities. When it comes to the disposal of revenue collected, misconduct or even illegal activities might occur. It is crucial to spot them early on, and here the internal control system and the accounting system have a key role, as they examine the financial and other information for management purposes. The aim of the paper was to investigate irregularities in the use of local funds by examining the data obtained by Financial Audits and to show the movement of appropriations (allocated funds at the county level.

  10. Methylphenidate: increased abuse or appropriate use?

    Science.gov (United States)

    Llana, M E; Crismon, M L

    1999-01-01

    To address the question of the significant increase in methylphenidate (MPD) prescriptions being written and to make recommendations for health care providers involved in providing care for patients with attention deficit hyperactivity disorder (ADHD) and their families. Medline search 1966-1998 for professional articles using the following search terms--methylphenidate, children, adolescents, abuse; Internet search using MPD, Ritalin, and ADHD; and Paper Chase search using methylphenidate. The available literature regarding potential abuse or diversion of MPD consists of case reports, review articles, newspaper articles, and a Drug Enforcement Administration (DEA) publication. All available literature sources were used. Although the media and DEA report significant abuse and diversion of prescribed MPD, a review of the available literature did not reveal data to substantiate these claims. Nonetheless, there are reasons to suspect that abuse and diversion occur. A potential contributing factor to abuse is the reported similarities in pharmacodynamics and pharmacokinetics between MPD and cocaine. Recommendations are made to decrease the possibility of abuse and diversion of prescribed MPD. A balanced middle ground must be found regarding the benefits of MPD and its abuse potential. Education of clinicians, patients, and family members is key in ensuring that MPD is used appropriately.

  11. Correlation Coefficients: Appropriate Use and Interpretation.

    Science.gov (United States)

    Schober, Patrick; Boer, Christa; Schwarte, Lothar A

    2018-05-01

    Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.

  12. Measurements of the n vector p vector total cross section differences for pure helicity states at 1.20, 2.50 and 3.66 GeV

    International Nuclear Information System (INIS)

    Sharov, V.I.; Zaporozhets, S.A.; Ad''yasevich, B.P.

    1996-01-01

    The quantity Δσ L (n vector p vector), the difference of n vector p vector total cross sections for antiparallel and parallel longitudinal (L) spin states, has been measured for the first time in an energy region of several GeV using a free polarized neutron beam and a polarized proton target. The new data are discussed together with existing results and modern theoretical predictions. This is the first of a planned series of measurements of Δσ L,T (n vector p vector) in this new energy region. 28 refs., 3 figs

  13. The emergency department: An appropriate referral rate for radiography

    International Nuclear Information System (INIS)

    Richards, P.J.; Tins, B.; Cherian, R.; Rae, F.; Dharmarajah, R.; Phair, I.C.; McCall, I.

    2002-01-01

    AIM: To evaluate the hypothesis that where there is good clinical practice in an emergency department (ED), there is a low uptake of plain radiography. MATERIALS AND METHODS: Emergency notes and radiography records were reviewed over one week in January 1999, to determine the rate of radiography of first time attenders at the North Staffordshire NHS Trust. The clinical appropriateness of the imaging was assessed by pairs of radiology specialist registrars and casualty physicians. They judged the appropriateness of the imaging by the 1998 Royal College of Radiologists (RCR) guidelines and/or their clinical judgement, by consensus. Where there was no consensus or the data appeared incomplete, the radiology and ED consultant reviewed the notes. RESULTS: A total of 1615 notes were found out of 1643 (98%). Of these, 147 (9%) return attenders were excluded and 32 patients left without being seen. The number of first time attenders was 1436 (87%), of whom 637 (44%) were radiographed; 95% of these radiography examinations were appropriate and 5% were inappropriate. Of the first time attenders who were not radiographed the decision was appropriate in 95% of cases, and inappropriate for 5%, i.e. 5% of those who had no radiography, should have been X-rayed. There were no disagreements between RCR guidelines and the clinical judgements, but in 16% there were no suitable RCR guidelines. Junior doctors were not always able to find the relevant RCR guideline (relevant clinical guideline found in 73% of cases) in the guideline book, compared to the consultants (relevant clinical guideline found in 84% of cases). CONCLUSION: The application of the RCR guidelines is taken as representing good clinical practice in determining when to refer a patient for radiography. Based on this assumption, a referral rate for radiography of 44% of first time attenders was found to be appropriate. This referral rate can be taken as a benchmark. A benchmark is necessary in order to allow departments

  14. Systematic continuum-discretized coupled-channels calculations of total fusion for 6Li with targets 28Si, 59Co, 96Zr, 198Pt, and 209Bi: Effect of resonance states

    Science.gov (United States)

    Gómez Camacho, A.; Wang, Bing; Zhang, H. Q.

    2018-05-01

    Continuum discretized coupled-channel (CDCC) calculations of total fusion cross sections for reactions induced by the weakly bound nucleus 6Li with targets 28Si, 59Co, 96Zr, 198Pt, and 209Bi at energies around the Coulomb barrier are presented. In the cluster structure frame of 6Li→α +d , short-range absorption potentials are considered for the interactions between the α and d fragments with the targets. The effect of resonance (l =2 , Jπ=3+,2+,1+ ) and nonresonance states of 6Li on fusion is studied by using two approaches: (1) by omitting the resonance states from the full discretized CDCC breakup space and (2) by considering only the resonance subspace. A systematic analysis of the effect on fusion from resonance breakup couplings is carried out from light to heavy mass targets. Among other things, it is found that resonance breakup states produce strong repulsive polarization potentials that lead to fusion suppression. Couplings from nonresonance states give place to weak repulsive potentials at high energies; however, these become attractive for the heavier targets at low energies.

  15. Ecobuilding: towards an appropriate architectonic expression

    CSIR Research Space (South Africa)

    Van Wyk, Llewellyn V

    2009-02-01

    Full Text Available into that pattern will change planetary systems in a fundamental and life-threatening manner. A global agenda for change 1 100 Photographs that Changed the World by Life, The Digital Journalist 2 UN (1987). Our... poor, and extending to all the opportunity to satisfy their aspirations for a better life; ii) Limitations – the idea of limitations imposed by the state of technology and social organisation on the environment’s ability to meet present and future...

  16. S.1043: a Bill to authorize appropriations for the Department of Energy for national security programs for fiscal year 1986, and for other purposes. Introduced in the Senate of the United States, Ninety-Ninth Congress, First Session, May 1, 1985

    International Nuclear Information System (INIS)

    1985-01-01

    The National Security Programs Authorization Act for Fiscal Year 1986 authorizes funds for research and development of weapons, critical materials, and the processing and waste disposal of nuclear materials. Section 102 identifies 72 specific projects by location involving plant and capital equipment. Section 202 specifies the conditions for placing limits on construction projects when current estimated costs exceed appropriated amounts by more than 25%. The Bill concludes with provisions for transferring funds, authority for emergency design funds, and the availability of appropriated funds

  17. Developing appropriate criteria for Benign Prostatic Hyperplasia Surgery Using RAND Appropriateness Method (RAM

    Directory of Open Access Journals (Sweden)

    R Ostovar

    2009-07-01

    Full Text Available ABSTRACT: Introduction & Objective: Results of different studies show that a relatively large number of healthcare services offered are inappropriate or unnecessary. Benign prostatic hyperplasia is a benign enlargement of the prostate gland. Clinical features of this disease are one of the most common problems encountered by elderly males. The aim of this study was to assess the appropriateness of benign prostatic hyperplasia surgery. Materials & Methods: In this qualitative study which was conducted in 2008-9, in Tehran University of Medical Sciences, the RAN/UCLA method was used, which was designed in 1980 by the RAND institute and the University of California in Los Angeles. Regarding the stages of our method, scenarios and indications for benign prostatic hyperplasia surgery were chosen from the latest approved scientific resources and subsequently sent to urology specialists, who were chosen as members of the specialized panel. Panel members gave scores ranging from 1 to 9 to each indication and scenario based on scientific resources, clinical experiences and patient’s condition in two separate panel sessions. After compilation, the indications were finally grouped as appropriate, equivocal, and inappropriate so that they could be used to determine appropriateness of benign prostatic hyperplasia surgery in hospitals. In this study, the most suitable and most approved clinical guidelines related to benign prostatic hyperplasia, the Guidelines Evaluation and Research Appraisal (AGREE were used.The selected guidelines were used as scientific resources for choosing the indications of benign prostatic hyperplasia surgery. SPSS version 16 and kappa weighted value were used in analysis process of the study. Results: Out of 282 scenarios grouped as 9 conditions related to benign prostatic hyperplasia surgery, which were extracted from scientific sources, 73 cases (25.9% were considered as appropriate, 14 cases (5% as equivocal and 7 cases (2

  18. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  19. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  20. The appropriateness of a proton pump inhibitor prescription.

    LENUS (Irish Health Repository)

    Moran, N

    2014-11-01

    Proton pump inhibitors (PPIs) are one of the most commonly prescribed groups of drug in Ireland, at great expense to the Irish healthcare executive. This study aims to evaluate the appropriateness of PPI prescriptions on admission and discharge in a tertiary referral hospital. All non-elective admissions in the Emergency Department in one week were included in the study. 102 patients in total were included, with 36 (35.4%) treated with a PPI on admission. Of these, only 3 (8.3%) had a clear indication noted as per current NICE guidelines. 18 new in-hospital PPI prescriptions were documented. 11 (61%) of which were present on discharge prescriptions. Continuing PPI prescription on discharge into the community may be inappropriate, costly and potentially harmful. Brief interventions aimed at reducing inappropriate PPI prescriptions have been shown to be effective at reducing the cost and potential harm of unnecessary treatment.

  1. Is BMD testing appropriate for all menopausal women?

    Science.gov (United States)

    Kleerekoper, Michael; Nelson, Dorothy A

    2005-01-01

    The United States Preventive Services Task Force has provided an evidence-based guideline indicating that bone mineral density (BMD) testing is appropriate for all women aged 65 or older. This does not preclude BMD testing in younger postmenopausal women but places the onus on the treating physician to justify the procedure to the patient and often the patient's insurance carrier. There are very few circumstances in which BMD testing is appropriate for healthy premenopausal women, but BMD testing in younger postmenopausal women is often appropriate: when there is a family history of osteoporosis with fracture, a personal history of fracture as an adult, and a medical, surgical or therapeutic history that might be associated with accelerated bone loss or increased risk of fracture. Medical conditions include intestinal diseases associated with malabsorption, such as non-tropical sprue, or primary hyperparathyroidism. Women who have neurologic conditions that increase the risk of falling should also be tested. There are data to suggest that patients with hemoglobinopathy are at increased risk for osteoporosis. Surgical conditions include the increasingly performed surgery for obesity and other surgery resulting in bowel resection (e.g., for inflammatory bowel disease). The major medication-related concern is corticosteroid therapy, but chronic or over-treatment with thyroxine, and chronic heparin therapy, should also be considered risk factors for osteoporosis. When performing a BMD test for the first time, it is essential to remember that 50% of women at menopause will have a negative T-score, but this does not imply that the patient has indeed lost any bone from her peak bone mass.

  2. From Adaptation to Appropriation: Framing the World Through News Translation

    Directory of Open Access Journals (Sweden)

    Valdeón Roberto A.

    2014-02-01

    Full Text Available Terminological issues are problematic in the analysis of translation processes in news production. In the 1980s, Stetting coined the term “transediting”, which has been widely used in the translation studies literature, but “translation” itself becomes contentious in communication studies, a discipline closely related to news translation research. Only a few communication scholars have specifically dealt with the linguistic and cultural transformations of source texts, but they tend to regard translation as word-for-word transfer, unusual news production. More productive for the study of news translation seems to be the application of the concept of framing, widely used in communication studies. Framing considers the linguistic and paralinguistic elements of news texts in the promotion of certain organizing ideas that the target audience can identify with. In news translation, this entails the adaptation of a text for the target readership, a process can lead to appropriation of source material. Two examples are mentioned to illustrate this point: the appropriation of the US Department of State cables by the Wikileak organisation, and the pro-Romanian slogans produced by the Gandul newspaper as a response to Britain’s anti-immigration campaigns. The final section relates news adaptation to adaptation of other text types, such as literary and historical works.

  3. Selecting appropriate technology for hydrogen production

    International Nuclear Information System (INIS)

    Tamhankar, S.S.

    2004-01-01

    'Full text:' Technologies for the production of synthesis gas (H2 + CO), a precursor to hydrogen, from a variety of fossil fuels are well known in industrial applications at relatively large scale. These include Steam Reforming (SR), Auto-Thermal Reforming (ATR) and Partial Oxidation (POX). A particular technology is selected based on the feed type and the desired products. Steam reforming is a mature technology, and is most prevalent for hydrogen production because of its high efficiency. However, at the smaller scale, the capital cost becomes a more significant factor, and a substantial reduction in this cost is necessary to meet the overall H2 gas cost targets, such as that stated by DOE ($1.50/kg). In developing small-scale H2 technologies, often, incremental improvements are incorporated. While useful, these are not adequate for the desired cost reduction. Also, for effective cost reduction, the whole system, including production, purification and associated equipment needs to be evaluated; cost reduction in just one of the units is not sufficient. This paper provides a critical assessment of the existing as well as novel technology options, specifically targeted at small scale H2 production. The technology options are evaluated to clearly point out which may or may not work and why. (author)

  4. Improved human performance through appropriate work scheduling

    International Nuclear Information System (INIS)

    Morisseau, D.S.; Lewis, P.M.; Persensky, J.J.

    1987-01-01

    The Nuclear Regulatory Commission (NRC) has had a policy, Generic Letter 82-12, on hours of work since 1982. The policy states that licensees should establish controls to prevent situations where fatigue could reduce the ability of operating personnel to perform their duties safely (USNRC 1982). While that policy does give guidance on hours of work and overtime, it does not address periods of longer than 7 days or work schedules other than the routine 8-hour day, 40-hour week. Recognizing that NRC policy could provide broader guidance for shift schedules and hours of overtime work, the Division of Human Factors Safety conducted a project with Pacific Northwest Laboratories (PNL) to help the NRC better understand the human factors principles and issues concerning hours of work so that the NRC could consider updating their policy as necessary. The results of this project are recommendations for guidelines and limits for periods of 14 days, 28 days, and 1 year to take into account the cumulative effects of fatigue. In addition, routine 12-hour shifts are addressed. This latter type of shift schedule has been widely adopted in the petroleum and chemical industries and several utilities operating nuclear power plants have adopted it as well. Since this is the case, it is important to consider including guidelines for implementing this type of schedule. This paper discusses the bases for the PNL recommendations which are currently being studied by the NRC

  5. The appropriateness of XML for diagnostic description

    Energy Technology Data Exchange (ETDEWEB)

    Neto, A. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)], E-mail: andre.neto@cfn.ist.utl.pt; Lister, J.B. [CRPP-EPFL, Association EURATOM-Confederation Suisse, 1015 Lausanne (Switzerland); Fernandes, H. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal); Yonekawa, I. [JAEA, Japan Atomic Energy Agency Naka (Japan); Varandas, C.A.F. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)

    2007-10-15

    A standard for the self-description of fusion plasma diagnostics will be required in the near future. The motivation is to maintain and organize the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money. Since there is no existing standard to organize this kind of information, every EU Association stores and organizes each experiment in different ways. This can lead to severe problems when the particular organization schema is poorly documented. Standardization is the key to solve these problems. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalization (information at least in English and a local language). This problem will be met on the ITER project, for which a solution is essential. A strong candidate solution is the Extensible Markup Language (XML). In this paper, a review of the current status of XML related technologies will be presented.

  6. The appropriateness of XML for diagnostic description

    International Nuclear Information System (INIS)

    Neto, A.; Lister, J.B.; Fernandes, H.; Yonekawa, I.; Varandas, C.A.F.

    2007-01-01

    A standard for the self-description of fusion plasma diagnostics will be required in the near future. The motivation is to maintain and organize the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money. Since there is no existing standard to organize this kind of information, every EU Association stores and organizes each experiment in different ways. This can lead to severe problems when the particular organization schema is poorly documented. Standardization is the key to solve these problems. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalization (information at least in English and a local language). This problem will be met on the ITER project, for which a solution is essential. A strong candidate solution is the Extensible Markup Language (XML). In this paper, a review of the current status of XML related technologies will be presented

  7. Chinese National Strategy of Total War

    National Research Council Canada - National Science Library

    Good, Michael J

    2008-01-01

    ... concept of total warfare. This research seeks to determine if China is currently engaged in a total war with the United States across nontraditional forms of conflict including economic, political, information, financial...

  8. [The influence of carbon dioxide baths differing in the total mineralization levels on the functional state of the cardiovascular system of the patients presenting with hypertensive disease associated with coronary heart disease].

    Science.gov (United States)

    L'vova, N V; Tupitsyna, Iu Iu; Badalov, N G; Krasnikov, V E; Lebedeva, O D

    2013-01-01

    The results of the study on the influence of carbon dioxide baths differing in the total mineralization levels on the clinical course of hypertensive disease associated with coronary heart disease and on various functional systems of the body. The data obtained provide an insight into the role of salt concentrations (10 and 20 g/l) in carbon dioxide bath water (1.2 g/l) applied for the traditional treatment of the patients with hypertensive disease associated with concomitant coronary heart disease and musculoskeletal pathology. Highly mineralized bath water has a greater influence on the functional state of the cardiovascular system by causing a more pronounced decrease in peripheral vascular resistance and hypotensive effect. Baths with a salt concentration of 20 g/l markedly reduced pain and had anti-inflammatory effect in the patients with pathology of support and locomotor organs.

  9. Effects of solid-state fermentation with two filamentous fungi on the total phenolic contents, flavonoids, antioxidant activities and lipid fractions of plum fruit (Prunus domestica L.) by-products.

    Science.gov (United States)

    Dulf, Francisc Vasile; Vodnar, Dan Cristian; Socaciu, Carmen

    2016-10-15

    Evolutions of phenolic contents and antioxidant activities during solid-state fermentation (SSF) of plum pomaces (from the juice industry) and brandy distillery wastes with Aspergillus niger and Rhizopus oligosporus were investigated. The effect of fermentation time on the oil content and major lipid classes in the plum kernels was also studied. Results showed that total phenolic (TP) amounts increased by over 30% for SSF with Rhizopus oligosporus and by >21% for SSF with A. niger. The total flavonoid contents presented similar tendencies to those of the TPs. The free radical scavenging activities of methanolic extracts were also significantly enhanced. The HPLC-MS analysis showed that quercetin-3-glucoside was the major phenolic compound in both fermented plum by-products. The results also demonstrated that SSF not only helped to achieve higher lipid recovery from plum kernels, but also resulted in oils with better quality attributes (high sterol ester and n-3 PUFA-rich polar lipid contents). Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 43 CFR 20.506 - Appropriations, legislation and lobbying.

    Science.gov (United States)

    2010-10-01

    ... money appropriated by any enactment of Congress to pay for any personal service, advertisement, telegram... appropriations which they deem necessary for the efficient conduct of the public business (18 U.S.C. 1913). (b...

  11. ACR Appropriateness Criteria®  Resectable Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Jones William E

    2012-09-01

    Full Text Available Abstract The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+ benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The use of IMRT requires knowledge of the patterns of spreads and anatomy. Clinical trials demonstrate high variability in target delineation without specific guidance demonstrating the need for peer review and the use of a consensus atlas. Concomitant with radiation, fluorouracil based chemotherapy remains the standard, and although toxicity is decreased with continuous infusion fluorouracil, oral capecitabine is non-inferior to the continuous infusion regimen. Additional chemotherapeutic agents, including oxaliplatin, continue to be investigated, however currently should only be utilized on clinical trials as increased toxicity and no definitive benefit has been demonstrated in clinical trials. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to

  12. SUSTAINABLE URBAN LANDSCAPE: AN APPROACH FOR ASSESSING AND APPROPRIATING INDICATORS

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Amin

    2012-07-01

    Full Text Available The impact of development on its context is considered a key issue that governs the discussion and understanding of sustainability. For the reason, that ethics of sustainability are based on developing with no or less negative impacts on the contextual environment despite its urban scale whether limited or extended. This describes types of development that increase the good impacts on the tangible and intangible aspects of the built environment. Thus, achieving sustainability is no more a choice but it is a must especially, in an environment suffering from a lot of threats and stresses that affect all aspects of life; socially, economically, environmentally and also affect the beauty and aesthetics of urban fabrics. Assessing sustainability, the applied indicators and ways of assessment are allimportant concerns for urban sustainability discourses. Especially in such sensitive interacting domains as landscape, that links nature with the built environment. Approaching these concerns has a great deal when enhancing our environment aiming at better urban life containers. This paper aims at investigating the issue of sustainable urban landscape assessment through discussing the hue of indicators, their ways of classification, the criteria of selection and stating the variety of methods in which they can be assessed. Finally, it appropriates an approach for stating and assessing urban landscape sustainability indicators, which evaluates their both qualitative and quantitative value upon performance scale.

  13. Aplicação do método da carga máxima total diária (CMTD para a amônia no Rio Atibaia, região de Campinas/Paulínia - SP Application of ammonia total maximum daily load (TMDL to Atibaia River, Campinas/Paulínia region - São Paulo state

    Directory of Open Access Journals (Sweden)

    Gilberto Silvério da Silva

    2007-06-01

    Full Text Available Neste estudo foram avaliadas a capacidade de suporte e o estado de degradação do Rio Atibaia, considerando a ameaça para a vida aquática pela presença da Amônia, a qual representa um dos principais riscos às comunidades aquáticas no Rio Atibaia. Com este objetivo foi aplicado o método da Carga Máxima Total Diária (CMTD, da Agência de Proteção Ambiental dos Estados Unidos (EPA. Os resultados revelaram que as cargas de Amônia aumentavam progressivamente ao longo do Rio Atibaia, principalmente devido às fontes pontuais. As cargas de Amônia diárias assumiram valores de 30 a 5000 kg NH3. A capacidade de suporte das águas Rio Atibaia, para proteger a vida aquática contra os efeitos tóxicos da Amônia, tem sido violadas em trechos próximos à sua foz. A degradação dessas águas foi mais intensa na estação seca. Este trabalho mostrou que o esgoto doméstico não-tratado de uma população aproximada de 250 mil habitantes da cidade de Campinas, via Ribeirão Anhumas, é a principal fonte de Amônia na bacia do Rio Atibaia, apesar do grande número de indústrias ali presentes.This study evaluated the tolerance capacity and the impairment state of the Atibaia River, considering the threat to aquatic life by the presence of Ammonia, which represents one of the main risks to the aquatic communities in the Atibaia River. With this aim, the method Total Maximum Daily Load (TMDL, from the United States Environmental Protection Agency (EPA, was applied. The results revealed that the Ammonia loads increased progressively through the Atibaia River, especially due to the point sources. The daily Ammonia loads assumed values that ranged from 30 to 5000 kg NH3. The tolerance capacity of the waters of the Atibaia River, to protect aquatic life against the toxic effects of the Ammonia, has been violated in reaches near its mouth. The impairment of these waters was more intense during the dry season. This study showed that the domestic sewer

  14. 17 CFR 256.215 - Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Appropriated retained earnings... UTILITY HOLDING COMPANY ACT OF 1935 Liabilities and Other Credit Accounts § 256.215 Appropriated retained earnings. This account shall include the amount of retained earnings which has been appropriated or set...

  15. 45 CFR 84.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Free appropriate public education. 84.33 Section..., Elementary, and Secondary Education § 84.33 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate...

  16. 7 CFR 15b.22 - Free appropriate public education.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Free appropriate public education. 15b.22 Section 15b... Extension Education § 15b.22 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate public...

  17. 45 CFR 605.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Free appropriate public education. 605.33 Section... Preschool, Elementary, and Secondary Education § 605.33 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program shall provide a free appropriate...

  18. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  19. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  20. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  1. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  2. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  3. Total cross section of highly excited strings

    International Nuclear Information System (INIS)

    Lizzi, F.; Senda, I.

    1990-01-01

    The unpolarized total cross section for the joining of two highly excited strings is calculated. The calculation is performed by taking the average overall states in the given excitation levels of the initial strings. We find that the total cross section grows with the energy and momentum of the initial states. (author). 8 refs, 1 fig

  4. Survey of commercially available chocolate- and cocoa-containing products in the United States. 2. Comparison of flavan-3-ol content with nonfat cocoa solids, total polyphenols, and percent cacao.

    Science.gov (United States)

    Miller, Kenneth B; Hurst, W Jeffrey; Flannigan, Nancy; Ou, Boxin; Lee, C Y; Smith, Nancy; Stuart, David A

    2009-10-14

    A survey of a broad range of chocolate- and cocoa-containing products marketed in the United States was conducted to provide a more detailed analysis of flavan-3-ol monomers, oligomers, and polymers, which can be grouped into a class of compounds called procyanidins. Samples consisted of the three or four top-selling products within the following six categories: natural cocoa powder, unsweetened baking chocolate, dark chocolate, semisweet baking chips, milk chocolate, and chocolate syrup. Composite samples were characterized for percent fat (% fat), percent nonfat cocoa solids (% NFCS), antioxidant level by ORAC, total polyphenols, epicatechin, catechin, total monomers, and flavan-3-ol oligomers and polymers (procyanidins). On a gram weight basis epicatechin and catechin content of the products follow in decreasing order: cocoa powder > baking chocolate > dark chocolate = baking chips > milk chocolate > chocolate syrup. Analysis of the monomer and oligomer profiles within product categories shows there are two types of profiles: (1) products that have high monomers with decreasing levels of oligomers and (2) products in which the level of dimers is equal to or greater than the monomers. Results show a strong correlation (R(2) = 0.834) of epicatechin to the level of % NFCS and also very good correlations for N = 2-5 oligomers to % NFCS. A weaker correlation was observed for catechin to % NFCS (R(2) = 0.680). Other analyses show a similar high degree of correlation with epicatechin and N = 2-5 oligomers to total polyphenols, with catechin being less well correlated to total polyphenols. A lesser but still good correlation exists between the calculated percent cacao (calcd % cacao) content, a proxy for percent cacao, and these same flavanol measures, with catechin again showing a lesser degree of correlation to calcd % cacao. Principal component analysis (PCA) shows that the products group discretely into five classes: (1) cocoa powder, (2) baking chocolate, (3) dark

  5. Importância das espécies minerais no potássio total da fração argila de solos do Triângulo Mineiro Importance of mineral species in total potassium content of clay fraction in soils of the Triângulo Mineiro, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    V. F. Melo

    2003-10-01

    arenito da Formação Uberaba, migmatito/micaxisto do Grupo Araxá e basalto da Formação Serra Geral.Few studies relate the K reserve in soils developed in a humid tropic climate with the minerals found in the clay fraction. Nineteen soils were collected for this purpose in the Triângulo Mineiro region, Minas Gerais State, Brazil, developed from different parent materials and different weathering degrees. Due to the greater occurrence, a larger number of samples of the Bauru Group was collected, comprising all the geological formations found in the region. The total K content in soil and the sand, silt, and clay fractions were determined after the digestion of the soil samples by HF, HNO3 and H2SO4. To quantify the contribution of each mineral species to the total K content, Na-saturated clay samples were submitted by a sequential and selective mineral extraction procedure, following the order: amorphous Al and Fe oxides; crystalline Fe oxides; kaolinite and gibbsite; mica and other 2:1 minerals and; feldspar and resistant minerals. The clay mineralogy composition reflects the high weathering and leaching degree in soils of the Triângulo Mineiro, with low contents of amorphous minerals, a predominant proportion of kaolinite and the presence of other secondary resistant minerals. In spite of this mineral composition, the clay fraction presented the highest total K content, mainly in the most weathered soils. Due to the high proportion of kaolinite in the clay fraction, this mineral was an important source of non-exchangeable K forms. On the other hand, the contribution of amorphous Fe and Al oxides and crystalline Fe oxides to the total K content of the clay fraction was negligible. In general, easily weathered primary minerals (mica and feldspar contributed largely to the total K of the clay fraction, principally to the youngest soils developed from the Uberaba (sandstone and Serra Geral (basalt Formations, and the Araxá Group (migmatite/micaschist.

  6. Appropriate Separator Sizing: A Modified Stewart and Arnold Method

    Directory of Open Access Journals (Sweden)

    F. Boukadi

    2012-01-01

    Full Text Available Oil and gas separators were one of the first pieces of production equipment to be used in the petroleum industry. The different stages of separation are completed using the following three principles: gravity, centrifugal force, and impingement. The sizes of the oil droplets, in the production water, are based mainly on the choke valve pressure drop. The choke valve pressure drop creates a shearing effect; this reduces the ability of the droplets to combine. One of the goals of oil separation is to reduce the shearing effect of the choke. Separators are conventionally designed based on initial flow rates; as a result, the separator is no longer able to accommodate totality of produced fluids. Changing fluid flow rates as well as emulsion viscosity effect separator design. The reduction in vessel performance results in recorded measurements that do not match actual production levels inducing doubt into any history matching process and distorting reservoir management programs. In this paper, the new model takes into account flow rates and emulsion viscosity. The generated vessel length, vessel diameter, and slenderness ratio monographs are used to select appropriate separator size based on required retention time. Model results are compared to API 12J standards.

  7. NIF total neutron yield diagnostic

    International Nuclear Information System (INIS)

    Cooper, Gary W.; Ruiz, Carlos L.

    2001-01-01

    We have designed a total neutron yield diagnostic for the National Ignition Facility (NIF) which is based on the activation of In and Cu samples. The particular approach that we have chosen is one in which we calibrate the entire counting system and which we call the ''F factor'' method. In this method, In and/or Cu samples are exposed to known sources of DD and DT neutrons. The activated samples are then counted with an appropriate system: a high purity Ge detector for In and a NaI coincidence system for Cu. We can then calculate a calibration factor, which relates measured activity to total neutron yield. The advantage of this approach is that specific knowledge of such quantities as cross sections and detector efficiencies is not needed. Unless the actual scattering environment of the NIF can be mocked up in the calibration experiment, the F factor will have to be modified using the results of a numerical simulation of the NIF scattering environment. In this article, the calibration factor methodology will be discussed and experimental results for the calibration factors will be presented. Total NIF neutron yields of 10 9 --10 19 can be measured with this method assuming a 50 cm stand-off distance can be employed for the lower yields

  8. Properties of the Higgs boson in the 4 lepton final state at the LHC with the ATLAS experiment: mass, limits on the high mass contribution and on the total width

    CERN Document Server

    AUTHOR|(SzGeCERN)719049

    The theme of the analyses presented in this Thesis is the measurement of the Higgs boson properties in the H$\\rightarrow$ZZ$\\rightarrow$4l decay channel with the ATLAS experiment at the LHC. A detailed overview on the electron calibration process is first presented. In this regard, the track-cluster combination algorithm is found to improve the energy resolution of low $E_{T}$ electrons by exploiting both track and cluster information into a maximum likelihood fit. The improvement in resolution is approximately 18-20% for J/$\\Psi$ dielectron decays, and of the order of 3% for Z$\\rightarrow$ee events. In addition, the E-p combination algorithm has also been applied to the H$\\rightarrow$ZZ$\\rightarrow$4l channel with electrons in the final state resulting in a non-negligible gain on the invariant mass distribution (4-5%). Secondly, the Higgs mass and its total width are evaluated in the H$\\rightarrow$ZZ$\\rightarrow$4l channel. The Higgs mass is measured in the 4l decay channel with particular interest on the be...

  9. Dissolved inorganic carbon, total alkalinity, pH, and other variables collected from surface discrete observations using spectrophotometer and other instruments from NOAA Ship Henry B. Bigelow off the Northeastern coast of the United States from 2014-09-10 to 2014-11-05 (NCEI Accession 0138983)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This archival package contains surface measurements of dissolved inorganic, total alkalinity, pH measurements off the Northeastern coast of the United States....

  10. Defense Authorization and Appropriations Bills: FY1970-FY2017

    Science.gov (United States)

    2017-01-18

    textbooks on legislative procedure. Tracking DOD authorization or appropriation bills can be confusing and time-consuming. This has been particularly...by the President through the White House Office of Management and Budget) to the defense authorizing and appropriations committees. Then, for...maintain operations . 3 This might be considered a “line of credit” against the enactment of the relevant appropriations for the new fiscal year

  11. Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

    Data.gov (United States)

    Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

  12. Total diet study in Sao Paulo State: estimation of dietary intakes of toxic (arsenic and cadmium) and essential elements (calcium, chromium, iron, selenium, sodium, potassium and zinc); Estudo de dieta total no Estado de Sao Paulo: estimativa de ingestao dietetica de elementos toxicos (arsenio e cadmio) e essenciais (calcio, cromo, ferro, selenio, sodio, potassio e zinco)

    Energy Technology Data Exchange (ETDEWEB)

    Avegliano, Roseane Pagliaro

    2009-07-01

    Total Diet Study (TDS) is based on the evaluation of food samples representing a market basket, which shows dietary habits of a given population. The World Health Organization (WHO) has encouraged countries to conduct their own TDS, which is already being done in several countries, but not yet in Brazil. This study involved essential steps to establish a TDS in Sao Paulo State: a) information about food consumption (a recent national household food budget survey 'POF 2002-2003' by the Brazilian Institute for Geography and Statistics (IBGE), including 5,440 foods); b) development of a Market Basket (sampling of 71 foods consumed more than 2g/day/person, grouped into 30 food groups: cereals; leguminous; leafy, fruity and tuberous vegetables; tropical fruits; other fruits; flours; pasta; breads; biscuits; prime and standard grade beef; pork meat; sausages; poultry; milk/cream; other dairy products; sugars; sweet dishes; salts, sauces; oils, fats, alcoholic beverages; non-alcoholic beverages; coffee; ready-made dishes; seawater and freshwater fishes); c) collection and kitchen preparation in restaurants of the Food service Department of the Coordination of Social Assistance of the University of Sao Paulo (preparing ready-to- consume foods, individually and mixing foods of the same food group); d) chemical analysis (food groups were homogenized, pulverized and analyzed by Instrumental Neutron Activation and GF Atomic Absorption Spectroscopy). Element contents were determined in the 30 food groups. Average element range concentrations and daily dietary intakes were determined. The results of daily dietary intakes in this study (275{+-}31mg Ca; 20.7{+-}1.9{mu}g Cr; 5.7{+-}0.4mg Fe; 861{+-}46mg K; 9.44{+-}0.48{mu}g Se; 1928{+-}278mg Na; 4.25{+-}0.24mg Zn; 1.53{+-}0.43{mu}g As and 1.31{+-}0.16{mu}g Cd) were lower than or similar the results of other Brazilian studies and lower than results of TDS of other countries. This is probably due to the fact that the Market

  13. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  14. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  15. High-Level Football and Appropriations to Universities: Are Sports-Crazed Representatives Responsive to NCAA Divisional Affiliation?

    Science.gov (United States)

    Jones, Willis A.

    2015-01-01

    Does fielding a Football Bowl Subdivision (FBS) program help an institution of higher education obtain aid in the form of state appropriations? Two published studies have found some evidence of a positive correlation between having an FBS-level football program and the amount of appropriations received by public universities. This study looked to…

  16. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  17. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  18. Normal Non-HDL Cholesterol, Low Total Cholesterol, and HDL Cholesterol Levels in Sickle Cell Disease Patients in the Steady State: A Case-Control Study of Tema Metropolis.

    Science.gov (United States)

    Ephraim, Richard K D; Adu, Patrick; Ake, Edem; Agbodzakey, Hope; Adoba, Prince; Cudjoe, Obed; Agoni, Clement

    2016-01-01

    Background. Abnormal lipid homeostasis in sickle cell disease (SCD) is characterized by defects in plasma and erythrocyte lipids and may increase the risk of cardiovascular disease. This study assessed the lipid profile and non-HDL cholesterol level of SCD patients. Methods. A hospital-based cross-sectional study was conducted in 50 SCD patients, in the steady state, aged 8-28 years, attending the SCD clinic, and 50 healthy volunteers between the ages of 8-38 years. Serum lipids were determined by enzymatic methods and non-HDL cholesterol calculated by this formula: non-HDL-C = TC-HDL-C. Results. Total cholesterol (TC) ( p = 0.001) and high-density lipoprotein cholesterol (HDL-C) ( p < 0.0001) were significantly decreased in cases compared to controls. The levels of non-HDL-C, low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were similar among the participants. The levels of decrease in TC and HDL were associated with whether a patient was SCD-SS or SCD-SC. Systolic blood pressure and diastolic blood pressure were each significantly associated with increased VLDL [SBP, p = 0.01, OR: 0.74 (CI: 0.6-0.93); DBP, p = 0.023, OR: 1.45 (CI: 1.05-2.0)]. Conclusion. Dyslipidemia is common among participants in this study. It was more pronounced in the SCD-SS than in SCD-SC. This dyslipidemia was associated with high VLDL as well as increased SBP and DBP.

  19. How Building Principals Made Sense of Free and Appropriate Public Education in the Least Restrictive Environment

    Science.gov (United States)

    Sumbera, Meagan J.; Pazey, Barbara L.; Lashley, Carl

    2014-01-01

    Confusion among school leaders regarding how to interpret and implement special education legislation, and specific federal and state policies and mandates such as a free and appropriate public education (FAPE), in the least restrictive environment (LRE) at the school-site level has existed since the 1970s and continues to exist. This…

  20. Youth as Design Partners: Age-Appropriate Websites for Middle and High School Students

    Science.gov (United States)

    Chow, Anthony S.; Smith, Kathelene McCarty; Sun, Katherine

    2012-01-01

    This study explored the impact of using best practices identified in previous studies in designing age-appropriate websites for middle and high school youth. Utilizing a mixed-method approach, 31 middle and 22 high school youth took part in six focus groups across four states. Participants were introduced to a website specifically designed for…

  1. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  2. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  3. Healthy Eating and Risks of Total and Cause-Specific Death among Low-Income Populations of African-Americans and Other Adults in the Southeastern United States: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Danxia Yu

    2015-05-01

    Full Text Available A healthy diet, as defined by the US Dietary Guidelines for Americans (DGA, has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals. It is unknown whether this association can be extrapolated to African-Americans and low-income populations.We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study, a prospective study that recruited 84,735 American adults, aged 40-79 y, from 12 southeastern US states during 2002-2009, mostly through community health centers that serve low-income populations. The present analysis included 50,434 African-Americans, 24,054 white individuals, and 3,084 individuals of other racial/ethnic groups, among whom 42,759 participants had an annual household income less than US$15,000. Usual dietary intakes were assessed using a validated food frequency questionnaire at baseline. Adherence to the DGA was measured by the Healthy Eating Index (HEI, 2010 and 2005 editions (HEI-2010 and HEI-2005, respectively. During a mean follow-up of 6.2 y, 6,906 deaths were identified, including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases. A higher HEI-2010 score was associated with lower risks of disease death, with adjusted hazard ratios (HRs of 0.80 (95% CI, 0.73-0.86 for all-disease mortality, 0.81 (95% CI, 0.70-0.94 for cardiovascular disease mortality, 0.81 (95% CI, 0.69-0.95 for cancer mortality, and 0.77 (95% CI, 0.67-0.88 for other disease mortality, when comparing the highest quintile with the lowest (all p-values for trend 0.50. Several component scores in the HEI-2010, including whole grains, dairy, seafood and plant proteins, and ratio of unsaturated to saturated fatty acids, showed significant inverse associations with total mortality. HEI-2005 score was also associated with lower disease mortality, with a HR of 0.86 (95

  4. Appropriate Technology and Journal Writing: Structured Dialogues that Enhance Learning

    Science.gov (United States)

    Longhurst, James; Sandage, Scott A.

    2004-01-01

    Of the many available options, instructors should choose "appropriate technology" that meets pedagogical goals with minimum disruption. Student journal assignments follow many teaching "best practices" but consume time and energy; we recommend e-mail as the most appropriate choice for journal assignments. E-mail encourages fast and personalized…

  5. 18 CFR 367.2150 - Account 215, Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 215, Appropriated retained earnings. 367.2150 Section 367.2150 Conservation of Power and Water Resources FEDERAL... retained earnings. This account must include the amount of retained earnings that has been appropriated or...

  6. Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

    Directory of Open Access Journals (Sweden)

    Francesco Napolitano

    Full Text Available BACKGROUND: The appropriate use of antibiotics prophylaxis in the prevention and reduction in the incidence of surgical site infection is widespread. This study evaluates the appropriateness of the prescription of antibiotics prophylaxis prior to surgery amongst hospitalized patients in the geographic area of Avellino, Caserta, and Naples (Italy and the factors associated with a poor adherence. METHODS: A sample of 382 patients admitted to 23 surgical wards and undergoing surgery in five hospitals were randomly selected. RESULTS: Perioperative antibiotic prophylaxis was appropriate in 18.1% of cases. The multivariate logistic regression analysis showed that patients with hypoalbuminemia, with a clinical infection, with a wound clean were more likely to receive an appropriate antibiotic prophylaxis. Compared with patients with an American Society of Anesthesiologists (ASA score ≥4, those with a score of 2 were correlated with a 64% reduction in the odds of having an appropriate prophylaxis. The appropriateness of the timing of prophylactic antibiotic administration was observed in 53.4% of the procedures. Multivariate logistic regression model showed that such appropriateness was more frequent in older patients, in those admitted in general surgery wards, in those not having been underwent an endoscopic surgery, in those with a higher length of surgery, and in patients with ASA score 1 when a score ≥4 was chosen as the reference category. The most common antibiotics used inappropriately were ceftazidime, sultamicillin, levofloxacin, and teicoplanin. CONCLUSIONS: Educational interventions are needed to improve perioperative appropriate antibiotic prophylaxis.

  7. 16 CFR 614.1 - Appropriate proof of identity.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Appropriate proof of identity. 614.1 Section... IDENTITY § 614.1 Appropriate proof of identity. (a) Consumer reporting agencies shall develop and implement reasonable requirements for what information consumers shall provide to constitute proof of identity for...

  8. 38 CFR 18.433 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ... education. 18.433 Section 18.433 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., Secondary, and Adult Education § 18.433 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program shall provide a free appropriate public...

  9. Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

    Science.gov (United States)

    2017-02-27

    eight divisions that are further divided into 38 districts.2 This report provides an overview of the Corps water resource activities , including...rules associated with authorization and appropriation earmarks, individual Members often brought attention to similar activities for congressional...Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities Nicole T. Carter Specialist in Natural Resources Policy

  10. Primary to comprehensive stroke center transfers: Appropriateness, not futility.

    Science.gov (United States)

    Goyal, Mayank; Menon, Bijoy K; Wilson, Alexis T; Almekhlafi, Mohammed A; McTaggart, Ryan; Jayaraman, Mahesh; Demchuk, Andrew M; Hill, Michael D

    2018-01-01

    Background and purpose Ischemic stroke patients must be transferred to comprehensive stroke centers for endovascular treatment, but this transfer can be interpreted post hoc as "futile" if patients do not ultimately undergo the procedure or have a poor outcome. We posit that transfer decisions must instead be evaluated in terms of appropriateness at the time of decision-making. Methods We propose a classification schema for Appropriateness of Transfer for Endovascular Thrombectomy based on patient, logistic, and center characteristics. Results The classification outline characteristics of patients that are 1. Appropriate for transfer for endovascular treatment; 2. Inappropriate for transfer; and 3. Appropriate for transfer for higher level of care. Conclusions Appropriate transfer decisions for endovascular treatment are significant for patient outcomes. A more nuanced understanding of transfer decision-making and a classification for such transfers can help minimize inappropriate transfers in acute stroke.

  11. APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

    Directory of Open Access Journals (Sweden)

    Cornelia DUMITRU

    2015-07-01

    Full Text Available The ownership, either public or private, is an expression for appropriating goods. Consequently, the appropriation takes the form of private (i.e. private property and common forms (i.e. public property. The common law property defines appropriation as „a deliberate act of acquisition of something, often without the permission of the owner”, but the intellectual property rights do not protect goods. Particularly in this case „the object” of appropriation does not represent a „res nullius” simply because the intellectual property right arises from the act of creation, therefore the appropriation of somebody else’s creation becomes equivalent with stealing (plagiarism. Consequently, if we are to admit that the authors have a right of ownership over them, then ownership in intellectual property law has (it must have other manifestations than those known and accepted in the common law of property.

  12. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  13. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  14. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  15. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  16. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  17. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  18. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  19. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  20. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  1. Public Opinion Regarding Whether Speaking With Patients About Firearms Is Appropriate: Results of a National Survey.

    Science.gov (United States)

    Betz, Marian E; Azrael, Deborah; Barber, Catherine; Miller, Matthew

    2016-10-18

    Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear. To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms. Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates. U.S. adults. 3914 English-speaking adults (55% participation rate). Participants were asked, "In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?" A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]). The provider discussion question did not specify clinical context. Two thirds of non-firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes

  2. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  3. Optimising performance in steady state for a supermarket refrigeration system

    DEFF Research Database (Denmark)

    Green, Torben; Kinnaert, Michel; Razavi-Far, Roozbeh

    2012-01-01

    Using a supermarket refrigeration system as an illustrative example, the paper postulates that by appropriately utilising knowledge of plant operation, the plant wide performance can be optimised based on a small set of variables. Focusing on steady state operations, the total system performance...

  4. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  5. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  6. Impact of appropriate empirical antibiotic treatment on recurrence and mortality in patients with bacteraemia

    DEFF Research Database (Denmark)

    Gradel, Kim O.; Jensen, Ulrich S; Schønheyder, Henrik C.

    2017-01-01

    of bacteraemia patients. Methods: A cohort study including all patients hospitalized with incident bacteraemia during 2007-2008 in the Copenhagen City and County areas and the North Denmark Region. EAT was defined as the antibiotic treatment given at the 1st notification of a positive blood culture...... models. Results: In 6483 eligible patients, 712 (11%) had a recurrent episode. A total of 3778 (58%) patients received appropriate EAT, 1290 (20%) received inappropriate EAT, while EAT status was unrecorded for 1415 (22%) patients. The 2-30 day mortality was 15.1%, 17.4% and 19.2% in patients receiving...... appropriate EAT, inappropriate EAT, and unknown EAT, respectively. Among patients alive on day 30, the 31-365 day mortality was 22.3% in patients given appropriate EAT compared to 30.7% in those given inappropriate EAT. Inappropriate EAT was independently associated with recurrence (HR 1.25; 95% CI = 1...

  7. Interior, Environment, and Related Agencies: FY2007 Appropriations

    National Research Council Canada - National Science Library

    Vincent, Carol H; Bearden, David M; Corn, M. L; Gorte, Ross W; Humphries, Marc; Sheikh, Pervaze A; Whiteman, David L; Boren, Susan; Walke, Roger; Bea, Keith

    2007-01-01

    ... of Health and Human Services. It also includes funding for arts and cultural agencies; the Environmental Protection Agency, which was recently transferred to the appropriations subcommittees that deal with Interior and Related Agencies...

  8. Appropriate technology: Often, the best answers can be found right ...

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

    2010-10-28

    Oct 28, 2010 ... In each case, however, the technologies have done their job – they have led to lasting solutions ... Appropriate technology: Often, the best answers can be found right at home ... In a Bookless Society, Why Start With Books?

  9. Appropriate models for estimating stresses and strains in asphalt layers

    CSIR Research Space (South Africa)

    Jooste, FJ

    1998-09-01

    Full Text Available The broad objective is to make recommendations for appropriate modelling procedures to be used in the structural design of asphalt layers. Findings of this investigation are intended to be used in refining and validating existing asphalt pavement...

  10. Financial Status of Air Force Expired Year Appropriations

    National Research Council Canada - National Science Library

    1994-01-01

    ... Procurement appropriations. In our report on that audit, we found that the Air Force experienced deficits and accounting problems relating to funding upward cost adjustments to obligations when such costs were charged...

  11. Determining the appropriate code in a South African business ...

    African Journals Online (AJOL)

    Determining the appropriate code in a South African business environment. ... Southern African Linguistics and Applied Language Studies ... would be perceived to enhance the quality of the interaction between client and service provider.

  12. The application of appropriate technologies and systems for sustainable sanitation

    CSIR Research Space (South Africa)

    Duncker, Louiza C

    2014-11-01

    Full Text Available and environmental factors into planning, implementation and decision-making so as to ensure that development serves present and future generations. The chapter discusses the use of appropriate technologies and systems to render sanitation technologies and services...

  13. Appropriate tools and methods for tropical microepidemiology: a ...

    African Journals Online (AJOL)

    Appropriate tools and methods for tropical microepidemiology: a case-study of malaria clustering in Ethiopia. Tedros A Ghebreyesus, Peter Byass, Karen H Witten, Asfaw Getachew, Mitiku Haile, Mekonnen Yohannes, Steven W Lindsay ...

  14. Age-Appropriate Immunization (AAI) as an Intractable Issue ...

    African Journals Online (AJOL)

    Dinesh Kumar

    ) approved. 30 cluster ... As FI measures coverage for services, but age appropriate ..... providers need to be effectively oriented towards importance of ... planning and management interventions for improving age- ... BMC Health Serv Res.

  15. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  16. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  17. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  18. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  19. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  20. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  1. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  2. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  3. ACR Appropriateness Criteria® Colorectal Cancer Screening.

    Science.gov (United States)

    Moreno, Courtney; Kim, David H; Bartel, Twyla B; Cash, Brooks D; Chang, Kevin J; Feig, Barry W; Fowler, Kathryn J; Garcia, Evelyn M; Kambadakone, Avinash R; Lambert, Drew L; Levy, Angela D; Marin, Daniele; Peterson, Christine M; Scheirey, Christopher D; Smith, Martin P; Weinstein, Stefanie; Carucci, Laura R

    2018-05-01

    This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. The appropriateness of health services for adolescents: youth's opinions and attitudes.

    Science.gov (United States)

    Resnick, M; Blum, R W; Hedin, D

    1980-12-01

    Minnesota high school students were surveyed about their attitudes, beliefs, and opinions about health, illness, and medical care. Data were obtained from small group discussions conducted by the adolescents themselves in schools and agencies throughout the state. This paper reports their views toward adolescent medical services. Teenagers emphasized the idea of service appropriateness as central to promoting service utilization. Key to the concept of appropriateness were the components of staff, cost and confidentiality. Each of these dimensions is examined from the view of youth as to implications for increased appropriateness of services for both utilization and improved health. Findings are discussed in terms of differences in problem definition between the adolescent and professional, and their implications for medical care in conventional and alternative settings.

  5. Selection of an appropriately simple storm runoff model

    Directory of Open Access Journals (Sweden)

    A. I. J. M. van Dijk

    2010-03-01

    Full Text Available An appropriately simple event runoff model for catchment hydrological studies was derived. The model was selected from several variants as having the optimum balance between simplicity and the ability to explain daily observations of streamflow from 260 Australian catchments (23–1902 km2. Event rainfall and runoff were estimated from the observations through a combination of baseflow separation and storm flow recession analysis, producing a storm flow recession coefficient (kQF. Various model structures with up to six free parameters were investigated, covering most of the equations applied in existing lumped catchment models. The performance of alternative structures and free parameters were expressed in Aikake's Final Prediction Error Criterion (FPEC and corresponding Nash-Sutcliffe model efficiencies (NSME for event runoff totals. For each model variant, the number of free parameters was reduced in steps based on calculated parameter sensitivity. The resulting optimal model structure had two or three free parameters; the first describing the non-linear relationship between event rainfall and runoff (Smax, the second relating runoff to antecedent groundwater storage (CSg, and a third that described initial rainfall losses (Li, but which could be set at 8 mm without affecting model performance too much. The best three parameter model produced a median NSME of 0.64 and outperformed, for example, the Soil Conservation Service Curve Number technique (median NSME 0.30–0.41. Parameter estimation in ungauged catchments is likely to be challenging: 64% of the variance in kQF among stations could be explained by catchment climate indicators and spatial correlation, but corresponding numbers were a modest 45% for CSg, 21% for Smax and none for Li, respectively. In gauged catchments, better

  6. Vibrational enhancement of total breakup cross sections

    International Nuclear Information System (INIS)

    Haftel, M.I.; Lim, T.K.

    1984-01-01

    This paper considers the role of multi-two-body bound states, namely vibrational excitations, on total three-body breakup cross-sections. Total cross-sections are usually easy to measure, and they play a fundamental role in chemical kinetics. (orig.)

  7. Deterministic Assisted Clone of an Arbitrary Two- and Three-qubit States via Multi-qubit Brown State

    Science.gov (United States)

    Hou, Kui; Zhu, Cheng-Jie; Yang, Ya-Ping

    2017-08-01

    We present two schemes for deterministic assisted clone(DAC) of an unknown two- and three-qubit entangled states with assistance via muti-qubit Brown state. In the schemes, the sender wish to teleport an unknown original entangled state which from the state preparer, and then create a perfect copy of the unknown state at her place. The DAC schemes include two stages. The first stage requires teleportation with Bell-state measurements via a five-qubit Brown state(or seven-qubit Brown state) as the quantum channel. In the second stage, to help the sender realize the quantum cloning, the state preparer performs projective measurements on their own particles which from the sender, then the sender can acquire a perfect copy of the unknown state by means of some appropriate unitary operations. Furthermore, the total success probability for assisted cloning a perfect copy of the unknown state can reach 1 in our schemes.

  8. Discordance between age- and size-based criteria of child passenger restraint appropriateness.

    Science.gov (United States)

    Smiley, Mary L; Bingham, C Raymond; Jacobson, Peter D; Macy, Michelle L

    2018-04-03

    In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015. Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics. Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with

  9. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  10. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  11. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  12. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  13. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  14. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  15. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  16. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  17. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  18. Analysis of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach.

    Science.gov (United States)

    Keyvanara, Mahmoud; Sohrabi, Mozaffar Cheshmeh; Zare, Firoozeh; Hassnazadeh, Akbar; Malekahmadi, Parisa

    2014-01-01

    Numerous researches conducted on about the quality of perception of media messages shows that the people are not passive receivers but they have the ability of understanding, interpreting and accepting or rejecting messages. In order to make clear the relationship of information and communication technologies with social changes and to gain a broader vision from this scope, sociological theories about information and communication technologies' usage, especially appropriation approach can be very useful. So, keeping in mind the important role of Databases in the qualitative expansion of education, research, diagnosis, remedy and medical services presentation, this research was carried out with the aim of status determination of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach in 2012. This is an applicative research of an analytical-descriptive type, which was carried out by measurement approach. The statistical society of this research was composed of the academic staffs of the Iranian Universities of Medical Sciences in 2012 and finally 390 academic staffs were selected according to the Cochran's formula were selected. The research tool are searcher's made questionnaire, which was composed of nine separate parts. Its validity was accepted by the specialists and its reliability was calculated and found to be 0.961 by Cronbakh's alpha. Database appropriation score in the academic staffs of Iranian Universities of Medical Sciences with 65.020% was in a good status and data bases dis appropriation score with 71.484 was in a high status. According to the findings of this research, Librarians and politicians in this scope-with determination of the academic staff's positive and negative points in usage and appropriation would be capable of accurately diagnozing and analyzing the chances and challenges of the academic staffs members in using databases and would also be capable of

  19. Operational resource theory of total quantum coherence

    Science.gov (United States)

    Yang, Si-ren; Yu, Chang-shui

    2018-01-01

    Quantum coherence is an essential feature of quantum mechanics and is an important physical resource in quantum information. Recently, the resource theory of quantum coherence has been established parallel with that of entanglement. In the resource theory, a resource can be well defined if given three ingredients: the free states, the resource, the (restricted) free operations. In this paper, we study the resource theory of coherence in a different light, that is, we consider the total coherence defined by the basis-free coherence maximized among all potential basis. We define the distillable total coherence and the total coherence cost and in both the asymptotic regime and the single-copy regime show the reversible transformation between a state with certain total coherence and the state with the unit reference total coherence. Extensively, we demonstrate that the total coherence can also be completely converted to the total correlation with the equal amount by the free operations. We also provide the alternative understanding of the total coherence, respectively, based on the entanglement and the total correlation in a different way.

  20. Total Evidence, Uncertainty and A Priori Beliefs

    NARCIS (Netherlands)

    Bewersdorf, Benjamin; Felline, Laura; Ledda, Antonio; Paoli, Francesco; Rossanese, Emanuele

    2016-01-01

    Defining the rational belief state of an agent in terms of her initial or a priori belief state as well as her total evidence can help to address a number of important philosophical problems. In this paper, I discuss how this strategy can be applied to cases in which evidence is uncertain. I argue

  1. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  2. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  3. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  4. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  5. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  6. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  7. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  8. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  9. Beyond Brazilian Coalition Presidentialism: the Appropriation of the Legislative Agenda

    Directory of Open Access Journals (Sweden)

    Rafael Silveira e Silva

    2014-12-01

    Full Text Available Even though they possess several power resources, Brazilian Presidents also elaborate their legislative proposals based upon bills already being processed in Congress through a phenomenon called Appropriation of the legislative agenda. In this paper I examine the conditions under which this phenomenon occurs by means of a typology and a qualitative comparative analysis (QCA. I conclude that Appropriation provides the President with the expansion of the formal support base by controlling the agenda of allied and opposition parties as well as obtaining the "paternity" of several policies already in motion in Congress, thus enabling a public association of the President's actions and his or her party with the possibility of social benefits. Be it in the pursuit of promising agendas or for the maintenance of their own dominance, Appropriation shows that Brazilian Presidents must go beyond coalition presidentialism.

  10. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul(Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

  11. Appropriate selection for omalizumab treatment in patients with severe asthma?

    DEFF Research Database (Denmark)

    Nygaard, Leo; Henriksen, Daniel Pilsgaard; Madsen, Hanne

    2017-01-01

    Background: Omalizumab improves asthma control in patients with uncontrolled severe allergic asthma; however, appropriate patient selection is crucial. Information in this field is sparse. Objective: We aimed to estimate whether potential omalizumab candidates were appropriately selected according...... to guidelines, and the clinical effect of omalizumab treatment over time. Design: We performed a retrospective observational study on adult patients with asthma treated with omalizumab during 2006-2015 at the Department of Respiratory Medicine at Odense University Hospital (OUH), Denmark. Data were obtained...... from the Electronic Patient Journal of OUH and Odense Pharmaco-Epidemiological Database. Guideline criteria for omalizumab treatment were used to evaluate the appropriateness of omalizumab candidate selection, and the Asthma Control Test (ACT) to assess the clinical effects of omalizumab at weeks 16...

  12. Evaluation of appropriate technologies for grey water treatments and reuses.

    Science.gov (United States)

    Li, Fangyue; Wichmann, Knut; Otterpohl, Ralf

    2009-01-01

    As water is becoming a rare resource, the onsite reuse and recycling of grey water is practiced in many countries as a sustainable solution to reduce the overall urban water demand. However, the lack of appropriate water quality standards or guidelines has hampered the appropriate grey water reuses. Based on literature review, a non-potable urban grey water treatment and reuse scheme is proposed and the treatment alternatives for grey water reuse are evaluated according to the grey water characteristics, the proposed standards and economical feasibility.

  13. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  14. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Total quality management in American industry.

    Science.gov (United States)

    Widtfeldt, A K; Widtfeldt, J R

    1992-07-01

    The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.

  16. The Appropriation of Fine Art into Contemporary Narrative Picturebooks

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

    Many picturebook artists have been formally trained in specific artistic styles, movements, and techniques. These artists appropriate and transform works of fine art to varying degrees to fit the themes and designs of the stories they illustrate and publish, and to increase the significance and impact of their illustrations. The…

  17. MySQL based selection of appropriate indexing technique in ...

    African Journals Online (AJOL)

    This paper deals with selection of appropriate indexing technique applied on MySQL Database for a health care system and related performance issues using multiclass support vector machine (SVM). The patient database is generally huge and contains lot of variations. For the quick search or fast retrieval of the desired ...

  18. Appropriate assessment of English language competency for South ...

    African Journals Online (AJOL)

    Appropriate assessment of English language competency for South African teachers-in-training. ... albeit having regard to learner attitudes and purposes. The paper concludes that using the new communicative methods of language testing with foundation phase teachers-in-training may improve classroom practice.

  19. Educating Parents on Developmentally Age-Appropriate Learning in Preschool.

    Science.gov (United States)

    Brown, Mitzi C.

    This practicum paper reports on a project undertaken to enhance the knowledge of age-appropriate learning for parents of 3-year-old preschoolers. The project implemented a variety of techniques and strategies to improve parent knowledge, including parent education classes, a monthly newsletter for parents that addressed current research on…

  20. Relations between the technological standards and technological appropriation

    Directory of Open Access Journals (Sweden)

    Carlos Alberto PRADO GUERRERO

    2010-06-01

    Full Text Available The objective of this study is to analyze the educational practices of using Blackboard in blended learning environments with students of higher education to understand the relationship between technological appropriation and standards of educational technology. To achieve that goal, the following research question was raised: ¿To what extent are the standards of education technology with the appropriation of technology in blended learning environments in higher educa­tion related? The contextual framework of this work includes the following topics: the institution, teaching, teachers and students. The design methodology that was used is of a correlation type. Correlations were carried out to determine the frequency and level in the technological standards as well as the appropriation of technology. In the comparison of the results obtained by the students, the teachers and the platform; we found that students in the school study showed a high degree of technology ownership and this was the same for the performance shown on the technological standards. It was established that teachers play a key role in developing the techno­logical appropriation of students and performance in technology standards.

  1. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

  2. 12 CFR 269.4 - Determination of appropriate bargaining unit.

    Science.gov (United States)

    2010-01-01

    ... requesting a representation election signed by at least thirty percent (30%) of the employees in a unit which... the labor organization should disagree with the Special Tribunal's decision, the party in disagreement... percent (30%) of the employees in a unit claimed by a labor organization as appropriate or subsequently...

  3. 5 CFR 532.217 - Appropriated fund survey jobs.

    Science.gov (United States)

    2010-01-01

    ... Laundry Worker 1 Food Service Worker 2 Cook 8 (e) A lead agency must obtain prior approval of OPM to add a... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Appropriated fund survey jobs. 532.217 Section 532.217 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS...

  4. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2014-11-15

    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  5. towards an appropriate extension approach for agricultural and rural ...

    African Journals Online (AJOL)

    empowered to do so, an important condition is an appropriate organisational structure, which can support the process and take it forward. The community structure required is one that serves as an effective linkage structure to facilitate an effective partnership interaction between the development agent. (or organisation) and ...

  6. Is the New Partnership for Africa's Development an Appropriate ...

    African Journals Online (AJOL)

    The New Partnership for Africa's Development (NEPAD) is the African Union's socio-political and economic development programme, and one of its tasks is to accelerate African continental integration. The fundamental question is, however, whether it is the appropriate programme for this. Its success depends on the ...

  7. 34 CFR 104.33 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Free appropriate public education. 104.33 Section 104.33 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

  8. FTA Training Programs: Searching for Appropriate Teaching Styles.

    Science.gov (United States)

    Byrd, Patricia; Constantinides, Janet C.

    1988-01-01

    In addition to acquiring communicative competence, teaching assistants who speak English as a second language must learn human relations skills, and how to teach content through appropriate teaching methods and skills that will help them bridge the cultural and language differences they experience in U.S. institutions of higher education. (CB)

  9. Herbal dietary supplements and knowledge of appropriate use ...

    African Journals Online (AJOL)

    %) and Aloe vera (32.2%). Fifty eight (71.6%) out of the 81 respondents on prescription drugs were using it alongside HDS. Respondents with poor, fair and good knowledge of appropriate use of HDS were 69.1%, 27.3% and 3.6% respectively.

  10. In search of an appropriate contemporary approach in Christian ...

    African Journals Online (AJOL)

    The article addresses the question: 'To what extent can Max Weber's ethic of responsibility be a helpful resource in the search of Christian Social Ethics for an appropriate contemporary approach'? This question is addressed by, first of all, providing a summary of Weber's famous speech Politics as a Vocation in which he ...

  11. A case study of culturally appropriate conservation education

    Science.gov (United States)

    David N. Bengston; Michele Schermann

    2016-01-01

    Create culturally appropriate conservation education materials for Hmong Americans, including new refugees and elders with little proficiency in English, as well as the broader, multigenerational Hmong community. This case study discusses an organizational response from the USDA Forest Service, in partnership with others, to better serve the Hmong American community....

  12. Counselling as a psychological approach to fostering appropriate ...

    African Journals Online (AJOL)

    The focus of this paper is on counselling as a psychological approach to fostering appropriate learning behaviour in Nigerian secondary school students. The paper drew attention to the confrontation, mentoring, behavioural, appraisal, and standards blending models to appeal to the consciences of students with ...

  13. Developing an Appropriate Goalball Unit for Secondary Physical Education

    Science.gov (United States)

    Laughlin, Michael K.; Happel, Kathleen

    2016-01-01

    Goalball, a sport designed for those with visual impairments, is a competitive and recreational sport enjoyed by athletes around the world. Students with and without visual impairments can experience positive outcomes when teachers appropriately include a goalball unit as part of their inclusive secondary physical education curriculum. This…

  14. Social Appropriateness in EU Counter-Terrorism Law and Policy

    DEFF Research Database (Denmark)

    Martins, Bruno Oliveira

    2015-01-01

    versus justice equation, on the issues of privacy and data protection, and on the broader respect for fundamental rights more generally. In this process, the legitimacy and the social appropriateness of some of these measures have been questioned, both at the societal level and before or by European...

  15. ACR Appropriateness Criteria® Ovarian Cancer Screening.

    Science.gov (United States)

    Pandharipande, Pari V; Lowry, Kathryn P; Reinhold, Caroline; Atri, Mostafa; Benson, Carol B; Bhosale, Priyadarshani R; Green, Edward D; Kang, Stella K; Lakhman, Yulia; Maturen, Katherine E; Nicola, Refky; Salazar, Gloria M; Shipp, Thomas D; Simpson, Lynn; Sussman, Betsy L; Uyeda, Jennifer; Wall, Darci J; Whitcomb, Bradford; Zelop, Carolyn M; Glanc, Phyllis

    2017-11-01

    There has been much interest in the identification of a successful ovarian cancer screening test, in particular, one that can detect ovarian cancer at an early stage and improve survival. We reviewed the currently available data from randomized and observational trials that examine the role of imaging for ovarian cancer screening in average-risk and high-risk women. We found insufficient evidence to recommend ovarian cancer screening, when considering the imaging modality (pelvic ultrasound) and population (average-risk postmenopausal women) for which there is the greatest available published evidence; randomized controlled trials have not demonstrated a mortality benefit in this setting. Screening high-risk women using pelvic ultrasound may be appropriate in some clinical situations; however, related data are limited because large, randomized trials have not been performed in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. The anaerobic baffled reactor (ABR): An appropriate technology for ...

    African Journals Online (AJOL)

    This project has studied the appropriateness of the ABR for on-site primary sanitation in low-income communities. The baffled design of the ABR ensures high solids retention resulting in high treatment rates, while the overall sludge production is characteristically low. Effluent COD values measured from a 3 000 l pilot ABR ...

  17. Identification of appropriate tools of information and communication ...

    African Journals Online (AJOL)

    Access to sufficient and desirable food is one of the principles of any developing and healthy society. One of the important means for attainment of food security is information and communication technologies (ICT). The purpose of the research was to identify appropriate tools of ICT in improving food security of Iran's rural ...

  18. Differences between Males and Females Concerning Perceived Electronic Mail Appropriateness

    Science.gov (United States)

    Harper, Vernon B., Jr.

    2008-01-01

    Electronic mail is one of the most successfully diffused modern communication technologies. Yet, few researchers have investigated whether gender differences exist in perceptions of the types of appropriateness embedded within electronic mail messages. A framework originally created by Wiemann and Backlund (1980) served as the basis for the…

  19. Appropriate hydrological modelling of climate change on river flooding

    NARCIS (Netherlands)

    Booij, Martijn J.; Rizzoli, A.E.; Jakeman, A.J.

    2002-01-01

    How good should a river basin model be to assess the impact of climate change on river flooding for a specific geographical area? The determination of such an appropriate model should reveal which physical processes should be incorporated and which data and mathematical process descriptions should

  20. Appropriability mechanisms, innovation and productivity: Evidence from the UK

    NARCIS (Netherlands)

    Hall, B.H.; Sena, V.

    2014-01-01

    We use an extended version of the well-established Crepon, Duguet and Mairesse model (1998) to model the relationship between appropriability mechanisms, innovation and firm-level productivity. We enrich this model in several ways. First, we consider different types of innovation spending and study

  1. Mediating Third-Wave Feminism: Appropriation as Postmodern Media Practice.

    Science.gov (United States)

    Shugart, Helene A.; Waggoner, Catherine Egley; Hallstein, D. Lynn O'Brien

    2001-01-01

    Analyzes gendered representations of Alanis Morissette, Kate Moss, and Ally McBeal. Argue that, in each case, the appropriation of third-wave feminist tenets is accomplished via a postmodern aesthetic code of juxtaposition that serves to recontextualize and reinscribe those sensibilities in a way that ultimately functions to reify dominant…

  2. ACTUAL ASPECTS OF SCHOOL MEALS, AGE APPROPRIATE PHYSIOLOGICAL NEEDS

    Directory of Open Access Journals (Sweden)

    G. O. Magomedov

    2014-01-01

    Full Text Available Analysis of the current state of school meals, determination of ways of optimization for food, biological values and balanced school meals relevant age-related physiological needs. The greatest contribution to the optimization of school meals can make enriched products of mass consumption, first of necessity, the need and favorite products to children. In this regard, the fol-lowing tasks were defined: analysis of normative documents on creation of school meals , the relevant age-related physiological needs for nutrients and energy for protein, carbohydrates, fats, vitamins, minerals, dietary fiber and organic acids; definition of the balance of the products of the school menu categories for children aged 7-11 years, 11 - 17; study of the composition of food school menu; comparison of total deviation calorie Breakfast, lunch and development of measures on optimization of the system of school nutrition. In the structure of nutrition of children and adolescents major role bread, drinks, confectionery products as are the sources of energy and nutrients (carbohydrates, proteins, vitamins, macro - and microelements, organic acids, including polyunsaturated fatty CI slot, Therefore one of the ways of solving of optimization problems of preschool and school meals are of great TRANS-perspective bakery and confectionery products, drinks of high food and biological value and coordination and composition, as on the basic structural elements and micronutrients obtained innovative technology complex processing of raw sources with maximum preservation of their original nutritional value. TA-thus, the performed literature analysis found that rational nutrition of schoolchildren aimed at prevention of alimentary (cardiovascular, gastrointestinal, allergic diseases that meet energy, plastic and other needs of the body, provides the necessary level of metabolism.

  3. Annual Status Report on Nationally Appropriate Mitigation Actions (NAMAs) 2012

    Energy Technology Data Exchange (ETDEWEB)

    Haensel, G.; Roeser, F.; Hoehne, N. [Ecofys, Utrecht (Netherlands); Van Tilburg, X.; Cameron, L. [ECN Policy Studies, Amsterdam (Netherlands)] (eds.)

    2012-11-15

    The development of Nationally Appropriate Mitigation Actions (NAMAs) has increased significantly over the last few years. The flexibility of the NAMA mechanism is widely regarded as an opportunity to deliver benefits that go far beyond greenhouse gas (GHG) emission reductions. Many developing countries are developing pilot NAMAs that deliver important insights into the challenges of, and opportunities for, NAMA development from a national perspective. A few countries are already a step ahead and experiences gained from pilot NAMA development are feeding into the formulation of national climate change policies in which NAMAs are becoming a key element. To maintain the momentum in NAMA development, clear signs at the international level are needed that developed countries will follow through with their financial commitments made under the Copenhagen Accord. Without this financial support, NAMAs will not be able to realise their full potential and induce transformational change. The Annual Status Report on NAMAs 2012 is a continuation of previously published NAMA Status Reports. The report presents an overview of the state of play of NAMAs and of support activities for NAMA development and implementation. A new feature of the Annual Status Report on NAMAs 2012 is that it is produced as a joint effort by several organizations that are closely involved in analysing and supporting NAMA development processes worldwide. The Annual Status Report on NAMAs 2012 is written by authors from Ecofys, the Energy research Centre of the Netherlands, the Center of Clean Air Policy (CCAP), the World Resources Institute (WRI) and Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ). In the section on 'Selected contributions on NAMAs', each organization discusses a specific topic of interest in relation to NAMA development that is closely related to their current NAMA activities or that is expected to provide 'food for thought' on potential ways forward for

  4. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

    Hessel, Stephane; Jacquard, Albert

    2012-01-01

    This bibliographical note presents a book, in which the authors make a plea for a total nuclear disarmament. They think that humanity cannot be found in competition, but in emulation, and examine how we can get rid of the nuclear bomb. They discuss the background of nuclear energy, state that nuclear weapons have always been useless and extremely dangerous, consider arms race as crazy and as a crime against humanity, recall that nuclear weapons already made numerous victims (Hiroshima, Nagasaki, nuclear tests), that they are a sword of Damocles over 7 billions human beings, that nuclear winter would be an apocalypse, that the Non Proliferation Treaty is a decoy. They discuss the political role of nuclear weapons, and outline that the only solution is their abolition. They discuss what has already been done and what is still to be done, and formulate a strategy for the future

  5. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  6. The taxation of the petroleum products in the appropriation bill for 2001 and the correcting appropriation bill for 2000

    International Nuclear Information System (INIS)

    2000-01-01

    This document provides information on the petroleum products taxation in the framework of the appropriation bills. The following aspects are presented : the utilization of fuels more respectful of the environment, the taxation lightening measures, measures in favor of the transportation sector, the juridical references and elements for the economic situation. (A.L.B.)

  7. A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

    Science.gov (United States)

    1984-08-01

    their role in the hospital. The book Megatrends points out that there are six States which set the pace for national trends. One of these is California...care hospitals but two. Again, one must recall what the book Megatrends says about California and national trends. Another key according to this study...Catholic Hospitals," Ethics Committees Newsletter, Vol 1, No. 2, November 1983, p. 2. 7. R. Veatch, Death, PyiLn and the Biological Revolution, New Haven

  8. Narrative self-appropriation: embodiment, alienness, and personal responsibility in the context of borderline personality disorder.

    Science.gov (United States)

    Køster, Allan

    2017-12-01

    It is often emphasised that persons diagnosed with borderline personality disorder (BPD) show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person's own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern 'from behind'. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD, particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame.

  9. ACR Appropriateness Criteria® Routine Chest Radiography.

    Science.gov (United States)

    McComb, Barbara L; Chung, Jonathan H; Crabtree, Traves D; Heitkamp, Darel E; Iannettoni, Mark D; Jokerst, Clinton; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H; Ravenel, James G

    2016-03-01

    Chest radiographs are sometimes taken before surgeries and interventional procedures on hospital admissions and outpatients. This manuscript summarizes the American College of Radiology review of the literature and recommendations on routinely performed chest radiographies in these settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  10. Software appropriation over time: from adoption to stabilization and beyond

    Directory of Open Access Journals (Sweden)

    Antonette Mendoza

    2010-01-01

    Full Text Available Technologies are introduced into an organization with the aim of improving productivity. However, persistent use of an information system is required to enhance productivity and user satisfaction. In this paper, we examine the process of technology appropriation and the factors that encourage and discourage use of an information system over time. In a longitudinal field study in an educational setting, we identify changing expectations and influences that encourage persistent use of a technology above and beyond adoption. Our work indicates that stabilization of a technology may only be a temporary plateau. Further appropriation may occur beyond initial stabilization as expectations and influences encourage persistent use of a technology. We have found that the driving forces in encouraging productive use of a technology are the ability for users to experience the technology as useful and to have easy access to ongoing training.

  11. Appropriate Determination of Net Working Capital in Corporate Financial Management

    Directory of Open Access Journals (Sweden)

    Zdeněk Motlíček

    2015-01-01

    Full Text Available Liquidity and working capital management belongs to one of the fundamental tasks of short-term financial management. However, in the context of net working capital, the issue of management of current assets and liabilities significantly overlaps with long-term financial management, in which the effects of various decisions have long-term consequences, with considerable inertia and possibility of high losses. The present study is therefore focused on the determination of appropriate amount of working capital, as an important part of financial decision making process in the company. The paper presents an empirical research aiming to identify the appropriate approach to accurate calculations of net working capital and determining its needs. The main contribution of the study can be found in the verification of calculation method of net working capital needs, which, according to the authors, may be beneficial both for business practice and teaching of financial management at universities.

  12. Development planning and appropriate technology: a dilemma and a proposal

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, G.

    1981-03-01

    This paper examines the present system of project paper preparation and project planning used by the US Agency for International Development and many donor agencies. Three approaches for meeting the evident weaknesses of the system - a holistic approach to the planning problem, an operant-conditioning approach to implementation, and a process approach to planning and implementation - are presented and critiqued. On the basis of the critique, an approach grounded in a search for an approximately appropriate technology is supported; and a proposal for an appropriate-technology evaluation system which would analyze alternative technologies, deliver information to the field level, supply needed information on technologies and implementation, constrain donor planners, reduce lag time, incorporate evaluations into future planning, and reduce dependence upon planners is presented. 66 references.

  13. Methods of achieving and maintaining an appropriate caesarean section rate.

    LENUS (Irish Health Repository)

    Robson, Michael

    2013-04-01

    Caesarean section rates continue to increase worldwide. The appropriate caesarean section rate remains a topic of debate among women and professionals. Evidence-based medicine has not provided an answer and depends on interpretation of the literature. Overall caesarean section rates are unhelpful, and caesarean section rates should not be judged in isolation from other outcomes and epidemiological characteristics. Better understanding of caesarean section rates, their consequences and their benefits will improve care, and enable learning between delivery units nationally and internationally. To achieve and maintain an appropriate caesarean section rate requires a Multidisciplinary Quality Assurance Programme in each delivery unit, recognising caesarean section rates as one of many factors that determine quality. Women will always choose the type of delivery that seems safest to them and their babies. Professionals need to monitor the quality of their practice continuously in a standardised way to ensure that women can make the right choice.

  14. Diligence in determining the appropriate form of stationarity

    Directory of Open Access Journals (Sweden)

    André Heymans

    2014-11-01

    Full Text Available Orientation: One of the most vexing problems of modelling time series data is determining the appropriate form of stationarity, as it can have a significant influence on the model’s explanatory properties, which makes interpreting the results problematic. Research purpose: This article challenged the assumption that most financial time series are first differenced stationary. The common difference first, ask questions later approach was revisited by taking a more systematic approach when analysing the statistical properties of financial time series data. Motivation for the study: Since Nelson and Plosser’s (1982 argued that many macroeconomic time series are difference stationary, many econometricians simply differenced data in order to achieve stationarity. However, the inherent properties of time series data have changed over the past 30 years. This necessitates a proper evaluation of the properties of data before deciding on the appropriate course of action, in order to avoid over-differencing which causes variables to lose their explanatory ability that leads to spurious results. Research approach, design and method: This article introduced a rigorous process that enables econometricians to determine the most appropriate form of stationarity, which is led by the underlying statistical properties of several financial and economic variables. Main findings: The results highlighted the importance of consulting the d parameter to makea more informed decision, rather than only assuming that the data are I(1. Evidence also suggested that the appropriate form of stationarity can vary, but emphasises the importance to consider a series to be fractionally differenced. Practical/managerial implications: Only when data are correctly classified and transformed accordingly will the data be neither under- nor over-differenced, thus enhancing the validity of the results generated by statistical models. Contribution/value-add: By utilising this rigorous

  15. Appropriate Utilization and Stocking of Antidotes in Qatar Public Hospitals

    OpenAIRE

    Rawan Salameh; Waleed Awad Salem; ISMA Qureshi; Asma Al-Bukari; Eman Shaat; Jibin Moinudheen; Galal Aleassi; Robert Hoffman

    2017-01-01

    Background: There are a few studies that evaluate preparedness and availability of antidotes in the emergency setting and none have been conducted in Qatar. Published studies show that timely availability of antidotes in the emergency department setting is a common issue. To address this, we conducted a study to evaluate antidote stocking and utilization in Qatar hospital pharmacies and emergency departments. Methods: In order to evaluate the appropriate use and timely administration of antid...

  16. Appeal to fear in health care: appropriate or inappropriate?

    OpenAIRE

    Simpson, J. Keith

    2017-01-01

    Aim This paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use. Background Appeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use a...

  17. Appropriability mechanisms, innovation and productivity: Evidence from the UK

    OpenAIRE

    Hall, B.H.; Sena, V.

    2014-01-01

    We use an extended version of the well-established Crepon, Duguet and Mairesse model (1998) to model the relationship between appropriability mechanisms, innovation and firm-level productivity. We enrich this model in several ways. First, we consider different types of innovation spending and study the differences in estimates when innovation spending (rather than R&D spending) is used to predict innovation in the CDM model. Second, we assume that a firm simultaneously innovates and chooses a...

  18. Textual appropriation in engineering master's theses: a preliminary study.

    Science.gov (United States)

    Eckel, Edward J

    2011-09-01

    In the thesis literature review, an engineering graduate student is expected to place original research in the context of previous work by other researchers. However, for some students, particularly those for whom English is a second language, the literature review may be a mixture of original writing and verbatim source text appropriated without quotations. Such problematic use of source material leaves students vulnerable to an accusation of plagiarism, which carries severe consequences. Is such textual appropriation common in engineering master's writing? Furthermore, what, if anything, can be concluded when two texts have been found to have textual material in common? Do existing definitions of plagiarism provide a sufficient framework for determining if an instance of copying is transgressive or not? In a preliminary attempt to answer these questions, text strings from a random sample of 100 engineering master's theses from the ProQuest Dissertations and Theses database were searched for appropriated verbatim source text using the Google search engine. The results suggest that textual borrowing may indeed be a common feature of the master's engineering literature review, raising questions about the ability of graduate students to synthesize the literature. The study also illustrates the difficulties of making a determination of plagiarism based on simple textual similarity. A context-specific approach is recommended when dealing with any instance of apparent copying.

  19. Guideline for appropriate use of cardiac CT in heart disease

    International Nuclear Information System (INIS)

    Kim, Young Jin; Hong, Yoo Jin; Yong, Hwan Seok; Kim, Sung Mok; Kim, Jeong A; Yang, Dong Hyun

    2014-01-01

    Heart disease is one of the leading causes of deaths in Korea, along with malignant neoplasms and cerebrovascular diseases. The proper diagnosis and management for patients with suspected heart diseases should be warranted for the public health care. Advances in CT technology have allowed detailed images of the heart to be obtained, which enable evaluations not only of the coronary arteries but also of other cardiac structures. Currently, the latest multi-detector CT machines are widespread around Korea. The appropriate use of cardiac CT may lead to improvements of the physicians' medical performances and to reduce medical costs which eventually contribute to promotions of public health. However, until now, there has been no guidelines regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist the clinicians and other health professionals when using cardiac CT for diagnosis and treatments of heart diseases.

  20. APPROPRIATE ALLOCATION OF CONTINGENCY USING RISK ANALYSIS METHODOLOGY

    Directory of Open Access Journals (Sweden)

    Andi Andi

    2004-01-01

    Full Text Available Many cost overruns in the world of construction are attributable to either unforeseen events or foreseen events for which uncertainty was not appropriately accommodated. It is argued that a significant improvement to project management performance may result from greater attention to the process of analyzing project risks. The objective of this paper is to propose a risk analysis methodology for appropriate allocation of contingency in project cost estimation. In the first step, project risks will be identified. Influence diagramming technique is employed to identify and to show how the risks affect the project cost elements and also the relationships among the risks themselves. The second step is to assess the project costs with regards to the risks under consideration. Using a linguistic approach, the degree of uncertainty of identified project risks is assessed and quantified. The problem of dependency between risks is taken into consideration during this analysis. For the final step, as the main purpose of this paper, a method for allocating appropriate contingency is presented. Two types of contingencies, i.e. project contingency and management reserve are proposed to accommodate the risks. An illustrative example is presented at the end to show the application of the methodology.

  1. ACR Appropriateness Criteria® Suspected Pulmonary Hypertension.

    Science.gov (United States)

    Sirajuddin, Arlene; Donnelly, Edwin F; Crabtree, Traves P; Henry, Travis S; Iannettoni, Mark D; Johnson, Geoffrey B; Kazerooni, Ella A; Maldonado, Fabien; Olsen, Kathryn M; Wu, Carol C; Mohammed, Tan-Lucien; Kanne, Jeffrey P

    2017-05-01

    Pulmonary hypertension may be idiopathic or related to a large variety of diseases. Various imaging examinations that may be helpful in diagnosing and determining the etiology of pulmonary hypertension are discussed. Imaging examinations that may aid in the diagnosis of pulmonary hypertension include chest radiography, ultrasound echocardiography, ventilation/perfusion scans, CT, MRI, right heart catheterization, pulmonary angiography, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia

    Science.gov (United States)

    Kabbara, Wissam K; Ramadan, Wijdan H; Rahbany, Peggy; Al-Natour, Souhaila

    2015-01-01

    Background Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged. Objective The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia) in diabetic and nondiabetic patients. Methods A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin) were identified. Patients were mainly recruited from internal medicine floors and intensive care units. Results The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%), followed by levofloxacin (42.4%) and moxifloxacin (7.6%). Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%), followed by ciprofloxacin (39.0%) and moxifloxacin (33.3%). In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was more common with moxifloxacin (11.1%) and levofloxacin (6.0%). Conclusion The major clinical interventions for the future will adjust the dose and duration of therapy with commonly prescribed fluoroquinolones. The incidence of hypoglycemia was less common than hyperglycemia. PMID:25960658

  3. United States Marine Corps 2012 Financial Report. Schedule of Budgetary Activity for Fiscal Year 2012 Appropriations

    Science.gov (United States)

    2012-01-01

    risk of potential misstatement at the financial reporting level. Business feeder systems owned by others are under their control and responsibility...deficiencies, in internal control such that then~ is a r·easonahle possihility that a material misstatement of the entity’s financial statements will not be...Although new controls have been implemented, they are not occurring In a consistent and timely manner to detect or correct misstatements of expenses

  4. An Evaluation of Industry Relationships Among Contributors to AAOS Clinical Practice Guidelines and Appropriate Use Criteria.

    Science.gov (United States)

    Checketts, Jake X; Cook, Courtney; Vassar, Matt

    2018-01-17

    A long-standing relationship between orthopaedic surgeons and industry has made financial conflicts of interest a concerning issue. Research supports that financial conflicts of interest can influence both medical research and clinical practice. Financial conflicts of interest may also influence clinical practice guideline recommendations and their corresponding appropriate use criteria. Because of the influential nature of these guidelines, it is imperative that care be taken to minimize bias during guideline development. We retrieved clinical practice guidelines and their corresponding appropriate use criteria from the American Academy of Orthopaedic Surgery that were published or revised between 2013 and 2016. We extracted industry payments received by physicians using the Centers for Medicare & Medicaid Services Open Payments database. We then evaluated the value and types of these payments. We also used these data to determine whether disclosure statements were accurate and whether guideline development was in adherence with the Institute of Medicine's (IOM's) standards. Of the 106 physicians that were evaluated, 85 (80%) received at least 1 industry payment, 56 (53%) accepted >$1,000, and 35 (33%) accepted >$10,000. Financial payments amounted to a mean of $93,512 per physician. Total reimbursement for the 85 clinical practice guideline and appropriate use criteria contributors was $9,912,309. We found that disclosure statements disagreed with the Open Payments data and that the IOM standards were not completely enforced. Clinical practice guideline and appropriate use criteria contributors received substantial payments from industry, many disclosure statements were inaccurate, and the IOM standards were not completely met. Clinical practice guidelines and appropriate use criteria are critical for practicing evidence-based medicine. If financial conflicts of interest are present during their development, it is possible that patient care may be compromised.

  5. [Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital].

    Science.gov (United States)

    López-Picazo Ferrer, J J; Tomás García, N; Cubillana Herrero, J D; Gómez Company, J A; de Dios Cánovas García, J

    2014-01-01

    To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level («A» to «D») increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. There were 22.4±6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. AEP is useful to assess the admission appropriateness and may be included in the «Emergencies» process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  6. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  7. Total neutron cross section of lead

    International Nuclear Information System (INIS)

    Kanda, K.; Aizawa, O.

    1976-01-01

    The total thermal-neutron cross section of natural lead under various physical conditions was measured by the transmission method. It became clear that the total cross section at room temperature previously reported is lower than the present data. The total cross section at 400, 500, and 600 0 C, above the melting point of lead, 327 0 C, was also measured, and the changes in the cross section as a function of temperature were examined, especially near and below the melting point. The data obtained for the randomly oriented polycrystalline state at room temperature were in reasonable agreement with the theoretical values calculated by the THRUSH and UNCLE-TOM codes

  8. A combined method to estimate the appropriate age value of closed uraniun-lead system

    International Nuclear Information System (INIS)

    Malakhov, S.S.

    1982-01-01

    A new method is proposed for obtaining the appropriate age values of closed uranium-lead systems taking into account total indeependent information delivered as a result of spectral and isotope-lead analyses. A simple mathematical apparatus which permits to perform a geochronological interpretation of samples using miniature computers is considered and suggested. A simple estimation formula for determining the age of uranium-lead systems under the assumption of model development of isotope ratios of ordinary lead is derived and tested basing on the facts

  9. ACR Appropriateness Criteria Assessment of Fetal Well-Being.

    Science.gov (United States)

    Simpson, Lynn; Khati, Nadia J; Deshmukh, Sandeep P; Dudiak, Kika M; Harisinghani, Mukesh G; Henrichsen, Tara L; Meyer, Benjamin J; Nyberg, David A; Poder, Liina; Shipp, Thomas D; Zelop, Carolyn M; Glanc, Phyllis

    2016-12-01

    Although there is limited evidence that antepartum testing decreases the risk for fetal death in low-risk pregnancies, women with high-risk factors for stillbirth should undergo antenatal fetal surveillance. The strongest evidence supporting antepartum testing pertains to pregnancies complicated by intrauterine fetal growth restriction secondary to uteroplacental insufficiency. The main ultrasound-based modalities to determine fetal health are the biophysical profile, modified biophysical profile, and duplex Doppler velocimetry. In patients at risk for cardiovascular compromise, fetal echocardiography may also be indicated to ensure fetal well-being. Although no single antenatal test has been shown to be superior, all have high negative predictive values. Weekly or twice-weekly fetal testing has become the standard practice in high-risk pregnancies. The timing for the initiation of assessments of fetal well-being should be tailored on the basis of the risk for stillbirth and the likelihood of survival with intervention. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. ACR Appropriateness Criteria® First Trimester Vaginal Bleeding.

    Science.gov (United States)

    Brown, Douglas L; Packard, Ann; Maturen, Katherine E; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara L; Meyer, Benjamin J; Poder, Liina; Sadowski, Elizabeth A; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M; Glanc, Phyllis

    2018-05-01

    Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention. Less common causes of first trimester vaginal bleeding include gestational trophoblastic disease and arteriovenous malformations. Pulsed methods of Doppler US should generally be avoided in the first trimester when there is a normal, or a potentially normal, IUP. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as retained products of conception or arteriovenous malformations are suspected. MRI may occasionally be helpful as a problem-solving tool. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Trends in metformin utilisation and dose appropriateness in Australia.

    Science.gov (United States)

    Moon, J; Kumar, S S; Graham, G G; Baysari, M T; Williams, K M; Chen, W; Viardot, A; Greenfield, J R; Day, R O

    2016-12-01

    The study aimed to (1) determine the trends in the utilisation of metformin in Australia, (2) determine the appropriateness of metformin dosing in an Australian teaching hospital and (3) gather the opinions of prescribers on the relationship between metformin dose and renal function. National prescription data between 1990 and 2012 were accessed. A retrospective audit (2008-2012) of metformin doses and patient renal function (20 % random sample of all in-patients prescribed metformin) was conducted at St Vincent's Hospital (SVH), Sydney. Prescribers of metformin were interviewed (semi-structured; consultants at SVH) or surveyed (Australian endocrinologists) to gather their understanding of metformin dosing in relation to renal function. Metformin utilisation increased fivefold nationally between 1995 and 2012. Metformin tended to be under-dosed in SVH patients with normal renal function (83.5 %) and over-dosed in patients with impaired renal function (estimated glomerular filtration rate (eGFR) metformin doses needed to be reduced in renal impairment. Most endocrinologists (61 %) were comfortable prescribing metformin down to eGFRs around 30 mL/min. The use of metformin increased greatly over the period of the study. Metformin is prescribed frequently for patients with eGFR values below the minimal level approved in the product label (60 mL/min). While prescribers expressed their understanding of the need to reduce metformin doses in patients with renal impairment, we found that metformin doses were higher than appropriate in patients with impaired renal function. Metformin may be used safely when renal function is poor provided dosage is appropriately reduced.

  12. ACR Appropriateness Criteria® Breast Cancer Screening.

    Science.gov (United States)

    Mainiero, Martha B; Moy, Linda; Baron, Paul; Didwania, Aarati D; diFlorio, Roberta M; Green, Edward D; Heller, Samantha L; Holbrook, Anna I; Lee, Su-Ju; Lewin, Alana A; Lourenco, Ana P; Nance, Kara J; Niell, Bethany L; Slanetz, Priscilla J; Stuckey, Ashley R; Vincoff, Nina S; Weinstein, Susan P; Yepes, Monica M; Newell, Mary S

    2017-11-01

    Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. APpropriAteness of percutaneous Coronary interventions in patients with ischaemic HEart disease in Italy: the APACHE pilot study

    Science.gov (United States)

    Marino, Marcello; Crimi, Gabriele; Maiorana, Florinda; Rizzotti, Diego; Lettieri, Corrado; Bettari, Luca; Zuccari, Marco; Sganzerla, Paolo; Tresoldi, Simone; Adamo, Marianna; Ghiringhelli, Sergio; Sponzilli, Carlo; Pasquetto, Giampaolo; Pavei, Andrea; Pedon, Luigi; Bassan, Luciano; Bollati, Mario; Camisasca, Paola; Trabattoni, Daniela; Brancati, Marta; Poli, Arnaldo; Panciroli, Claudio; Lettino, Maddalena; Tarelli, Giuseppe; Tarantini, Giuseppe; De Luca, Leonardo; Varbella, Ferdinando; Musumeci, Giuseppe; De Servi, Stefano

    2017-01-01

    Objectives To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. Design Retrospective, pilot study. Setting 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. Participants 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics. Primary and secondary outcome measures Proportion of patients who received appropriate PCI using validated appropriate use scores (ie, AUS≥7). Also, in patients with stable CAD, we examined adherence to the following European Society of Cardiology recommendations: (A) per cent of patients with complex coronary anatomy treated after heart team discussion; (B) per cent of fractional flow reserve-guided PCI for borderline stenoses in patients without documented ischaemia; (C) per cent of patients receiving guideline-directed medical therapy at the time of PCI as well as use of provocative test of ischaemia according to pretest probability (PTP) of CAD. Results Of the 401 mappable PCIs (91%), 38.7% (95% CI 33.9 to 43.6) were classified as appropriate, 47.6% (95% CI 42.7 to 52.6) as uncertain and 13.7% (95% CI 10.5% to 17.5%) as inappropriate. Median PTP in patients with stable CAD without known coronary anatomy was 69% (78% intermediate PTP, 22% high PTP). Ischaemia testing use was similar (p=0.71) in patients with intermediate (n=140, 63%) and with high PTP (n=40, 66%). In patients with stable CAD (n=352) guideline adherence to the three recommendations explored was: (A) 11%; (B) 25%; (C) 23%. AUS was higher in patients evaluated by the heart team as compared with patients who were not (7 (6.8) vs 5 (4.7); p=0.001). Conclusions Use of heart team approaches and adherence to guideline recommendations on coronary revascularisation in a real-world setting

  14. Appropriateness criteria of FDG PET/CT in oncology

    International Nuclear Information System (INIS)

    Agrawal, Archi; Rangarajan, Venkatesh

    2015-01-01

    18 Fluorine-2-fluoro-2-Deoxy-d-glucose ( 18 F-FDG) positron emission tomography/computerized tomography (PET/CT) is a well-established functional imaging method widely used in oncology. In this article, we have incorporated the various indications for 18 FDG PET/CT in oncology based on available evidence and current guidelines. Growing body of evidence for use of 18 FDG PET/CT in select tumors is also discussed. This article attempts to give the reader an overview of the appropriateness of using 18 F-FDG PET/CT in various malignancies

  15. The Subordinates in the Fictions of Appropriation of Minors

    OpenAIRE

    Souto, Luz Celestina

    2013-01-01

    the rol of the subordinates in the appropriation of children during the Argentinian Dictatorship has been questioned in several disciplines. However, are the works of  the writer Martín Kohan which have managed to tell the untold history in a very effective way by condensing it in the creation of a credible fictional world and, because of that, grinding. In Dos veces junio, as well as in Cuentas pendientes, the consequences of the banality of evil are obvious, since it represents the consensu...

  16. Appropriate Contrast Enhancement Measures for Brain and Breast Cancer Images

    Directory of Open Access Journals (Sweden)

    Suneet Gupta

    2016-01-01

    Full Text Available Medical imaging systems often produce images that require enhancement, such as improving the image contrast as they are poor in contrast. Therefore, they must be enhanced before they are examined by medical professionals. This is necessary for proper diagnosis and subsequent treatment. We do have various enhancement algorithms which enhance the medical images to different extents. We also have various quantitative metrics or measures which evaluate the quality of an image. This paper suggests the most appropriate measures for two of the medical images, namely, brain cancer images and breast cancer images.

  17. Understanding the Concept of Nationally Appropriate Mitigation Action

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept...... and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman’s terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA...

  18. The appropriate use of the emergengy department for paediatric patients

    OpenAIRE

    Benahmed, Nadia; Laokri, Samia; Zhang, Wei Hong; Cohen, Laurent; Karlin, Sophie; De Wever, Alain

    2011-01-01

    Objective: To determine the factors associated with paediatric inappropriate use (IU) of the accident and emergency department (A&E). Method: An observational prospective survey was performed. All the patients (< 16 years) attending A&E in 12 Belgian hospitals during 2 weeks in 2010 were included. The use of A&E was considered appropriate if, at least, one of the following criteria was met: child referred by a doctor or the police, brought by ambulance, need for a short stay, need for technic...

  19. What is "appropriate" for school-aged children with autism?

    Science.gov (United States)

    Conroy, Tim; Conroy, Terrye

    2006-10-01

    Compliance with the IDEA and S.C. Board of Education procedures is only the first step toward providing a student with autism with an IEP that is reasonably calculated to enable that student to receive educational benefits--a FAPE. At the heart of the IEP process is instruction specially designed to meet the unique needs, talents, and experiences of each child. While disagreements over the appropriateness of the IEP, including the methodologies used to provide such instruction, may arise, it is through the successful collaboration of parents, health care providers, and school professionals that a child with autism will develop into an adult with a life of community and meaning.

  20. Attenuated Total Reflection Fourier Transform Infrared (ATR FT-IR) Spectroscopy as a Forensic Method to Determine the Composition of Inks Used to Print the United States One-cent Blue Benjamin Franklin Postage Stamps of the 19th Century.

    Science.gov (United States)

    Brittain, Harry G

    2016-01-01

    Through the combined use of infrared (IR) absorption spectroscopy and attenuated total reflectance (ATR) sampling, the composition of inks used to print the many different types of one-cent Benjamin Franklin stamps of the 19th century has been established. This information permits a historical evaluation of the formulations used at various times, and also facilitates the differentiation of the various stamps from each other. In two instances, the ink composition permits the unambiguous identification of stamps whose appearance is identical, and which (until now) have only been differentiated through estimates of the degree of hardness or softness of the stamp paper, or through the presence or absence of a watermark in the paper. In these instances, the use of ATR Fourier transform infrared spectroscopy (FT-IR) spectroscopy effectively renders irrelevant two 100-year-old practices of stamp identification. Furthermore, since the use of ATR sampling makes it possible to obtain the spectrum of a stamp still attached to its cover, it is no longer necessary to identify these blue Franklin stamps using their cancellation dates. © The Author(s) 2015.

  1. scaphoid dimensions and appropriate screw sizes in a kenyan

    African Journals Online (AJOL)

    There were no side to side differences in the total length or the distal pole. Conclusion: Scaphoid screws .... gender differences in prehension may contribute to .... differences between males and females. Sports. Med Arthroscopy Review. 2002 ...

  2. Ground-fire effects on the composition of dissolved and total organic matter in forest floor and soil solutions from Scots pine forests in Germany: new insights from solid state 13C NMR analysis

    Science.gov (United States)

    Näthe, Kerstin; Michalzik, Beate; Levia, Delphis; Steffens, Markus

    2016-04-01

    Fires represent an ecosystem disturbance and are recognized to seriously pertubate the nutrient budgets of forested ecosystems. While the effects of fires on chemical, biological, and physical soil properties have been intensively studied, especially in Mediterranean areas and North America, few investigations examined the effects of fire-induced alterations in the water-bound fluxes and the chemical composition of dissolved and particulate organic carbon and nitrogen (DOC, POC, DN, PN). The exclusion of the particulate organic matter fraction (0.45 μm Independent from fire manipulation, the composition of TOM was generally less aromatic (aromaticity index [%] according to Hatcher et al., 1981) with values between 18 (FF) - 25% (B horizon) than the DOM fraction with 23 (FF) - 27% (B horizon). For DOM in FF solution, fire manipulation caused an increase in aromaticity from 23 to 27% compared to the control, due to an increase of the aryl-C and a decrease of the O-alkyl-C and alkyl-C signal. Fire effects were leveled out in the mineral soil. For TOM, fire effects became notable only in the A horizon, exhibiting a decrease in aromaticity from 22 to 18% compared to the control, due to increased O-alkyl-C and diminished aryl-C proportions. Compared to the control, fire only caused minor DOC release rates (events did not significantly enhance the proportion of POC and PN in the total C and N amounts exhibiting values between 10 and 20%. To fully understand the quality and amount of translocated organic C and N compounds within soils under both ambient as well as fire environments, dissolved and particulate size fractions need to be considered.

  3. The influence of the solid waste disposal areas in Campinas city, Sao Paulo state (Brazil) on water quality: determination of metals using synchrotron radiation total reflection X-ray fluorescence

    International Nuclear Information System (INIS)

    Oliveira, Bruna F.F.; Moreira, Silvana; Canteras, Felippe Benavente

    2013-01-01

    Among the many forms of waste disposal, landfills today are best suited to Brazilian conditions, this because their construction allows minimizing the negative effects of landfill gas and slurry produced. However, the confinement of pollutants from landfills is linked to its construction and operation and when the construction and/or is wrong they can endanger air, groundwater and surface waters qualities. Thus, the main objective of this study was to analyze the concentration of heavy metals in samples of groundwater, surface water and slurry coming from solid waste disposal locations in the city of Campinas, SP - Delta, Santa Barbara and Pirelli Landfills. The samples were analyzed at the Brazilian Synchrotron Light Laboratory using Synchrotron Radiation Total Reflection X-Ray Fluorescence technique (SR-TXRF). In Pirelli Landfill, the highest concentrations were observed in one of the wells located to downstream of the Landfill (in relation to the groundwater flux) - the monitoring well PM04, exceeding the intervention value defined by CETESB. For Santa Barbara landfill in one upstream monitoring well the concentrations of Ni, Mn, Pb and Cr, surpassed the maximum permissive values. The manganese in Landfill Delta showed to be higher in wells located downstream and 50% of the wells analyzed exceeded the maximum permissive value for groundwater samples. In the case of surface waters located in the vicinity of landfill sites, the metals that surpassed the maximum permissive values according the legislation in most of the points analyzed were Mn, Cu and Pb. For slurry samples collected in Delta Landfill, the average concentrations for Mn, Ni, Cu and Pb not exceeded the maximum permissive values during the period studied. Moreover for Santa Barbara the average concentration of Mn, Cu and Zn surpassed the permissive limits, as was observed for Mn in the Pirelli Landfill. (author)

  4. Hiring appropriate providers for different populations: acute care nurse practitioners.

    Science.gov (United States)

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

  5. Diverse structural approaches to haem appropriation by pathogenic bacteria.

    Science.gov (United States)

    Hare, Stephen A

    2017-04-01

    The critical need for iron presents a challenge for pathogenic bacteria that must survive in an environment bereft of accessible iron due to a natural low bioavailability and their host's nutritional immunity. Appropriating haem, either direct from host haemoproteins or by secreting haem-scavenging haemophores, is one way pathogenic bacteria can overcome this challenge. After capturing their target, haem appropriation systems must remove haem from a high-affinity binding site (on the host haemoprotein or bacterial haemophore) and transfer it to a binding site of lower affinity on a bacterial receptor. Structural information is now available to show how, using a combination of induced structural changes and steric clashes, bacteria are able to extract haem from haemophores, haemopexin and haemoglobin. This review focuses on structural descriptions of these bacterial haem acquisition systems, summarising how they bind haem and their target haemoproteins with particularly emphasis on the mechanism of haem extraction. Copyright © 2017 The Author. Published by Elsevier B.V. All rights reserved.

  6. Appropriate methodologies for empirical bioethics: it's all relative.

    Science.gov (United States)

    Ives, Jonathan; Draper, Heather

    2009-05-01

    In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached.

  7. HOW TO SELECT APPROPRIATE STATISTICAL TEST IN SCIENTIFIC ARTICLES

    Directory of Open Access Journals (Sweden)

    Vladimir TRAJKOVSKI

    2016-09-01

    Full Text Available Statistics is mathematical science dealing with the collection, analysis, interpretation, and presentation of masses of numerical data in order to draw relevant conclusions. Statistics is a form of mathematical analysis that uses quantified models, representations and synopses for a given set of experimental data or real-life studies. The students and young researchers in biomedical sciences and in special education and rehabilitation often declare that they have chosen to enroll that study program because they have lack of knowledge or interest in mathematics. This is a sad statement, but there is much truth in it. The aim of this editorial is to help young researchers to select statistics or statistical techniques and statistical software appropriate for the purposes and conditions of a particular analysis. The most important statistical tests are reviewed in the article. Knowing how to choose right statistical test is an important asset and decision in the research data processing and in the writing of scientific papers. Young researchers and authors should know how to choose and how to use statistical methods. The competent researcher will need knowledge in statistical procedures. That might include an introductory statistics course, and it most certainly includes using a good statistics textbook. For this purpose, there is need to return of Statistics mandatory subject in the curriculum of the Institute of Special Education and Rehabilitation at Faculty of Philosophy in Skopje. Young researchers have a need of additional courses in statistics. They need to train themselves to use statistical software on appropriate way.

  8. Bounded authority: Expanding "appropriate" police behavior beyond procedural justice.

    Science.gov (United States)

    Trinkner, Rick; Jackson, Jonathan; Tyler, Tom R

    2018-06-01

    This paper expands previous conceptualizations of appropriate police behavior beyond procedural justice. The focus of the current study is on the notion of bounded authority-that is, acting within the limits of one's rightful authority. According to work on legal socialization, U.S. citizens come to acquire three dimensions of values that determine how authorities ought to behave: (a) neutral, consistent, and transparent decision-making; (b) interpersonal treatment that conveys respect, dignity, and concern; and (c) respecting the limits of one's rightful power. Using survey data from a nationally representative sample of U.S. adults, we show that concerns over bounded authority, respectful treatment, and neutral decision-making combine to form a strong predictor of police and legal legitimacy. We also find that legal legitimacy is associated with greater compliance behavior, controlling for personal morality and perceived likelihood of sanctions. We discuss the implications of a boundary perspective with respect to ongoing debates over the appropriate scope of police power and the utility of concentrated police activities. We also highlight the need for further research specifically focused on the psychological mechanisms underlying the formation of boundaries and why they shape the legitimacy of the police and law. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Appropriateness of lumbar spine magnetic resonance imaging in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, Francisco M. [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Research Department, Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Arana, Estanislao, E-mail: aranae@uv.es [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Servicio de Radiología, Fundación Instituto Valenciano de Oncología, Valencia (Spain); Fundación Instituto de Investigación en Servicios de Salud, Valencia (Spain); Royuela, Ana [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); CIBER Epidemiología y Salud Pública (CIBERESP) (Spain); Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, IRYCIS, Ctra. Colmenar Km. 9.1, 28034 Madrid (Spain); Cabrera, Alberto [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao, Vizcaya (Spain); Casillas, Carlos [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Instituto de Traumatología Unión de Mutuas, Av. del Lledó, C/Juan de Herrera, 27 12004 Castellón (Spain); and others

    2013-06-15

    Objectives: To determine the minimum percentage of lumbar spine magnetic resonance imaging (LSMRI) which are inappropriately prescribed in routine practice. Methods: LSMRI performed prospectively on 602 patients in 12 Radiology Services across 6 regions in Spain, were classified as “appropriate”, “uncertain” or “inappropriate” based on the indication criteria established by the National Institute for Clinical Excellence, the American College of Physicians and Radiology, and current evidence-based clinical guidelines. Studies on patients reporting at least one “red flag” were classified as “appropriate”. A logistic regression model was developed to identify factors associated with a higher likelihood of inappropriate LSMRI, including gender, reporting of referred pain, health care setting (private/public), and specialty of prescribing physician. Before performing the LSMRI, the radiologists also assessed the appropriateness of the prescription. Results: Eighty-eight percent of LSMRI were appropriate, 1.3% uncertain and 10.6% inappropriate. The agreement of radiologists’ assessment with this classification was substantial (k = 0.62). The odds that LSMRI prescriptions were inappropriate were higher for patients without referred pain [OR (CI 95%): 13.75 (6.72; 28.16)], seen in private practice [2.25 (1.20; 4.22)], by orthopedic surgeons, neurosurgeons or primary care physicians [2.50 (1.15; 5.56)]. Conclusion: Efficiency of LSMRI could be improved in routine practice, without worsening clinical outcomes.

  10. Classifying decommissioning wastes for allocation to appropriate final repositories

    International Nuclear Information System (INIS)

    Alder, J.C.; Tunaboylu, K.

    1982-01-01

    For the safe disposal of radioactive wastes in different repositories, it is of advantage to classify them in well-defined conditioned categories, appropriate for final disposal. These categories, the so-called waste sorts are characterized by similar radionuclide distribution, similar nuclide-specific activity concentrations and similar waste matrix. A methodology is presented for classifying decommissioning wastes and is applied to the decommissioning wastes arising from a Swiss program of 6 GWe. The amounts and nuclide-specific activity inventories of the decommissioning waste sorts have been estimated. A first allocation into two different repository types has been performed. Such a classification enables one to define the source parameters for repository safety analysis and allows one to allocate the different waste categories into appropriate final repositories. This work presents a first iteration to determine which waste sorts belong to which repository type. The characteristics of waste sorts have to be better defined and the protective strength of the repository barriers has to be optimized. 7 references, 2 figures, 4 tables

  11. Natura 2000 appropriate assessment: Shortcomings and improvements in Finnish practice

    International Nuclear Information System (INIS)

    Soederman, Tara

    2009-01-01

    The EU Habitats Directive 92/43/EEC requires impact assessments called Appropriate Assessments (AA) for plans and projects probably having adverse effects on the sites of European ecological importance, Natura 2000 sites. Seventy-three Appropriate Assessment reports and seventy official opinions given on them by regional environmental authorities from 1997 to 2005 were reviewed. The findings of the study demonstrate typical shortcomings of ecological impact assessment: a weak information basis for assessment outcomes and lack of proper cumulative impact assessment with respect to ecological structures and processes. The quality of reporting has improved over time with respect to direct impacts on individual habitat types and species and detailed mitigation measures. Regional environment centres considered one fifth of the AA reports to be inadequate because of lacking data. In most cases the regional environment centres demanded a change of plan or project, added mitigation measures, choice of only one alternative for further planning or a new completed assessment with additional information in order to be able to evaluate the significance of the effects. The study underlines the need for iterative planning practices in which the preparation of a plan or project with alternative options goes hand in hand with the impact assessment equipped with sufficient data

  12. Appropriating religion: understanding religion as an object of science

    Directory of Open Access Journals (Sweden)

    Donald Wiebe

    1999-01-01

    Full Text Available In this paper, the author focuses on the study of religion as a scientific project, for it is the scientific interest in religion which has constituted the grounds for admitting the study of religion into the curriculum of the modern Western university. Despite that academic legitimation, however, the study of religion in the setting of the modern research university is not held in high esteem relative to the other sciences. It if the scientific study of religion is to be legitimately ensconced in the modern research university, the notion of religion will have to be wholly appropriated by science; only then will we be able to establish a conceptual foundation from which to make valid knowledge claims about religion on a level commensurate with the pronouncements of the natural and social sciences. Indeed, to go one step further, given the hold on the concept of religion by those committed to the humanistic study of religion, we might need to talk here not of the appropriation but of expropriation of religion by science—that is, of wresting ownership of the concept from the humanists by using it solely as a taxonomic device to differentiate and explain a peculiar range of human behaviour demonstrated in religious practices.

  13. Appropriateness of lumbar spine magnetic resonance imaging in Spain

    International Nuclear Information System (INIS)

    Kovacs, Francisco M.; Arana, Estanislao; Royuela, Ana; Cabrera, Alberto; Casillas, Carlos

    2013-01-01

    Objectives: To determine the minimum percentage of lumbar spine magnetic resonance imaging (LSMRI) which are inappropriately prescribed in routine practice. Methods: LSMRI performed prospectively on 602 patients in 12 Radiology Services across 6 regions in Spain, were classified as “appropriate”, “uncertain” or “inappropriate” based on the indication criteria established by the National Institute for Clinical Excellence, the American College of Physicians and Radiology, and current evidence-based clinical guidelines. Studies on patients reporting at least one “red flag” were classified as “appropriate”. A logistic regression model was developed to identify factors associated with a higher likelihood of inappropriate LSMRI, including gender, reporting of referred pain, health care setting (private/public), and specialty of prescribing physician. Before performing the LSMRI, the radiologists also assessed the appropriateness of the prescription. Results: Eighty-eight percent of LSMRI were appropriate, 1.3% uncertain and 10.6% inappropriate. The agreement of radiologists’ assessment with this classification was substantial (k = 0.62). The odds that LSMRI prescriptions were inappropriate were higher for patients without referred pain [OR (CI 95%): 13.75 (6.72; 28.16)], seen in private practice [2.25 (1.20; 4.22)], by orthopedic surgeons, neurosurgeons or primary care physicians [2.50 (1.15; 5.56)]. Conclusion: Efficiency of LSMRI could be improved in routine practice, without worsening clinical outcomes

  14. Choosing Appropriate Theories for Understanding Hospital Reporting of Adverse Drug Events, a Theoretical Domains Framework Approach.

    Science.gov (United States)

    Shalviri, Gloria; Yazdizadeh, Bahareh; Mirbaha, Fariba; Gholami, Kheirollah; Majdzadeh, Reza

    2018-01-01

    Adverse drug events (ADEs) may cause serious injuries including death. Spontaneous reporting of ADEs plays a great role in detection and prevention of them; however, underreporting always exists. Although several interventions have been utilized to solve this problem, they are mainly based on experience and the rationale for choosing them has no theoretical base. The vast variety of behavioural theories makes it difficult to choose appropriate theory. Theoretical domains framework (TDF) is suggested as a solution. The objective of this study was to select the best theory for evaluating ADE reporting in hospitals based on TDF. We carried out three focus group discussions with hospital pharmacists and nurses, based on TDF questions. The analysis was performed through five steps including coding discussions transcript, extracting beliefs, selecting relevant domains, matching related constructs to the extracted beliefs, and determining the appropriate theories in each domain. The theory with the highest number of matched domains and constructs was selected as the theory of choice. A total of six domains were identified relevant to ADE reporting, including "Knowledge", "Skills", "Beliefs about consequences", "Motivation and goals", "Environmental context and resources" and "Social influences". We found theory of planned behavior as the comprehensive theory to study factors influencing ADE reporting in hospitals, since it was relevant theory in five out of six relevant domains and the common theory in 55 out of 75 identified beliefs. In conclusion, we suggest theory of planned behavior for further studies on designing appropriate interventions to increase ADE reporting in hospitals.

  15. Coordinating Council. Ninth Meeting: Total Quality Management

    Science.gov (United States)

    1992-01-01

    This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

  16. Multicultural Leadership, Sustainable Total School Environment

    Science.gov (United States)

    Yeung, See-Wai Alison; Lee, Yeung; Yue, K. W. Ryan

    2006-01-01

    Banks (2002) stated that to implement multicultural education successfully, we must think of the school as a social system. Therefore, if educational equity and excellence are to be provided to all students, a systemic Total School Environment [Banks (2001) "Cultural diversity and education: Foundations curriculum and teaching, 4th ed." Allyn and…

  17. Improving the radiologist–CAD interaction: designing for appropriate trust

    International Nuclear Information System (INIS)

    Jorritsma, W.; Cnossen, F.; Ooijen, P.M.A. van

    2015-01-01

    Computer-aided diagnosis (CAD) has great potential to improve radiologists' diagnostic performance. However, the reported performance of the radiologist–CAD team is lower than what might be expected based on the performance of the radiologist and the CAD system in isolation. This indicates that the interaction between radiologists and the CAD system is not optimal. An important factor in the interaction between humans and automated aids (such as CAD) is trust. Suboptimal performance of the human–automation team is often caused by an inappropriate level of trust in the automation. In this review, we examine the role of trust in the radiologist–CAD interaction and suggest ways to improve the output of the CAD system so that it allows radiologists to calibrate their trust in the CAD system more effectively. Observer studies of the CAD systems show that radiologists often have an inappropriate level of trust in the CAD system. They sometimes under-trust CAD, thereby reducing its potential benefits, and sometimes over-trust it, leading to diagnostic errors they would not have made without CAD. Based on the literature on trust in human–automation interaction and the results of CAD observer studies, we have identified four ways to improve the output of CAD so that it allows radiologists to form a more appropriate level of trust in CAD. Designing CAD systems for appropriate trust is important and can improve the performance of the radiologist–CAD team. Future CAD research and development should acknowledge the importance of the radiologist–CAD interaction, and specifically the role of trust therein, in order to create the perfect artificial partner for the radiologist. This review focuses on the role of trust in the radiologist–CAD interaction. The aim of the review is to encourage CAD developers to design for appropriate trust and thereby improve the performance of the radiologist–CAD team. - Highlights: • Radiologists often have an inappropriate

  18. Study on risk indicator for appropriate plant maintenance considering aging effect

    International Nuclear Information System (INIS)

    Mano, Akihiro; Yamaguchi, Akira; Takata, Takashi

    2014-01-01

    Since, nuclear power plants run for a long term and plant component may deteriorate due to aging, plant safety must be maintained through maintenance activities of components. The maintenance will become more important as the number of aged plant increases. In the planning of maintenance, one must select appropriate components and interval. In general, Fussell-Vesely importance (FV) and Risk Achievement Worth (RAW) are used as a risk indicator for the maintenance. A priority order of each component can be evaluated using those risk indicators at a certain condition. However, the influence of aging (time history) on the order cannot be estimated directly. In the paper, a change of conditional core damage probability (ΔCCDP) and a change of conditional containment failure probability (ΔCCFP) are proposed as additional indicators in which the aging effect is evaluated directly so as to determine the priority order. A simplified level one probabilistic risk assessment (PRA) has been carried out in order to investigate the change of the risk indicators by considering the change of a component failure probability due to aging. In the analyses, three conditions are assumed; base (original) state, aging state and further aging state without maintenance activities. It is demonstrated that the proposed indicator (ΔCCDP and ΔCCFP) reveals the aging effect of each component, while the change of the FV and RAW represent unrealistic behavior through the states. As a result, it is found that the ΔCCDP and ΔCCFP are superior to the others in terms of the ability to evaluate components appropriately in deteriorated (aging) states and take account of differences of deterioration behavior. It is also found that the priority order of the multiple-components maintenance at the same time can also be evaluated using the ΔCCDP and ΔCCFP. Additionally, a risk informed decision making based on the risk acceptance criteria can be discussed for the maintenance procedure using the

  19. Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

    Science.gov (United States)

    Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

    2010-06-01

    Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

  20. Pediatric Biopharmaceutical Classification System: Using Age-Appropriate Initial Gastric Volume.

    Science.gov (United States)

    Shawahna, Ramzi

    2016-05-01

    Development of optimized pediatric formulations for oral administration can be challenging, time consuming, and financially intensive process. Since its inception, the biopharmaceutical classification system (BCS) has facilitated the development of oral drug formulations destined for adults. At least theoretically, the BCS principles are applied also to pediatrics. A comprehensive age-appropriate BCS has not been fully developed. The objective of this work was to provisionally classify oral drugs listed on the latest World Health Organization's Essential Medicines List for Children into an age-appropriate BCS. A total of 38 orally administered drugs were included in this classification. Dose numbers were calculated using age-appropriate initial gastric volume for neonates, 6-month-old infants, and children aging 1 year through adulthood. Using age-appropriate initial gastric volume and British National Formulary age-specific dosing recommendations in the calculation of dose numbers, the solubility classes shifted from low to high in pediatric subpopulations of 12 years and older for amoxicillin, 5 years, 12 years and older for cephalexin, 9 years and older for chloramphenicol, 3-4 years, 9-11 and 15 years and older for diazepam, 18 years and older (adult) for doxycycline and erythromycin, 8 years and older for phenobarbital, 10 years and older for prednisolone, and 15 years and older for trimethoprim. Pediatric biopharmaceutics are not fully understood where several knowledge gaps have been recently emphasized. The current biowaiver criteria are not suitable for safe application in all pediatric populations.

  1. Appropriateness of mechanistic and non-mechanistic models for the application of ultrafiltration to mixed waste

    International Nuclear Information System (INIS)

    Foust, Henry; Ghosehajra, Malay

    2007-01-01

    This study asks two questions: (1) How appropriate is the use of a basic filtration equation to the application of ultrafiltration of mixed waste, and (2) How appropriate are non-parametric models for permeate rates (volumes)? To answer these questions, mechanistic and non-mechanistic approaches are developed for permeate rates and volumes associated with an ultrafiltration/mixed waste system in dia-filtration mode. The mechanistic approach is based on a filtration equation which states that t/V vs. V is a linear relationship. The coefficients associated with this linear regression are composed of physical/chemical parameters of the system and based the mass balance equation associated with the membrane and associated developing cake layer. For several sets of data, a high correlation is shown that supports the assertion that t/V vs. V is a linear relationship. It is also shown that non-mechanistic approaches, i.e., the use of regression models to are not appropriate. One models considered is Q(p) = a*ln(Cb)+b. Regression models are inappropriate because the scale-up from a bench scale (pilot scale) study to full-scale for permeate rates (volumes) is not simply the ratio of the two membrane surface areas. (authors)

  2. Technical rigidity and appropriate technology in less-developed countries

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, D J.C. [Univ. of Strathyclyde, England; McBain, N S; Solomon, R F

    1980-05-01

    The extent to which the use of capital-intensive methods in LDCs can properly be ascribed to the inherent rigidity of the factor proportions embodied in modern technology - rather than to distortions and aberrrations in the process of technology choice - is still a matter of considerable uncertainty after two decades of debate. In this study, an engineering-based index is developed to summarize the opportunities for, and barriers to, substitution of labor for capital in a wide range of industries. The index is used to compare the technology actually installed in manufacturing in Ghana, the Philippines, Turkey, and Malaysia with the feasible alternatives. The finding that opportunities for use of labor-intensive methods are to a large extent exploited is interpreted as casting doubt on the ability of even the most appropriate choice from currently feasible technologies to reduce unemployment significantly. 46 references, 5 figures, 6 tables.

  3. Appropriate electromagnetic techniques for imaging geothermal fracture zones

    Energy Technology Data Exchange (ETDEWEB)

    Groom, R; Walker, P [PetRos EiKon Incorporated, Ontario (Canada)

    1996-05-01

    Electromagnetic surface detection of fracture zones has often been approached by using the magnetotelluric method. This technique suffers greatly from the quantity and scale of the conductive inhomogeneities lying above the fracture zones. Additionally, it suffers from the inherent inability to focus the source on the target. There are no such source focusing capabilities in magnetotellurics. Accordingly, the quantity of magnetotelluric data required to resolve targets in such complex conditions can make the technique inefficient and insufficient from a cost perspective. When attempting to reveal a subsurface structure and image it, the basic physical responses at hand must be kept in mind, and the appropriate source must be utilized, which most effectively illuminates the target. A further advantage to controlled sources is that imaging techniques may be used to accentuate the response due to knowledge and control of the source.

  4. Determination of appropriate models and parameters for premixing calculations

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ik-Kyu; Kim, Jong-Hwan; Min, Beong-Tae; Hong, Seong-Wan

    2008-03-15

    The purpose of the present work is to use experiments that have been performed at Forschungszentrum Karlsruhe during about the last ten years for determining the most appropriate models and parameters for premixing calculations. The results of a QUEOS experiment are used to fix the parameters concerning heat transfer. The QUEOS experiments are especially suited for this purpose as they have been performed with small hot solid spheres. Therefore the area of heat exchange is known. With the heat transfer parameters fixed in this way, a PREMIX experiment is recalculated. These experiments have been performed with molten alumina (Al{sub 2}O{sub 3}) as a simulant of corium. Its initial temperature is 2600 K. With these experiments the models and parameters for jet and drop break-up are tested.

  5. Registered indians and tobacco taxation: a culturally-appropriate strategy?

    Science.gov (United States)

    Wardman, A E Dennis; Khan, Nadia A

    2005-01-01

    Taxation of tobacco is a widely-used strategy that prompts smoking cessation among adults and reduces cigarette consumption among continuing smokers. Registered Indian tobacco use prevalence is at least double that of the rest of Canadians and is in part due to the lower cost of tobacco products purchased on reserve by Registered Indians (RIs) as they are tax exempt. Although registered Indian communities have the ability to collect tax on tobacco products and direct the use of these revenues, this strategy is rarely utilized. Tobacco taxation could have substantial health and economic benefits to RI communities, but perhaps is not culturally-appropriate. In order to better support RI communities, governments and other organizations need to examine this policy instrument in the context of RI populations.

  6. Appropriate location of the nipple-areola complex in males.

    Science.gov (United States)

    Shulman, O; Badani, E; Wolf, Y; Hauben, D J

    2001-08-01

    Gynecomastia is a common deformity encountered by plastic surgeons. The appropriate location of the nipple-areola complex is a major determinant of the aesthetic success of the procedure. To study the natural location of the nipple-areola complex in the normally built male, 50 nonobese men with no evidence of gynecomastia and an average age of 27.9 years were examined. Three ratios were calculated and found to be relatively constant; they were the ratio between the height of the nipple and the height of the patient, the ratio between the distance between the nipples and chest circumference, and the ratio between the suprasternal notch-to-nipple distance and the height of the patient. Using these three parameters, a method of locating the nipple-areola complex on the male chest wall was devised. The method is advocated as a reliable, simple, and useful technique.

  7. An Assessment of Culturally Appropriate Design: A Malaysian University Context

    Directory of Open Access Journals (Sweden)

    Shamsul Arrieya Ariffin

    2018-03-01

    Full Text Available The growing popularity of mobile devices, together with the constant technological improvement of mobile websites and applications informed about the quality of the user interface design. However, the particularities of mobile devices require special attention in terms of their usability aspects, such as culture. Therefore, this study evaluated the use of culturally appropriate design guidelines for a mobile learning web site. The research methodology used comprised a survey from heuristic evaluation questionnaires with undergraduate students. This research captured the students’ experiences in using the MLearn website of Universiti Pendidikan Sultan Idris, Malaysia.  From the study, the lowest ranking is realistic error management at 3.5, and the highest is suitable content for local culture at 4.6.  This study affirmed that general usability and cultural principles in design are important for a usable mobile learning website system in a local university context.

  8. Determination of appropriate models and parameters for premixing calculations

    International Nuclear Information System (INIS)

    Park, Ik-Kyu; Kim, Jong-Hwan; Min, Beong-Tae; Hong, Seong-Wan

    2008-03-01

    The purpose of the present work is to use experiments that have been performed at Forschungszentrum Karlsruhe during about the last ten years for determining the most appropriate models and parameters for premixing calculations. The results of a QUEOS experiment are used to fix the parameters concerning heat transfer. The QUEOS experiments are especially suited for this purpose as they have been performed with small hot solid spheres. Therefore the area of heat exchange is known. With the heat transfer parameters fixed in this way, a PREMIX experiment is recalculated. These experiments have been performed with molten alumina (Al 2 O 3 ) as a simulant of corium. Its initial temperature is 2600 K. With these experiments the models and parameters for jet and drop break-up are tested

  9. Narrative Intertextuality: How Pacheco Appropriates The Go-Between

    Directory of Open Access Journals (Sweden)

    Jorge Alcázar

    2016-01-01

    Full Text Available This essay explores the role of rewriting in postmodern fiction, whether it goes under such names as appropriation, adaptation or the interaction between a hypotext and a hypertext. The core of the article is concerned with a minute comparison between H. P. Hartley’s novel The Go-Between (1953 and José Emilio Pacheco’s Las batallas en el desierto (1981. Similarities such as the role of a child/adult narrator, his infatuation with a mature woman, the traumatic experience it entails, how a distant past is recreated, the clash of opposite social classes, the narrative thematics of music, as well as other minor details are brought to the fore.

  10. Cultural Appropriations; Ethnic-Racial Representations; Black Press

    Directory of Open Access Journals (Sweden)

    Maria Angélica Zubaran

    2015-12-01

    Full Text Available This paper investigates the exchange and circulation of ideas in the black diaspora, particularly in the newspaper The Example, mapping and discussing the ethnic-racial and gender representations constructed in the narratives produced by the editors of this newspaper, during the campaign for the construction of a monument to the “Black Mother”. The aim is to analyze how the newspaper’s editors have appropriated texts that circulated in other newspapers about the campaign to the monument of the “Black Mother”, adapted them to their own interests and given them new meanings. From the theoretical approach of Cultural Studies, we understand the black press as a cultural artifact that not only informs but also produces discourses and representations that contribute to the formation of black subjectivities and identities.

  11. Determination of the appropriate energy policy for Turkey

    International Nuclear Information System (INIS)

    Ulutas, B.H.

    2005-01-01

    Energy is an inevitable necessity for human beings. But the energy source is predicted to be scarce in the coming years as a result of population growth. Therefore people prefer energy sources that are renewable, clean and cost effective. Unfortunately there is not a sole energy source to meet these demands. Determination of the appropriate energy policy problem with interactive criteria and alternatives can be viewed as a multiple criteria decision making (MCDM) problem within the context of the long range and strategic process. The analytic network process (ANO), one of MCDM methods, deals with the dependency and feedback that the problem has. The goal of this paper is to apply the ANP model to evaluate the alternative energy sources for the country. Finally when the results are discussed, it is apparent that the model can produce reasonable and applicable solutions for the case. (author)

  12. The importance of having an appropriate data segmentation (partitioning)

    CERN Document Server

    Dimitrov, Gancho; The ATLAS collaboration

    2014-01-01

    In this presentation will be shown real life examples from database applications in the ATLAS experiment @ LHC where we make use of many Oracle partitioning techniques available in Oracle 11g. With the broadly used range partitioning and its option of automatic interval partitioning we add our own logic in PLSQL for sustaining data sliding windows in order to enforce various data retention policies. We also make use of the reference partitioning in some use cases, however the most challenging was to segment the data of a large bookkeeping system which resulted in tens of thousands list partitions and list sub-partitions. Partition and sub-partition management, index strategy, statistics gathering and queries execution plan stability are important factors when choosing an appropriate for the use case data management model. The gained experience with all of those will be shared with the audience.

  13. The importance of applying an appropriate data partitioning

    CERN Document Server

    Dimitrov, Gancho; The ATLAS collaboration

    2015-01-01

    In this presentation are described specific technical solutions put in place in various database applications of the ATLAS experiment at LHC where we make use of several partitioning techniques available in Oracle 11g. With the broadly used range partitioning and its option of automatic interval partitioning we add our own logic in PLSQL procedures and scheduler jobs to sustain data sliding windows in order to enforce various data retention policies. We also make use of the new Oracle 11g reference partitioning in the ATLAS Nightly Build System to achieve uniform data segmentation. However the most challenging was to segment the data of the new ATLAS Distributed Data Management system, which resulted in tens of thousands list type partitions and sub-partitions. Partition and sub-partition management, index strategy, statistics gathering and queries execution plan stability are important factors when choosing an appropriate physical model for the application data management. The so-far accumulated knowledge wi...

  14. Solid state video cameras

    CERN Document Server

    Cristol, Y

    2013-01-01

    Solid State Video Cameras reviews the state of the art in the field of solid-state television cameras as compiled from patent literature. Organized into 10 chapters, the book begins with the basic array types of solid-state imagers and appropriate read-out circuits and methods. Documents relating to improvement of picture quality, such as spurious signal suppression, uniformity correction, or resolution enhancement, are also cited. The last part considerssolid-state color cameras.

  15. Appropriate use of the increment entropy for electrophysiological time series.

    Science.gov (United States)

    Liu, Xiaofeng; Wang, Xue; Zhou, Xu; Jiang, Aimin

    2018-04-01

    The increment entropy (IncrEn) is a new measure for quantifying the complexity of a time series. There are three critical parameters in the IncrEn calculation: N (length of the time series), m (dimensionality), and q (quantifying precision). However, the question of how to choose the most appropriate combination of IncrEn parameters for short datasets has not been extensively explored. The purpose of this research was to provide guidance on choosing suitable IncrEn parameters for short datasets by exploring the effects of varying the parameter values. We used simulated data, epileptic EEG data and cardiac interbeat (RR) data to investigate the effects of the parameters on the calculated IncrEn values. The results reveal that IncrEn is sensitive to changes in m, q and N for short datasets (N≤500). However, IncrEn reaches stability at a data length of N=1000 with m=2 and q=2, and for short datasets (N=100), it shows better relative consistency with 2≤m≤6 and 2≤q≤8 We suggest that the value of N should be no less than 100. To enable a clear distinction between different classes based on IncrEn, we recommend that m and q should take values between 2 and 4. With appropriate parameters, IncrEn enables the effective detection of complexity variations in physiological time series, suggesting that IncrEn should be useful for the analysis of physiological time series in clinical applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. A guide to public engagement and appropriate dispute resolution

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, C.

    2006-10-15

    This guide was developed to help oil and gas companies operating in British Columbia to understand what tools are available to them when entering a public engagement process. It describes the BC Oil and Gas Commission's (OGC's) expectations regarding public engagement and appropriate dispute resolutions (ADR) associated with applications for oil and gas exploration, development and production in the province. The OGC's comprehensive application review process is designed to balance environmental, economic and social factors. The public engagement process is intended to allow the public to express concerns about how proposed oil and gas operations may affect them. This document also emphasized the government's responsibility to consult with First Nations on their treaty rights. The guide presented key concepts and best practices in the public engagement process and explained how to engage participants before, during and after application decisions are made. The OGC may impose conditions on the applicant to mitigate concerns of the affected public. The concerns typically range from noise of oil and gas machinery; air pollution; concern for health and safety; traffic control; water quality; and, aesthetics. A table of possible mitigative measures to these concerns was presented to demonstrate some options that may be used by industry and the affected public in resolving issues related to oil and gas activities. The OGC promotes the independent resolution of concerns. However, if conflicts exist, the OGC encourages participants to use appropriate dispute resolution (ADR) to help resolve any differences. Although participation in ADR is voluntary, its use allows affected parties to gain a sense of ownership over the proceedings and outcomes. In addition to being less costly than legal proceedings, ADR can lead to win-win outcomes, improve relationships and lead to more routine applications for oil and gas activities. refs., tabs., figs.

  17. Encouraging appropriate, evidence-based use of oral nutritional supplements.

    Science.gov (United States)

    Stratton, Rebecca J; Elia, Marinos

    2010-11-01

    With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

  18. Male appropriation and medicalization of childbirth: an historical analysis.

    Science.gov (United States)

    Cahill, H A

    2001-02-01

    This paper aims to explore through historical analysis some of the means by which medicine successfully appropriated and medicalized pregnancy and childbirth and to consider the impact that this has had on women's experiences within maternity care. The appropriation and medicalization of pregnancy and childbirth by men are rooted in a patriarchal model that has been centuries in the making. A model that perceives women as essentially abnormal, as victims of their reproductive systems and hormones, it is also one that defines pregnancy as inherently pathological - a clinical crisis worthy of active intervention. In both law and medicine men have used their power to define reproduction as a biological defect (LeMoncheck L. 1996 Journal of Clinical Ethics 7, 160--176), requiring both legal regulation and medical intervention, whilst feminist writers have long argued that women's experiences within the health care system at least to some extent reflects their social position. Male justifications of female inferiority have been developed and nurtured through professional discourses and socialization processes inherent within medical education and practice (Cahill H. 1999 MA Thesis, University of Keele). These assumptions are internalized and reproduced to shape quite profoundly, the nature of doctors' interactions with women in their care. Perhaps more fundamentally, such discursive explanations of women's bodies as inherently defective continue to shape women's position in society. Maternity care is a key area in which women's ability to exercise real choice and make informed decisions is limited and where doctor-patient interactions are themselves constructions of existing gender orders; women's autonomy continues to be violated through both quite subtle and overt discourse and practice.

  19. Defining appropriate incentive levels: A review of theory and practice

    International Nuclear Information System (INIS)

    Parfett, R.S.; Lodola, J.C.

    1990-01-01

    The theoretical and practical aspects related to determining the incentive levels for demand-side management (DSM) programs are discussed. The theoretical aspects comprise the efficiency criteria, from a social point of view; the equity issue, or ensuring that no one pays higher rates as a result of conservation programs; and the method of recovering the customer's investment, or the implicit discount rate method. The study of these theoretical aspects takes into account the perspectives of all the concerned parties and focuses on the need to harmonize the efficiency criteria which are in opposition. From this process are derived general criteria for aiding program planners and managers to determine the incentive levels for their DSM programs. Past experience has shown that incentive levels cannot be determined in an isolated manner. Other characteristics affecting the carrying out of DSM programs will also have repercussions on the success rate. To determine the appropriate incentives, it is important to have a clear understanding of what the DSM program intends to achieve. Factors such as the market sector, the technology chosen, and demographic characteristics can influence all aspects of the design and implementation of the program, including the type and level of incentive offered. When the goals of the program are clearly established and the intended market is clearly determined, a strategy should be formed which will have the greatest chance of fulfilling the program objectives. The role of each element in the program must be well understood. It is only at this stage that it is possible to determine an appropriate level of incentive. 7 refs

  20. Visual Approach and Design: The Appropriate Characteristics of Instructional Photos as a Tool to Support Elementary Setting in Kuwait

    Science.gov (United States)

    Buhamad, Ali

    2016-01-01

    This study provided a guide for appropriate characteristics of Instructional Photo to be used by teachers, trainers, coaches, instructors, and anyone else who desires to deliver knowledge and present content with visual meaning to elementary students in the state of Kuwait as a teaching style that supports teachers, facilitates clarification, and…

  1. Choosing the Right Words: The Development of Guidelines for the Selection of the "Appropriate" Crisis-Response Strategies.

    Science.gov (United States)

    Coombs, W. Timothy

    1995-01-01

    States that although crisis management has evolved rapidly in the past decade, the symbolic aspect of crisis management has been ignored. Indicates little research has been done to examine the effects of crisis-response strategies to see how they shape public opinion. Presents a list of guidelines for appropriate use of a given strategy (based on…

  2. Appropriate use of medical imaging in two Spanish public hospitals: a cross-sectional analysis.

    Science.gov (United States)

    Vilar-Palop, Jorge; Hernandez-Aguado, Ildefonso; Pastor-Valero, María; Vilar, José; González-Alvarez, Isabel; Lumbreras, Blanca

    2018-03-16

    To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Cross-sectional retrospective study. Two Spanish public tertiary hospitals. 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient's clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on sociodemographic and clinical characteristics such as sex, age, referral physician and medical imaging test

  3. Imaging Total Stations - Modular and Integrated Concepts

    Science.gov (United States)

    Hauth, Stefan; Schlüter, Martin

    2010-05-01

    Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

  4. Physician Contacts and Their Influence on the Appropriateness of Pain Medication in Nursing Home Residents: A Cross-Sectional Study.

    Science.gov (United States)

    Flaig, Tanja Maria; Budnick, Andrea; Kuhnert, Ronny; Kreutz, Reinhold; Dräger, Dagmar

    2016-09-01

    This study assessed the frequency of physician contacts for individual nursing home residents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs. Observational cross-sectional study conducted between March 2009 and April 2010. Forty nursing homes in Berlin and Brandenburg, Germany. A total of 560 NHRs. The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model. The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056). Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  5. Carl Schmitt's attitude towards total war and total enemy on the eve of the outbreak of WWII

    Directory of Open Access Journals (Sweden)

    Molnar Aleksandar

    2010-01-01

    Full Text Available Carl Schmitt is usually perceived as the theorist of total state, total war and total hostility. In the article, the author however tries to show that from 1937 to 1944, Schmitt was arguing that total war and total hostility were dangerous for Germany (as well as for the rest of Europe and warned against perpetuation of all efforts to totalize enemy that started in 1914. In his theoretical endeavors in this period there was place for the total state only - and especially for the total state strong enough to resist temptation of declaring total war on total enemy. The total state he recommended Hitler and his Nazi comrades was German Reich, as a part of Europe ordered and divided in the huge spaces (Grossraumordnung. Positioned in the centre of Europe, between the rest of the powers (France, Italy, USSR as well as the Scandinavian states, Germany should be careful enough to wage war only against its Eastern enemies (Poland and maybe USSR and only in order to achieve 'just' borders. Occupying in this way its huge space Germany should devote itself to the task of exploitation of various peoples such as Poles, Chechs and Slovaks, which were perceived as incapable of having their states and doomed to serve the master race - the Germans.

  6. Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: Predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Candan, Ozkan; Gecmen, Cetin; Bayam, Emrah; Guner, Ahmet; Celik, Mehmet; Doğan, Cem

    2017-06-01

    In this study, we investigated whether mechanical dispersion which reflects electrical abnormality and other echocardiographic and clinic parameters predict appropriate ICD shock in patients undergone ICD implantation for hypertrophic cardiomyopathy. Sixty-three patients who received ICD implantation for primary or secondary prevention were included in the study. Patients' clinical, electrocardiographic, 2D classic, and speckle tracking echocardiographic data were collected. Mechanical dispersion was defined as the standard deviation of time to peak negative strain in 18 left ventricular segments. Appropriate ICD therapy was defined as cardioversion or defibrillation due to ventricular tachycardia or fibrillation. Patients were divided into two groups as occurrence or the absence of appropriate ICD therapy. A total of 17 (26.9%) patients were observed to have an appropriate ICD therapy during follow-up periods. In patients who performed appropriate ICD therapy, a larger left atrial volume index, higher sudden cardiac death (SCD)-Risk Score, longer mechanical dispersion, and decreased global longitudinal peak strain (GLPS) were observed. In multivariate logistic regression analysis, including (GLPS, mechanical dispersion, LAVi, and SCD-Risk Score) was used to determine independent predictors of occurrence of appropriate ICD therapy during the follow-up. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be independent predictors of occurrence of appropriate ICD therapy. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be predictive for appropriate ICD therapy in patients receiving ICD implantation. Readily measurable mechanical dispersion and GLPS could be helpful to distinguish patients at high risk who could optimally benefit from ICD therapy. © 2017, Wiley Periodicals, Inc.

  7. Is the DLQI appropriate for medical decision-making in psoriasis patients?

    Science.gov (United States)

    Poór, Adrienn Katalin; Brodszky, Valentin; Péntek, Márta; Gulácsi, László; Ruzsa, Gábor; Hidvégi, Bernadett; Holló, Péter; Kárpáti, Sarolta; Sárdy, Miklós; Rencz, Fanni

    2018-01-01

    Dermatology Life Quality Index (DLQI) is the most commonly applied measure of health-related quality of life (HRQoL) in psoriasis patients. It is among defining criteria of moderate-to-severe psoriasis and present in treatment guidelines. Our objective was to estimate preference-based HRQoL values (i.e., utilities) for hypothetical health states described by the 10 items of the DLQI in psoriasis patients. Moreover, we compare results to findings of a similar study previously conducted among the general public. A cross-sectional survey was carried out among 238 psoriasis patients. Seven hypothetical DLQI-defined health states with total scores of 6, 11, and 16 (3-3 and 1 states, respectively) were evaluated by time trade-off method. The difference in DLQI scores between hypothetical health states was set at 5 points, as it exceeds the minimal clinically important difference (MCID). Utility scores were found to be homogenous across the seven hypothetical health states (range of means for the 6-point states 0.85-0.91, range of means for the 11-point states 0.83-0.85, and mean of 0.84 for the 16-point state). Overall, mean utilities assessed by psoriasis patients were higher for all seven states compared with the general public (mean difference 0.16-0.28; p definition of moderate-to-severe disease and reconsideration of the DLQI in clinical assessment of psoriasis patients are suggested.

  8. Formal and informal appropriation mechanisms: the role of openness and innovativeness

    NARCIS (Netherlands)

    Zobel, Ann-Kristin; Lokshin, Boris; Hagedoorn, John

    2016-01-01

    This paper analyses how firms’ degree of openness and innovativeness influence their use of formal and informal appropriation mechanisms. Patents, trademarks, copyrights, and design rights are formal appropriation mechanisms. Secrecy, lead-time, and complexity are examples of informal appropriation

  9. Total robotic pancreaticoduodenectomy: a systematic review of the literature.

    Science.gov (United States)

    Kornaropoulos, Michail; Moris, Demetrios; Beal, Eliza W; Makris, Marinos C; Mitrousias, Apostolos; Petrou, Athanasios; Felekouras, Evangelos; Michalinos, Adamantios; Vailas, Michail; Schizas, Dimitrios; Papalampros, Alexandros

    2017-11-01

    Pancreaticoduodenectomy (PD) is a complex operation with high perioperative morbidity and mortality, even in the highest volume centers. Since the development of the robotic platform, the number of reports on robotic-assisted pancreatic surgery has been on the rise. This article reviews the current state of completely robotic PD. A systematic literature search was performed including studies published between January 2000 and July 2016 reporting PDs in which all procedural steps (dissection, resection and reconstruction) were performed robotically. Thirteen studies met the inclusion criteria, including a total of 738 patients. Data regarding perioperative outcomes such as operative time, blood loss, mortality, morbidity, conversion and oncologic outcomes were analyzed. No major differences were observed in mortality, morbidity and oncologic parameters, between robotic and non-robotic approaches. However, operative time was longer in robotic PD, whereas the estimated blood loss was lower. The conversion rate to laparotomy was 6.5-7.8%. Robotic PD is feasible and safe in high-volume institutions, where surgeons are experienced and medical staff are appropriately trained. Randomized controlled trials are required to further investigate outcomes of robotic PD. Additionally, cost analysis and data on long-term oncologic outcomes are needed to evaluate cost-effectiveness of the robotic approach in comparison with the open technique.

  10. Appropriate and Inappropriate Instructional Behaviors for International Training.

    Science.gov (United States)

    Burba, Fengjiao Ji; Petrosko, Joseph M.; Boyle, Mike A.

    2001-01-01

    Teacher behaviors were rated by 102 students from the United States, 142 from Asian cultures, and 73 from Western cultures (Canada, Europe). U.S. students rated clarity, enthusiasm, interaction, and spatial-behavioral communication more highly than Eastern students did. Western students rated all but spatial-behavioral communication more highly…

  11. Gorleben. Waste management site based on an appropriate selection procedure

    International Nuclear Information System (INIS)

    Tiggemann, Anselm

    2010-01-01

    On February 22, 1977, the Lower Saxony state government decided in favor of Gorleben as a ''preliminary'' site of a ''potential'' facility for managing the back end of the fuel cycle of the nuclear power plants in the Federal Republic of Germany. The Lower Saxony files, closed until recently, now allow both the factual basis and the political background to be reconstructed comprehensively. The first selection procedure, financed by the federal government, for the site of a ''nuclear waste management center,'' which had been conducted by Kernbrennstoff-Wiederaufarbeitungsgesellschaft (KEWA) in 1974, had not considered Gorleben in any detail. As early as in the winter of 1975/76, Gorleben and a number of other potential sites were indicated to KEWA by the Lower Saxony State Ministry of Economics. The new finding is KEWA's conclusion of 1976 that Gorleben surpassed all potential sites examined so far in terms of suitability. As a consequence, Gorleben was regarded as an alternative alongside the 3 sites favored before, i.e. Wahn, Lutterloh, and Lichtenhorst, when the 3 Federal Ministers, Hans Matthoefer (SPD), Werner Maihofer (F.D.P.), and Hans Friderichs (F.D.P.), discussed the nuclear waste management project with Minister President Albrecht (CDU) in November 1976. The Lower Saxony State Cabinet commissioned an interministerial working party (IMAK) to find other potential sites besides Wahn, Lutterloh, Lichtenhorst, and Gorleben. IMAK proposed Gorleben, Lichtenhorst, Mariaglueck, and Wahn for further examination. IMAK recommended to the State Cabinet in another proposal to earmark either Gorleben or Lichtenhorst. (orig.)

  12. 26 CFR 1.801-5 - Total reserves.

    Science.gov (United States)

    2010-04-01

    ... TAXES Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of... its highest aggregate reserve by taking State A's requirement of 10 against its life insurance business and adding it to State B's requirement of 7 against its annuity business. (b) Reserves required by...

  13. Defense: FY2017 Budget Request, Authorization, and Appropriations

    Science.gov (United States)

    2016-04-12

    adjusted the limits on defense and non-defense spending —each time adjusting only the limits for the two succeeding years. 13 Nevertheless, each of... employee hour worked . The Bureau of Labor Statistics reports the ECI which is computed from compensation cost data collected from a sample of jobs...with $9.6 billion in mandatory spending , brought the Administration’s total FY2017 National Defense budget request to $619.5 billion. In shaping the

  14. [Appropriateness of ketorolac use in a trauma hospital].

    Science.gov (United States)

    Angeles González-Fernández, M

    2009-06-01

    To evaluate the suitability of ketorolac and non-steroidal anti-inflamatory drugs (NSAIDs) and other analgesic drugs currently used in the hospital. We have followed the steps to develop a PDCA cycle (plan, do, check, act) or quality improvement cycle. The quality problem was analysed using an Ishikawa diagram. We defined both qualitative quality indicators, those that measure prescription quality, and quantitative ones (defined daily dose, DDD/100BDs), which measure drug consumption, being the objectives to achieve. The study was conducted in all patients admitted to the hospital and who were admitted to orthopaedic and trauma surgery and plastic surgery departments with unit-dose dispensing systems. The strategy used was to give information to physicians through meetings and documentation. Finally, the results were analysed and compared with the initial objectives. The study was performed on 260 patients in the first study period and 292 in the second. Qualitative indicators: intravenous ketorolac use or =65 years old at dose < or =60 mg/day it increased 27.7% (p<0.05). Quantitative indicators: in the second study period, ketorolac use decreased (plastic surgery department: 61.8 DDD/100BDs to 14.8), whereas tramadol, ibuprofen and metamizole increased (plastic surgery department: 0 to 14.1 in tramadol, 8.7 to 48.6 in ibuprofen and 50.1 to 71 in metamizole). Appropriateness of ketorolac, NSAIDs and tramadol use has been achieved, thus improving patient safety. Strategies have been effective.

  15. Cambridge Polytrauma Pathway: Are we making appropriately guided decisions?

    Science.gov (United States)

    Wynell-Mayow, William; Guevel, Borna; Quansah, Benjamin; O'Leary, Ronan; Carrothers, Andrew D

    2016-10-01

    Addenbrooke's Hospital, the Major Trauma Centre for the East of England Trauma Network, received 1070 major trauma patients between 1st January and 31st December 2014. In order to improve care, an audit was performed of 59 patients meeting our own selection criteria for orthopaedic polytrauma between 1st January 2013 and 31st December 2013. The Cambridge Polytrauma Pathway was devised through NCEPOD guidelines, literature review, internal and external discussion. It facilitates provision of best practice Early Appropriate Care, encompassing - multidisciplinary consultant decisions around the patient in our Neurological and Trauma Critical Care Unit, early full body trauma CT scans, serial measurements of lactate and fibrinogen levels, and out-of-hours orthopaedic theatre reserved for life-and-limb threatening injuries. Re-audit was conducted of 15 patients meeting selection criteria, admitted between 1st October 2014 and 31st March 2015. Significant improvements in recording of lactate and fibrinogen were demonstrated, both on admission (lactate - ppolytrauma patients and it is recommended that either the GOS-E, or the EQ-5D scoring systems be introduced to assess this. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  16. Sugammadex: Appropriate Use in the Context of Budgetary Constraints.

    Science.gov (United States)

    Cammu, Guy

    2018-01-01

    The purpose of this review is to assess how sugammadex impacts postoperative residual curarization using appropriate doses based on neuromuscular transmission monitoring and whether the advantages of sugammadex versus neostigmine outweigh its higher cost. An accurate assessment of neuromuscular blockade with monitoring is necessary before selecting neostigmine versus sugammadex for reversal at the end of surgery to overcome incomplete neuromuscular recovery. The main advantages of sugammadex over neostigmine are its predictability and its ability to extend the range of blockade reversal. The cost of sugammadex is greater when higher doses of sugammadex are required for antagonism of deep block. Sugammadex probably has the potential to be cost-effective compared with neostigmine if its time savings are put to productive use in clinical practice. However, to date, the economic benefits of the drug are unknown. With sugammadex, almost any degree of neuromuscular block can be antagonized within 2-3 min; neostigmine is the only reversal agent effective against benzylisoquinolines and can ideally be used for reversal of lower levels of residual paralysis. The performance of the more expensive sugammadex on improving patient outcomes may depend on several elements of clinical strategy.

  17. Survey of appropriate endothermic processes for association with the HTR

    International Nuclear Information System (INIS)

    Brown, G.; Harrison, G.E.; Gent, C.W.; Plummer, J.

    1975-01-01

    Emphasis is placed on association of the HTR system as a heat source with chemical processes requiring temperatures up to 850 to 900 0 C, corresponding to a reactor coolant temperature of 950 0 C, though processes requiring temperatures up to 1100 0 C and above are reviewed. Particular attention is given to processes for the production of hydrogen-containing gases, including coal/lignite gasification which has been the subject of a recent study. Rising fuel prices make the HTR an attractive proposition if design concepts and materials can be developed to match the requirements. Other appropriate endothermic processes considered are oil processing, including tar sands and shales, and also energy production. Since the full temperature range of the reactor system must be utilised mention is made of low grade heat uses. Even very large chemical works have relatively small energy requirement by nuclear heat standards and adoption of the HTR as a heat source is likely only if it is associated with a large chemical/metallurgical complex or with the processing of a natural resource. (author)

  18. Hepatitis B virus reactivation during immunosuppressive therapy: Appropriate risk stratification.

    Science.gov (United States)

    Seto, Wai-Kay

    2015-04-28

    Our understanding of hepatitis B virus (HBV) reactivation during immunosuppresive therapy has increased remarkably during recent years. HBV reactivation in hepatitis B surface antigen (HBsAg)-positive individuals has been well-described in certain immunosuppressive regimens, including therapies containing corticosteroids, anthracyclines, rituximab, antibody to tumor necrosis factor (anti-TNF) and hematopoietic stem cell transplantation (HSCT). HBV reactivation could also occur in HBsAg-negative, antibody to hepatitis B core antigen (anti-HBc) positive individuals during therapies containing rituximab, anti-TNF or HSCT.For HBsAg-positive patients, prophylactic antiviral therapy is proven to the effective in preventing HBV reactivation. Recent evidence also demonstrated entecavir to be more effective than lamivudine in this aspect. For HBsAg-negative, anti-HBc positive individuals, the risk of reactivations differs with the type of immunosuppression. For rituximab, a prospective study demonstrated the 2-year cumulative risk of reactivation to be 41.5%, but prospective data is still lacking for other immunosupressive regimes. The optimal management in preventing HBV reactivation would involve appropriate risk stratification for different immunosuppressive regimes in both HBsAg-positive and HBsAg-negative, anti-HBc positive individuals.

  19. Translation research: from accurate diagnosis to appropriate treatment

    Directory of Open Access Journals (Sweden)

    Pass Harvey I

    2004-10-01

    Full Text Available Abstract This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB and Health Insurance Portability and Accountability Act (HIPAA compliance, data standardization, sample procurement, quality control (QC, quality assurance (QA, data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease.

  20. PATTERNS FOR IDENTIFYING APPROPRIATE KNOWLEDGE MANAGEMENT STRATEGIES IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Khadijeh Salmani

    2012-06-01

    Full Text Available Nowadays, striving to find an efficient way for developing or identifying appropriate knowledge management strategies in organizations has become so critical. Researchers and practitioners have attached great importance to information pyramids in organizations and have highlighted the lack of trained and skilled staff as a serious problem. On the other hand, having more flexibility at workplace, offering better service, and fulfilling customers' demands require a strategy for managing knowledge and its consequence. Knowledge management provides a wide range of different strategies and methods for identifying, creating, and sharing knowledge in organizations. This deep insight which consists of individual, organization’s experience, knowledge, and understanding helps organization respond to both internal and external stimuli and act in harmony. One fact which has seemingly achieved a consensus is the need for different strategies of knowledge management. Among the wide range of various and often unclear knowledge management strategies one can choose a strategy in a specific situation. The aim of this paper is to respond to strategic questions which emphasize competitive intelligence and internal knowledge retrieval system. The implications are discussed in detail.

  1. Developing a culturally appropriate mental health care service for Samoa.

    Science.gov (United States)

    Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

    2013-06-01

    Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  2. Evaluating the Appropriateness and Use of Domain Critical Errors

    Directory of Open Access Journals (Sweden)

    Chad W. Buckendahl

    2012-10-01

    Full Text Available The consequences associated with the uses and interpretations of scores for many credentialing testing programs have important implications for a range of stakeholders. Within licensure settings specifically, results from examination programs are often one of the final steps in the process of assessing whether individuals will be allowed to enter practice. This article focuses on the concept of domain critical errors and suggests a framework for considering their use in practice. Domain critical errors are defined here as knowledge, skills, abilities, or judgments that are essential to the definition of minimum qualifications in a testing program's pass-'fail decision-making process. Using domain critical errors has psychometric and policy implications, particularly for licensure programs that are mandatory for entry-level practice. Because these errors greatly influence pass-'fail decisions, the measurement community faces an ongoing challenge to promote defensible practices while concurrently providing assessment literacy development about the appropriate design and use of testing methods like domain critical errors.

  3. Understanding the concept of nationally appropriate mitigation action

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S.; Desgain, D.

    2013-05-15

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman's terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA and related MRV and financing issues have evolved through the different COPs. The second chapter clarifies the understanding of NAMAs in the context of the global temperature goal, and moves on to discuss the legal nature and scope of NAMAs. The chapter subsequently analyses the diversity of NAMAs submitted by developing countries to the UNFCCC, and ends by proposing a structure for formal submission of a NAMA. The third chapter specifically addresses the concept of measurement, reporting and verification (MRV), and describes the implications for countries implementing the MRV requirements. The last chapter discusses institutional arrangements, under the Convention, for providing financing to develop and implement NAMAs. The chapter also briefly discusses the different financial sources for implementing NAMAs, and concludes by explaining the concept of incremental cost in this specific context. (Author)

  4. Appropriate treatment of acute sigmoid volvulus in the emergency setting

    Science.gov (United States)

    Lou, Zheng; Yu, En-Da; Zhang, Wei; Meng, Rong-Gui; Hao, Li-Qiang; Fu, Chuan-Gang

    2013-01-01

    AIM: To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting. METHODS: A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery, Changhai Hospital, Shanghai from January 2001 to July 2012 was performed. Following the diagnosis of acute sigmoid volvulus, an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis. RESULTS: Of the 28 patients with acute sigmoid volvulus, 19 (67.9%) were male and 9 (32.1%) were female. Their mean age was 63.1 ± 22.9 years (range, 21-93 years). Six (21.4%) patients had a history of abdominal surgery, and 17 (60.7%) patients had a history of constipation. Abdominal radiography or computed tomography was performed in all patients. Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8% (26/28). Emergency surgery was required in the other two patients. Of the 26 successfully treated patients, seven (26.9%) had recurrent volvulus. CONCLUSION: Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus. Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful, or in those with peritonitis. PMID:23946604

  5. Who owns urban waste? Appropriation conflicts in emerging countries.

    Science.gov (United States)

    Cavé, Jérémie

    2014-09-01

    Managing solid waste in developing cities is not an easy task and many public policies have failed to bring the expected results. It is here argued that comprehending the solid waste handling in the South implies reconsidering the proper definition of waste. Where does the product end and where does rubbish begin? The answer to this question is far from being obvious. Solid waste appears as a blurred concept. Such a thorny issue is all the more relevant today, as municipal solid waste management approaches in the developing world are being reformulated: dumping sites are banned, sanitary landfills are imposed, and separate collection is being introduced. The current sector transformations are here analysed through a novel theoretical analysis combined with an original qualitative and quantitative empirical work. Through two case-studies of one-million inhabitant cities from emerging countries, it is shown that if appropriation conflicts arise that is because the urban solid waste deposit in Southern countries can be defined as an impure public good. This issue does not only involve private service operators and informal wastepickers; several other actors covet the urban solid waste deposit's cream, that is, recyclable items. In emerging countries, huge industrial groups are starting to target domestic recyclable waste as an alternative for raw materials, which costs are increasing ever more. © The Author(s) 2014.

  6. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia

    Directory of Open Access Journals (Sweden)

    Kabbara WK

    2015-04-01

    Full Text Available Wissam K Kabbara,1 Wijdan H Ramadan,1 Peggy Rahbany,2 Souhaila Al-Natour3 1Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon; 2Children’s National Medical Center, Washington, DC, USA; 3Medex Pharmaceutical Company, Beirut, Lebanon Background: Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged.Objective: The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia in diabetic and nondiabetic patients.Methods: A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin were identified. Patients were mainly recruited from internal medicine floors and intensive care units.Results: The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%, followed by levofloxacin (42.4% and moxifloxacin (7.6%. Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%, followed by ciprofloxacin (39.0% and moxifloxacin (33.3%. In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was

  7. French government to trim direct stake in Total

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that the French government has decided to slash its direct stake in partly state owned oil company Total to 5% from 31.7%, a surprise move expected to raise 10 billion francs ($1.8 billion). At the same time, other state owned entities will be asked to boost their combined 2.2% stake in Total to 10%, leaving the government with a net 15% interest in Total vs. the current 34%. Initially, state owned insurance companies Groupe des Assurances Nationales and Assurances Generale de France will be asked to hike their stakes in Total, but others could be asked to join if needed to meet the 10% target. The government the its phase-down of participation in Total, established in 1924 to manage French interests in Iraq Petroleum Co., was prompted by the evolution of the oil context, which differs greatly from what had prompted a significant stake of the state in Total's capital

  8. Exploring health providers’ and community perceptions and experiences with malaria tests in South-East Nigeria: a critical step towards appropriate treatment

    Directory of Open Access Journals (Sweden)

    Ezeoke Ogochukwu P

    2012-11-01

    Full Text Available Abstract Background The adoption of ACT as the first line treatment for uncomplicated malaria in Nigeria has concentrated attention on the role of testing in appropriate malaria treatment. There are calls at both national and global level for malaria treatment to be based on test result, but it is still unclear how testing can be incorporated into treatment-seeking and practices of health providers. This study explored community members and health providers’ perceptions and experiences with malaria tests in south east Nigeria. Methods The study was conducted in urban and rural areas of Enugu state in south-eastern Nigeria. A total of 18 focus group discussions with 179 community members including sub-groups of primary caregivers, adult men and adult women aged 15 years and above. Twenty- six (26 In-depth interviews were held with public and private health providers involved in prescribing medicines at public and private health facilities in the study area. Results Both providers and community members were familiar with malaria tests and identified malaria tests as an important step to distinguish malaria from other illnesses with similar symptoms and as a means of delivering appropriate treatment. However, the logic of test-directed treatment was undermined by cost of test and a lack of testing facilities but above all concerns over the reliability of negative test results, with community members and providers observing inconsistencies between results and symptoms, and providers attributing inaccurate results to incompetencies of technicians. Recognition of malaria symptoms was deemed most important in determining the use of antimalarial drugs rather than the result of a malaria test. Conclusion The results highlight important areas of intervention to promote appropriate malaria treatment. If tests are to play a role in patient management, demand and supply side interventions are needed to change people’s attitude towards malaria test

  9. Comparison of Serum Concentrations of Total Cholesterol and Total ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is one of the most dangerous tropical diseases that complicates HIV infection in Nigeria to date. Over two million Nigerians are known to be infected with TB and many more are at risk of the infection. Serum concentrations of total cholesterol and total lipid of 117 female TB patients attending chest clinic at ...

  10. Changes in total and differential white cell counts, total lymphocyte ...

    African Journals Online (AJOL)

    Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, ...

  11. Waste not - want not. DOE appropriate technology small grants program

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    The work reported was to look at various alternatives for local solid waste management and develop an implementation strategy for a resource conservation and recovery plan for the community of Berea, Kentucky. A library on recycling and conservation of resources was compiled, and state and local plans were examined. To get a better understanding of how the community would respond to a waste reduction and recycling program, a series of surveys was conducted. A community recycling project plan is proposed. (LEW)

  12. An Analysis of the State of Total Quality In Academia

    Science.gov (United States)

    1991-12-01

    sense, quality is anything that can be improved." [Imai, 1986] 3. Joseph M. Juran "Quality is fitness for use." [Juran, 19891 4. Kaoru Ishikawa ...121 v L m 1111 X. INTRODUCTION "Quality Control begins with education and ends with education" Karou Ishikawa [ Ishikawa , 1985...revolution, the magnitude of which has been compared to that of the industrial revolution. [ Ishikawa , 1985, Deming, 1982] Dramatic changes are

  13. Highlights of TOMS Version 9 Total Ozone Algorithm

    Science.gov (United States)

    Bhartia, Pawan; Haffner, David

    2012-01-01

    The fundamental basis of TOMS total ozone algorithm was developed some 45 years ago by Dave and Mateer. It was designed to estimate total ozone from satellite measurements of the backscattered UV radiances at few discrete wavelengths in the Huggins ozone absorption band (310-340 nm). Over the years, as the need for higher accuracy in measuring total ozone from space has increased, several improvements to the basic algorithms have been made. They include: better correction for the effects of aerosols and clouds, an improved method to account for the variation in shape of ozone profiles with season, latitude, and total ozone, and a multi-wavelength correction for remaining profile shape errors. These improvements have made it possible to retrieve total ozone with just 3 spectral channels of moderate spectral resolution (approx. 1 nm) with accuracy comparable to state-of-the-art spectral fitting algorithms like DOAS that require high spectral resolution measurements at large number of wavelengths. One of the deficiencies of the TOMS algorithm has been that it doesn't provide an error estimate. This is a particular problem in high latitudes when the profile shape errors become significant and vary with latitude, season, total ozone, and instrument viewing geometry. The primary objective of the TOMS V9 algorithm is to account for these effects in estimating the error bars. This is done by a straightforward implementation of the Rodgers optimum estimation method using a priori ozone profiles and their error covariances matrices constructed using Aura MLS and ozonesonde data. The algorithm produces a vertical ozone profile that contains 1-2.5 pieces of information (degrees of freedom of signal) depending upon solar zenith angle (SZA). The profile is integrated to obtain the total column. We provide information that shows the altitude range in which the profile is best determined by the measurements. One can use this information in data assimilation and analysis. A side

  14. Soft-tissue tension total knee arthroplasty.

    Science.gov (United States)

    Asano, Hiroshi; Hoshino, Akiho; Wilton, Tim J

    2004-08-01

    It is far from clear how best to define the proper strength of soft-tissue tensioning in total knee arthroplasty (TKA). We attached a torque driver to the Monogram balancer/tensor device and measured soft-tissue tension in full extension and 90 degrees flexion during TKA. In our surgical procedure, when we felt proper soft-tissue tension was being applied, the mean distraction force was noted to be 126N in extension and 121N in flexion. There was no significant correlation between soft-tissue tension and the postoperative flexion angle finally achieved. To the best of our knowledge, this is the first study to assess the actual distraction forces in relation to soft-tissue tension in TKA. Further study may reveal the most appropriate forces to achieve proper soft-tissue tension in the wide variety of circumstances presenting at knee arthroplasty.

  15. Appropriate bare potentials for studying fusion induced by 6He

    International Nuclear Information System (INIS)

    Crema, E; Chamon, L.C; Gomes, P.R.S.

    2007-01-01

    Although there are some recent studies questioning the use of the same optical potential to explain simultaneously fusion and quasi-elastic experimental data [1] or even to explain deep sub-barrier- and above-barrier fusion [2], during the last decades, the bare nuclear interaction between the nuclei at near barrier energies has been widely represented by a frozen potential with a Woods-Saxon shape. Another well established fact is the strong dependence of nuclear reaction calculations on the choice of the primary interaction. Of course, comparison between data and theoretical calculations are strongly potential-dependent. So, the choice of an appropriate nuclear bare interaction between two colliding nuclei, although it is a difficult task, is a crucial step in the data interpretation. As one has not direct access to the true bare potential, some procedures have been developed in order to constrain the choice of the bare potential to be used. The first procedure is the analysis of the elastic scattering data within the context of an optical potential, where an imaginary potential is added to the real potential, in order to take into account the flux deviated from the elastic channel. The optical potential that gives the best fit to the elastic scattering data is then used to describe other reaction channels, even in coupled channel calculations including inelastic and transfer reactions in the coupling matrix. However, this kind of calculation suffers from several inconsistencies. Another procedure that has been widely used to obtain the bare potential is the fit of the high-energy fusion data by a single barrier penetration model (BPM). However this method also has its uncertainties, since there might be channels that hinder the fusion cross section at energies near and above the Coulomb barrier. Hence, the bare potential extracted through this method can be contaminated by different processes. The derivation of experimental barrier distributions probably is the

  16. Appropriate Utilization and Stocking of Antidotes in Qatar Public Hospitals

    Directory of Open Access Journals (Sweden)

    Rawan Salameh

    2017-09-01

    Full Text Available Background: There are a few studies that evaluate preparedness and availability of antidotes in the emergency setting and none have been conducted in Qatar. Published studies show that timely availability of antidotes in the emergency department setting is a common issue. To address this, we conducted a study to evaluate antidote stocking and utilization in Qatar hospital pharmacies and emergency departments. Methods: In order to evaluate the appropriate use and timely administration of antidotes, research assistants prospectively collected data on ED patients. All ED patients who received any key antidote over the 6-month study period were identified through both ED and pharmacy records. In order to evaluate the stocking of the 31 most important antidotes in our main public hospitals, a survey assessing the stocking of these key antidotes was sent to the four general hospitals in Qatar, to determine their availability and whether they are stocked in the ED or only in the main pharmacy. Results: Poison exposure was evaluated in 471 cases. Antidotes were given within 30 minutes in 73% of cases, which included atropine, calcium, dextrose, flumazenil, naloxone, pralidoxime, sodium bicarbonate, thiamine, vitamin K and scorpion and snake antivenoms. Administration occurred later than 60 minutes in 2% of cases, exclusively with N-acetylcysteine and activated charcoal. Atropine, calcium, dextrose, naloxone, pralidoxime (2-PAM, sodium bicarbonate, and anti-venoms were clinically indicated 92% of the times they were ordered. N-acetylcysteine was indicated in only 51.5% of administrations. Significant variation in antidote stocking existed between hospitals, and there was no stocked hydroxocobalamin as antidotes for cyanide poisoning or fomepizole for toxic alcohol poisoning. Conclusion: Antidote stocking varied significantly between hospitals, and antidotes necessary for cyanide and toxic alcohol poisoning were deficient in all public hospitals. The

  17. Fluxes of radiocesium to milk and appropriate countermeasures

    International Nuclear Information System (INIS)

    Howard, J.; Hove, K.; Prister, B.; Sobolev, A; Ratnikov, A; Travnikova, I.; Averin, V.; Tronevitch, V.; Strand, P.; Bogdanov, G.

    1996-01-01

    Radiocesium contamination of milk persists in some areas of Belarus, Ukraine and Russian Federation which received fallout from the Chernobyl accident. In general, effective countermeasures have been used which ensure that radiocesium activity concentrations in milk from collective farms does not exceed intervention limits. However, farming practices differ greatly between the large collective farms, and the small, family operated private farms which are responsible for a major part of the food consumed in many rural areas. As a result of comparative low rate of use of fertilizers and utilization of poor quality land 137 Cs activity concentrations in milk from family-owned cows continues to exceed intervention limits in some areas. It is therefore important to be able reliably to quantify the rates of transfer of 137 Cs to private milk, so that all areas where persistent problems occur are identified, and appropriate countermeasure strategies applied. Where there is considerable variation, within a few km 2 , in both soil type and deposition, the 137 Cs content of private milk is highly variable. However, combining information about soil type, transfer rates for each major soil type, deposition, pasture size and grazing strategies can be a useful method of quantifying transfer of radiocesium to milk. Geographical information systems provide a promising new tool to integrate these factors. Effective Countermeasures are available to reduce radiocesium transfer to private milk. Private farmers are more sceptical of such methods than the scientists, administrators and agriculturalists in their society, particularly those methods involving the use of chemical additives given to their animals. Increased information efforts on the local level appears to be a prerequisite for a successful implementation of necessary Countermeasures

  18. RAND-like appropriateness methodology consensus for primary open-angle glaucoma in Latin America.

    Science.gov (United States)

    Lerner, S Fabian; Singh, Kuldev; Susanna, Remo; Wilson, M Roy; Lee, Brian L; Maul, Eugenio

    2012-09-01

    To report the results of a Latin American consensus panel regarding the diagnosis and management of primary open-angle glaucoma and to compare these results with those from a similar panel in the United States. A RAND-like (Research and Development) appropriateness methodology was used to assess glaucoma practice in Latin America. The 148 polling statements created for the RAND- like analysis in the United States and 10 additional statements specific to glaucoma care in Latin America were presented to a panel of Latin American glaucoma experts. Panelists were polled in private using the RAND- like methodology before and after the panel meeting. Consensus agreement or disagreement among Latin American experts was reached for 51.3% of statements before the meeting and increased to 66.5% in the private, anonymous meeting after polling (79.0% agreement, 21.0% disagreement). Although there was a high degree of concordance (111 of 148 statements; 75%) between the results of this Latin American panel and the United States panel, there were some notable exceptions relating to diagnostic and therapeutic decision making. This RAND-like consensus methodology provides a perspective of how Latin American glaucoma practitioners view many aspects of glaucoma and compares these results with those obtained using a similar methodology from practitioners in the United States. These findings may be helpful to ophthalmologists providing glaucoma care in Latin America and in other regions of the world. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Total dissociation cross section of halo nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Formanek, J. [Karlova Univ., Prague (Czech Republic). Fakulta Matematicko-Fyzikalni; Lombard, R.J. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire

    1996-10-01

    Calculations of the total dissociation cross section is performed in the impact parameter representation. The case of {sup 11}Be and {sup 11}Li loosing one and two neutron(s), respectively, by collision on a {sup 12}C target, which remains in its ground state are discussed. The results are found to depend essentially on the rms radius of the halo wave function. (author). 12 refs.

  20. Counterterrorism and cybersecurity total information awareness

    CERN Document Server

    Lee, Newton

    2013-01-01

    Provides a broad survey of the United States' counterterrorism history, the use of artificial intelligence in data mining, social media and privacy, cyber attacks and prevention, and longstanding issues of war and peace Closely examines how Total Information Awareness, a governmental data mining project focused on scanning public and private data, plays an integral role in cybersecurity Analyzes recent cyberattacks across the globe orchestrated by 'hacktivist' groups, such as Anonymous