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Sample records for units vary appropriately

  1. Does appropriate empiric antibiotic therapy modify intensive care unit-acquired Enterobacteriaceae bacteraemia mortality and discharge?

    NARCIS (Netherlands)

    Pouwels, K B; Van Kleef, E; Vansteelandt, S; Batra, R; Edgeworth, J D; Smieszek, T; Robotham, J V

    2017-01-01

    BACKGROUND: Conflicting results have been found regarding outcomes of intensive care unit (ICU)-acquired Enterobacteriaceae bacteraemia and the potentially modifying effect of appropriate empiric antibiotic therapy. AIM: To evaluate these associations while adjusting for potential time-varying

  2. Does appropriate empiric antibiotic therapy modify intensive care unit-acquired Enterobacteriaceae bacteraemia mortality and discharge?

    Science.gov (United States)

    Pouwels, K B; Van Kleef, E; Vansteelandt, S; Batra, R; Edgeworth, J D; Smieszek, T; Robotham, J V

    2017-05-01

    Conflicting results have been found regarding outcomes of intensive care unit (ICU)-acquired Enterobacteriaceae bacteraemia and the potentially modifying effect of appropriate empiric antibiotic therapy. To evaluate these associations while adjusting for potential time-varying confounding using methods from the causal inference literature. Patients who stayed more than two days in two general ICUs in England between 2002 and 2006 were included in this cohort study. Marginal structural models with inverse probability weighting were used to estimate the mortality and discharge associated with Enterobacteriaceae bacteraemia and the impact of appropriate empiric antibiotic therapy on these outcomes. Among 3411 ICU admissions, 195 (5.7%) ICU-acquired Enterobacteriaceae bacteraemia cases occurred. Enterobacteriaceae bacteraemia was associated with an increased daily risk of ICU death [cause-specific hazard ratio (HR): 1.48; 95% confidence interval (CI): 1.10-1.99] and a reduced daily risk of ICU discharge (HR: 0.66; 95% CI: 0.54-0.80). Appropriate empiric antibiotic therapy did not significantly modify ICU mortality (HR: 1.08; 95% CI: 0.59-1.97) or discharge (HR: 0.91; 95% CI: 0.63-1.32). ICU-acquired Enterobacteriaceae bacteraemia was associated with an increased daily risk of ICU mortality. Furthermore, the daily discharge rate was also lower after acquiring infection, even when adjusting for time-varying confounding using appropriate methodology. No evidence was found for a beneficial modifying effect of appropriate empiric antibiotic therapy on ICU mortality and discharge. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. 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...

  4. 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…

  5. Visual-Haptic Integration: Cue Weights are Varied Appropriately, to Account for Changes in Haptic Reliability Introduced by Using a Tool

    Directory of Open Access Journals (Sweden)

    Chie Takahashi

    2011-10-01

    Full Text Available Tools such as pliers systematically change the relationship between an object's size and the hand opening required to grasp it. Previous work suggests the brain takes this into account, integrating visual and haptic size information that refers to the same object, independent of the similarity of the ‘raw’ visual and haptic signals (Takahashi et al., VSS 2009. Variations in tool geometry also affect the reliability (precision of haptic size estimates, however, because they alter the change in hand opening caused by a given change in object size. Here, we examine whether the brain appropriately adjusts the weights given to visual and haptic size signals when tool geometry changes. We first estimated each cue's reliability by measuring size-discrimination thresholds in vision-alone and haptics-alone conditions. We varied haptic reliability using tools with different object-size:hand-opening ratios (1:1, 0.7:1, and 1.4:1. We then measured the weights given to vision and haptics with each tool, using a cue-conflict paradigm. The weight given to haptics varied with tool type in a manner that was well predicted by the single-cue reliabilities (MLE model; Ernst and Banks, 2002. This suggests that the process of visual-haptic integration appropriately accounts for variations in haptic reliability introduced by different tool geometries.

  6. 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

  7. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

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    Yoshito Kawakatsu

    2017-02-01

    Full Text Available Abstract Background The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW. The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. Methods The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS. In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Results Factors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Conclusions Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate

  8. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  9. 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

  10. Cost and appropriateness of treating asthma with fixed-combination drugs in local health care units in Italy

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    Ruggeri I

    2012-12-01

    Full Text Available Isabella Ruggeri,1 Donatello Bragato,2 Giorgio L Colombo,3,4 Emanuela Valla,3 Sergio Di Matteo41Servizio Governo Area Farmaceutica, Azienda Sanitaria Locale, Milano, Binasco, 2Data Solution Provider, Milan, 3University of Pavia, Department of Drug Sciences, School of Pharmacy, 4Studi Analisi Valutazioni Economiche, MilanBackground: Bronchial asthma is a chronic airways disease and is considered to be one of the major health problems in the Western world. During the last decade, a significant increase in the use of β2-agonists in combination with inhaled corticosteroids has been observed. The aim of this study was to assess the appropriateness of expenditure on these agents in an asthmatic population treated in a real practice setting.Methods: This study used data for a resident population of 635,906 citizens in the integrated patient database (Banca Dati Assistito of a local health care unit (Milano 2 Azienda Sanitaria Locale in the Lombardy region over 3 years (2007–2009. The sample included 3787–4808 patients selected from all citizens aged ≥ 18 years entitled to social security benefits, having a prescription for a corticosteroid + β2-agonist combination, and an ATC code corresponding to R03AK, divided into three groups, ie, pressurized (spray drugs, inhaled powders, and extrafine formulations. Patients with chronic obstructive lung disease were excluded. Indicators of appropriateness were 1–3 packs per year (underdosed, inappropriate, 4–12 packs per year (presumably appropriate, and ≥13 packs per year (overtreatment, inappropriate.Results: The corticosteroid + β2-agonist combination per treated asthmatic patient increased from 37% in 2007 to 45% in 2009 for the total of prescribed antiasthma drugs, and 28%–32% of patients used the drugs in an appropriate manner (4–12 packs per years. The cost of inappropriately used packs increased combination drug expenditure by about 40%, leading to inefficient use of health care

  11. Use of the exposure unit concept in risk assessments: A case study for Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Hartmann, H.M.; Butler, J.P.; Dorries, A.M.; Beck, J.R.

    1993-10-01

    The use of the exposure unit concept to refine intake estimates in quantitative risk assessments is explained. The selection of appropriate exposure unit areas for varying receptors and the application of the concept to large sites and to relatively small solid waste management units (SWMUs) are discussed. Examples are presented

  12. Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial

    DEFF Research Database (Denmark)

    Jensen, Jens U; Hein, Lars; Lundgren, Bettina

    2011-01-01

    For patients in intensive care units, sepsis is a common and potentially deadly complication and prompt initiation of appropriate antimicrobial therapy improves prognosis. The objective of this trial was to determine whether a strategy of antimicrobial spectrum escalation, guided by daily measure...

  13. Bed Utilisation in an Irish Regional Paediatric Unit A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

    LENUS (Irish Health Repository)

    Ó hAiseadha, Coilín

    2016-05-01

    Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources.

  14. Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit.

    Science.gov (United States)

    Lazaryan, Moran; Abu-Kishk, Ibrahim; Rosenfeld-Yehoshua, Noa; Berkovitch, Sofia; Toledano, Michal; Reshef, Iris; Kanari, Tal; Ziv-Baran, Tomer; Berkovitch, Matitiahu

    2016-01-01

    One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available. To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU). A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded. The review time for one medical record was 8.9 (95% CI, 6.9-10.9) min. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11) min. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8) and 12 (9-15) min, respectively, for patients with psychiatric-neurologic disorders compared to those without (p = 0.032). Usually, a daily workload of 240 min was needed for the pharmacist accompanying the round in contrast to 108 min per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9%, and made no comment on 36.9% of the recommendations. Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

  15. Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moran Lazaryan

    2016-08-01

    Full Text Available Background: One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available.Objective: To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU. Methods: A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded.Results: The review time for one medical record was 8.9 (95% CI, 6.9-10.9 minutes. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11 minutes. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8 and 12 (9-15 minutes, respectively, for patients with psychiatric-neurologic disorders compared to those without (p=0.032. Usually, a daily workload of 240 minutes was needed for the pharmacist accompanying the round in contrast to 108 minutes per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9% and made no comment on 36.9% of the recommendations. Conclusion: Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

  16. A varying-α brane world cosmology

    International Nuclear Information System (INIS)

    Youm, Donam

    2001-08-01

    We study the brane world cosmology in the RS2 model where the electric charge varies with time in the manner described by the varying fine-structure constant theory of Bekenstein. We map such varying electric charge cosmology to the dual variable-speed-of-light cosmology by changing system of units. We comment on cosmological implications for such cosmological models. (author)

  17. Tracking time-varying coefficient-functions

    DEFF Research Database (Denmark)

    Nielsen, Henrik Aalborg; Nielsen, Torben Skov; Joensen, Alfred K.

    2000-01-01

    is a combination of recursive least squares with exponential forgetting and local polynomial regression. It is argued, that it is appropriate to let the forgetting factor vary with the value of the external signal which is the argument of the coefficient functions. Some of the key properties of the modified method...... are studied by simulation...

  18. 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.…

  19. The effect of product–context appropriateness on emotion associations in evoked eating occasions

    NARCIS (Netherlands)

    Piqueras Fiszman, B.; Jaeger, S.R.

    2015-01-01

    The aim of this research was to investigate the impact that perceived product–context appropriateness exerts on elicited emotion associations. The experimental approach consisted in creating eating occasions (as a multi-component entity) varying in appropriateness, which consumers were instructed to

  20. ASP Strategies and Appropriate Antibiotic Use

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    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

  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. Motor unit recruitment for dynamic tasks: current understanding and future directions.

    Science.gov (United States)

    Hodson-Tole, Emma F; Wakeling, James M

    2009-01-01

    Skeletal muscle contains many muscle fibres that are functionally grouped into motor units. For any motor task there are many possible combinations of motor units that could be recruited and it has been proposed that a simple rule, the 'size principle', governs the selection of motor units recruited for different contractions. Motor units can be characterised by their different contractile, energetic and fatigue properties and it is important that the selection of motor units recruited for given movements allows units with the appropriate properties to be activated. Here we review what is currently understood about motor unit recruitment patterns, and assess how different recruitment patterns are more or less appropriate for different movement tasks. During natural movements the motor unit recruitment patterns vary (not always holding to the size principle) and it is proposed that motor unit recruitment is likely related to the mechanical function of the muscles. Many factors such as mechanics, sensory feedback, and central control influence recruitment patterns and consequently an integrative approach (rather than reductionist) is required to understand how recruitment is controlled during different movement tasks. Currently, the best way to achieve this is through in vivo studies that relate recruitment to mechanics and behaviour. Various methods for determining motor unit recruitment patterns are discussed, in particular the recent wavelet-analysis approaches that have allowed motor unit recruitment to be assessed during natural movements. Directions for future studies into motor recruitment within and between functional task groups and muscle compartments are suggested.

  3. The Environmental Kuznets Curve for Water Quality: An Analysis of its Appropriateness Using Unit Root and Cointegration Tests

    Directory of Open Access Journals (Sweden)

    Juan Carlos Muñoz

    2008-12-01

    Full Text Available The Environmental Kuznets Curve hypothesis suggests the existence of an inverted U-shaped relationship between environmental degradation and income. Several economists assume that the environmental impacts occurred during the first stages of the development process will be reverted as a result of economic growth. Yet Perman and Stern (2003 have argued that the econometric methods used in the earlier analysis of the EKC are inappropriate, given the time properties of the series. This article examines the appropriateness of the EKC for a panel of 46 countries and 21 periods by implementing individual and panel tests for unit roots and cointegration. An error correction model is also estimated. The results do not support evidence of a common EKC for the countries analyzed.

  4. The right to appropriate and meaningful education for children with ASD.

    Science.gov (United States)

    Marshall, David; Goodall, Craig

    2015-10-01

    This paper will explore from a 'child's rights perspective' the 'right' of children with autistic spectrum disorder (ASD) to appropriate and meaningful education. Human 'rights' principles within international law will be evaluated in relation to how they have been interpreted and applied in relation to achieving this 'right'. The International Convention of the Rights of the Child (United Nations in Convention on the rights of the child, office of the high commissioner, United Nations, Geneva, 1989) and the convention on the rights of the person with disability (United Nations in Convention on the rights of person's with disabilities and optional protocol, office of the high commissioner, United Nations, Geneva, 2006) amongst others will be utilised to argue the case for 'inclusive' educational opportunities to be a 'right' of every child on the autistic spectrum. The efficacy of mainstream inclusion is explored, identifying the position that a 'one size fits all' model of education is not appropriate for all children with ASD.

  5. 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…

  6. Behavioral Dynamics in Swimming: The Appropriate Use of Inertial Measurement Units.

    Science.gov (United States)

    Guignard, Brice; Rouard, Annie; Chollet, Didier; Seifert, Ludovic

    2017-01-01

    Motor control in swimming can be analyzed using low- and high-order parameters of behavior. Low-order parameters generally refer to the superficial aspects of movement (i.e., position, velocity, acceleration), whereas high-order parameters capture the dynamics of movement coordination. To assess human aquatic behavior, both types have usually been investigated with multi-camera systems, as they offer high three-dimensional spatial accuracy. Research in ecological dynamics has shown that movement system variability can be viewed as a functional property of skilled performers, helping them adapt their movements to the surrounding constraints. Yet to determine the variability of swimming behavior, a large number of stroke cycles (i.e., inter-cyclic variability) has to be analyzed, which is impossible with camera-based systems as they simply record behaviors over restricted volumes of water. Inertial measurement units (IMUs) were designed to explore the parameters and variability of coordination dynamics. These light, transportable and easy-to-use devices offer new perspectives for swimming research because they can record low- to high-order behavioral parameters over long periods. We first review how the low-order behavioral parameters (i.e., speed, stroke length, stroke rate) of human aquatic locomotion and their variability can be assessed using IMUs. We then review the way high-order parameters are assessed and the adaptive role of movement and coordination variability in swimming. We give special focus to the circumstances in which determining the variability between stroke cycles provides insight into how behavior oscillates between stable and flexible states to functionally respond to environmental and task constraints. The last section of the review is dedicated to practical recommendations for coaches on using IMUs to monitor swimming performance. We therefore highlight the need for rigor in dealing with these sensors appropriately in water. We explain the

  7. Conservative care for ESRD in the United Kingdom: a national survey.

    Science.gov (United States)

    Okamoto, Ikumi; Tonkin-Crine, Sarah; Rayner, Hugh; Murtagh, Fliss E M; Farrington, Ken; Caskey, Fergus; Tomson, Charles; Loud, Fiona; Greenwood, Roger; O'Donoghue, Donal J; Roderick, Paul

    2015-01-07

    Conservative kidney management (CKM) has been developed in the United Kingdom (UK) as an alternative to dialysis for older patients with stage 5 CKD (CKD5) and multiple comorbidities. This national survey sought to describe the current scale and pattern of delivery of conservative care in UK renal units and identify their priorities for its future development. A survey on practice patterns of CKM for patients age 75 and older with CKD5 was sent to clinical directors of all 71 adult renal units in the UK in March 2013. Sixty-seven units (94%) responded. All but one unit reported providing CKM for some patients. Terminology varied, although "conservative management" was the most frequently used term (46%). Lack of an agreed-upon definition of when a patient is receiving CKM made it difficult to obtain meaningful data on the numbers of such patients. Fifty-two percent provided the number of CKM patients age ≥ 75 years in 2012; the median was 45 per unit (interquartile range [IQR], 20-83). The median number of symptomatic CKM patients who would otherwise have started dialysis was eight (IQR, 4.5-22). CKM practice patterns varied: 35% had a written guideline, 23% had dedicated CKM clinics, 45% had dedicated staff, and 50% provided staff training on CKM. Most units (88%) provided primary care clinicians with information/advice regarding CKM. Eighty percent identified a need for better evidence comparing outcomes on CKM versus dialysis, and 65% considered it appropriate to enter patients into a randomized trial. CKM is provided in almost all UK renal units, but scale and organization vary widely. Lack of common terminology and definitions hinders the development and assessment of CKM. Many survey respondents expressed support for further research comparing outcomes with conservative care versus dialysis. Copyright © 2015 by the American Society of Nephrology.

  8. 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.)

  9. 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.)

  10. Bed Utilisation in an Irish Regional Paediatric Unit – A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP

    Directory of Open Access Journals (Sweden)

    Coilín ÓhAiseadha

    2016-11-01

    Full Text Available Background Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU in University Hospital Limerick (UHL, Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources. Methods We used a questionnaire based on the paediatric appropriateness evaluation protocol (PAEP, modified and validated for use in the United Kingdom, to prospectively gather data regarding reasons for admission and for ongoing care after 2 days, from case records for all inpatients during 11 days in February (winter and 7 days in May–June (summer. We conducted bivariate and multivariate analysis to explore associations between failure to meet PAEP criteria and patient attributes including age, gender, admission outside of office hours, arrival by ambulance, and private health insurance. Inpatient bed occupancy and day ward activity were also scrutinised. Results Mean bed occupancy was 84.1%. In all, 12/355 (3.4%, 95% CI: 1.5%–5.3% of children failed to meet PAEP admission criteria, and 27/189 (14.3%, 95% CI: 9.3%–19.3% who were still inpatients after 2 days failed to meet criteria for ongoing care. 35/355 (9.9%, 95% CI: 6.8%–13.0% of admissions fulfilled only the PAEP criterion for intravenous medications or fluid replacement. A logistic regression model constructed by forward selection identified a significant association between failure to meet PAEP criteria for ongoing care 2 days after admission and admission during office hours (08.00–17.59 (P = .020, and a marginally significant association between this outcome and arrival by ambulance (P = .054. Conclusion At a mean bed occupancy of 84.1%, an Irish RPU can achieve 96.6% appropriate admissions

  11. Wiffle Ball: Turning a Backyard Favorite into an Appropriate Physical Education Unit

    Science.gov (United States)

    Layne, Todd E.

    2017-01-01

    Wiffle ball is a game that has been played for many years (Santora, 2003). Unfortunately, implementation in physical education has been inconsistent at best. The sport education model outlined in this article provides an appropriate method for teaching skills associated with wiffle ball for a variety of ages. Students can develop appropriate…

  12. 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.

  13. 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...

  14. Method for Determining Appropriate Clustering Criteria of Location-Sensing Data

    Directory of Open Access Journals (Sweden)

    Youngmin Lee

    2016-08-01

    Full Text Available Large quantities of location-sensing data are generated from location-based social network services. These data are provided as point properties with location coordinates acquired from a global positioning system or Wi-Fi signal. To show the point data on multi-scale map services, the data should be represented by clusters following a grid-based clustering method, in which an appropriate grid size should be determined. Currently, there are no criteria for determining the proper grid size, and the modifiable areal unit problem has been formulated for the purpose of addressing this issue. The method proposed in this paper is applies a hexagonal grid to geotagged Twitter point data, considering the grid size in terms of both quantity and quality to minimize the limitations associated with the modifiable areal unit problem. Quantitatively, we reduced the original Twitter point data by an appropriate amount using Töpfer’s radical law. Qualitatively, we maintained the original distribution characteristics using Moran’s I. Finally, we determined the appropriate sizes of clusters from zoom levels 9–13 by analyzing the distribution of data on the graphs. Based on the visualized clustering results, we confirm that the original distribution pattern is effectively maintained using the proposed method.

  15. Theoretical Investigation of Combined Use of PSO, Tabu Search and Lagrangian Relaxation methods to solve the Unit Commitment Problem

    Directory of Open Access Journals (Sweden)

    Sahbi Marrouchi

    2018-02-01

    Full Text Available Solving the Unit Commitment problem (UCP optimizes the combination of production units operations and determines the appropriate operational scheduling of each production units to satisfy the expected consumption which varies from one day to one month. Besides, each production unit is conducted to constraints that render this problem complex, combinatorial and nonlinear. In this paper, we proposed a new strategy based on the combination three optimization methods: Tabu search, Particle swarm optimization and Lagrangian relaxation methods in order to develop a proper unit commitment scheduling of the production units while reducing the production cost during a definite period. The proposed strategy has been implemented on a the IEEE 9 bus test system containing 3 production unit and the results were promising compared to strategies based on meta-heuristic and deterministic methods.

  16. Synchronization of uncertain time-varying network based on sliding mode control technique

    Science.gov (United States)

    Lü, Ling; Li, Chengren; Bai, Suyuan; Li, Gang; Rong, Tingting; Gao, Yan; Yan, Zhe

    2017-09-01

    We research synchronization of uncertain time-varying network based on sliding mode control technique. The sliding mode control technique is first modified so that it can be applied to network synchronization. Further, by choosing the appropriate sliding surface, the identification law of uncertain parameter, the adaptive law of the time-varying coupling matrix element and the control input of network are designed, it is sure that the uncertain time-varying network can synchronize effectively the synchronization target. At last, we perform some numerical simulations to demonstrate the effectiveness of the proposed results.

  17. Flexible time-varying filter banks

    Science.gov (United States)

    Tuncer, Temel E.; Nguyen, Truong Q.

    1993-09-01

    Linear phase maximally flat FIR Butterworth filter approximations are discussed and a new filter design method is introduced. This variable cutoff filter design method uses the cosine modulated versions of a prototype filter. The design procedure is simple and different variants of this procedure can be used to obtain close to optimum linear phase filters. Using this method, flexible time-varying filter banks with good reconstruction error are introduced. These types of oversampled filter banks have small magnitude error which can be easily controlled by the appropriate choice of modulation frequency. This error can be further decreased by magnitude equalization without increasing the computational complexity considerably. Two dimensional design examples are also given.

  18. Fitting Social Network Models Using Varying Truncation Stochastic Approximation MCMC Algorithm

    KAUST Repository

    Jin, Ick Hoon

    2013-10-01

    The exponential random graph model (ERGM) plays a major role in social network analysis. However, parameter estimation for the ERGM is a hard problem due to the intractability of its normalizing constant and the model degeneracy. The existing algorithms, such as Monte Carlo maximum likelihood estimation (MCMLE) and stochastic approximation, often fail for this problem in the presence of model degeneracy. In this article, we introduce the varying truncation stochastic approximation Markov chain Monte Carlo (SAMCMC) algorithm to tackle this problem. The varying truncation mechanism enables the algorithm to choose an appropriate starting point and an appropriate gain factor sequence, and thus to produce a reasonable parameter estimate for the ERGM even in the presence of model degeneracy. The numerical results indicate that the varying truncation SAMCMC algorithm can significantly outperform the MCMLE and stochastic approximation algorithms: for degenerate ERGMs, MCMLE and stochastic approximation often fail to produce any reasonable parameter estimates, while SAMCMC can do; for nondegenerate ERGMs, SAMCMC can work as well as or better than MCMLE and stochastic approximation. The data and source codes used for this article are available online as supplementary materials. © 2013 American Statistical Association, Institute of Mathematical Statistics, and Interface Foundation of North America.

  19. Treating floodplain lakes of large rivers as study units for variables that vary within lakes; an evaluation using chlorophyll a and inorganic suspended solids data from floodplain lakes of the Upper Mississippi River

    Science.gov (United States)

    Gray, B.R.; Rogala, J.R.; Houser, J.N.

    2013-01-01

    Contiguous floodplain lakes ('lakes') have historically been used as study units for comparative studies of limnological variables that vary within lakes. The hierarchical nature of these studies implies that study variables may be correlated within lakes and that covariate associations may differ not only among lakes but also by spatial scale. We evaluated the utility of treating lakes as study units for limnological variables that vary within lakes based on the criteria of important levels of among-lake variation in study variables and the observation of covariate associations that vary among lakes. These concerns were selected, respectively, to ensure that lake signatures were distinguishable from within-lake variation and that lake-scale effects on covariate associations might provide inferences not available by ignoring those effects. Study data represented chlorophyll a (CHL) and inorganic suspended solids (ISS) data from lakes within three reaches of the Upper Mississippi River. Sampling occurred in summer from 1993 through 2005 (except 2003); numbers of lakes per reach varied from 7 to 19, and median lake area varied from 53 to 101 ha. CHL and ISS levels were modelled linearly, with lake, year and lake x year effects treated as random. For all reaches, the proportions of variation in CHL and ISS attributable to differences among lakes (including lake and lake x year effects) were substantial (range: 18%-73%). Finally, among-lake variation in CHL and ISS was strongly associated with covariates and covariate effects that varied by lakes or lake-years (including with vegetation levels and, for CHL, log(ISS)). These findings demonstrate the utility of treating floodplain lakes as study units for the study of limnological variables and the importance of addressing hierarchy within study designs when making inferences from data collected within floodplain lakes.

  20. The neural basis of novelty and appropriateness in processing of creative chunk decomposition.

    Science.gov (United States)

    Huang, Furong; Fan, Jin; Luo, Jing

    2015-06-01

    Novelty and appropriateness have been recognized as the fundamental features of creative thinking. However, the brain mechanisms underlying these features remain largely unknown. In this study, we used event-related functional magnetic resonance imaging (fMRI) to dissociate these mechanisms in a revised creative chunk decomposition task in which participants were required to perform different types of chunk decomposition that systematically varied in novelty and appropriateness. We found that novelty processing involved functional areas for procedural memory (caudate), mental rewarding (substantia nigra, SN), and visual-spatial processing, whereas appropriateness processing was mediated by areas for declarative memory (hippocampus), emotional arousal (amygdala), and orthography recognition. These results indicate that non-declarative and declarative memory systems may jointly contribute to the two fundamental features of creative thinking. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States

    Directory of Open Access Journals (Sweden)

    Hoehun Ha

    2018-04-01

    Full Text Available Suicide is a serious but preventable public health issue. Several previous studies have revealed a positive association between altitude and suicide rates at the county level in the contiguous United States. We assessed the association between suicide rates and altitude using a cross-county ecological study design. Data on suicide rates were obtained from a Web-based Injury Statistics Query and Reporting System (WISQARS, maintained by the U.S. National Center for Injury Prevention and Control (NCIPC. Altitude data were collected from the United States Geological Survey (USGS. We employed an ordinary least square (OLS regression to model the association between altitude and suicide rates in 3064 counties in the contiguous U.S. We conducted a geographically weighted regression (GWR to examine the spatially varying relationship between suicide rates and altitude after controlling for several well-established covariates. A significant positive association between altitude and suicide rates (average county rates between 2008 and 2014 was found in the dataset in the OLS model (R2 = 0.483, p < 0.001. Our GWR model fitted the data better, as indicated by an improved R2 (average: 0.62; range: 0.21–0.64 and a lower Akaike Information Criteria (AIC value (13,593.68 vs. 14,432.14 in the OLS model. The GWR model also significantly reduced the spatial autocorrelation, as indicated by Moran’s I test statistic (Moran’s I = 0.171; z = 33.656; p < 0.001 vs. Moran’s I = 0.323; z = 63.526; p < 0.001 in the OLS model. In addition, a stronger positive relationship was detected in areas of the northern regions, northern plain regions, and southeastern regions in the U.S. Our study confirmed a varying overall positive relationship between altitude and suicide. Future research may consider controlling more predictor variables in regression models, such as firearm ownership, religion, and access to mental health services.

  2. Coffee Drinking Is Widespread in the United States, but Usual Intake Varies by Key Demographic and Lifestyle Factors123

    Science.gov (United States)

    Loftfield, Erikka; Freedman, Neal D; Dodd, Kevin W; Vogtmann, Emily; Xiao, Qian; Sinha, Rashmi; Graubard, Barry I

    2016-01-01

    Background: Despite widespread popularity and possible health effects, the prevalence and distribution of coffee consumption in US adults are poorly characterized. Objective: We sought to estimate usual daily coffee intakes from all coffee-containing beverages, including decaffeinated and regular coffee, among US adults according to demographic, socioeconomic, and health-related factors. Methods: Dietary intake data from ≤2 nonconsecutive 24-h dietary recalls and a food-frequency questionnaire administered during the NHANES 2003–2006 were used to estimate the person-specific probability of consuming coffee on a particular day and the usual amount consumed on consumption days. Trends in population mean coffee consumption over time were evaluated by using multiple linear regression and 1-d 24-h recall data from NHANES 2003–2012. Analyses were weighted to be representative of the US adult population aged ≥20 y. Results: An estimated 154 million adults, or 75% of the US population, aged ≥20 y reported drinking coffee; 49% reported drinking coffee daily. Prevalence did not vary by sex, education, income, or self-reported general health (all P ≥ 0.05) but did vary by age, race/ethnicity, smoking status, and alcohol drinking (all P coffee drinkers, the mean ± SE usual intake was 14.1 ± 0.5 fluid ounces/d (417 ± 15 mL/d). Mean usual intakes were higher in men than women, in older age groups than in those aged 20 to coffee consumption was stable from 2003 to 2012 (P-trend = 0.09). Conclusions: Coffee is widely consumed in the United States, with usual intakes varying by lifestyle and demographic factors, most notably by age. Longitudinal studies are needed to determine whether observed differences by age reflect birth cohort effects or changes in drinking patterns over the lifetime. PMID:27489008

  3. Challenges in Selecting an Appropriate Heat Stress Index to Protect Workers in Hot and Humid Underground Mines

    Directory of Open Access Journals (Sweden)

    Pedram Roghanchi

    2018-03-01

    Full Text Available Background: A detailed evaluation of the underground mine climate requires extensive measurements to be performed coupled to climatic modeling work. This can be labor-intensive and time-consuming, and consequently impractical for daily work comfort assessments. Therefore, a simple indicator like a heat stress index is needed to enable a quick, valid, and acceptable evaluation of underground climatic conditions on a regular basis. This can be explained by the unending quest to develop a “universal index,” which has led to the proliferation of many proposed heat stress indices. Methods: The aim of this research study is to discuss the challenges in identifying and selecting an appropriate heat stress index for thermal planning and management purposes in underground mines. A method is proposed coupled to a defined strategy for selecting and recommending heat stress indices to be used in underground metal mines in the United States and worldwide based on a thermal comfort model. Results: The performance of current heat stress indices used in underground mines varies based on the climatic conditions and the level of activities. Therefore, carefully selecting or establishing an appropriate heat stress index is of paramount importance to ensure the safety, health, and increasing productivity of the underground workers. Conclusion: This method presents an important tool to assess and select the most appropriate index for certain climatic conditions to protect the underground workers from heat-related illnesses. Although complex, the method presents results that are easy to interpret and understand than any of the currently available evaluation methods. Keywords: climatic conditions, heat stress index, thermal comfort, underground mining

  4. Admission time to hospital: a varying standard for a critical definition for admissions to an intensive care unit from the emergency department.

    Science.gov (United States)

    Nanayakkara, Shane; Weiss, Heike; Bailey, Michael; van Lint, Allison; Cameron, Peter; Pilcher, David

    2014-11-01

    Time spent in the emergency department (ED) before admission to hospital is often considered an important key performance indicator (KPI). Throughout Australia and New Zealand, there is no standard definition of 'time of admission' for patients admitted through the ED. By using data submitted to the Australian and New Zealand Intensive Care Society Adult Patient Database, the aim was to determine the differing methods used to define hospital admission time and assess how these impact on the calculation of time spent in the ED before admission to an intensive care unit (ICU). Between March and December of 2010, 61 hospitals were contacted directly. Decision methods for determining time of admission to the ED were matched to 67,787 patient records. Univariate and multivariate analyses were conducted to assess the relationship between decision method and the reported time spent in the ED. Four mechanisms of recording time of admission were identified, with time of triage being the most common (28/61 hospitals). Reported median time spent in the ED varied from 2.5 (IQR 0.83-5.35) to 5.1 h (2.82-8.68), depending on the decision method. After adjusting for illness severity, hospital type and location, decision method remained a significant factor in determining measurement of ED length of stay. Different methods are used in Australia and New Zealand to define admission time to hospital. Professional bodies, hospitals and jurisdictions should ensure standardisation of definitions for appropriate interpretation of KPIs as well as for the interpretation of studies assessing the impact of admission time to ICU from the ED. WHAT IS KNOWN ABOUT THE TOPIC?: There are standards for the maximum time spent in the ED internationally, but these standards vary greatly across Australia. The definition of such a standard is critically important not only to patient care, but also in the assessment of hospital outcomes. Key performance indicators rely on quality data to improve decision

  5. Perceptions of safety culture vary across the intensive care units of a single institution.

    Science.gov (United States)

    Huang, David T; Clermont, Gilles; Sexton, J Bryan; Karlo, Crystal A; Miller, Rachel G; Weissfeld, Lisa A; Rowan, Kathy M; Angus, Derek C

    2007-01-01

    To determine whether safety culture factors varied across the intensive care units (ICUs) of a single hospital, between nurses and physicians, and to explore ICU nursing directors' perceptions of their personnel's attitudes. Cross-sectional surveys using the Safety Attitudes Questionnaire-ICU version, a validated, aviation industry-based safety culture survey instrument. It assesses culture across six factors: teamwork climate, perceptions of management, safety climate, stress recognition, job satisfaction, and work environment. Four ICUs in one tertiary care hospital. All ICU personnel. We conducted the survey from January 1 to April 1, 2003, and achieved a 70.2% response rate (318 of 453). We calculated safety culture factor mean and percent-positive scores (percentage of respondents with a mean score of > or =75 on a 0-100 scale for which 100 is best) for each ICU. We compared mean ICU scores by ANOVA and percent-positive scores by chi-square. Mean and percent-positive scores by job category were modeled using a generalized estimating equations approach and compared using Wald statistics. We asked ICU nursing directors to estimate their personnel's mean scores and generated ratios of their estimates to the actual scores.Overall, factor scores were low to moderate across all factors (range across ICUs: 43.4-74.9 mean scores, 8.6-69.4 percent positive). Mean and percent-positive scores differed significantly (p safety culture variation exists across ICUs of a single hospital. ICU nursing directors tend to overestimate their personnel's attitudes, particularly for teamwork. Culture assessments based on institutional level analysis or director opinion may be flawed.

  6. Chronic obstructive pulmonary disease pathways as a tool to improve appropriateness in Internal Medicine Departments

    Directory of Open Access Journals (Sweden)

    Francesco Ventrella

    2014-09-01

    Full Text Available In recent decades, in the medical field, criteria and methods of decision-making have radically changed, going from an environment dominated by opinions and knowledge transmitted from experts to a context of evidence-based medicine, that finds its practical realization in the drafting of guidelines (GL. However, GL have a poor implementation in the real world for several factors. In the field of chronic obstructive pulmonary disease (COPD, there are already many GL, international, national, regional and by specific scientific societies. This multiplicity, while it responds to the legitimate needs to respect the diversity of interpretation of the available scientific data, on the other hand, however, can be an element of confusion for physicians. In this varied scenery we have tried to create some new tools, easy and quick to use, in order to improve the local application of existing GL on COPD, by planning a limited number of pathways in the management of acute exacerbation of COPD, which focus on the fundamental diagnostic and therapeutic aspects, as a tool to improve appropriateness in Internal Medicine Departments. These pathways, reported on individual sheets, which can be distributed to medical personnel of wards/units involved in the care of patients with COPD (First Aid, Internal Medicine, Geriatrics, Pulmonology, Intensive Respiratory Care Unit, Resuscitation, are useful to support the physician in the decision-making process and help you to resolve any disputes.

  7. Characteristics of unit-level patient safety culture in hospitals in Japan: a cross-sectional study.

    Science.gov (United States)

    Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

    2014-10-22

    Patient safety culture (PSC) has an important role in determining safety and quality in healthcare. Currently, little is known about the status of unit-level PSC in hospitals in Japan. To develop appropriate strategies, characteristics of unit-level PSC should be investigated. Work units may be classified according to the characteristics of PSC, and common problems and appropriate strategies may be identified for each work unit category. This study aimed to clarify the characteristics of unit-level PSC in hospitals in Japan. In 2012, a cross-sectional study was conducted at 18 hospitals in Japan. The Hospital Survey on Patient Safety Culture questionnaire, developed by the United States Agency for Healthcare Research and Quality, was distributed to all healthcare workers (n =12,076). Percent positive scores for 12 PSC sub-dimensions were calculated for each unit, and cluster analysis was used to categorise the units according to the percent positive scores. A generalised linear mixed model (GLMM) was used to analyse the results of the cluster analysis, and odds ratios (ORs) for categorisation as high-PSC units were calculated for each unit type. A total of 9,124 respondents (75.6%) completed the questionnaire, and valid data from 8,700 respondents (72.0%) were analysed. There were 440 units in the 18 hospitals. According to the percent positive scores for the 12 sub-dimensions, the 440 units were classified into 2 clusters: high-PSC units (n =184) and low-PSC units (n =256). Percent positive scores for all PSC sub-dimensions for high-PSC units were significantly higher than those for low-PSC units. The GLMM revealed that the combined unit type of 'Obstetrics and gynaecology ward, perinatal ward or neonatal intensive care unit' was significantly more likely to be categorised as high-PSC units (OR =9.7), and 'Long-term care ward' (OR =0.2), 'Rehabilitation unit' (OR =0.2) and 'Administration unit' (OR =0.3) were significantly less likely to be categorised as high

  8. Consistency of motor-unit identification during force-varying static contractions

    DEFF Research Database (Denmark)

    Pilegaard, M; Jensen, B R; Sjøgaard, G

    2000-01-01

    active either before or after the 1 s at 0% MVC, and 18 as being de-recruited during force decreases and recruited during force increases. Both operators agreed that 16 of these 18 MUs were de-recruited at a higher force level than that at which they were recruited, which may be due...... to the electromechanical delay. The coefficient of variation for double determination of the results obtained by operators A and B was 8.5% for the number of MU firings, 4.5% for the MU mean firing rate, and 8.4% for the MU action potential (MUAP) amplitude. Therefore, the operator interactive decomposition method...... was considered to be valid for studying recruitment and de-recruitment as well as firing rate and MUAP amplitude during static, force-varying ramp contractions....

  9. Selecting Appropriate Spatial Scale for Mapping Plastic-Mulched Farmland with Satellite Remote Sensing Imagery

    Directory of Open Access Journals (Sweden)

    Hasituya

    2017-03-01

    Full Text Available In recent years, the area of plastic-mulched farmland (PMF has undergone rapid growth and raised remarkable environmental problems. Therefore, mapping the PMF plays a crucial role in agricultural production, environmental protection and resource management. However, appropriate data selection criteria are currently lacking. Thus, this study was carried out in two main plastic-mulching practice regions, Jizhou and Guyuan, to look for an appropriate spatial scale for mapping PMF with remote sensing. The average local variance (ALV function was used to obtain the appropriate spatial scale for mapping PMF based on the GaoFen-1 (GF-1 satellite imagery. Afterwards, in order to validate the effectiveness of the selected method and to interpret the relationship between the appropriate spatial scale derived from the ALV and the spatial scale with the highest classification accuracy, we classified the imagery with varying spatial resolution by the Support Vector Machine (SVM algorithm using the spectral features, textural features and the combined spectral and textural features respectively. The results indicated that the appropriate spatial scales from the ALV lie between 8 m and 20 m for mapping the PMF both in Jizhou and Guyuan. However, there is a proportional relation: the spatial scale with the highest classification accuracy is at the 1/2 location of the appropriate spatial scale generated from the ALV in Jizhou and at the 2/3 location of the appropriate spatial scale generated from the ALV in Guyuan. Therefore, the ALV method for quantitatively selecting the appropriate spatial scale for mapping PMF with remote sensing imagery has theoretical and practical significance.

  10. Spatially varying predictors of teenage birth rates among counties in the United States

    Directory of Open Access Journals (Sweden)

    Carla Shoff

    2012-09-01

    Full Text Available BACKGROUND Limited information is available about teenage pregnancy and childbearing in rural areas, even though approximately 20 percent of the nation's youth live in rural areas. Identifying whether there are differences in the teenage birth rate (TBR across metropolitan and nonmetropolitan areas is important because these differences may reflect modifiable ecological-level influences such as education, employment, laws, healthcare infrastructure, and policies that could potentially reduce the TBR. OBJECTIVE The goals of this study are to investigate whether there are spatially varying relationships between the TBR and the independent variables, and if so, whether these associations differ between metropolitan and nonmetropolitan counties. METHODS We explore the heterogeneity within metropolitan/nonmetropolitan county groups separately using geographically weighted regression (GWR, and investigate the difference between metropolitan/nonmetropolitan counties using spatial regime models with spatial errors. These analyses were applied to county-level data from the National Center for Health Statistics and the US Census Bureau. RESULTS GWR results suggested that non-stationarity exists in the associations between TBR and determinants within metropolitan/nonmetropolitan groups. The spatial regime analysis indicated that the effect of socioeconomic disadvantage on TBR significantly varied by the metropolitan status of counties. CONCLUSIONS While the spatially varying relationships between the TBR and independent variables were found within each metropolitan status of counties, only the magnitude of the impact of the socioeconomic disadvantage index is significantly stronger among metropolitan counties than nonmetropolitan counties. Our findings suggested that place-specific policies for the disadvantaged groups in a county could be implemented to reduce TBR in the US.

  11. 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

  12. The characteristics and prognosis of patients fulfilling the Appropriateness Evaluation Protocol in a medical admission unit; a prospective observational study

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Knudsen, Torben; Hallas, Jesper

    2011-01-01

    To examine the prognostic significance of fulfilling at least one of the Appropriateness Evaluation Protocol (AEP) criteria.......To examine the prognostic significance of fulfilling at least one of the Appropriateness Evaluation Protocol (AEP) criteria....

  13. Hanford Site Waste management units report

    International Nuclear Information System (INIS)

    1992-01-01

    This report summarizes the operable units in several areas of the Hanford Site Waste Facility. Each operable unit has several waste units (crib, ditch, pond, etc.). The operable units are summarized by describing each was unit. Some of the descriptions are unit name, unit type, waste category start data, site description, etc. The descriptions will vary for each waste unit in each operable unit and area of the Hanford Site

  14. 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.

  15. ACR Appropriateness Criteria® Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer.

    Science.gov (United States)

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

    2017-11-01

    Patients with locally advanced invasive breast cancers are often treated with neoadjuvant chemotherapy prior to definitive surgical intervention. The primary aims of this approach are to: 1) reduce tumor burden thereby permitting breast conservation rather than mastectomy; 2) promptly treat possible metastatic disease, whether or not it is detectable on preoperative staging; and 3) potentially tailor future chemotherapeutic decisions by monitoring in-vivo tumor response. Accurate radiological assessment permits optimal management and planning in this population. However, assessment of tumor size and response to treatment can vary depending on the modality used, the measurement technique (such as single longest diameter, 3-D measurements, or calculated tumor volume), and varied response of different tumor subtypes to neoadjuvant chemotherapy (such as concentric shrinkage or tumor fragmentation). As discussed in further detail, digital mammography, digital breast tomosynthesis, US and MRI represent the key modalities with potential to help guide patient management. 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. Model Complexities of Shallow Networks Representing Highly Varying Functions

    Czech Academy of Sciences Publication Activity Database

    Kůrková, Věra; Sanguineti, M.

    2016-01-01

    Roč. 171, 1 January (2016), s. 598-604 ISSN 0925-2312 R&D Projects: GA MŠk(CZ) LD13002 Grant - others:grant for Visiting Professors(IT) GNAMPA-INdAM Institutional support: RVO:67985807 Keywords : shallow networks * model complexity * highly varying functions * Chernoff bound * perceptrons * Gaussian kernel units Subject RIV: IN - Informatics, Computer Science Impact factor: 3.317, year: 2016

  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. 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...

  19. 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

  20. 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...

  1. 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...

  2. 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

  3. Estimation of time-varying reactivity by the H∞ optimal linear filter

    International Nuclear Information System (INIS)

    Suzuki, Katsuo; Shimazaki, Junya; Watanabe, Koiti

    1995-01-01

    The problem of estimating the time-varying net reactivity from flux measurements is solved for a point reactor kinetics model using a linear filtering technique in an H ∞ settings. In order to sue this technique, an appropriate dynamical model of the reactivity is constructed that can be embedded into the reactor model as one of its variables. A filter, which minimizes the H ∞ norm of the estimation error power spectrum, operates on neutron density measurements corrupted by noise and provides an estimate of the dynamic net reactivity. Computer simulations are performed to reveal the basic characteristics of the H ∞ optimal filter. The results of the simulation indicate that the filter can be used to determine the time-varying reactivity from neutron density measurements that have been corrupted by noise

  4. 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),…

  5. 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...

  6. 28 CFR 0.190 - Changes within organizational units.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Changes within organizational units. 0... JUSTICE Sections and Subunits § 0.190 Changes within organizational units. (a) The head of each Office... termination of major functions within his organizational unit as he may deem necessary or appropriate. In each...

  7. 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.

  8. The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

    International Nuclear Information System (INIS)

    Gerbaud, Laurent; Manhes, Geraud; Debourse, Juliette; Gouby, Gerald; Glanddier, Phyllis-Yvonne; Vader, John-Paul; Boyer, Louis; Deteix, Patrice

    2008-01-01

    Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis (≥70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http

  9. Passivity of memristive BAM neural networks with leakage and additive time-varying delays

    Science.gov (United States)

    Wang, Weiping; Wang, Meiqi; Luo, Xiong; Li, Lixiang; Zhao, Wenbing; Liu, Linlin; Ping, Yuan

    2018-02-01

    This paper investigates the passivity of memristive bidirectional associate memory neural networks (MBAMNNs) with leakage and additive time-varying delays. Based on some useful inequalities and appropriate Lyapunov-Krasovskii functionals (LKFs), several delay-dependent conditions for passivity performance are obtained in linear matrix inequalities (LMIs). Moreover, the leakage delays as well as additive delays are considered separately. Finally, numerical simulations are provided to demonstrate the feasibility of the theoretical results.

  10. A control approach for the operation of DG units under variations of interfacing impedance in grid-connected mode

    DEFF Research Database (Denmark)

    Hoseini, S. Kazem; Pouresmaeil, E.; Hosseinnia, S. H.

    2016-01-01

    . However, the converter-based DG interface is subjected to the unexpected uncertainties, which highly influence performance of control loop of DG unit and operation of interfaced converter. The interfacing impedance seen by interfaced VSC may considerably vary in power grid, and the stability of interfaced...... converter is highly sensitive to the impacts of this impedance changes; then, DG unit cannot inject appropriate currents. To deal with the instability problem, a control method based on fractional order active sliding mode is proposed in this paper, which is less sensitive to variations of interfacing...... impedance. A fractional sliding surface, which demonstrates the desired dynamics of system is developed and then, the controller is designed in two phases as sliding and reaching phases to keep the control loop stable. Stability issues of the control method are discussed in details and the conditions...

  11. 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 ...

  12. Magnetohydrodynamic Stability of Streaming Jet Pervaded Internally by Varying Transverse Magnetic Field

    Directory of Open Access Journals (Sweden)

    Alfaisal A. Hasan

    2012-01-01

    Full Text Available The Magnetohydrodynamic stability of a streaming cylindrical model penetrated by varying transverse magnetic field has been discussed. The problem is formulated, the basic equations are solved, upon appropriate boundary conditions the eigenvalue relation is derived and discussed analytically, and the results are verified numerically. The capillary force is destabilizing in a small axisymmetric domain 0<<1 and stabilizing otherwise. The streaming has a strong destabilizing effect in all kinds of perturbation. The toroidal varying magnetic field interior the fluid has no direct effect at all on the stability of the fluid column. The axial exterior field has strong stabilizing effect on the model. The effect of all acting forces altogether could be identified via the numerical analysis of the stability theory of the present model.

  13. Perfect fluid Bianchi Type-I cosmological models with time varying G ...

    Indian Academy of Sciences (India)

    Abstract. Bianchi Type-I cosmological models containing perfect fluid with time vary- ing G and Λ have been presented. The solutions obtained represent an expansion scalar θ bearing a constant ratio to the anisotropy in the direction of space-like unit vector λi. Of the two models obtained, one has negative vacuum energy ...

  14. Information Literacy in Postsecondary Education in the United Kingdom, the United States, Australia, and New Zealand

    Science.gov (United States)

    Folk, Amanda L.

    2016-01-01

    This comparison seeks to determine if the three documents addressing information literacy skills and competence developed by professional library associations for postsecondary education in four predominantly English-speaking countries--the United Kingdom, the United States, Australia, and New Zealand--have similar or varying conceptions of…

  15. Appropriate technology for domestic wastewater management in under-resourced regions of the world

    Science.gov (United States)

    Oladoja, Nurudeen Abiola

    2017-11-01

    Centralized wastewater management system is the modern day waste management practice, but the high cost and stringent requirements for the construction and operation have made it less attractive in the under-resourced regions of the world. Considering these challenges, the use of decentralized wastewater management system, on-site treatment system, as an appropriate technology for domestic wastewater treatment is hereby advocated. Adopting this technology helps save money, protects home owners' investment, promotes better watershed management, offers an appropriate solution for low-density communities, provides suitable alternatives for varying site conditions and furnishes effective solutions for ecologically sensitive areas. In the light of this, an overview of the on-site treatment scheme, at the laboratory scale, pilot study stage, and field trials was conducted to highlight the operational principles' strength and shortcomings of the scheme. The operational requirements for the establishing and operation of the scheme and best management practice to enhance the performance and sustenance were proffered.

  16. Lyapunov Functions to Caputo Fractional Neural Networks with Time-Varying Delays

    Directory of Open Access Journals (Sweden)

    Ravi Agarwal

    2018-05-01

    Full Text Available One of the main properties of solutions of nonlinear Caputo fractional neural networks is stability and often the direct Lyapunov method is used to study stability properties (usually these Lyapunov functions do not depend on the time variable. In connection with the Lyapunov fractional method we present a brief overview of the most popular fractional order derivatives of Lyapunov functions among Caputo fractional delay differential equations. These derivatives are applied to various types of neural networks with variable coefficients and time-varying delays. We show that quadratic Lyapunov functions and their Caputo fractional derivatives are not applicable in some cases when one studies stability properties. Some sufficient conditions for stability of equilibrium of nonlinear Caputo fractional neural networks with time dependent transmission delays, time varying self-regulating parameters of all units and time varying functions of the connection between two neurons in the network are obtained. The cases of time varying Lipschitz coefficients as well as nonLipschitz activation functions are studied. We illustrate our theory on particular nonlinear Caputo fractional neural networks.

  17. Unit Pricing and Alternatives: Developing an Individualized Shopping Strategy.

    Science.gov (United States)

    Cude, Brenda; Walker, Rosemary

    1985-01-01

    This article offers a new perspective on the teaching of unit pricing in consumer economics classes by identifying ways to teach the costs as well as the benefits of unit pricing and realistic guidelines for suggesting situations in which it is most appropriate. Alternatives to unit pricing will also be explored. (CT)

  18. 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…

  19. The costume of Shangri-La: thoughts on white privilege, cultural appropriation, and anti-asian racism.

    Science.gov (United States)

    Kleisath, C Michelle

    2014-01-01

    This piece poses cultural appropriation as an undertheorized aspect of white privilege in White Privilege Studies. By way of narrative exploration, it asserts that a paucity of scholarship on Orientalism and anti-Asian racism has created a gap in White Privilege Studies that curbs its radical transformative potential. It argues for the value of a structural and historically focused lens for understanding the issue of cultural appropriation, and extends questions of culture and race relations beyond the borders of the United States. It also explores the complex ways that interracial and transnational relationships can influence white racial identity, and illustrates the disruptive potential that queer interracial relationships can offer to dominant historical patterns of white behavior.

  20. 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...

  1. Economics of superconductive energy storage inductor-converter units in power systems

    International Nuclear Information System (INIS)

    Yadavalli, S.R.

    1975-01-01

    Since the original proposal by Boom and Peterson in 1972, there has been growing interest in superconductive energy storage inductor converter units (IC units) for use in large power systems for peak shaving and load leveling. Different aspects of it are being studied at the University of Wisconsin and elsewhere. An economic study of such IC units shows that large IC units, bigger than about 1000 MWh, are economically competitive with other peaking alternatives, larger units being more economical. External electrical circuit losses in IC units have negligible effect on their storage and power capacities. There are three credits which could be of significant economic value to IC units. These are: (1) transmission credit which varied from about $4 to $60/kW peak power, with a typical value of about $35/kW; (2) pollution credit which varied from about $5 to $160/kW with a typical value of $80/kW; and Spinning Reserve Credit which varied from about $20 to $370/kW with a typical value of $90/kW

  2. Varying coefficient subdistribution regression for left-truncated semi-competing risks data.

    Science.gov (United States)

    Li, Ruosha; Peng, Limin

    2014-10-01

    Semi-competing risks data frequently arise in biomedical studies when time to a disease landmark event is subject to dependent censoring by death, the observation of which however is not precluded by the occurrence of the landmark event. In observational studies, the analysis of such data can be further complicated by left truncation. In this work, we study a varying co-efficient subdistribution regression model for left-truncated semi-competing risks data. Our method appropriately accounts for the specifical truncation and censoring features of the data, and moreover has the flexibility to accommodate potentially varying covariate effects. The proposed method can be easily implemented and the resulting estimators are shown to have nice asymptotic properties. We also present inference, such as Kolmogorov-Smirnov type and Cramér Von-Mises type hypothesis testing procedures for the covariate effects. Simulation studies and an application to the Denmark diabetes registry demonstrate good finite-sample performance and practical utility of the proposed method.

  3. Working Together to Define Antibiotic Appropriateness: Point Prevalence Survey in 47 Intensive Care Units from 12 US Hospitals, Partnership for Quality Care, March 2017

    Science.gov (United States)

    Trivedi, Kavita K; Ostrowsky, Belinda; Abbo, Lilian M; Srinivasan, Arjun; Bartash, Rachel; Cassera, Fred; Fleisher, Jorge; Kubiak, David W; Letourneau, Alyssa R; Nori, Priya; Parodi, Stephen; Aragon, Laura; Dollard, Eliza; Gagliardo, Christina; Ghitan, Monica; Giles, Amber; Mayer, Suri; Quevedo, Jennifer; Rieg, Gunter; Shteyman, Galina; Vargas, Jaclyn; Kelley, Shannon; Silver, Phyllis

    2017-01-01

    Abstract Background A national assessment of antibiotic appropriateness in intensive care units (ICUs) with benchmarking was performed to assist antibiotic stewardship programs (ASPs) identify improvement opportunities. Methods A Centers for Disease Control and Prevention tool was adapted by an expert panel from the Partnership for Quality Care (PQC), a coalition dedicated to high quality care in US hospitals, to validate appropriate antibiotic use measurement via a point prevalence survey on a single day. Data were collected by ASP personnel at each hospital, de-identified and submitted in aggregate to PQC for benchmarking. Hospitals identified reasons for inappropriate antibiotic use by category and antibiotics misused. Results Forty-seven ICUs from 12 PQC hospitals participated: California (2), Florida (2), Massachusetts (3), Minnesota (1), and New York (4). Most hospitals identified as teaching (83%) with 252-1550 bed size (median: 563) and 20–270 licensed ICU beds (median: 70). All hospitals reported a formal ASP. On March 1, 2017, 362 (54%) of 667 patients in participating ICUs were on antibiotics (range: 8-81 patients); 1 patient was not assessed. Of the remaining 361 antibiotic regimens, 112 (31%) were identified as inappropriate from among all 12 hospitals (range: 9-82%) (figure). The table displays inappropriate antibiotic use by ICU type. Reasons for inappropriate use included unnecessarily broad spectrum of activity (29%), duration longer than necessary (21%), and treatment of a non-infectious syndrome (19%). The antibiotic most commonly misused was vancomycin in 7 (58%) hospitals. Conclusion Up to 80% of antibiotic use in some ICUs is inappropriate, underscoring the need for ASP interventions, standardized assessment tools and benchmarking. Strategies should focus on de-escalation of broad-spectrum antibiotics and reducing duration of therapy. Disclosures D. W. Kubiak, Shionogi: Consultant, Consulting fee. Astellas Pharma: Consultant, Consulting

  4. Karl Marx, Ludwig Wittgenstein, and Black Underachievement in the United States and United Kingdom

    Science.gov (United States)

    Tomlin, Carol; Wright, Cecile; Mocombe, Paul C.

    2013-01-01

    This article synthesizes Marxian conceptions of identity construction within capitalist relations of production with the Wittgensteinian notion of "language games" to offer a more appropriate relational framework within which scholars ought to understand the Black-White academic achievement gap in America, the United Kingdom, and…

  5. Adaptive Neural Network Control for Nonlinear Hydraulic Servo-System with Time-Varying State Constraints

    Directory of Open Access Journals (Sweden)

    Shu-Min Lu

    2017-01-01

    Full Text Available An adaptive neural network control problem is addressed for a class of nonlinear hydraulic servo-systems with time-varying state constraints. In view of the low precision problem of the traditional hydraulic servo-system which is caused by the tracking errors surpassing appropriate bound, the previous works have shown that the constraint for the system is a good way to solve the low precision problem. Meanwhile, compared with constant constraints, the time-varying state constraints are more general in the actual systems. Therefore, when the states of the system are forced to obey bounded time-varying constraint conditions, the high precision tracking performance of the system can be easily realized. In order to achieve this goal, the time-varying barrier Lyapunov function (TVBLF is used to prevent the states from violating time-varying constraints. By the backstepping design, the adaptive controller will be obtained. A radial basis function neural network (RBFNN is used to estimate the uncertainties. Based on analyzing the stability of the hydraulic servo-system, we show that the error signals are bounded in the compacts sets; the time-varying state constrains are never violated and all singles of the hydraulic servo-system are bounded. The simulation and experimental results show that the tracking accuracy of system is improved and the controller has fast tracking ability and strong robustness.

  6. Wave scattering by an axisymmetric ice floe of varying thickness

    Science.gov (United States)

    Bennetts, Luke G.; Biggs, Nicholas R. T.; Porter, David

    2009-04-01

    The problem of water wave scattering by a circular ice floe, floating in fluid of finite depth, is formulated and solved numerically. Unlike previous investigations of such situations, here we allow the thickness of the floe (and the fluid depth) to vary axisymmetrically and also incorporate a realistic non-zero draught. A numerical approximation to the solution of this problem is obtained to an arbitrary degree of accuracy by combining a Rayleigh-Ritz approximation of the vertical motion with an appropriate variational principle. This numerical solution procedure builds upon the work of Bennets et al. (2007, J. Fluid Mech., 579, 413-443). As part of the numerical formulation, we utilize a Fourier cosine expansion of the azimuthal motion, resulting in a system of ordinary differential equations to solve in the radial coordinate for each azimuthal mode. The displayed results concentrate on the response of the floe rather than the scattered wave field and show that the effects of introducing the new features of varying floe thickness and a realistic draught are significant.

  7. 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.

  8. 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.

  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. Cold fission description with constant and varying mass asymmetries

    International Nuclear Information System (INIS)

    Duarte, S.B.; Rodriguez, O.; Tavares, O.A.P.; Goncalves, M.; Garcia, F.; Guzman, F.

    1998-01-01

    Different description for varying the mass asymmetry in the fragmentation process are used to calculate the cold fission barrier penetrability. The relevance of the appropriate choice for both the description of the pre-scission phase and inertia coefficient to unify alpha decay, cluster radioactivity, and spontaneous cold fission processes in the same theoretical framework is explicitly shown. We calculate the half-life of all possible partition modes of nuclei of A > 200 following the most recent Mass Table by Audi and Wapstra. It is shown that if one uses the description in which the mass asymmetry is maintained constant during the fragmentation process, the experimental half-life-values and mass yield of 234 U cold fission are satisfactorily reproduced. (author)

  11. Human appropriation of net primary production in the United Kingdom, 1800-2000. Changes in society's impact on ecological energy flows during the agrarian-industrial transition

    International Nuclear Information System (INIS)

    Musel, Annabella

    2009-01-01

    This paper presents an empirical analysis of the United Kingdom's society's long-term intervention into the energy flows of domestic terrestrial ecosystems through the human appropriation of aboveground net primary production (aHANPP) covering the period 1800-2000. The depicted aHANPP trajectory and the historical development of its components are discussed in view of a continuously increasing population and the transition process from an agrarian to an industrial socioecological regime. During the 19th century, aHANPP shows a steady decline from its level of 71% in 1800. While even higher levels were reached during the mid 20th century, the trend during the last forty years of the period under investigation again shows a reduction of aHANPP, which lies at 68% in the year 2000. The high values of aHANPP in the United Kingdom are primarily attributable to the limited amount of forest in comparison to large agricultural areas. At the beginning of the studied period, the relative stabilisation or even decrease in aHANPP in comparison to population development was made possible through the area expansion of and productivity increases on cropland and permanent pastures. Later this was made possible through the outsourcing of biomass harvest, by satisfying local nutritional demands by means of overseas imports, and as from the mid 20th century through huge amounts of fossil fuel based inputs into agriculture (e.g. increased amounts of fertilizers and motorized traction) which allowed increases in biomass harvest to be decoupled from HANPP. (author)

  12. Method and apparatus of prefetching streams of varying prefetch depth

    Science.gov (United States)

    Gara, Alan [Mount Kisco, NY; Ohmacht, Martin [Yorktown Heights, NY; Salapura, Valentina [Chappaqua, NY; Sugavanam, Krishnan [Mahopac, NY; Hoenicke, Dirk [Seebruck-Seeon, DE

    2012-01-24

    Method and apparatus of prefetching streams of varying prefetch depth dynamically changes the depth of prefetching so that the number of multiple streams as well as the hit rate of a single stream are optimized. The method and apparatus in one aspect monitor a plurality of load requests from a processing unit for data in a prefetch buffer, determine an access pattern associated with the plurality of load requests and adjust a prefetch depth according to the access pattern.

  13. 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...

  14. The United States Approach to PLiM for LTO

    International Nuclear Information System (INIS)

    2015-01-01

    The organizational structure for PLiM in the United States of America varies widely from plant to plant. For example, some plants may have a dedicated PLiM organization that coordinates the PLiM activities and provides the PLiM study results to the appropriate plant organizations (e.g. maintenance, engineering and operations) for implementation. Other plants may not have a dedicated PLiM organization, but rely on various organizations (e.g. design engineering, system engineering and maintenance) to conduct needed PLiM studies for LTO on a case by case (e.g. by component groups, such as piping, cables and transformers) or by individual components (turbine generator or steam generator). The organizational structure for preparing an LRA varies from utility to utility, but a typical structure is based on creating a project team to address each major discipline of the needed studies. The team members may be from utility organizations, contracted consultants who specialize in preparing LRAs, or a combination of the two groups, which is most common. A typical organizational structure is shown. The team typically consists of 10 to 20 full time members, with several other part time support members from various expert organizations (both utility and contracted consultants) needed to perform the engineering, ageing management and environmental studies and to prepare the supporting documentation for the LRA project

  15. Analytic strategies to evaluate the association of time-varying exposures to HIV-related outcomes: Alcohol consumption as an example.

    Science.gov (United States)

    Cook, Robert L; Kelso, Natalie E; Brumback, Babette A; Chen, Xinguang

    2016-01-01

    As persons with HIV are living longer, there is a growing need to investigate factors associated with chronic disease, rate of disease progression and survivorship. Many risk factors for this high-risk population change over time, such as participation in treatment, alcohol consumption and drug abuse. Longitudinal datasets are increasingly available, particularly clinical data that contain multiple observations of health exposures and outcomes over time. Several analytic options are available for assessment of longitudinal data; however, it can be challenging to choose the appropriate analytic method for specific combinations of research questions and types of data. The purpose of this review is to help researchers choose the appropriate methods to analyze longitudinal data, using alcohol consumption as an example of a time-varying exposure variable. When selecting the optimal analytic method, one must consider aspects of exposure (e.g. timing, pattern, and amount) and outcome (fixed or time-varying), while also addressing minimizing bias. In this article, we will describe several analytic approaches for longitudinal data, including developmental trajectory analysis, generalized estimating equations, and mixed effect models. For each analytic strategy, we describe appropriate situations to use the method and provide an example that demonstrates the use of the method. Clinical data related to alcohol consumption and HIV are used to illustrate these methods.

  16. 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...

  17. Impact of oncology-related direct-to-consumer advertising: association with appropriate and inappropriate prescriptions.

    Science.gov (United States)

    Abel, Gregory A; Chen, Kun; Taback, Nathan; Hassett, Michael J; Schrag, Deborah; Weeks, Jane C

    2013-03-01

    Little is known about the impact of direct-to-consumer advertising (DTCA) on appropriate versus inappropriate prescribing. Aromatase inhibitor (AI) therapy for breast cancer provides an ideal paradigm for studying this issue, because AIs have been the focus of substantial DTCA, and because they should only be used in postmenopausal women, age can serve as a simple surrogate marker of appropriateness. Data regarding national DTCA spending for the AIs were obtained from TNS Multimedia; hormonal therapy prescription data were obtained from IMS Health. Time series analyses were performed to characterize the association between monthly changes in DTCA spending for the AIs and monthly changes in the proportion of all new hormonal therapy prescriptions represented by the AIs from October 2005 to September 2007. Analyses were stratified by age, considering prescriptions for women ≤ 40 (likely premenopausal) to be inappropriate and those for women > 60 (likely postmenopausal) to be appropriate. Monthly dollars spent on AI-associated DTCA varied considerably ($118,600 to $22,019,660). Time series analysis revealed that for every million dollars spent on DTCA for the AIs, there was an associated increase 3 months later in the new AI prescription proportion of 0.15% for all ages (P 60 years (P < .0001), but no significant change for those ≤ 40 at any time from 0 to 6 months. DTCA for the AIs was associated with increases in appropriate prescriptions with no significant effect on inappropriate prescriptions, suggesting that DTCA may not foster inappropriate medication use for certain drug classes. Copyright © 2012 American Cancer Society.

  18. 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.

  19. 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.

  20. A discrete time-varying internal model-based approach for high precision tracking of a multi-axis servo gantry.

    Science.gov (United States)

    Zhang, Zhen; Yan, Peng; Jiang, Huan; Ye, Peiqing

    2014-09-01

    In this paper, we consider the discrete time-varying internal model-based control design for high precision tracking of complicated reference trajectories generated by time-varying systems. Based on a novel parallel time-varying internal model structure, asymptotic tracking conditions for the design of internal model units are developed, and a low order robust time-varying stabilizer is further synthesized. In a discrete time setting, the high precision tracking control architecture is deployed on a Voice Coil Motor (VCM) actuated servo gantry system, where numerical simulations and real time experimental results are provided, achieving the tracking errors around 3.5‰ for frequency-varying signals. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Non-linear Loudspeaker Unit Modelling

    DEFF Research Database (Denmark)

    Pedersen, Bo Rohde; Agerkvist, Finn T.

    2008-01-01

    Simulations of a 6½-inch loudspeaker unit are performed and compared with a displacement measurement. The non-linear loudspeaker model is based on the major nonlinear functions and expanded with time-varying suspension behaviour and flux modulation. The results are presented with FFT plots of thr...... frequencies and different displacement levels. The model errors are discussed and analysed including a test with loudspeaker unit where the diaphragm is removed....

  2. Some pitfalls in unit root testing

    NARCIS (Netherlands)

    Bakker, B.B.; Koning, Ruud H.

    1991-01-01

    Testing for unit roots is now common practice for economists. The most popular procedure is the approach developed by Dickey and Fuller (1979, 1981), which only requires running appropriately specified regressions. However, application of the Dickey-Fuller procedure requires that the disturbance

  3. 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)

  4. 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...

  5. Multiperiod Maximum Loss is time unit invariant.

    Science.gov (United States)

    Kovacevic, Raimund M; Breuer, Thomas

    2016-01-01

    Time unit invariance is introduced as an additional requirement for multiperiod risk measures: for a constant portfolio under an i.i.d. risk factor process, the multiperiod risk should equal the one period risk of the aggregated loss, for an appropriate choice of parameters and independent of the portfolio and its distribution. Multiperiod Maximum Loss over a sequence of Kullback-Leibler balls is time unit invariant. This is also the case for the entropic risk measure. On the other hand, multiperiod Value at Risk and multiperiod Expected Shortfall are not time unit invariant.

  6. 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

  7. Regionally-varying and regionally-uniform electricity pricing policies compared across four usage categories

    International Nuclear Information System (INIS)

    Cho, Seong-Hoon; Kim, Taeyoung; Kim, Hyun Jae; Park, Kihyun; Roberts, Roland K.

    2015-01-01

    The objective of our research is to predict how electricity demand varies spatially between status quo regionally-uniform electricity pricing and hypothetical regionally-varying electricity pricing across usage categories. We summarize the empirical results of a case study of electricity demand in South Korea with three key findings and their related implications. First, the price elasticities of electricity demand differ across usage categories. Specifically, electricity demands for manufacturing and retail uses are price inelastic and close to unit elastic, respectively, while those for agricultural and residential uses are not statistically significant. This information is important in designing energy policy, because higher electricity prices could reduce electricity demands for manufacturing and retail uses, resulting in slower growth in those sectors. Second, spatial spillovers in electricity demand vary across uses. Understanding the spatial structure of electricity demand provides useful information to energy policy makers for anticipating changes in demand across regions via regionally-varying electricity pricing for different uses. Third, simulation results suggest that spatial variations among electricity demands by usage category under a regionally-varying electricity-pricing policy differ from those under a regionally-uniform electricity-pricing policy. Differences in spatial changes between the policies provide information for developing a realistic regionally-varying electricity-pricing policy according to usage category. - Highlights: • We compare regionally-varying and regionally-uniform electricity pricing policies. • We summarize empirical results of a case study of electricity demand in South Korea. • We confirm that spatial spillovers in electricity demands vary across different uses. • We find positive spatial spillovers in the manufacturing and residential sectors. • Our methods help policy makers evaluate regionally-varying pricing

  8. Use of Indirect Calorimetry to Detect Overfeeding in Critically Ill Children: Finding the Appropriate Definition.

    Science.gov (United States)

    Kerklaan, Dorian; Hulst, Jessie M; Verhoeven, Jennifer J; Verbruggen, Sascha C A T; Joosten, Koen F M

    2016-10-01

    Overfeeding during critical illness is associated with adverse effects such as metabolic disturbances and increased risk of infection. Because of the lack of sound studies with clinical endpoints, overfeeding is arbitrarily defined as the ratio caloric intake/measured resting energy expenditure (mREE) or alternatively as a comparison of measured respiratory quotient (RQ) to the predicted RQ based on the macronutrient intake (RQmacr). We aimed to compare definitions of overfeeding in critically ill mechanically ventilated children based on mREE, RQ, and caloric intake to find an appropriate definition. Indirect calorimetry measurements were performed in 78 mechanically ventilated children, median age 6.3 months. Enteral and/or parenteral nutrition was provided according to the local guidelines. Definitions used to indicate overfeeding were the ratio caloric intake/mREE of >110% and >120% and by the measured RQ > RQmacr + 0.05. The proportion of patients identified as overfed varied widely depending on the definition used, ranging from 22% (RQ > RQmacr + 0.05), to 40% and 50% (caloric intake/mREE of >120% and >110%, respectively). Linear regression analysis showed that all patients would be identified as overfed with the definition RQ > RQmacr + 0.05 when the ratio caloric intake/mREE exceeded 165%. Caloric intake was higher in children with a standard deviation-score weight for age definition applied. These currently used definitions fail to take into account several relevant factors affecting metabolism during critical illness and are therefore not generally applicable to the pediatric intensive care unit population.

  9. 31 CFR 540.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 540.705 Section 540.705 Money and Finance: Treasury... Administrative collection; referral to United States Department of Justice. In the event that the respondent does... Treasury or to the United States Department of Justice for appropriate action to recover the penalty in a...

  10. 31 CFR 586.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 586.705 Section 586.705 Money and Finance: Treasury....705 Administrative collection; referral to United States Department of Justice. In the event that the... Treasury or to the United States Department of Justice for appropriate action to recover the penalty in a...

  11. 31 CFR 597.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 597.705 Section 597.705 Money and Finance: Treasury... collection; referral to United States Department of Justice. In the event that the respondent does not pay... Department of the Treasury or to the United States Department of Justice for appropriate action to recover...

  12. 31 CFR 587.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 587.705 Section 587.705 Money and Finance: Treasury... § 587.705 Administrative collection; referral to United States Department of Justice. In the event that... Department of the Treasury or to the United States Department of Justice for appropriate action to recover...

  13. The disconnect in the appropriation of new technologies into students’ everyday lives. A three country comparison.

    Directory of Open Access Journals (Sweden)

    André H. Caron

    2011-12-01

    Full Text Available There is little doubt that students eagerly appropriate new technologies into their lives.  However, the authors wanted to explore what steps would be needed to ensure a proper appropriation of new technologies when applied to academic settings.  This paper presents a 3-country comparison of students reporting on their academic activities and technology use in everyday life. Though the numbers vary slightly within each country, the final results show an overall disconnect between the amount of time students allot to technology use and academic activities. Overall, the findings shed some much needed statistical light on the current reality of students’ technological and academic habits. The authors propose possible next steps to take in order to better understand this phenomenon. Ultimately, this study urges educators and students alike to gather more information about the role social media plays in students’ lives. A better understanding of the situation could eventually lead to the successful integration of new technologies in academia.

  14. 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...

  15. 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...

  16. 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.

  17. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  18. Human appropriation of net primary production in the United Kingdom, 1800-2000. Changes in society's impact on ecological energy flows during the agrarian-industrial transition

    Energy Technology Data Exchange (ETDEWEB)

    Musel, Annabella [Institute of Social Ecology, Alpen-Adria University Klagenfurt - Graz - Wien, Schottenfeldgasse 29, 1070 Vienna (Austria)

    2009-12-15

    This paper presents an empirical analysis of the United Kingdom's society's long-term intervention into the energy flows of domestic terrestrial ecosystems through the human appropriation of aboveground net primary production (aHANPP) covering the period 1800-2000. The depicted aHANPP trajectory and the historical development of its components are discussed in view of a continuously increasing population and the transition process from an agrarian to an industrial socioecological regime. During the 19th century, aHANPP shows a steady decline from its level of 71% in 1800. While even higher levels were reached during the mid 20th century, the trend during the last forty years of the period under investigation again shows a reduction of aHANPP, which lies at 68% in the year 2000. The high values of aHANPP in the United Kingdom are primarily attributable to the limited amount of forest in comparison to large agricultural areas. At the beginning of the studied period, the relative stabilisation or even decrease in aHANPP in comparison to population development was made possible through the area expansion of and productivity increases on cropland and permanent pastures. Later this was made possible through the outsourcing of biomass harvest, by satisfying local nutritional demands by means of overseas imports, and as from the mid 20th century through huge amounts of fossil fuel based inputs into agriculture (e.g. increased amounts of fertilizers and motorized traction) which allowed increases in biomass harvest to be decoupled from HANPP. (author)

  19. A Simulation Based Analysis of Motor Unit Number Index (MUNIX) Technique Using Motoneuron Pool and Surface Electromyogram Models

    Science.gov (United States)

    Li, Xiaoyan; Rymer, William Zev; Zhou, Ping

    2013-01-01

    Motor unit number index (MUNIX) measurement has recently achieved increasing attention as a tool to evaluate the progression of motoneuron diseases. In our current study, the sensitivity of the MUNIX technique to changes in motoneuron and muscle properties was explored by a simulation approach utilizing variations on published motoneuron pool and surface electromyogram (EMG) models. Our simulation results indicate that, when keeping motoneuron pool and muscle parameters unchanged and varying the input motor unit numbers to the model, then MUNIX estimates can appropriately characterize changes in motor unit numbers. Such MUNIX estimates are not sensitive to different motor unit recruitment and rate coding strategies used in the model. Furthermore, alterations in motor unit control properties do not have a significant effect on the MUNIX estimates. Neither adjustment of the motor unit recruitment range nor reduction of the motor unit firing rates jeopardizes the MUNIX estimates. The MUNIX estimates closely correlate with the maximum M wave amplitude. However, if we reduce the amplitude of each motor unit action potential rather than simply reduce motor unit number, then MUNIX estimates substantially underestimate the motor unit numbers in the muscle. These findings suggest that the current MUNIX definition is most suitable for motoneuron diseases that demonstrate secondary evidence of muscle fiber reinnervation. In this regard, when MUNIX is applied, it is of much importance to examine a parallel measurement of motor unit size index (MUSIX), defined as the ratio of the maximum M wave amplitude to the MUNIX. However, there are potential limitations in the application of the MUNIX methods in atrophied muscle, where it is unclear whether the atrophy is accompanied by loss of motor units or loss of muscle fiber size. PMID:22514208

  20. Latex allergy: assessment of knowledge, appropriate use of gloves and prevention practice among hospital healthcare workers.

    Science.gov (United States)

    Al-Niaimi, F; Chiang, Y Z; Chiang, Y N; Williams, J

    2013-01-01

    Healthcare workers and patients are often exposed to natural rubber latex (NRL) through contact with gloves and various healthcare products, which can potentially cause allergic reactions, with varying degrees of severity. In 2008, the Royal College of Physicians published their first evidence-based guidance on occupational health interventions for latex allergy, which emphasized the importance of healthcare workers having knowledge of latex allergy. This study aimed to survey the knowledge of healthcare workers (n = 156) about latex gloves and NRL allergy, routine prevention practice and the appropriate use of gloves in patient care. Healthcare workers in a large teaching hospital were surveyed using a standard questionnaire. We found that only 1% of healthcare workers were able to correctly match the appropriate gloves to the specifically designed procedure. More than half (n = 74.53%) were unable to recognize the presentation of type 1 allergy to NRL. Of the 156 participants, 131 (84%) considered that they would benefit from training about NRL allergy and the use of different types of gloves in clinical care. This survey indicates the importance of education regarding appropriate use of gloves and prevention of NRL allergy among healthcare workers, and dermatologists should play an important role in facilitating this. © The Author(s). CED © 2012 British Association of Dermatologists.

  1. 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.

  2. 31 CFR 593.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 593.705 Section 593.705 Money and Finance: Treasury... collection; referral to United States Department of Justice. In the event that the respondent does not pay... United States Department of Justice for appropriate action to recover the penalty in a civil suit in a...

  3. 31 CFR 539.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 539.705 Section 539.705 Money and Finance: Treasury... collection; referral to United States Department of Justice. In the event that the respondent does not pay... United States Department of Justice for appropriate action to recover the penalty in a civil suit in a...

  4. 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)

  5. Response-only modal identification using random decrement algorithm with time-varying threshold level

    International Nuclear Information System (INIS)

    Lin, Chang Sheng; Tseng, Tse Chuan

    2014-01-01

    Modal Identification from response data only is studied for structural systems under nonstationary ambient vibration. The topic of this paper is the estimation of modal parameters from nonstationary ambient vibration data by applying the random decrement algorithm with time-varying threshold level. In the conventional random decrement algorithm, the threshold level for evaluating random dec signatures is defined as the standard deviation value of response data of the reference channel. The distortion of random dec signatures may be, however, induced by the error involved in noise from the original response data in practice. To improve the accuracy of identification, a modification of the sampling procedure in random decrement algorithm is proposed for modal-parameter identification from the nonstationary ambient response data. The time-varying threshold level is presented for the acquisition of available sample time history to perform averaging analysis, and defined as the temporal root-mean-square function of structural response, which can appropriately describe a wide variety of nonstationary behaviors in reality, such as the time-varying amplitude (variance) of a nonstationary process in a seismic record. Numerical simulations confirm the validity and robustness of the proposed modal-identification method from nonstationary ambient response data under noisy conditions.

  6. 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.

  7. [Appropriateness admissions to the Department of Internal Medicine of the Hospital de Santa Luzia (Elvas) evaluated by the AEP (Appropriateness Evaluation Protocol)].

    Science.gov (United States)

    Cordero, A; Aguila, J; Massalana, A; Escoto, V; Lopes, L; Susano, R

    2004-01-01

    The authors analyse the appropriateness admissions to the Internal Medicine ward of the Hospital de Santa Luzia (Elvas). A retrospective study was performed during 6 months of 2001, using the Appropriateness Evaluation Protocol (AEP). Non-appropriateness admissions were found in 19% (CI95%: 16-22), and this group of patients had less mean age (63 + 16 vs 69 + 16; p <0.01), and less mean days of admission (7.1 + 6 vs 9.3 + 7; p <0.01) than group with appropriateness admissions. Appropriateness admissions were mainly found in patients admitted from the emergency room (86% vs 49%; p <0.001). Most of patients with non-appropriate admissions were admitted to undergo diagnostic tests (44%; CI95%: 35-53), or to be referred to other medical centres for specialized study and/or treatment (12%; CI95%: 6-18).

  8. Adaptive fuzzy dynamic surface control of nonlinear systems with input saturation and time-varying output constraints

    Science.gov (United States)

    Edalati, L.; Khaki Sedigh, A.; Aliyari Shooredeli, M.; Moarefianpour, A.

    2018-02-01

    This paper deals with the design of adaptive fuzzy dynamic surface control for uncertain strict-feedback nonlinear systems with asymmetric time-varying output constraints in the presence of input saturation. To approximate the unknown nonlinear functions and overcome the problem of explosion of complexity, a Fuzzy logic system is combined with the dynamic surface control in the backstepping design technique. To ensure the output constraints satisfaction, an asymmetric time-varying Barrier Lyapunov Function (BLF) is used. Moreover, by applying the minimal learning parameter technique, the number of the online parameters update for each subsystem is reduced to 2. Hence, the semi-globally uniformly ultimately boundedness (SGUUB) of all the closed-loop signals with appropriate tracking error convergence is guaranteed. The effectiveness of the proposed control is demonstrated by two simulation examples.

  9. 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

  10. 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

  11. Closeness-Centrality-Based Synchronization Criteria for Complex Dynamical Networks With Interval Time-Varying Coupling Delays.

    Science.gov (United States)

    Park, Myeongjin; Lee, Seung-Hoon; Kwon, Oh-Min; Seuret, Alexandre

    2017-09-06

    This paper investigates synchronization in complex dynamical networks (CDNs) with interval time-varying delays. The CDNs are representative of systems composed of a large number of interconnected dynamical units, and for the purpose of the mathematical analysis, the leading work is to model them as graphs whose nodes represent the dynamical units. At this time, we take note of the importance of each node in networks. One way, in this paper, is that the closeness-centrality mentioned in the field of social science is grafted onto the CDNs. By constructing a suitable Lyapunov-Krasovskii functional, and utilizing some mathematical techniques, the sufficient and closeness-centrality-based conditions for synchronization stability of the networks are established in terms of linear matrix inequalities. Ultimately, the use of the closeness-centrality can be weighted with regard to not only the interconnection relation among the nodes, which was utilized in the existing works but also more information about nodes. Here, the centrality will be added as the concerned information. Moreover, to avoid the computational burden causing the nonconvex term including the square of the time-varying delay, how to deal with it is applied by estimating it to the convex term including time-varying delay. Finally, two illustrative examples are given to show the advantage of the closeness-centrality in point of the robustness on time-delay.

  12. 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.

  13. Investigation and management of gastro-oesophageal reflux in United Kingdom neonatal intensive care units.

    Science.gov (United States)

    Rossor, Thomas; Andradi, Gwendolyn; Bhat, Ravindra; Greenough, Anne

    2018-01-01

    In 2004, wide variation in the investigation and management of gastro-oesophageal reflux (GOR) of infants on UK major neonatal units was demonstrated. Our aim was to resurvey neonatal practitioners to determine current practice and whether it was now evidence based. A questionnaire was sent to all 207 UK neonatal units. Responses were obtained from 84% of units. The most frequent 'investigation' was a trial of therapy (83% of units); pH studies were used in 38%, upper GI contrast studies in 19% and multichannel intraluminal impedance (MII)/pH studies in 5%. Only six units suggested a threshold for an abnormal pH study and two units for an abnormal MII study. Infants were commenced on antireflux medication without investigation always in 32% of units, often in 29%, occasionally in 19% and only never in 1%. Gaviscon was used as first line treatment in 60% of units, and other medications included ranitidine in 53%, thickening agents in 27%, proton pump inhibitors in 23%, domperidone in 22% and erythromycin in 6%. There remains a wide variation in diagnostic and treatment strategies for infants with suspected GOR on neonatal intensive care units, emphasising the need for randomised trials to determine appropriate GOR management. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. 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

  15. 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.

  16. Gas metal arc welding of butt joint with varying gap width based on neural networks

    DEFF Research Database (Denmark)

    Christensen, Kim Hardam; Sørensen, Torben

    2005-01-01

    penetration, when the gap width is varying during the welding process. The process modeling to facilitate the mapping from joint geometry and reference weld quality to significant welding parameters, has been based on a multi-layer feed-forward network. The Levenberg-Marquardt algorithm for non-linear least......This paper describes the application of the neural network technology for gas metal arc welding (GMAW) control. A system has been developed for modeling and online adjustment of welding parameters, appropriate to guarantee a certain degree of quality in the field of butt joint welding with full...

  17. Prototype unit for the air decontamination

    International Nuclear Information System (INIS)

    Garcia A, J.

    1991-01-01

    In this work it has the objective of to design and to manufacture an unit that took advantage of the filters of national production in appropriate form, and to offer a wide protection to the maintenance personnel that carries out the replacement, besides to be able to be installed in any position and to facilitate the adsorber installation

  18. Unified electronic unit for miniature radioactivity logging equipment

    International Nuclear Information System (INIS)

    Bragin, A.A.; Goldshtejn, L.M.; Fedorov, R.F.; Shikhman, A.S.

    1981-01-01

    Appropriateness and urgency of the unification of components of radioactivity logging equipment used for the investigation of wells at solid mineral deposits is substantiated. A two-channel electronic unit for miniature equipment for radioactivity logging is described and its basic specifications and performance are given. All functional assemblies of the unit are structurally made in the form of printed circuit boards placed in a pan-shaped chassis 28 mm in diameter. The unit's general design provides for the possibility to attach two probes with detection devices to the unit. The unit is used in the two-channel radioactivity logging instrument ''Kura-2'' and in the two-channel radiometer ''RUR-2''. The outer diameter of these instruments is 48 mm and they ensure the investigation of ore and coal wells with a combination radioactivity methods [ru

  19. Microsatellites in varied arenas of research

    Directory of Open Access Journals (Sweden)

    K S Remya

    2010-01-01

    Full Text Available Microsatellites known as simple-sequence repeats (SSRs or short-tandem repeats (STRs, represent specific sequences of DNA consisting of tandemly repeated units of one to six nucleotides. The repetitive nature of microsatellites makes them particularly prone to grow or shrink in length and these changes can have both good and bad consequences for the organisms that possess them. They are responsible for various neurological diseases and hence the same cause is now utilized for the early detection of various diseases, such as, Schizophrenia and Bipolar Disorder, Congenital generalized Hypertrichosis, Asthma, and Bronchial Hyperresponsiveness. These agents are widely used for forensic identification and relatedness testing, and are predominant genetic markers in this area of application. The application of microsatellites is an extending web and covers the varied scenarios of science, such as, conservation biology, plant genetics, and population studies. At present, researches are progressing round the globe to extend the use of these genetic repeaters to unmask the hidden genetic secrets behind the creation of the world.

  20. Impact of Qualification Framework in United Arab Emirates: A case ...

    African Journals Online (AJOL)

    QFE) on the undergraduate Bachelor of Pharmacy (BPharm) curriculum in the United Arab Emirates (UAE) context. Method: Curriculum developers (faculty and other stakeholders) have selected appropriate teaching, learning and assessment ...

  1. Dealing with time-varying recruitment and length in Hill-type muscle models.

    Science.gov (United States)

    Hamouda, Ahmed; Kenney, Laurence; Howard, David

    2016-10-03

    Hill-type muscle models are often used in muscle simulation studies and also in the design and virtual prototyping of functional electrical stimulation systems. These models have to behave in a sufficiently realistic manner when recruitment level and contractile element (CE) length change continuously. For this reason, most previous models have used instantaneous CE length in the muscle׳s force vs. length (F-L) relationship, but thereby neglect the instability problem on the descending limb (i.e. region of negative slope) of the F-L relationship. Ideally CE length at initial recruitment should be used but this requires a multiple-motor-unit muscle model to properly account for different motor-units having different initial lengths when recruited. None of the multiple-motor-unit models reported in the literature have used initial CE length in the muscle׳s F-L relationship, thereby also neglecting the descending limb instability problem. To address the problem of muscle modelling for continuously varying recruitment and length, and hence different values of initial CE length for different motor-units, a new multiple-motor-unit muscle model is presented which considers the muscle to comprise 1000 individual Hill-type virtual motor-units, which determine the total isometric force. Other parts of the model (F-V relationship and passive elements) are not dependent on the initial CE length and, therefore, they are implemented for the muscle as a whole rather than for the individual motor-units. The results demonstrate the potential errors introduced by using a single-motor-unit model and also the instantaneous CE length in the F-L relationship, both of which are common in FES control studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Augmented brain function by coordinated reset stimulation with slowly varying sequences

    Directory of Open Access Journals (Sweden)

    Magteld eZeitler

    2015-03-01

    Full Text Available Several brain disorders are characterized by abnormally strong neuronal synchrony. Coordinated Reset (CR stimulation was developed to selectively counteract abnormal neuronal synchrony by desynchronization. For this, phase resetting stimuli are delivered to different subpopulations in a timely coordinated way. In neural networks with spike timing-dependent plasticity CR stimulation may eventually lead to an anti-kindling, i.e. an unlearning of abnormal synaptic connectivity and abnormal synchrony. The spatiotemporal sequence by which all stimulation sites are stimulated exactly once is called the stimulation site sequence, or briefly sequence. So far, in simulations, pre-clinical and clinical applications CR was applied either with fixed sequences or rapidly varying sequences (RVS. In this computational study we show that appropriate repetition of the sequence with occasional random switching to the next sequence may significantly improve the anti-kindling effect of CR. To this end, a sequence is applied many times before randomly switching to the next sequence. This new method is called SVS CR stimulation, i.e. CR with slowly varying sequences. In a neuronal network with strong short-range excitatory and weak long-range inhibitory dynamic couplings SVS CR stimulation turns out to be superior to CR stimulation with fixed sequences or RVS.

  3. Augmented brain function by coordinated reset stimulation with slowly varying sequences.

    Science.gov (United States)

    Zeitler, Magteld; Tass, Peter A

    2015-01-01

    Several brain disorders are characterized by abnormally strong neuronal synchrony. Coordinated Reset (CR) stimulation was developed to selectively counteract abnormal neuronal synchrony by desynchronization. For this, phase resetting stimuli are delivered to different subpopulations in a timely coordinated way. In neural networks with spike timing-dependent plasticity CR stimulation may eventually lead to an anti-kindling, i.e., an unlearning of abnormal synaptic connectivity and abnormal synchrony. The spatiotemporal sequence by which all stimulation sites are stimulated exactly once is called the stimulation site sequence, or briefly sequence. So far, in simulations, pre-clinical and clinical applications CR was applied either with fixed sequences or rapidly varying sequences (RVS). In this computational study we show that appropriate repetition of the sequence with occasional random switching to the next sequence may significantly improve the anti-kindling effect of CR. To this end, a sequence is applied many times before randomly switching to the next sequence. This new method is called SVS CR stimulation, i.e., CR with slowly varying sequences. In a neuronal network with strong short-range excitatory and weak long-range inhibitory dynamic couplings SVS CR stimulation turns out to be superior to CR stimulation with fixed sequences or RVS.

  4. 18 CFR 367.4360 - Account 436, Appropriations of retained earnings.

    Science.gov (United States)

    2010-04-01

    ..., Appropriations of retained earnings. 367.4360 Section 367.4360 Conservation of Power and Water Resources FEDERAL... NATURAL GAS ACT Retained Earnings Accounts § 367.4360 Account 436, Appropriations of retained earnings. This account must include appropriations of retained earnings as follows: (a) Appropriations required...

  5. Neuromuscular mechanisms and neural strategies in the control of time-varying muscle contractions.

    Science.gov (United States)

    Erimaki, Sophia; Agapaki, Orsalia M; Christakos, Constantinos N

    2013-09-01

    The organization of the neural input to motoneurons that underlies time-varying muscle force is assumed to depend on muscle transfer characteristics and neural strategies or control modes utilizing sensory signals. We jointly addressed these interlinked, but previously studied individually and partially, issues for sinusoidal (range 0.5-5.0 Hz) force-tracking contractions of a human finger muscle. Using spectral and correlation analyses of target signal, force signal, and motor unit (MU) discharges, we studied 1) patterns of such discharges, allowing inferences on the motoneuronal input; 2) transformation of MU population activity (EMG) into quasi-sinusoidal force; and 3) relation of force oscillation to target, carrying information on the input's organization. A broad view of force control mechanisms and strategies emerged. Specifically, synchronized MU and EMG modulations, reflecting a frequency-modulated motoneuronal input, accompanied the force variations. Gain and delay drops between EMG modulation and force oscillation, critical for the appropriate organization of this input, occurred with increasing target frequency. According to our analyses, gain compensation was achieved primarily through rhythmical activation/deactivation of higher-threshold MUs and secondarily through the adaptation of the input's strength expected during tracking tasks. However, the input's timing was not adapted to delay behaviors and seemed to depend on the control modes employed. Thus, for low-frequency targets, the force oscillation was highly coherent with, but led, a target, this timing error being compatible with predictive feedforward control partly based on the target's derivatives. In contrast, the force oscillation was weakly coherent, but in phase, with high-frequency targets, suggesting control mainly based on a target's rhythm.

  6. The Effect of Varied Gender Groupings on Argumentation Skills among Middle School Students in Different Cultures

    Science.gov (United States)

    Hsu, Pi-Sui; Van Dyke, Margot; Smith, Thomas J.

    2017-01-01

    The purpose of this mixed-methods study was to explore the effect of varied gender groupings on argumentation skills among middle school students in Taiwan and the United States in a project-based learning environment that incorporated a graph-oriented computer-assisted application (GOCAA). A total of 43 students comprised the treatment condition…

  7. A cost effective model for appropriate administration of red cell units and salvaging un-transfused red cell units by using temperature sensitive indicators for blood component transportation in a hospital setting

    Directory of Open Access Journals (Sweden)

    Aseem K Tiwari

    2015-01-01

    Full Text Available Background: A rule called "30-min rule" defines that red cell unit cannot be used if it has been out of blood bank refrigerator for over 30 min. This rule is useful to guide initiation of transfusion, but is inadequate for deciding whether to reuse or discard units received-back at blood transfusion services (BTS. A simple cost-effective temperature-sensitive indicator was evaluated to decide upon reuse (cold chain was uninterrupted or discard (where cold chain was interrupted in a simulation exercise. Materials and Methods: Temperature-sensitive indicators TH-F™ that irreversibly changed color from white to red demonstrated that heat excursion has occurred and the cumulative temperature has exceeded 10°C for over 30 min, were used in outdated red cells for simulating units, which are not used and received-back. These units were also tagged with a standard temperature monitoring device, which was a re-usable credit card sized device, which would log the actual time and temperature. In few units percent hemolysis was also calculated. Results: Statistically insignificant elevation in average temperature was noted in 102 simulated units at the time of return to BTS (Δ 0.04°C, despite the fact that these units were in the transport box for over 4 h. The average supernatant hemoglobin in these units was 0.24%, much below the prescribed threshold. Conclusion: Transportation of blood in controlled conditions with temperature-sensitive indicator is a cost-effective model to save blood, a precious human resource.

  8. 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...

  9. [Attaching single- and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Kreulen, C.M.; Wolke, J.G.C.; Baat, C. de; Creugers, N.H.J.

    2013-01-01

    A single- or multi-unit fixed dental prosthesis can be attached to the abutment teeth through mechanical retention and gap sealing or by adhesion. For sealing the gap, water-soluble cements are appropriate, such as zinc phosphate, polycarboxylate, and (resin-modified) glasionomer cement. Attachment

  10. 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

  11. Hanford Site Waste Management Units Report

    International Nuclear Information System (INIS)

    1991-01-01

    This Hanford Site Waste Management Units Report (HSWMUR) was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments (HSWA) of the 1984 United States Code (USC). The report provides a comprehensive inventory of all types of waste management units at the Hanford Site and consists of waste disposal units, including (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structure, (5) RCRA treatment and storage units, and (6) other storage areas. Because of the comprehensive nature of this report, the listing of sites is more extensive than required by Section 3004(u) of HSWA. In support of the Hanford RCRA permit, a field was added to designate whether the waste management unit is a solid waste management unit (SWMU). As SWMUs are identified, they will added to the Hanford Waste Information Data System (WIDS), which is the database supporting this report, and added to the report at its next annual update. A quality review of the WIDS was conducted this past year. The review included checking all data against their reference and making appropriate changes, updating the data elements using the most recent references, marking duplicate units for deletion, and addition additional information. 6 refs

  12. Hanford Site Waste Management Units Report

    International Nuclear Information System (INIS)

    1991-01-01

    This Hanford Site Waste Management Units Report (HSWMUR) was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments (HSWA) of the 1984 United States Code (USC). The report provides a comprehensive inventory of all types of waste management units at the Hanford Site and consists of waste disposal units, including (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structures, (5) RCRA treatment and storage units, and (6) other storage areas. Because of the comprehensive nature of this report, the listing of sites is more extensive than required by Section 3004(u) of HSWA. In support of the Hanford RCRA permit, a field was added to designate whether the waste management unit is a solid waste management unit (SWMU). As SWMUs are identified, they will added to the Hanford Waste Information Data System (WIDS), which is the database supporting this report, and added to the report at its next annual update. A quality review of the WIDS was conducted this past year. The review included checking all data against their reference and making appropriate changes, updating the data elements using the most recent references, marking duplicate units for deletion, and adding additional information. 6 refs

  13. 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...

  14. 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.

  15. 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...

  16. On the Appropriateness of Incident Management Systems in Developing Countries: A Case from the UAE

    Directory of Open Access Journals (Sweden)

    Faouzi Kamoun

    2010-12-01

    Full Text Available Road traffic incidents are eliciting growing public concerns due to their devastating social, economical, and environmental impacts. The severity of these random events is particularly alarming in developing countries, where the situation is just worsening. Recently, Incident Management Systems (IMSs have been proposed as powerful tools to enhance the coordination and management of rescue operations during traffic accidents. However, most of the available commercial IMS solutions are designed for large metropolitan cities and within the contexts of developed nations. This paper explores the issues of appropriateness and customization of IMS solutions in developing countries through an exploratory inquiry consisting of a case study from the United Arab Emirates (UAE. The paper also explores the important issues related to managing the organizational changes that an IMS introduces to the operations of the command and control room. This contribution calls for the development of more comprehensive theoretical frameworks that can guide towards the implementation of appropriate IMS solutions in developing countries. Our research highlights the need for developing countries to acquire appropriate IMS solutions that are tailored to the local organizational work context in which these systems will be used. The experience reported herein can also inspire other public safety agencies in developing countries to consider the option of developing customized IMS solutions that best suit their needs.

  17. 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...

  18. 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.

  19. Inferring time‐varying recharge from inverse analysis of long‐term water levels

    Science.gov (United States)

    Dickinson, Jesse; Hanson, R.T.; Ferré, T.P.A.; Leake, S.A.

    2004-01-01

    Water levels in aquifers typically vary in response to time‐varying rates of recharge, suggesting the possibility of inferring time‐varying recharge rates on the basis of long‐term water level records. Presumably, in the southwestern United States (Arizona, Nevada, New Mexico, southern California, and southern Utah), rates of mountain front recharge to alluvial aquifers depend on variations in precipitation rates due to known climate cycles such as the El Niño‐Southern Oscillation index and the Pacific Decadal Oscillation. This investigation examined the inverse application of a one‐dimensional analytical model for periodic flow described by Lloyd R. Townley in 1995 to estimate periodic recharge variations on the basis of variations in long‐term water level records using southwest aquifers as the case study. Time‐varying water level records at various locations along the flow line were obtained by simulation of forward models of synthetic basins with applied sinusoidal recharge of either a single period or composite of multiple periods of length similar to known climate cycles. Periodic water level components, reconstructed using singular spectrum analysis (SSA), were used to calibrate the analytical model to estimate each recharge component. The results demonstrated that periodic recharge estimates were most accurate in basins with nearly uniform transmissivity and the accuracy of the recharge estimates depends on monitoring well location. A case study of the San Pedro Basin, Arizona, is presented as an example of calibrating the analytical model to real data.

  20. 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.

  1. Appropriate customization of radiation therapy for stage II and III rectal cancer: Executive summary of an ASTRO Clinical Practice Statement using the RAND/UCLA Appropriateness Method.

    Science.gov (United States)

    Goodman, Karyn A; Patton, Caroline E; Fisher, George A; Hoffe, Sarah E; Haddock, Michael G; Parikh, Parag J; Kim, John; Baxter, Nancy N; Czito, Brian G; Hong, Theodore S; Herman, Joseph M; Crane, Christopher H; Hoffman, Karen E

    2016-01-01

    To summarize results of a Clinical Practice Statement on radiation therapy for stage II-III rectal cancer, which addressed appropriate customization of (neo)adjuvant radiation therapy and use of non-surgical therapy for patients who are inoperable or refuse abdominoperineal resection. The RAND/University of California, Los Angeles, Appropriateness Method was applied to combine current evidence with multidisciplinary expert opinion. A systematic literature review was conducted and used by the expert panel to rate appropriateness of radiation therapy options for different clinical scenarios. Treatments were categorized by median rating as Appropriate, May Be Appropriate, or Rarely Appropriate. In the neoadjuvant setting, chemoradiation was rated Appropriate and the ratings indicated short-course radiation therapy, chemotherapy alone, and no neoadjuvant therapy are potential options in selected patients. However, neoadjuvant endorectal brachytherapy was rated Rarely Appropriate. For adjuvant therapy, chemoradiation (plus ≥4 months of chemotherapy) was rated Appropriate and chemotherapy alone May Be Appropriate for most scenarios. For medically inoperable patients, definitive external beam radiation therapy and chemotherapy alone were rated May Be Appropriate, whereas endorectal brachytherapy and chemoradiation plus endorectal brachytherapy were possible approaches for some scenarios. The last option, definitive chemoradiation, was rated Appropriate to May Be Appropriate based on performance status. Finally, for patients with low-lying tumors refusing abdominoperineal resection, definitive chemoradiation alone, chemoradiation plus endorectal brachytherapy, and chemoradiation plus external beam radiation therapy were all rated Appropriate. This Clinical Practice Statement demonstrated the central role of radiation therapy in stage II-III rectal cancer management and evaluated ways to better individualize its use in the neoadjuvant, adjuvant, and definitive settings

  2. Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

    Science.gov (United States)

    Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

    2018-04-13

    Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

  3. Evaluation of the appropriateness of imipenem/cilastatin prescription and dosing in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kabbara WK

    2015-03-01

    Full Text Available Wissam K Kabbara, George T Nawas, Wijdan H RamadanDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon Background: Imipenem/cilastatin is an antibacterial agent of the carbapenem class of β-lactams that is known to have an extremely wide spectrum of activity against Gram-positive, Gram-negative, aerobic, anaerobic, and even multidrug-resistant strains. The objective of this study was to evaluate the appropriate use of imipenem/cilastatin in a local tertiary care hospital. The study assessed the indication both empirically and after the culture results were available, the dose and dose adjustment in renal failure, as well as the incidence of seizure in hospitalized patients receiving imipenem/cilastatin. Methods: This observational study was conducted in a tertiary care hospital over a 3-month period. The treatment of 100 patients with imipenem/cilastatin was evaluated both empirically and after culture results were available. Analysis of the appropriateness of imipenem/cilastatin indication, dose, and monitoring of seizure frequency was based on the package insert, updated published guidelines, and clinical judgment. Results: Patients from internal medicine and intensive care units comprised approximately 50% of the population in the study. The patients received imipenem/cilastatin mainly for urinary tract infections (27% or for sepsis of an unknown focus (22%. The use of imipenem/cilastatin empirically was appropriate in 97.2% (n=69/71 of the cases, and its use postculture in 86% of the cases. There were 29% of the patients who were not started on imipenem/cilastatin empirically. Four patients out of the 29 patients (13.8% who were not started on imipenem/cilastatin empirically inappropriately received imipenem/cilastatin post-culture results. Thirty-three patients (33% were not dosed appropriately, 30 of whom had renal impairment and creatinine clearance fluctuations. Only one patient developed a

  4. The Yerkes-Dodson law and appropriate stimuli for conditioned taste aversion in Lymnaea.

    Science.gov (United States)

    Ito, Etsuro; Yamagishi, Miki; Takigami, Satoshi; Sakakibara, Manabu; Fujito, Yutaka; Lukowiak, Ken

    2015-02-01

    The pond snail Lymnaea stagnalis can learn conditioned taste aversion and then consolidate it into long-term memory (LTM). A high-voltage electric shock was used as the unconditioned stimulus, where we have previously used KCl. We varied the strength of both the conditioned and unconditioned stimuli to determine whether the so-called Yerkes-Dodson law prevailed. This is an empirical relationship between the state of arousal and LTM formation, showing that there is an optimal level of arousal leading to memory formation. However, too little or too much arousal results in poorer LTM. We found here that the most appropriate stimuli to use in taste aversion training in Lymnaea were a 10 mmol l(-1) sucrose solution as the conditioned stimulus and a 3 s electric shock as the unconditioned stimulus. © 2015. Published by The Company of Biologists Ltd.

  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. 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...

  7. [Audit as a tool to assess and promote the quality of medical records and hospital appropriateness: metodology and preliminary results].

    Science.gov (United States)

    Poscia, Andrea; Cambieri, Andrea; Tucceri, Chiara; Ricciardi, Walter; Volpe, Massimo

    2015-01-01

    great discrepancies among departments and among Care Units: the higher problems are centered in DHs, which are generally lacking on both profiles. Finally, our audit model, that could be considered a good project according the NHS (score of 20/25), has allowed to involve in 34 editions 480 professionals of different care Unit which are satisfied and stimulated to keep going in continuous improvement of the quality and appropriateness with these arrangements. The tools used in the project have proven their value for measuring the minimum quality of healthcare documentation and organizational appropriateness: furthermore, the audit has been shown as an effective methodology for their introduction because it ensures their acceptability among the staff and creates the basis for a rapid and quantifiable improvement that, through the promotion of accountability and transparency, could support the risk management activities and ensure greater efficiency in hospitalization.

  8. Is the tourism-economic growth nexus time-varying? Bootstrap rolling-window causality analysis for the top ten tourist destinations

    OpenAIRE

    Shahbaz, Muhammad; Ferrer, Román; Hussain Shahzad, Syed Jawad; Haouas, Ilham

    2017-01-01

    This paper explores the time-varying causal nexus between tourism development and economic growth for the top ten tourist destinations in the world, namely China, France, Germany, Italy, Mexico, the Russian Federation, Spain, Turkey, the United Kingdom and the United States of America, over the period 1990-2015. To that end, a bootstrap rolling window Granger causality approach based on the modified Granger causality test developed by Toda and Yamamoto (1995) and Dolado and Lütkepohl (1996), ...

  9. 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.

  10. 31 CFR 536.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 536.705 Section 536.705 Money and Finance: Treasury...; referral to United States Department of Justice. In the event that the respondent does not pay the penalty... Department of Justice for appropriate action to recover the penalty in a civil suit in a Federal district...

  11. 31 CFR 592.605 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 592.605 Section 592.605 Money and Finance: Treasury... United States Department of Justice. In the event that the respondent does not pay the penalty imposed... Department of Justice for appropriate action to recover the penalty in a civil suit in a federal district...

  12. 31 CFR 538.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 538.705 Section 538.705 Money and Finance: Treasury... States Department of Justice. In the event that the respondent does not pay the penalty imposed pursuant... United States Department of Justice for appropriate action to recover the penalty in a civil suit in a...

  13. 31 CFR 588.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 588.705 Section 588.705 Money and Finance: Treasury... to United States Department of Justice. In the event that the respondent does not pay the penalty... Department of Justice for appropriate action to recover the penalty in a civil suit in a federal district...

  14. 31 CFR 595.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 595.705 Section 595.705 Money and Finance: Treasury... States Department of Justice. In the event that the person named does not pay the penalty imposed... United States Department of Justice for appropriate action to recover the penalty in a civil suit in a...

  15. 31 CFR 594.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 594.705 Section 594.705 Money and Finance: Treasury... United States Department of Justice. In the event that the respondent does not pay the penalty imposed... Department of Justice for appropriate action to recover the penalty in a civil suit in a federal district...

  16. 31 CFR 598.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 598.705 Section 598.705 Money and Finance: Treasury...; referral to United States Department of Justice. In the event that the respondent does not pay a penalty... Department of Justice for appropriate action to recover the penalty in a civil suit in a Federal district...

  17. 31 CFR 535.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 535.705 Section 535.705 Money and Finance: Treasury... United States Department of Justice. In the event that the person named does not pay the penalty imposed... Department of Justice for appropriate action to recover the penalty in a civil suit in a Federal district...

  18. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  19. 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

  20. Health care-associated infections in the neonatal intensive care unit.

    Science.gov (United States)

    Brady, Michael T

    2005-06-01

    Neonates represent a unique and highly vulnerable patient population. Advances in medical technology that have occurred over the last few decades have improved the survival and quality of life for neonates, particularly those infants born with extreme prematurity or with congenital defects. Although immunologic immaturity and altered cutaneous barriers play some role in the vulnerability of neonates to nosocomial infections, clearly, therapeutic interventions that have proven to be lifesaving for these fragile infants also appear to be associated with the majority of infectious complications resulting in neonatal morbidity and mortality. Rates of infections in neonatal intensive care units (NICUs) have varied from 6% to 40% of neonatal patients, with the highest rates in those facilities having larger proportions of very low-birth-weight infants (birthweight NICU infants include the following: (1) optimal infection control practices, especially good hand hygiene and good nursery design; (2) prudent use of invasive interventions with particular attention to early removal of invasive devices after they are no longer essential; and (3) judicious use of antimicrobial agents, with an emphasis on targeted (narrow spectrum) rather than broad-spectrum antibiotics and appropriate indications (proven or suspected bacterial infections).

  1. Holographic cinematography of time-varying reflecting and time-varying phase objects using a Nd:YAG laser

    Science.gov (United States)

    Decker, A. J.

    1982-01-01

    The use of a Nd:YAG laser to record holographic motion pictures of time-varying reflecting objects and time-varying phase objects is discussed. Sample frames from both types of holographic motion pictures are presented. The holographic system discussed is intended for three-dimensional flow visualization of the time-varying flows that occur in jet-engine components.

  2. Time-varying BRDFs.

    Science.gov (United States)

    Sun, Bo; Sunkavalli, Kalyan; Ramamoorthi, Ravi; Belhumeur, Peter N; Nayar, Shree K

    2007-01-01

    The properties of virtually all real-world materials change with time, causing their bidirectional reflectance distribution functions (BRDFs) to be time varying. However, none of the existing BRDF models and databases take time variation into consideration; they represent the appearance of a material at a single time instance. In this paper, we address the acquisition, analysis, modeling, and rendering of a wide range of time-varying BRDFs (TVBRDFs). We have developed an acquisition system that is capable of sampling a material's BRDF at multiple time instances, with each time sample acquired within 36 sec. We have used this acquisition system to measure the BRDFs of a wide range of time-varying phenomena, which include the drying of various types of paints (watercolor, spray, and oil), the drying of wet rough surfaces (cement, plaster, and fabrics), the accumulation of dusts (household and joint compound) on surfaces, and the melting of materials (chocolate). Analytic BRDF functions are fit to these measurements and the model parameters' variations with time are analyzed. Each category exhibits interesting and sometimes nonintuitive parameter trends. These parameter trends are then used to develop analytic TVBRDF models. The analytic TVBRDF models enable us to apply effects such as paint drying and dust accumulation to arbitrary surfaces and novel materials.

  3. 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...

  4. 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.

  5. Implementation of an Integrated Neuroscience Unit.

    Science.gov (United States)

    Breslin, Rory P; Franker, Lauren; Sterchi, Suzanne; Sani, Sepehr

    2016-02-01

    Many challenges exist in today's health care delivery system, and much focus and research are invested into ways to improve care with cost-effective measures. Specialty-specific dedicated care units are one solution for inpatient hospital care because they improve outcomes and decrease mortality. The neuroscience population encompasses a wide variety of diagnoses of spinal to cranial issues with a wide spectrum of needs varying from one patient to the next. Neuroscience care must be patient-specific during the course of frequent acuity changes, and one way to achieve this is through a neuroscience-focused unit. Few resources are available on how to implement this type of unit. Advanced practice nurses are committed to providing high-quality, safe, and cost-effective care and are instrumental in the success of instituting a unit dedicated to the care of neuroscience patients.

  6. 14 CFR 91.707 - Flights between Mexico or Canada and the United States.

    Science.gov (United States)

    2010-01-01

    ... Canada and the United States without filing an IFR or VFR flight plan, as appropriate. ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flights between Mexico or Canada and the... Rules Governing Persons on Board Such Aircraft § 91.707 Flights between Mexico or Canada and the United...

  7. The Application of Fuzzy Analytical Network Process (FANP Approach for Appropriate Location Selection of Health Centers: case study in ramsar cite

    Directory of Open Access Journals (Sweden)

    Dariush Mohammadi Zanjirani

    2012-06-01

    Full Text Available Background: Appropriate location selection for health Services unites is a Strategic decision which is based on gathering information and also exact analysis of related alternatives. It's clear that result of this decision is really important and will led to long time improvement in all dimensions including economic, social, and etc. Otherwise, the most studies of location have done in background manufacturing rather than service area and there are just few articles which have focused in field of healthcare. This study attempted to solve this stock of researches. Methods: By using an almost comprehensive literatures review, objective and subjective criteria are identified. After finalizing criteria's, Are used from decision-makers’ assessments for collection data. Fuzzy Analytical Network Process is used for analyzing the data. Results: The finding indicates that the criteria's of proposed model are high validity and reliability for appropriate location selection of Health Centers. Conclusion: The analyzing of data indicates that lamtar locate is selected appropriate location.

  8. Alleviating Border Effects in Wavelet Transforms for Nonlinear Time-varying Signal Analysis

    Directory of Open Access Journals (Sweden)

    SU, H.

    2011-08-01

    Full Text Available Border effects are very common in many finite signals analysis and processing approaches using convolution operation. Alleviating the border effects that can occur in the processing of finite-length signals using wavelet transform is considered in this paper. Traditional methods for alleviating the border effects are suitable to compression or coding applications. We propose an algorithm based on Fourier series which is proved to be appropriate to the application of time-frequency analysis of nonlinear signals. Fourier series extension method preserves the time-varying characteristics of the signals. A modified signal duration expression for measuring the extent of border effects region is presented. The proposed algorithm is confirmed to be efficient to alleviate the border effects in comparison to the current methods through the numerical examples.

  9. Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults.

    Science.gov (United States)

    Hammond, Drayton A; Killingsworth, Catherine A; Painter, Jacob T; Pennick, Rose E; Chatterjee, Kshitij; Boye, Bradley; Meena, Nikhil

    2017-01-01

    Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU) at an academic medical center between January to June of 2014 (no intervention) and January to June of 2015 (intervention) was conducted. The percentage of patients prescribed inappropriate AST, inappropriate AST at ICU transfer and hospital discharge, doses of inappropriate AST, and adverse effects associated with AST use were compared between periods using chi-square tests. Patients in the intervention group (n=118) were 5 years older than patients in the no intervention group (n=101). AST was inappropriately initiated more frequently in the no intervention group (23% vs. 11%, p=0.012). Continuation of inappropriate AST at ICU transfer and hospital discharge was similar between groups (60% vs. 53%, p=0.277 and 18% vs. 14%, p=0.368, respectively). Patients had appropriate AST initiated and inappropriate AST withheld more frequently when formal education was provided. This low-cost intervention strategy can be implemented easily at institutions where pharmacists interact with physicians on rounding services and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations.

  10. Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults

    Directory of Open Access Journals (Sweden)

    Hammond DA

    2017-09-01

    Full Text Available Background: Acid suppression therapy (AST is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB. Objective: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. Methods: A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU at an academic medical center between January to June of 2014 (no intervention and January to June of 2015 (intervention was conducted. The percentage of patients prescribed inappropriate AST, inappropriate AST at ICU transfer and hospital discharge, doses of inappropriate AST, and adverse effects associated with AST use were compared between periods using chi-square tests. Results: Patients in the intervention group (n=118 were 5 years older than patients in the no intervention group (n=101. AST was inappropriately initiated more frequently in the no intervention group (23% vs. 11%, p=0.012. Continuation of inappropriate AST at ICU transfer and hospital discharge was similar between groups (60% vs. 53%, p=0.277 and 18% vs. 14%, p=0.368, respectively. Conclusion: Patients had appropriate AST initiated and inappropriate AST withheld more frequently when formal education was provided. This low-cost intervention strategy can be implemented easily at institutions where pharmacists interact with physicians on rounding services and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations.

  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. Eddy current tube testing unit

    International Nuclear Information System (INIS)

    Dufayet, J.P.; Duret, G.

    1975-01-01

    The unit described can check a wide variety of tubes in quick succession and its modular design gives it a high degree of versability. Suitably defined working conditions and specific fittings enable most of the faults encountered in the manufacture of a tube to be detected. By appropriate means of selection based on signal amplitude, phase and frequency analyses it is possible to adapt selection criteria to the seriousness of the different categories of defect [fr

  13. 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.

  14. 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.

  15. 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.

  16. Time-varying block codes for synchronisation errors: maximum a posteriori decoder and practical issues

    Directory of Open Access Journals (Sweden)

    Johann A. Briffa

    2014-06-01

    Full Text Available In this study, the authors consider time-varying block (TVB codes, which generalise a number of previous synchronisation error-correcting codes. They also consider various practical issues related to maximum a posteriori (MAP decoding of these codes. Specifically, they give an expression for the expected distribution of drift between transmitter and receiver because of synchronisation errors. They determine an appropriate choice for state space limits based on the drift probability distribution. In turn, they obtain an expression for the decoder complexity under given channel conditions in terms of the state space limits used. For a given state space, they also give a number of optimisations that reduce the algorithm complexity with no further loss of decoder performance. They also show how the MAP decoder can be used in the absence of known frame boundaries, and demonstrate that an appropriate choice of decoder parameters allows the decoder to approach the performance when frame boundaries are known, at the expense of some increase in complexity. Finally, they express some existing constructions as TVB codes, comparing performance with published results and showing that improved performance is possible by taking advantage of the flexibility of TVB codes.

  17. The carbon footprint of an Australian satellite haemodialysis unit.

    Science.gov (United States)

    Lim, Allan E K; Perkins, Anthony; Agar, John W M

    2013-06-01

    This study aimed to better understand the carbon emission impact of haemodialysis (HD) throughout Australia by determining its carbon footprint, the relative contributions of various sectors to this footprint, and how contributions from electricity and water consumption are affected by local factors. Activity data associated with HD provision at a 6-chair suburban satellite HD unit in Victoria in 2011 was collected and converted to a common measurement unit of tonnes of CO2 equivalents (t CO2-eq) via established emissions factors. For electricity and water consumption, emissions factors for other Australian locations were applied to assess the impact of local factors on these footprint contributors. In Victoria, the annual per-patient carbon footprint of satellite HD was calculated to be 10.2t CO2-eq. The largest contributors were pharmaceuticals (35.7%) and medical equipment (23.4%). Throughout Australia, the emissions percentage attributable to electricity consumption ranged from 5.2% to 18.6%, while the emissions percentage attributable to water use ranged from 4.0% to 11.6%. State-by-state contributions of energy and water use to the carbon footprint of satellite HD appear to vary significantly. Performing emissions planning and target setting at the state level may be more appropriate in the Australian context. What is known about the topic? Healthcare provision carries a significant environmental footprint. In particular, conventional HD uses substantial amounts of electricity and water. In the UK, provision of HD and peritoneal dialysis was found to have an annual per-patient carbon footprint of 7.1t CO2-eq. What does this paper add? This is the first carbon-footprinting study of HD in Australia. In Victoria, the annual per-patient carbon footprint of satellite conventional HD is 10.2t CO2-eq. Notably, the contributions of electricity and water consumption to the carbon footprint varies significantly throughout Australia when local factors are taken into

  18. Indications for Use of Damage Control Surgery in Civilian Trauma Patients: A Content Analysis and Expert Appropriateness Rating Study.

    Science.gov (United States)

    Roberts, Derek J; Bobrovitz, Niklas; Zygun, David A; Ball, Chad G; Kirkpatrick, Andrew W; Faris, Peter D; Brohi, Karim; D'Amours, Scott; Fabian, Timothy C; Inaba, Kenji; Leppäniemi, Ari K; Moore, Ernest E; Navsaria, Pradeep H; Nicol, Andrew J; Parry, Neil; Stelfox, Henry T

    2016-05-01

    To characterize and evaluate indications for use of damage control (DC) surgery in civilian trauma patients. Although DC surgery may improve survival in select, severely injured patients, the procedure is associated with significant morbidity, suggesting that it should be used only when appropriately indicated. Two investigators used an abbreviated grounded theory method to synthesize indications for DC surgery reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications. An international panel of trauma surgery experts (n = 9) then rated the appropriateness (expected benefit-to-harm ratio) of the coded indications for use in surgical practice. The 1107 indications identified in the literature were synthesized into 123 unique pre- (n = 36) and intraoperative (n = 87) indications. The panel assessed 101 (82.1%) of these indications to be appropriate. The indications most commonly reported and assessed to be appropriate included pre- and intraoperative hypothermia (median temperature 10 units), inability to close the abdominal wall without tension, development of abdominal compartment syndrome during attempted abdominal wall closure, and need to reassess extent of bowel viability. This study identified a comprehensive list of candidate indications for use of DC surgery. These indications provide a practical foundation to guide surgical practice while studies are conducted to evaluate their impact on patient care and outcomes.

  19. 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

  20. Appropriateness of hospitalization for CAP-affected pediatric patients: report from a Southern Italy General Hospital

    Directory of Open Access Journals (Sweden)

    Antonelli Fabio

    2009-09-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is a common disease, responsible for significant healthcare expenditures, mostly because of hospitalization. Many practice guidelines on CAP have been developed, including admission criteria, but a few on appropriate hospitalization in children. The aim of this study was to evaluate appropriate hospital admission for CAP in a pediatric population. Methods We evaluated appropriate admission to a Pediatric Unit performing a retrospective analysis on CAP admitted pediatric patients from a Southern Italy area. Diagnosis was made based on clinical and radiological signs. Appropriate hospital admission was evaluated following clinical and non-clinical international criteria. Family ability to care children was assessed by evaluating social deprivation status. Results In 2 winter seasons 120 pediatric patients aged 1-129 months were admitted because of CAP. Median age was 28.7 months. Raised body temperature was scored in 68.3% of patients, cough was present in 100% of cases, and abdominal pain was rarely evidenced. Inflammatory indices (ESR and CRP were found elevated in 33.3% of cases. Anti-Mycoplasma pneumoniae antibodies were found positive in 20.4%. Trans-cutaneous (TC SaO2 was found lower than 92% in 14.6%. Dyspnoea was present in 43.3%. Dehydration requiring i.v. fluid supplementation was scored in 13.3%. Evaluation of familial ability to care their children revealed that 76% of families (derived from socially depressed areas were "at social risk", thus not able to appropriately care their children. Furthermore, analysis of CAP patients revealed that "at social risk" people accessed E.D. and were hospitalized more frequently than "not at risk" patients (odds ratio = 3.59, 95% CI: 1,15 to 11,12; p = 0.01, and that admitted "at social risk" people presented without clinical signs of severity (namely dyspnoea, and/or SaO2 ≤ 92%, and/or dehydration more frequently than "not at risk" population

  1. 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

  2. MAPPING POTENTIAL TECHNOLOGY APPROPRIATE SMALL AND MEDIUM ENTERPRISES AS EFFORTS TO IMPROVE TECHNOLOGY PREPARATION LEADERSHIP IN REGION OF PONOROGO

    Directory of Open Access Journals (Sweden)

    Rochmat Aldy Purnomo

    2017-10-01

    Full Text Available Research Objectives "Mapping the Potential of Appropriate Technology for Small and Medium Enterprises as an Effort to Improve the Capability of Technology Readiness in Ponorogo District" is to describe the profile of small and medium enterprises (SMEs, evaluate and measure the level of technological readiness ability (TK2T of SMEs in Ponorogo District. The analytical tool used is a technometer that serves to measure the level of technological readiness capability used for the production of SMEs divided into three stages, basic (level 1 to level 3, medium (level 4 to level 6 and ready (Level 7 to With Level 9. By using teknometer is expected to provide basic information about mapping the potential needs and the use of appropriate technology (TTG both tools, processes and production results in Ponorogo regency. SMEs in Ponorogo Regency are dominated in the field of food, handicraft and textile fields. The SME food business unit still requires major government intervention on production process issues. The majority of SMEs business unit in the field of food still use technology (tools simple and potluck. The production process of SMEs business still neglects the hygienic side of both the production and production. The results of the evaluation and measurement of SME TK2T in Ponorogo District indicate that all samples have passed measurements at level 1 to level 3. Less than 50% pass the middle level ie level 4 to level 6, while less than 10% have passed the top level measurement , Which is level 7 to level 9. This explains that the production of SMEs in Ponorogo Regency still need government intervention both in the use of appropriate technology, as well as supporting indicators such as management, hygiene in production, human resources.

  3. 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.

  4. 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.

  5. Appropriate Natural Disaster Handling Policy To Guarantee Effectiveness Of Post-Disaster Assistance

    Directory of Open Access Journals (Sweden)

    Widyawati Boediningsih

    2017-09-01

    Full Text Available Indonesia is a very rich country fascinating the beauty of the panoramic so attract much foreign tourists to come and see its beauty. Furthermore Indonesia is a country that often experience natural disasters ranging from floods mount erupted until to Tsunami Indonesia Located in a geographical location that is prone to disaster. Disasters can be caused by both natural and behavioral factors that are not responsible for utilizing and managing natural resources and the environment. In some areas of Indonesia disasters examples that hit the country. So far there are available disaster management regulation tools namely Law Number 24 Year 2007 which provides disaster management framework Pre-disaster comprehend emergency response and post-disaster. Although the law has outlined comprehensive disaster management provisions so far is still focused on the emergency response period. Further actions such as mitigation rehabilitation and reconstruction appear not to be a top priority of disaster management activities. Other issues that are still scattered are coordination rescue aid appropriateness of assistance and distribution spread evenly. Institutional On the mandate of Law 242007 also institutional had been formed National Disaster Management Agency BNPB at the local level throughout and Indonesia.BNPB also set up a technically existing technical unit UPTD of 12 units. A BNPB Institution supported by trained human resources HR trained to be deployed to even the most difficult terrain.

  6. 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.

  7. 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.

  8. Choices: A Unit on Conflict and Nuclear War.

    Science.gov (United States)

    Massachusetts Teachers Association, Boston.

    Ten lessons on the evolution of the nuclear arms race, the nature and consequences of using nuclear weapons, and new ways that conflicts among nations might be resolved are presented for the junior high school level. The unit contains age-appropriate materials to equip students with skills and knowledge to understand what choices can be made to…

  9. A Study for Appropriateness of National Nuclear Policy by using Economic Analysis Methodology after Fukushima accident

    International Nuclear Information System (INIS)

    Shim, Jong Myoung; Roh, Myung Sub

    2013-01-01

    The aim of this paper is to clarify the appropriateness of national nuclear policy in BPE of Korea from an economic perspective. To do this, this paper only focus on the economic analysis methodology without any considering other conditions such as political, cultural, or historical things. In a number of countries, especially Korea, nuclear energy policy is keeping the status quo after Fukushima accident. However the nation's nuclear policy may vary depending on the choice of people. Thus, to make the right decisions, it is important to deliver accurate information and knowledge about nuclear energy to the people. As proven in this paper, the levelized cost of nuclear power is the most inexpensive among the base load units. As the reliance on nuclear power is getting stronger through the economic logic, the nuclear safety and environmental elements will be strengthened. Based on this, national nuclear policy should be promoted. In the aftermath of the Fukushima accident recognized as the world's worst nuclear disaster since the Chernobyl, there are some changes in the nuclear energy policy of various countries. Germany, for example, called a halt to operate Nuclear Power Plant (NPP) which accounts for about 7.5% of the national power generation capacity of 6.3GW. In developing countries such as China and India they conducted the safety check of the nuclear power plants again before preceding their nuclear business. Korea government announced 'The 6th Basic Plan for Long-term Electricity Supply and Demand (BPE)', considering the safety and general public acceptance of the nuclear power plants. According to BPE, they postponed a plan for additional NPP construction, except for constructions that had been already reflected in the 5th BPE. All told, the responses for nuclear energy policy of countries are different depending on their own circumstances

  10. A Study for Appropriateness of National Nuclear Policy by using Economic Analysis Methodology after Fukushima accident

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Jong Myoung; Roh, Myung Sub [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    The aim of this paper is to clarify the appropriateness of national nuclear policy in BPE of Korea from an economic perspective. To do this, this paper only focus on the economic analysis methodology without any considering other conditions such as political, cultural, or historical things. In a number of countries, especially Korea, nuclear energy policy is keeping the status quo after Fukushima accident. However the nation's nuclear policy may vary depending on the choice of people. Thus, to make the right decisions, it is important to deliver accurate information and knowledge about nuclear energy to the people. As proven in this paper, the levelized cost of nuclear power is the most inexpensive among the base load units. As the reliance on nuclear power is getting stronger through the economic logic, the nuclear safety and environmental elements will be strengthened. Based on this, national nuclear policy should be promoted. In the aftermath of the Fukushima accident recognized as the world's worst nuclear disaster since the Chernobyl, there are some changes in the nuclear energy policy of various countries. Germany, for example, called a halt to operate Nuclear Power Plant (NPP) which accounts for about 7.5% of the national power generation capacity of 6.3GW. In developing countries such as China and India they conducted the safety check of the nuclear power plants again before preceding their nuclear business. Korea government announced 'The 6th Basic Plan for Long-term Electricity Supply and Demand (BPE)', considering the safety and general public acceptance of the nuclear power plants. According to BPE, they postponed a plan for additional NPP construction, except for constructions that had been already reflected in the 5th BPE. All told, the responses for nuclear energy policy of countries are different depending on their own circumstances.

  11. 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...

  12. Stability Analysis for Operation of DG Units in Smart Grids

    DEFF Research Database (Denmark)

    Pouresmaeil, Edris; Shaker, Hamid Reza; Mehrasa, Majid

    2015-01-01

    This paper presents a multifunction control strategy for the stable operation of Distributed Generation (DG) units during grid integration. The proposed control model is based on Direct Lyapunov Control (DLC) theory and provides a stable region for the appropriate operation of DG units during grid....... Application of this concept can guarantee to reduce the stress on the grid during the energy demand peak. Simulation results are presented to demonstrate the proficiency and performance of the proposed DLC technique in DG technology....

  13. 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

  14. Friendships of Indonesian and United States Youth

    Science.gov (United States)

    French, Doran C.; Pidada, Sri; Victor, Andrea

    2005-01-01

    Issues in the study of friendship across cultures were explored by reviewing a set of studies focusing on the friendships of Indonesian and United States youth. Four topics are considered: similarity of friendships across cultures, dimensions of friendships that vary across cultures, the utility of the individualism/collectivism dimension for…

  15. Assessment of inpatient multimodal cardiac imaging appropriateness at large academic medical centers.

    Science.gov (United States)

    Remfry, Andrew; Abrams, Howard; Dudzinski, David M; Weiner, Rory B; Bhatia, R Sacha

    2015-11-14

    Responding to concerns regarding the growth of cardiac testing, the American College of Cardiology Foundation (ACCF) published Appropriate Use Criteria (AUC) for various cardiac imaging modalities. Single modality cardiac imaging appropriateness has been reported but there have been no studies assessing the appropriateness of multiple imaging modalities in an inpatient environment. A retrospective study of the appropriateness of cardiac tests ordered by the inpatient General Internal Medicine (GIM) and Cardiology services at three Canadian academic hospitals was conducted over two one-month periods. Cardiac tests characterized were transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), single-photon emission tomography myocardial perfusion imaging (SPECT), and diagnostic cardiac catheterization. Overall, 553 tests were assessed, of which 99.8% were classifiable by AUC. 91% of all studies were categorized as appropriate, 4% may be appropriate and 5% were rarely appropriate. There were high rates of appropriate use of all modalities by GIM and Cardiology throughout. Significantly more appropriate diagnostic catheterizations were ordered by Cardiology than GIM (93% vs. 82%, p = imaging modalities in this multi-centered study on Cardiology and GIM inpatients in the acute care setting. The rate of appropriate ordering was high across all imaging modalities. We recommend further work towards improving appropriate utilization of cardiac imaging resources focus on the out-patient setting.

  16. Chapter4 - Drought patterns in the conterminous United States and Hawaii.

    Science.gov (United States)

    Frank H. Koch; William D. Smith; John W. Coulston

    2014-01-01

    Droughts are common in virtually all U.S. forests, but their frequency and intensity vary widely both between and within forest ecosystems (Hanson and Weltzin 2000). Forests in the Western United States generally exhibit a pattern of annual seasonal droughts. Forests in the Eastern United States tend to exhibit one of two prevailing patterns: random occasional droughts...

  17. Guidelines for planning and design of mobile radiological units

    Energy Technology Data Exchange (ETDEWEB)

    Schelenz, R [Federal Office for Environmental Radioactivity in Food, Total Diet and Infant Food, Federal Research Centre for Nutrition, Karlsruhe (Germany)

    1995-07-01

    A significant number of mobile radiological units are in operation worldwide aiming to provide reliable radiological data. They mainly have been designed and constructed on a national basis according to the particular needs and commitments of the specific laboratory or country. In most cases, these units are intended to be used in emergency situations for in-situ radiological measurements of accidentally released radioactivity, sometimes for monitoring environmental pollution. As the purpose of these units is very diversified in regard to the kind of vehicle and its in-built measuring equipment the varying outfit of these units cannot be adopted in general for other countries aiming to improve their capability for in-situ radiological measurement. In order to achieve harmonization of equipment and comparability of radiological data being obtained from field measurements it is necessary to have general guidelines available for designing mobile radiological units taking into account different sceneries and tasks to be achieved. In the very early stages of an accident most of the information available on the quantity of radioactive material being released, its radionuclide composition and the likely progression of the accident will come from the operator, and will be based on the conditions in the plant. Few environmental monitoring results from off-side can be expected within the first few hours. In this very early phase, decisions on the application of protective measures will therefore, be based largely on plant status and forecasts of changes in that status as well as on meteorological data. As time progresses, results will increasingly become available from the monitoring of radionuclides in the environment (e.g. dose rates and concentration of radionuclides in air and particular materials such as water, food etc). Monitoring results can be used to estimate potential doses to people and the need for further protective measures can thus be determined from a

  18. Guidelines for planning and design of mobile radiological units

    International Nuclear Information System (INIS)

    Schelenz, R.

    1995-01-01

    A significant number of mobile radiological units are in operation worldwide aiming to provide reliable radiological data. They mainly have been designed and constructed on a national basis according to the particular needs and commitments of the specific laboratory or country. In most cases, these units are intended to be used in emergency situations for in-situ radiological measurements of accidentally released radioactivity, sometimes for monitoring environmental pollution. As the purpose of these units is very diversified in regard to the kind of vehicle and its in-built measuring equipment the varying outfit of these units cannot be adopted in general for other countries aiming to improve their capability for in-situ radiological measurement. In order to achieve harmonization of equipment and comparability of radiological data being obtained from field measurements it is necessary to have general guidelines available for designing mobile radiological units taking into account different sceneries and tasks to be achieved. In the very early stages of an accident most of the information available on the quantity of radioactive material being released, its radionuclide composition and the likely progression of the accident will come from the operator, and will be based on the conditions in the plant. Few environmental monitoring results from off-side can be expected within the first few hours. In this very early phase, decisions on the application of protective measures will therefore, be based largely on plant status and forecasts of changes in that status as well as on meteorological data. As time progresses, results will increasingly become available from the monitoring of radionuclides in the environment (e.g. dose rates and concentration of radionuclides in air and particular materials such as water, food etc). Monitoring results can be used to estimate potential doses to people and the need for further protective measures can thus be determined from a

  19. 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

  20. Expanding the usefulness of unit supply cost

    International Nuclear Information System (INIS)

    McKenzie, M.B.; Petr, K.

    1992-01-01

    Unit supply cost is a widely used tool in the energy business for providing a one number-unit cost description. For example, controllable costs such as finding costs, development costs and operating costs have traditionally been described in an average cost per unit of reserves format for the oil and gas industry, however using this approach on more specific applications is not always informative. Projects with widely varying controllable parameters can still yield the same unit cost, making comparisons difficult. The application of unit supply cost can be readily expanded by adding a new unit cost component termed cost of capital. This element introduces the impacts of timing and return on investment into the supply cost determination through discounting annual costs. The cost of capital component adds the ability to represent a project's unique characteristics, particularly reserves' depletion rate and the timing or phasing of development. Introducing the cost of capital element into the supply cost analysis provides additional information and improves the likelihood of drawing correct conclusions when comparing and ranking projects. 4 figs., 6 tabs

  1. A Unit on Hitler and Nazism for Advanced Students.

    Science.gov (United States)

    Williams, Elinor C.

    1993-01-01

    This unit on Hitler, the Third Reich, and its echoes in Germany today is based on original source material, such as "Mein Kampf," as well as more recent reports by those directly affected, such as Sichrovsky's "Schuldig Geboren." Teachers of advanced high school or college classes are introduced to some appropriate materials…

  2. A special case of reduced rank models for identification and modelling of time varying effects in survival analysis.

    Science.gov (United States)

    Perperoglou, Aris

    2016-12-10

    Flexible survival models are in need when modelling data from long term follow-up studies. In many cases, the assumption of proportionality imposed by a Cox model will not be valid. Instead, a model that can identify time varying effects of fixed covariates can be used. Although there are several approaches that deal with this problem, it is not always straightforward how to choose which covariates should be modelled having time varying effects and which not. At the same time, it is up to the researcher to define appropriate time functions that describe the dynamic pattern of the effects. In this work, we suggest a model that can deal with both fixed and time varying effects and uses simple hypotheses tests to distinguish which covariates do have dynamic effects. The model is an extension of the parsimonious reduced rank model of rank 1. As such, the number of parameters is kept low, and thus, a flexible set of time functions, such as b-splines, can be used. The basic theory is illustrated along with an efficient fitting algorithm. The proposed method is applied to a dataset of breast cancer patients and compared with a multivariate fractional polynomials approach for modelling time-varying effects. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. 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

  4. Optimization methods for the Train Unit Shunting Problem

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin; Wagenaar, Joris Camiel

    2017-01-01

    We consider the Train Unit Shunting Problem, an important planning problem for passenger railway operators. This problem entails assigning train units from shunting yards to scheduled train services in such a way that the resulting operations are without conflicts. The problem arises at every...... shunting yard in the railway network and involves matching train units to arriving and departing train services as well as assigning the selected matchings to appropriate shunting yard tracks. We present an extensive comparison benchmark of multiple solution approaches for this problem, some of which...... are novel. In particular, we develop a constraint programming formulation, a column generation approach, and a randomized greedy heuristic. We compare and benchmark these approaches with two existing methods, a mixed integer linear program and a two-stage heuristic. The benchmark contains multiple real...

  5. New results on global exponential dissipativity analysis of memristive inertial neural networks with distributed time-varying delays.

    Science.gov (United States)

    Zhang, Guodong; Zeng, Zhigang; Hu, Junhao

    2018-01-01

    This paper is concerned with the global exponential dissipativity of memristive inertial neural networks with discrete and distributed time-varying delays. By constructing appropriate Lyapunov-Krasovskii functionals, some new sufficient conditions ensuring global exponential dissipativity of memristive inertial neural networks are derived. Moreover, the globally exponential attractive sets and positive invariant sets are also presented here. In addition, the new proposed results here complement and extend the earlier publications on conventional or memristive neural network dynamical systems. Finally, numerical simulations are given to illustrate the effectiveness of obtained results. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 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...

  7. 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...

  8. Effect of Geography on the Analysis of Coccidioidomycosis-Associated Deaths, United States.

    Science.gov (United States)

    Noble, Jason A; Nelson, Robert G; Fufaa, Gudeta D; Kang, Paul; Shafir, Shira Chani; Galgiani, John N

    2016-10-01

    Because coccidioidomycosis death rates vary by region, we reanalyzed coccidioidomycosis-associated mortality in the United States by race/ethnicity, then limited analysis to Arizona and California. Coccidioidomycosis-associated deaths were shown to increase among African-Americans but decrease among Native Americans and Hispanics. Separately, in a Native American cohort, diabetes co-varied with coccidioidomycosis-associated death.

  9. Robust Stability and H∞ Stabilization of Switched Systems with Time-Varying Delays Using Delta Operator Approach

    Directory of Open Access Journals (Sweden)

    Chen Qin

    2013-01-01

    Full Text Available This paper considers the problems of the robust stability and robust H∞ controller design for time-varying delay switched systems using delta operator approach. Based on the average dwell time approach and delta operator theory, a sufficient condition of the robust exponential stability is presented by choosing an appropriate Lyapunov-Krasovskii functional candidate. Then, a state feedback controller is designed such that the resulting closed-loop system is exponentially stable with a guaranteed H∞ performance. The obtained results are formulated in the form of linear matrix inequalities (LMIs. Finally, a numerical example is provided to explicitly illustrate the feasibility and effectiveness of the proposed method.

  10. Harbour porpoise distribution can vary at small spatiotemporal scales in energetic habitats

    Science.gov (United States)

    Benjamins, Steven; van Geel, Nienke; Hastie, Gordon; Elliott, Jim; Wilson, Ben

    2017-07-01

    Marine habitat heterogeneity underpins species distribution and can be generated through interactions between physical and biological drivers at multiple spatiotemporal scales. Passive acoustic monitoring (PAM) is used worldwide to study potential impacts of marine industrial activities on cetaceans, but understanding of animals' site use at small spatiotemporal scales (marine renewable energy development (MRED) sites was investigated by deploying dense arrays of C-POD passive acoustic detectors at a wave energy test site (the European Marine Energy Centre [Billia Croo, Orkney]) and by a minor tidal-stream site (Scarba [Inner Hebrides]). Respective arrays consisted of 7 and 11 moorings containing two C-PODs each and were deployed for up to 55 days. Minimum inter-mooring distances varied between 300-600 m. All C-POD data were analysed at a temporal resolution of whole minutes, with each minute classified as 1 or 0 on the basis of presence/absence of porpoise click trains (Porpoise-Positive Minutes/PPMs). Porpoise detection rates were analysed using Generalised Additive Models (GAMs) with Generalised Estimation Equations (GEEs). Although there were many porpoise detections (wave test site: N=3,432; tidal-stream site: N=17,366), daily detection rates varied significantly within both arrays. Within the wave site array (<1 km diameter), average daily detection rates varied from 4.3 to 14.8 PPMs/day. Within the tidal-stream array (<2 km diameter), average daily detection rates varied from 10.3 to 49.7 PPMs/day. GAM-GEE model results for individual moorings within both arrays indicated linkages between porpoise presence and small-scale heterogeneity among different environmental covariates (e.g., tidal phase, time of day). Porpoise detection rates varied considerably but with coherent patterns between moorings only several hundred metres apart and within hours. These patterns presumably have ecological relevance. These results indicate that, in energetically active and

  11. Zhang neural network for online solution of time-varying convex quadratic program subject to time-varying linear-equality constraints

    International Nuclear Information System (INIS)

    Zhang Yunong; Li Zhan

    2009-01-01

    In this Letter, by following Zhang et al.'s method, a recurrent neural network (termed as Zhang neural network, ZNN) is developed and analyzed for solving online the time-varying convex quadratic-programming problem subject to time-varying linear-equality constraints. Different from conventional gradient-based neural networks (GNN), such a ZNN model makes full use of the time-derivative information of time-varying coefficient. The resultant ZNN model is theoretically proved to have global exponential convergence to the time-varying theoretical optimal solution of the investigated time-varying convex quadratic program. Computer-simulation results further substantiate the effectiveness, efficiency and novelty of such ZNN model and method.

  12. Autoregressive spatially varying coefficients model for predicting daily PM2.5 using VIIRS satellite AOT

    Science.gov (United States)

    Schliep, E. M.; Gelfand, A. E.; Holland, D. M.

    2015-12-01

    There is considerable demand for accurate air quality information in human health analyses. The sparsity of ground monitoring stations across the United States motivates the need for advanced statistical models to predict air quality metrics, such as PM2.5, at unobserved sites. Remote sensing technologies have the potential to expand our knowledge of PM2.5 spatial patterns beyond what we can predict from current PM2.5 monitoring networks. Data from satellites have an additional advantage in not requiring extensive emission inventories necessary for most atmospheric models that have been used in earlier data fusion models for air pollution. Statistical models combining monitoring station data with satellite-obtained aerosol optical thickness (AOT), also referred to as aerosol optical depth (AOD), have been proposed in the literature with varying levels of success in predicting PM2.5. The benefit of using AOT is that satellites provide complete gridded spatial coverage. However, the challenges involved with using it in fusion models are (1) the correlation between the two data sources varies both in time and in space, (2) the data sources are temporally and spatially misaligned, and (3) there is extensive missingness in the monitoring data and also in the satellite data due to cloud cover. We propose a hierarchical autoregressive spatially varying coefficients model to jointly model the two data sources, which addresses the foregoing challenges. Additionally, we offer formal model comparison for competing models in terms of model fit and out of sample prediction of PM2.5. The models are applied to daily observations of PM2.5 and AOT in the summer months of 2013 across the conterminous United States. Most notably, during this time period, we find small in-sample improvement incorporating AOT into our autoregressive model but little out-of-sample predictive improvement.

  13. 42 CFR 1007.11 - Duties and responsibilities of the unit.

    Science.gov (United States)

    2010-10-01

    ... it to an appropriate criminal investigative or prosecutive authority. (3) If the initial review does... prosecution) violations of all applicable State laws pertaining to fraud in the administration of the Medicaid... the State Medicaid plan. (b) (1) The unit will also review complaints alleging abuse or neglect of...

  14. 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

  15. Applicability of common stomatal conductance models in maize under varying soil moisture conditions.

    Science.gov (United States)

    Wang, Qiuling; He, Qijin; Zhou, Guangsheng

    2018-07-01

    In the context of climate warming, the varying soil moisture caused by precipitation pattern change will affect the applicability of stomatal conductance models, thereby affecting the simulation accuracy of carbon-nitrogen-water cycles in ecosystems. We studied the applicability of four common stomatal conductance models including Jarvis, Ball-Woodrow-Berry (BWB), Ball-Berry-Leuning (BBL) and unified stomatal optimization (USO) models based on summer maize leaf gas exchange data from a soil moisture consecutive decrease manipulation experiment. The results showed that the USO model performed best, followed by the BBL model, BWB model, and the Jarvis model performed worst under varying soil moisture conditions. The effects of soil moisture made a difference in the relative performance among the models. By introducing a water response function, the performance of the Jarvis, BWB, and USO models improved, which decreased the normalized root mean square error (NRMSE) by 15.7%, 16.6% and 3.9%, respectively; however, the performance of the BBL model was negative, which increased the NRMSE by 5.3%. It was observed that the models of Jarvis, BWB, BBL and USO were applicable within different ranges of soil relative water content (i.e., 55%-65%, 56%-67%, 37%-79% and 37%-95%, respectively) based on the 95% confidence limits. Moreover, introducing a water response function, the applicability of the Jarvis and BWB models improved. The USO model performed best with or without introducing the water response function and was applicable under varying soil moisture conditions. Our results provide a basis for selecting appropriate stomatal conductance models under drought conditions. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Evaluation of mycological contamination of dental unit waterlines.

    Science.gov (United States)

    Szymańska, Jolanta

    2005-01-01

    The quality of dental unit water is of great importance since patients and dental staff are regularly exposed to water from aerosols generated during work. The main purpose of this investigation was mycological evaluation of dental unit waterlines (DUWL). The author determined the number and species of fungi present in the water from a unit reservoir which is the source of water for a dental unit, in the water flowing from a high-speed handpiece of a unit, and in the swab sample collected from the wall of a waterline connecting a unit reservoir and dental handpieces. The following mould fungi were identified: Aspergillus amstelodami, Aspergillus fumigatus, Aspergillus spp. from Aspergillus glaucus group, Aspergillus repens, Citromyces spp., Geotrichum candidum, Penicillium aspergilliforme, Penicillium pusillum, Penicillium turolense, Sclerotium sclerotiorum; yeast-like fungi: Candida albicans, Candida curvata and other yeasts. Some of them, in certain circumstances, especially in people with immunological disorders, may be a cause of opportunistic infections. Thus, it is necessary that the DUWL should be submitted to a decontamination protocol and to routine microbial monitoring to guarantee an appropriate quality of water used in dental treatment.

  17. Money laundering and the United Kingdom: A haven for dirty money and an endless cycle? A critical reflection on the United Kingdom’s anti-money laundering policies

    OpenAIRE

    Ryder, N.

    2015-01-01

    This paper critically assesses the effectiveness and appropriateness of the United Kingdom's anti-money laundering policy. The paper concentrates on Part 7 of the Proceeds of Crime Act, the Terrorism Act 2000 and the enforcement policies of the Financial Conduct Authority.

  18. A multiscale network analysis of protected-area connectivity for mammals in the United States.

    Science.gov (United States)

    Minor, Emily S; Lookingbill, Todd R

    2010-12-01

    Protected areas must be close, or connected, enough to allow for the preservation of large-scale ecological and evolutionary processes, such as gene flow, migration, and range shifts in response to climate change. Nevertheless, it is unknown whether the network of protected areas in the United States is connected in a way that will preserve biodiversity over large temporal and spatial scales. It is also unclear whether protected-area networks that function for larger species will function for smaller species. We assessed the connectivity of protected areas in the three largest biomes in the United States. With methods from graph theory--a branch of mathematics that deals with connectivity and flow--we identified and measured networks of protected areas for three different groups of mammals. We also examined the value of using umbrella species (typically large-bodied, far-ranging mammals) in designing large-scale networks of protected areas. Although the total amount of protected land varied greatly among biomes in the United States, overall connectivity did not. In general, protected-area networks were well connected for large mammals but not for smaller mammals. Additionally, it was not possible to predict connectivity for small mammals on the basis of connectivity for large mammals, which suggests the umbrella species approach may not be an appropriate design strategy for conservation networks intended to protect many species. Our findings indicate different strategies should be used to increase the likelihood of persistence for different groups of species. Strategic linkages of existing lands should be a conservation priority for smaller mammals, whereas conservation of larger mammals would benefit most from the protection of more land. © 2010 Society for Conservation Biology.

  19. Stability of Nonlinear Systems with Unknown Time-varying Feedback Delay

    Science.gov (United States)

    Chunodkar, Apurva A.; Akella, Maruthi R.

    2013-12-01

    This paper considers the problem of stabilizing a class of nonlinear systems with unknown bounded delayed feedback wherein the time-varying delay is 1) piecewise constant 2) continuous with a bounded rate. We also consider application of these results to the stabilization of rigid-body attitude dynamics. In the first case, the time-delay in feedback is modeled specifically as a switch among an arbitrarily large set of unknown constant values with a known strict upper bound. The feedback is a linear function of the delayed states. In the case of linear systems with switched delay feedback, a new sufficiency condition for average dwell time result is presented using a complete type Lyapunov-Krasovskii (L-K) functional approach. Further, the corresponding switched system with nonlinear perturbations is proven to be exponentially stable inside a well characterized region of attraction for an appropriately chosen average dwell time. In the second case, the concept of the complete type L-K functional is extended to a class of nonlinear time-delay systems with unknown time-varying time-delay. This extension ensures stability robustness to time-delay in the control design for all values of time-delay less than the known upper bound. Model-transformation is used in order to partition the nonlinear system into a nominal linear part that is exponentially stable with a bounded perturbation. We obtain sufficient conditions which ensure exponential stability inside a region of attraction estimate. A constructive method to evaluate the sufficient conditions is presented together with comparison with the corresponding constant and piecewise constant delay. Numerical simulations are performed to illustrate the theoretical results of this paper.

  20. Spacetime-varying couplings and Lorentz violation

    International Nuclear Information System (INIS)

    Kostelecky, V. Alan; Lehnert, Ralf; Perry, Malcolm J.

    2003-01-01

    Spacetime-varying coupling constants can be associated with violations of local Lorentz invariance and CPT symmetry. An analytical supergravity cosmology with a time-varying fine-structure constant provides an explicit example. Estimates are made for some experimental constraints

  1. Budget Surpluses: Experiences of Other Nations and Implications for the United States

    National Research Council Canada - National Science Library

    1999-01-01

    ... should be used. While balancing the budget has been the clear and generally accepted fiscal goal for many years in the United States, there is not yet agreement on the appropriate fiscal policy during a period of budget surpluses...

  2. Selected Oral Health Indicators in the United States, 2005-2008

    Science.gov (United States)

    ... restoration prevalence varied by race and ethnicity and poverty level across the lifespan. Prevalence of untreated caries ... in teeth, by sex, race and ethnicity, and poverty level: United States, 2005–2008 Characteristic Untreated dental ...

  3. [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.

  4. Identity appropriateness and the structure of the theory of planned behaviour.

    Science.gov (United States)

    Case, Philippa; Sparks, Paul; Pavey, Louisa

    2016-03-01

    In contrast to the cost-benefit, utility-based approach to decision-making implicit in models such as the theory of planned behaviour (TPB), the logic of appropriateness (March, 1994. A Primer on Decision Making: How decisions happen. New York, NY: The Free Press) describes decision-making in terms of heuristic decision rules that involve matching identities to situations. This research is the first to apply the logic of appropriateness in conjunction with the theoretical structure of the TPB and assessed whether a measure of identity appropriateness might independently predict adults' intentions to engage in binge drinking. In Study 1, participants (N = 197) completed questionnaires assessing attitudes, subjective norm, perceived behavioural control, past behaviour, and identity appropriateness in relation to binge drinking. Path analysis revealed an independent predictive effect of identity appropriateness on intentions in addition to an indirect effect via attitudes. In Study 2 (N = 179), a prospective measure of behaviour was included in a similar study: Identity appropriateness again predicted intentions independently of the extended TPB predictors. It was again also found to be a strong predictor of attitudes. We suggest that the notion of identity appropriateness may assist in explaining the capacity of measures of self-identity to predict people's behavioural intentions. © 2015 The British Psychological Society.

  5. A delay-dependent LMI approach to dynamics analysis of discrete-time recurrent neural networks with time-varying delays

    International Nuclear Information System (INIS)

    Song, Qiankun; Wang, Zidong

    2007-01-01

    In this Letter, the analysis problem for the existence and stability of periodic solutions is investigated for a class of general discrete-time recurrent neural networks with time-varying delays. For the neural networks under study, a generalized activation function is considered, and the traditional assumptions on the boundedness, monotony and differentiability of the activation functions are removed. By employing the latest free-weighting matrix method, an appropriate Lyapunov-Krasovskii functional is constructed and several sufficient conditions are established to ensure the existence, uniqueness, and globally exponential stability of the periodic solution for the addressed neural network. The conditions are dependent on both the lower bound and upper bound of the time-varying time delays. Furthermore, the conditions are expressed in terms of the linear matrix inequalities (LMIs), which can be checked numerically using the effective LMI toolbox in MATLAB. Two simulation examples are given to show the effectiveness and less conservatism of the proposed criteria

  6. Treatment of skin and soft tissue infections in a pediatric observation unit.

    Science.gov (United States)

    Lane, Roni D; Sandweiss, David R; Corneli, Howard M

    2014-05-01

    To report the success rate of observation unit (OU) treatment of pediatric skin and soft tissue infections (SSTIs) and to see if we could identify variables at the time of initial evaluation that predicted successful OU treatment. A retrospective review of children less than 18 years of age admitted for SSTI treatment to our OU from the emergency department between January 2003 and June 2009. On records review, 853 patients matched eligibility criteria; median age was 5.2 years (interquartile range = 2.5-9 years). Of the 853 patients, 597 (70.0%) met the primary outcome criteria of successful OU discharge within 26 hours. Secondary analysis revealed that 82% of the patients achieved successful discharge from the OU within 48 hours. Although some laboratory variables demonstrated statistical association with success, none achieved a combination of high sensitivity and specificity to predict OU failure. OU success rates varied by location. Dental and face infections and those of the extremities or multiple sites demonstrated OU success rates higher than 65%, while infection of the groin, buttocks, trunk, or neck had success rates between 24% (neck) and 60% (groin). In multivariate analysis, only 3 variables remained significant. Unfavorable location was most strongly associated with OU failure, followed by C-reactive protein > 4 and then by erythrocyte sedimentation rate > 20. Our findings suggest that successful OU treatment is possible in a large group of patients needing hospitalization for SSTIs. Consideration of infection location may assist the emergency department clinician in determining the most appropriate unit for admission.

  7. 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.

  8. A Hilbert transform method for parameter identification of time-varying structures with observer techniques

    International Nuclear Information System (INIS)

    Wang, Zuo-Cai; Ren, Wei-Xin; Chen, Gen-Da

    2012-01-01

    This paper presents a recursive Hilbert transform method for the time-varying property identification of large-scale shear-type buildings with limited sensor deployments. An observer technique is introduced to estimate the building responses from limited available measurements. For an n-story shear-type building with l measurements (l ≤ n), the responses of other stories without measurements can be estimated based on the first r mode shapes (r ≤ l) as-built conditions and l measurements. Both the measured responses and evaluated responses and their Hilbert transforms are then used to track any variation of structural parameters of a multi-story building over time. Given floor masses, both the stiffness and damping coefficients of the building are identified one-by-one from the top to the bottom story. When variations of parameters are detected, a new developed branch-and-bound technique can be used to update the first r mode shapes with the identified parameters. A 60-story shear building with abruptly varying stiffness at different floors is simulated as an example. The numerical results indicate that the proposed method can detect variations of the parameters of large-scale shear-type buildings with limited sensor deployments at appropriate locations. (paper)

  9. Numerical analysis of a PCM thermal storage system with varying wall temperature

    International Nuclear Information System (INIS)

    Halawa, E.; Bruno, F.; Saman, W.

    2005-01-01

    Numerical analysis of melting and freezing of a PCM thermal storage unit (TSU) with varying wall temperature is presented. The TSU under analysis consists of several layers of thin slabs of a PCM subjected to convective boundary conditions where air flows between the slabs. The model employed takes into account the variations in wall temperature along the direction of air flow as well as the sensible heat. The paper discusses typical characteristics of the melting/freezing of PCM slabs in an air stream and presents some results of the numerical simulation in terms of air outlet temperatures and heat transfer rates during the whole periods of melting and freezing. Considerations in the design of the TSU are also given

  10. 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 ...

  11. Theoretical and experimental investigations of efficient light coupling with spatially varied all dielectric striped waveguides

    Science.gov (United States)

    Yilmaz, Y. A.; Tandogan, S. E.; Hayran, Z.; Giden, I. H.; Turduev, M.; Kurt, H.

    2017-07-01

    Integrated photonic systems require efficient, compact, and broadband solutions for strong light coupling into and out of optical waveguides. The present work investigates an efficient optical power transferring the problem between optical waveguides having different widths of in/out terminals. We propose a considerably practical and feasible concept to implement and design an optical coupler by introducing gradually index modulation to the coupler section. The index profile of the coupler section is modulated with a Gaussian function by the help of striped waveguides. The effective medium theory is used to replace the original spatially varying index profile with dielectric stripes of a finite length/width having a constant effective refractive index. 2D and 3D finite-difference time-domain analyzes are utilized to investigate the sampling effect of the designed optical coupler and to determine the parameters that play a crucial role in enhancing the optical power transfer performance. Comparing the coupling performance of conventional benchmark adiabatic and butt couplers with the designed striped waveguide coupler, the corresponding coupling efficiency increases from approximately 30% to 95% over a wide frequency interval. In addition, to realize the realistic optical coupler appropriate to integrated photonic applications, the proposed structure is numerically designed on a silicon-on-insulator wafer. The implemented SOI platform based optical coupler operates in the telecom wavelength regime (λ = 1.55 μm), and the dimensions of the striped coupler are kept as 9.77 μm (along the transverse to propagation direction) and 7.69 μm (along the propagation direction) where the unit distance is fixed to be 465 nm. Finally, to demonstrate the operating design principle, the microwave experiments are conducted and the spot size conversion ratio as high as 7.1:1 is measured, whereas a coupling efficiency over 60% in the frequency range of 5.0-16.0 GHz has been also

  12. 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.

  13. The covariant formulation of Maxwell's equations expressed in a form independent of specific units

    International Nuclear Information System (INIS)

    Heras, Jose A; Baez, G

    2009-01-01

    The covariant formulation of Maxwell's equations can be expressed in a form independent of the usual systems of units by introducing the constants α, β and γ into these equations. Maxwell's equations involving these constants are then specialized to the most commonly used systems of units: Gaussian, SI and Heaviside-Lorentz by giving the constants α, β and γ the values appropriate to each system

  14. Time-varying acceleration coefficients IPSO for solving dynamic economic dispatch with non-smooth cost function

    International Nuclear Information System (INIS)

    Mohammadi-ivatloo, Behnam; Rabiee, Abbas; Ehsan, Mehdi

    2012-01-01

    Highlights: ► New approach to solve power systems dynamic economic dispatch. ► Considering Valve-point effect, prohibited operation zones. ► Proposing TVAC-IPSO algorithm. - Abstract: The objective of the dynamic economic dispatch (DED) problem is to schedule power generation for the online units for a given time horizon economically, satisfying various operational constraints. Due to the effect of valve-point effects and prohibited operating zones (POZs) in the generating units cost functions, DED problem is a highly non-linear and non-convex optimization problem. The DED problem even may be more complicated if transmission losses and ramp-rate constraints are taken into account. This paper presents a novel and heuristic algorithm to solve DED problem of generating units, by employing time varying acceleration coefficients iteration particle swarm optimization (TVAC-IPSO) method. The effectiveness of the proposed method is examined and validated by carrying out extensive tests on different test systems, i.e. 5-unit and 10-unit test systems. Valve-point effects, POZs and ramp-rate constraints along with transmission losses are considered. To examine the efficiency of the proposed TVAC-IPSO algorithm, comprehensive studies are carried out, which compare convergence properties of the proposed TVAC-IPSO approach with conventional PSO algorithm, in addition to the other recently reported approaches. Numerical results show that the TVAC-IPSO method has good convergence properties and the generation costs resulted from the proposed method are lower than other algorithms reported in recent literature.

  15. 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.

  16. 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

  17. Fast Semantic Segmentation of 3d Point Clouds with Strongly Varying Density

    Science.gov (United States)

    Hackel, Timo; Wegner, Jan D.; Schindler, Konrad

    2016-06-01

    We describe an effective and efficient method for point-wise semantic classification of 3D point clouds. The method can handle unstructured and inhomogeneous point clouds such as those derived from static terrestrial LiDAR or photogammetric reconstruction; and it is computationally efficient, making it possible to process point clouds with many millions of points in a matter of minutes. The key issue, both to cope with strong variations in point density and to bring down computation time, turns out to be careful handling of neighborhood relations. By choosing appropriate definitions of a point's (multi-scale) neighborhood, we obtain a feature set that is both expressive and fast to compute. We evaluate our classification method both on benchmark data from a mobile mapping platform and on a variety of large, terrestrial laser scans with greatly varying point density. The proposed feature set outperforms the state of the art with respect to per-point classification accuracy, while at the same time being much faster to compute.

  18. Units for radiation protection work

    International Nuclear Information System (INIS)

    Lindborg, L.

    1997-06-01

    ICRU has defined special measurable (operational) quantities for radiation protection. A consequence of using the operational quantities is that hand-held and personal dosemeters can give different measuring results in the same radiation situation. The differences vary and are caused by the geometry of the radiation field. The units have well documented relations to e.g. the ICRP effective dose and equivalent dose to an organ or tissue. Therefore, it is possible to estimate these doses from a measured value of e.g. the ambient dose equivalent. ICRU and ICRP have recently reviewed these relations in two important commonly issued reports (Report 57 and Publication 74). This report tries to show the value of understanding these units and their relations and is primarily meant to be used for educational purposes. 11 refs

  19. The State of the World Environment, 1987. United Nations Environment Programme.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    One of the main activities assigned to the Governing Council of the United Nations Environment Programme (UNEP) is to review the world environmental situation to insure that emerging environmental problems of wide international significance receive appropriate and adequate consideration by governments. Accordingly, UNEP has assessed the state of…

  20. A comparison of private and public sector intensive care unit ...

    African Journals Online (AJOL)

    achieving the optimal physical structure that facilitates the care of ... patients with varying levels of need in terms of ICU equipment. As part of .... Prevention and Control Unit and is based on the R158 regulations, ..... and organizational aspects.

  1. Mineral and Nutrient Leaf Composition of Two Cassava (Manihot esculenta Crantz Cultivars Defoliated at Varying Phenological Phases

    Directory of Open Access Journals (Sweden)

    Oyeyemi Adigun DADA

    2010-12-01

    Full Text Available The effect of defoliation on mineral and food value of two cassava varieties defoliated at varying phenological phases was studied to ascertain the appropriate phenological phase when harvested leaves would contain the optimum mineral and proximate composition, gross energy and the least cyanide content. Two cassava cultivars were subjected to defoliation at varying phenological stages including logarithmic, vegetative and physiological maturity phases. The mineral content was highest at the logarithmic phase than any other phases. The proximate composition of the cassava leaves showed that crude protein was highest at physiological maturity, while the least HCN was observed in cassava defoliated at logarithmic phase. Analysis of mineral and proximate content showed that leaf of the �TMS30572� cultivar had the highest mineral content, fat, fibre, ash, dry matter and gross energy at the logarithm phase while �Oko-Iyawo� had the highest crude protein and HCN at physiological maturity. This study indicates the high potential of cassava leaf as an unconventional source of protein for both humans and animals when defoliated at logarithmic growth phase.

  2. 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.

  3. Matching soil grid unit resolutions with polygon unit scales for DNDC modelling of regional SOC pool

    Science.gov (United States)

    Zhang, H. D.; Yu, D. S.; Ni, Y. L.; Zhang, L. M.; Shi, X. Z.

    2015-03-01

    Matching soil grid unit resolution with polygon unit map scale is important to minimize uncertainty of regional soil organic carbon (SOC) pool simulation as their strong influences on the uncertainty. A series of soil grid units at varying cell sizes were derived from soil polygon units at the six map scales of 1:50 000 (C5), 1:200 000 (D2), 1:500 000 (P5), 1:1 000 000 (N1), 1:4 000 000 (N4) and 1:14 000 000 (N14), respectively, in the Tai lake region of China. Both format soil units were used for regional SOC pool simulation with DeNitrification-DeComposition (DNDC) process-based model, which runs span the time period 1982 to 2000 at the six map scales, respectively. Four indices, soil type number (STN) and area (AREA), average SOC density (ASOCD) and total SOC stocks (SOCS) of surface paddy soils simulated with the DNDC, were attributed from all these soil polygon and grid units, respectively. Subjecting to the four index values (IV) from the parent polygon units, the variation of an index value (VIV, %) from the grid units was used to assess its dataset accuracy and redundancy, which reflects uncertainty in the simulation of SOC. Optimal soil grid unit resolutions were generated and suggested for the DNDC simulation of regional SOC pool, matching with soil polygon units map scales, respectively. With the optimal raster resolution the soil grid units dataset can hold the same accuracy as its parent polygon units dataset without any redundancy, when VIV indices was assumed as criteria to the assessment. An quadratic curve regression model y = -8.0 × 10-6x2 + 0.228x + 0.211 (R2 = 0.9994, p < 0.05) was revealed, which describes the relationship between optimal soil grid unit resolution (y, km) and soil polygon unit map scale (1:x). The knowledge may serve for grid partitioning of regions focused on the investigation and simulation of SOC pool dynamics at certain map scale.

  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. Effect of varying geometrical parameters of trapezoidal corrugated-core sandwich structure

    Directory of Open Access Journals (Sweden)

    Zaid N.Z.M.

    2017-01-01

    Full Text Available Sandwich structure is an attractive alternative that increasingly used in the transportation and aerospace industry. Corrugated-core with trapezoidal shape allows enhancing the damage resistance to the sandwich structure, but on the other hand, it changes the structural response of the sandwich structure. The aim of this paper is to study the effect of varying geometrical parameters of trapezoidal corrugated-core sandwich structure under compression loading. The corrugated-core specimen was fabricated using press technique, following the shape of trapezoidal shape. Two different materials were used in the study, glass fibre reinforced plastic (GFRP and carbon fibre reinforced plastic (CFRP. The result shows that the mechanical properties of the core in compression loading are sensitive to the variation of a number of unit cells and the core thickness.

  6. Effect of arylamine hole-transport units on the performance of blue polyspirobifulorene light-emitting diodes

    NARCIS (Netherlands)

    Abbaszadeh, D.; Nicolai, H.T.; Crəciun, N.I.; Blom, P.W.M.

    2014-01-01

    The operation of blue light-emitting diodes based on polyspirobifluorene with a varying number of N,N,N′,N′ tetraaryldiamino biphenyl (TAD) hole-transport units (HTUs) is investigated. Assuming that the electron transport is not affected by the incorporation of TAD units, model calculations predict

  7. Recruitment of rat diaphragm motor units across motor behaviors with different levels of diaphragm activation.

    Science.gov (United States)

    Seven, Yasin B; Mantilla, Carlos B; Sieck, Gary C

    2014-12-01

    Phrenic motor neurons are recruited across a range of motor behaviors to generate varying levels of diaphragm muscle (DIAm) force. We hypothesized that DIAm motor units are recruited in a fixed order across a range of motor behaviors of varying force levels, consistent with the Henneman Size Principle. Single motor unit action potentials and compound DIAm EMG activities were recorded in anesthetized, neurally intact rats across different motor behaviors, i.e., eupnea, hypoxia-hypercapnia (10% O2 and 5% CO2), deep breaths, sustained airway occlusion, and sneezing. Central drive [estimated by root-mean-squared (RMS) EMG value 75 ms after the onset of EMG activity (RMS75)], recruitment delay, and onset discharge frequencies were similar during eupnea and hypoxia-hypercapnia. Compared with eupnea, central drive increased (∼25%) during deep breaths, and motor units were recruited ∼12 ms earlier (P motor units were recruited ∼30 ms earlier (P motor unit onset discharge frequencies were significantly higher (P Recruitment order of motor unit pairs observed during eupnea was maintained for 98%, 87%, and 84% of the same pairs recorded during hypoxia-hypercapnia, deep breaths, and airway occlusion, respectively. Reversals in motor unit recruitment order were observed primarily if motor unit pairs were recruited motor unit recruitment order being determined primarily by the intrinsic size-dependent electrophysiological properties of phrenic motor neurons. Copyright © 2014 the American Physiological Society.

  8. Control technique for enhancing the stable operation of distributed generation units within a microgrid

    International Nuclear Information System (INIS)

    Mehrasa, Majid; Pouresmaeil, Edris; Mehrjerdi, Hasan; Jørgensen, Bo Nørregaard; Catalão, João P.S.

    2015-01-01

    Highlights: • A control technique for enhancing the stable operation of distributed generation units is proposed. • Passivity-based control technique is considered to analyze the dynamic and steady-state behaviors. • The compensation of instantaneous variations in the reference current components is considered. • Simulation results confirm the performance of the control scheme within the microgrid. - Abstract: This paper describes a control technique for enhancing the stable operation of distributed generation (DG) units based on renewable energy sources, during islanding and grid-connected modes. The Passivity-based control technique is considered to analyze the dynamic and steady-state behaviors of DG units during integration and power sharing with loads and/or power grid, which is an appropriate tool to analyze and define a stable operating condition for DG units in microgrid technology. The compensation of instantaneous variations in the reference current components of DG units in ac-side, and dc-link voltage variations in dc-side of interfaced converters, are considered properly in the control loop of DG units, which is the main contribution and novelty of this control technique over other control strategies. By using the proposed control technique, DG units can provide the continuous injection of active power from DG sources to the local loads and/or utility grid. Moreover, by setting appropriate reference current components in the control loop of DG units, reactive power and harmonic current components of loads can be supplied during the islanding and grid-connected modes with a fast dynamic response. Simulation results confirm the performance of the control scheme within the microgrid during dynamic and steady-state operating conditions

  9. Market Risk in Demutualised Self-Listed Stock Exchanges: An International Analysis of Selected Time-Varying Betas

    OpenAIRE

    Andrew Worthington; Helen Higgs

    2005-01-01

    This paper examines market risk in four demutualised and self-listed stock exchanges: the Australian Stock Exchange, the Deutsche Börse, the London Stock Exchange and the Singapore Stock Exchange. Daily company and MSCI index returns provide the respective asset and market portfolio data. A bivariate MA-GARCH model is used to estimate time-varying betas for each exchange from listing until 7 June 2005. While the results indicate significant beta volatility, unit root tests show the betas to b...

  10. The relationship between parity and overweight varies with household wealth and national development.

    Science.gov (United States)

    Kim, Sonia A; Yount, Kathryn M; Ramakrishnan, Usha; Martorell, Reynaldo

    2007-02-01

    Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth. We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development. Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development. As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.

  11. Pharmacy-Driven Dexmedetomidine Stewardship and Appropriate Use Guidelines in a Community Hospital Setting.

    Science.gov (United States)

    Schickli, M Alexandra; Eberwein, Kip A; Short, Marintha R; Ratliff, Patrick D

    2017-01-01

    Dexmedetomidine is a widely utilized agent in the intensive care unit (ICU) because it does not suppress respiratory drive and may be associated with less delirium than midazolam or propofol. Cost of dexmedetomidine therapy and debate as to the proper duration of use has brought its use to the forefront of discussion. To validate the efficacy and cost savings associated with pharmacy-driven dexmedetomidine appropriate use guidelines and stewardship in mechanically ventilated patients. This was a retrospective cohort study of adult patients who received dexmedetomidine for ICU sedation while on mechanical ventilation at a 433-bed not-for-profit community hospital. Included patients were divided into pre-enactment (PRE) and postenactment (POST) of dexmedetomidine guideline groups. A total of 100 patients (50 PRE and 50 POST) were included in the analysis. A significant difference in duration of mechanical ventilation (11.1 vs 6.2 days, P = 0.006) and incidence of reintubation (36% vs 18% of patients, P = 0.043) was seen in the POST group. Aggregate use of dexmedetomidine 200-µg vials (37.1 vs 18.4 vials, P = 0.010) and infusion days (5.4 vs 2.5 days, P = 0.006) were significantly lower in the POST group. Dexmedetomidine acquisition cost savings were calculated at $374 456.15 in the POST group. There was no difference between the PRE and POST groups with regard to ICU length of stay, expected mortality, and observed mortality. Pharmacy-driven dexmedetomidine appropriate use guidelines decreased the use of dexmedetomidine and increased cost savings at a community hospital without adversely affecting clinical outcomes.

  12. 31 CFR 585.705 - Referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... of Justice. 585.705 Section 585.705 Money and Finance: Treasury Regulations Relating to Money and... HERZEGOVINA SANCTIONS REGULATIONS Penalties § 585.705 Referral to United States Department of Justice. In the... States Department of Justice for appropriate action to recover the penalty in a civil suit in a Federal...

  13. The Living, Dynamic and Complex Environment Care in Intensive Care Unit.

    Science.gov (United States)

    Backes, Marli Terezinha Stein; Erdmann, Alacoque Lorenzini; Büscher, Andreas

    2015-01-01

    to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care. Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units. built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions); "Providing a suitable environment" and "having relatives with concern" (context); "Mediating facilities and difficulties" (intervenienting conditions); "Organizing the environment and managing the dynamics of the unit" (strategy) and "finding it difficult to accept and deal with death" (consequences). confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

  14. 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…

  15. The ChemCam Instrument Suite on the Mars Science Laboratory (MSL) Rover: Science Objectives and Mast Unit Description

    Science.gov (United States)

    Maurice, S.; Wiens, R.C.; Saccoccio, M.; Barraclough, B.; Gasnault, O.; Forni, O.; Mangold, N.; Baratoux, D.; Bender, S.; Berger, G.; Bernardin, J.; Berthé, M.; Bridges, N.; Blaney, D.; Bouyé, M.; Caïs, P.; Clark, B.; Clegg, S.; Cousin, A.; Cremers, D.; Cros, A.; DeFlores, L.; Derycke, C.; Dingler, B.; Dromart, G.; Dubois, B.; Dupieux, M.; Durand, E.; d'Uston, L.; Fabre, C.; Faure, B.; Gaboriaud, A.; Gharsa, T.; Herkenhoff, K.; Kan, E.; Kirkland, L.; Kouach, D.; Lacour, J.-L.; Langevin, Y.; Lasue, J.; Le Mouélic, S.; Lescure, M.; Lewin, E.; Limonadi, D.; Manhès, G.; Mauchien, P.; McKay, C.; Meslin, P.-Y.; Michel, Y.; Miller, E.; Newsom, Horton E.; Orttner, G.; Paillet, A.; Parès, L.; Parot, Y.; Pérez, R.; Pinet, P.; Poitrasson, F.; Quertier, B.; Sallé, B.; Sotin, Christophe; Sautter, V.; Séran, H.; Simmonds, J.J.; Sirven, J.-B.; Stiglich, R.; Striebig, N.; Thocaven, J.-J.; Toplis, M.J.; Vaniman, D.

    2012-01-01

    ChemCam is a remote sensing instrument suite on board the "Curiosity" rover (NASA) that uses Laser-Induced Breakdown Spectroscopy (LIBS) to provide the elemental composition of soils and rocks at the surface of Mars from a distance of 1.3 to 7 m, and a telescopic imager to return high resolution context and micro-images at distances greater than 1.16 m. We describe five analytical capabilities: rock classification, quantitative composition, depth profiling, context imaging, and passive spectroscopy. They serve as a toolbox to address most of the science questions at Gale crater. ChemCam consists of a Mast-Unit (laser, telescope, camera, and electronics) and a Body-Unit (spectrometers, digital processing unit, and optical demultiplexer), which are connected by an optical fiber and an electrical interface. We then report on the development, integration, and testing of the Mast-Unit, and summarize some key characteristics of ChemCam. This confirmed that nominal or better than nominal performances were achieved for critical parameters, in particular power density (>1 GW/cm2). The analysis spot diameter varies from 350 μm at 2 m to 550 μm at 7 m distance. For remote imaging, the camera field of view is 20 mrad for 1024×1024 pixels. Field tests demonstrated that the resolution (˜90 μrad) made it possible to identify laser shots on a wide variety of images. This is sufficient for visualizing laser shot pits and textures of rocks and soils. An auto-exposure capability optimizes the dynamical range of the images. Dedicated hardware and software focus the telescope, with precision that is appropriate for the LIBS and imaging depths-of-field. The light emitted by the plasma is collected and sent to the Body-Unit via a 6 m optical fiber. The companion to this paper (Wiens et al. this issue) reports on the development of the Body-Unit, on the analysis of the emitted light, and on the good match between instrument performance and science specifications.

  16. Pragmatic awareness of Suggestions: From (Im)Polite Mannerism to Attitudinal Appropriateness

    OpenAIRE

    Hamid Allami; Nasim Boustani

    2017-01-01

    The present research seeks to determine: (a) Iranian EFL learners’ application of suggestion semantic formulae ;(b) their attitude of appropriateness in terms of confidence in the employment of appropriate supportive moves; (c), their (im)polite mannerism with respect to the selected strategies; and (d) the relationship between attitude of appropriateness and mannerism of (im)politeness. An Oxford Quick placement Test (OQPT) was administered among 60 Iranian EFL learners to check their langua...

  17. Mixed Inter Second Order Cone Programming Taking Appropriate Approximation for the Unit Commitment in Hybrid AC-DC Grid

    DEFF Research Database (Denmark)

    Zhou, Bo; Ai, Xiaomeng; Fang, Jiakun

    2017-01-01

    With the rapid development and deployment of voltage source converter (VSC) based HVDC, the traditional power system is evolving to the hybrid AC-DC grid. New optimization methods are urgently needed for these hybrid AC-DC power systems. In this paper, mixed-integer second order cone programming...... (MISOCP) for the hybrid AC-DC power systems is proposed. The second order cone (SOC) relaxation is adopted to transform the AC and DC power flow constraints to MISOCP. Several IEEE test systems are used to validate the proposed MISCOP formulation of the optimal power flow (OPF) and unit commitment (UC...

  18. Bilingual Preschool Education in the United States and Panama: A Comparative Analysis.

    Science.gov (United States)

    Valdivia, Rebeca

    This paper compares bilingual education policy and practice in Panama and the United States. Particular issues studied include the following: the social context of bilingual education in the two countries; programming and policy differences; teacher qualifications; availability of age-appropriate materials; and administrative support, level of…

  19. An RF energy harvesting power management circuit for appropriate duty-cycled operation

    Science.gov (United States)

    Shirane, Atsushi; Ito, Hiroyuki; Ishihara, Noboru; Masu, Kazuya

    2015-04-01

    In this study, we present an RF energy harvesting power management unit (PMU) for battery-less wireless sensor devices (WSDs). The proposed PMU realizes a duty-cycled operation that is divided into the energy charging time and discharging time. The proposed PMU detects two types of timing, thus, the appropriate timing for the activation can be recognized. The activation of WSDs at the proper timing leads to energy efficient operation and stable wireless communication. The proposed PMU includes a hysteresis comparator (H-CMP) and an RF signal detector (RF-SD) to detect the timings. The proposed RF-SD can operate without the degradation of charge efficiency by reusing the RF energy harvester (RF-EH) and H-CMP. The PMU fabricated in a 180 nm Si CMOS demonstrated the charge operation using the RF signal at 915 MHz and the two types of timing detection with less than 124 nW in the charge phase. Furthermore, in the active phase, the PMU generates a 0.5 V regulated power supply from the charged energy.

  20. Nutrient Intake Values for Folate during Pregnancy and Lactation Vary Widely around the World

    Directory of Open Access Journals (Sweden)

    Lisa A. Houghton

    2013-09-01

    Full Text Available Folate is a B-vitamin with particular importance during reproduction due to its role in the synthesis and maintenance of DNA. Folate is well known for its role in preventing neural tube defects (NTDs during the periconceptional period. There is also an increased need for folate throughout pregnancy to support optimal growth and development of the fetus and blood volume expansion and tissue growth of the mother. During lactation, women are at risk of folate deficiency due to increased demands to accommodate milk folate levels. Nutrient Intake Values (NIVs for folate have been calculated to take into account additional needs during pregnancy and lactation. However, these values vary widely between countries. For example, the folate requirement that is set to meet the needs of almost all healthy women during pregnancy varies from 300 µg/day in the United Kingdom to 750 µg/day in Mexico. Currently, there is no accepted standardized terminology or framework for establishing NIVs. This article reviews country-specific NIVs for folate during pregnancy and lactation and the basis for setting these reference values.

  1. Educational Inequality in the United States: Can We Reverse the Tide?

    Science.gov (United States)

    Gamoran, Adam; Bruch, Sarah K.

    2017-01-01

    Educational inequality is a pressing problem in much of the English-speaking world and especially in the United States, as the last three decades have witnessed rising inequality on several measures. This is an appropriate subject for a special issue commemorating the contributions of David Raffe, whose career of scholarship greatly enhanced our…

  2. Report of the CIRRPC Policy Subpanel on SI metric radiation units

    International Nuclear Information System (INIS)

    1986-12-01

    Recognizing that use of the International System of Units (SI) for radiological quantities is increasing internationally but is not currently widely accepted in the United States, and recognizing that the existing US policy is to plan for the increasing voluntary use of SI units domestically, it is recommended that it be US policy to use dual radiation units in Federal activities. However, it is recognized that in certain operational situations, by reason of economy or safety, the utilization of dual units is undesirable. Therefore, in justified situations, agencies may adopt that system of units which best meets their needs. The objective of the recommended use of dual units is primarily to familiarize people with the SI units. This should serve to ease transition when and where transition is appropriate and mitigate economic and safety concerns. The Subpanel has made suggestions on how this policy should be implemented by Federal agencies: using dual units in issuing regulations containing radiation units, except where determined to be impractical, incorporating dual units in agency internal operating procedures as they are written or revised; and using dual units in contracts and procurement. The Subpanel recommends that this policy be reexamined in about five years following an assessment of the use of SI radiation units both internationally and within the United States. 11 refs

  3. Cesarean Delivery Rates Vary 10-Fold Among US Hospitals; Reducing Variation May Address Quality, Cost Issues

    Science.gov (United States)

    Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.

    2013-01-01

    Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732

  4. Nuclear units operating improvement by using operating experience

    International Nuclear Information System (INIS)

    Rotaru, I.; Bilegan, I.C.

    1997-01-01

    The paper presents how the information experience can be used to improve the operation of nuclear units. This areas include the following items: conservative decision making; supervisory oversight; teamwork; control room distraction; communications; expectations and standards; operator training and fundamental knowledge, procedure quality and adherence; plant status awareness. For each of these topics, the information illustrate which are the principles, the lessons learned from operating experience and the most appropriate exemplifying documents. (authors)

  5. Pragmatic awareness of Suggestions: From (ImPolite Mannerism to Attitudinal Appropriateness

    Directory of Open Access Journals (Sweden)

    Hamid Allami

    2017-09-01

    Full Text Available The present research seeks to determine: (a Iranian EFL learners’ application of suggestion semantic formulae ;(b their attitude of appropriateness in terms of confidence in the employment of appropriate supportive moves; (c, their (impolite mannerism with respect to the selected strategies; and (d the relationship between attitude of appropriateness and mannerism of (impoliteness. An Oxford Quick placement Test (OQPT was administered among 60 Iranian EFL learners to check their language proficiency level and to satisfy the assumption of homogeneity among the learners. These participants along with 10 American native speakers then underwent a suggestion DCT. The questionnaire included questions addressing interlocutors’ with higher, lower or equal power status and intimate or strange social distance. The DCT also involved attitudinal appropriateness scale and (impoliteness mannerism likert scale to examine the learners’ degree of confidence and mannerism. Besides similarities and differences in the application of suggestion semantic formulae between the Iranian learners and American speakers, the results revealed variations in the two groups’ performances for appropriateness and (impoliteness. The results also indicated a positive relationship between the attitude and mannerism scales.

  6. Assessment of Motor Units in Neuromuscular Disease.

    Science.gov (United States)

    Henderson, Robert D; McCombe, Pamela A

    2017-01-01

    The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.

  7. Matching Value Propositions with Varied Customer Needs

    DEFF Research Database (Denmark)

    Heikka, Eija-Liisa; Frandsen, Thomas; Hsuan, Juliana

    2018-01-01

    Organizations seek to manage varied customer segments using varied value propositions. The ability of a knowledge-intensive business service (KIBS) provider to formulate value propositions into attractive offerings to varied customers becomes a competitive advantage. In this specific business based...... on often highly abstract service offerings, this requires the provider to have a clear overview of its knowledge and resources and how these can be configured to obtain the desired customization of services. Hence, the purpose of this paper is to investigate how a KIBS provider can match value propositions...... with varied customer needs utilizing service modularity. To accomplish this purpose, a qualitative multiple case study is organized around 5 projects allowing within-case and cross-case comparisons. Our findings describe how through the configuration of knowledge and resources a sustainable competitive...

  8. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff.

    Science.gov (United States)

    Vedana, Kelly Graziani Giacchero; da Silva, Danielle Maria; Ventura, Carla Aparecida Arena; Giacon, Bianca Cristina Ciccone; Zanetti, Ana Carolina Guidorizzi; Miasso, Adriana Inocenti; Borges, Tatiana Longo

    2018-06-01

    Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated. Aim In this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units. Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism. Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior. This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

    Science.gov (United States)

    2014-01-01

    Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

  10. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

    Science.gov (United States)

    Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

    2014-01-28

    It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a

  11. Surveys from inside: An assessment of unit nonresponse bias with internal criteria

    Directory of Open Access Journals (Sweden)

    Ulrich Kohler

    2007-06-01

    Full Text Available The article uses the so called “internal criteria of representativeness” to assess the unit nonresponse bias in five European comparative survey projects. It then goes on investigating several ideas why unit nonresponse bias might vary between surveys and countries. It is proposed that unit nonresponse bias is either caused by country characteristics or survey methodology. The empirical evidence presented speaks more in favour of the latter than of the former. Among the survey characteristics the features that strengthen the leverage to control interviewers’ behaviour have top priority

  12. Entomology: Self-Directed Study Units for Grades K-3 and 4-8, Gifted. Easily Adapted for Regular Classrrom Use. Zephyr Learning Project.

    Science.gov (United States)

    Clements, Sue; And Others

    These reproducible entomology units are an introduction to a fascinating world within a world. Originally designed for gifted students, these units emphasize the use of higher order thinking skills and are appropriate for use in any classroom. Interdisciplinary in content, the units provide a broad view of entomology. Included are two complete…

  13. The United Nations at 40

    International Nuclear Information System (INIS)

    1985-01-01

    The United Nations adopted a resolution expressing the hope that 1985 would mark the beginning of an era of durable and global peace and justice, social and economic development and progress and independence of all peoples. 1985 is the organization's 40th anniversary year - the United Nations Charter entered into force on 24 October 1945 - and the Assembly has chosen 'United Nations for a better world' as the anniversary theme. It also has decided to hold a brief commemorative session culminating on 24 October this year. Member States of the UN also have been urged to organize appropriate observance of the anniversary, with the widest possible participation, and to consider the creation of national committees to evaluate the contribution of the UN system over the past four decades, its continuing relevance in the current international situation, and ways in which it could be strengthened and made more effective. Among other things, the Assembly in its resolution appealed to the international mass media, both public and private, to contribute more effectively to dissemination of information on UN activities. During the commemorative session planned this October, a final document is expected to be adopted for which the Assembly has asked the Preparatory Committee for the Fortieth Anniversary of the United Nations to compose a suitable text. The Preparatory Committee had been established by the Assembly in 1983, and by December 1984, 98 countries had joined in its work, which relates to various activities

  14. The United Nations at 40

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-10-01

    The United Nations adopted a resolution expressing the hope that 1985 would mark the beginning of an era of durable and global peace and justice, social and economic development and progress and independence of all peoples. 1985 is the organization's 40th anniversary year - the United Nations Charter entered into force on 24 October 1945 - and the Assembly has chosen 'United Nations for a better world' as the anniversary theme. It also has decided to hold a brief commemorative session culminating on 24 October this year. Member States of the UN also have been urged to organize appropriate observance of the anniversary, with the widest possible participation, and to consider the creation of national committees to evaluate the contribution of the UN system over the past four decades, its continuing relevance in the current international situation, and ways in which it could be strengthened and made more effective. Among other things, the Assembly in its resolution appealed to the international mass media, both public and private, to contribute more effectively to dissemination of information on UN activities. During the commemorative session planned this October, a final document is expected to be adopted for which the Assembly has asked the Preparatory Committee for the Fortieth Anniversary of the United Nations to compose a suitable text. The Preparatory Committee had been established by the Assembly in 1983, and by December 1984, 98 countries had joined in its work, which relates to various activities.

  15. Hypothyroidism among military infants born in countries of varied iodine nutrition status

    Directory of Open Access Journals (Sweden)

    Smith Tyler C

    2010-02-01

    Full Text Available Abstract Background Iodine deficiency is a global problem representing the most common preventable cause of mental retardation. Recently, the impact of subtle deficiencies in iodine intake on children and pregnant women has been questioned. This study was designed to compare hypothyroidism among infants born to US military families in countries of varied iodine nutrition status. Methods A cohort design was used to analyze data from the Department of Defense Birth and Infant Health Registry for infants born in 2000-04 (n = 447,691. Hypothyroidism was defined using ICD-9-CM codes from the first year of life (n = 698. The impact of birth location on hypothyroidism was assessed by comparing rates in Germany, Japan, and US territories with the United States, while controlling for infant gender, plurality, gestational age, maternal age, maternal military status, and military parent's race/ethnicity. Results Hypothyroidism did not vary by birth location with adjusted odds ratios (OR as follows: Germany (OR 0.82, [95% CI 0.50, 1.35], Japan (OR 0.67, [95% CI 0.37, 1.22], and US territories (OR 1.29, [95% CI 0.57, 2.89]. Hypothyroidism was strongly associated with preterm birth (OR 5.44, [95% CI 4.60, 6.42]. Hypothyroidism was also increased among infants with civilian mothers (OR 1.24, [95% CI 1.00, 1.54], and older mothers, especially ages 40 years and older (OR 2.09, [95% CI 1.33, 3.30]. Conclusions In this study, hypothyroidism in military-dependent infants did not vary by birth location, but was associated with other risk factors, including preterm birth, civilian maternal status, and advanced maternal age.

  16. Transformation of binaural response properties in the ascending auditory pathway: influence of time-varying interaural phase disparity.

    Science.gov (United States)

    Spitzer, M W; Semple, M N

    1998-12-01

    Transformation of binaural response properties in the ascending auditory pathway: influence of time-varying interaural phase disparity. J. Neurophysiol. 80: 3062-3076, 1998. Previous studies demonstrated that tuning of inferior colliculus (IC) neurons to interaural phase disparity (IPD) is often profoundly influenced by temporal variation of IPD, which simulates the binaural cue produced by a moving sound source. To determine whether sensitivity to simulated motion arises in IC or at an earlier stage of binaural processing we compared responses in IC with those of two major IPD-sensitive neuronal classes in the superior olivary complex (SOC), neurons whose discharges were phase locked (PL) to tonal stimuli and those that were nonphase locked (NPL). Time-varying IPD stimuli consisted of binaural beats, generated by presenting tones of slightly different frequencies to the two ears, and interaural phase modulation (IPM), generated by presenting a pure tone to one ear and a phase modulated tone to the other. IC neurons and NPL-SOC neurons were more sharply tuned to time-varying than to static IPD, whereas PL-SOC neurons were essentially uninfluenced by the mode of stimulus presentation. Preferred IPD was generally similar in responses to static and time-varying IPD for all unit populations. A few IC neurons were highly influenced by the direction and rate of simulated motion, but the major effect for most IC neurons and all SOC neurons was a linear shift of preferred IPD at high rates-attributable to response latency. Most IC and NPL-SOC neurons were strongly influenced by IPM stimuli simulating motion through restricted ranges of azimuth; simulated motion through partially overlapping azimuthal ranges elicited discharge profiles that were highly discontiguous, indicating that the response associated with a particular IPD is dependent on preceding portions of the stimulus. In contrast, PL-SOC responses tracked instantaneous IPD throughout the trajectory of simulated

  17. 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)

  18. 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.

  19. 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 ...

  20. 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...

  1. 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

  2. Simulation studies of a new 'OpenPET' geometry based on a quad unit of detector rings

    Energy Technology Data Exchange (ETDEWEB)

    Yamaya, Taiga; Yoshida, Eiji; Nishikido, Fumihiko; Shibuya, Kengo; Inadama, Naoko; Murayama, Hideo [Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); Inaniwa, Taku [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan)], E-mail: taiga@nirs.go.jp

    2009-03-07

    We have proposed an 'OpenPET' geometry which consists of two detector rings of axial length W each axially separated by a gap G. In order to obtain an axially continuous field-of-view (FOV) of 2W+G, the maximum limit for G must be W. However, two valleys of sensitivity appear, one on each side of the gap. In practice, the gap should be Gunits of detector rings obtained by dividing each right and left unit of detector rings into two units. The inner two units formed the main gap, and the outer two units were appropriately placed to improve the uniformity of sensitivity. The geometry was optimized to minimize the standard deviation of the sensitivity distribution. Numerical simulation results supported the effectiveness of the proposed method. The outer units compensated for the sensitivity valleys on both sides of the main gap. A more appropriate geometry should be designed for the desired application, such as a long axial FOV PET and in-beam PET.

  3. Design of 2D time-varying vector fields.

    Science.gov (United States)

    Chen, Guoning; Kwatra, Vivek; Wei, Li-Yi; Hansen, Charles D; Zhang, Eugene

    2012-10-01

    Design of time-varying vector fields, i.e., vector fields that can change over time, has a wide variety of important applications in computer graphics. Existing vector field design techniques do not address time-varying vector fields. In this paper, we present a framework for the design of time-varying vector fields, both for planar domains as well as manifold surfaces. Our system supports the creation and modification of various time-varying vector fields with desired spatial and temporal characteristics through several design metaphors, including streamlines, pathlines, singularity paths, and bifurcations. These design metaphors are integrated into an element-based design to generate the time-varying vector fields via a sequence of basis field summations or spatial constrained optimizations at the sampled times. The key-frame design and field deformation are also introduced to support other user design scenarios. Accordingly, a spatial-temporal constrained optimization and the time-varying transformation are employed to generate the desired fields for these two design scenarios, respectively. We apply the time-varying vector fields generated using our design system to a number of important computer graphics applications that require controllable dynamic effects, such as evolving surface appearance, dynamic scene design, steerable crowd movement, and painterly animation. Many of these are difficult or impossible to achieve via prior simulation-based methods. In these applications, the time-varying vector fields have been applied as either orientation fields or advection fields to control the instantaneous appearance or evolving trajectories of the dynamic effects.

  4. 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,…

  5. 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.

  6. 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.

  7. 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...

  8. Design of 2D Time-Varying Vector Fields

    KAUST Repository

    Chen, Guoning

    2012-10-01

    Design of time-varying vector fields, i.e., vector fields that can change over time, has a wide variety of important applications in computer graphics. Existing vector field design techniques do not address time-varying vector fields. In this paper, we present a framework for the design of time-varying vector fields, both for planar domains as well as manifold surfaces. Our system supports the creation and modification of various time-varying vector fields with desired spatial and temporal characteristics through several design metaphors, including streamlines, pathlines, singularity paths, and bifurcations. These design metaphors are integrated into an element-based design to generate the time-varying vector fields via a sequence of basis field summations or spatial constrained optimizations at the sampled times. The key-frame design and field deformation are also introduced to support other user design scenarios. Accordingly, a spatial-temporal constrained optimization and the time-varying transformation are employed to generate the desired fields for these two design scenarios, respectively. We apply the time-varying vector fields generated using our design system to a number of important computer graphics applications that require controllable dynamic effects, such as evolving surface appearance, dynamic scene design, steerable crowd movement, and painterly animation. Many of these are difficult or impossible to achieve via prior simulation-based methods. In these applications, the time-varying vector fields have been applied as either orientation fields or advection fields to control the instantaneous appearance or evolving trajectories of the dynamic effects. © 1995-2012 IEEE.

  9. Design of 2D Time-Varying Vector Fields

    KAUST Repository

    Chen, Guoning; Kwatra, Vivek; Wei, Li-Yi; Hansen, Charles D.; Zhang, Eugene

    2012-01-01

    Design of time-varying vector fields, i.e., vector fields that can change over time, has a wide variety of important applications in computer graphics. Existing vector field design techniques do not address time-varying vector fields. In this paper, we present a framework for the design of time-varying vector fields, both for planar domains as well as manifold surfaces. Our system supports the creation and modification of various time-varying vector fields with desired spatial and temporal characteristics through several design metaphors, including streamlines, pathlines, singularity paths, and bifurcations. These design metaphors are integrated into an element-based design to generate the time-varying vector fields via a sequence of basis field summations or spatial constrained optimizations at the sampled times. The key-frame design and field deformation are also introduced to support other user design scenarios. Accordingly, a spatial-temporal constrained optimization and the time-varying transformation are employed to generate the desired fields for these two design scenarios, respectively. We apply the time-varying vector fields generated using our design system to a number of important computer graphics applications that require controllable dynamic effects, such as evolving surface appearance, dynamic scene design, steerable crowd movement, and painterly animation. Many of these are difficult or impossible to achieve via prior simulation-based methods. In these applications, the time-varying vector fields have been applied as either orientation fields or advection fields to control the instantaneous appearance or evolving trajectories of the dynamic effects. © 1995-2012 IEEE.

  10. 78 FR 65977 - Board of Visitors, United States Military Academy (USMA)

    Science.gov (United States)

    2013-11-04

    [email protected]us.army.mil . 7. Due to the lapse of appropriations, the Department of Defense cancelled the... DEPARTMENT OF DEFENSE Department of the Army Board of Visitors, United States Military Academy... the Sunshine Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, the Department of Defense...

  11. Age and admission times as predictive factors for failure of admissions to discharge-stream short-stay units.

    Science.gov (United States)

    Shetty, Amith L; Shankar Raju, Savitha Banagar; Hermiz, Arsalan; Vaghasiya, Milan; Vukasovic, Matthew

    2015-02-01

    Discharge-stream emergency short-stay units (ESSU) improve ED and hospital efficiency. Age of patients and time of hospital presentations have been shown to correlate with increasing complexity of care. We aim to determine whether an age and time cut-off could be derived to subsequently improve short-stay unit success rates. We conducted a retrospective audit on 6703 (5522 inclusions) patients admitted to our discharge-stream short-stay unit. Patients were classified as appropriate or inappropriate admissions, and deemed successful if discharged out of the unit within 24 h; and failures if they needed inpatient admission into the hospital. We calculated short-stay unit length of stay for patients in each of these groups. A 15% failure rate was deemed as acceptable key performance indicator (KPI) for our unit. There were 197 out of 4621 (4.3%, 95% CI 3.7-4.9%) patients up to the age of 70 who failed admission to ESSU compared with 67 out of 901 (7.4%, 95% CI 5.9-9.3%, P 70 years of age have higher rates of failure after admission to discharge-stream ESSU. Although in appropriately selected discharge-stream patients, no age group or time-band of presentation was associated with increased failure rate beyond the stipulated KPI. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Time-varying Crash Risk

    DEFF Research Database (Denmark)

    Christoffersen, Peter; Feunoua, Bruno; Jeon, Yoontae

    We estimate a continuous-time model with stochastic volatility and dynamic crash probability for the S&P 500 index and find that market illiquidity dominates other factors in explaining the stock market crash risk. While the crash probability is time-varying, its dynamic depends only weakly on re...

  13. Collaboration, campaigns and champions for appropriate imaging: feedback from the Zagreb workshop.

    Science.gov (United States)

    Remedios, D; Brkljacic, B; Ebdon-Jackson, S; Hierath, M; Sinitsyn, V; Vassileva, J

    2018-04-01

    Leading radiologists and representatives from national radiation protection regulatory authorities and health ministries from 19 countries of the European region worked together with five experts at the workshop on justification and appropriate use of imaging in Zagreb, Croatia, from 26 to 28 October 2017 jointly organised by the IAEA and the European Society of Radiology. The workshop served as a forum to exchange information on challenges and solutions for improving justification and the appropriate use of diagnostic imaging. Common barriers to improving the use of imaging referral guidelines were discussed and the need for increased collaboration identified. Examples of good practices were presented, including use of Clinical Decision Support (CDS) systems to facilitate rapid and good justification decisions. The workshop identified some of the needs of European countries for achieving more appropriate imaging proposing wider use of collaboration, campaigns and champions. • Drivers for appropriate imaging in Europe are similar to those elsewhere globally. • Implementing imaging referral guidelines is the main barrier to more appropriate imaging. • Clinical Decision Support systems (CDS) facilitates good referral practice and justification decisions. • Collaboration, campaigns and champions may improve awareness, appropriateness and audit.

  14. Marine Biology: Self-Directed Study Units for Grades K-3 and 4-8, Gifted. Easily Adapted for Regular Classroom Use. Zephyr Learning Project.

    Science.gov (United States)

    Tanner, Joey

    Originally designed for the gifted student, these reproducible marine biology units emphasize the use of higher order thinking skills and are appropriate for use in any classroom. Interdisciplinary in content, the units provide a broad view of marine biology. Included are two complete units, one created for the upper elementary gifted student and…

  15. Time varying voltage combustion control and diagnostics sensor

    Science.gov (United States)

    Chorpening, Benjamin T [Morgantown, WV; Thornton, Jimmy D [Morgantown, WV; Huckaby, E David [Morgantown, WV; Fincham, William [Fairmont, WV

    2011-04-19

    A time-varying voltage is applied to an electrode, or a pair of electrodes, of a sensor installed in a fuel nozzle disposed adjacent the combustion zone of a continuous combustion system, such as of the gas turbine engine type. The time-varying voltage induces a time-varying current in the flame which is measured and used to determine flame capacitance using AC electrical circuit analysis. Flame capacitance is used to accurately determine the position of the flame from the sensor and the fuel/air ratio. The fuel and/or air flow rate (s) is/are then adjusted to provide reduced flame instability problems such as flashback, combustion dynamics and lean blowout, as well as reduced emissions. The time-varying voltage may be an alternating voltage and the time-varying current may be an alternating current.

  16. Time-varying predictability in crude-oil markets: the case of GCC countries

    International Nuclear Information System (INIS)

    El Hedi Arouri, Mohamed; Thanh Huong Dinh; Duc Khuong Nguyen

    2010-01-01

    This paper uses a time-varying parameter model with generalized autoregressive conditional heteroscedasticity effects to examine the dynamic behavior of crude-oil prices for the period February 7, 1997-January 8, 2010. Using data from four countries of the Gulf Cooperation Council, we find evidence of short-term predictability in oil-price changes over time, except for several short sub-periods. However, the hypothesis of convergence towards weak-form informational efficiency is rejected for all markets. In addition, we explore the possibility of structural breaks in the time-paths of the estimated predictability indices and detect only one breakpoint, for the oil markets in Qatar and the United Arab Emirates. Our empirical results therefore call for new empirical research to further gauge the predictability characteristics and the determinants of oil-price changes.

  17. Hispanic Literatures in the United States: Differences and Similarities.

    Science.gov (United States)

    Romero, Hector R.

    Currently, the interest in the Latino literature written in the United States has been growing steadily. Many colleges and universities offer specific courses in these literatures, and their content varies from a concentration on a specific culture group to a more inclusive attempt to group all Latino writers under the same umbrella. This paper…

  18. The Living, Dynamic and Complex Environment Care in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Marli Terezinha Stein Backes

    2015-06-01

    Full Text Available OBJECTIVE: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care.METHOD: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units.RESULTS: built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions; "Providing a suitable environment" and "having relatives with concern" (context; "Mediating facilities and difficulties" (intervenienting conditions; "Organizing the environment and managing the dynamics of the unit" (strategy and "finding it difficult to accept and deal with death" (consequences.CONCLUSION: confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

  19. Mobile phone appropriation in the favelas of Rio de Janeiro, Brazil

    DEFF Research Database (Denmark)

    de Souza e Silva, Adriana Araujo; Sutko, Daniel; Salis, Fernando

    2011-01-01

    This qualitative case study describes the social appropriation of mobile phones among low-income communities in Rio de Janeiro (Brazil) by asking how favela (slum) residents appropriate cell phones. Findings highlight the difficulty these populations encounter in acquiring and using cell phones due...

  20. 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.

  1. Explicit appropriate basis function method for numerical solution of stiff systems

    International Nuclear Information System (INIS)

    Chen, Wenzhen; Xiao, Hongguang; Li, Haofeng; Chen, Ling

    2015-01-01

    Highlights: • An explicit numerical method called the appropriate basis function method is presented. • The method differs from the power series method for obtaining approximate numerical solutions. • Two cases show the method is fit for linear and nonlinear stiff systems. • The method is very simple and effective for most of differential equation systems. - Abstract: In this paper, an explicit numerical method, called the appropriate basis function method, is presented. The explicit appropriate basis function method differs from the power series method because it employs an appropriate basis function such as the exponential function, or periodic function, other than a polynomial, to obtain approximate numerical solutions. The method is successful and effective for the numerical solution of the first order ordinary differential equations. Two examples are presented to show the ability of the method for dealing with linear and nonlinear systems of differential equations

  2. Detection of dynamically varying interaural time differences

    DEFF Research Database (Denmark)

    Kohlrausch, Armin; Le Goff, Nicolas; Breebaart, Jeroen

    2010-01-01

    of fringes surrounding the probe is equal to the addition of the effects of the individual fringes. In this contribution, we present behavioral data for the same experimental condition, called dynamically varying ITD detection, but for a wider range of probe and fringe durations. Probe durations varied...

  3. ACR Appropriateness Criteria® Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Singh-Bhinder, Nimarta; Kim, David H; Holly, Brian P; Johnson, Pamela T; Hanley, Michael; Carucci, Laura R; Cash, Brooks D; Chandra, Ankur; Gage, Kenneth L; Lambert, Drew L; Levy, Angela D; Oliva, Isabel B; Peterson, Christine M; Strax, Richard; Rybicki, Frank J; Dill, Karin E

    2017-05-01

    Upper gastrointestinal bleeding (UGIB) remains a significant cause of morbidity and mortality with mortality rates as high as 14%. This document addresses the indications for imaging UGIB that is nonvariceal and unrelated to portal hypertension. The four variants are derived with respect to upper endoscopy. For the first three, it is presumed that upper endoscopy has been performed, with three potential initial outcomes: endoscopy reveals arterial bleeding source, endoscopy confirms UGIB without a clear source, and negative endoscopy. The fourth variant, "postsurgical and traumatic causes of UGIB; endoscopy contraindicated" is considered separately because upper endoscopy is not performed. When endoscopy identifies the presence and location of bleeding but bleeding cannot be controlled endoscopically, catheter-based arteriography with treatment is an appropriate next study. CT angiography (CTA) is comparable with angiography as a diagnostic next step. If endoscopy demonstrates a bleed but the endoscopist cannot identify the bleeding source, angiography or CTA can be typically performed and both are considered appropriate. In the event of an obscure UGIB, angiography and CTA have been shown to be equivalent in identifying the bleeding source; CT enterography may be an alternative to CTA to find an intermittent bleeding source. In the postoperative or traumatic setting when endoscopy is contraindicated, primary angiography, CTA, and CT with intravenous contrast are considered appropriate. 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

  4. The effect of combined antiretroviral therapy on the overall mortality of HIV-infected individuals

    NARCIS (Netherlands)

    Phillips, A. N.; Gilson, R.; Easterbrook, P.; Fisher, M.; Gazzard, B.; Johnson, M.; Walsh, J.; Leen, C.; Orkin, C.; Anderson, J.; Pillay, D.; Delpech, V.; Schwenk, A.; Dunn, D.; Gompels, M.; Hill, T.; Porter, K.; Babiker, A.; Sabin, C.; Waters, A.; Crates, D.; Mohamed-Saad, S.; Perry, N.; Pullin, A.; Churchill, D.; Harris, W.; Nelson, M.; Asboe, D.; Bulbeck, S.; Mandalia, S.; Clarke, J.; Dodds, J.; Rider, A.; Youle, M.; Lampe, F.; Smith, C.; Gumley, H.; Chaloner, C.; Ismajani, D.; Weber, J.; Cashin, S.; Kemble, C.; Mackie, N.; Thomas, R.; Jones, K.; Gann, S.; Wilson, A.; Ainsworth, J.; de Wolf, F.; Bezemer, D. O.; Gras, L. A. J.; Kesselring, A. M.; van Sighem, A. I.; Smit, C.; Zhang, S.; Zaheri, S.; Prins, J. M.; Bos, J. C.; Eeftinck-Schattenkerk, J. K. M.; Geerlings, S. E.; Godfried, M. H.; Lange, J. M. A.; van der Meer, J. T. M.; Nellen, F. J. B.; Olszyna, D. P.; van der Poll, M.; Reiss, P.; Sankatsing, S. U. C.; Steingrover, R.; van der Valk, M.; Vermeulen, J. N.; Vrouenraets, S. M. E.; van Vugt, M.; Wit, F. W. M. N.; Schreij, G.; van der Geest, S.; Oude Lashof, A.; Lowe, S.; Verbon, A.; Kuijpers, T. W.; Pajkrt, D.; Scherpbier, H. J.; van der Ende, M. E.; Bax, H.; van der Feltz, M.; Gelinck, L. B. S.; Nouwen, J. L.; Rijnders, B. J. A.; de Ruiter, E. D.; Slobbe, L.; Schurink, C. A. M.; de Vries, T. E. M. S.; Driessen, G.; van der Flier, M.; Hartwig, N. G.; Branger, J.; Kauffmann, R. H.; Schippers, E. F.; Groeneveld, P. H. P.; Alleman, M. A.; ten Kate, R. W.; Soetekouw, R.; Kroon, F. P.; Arend, S. M.; de Boer, M. G. J.; van den Broek, P. J.; van Dissel, J. T.; van Nieuwkoop, C.; den Hollander, J. G.; Bronsveld, W.; Vriesendorp, R.; Jeurissen, F. J. F.; Leyten, E. M. S.; van Houte, D.; Polée, M. B.; ten Napel, C. H. H.; Kootstra, G. J.; Brinkman, K.; van den Berk, G. E. L.; Blok, W. L.; Frissen, P. H. J.; Schouten, W. E. M.; van Eeden, A.; Verhagen, D. W. M.; Mulder, J. W.; van Gorp, E. C. M.; Mairuhu, A. T. A.; Wagenaar, J.; Juttmann, J. R.; van Kasteren, M. E. E.; Veenstra, J.; Vasmel, W. L. E.; Koopmans, P. P.; Brouwer, A. M.; Dofferhoff, A. S. M.; de Groot, R.; ter Hofstede, H. J. M.; Keuter, M.; van der Ven, A. J. A. M.; Sprenger, H. G.; van Assen, S.; van Leeuwen, J. T. M.; Stek, C. J.; Doedens, R.; Scholvinck, E. H.; Hoepelman, I. M.; Schneider, M. M. E.; Bonten, M. J. M.; Ellerbroek, P. M.; Jaspers, C. A. J. J.; Maarschalk-Ellerbroek, L. J.; Oosterheert, J. J.; Peters, E. J. G.; Mudrikova, T.; Wassenberg, M. W. M.; Weijer, S.; Geelen, S. P. M.; Wolfs, T. F. W.; Danner, S. A.; van Agtmael, M. A.; Bierman, W. F. W.; Claessen, F. A. P.; Hillebrand, M. E.; de Jong, E. V.; Kortmann, W.; Perenboom, R. M.; bij de Vaate, E. A.; Richter, C.; van der Berg, J.; Gisolf, E. H.; Tanis, A. A.; Duits, A. J.; Winkel, K.; Elisabeth, S. T.; Abgrall, S.; Barin, F.; Bentata, M.; Billaud, E.; Boué, F.; Burty, C.; Cabié, A.; Costagliola, D.; Cotte, L.; de Truchis, P.; Duval, X.; Duvivier, C.; Enel, P.; Fredouille-Heripret, L.; Gasnault, J.; Gaud, C.; Gilquin, J.; Grabar, S.; Katlama, C.; Khuong, M. A.; Lang, J. M.; Lascaux, A. S.; Launay, O.; Mahamat, A.; Mary-Krause, M.; Matheron, S.; Meynard, J. L.; Pavie, J.; Pialoux, G.; Pilorgé, F.; Poizot-Martin, I.; Pradier, C.; Reynes, J.; Rouveix, E.; Simon, A.; Tattevin, P.; Tissot-Dupont, H.; Viard, J. P.; Viget, N.; Salomon, Valérie; Jacquemet, N.; Guiguet, M.; Lanoy, E.; Liévre, L.; Selinger-Leneman, H.; Lacombe, J. M.; Potard, V.; Bricaire, F.; Herson, S.; Desplanque, N.; Girard, P. M.; Meyohas, M. C.; Picard, O.; Cadranel, J.; Mayaud, C.; Clauvel, J. P.; Decazes, J. M.; Gerard, L.; Molina, J. M.; Diemer, M.; Sellier, P.; Honoré, P.; Jeantils, V.; Tassi, S.; Mechali, D.; Taverne, B.; Berthé, H.; Dupont, C.; Chandemerle, C.; Mortier, E.; Tisne-Dessus, D.; Weiss, L.; Salmon, D.; Auperin, I.; Roudière, L.; Fior, R.; Delfraissy, J. F.; Goujard, C.; Jung, C.; Lesprit, P. H.; Vittecoq, D.; Fraisse, P.; Rey, D.; Beck-Wirth, G.; Stahl, J. P.; Lecercq, P.; Gourdon, F.; Laurichesse, H.; Fresard, A.; Lucht, F.; Bazin, C.; Verdon, R.; Chavanet, P.; Arvieux, C.; Michelet, C.; Choutet, P.; Goudeau, A.; Maître, M. F.; Hoen, B.; Eglinger, P.; Faller, J. P.; Borsa-Lebas, F.; Caron, F.; Daures, J. P.; May, T.; Rabaud, C.; Berger, J. L.; Rémy, G.; Arlet-Suau, E.; Cuzin, L.; Massip, P.; Legrand, M. F. Thiercelin; Pontonnier, G.; Yasdanpanah, Y.; Dellamonica, P.; Pugliese, P.; Aleksandrowicz, K.; Quinsat, D.; Ravaux, I.; Delmont, J. P.; Moreau, J.; Gastaut, J. A.; Retornaz, F.; Soubeyrand, J.; Galinier, A.; Ruiz, J. M.; Allegre, T.; Blanc, P. A.; Bonnet-Montchardon, D.; Lepeu, G.; Granet-Brunello, P.; Esterni, J. P.; Pelissier, L.; Cohen-Valensi, R.; Nezri, M.; Chadapaud, S.; Laffeuillade, A.; Raffi, F.; Boibieux, A.; Peyramond, D.; Livrozet, J. M.; Touraine, J. L.; Trepo, C.; Strobel, M.; Bissuel, F.; Pradinaud, R.; Sobesky, M.; Contant, M.; Aebi, C.; Battegay, M.; Bernasconi, E.; Böni, J.; Brazzola, P.; Bucher, H. C.; Bürgisser, P. H.; Calmy, A.; Cattacin, S.; Cavassini, M.; Cheseaux, J.-J.; Drack, G.; Dubs, R.; Egger, M.; Elzi, L.; Fischer, M.; Flepp, M.; Fontana, A.; Francioli, P.; Furrer, H. J.; Fux, C.; Gayet-Ageron, A.; Gerber, S.; Gorgievski, M.; Günthard, H.; Gyr, T. H.; Hirsch, H.; Hirschel, B.; Hösli, I.; Hüsler, M.; Kaiser, L.; Kahlert, C. H.; Karrer, U.; Kind, C.; Klimkait, T. H.; Ledergerber, B.; Martinetti, G.; Martinez, B.; Müller, N.; Nadal, D.; Paccaud, F.; Pantaleo, G.; Raio, L.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schüpbach, J.; Speck, R.; Taffé, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Wyler, C.-A.; Yerly, S.; Casabona, J.; Miró, J. M.; Alquézar, A.; Isern, V.; Esteve, A.; Podzamczer, D.; Murillas, J.; Gatell, J. M.; Agüero, F.; Tural, C.; Clotet, B.; Ferrer, E.; Riera, M.; Segura, F.; Navarro, G.; Force, L.; Vilaró, J.; Masabeu, A.; García, I.; Guadarrama, M.; Romero, A.; Agustí, C.; Montoliu, A.; Ortega, N.; Lazzari, E.; Puchol, E.; Sanchez, M.; Blanco, J. L.; Garcia-Alcaide, F.; Martínez, E.; López-Dieguez, M.; García-Goez, J. F.; Sirera, G.; Romeu, J.; Jou, A.; Negredo, E.; Miranda, C.; Capitan, M. C.; Olmo, M.; Barragan, P.; Saumoy, M.; Bolao, F.; Cabellos, C.; Peña, C.; Sala, M.; Cervantes, M.; Amengual, M. J.; Navarro, M.; Penelo, E.; Berenguer, J.; del Amo, J.; García, F.; Gutiérrez, F.; Labarga, P.; Moreno, S.; Muñoz, M. A.; Caro-Murillo, A. M.; Sobrino, P.; Jarrín, I.; Sirvent, J. L. Gómez; Rodríguez, P.; Alemán, M. R.; Alonso, M. M.; López, A. M.; Hernández, M. I.; Soriano, V.; Barreiro, P.; Medrano, J.; Rivas, P.; Herrero, D.; Blanco, F.; Vispo, M. E.; Martín, L.; Ramírez, G.; de Diego, M.; Rubio, R.; Pulido, F.; Moreno, V.; Cepeda, C.; Hervás, R. I.; Iribarren, J. A.; Arrizabalaga, J.; Aramburu, M. J.; Camino, X.; Rodríguez-Arrondo, F.; von Wichmann, M. A.; Pascual, L.; Goenaga, M. A.; Masiá, M.; Ramos, J. M.; Padilla, S.; Sánchez-Hellín, V.; Bernal, E.; Escolano, C.; Montolio, F.; Peral, Y.; López, J. C.; Miralles, P.; Cosín, J.; Sánchez, M.; Gutiérrez, I.; Ramírez, M.; Padilla, B.; Vidal, F.; Sanjuan, M.; Peraire, J.; Veloso, S.; Viladés, C.; López-Dupla, M.; Olona, M.; Vargas, M.; Aldeguer, J. L.; Blanes, M.; Lacruz, J.; Salavert, M.; Montero, M.; Cuéllar, S.; de los Santos, I.; Sanz, J.; Oteo, J. A.; Blanco, J. R.; Ibarra, V.; Metola, L.; Sanz, M.; Pérez-Martínez, L.; Sola, J.; Uriz, J.; Castiello, J.; Reparaz, J.; Arriaza, M. J.; Irigoyen, C.; Antela, A.; Casado, J. L.; Dronda, F.; Moreno, A.; Pérez, M. J.; López, D.; Gutiérrez, C.; Hernández, B.; Pumares, M.; Martí, P.; García, L.; Page, C.; Hernández, J.; Peña, A.; Muñoz, L.; Parra, J.; Viciana, P.; Leal, M.; López-Cortés, L. F.; Trastoy, M.; Mata, R.; Justice, A. C.; Fiellin, D. A.; Rimland, D.; Jones-Taylor, C.; Oursler, K. A.; Titanji, R.; Brown, S.; Garrison, S.; Rodriguez-Barradas, M.; Masozera, N.; Goetz, M.; Leaf, D.; Simberkoff, M.; Blumenthal, D.; Leung, J.; Butt, A.; Hoffman, E.; Gibert, C.; Peck, R.; Mattocks, K.; Braithwaite, S.; Brandt, C.; Bryant, K.; Cook, R.; Conigliaro, J.; Crothers, K.; Chang, J.; Crystal, S.; Day, N.; Erdos, J.; Freiberg, M.; Kozal, M.; Gandhi, N.; Gaziano, M.; Gerschenson, M.; Good, B.; Gordon, A.; Goulet, J. L.; Hernán, M. A.; Kraemer, K.; Lim, J.; Maisto, S.; Miller, P.; Mole, L.; O'Connor, P.; Papas, R.; Robins, J. M.; Rinaldo, C.; Roberts, M.; Samet, J.; Tierney, B.; Whittle, J.; Phillips, A.; Brettle, R.; Darbyshire, J.; Fidler, S.; Goldberg, D.; Hawkins, D.; Jaffe, H.; McLean, K.; Porter, Kholoud; Cursley, Adam; Ewings, Fiona; Fairbrother, Keith; Gnatiuc, Louisa; Lodi, Sara; Murphy, Brendan; Douglas, G.; Kennedy, N.; Pritchard, J.; Andrady, U.; Gwynedd, Ysbyty; Rajda, N.; Maw, R.; McKernan, S.; Drake, S.; Gilleran, G.; White, D.; Ross, J.; Toomer, S.; Hewart, R.; Wilding, H.; Woodward, R.; Dean, G.; Heald, L.; Horner, P.; Glover, S.; Bansaal, D.; Eduards, S.; Carne, C.; Browing, M.; Das, R.; Stanley, B.; Estreich, S.; Magdy, A.; O'Mahony, C.; Fraser, P.; Hayman, B.; Jebakumar, S. P. R.; Joshi, U.; Ralph, S.; Wade, A.; Mette, R.; Lalik, J.; Summerfield, H.; El-Dalil, A.; France, A. J.; White, C.; Robertson, R.; Gordon, S.; McMillan, S.; Morris, S.; Lean, C.; Vithayathil, K.; McLean, L.; Winter, A.; Gale, D.; Jacobs, S.; Tayal, S.; Short, L.; Green, S.; Williams, G.; Sivakumar, K.; Bhattacharyya, D. N.; Monteiro, E.; Minton, J.; Dhar, J.; Nye, F.; DeSouza, C. B.; Isaksen, A.; McDonald, L.; Franca, A.; William, L.; Jendrulek, I.; Shaunak, S.; El-Gadi, S.; Easterbrook, P. J.; Mazhude, C.; Johnstone, R.; Fakoya, A.; Mchale, J.; Kegg, S.; Mitchell, S.; Byrne, P.; Rice, P.; Mullaney, S. A.; McCormack, S.; David, D.; Melville, R.; Phillip, K.; Balachandran, T.; Mabey-Puttock, S.; Sukthankar, A.; Murphy, C.; Wilkins, E.; Ahmad, S.; Haynes, J.; Evans, E.; Ong, E.; Grey, R.; Meaden, J.; Bignell, C.; Loay, D.; Peacock, K.; Girgis, M. R.; Morgan, B.; Palfreeman, A.; Wilcox, J.; Tobin, J.; Tucker, L.; Saeed, A. M.; Chen, F.; Deheragada, A.; Williams, O.; Lacey, H.; Herman, S.; Kinghorn, D.; Devendra, S. V.; Wither, J.; Dawson, S.; Rowen, D.; Harvey, J.; Bridgwood, A.; Singh, G.; Chauhan, M.; Kellock, D.; Young, S.; Dannino, S.; Kathir, Y.; Rooney, G.; Currie, J.; Fitzgerald, M.; Devendra, S.; Keane, F.; Booth, G.; Green, T.; Arumainayyagam, J.; Chandramani, S.; Rajamanoharan, S.; Robinson, T.; Curless, E.; Gokhale, R.; Tariq, A.; Luzzi, G.; Fairley, I.; Wallis, F.; Smit, E.; Ward, F.; Morlat, P.; Bonarek, M.; Bonnet, F.; Nouts, C.; Louis, J.; Reliquet, V.; Sauser, F.; Biron, C.; Mounoury, O.; Hue, H.; Brosseau, D.; Ghosn, J.; Rannou, M. T.; Bergmann, J. F.; Badsi, E.; Rami, A.; Parrinello, M.; Samanon-Bollens, D.; Campa, P.; Tourneur, M.; Desplanques, N.; Jeanblanc, F.; Chiarello, P.; Makhloufi, D.; Blanc, A. P.; Allègre, T.; Baillat, V.; Lemoing, V.; de Boever, C. Merle; Tramoni, C.; Sobesky, G.; Abel, S.; Beaujolais, V.; Slama, L.; Chakvetadze, C.; Berrebi, V.; Yeni, P.; Bouvet, E.; Fournier, I.; Gerbe, J.; Koffi, K.; Augustin-Normand, C.; Miailhes, P.; Thoirain, V.; Brochier, C.; Souala, F.; Ratajczak, M.; Beytoux, J.; Jacomet, C.; Morelon, S.; Olivier, C.; Lortholary, O.; Dupont, B.; Maignan, A.; Ragnaud, J. M.; Raymond, I.; Leport, C.; Jadand, C.; Jestin, C.; Longuet, P.; Boucherit, S.; Sereni, D.; Lascoux, C.; Prevoteau, F.; Sobel, A.; Levy, Y.; Lelièvre, J. D.; Dominguez, S.; Dumont, C.; Aumaître, H.; Delmas, B.; Saada, M.; Medus, M.; Guillevin, L.; Tahi, T.; Yazdanpanah, Y.; Pavel, S.; Marien, M. C.; Drenou, B.; Beck, C.; Benomar, M.; Tubiana, R.; Mohand, H. Ait; Chermak, A.; Abdallah, S. Ben; Touam, F.; Drobacheff, C.; Folzer, A.; Obadia, M.; Prudhomme, L.; Bonnet, E.; Balzarin, F.; Pichard, E.; Chennebault, J. M.; Fialaire, P.; Loison, J.; Galanaud, P.; Bornarel, D.; Six, M.; Ferret, P.; Batisse, D.; Gonzales-Canali, G.; Devidas, A.; Chevojon, P.; Turpault, I.; Lafeuillade, A.; Cheret, A.; Philip, G.; Morel, P.; Timsit, J.; Amirat, N.; Brancion, C.; Cabane, J.; Tredup, J.; Stein, A.; Ravault, I.; Chavanet, C.; Buisson, M.; Treuvetot, S.; Nau, P.; Bastides, F.; Boyer, L.; Wassoumbou, S.; Oksenhendeler, E.; Gérard, L.; Bernard, L.; Domart, Y.; Merrien, D.; Belan, A. Greder; Gayraud, M.; Bodard, L.; Meudec, A.; Beuscart, C.; Daniel, C.; Pape, E.; Vinceneux, P.; Simonpoli, A. M.; Zeng, A.; Fournier, L.; Fuzibet, J. G.; Sohn, C.; Rosenthal, E.; Quaranta, M.; Chaillou, S.; Sabah, M.; Audhuy, B.; Schieber, A.; Moreau, P.; Niault, M.; Vaillant, O.; Huchon, G.; Compagnucci, A.; Szmania, I. De Lacroix; Richier, L.; Lamaury, I.; Saint-Dizier, F.; Garipuy, D.; Drogoul, M. P.; Martin, I. Poizot; Fabre, G.; de Cursay, G. Lambert; Abraham, B.; Perino, C.; Lagarde, P.; David, F.; Roche-Sicot, J.; Saraux, J. L.; Leprêtre, A.; Fampin, B.; Uludag, A.; Morin, A. S.; Bletry, O.; Zucman, D.; Regnier, A.; Girard, J. J.; Quinsat, D. T.; Heripret, L.; Grihon, F.; Houlbert, D.; Ruel, M.; Chemlal, K.; Debab, Y.; Tremollieres, F.; Perronne, V.; Slama, B.; Perré, P.; Miodovski, C.; Guermonprez, G.; Dulioust, A.; Boudon, P.; Malbec, D.; Patey, O.; Semaille, C.; Deville, J.; Remy, G.; Béguinot, I.; Boue, F.; Chambrin, V.; Pignon, C.; Estocq, G. A.; Levy, A.; Duracinsky, M.; Le Bras, P.; Ngussan, M. S.; Peretti, D.; Medintzeff, N.; Lambert, T.; Segeral, O.; Lezeau, P.; Laurian, Y.; Piketty, C.; Karmochkine, M.; Eliaszewitch, M.; Jayle, D.; Tisne- Dessus, D.; Kazatchkine, M.; Colasante, U.; Nouaouia, W.; Vilde, J. L.; Bollens, D.; Binet, D.; Diallo, B.; Fonquernie, L.; Lagneau, J. L.; Pietrie, M. P.; Sicard, D.; Stieltjes, N.; Michot, J.; Bourdillon, F.; Lelievre, J. D.; Obenga, G.; Escaut, L.; Bolliot, C.; Schneider, L.; Iguertsira, M.; Tomei, C.; Dhiver, C.; Dupont, H. Tissot; Vallon, A.; Gallais, J.; Gallais, H.; Durant, J.; Mondain, V.; Perbost, I.; Cassuto, J. P.; Karsenti, J. M.; Venti, H.; Ceppi, C.; Krivitsky, J. A.; Bouchaud, O.; Honore, P.; Delgado, J.; Rouzioux, C.; Burgard, M.; Boufassa, L.; Peynet, J.; Hoyos, S. Pérez; Ferreros, I.; Hurtado, I.; González, C.; Caro, A. M.; Muga, R.; Sanvicens, A.; Tor, J.; del Romero, J.; Raposo, P.; Rodríguez, C.; García, Soledad; Alastrue, I.; Belda, J.; Trullen, P.; Fernández, E.; Santos, C.; Tasa, T.; Zafra, T.; Guerrero, R.; Marco, A.; Quintana, M.; Ruiz, I.; Nuñez, R.; Pérez, R.; Castilla, J.; Guevara, M.; de Mendoza, C.; Zahonero, N.

    2010-01-01

    OBJECTIVE: To estimate the effect of combined antiretroviral therapy (cART) on mortality among HIV-infected individuals after appropriate adjustment for time-varying confounding by indication. DESIGN: A collaboration of 12 prospective cohort studies from Europe and the United States (the HIV-CAUSAL

  5. Vitamin A degradation in triglycerides varying by their saturation levels.

    Science.gov (United States)

    Moccand, Cyril; Martin, Fréderic; Martiel, Isabelle; Gancel, Charlotte; Michel, Martin; Fries, Lennart; Sagalowicz, Laurent

    2016-10-01

    Vitamin A deficiency has a widespread occurrence globally and is considered as one of the world's most serious health risk factors. Potential solutions to address this deficiency include dietary diversification or supplementation, but food fortification is generally accepted as the most cost-effective solution. The main issue with food fortification of this vitamin is related to its high instability in food matrices. Dilution of vitamin A in triglycerides is a natural and appropriate way to stabilize this compound. We show here that vitamin A palmitate stability increases with increasing concentration of triglycerides. Moreover, we found that vitamin A palmitate displays improved stability in more saturated oils. Using various temperatures, and Arrhenius plots of experiments performed at storage temperatures between 30°C and 60°C for oils varying by their saturation and crystallinity, we demonstrate that crystallization is not responsible for this phenomenon. Additionally, we show by centrifugation that vitamin A is preferably solubilized in the liquid phase compared to the crystalline phase, explaining that triglyceride crystallization does not stabilize vitamin A palmitate. It is proposed that unsaturated fats generate more oxidation products such as radicals and peroxides, leading to a quicker degradation of vitamin A. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 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.

  7. Criteria of selection of basic linguacultural units within the context of cross-cultural communication

    Directory of Open Access Journals (Sweden)

    Khalupo Olga Ivanovna

    2016-03-01

    Full Text Available The article considers the problems associated with the analysis and selection of basic linguacultural units that are necessary for a more effective cross-cultural communication. To make the process of dialogue between different cultures and languages more appropriate and productive, it is necessary to possess certain knowledge, skills, which are acquired by man in the process of learning. Important in our opinion in this area are the mastery means which will prepare the person to communicate in a different communicative space. Such means, in our opinion, are the basic linguacultural units, which are considered as carriers of information and expression of cultural identity. They inform choice contributes to a worldview, understanding linguacultural picture of the world community. The basis of selection of linguistic units on the following criteria: the information content, functionality, sufficiency, cultural identity, realism, pivotal importance to the basic sense, social and cultural significance. Application of the proposed criteria allowing more appropriate to make the selection of the material and linguacultural integral components of the scope of cross-cultural interaction, which are characterized by their relevant material necessary for an adequate understanding of the processes occurring in different communicative space.

  8. [Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

    Science.gov (United States)

    Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

    Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lipton, Brandy J; Decker, Sandra L

    2016-02-01

    Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Cost-effectiveness of population based BRCA testing with varying Ashkenazi Jewish ancestry.

    Science.gov (United States)

    Manchanda, Ranjit; Patel, Shreeya; Antoniou, Antonis C; Levy-Lahad, Ephrat; Turnbull, Clare; Evans, D Gareth; Hopper, John L; Macinnis, Robert J; Menon, Usha; Jacobs, Ian; Legood, Rosa

    2017-11-01

    -adjusted life-years and $100,000 per quality-adjusted life-years willingness-to-pay thresholds for all 4 Ashkenazi-Jewish grandparent scenarios, with ≥95% simulations found to be cost-effective on probabilistic sensitivity analysis. Population-testing remains cost-effective in the absence of reduction in breast cancer risk from oophorectomy and at lower risk-reducing mastectomy (13%) or risk-reducing salpingo-oophorectomy (20%) rates. Population testing for BRCA mutations with varying levels of Ashkenazi-Jewish ancestry is cost-effective in the United Kingdom and the United States. These results support population testing in Ashkenazi-Jewish women with 1-4 Ashkenazi-Jewish grandparent ancestry. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Estimating varying coefficients for partial differential equation models.

    Science.gov (United States)

    Zhang, Xinyu; Cao, Jiguo; Carroll, Raymond J

    2017-09-01

    Partial differential equations (PDEs) are used to model complex dynamical systems in multiple dimensions, and their parameters often have important scientific interpretations. In some applications, PDE parameters are not constant but can change depending on the values of covariates, a feature that we call varying coefficients. We propose a parameter cascading method to estimate varying coefficients in PDE models from noisy data. Our estimates of the varying coefficients are shown to be consistent and asymptotically normally distributed. The performance of our method is evaluated by a simulation study and by an empirical study estimating three varying coefficients in a PDE model arising from LIDAR data. © 2017, The International Biometric Society.

  12. A new three-stage method for solving unit commitment problem

    Energy Technology Data Exchange (ETDEWEB)

    Khanmohammadi, S.; Amiri, M.; Haque, M. Tarafdar [Faculty of Electrical and Computer Engineering, University of Tabriz, P.O. Box 51665-343, Tabriz (Iran)

    2010-07-15

    This paper presents a new Three-Stage (THS) approach for solving Unit Commitment (UC) problem. The proposed method has a simple procedure to get at favorite solutions in a feasible duration of time by producing a primal schedule of status of units at the first step. In the second step the operating units take hourly values by doing Economic Dispatch (ED) on them via a hybrid serial algorithm of Artificial Intelligence (AI) including Particle Swarm Optimization (PSO) and Nelder-Mead (NM) algorithms. In spite of the acceptable solutions obtained by these two stages, the presented method takes another step called the solution modification process (SMP) to reach a more suitable solution. The simulation results over some standard cases of UC problem confirm that this method produces robust solutions and generally gets appropriate near-optimal solutions. (author)

  13. 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…

  14. 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 ...

  15. 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...

  16. 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.

  17. 31 CFR 542.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 542.705 Section 542.705 Money and Finance: Treasury... States Department of Justice. In the event that the respondent does not pay the penalty imposed pursuant... Justice for appropriate action to recover the penalty in a civil suit in a Federal District Court. ...

  18. 31 CFR 537.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 537.705 Section 537.705 Money and Finance: Treasury... States Department of Justice. In the event that the respondent does not pay the penalty imposed pursuant... Justice for appropriate action to recover the penalty in a civil suit in a federal district court. ...

  19. 31 CFR 541.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 541.705 Section 541.705 Money and Finance: Treasury... States Department of Justice. In the event that the respondent does not pay the penalty imposed pursuant... Justice for appropriate action to recover the penalty in a civil suit in a federal district court. ...

  20. 75 FR 28034 - National Protection and Programs Directorate; Agency Information Collection Activities: United...

    Science.gov (United States)

    2010-05-19

    ... enforcement agencies; and the Federal intelligence community to assist in the decisions they make related to... the collection of fingerprints from two prints to 10. The new collection time of 35 seconds, an... overseas posts; other DHS officers; and appropriate officers of the United States intelligence and law...

  1. Preservice and Inservice Teachers' Perceptions of Appropriateness of Teacher Self-Disclosure

    Science.gov (United States)

    Zhang, Shaoan; Shi, Qingmin; Tonelson, Stephen; Robinson, Jack

    2009-01-01

    This study investigated preservice and inservice teachers' perceptions of appropriateness of teacher self-disclosure. A sample of 180 preservice teachers and 135 preK-12 teachers participated in the study. Results showed statistically significant differences between the groups of teachers in their perceptions of appropriateness of teacher…

  2. The covariant formulation of Maxwell's equations expressed in a form independent of specific units

    Energy Technology Data Exchange (ETDEWEB)

    Heras, Jose A; Baez, G [Departamento de Ciencias Basicas, Universidad Autonoma Metropolitana Unidad Azcapotzalco, Av. San Pablo No. 180, Col. Reynosa, 02200 Mexico DF (Mexico)], E-mail: herasgomez@gmail.com, E-mail: gbaez@correo.azc.uam.mx

    2009-01-15

    The covariant formulation of Maxwell's equations can be expressed in a form independent of the usual systems of units by introducing the constants {alpha}, {beta} and {gamma} into these equations. Maxwell's equations involving these constants are then specialized to the most commonly used systems of units: Gaussian, SI and Heaviside-Lorentz by giving the constants {alpha}, {beta} and {gamma} the values appropriate to each system.

  3. 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...

  4. 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 ...

  5. New varying speed of light theories

    CERN Document Server

    Magueijo, J

    2003-01-01

    We review recent work on the possibility of a varying speed of light (VSL). We start by discussing the physical meaning of a varying $c$, dispelling the myth that the constancy of $c$ is a matter of logical consistency. We then summarize the main VSL mechanisms proposed so far: hard breaking of Lorentz invariance; bimetric theories (where the speeds of gravity and light are not the same); locally Lorentz invariant VSL theories; theories exhibiting a color dependent speed of light; varying $c$ induced by extra dimensions (e.g. in the brane-world scenario); and field theories where VSL results from vacuum polarization or CPT violation. We show how VSL scenarios may solve the cosmological problems usually tackled by inflation, and also how they may produce a scale-invariant spectrum of Gaussian fluctuations, capable of explaining the WMAP data. We then review the connection between VSL and theories of quantum gravity, showing how ``doubly special'' relativity has emerged as a VSL effective model of quantum space...

  6. 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.…

  7. Does the availability of snack foods in supermarkets vary internationally?

    Science.gov (United States)

    Thornton, Lukar E; Cameron, Adrian J; McNaughton, Sarah A; Waterlander, Wilma E; Sodergren, Marita; Svastisalee, Chalida; Blanchard, Laurence; Liese, Angela D; Battersby, Sarah; Carter, Mary-Ann; Sheeshka, Judy; Kirkpatrick, Sharon I; Sherman, Sandy; Cowburn, Gill; Foster, Charlie; Crawford, David A

    2013-05-14

    Cross-country differences in dietary behaviours and obesity rates have been previously reported. Consumption of energy-dense snack foods and soft drinks are implicated as contributing to weight gain, however little is known about how the availability of these items within supermarkets varies internationally. This study assessed variations in the display of snack foods and soft drinks within a sample of supermarkets across eight countries. Within-store audits were used to evaluate and compare the availability of potato chips (crisps), chocolate, confectionery and soft drinks. Displays measured included shelf length and the proportion of checkouts and end-of-aisle displays containing these products. Audits were conducted in a convenience sample of 170 supermarkets across eight developed nations (Australia, Canada, Denmark, Netherlands, New Zealand, Sweden, United Kingdom (UK), and United States of America (US)). The mean total aisle length of snack foods (adjusted for store size) was greatest in supermarkets from the UK (56.4 m) and lowest in New Zealand (21.7 m). When assessed by individual item, the greatest aisle length devoted to chips, chocolate and confectionery was found in UK supermarkets while the greatest aisle length dedicated to soft drinks was in Australian supermarkets. Only stores from the Netherlands (41%) had less than 70% of checkouts featuring displays of snack foods or soft drinks. Whilst between-country variations were observed, overall results indicate high levels of snack food and soft drinks displays within supermarkets across the eight countries. Exposure to snack foods is largely unavoidable within supermarkets, increasing the likelihood of purchases and particularly those made impulsively.

  8. 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.

  9. Training for integrated digital I and C system of Tomari unit 3

    International Nuclear Information System (INIS)

    Tutiya, Akiyoshi; Sanbe, Takayuki; Hayashi, Hiroshi

    2009-01-01

    In Tomari nuclear power station Unit No.3, integrated digital I and C facilities was applied for each control unit including safety protection system overall and which connect them by bus (a network), and perform data communications for the first time as a Japanese PWR power station. For the continuation of safe and stable operation of Tomari nuclear power station Unit No.3 which is our greatest power supply, it is important to perform appropriate maintenance jobs about integrated digital I and C System at the time of normal operation, periodical inspection and trouble outbreak. For the assured accomplishment of these work by maintenance personnel, we clarified goal of necessary knowledge and skills and examined training facilities and curriculums. (author)

  10. 100-KR-1 Operable Unit focused feasibility study report

    International Nuclear Information System (INIS)

    1994-11-01

    The standard Comprehensive Environmental Response, Compensation, and Liability Act of 1980 Feasibility Study (FS) includes development and screening of alternatives and the detailed analysis of alternatives. This focused feasibility study (FFS) was conducted for the 100-KR-1 Operable Unit at the Hanford Site in southeastern Washington. The objective of this operable unit-specific FFS is to provide decision makers with sufficient information to allow appropriate and timely selection of interim remedial measures (IRM) for the five sites (116-K-1 crib, 116-K-2 trench, 116-KE-4 and 116-KW-3 retention basins, and process effluent pipelines) associated with the 100-KR-1 Operable Unit. The IRM candidate waste sites are determined in the limited field investigation. Site profiles are developed for each of these waste site. The site profiles are used in the application of the plug-in approach. The waste site either plugs into the analysis of the alternatives for the group, or deviations from the developed group alternatives are described and documented

  11. HANPP Collection: Global Patterns in Human Appropriation of Net Primary Productivity (HANPP)

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Patterns in Human Appropriation of Net Primary Productivity (HANPP) portion of the HANPP Collection represents a digital map of human appropriation of net...

  12. 31 CFR 575.705 - Administrative collection; referral to United States Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... to United States Department of Justice. 575.705 Section 575.705 Money and Finance: Treasury... States Department of Justice. In the event that the person named does not pay the penalty imposed... Department of Justice for appropriate action to recover the penalty in a civil suit in a Federal district...

  13. 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.)

  14. Water and Wastewater Annual Price Escalation Rates for Selected Cities across the United States

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2017-10-27

    Pacific Northwest National Laboratory conducted this study for the Federal Energy Management Program to identify trends in annual water and wastewater price escalation rates across the United States. This study can be used to inform the selection of an appropriate escalation rates for inclusion in LCCA.

  15. 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

  16. Some problems raised by the operation of large nuclear turbo-generator sets. Automatic control system for steam turbo-generator units

    International Nuclear Information System (INIS)

    Cecconi, F.

    1976-01-01

    The design of an appropriate automatic system was found to be useful to improve the control of large size turbo-generator units so as to provide easy and efficient control and monitoring. The experience of the manufacturer of these turbo-generator units allowed a system well suited for this function to be designed [fr

  17. Defining conservation units in a stocking-induced genetic melting pot: unraveling native and multiple exotic genetic imprints of recent and historical secondary contact in Adriatic grayling.

    Science.gov (United States)

    Meraner, Andreas; Cornetti, Luca; Gandolfi, Andrea

    2014-04-01

    The definition of conservation units is crucial for the sustainable management of endangered species, though particularly challenging when recent and past anthropogenic and natural gene flow might have played a role. The conservation of the European grayling, Thymallus thymallus, is particularly complex in its southern distribution area, where the Adriatic evolutionary lineage is endangered by a long history of anthropogenic disturbance, intensive stocking and potentially widespread genetic introgression. We provide mtDNA sequence and microsatellite data of 683 grayling from 30 sites of Adriatic as well as Danubian and Atlantic origin. We apply Bayesian clustering and Approximate Bayesian Computation (ABC) to detect microgeographic population structure and to infer the demographic history of the Adriatic populations, to define appropriate conservation units. Varying frequencies of indigenous genetic signatures of the Adriatic grayling were revealed, spanning from marginal genetic introgression to the collapse of native gene pools. Genetic introgression involved multiple exotic source populations of Danubian and Atlantic origin, thus evidencing the negative impact of few decades of stocking. Within the Adige River system, a contact zone of western Adriatic and eastern Danubian populations was detected, with ABC analyses suggesting a historical anthropogenic origin of eastern Adige populations, most likely founded by medieval translocations. Substantial river-specific population substructure within the Adriatic grayling Evolutionary Significant Unit points to the definition of different conservation units. We finally propose a catalog of management measures, including the legal prohibition of stocking exotic grayling and the use of molecular markers in supportive- and captive-breeding programs.

  18. Varying constants, black holes, and quantum gravity

    International Nuclear Information System (INIS)

    Carlip, S.

    2003-01-01

    Tentative observations and theoretical considerations have recently led to renewed interest in models of fundamental physics in which certain 'constants' vary in time. Assuming fixed black hole mass and the standard form of the Bekenstein-Hawking entropy, Davies, Davis and Lineweaver have argued that the laws of black hole thermodynamics disfavor models in which the fundamental electric charge e changes. I show that with these assumptions, similar considerations severely constrain 'varying speed of light' models, unless we are prepared to abandon cherished assumptions about quantum gravity. Relaxation of these assumptions permits sensible theories of quantum gravity with ''varying constants,'' but also eliminates the thermodynamic constraints, though the black hole mass spectrum may still provide some restrictions on the range of allowable models

  19. Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry improves appropriateness of antibiotic treatment of bacteremia.

    Directory of Open Access Journals (Sweden)

    Anne L M Vlek

    Full Text Available Matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS allows the identification of microorganisms directly from positive blood culture broths. Use of the MALDI-TOF MS for rapid identification of microorganisms from blood culture broths can reduce the turnaround time to identification and may lead to earlier appropriate treatment of bacteremia. During February and April 2010, direct MALDI-TOF MS was routinely performed on all positive blood cultures. During December 2009 and March 2010 no direct MALDI-TOF MS was used. Information on antibiotic therapy was collected from the hospital and intensive care units' information systems from all positive blood cultures during the study period. In total, 253 episodes of bacteremia were included of which 89 during the intervention period and 164 during the control period. Direct performance of MALDI-TOF MS on positive blood culture broths reduced the time till species identification by 28.8-h and was associated with an 11.3% increase in the proportion of patients receiving appropriate antibiotic treatment 24 hours after blood culture positivity (64.0% in the control period versus 75.3% in the intervention period (p0.01. Routine implementation of this technique increased the proportion of patients on adequate antimicrobial treatment within 24 hours.

  20. Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry improves appropriateness of antibiotic treatment of bacteremia.

    Science.gov (United States)

    Vlek, Anne L M; Bonten, Marc J M; Boel, C H Edwin

    2012-01-01

    Matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) allows the identification of microorganisms directly from positive blood culture broths. Use of the MALDI-TOF MS for rapid identification of microorganisms from blood culture broths can reduce the turnaround time to identification and may lead to earlier appropriate treatment of bacteremia. During February and April 2010, direct MALDI-TOF MS was routinely performed on all positive blood cultures. During December 2009 and March 2010 no direct MALDI-TOF MS was used. Information on antibiotic therapy was collected from the hospital and intensive care units' information systems from all positive blood cultures during the study period. In total, 253 episodes of bacteremia were included of which 89 during the intervention period and 164 during the control period. Direct performance of MALDI-TOF MS on positive blood culture broths reduced the time till species identification by 28.8-h and was associated with an 11.3% increase in the proportion of patients receiving appropriate antibiotic treatment 24 hours after blood culture positivity (64.0% in the control period versus 75.3% in the intervention period (p0.01)). Routine implementation of this technique increased the proportion of patients on adequate antimicrobial treatment within 24 hours.

  1. 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.

  2. United Kingdom national report

    International Nuclear Information System (INIS)

    Tomkins, B.

    1998-01-01

    Report of the United Kingdom deals with life extension granted to Calder Hall and Chapelcross reactors for further 10 years operation. The two well recognised life-limiting features of Magnox type reactors are graphite core ageing and materials properties of the reactor pressure circuit components. These features have been scrutinised particularly closely and the conclusion has been reached that there are no safety factors which will necessarily limit the plant life to less than 50 years. Two other life-limiting factors are hear exchanger tubes and the heat exchanger tube failures internal to boiler shells and the integrity of the main engineering structures of the plant. It was concluded that appropriate routine ageing monitoring programs are in place in respect to these features to support continuing operation beyond 40 years

  3. A 3D domain decomposition approach for the identification of spatially varying elastic material parameters

    KAUST Repository

    Moussawi, Ali

    2015-02-24

    Summary: The post-treatment of (3D) displacement fields for the identification of spatially varying elastic material parameters is a large inverse problem that remains out of reach for massive 3D structures. We explore here the potential of the constitutive compatibility method for tackling such an inverse problem, provided an appropriate domain decomposition technique is introduced. In the method described here, the statically admissible stress field that can be related through the known constitutive symmetry to the kinematic observations is sought through minimization of an objective function, which measures the violation of constitutive compatibility. After this stress reconstruction, the local material parameters are identified with the given kinematic observations using the constitutive equation. Here, we first adapt this method to solve 3D identification problems and then implement it within a domain decomposition framework which allows for reduced computational load when handling larger problems.

  4. Comprehensive Review of Ultraviolet Radiation and the Current Status on Sunscreens

    OpenAIRE

    Dale Wilson, Brummitte; Moon, Summer; Armstrong, Frank

    2012-01-01

    In the past, manufacturers’ labeling of sunscreen varied greatly, confusing the consumers regarding efficacy and the appropriate photoprotection provided by their products. Therefore, in June 2011, the United States Food and Drug Administration issued new guidelines for sunscreen labeling. Sunscreen products are over-the-counter drugs; therefore, they are regulated by the United States Food and Drug Administration to determine safety, efficacy, and labeling. This article discusses ultraviolet...

  5. Infliximab for Crohn's disease in the Swiss IBD Cohort Study: clinical management and appropriateness.

    Science.gov (United States)

    Juillerat, Pascal; Pittet, Valérie; Vader, John-Paul; Burnand, Bernard; Gonvers, Jean-Jacques; de Saussure, Philippe; Mottet, Christian; Seibold, Frank; Rogler, Gerhard; Sagmeister, Markus; Felley, Christian; Michetti, Pierre; Froehlich, Florian

    2010-11-01

    Antitumor necrosis factor a agents have significantly improved the management of Crohn's disease (CD), but not all patients benefit from this therapy. We used data from the Swiss Inflammatory Bowel Disease Cohort Study and predefined appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients. EPACT II (European Panel on the Appropriateness of CD Therapy, 2007; www.epact.ch) appropriateness criteria have been developed using a formal explicit panel process combining evidence from the published literature and expert opinion. Questionnaires relating to EPACT II criteria were used at enrollment and follow-up of all Swiss Inflammatory Bowel Disease Cohort Study patients. A step-by-step analysis of all possible indications for IFX therapy in a given patient allowed identification of the most appropriate indication and final classification in a single appropriateness category (appropriate, uncertain, inappropriate). Eight hundred and twenty-one CD patients were prospectively enrolled between November 2006 and March 2009. IFX was administered to 146 patients (18%) at enrollment and was most frequently used for complex fistulizing disease and for the maintenance of remission induced by biological therapy. IFX therapy was considered appropriate in 44%, uncertain in 44%, and inappropriate in 10% of patients. In this cohort, 9 out of 10 indications for IFX therapy were clinically generally acceptable (appropriate or uncertain) according to EPACT II criteria. Uncertain indications resulted mainly from the current more liberal use of IFX in clinical practice as compared with the EPACT II criteria.

  6. Retinopathy of prematurity: Risk factors and variability in Canadian neonatal intensive care units.

    Science.gov (United States)

    Thomas, K; Shah, P S; Canning, R; Harrison, A; Lee, S K; Dow, K E

    2015-01-01

    To identify predictors of severe retinopathy of prematurity (ROP) in a large population-based cohort and to examine risk-adjusted variations across units. Retrospective analysis of Canadian Neonatal Network data on neonates with birth weight <1500 g who were screened for ROP between 2003 and 2010. Characteristics of infants with and without ROP were compared and a risk-adjusted model for severe ROP was developed. Rates of severe ROP were compared between sites. 1163 of 9187 (12.7%) infants developed severe ROP. Lower gestational age, male sex, small for gestational age, patent ductus arteriosus, late onset sepsis, more than two blood transfusions, inotrope use, and outborn status were associated with an increased risk of severe ROP. Severe ROP rates varied significantly between units. Younger, smaller and sicker male infants had higher adjusted risks of severe ROP and rates varied significantly among sites.

  7. 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.

  8. Expression of results in quantum chemistry physical chemistry division commission on physicochemical symbols, terminology and units

    CERN Document Server

    Whiffen, D H

    2013-01-01

    Expression of Results in Quantum Chemistry recommends the appropriate insertion of physical constants in the output information of a theoretical paper in order to make the numerical end results of theoretical work easily transformed to SI units by the reader. The acceptance of this recommendation would circumvent the need for a set of atomic units each with its own symbol and name. It is the traditional use of the phrase """"atomic units"""" in this area which has obscured the real problem. The four SI dimensions of length, mass, time, and current require four physical constants to be permitte

  9. Mediation analysis with time varying exposures and mediators.

    Science.gov (United States)

    VanderWeele, Tyler J; Tchetgen Tchetgen, Eric J

    2017-06-01

    In this paper we consider causal mediation analysis when exposures and mediators vary over time. We give non-parametric identification results, discuss parametric implementation, and also provide a weighting approach to direct and indirect effects based on combining the results of two marginal structural models. We also discuss how our results give rise to a causal interpretation of the effect estimates produced from longitudinal structural equation models. When there are time-varying confounders affected by prior exposure and mediator, natural direct and indirect effects are not identified. However, we define a randomized interventional analogue of natural direct and indirect effects that are identified in this setting. The formula that identifies these effects we refer to as the "mediational g-formula." When there is no mediation, the mediational g-formula reduces to Robins' regular g-formula for longitudinal data. When there are no time-varying confounders affected by prior exposure and mediator values, then the mediational g-formula reduces to a longitudinal version of Pearl's mediation formula. However, the mediational g-formula itself can accommodate both mediation and time-varying confounders and constitutes a general approach to mediation analysis with time-varying exposures and mediators.

  10. Differences in nutrient uptake capacity of the benthic filamentous algae Cladophora sp., Klebsormidium sp. and Pseudanabaena sp. under varying N/P conditions.

    Science.gov (United States)

    Liu, Junzhuo; Vyverman, Wim

    2015-03-01

    The N/P ratio of wastewater can vary greatly and directly affect algal growth and nutrient removal process. Three benthic filamentous algae species Cladophora sp., Klebsormidium sp. and Pseudanabaena sp. were isolated from a periphyton bioreactor and cultured under laboratory conditions on varying N/P ratios to determine their ability to remove nitrate and phosphorus. The N/P ratio significantly influenced the algal growth and phosphorus uptake process. Appropriate N/P ratios for nitrogen and phosphorus removal were 5-15, 7-10 and 7-20 for Cladophora sp., Klebsormidium sp. and Pseudanabaena sp., respectively. Within these respective ranges, Cladophora sp. had the highest biomass production, while Pseudanabaena sp. had the highest nitrogen and phosphorus contents. This study indicated that Cladophora sp. had a high capacity of removing phosphorus from wastewaters of low N/P ratio, and Pseudanabaena sp. was highly suitable for removing nitrogen from wastewaters with high N/P ratio. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

    DEFF Research Database (Denmark)

    Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian

    2012-01-01

    building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful...

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Eestlased Karlovy Varys / J. R.

    Index Scriptorium Estoniae

    J. R.

    2007-01-01

    Ilmar Raagi mängufilm "Klass" osaleb 42. Karlovy Vary rahvusvahelise filmifestivali võistlusprogrammis "East of the West" ja Asko Kase lühimängufilm "Zen läbi prügi" on valitud festivali kõrvalprogrammi "Forum of Independents"

  17. 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.

  18. Consumer access to clozapine in Australia: how does this compare to New Zealand and the United Kingdom?

    Science.gov (United States)

    Knowles, Sally-Anne; Mcmillan, Sara S; Wheeler, Amanda J

    2016-01-01

    Clozapine is an antipsychotic medication used in treatment resistant schizophrenia. However, clozapine is associated with a significant adverse effect profile and extensive monitoring is required to optimise consumer safety. Traditionally, clozapine can only be prescribed by a psychiatrist and dispensed at a hospital or hospital affiliated pharmacy in Australia. These restrictions could result in significant treatment burden for consumers taking clozapine. To identify (1) the different models of supply that exist for people living in the community taking clozapine in Australia and compare to those in New Zealand and the United Kingdom, and (2) explore how these supply models may impact on consumer burden from the perspective of professionals involved in the supply of clozapine. Key informants were interviewed (n=8) from Australia, New Zealand and the United Kingdom regarding how consumers, who lived in the community, accessed clozapine. Data were analysed and led to the development of four clozapine supply models. These four models were further validated by an online survey of a wider sample (n=30). Data were analysed thematically and via simple descriptive statistics. Clozapine supply varied depending on location. A secondary care model was utilised in the United Kingdom compared to a community based (primary care) model in New Zealand; Australia utilised a mixture of both secondary and primary care. A key theme from all study participants was that community pharmacy should be utilised to dispense clozapine to consumers living in the community, provided adequate training and safeguards are in place. It was noted that the utilisation of community pharmacies could improve access and flexibility, thereby reducing treatment burden for these consumers. There are predominately two models for supply of clozapine to consumers living in the community in Australia, New Zealand and the United Kingdom. One model utilises secondary care facilities and the other community

  19. Consumer access to clozapine in Australia: how does this compare to New Zealand and the United Kingdom?

    Directory of Open Access Journals (Sweden)

    Knowles SA

    2016-06-01

    Full Text Available Background: Clozapine is an antipsychotic medication used in treatment resistant schizophrenia. However, clozapine is associated with a significant adverse effect profile and extensive monitoring is required to optimise consumer safety. Traditionally, clozapine can only be prescribed by a psychiatrist and dispensed at a hospital or hospital affiliated pharmacy in Australia. These restrictions could result in significant treatment burden for consumers taking clozapine. Objective: To identify (1 the different models of supply that exist for people living in the community taking clozapine in Australia and compare to those in New Zealand and the United Kingdom, and (2 explore how these supply models may impact on consumer burden from the perspective of professionals involved in the supply of clozapine. Method: Key informants were interviewed (n=8 from Australia, New Zealand and the United Kingdom regarding how consumers, who lived in the community, accessed clozapine. Data were analysed and led to the development of four clozapine supply models. These four models were further validated by an online survey of a wider sample (n=30. Data were analysed thematically and via simple descriptive statistics. Results: Clozapine supply varied depending on location. A secondary care model was utilised in the United Kingdom compared to a community based (primary care model in New Zealand; Australia utilised a mixture of both secondary and primary care. A key theme from all study participants was that community pharmacy should be utilised to dispense clozapine to consumers living in the community, provided adequate training and safeguards are in place. It was noted that the utilisation of community pharmacies could improve access and flexibility, thereby reducing treatment burden for these consumers. Conclusion: There are predominately two models for supply of clozapine to consumers living in the community in Australia, New Zealand and the United Kingdom. One

  20. 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.

  1. Comparison of Linear Microinstability Calculations of Varying Input Realism

    International Nuclear Information System (INIS)

    Rewoldt, G.

    2003-01-01

    The effect of varying ''input realism'' or varying completeness of the input data for linear microinstability calculations, in particular on the critical value of the ion temperature gradient for the ion temperature gradient mode, is investigated using gyrokinetic and gyrofluid approaches. The calculations show that varying input realism can have a substantial quantitative effect on the results

  2. Comparison of linear microinstability calculations of varying input realism

    International Nuclear Information System (INIS)

    Rewoldt, G.; Kinsey, J.E.

    2004-01-01

    The effect of varying 'input realism' or varying completeness of the input data for linear microinstability calculations, in particular on the critical value of the ion temperature gradient for the ion temperature gradient mode, is investigated using gyrokinetic and gyrofluid approaches. The calculations show that varying input realism can have a substantial quantitative effect on the results

  3. Accuracy of Spindle Units with Hydrostatic Bearings

    Directory of Open Access Journals (Sweden)

    Fedorynenko Dmytro

    2016-06-01

    Full Text Available The work is devoted to the research of precision regularities in a spindle unit by the trajectory of the spindle installed on hydrostatic bearings. The mathematical model of trajectories spindle with lumped parameters that allows to define the position of the spindle with regard the simultaneous influence of design parameters, geometrical deviations ofform, temperature deformation bearing surfaces, the random nature of operational parameters and technical loads of hydrostatic bearings has been developed. Based on the results of numerical modeling the influence of shape errors of bearing surface of hydrostatic bearing on the statistical characteristics of the radius vector trajectories of the spindle by varying the values rotational speed of the spindle and oil pressure in front hydrostatic bearing has been developed. The obtained statistical regularities of precision spindle unit have been confirmed experimentally. It has been shown that an effective way to increase the precision of spindle units is to regulate the size of the gap in hydrostatic spindle bearings. The new design of an adjustable hydrostatic bearing, which can improve the accuracy of regulation size gap has been proposed.

  4. 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 ...

  5. On the search for an appropriate metric for reaction time to suprathreshold increments and decrements.

    Science.gov (United States)

    Vassilev, Angel; Murzac, Adrian; Zlatkova, Margarita B; Anderson, Roger S

    2009-03-01

    Weber contrast, DeltaL/L, is a widely used contrast metric for aperiodic stimuli. Zele, Cao & Pokorny [Zele, A. J., Cao, D., & Pokorny, J. (2007). Threshold units: A correct metric for reaction time? Vision Research, 47, 608-611] found that neither Weber contrast nor its transform to detection-threshold units equates human reaction times in response to luminance increments and decrements under selective rod stimulation. Here we show that their rod reaction times are equated when plotted against the spatial luminance ratio between the stimulus and its background (L(max)/L(min), the larger and smaller of background and stimulus luminances). Similarly, reaction times to parafoveal S-cone selective increments and decrements from our previous studies [Murzac, A. (2004). A comparative study of the temporal characteristics of processing of S-cone incremental and decremental signals. PhD thesis, New Bulgarian University, Sofia, Murzac, A., & Vassilev, A. (2004). Reaction time to S-cone increments and decrements. In: 7th European conference on visual perception, Budapest, August 22-26. Perception, 33, 180 (Abstract).], are better described by the spatial luminance ratio than by Weber contrast. We assume that the type of stimulus detection by temporal (successive) luminance discrimination, by spatial (simultaneous) luminance discrimination or by both [Sperling, G., & Sondhi, M. M. (1968). Model for visual luminance discrimination and flicker detection. Journal of the Optical Society of America, 58, 1133-1145.] determines the appropriateness of one or other contrast metric for reaction time.

  6. Configurations of Leadership Practices in Hospital Units

    DEFF Research Database (Denmark)

    Meier, Ninna

    2015-01-01

    configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested “configurations of practice” as a way to carve out similarities and differences in leadership practices across settings....... and interviews with ten interdisciplinary clinical managers. Findings: – Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied...

  7. Intervention to Improve Appropriate Prescribing and Reduce Polypharmacy in Elderly Patients Admitted to an Internal Medicine Unit.

    Directory of Open Access Journals (Sweden)

    Milena Urfer

    Full Text Available Polypharmacy and inappropriate medication prescriptions are associated with increased morbidity and mortality. Most interventions proposed to improve appropriate prescribing are time and resource intensive and therefore hardly applicable in daily clinical practice.To test the efficacy of an easy-to-use checklist aimed at supporting the therapeutic reasoning of physicians in order to reduce inappropriate prescribing and polypharmacy.We assessed the efficacy and safety of a 5-point checklist to be used by all physicians on the internal medicine wards of a Swiss hospital by comparing outcomes in 450 consecutive patients aged ≥65 years hospitalized after the introduction of the checklist, and in 450 consecutive patients ≥65 years hospitalized before the introduction of the checklist. The main measures were the proportion of patients with prescription of potentially inappropriate medications (PIMs at discharge, according to STOPP criteria, and the number of prescribed medications at discharge, before and after the introduction of the checklist. Secondary outcomes were the prevalence of polypharmacy (≥ 5 drugs and hyperpolypharmacy (≥ 10 drugs, and the prevalence of potentially inappropriate prescribing omissions (PPOs according to START criteria.At admission 59% of the 900 patients were taking > 5 drugs, 13% ≥ 10 drugs, 37% had ≥ 1 PIM and 25% ≥ 1 PPO. The introduction of the checklist was associated with a significant reduction by 22% of the risk of being prescribed ≥ 1 PIM at discharge (adjusted risk ratios [RR] 0.78; 95% CI: 0.68-0.94, but not with a reduction of at least 20% of the number of drugs prescribed at discharge, nor with a reduction of the risk of PPOs at discharge.The introduction of an easy-to-use 5-point checklist aimed at supporting therapeutic reasoning of physicians on internal medicine wards significantly reduced the risk of prescriptions of inappropriate medications at discharge.

  8. Adoption, adaptation, and abandonment: Appropriation of science education professional development learning

    Science.gov (United States)

    Longhurst, Max L.

    Understanding factors that impact teacher utilization of learning from professional development is critical in order maximize the educational and financial investment in teacher professional learning. This study used a multicase mixed quantitative and qualitative methodology to investigate the factors that influence teacher adoption, adaption, or abandonment of learning from science teacher professional development. The theoretical framework of activity theory was identified as a useful way to investigate the phenomenon of teacher appropriation of pedagogical practices from professional development. This framework has the capacity to account for a multitude of elements in the context of a learning experience. In this study educational appropriation is understood through a continuum of how an educator acquires and implements both practical and conceptual aspects of learning from professional development within localized context. The variability associated with instructional changes made from professional development drives this inquiry to search for better understandings of the appropriation of pedagogical practices. Purposeful sampling was used to identify two participants from a group of eighth-grade science teachers engaged in professional development designed to investigate how cyber-enabled technologies might enhance instruction and learning in integrated science classrooms. The data from this investigation add to the literature of appropriation of instructional practices by connecting eight factors that influence conceptual and practical tools with the development of ownership of pedagogical practices in the appropriation hierarchy. Recommendations are shared with professional development developers, providers, and participants in anticipation that future science teaching experiences might be informed by findings from this study.

  9. Providing Appropriate Technology for Emerging Markets: Case Study on China’s Solar Thermal Industry

    Directory of Open Access Journals (Sweden)

    Jianghua Zhou

    2017-01-01

    Full Text Available Building on a case study of five Chinese solar thermal companies and one association, our study aims to understand how the innovator’s choices regarding the use of technology and organizational practices for new product development enable companies to design and diffuse appropriate technology in emerging markets. The study uncovers two critical factors that enhance the appropriateness of technology: redefining the identity of technology and building a local supply system. Our analysis shows that synergic innovation in both architecture and component leads to the appropriate functionalities desired by emerging markets. Moreover, modular design and the building of a local supply system enhance the process appropriateness of technology. Our study provides an empirical basis for advocating going beyond minor adaptations of existing products to creating appropriate technology for emerging markets, and extends our understandings of the upstream process of designing appropriate technology. Moreover, the emphasis on the local supply system reflects a holistic framework for shaping and delivering appropriate technology, expanding the existing research focus on the perspective of the technology itself. Our research also has managerial implications that may help firms tap into emerging markets.

  10. How does sagittal imbalance affect the appropriateness of surgical indications and selection of procedure in the treatment of degenerative scoliosis? Findings from the RAND/UCLA Appropriate Use Criteria study.

    Science.gov (United States)

    Daubs, Michael D; Brara, Harsimran S; Raaen, Laura B; Chen, Peggy Guey-Chi; Anderson, Ashaunta T; Asch, Steven M; Nuckols, Teryl K

    2018-05-01

    Degenerative lumbar scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. The goals of this article were to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present. This study included a literature review and an expert panel using the RAND/University of California at Los Angeles (UCLA) Appropriateness Method. To develop appropriate use criteria for DLS, researchers at the RAND Corporation recently employed the RAND/UCLA Appropriateness Method, which involves a systematic review of the literature and multidisciplinary expert panel process. Experts reviewed a synopsis of published literature and rated the appropriateness of five common operative approaches for 260 different clinical scenarios. In the present work, we updated the literature review and compared panelists' ratings in scenarios where imbalance was present versus absent. This work was funded by the Collaborative Spine Research Foundation, a group of surgical specialty societies and device manufacturers. On the basis of 13 eligible studies that examined sagittal imbalance and outcomes in patients with DLS, imbalance was associated with worse functional status in the absence of surgery and worse symptoms and complications postoperatively. Panelists' ratings demonstrated a consistent pattern across the diverse clinical scenarios. In general, when imbalance was present, surgery was more likely to be appropriate or necessary, including in some situations where surgery would otherwise be inappropriate. For patients with moderate to severe symptoms and imbalance, a deformity correction procedure was usually appropriate

  11. Marketingový mix HC Enegie Karlovy Vary

    OpenAIRE

    Štrobl, Adam

    2016-01-01

    Title: Marketing mix of HC Energie Karlovy Vary Objectives: This thesis is based on a questionnaire responses obtained from HC Energie Karlovy Vary fans. Its objective is focused on evaluation of their opinions on the marketing mix, their subsequent interpretation, and finally even development of recommendations for improvement based on previous analysis. Methods: Two methods are used to analyse the marketing mix. The first method is qualitative participant observation. The second method is a...

  12. Native American Arts and Crafts of the United States. Bibliography 1.

    Science.gov (United States)

    Indian Arts and Crafts Board, Washington, DC.

    The selected readings listed in this annotated bibliography are suggested as an introduction to the varied arts and crafts created from prehistoric to modern times by Native American peoples of the United States. The publications are organized by culture area to encompass major media practiced by Native American artists and craftsmen of these…

  13. 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...

  14. 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...

  15. Õunpuu Karlovy Varys edukas

    Index Scriptorium Estoniae

    2010-01-01

    45. Karlovy Vary filmifestivali võistlusprogrammis "East of the West" märgiti ära Veiko Õunpuu film "Püha Tõnu kiusamine". Peaauhind läks rumeenlase Cristi Puiu filmile "Aurora". Grand prix´sai Augustĺ Vila film "La mosquitera". Teisi preemiasaajaid

  16. [Appropriate use of benzodiazepines zolpidem and zopiclone in diseases attended in primary care].

    Science.gov (United States)

    Granados Menéndez, M Isabel; Salinero Fort, Miguel Angel; Palomo Ancillo, Marta; Aliaga Gutiérrez, Laura; García Escalonilla, Carmen; Ortega Orcos, Rebeca

    2006-01-01

    To estimate the proportion of benzodiazepine prescriptions that comply with the guidelines for appropriate prescription. To identify the variables associated with appropriate prescription. Observational, cross-sectional study. Monóvar Health Centre in Area IV, Madrid, Spain. Random sample of 270 active benzodiazepine prescriptions in adult patients from the prescriptions record of the OMI-AP V. 5.0 computer system. The chosen dimensions for appropriate prescription were: a) correct diagnostic indication; b) absence of benzodiazepines with long half-life in the elderly; c) existence of support or monitoring visits; d) overall appropriateness or coexistence of correct diagnostic indications and monitoring visits. Independent variables were recorded in relation to patient, person prescribing and prescription. Diagnostic indication, 75.6%; absence of benzodiazepines with long half-life in the elderly, 79.8%; existence of support visits, 63.3%; overall appropriateness, 53%. Main diagnoses: pure anxiety, 29%; anxiety related to other illness, 18.6%; insomnia, 14.8%; cardiovascular illness, 14.8%; alcohol and drug abuse, 4.5%; osteo-muscular illness, 4.4%; schizophrenia, 4.4%. Most prescribed substances: lorazepam, 27.8%; bromazepam, 23.7%. Average life of prescriptions: 18.58 months. Origins: health centre, 68.5%; out-patient psychiatry, 10%; hospital, 10%. The variable that is most closely associated with overall appropriateness, fitted with the rest of the variables, is out-patient psychiatry prescription (OR, 6.67; 95% CI, 1.92-23.18). The mean duration of the prescriptions infringes all standards. The overall appropriateness or correct coexistence of adequate diagnostic indication with follow-up visits is associated with out-patient Psychiatry prescription.

  17. Do Social Factors Predict Appropriate Treatment of Child Diarrheal Disease in Peru?

    Science.gov (United States)

    Volpicelli, Kathryn; Buttenheim, Alison M

    2016-11-01

    Objectives Diarrheal disease is a significant cause of morbidity among children in Peru. Oral rehydration therapy (ORT) is a cost-effective evidence-based approach to treat diarrhea in young children, yet many Peruvian children in poorer households do not receive this life-saving treatment. This study investigates the social determinants of care-seeking behavior and utilization of appropriate home treatment for diarrheal episodes. Methods We used the nationally-representative 2008 Peru Demographic and Health Survey to: (1) describe the burden of non-bloody diarrheal disease among children <5 years old; and (2) identify socioeconomic correlates of care-seeking behavior and utilization/appropriateness of treatment among mothers of children with recent non-bloody diarrheal episodes (N = 1365). For the former, we reported descriptive statistics; for the latter, we utilized logistic regression to generate odds ratios. Results 2-week period prevalence of diarrheal disease was almost twice as high among poor (17 %) compared with wealthier (10 %) children, higher among children aged 12-23 months old (22 %), and higher among children from households that do not have an improved source of drinking water (16 %) compared with those that have an improved source (12 %). Interestingly, rural residence was a significant predictor of seeking care for diarrhea. Furthermore, although widely available, few mothers (15 %) used appropriate treatment for a recent diarrheal episode. Water source, mother's education, and wealth were significant predictors of appropriate home treatment. Conclusions Mothers in rural areas-typically with less access to care-were more likely to seek care for diarrheal disease in their children, even when adjusting for other variables. However, this increase in care seeking behavior did not extend to appropriate home treatment. Innovative behavior change strategies to reduce barriers to access and appropriate home treatment for diarrheal disease are

  18. Evaluation of Adult Literacy Education in the United States: A Review of Methodological Issues

    Science.gov (United States)

    Shi, Yan; Tsang, Mun C.

    2008-01-01

    This is a critical review of methodological issues in the evaluation of adult literacy education programs in the United States. It addresses the key research questions: What are the appropriate methods for evaluating these programs under given circumstances. It identifies 15 evaluation studies that are representative of a range of adult literacy…

  19. Global Stability of Polytopic Linear Time-Varying Dynamic Systems under Time-Varying Point Delays and Impulsive Controls

    Directory of Open Access Journals (Sweden)

    M. de la Sen

    2010-01-01

    Full Text Available This paper investigates the stability properties of a class of dynamic linear systems possessing several linear time-invariant parameterizations (or configurations which conform a linear time-varying polytopic dynamic system with a finite number of time-varying time-differentiable point delays. The parameterizations may be timevarying and with bounded discontinuities and they can be subject to mixed regular plus impulsive controls within a sequence of time instants of zero measure. The polytopic parameterization for the dynamics associated with each delay is specific, so that (q+1 polytopic parameterizations are considered for a system with q delays being also subject to delay-free dynamics. The considered general dynamic system includes, as particular cases, a wide class of switched linear systems whose individual parameterizations are timeinvariant which are governed by a switching rule. However, the dynamic system under consideration is viewed as much more general since it is time-varying with timevarying delays and the bounded discontinuous changes of active parameterizations are generated by impulsive controls in the dynamics and, at the same time, there is not a prescribed set of candidate potential parameterizations.

  20. Interventions during labor and birth in the United States: a qualitative analysis of women's experiences.

    Science.gov (United States)

    Bibeau, Alana M

    2014-12-01

    To explore and describe hospital-birthing women's understandings of and experiences with interventions during labor and birth. Qualitative data was collected as part of a larger ethnographic study of childbirth in the United States. The grounded theory method was employed to analyze interviews with 59 women from three states who had recently given birth in hospitals with physicians or certified nurse-midwives in attendance. Four themes emerged from the data. The themes safety/risk and provider match, described women's expectations regarding intervention and their interactions with providers. A third theme addressed how women experienced interventions and their perceptions of control over decision-making. A final theme characterized women's satisfaction with maternity care. Women who received interventions expressed varying levels of comfort or apprehension associated with both expectations of maternity care and provider match. Women whose expectations matched those of the provider reported more positive experiences. Regardless of provider match, women expressed ambivalence about the use of interventions and confusion over their appropriate place. Women's ability to make sense of interventions was related to how well they navigated a complicated and bureaucratic maternity system. Increasing attention needs to be paid to the impact of these factors on women's perceptions of care during pregnancy and childbirth. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. HANPP Collection: Human Appropriation of Net Primary Productivity (HANPP) by Country and Product

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Patterns in Human Appropriation of Net Primary Productivity (HANPP) portion of the HANPP Collection represents a digital map of human appropriation of net...

  2. 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.

  3. 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.

  4. 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.

  5. Unit bias. A new heuristic that helps explain the effect of portion size on food intake.

    Science.gov (United States)

    Geier, Andrew B; Rozin, Paul; Doros, Gheorghe

    2006-06-01

    People seem to think that a unit of some entity (with certain constraints) is the appropriate and optimal amount. We refer to this heuristic as unit bias. We illustrate unit bias by demonstrating large effects of unit segmentation, a form of portion control, on food intake. Thus, people choose, and presumably eat, much greater weights of Tootsie Rolls and pretzels when offered a large as opposed to a small unit size (and given the option of taking as many units as they choose at no monetary cost). Additionally, they consume substantially more M&M's when the candies are offered with a large as opposed to a small spoon (again with no limits as to the number of spoonfuls to be taken). We propose that unit bias explains why small portion sizes are effective in controlling consumption; in some cases, people served small portions would simply eat additional portions if it were not for unit bias. We argue that unit bias is a general feature in human choice and discuss possible origins of this bias, including consumption norms.

  6. Teaching Young Adults with Disabilities to Respond Appropriately to Lures from Strangers

    Science.gov (United States)

    Fisher, Marisa H.; Burke, Meghan M.; Griffin, Megan M.

    2013-01-01

    We taught 5 adults with mild intellectual disabilities to respond appropriately to lures from strangers. Skills were taught in the classroom first and then in situ. Before training, participants did not walk away from confederate strangers who tried to lure them away. Participants demonstrated appropriate responses during classroom and in situ…

  7. Test of four stand growth simulators for the northeastern United States

    Science.gov (United States)

    Thomas M. Schuler; David A. Marquis; Richard L. Ernst; Brian T. Simpson; Brian T. Simpson

    1993-01-01

    Evaluates SILVAH, FIBER, NE-TWIGS, and OAKSIM, simulators commonly used in the northeastern United States, by comparing predicted stand development with actual stand development records for periods ranging from 15 to 50 years. Results varied with stand parameter, forest type, projection length, and geographic area. Except in the spruce-fir forest type where FIBER...

  8. 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.

  9. 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...

  10. 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)

  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. The operating performance tests of power unit A1 in HPP 'Zvornik' in load-frequency control

    Directory of Open Access Journals (Sweden)

    Stanojčić Vladimir

    2012-01-01

    Full Text Available The turbine-governing system characteristics derived from testing hydropower unit A1 in HPP 'Zvornik' are presented. These tests give insights into the setup state and parameters of the governing system, as well as the qualitative analysis of load-frequency control response of the case study power unit within the power system of Serbia. Verification of relevant turbine-governing parameters was performed by direct application of appropriate standards and policies. The presented results can be used as a basis for the derivation of a turbine governor mathematical model and for a complete mathematical model of a hydropower unit as an element embedded in the power system.

  13. Development or Deployment of 'Grid-Appropriate' Reactors for the Global Nuclear Energy Partnership

    International Nuclear Information System (INIS)

    Ingersoll, D. T.

    2008-01-01

    The world energy demand is expected to nearly double by 2030, largely driven by rapidly increasing demand in the developing parts of the world. Many of the countries that will experience the greatest growth in energy demand have little or no current nuclear power experience and have significant constraints on the size and type of power plant that can be accommodated. Although a few reactor vendors are beginning to address this market need, most traditional vendors continue to offer only very large nuclear power plants with capacities exceeding 1500 MWe per unit. The Global Nuclear Energy Partnership (GNEP), which was initiated in the United States and now includes a partnership of 20 countries, seeks to facilitate the large-scale global growth in nuclear power. Within the GNEP program, the 'grid-appropriate' reactors (GAR) campaign has been initiated to coordinate and facilitate the development, demonstration, and deployment of reactor designs that are better suited for those countries that need or prefer smaller power plant capacities. The GNEP/GAR program addresses the full spectrum of issues for the deployment of new reactor designs to new nuclear power countries, including: reactor technology and engineering, licensing and regulatory impacts, and infrastructure needs (physical, workforce, and institutional). Initially, the program is focused on meeting the current global demand for small or medium-sized reactors using demonstrated technologies. The program will also address the development of new reactor technologies that will further enhance the safety, security, and proliferation resistance of future designs. International collaborations are being established to: (1) develop suitable requirements and criteria for GAR designs, (2) conduct R and D for longer-term reactor technologies and innovative designs, and (3) assisting new nuclear power countries in assessing their infrastructure needs. The status of these activities will be presented and future program

  14. Electrochemical characterization of a polybenzimidazole-based high temperature proton exchange membrane unit cell

    DEFF Research Database (Denmark)

    Jespersen, Jesper Lebæk; Schaltz, Erik; Kær, Søren Knudsen

    2009-01-01

    This work constitutes detailed EIS (Electrochemical Impedance Spectroscopy) measurements on a PBIbased HT-PEM unit cell. By means of EIS the fuel cell is characterized in several modes of operation by varying the current density, temperature and the stoichiometry of the reactant gases. Using...

  15. Optimistlik Karlovy Vary / Jaan Ruus

    Index Scriptorium Estoniae

    Ruus, Jaan, 1938-2017

    2007-01-01

    42. Karlovy Vary rahvusvahelise filmifestivali auhinnatud filmidest (žürii esimees Peter Bart). Kristallgloobuse sai Islandi-Saksamaa "Katseklaasilinn" (režii Baltasar Kormakur), parimaks režissööriks tunnistati norralane Bard Breien ("Negatiivse mõtlemise kunst"). Austraallase Michael James Rowlandi "Hea õnne teekond" sai žürii eripreemia

  16. Backstepping-based nonlinear adaptive control for coal-fired utility boiler-turbine units

    International Nuclear Information System (INIS)

    Fang, Fang; Wei, Le

    2011-01-01

    The control system of boiler-turbine unit plays an important role in improving efficiency and reducing emissions of power generation unit. The nonlinear, coupling and uncertainty of the unit caused by varying working conditions should be fully considered during the control system design. This paper presents an efficient control scheme based on backstepping theory for improving load adaptability of boiler-turbines in wide operation range. The design process of the scheme includes model preprocessing, control Lyapunov functions selection, interlaced computation of adaptive control laws, etc. For simplification and accuracy, differential of steam pipe inlet pressure and integral terms of target errors are adopted. Also, to enhance practicality, implementation steps of the scheme are proposed. A practical nonlinear model of a 500 MW coal-fired boiler-turbine unit is used to test the efficiency of the proposed scheme in different conditions.

  17. Risk analysis of NPP in multi-unit site for configuration of AAC power source

    International Nuclear Information System (INIS)

    Kim, Myung Ki

    2000-01-01

    Because of the difficulties in finding new sites for nuclear power plants, more units are being added to the existing sites. In these multi-unit sites, appropriate countermeasures should be established to cope with the potential station blackout (SBO) accident. Currently, installation of additional diesel generator (DG) is considered to ensure an alternative AC power source, but it has not been decided yet how many DGs should be installed in a multi-unit site. In this paper, risk informed decision making method, which evaluates reliability of electrical system, core damage frequency, and site average core damage frequency, is introduced to draw up the suitable number of DG in multi-unit site. The analysis results show that installing two DGs lowered the site average core damage frequency by 1.4% compared to one DG in six unit site. In the light of risk-informed decisions in regulatory guide 1.174, there is no difference of safety between two alternatives. It is concluded that one emergency diesel generator sufficiently guarantees safety against station blackout of nuclear power plants in multi-unit site. (author)

  18. 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 ...

  19. Time-varying surface electromyography topography as a prognostic tool for chronic low back pain rehabilitation.

    Science.gov (United States)

    Hu, Yong; Kwok, Jerry Weilun; Tse, Jessica Yuk-Hang; Luk, Keith Dip-Kei

    2014-06-01

    Nonsurgical rehabilitation therapy is a commonly used strategy to treat chronic low back pain (LBP). The selection of the most appropriate therapeutic options is still a big challenge in clinical practices. Surface electromyography (sEMG) topography has been proposed to be an objective assessment of LBP rehabilitation. The quantitative analysis of dynamic sEMG would provide an objective tool of prognosis for LBP rehabilitation. To evaluate the prognostic value of quantitative sEMG topographic analysis and to verify the accuracy of the performance of proposed time-varying topographic parameters for identifying the patients who have better response toward the rehabilitation program. A retrospective study of consecutive patients. Thirty-eight patients with chronic nonspecific LBP and 43 healthy subjects. The accuracy of the time-varying quantitative sEMG topographic analysis for monitoring LBP rehabilitation progress was determined by calculating the corresponding receiver-operating characteristic (ROC) curves. Physiologic measure was the sEMG during lumbar flexion and extension. Patients who suffered from chronic nonspecific LBP without the history of back surgery and any medical conditions causing acute exacerbation of LBP during the clinical test were enlisted to perform the clinical test during the 12-week physiotherapy (PT) treatment. Low back pain patients were classified into two groups: "responding" and "nonresponding" based on the clinical assessment. The responding group referred to the LBP patients who began to recover after the PT treatment, whereas the nonresponding group referred to some LBP patients who did not recover or got worse after the treatment. The results of the time-varying analysis in the responding group were compared with those in the nonresponding group. In addition, the accuracy of the analysis was analyzed through ROC curves. The time-varying analysis showed discrepancies in the root-mean-square difference (RMSD) parameters between the

  20. Selecting the most appropriate inferential statistical test for your quantitative research study.

    Science.gov (United States)

    Bettany-Saltikov, Josette; Whittaker, Victoria Jane

    2014-06-01

    To discuss the issues and processes relating to the selection of the most appropriate statistical test. A review of the basic research concepts together with a number of clinical scenarios is used to illustrate this. Quantitative nursing research generally features the use of empirical data which necessitates the selection of both descriptive and statistical tests. Different types of research questions can be answered by different types of research designs, which in turn need to be matched to a specific statistical test(s). Discursive paper. This paper discusses the issues relating to the selection of the most appropriate statistical test and makes some recommendations as to how these might be dealt with. When conducting empirical quantitative studies, a number of key issues need to be considered. Considerations for selecting the most appropriate statistical tests are discussed and flow charts provided to facilitate this process. When nursing clinicians and researchers conduct quantitative research studies, it is crucial that the most appropriate statistical test is selected to enable valid conclusions to be made. © 2013 John Wiley & Sons Ltd.

  1. Units for radiation protection work; Storheter foer straalskyddsarbete

    Energy Technology Data Exchange (ETDEWEB)

    Lindborg, L

    1997-06-01

    ICRU has defined special measurable (operational) quantities for radiation protection. A consequence of using the operational quantities is that hand-held and personal dosemeters can give different measuring results in the same radiation situation. The differences vary and are caused by the geometry of the radiation field. The units have well documented relations to e.g. the ICRP effective dose and equivalent dose to an organ or tissue. Therefore, it is possible to estimate these doses from a measured value of e.g. the ambient dose equivalent. ICRU and ICRP have recently reviewed these relations in two important commonly issued reports (Report 57 and Publication 74). This report tries to show the value of understanding these units and their relations and is primarily meant to be used for educational purposes. 11 refs.

  2. Time-varying value of electric energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Mims, Natalie A.; Eckman, Tom; Goldman, Charles

    2017-06-30

    Electric energy efficiency resources save energy and may reduce peak demand. Historically, quantification of energy efficiency benefits has largely focused on the economic value of energy savings during the first year and lifetime of the installed measures. Due in part to the lack of publicly available research on end-use load shapes (i.e., the hourly or seasonal timing of electricity savings) and energy savings shapes, consideration of the impact of energy efficiency on peak demand reduction (i.e., capacity savings) has been more limited. End-use load research and the hourly valuation of efficiency savings are used for a variety of electricity planning functions, including load forecasting, demand-side management and evaluation, capacity and demand response planning, long-term resource planning, renewable energy integration, assessing potential grid modernization investments, establishing rates and pricing, and customer service. This study reviews existing literature on the time-varying value of energy efficiency savings, provides examples in four geographically diverse locations of how consideration of the time-varying value of efficiency savings impacts the calculation of power system benefits, and identifies future research needs to enhance the consideration of the time-varying value of energy efficiency in cost-effectiveness screening analysis. Findings from this study include: -The time-varying value of individual energy efficiency measures varies across the locations studied because of the physical and operational characteristics of the individual utility system (e.g., summer or winter peaking, load factor, reserve margin) as well as the time periods during which savings from measures occur. -Across the four locations studied, some of the largest capacity benefits from energy efficiency are derived from the deferral of transmission and distribution system infrastructure upgrades. However, the deferred cost of such upgrades also exhibited the greatest range

  3. Is the Appropriateness of Emotions Culture-Dependent? The Relevance of Social Meaning

    Directory of Open Access Journals (Sweden)

    Welpinghus Anna

    2018-02-01

    Full Text Available This paper contributes to the question to what extent the socio-cultural context is relevant for the appropriateness of emotions, while appropriateness of an emotion means that the emotion entails a correct, or adequate, evaluation of its object. In a first step, two adequacy conditions for theories of emotions are developed: the first condition ensures that the socio-cultural context is not neglected: theories must allow for the fact that appropriateness often depends on the social meaning of the emotion’s particular object. The second condition rules out implausible forms of cultural determinism. In a second step, an account that meets both conditions is presented: the Acceptance within Social Context account.

  4. Experimental evidence for amplitude death induced by a time-varying interaction

    Energy Technology Data Exchange (ETDEWEB)

    Suresh, K. [Centre for Nonlinear Dynamics, School of Physics, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India); Shrimali, M.D. [Department of Physics, Central University of Rajasthan, NH-8, Bandar Sindri, Ajmer 305 801 (India); Prasad, Awadhesh [Department of Physics and Astrophysics, University of Delhi, Delhi 110 007 (India); Thamilmaran, K., E-mail: maran.cnld@gmail.com [Centre for Nonlinear Dynamics, School of Physics, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India)

    2014-08-01

    In this paper, we study the time-varying interaction in coupled oscillatory systems. For this purpose, we have designed a novel time-varying resistive network using an analog switch and inverter circuits. We have applied this time-varying resistive network to mutually coupled identical Chua's oscillators. When the resistances are varied in time, we find that amplitude death arises in coupled identical oscillators. This has been observed numerically as well as verified through hardware experiments. - Highlights: • We have implemented the time-varying interaction in coupled oscillatory systems. • We have designed a novel time-varying resistive network using an analog switch and inverter circuits. • When the resistances are varied in time, we find that amplitude death arises in coupled identical oscillators.

  5. Brane world cosmologies with varying speed of light

    International Nuclear Information System (INIS)

    Youm, Donam

    2001-02-01

    We study cosmologies in the Randall-Sundrum models, incorporating the possibility of time-varying speed of light and Newton's constant. The cosmologies with varying speed of light (VSL) were proposed by Moffat and by Albrecht and Magueijo as an alternative to inflation for solving the cosmological problems. We consider the case in which the speed of light varies with time after the radion or the scale of the extra dimension has been stabilized. We elaborate on the conditions under which the flatness problem and the cosmological constant problem can be resolved. Particularly, the VSL cosmologies may provide a possible mechanism for bringing the quantum corrections to the fine-tuned brane tensions after the SUSY breaking under control. (author)

  6. Choosing the appropriate treatment setting: which information and decision-making needs do adult inpatients with mental disorders have? A qualitative interview study.

    Science.gov (United States)

    Kivelitz, Laura; Härter, Martin; Mohr, Jil; Melchior, Hanne; Goetzmann, Lutz; Warnke, Max Holger; Kleinschmidt, Silke; Dirmaier, Jörg

    2018-01-01

    Decisions on medical treatment setting are perceived as important but often difficult to make for patients with mental disorders. Shared decision-making as a strategy to decrease decisional conflict has been recommended, but is not yet widely implemented. This study aimed to investigate the information needs and the decision-making preferences of patients with mental disorders prior to the decision for a certain treatment setting. The results will serve as a prerequisite for the development of a high-quality patient decision aid (PtDA) regarding the treatment setting decision. We conducted retrospective individual semi-structured interviews with n=24 patients with mental disorders in three psychotherapeutic inpatient care units. The interviews were audiotaped, transcribed, coded, and content-analyzed. The majority of the patients wanted to be involved in the decision-making process. They reported high information needs regarding treatment options in order to feel empowered to participate adequately in the decision for a certain treatment setting. However, some patients did not want to participate or receive information, for example, because of their high burden of mental disorder. Whereas the majority were satisfied with the extent they were involved in the decision, few participants felt sufficiently informed about treatment options. Most patients reported that a decision aid regarding an appropriate treatment setting would have been helpful for them. Important information that should be included in a PtDA was general information about mental illness, effective treatment options, specific information about the different treatment settings, and access to treatment. The identified information and decision-making needs provide a valuable basis for the development of a PtDA aiming to support patients and caregivers regarding the decision for an adequate treatment setting. As preferences for participation vary among patients and also depend on the current mental state

  7. Important questions asked by family members of intensive care unit patients.

    Science.gov (United States)

    Peigne, Vincent; Chaize, Marine; Falissard, Bruno; Kentish-Barnes, Nancy; Rusinova, Katerina; Megarbane, Bruno; Bele, Nicolas; Cariou, Alain; Fieux, Fabienne; Garrouste-Orgeas, Maite; Georges, Hugues; Jourdain, Merce; Kouatchet, Achille; Lautrette, Alexandre; Legriel, Stephane; Regnier, Bernard; Renault, Anne; Thirion, Marina; Timsit, Jean-Francois; Toledano, Dany; Chevret, Sylvie; Pochard, Frédéric; Schlemmer, Benoît; Azoulay, Elie

    2011-06-01

    Relatives often lack important information about intensive care unit patients. High-quality information is crucial to help relatives overcome the often considerable situational stress and to acquire the ability to participate in the decision-making process, most notably regarding the appropriate level of care. We aimed to develop a list of questions important for relatives of patients in the intensive care unit. This was a multicenter study. Questions asked by relatives of intensive care unit patients were collected from five different sources (literature, panel of 28 intensive care unit nurses and physicians, 1-wk survey of nurses and 1-wk survey of physicians in 14 intensive care units, and in-depth interviews with 14 families). After a qualitative analysis (framework approach and thematic analysis), questions were rated by 22 relatives and 14 intensive care unit physicians, and the ratings were analyzed using principal component analysis and hierarchical clustering. The five sources produced 2,135 questions. Removal of duplicates and redundancies left 443 questions, which were distributed among nine predefined domains using a framework approach ("diagnosis," "treatment," "prognosis," "comfort," "interaction," "communication," "family," "end of life," and "postintensive care unit management"). Thematic analysis in each domain led to the identification of 46 themes, which were reworded as 46 different questions. Ratings by relatives and physicians showed that 21 of these questions were particularly important for relatives of intensive care unit patients. This study increases knowledge about the informational needs of relatives of intensive care unit patients. This list of questions may prove valuable for both relatives and intensive care unit physicians as a tool for improving communication in the intensive care unit.

  8. A Fourier transform Raman spectroscopy analysis of the degree of conversion of a universal hybrid resin composite cured with light-emitting diode curing units.

    Science.gov (United States)

    Lindberg, Anders; Emami, Nazanin; van Dijken, Jan W V

    2005-01-01

    The degree of conversion (DC), of a universal hybrid resin composite cured with LED curing units with low and high power densities and a 510 mW/cm2 quartz tungsten halogen unit, was investigated with Fourier Transform Raman spectroscopy. Three curing depths (0, 2, 4mm) and 0 and 7 mm light guide tip - resin composite (LT - RC) distances were tested. The DC of the LED units varied between 52.3% - 59.8% at the top surface and 46.4% - 57.0% at 4 mm depth. The DC of specimen cured with a 0 mm LT- RC distance at 4 mm depth varied between 50.8% - 57.0% and with 7 mm distance between 46.4% - 55.4%. The low power density LED unit showed a significantly lower DC for both distances at all depth levels compared to the other curing units (p units were only found at the 4 mm depth level cured from 7 mm distance (p units. It can be concluded that the improved LED curing units could cure the studied resin composite to the same DC as the control unit.

  9. Ethics under uncertainty: the morality and appropriateness of utilitarianism when outcomes are uncertain.

    Science.gov (United States)

    Kortenkamp, Katherine V; Moore, Colleen F

    2014-01-01

    Real-life moral dilemmas inevitably involve uncertainty, yet research has not considered how uncertainty affects utilitarian moral judgments. In addition, even though moral dilemma researchers regularly ask respondents, "What is appropriate?" but interpret it to mean, "What is moral?," little research has examined whether a difference exists between asking these 2 types of questions. In this study, 140 college students read moral dilemmas that contained certain or uncertain consequences and then responded as to whether it was appropriate and whether it was moral to kill 1 to save many (a utilitarian choice). Ratings of the appropriateness and morality of the utilitarian choice were lower under uncertainty than certainty. A follow-up experiment found that these results could not be explained entirely by a change in the expected values of the outcomes or a desire to avoid the worst-case scenario. In addition, the utilitarian choice to kill 1 to save many was rated as more appropriate than moral. The results imply that moral decision making may depend critically on whether uncertainties in outcomes are admitted and whether people are asked about appropriateness or morality.

  10. Sensory quality and appropriateness of raw and boiled Jerusalem artichoke tubers (Helianthus tuberosus L.).

    Science.gov (United States)

    Bach, Vibe; Kidmose, Ulla; Thybo, Anette K; Edelenbos, Merete

    2013-03-30

    The aim of the present study was to investigate the sensory attributes, dry matter and sugar content of five varieties of Jerusalem artichoke tubers and their relation to the appropriateness of the tubers for raw and boiled preparation. Sensory evaluation of raw and boiled Jerusalem artichoke tubers was performed by a trained sensory panel and a semi-trained consumer panel of 49 participants, who also evaluated the appropriateness of the tubers for raw and boiled preparation. The appropriateness of raw Jerusalem artichoke tubers was related to Jerusalem artichoke flavour, green nut flavour, sweetness and colour intensity, whereas the appropriateness of boiled tubers was related to celeriac aroma, sweet aroma, sweetness and colour intensity. In both preparations the variety Dwarf stood out from the others by being the least appropriate tuber. A few sensory attributes can be used as predictors of the appropriateness of Jerusalem artichoke tubers for raw and boiled consumption. Knowledge on the quality of raw and boiled Jerusalem artichoke tubers can be used to inform consumers on the right choice of raw material and thereby increase the consumption of the vegetable. © 2012 Society of Chemical Industry.

  11. The Future of the United States Antarctic Program

    Science.gov (United States)

    Thom, J. E.; Weidner, G. A.; Lazzara, M. A.; Knuth, S. L.; Cassano, J. J.

    2009-04-01

    The last three decades have seen Antarctic surface meteorological observations augmented by an increasing number of automated weather stations (AWS). Since 1980, the University of Wisconsin-Madison has managed an expanding array of AWS in Antarctica that are funded through the United States' National Science Foundation. The AWS network began with six stations and has grown to approximately 60 stations. The majority of the AWS use a custom electronics package designed in the 1970s and modified over approximately 20 years. However, dramatic changes in the electronics industry have led the UW-Madison to transition its AWS to commercial-off-the-shelf (COTS) components capable of integrating on-station storage, varied sensors, multiple data telemetry options, and a flexible operating system. Among the important technical issues arising from adopting a COTS-based AWS system are limited temperature certification for Antarctic conditions; non-standard integration of the varied telecommunications equipment; potentially inflexible data acquisition schemes; and frequent product upgrades, changes, and obsolescence. The UW-Madison presents the current status of its AWS system; its recent experience with new data loggers, sensors, and communication options; and its attempts to obtain a standardized AWS. The intent is to encourage the development of a forum where groups can document their experiences with varied AWS systems in the extreme polar climate. Recent events have added another challenge within the United States Antarctic Program, as it has become clear that budgetary and logistic limitations will drastically impact the AWS program. With logistical costs playing a bigger factor in funding AWS operations, international coordination and cooperation will be important in deploying and maintaining the AWS networks (such as GCOS) that are critical to monitoring the world's climate.

  12. [Unit cost variation in a social security company in Querétaro, México].

    Science.gov (United States)

    Villarreal-Ríos, Enrique; Campos-Esparza, Maribel; Garza-Elizondo, María E; Martínez-González, Lidia; Núñez-Rocha, Georgina M; Romero-Islas, Nestor R

    2006-01-01

    Comparing unit cost variation between departments and reasons for consultation in outpatient health services provided by a social security company from Querétaro, Mexico. A study of costs (in US dollars) was carried out in outpatient health service units during 2004. Fixed unit costs were estimated per department and adjusted for one year's productivity. Material, physical and consumer resources were included. Weighting was assigned to resources invested in each department. Unit cost was estimated by using the micro cost technique; medicaments, materials used during treatment and reagents were considered to be consumer items. Unit cost resulted from adding fixed unit cost to the variable unit cost corresponding to the reason for consulting. Units costs were then compared between the medical units. Unit cost per month for diabetic treatment varied from 34.8 US dollars, 32,2 US dollars to US 34 US dollars, pap smear screening test costs were 7,2 US dollars, 8,7 US dollars and 7,3 US dollars and dental treatment 27 US dollars, 33 US dollars, 6 and 28,7 US dollars. Unit cost variation was more important in the emergency room and the dental service.

  13. An international investigation into O red blood cell unit administration in hospitals: the GRoup O Utilization Patterns (GROUP) study.

    Science.gov (United States)

    Zeller, Michelle P; Barty, Rebecca; Aandahl, Astrid; Apelseth, Torunn O; Callum, Jeannie; Dunbar, Nancy M; Elahie, Allahna; Garritsen, Henk; Hancock, Helen; Kutner, José Mauro; Manukian, Belinda; Mizuta, Shuichi; Okuda, Makoto; Pagano, Monica B; Pogłód, Ryszard; Rushford, Kylie; Selleng, Kathleen; Sørensen, Claess Henning; Sprogøe, Ulrik; Staves, Julie; Weiland, Thorsten; Wendel, Silvano; Wood, Erica M; van de Watering, Leo; van Wordragen-Vlaswinkel, Maria; Ziman, Alyssa; Jan Zwaginga, Jaap; Murphy, Michael F; Heddle, Nancy M; Yazer, Mark H

    2017-10-01

    Transfusion of group O blood to non-O recipients, or transfusion of D- blood to D+ recipients, can result in shortages of group O or D- blood, respectively. This study investigated RBC utilization patterns at hospitals around the world and explored the context and policies that guide ABO blood group and D type selection practices. This was a retrospective study on transfusion data from the 2013 calendar year. This study included a survey component that asked about hospital RBC selection and transfusion practices and a data collection component where participants submitted information on RBC unit disposition including blood group and D type of unit and recipient. Units administered to recipients of unknown ABO or D group were excluded. Thirty-eight hospitals in 11 countries responded to the survey, 30 of which provided specific RBC unit disposition data. Overall, 11.1% (21,235/191,397) of group O units were transfused to non-O recipients; 22.6% (8777/38,911) of group O D- RBC units were transfused to O D+ recipients, and 43.2% (16,800/38,911) of group O D- RBC units were transfused to recipients that were not group O D-. Disposition of units and hospital transfusion policy varied within and across hospitals of different sizes, with transfusion of group O D- units to non-group O D- patients ranging from 0% to 33%. A significant proportion of group O and D- RBC units were transfused to compatible, nonidentical recipients, although the frequency of this practice varied across sites. © 2017 AABB.

  14. Measuring patient safety culture: an assessment of the clustering of responses at unit level and hospital level

    NARCIS (Netherlands)

    Smits, M.; Wagner, C.; Spreeuwenberg, P.; Wal, van der G.

    2009-01-01

    OBJECTIVES: To test the claim that the Hospital Survey on Patient Safety Culture (HSOPS) measures patient safety culture instead of mere individual attitudes and to determine the most appropriate level (individual, unit or hospital level) for interventions aimed at improving the culture of patient

  15. Measuring patient safety culture : an assessment of the clustering of responses at unit level and hospital level

    NARCIS (Netherlands)

    Smits, M.; Wagner, C.; Spreeuwenberg, P.; Wal, G. van der; Groenewegen, P.P.

    2009-01-01

    Objectives: To test the claim that the Hospital Survey on Patient Safety Culture (HSOPS) measures patient safety culture instead of mere individual attitudes and to determine the most appropriate level (individual, unit or hospital level) for interventions aimed at improving the culture of patient

  16. Esmaklassiline Karlovy Vary / Jaanus Noormets

    Index Scriptorium Estoniae

    Noormets, Jaanus

    2007-01-01

    Ilmar Raagi mängufilm "Klass" võitis 42. Karlovy Vary rahvusvahelise filmifestivalil kaks auhinda - ametliku kõrvalvõistlusprogrammi "East of the West" eripreemia "Special mention" ja Euroopa väärtfilmikinode keti Europa Cinemas preemia. Ka Asko Kase lühifilmi "Zen läbi prügi linastumisest ning teistest auhinnasaajatest ning osalejatest

  17. Checks for quality control of wedge dynamics in treatment units and the planning system

    International Nuclear Information System (INIS)

    Mateos Salvador, P.; Rodriguez Lopez, B.; Font Gelabert, J.; Hernandez Rodriguez, J.; Arino Gil, A.

    2013-01-01

    The objective of this study is to verify the implementation of enhanced dynamic wedge (EDW) vary in the Eclipse planning system and the experimental determination of the parameters that define the dosimetry characteristics of enhanced dynamic wedge of our treatment units. (Author)

  18. Selection of Forklift Unit for Warehouse Operation by Applying Multi-Criteria Analysis

    Directory of Open Access Journals (Sweden)

    Predrag Atanasković

    2013-07-01

    Full Text Available This paper presents research related to the choice of the criteria that can be used to perform an optimal selection of the forklift unit for warehouse operation. The analysis has been done with the aim of exploring the requirements and defining relevant criteria that are important when investment decision is made for forklift procurement, and based on the conducted research by applying multi-criteria analysis, to determine the appropriate parameters and their relative weights that form the input data and database for selection of the optimal handling unit. This paper presents an example of choosing the optimal forklift based on the selected criteria for the purpose of making the relevant investment decision.

  19. Anistropically varying conductivity in irreversible electroporation simulations.

    Science.gov (United States)

    Labarbera, Nicholas; Drapaca, Corina

    2017-11-01

    One recent area of cancer research is irreversible electroporation (IRE). Irreversible electroporation is a minimally invasive procedure where needle electrodes are inserted into the body to ablate tumor cells with electricity. The aim of this paper is to propose a mathematical model that incorporates a tissue's conductivity increasing more in the direction of the electrical field as this has been shown to occur in experiments. It was necessary to mathematically derive a valid form of the conductivity tensor such that it is dependent on the electrical field direction and can be easily implemented into numerical software. The derivation of a conductivity tensor that can take arbitrary functions for the conductivity in the directions tangent and normal to the electrical field is the main contribution of this paper. Numerical simulations were performed for isotropic-varying and anisotropic-varying conductivities to evaluate the importance of including the electrical field's direction in the formulation for conductivity. By starting from previously published experimental results, this paper derived a general formulation for an anistropic-varying tensor for implementation into irreversible electroporation modeling software. The anistropic-varying tensor formulation allows the conductivity to take into consideration both electrical field direction and magnitude, as opposed to previous published works that only took into account electrical field magnitude. The anisotropic formulation predicts roughly a five percent decrease in ablation size for the monopolar simulation and approximately a ten percent decrease in ablation size for the bipolar simulations. This is a positive result as previously reported results found the isotropic formulation to overpredict ablation size for both monopolar and bipolar simulations. Furthermore, it was also reported that the isotropic formulation overpredicts the ablation size more for the bipolar case than the monopolar case. Thus, our

  20. Analysis of time-varying psoriasis lesion image patterns

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær; Nielsen, Allan Aasbjerg

    2004-01-01

    The multivariate alteration detection transform is applied to pairs of within and between time varying registered psoriasis image patterns. Color band contribution to the variates explaining maximal change is analyzed.......The multivariate alteration detection transform is applied to pairs of within and between time varying registered psoriasis image patterns. Color band contribution to the variates explaining maximal change is analyzed....

  1. Specimen loading list for the varying temperature experiment

    International Nuclear Information System (INIS)

    Qualls, A.L.; Sitterson, R.G.

    1998-01-01

    The varying temperature experiment HFIR-RB-13J has been assembled and inserted in the reactor. Approximately 5300 specimens were cleaned, inspected, matched, and loaded into four specimen holders. A listing of each specimen loaded into the steady temperature holder, its position in the capsule, and the identification of the corresponding specimen loaded into the varying temperature holder is presented in this report

  2. The Development of Logistics Services in the United States

    OpenAIRE

    Yang, Yeonglin H; San Diego State University

    2015-01-01

    This research studies third party logistics (3PL) providers in the United States to investigate how the industry has strategically developed its service offerings in response to the customers’ growing needs in managing global supply chains. Logistics management has significant impacts on various aspects of supply chains such as response time, total supply chain cost, sourcing risk, customer service, security, etc. The results show that 3PL services vary based on industry served, region served...

  3. Patient-centered approach to ensuring appropriateness of care through blood management.

    Science.gov (United States)

    King, Rita; Michelman, Mark; Curran, Vivian; Bean, Jo; Rowden, Paul; Lindsey, Jeffrey

    2013-06-01

    Concerns have been raised about the safety and efficacy of blood transfusions. Blood products are in demand and a decreasing supply is projected, with resource conservation a global concern. A consultant group determined that the transfusion rate at Mease Countryside Hospital was higher than an average baseline. A process-improvement project was initiated using a multidisciplinary team approach to improve blood utilization and ensure appropriateness in transfusion practice. The foundation of this project was to create new guidelines for transfusion; provide detailed education, communication, reporting, and feedback; and develop criteria to ensure compliance. The mean monthly usage of red blood cell units per 1000 inpatient discharges between April 2010 and October 2011 was 321.4 compared with 212.0 for the 5 months after implementation. The mean monthly number of patients transfused per 1000 inpatient discharges from April 2010 to October 2011 was 135.2 compared with 90.2 after implementation. In both cases, this reduction was found to be statistically significant at a 95% confidence level (P = 0.000 in both respects). The success of this project was the result of careful planning and execution, administrative support, physician leadership, and teamwork. Blood management includes strategies to avoid inappropriate transfusions and proactively treat anemia. Anemia management should be based on the patient's symptoms, laboratory values, and clinical assessment. Treatment of anemia should encompass a patient-centered approach, with the aim of promoting patient safety and minimizing the risk from exposure to blood products.

  4. Attitudes Towards Prenatal Genetic Counseling, Prenatal Genetic Testing, and Termination of Pregnancy among Southeast and East Asian Women in the United States.

    Science.gov (United States)

    Tsai, Ginger J; Cameron, Carrie A; Czerwinski, Jennifer L; Mendez-Figueroa, Hector; Peterson, Susan K; Noblin, Sarah Jane

    2017-10-01

    Recognizing the heterogeneity of the Asian population with regards to acculturation, education, health awareness, and cultural values is vital for tailoring culturally sensitive and appropriate care. Prior studies show that cultural values influence perceptions of genetics within Asian populations. The reputation of the family unit factors into decisions such as pregnancy termination and disclosure of family medical history, and the nondirective model of American genetic counseling may conflict with the historical Asian model of paternalistic health care. Previous studies also provide conflicting evidence regarding correlations between education, acculturation, age, and awareness and perceptions of genetic testing. The aims of this study were to describe attitudes towards prenatal genetics among Southeast and East Asian women living in the United States for varying amounts of time and to explore sociocultural factors influencing those attitudes. Twenty-three Asian women who were members of Asian cultural organizations in the United States were interviewed via telephone about their attitudes towards prenatal genetic counseling, prenatal genetic testing, and termination of pregnancy. Responses were transcribed and coded for common themes using a thematic analysis approach. Four major themes emerged. In general, participants: (1) had diverse expectations for genetic counselors; (2) tended to weigh risks and benefits with regards to genetic testing decisions; (3) had mixed views on termination for lethal and non-lethal genetic conditions; and (4) identified cultural factors which influenced testing and termination such as lack of available resources, societal shame and stigma, and family pressure. These findings may allow prenatal genetic counselors to gain a richer, more nuanced understanding of their Asian patients and to offer culturally tailored prenatal genetic counseling.

  5. Varied line-space gratings and applications

    International Nuclear Information System (INIS)

    McKinney, W.R.

    1991-01-01

    This paper presents a straightforward analytical and numerical method for the design of a specific type of varied line-space grating system. The mathematical development will assume plane or nearly-plane spherical gratings which are illuminated by convergent light, which covers many interesting cases for synchrotron radiation. The gratings discussed will have straight grooves whose spacing varies across the principal plane of the grating. Focal relationships and formulae for the optical grating-pole-to-exist-slit distance and grating radius previously presented by other authors will be derived with a symbolic algebra system. It is intended to provide the optical designer with the tools necessary to design such a system properly. Finally, some possible advantages and disadvantages for application to synchrotron to synchrotron radiation beamlines will be discussed

  6. Visualizing Robustness of Critical Points for 2D Time-Varying Vector Fields

    KAUST Repository

    Wang, B.

    2013-06-01

    Analyzing critical points and their temporal evolutions plays a crucial role in understanding the behavior of vector fields. A key challenge is to quantify the stability of critical points: more stable points may represent more important phenomena or vice versa. The topological notion of robustness is a tool which allows us to quantify rigorously the stability of each critical point. Intuitively, the robustness of a critical point is the minimum amount of perturbation necessary to cancel it within a local neighborhood, measured under an appropriate metric. In this paper, we introduce a new analysis and visualization framework which enables interactive exploration of robustness of critical points for both stationary and time-varying 2D vector fields. This framework allows the end-users, for the first time, to investigate how the stability of a critical point evolves over time. We show that this depends heavily on the global properties of the vector field and that structural changes can correspond to interesting behavior. We demonstrate the practicality of our theories and techniques on several datasets involving combustion and oceanic eddy simulations and obtain some key insights regarding their stable and unstable features. © 2013 The Author(s) Computer Graphics Forum © 2013 The Eurographics Association and Blackwell Publishing Ltd.

  7. Visualizing Robustness of Critical Points for 2D Time-Varying Vector Fields

    KAUST Repository

    Wang, B.; Rosen, P.; Skraba, P.; Bhatia, H.; Pascucci, V.

    2013-01-01

    Analyzing critical points and their temporal evolutions plays a crucial role in understanding the behavior of vector fields. A key challenge is to quantify the stability of critical points: more stable points may represent more important phenomena or vice versa. The topological notion of robustness is a tool which allows us to quantify rigorously the stability of each critical point. Intuitively, the robustness of a critical point is the minimum amount of perturbation necessary to cancel it within a local neighborhood, measured under an appropriate metric. In this paper, we introduce a new analysis and visualization framework which enables interactive exploration of robustness of critical points for both stationary and time-varying 2D vector fields. This framework allows the end-users, for the first time, to investigate how the stability of a critical point evolves over time. We show that this depends heavily on the global properties of the vector field and that structural changes can correspond to interesting behavior. We demonstrate the practicality of our theories and techniques on several datasets involving combustion and oceanic eddy simulations and obtain some key insights regarding their stable and unstable features. © 2013 The Author(s) Computer Graphics Forum © 2013 The Eurographics Association and Blackwell Publishing Ltd.

  8. Biblis 1,300 MW unit B in operation for thirty years

    International Nuclear Information System (INIS)

    Lauer, H.

    2006-01-01

    Over the past thirty years, unit B of the Biblis nuclear power station has contributed towards safe, reliable and non-polluting electricity generation. Unit B was the first 1,300 MW unit in the world confirming the good experience accumulated in the construction and operation of plants this size. It laid the foundation for the advanced development of nuclear power plants up to the convoy line. The good availability this plant has achieved in its operating cycles proves the mature state of technology and the high level of qualification and motivation of the power plant staff and the personnel of external firms contracted to work for Biblis. Biblis B has served as a reference plant in German nuclear safety research, demonstrating that units this size can be operated safely. Unit B is also living proof of the possibility to raise nuclear power plants built in the seventies to the current state of the art by implementing the appropriate backfitting and modernization measures. Today, Biblis B is operated at a safety level clearly higher than that to be achieved for new plants internationally. This is also evident from comparison with the guiding values for the safety of new facilities as published by the International Atomic Energy Agency (IAEA). (orig.)

  9. 100 Area source operable unit focused feasibility study report. Draft A

    International Nuclear Information System (INIS)

    1994-09-01

    In accordance with the Hanford Past-Practice Strategy (HPPS), a focused feasibility study (FFS) is performed for those waste sites which have been identified as candidates for interim remedial measures (IRM) based on information contained in applicable work plans and limited field investigations (LFI). The FFS process for the 100 Area source operable units will be conducted in two stages. This report, hereafter referred to as the Process Document, documents the first stage of the process. In this stage, IRM alternatives are developed and analyzed on the basis of waste site groups associated with the 100 Area source operable units. The second stage, site-specific evaluation of the IRM alternatives presented in this Process Document, is documented in a series of operable unit-specific reports. The objective of the FFS (this Process Document and subsequent operable unit-specific reports) is to provide decision makers with sufficient information to allow appropriate and timely selection of IRM for sites associated with the 100 Area source operable units. Accordingly, the following information is presented: a presentation of remedial action objectives; a description of 100 Area waste site groups and associated group profiles; a description of IRM alternatives; and detailed and comparative analyses of the IRM alternatives

  10. Nonpoint and Point Sources of Nitrogen in Major Watersheds of the United States

    Science.gov (United States)

    Puckett, Larry J.

    1994-01-01

    Estimates of nonpoint and point sources of nitrogen were made for 107 watersheds located in the U.S. Geological Survey's National Water-Quality Assessment Program study units throughout the conterminous United States. The proportions of nitrogen originating from fertilizer, manure, atmospheric deposition, sewage, and industrial sources were found to vary with climate, hydrologic conditions, land use, population, and physiography. Fertilizer sources of nitrogen are proportionally greater in agricultural areas of the West and the Midwest than in other parts of the Nation. Animal manure contributes large proportions of nitrogen in the South and parts of the Northeast. Atmospheric deposition of nitrogen is generally greatest in areas of greatest precipitation, such as the Northeast. Point sources (sewage and industrial) generally are predominant in watersheds near cities, where they may account for large proportions of the nitrogen in streams. The transport of nitrogen in streams increases as amounts of precipitation and runoff increase and is greatest in the Northeastern United States. Because no single nonpoint nitrogen source is dominant everywhere, approaches to control nitrogen must vary throughout the Nation. Watershed-based approaches to understanding nonpoint and point sources of contamination, as used by the National Water-Quality Assessment Program, will aid water-quality and environmental managers to devise methods to reduce nitrogen pollution.

  11. Radioisotope applications on fluidized catalytic cracking units

    International Nuclear Information System (INIS)

    Charlton, J.S.

    1997-01-01

    Radioisotopes are used to trace the flow of all the phases of Fluidized Catalytic Cracking process in oil refineries. The gaseous phases, steam, hydrocarbon vapour and air, are generally traced using a noble-gas isotope, 41 Ar, 79 Kr or 85 Kr. An appropriate tracer for the catalyst is produced by irradiating a catalyst sample in a nuclear reactor. The activation products, 140 La and 24 Na provide appropriate radioactive 'labels' for the catalyst, which is reinjected into the FCC. An advantage of this approach is that it facilitates the study of the behaviour of different particle size fractions. Radioisotopes as sealed sources of gamma radiation are used to measure catalyst density variations and density distributions in critical parts of the unit. An important trend in radioisotope applications is the increasing use of the information they produce as inputs to or as validation of, mathematical process models. In line with the increasing sophistication of the models, the technology is undergoing continuous refinement. Developments include the investigation of more efficient, more convenient tracers, the introduction of systems to facilitate more rapid and comprehensive data acquisition and software refinements for enhanced data analysis

  12. Investigating the Language Learning Strategies of Students in the Foundation Program of United Arab Emirates University

    Science.gov (United States)

    Ismail, Sadiq Abdulwahed Ahmed; Al Khatib, Ahmad Z.

    2013-01-01

    Recently, language learning strategies have gained a lot of importance in different parts of the world, including the United Arab Emirates (UAE). Successful foreign or second language learning attempts are viewed in the light of using appropriate and effective language learning strategies. This study investigated the patterns of language learning…

  13. Unidad: Las influencias culturales en el arte mexicana (Unit: Cultural Influences in Mexican Art). Dos semanas.

    Science.gov (United States)

    Finere, Neal

    This two-week unit, appropriate for bilingual education settings as well as foreign language programs, deals with the three primary cultural influences found in Mexican contemporary art. The multisensory materials, pragmatic focus, and direct creative student involvement are designed to make it a microcosmic, real-life experience. The first part…

  14. Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

    Directory of Open Access Journals (Sweden)

    Hanna T

    2014-03-01

    Full Text Available Objective: To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods: Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG by three expert researchers. Results: In seven of nine scenarios (78%, the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency in the majority of scenarios. Due to this, only 47% (76/162 of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162 of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusion: Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

  15. Using scenarios to test the appropriateness of pharmacist prescribing in asthma management.

    Science.gov (United States)

    Hanna, Tamer; Bajorek, Beata; Lemay, Kate; Armour, Carol L

    2014-01-01

    To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists' confidence, and appropriateness, in the context of asthma management. Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

  16. Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

    Science.gov (United States)

    Hanna, Tamer; Bajorek, Beata; LeMay, Kate; Armour, Carol L.

    Objective To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. Results In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusions Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way. PMID:24644524

  17. Assessment of Clinical Practices for Crushing Medication in Geriatric Units.

    Science.gov (United States)

    Fodil, M; Nghiem, D; Colas, M; Bourry, S; Poisson-Salomon, A-S; Rezigue, H; Trivalle, C

    2017-01-01

    To assess the modification of the form of medication and evaluate staff observance of good clinical practices. One-day assessment of clinical practices. 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. Elderly in-patients with difficulties swallowing capsules and tablets. Assessment of target-patient prescriptions and direct observation of nurses' medical rounds. 155/526 in-patients (29.5%) were unable to swallow tablets or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in the rehabilitation unit and 11 (12.2%) in the acute care unit (p = .005). In thirty-nine (27.3%) of the 143 prescriptions studied all tablets were safe to crush and all capsules were safe to open. In 104 cases, at least one medication could not be safely modified, including 26 cases (18.2%) in which none of the prescribed drugs were safe to crush or open. In 48.2% of the 110 medications that were crushed, crushing was forbidden, and presented a potential threat in 12.7% of cases or a reduced efficacy in 8.2% of cases. Crushing methods were rarely appropriate: no specific protective equipment was used (81.8%), crushing equipment was shared between patients without cleaning (95.1%), medications were spilled or lost (69.9%). The method of administration was appropriate (water, jellified water) in 25% of the cases, questionable (soup, coffee, compote, juice, cream) in 55% of the cases and unacceptable (laxative) in 21% of the cases. Management of drug prescriptions in patients with swallowing difficulties is not optimal, and may even have iatrogenic effects. In this study, 12.7% of the modifications of the drug form could have been harmful. Doctors, pharmacists and nurses need to reevaluate their practices.

  18. Eesti film võistleb Karlovy Varys

    Index Scriptorium Estoniae

    2008-01-01

    8. juulil esilinastub Karlovy Vary filmifestivalil Rene Vilbre noortefilm "Mina olin siin", mille aluseks on Sass Henno romaan "Mina olin siin. Esimene arest", stsenaariumi kirjutas Ilmar Raag. Film võistleb võistlusprogrammis "East of the West"

  19. Parenteral nutrition in very low birth weight infants in the United Kingdom and Ireland.

    LENUS (Irish Health Repository)

    Hopewell, J

    2012-02-01

    Parenteral nutrition (PN) plays an important role in providing nutrients for infants unable to tolerate enteral feeds study was to look at PN prescribing in neonatal units in the United Kingdom (U.K.) and Ireland, in particular in infants < 1.5 kg. A postal questionnaire was administered to the 235 neonatal units. The response rate was 179 (76%), of which 136 (76%) used PN. The initial amount of protein prescribed was 0.1-2 g\\/kg\\/day in 102 units (91%), >2 g\\/kg\\/day in 4 (4%) and 5 (5%) used no protein. 88 (80%) started lipids with the first PN prescription. Only 5 units (5%) started with >1 g\\/kg\\/day. The maximum dose of lipids and protein both varied from 2 - >4 g\\/kg\\/day. The initial glucose infusion rate was 4-8 mg\\/kg\\/min. Interestingly only 44% of units started PN in the first 24 hours of age. Hence results show great variation in PN prescribing.

  20. Adsorption mechanism of alkyl polyglucoside (APG) on calcite nanoparticles in aqueous medium at varying pH

    Science.gov (United States)

    Suh, Seokjin; Choi, Kyeong-Ok; Yang, Seung-Chul; Kim, Yeong Eun; Ko, Sanghoon

    2017-07-01

    In this study, adsorption mechanism of alkyl polyglucoside (APG) on calcium carbonate (CaCO3) nanoparticles (CCNPs) in aqueous medium at varying pH was identified. An initial adsorption of APG on CCNP surface seemed to be occurred due to the van der Waals force. An initial surface charge influenced determination of a major driving force, which resulted in hydrogen bonds (pH 7) and the hydrophobic interaction (pH 10) as a main sources of adsorption of APG on the CCNP surface. Even if the initial surface charge of CCNPs had little effect on a quantitative adsorption of APG on CCNPs, eventually, it influence on the definitive adsorption structure between APG and CCNPs and improvement of dispersion stability of CCNPs in water. In conclusion, it was revealed that 0.39% APG aqueous solution was most appropriate to improve the dispersion stability of CCNPs, which is postulated to be used effectively in food and pharmaceutical fields.

  1. Entropy Rate of Time-Varying Wireless Networks

    DEFF Research Database (Denmark)

    Cika, Arta; Badiu, Mihai Alin; Coon, Justin P.

    2018-01-01

    In this paper, we present a detailed framework to analyze the evolution of the random topology of a time-varying wireless network via the information theoretic notion of entropy rate. We consider a propagation channel varying over time with random node positions in a closed space and Rayleigh...... fading affecting the connections between nodes. The existence of an edge between two nodes at given locations is modeled by a Markov chain, enabling memory effects in network dynamics. We then derive a lower and an upper bound on the entropy rate of the spatiotemporal network. The entropy rate measures...

  2. Transforming a conventional theatre into a gynaecological endoscopy unit.

    Science.gov (United States)

    Anastasakis, E; Protopapas, A; Daskalakis, G; Papadakis, M; Milingos, S; Antsaklis, A

    2007-01-01

    Most minimally invasive procedures are now performed in operating rooms that were originally designed for traditional open surgery. We designed an endoscopic theatre based on our experience with special features specific for gynaecological endoscopy. We designed a detailed plan with an architect's aid of a gynaecological unit (based on a Greek presidential decree published in 1991). The space utilized was that of a conventional theatre. With the architectural plan we anticipated every area needed in a gynaecological endoscopic theatre. A twin theatre was considered appropriate in order for the surgical team to operate alternatively in one theatre while the other is being cleaned and prepared for use. The design of a unit dedicated to gynaecologic laparoscopy is a multidisciplinary task where the endoscopic surgeon undertakes an active and prominent role. It is a project with great benefits and rewards for all parties involved. We present our design for evaluation.

  3. Unplanned pregnancies in the United States.

    Science.gov (United States)

    Grimes, D A

    1986-03-01

    Unplanned pregnancies constitute an epidemic in the United States. Over 3 million unplanned pregnancies occur, and over 1.5 million induced abortions are performed each year. Women of minority races and those with less than 12 years of education are at high risk of having unwanted children. Fear of complications (not the complications themselves) is the most powerful deterrent to women's use of contraception. Much of this fear is due to bad press. Recent good news about contraception, such as protection against ovarian and endometrial cancer, protection against ectopic pregnancy, and absence of teratogenic effects, has not received appropriate media coverage. For healthy women younger than 35 years, failure to use fertility control is more dangerous than use of any method.

  4. 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.

  5. Multivariate time-varying volatility modeling using probabilistic fuzzy systems

    NARCIS (Netherlands)

    Basturk, N.; Almeida, R.J.; Golan, R.; Kaymak, U.

    2016-01-01

    Methods to accurately analyze financial risk have drawn considerable attention in financial institutions. One difficulty in financial risk analysis is the fact that banks and other financial institutions invest in several assets which show time-varying volatilities and hence time-varying financial

  6. 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.

  7. Incentivizing professionals and patients: a consideration in the context of the United Kingdom and the United States.

    Science.gov (United States)

    Oliver, Adam; Brown, Lawrence D

    2011-02-01

    We are at the beginning of an era in which the pressure to secure the biggest possible "bang" for the health care "buck" is perhaps higher than it ever has been, on both sides of the Atlantic, and within the health policy discourse, incentives, for both professionals and patients, are occupying an increasingly prominent position. In this article, we consider issues related to motivating the professional and the patient to perform targeted actions, drawing on some of the evidence that has thus far been reported on experiences in the United Kingdom and the United States, and we present an admittedly somewhat speculative taxonomy of hypothesized effectiveness for some of the different methods by which each of these two broad types of incentives can be offered. We go on to summarize some of the problems of, and objections to, the use of incentives in health and health care, such as those relating to motivational crowding and gaming, but we conclude by positing that, following appropriate consideration, caution, and methodological and empirical investigation, health-related incentives, at least in some contexts, may contribute positively to the social good.

  8. 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...

  9. Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

    Science.gov (United States)

    Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

    2017-08-31

    The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

  10. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Umar M Lawan

    2014-01-01

    Full Text Available Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months and caregivers was systematically selected and studied. The data were analyzed using the MINITAB ® 12.21 (USA statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9 and attachment (78.7% during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2% of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7% had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers′ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs, infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to

  11. The co-movement of monetary policy and its time-varying nature: A DCCA approach

    Science.gov (United States)

    Rohit, Abhishek; Mitra, Subrata Kumar

    2018-02-01

    Employing a novel methodology of DCCA cross-correlation coefficient (ρDCCA), this study attempts to provide fresh evidences for the co-movement of monetary policies of the advanced (AEs) as well as the emerging economies (EMEs) vis-à-vis the United States. A higher degree of monetary co-movement as measured by ρDCCA values, is identified for the AEs as compared to the EMEs. Lower co-movement of monetary policy is especially noticeable in the short run for EMEs. We further investigate the time-varying nature of such co-movements for the AEs by splitting the period (1980-2014) into four sub periods and also by performing a rolling window estimation for the entire period to reveal smoother dynamics. Significant evidence of higher monetary coordination is revealed for sub-periods with stronger trade and financial linkages.

  12. Appropriating Geometric Series as a Cultural Tool: A Study of Student Collaborative Learning

    Science.gov (United States)

    Carlsen, Martin

    2010-01-01

    The aim of this article is to illustrate how students, through collaborative small-group problem solving, appropriate the concept of geometric series. Student appropriation of cultural tools is dependent on five sociocultural aspects: involvement in joint activity, shared focus of attention, shared meanings for utterances, transforming actions and…

  13. Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans - United States, 1999-2015.

    Science.gov (United States)

    Cunningham, Timothy J; Croft, Janet B; Liu, Yong; Lu, Hua; Eke, Paul I; Giles, Wayne H

    2017-05-05

    Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities vary across the life span might enhance the targeting of appropriate interventions. Trends during 1999-2015 in mortality rates for the leading causes of death were examined by black and white race and age group. Multiple 2014 and 2015 national data sources were analyzed to compare blacks with whites in selected age groups by sociodemographic characteristics, self-reported health behaviors, health-related quality of life indicators, use of health services, and chronic conditions. During 1999-2015, age-adjusted death rates decreased significantly in both populations, with rates declining more sharply among blacks for most leading causes of death. Thus, the disparity gap in all-cause mortality rates narrowed from 33% in 1999 to 16% in 2015. However, during 2015, blacks still had higher death rates than whites for all-cause mortality in all groups aged blacks in age groups deaths among blacks (especially cardiovascular disease and cancer and their risk factors) across the life span and create equal opportunities for health.

  14. 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

  15. A parametric study on unbalanced three phase islanded microgrids with inverter interfaced units

    DEFF Research Database (Denmark)

    Sanseverino, Eleonora Riva; Quang, Ninh Nguyen; Zizzo, Gaetano

    2013-01-01

    In this paper, the solution of the power flow for unbalanced three phase microgrids systems is proposed. The study aims at the integration of inverter interfaced units using the control law used for primary voltage and frequency regulation, so as to take into account possible small variations...... of these parameters to account for sudden load changes. The proposed study deals with unbalanced systems which is the typical case of small distribution systems and shows how the power losses term varies as the regulators parameters vary as well, thus showing that these are sensitive parameters that could have...

  16. Special requirements for the fluid mechanical design of hard coal-fired SCR retrofit units

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    The system design of high-dust SCR units for retrofits is a challenge that is to be mastered in order to meet the fluid mechanical requirements. Retrofitting power plants with NOx control technologies is a cost-intensive adventure that many utilities are undertaking. Except for a few recent new boiler installations, SCR installations must be considered as retrofit projects. In most cases the limitation of space on site entails unfavorable conditions that do not allow appropriate upstream conditions for SCR catalysts. To comply with the requirements of high performance DeNOx systems and to lower the investment costs for retrofit units, several technical solutions and concepts for the reactor layout, for NOx and dust distribution, for flow stabilization in diffusers, and advanced ammonia injection systems are explained in this paper. Balcke-Duerr offers customer-tailored solutions for flow optimization, which are evaluated by model studies. Physical flow and dust model tests in an appropriate scale provide flexibility to test various engineering concepts. The experience of Balcke-Duerr is based on continuous research and development activities over the last 25 years and more than 350 executed projects for gas flow optimization applications. The success of these installations is a direct result of the key decisions based on the improved fluid mechanical design and proper system integration. This paper also identifies the sensible design particularities and solutions that have two be considered in the fluid mechanical design of high-dust SCR retrofit units. This article demonstrates that the layout of SCR units must be carefully reviewed in order to meet the performance requirements and to avoid problems, i.e. wear, catalyst plugging and ammonia slip. 9 refs., 18 figs.

  17. Developing a Model for Identifying Students at Risk of Failure in a First Year Accounting Unit

    Science.gov (United States)

    Smith, Malcolm; Therry, Len; Whale, Jacqui

    2012-01-01

    This paper reports on the process involved in attempting to build a predictive model capable of identifying students at risk of failure in a first year accounting unit in an Australian university. Identifying attributes that contribute to students being at risk can lead to the development of appropriate intervention strategies and support…

  18. The Effects of a Developmentally Appropriate Music and Movement Program on Motor Performance

    Science.gov (United States)

    Zachopoulou, E.; Tsapakidou, A.; Derri, V.

    2004-01-01

    Basic motor skills development is achieved through the implementation of different types of physical education programs. The purpose of this study was to investigate and to compare the effect of a developmentally appropriate music and movement program and of a developmentally appropriate physical education program on the development of jumping and…

  19. Direct costs associated with the appropriateness of hospital stay in elderly population

    Directory of Open Access Journals (Sweden)

    Sánchez-García Sergio

    2009-08-01

    Full Text Available Abstract Background Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. Methods Appropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP. Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS, in Mexico City. Results The sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8 of hospital stay, of which 12.4% (n = 90 were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7. The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89. The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4, while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3, (p Conclusion Elderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.

  20. Genetic polymorphisms in varied environments.

    Science.gov (United States)

    Powell, J R

    1971-12-03

    Thirteen experimenital populationis of Drosophila willistoni were maintained in cages, in some of which the environments were relatively constant and in others varied. After 45 weeks, the populations were assayed by gel electrophoresis for polymorphisms at 22 protein loci. The average heterozygosity per individual and the average unmber of alleles per locus were higher in populations maintained in heterogeneous environments than in populations in more constant enviroments.

  1. Exposure to radiofrequency radiation from diathermy units in medicine

    International Nuclear Information System (INIS)

    Hrnjak, M.; Zivkovic, D.; Milicevic, L.

    1998-01-01

    Intensities of microwave (MW) and radio wave (short wave) radiation to whom personnel occupied in use of radiofrequency (RF) diathermy in physical therapy could be exposed were measured in two hospitals, in two therapy wards. The Narda Microwave Corp. (USA) Broadband Radiation Meter - Model 8616, with appropriate probes, was used for measurements. The measurements were performed around the 3 types of diathermy units in various ways of application. Results of the measurements showed that the intensities of short waves radiation around the applicators, cables and units (at the distance of 30 cm) ranged from 187 mW/cm sup 2 , and on the majority of measuring points were considerably over the upper exposure limit of 1,22 mW/cm sup 2 (according to JUS N.NO.205:1190 limits of exposure to RF fields). Intensities of microwave radiation in the vicinity of units and patient range from <0,002 to 1,45 mW/cm sup 2. The intensities of MW radiation are over the exposure limit of 1 mW/cm sup 2 in two measuring points. Results of measurements show that personnel occupied in use of microwave and short wave diathermy in medicine could be regularly exposed to radiation, and that this radiation has considerably high intensity in the vicinity of the therapy unit and patient (author)

  2. Pemodelan Markov Switching Dengan Time-varying Transition Probability

    OpenAIRE

    Savitri, Anggita Puri; Warsito, Budi; Rahmawati, Rita

    2016-01-01

    Exchange rate or currency is an economic variable which reflects country's state of economy. It fluctuates over time because of its ability to switch the condition or regime caused by economic and political factors. The changes in the exchange rate are depreciation and appreciation. Therefore, it could be modeled using Markov Switching with Time-Varying Transition Probability which observe the conditional changes and use information variable. From this model, time-varying transition probabili...

  3. 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.

  4. 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 ...

  5. 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

  6. Nutrient Partitioning and Stoichiometry in Unburnt Sugarcane Ratoon at Varying Yield Levels

    Directory of Open Access Journals (Sweden)

    José Marcos Leite

    2016-04-01

    Full Text Available Unraveling nutrient imbalances in contemporary agriculture is a research priority to improve whenever possible yield and nutrient use efficiency in sugarcane (Saccharum spp. systems while minimizing the costs of cultivation (e.g., use of fertilizers and environmental concerns. The main goal of this study was therefore to investigate biomass and nutrient [nitrogen (N, phosphorus (P, and potassium (K] content, partitioning, stoichiometry and internal efficiencies in sugarcane ratoon at varying yield levels. Three sites were established on highly weathered tropical soils located in the Southeast region of Brazil. At all sites, seasonal biomass and nutrient uptake patterns were synthesized from four sampling times taken throughout the sugarcane ratoon season. At all sites, in-season nutrient partitioning (in diverse plant components, internal efficiencies (yield to nutrient content ratio and nutrient ratios (N:P and N:K were determined at harvesting. Sugarcane exhibited three distinct phases of plant growth, as follows: lag, exponential-linear, and stationary. Across sites, nutrient requirement per unit of yield was 1.4 kg N, 0.24 kg P, and 2.7 kg K per Mg of stalk produced, but nutrient removal varied with soil nutrient status (based on soil plus fertilizer nutrient supply and crop demand (potential yield. Dry leaves had lower nutrient content (N, P, and K and broader N:P and N:K ratios when compared with tops and stalks plant fractions. Greater sugarcane yield and narrowed N:P ratio (6:1 were verified for tops of sugarcane when increasing both N and P content. High-yielding sugarcane systems were related to higher nutrient content and more balanced N:P (6:1 and N:K (0.5:1 ratios.

  7. Hot Ductility Behavior of Boron Containing Microalloyed Steels with Varying Manganese Contents

    Science.gov (United States)

    Brune, Tobias; Senk, Dieter; Walpot, Raphael; Steenken, Bernhard

    2015-02-01

    The hot ductility is measured for six different steel grades with different microalloying elements and with varying manganese contents using the hot tensile test machine with melting/solidification unit at the Department of Ferrous Metallurgy RWTH Aachen University. To identify the influence of manganese on hot ductility, tests are performed with varying the manganese content from 0.7 to 18.2 wt pct, a high manganese steel. Additionally, the effect of different cooling and strain rates is analyzed by changing the particular rate for selected samples in the minima. To investigate and detect the cause of cracking during testing, the fracture surfaces in the ductility minima are considered with scanning electron microscope-energy dispersive X-ray spectroscopy. Thermodynamic modeling is conducted on basis of the commercial software ThermoCalc©. A sharp decrease of the hot ductility is recognizable at 1398 K (1125 °C), at only 0.7 wt pct manganese because of the low manganese to sulfur ratio. The grades with a Mn content up to 1.9 wt pct show a good ductility with minimal ductility loss. In comparison, the steel grade with 18.2 wt pct has a poor hot ductility. Because of the formation of complex precipitates, where several alloying elements are involved, the influence of boron on hot ductility is not fully clarified. By increasing the cooling rate, the reduction of area values are shifted to smaller values. For high test temperatures, these measured values are decreased for lower strain rates. Thereby, an early drop of the ductility is noticeable for the high temperatures around 1373 K (1100 °C).

  8. 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.

  9. RUNOFF HYDROGRAPHS USING SNYDER AND SCS SYNTHETIC UNIT HYDROGRAPH METHODS: A CASE STUDY OF SELECTED RIVERS IN SOUTH WEST NIGERIA

    Directory of Open Access Journals (Sweden)

    Wahab Adebayo Salami

    2017-01-01

    Full Text Available This paper presents the development of runoff hydrographs for selected rivers in Ogun-Osun river catchment, south west, Nigeria using Snyder and Soil Conservation Service (SCS methods of synthetic unit hydrograph to determine the ordinates. The Soil Conservation Service (SCS curve Number method was used to estimate the excess rainfall from storm of different return periods. The peak runoff hydrographs were determined by convoluting the unit hydrographs ordinates with the excess rainfall and the value of peak flows obtained by both Snyder and SCS methods observed to vary from one river watershed to the other. The peak runoff hydrograph flows obtained based on the unit hydrograph ordinate determined with Snyder method for 20-yr, 50-yr, 100-yr, 200-yr and 500-yr, return period varied from 112.63m3/s and 13364.30m3/s, while those based on the SCS method varied from 304.43m3/s and 6466.84m3/s for the eight watersheds. However, the percentage difference shows that for values of peak flows obtained with Snyder and SCS methods varies from 13.14% to 63.30%. However, SCS method is recommended to estimate the ordinate required for the development of peak runoff hydrograph in the river watersheds because it utilized additional morphometric parameters such as watershed slope and the curve number (CN which is a function of the properties of the soil and vegetation cover of the watershed.

  10. Proposal for broader United States-Russian transparency of nuclear arms reductions

    International Nuclear Information System (INIS)

    Percival, C.M.; Ingle, T.H.; Bieniawski, A.J.

    1995-01-01

    During the January 1994 Summit Presidents Clinton and Yeltsin agreed on the goal of ensuring the ''transparency and irreversibility'' of the nuclear arms reduction process. As a result, negotiations are presently underway between the United States Government and the Russian Federation to confirm the stockpiles of plutonium and highly enriched uranium removed from nuclear weapons. In December 1994 the United States presented a paper to the Russian Federation proposing additional measures to provide broader transparency of nuclear arms reduction. The US Department of Energy is studying the implementation of these broader transparency measures at appropriate DOE facilities. The results of the studies include draft protocols for implementation, assessments of the implementation procedures and the impacts on the facilities and estimates of the cost to implement these measures at various facilities

  11. Development of Regulatory Audit Programs for Wolsong Unit 1 Continued Operation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hong Key; Nho, Seung Hwan; Song, Myung Ho [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2012-05-15

    Wolsong Unit 1 (PHWR type) design life expires on November 20, 2010. In relation to it, KHNP submitted its application to get approval of the MEST on December 30, 2009 and KINS is under review to confirm the appropriateness of continued operation. For the comprehensive review of Wolsong Unit 1 continued operation, KINS has developed the review guidelines for PHWR type reactor including a total of 39 aging management program (AMP) items and 7 time limited aging analysis (TLAA) items. Evaluations or calculations to verify the integrity of nuclear components are required for plant specific AMP and TLAA items as well as the ones specified in the guidelines. In this paper, audit calculation programs developed for KINS staff use in reviewing applicant's submitted evaluation results are presented

  12. Observer-based linear parameter varying H∞ tracking control for hypersonic vehicles

    Directory of Open Access Journals (Sweden)

    Yiqing Huang

    2016-11-01

    Full Text Available This article aims to develop observer-based linear parameter varying output feedback H∞ tracking controller for hypersonic vehicles. Due to the complexity of an original nonlinear model of the hypersonic vehicle dynamics, a slow–fast loop linear parameter varying polytopic model is introduced for system stability analysis and controller design. Then, a state observer is developed by linear parameter varying technique in order to estimate the unmeasured attitude angular for slow loop system. Also, based on the designed linear parameter varying state observer, a kind of attitude tracking controller is presented to reduce tracking errors for all bounded reference attitude angular inputs. The closed-loop linear parameter varying system is proved to be quadratically stable by Lypapunov function technique. Finally, simulation results show that the developed linear parameter varying H∞ controller has good tracking capability for reference commands.

  13. A novel algorithm for demand-control of a single-room ventilation unit with a rotary heat exchanger

    DEFF Research Database (Denmark)

    Smith, Kevin Michael; Jansen, Anders Lund; Svendsen, Svend

    in the indoor environment. Based on these values, a demand-control algorithm varies fan speeds to change airflow rates and varies the rotational speed of the heat exchanger to modulate heat and moisture recovery. The algorithm varies airflow rates to provide free cooling and limit CO2 concentrations and varies...... moisture recovery by varying the rotational speed and then safely unbalances airflows in a worst-case scenario. In the algorithm, frost protection and minimum supply temperature take the highest priority and override other controls. This paper documents the proposed demand control algorithm and analyses...... its impacts on compliance of building regulations in Denmark. The paper presents an algorithm that manufacturers can program into their controls. The commercially available single-room ventilation unit with a rotary heat exchanger uses this algorithm coded in the C language. Future work will document...

  14. Frontiers in Microbiology: Envisioning a Curriculum Unit for High School Biology

    Energy Technology Data Exchange (ETDEWEB)

    Mark Bloom

    2004-06-18

    Microbiology is undergoing a quiet revolution. Techniques such as polymerase chain reaction, high throughput DNA sequencing, whole genome shotgun sequencing, DNA microarrays, and bioinformatics analyses are greatly aiding our understanding of the estimated one billion species of microbes that inhabit the Earth. Unfortunately, the rapid pace of research in microbiology stands in contrast to the much slower pace of change in educational reform. Biological Sciences Curriculum Study (BSCS) hosted a two-day planning meeting to discuss whether or not a new curriculum unit on microbiology is desirable for the high school audience. Attending the meeting were microbiologists, high school biology teachers, and science educators. The consensus of the participants was that an inquiry-based unit dealing with advances in microbiology should be developed for a high school biology audience. Participants established content priorities for the unit, discussed the unit's conceptual flow, brainstormed potential student activities, and discussed the role of educational technology for the unit. As a result of the planning meeting discussions, BSCS staff sought additional funding to develop, disseminate, and evaluate the Frontiers in Microbiology curriculum unit. This unit was intended to be developed as a replacement unit suitable for an introductory biology course. The unit would feature inquiry-based student activities and provide approximately four weeks of instruction. As appropriate, activities would make use of multimedia. The development and production processes would require about two years for completion. Unfortunately, BSCS staff was not able to attract sufficient funding to develop the proposed curriculum unit. Since there were some unexpended funds left over from the planning meeting, BSCS requested and received permission from DOE to use the balance of the funds to prepare background materials about advances in microbiology that would be useful to teachers. These

  15. Estrelas variáveis

    OpenAIRE

    Viana, Sérgio Manuel de Oliveira

    2001-01-01

    A observação do céu nocturno é uma prática que vem da Antiguidade. Desde então e durante muito tempo pensou-se que as estrelas mantinham o brilho constante. Assim foi até ao século XVI, quando David Fabricius observou uma estrela cujo brilho variava periodicamente. Dois séculos mais tarde, Jonh Goodricke descobriu uma segunda estrela e com o desenvolvimento de instrumentos de observação este conjunto foi muito alargado e hoje inclui o Sol.A variação do brilho das estrelas variáveis permite d...

  16. Appropriating A Female Voice: Nicholas Breton And The Countess Of Pembroke

    Directory of Open Access Journals (Sweden)

    DASCĂL REGHINA

    2014-12-01

    Full Text Available The sixteenth century author Nicholas Breton appropriates a female voice in many of his writings, among which Marie Magdalens Loue and The Pilgrimage to Paradise joyned with the Countesse of Penbrookes Loue feature prominently. The Countess of Pembroke, celebrated by Aemilia Lanyer in her Salve Deus Rex Judaeorum as a paragon of female religious devotion, is often associated in Breton's texts with Mary Magdalene. This paper will analyse some of the anxieties engendered by this appropriation of voice and of the Magdalene figure, anxieties that prove to be disruptive of Elizabethan gender hierarchies.

  17. 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 ...

  18. 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 ...

  19. 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...

  20. 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