VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

Science.gov (United States)

Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

2013-03-01

To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

Use of DNA sequencing to detect pathogenic, saprotrophic, and stain fungi in sapwood of declining red pine (Pinus resinosa) in the Upper Midwest

Science.gov (United States)

M.T. Banik; D.L. Lindner; J. Juzwik; J.A. Glaeser

2013-01-01

An inexpensive kit was developed to collect wood samples for molecular detection of pathogenic, saprotrophic and stain fungi in declining Pinus resinosa in the Upper Midwest. The kit contained materials for "clean" collection of sapwood drill shavings, which were then subjected to PCR of the rDNA ITS region with fungal-specific primers,...

Soil Emissions of N2O and NO in Agricultural Production Systems in the Upper Midwest U.S.: Management Controls and Measurement Issues

Science.gov (United States)

Cropped fields in the upper Midwest have the potential to emit relatively large quantities of N2O and NO resulting from soil transformation of N fertilizers applied to crops such as corn and potatoes. The mitigation of N2O emissions may be an effective strategy for offsetting greenhouse gas emission...

76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

Science.gov (United States)

2011-07-08

... Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration... Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review... were granted power of attorney by veterans who have medical information recorded in VHA electronic...

Spatiotemporal distributions of intestinal helminths in female lesser scaup Aythya affinis during spring migration from the upper Midwest, USA.

Science.gov (United States)

England, J C; Levengood, J M; Osborn, J M; Yetter, A P; Kinsella, J M; Cole, R A; Suski, C D; Hagy, H M

2017-07-01

We examined the associations between intestinal helminth infracommunity structure and infection parameters and the age, size, and year and region of collection of 130 female lesser scaup (Aythya affinis) during their 2014-2015 spring migrations through the upper Midwest, USA. We identified a total of 647,174 individual helminths from 40 taxa, including 20 trematodes, 14 cestodes, 4 nematodes and 2 acanthocephalans parasitizing lesser scaup within the study area. Lesser scaup were each infected with 2-23 helminth taxa. One digenean, Plenosoma minimum, is reported for the first time in lesser scaup and in the Midwest. Mean trematode abundance and total helminth abundance was significantly less in 2015 than 2014, and we suspect that colder weather late in 2015 impacted the intermediate host fauna and caused the observed differences. Brillouin's species diversity of helminths was greatest in the northernmost region of the study area, which coincides with the range of a non-indigenous snail that indirectly causes annual mortality events of lesser scaup. While host age and size were not determined to be influential factors of helminth infracommunity structure, non-parametric ordination and permutational analysis of co-variance revealed that year and region of collection explained differences in helminth infracommunities. Our results suggest that spatiotemporal variations play an important role in the structure of intestinal helminth infracommunities found in migrating lesser scaup hosts, and may therefore impact host ability to build endogenous reserves at certain stopover locations in the Midwest.

Travel time and attrition from VHA care among women veterans: how far is too far?

Science.gov (United States)

Friedman, Sarah A; Frayne, Susan M; Berg, Eric; Hamilton, Alison B; Washington, Donna L; Saechao, Fay; Maisel, Natalya C; Lin, Julia Y; Hoggatt, Katherine J; Phibbs, Ciaran S

2015-04-01

Travel time, an access barrier, may contribute to attrition of women veterans from Veterans Health Administration (VHA) care. We examined whether travel time influences attrition: (a) among women veterans overall, (b) among new versus established patients, and (c) among rural versus urban patients. This retrospective cohort study used logistic regression to estimate the association between drive time and attrition, overall and for new/established and rural/urban patients. In total, 266,301 women veteran VHA outpatients in the Fiscal year 2009. An "attriter" did not return for VHA care during the second through third years after her first 2009 visit (T0). Drive time (log minutes) was between the patient's residence and her regular source of VHA care. "New" patients had no VHA visits within 3 years before T0. Models included age, service-connected disability, health status, and utilization as covariates. Overall, longer drive times were associated with higher odds of attrition: drive time adjusted odds ratio=1.11 (99% confidence interval, 1.09-1.14). The relationship between drive time and attrition was stronger among new patients but was not modified by rurality. Attrition among women veterans is sensitive to longer drive time. Linking new patients to VHA services designed to reduce distance barriers (telemedicine, community-based clinics, mobile clinics) may reduce attrition among women new to VHA.

VHA-19 is essential in Caenorhabditis elegans oocytes for embryogenesis and is involved in trafficking in oocytes.

Directory of Open Access Journals (Sweden)

Alison J Knight

Full Text Available There is an urgent need to develop new drugs against parasitic nematodes, which are a significant burden on human health and agriculture. Information about the function of essential nematode-specific genes provides insight to key nematode-specific processes that could be targeted with drugs. We have characterized the function of a novel, nematode-specific Caenorhabditis elegans protein, VHA-19, and show that VHA-19 is essential in the germline and, specifically, the oocytes, for the completion of embryogenesis. VHA-19 is also involved in trafficking the oocyte receptor RME-2 to the oocyte plasma membrane and is essential for osmoregulation in the embryo, probably because VHA-19 is required for proper eggshell formation via exocytosis of cortical granules or other essential components of the eggshell. VHA-19 may also have a role in cytokinesis, either directly or as an indirect effect of its role in osmoregulation. Critically, VHA-19 is expressed in the excretory cell in both larvae and adults, suggesting that it may have a role in osmoregulation in C. elegans more generally, probably in trafficking or secretion pathways. This is the first time a role for VHA-19 has been described.

Decision support system development at the Upper Midwest Environmental Sciences Center

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Fox, Timothy J.; Nelson, J. C.; Rohweder, Jason J.

2014-01-01

A Decision Support System (DSS) can be defined in many ways. The working definition used by the U.S. Geological Survey Upper Midwest Environmental Sciences Center (UMESC) is, “A spatially based computer application or data that assists a researcher or manager in making decisions.” This is quite a broad definition—and it needs to be, because the possibilities for types of DSSs are limited only by the user group and the developer’s imagination. There is no one DSS; the types of DSSs are as diverse as the problems they help solve. This diversity requires that DSSs be built in a variety of ways, using the most appropriate methods and tools for the individual application. The skills of potential DSS users vary widely as well, further necessitating multiple approaches to DSS development. Some small, highly trained user groups may want a powerful modeling tool with extensive functionality at the expense of ease of use. Other user groups less familiar with geographic information system (GIS) and spatial data may want an easy-to-use application for a nontechnical audience. UMESC has been developing DSSs for almost 20 years. Our DSS developers offer our partners a wide variety of technical skills and development options, ranging from the most simple Web page or small application to complex modeling application development.

Using GIS to integrate FIA and remotely sensed data to estimate the invasibility of major forest types by non-native invasive plants in the Upper Midwest, USA

Science.gov (United States)

Zhaofei Fan; W. Keith Moser; Michael K. Crosby; Weiming Yu

2012-01-01

Non-native invasive plants (NNIP) are rapidly spreading into natural ecosystems such as forests in the Upper Midwest. Using the strategic inventory data from the 2005-2006 U.S. Department of Agriculture, Forest Service’s Forest Inventory and Analysis (FIA) program and forest land cover data, we estimated the regional-invasibility patterns of NNIPs for major...

Assessing the influence of multiple stressors on stream diatom metrics in the upper Midwest, USA

Science.gov (United States)

Munn, Mark D.; Waite, Ian R.; Konrad, Christopher P.

2018-01-01

Water resource managers face increasing challenges in identifying what physical and chemical stressors are responsible for the alteration of biological conditions in streams. The objective of this study was to assess the comparative influence of multiple stressors on benthic diatoms at 98 sites that spanned a range of stressors in an agriculturally dominated region in the upper Midwest, USA. The primary stressors of interest included: nutrients, herbicides and fungicides, sediment, and streamflow; although the influence of physical habitat was incorporated in the assessment. Boosted Regression Tree was used to examine both the sensitivity of various diatom metrics and the relative importance of the primary stressors. Percent Sensitive Taxa, percent Highly Motile Taxa, and percent High Phosphorus Taxa had the strongest response to stressors. Habitat and total phosphorous were the most common discriminators of diatom metrics, with herbicides as secondary factors. A Classification and Regression Tree (CART) model was used to examine conditional relations among stressors and indicated that fine-grain streams had a lower percentage of Sensitive Taxa than coarse-grain streams, with Sensitive Taxa decreasing further with increased water temperature (>30 °C) and triazine concentrations (>1500 ng/L). In contrast, streams dominated by coarse-grain substrate contained a higher percentage of Sensitive Taxa, with relative abundance increasing with lower water temperatures (water depth (water temperature appears to be a major limiting factor in Midwest streams; whereas both total phosphorus and percent fines showed a slight subsidy-stress response. While using benthic algae for assessing stream quality can be challenging, field-based studies can elucidate stressor effects and interactions when the response variables are appropriate, sufficient stressor resolution is achieved, and the number and type of sites represent a gradient of stressor conditions and at least a quasi

VHA Chaplains: challenges, roles, rewards, and frustrations of the work.

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Beder, Joan; Yan, Grace W

2013-01-01

Chaplains working in the Veterans Health Administration have numerous roles and challenges. They work closely with other behavioral health professionals, especially social workers, to address the multiplicity of needs of the Veteran population. They are essentially an understudied subset of the military Chaplaincy service (most studies focus on those engaged in combat areas). In this exploratory qualitative study, VHA Chaplains responded to a survey to determine how they defined their role and professional challenges, what they felt were the rewards and frustrations of their work and their unique function within the VHA system. Findings showed that role differences between Chaplains and social workers and other behavioral health providers are clearly defined; rewards and challenges were diverse and frustrations were common to those working in a bureaucratic structure.

Practices and Processes of Leading High Performance Home Builders in the Upper Midwest

Energy Technology Data Exchange (ETDEWEB)

Von Thoma, E.; Ojczyk, C.

2012-12-01

The NorthernSTAR Building America Partnership team proposed this study to gain insight into the business, sales, and construction processes of successful high performance builders. The knowledge gained by understanding the high performance strategies used by individual builders, as well as the process each followed to move from traditional builder to high performance builder, will be beneficial in proposing more in-depth research to yield specific action items to assist the industry at large transform to high performance new home construction. This investigation identified the best practices of three successful high performance builders in the upper Midwest. In-depth field analysis of the performance levels of their homes, their business models, and their strategies for market acceptance were explored. All three builders commonly seek ENERGY STAR certification on their homes and implement strategies that would allow them to meet the requirements for the Building America Builders Challenge program. Their desire for continuous improvement, willingness to seek outside assistance, and ambition to be leaders in their field are common themes. Problem solving to overcome challenges was accepted as part of doing business. It was concluded that crossing the gap from code-based building to high performance based building was a natural evolution for these leading builders.

76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

Science.gov (United States)

2011-09-13

... (VSO Access to VHA Electronic Health Records) Under OMB Review AGENCY: Veterans Health Administration... Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review: Extension of a... power of attorney by veterans who have medical information recorded in VHA electronic health records...

Clinical Policy Recommendations from the VHA State-of-the-Art Conference on Non-Pharmacological Approaches to Chronic Musculoskeletal Pain.

Science.gov (United States)

Kligler, Benjamin; Bair, Matthew J; Banerjea, Ranjana; DeBar, Lynn; Ezeji-Okoye, Stephen; Lisi, Anthony; Murphy, Jennifer L; Sandbrink, Friedhelm; Cherkin, Daniel C

2018-05-01

As a large national healthcare system, Veterans Health Administration (VHA) is ideally suited to build on its work to date and develop a safe, evidence-based, and comprehensive approach to the care of chronic musculoskeletal pain conditions that de-emphasizes opioid use and emphasizes non-pharmacological strategies. The VHA Office of Health Services Research and Development (HSR&D) held a state-of-the-art (SOTA) conference titled "Non-pharmacological Approaches to Chronic Musculoskeletal Pain Management" in November 2016. Goals of the conference were (1) to establish consensus on the current state of evidence regarding non-pharmacological approaches to chronic musculoskeletal pain to inform VHA policy in this area and (2) to begin to identify priorities for the future VHA research agenda. Workgroups were established and asked to reach consensus recommendations on clinical and research priorities for the following treatment strategies: psychological/behavioral therapies, exercise/movement therapies, manual therapies, and models for delivering multimodal pain care. Participants in the SOTA identified nine non-pharmacological therapies with sufficient evidence to be implemented across the VHA system as part of pain care. Participants further recommended that effective integration of these non-pharmacological approaches across the VHA and especially into VHA primary care, pain care, and mental health settings should be a priority, and that these treatments should be offered early in the course of pain treatment and delivered in a team-based, multimodal treatment setting concurrently with active self-care and self-management approaches. In addition, we recommend that VHA leadership and policy makers systematically address the barriers to implementation of these approaches by expanding opportunities for clinician and veteran education on the effectiveness of these strategies; supporting and funding further research to determine optimal dosage, duration, sequencing

Challenges in referral communication between VHA primary care and specialty care.

Science.gov (United States)

Zuchowski, Jessica L; Rose, Danielle E; Hamilton, Alison B; Stockdale, Susan E; Meredith, Lisa S; Yano, Elizabeth M; Rubenstein, Lisa V; Cordasco, Kristina M

2015-03-01

Poor communication between primary care providers (PCPs) and specialists is a significant problem and a detriment to effective care coordination. Inconsistency in the quality of primary-specialty communication persists even in environments with integrated delivery systems and electronic medical records (EMRs), such as the Veterans Health Administration (VHA). The purpose of this study was to measure ease of communication and to characterize communication challenges perceived by PCPs and primary care personnel in the VHA, with a particular focus on challenges associated with referral communication. The study utilized a convergent mixed-methods design: online cross-sectional survey measuring PCP-reported ease of communication with specialists, and semi-structured interviews characterizing primary-specialty communication challenges. 191 VHA PCPs from one regional network were surveyed (54% response rate), and 41 VHA PCPs and primary care staff were interviewed. PCP-reported ease of communication mean score (survey) and recurring themes in participant descriptions of primary-specialty referral communication (interviews) were analyzed. Among PCPs, ease-of-communication ratings were highest for women's health and mental health (mean score of 2.3 on a scale of 1-3 in both), and lowest for cardiothoracic surgery and neurology (mean scores of 1.3 and 1.6, respectively). Primary care personnel experienced challenges communicating with specialists via the EMR system, including difficulty in communicating special requests for appointments within a certain time frame and frequent rejection of referral requests due to rigid informational requirements. When faced with these challenges, PCPs reported using strategies such as telephone and e-mail contact with specialists with whom they had established relationships, as well as the use of an EMR-based referral innovation called "eConsults" as an alternative to a traditional referral. Primary-specialty communication is a continuing

Implementing a cornerstone of culture change: Consistent staff assignment in VHA community living centers.

Science.gov (United States)

Lemke, Sonne; Brennan, Penny L; SooHoo, Sonya; Schutte, Kathleen K

2017-08-01

In 2011, the Veterans Health Administration (VHA) began implementing consistent staff assignment in its nursing homes (called Community Living Centers or CLCs). Consistent assignment, a cornerstone of culture change, minimizes the number of staff who provide a resident's care. The present research assessed the level and stability of consistent assignment in units within VHA CLCs and identified unit characteristics related to implementation of this staff assignment model. Schedulers in 185 of 335 organizational units that make up VHA CLCs completed a Staffing Practices Survey. For the month prior to the survey, 53% of CLC units had full implementation of consistent assignment. Tracked back over time, 37% of CLC units had stable high consistent assignment, 29% had stable low consistent assignment, and 34% were variable. Units with stable high consistent assignment were most likely to use care teams with stable membership and to obtain staff input for care assignments. Schedulers in these units reported more positive experiences with consistent staff assignment and better unit functioning in terms of staff absences, complaints about workload fairness, and resolution of scheduling problems. Units with stable low and variable consistent assignment were similar in most of these respects; however, units with variable consistent assignment made greater use of stable care teams and were less likely to change assignments at a staff member's request. Overall, consistent assignment implementation was not related to unit size, nursing hours per resident day, or specialty focus. Findings can help guide consistent staff assignment implementation in VHA and community nursing homes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A feasibility study of stationary and dual-axis tracking grid-connected photovoltaic systems in the Upper Midwest

Science.gov (United States)

Warren, Ryan Duwain

Three primary objectives were defined for this work. The first objective was to determine, assess, and compare the performance, heat transfer characteristics, economics, and feasibility of real-world stationary and dual-axis tracking grid-connected photovoltaic (PV) systems in the Upper Midwest. This objective was achieved by installing two grid-connected PV systems with different mounting schemes in central Iowa, implementing extensive data acquisition systems, monitoring operation of the PV systems for one full year, and performing detailed experimental performance and economic studies. The two PV systems that were installed, monitored, and analyzed included a 4.59 kWp roof-mounted stationary system oriented for maximum annual energy production, and a 1.02 kWp pole-mounted actively controlled dual-axis tracking system. The second objective was to demonstrate the actual use and performance of real-world stationary and dual-axis tracking grid-connected PV systems used for building energy generation applications. This objective was achieved by offering the installed PV systems to the public for demonstration purposes and through the development of three computer-based tools: a software interface that has the ability to display real-time and historical performance and meteorological data of both systems side-by-side, a software interface that shows real-time and historical video and photographs of each system, and a calculator that can predict performance and economics of stationary and dual-axis tracking grid-connected PV systems at various locations in the United States. The final objective was to disseminate this work to social, professional, scientific, and academic communities in a way that is applicable, objective, accurate, accessible, and comprehensible. This final objective will be addressed by publishing the results of this work and making the computer-based tools available on a public website (www.energy.iastate.edu/Renewable/solar). Detailed experimental

An economic analysis comparison of stationary and dual-axis tracking grid-connected photovoltaic systems in the US Upper Midwest

Science.gov (United States)

Choi, Wongyu; Pate, Michael B.; Warren, Ryan D.; Nelson, Ron M.

2018-05-01

This paper presents an economic analysis of stationary and dual-axis tracking photovoltaic (PV) systems installed in the US Upper Midwest in terms of life-cycle costs, payback period, internal rate of return, and the incremental cost of solar energy. The first-year performance and energy savings were experimentally found along with documented initial cost. Future PV performance, savings, and operating and maintenance costs were estimated over 25-year assumed life. Under the given assumptions and discount rates, the life-cycle savings were found to be negative. Neither system was found to have payback periods less than the assumed system life. The lifetime average incremental costs of energy generated by the stationary and dual-axis tracking systems were estimated to be 0.31 and 0.37 per kWh generated, respectively. Economic analyses of different scenarios, each having a unique set of assumptions for costs and metering, showed a potential for economic feasibility under certain conditions when compared to alternative investments with assumed yields.

BoB, a best-of-breed automated text de-identification system for VHA clinical documents.

Science.gov (United States)

Ferrández, Oscar; South, Brett R; Shen, Shuying; Friedlin, F Jeffrey; Samore, Matthew H; Meystre, Stéphane M

2013-01-01

De-identification allows faster and more collaborative clinical research while protecting patient confidentiality. Clinical narrative de-identification is a tedious process that can be alleviated by automated natural language processing methods. The goal of this research is the development of an automated text de-identification system for Veterans Health Administration (VHA) clinical documents. We devised a novel stepwise hybrid approach designed to improve the current strategies used for text de-identification. The proposed system is based on a previous study on the best de-identification methods for VHA documents. This best-of-breed automated clinical text de-identification system (aka BoB) tackles the problem as two separate tasks: (1) maximize patient confidentiality by redacting as much protected health information (PHI) as possible; and (2) leave de-identified documents in a usable state preserving as much clinical information as possible. We evaluated BoB with a manually annotated corpus of a variety of VHA clinical notes, as well as with the 2006 i2b2 de-identification challenge corpus. We present evaluations at the instance- and token-level, with detailed results for BoB's main components. Moreover, an existing text de-identification system was also included in our evaluation. BoB's design efficiently takes advantage of the methods implemented in its pipeline, resulting in high sensitivity values (especially for sensitive PHI categories) and a limited number of false positives. Our system successfully addressed VHA clinical document de-identification, and its hybrid stepwise design demonstrates robustness and efficiency, prioritizing patient confidentiality while leaving most clinical information intact.

Climate induced changes in biome distribution, NPP and hydrology for potential vegetation of the Upper Midwest U.S

Science.gov (United States)

Motew, M.; Kucharik, C. J.

2011-12-01

While much attention is focused on future impacts of climate change on ecosystems, much can be learned about the previous interactions of ecosystems with recent climate change. In this study, we investigated the impacts of climate change on potential vegetation distributions (i.e. grasses, trees, and shrubs) and carbon and water cycling across the Upper Midwest USA from 1948-2007 using the Agro-IBIS dynamic vegetation model. We drove the model using a historical, gridded daily climate data set (temperature, precipitation, humidity, solar radiation, and wind speed) at a spatial resolution of 5 min x 5 min. While trends in climate variables exhibited heterogeneous spatial patterns over the study period, the overall impact of climate change on vegetation productivity was positive. We observed total increases in net primary productivity (NPP) ranging from 20-150 g C m-2, based on linear regression analysis. We determined that increased summer relative humidity, increased annual precipitation and decreased mean maximum summer temperatures were key variables contributing to these positive trends, likely through a reduction in soil moisture stress (e.g., increased available water) and heat stress. Model simulations also illustrated an increase in annual drainage throughout the region of 20-140 mm yr-1, driven by substantial increases in annual precipitation. Evapotranspiration had a highly variable spatial trend over the 60-year period, with total change over the study period ranging between -100 and +100 mm yr-1. We also analyzed potential changes in plant functional type (PFT) distributions at the biome level, but hypothesize that the model may be unable to adequately capture competitive interactions among PFTs as well as the dynamics between upper and lower canopies consisting of trees, grasses and shrubs. An analysis of the bioclimatic envelopes for PFTs common to the region revealed no significant change to the boreal conifer tree climatic domain over the study

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

Science.gov (United States)

Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

The Citrus transcription factor, CitERF13, regulates citric acid accumulation via a protein-protein interaction with the vacuolar proton pump, CitVHA-c4.

Science.gov (United States)

Li, Shao-jia; Yin, Xue-ren; Xie, Xiu-lan; Allan, Andrew C; Ge, Hang; Shen, Shu-ling; Chen, Kun-song

2016-02-03

Organic acids are essential to fruit flavor. The vacuolar H(+) transporting adenosine triphosphatase (V-ATPase) plays an important role in organic acid transport and accumulation. However, less is known of V-ATPase interacting proteins and their relationship with organic acid accumulation. The relationship between V-ATPase and citric acid was investigated, using the citrus tangerine varieties 'Ordinary Ponkan (OPK)' and an early maturing mutant 'Zaoshu Ponkan (ZPK)'. Five V-ATPase genes (CitVHA) were predicted as important to citric acid accumulation. Among the genes, CitVHA-c4 was observed, using a yeast two-hybrid screen, to interact at the protein level with an ethylene response factor, CitERF13. This was verified using bimolecular fluorescence complementation assays. A similar interaction was also observed between Arabidopsis AtERF017 (a CitERF13 homolog) and AtVHA-c4 (a CitVHA-c4 homolog). A synergistic effect on citric acid levels was observed between V-ATPase proteins and interacting ERFs when analyzed using transient over-expression in tobacco and Arabidopsis mutants. Furthermore, the transcript abundance of CitERF13 was concomitant with CitVHA-c4. CitERF13 or AtERF017 over-expression leads to significant citric acid accumulation. This accumulation was abolished in an AtVHA-c4 mutant background. ERF-VHA interactions appear to be involved in citric acid accumulation, which was observed in both citrus and Arabidopsis.

Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers

Science.gov (United States)

Shipherd, Jillian C.; Kauth, Michael R.; Firek, Anthony F.; Garcia, Ranya; Mejia, Susan; Laski, Sandra; Walden, Brent; Perez-Padilla, Sonia; Lindsay, Jan A.; Brown, George; Roybal, Lisa; Keo-Meier, Colton L.; Knapp, Herschel; Johnson, Laura; Reese, Rebecca L.; Byne, William

2016-01-01

Abstract Purpose: The Veteran's Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program's structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network–Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge. PMID:29159298

VH gene expression and regulation in the mutant Alicia rabbit. Rescue of VHa2 allotype expression.

Science.gov (United States)

Chen, H T; Alexander, C B; Young-Cooper, G O; Mage, R G

1993-04-01

Rabbits of the Alicia strain, derived from rabbits expressing the VHa2 allotype, have a mutation in the H chain locus that has a cis effect upon the expression of VHa2 and VHa- genes. A small deletion at the most J-proximal (3') end of the VH locus leads to low expression of all the genes on the entire chromosome in heterozygous ali mutants and altered relative expression of VH genes in homozygotes. To study VH gene expression and regulation, we used the polymerase chain reaction to amplify the VH genes expressed in spleens of young and adult wild-type and mutant Alicia rabbits. The cDNA from reverse transcription of splenic mRNA was amplified and polymerase chain reaction libraries were constructed and screened with oligonucleotides from framework regions 1 and 3, as well as JH. Thirty-three VH-positive clones were sequenced and analyzed. We found that in mutant Alicia rabbits, products of the first functional VH gene (VH4a2), (or VH4a2-like genes) were expressed in 2- to 8-wk-olds. Expression of both the VHx and VHy types of VHa- genes was also elevated but the relative proportions of VHx and VHy, especially VHx, decreased whereas the relative levels of expression of VH4a2 or VH4a2-like genes increased with age. Our results suggest that the appearance of sequences resembling that of the VH1a2, which is deleted in the mutant ali rabbits, could be caused by alterations of the sequences of the rearranged VH4a2 genes by gene conversions and/or rearrangement of upstream VH1a2-like genes later in development.

75 FR 48412 - Proposed Information Collection (Six-Month Post-Exit Focus Interview of Former VHA Employees...

Science.gov (United States)

2010-08-10

... Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235... develop strategic objectives that will increase workforce recruitment and retention throughout VHA...

Midwest Clean Energy Application Center

Energy Technology Data Exchange (ETDEWEB)

Cuttica, John; Haefke, Cliff

2013-12-31

The Midwest Clean Energy Application Center (CEAC) was one of eight regional centers that promoted and assisted in transforming the market for combined heat and power (CHP), waste heat to power (WHP), and district energy (DE) technologies and concepts throughout the United States between October 1, 2009 and December 31, 2013. The key services the CEACs provided included: Market Opportunity Analyses – Supporting analyses of CHP market opportunities in diverse markets including industrial, federal, institutional, and commercial sectors. Education and Outreach – Providing information on the energy and non-energy benefits and applications of CHP to state and local policy makers, regulators, energy end-users, trade associations and others. Information was shared on the Midwest CEAC website: www.midwestcleanergy.org. Technical Assistance – Providing technical assistance to end-users and stakeholders to help them consider CHP, waste heat to power, and/or district energy with CHP in their facility and to help them through the project development process from initial CHP screening to installation. The Midwest CEAC provided services to the Midwest Region that included the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.

Flight Synchrony among the Major Moth Pests of Cranberries in the Upper Midwest, USA

Directory of Open Access Journals (Sweden)

Shawn A. Steffan

2017-02-01

Full Text Available The cranberry fruitworm (Acrobasis vaccinii Riley, sparganothis fruitworm (Sparganothis sulfureana Clemens, and blackheaded fireworm (Rhopobota naevana Hübner are historically significant pests of cranberries (Vaccinium macrocarpon Aiton in the Upper Midwest (Wisconsin, USA. Their respective natural histories are well documented but correlations between developmental benchmarks (e.g., larval eclosion and degree-day accruals are not yet known. Treatment timings are critical to the optimization of any given control tactic, and degree-day accrual facilitates optimization by quantifying the developmental status of pest populations. When key developmental benchmarks in the pest life cycle are linked to degree-days, real-time weather data can be used to predict precise treatment timings. Here, we provide the degree-day accumulations associated with discrete biological events (i.e., initiation of flight and peak flight for the three most consistent moth pests of cranberries in Wisconsin. Moths were trapped each spring and summer from 2003 to 2011. To characterize flight dynamics and average timing of flight initiation, pheromone-baited trap-catch data were tallied for all three pest species within each of seven growing seasons. These flight dynamics were then associated with the corresponding degree-day accumulations generated using the cranberry plant’s developmental thresholds. Finally, models were fit to the data in order to determine the peak flight of each species. The initiation of the spring flight among all three moth species was highly synchronous, aiding in the timing of control tactics; however, there were substantial differences in the timing of peak flight among the moth species. Characterization of the relationship between temperature and pest development allows pest management professionals to target specific life stages, improving the efficacy of any given pest control tactic.

Molecular characterization, light-dependent expression, and cellular localization of a host vacuolar-type H+-ATPase (VHA) subunit A in the giant clam, Tridacna squamosa, indicate the involvement of the host VHA in the uptake of inorganic carbon and its supply to the symbiotic zooxanthellae.

Science.gov (United States)

Ip, Yuen K; Hiong, Kum C; Lim, Leon J Y; Choo, Celine Y L; Boo, Mel V; Wong, Wai P; Neo, Mei L; Chew, Shit F

2018-06-15

The giant clam, Tridacna squamosa, represents a clam-zooxanthellae association. In light, the host clam and the symbiotic zooxanthellae conduct light-enhanced calcification and photosynthesis, respectively. We had cloned the cDNA coding sequence of a Vacuolar-type Proton ATPase (VHA) subunit A, ATP6V1A, from T. squamosa, whereby the VHA is an electrogenic transporter that actively 'pumps' H + out of the cell. The ATP6V1A of T. squamosa comprised 1866 bp, encoding a protein of 622 amino acids and 69.9 kDa, and had a host-origin. Its gene expression was strong in the ctenidium and the colorful outer mantle, but weak in the whitish inner mantle, corroborating a previous proposition that VHA might have a trivial role in light-enhanced calcification. Light exposure led to significant increases in the gene and protein expression levels of ATP6V1A/ATP6V1A in the ctenidium and the outer mantle. In the ctenidium, the ATP6V1A was localized in the apical epithelia of the filaments and tertiary water channels, indicating that the VHA could participate in the increased excretion of H + produced during light-enhanced calcification. Additionally, the excreted H + would augment HCO 3 - dehydration in the external medium and facilitate the uptake of CO 2 by the ctenidium during insolation. In the outer mantle, the ATP6V1A was detected in intracellular vesicles in a type of cells, presumably iridocytes, surrounding the zooxanthellal tubules, and in the apical epithelium of zooxanthellal tubules. Hence, the host VHA could participate in the transfer of inorganic carbon from the hemolymph to the luminal fluid of the tubules by increasing the supply of H + for the dehydration of HCO 3 - to CO 2 during insolation to benefit the photosynthesizing zooxanthellae. Copyright © 2018 Elsevier B.V. All rights reserved.

Is Miscanthus a High Risk Biofuel Feedstock Prospect for the Upper Midwest US?

Science.gov (United States)

Kucharik, C. J.; VanLoocke, A. D.

2011-12-01

Miscanthus is a highly productive C4 perennial rhizomatous grass that is native to Southeast Asia, but its potential as a feedstock for cellulosic biofuel in the Midwest US is intriguing given extremely high productivity for low amounts of agrochemical inputs. However, Miscanthus x giganteus, a key variety currently studied is not planted from seed, but rather from rhizomes planted at a soil depth of 5 to 10 cm. Therefore, it is costly to establish on the basis of both time and money, making it a potentially risky investment in geographic regions that experience cold wintertime temperatures that can effectively kill the crop. The 50% kill threshold for M. giganteus rhizomes occurs when soil temperatures fall below -3.5C, which may contribute to a high risk of improper establishment during the first few seasons. Our first objective here was to study a historical, simulated reconstruction of daily wintertime soil temperatures at high spatial resolution (5 min) across the Midwest US from 1948-2007, and use this information to quantify the frequency that lethal soil temperature thresholds for Miscanthus were reached. A second objective was to investigate how the use of crop residues could impact wintertime soil temperatures. In this study, a dynamic agroecosystem model (Agro-IBIS) that has been modified to simulate Miscanthus growth and phenology was used in conjunction with high-resolution datasets of soil texture and daily gridded weather data. Model simulations suggest that across the states of North and South Dakota, Nebraska, Minnesota, Wisconsin, Michigan, and the northern half of Iowa, the kill threshold of -3.5C at a 10cm soil depth was reached in 70-95% of the simulation years. A boundary representing a 50% likelihood of reaching -3.5C at 10cm depth in any given year runs approximately from east central Colorado, thought northern Kansas and Missouri, through central Illinois, central Indiana, and central Ohio. An analysis of monthly mean 10cm soil temperatures

A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model.

Science.gov (United States)

Luck, Jeff; Hagigi, Fred; Parker, Louise E; Yano, Elizabeth M; Rubenstein, Lisa V; Kirchner, JoAnn E

2009-09-28

Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.

A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model

Science.gov (United States)

2009-01-01

Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. PMID:19785754

Midwest regional management plan

International Nuclear Information System (INIS)

Paton, R.F.

1986-01-01

In response to the Low-Level Radioactive Waste Policy Act of 1980, the States of Indiana, Iowa, Michigan, Minnesota, Missouri, Ohio and Wisconsin formed the Midwest Interstate Low-Level Radioactive Waste Compact. One of the top priorities of the Compact Commission is the development of a comprehensive regional waste management plan. The plan consists of five major elements: (1) waste inventory; (2) waste stream projections; (3) analysis of waste management and disposal options; (4) development of a regional waste management system; and (5) selection of a host state(s) for future low-level waste facilities. When completed, the Midwest Management Plan will serve as the framework for future low-level radioactive waste management and disposal decisions

Management, operational, animal health, and economic characteristics of large dairy herds in 4 states in the Upper Midwest of the United States.

Science.gov (United States)

Evink, T L; Endres, M I

2017-11-01

Recent trends in dairy farm structure in the United States have included a decreasing number of farms, although farm size has increased, especially the share of milk production from very large herds (>2,500 cows). The objectives of this observational study were to describe common management practices; to characterize labor and operational structure; to measure some aspects of animal health, including lameness, hock lesions, mortality, and mastitis incidence; and to summarize cost of production on farms with more than 2,500 cows in 4 states in the Upper Midwest of the United States. The study included 15 dairy farms in Minnesota, Wisconsin, Iowa, and South Dakota. Farms were visited twice, once each year, and on-farm herd records were collected for those 2 yr. On-farm herd records were used to investigate mortality, culling, pregnancy rate, and clinical mastitis incidence. At least 1 high-producing pen of mature cows and 1 pen of fresh cows were scored for locomotion. Likewise, at least 1 pen of high-producing mature cows was scored for cleanliness and hock lesions. Median herd size was 3,975 cows (range = 2,606-13,266). Milk sold per employee was 1,120,745 kg and the number of cows per employee was 105. Eighty percent of the farms had Holstein cows, 13% had Jersey, and 7% had Jersey-Holstein crosses. All farms used artificial insemination as the sole form of breeding and 100% of the farms used hormonal synchronization or timed artificial insemination programs in their reproductive protocols; 21-d pregnancy rate was 21.7%. Median lameness prevalence was 18.3% and median severe lameness prevalence was 5.1%. Median hock lesion prevalence was 17.4% and median severe hock lesion prevalence was 1.9%; mortality rate was 7.4%. Clinical mastitis incidence was 62.5 cases per 100 cow-years. Feed costs accounted for approximately 53% of the total cost of producing milk, followed by labor at 11%, interest and depreciation expenses at 10%, and replacement costs at 9.5%. Herds in

Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

Science.gov (United States)

Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

2018-01-01

Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

Hepatitis C Virus (HCV) Registry Veterans in VHA Care in 2015, for the Nation, by VISN and by Station

Data.gov (United States)

Department of Veterans Affairs — This report describes the number of Hepatitis C Virus (HCV) registry Veterans in VHA care in 2015 based on serologic evidence of HCV infection status (HCV Positive)...

Climatic and hydrologic aspects of the 2008 Midwest floods

Science.gov (United States)

Budikova, D.; Coleman, J.; Strope, S. A.

2010-12-01

Between May and June 2008 the Midwest region of the United States (U.S.) experienced record flooding. The event was produced by distinct hydroclimatic conditions that included saturated antecedent soil moisture conditions and atmospheric circulation that guided moist air from the Gulf of Mexico into the area between late May and mid-June. The latter included a well-developed trough over the central/west U.S., a strong Great Plains Low Level Jet (GPLLJ), and unseasonably strong westerlies that promoted upper level divergence in regions of positive vorticity advection. The flooding coincided with a strongly negative phase of the North Atlantic Oscillation linked to the strength of the GPLLJ. The atmospheric flow contributed to flooding within three river basins across nine states. Iowa, southern Wisconsin, and central Indiana located within the Upper Mississippi River Basin (UMRB) and the Wabash River Basin were most impacted and also recorded the greatest anomalies in rainfall. Record rainfall, persistent multi-day precipitation events, high frequency of localized high-intensity rainfall events all contributed to the severity of the flooding. Conditions peaked between May 21 and June 13 when rain fell somewhere within the region each day. River discharge rates reached record levels in June at many locations; return periods throughout Iowa, southern Wisconsin and in central Indiana were estimated to exceed 100 years, and often times 200 years. Record river stage levels were observed during this time in similar areas. Conditions began to recover into July and August. The timing of occurrence of the precipitation and hydrological anomalies towards late spring and into early summer in the Midwest was rather unusual. The 2008 flood event occurred 15 years after the infamous 1993 event. The importance of its occurrence is underscored by the observed increasing trends in extreme and flood-related precipitation characteristics during the 20th century and the anticipated

An operations-partnered evaluation of care redesign for high-risk patients in the Veterans Health Administration (VHA): Study protocol for the PACT Intensive Management (PIM) randomized quality improvement evaluation.

Science.gov (United States)

Chang, Evelyn T; Zulman, Donna M; Asch, Steven M; Stockdale, Susan E; Yoon, Jean; Ong, Michael K; Lee, Martin; Simon, Alissa; Atkins, David; Schectman, Gordon; Kirsh, Susan R; Rubenstein, Lisa V

2018-06-01

Patient-centered medical homes have made great strides providing comprehensive care for patients with chronic conditions, but may not provide sufficient support for patients at highest risk for acute care use. To address this, the Veterans Health Administration (VHA) initiated a five-site demonstration project to evaluate the effectiveness of augmenting the VA's Patient Aligned Care Team (PACT) medical home with PACT Intensive Management (PIM) teams for Veterans at highest risk for hospitalization. Researchers partnered with VHA leadership to design a mixed-methods prospective multi-site evaluation that met leadership's desire for a rigorous evaluation conducted as quality improvement rather than research. We conducted a randomized QI evaluation and assigned high-risk patients to participate in PIM and compared them with high-risk Veterans receiving usual care through PACT. The summative evaluation examines whether PIM: 1) decreases VHA emergency department and hospital use; 2) increases satisfaction with VHA care; 3) decreases provider burnout; and 4) generates positive returns on investment. The formative evaluation aims to support improved care for high-risk patients at demonstration sites and to inform future initiatives for high-risk patients. The evaluation was reviewed by representatives from the VHA Office of Research and Development and the Office of Research Oversight and met criteria for quality improvement. VHA aims to function as a learning organization by rapidly implementing and rigorously testing QI innovations prior to final program or policy development. We observed challenges and opportunities in designing an evaluation consistent with QI standards and operations priorities, while also maintaining scientific rigor. This trial was retrospectively registered at ClinicalTrials.gov on April 3, 2017: NCT03100526. Protocol v1, FY14-17. Copyright © 2018 Elsevier Inc. All rights reserved.

Streamflow response to potential land use and climate changes in the James River watershed, Upper Midwest United States

Directory of Open Access Journals (Sweden)

Laurent Ahiablame

2017-12-01

Full Text Available Study region: North and South Dakotas, United States Study focus: Changes in watershed hydrology are mainly driven by changes in land use and climate. This study evaluated the impacts of climate and land use changes on streamflow in an agricultural watershed in the Upper Midwest. Three projected climate change scenarios (A1B, A2 and B1 of three general circulation models (CGCM3.1, GFDL-CM2.1, and HADCM3 were developed for mid (2046–2065 and end (2080–2099 of the 21st century. Corresponding land use maps for years 2055 and 2090 were obtained from the FOREcasting SCEnarios of Land-Cover (FORE-SCE model. The scenarios were designed in a way that land use was changed while climate conditions remain constant, land use was then held constant under a changing climate, and finally both land use and climate were changed simultaneously to reflect possible future land use and climate conditions. New hydrological insights for the region: Potential land use and climate changes would result in 12–18% % and 17–41% increases in annual streamflow, respectively, by end of the century. The combined effects of land use and climate changes would intensify future streamflow responses with 13–60% increases in the region. This study provides a broad perspective on plausible hydrologic alterations in the region, prompting individual and collective opportunities to engage with this topic for sustainable planning and management of watersheds. Keywords: Watershed modeling, Precipitation, Agricultural land, Grassland, Dakota, SWAT

75 FR 51996 - Notice of Commission Staff Attendance at Midwest ISO Meetings

Science.gov (United States)

2010-08-24

... Midwest ISO Meetings August 16, 2010. The Federal Energy Regulatory Commission hereby gives notice that members of the Commission and Commission staff may attend the following Midwest ISO-related meetings...., St. Paul, MN) [cir] September 15 [cir] October 20 [cir] November 17 [cir] December 1 Midwest ISO...

76 FR 4104 - Notice of Commission Staff Attendance at Midwest ISO Meetings

Science.gov (United States)

2011-01-24

... Midwest ISO Meetings January 13, 2011. The Federal Energy Regulatory Commission hereby gives notice that members of the Commission and Commission staff may attend the following Midwest ISO-related meetings...] September 14 [cir] October 19 [cir] November 16 [cir] December 6 Midwest ISO Informational Forum (3 p.m.-5 p...

75 FR 3228 - Notice of Commission Staff Attendance at Midwest ISO Meetings

Science.gov (United States)

2010-01-20

... Midwest ISO Meetings January 12, 2010. The Federal Energy Regulatory Commission hereby gives notice that members of the Commission and Commission staff may attend the following Midwest ISO-related meetings...] November 17 [cir] December 1 Midwest ISO Informational Forum (3 p.m.-5 p.m., ET) [cir] January 19 [cir...

Fuel-Cycle Fossil Energy Use and Greenhouse Gas Emissions of Fuel Ethanol Produced from U.S. Midwest Corn

Energy Technology Data Exchange (ETDEWEB)

Wang, Michael [Argonne National Lab. (ANL), Argonne, IL (United States); Saricks, Christoper [Argonne National Lab. (ANL), Argonne, IL (United States); Wu, May [Argonne National Lab. (ANL), Argonne, IL (United States)

1997-12-19

This study addresses two issues: (1) data and information essential to an informed choice about the corn-to-ethanol cycle are in need of updating, thanks to scientific and technological advances in both corn farming and ethanol production; and (2) generalized national estimates of energy intensities and greenhouse gas (GHG) production are of less relevance than estimates based specifically on activities and practices in the principal domestic corn production and milling region -- the upper Midwest.

Midwest Logging Firm Perspectives: Harvesting on Increasingly Parcelized Forestlands

Directory of Open Access Journals (Sweden)

Shorna Allred

2011-01-01

Full Text Available Loggers play a critical role in the sustainable production of wood and paper products, and harvesting activities contribute to economic health and viability of many Upper Midwest communities in the United States. If the logging sector is unable to procure wood efficiently and economically from an increasingly parcelized land base, the competitive ability of the forest industry could be jeopardized. Little is known about the functions of the logging sector related to the forest resource land base on which they depend, and it is imperative to improve our understanding of this important part of the forest industry. The purpose of this study was to determine prospective attitudes about the future of the logging industry and how trends in forestland parcelization and harvesting mechanization are impacting the logging industry, especially as it relates to smaller tracts of land.

Site development in the Central Midwest Compact Region

International Nuclear Information System (INIS)

Lash, T.R.

1986-01-01

Illinois and Kentucky, the two members of the Central Midwest Interstate Low-Level Radioactive Waste Compact, are well along in fulfilling their responsibility to provide new low-level radioactive waste (LLW) disposal capacity, which has been delegated to states and regions by federal law. The host state for facilities under the compact will be Illinois, and thus the focus of this paper is on Illinois' siting process. Illinois has both the statutory authority for LLW management and a cabinet-level agency, the Illinois Department of Nuclear Safety (IDNS), which has the responsibility for implementing the state management act. Based on activities to date, the Central Midwest Region expects to meet the milestones established by the federal Low-Level Radioactive Waste Policy Amendments Act of 1985. Illinois, however, cannot take further progress toward managing and disposing of our LLW for granted. IDNS and the Central Midwest Compact Commission (CMCC) must continue vigorously to press ahead to assure timely development of new disposal capacity. This paper provides background information on (1) the laws under which new facilities will be established in the Central Midwest Region, (2) the activities of IDNS and CMCC, and (3) planned activities by both IDNS and the CMCC

Selling from Ontario into the U.S. midwest

International Nuclear Information System (INIS)

Green, B.

2002-01-01

The market structure of the Midwest Independent System Operator (MISO) for the electric power grid was described with reference to physical bilateral markets, multi-control areas, and MISO services such as security coordination, congestion management, billing, generator interconnections, tariff administration, energy imbalance, market monitoring, and electronic scheduling. The drivers impacting MISO development include MISO-PJM-SPP common market initiative, the FERC Standard Market Design initiative, the integration of alliance companies with MISO, and the division of functional responsibilities between RTOs and ITCs. The characteristics of the Michigan market were described, along with participation in the midwest (Ohio and Michigan) wholesale and retail markets. It was noted that in order for Ontario to sell to the midwest, the Ontario market design would need a successful export bid each hour to get power out of the province. Sales of ancillary services from Ontario-based generation are not permitted in the initial Ontario market design. Energy and transmission is currently bundled in Ontario tariffs. 1 fig

Selling from Ontario into the U.S. midwest

Energy Technology Data Exchange (ETDEWEB)

Green, B. [Ontario Power Generation Inc., Toronto, ON (Canada)

2002-07-01

The market structure of the Midwest Independent System Operator (MISO) for the electric power grid was described with reference to physical bilateral markets, multi-control areas, and MISO services such as security coordination, congestion management, billing, generator interconnections, tariff administration, energy imbalance, market monitoring, and electronic scheduling. The drivers impacting MISO development include MISO-PJM-SPP common market initiative, the FERC Standard Market Design initiative, the integration of alliance companies with MISO, and the division of functional responsibilities between RTOs and ITCs. The characteristics of the Michigan market were described, along with participation in the midwest (Ohio and Michigan) wholesale and retail markets. It was noted that in order for Ontario to sell to the midwest, the Ontario market design would need a successful export bid each hour to get power out of the province. Sales of ancillary services from Ontario-based generation are not permitted in the initial Ontario market design. Energy and transmission is currently bundled in Ontario tariffs. 1 fig.

Challenges with modifications of the McClean Lake mill to process midwest ore

International Nuclear Information System (INIS)

Nguyen, T.T.; Backham, L.

2010-01-01

Midwest is a unique uranium deposit with exceptionally high arsenic content. The ore body is located 17 km west of the McClean Lake operation. The McClean Lake mill will be modified to process Midwest ore and handle solid wastes from the Midwest water treatment plant. This paper describes the modifications required of the McClean Lake mill, process challenges associated with treatment of the arsenic, and the possibility of recovering nickel and cobalt as a by-product. It also reviews the complexity in the design of the Midwest water treatment facility which incorporates reverse osmosis technology with conventional physical-chemical water treatment. (author)

Demographic characteristics associated with homelessness and risk among female and male veterans accessing VHA outpatient care.

Science.gov (United States)

Montgomery, Ann Elizabeth; Dichter, Melissa E; Thomasson, Arwin M; Fu, Xiaoying; Roberts, Christopher B

2015-01-01

This study explored demographic influences on veterans' reports of homelessness or imminent risk of homelessness with a particular focus on gender. We analyzed data for a cohort of veterans who responded to the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA) universal screener for homelessness and risk during a 3-month period. Multinomial mixed effects models-stratified by gender-predicted veterans' reports of homelessness or risk based on age, race, marital status, and receipt of VA compensation. The proportion of positive screens-homelessness or risk-was 2.7% for females and 1.7% for males. Women more likely to report being at risk of homelessness were aged 35 to 54 years, Black, and unmarried; those more likely to experience homelessness were Black and unmarried. Among male veterans, the greatest predictors of both homelessness and risk were Black race and unmarried status. Among both genders, receiving VA disability compensation was associated with lesser odds of being homeless or at risk. The findings describe the current population of veterans using VHA health care services who may benefit from homelessness prevention or intervention services, identify racial differences in housing stability, and distinguish subpopulations who may be in particular need of intervention. Interventions to address these needs are described. Published by Elsevier Inc.

Tobacco direct mail marketing and smoking behaviors in a cohort of adolescents and young adults from the U.S. upper Midwest: a prospective analysis.

Science.gov (United States)

Choi, Kelvin; Forster, Jean

2014-06-01

We assessed the characteristics of adolescents and young adults who received tobacco direct mail materials and the association of receiving these materials with subsequent smoking behaviors. Adolescents from the upper Midwest region of the United States were sampled through clustered random sampling in 2000 and surveyed every 6 months. Participants (n = 3546) were asked at baseline (October 2006-March 2007) whether they had received direct mail materials from tobacco companies during the previous 6 months. Smoking behaviors were assessed 6 months later (April-September 2007). We assessed associations between demographics and receiving tobacco direct mail materials at baseline and the association of receiving these materials with smoking behaviors at follow-up, stratified by baseline smoking status. Overall, 5.2% of nonsmokers and 23.9% of current smokers in our sample received tobacco direct mail materials during the past 6 months (2.6% and 17.1% among nonsmokers and smokers smoked more cigarettes during the previous 30 days at follow-up (p smoked during the past 30 days at follow up (p marketing. Exposure to this market strategy is associated with faster escalation of cigarette consumption among nonsmokers and lower likelihood of smoking reduction among smokers in this adolescent and young adult sample.

MIDWEST PROGRAM ON AIRBORNE TELEVISION INSTRUCTION -- A REGIONAL EXPLORATION IN EDUCATION.

Science.gov (United States)

IVEY, JOHN E.; AND OTHERS

STARTING IN FEBRUARY 1961, THE MIDWEST PROGRAM ON AIRBORNE TELEVISION INSTRUCTION (MPATI) TRANSMITTED COURSES IN FOREIGN LANGUAGES, SCIENCE, ARITHMETIC, ART, THE HUMANITIES, MUSIC, SOCIAL STUDIES, AND INTERNATIONAL RELATIONS TO 18 SCHOOLS IN THE MIDWEST. THE AIRBORNE TELECAST OPERATED OVER NORTH CENTRAL INDIANA AND TRANSMITTED COURSES OVER AN AREA…

75 FR 3225 - Notice of Commission Staff Attendance at Organization of MISO States and Midwest ISO Meetings

Science.gov (United States)

2010-01-20

... Organization of MISO States and Midwest ISO Meetings January 12, 2010. The Federal Energy Regulatory Commission...: Midwest ISO Headquarters, 720 City Center Drive, Carmel, IN 46032. Except as otherwise noted above, the... Operator, Inc. Docket No. ER08-15, Midwest ISO Transmission Owners Docket No. ER08-55, Midwest Independent...

Comparison of upper arm and forearm blood pressure.

Science.gov (United States)

Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

2008-11-01

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

A multivariate fall risk assessment model for VHA nursing homes using the minimum data set.

Science.gov (United States)

French, Dustin D; Werner, Dennis C; Campbell, Robert R; Powell-Cope, Gail M; Nelson, Audrey L; Rubenstein, Laurence Z; Bulat, Tatjana; Spehar, Andrea M

2007-02-01

The purpose of this study was to develop a multivariate fall risk assessment model beyond the current fall Resident Assessment Protocol (RAP) triggers for nursing home residents using the Minimum Data Set (MDS). Retrospective, clustered secondary data analysis. National Veterans Health Administration (VHA) long-term care nursing homes (N = 136). The study population consisted of 6577 national VHA nursing home residents who had an annual assessment during FY 2005, identified from the MDS, as well as an earlier annual or admission assessment within a 1-year look-back period. A dichotomous multivariate model of nursing home residents coded with a fall on selected fall risk characteristics from the MDS, estimated with general estimation equations (GEE). There were 17 170 assessments corresponding to 6577 long-term care nursing home residents. The increased odds ratio (OR) of being classified as a faller relative to the omitted "dependent" category of activities of daily living (ADL) ranged from OR = 1.35 for "limited" ADL category up to OR = 1.57 for "extensive-2" ADL (P canes, walkers, or crutches, or the use of wheelchairs increases the odds of being a faller (OR = 1.17, P falls in long-term care settings. The model incorporated an ADL index and adjusted for case mix by including only long-term care nursing home residents. The study offers clinicians practical estimates by combining multiple univariate MDS elements in an empirically based, multivariate fall risk assessment model.

Diversity in growth and expression pattern of PoHKT1 and PoVHA transporter genes under NaCl stress in Portulaca oleracea taxa

Directory of Open Access Journals (Sweden)

El-Bakatoushi R.

2016-01-01

Full Text Available Plant growth and the expression of two transporter genes; PoHKT1 and PoVHA transcripts in root and shoot tissues were studied under salt stress of three Portulaca oleracea s.l. taxa. The study showed no significant differences in ratios between root lengths in saline and non-saline treatments of the three taxa, which was correlated with a clear down-regulation of the PoHKT1 transcripts in the root after 150mM NaCl. All measured growth parameters except root length increased in P. oleraceae, decreased in P. granulatostellulata and remain unchanged after 100mM NaCl in P. nitida compared to control under saline conditions. The result was consistent with the type of taxon which had significant effect on the shoot length, number of leaves and dry weight (P< 0.05. All measured growth parameters except root length showed a significant negative correlation with the shoot fold change of PoHKT1 transcripts (r = -0.607, -0.693 and -0.657 respectively. The regulation of PoVHA in root and shoot tissues in the three taxa are significantly different. Under salt stress, both decreased uptake of Na+ into the cytosol by decreasing the expression of PoHKT1 and increased vascular compartmentalization ability of Na+ by inducing the expression of PoVHA seem to work more efficiently in P. oleraceae and P. nitida than in P. granulato-stellulata.

77 FR 60457 - Draft Midwest Wind Energy Multi-Species Habitat Conservation Plan Within Eight-State Planning...

Science.gov (United States)

2012-10-03

...-FF03E00000] Draft Midwest Wind Energy Multi-Species Habitat Conservation Plan Within Eight-State Planning... of comments pertaining to the development of the Midwest Wind Energy Multi-Species Habitat..., intend to prepare the Midwest Wind Energy Multi-Species Habitat Conservation Plan (MSHCP) under the...

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

Science.gov (United States)

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Occurrence of Coliform and Escherichia coli Contamination and Absence of Escherichia coli O157:H7 on Romaine Lettuce from Retail Stores in the Upper Midwest.

Science.gov (United States)

Greve, Josephine D; Zietlow, Mark S; Miller, Kevin M; Ellingson, Jay L E

2015-09-01

A total of 720 whole, romaine lettuce heads were purchased from retail locations in the Upper Midwest and assessed for coliform and Escherichia coli contamination and for the presence of E. coli O157:H7. During a 16-month period (August 2010 through December 2011), coliform and E. coli counts were enumerated on Petrifilm, and the presence of E. coli O157:H7 and the virulence gene eae was evaluated by real-time PCR (qPCR). Over half (400 of 720) of the lettuce samples were processed with an immunomagnetic separation step before the qPCR assay. All retail lettuce samples were negative for E. coli O157:H7 when tested with the R.A.P.I.D. LT qPCR targeting a region of the O-antigen, and only two (0.28%) were positive for the eae gene when tested with LightCycler qPCR. On Petrifilm, coliform counts of most lettuce samples (96.4%) were between lettuce samples (98.2%) were lettuce heads. These results contribute to the limited recorded data and understanding of microbial contamination of whole romaine lettuce heads purchased from retail locations, specifically revealing the absence of E. coli O157:H7 and low levels of contamination with coliforms and other E. coli strains.

Preparing tomorrow's transportation workforce : a Midwest summit.

Science.gov (United States)

2010-08-01

Preparing Tomorrows Transportation Workforce: A Midwest Summit, held April 2728, 2010, in Ames, Iowa, was one of several : regional transportation workforce development summits held across the United States in 2009 and 2010 as part of a coordin...

Assess and Adapt: Coordinated Ecoregional Forest Vulnerability Assessments Covering the Upper Midwest and Northeast in Support of Climate-informed Decision-making

Science.gov (United States)

Swanston, C.; Janowiak, M.; Handler, S.; Butler, P.; Brandt, L.; Iverson, L.; Thompson, F.; Ontl, T.; Shannon, D.

2016-12-01

Forest ecosystem vulnerability assessments are rapidly becoming an integral component of forest management planning, in which there is increasing public expectation that even near-term activities explicitly incorporate information about anticipated climate impacts and risks. There is a clear desire among forest managers for targeted assessments that address critical questions about species and ecosystem vulnerabilities while delivering this information in an accessible format. We developed the Ecosystem Vulnerability Assessment Approach (EVAA), which combines multiple quantitative models, expert elicitation from scientists and land managers, and a templated report structure oriented to natural resource managers. The report structure includes relevant information on the contemporary landscape, past climate, future climate projections, impact model results, and a transparent vulnerability assessment of species and ecosystems. We have used EVAA in seven ecoregional assessments covering 246 million acres of forestland across the upper Midwest and Northeast (www.forestadaptation.org; five published, two in review). We convened a panel of local forest ecology and management experts in each assessment area to examine projected climate effects on system drivers, stressors, and dominant species, as well as the current adaptive capacity of the major ecoregional forest ecosystems. The panels provided a qualitative assessment of the vulnerability of forest ecosystems to climate change over the next century. Over 130 authors from dozens of organizations collaborated on these peer-reviewed assessment publications, which are delivered to thousands of stakeholders through live and recorded webinars, online briefs, and in-person trainings and seminars. The assessments are designed to be used with the Adaptation Workbook (www.adaptationworkbook.org), a planning tool that works at multiple scales and has generated more than 200 real-world forest adaptation demonstration projects.

Midwest Transmission Workshop II Summary

Energy Technology Data Exchange (ETDEWEB)

Kevin Bryan

2002-12-05

OAK-B135 After introductions of all participants, Abby Arnold, RESOLVE, reviewed the purpose of the meeting and the agenda. The purpose of the workshop was to share the results of the Midwest Independent System Operator (MISO) scenario development for wind and other fuel sources and the corresponding implications for transmission throughout the MISO control area. The workshop agenda is included in Attachment A.

The brazilian midwest and its economic transformations from 1970 to 2012

OpenAIRE

Haddad, Marcos Bittar; Pastre, Rafael

2016-01-01

The Midwest is the Brazilian region comprising the Central Highlands in the Country. It is the second least populated region of Brazil. Its vegetation is predominantly composed of the Cerrado ecosystem and the region holds important fresh water reserve and focuses the headwaters of rivers belonging to the main river basins of South America. Politically, the Midwest is the seat of the national political administrative decisions, housing the Federal District. Economically, after the decline of ...

Integrating climate change into northeast and midwest State Wildlife Action Plans

Science.gov (United States)

Staudinger, Michelle D.; Morelli, Toni Lyn; Bryan, Alexander

2015-01-01

The Department of Interior Northeast Climate Science Center (NE CSC) conducts research that responds to the regional natural resource management community’s needs to anticipate, monitor, and adapt to climate change. The NE CSC is supported by a consortium of partners that includes the University of Massachusetts Amherst, College of Menominee Nation, Columbia University, Marine Biological Laboratory, University of Minnesota, University of Missouri Columbia, and University of Wisconsin. The NE CSC also engages and collaborates with a diversity of other federal, state, academic, tribal, and non-governmental organizations (NGOs) to conduct collaborative, stakeholder-driven, and climate-focused work. The State Wildlife Action Plans (SWAPs) are revised every 10 years; states are currently working towards a target deadline of October 2015. SWAP coordinators have been challenged to incorporate climate change impacts and species responses into their current revisions. This synthesis is intended to inform the science going into Northeast and Midwest SWAPs across the 22 NE CSC states ranging from Maine to Virginia, and Minnesota and Missouri in the eastern United States. It is anticipated that this synthesis will help guide SWAP authors in writing specific sections, help revise and finalize existing sections, or be incorporated as an appendix or addendum. The purpose of this NE CSC-led cooperative report is to provide a synthesis of what is known and what is uncertain about climate change and its impacts across the NE CSC region, with a particular focus on the responses and vulnerabilities of Regional Species of Greatest Conservation Need (RSGCN) and the habitats they depend on. Another goal is to describe a range of climate change adaptation approaches, processes, tools, and potential partnerships that are available to State natural resource managers across the Northeast and Midwest regions of the United States. Through illustrative case studies submitted by the NE CSC and

The impact of expanding Canadian gas imports in the U.S. Midwest

International Nuclear Information System (INIS)

Parker, S.

2000-01-01

The new competitive natural gas market in the U. S. Midwest is surveyed from an interstate pipeline point of view, taking into account Canadian gas imports, increase in Rocky Mountain imports competing with Canadian imports, the flow dynamics in the Midwest market, supply basin production trends, the infrastructure improvements in local distribution companies, improvements in storage facilities, and the growing demand for natural gas-fired generation

The Ideological Foundations of Midwest Rural Education.

Science.gov (United States)

Theobald, Paul

A relationship exists between agrarian thought and the practice of formal schooling in the rural Midwest. Three traditions have shaped agrarian thinking about democracy and its application to social institutions, especially education. Fundamentalism, localism, and pastoralism have combined to form the ideological base for rural resistance to…

Assessment of waste characteristics and waste management practices for the Midwest Compact Region: Regional Management Plan

International Nuclear Information System (INIS)

1986-01-01

This report has described how the Midwest Compact region's low-level radioactive waste characteristics were determined and has provided assessments of several key characteristics of the waste. Sources of the data used and comments on the validity and uncertainty of both the raw information and the region-wide estimates that have been generated are indicated. The contents and organization of the computerized Midwest Data Base are also presented. This data base is a resource for rational development of the Midwest Compact's Regional Management Plan. The value of the level of detail contained in Midwest Data Base is demonstrated in its use to analyze the viability of LLW treatment alternatives in other aspects of the regional management plan (RAE86). 10 refs., 7 figs., 13 tabs

The evaporation from ponds in the French Midwest

Directory of Open Access Journals (Sweden)

Mohammad AL DOMANY

2013-12-01

Full Text Available This research shows the results of a study about evaporation in five ponds in the Midwest of France. To realize this study we used climate data from the meteorological station of the Limoges-Bellegarde airport and the data of a weather station installed by us near one of the ponds. We used eight different methods to calculate the evaporation rate and we modified the Penman-Monteith method by replacing the air temperature by water temperature. To understand the role of ponds in water loss through evaporation, we proposed a hypothesis that says : if the pond did not exist, what results would we get? Based on this hypothesis we calculated the potential evapotranspiration rate taking into account the percentage of interception by vegetation. In conclusion, this study indicates that the ponds in the French Midwest present a gain of water

Data-base system for northern Midwest regional aquifer-system analysis

Science.gov (United States)

Kontis, A.L.; Mandle, Richard J.

1980-01-01

The U.S. Geological Survey is conducting a study of the Cambrian and Ordovician aquifer system of the northern Midwest as part of a national series of Regional Aquifer-Systems Analysis (RASA). An integral part of this study will be a simulation of the ground-water flow regime using the Geological Survey's three-dimensional finite-difference model. The first step in the modeling effort is the design and development of a systematic set of processes to facilitate the collection, evaluation, manipulation, and use of large quantities of information. A computerized data-base system to accomplish these goals has been completed for the northern Midwest RASA.

Biochemical conversions of lignocellulosic biomass for sustainable fuel-ethanol production in the upper Midwest

Science.gov (United States)

Brodeur-Campbell, Michael J.

Biofuels are an increasingly important component of worldwide energy supply. This research aims to understand the pathways and impacts of biofuels production, and to improve these processes to make them more efficient. In Chapter 2, a life cycle assessment (LCA) is presented for cellulosic ethanol production from five potential feedstocks of regional importance to the upper Midwest — hybrid poplar, hybrid willow, switchgrass, diverse prairie grasses, and logging residues — according to the requirements of Renewable Fuel Standard (RFS). Direct land use change emissions are included for the conversion of abandoned agricultural land to feedstock production, and computer models of the conversion process are used in order to determine the effect of varying biomass composition on overall life cycle impacts. All scenarios analyzed here result in greater than 60% reduction in greenhouse gas emissions relative to petroleum gasoline. Land use change effects were found to contribute significantly to the overall emissions for the first 20 years after plantation establishment. Chapter 3 is an investigation of the effects of biomass mixtures on overall sugar recovery from the combined processes of dilute acid pretreatment and enzymatic hydrolysis. Biomass mixtures studied were aspen, a hardwood species well suited to biochemical processing; balsam, a high-lignin softwood species, and switchgrass, an herbaceous energy crop with high ash content. A matrix of three different dilute acid pretreatment severities and three different enzyme loading levels was used to characterize interactions between pretreatment and enzymatic hydrolysis. Maximum glucose yield for any species was 70% of theoretical for switchgrass, and maximum xylose yield was 99.7% of theoretical for aspen. Supplemental β-glucosidase increased glucose yield from enzymatic hydrolysis by an average of 15%, and total sugar recoveries for mixtures could be predicted to within 4% by linear interpolation of the pure

77 FR 62535 - Hydro Aluminum North America, Inc., Midwest Region, Including On-Site Leased Workers From...

Science.gov (United States)

2012-10-15

... Aluminum North America, Inc., Midwest Region, Including On- Site Leased Workers From Employment Group, Aerotek, and Manpower, Kalamazoo, Michigan; Hydro Aluminum North America, Inc., Midwest Region, Including... Aluminum North America, Inc., Kalamazoo, Michigan. The subject worker group includes on-site leased workers...

2017 Midwest Zebrafish Meeting Report.

Science.gov (United States)

Sandquist, Elizabeth; Petersen, Sarah C; Smith, Cody J

2017-12-01

The 2017 Midwest Zebrafish meeting was held from June 16 to 18 at the University of Cincinnati, sponsored by the Cincinnati Children's Hospital Divisions of Developmental Biology, Molecular Cardiovascular Biology, and Gastroenterology, Hepatology, and Nutrition. The meeting, organized by Saulius Sumanas, Joshua Waxman, and Chunyue Yin, hosted >130 attendees from 16 different states. Scientific sessions were focused on morphogenesis, neural development, novel technologies, and disease models, with Steve Ekker, Stephen Potter, and Lila Solnica-Krezel presenting keynote talks. In this article, we highlight the results and emerging themes from the meeting.

Understanding the land-atmospheric interaction in drought forecast from CFSv2 for the 2011 Texas and 2012 Upper Midwest US droughts

Science.gov (United States)

Zhang, Y.; Roundy, J. K.; Ek, M. B.; Wood, E. F.

2015-12-01

Prediction and thus preparedness in advance of hydrological extremes, such as drought and flood events, is crucial for proactively reducing their social and economic impacts. In the summers of 2011 Texas, and 2012 the Upper Midwest, experienced intense droughts that affected crops and the food market in the US. It is expected that seasonal forecasts with sufficient skill would reduce the negative impacts through planning and preparation. However, the forecast skill from models such as Climate Forecast System Version 2 (CFSv2) from National Centers for Environmental Prediction (NCEP) is low over the US, especially during the warm season (Jun - Sep), which restricts their practical use for drought prediction. This study analyzes the processes that lead to premature termination of 2011 and 2012 US summer droughts in CFSv2 forecast resulting in its low forecast skill. Using the North American Land Data Assimilation System version 2 (NLDAS2) and Climate Forecast System Reanalysis (CFSR) as references, this study investigates the forecast skills of CFSv2 initialized at 00, 06, 12, 18z from May 15 - 31 (leads out to September) for each event in terms of land-atmosphere interaction, through a recently developed Coupling Drought Index (CDI), which is based on the Convective Triggering Potential-Humidity Index-soil moisture (CTP-HI-SM) classification of four climate regimes: wet coupling, dry coupling, transitional and atmospherically controlled. A recycling model is used to trace the moisture sources in the CFSv2 forecasts of anomalous precipitation, which lead to the breakdown of drought conditions and a lack of drought forecasting skills. This is then compared with tracing the moisture source in CFSR with the same recycling model, which is used as the verification for the same periods. This helps to identify the parameterization that triggered precipitation in CFSv2 during 2011 and 2012 summer in the US thus has the potential to improve the forecast skill of CSFv2.

CITGO Petroleum Corporation and PDV Midwest Refining, LLC Settlement

Science.gov (United States)

CITGO Petroleum Corporation and PDV Midwest Refining, LLC (collectively, CITGO) have agreed to pay a $1,955,000 civil penalty, perform environmental projects totaling more than $2 million, and spend an estimated $42 million in injunctive relief to resolve.

Reflections on the 34th Midwest Solid State Conference

International Nuclear Information System (INIS)

Feldman, B.J.

1987-01-01

The 34th Midwest Solid State Conference was held October 24 and 25, 1986 in St. Louis, Missouri. The topics covered included quantum wells, superlattices, tunneling current, periodicities in liquid crystals, nonlinear patterns in dendritic crystal growth, and current fluctuations in disordered metals

Outbreak of caprine abortion by Toxoplasma gondii in Midwest Brazil

Directory of Open Access Journals (Sweden)

Flávio Henrique Bravim Caldeira

2011-11-01

Full Text Available An outbreak of abortion by Toxoplasma gondii in goats on a farm in the Brazilian Midwest is reported. Gross lesions were not observed in seven aborted fetuses submitted to the Veterinary Pathology Laboratory, Federal University of Mato Grosso, for necropsy investigation. The main histologic lesions were mononuclear cell pneumonia and necrotizing encephalitis in varying degrees of intensity. PCR for Brucella abortus and Neospora caninum and aerobic cultures were negative in all cases. Antibody titles against T. gondii varying from 1:1024 to 1:32.768 were detected in serum samples from four aborted goats. Nested-PCR assay for T. gondii were positive in brain samples of all cases submitted. These findings indicate that T. gondii infection should be considered in the diagnosis of abortion in goats in Midwest Brazil.

The “Maya Express”: Floods in the U.S. Midwest

Science.gov (United States)

Dirmeyer, Paul A.; Kinter, James L.

2009-03-01

The 2008 floods in the U.S. Midwest culminated in severe river flooding, with many rivers in the region cresting at record levels during May and particularly June. Twenty-four people were killed and more than 140 were injured as a result of the floods. Nine states were affected: Illinois, Indiana, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin. In Iowa, 83 of the state's 99 counties were declared disaster areas. Cedar Rapids, Iowa, was among the cities hardest hit by flooding. At one point, water covered 1300 city blocks across 24 square kilometers, inundating 3900 homes and most of the city's infrastructure and municipal facilities. The flood, which also damaged the Midwest's corn and soybean crops, was presaged by unusually heavy snowpack the preceding winter and by anomalously heavy rainfall during the spring.

77 FR 52754 - Draft Midwest Wind Energy Multi-Species Habitat Conservation Plan Within Eight-State Planning Area

Science.gov (United States)

2012-08-30

...-FF03E00000] Draft Midwest Wind Energy Multi-Species Habitat Conservation Plan Within Eight-State Planning... our planning partners, intend to prepare the Midwest Wind Energy Multi-Species Habitat Conservation... decommissioning of wind energy facilities within all or portions of the eight-State planning area. Activities...

Animal welfare in cross-ventilated, compost-bedded pack, and naturally ventilated dairy barns in the upper Midwest.

Science.gov (United States)

Lobeck, K M; Endres, M I; Shane, E M; Godden, S M; Fetrow, J

2011-11-01

The objective of this cohort study was to investigate animal welfare in 2 newer dairy housing options in the upper Midwest, cross-ventilated freestall barns (CV) and compost-bedded-pack barns (CB), compared with conventional, naturally ventilated freestall barns (NV). The study was conducted on 18 commercial dairy farms, 6 of each housing type, in Minnesota and eastern South Dakota. The primary breed in all farms was Holstein; 1 CV and 1 NV herd had approximately 30% Jersey-Holstein crossbreds. All freestall herds used sand for bedding. Farms were visited 4 times (once in each season) between January and November 2008, and approximately 93% of all animals in each pen were visually scored on each visit. Outcome-based measurements of welfare (locomotion, hock lesions, body condition score, hygiene, respiration rates, mortality, and mastitis prevalence) were collected on each farm. Lameness prevalence (proportion of cows with locomotion score ≥3 on a 1 to 5 scale, where 1=normal and 5=severely lame) in CB barns (4.4%) was lower than that in NV (15.9%) and CV (13.1%) barns. Lameness prevalence was similar between CV and NV barns. Hock lesion prevalence (proportion of cows with a lesion score ≥2 on a 1 to 3 scale, where 1=normal, 2=hair loss, and 3=swelling) was lower in CB barns (3.8%) than in CV (31.2%) and NV barns (23.9%). Hygiene scores (1 to 5 scale, where 1=clean and 5=very dirty) were higher for CB (3.18) than CV (2.83) and NV (2.77) barns, with no differences between CV and NV barns. Body condition scores, respiration rates, mastitis prevalence, culling, and mortality rates did not differ among housing systems. The CV and NV barns were evaluated using the cow comfort index (proportion of cows lying down in a stall divided by all animals touching a stall) and the stall usage index (proportion of cows lying divided by all animals in the pen not eating). The CV barns tended to have greater cow comfort index (85.9%) than the NV barns (81.4%) and had greater

Survey of facility and management characteristics of large, Upper Midwest dairy herds clustered by Dairy Herd Improvement records.

Science.gov (United States)

Brotzman, R L; Döpfer, D; Foy, M R; Hess, J P; Nordlund, K V; Bennett, T B; Cook, N B

2015-11-01

A survey of management practices was conducted to investigate potential associations with groupings of herds formed by cluster analysis (CA) of Dairy Herd Improvement (DHI) data of 557 Upper Midwest herds of 200 cows or greater. Differences in herd management practices were identified between the groups, despite underlying similarities; for example, freestall housing and milking in a parlor. Group 6 comprised larger herds with a high proportion of primiparous cows and most frequently utilized practices promoting increased production [e.g., 84.4% used recombinant bovine somatotropin (rbST)], decreased lameness (e.g., 96.9% used routine hoof trimming for cows), and improved efficiency in reproduction [e.g., 93.8% synchronized the first breeding in cows (SYNCH)] and labor (e.g., mean ± SD, 67 ± 19 cows per 50-h per week full-time equivalent worker). Group 1 had the best mean DHI performances and followed most closely group 6 for the rate of adoption of intensive management practices while tending to outperform group 6 despite a generally smaller mean herd size (e.g., 42.3 ± 3.6 kg vs. 39.9 ± 3.6 kg of energy-corrected milk production; 608 ± 352 cows vs. 1,716 ± 1,405 cows). Group 2 were smaller herds with relatively high levels of performance that used less intensive management (e.g., 100% milked twice daily) and less technology (33.3 vs. 73.0% of group 1 used rbST). Group 4 were smaller but poorer-performing herds with low turnover and least frequently used intensive management practices (e.g., 39.1% SYNCH; 30.4% allowed mature, high-producing cows access to pasture). Group 5 used modern technologies and practices associated with improved production, yet had the least desirable mean DHI performance of all 6 groups. This group had the lowest proportion of deep loose-bedded stalls (only 52.2% used sand bedding) and the highest proportion (34.8%) of herds not using routine hoof trimming. The survey of group 3 herds did not reveal strong trends in management. The

Methodologies Used by Midwest Region States for Studying Teacher Supply and Demand. Issues & Answers. REL 2009-080

Science.gov (United States)

Lindsay, James J.; Wan, Yinmei; Gossin-Wilson, Will

2009-01-01

This report describes how state education agencies in the Midwest Region monitor teacher supply, demand, and shortage; details why they monitor these data; and offers estimates of the monetary costs incurred in performing such studies. This study responds to a request from state education agencies in the Midwest Region (Illinois, Indiana, Iowa,…

Plans for dealing with loss of access to the Midwest Compact Regional Disposal Facility: Regional Management Plan

International Nuclear Information System (INIS)

1986-01-01

This report describes events that could lead to the premature closure of a disposal facility and the prospects that the closed facility could eventually be reopened. Possible courses of action leading to disposal outside the Midwest region while the Midwest Compact works to reestablish a regional disposal capability are also discussed. A likely division of responsibilities between the Compact Commission and the individual member states, with emphasis on managing low-level waste after a loss of access when disposal outside the Midwest is not possible is presented. Key elements in an agreement between compacts to accept each other's waste when one compact has experienced an unexpected interruption of its disposal operation are described

Funding Models of Community Colleges in 10 Midwest States

Science.gov (United States)

Kenton, Carol Piper; Schuh, John H.; Huba, Mary E.; Shelley, Mack C., II

2004-01-01

The extent to which community colleges in 10 Midwest states relied on 12 current funds revenue sources between 1990 and 2000 is presented in this study. Four models of funding were identified and evaluated. All models generated revenue in excess of the change in the Higher Education Price Index (HEPI), a measure of inflation over the period…

Adapting to warmer climate through prolonged maize grain filling period in the US Midwest

Science.gov (United States)

Zhu, P.; Zhuang, Q.; Jin, Z.

2017-12-01

Climate warming is expected to negatively impact the US food productivity. How to adapt to the future warmer environment and meet the rising food requirement becomes unprecedented urgent. Continuous satellite observational data provides an opportunity to examine the historic responses of crop plants to climate variation. Here 16 years crop growing phases information across US Midwest is generated based on satellite observations. We found a prolonged grain-filling period during 2000-2015, which could partly explain the increasing trend in Midwest maize yield. This longer grain-filling period might be resulted from the adoption of longer maturity group varieties or more resistant varieties to temperature variation. Other management practice changes like advance in planting date could be also an effective way of adapting future warmer climate through lowering the possibility of exposure to heat and drought stresses. If the progress in breeding technology enables the maize grain-filling period to prolong with the current rate, the maize grain filling length could be longer and maize yield in Midwest could adapt to future climate despite of the warming.

Selecting the recommended waste management system for the midwest compact

International Nuclear Information System (INIS)

Sutherland, A.A.; Robertson, B.C.; Drobny, N.L.

1987-01-01

One of the early important steps in the evolution of a low-level waste Compact is the development of a Regional Management Plan. Part of the Regional Management Plan is a description of the waste management system that indicates what kinds of facilities that will be available within the compact's region. The facilities in the waste management system can include those for storage, treatment and disposal of low-level radioactive waste. The Regional Management Plan also describes the number of facilities that will be operated simultaneously. This paper outlines the development of the recommended waste management system for the Midwest Compact. It describes the way a data base on low-level radioactive waste from the Compact was collected and placed into a computerized data base management system, and how that data base was subsequently used to analyze various options for treatment and disposal of low-level radioactive waste within the Midwest Compact. The paper indicates the thought process that led to the definition of four recommended waste management systems. Six methods for reducing the volume of waste to be disposed of in the Midwest Compact were considered. Major attention was focused on the use of regional compaction or incineration facilities. Seven disposal technologies, all different from the shallow land burial currently practiced, were also considered for the waste management system. After evaluating the options available, the Compact Commissioners recommended four waste disposal technologies--above-ground vaults, below-ground vaults, concrete canisters placed above ground, and concrete canisters placed below ground--to the host state that will be chosen in 1987. The Commissioners did not recommend use of a regional waste treatment facility

76 FR 63991 - Midwest Rail d/b/a Toledo, Lake Erie and Western Railway-Lease and Operation Exemption-Toledo...

Science.gov (United States)

2011-10-14

... provide common carrier rail service over the Line, connecting with and interchanging traffic with NSR, and... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35555] Midwest Rail d/b/a... Railway and Museum, Inc. Midwest Rail d/b/a Toledo, Lake Erie and Western Railway (Toledo), a noncarrier...

Organizational Contexts and Texts: The Redesign of the Midwest Bell Telephone Bill.

Science.gov (United States)

Keller-Cohen, Deborah

1987-01-01

Offers a retrospective view of organizational factors affecting the redesign of the Midwest Bell Telephone Bill. Shows how financial considerations, organizational time frame, and employee training and experience influenced the bill's development process. (MM)

Assessment of waste characteristics and waste management practices for the Midwest compact region:

International Nuclear Information System (INIS)

Sutherland, A.A.

1986-01-01

To define that system and optimize its components, it is necessary to know various characteristics of the LLW generated in the Midwest Compact Region. It must have projections for the annual volumes from the states in the compact to determine the size and lifetimes of waste management facilities. Information on the different volumes of the region's LLW that fall into NRC waste classes will help determine volumes of waste that may need separate disposal. Eventually, licensing a LLW disposal facility will require source terms /emdash/ quantities and concentrations of nuclides placed in the facility /emdash/ in order to conduct performance assessments. To provide the information needed to make informed decisions about the nature and size of the Midwest region's low-level waste management system, information was gathered from a number of sources. The information was placed in a computer data base to preserve it and to facilitate extracton of combinations of data. This report describes how the information was assembled and the nature of the computerized data base. It also provides a baseline characterization of the low-level waste being generated and shipped for disposal from the Midwest region in the late 1980's. 10 refs., 7 figs., 13 tabs

Mapping of sand deposition from 1993 midwest floods with electromagnetic induction measurements

International Nuclear Information System (INIS)

Kitchen, N.R.; Sudduth, K.A.; Drummond, S.T.

1996-01-01

Sand deposition on river-bottom farmland was extensive from the 1993 Midwest floods. A technique coupling electromagnetic induction (EM) ground conductivity sensing and Global Positioning System (GPS) location data was used to map sand deposition depth at four sites in Missouri along the Missouri River. A strong relationship between EM reading and probe measured depth of sand deposition (r 2 values between 0.73-0.94) was found. This relationship differed significantly between sites, so calibration by ground-truthing was required for each sand deposition survey. An example of the sand deposition mapping using the EM/GPS system is shown for two 50-60 ha (125-150 ac) sites. Such maps can provide valuable detailed information for developing restoration plans for land affected by 1993 Midwest floods. (author)

Midwest Superconductivity Consortium: 1994 Progress report

Energy Technology Data Exchange (ETDEWEB)

1995-01-01

The mission of the Midwest Superconductivity Consortium, MISCON, is to advance the science and understanding of high {Tc} superconductivity. During the past year, 27 projects produced over 123 talks and 139 publications. Group activities and interactions involved 2 MISCON group meetings (held in August and January); with the second MISCON Workshop held in August; 13 external speakers; 79 collaborations (with universities, industry, Federal laboratories, and foreign research centers); and 48 exchanges of samples and/or measurements. Research achievements this past year focused on understanding the effects of processing phenomena on structure-property interrelationships and the fundamental nature of transport properties in high-temperature superconductors.

Midwest Superconductivity Consortium: 1994 Progress report

International Nuclear Information System (INIS)

1995-01-01

The mission of the Midwest Superconductivity Consortium, MISCON, is to advance the science and understanding of high T c superconductivity. During the past year, 27 projects produced over 123 talks and 139 publications. Group activities and interactions involved 2 MISCON group meetings (held in August and January); with the second MISCON Workshop held in August; 13 external speakers; 79 collaborations (with universities, industry, Federal laboratories, and foreign research centers); and 48 exchanges of samples and/or measurements. Research achievements this past year focused on understanding the effects of processing phenomena on structure-property interrelationships and the fundamental nature of transport properties in high-temperature superconductors

Geographic Constructions of Race: The Midwest Asian American Students Union

Science.gov (United States)

Kodama, Corinne M.; Poon, OiYan A.; Manzano, Lester J.; Sihite, Ester U.

2017-01-01

This case study was focused on the establishment of the Midwest Asian American Students Union (MAASU) as a racial project reflecting students' articulations of a regional, panethnic identity in response to racism. A critical race theory lens was used to analyze interviews with 13 MAASU founders. Findings highlight the role of social context (in…

Structural-equation models of migration: an example from the Upper Midwest USA.

Science.gov (United States)

Cadwallader, M

1985-01-01

"To date, most migration models have been specified in terms of a single equation, whereby a set of regional characteristics are used to predict migration rates for various kinds of spatial units. These models are inadequate in at least two respects. First, they omit any causal links between the explanatory variables, thus ignoring indirect effects between these variables and migration. Second, they ignore the possibility of reciprocal causation, or feedback effects, between migration and the explanatory variables...." The author uses data for State Economic Areas to construct a path model and simultaneous-equation model to identify both indirect and feedback effects on migration in the Upper Midwestern United States. "On the basis of the path model, it is suggested that the direct effects of many variables on migration are at least partially offset by the indirect effects, whereas the simultaneous-equation model emphasizes the reciprocal relationship between income and migration." excerpt

Development of a socketed foundation for the Midwest Weak Post (MWP) v1.

Science.gov (United States)

2014-07-01

A socketed foundation was designed and evaluated for use with the Midwest Weak Post (MWP), Version 1. : Dynamic component testing was conducted on five different design configurations with varying embedment : depths, steel reinforcement, and soil con...

Drivers of Change in Managed Water Resources: Modeling the Impacts of Climate and Socioeconomic Changes Using the US Midwest as a Case Study

Energy Technology Data Exchange (ETDEWEB)

Voisin, Nathalie; Leung, Lai-Yung R.; Hejazi, Mohamad I.

2016-08-01

A global integrated assessment model including a water-demand model driven by socio-economics, is coupled in a one-way fashion with a land surface hydrology – routing – water resources management model. The integrated modeling framework is applied to the U.S. Upper Midwest (Missouri, Upper Mississippi, and Ohio) to advance understanding of the regional impacts of climate and socio-economic changes on integrated water resources. Implications for future flow regulation, water supply, and supply deficit are investigated using climate change projections with the B1 and A2 emission scenarios, which affect both natural flow and water demand. Changes in water demand are driven by socio-economic factors, energy and food demands, global markets and prices. The framework identifies the multiple spatial scales of interactions between the drivers of changes (natural flow and water demand) and the managed water resources (regulated flow, supply and supply deficit). The contribution of the different drivers of change are quantified regionally, and also evaluated locally, using covariances. The integrated framework shows that water supply deficit is more predictable over the Missouri than the other regions in the Midwest. The predictability of the supply deficit mostly comes from long term changes in water demand although changes in runoff has a greater contribution, comparable to the contribution of changes in demand, over shorter time periods. The integrated framework also shows that spatially, water demand drives local supply deficit. Using elasticity, the sensitivity of supply deficit to drivers of change is established. The supply deficit is found to be more sensitive to changes in runoff than to changes in demand regionally. It contrasts with the covariance analysis that shows that water demand is the dominant driver of supply deficit over the analysed periods. The elasticity indicates the level of mitigation needed to control the demand in order to reduce the

A data library management system for midwest FreightView and its data repository.

Science.gov (United States)

2011-03-01

Midwest FreightView (MWFV) and its associated data repository is part of a large multifaceted : effort to promote regional economic development throughout the Great Lakes : system. The main objective for the system is to promote sustainable maritime ...

Midwest Nuclear Science and Engineering Consortium

International Nuclear Information System (INIS)

Volkert, Wynn; Kumar, Arvind; Becker, Bryan; Schwinke, Victor; Gonzalez, Angel; McGregor, Douglas

2010-01-01

The objective of the Midwest Nuclear Science and Engineering Consortium (MNSEC) is to enhance the scope, quality and integration of educational and research capabilities of nuclear sciences and engineering (NS/E) programs at partner schools in support of the U.S. nuclear industry (including DOE laboratories). With INIE support, MNSEC had a productive seven years and made impressive progress in achieving these goals. Since the past three years have been no-cost-extension periods, limited -- but notable -- progress has been made in FY10. Existing programs continue to be strengthened and broadened at Consortium partner institutions. The enthusiasm generated by the academic, state, federal, and industrial communities for the MNSEC activities is reflected in the significant leveraging that has occurred for our programs.

Midwest Superconductivity Consortium: 1995 Progress report

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-01-01

The mission of the Midwest Superconductivity Consortium, MISCON, is to advance the science and understanding of high Tc superconductivity. During the past year, 26 projects produced over 133 talks and 127 publications. Three Master`s Degrees and 9 Doctor`s of Philosophy Degrees were granted to students working on MISCON projects. Group activities and interactions involved 2 MISCON group meetings (held in January and July); the third MISCON Summer School held in July; 12 external speakers; 81 collaborations (with universities, industry, Federal laboratories, and foreign research centers); and 54 exchanges of samples and/or measurements. Research achievements this past year focused on understanding the effects of processing phenomena on structure-property interrelationships and the fundamental nature of transport properties in high-temp superconductors.

Midwest Nuclear Science and Engineering Consortium

Energy Technology Data Exchange (ETDEWEB)

Dr. Wynn Volkert; Dr. Arvind Kumar; Dr. Bryan Becker; Dr. Victor Schwinke; Dr. Angel Gonzalez; Dr. DOuglas McGregor

2010-12-08

The objective of the Midwest Nuclear Science and Engineering Consortium (MNSEC) is to enhance the scope, quality and integration of educational and research capabilities of nuclear sciences and engineering (NS/E) programs at partner schools in support of the U.S. nuclear industry (including DOE laboratories). With INIE support, MNSEC had a productive seven years and made impressive progress in achieving these goals. Since the past three years have been no-cost-extension periods, limited -- but notable -- progress has been made in FY10. Existing programs continue to be strengthened and broadened at Consortium partner institutions. The enthusiasm generated by the academic, state, federal, and industrial communities for the MNSEC activities is reflected in the significant leveraging that has occurred for our programs.

Midwest Superconductivity Consortium: 1995 Progress report

International Nuclear Information System (INIS)

1996-01-01

The mission of the Midwest Superconductivity Consortium, MISCON, is to advance the science and understanding of high Tc superconductivity. During the past year, 26 projects produced over 133 talks and 127 publications. Three Master's Degrees and 9 Doctor's of Philosophy Degrees were granted to students working on MISCON projects. Group activities and interactions involved 2 MISCON group meetings (held in January and July); the third MISCON Summer School held in July; 12 external speakers; 81 collaborations (with universities, industry, Federal laboratories, and foreign research centers); and 54 exchanges of samples and/or measurements. Research achievements this past year focused on understanding the effects of processing phenomena on structure-property interrelationships and the fundamental nature of transport properties in high-temp superconductors

Molecular Typing of Mycobacterium bovis from Cattle Reared in Midwest Brazil.

Directory of Open Access Journals (Sweden)

Ricardo César Tavares Carvalho

Full Text Available Mycobacterium bovis is the causative agent of bovine tuberculosis (BTB, the pathogen responsible for serious economic impact on the livestock sector. In order to obtain data on isolated M. bovis strains and assist in the control and eradication program for BTB, a cross sectional descriptive molecular epidemiology study in the Brazilian Midwest was conducted. Through spoligotyping and 24-loci MIRU-VNTR methods, 37 clinical isolates of M. bovis circulating in the region were analyzed, 10 isolated from the state of Mato Grosso, 12 from the state of Mato Grosso do Sul and 15 from the state of Goiás. The spoligotyping analysis identified 10 distinct M. bovis profiles (SB0121 n = 14, SB0295 n = 6, SB0140 n = 6, SB0881 n = 3, SB1144 n = 2, SB1145 n = 2, SB0134 n = 1, SB1050 n = 1, SB1055 n = 1, SB1136 n = 1 grouped in six clusters and four orphan patterns. The MIRU-VNTR 24-loci grouped the same isolates in six clusters and 22 unique orphan patterns, showing higher discriminatory power than spoligotyping. When associating the results of both techniques, the isolates were grouped in five clusters and 24 unique M. bovis profiles. Among the 24-loci MIRU-VNTR evaluated, two, ETR-A and QUB 11b loci, showed high discriminatory ability (h = ≥ 0.50, while MIRU 16, MIRU 27, ETR-B, ETR-C, Mtub21 and QUB 26 loci showed moderate ability (h = 0.33 or h = 0.49 and were the most effective in evaluating the genotypic similarities among the clinical M. bovis isolate samples. Herein, the 29 patterns found amongst the 37 isolates of M. bovis circulating in the Brazilian Midwest can be due to the animal movement between regions, municipalities and farms, thus causing the spread of various M. bovis strains in herds from Midwest Brazil.

NOAA predicts moderate flood potential in Midwest, elevated risk of ice

Science.gov (United States)

March 20, 2014 U.S. Spring Flood Risk Map for 2014. U.S. Spring Flood Risk Map for 2014. (Credit: NOAA moderate flood potential in Midwest, elevated risk of ice jams; California and Southwest stuck with drought minor or moderate risk of exceeding flood levels this spring with the highest threat in the southern

System reliability worth assessment at a midwest utility-survey results for residential customers

Energy Technology Data Exchange (ETDEWEB)

Chowdhury, A.A.; Mielnik, T.C. [Electric System Planning, MidAmerican Energy Company, Davenport, Iowa (United States); Lawton, L.E.; Sullivan, M.J.; Katz, A. [Population Research Systems, San Francisco, CA (United States)

2005-12-01

This paper presents the overall results of a residential customer survey conducted in service areas of MidAmerican Energy Company, a Midwest utility. A similar survey was conducted concurrently in the industrial, commercial and institutional sectors and the survey results are presented in a companion paper. The results of this study are compared with the results of other studies performed in the high cost areas of the US east and west coasts. This is the first ever study of this nature performed for the residential customers in the US Midwest region. Methodological differences in the study design compared to coastal surveys are discussed. Customer survey costing techniques can be categorized into three main groups: contingent valuation techniques, direct costing techniques and indirect costing techniques. Most customer surveys conducted by different organizations in the last two decades used a combination of all three techniques. The selection of a technique is mainly dependent on the type of customer being surveyed. In this MidAmerican study, contingent valuation techniques and an indirect costing technique have been used, as most consequences of power outages to residential users are related to inconvenience or disruption of housekeeping and leisure activities that are intangible in nature. The major contribution of this paper is that particulars of Midwest residential customers compared to residential customers of coastal utilities are noted and customer responses on power quality issues that are important to customers are summarized. (author)

Factors Affecting the Job Satisfaction of Latino/a Immigrants in the Midwest

Science.gov (United States)

Valdivia, Corinne; Flores, Lisa Y.

2012-01-01

This study examined the job satisfaction of 253 Latino/a newcomers in three rural communities in the Midwest. Specifically, the authors explored the effects of ethnic identity, Anglo acculturation, Latino/a acculturation, perceptions of the community (social relations, discrimination/racism, and language pressures), job tenure, work hours, and…

Recent Acceleration of the Terrestrial Hydrologic Cycle in the U.S. Midwest

Science.gov (United States)

Yeh, Pat J.-F.; Wu, Chuanhao

2018-03-01

Most hydroclimatic trend studies considered only a subset of water budget variables; hence, the trend consistency and a holistic assessment of hydrologic changes across the entire water cycle cannot be evaluated. Here we use a unique 31 year (1983-2013) observed data set in Illinois (a representative region of the U.S. Midwest), including temperature (T), precipitation (P), evaporation (E), streamflow (R), soil moisture, and groundwater level (GWL), to estimate the trends and their sensitivity to different data periods and lengths. Both the Mann-Kendall trend test and the least squares linear method identify trends in close agreement. Despite no clear trends during 1983-2013, increasing trends are found in P (8.73-9.05 mm/year), E (6.87-7.47 mm/year), and R (1.57-3.54 mm/year) during 1992-2013, concurrently with a pronounced warming trend of 0.029-0.037 °C/year. However, terrestrial water storageis decreased by -2.0 mm/year (mainly due to declining GWL), suggesting that the increased R is caused by increased surface runoff rather than baseflow. Monthly analyses identify warming trends for all months except winter. In summer, P (E) exhibits an increasing (decreasing) trend, leading to increasing R, soil moisture, GWL, and terrestrial water storage. Most trends estimated for different subperiods are found to be sensitive to data lengths and periods. Overall, this study provides an internally consistent observed evidence on the intensification of the hydrologic cycle in response to recent climate warming in U.S. Midwest, in agreement with and well supported by several recent studies consistently reporting the increased P, R and E over the Midwest and Mississippi River basin.

77 FR 12896 - Self-Regulatory Organizations; Midwest Clearing Corporation; Order Cancelling Clearing Agency...

Science.gov (United States)

2012-03-02

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66458; File No. 600-9] Self-Regulatory Organizations; Midwest Clearing Corporation; Order Cancelling Clearing Agency Registration February 24, 2012. I... Act provides that in the event any self- regulatory organization is no longer in existence or has...

Automated lidar-derived canopy height estimates for the Upper Mississippi River System

Science.gov (United States)

Hlavacek, Enrika

2015-01-01

Land cover/land use (LCU) classifications serve as important decision support products for researchers and land managers. The LCU classifications produced by the U.S. Geological Survey’s Upper Midwest Environmental Sciences Center (UMESC) include canopy height estimates that are assigned through manual aerial photography interpretation techniques. In an effort to improve upon these techniques, this project investigated the use of high-density lidar data for the Upper Mississippi River System to determine canopy height. An ArcGIS tool was developed to automatically derive height modifier information based on the extent of land cover features for forest classes. The measurement of canopy height included a calculation of the average height from lidar point cloud data as well as the inclusion of a local maximum filter to identify individual tree canopies. Results were compared to original manually interpreted height modifiers and to field survey data from U.S. Forest Service Forest Inventory and Analysis plots. This project demonstrated the effectiveness of utilizing lidar data to more efficiently assign height modifier attributes to LCU classifications produced by the UMESC.

Lipid catabolism of invertebrate predator indicates widespread wetland ecosystem degradation

Science.gov (United States)

Anteau, Michael J.; Afton, Alan D.

2011-01-01

Animals frequently undergo periods when they accumulate lipid reserves for subsequent energetically expensive activities, such as migration or breeding. During such periods, daily lipid-reserve dynamics (DLD) of sentinel species can quantify how landscape modifications affect function, health, and resilience of ecosystems. Aythya affinis (Eyton 1838; lesser scaup; diving duck) are macroinvertebrate predators; they migrate through an agriculturally dominated landscape in spring where they select wetlands with the greatest food density to refuel and accumulate lipid reserves for subsequent reproduction. We index DLD by measuring plasma-lipid metabolites of female scaup (n = 459) that were refueling at 75 spring migration stopover areas distributed across the upper Midwest, USA. We also indexed DLD for females (n = 44) refueling on a riverine site (Pool 19) south of our upper Midwest study area. We found that mean DLD estimates were significantly (P<0.05) less than zero in all ecophysiographic regions of the upper Midwest, and the greatest negative value was in the Iowa Prairie Pothole region (-31.6). Mean DLD was 16.8 at Pool 19 and was markedly greater than in any region of the upper Midwest. Our results indicate that females catabolized rather than stored lipid reserves throughout the upper Midwest. Moreover, levels of lipid catabolism are alarming, because scaup use the best quality wetlands available within a given stopover area. Accordingly, these results provide evidence of wetland ecosystem degradation across this large agricultural landscape and document affects that are carried-up through several trophic levels. Interestingly, storing of lipids by scaup at Pool 19 likely reflects similar ecosystem perturbations as observed in the upper Midwest because wetland drainage and agricultural runoff nutrifies the riverine habitat that scaup use at Pool 19. Finally, our results underscore how using this novel technique to monitor DLD, of a carefully selected sentinel

Lipid catabolism of invertebrate predator indicates widespread wetland ecosystem degradation.

Directory of Open Access Journals (Sweden)

Michael J Anteau

Full Text Available Animals frequently undergo periods when they accumulate lipid reserves for subsequent energetically expensive activities, such as migration or breeding. During such periods, daily lipid-reserve dynamics (DLD of sentinel species can quantify how landscape modifications affect function, health, and resilience of ecosystems. Aythya affinis (Eyton 1838; lesser scaup; diving duck are macroinvertebrate predators; they migrate through an agriculturally dominated landscape in spring where they select wetlands with the greatest food density to refuel and accumulate lipid reserves for subsequent reproduction. We index DLD by measuring plasma-lipid metabolites of female scaup (n = 459 that were refueling at 75 spring migration stopover areas distributed across the upper Midwest, USA. We also indexed DLD for females (n = 44 refueling on a riverine site (Pool 19 south of our upper Midwest study area. We found that mean DLD estimates were significantly (P<0.05 less than zero in all ecophysiographic regions of the upper Midwest, and the greatest negative value was in the Iowa Prairie Pothole region (-31.6. Mean DLD was 16.8 at Pool 19 and was markedly greater than in any region of the upper Midwest. Our results indicate that females catabolized rather than stored lipid reserves throughout the upper Midwest. Moreover, levels of lipid catabolism are alarming, because scaup use the best quality wetlands available within a given stopover area. Accordingly, these results provide evidence of wetland ecosystem degradation across this large agricultural landscape and document affects that are carried-up through several trophic levels. Interestingly, storing of lipids by scaup at Pool 19 likely reflects similar ecosystem perturbations as observed in the upper Midwest because wetland drainage and agricultural runoff nutrifies the riverine habitat that scaup use at Pool 19. Finally, our results underscore how using this novel technique to monitor DLD, of a carefully

Listening to rural Hispanic immigrants in the Midwest: a community-based participatory assessment of major barriers to health care access and use.

Science.gov (United States)

Cristancho, Sergio; Garces, D Marcela; Peters, Karen E; Mueller, Benjamin C

2008-05-01

Hispanic immigrants are increasingly residing in rural communities, including in the midwestern United States. Limitations in the ability of rural Hispanics to access and utilize health care contribute to patterns of poor health and health disparity. A conceptual model of "vulnerability" guides this community-based participatory assessment project designed to explore rural Hispanics' perceived barriers to accessing and utilizing health care. Findings from a series of 19 focus groups with 181 participants from three communities in the upper Midwest identified perceived barriers at the individual and health care system levels. The most commonly perceived barriers were the lack of and limitations in health insurance coverage, high costs of health care services, communication issues involving patients and providers, legal status/discrimination, and transportation concerns. Findings imply that these barriers could be addressed using multiple educational and health service delivery policy-related strategies that consider the vulnerable nature of this growing population.

77 FR 12898 - Self-Regulatory Organizations; Midwest Securities Trust Company; Order Cancelling Clearing Agency...

Science.gov (United States)

2012-03-02

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66461; File No. 600-7] Self-Regulatory Organizations; Midwest Securities Trust Company; Order Cancelling Clearing Agency Registration February 24, 2012... the event any self-regulatory organization is no longer in existence or has ceased to do business in...

Biophysical impacts of climate-smart agriculture in the Midwest United States.

Science.gov (United States)

Bagley, Justin E; Miller, Jesse; Bernacchi, Carl J

2015-09-01

The potential impacts of climate change in the Midwest United States present unprecedented challenges to regional agriculture. In response to these challenges, a variety of climate-smart agricultural methodologies have been proposed to retain or improve crop yields, reduce agricultural greenhouse gas emissions, retain soil quality and increase climate resilience of agricultural systems. One component that is commonly neglected when assessing the environmental impacts of climate-smart agriculture is the biophysical impacts, where changes in ecosystem fluxes and storage of moisture and energy lead to perturbations in local climate and water availability. Using a combination of observational data and an agroecosystem model, a series of climate-smart agricultural scenarios were assessed to determine the biophysical impacts these techniques have in the Midwest United States. The first scenario extended the growing season for existing crops using future temperature and CO2 concentrations. The second scenario examined the biophysical impacts of no-till agriculture and the impacts of annually retaining crop debris. Finally, the third scenario evaluated the potential impacts that the adoption of perennial cultivars had on biophysical quantities. Each of these scenarios was found to have significant biophysical impacts. However, the timing and magnitude of the biophysical impacts differed between scenarios. © 2014 John Wiley & Sons Ltd.

76 FR 49762 - FirstEnergy Service Co. v. Midwest Independent Transmission System Operator, Inc.; Notice of...

Science.gov (United States)

2011-08-11

... declaratory order asking that the Commission declare that Multi-Value Project (MVP) transmission usage charges... unreasonable to apply MVP transmission usage charges to FirstEnergy or its customers migrated from the Midwest...

77 FR 24950 - Midwest Independent Transmission, System Operator, Inc.; Supplemental Notice of Technical Conference

Science.gov (United States)

2012-04-26

... Conference. The Midwest Independent Transmission System Operator, Inc. (MISO) and/or Potomac Economics, Inc... that is less than 50 percent of the applicable Reference Level. Provide a justification for this... committed? Please explain. b. Can units committed based on economics in the SCUC and SCED processes be...

Status of neotropical migrant landbirds in the Midwest: identifying species of management concern

Science.gov (United States)

Frank R. Thompson; Stephen J. Lewis; Janet D. Green; David N. Ewert

1993-01-01

We ranked species of neotropical migrant landbirds by decreasing management concern for their viability in the Midwest. This was part of a coordinated effort by regional working groups of the Partners In Flight Program, an interagency program for the conservation of neotropical migratory birds (NTMBs). Species were ranked by seven criteria, developed by working group...

Regional effects of agricultural conservation practices on nutrient transport in the Upper Mississippi River Basin

Science.gov (United States)

Garcia, Ana Maria.; Alexander, Richard B.; Arnold, Jeffrey G.; Norfleet, Lee; White, Michael J.; Robertson, Dale M.; Schwarz, Gregory E.

2016-01-01

Despite progress in the implementation of conservation practices, related improvements in water quality have been challenging to measure in larger river systems. In this paper we quantify these downstream effects by applying the empirical U.S. Geological Survey water-quality model SPARROW to investigate whether spatial differences in conservation intensity were statistically correlated with variations in nutrient loads. In contrast to other forms of water quality data analysis, the application of SPARROW controls for confounding factors such as hydrologic variability, multiple sources and environmental processes. A measure of conservation intensity was derived from the USDA-CEAP regional assessment of the Upper Mississippi River and used as an explanatory variable in a model of the Upper Midwest. The spatial pattern of conservation intensity was negatively correlated (p = 0.003) with the total nitrogen loads in streams in the basin. Total phosphorus loads were weakly negatively correlated with conservation (p = 0.25). Regional nitrogen reductions were estimated to range from 5 to 34% and phosphorus reductions from 1 to 10% in major river basins of the Upper Mississippi region. The statistical associations between conservation and nutrient loads are consistent with hydrological and biogeochemical processes such as denitrification. The results provide empirical evidence at the regional scale that conservation practices have had a larger statistically detectable effect on nitrogen than on phosphorus loadings in streams and rivers of the Upper Mississippi Basin.

Regional Effects of Agricultural Conservation Practices on Nutrient Transport in the Upper Mississippi River Basin.

Science.gov (United States)

García, Ana María; Alexander, Richard B; Arnold, Jeffrey G; Norfleet, Lee; White, Michael J; Robertson, Dale M; Schwarz, Gregory

2016-07-05

Despite progress in the implementation of conservation practices, related improvements in water quality have been challenging to measure in larger river systems. In this paper we quantify these downstream effects by applying the empirical U.S. Geological Survey water-quality model SPARROW to investigate whether spatial differences in conservation intensity were statistically correlated with variations in nutrient loads. In contrast to other forms of water quality data analysis, the application of SPARROW controls for confounding factors such as hydrologic variability, multiple sources and environmental processes. A measure of conservation intensity was derived from the USDA-CEAP regional assessment of the Upper Mississippi River and used as an explanatory variable in a model of the Upper Midwest. The spatial pattern of conservation intensity was negatively correlated (p = 0.003) with the total nitrogen loads in streams in the basin. Total phosphorus loads were weakly negatively correlated with conservation (p = 0.25). Regional nitrogen reductions were estimated to range from 5 to 34% and phosphorus reductions from 1 to 10% in major river basins of the Upper Mississippi region. The statistical associations between conservation and nutrient loads are consistent with hydrological and biogeochemical processes such as denitrification. The results provide empirical evidence at the regional scale that conservation practices have had a larger statistically detectable effect on nitrogen than on phosphorus loadings in streams and rivers of the Upper Mississippi Basin.

Evaluation and analysis of Texas biofuel supply chains originating in the United States Midwest and Brazil.

Science.gov (United States)

2009-05-01

This 2009 study, funded by the Southwest Region University Transportation Center, investigates : competing ethanol supply chains terminating in the State of Texas. Midwest corn ethanol and : Brazilian sugarcane ethanol constitute two sources of the b...

Food Security and Diet Among American Indians in the Midwest.

Science.gov (United States)

Berryhill, Kelly; Hale, Jason; Chase, Brian; Clark, Lauren; He, Jianghua; Daley, Christine M

2018-04-05

The purpose of this study was to determine levels of food security among American Indians (AI) living in the Midwest and possible correlations between food security levels and various health outcomes, diet, and demographic variables. This study used a cross-sectional design to determine health behaviors among AI. Participants (n = 362) were recruited by AI staff through various cultural community events in the Midwest, such as powwows and health fairs. Inclusion criteria included the following: age 18 years or older, self-identify as an AI, and willing to participate in the survey. Of all participants, 210 (58%) had either low or very low food security, with 96 in the very low category (26.5%). Participants with very low food security tended to have significantly more chronic conditions. Additional significant differences for very low food security existed by demographic variables, including having no insurance (p security levels and the consumption of fast food within the past week (p value = 0.0420), though no differences were found in fruit and vegetable consumption. AI in our sample had higher levels of food insecurity than those reported in the literature for other racial/ethnic groups. AI and non-Native health professionals should be aware of the gravity of food insecurity and the impact it has on overall health. Additional research is needed to determine specific aspects of food insecurity affecting different Native communities to develop appropriate interventions.

The spiritual care meanings of adults residing in the midwest.

Science.gov (United States)

Sellers, S C

2001-07-01

Only limited nursing knowledge exists as theoretical guidance for nurses in providing spiritual care. Using Leininger's theory of culture care diversity and universality, the purpose of this ethnonursing research study was to discover the embedded spiritual care meanings, expressions, lived experiences, and practices of adults residing in the Midwest and their perceptions of spiritual nursing care. Data were collected through interviews of 6 key and 12 general informants. Five universal spiritual themes were supported by the findings. Culture care modes were used to explicate spiritual knowledge that can be integrated into nursing practice.

An examination of ethnic entrepreneurship in the Mid-West of Ireland

OpenAIRE

Birdthistle, Naomi

2012-01-01

non-peer-reviewed EXECUTIVE SUMMARYThis research was commissioned by Doras Luimní  with the aim of providing a micro and strategic analysis of ethnic entrepreneurs in the Midwest region of Ireland. A number of objectives were formed in order to answer this aim. The study examined two sets of entrepreneurs: those in the planning phase and those that have been established. Both established entrepreneurs and entrepreneurs in the planning phase were studied so as to provide a skill set analysi...

Past and future changes in streamflow in the U.S. Midwest: Bridging across time scales

Science.gov (United States)

Villarini, G.; Slater, L. J.; Salvi, K. A.

2017-12-01

Streamflows have increased notably across the U.S. Midwest over the past century, principally due to changes in precipitation and land use / land cover. Improving our understanding of the physical drivers that are responsible for the observed changes in discharge may enhance our capability of predicting and projecting these changes, and may have large implications for water resources management over this area. This study will highlight our efforts towards the statistical attribution of changes in discharge across the U.S. Midwest, with analyses performed at the seasonal scale from low to high flows. The main drivers of changing streamflows that we focus on are: urbanization, agricultural land cover, basin-averaged temperature, basin-averaged precipitation, and antecedent soil moisture. Building on the insights from this attribution, we will examine the potential predictability of streamflow across different time scales, with lead times ranging from seasonal to decadal, and discuss a potential path forward for engineering design for future conditions.

Low-level radioactive waste in the Midwest: an economic analysis of selected management options

International Nuclear Information System (INIS)

1983-06-01

Possible economic scenarios for disposal of low-level radioactive waste generated in the Midwest are presented. Relative waste disposal site costs are estimated for each state separately, and for 5-state, 13-state, and 16-state regions. Costs for publicly and privately owned and operated sites are estimated as are incineration and transportation costs

Fruit and Vegetable Intake and Dietary Patterns of Preadolescents Attending Schools in the Midwest

Science.gov (United States)

Nepper, Martha J.; Chai, Weiwen

2015-01-01

Objectives: The present study examined dietary intake of fruit and vegetables and dietary patterns of preadolescents attending schools in the Midwest. Methods: A total of 506 students (11.2 ± 1.3 years) from four public and private schools in Nebraska completed a validated 41-item Food Frequency Questionnaire to assess their dietary intake.…

Wood-plastic composites utilizing wood flours derived from fast- growing trees common to the midwest

Science.gov (United States)

There are several non- or under-utilized hardwood trees common to the Midwestern states. Wood flour (WF) derived from fast-growing Midwest trees (Osage orange, Black Locust and Red Mulberry) were evaluated as a source of bio-based fiber reinforcements. Wood plastic composites (WPC) of high density p...

Exploring the Special Education versus Regular Education Decisions of Future Teachers in the Rural Midwest

Science.gov (United States)

DeSutter, Keri L.; Lemire, Steven Dale

2016-01-01

Persistent shortages of special education teachers, particularly in rural areas, exist across the country. This study assessed the openness of teacher candidates enrolled in an introductory education course at two rural Midwest universities to a special education career path. Survey findings confirmed that work or volunteer experience involving…

76 FR 43682 - Shetek Wind Inc. Jeffers South, LLC Allco Renewable Energy Limited v. Midwest Independent...

Science.gov (United States)

2011-07-21

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-53-000] Shetek Wind Inc. Jeffers South, LLC Allco Renewable Energy Limited v. Midwest Independent Transmission System Operator, Inc...), Shetek Wind Inc., Jeffers South, LLC, and Allco Renewable Energy Limited (collectively Complainants...

Ethical issues in purchasing: a field study of Midwest hospitals.

Science.gov (United States)

Tomaszewski, K; Motwani, J

1995-01-01

A large sum of money is spent annually by salespeople on gifts and favors for purchasing executives. The provision of gifts and favors to buyers remains a common practice despite the fact that it often leads to ethical conflicts for purchasing executives, sales managers, and salespeople. This paper investigates the perceptions of 51 purchasing executives of midwest hospitals regarding their behavior towards certain buying practices, the favors offered by vendors, favors actually accepted, as well as purchasers' discomfort and repayment levels regarding indebtedness. Based on the data analysis, this paper provides conclusions and directions for future research.

Preferrential rearrangement in normal rabbits of the 3' VHa allotype gene that is deleted in Alicia mutants; somatic hypermutation/conversion may play a major role in generating the heterogeneity of rabbit heavy chain variable region sequences.

Science.gov (United States)

Allegrucci, M; Young-Cooper, G O; Alexander, C B; Newman, B A; Mage, R G

1991-02-01

The rabbit is unique in having well-defined allotypes in the variable region of the heavy chain. Products of the VHa locus, (with alleles a1, a2, and a3), account for the majority of the serum immunoglobulins. A small percentage of the serum immunoglobulins are a-negative. In 1986, Kelus and Weiss described a mutation that depressed the expression of the Ig VH a2 genes in an a1/a2 rabbit. From this animal the Alicia rabbit strain was developed and the mutation was termed ali. We previously showed, using Southern analysis and the transverse alternating field electrophoresis technique, that the difference between the ali rabbit and normal is a relatively small deletion including some of the most 3' VH genes. The most JH proximal 3' VH1 genes in DNA from normal rabbits of a1, a2 and a3 haplotypes encode a1, a2 and a3 molecules respectively, and it has been suggested that these genes are responsible for allelic inheritance of VHa allotypes. The present study suggests that the 3' end of the VH locus probably plays a key role in regulation of VH gene expression in rabbits because VH gene(s) in this region are the target(s) of preferential VDJ rearrangements. This raises the possibility that mechanisms such as somatic gene conversion and hypermutation are at work to generate the antibody repertoire in this species. Our data support the view that the 3' VH1 gene may be the preferred target for rearrangement in normal rabbits, and for the normal chromosome in heterozygous ali animals. However, homozygous ali rabbits with a deletion that removed the a2-encoding VH1 on both chromosomes do survive, rearrange other VH genes and produce normal levels of immunoglobulins as well as a significant percentage of B cells which bear the a2 allotype. This challenges the view that one VH gene, VH1, is solely responsible for the inheritance pattern of VHa allotypes.

Vulnerability of grain crops and croplands in the Midwest to climatic variability and adaptation strategies

Science.gov (United States)

Maize (Zea mays L.) and soybean (Gylcine max (L.) Merr.) are the dominant grain crops across the Midwest and are grown on 75% of the arable land with wheat (Triticum aestivum L.) and oats (Avena sativa L.) small but economically important crops. Historically there have been variations in annual yiel...

Risk and Protective Factors for Breast Cancer in Midwest of Brazil

Directory of Open Access Journals (Sweden)

Lívia Emi Inumaru

2012-01-01

Full Text Available Patterns of physical activity, body composition, and breastfeeding are closely related to health and are influenced by environmental, economic, and social factors. With the increase of sedentary lifestyle and overweight, many chronic diseases have also increased, including cancer. Breast cancer is the most common cancer in women worldwide, and the knowledge of its risk and protective factors is important to the adoption of primary prevention strategies. We aimed to investigate some risk and protective factors for breast cancer among women from Midwest Brazil. It is a case-control study of outpatient basis, carried out with 93 breast cancer cases and 186 controls. Socioeconomic, gynecological, anthropometric, and lifestyle variables were collected, and odds ratios (ORs values were estimated (significance level, 5%; confidence interval (CI, 95%. Per capita income equal to or lower than 1/2 Brazilian minimum wage (OR=1.88; CI=1.06–3.29, residence in rural area (OR=4.93; CI=1.65–14.73, and presence of family history of breast cancer (OR=5.38; CI=1.46–19.93 are risk factors for breast cancer. In turn, physical activity (past 6 months (OR=0.23; CI=0.10–0.55 and leisure physical activity at 20 years old (OR=0.13; CI=0.03–0.54 are protective factors for the disease in women who live in Midwest of Brazil.

76 FR 71007 - Shetek Wind Inc., Jeffers South, LLC and Allco Renewable Energy Limited, Midwest Independent...

Science.gov (United States)

2011-11-16

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-53-000] Shetek Wind Inc., Jeffers South, LLC and Allco Renewable Energy Limited, Midwest Independent Transmission System Operator... an original and 14 copies of the protest or intervention to the Federal Energy Regulatory Commission...

Adaptation resources for agriculture: Responding to climate variability and change in the midwest and northeast

Science.gov (United States)

Maria K. Janowiak; Daniel D. Dostie; Michael A. Wilson; Michael J. Kucera; R. Howard Skinner; Jerry L. Hatfield; David Hollinger; Christopher W. Swanston

2016-01-01

Changes in climate and extreme weather are already increasing challenges for agriculture nationally and globally, and many of these impacts will continue into the future. This technical bulletin contains information and resources designed to help agricultural producers, service providers, and educators in the Midwest and Northeast regions of the United States integrate...

78 FR 24192 - J.P. Morgan Ventures Energy Corp. v. Midwest Independent System Operator, Inc. PJM...

Science.gov (United States)

2013-04-24

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-58-000] J.P. Morgan Ventures Energy Corp. v. Midwest Independent System Operator, Inc. PJM Interconnection, L.L.C.; Notice of Complaint Take notice that on April 10, 2013, J.P. Morgan Ventures Energy Corporation (JPMVEC or Complainant...

The business of optimism. Wisconsin's Midwest Renewable Energy Fair

International Nuclear Information System (INIS)

Decker, J.

2006-01-01

The paper reports on the Wisconsin Midwest Renewable Energy Fair. The renewable energy business is said to be based on sound technology and sustainable development and is being largely embraced with enthusiasm. However, the keynote speaker, James Kunstler, warned that the transition from fossil fuels to renewables will be complicated and messy. The report mentions the views of several speakers but not all shared Kunstler's views. There were more than 100 workshops at the fair. Although big business was well represented, there were also home-made devices on show including a motorcycle powered by electricity. The importance of the fair is probably best judged by the way in which it generates enthusiasm for preserving the planet through the sustainable development of environmentally-friendly technology. (author)

Understanding the economic, environmental and energy consequences of the Panama Canal expansion on Midwest grain and agricultural exports.

Science.gov (United States)

2011-05-01

The Panama Canal Authority (ACP) is currently building a third lock scheduled to open in 2014, significantly changing the capacity of the : canal for inter-ocean movements. Midwest specialty grain and agricultural product exporters will be directly a...

Management and characteristics of recycled manure solids used for bedding in Midwest freestall dairy herds.

Science.gov (United States)

Husfeldt, A W; Endres, M I; Salfer, J A; Janni, K A

2012-04-01

Interest in using recycled manure solids (RMS) as a bedding material for dairy cows has grown in the US Midwest. Cost of common bedding materials has increased in recent years and availability has decreased. Information regarding the composition of RMS and its use as a bedding material for dairy cows in the Midwest is very limited. The objectives of this study were to characterize RMS as a bedding material, observe bedding management practices, document methods of obtaining RMS, and describe housing facilities. We visited 38 Midwest dairy operations bedding freestalls with RMS to collect data. Methods of obtaining RMS for bedding included separation of anaerobic digested manure, separation of raw manure, and separation of raw manure followed by mechanical drum-composting for 18 to 24 h. Average bedding moisture of unused RMS was 72.4% with a pH of 9.16. Unused samples contained (on a dry basis) 1.4% N, 44.9% C, 32.7C:N ratio, 0.44% P, 0.70% K, 76.5% neutral detergent fiber, 9.4% ash, 4.4% nonfiber carbohydrates, and 1.1% fat. Moisture was lowest for drum-composted solids before and after use as freestall bedding. After use in the stalls, digested solids had lower neutral detergent fiber content (70.5%) than drum-composted (75.0%) and separated raw (73.1%) solids. Total N content was greater in digested solids (2.0%) than in separated raw (1.7%) solids. Total bacterial populations in unused bedding were greatest in separated raw manure solids but were similar between digested and drum-composted manure solids. Drum-composted manure solids had no coliform bacteria before use as freestall bedding. After use as bedding, digested manure solids had lower total bacteria counts compared with drum-composted and separated raw manure solids, which had similar counts. Used bedding samples of digested solids contained fewer environmental streptococci than drum-composted and separated raw solids and had reduced Bacillus counts compared with separated raw solids. Coliform counts

Midwest Lake uranium discovery, Saskatchewan, Canada

International Nuclear Information System (INIS)

Scott, F.

1981-01-01

The discovery of the Midwest Lake uranium deposit in Saskatchewan came some ten years after the start of exploration. The original mining rights were acquired on the basis of regional published, geology and proximity to the earlier discovery. Aerial radiometric surveys led to the location of a train of radioactive, glacially transported sandstone boulders and cobbles. The source of these mineralized erratics did not outcrop, and an extensive series of magnetic, electromagnetic, seismic and gravity surveys was carried out in an unsuccessful attempt to identify the source location. These surveys were followed by several programmes of diamond drilling, geochemical surveys and Pleistocene geological studies. None of these programmes or surveys encountered bedrock mineralization. When information about ore controls in the Athabasca Basin became available, a limited programme of three 300-m wildcat diamond-drill holes was proposed. The second of these holes cut weak radioactivity in a poorly cored intersection. This intersection was at an unconformity at a depth of 200 m. The programme terminated prematurely with early melting of lake ice. The first hole in the subsequent winter's follow-up drilling intersected uranium values in excess of 8%. (author)

Evaluation of selected near-term energy-conservation options for the Midwest

Energy Technology Data Exchange (ETDEWEB)

Evans, A.R.; Colsher, C.S.; Hamilton, R.W.; Buehring, W.A.

1978-11-01

This report evaluates the potential for implementation of near-term energy-conservation practices for the residential, commercial, agricultural, industrial, transportation, and utility sectors of the economy in twelve states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. The information used to evaluate the magnitude of achievable energy savings includes regional energy use, the regulatory/legislative climate relating to energy conservation, technical characteristics of the measures, and their feasibility of implementation. This work is intended to provide baseline information for an ongoing regional assessment of energy and environmental impacts in the Midwest. 80 references.

The Use of Cover Crops as Climate-Smart Management in Midwest Cropping Systems

Science.gov (United States)

Basche, A.; Miguez, F.; Archontoulis, S.; Kaspar, T.

2014-12-01

The observed trends in the Midwestern United States of increasing rainfall variability will likely continue into the future. Events such as individual days of heavy rain as well as seasons of floods and droughts have large impacts on agricultural productivity and the natural resource base that underpins it. Such events lead to increased soil erosion, decreased water quality and reduced corn and soybean yields. Winter cover crops offer the potential to buffer many of these impacts because they essentially double the time for a living plant to protect and improve the soil. However, at present, cover crops are infrequently utilized in the Midwest (representing 1-2% of row cropped land cover) in particular due to producer concerns over higher costs and management, limited time and winter growing conditions as well as the potential harm to corn yields. In order to expand their use, there is a need to quantify how cover crops impact Midwest cropping systems in the long term and namely to understand how to optimize the benefits of cover crops while minimizing their impacts on cash crops. We are working with APSIM, a cropping systems platform, to specifically quantify the long term future impacts of cover crop incorporation in corn-based cropping systems. In general, our regional analysis showed only minor changes to corn and soybean yields (<1% differences) when a cover crop was or was not included in the simulation. Further, a "bad spring" scenario (where every third year had an abnormally wet/cold spring and cover crop termination and planting cash crop were within one day) did not result in any major changes to cash crop yields. Through simulations we estimate an average increase of 4-9% organic matter improvement in the topsoil and an average decrease in soil erosion of 14-32% depending on cover crop planting date and growth. Our work is part of the Climate and Corn-based Cropping Systems Coordinated Agriculture Project (CSCAP), a collaboration of eleven Midwestern

The Big Squeeze on Tax Revenues for the Public Schools: The Midwest in the 1980s.

Science.gov (United States)

Geske, Terry G.

Potential revenue prospects for the public schools in the Midwest basically depend on the future outlook for the midwestern economy as a whole. Accordingly, a comprehensive analysis is undertaken of the midwestern economy and tax base, and then of trends in educational spending. Topics include: (1) economic growth and taxation systems; (2)…

Nutrient Concentrations and Stable Isotopes of Runoff from a Midwest Tile-Drained Corn Field

Science.gov (United States)

Wilkins, B. P.; Woo, D.; Li, J.; Michalski, G. M.; Kumar, P.; Conroy, J. L.; Keefer, D. A.; Keefer, L. L.; Hodson, T. O.

2017-12-01

Tile drains are a common crop drainage device used in Midwest agroecosystems. While efficient at drainage, the tiles provide a quick path for nutrient runoff, reducing the time available for microbes to use nutrients (e.g., NO3- and PO43-) and reduce export to riverine systems. Thus, understanding the effects of tile drains on nutrient runoff is critical to achieve nutrient reduction goals. Here we present isotopic and concentration data collected from tile drain runoff of a corn field located near Monticello, IL. Tile flow samples were measured for anion concentrations and stable isotopes of H2O and NO3-, while precipitation was measured for dual isotopes of H2O. Results demonstrate early tile flow from rain events have a low Cl- concentration (60% contribution) in the beginning of the hydrograph. As flow continues H2O isotopic values reflect pre-event water (ground and soil water), and Cl- concentrations increase representing a greater influence by matrix flow (60-90% contribution). Nitrate concentrations change dramatically, especially during the growing season, and do not follow a similar trend as the conservative Cl-, often decreasing days before, which represents missing nitrate in the upper surface portion of the soil. Nitrate isotopic data shows significant changes in 15N (4‰) and 18O (4‰) during individual hydrological events, representing that in addition to plant uptake and leaching, considerate NO3- is lost through denitrification. It is notable, that throughout the season d15N and d18O of nitrate change significantly representing that seasonally, substantial denitrification occurs.

Coordinators for health science libraries in the Midwest Health Science Library Network.

Science.gov (United States)

Holtum, E A; McKloskey, J; Mahan, R

1977-04-01

In the summer of 1973 one resource library in each of the six states of the Midwest Health Science Library Network received funding from the National Library of Medicine to hire a coordinator for health science libraries. The development of the role of coordinator is examined and evaluated. The coordinators have proved valuable in the areas of consortium formation, basic unit development, communication facilitation, and program initiation. The function of the coordinators in the extensive planning effort now being undertaken by the network and the future need for the coordinator positions are discussed.

Location of cancer surgery for older veterans with cancer.

Science.gov (United States)

Kouri, Elena M; Landrum, Mary Beth; Lamont, Elizabeth B; Bozeman, Sam; McNeil, Barbara J; Keating, Nancy L

2012-04-01

Many veterans undergo cancer surgery outside of the Veterans Health Administration (VHA). We assessed to what extent these patients obtained care in the VHA before surgery. VHA-Medicare data, VHA administrative data, and Veterans Affairs Central Cancer Registry data. We identified patients aged ≥65 years in the VHA-Medicare cohort who underwent lung or colon cancer resection outside the VHA and assessed VHA visits in the year before surgery. Over 60% of patients in the VHA-Medicare cohort who received lung or colon cancer surgeries outside the VHA did not receive any care in VHA before surgery. Veterans' receipt of major cancer surgery outside the VHA probably reflects usual private sector care among veterans who are infrequent VHA users. © Health Research and Educational Trust.

The Year in Forestry State and Private Forestry in the Northeast and Midwest Fiscal Year 2005

Science.gov (United States)

Northeastern Area State and Private Forestry

2006-01-01

The geographic region we call the Northeast and Midwest stretches from Maine to Minnesota, south to Missouri, and east to Maryland and the District of Columbia. Nearly half of the Nation's population lives here on slightly less than 20 percent of the Nation's land area. Representing one of the largest concentrations of privately owned forests in the world,...

Identity and Mobility: Historical Fractionalization, Parochial Institutions, and Occupational Choice in the American Midwest

OpenAIRE

Kaivan Munshi; Nicholas Wilson

2010-01-01

This paper examines the role played by identity, or a sense of belonging to a home community, in determining occupational choice and mobility. The analysis links competition between migrant networks in the Midwest when it was rst developing, and the in-group identity that emerged endogenously to support these networks, to institutional participation and occupational choice today. Individuals born in counties with greater ethnic fractionalization in 1860, where identity was more likely to have...

75 FR 55820 - Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews of Seven Midwest Species

Science.gov (United States)

2010-09-14

...] Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews of Seven Midwest Species AGENCY: Fish... CFR 424.02: (A) Species includes any species or subspecies of fish, wildlife, or plant, and any... species means any species that is in danger of extinction throughout all or a significant portion of its...

Renewables in the Midwest

International Nuclear Information System (INIS)

Wager, J.S.

1994-01-01

Over the past three years, the Union of Concerned Scientists (UCS) has evaluated the potential for using renewable energy for electricity in the Midwest, and has been carrying out a multifaceted effort to expand the use of renewables in the region. The UCS study presents a strategy for developing renewable-electric technologies and resources in 12 midwestern states. UCS analysts used a geographic information system (GIS) to create data-bases of renewable resources, land uses, vegetation cover, terrain elevation and locations of utility transmission lines, and to analyze and present information on a .6 mi x .6 mi (1 km x 1 km) grid scale. In addition, UCS developed a model to calculate the net employment impact of renewable versus conventional electricity technologies on a state-by-state basis. In evaluating the costs and benefits of renewable energy sources, UCS analysts explored a cost assessment that accounted for the impact of pollution from fossil fuels on energy resource cost. Researchers also considered the risks associated with fuel-price volatility, environmental regulation, construction lead times and other uncertainties. Finally, UCS researchers suggested steps to remove the institutional, regulatory and legislative barriers that inhibit renewable energy development, and proposed policies to expand the use of the region's renewable resources. The UCS analysis showed that wind is currently the least expensive renewable resource. UCS also found numerous opportunities to expand biomass-electric generation in the near term, such as converting small coal-fired power plants to wood fuel, making greater use of logging residues and co-firing a small percentage of biomass with fossil fuel at large power plants

A Research Agenda for Advancing Non-pharmacological Management of Chronic Musculoskeletal Pain: Findings from a VHA State-of-the-art Conference.

Science.gov (United States)

Becker, William C; DeBar, Lynn L; Heapy, Alicia A; Higgins, Diana; Krein, Sarah L; Lisi, Anthony; Makris, Una E; Allen, Kelli D

2018-05-01

Chronic pain is widely prevalent among Veterans and can have serious negative consequences for functional status and quality of life among other domains. The Veterans Health Administration (VHA) convened a state-of-the-art (SOTA) conference to develop research priorities for advancing the science and clinical practice of non-pharmacological management of chronic musculoskeletal pain. In this perspective article, we present the methods and consensus recommendations for research priorities emanating from the SOTA. In the months leading up to the SOTA, a core group of researchers defined four areas of focus: psychological/behavioral therapies; exercise/movement therapies; manual therapies; and models for delivering multi-modal pain care and divided into workgroups. Each workgroup, in their respective areas of focus, identified seminal studies capturing the state of the evidence. Herein, we present consensus recommendations ranging from efficacy to effectiveness to implementation/dissemination research depending on the state of the evidence as assessed by participants, including commentary on common elements across workgroups and future areas of innovation in study design, measurement, and outcome ascertainment.

Voices of Women in the Field--The Midwest Women's Leadership Institute--Responding to a Call to Lead

Science.gov (United States)

Haar, Jean

2009-01-01

The Midwest Women's Leadership Institute at Minnesota State University did not occur by chance nor did it happen quickly. Rather, it was the direct result of the work, support, and dedication of a number of people committed to strengthening leadership opportunities for women in higher education. In this article, the author relates how the…

Coordination of Retail Demand Response with Midwest ISO Markets

Energy Technology Data Exchange (ETDEWEB)

Bharvirkar, Ranjit; Bharvirkar, Ranjit; Goldman, Charles; Heffner, Grayson; Sedano, Richard

2008-05-27

The Organization of Midwest ISO States (OMS) launched the Midwest Demand Resource Initiative (MWDRI) in 2007 to identify barriers to deploying demand response (DR) resources in the Midwest Independent System Operator (MISO) region and develop policies to overcome them. The MWDRI stakeholders decided that a useful initial activity would be to develop more detailed information on existing retail DR programs and dynamic pricing tariffs, program rules, and utility operating practices. This additional detail could then be used to assess any"seams issues" affecting coordination and integration of retail DR resources with MISO's wholesale markets. Working with state regulatory agencies, we conducted a detailed survey of existing DR programs, dynamic pricing tariffs, and their features in MISO states. Utilities were asked to provide information on advance notice requirements to customers, operational triggers used to call events (e.g. system emergencies, market conditions, local emergencies), use of these DR resources to meet planning reserves requirements, DR resource availability (e.g., seasonal, annual), participant incentive structures, and monitoring and verification (M&V) protocols. This report describes the results of this comprehensive survey and discusses policy implications for integrating legacy retail DR programs and dynamic pricing tariffs into organized wholesale markets. Survey responses from 37 MISO members and 4 non-members provided information on 141 DR programs and dynamic pricing tariffs with a peak load reduction potential of 4,727 MW of retail DR resource. Major findings of this study area:- About 72percent of available DR is from interruptible rate tariffs offered to large commercial and industrial customers, while direct load control (DLC) programs account for ~;;18percent. Almost 90percent of the DR resources included in this survey are provided by investor-owned utilities. - Approximately, 90percent of the DR resources are available with less than

Effects of Land Use Change for Crops on Water and Carbon Budgets in the Midwest USA

Directory of Open Access Journals (Sweden)

Jian Sun

2017-02-01

Full Text Available Increasing demand for food and bioenergy has altered the global landscape dramatically in recent years. Land use and land cover change affects the environmental system in many ways through biophysical and biogeochemical mechanisms. In this study, we evaluate the impacts of land use and land cover change driven by recent crop expansion and conversion on the water budget, carbon exchange, and carbon storage in the Midwest USA. A dynamic global vegetation model was used to simulate and examine the impacts of landscape change in a historical case based on crop distribution data from the United States Department of Agriculture National Agricultural Statistics Services. The simulation results indicate that recent crop expansion not only decreased soil carbon sequestration (60 Tg less of soil organic carbon and net carbon flux into ecosystems (3.7 Tg·year−1 less of net biome productivity, but also lessened water consumption through evapotranspiration (1.04 × 1010 m3·year−1 less over 12 states in the Midwest. More water yield at the land surface does not necessarily make more water available for vegetation. Crop residue removal might also exacerbate the soil carbon loss.

Technical Report: Investigation of Carbon Cycle Processes within a Managed Landscape: An Ecosystem Manipulation and Isotope Tracer Approach

Energy Technology Data Exchange (ETDEWEB)

Griffis, Timothy J; Baker, John M; Billmark, Kaycie

2009-06-01

The goal of this research is to provide a better scientific understanding of carbon cycle processes within an agricultural landscape characteristic of the Upper Midwest. This project recognizes the need to study processes at multiple spatial and temporal scales to reduce uncertainty in ecosystem and landscape-scale carbon budgets to provide a sound basis for shaping future policy related to carbon management. Specifically, this project has attempted to answer the following questions: 1. Would the use of cover crops result in a shift from carbon neutral to significant carbon gain in corn-soybean rotation ecosystems of the Upper Midwest? 2. Can stable carbon isotope analyses be used to partition ecosystem respiration into its autotrophic and heterotrophic components? 3. Can this partitioning be used to better understand the fate of crop residues to project changes in the soil carbon reservoir? 4. Are agricultural ecosystems of the Upper Midwest carbon neutral, sinks, or sources? Can the proposed measurement and modeling framework help address landscape-scale carbon budget uncertainties and help guide future carbon management policy?

Comparison of performance of tile drainage routines in SWAT 2009 and 2012 in an extensively tile-drained watershed in Midwest

Science.gov (United States)

Subsurface tile drainage systems are widely used in agricultural watersheds in the Midwestern U.S. Tile drainage systems enable the Midwest area to become highly productive agricultural lands, but can also create environmental problems, for example nitrate-N contamination associated with drainage w...

Regional climate change projections of streamflow characteristics in the Northeast and Midwest U.S.

Directory of Open Access Journals (Sweden)

Eleonora M.C. Demaria

2016-03-01

Full Text Available Study region: Northeast and Midwest, United States. Study focus: Assessing the climate change impacts on the basin scale is important for water and natural resource managers. Here, the presence of monotonic trends and changes in climate-driven simulated 3-day peak flows, 7-day low flows, and mean base flows are evaluated in the Northeast and Midwest U.S. during the 20th and the 21st centuries using climate projections from sixteen climate models. Proven statistical methods are used to spatially and temporally disaggregate precipitation and temperature fields to a finer resolution before being used as drivers for a hydrological model. New hydrological insights for the region: Changes in the annual cycle of precipitation are likely to occur during the 21st century as winter precipitation increases and warmer temperatures reduce snow coverage across the entire domain especially in the northern basins. Maximum precipitation intensities are projected to become more intense across the region by mid-century especially along the coast. Positive trends in 3-day peak flows are also projected in the region as a result of the more intense precipitation, whereas the magnitude of 7-day low flows and mean base flows are projected to decrease. The length of the low flows season will likely extend by mid-century despite the increased precipitation as the atmospheric demand increases. Keywords: Streamflow peaks, Low flows, Trend analysis, Intense precipitation, Base flows

Long-term monitoring studies of pollutants on public lands: Bald Eagles in the Midwest

Energy Technology Data Exchange (ETDEWEB)

Bowerman, W.W. [Eagle Environmental Inc., Haslett, MI (United States)

1995-12-31

The role of public agencies to monitor the populations of wildlife species with protected status is paramount to the recovery of these species. Since the early 1960s, the bald eagle (Haliaeetus leucocephalus) populations within the Midwest have been monitored to determine number of breeding pairs, nest occupancy, and success rates. In addition to the reproductive outcome studies, abandoned eggs, blood samples, and feather samples have been collected to determine concentrations of organochlorine pesticides, PCBs, and heavy metals. These surveys give an actual measure of population dynamics of a top-predator species in aquatic systems that integrates the effects of many different environmental pollutants. As concentrations of the organochlorine compounds have declined, bald eagle populations have increased in numbers and their reproductive success has improved. The recovery of this species has not been uniform however. In regions where DDT and PCB concentrations are still above thresholds associated with reproductive impairment, eagles still have impaired reproduction. These areas include the shorelines of the Great Lakes and Voyageurs National Park. Some areas such as the Chippewa National Forest have begun to show declines in reproduction due to density dependent factors. Recent proposals for ecosystem management and reclassification of the bald eagle have led to reduced emphasis for maintaining these long-term data sets. The utility and importance of maintaining surveys of top-predators that can give a measure of population-level effects of pollutants rather than an index will be discussed using examples from the Midwest.

The Influence of a Career Exploration Course on New First-Time Student Retention at a Public Midwest Community College

Science.gov (United States)

French, Brenda F.

2013-01-01

The purpose of this study was to examine whether a relationship exists between new first- time students enrolled in a career exploration course and retention during the academic years of 2009 to 2011 at a public Midwest community college. Change of major after the first semester was also investigated. The study utilized quantitative, archival data…

Changes in forest habitat classes under alternative climate and land-use change scenarios in the northeast and midwest, USA

Science.gov (United States)

Brian G. Tavernia; Mark D. Nelson; Michael E. Goerndt; Brian F. Walters; Chris Toney

2013-01-01

Large-scale and long-term habitat management plans are needed to maintain the diversity of habitat classes required by wildlife species. Planning efforts would benefit from assessments of potential climate and land-use change effects on habitats. We assessed climate and land-use driven changes in areas of closed- and open-canopy forest across the Northeast and Midwest...

Threatened and endangered fish and wildlife of the midwest

Energy Technology Data Exchange (ETDEWEB)

Schafer, D.W.; Robeck, K.E.

1980-06-01

This report contains information of federally-listed endangered and/or threatened fish and wildlife occurring in the midwestern states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, and Wisconsin. The information was compiled as a support document for the Regional Issue Identification and Assessment (RIIA) project sponsored by the Regional Assessments Division of the Office of Technology Impacts within the Department of Energy. The information on midwestern endangered species distribution, habitats, and reasons for population decline included in this document are designed to help assess the potential for adverse impacts if energy activities are sited within the general range of an endangered species. It is hoped that this document will thereby enhance the reliability of one portion of energy-related assessments performed in the Midwest. This report considers only those species listed prior to October 1979 as endangered and/or threatened in the federal endangered species list published in the Federal Register and that have been known to occur in the region in the last 20 years.

Forests, Water and People: Drinking water supply and forest lands in the Northeast and Midwest United States, June 2009

Science.gov (United States)

Martina Barnes; Albert Todd; Rebecca Whitney Lilja; Paul Barten

2009-01-01

Forests are critically important to the supply of clean drinking water in the Northeast and Midwest portion of the United States. In this part of the country more than 52 million people depend on surface water supplies that are protected in large part by forested lands. The public is generally unaware of the threats to their water supplies or the connection between...

Efficiency in Midwest US corn ethanol plants: A plant survey

International Nuclear Information System (INIS)

Perrin, Richard K.; Fretes, Nickolas F.; Sesmero, Juan Pablo

2009-01-01

Continuation of policy support for the US corn ethanol industry is being debated due to doubts about the greenhouse gas effects of the industry and the effects of the industry on food prices. Yet there is no publicly available data on the economic and technical performance of the current generation of plants, which constitute the overwhelming majority of the industry. This study helps to fill that gap. Seven recently constructed ethanol plants in seven Midwest US states provided details on input requirements and operating costs during 2006 and 2007. Results show that technical performance is substantially better than current estimates available in the literature. Average net operating returns exceeded capital costs during the survey period, but price changes by mid-2008 reduced these margins to near zero. While the economic performance of the industry is currently viable, this study demonstrates that it can be threatened by current price trends, and certainly would be in the absence of current subsidies

Caution, the Use of Humor May Lead to Confusion: Evaluation of a Video Podcast of the Midwest Teen Sex Show

Science.gov (United States)

Campo, Shelly; Askelson, Natoshia M.; Spies, Erica L.; Losch, Mary

2010-01-01

Web sites about sexual health lack the interactivity, humor, and "viral" nature required to attract young adults. The Midwest Teen Sex Show (www.midwestteensexshow.com) is an interactive, humor-based Web site that provides sexual health information to young adults. One episode from the Web site was shown to six focus groups of young women, ages…

Focus on Energy: A School Transportation Handbook. Proceedings of the Midwest School Transportation Fleet Management Seminar (Lansing, Michigan, November 28-29, 1979).

Science.gov (United States)

Michigan State Dept. of Commerce, Lansing.

Presented are proceedings and supplementary reports of the Midwest School Transportation Fleet Management Seminar, which was held in Lansing, Michigan, November 28-29, 1979. Among the school bus energy management topics discussed are energy feasibility studies, the use of programmed information systems, energy conservation strategies, and…

Design and methods of the Midwest Stream Quality Assessment (MSQA), 2013

Science.gov (United States)

Garrett, Jessica D.; Frey, Jeffrey W.; Van Metre, Peter C.; Journey, Celeste A.; Nakagaki, Naomi; Button, Daniel T.; Nowell, Lisa H.

2017-10-18

During 2013, the U.S. Geological Survey (USGS) National Water-Quality Assessment Project (NAWQA), in collaboration with the USGS Columbia Environmental Research Center, the U.S. Environmental Protection Agency (EPA) National Rivers and Streams Assessment (NRSA), and the EPA Office of Pesticide Programs assessed stream quality across the Midwestern United States. This Midwest Stream Quality Assessment (MSQA) simultaneously characterized watershed and stream-reach water-quality stressors along with instream biological conditions, to better understand regional stressor-effects relations. The MSQA design focused on effects from the widespread agriculture in the region and urban development because of their importance as ecological stressors of particular concern to Midwest region resource managers.A combined random stratified selection and a targeted selection based on land-use data were used to identify and select sites representing gradients in agricultural intensity across the region. During a 14-week period from May through August 2013, 100 sites were selected and sampled 12 times for contaminants, nutrients, and sediment. This 14-week water-quality “index” period culminated with an ecological survey of habitat, periphyton, benthic macroinvertebrates, and fish at all sites. Sediment was collected during the ecological survey for analysis of sediment chemistry and toxicity testing. Of the 100 sites, 50 were selected for the MSQA random stratified group from 154 NRSA sites planned for the region, and the other 50 MSQA sites were selected as targeted sites to more evenly cover agricultural and urban stressor gradients in the study area. Of the 50 targeted sites, 12 were in urbanized watersheds and 21 represented “good” biological conditions or “least disturbed” conditions. The remaining 17 targeted sites were selected to improve coverage of the agricultural intensity gradient or because of historical data collection to provide temporal context for the

Precipitation and lake-level changes in the West and Midwest over the past 10,000 to 24,000 years. Final report

Energy Technology Data Exchange (ETDEWEB)

Webb, T. III; Street, F.A.; Howe, S.

1980-02-04

The goal of the research described in this report is to document the climatic variability over the past 10,000 to 20,000 years in areas in which sites may be designated for the burial of nuclear wastes. Three separate data sets were studied, and the results are presented in three chapters. The first data set consisted of radiocarbon dates documenting past changes in lake levels in lakes and playas in the western United States. The sites were mapped where water levels were higher than the levels today and were presented in a table telling what evidence is available at each site. The lake-level fluctuations for the past 24,000 years at sites in the West were also mapped and time series for these fluctuations at four sites were presented. The second data set was a selection of the published radiocarbon-dated pollen diagrams from the western United States. These data are a valuable source of climatic information and complement the geological evidence of lake-level fluctuations in the West. A table is presented that gives the location, elevation, and number of radiocarbon dates for each site. The third data set was a set of fossil pollen data from 20 sites in the upper Midwest. These data were calibrated in terms of precipitation changes over the past 10,000 years, and maps are presented of the estimated precipitation changes between 10,000 and 7000 years ago and between 7000 years ago and today.

Precipitation and lake-level changes in the West and Midwest over the past 10,000 to 24,000 years. Final report

International Nuclear Information System (INIS)

Webb, T. III; Street, F.A.; Howe, S.

1980-01-01

The goal of the research described in this report is to document the climatic variability over the past 10,000 to 20,000 years in areas in which sites may be designated for the burial of nuclear wastes. Three separate data sets were studied, and the results are presented in three chapters. The first data set consisted of radiocarbon dates documenting past changes in lake levels in lakes and playas in the western United States. The sites were mapped where water levels were higher than the levels today and were presented in a table telling what evidence is available at each site. The lake-level fluctuations for the past 24,000 years at sites in the West were also mapped and time series for these fluctuations at four sites were presented. The second data set was a selection of the published radiocarbon-dated pollen diagrams from the western United States. These data are a valuable source of climatic information and complement the geological evidence of lake-level fluctuations in the West. A table is presented that gives the location, elevation, and number of radiocarbon dates for each site. The third data set was a set of fossil pollen data from 20 sites in the upper Midwest. These data were calibrated in terms of precipitation changes over the past 10,000 years, and maps are presented of the estimated precipitation changes between 10,000 and 7000 years ago and between 7000 years ago and today

Et småstatsperspektiv

DEFF Research Database (Denmark)

Møller, Bjørn

2015-01-01

En gennemgang af, hvad man kunne have gjort vha. diplomati og ulandsbistand, og hvad man stadig kunne gøre vha. asyl og humanitær bistand......En gennemgang af, hvad man kunne have gjort vha. diplomati og ulandsbistand, og hvad man stadig kunne gøre vha. asyl og humanitær bistand...

Mumps epidemiology in the mid-west of Ireland 2004-2008: increasing disease burden in the university/college setting.

LENUS (Irish Health Repository)

Whyte, D

2009-01-01

Mumps is a contagious vaccine-preventable viral disease that is experiencing a revival in students attending second and third level colleges. Large mumps outbreaks have been reported in several countries despite the presence of childhood immunisation programmes over many years, including measles, mumps, and rubella (MMR) vaccination. In 2008, 1,377 cases of mumps were notified in Ireland and 1,734 in the first three months of 2009 (provisional data). This paper reviews the recent epidemiology of mumps in the Mid-West region of Ireland and highlights preventive measures. A substantial proportion of cases were not laboratory-confirmed and it is important that doctors continue to notify suspected cases. In the Irish Mid-West, data from enhanced surveillance shows a high proportion of mumps in the age group 15-24 years. Complications were uncommon and rarely severe. Where data were available, over half of the cases did not recall having received two doses of MMR, but most recalled one dose. Parents should continue to ensure children receive both MMR vaccinations so that uptake is optimal for protection. Steps were taken to increase awareness of the disease in the school, college and university settings. Preventive measures implemented to limit mumps transmission in the school\\/college setting over recent years included vaccination of close contacts, isolation for five days and hand hygiene.

Farmers' Market Manager's Level of Communication and Influence on Electronic Benefits Transfer (EBT) Adoption at Midwest Farmers' Markets.

Science.gov (United States)

Hasin, Afroza; Smith, Sylvia

2018-01-01

To understand market managers' level of communication and use of technology that might influence decision to adopt Electronic Benefits Transfer (EBT) at farmers' markets. Cross-sectional study using the Theory of Diffusion of Innovation. Electronic survey administered in midwest states of Illinois, Michigan, and Wisconsin. Farmers' market managers in Illinois, Michigan, and Wisconsin. Information on EBT adoption, market managers' communication, and technology use. Binary logistic regression analysis with EBT adoption as the dependent variable and frequency of technology use, partnership with organizations, farmers' market association (FMA) membership, Facebook page and Web site for the market, and primary source of information as independent variables. Chi-square tests and ANOVA were used to compare states and adopter categories. Logistic regression results showed that the odds of adopting EBT was 7.5 times higher for markets that had partnership with other organizations. Compared with non-adopters, a significantly greater number of early adopters had partnership, FMA membership, and a Facebook page and Web site for market, and reported to a board of directors. Markets that had partnership, FMA membership, a Facebook page and Web site, and mandatory reporting to a board of directors were important factors that influenced EBT adoption at midwest farmers' markets. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Northeast and Midwest regional species and habitats at greatest risk and most vulnerable to climate impacts

Science.gov (United States)

Staudinger, Michelle D.; Hilberg, Laura; Janowiak, Maria; Swanton, C.O.

2016-01-01

The objectives of this Chapter are to describe climate change vulnerability, it’s components, the range of assessment methods being implemented regionally, and examples of training resources and tools. Climate Change Vulnerability Assessments (CCVAs) have already been conducted for numerous Regional Species of Greatest Conservation Need and their dependent 5 habitats across the Northeast and Midwest. This chapter provides a synthesis of different assessment frameworks, information on the locations (e.g., States) where vulnerability assessments were conducted, lists of individual species and habitats with their respective vulnerability rankings, and a comparison of how vulnerability rankings were determined among studies.

1986 viewpoint of emergency preparedness in the upper midwest

International Nuclear Information System (INIS)

Parkyn, J.D.

1986-01-01

The recent Soviet emergency preparedness disaster has started a new round of interactions between utilities and civil governments regarding the adequacy of emergency preparedness around nuclear plants. The 1986 annual meeting of the cooperative produced several questions regarding the potentials of the plant and its impact on the public and the cooperative in the event of an off-normal situation. Emergency preparedness requires a real partnership between local civil authorities and the utility in a close spirit of cooperation with local law enforcement, which is frequently charged with the strongest burdens of emergency planning. It is more evident that the virtual veto power of local branches of government over emergency preparedness needs to be more fully recognized by utilities. Early notification and warning systems are coming under a tighter scrutiny as public perception of their fallibility increases. Another continuing problem with emergency preparedness has been the recognition that guarantees of reaching every individual, particularly in more hostile environments, can not be easily made. The lessons learned in nuclear planning indicate that this is an area too often not given a high enough threshold in the total spectrum of nuclear safety and which, from the utility standpoint, needs to be elevated to a higher threshold of importance

Treatment experiences among LGBT veterans with discrimination-based trauma exposure: A pilot study.

Science.gov (United States)

Shipherd, Jillian C; Ruben, Mollie A; Livingston, Nicholas A; Curreri, Andrew; Skolnik, Avy A

2018-01-01

Past research suggests that rates of trauma exposure and Posttraumatic Stress Disorder (PTSD) are elevated among lesbian, gay, bisexual, and transgender (LGBT) veterans compared to heterosexual and cisgender veterans. Given higher rates of trauma exposure and PTSD, and the culture associated with the Department of Defense's history of policies excluding LGBT people, it is important to understand if LGBT veterans are seeking PTSD treatment following discrimination-based traumatic events, where they seek care, and if they are satisfied with treatment. This study aimed to describe the experiences of discrimination-based trauma-exposed LGBT veterans' (n = 47) experiences with PTSD treatment, including location of treatment (Veterans Health Administration [VHA] versus non-VHA) and satisfaction with care. The majority of veterans had received a PTSD diagnosis from a health-care provider in their lifetimes (78.72%, n = 37), and over half reported currently experiencing PTSD symptoms. Approximately 47% of LGBT veterans with discrimination-based trauma histories preferred to seek PTSD treatment exclusively at VHA (46.81%) or with a combination of VHA and non-VHA services (38.30%). Veterans who received PTSD treatment exclusively from VHA reported higher satisfaction ratings (7.44 on 0-9 scale) than veterans who received PTSD treatment exclusively from outside VHA (5.25 on 0-9 scale). For veterans who sought PTSD treatment at both VHA and non-VHA facilities, there were no significant differences regarding satisfaction ratings for their PTSD treatment in the two settings. Results are discussed in terms of VHA's continued efforts to establish equitable, patient-centered health care for all veterans and the importance of non-VHA facilities to recognize veteran identities.

Midwest Joint Venture high-grade uranium mining

International Nuclear Information System (INIS)

Fredrickson, H.K.

1992-01-01

Midwest Joint Venture (MJV) owns a high-grade uranium deposit in northern Saskatchewan. The deposit is located too deep below surface to be mined economically by open pit methods, and as a consequence, present plans are that it will be mined by underground methods. High-grade uranium ore of the type at MJV, encased in weak, highly altered ground and with radon-rich water inflows, has not before been mined by underground methods. The test mining phase of the project, completed in 1989, had three objectives: To evaluate radiation protection requirements associated with the handling of large quantities of radon-rich water and mining high-grade uranium ore in an underground environment; to investigate the quantity and quality of water inflows into the mine; and, to investigate ground conditions in and around the ore zone as an aid in determining the production mining method to be used. With information gained from the test mining project, a mining method for the production mine has been devised. Level plans have been drawn up, ventilation system designed, pumping arrangements made and methods of ore handling considered. All this is to be done in a manner that will be safe for those doing the work underground. Some of the mining methods planned are felt to be unique in that they are designed to cope with mining problems not known to have been encountered before. New problems underground have required new methods to handle them. Remote drilling, blasting, mucking and backfilling form the basis of the planned mining method

Gravity changes in mid-west Greenland from GOCE gravity model and gradient data using ground and airborne gravity

DEFF Research Database (Denmark)

Tscherning, Carl Christian; Herceg, Matija; Fredenslund Levinsen, Joanna

GOCE TRF (terrestrial reference frame) vertical anomalous gradients (Tzz) from two periods have been used to determine gravity anomalies changes in mid-west Greenland, where a large mass-loss has been detected using GRACE (Fig. 1). As additional data were used the GOCE DIR-3 model and ground...... gravity at the coast on solid rock, where no mass loss is expected. The methods of Least-Squares Collocation (LSC) and the Reduced Point Mass (RPM) methods have been used, however only LSC included the ground data....

¿Es necesario investigar anticuerpos IgM contra el virus de la hepatitis A cuando el enzimograma hepático es normal?

Directory of Open Access Journals (Sweden)

C. Coitinho

Full Text Available La hepatitis por virus A (VHA es la más frecuente de las hepatitis virales en el mundo, especialmente en los países subdesarrollados. Donde esta enfermedad es endémica, se suelen realizar un gran número de estudios de laboratorio para confirmarla. El objetivo del presente trabajo fue evaluar la utilidad de investigar anticuerpos IgM anti hepatitis A (IgM anti-VHA para el diagnóstico de la VHA en pacientes con niveles séricos normales de aspartato y alanina aminotransferasas (AST/ALT. Todos los pacientes que concurrieron al laboratorio con solicitud de enzimograma hepático y anticuerpos IgM anti-VHA durante el período octubre 2005-marzo 2006 fueron evaluados en este estudio. Los datos clínicos más frecuentes fueron presunción de hepatitis e ictericia (27,5 y 12,7%. La determinación de IgM anti-VHA se realizó por ensayo inmunoenzimático de micropartículas (MEIA; la de enzimas hepáticas en un multianalizador. De los 158 pacientes estudiados, 84 tenían valores elevados de AST/ALT; dentro de este grupo, el 82% fue reactivo para IgM anti-VHA. Los 74 pacientes restantes mostraron niveles normales de AST/ALT y solo 7 de ellos, bajo control de evolución por VHA ya confirmada, fueron reactivos para IgM anti-VHA. El 49% de los pacientes IgM anti-VHA reactivos correspondió a menores de 10 años. De acuerdo con estas observaciones, sugerimos que los estudios de laboratorio para confirmar infección aguda por VHA deberían realizarse en forma secuencial, ya que es innecesaria la determinación de anticuerpos IgM anti-VHA cuando las aminotransferasas séricas son normales.

Frequency and characteristics associated with exposure to tobacco direct mail marketing and its prospective effect on smoking behaviors among young adults from the US Midwest.

Science.gov (United States)

Choi, Kelvin; Forster, Jean L

2014-11-01

We examined the exposure to tobacco direct mail marketing and its effect on subsequent smoking behaviors in a US Midwest regional cohort of young adults. Data were collected from 2622 young adults (mean age = 24 years) in 2010 to 2011 (baseline) and 2011 to 2012 (follow-up). We collected information on demographics, tobacco use, and exposure to tobacco direct mail materials in the previous 6 months at baseline. Smoking behaviors were reassessed at follow-up. We investigated the characteristics associated with receiving these materials at baseline, and the associations between receiving cigarette coupons in the mail at baseline and smoking behaviors at follow-up. Thirteen percent of participants reported receiving tobacco direct mail materials in the previous 6 months. Receipt of these materials was associated with age, education, and tobacco use (P marketing promoted and sustained smoking behaviors among US Midwest young adults. Regulating this marketing strategy might reduce the prevalence of smoking in this population.

Disaster preparedness networks in rural Midwest communities: Organizational roles, collaborations, and support for older residents.

Science.gov (United States)

Ashida, Sato; Zhu, Xi; Robinson, Erin L; Schroer, Audrey

2018-05-17

This study investigated the roles and interconnections among community organizations belonging to local disaster coalitions in Midwest in supporting older residents. Representatives from 44 organizations participated in one-time survey. Most were non-profit (68%) or federal/state/local government agencies (23%). The analyses of 761 relationships showed stronger collaborations in assessment (average strength=2.88 on a 5-point scale), emergency response (2.72), and planning (2.61); and weaker collaborations in co-sponsoring programs (1.71) and supporting older residents (2.03). The extent of collaboration (network density) to support older adults was also low. Coalitions may enhance network density and centralization by developing sub-committee structure and strengthening existing collaborations.

Increasing drought and diminishing benefits of elevated carbon dioxide for soybean yields across the US Midwest.

Science.gov (United States)

Jin, Zhenong; Ainsworth, Elizabeth A; Leakey, Andrew D B; Lobell, David B

2018-02-01

Elevated atmospheric CO 2 concentrations ([CO 2 ]) are expected to increase C3 crop yield through the CO 2 fertilization effect (CFE) by stimulating photosynthesis and by reducing stomatal conductance and transpiration. The latter effect is widely believed to lead to greater benefits in dry rather than wet conditions, although some recent experimental evidence challenges this view. Here we used a process-based crop model, the Agricultural Production Systems sIMulator (APSIM), to quantify the contemporary and future CFE on soybean in one of its primary production area of the US Midwest. APSIM accurately reproduced experimental data from the Soybean Free-Air CO 2 Enrichment site showing that the CFE declined with increasing drought stress. This resulted from greater radiation use efficiency (RUE) and above-ground biomass production at elevated [CO 2 ] that outpaced gains in transpiration efficiency (TE). Using an ensemble of eight climate model projections, we found that drought frequency in the US Midwest is projected to increase from once every 5 years currently to once every other year by 2050. In addition to directly driving yield loss, greater drought also significantly limited the benefit from rising [CO 2 ]. This study provides a link between localized experiments and regional-scale modeling to highlight that increased drought frequency and severity pose a formidable challenge to maintaining soybean yield progress that is not offset by rising [CO 2 ] as previously anticipated. Evaluating the relative sensitivity of RUE and TE to elevated [CO 2 ] will be an important target for future modeling and experimental studies of climate change impacts and adaptation in C3 crops. © 2017 John Wiley & Sons Ltd.

Gender differences in substance abuse, PTSD and intentional self-harm among veterans health administration patients.

Science.gov (United States)

Gradus, Jaimie L; Leatherman, Sarah; Curreri, Andrew; Myers, Lisa G; Ferguson, Ryan; Miller, Matthew

2017-02-01

Epidemiologic studies have reported substance abuse and posttraumatic stress disorder (PTSD) diagnoses as risk factors for suicide among Veterans Health Administration (VHA) patients. Research on risk factors for suicide may not generalize to our understanding of non-fatal intentional self-harm (ISH), given the evidence that these outcomes have unique risk factors. The aims of this study were to examine (1) gender-stratified rates of non-fatal ISH in VHA patients with alcohol abuse/dependence, drug abuse/dependence, and PTSD and (2) gender-stratified interaction between alcohol abuse and dependence and drug abuse and dependence and PTSD in predicting non-fatal ISH. Participants include all VHA care users who received a PTSD diagnosis in Massachusetts from 2000 to 2008 (n=16,004) and an age- and gender-matched comparison group (n=52,502). Data were obtained from the VHA administrative registries. We found evidence of stronger interactions between substance abuse diagnoses and PTSD in predicting non-fatal ISH for females than for males. The interaction contrast (IC) for alcohol abuse and dependence and PTSD in predicting non-fatal ISH among female VHA patients was 62.35/100,000 person-years; for male VHA patients the comparable IC was 21.49/100,000 person-years. For female VHA patients the IC for drug abuse and dependence and PTSD predicting ISH was 256.33/100,000 person-years; no interaction was observed for male VHA patients. This study contributes to the scant literature on gender differences in substance abuse and PTSD among VHA patients. The findings highlight comorbid diagnoses as particularly important risk factors for non-fatal ISH among female VHA patients. Published by Elsevier B.V.

Improving the care of veterans: The role of nurse practitioners in team-based population health management.

Science.gov (United States)

Hobson, Alexandra; Curtis, Alexa

2017-11-01

Improving healthcare delivery for U.S. veterans is a national priority. The Veterans Health Administration (VHA) employs a variety of team-based, population health strategies to address critical issues in veterans' health including the effective management of chronic disease. Nurse practitioners (NPs) are integral members of the VHA patient care team with a substantial role to play in the organization and delivery of healthcare services for veterans. This report explores the contributions of NPs in team-based, population health strategies within the VHA. This review of the literature examines peer-reviewed articles published between 2006 and 2017 to explore the contributions of NPs in team-based, population health strategies within the VHA. Search words include veterans, VHA, NPs, population health, panel management, and chronic disease. NPs are vital members of the VHA primary care team; however, there is a dearth of available evidence reflecting the unique contribution of NPs within VHA team-based, population health management strategies. The VHA adoption of full practice authority for NP practice provides NPs with an expanded capacity to lead improvements in veterans' health. Future research is needed to fully understand the unique role of the NP in the delivery of population health management strategies for veterans. ©2017 American Association of Nurse Practitioners.

Lyme Disease Frequently Asked Questions (FAQ)

Science.gov (United States)

... the Northeast and upper Midwest, with 14 states accounting for over 96% of cases reported to CDC. ... of Notifiable Diseases . What is a surveillance case definition? Reporting of all nationally notifiable diseases, including Lyme ...

Perceived Stigma, Discrimination, and Disclosure of Sexual Orientation Among a Sample of Lesbian Veterans Receiving Care in the Department of Veterans Affairs.

Science.gov (United States)

Mattocks, Kristin M; Sullivan, J Cherry; Bertrand, Christina; Kinney, Rebecca L; Sherman, Michelle D; Gustason, Carolyn

2015-06-01

Many lesbian women experience stigma and discrimination from their healthcare providers as a result of their sexual orientation. Additionally, others avoid disclosure of their sexual orientation to their providers for fear of mistreatment. With the increasing number of lesbian, gay, bisexual, and transgender (LGBT) veterans seeking care from the Veterans Health Administration (VHA), it is important to understand lesbian veterans' experiences with stigma, discrimination, and disclosure of sexual orientation. This article examines lesbian veterans' experiences with perceived stigma and discrimination in VHA healthcare, their perspectives on disclosure of sexual orientation to VHA providers, and their recommendations for improvements in VHA healthcare to create a welcoming environment for lesbian veterans. This is a mixed methods study of twenty lesbian veterans at four VHA facilities. The women veterans participated in a one-hour interview and then completed an anonymous survey. Ten percent of lesbian veterans had experienced mistreatment from VHA staff or providers, but nearly 50% feared that their Veterans Affairs (VA) providers would mistreat them if they knew about their sexual orientation. A majority of lesbian veterans (70%) believed that VHA providers should never ask about sexual orientation or should only ask if the veteran wanted to discuss it. A majority (80%) believed the VHA had taken steps to create a welcoming environment for LBGT veterans. Though many lesbian veterans have fears of stigma and discrimination in the context of VHA care, few have experienced this. Most lesbian veterans believed the VHA was trying to create a welcoming environment for its LGBT veterans. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.

Limited number of immunoglobulin VH regions expressed in the mutant rabbit "Alicia".

Science.gov (United States)

DiPietro, L A; Short, J A; Zhai, S K; Kelus, A S; Meier, D; Knight, K L

1990-06-01

A unique feature of rabbit Ig is the presence of VH region allotypic specificities. In normal rabbits, more than 80% of circulating immunoglobulin molecules bear the VHa allotypic specificities, al, a2 or a3; the remaining 10% to 20% of immunoglobulin molecules lack VHa allotypic specificities and are designated VHa-. A mutant rabbit designated Alicia, in contrast, has predominantly serum immunoglobulin molecules that lack the VHa allotypic specificities (Kelus and Weiss, Proc. Natl. Acad. Sci. USA 1986. 83: 4883). To study the nature and molecular complexity of VHa- molecules, we cloned and determined the nucleotide sequence of seven cDNA prepared from splenic RNA of an Alicia rabbit. Six of the clones appeared to encode VHa- molecules; the framework regions encoded by these clones were remarkably similar to each other, each having an unusual insertion of four amino acids at position 10. This insertion of four amino acids has been seen in only 2 of 54 sequenced rabbit VH genes. The similarity of the sequences of the six VHa- clones to each other and their dissimilarity to most other VH genes leads us to suggest that the VHa- molecules in Alicia rabbits are derived predominantly from one or a small number of very similar VH genes. Such preferential utilization of a small number of VH genes may explain the allelic inheritance of VH allotypes.

Measure of Truck Delay and Reliability at the Corridor Level

Science.gov (United States)

2018-04-01

Freight transportation provides a significant contribution to our nations economy. A reliable and accessible freight network enables business in the Twin Cities to be more competitive in the Upper Midwest region. Accurate and reliable freight data...

Hydrogeology of the Cambrian-Ordovician aquifer system in the northern Midwest: B in Regional aquifer-system analysis

Science.gov (United States)

Young, H.L.; Siegel, D.I.

1992-01-01

The Cambrian-Ordovician aquifer system contains the most extensive and continuous aquifers in the northern Midwest of the United States. It is the source of water for many municipalities, industries, and rural water users. Since the beginning of ground-water development from the aquifer system in the late 1800's, hydraulic heads have declined hundreds of feet in the heavily pumped Chicago-Milwaukee area and somewhat less in other metropolitan areas. The U.S. Geological Survey has completed a regional assessment of this aquifer system within a 161,000-square-mile area encompassing northern Illinois, northwestern Indiana, Iowa, southeastern Minnesota, northern Missouri, and Wisconsin.

Understanding variation in primary prostate cancer treatment within the Veterans Health Administration.

Science.gov (United States)

Nambudiri, Vinod E; Landrum, Mary Beth; Lamont, Elizabeth B; McNeil, Barbara J; Bozeman, Samuel R; Freedland, Stephen J; Keating, Nancy L

2012-03-01

To examine the variation in prostate cancer treatment in the Veterans Health Administration (VHA)--a national, integrated delivery system. We also compared the care for older men in the VHA with that in fee-for-service Medicare. We used data from the Veterans Affairs Central Cancer Registry linked with administrative data and Surveillance, Epidemiology, and End Results-Medicare data to identify men with local or regional prostate cancer diagnosed during 2001 to 2004. We used multinomial logistic and hierarchical regression models to examine the patient, tumor, and facility characteristics associated with treatment in the VHA and, among older patients, used propensity score methods to compare primary therapy between the VHA and fee-for-service Medicare. The rates of radical prostatectomy and radiotherapy varied substantially across VHA facilities. Among the VHA patients, older age, black race/ethnicity, and greater comorbidity were associated with receiving neither radical prostatectomy nor radiotherapy. Facilities with more black patients with prostate cancer had lower rates of radical prostatectomy, and those with less availability of external beam radiotherapy had lower radiotherapy rates. The adjusted rates of radiotherapy (39.7% vs 52.0%) and radical prostatectomy (12.1% vs 15.8%) were lower and the rates of receiving neither treatment greater (48.2% vs 32.2%) in the VHA versus fee-for-service Medicare (P < .001). In the VHA, the treatment rates varied substantially across facilities, and black men received less aggressive prostate cancer treatment than white men, suggesting factors other than patient preferences influence the treatment decisions. Also, primary prostate cancer therapy for older men is less aggressive in the VHA than in fee-for-service Medicare. Copyright © 2012 Elsevier Inc. All rights reserved.

Multiple Sources of Prescription Payment and Risky Opioid Therapy Among Veterans.

Science.gov (United States)

Becker, William C; Fenton, Brenda T; Brandt, Cynthia A; Doyle, Erin L; Francis, Joseph; Goulet, Joseph L; Moore, Brent A; Torrise, Virginia; Kerns, Robert D; Kreiner, Peter W

2017-07-01

Opioid overdose and other related harms are a major source of morbidity and mortality among US Veterans, in part due to high-risk opioid prescribing. We sought to determine whether having multiple sources of payment for opioids-as a marker for out-of-system access-is associated with risky opioid therapy among veterans. Cross-sectional study examining the association between multiple sources of payment and risky opioid therapy among all individuals with Veterans Health Administration (VHA) payment for opioid analgesic prescriptions in Kentucky during fiscal year 2014-2015. Source of payment categories: (1) VHA only source of payment (sole source); (2) sources of payment were VHA and at least 1 cash payment [VHA+cash payment(s)] whether or not there was a third source of payment; and (3) at least one other noncash source: Medicare, Medicaid, or private insurance [VHA+noncash source(s)]. Our outcomes were 2 risky opioid therapies: combination opioid/benzodiazepine therapy and high-dose opioid therapy, defined as morphine equivalent daily dose ≥90 mg. Of the 14,795 individuals in the analytic sample, there were 81.9% in the sole source category, 6.6% in the VHA+cash payment(s) category, and 11.5% in the VHA+noncash source(s) category. In logistic regression, controlling for age and sex, persons with multiple payment sources had significantly higher odds of each risky opioid therapy, with those in the VHA+cash having significantly higher odds than those in the VHA+noncash source(s) group. Prescribers should examine the prescription monitoring program as multiple payment sources increase the odds of risky opioid therapy.

Physician-Assisted Suicide and Midwest Social Workers: Where Do They Stand?

Science.gov (United States)

Gaston, N Rose; Randall, Jill M; Kiesel, Lisa R

2018-01-01

Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers' attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey. The results indicated that over one-half of the participants supported PAS legislation and is consistent with previous research on social workers across the country. While there was a range of perceived preparedness for implementation, a majority felt moderately to very prepared. Professional and personal values as well as professional experience influenced their perceived preparedness. Few social workers had accurate awareness of PAS legislation in their state or had attended workshops/events for further education or as a policy advocate. To practice competently and advocate at all levels of practice, hospice and palliative care at end-of-life social workers' need to understand their own attitudes and values toward PAS and pursue additional education around this ethical issue.

The greenhouse gas intensity and potential biofuel production capacity of maize stover harvest in the US Midwest

Energy Technology Data Exchange (ETDEWEB)

Jones, Curtis D. [Department of Geographical Sciences, University of Maryland, College Park MD 20742 USA; Zhang, Xuesong [Joint Global Change Research Institute, Pacific Northwest National Laboratory and University of Maryland, College Park MD 20740 USA; Reddy, Ashwan D. [Department of Geographical Sciences, University of Maryland, College Park MD 20742 USA; Robertson, G. Philip [Great Lakes Bioenergy Research Center, Michigan State University, East Lansing MI 48824 USA; W.K. Kellogg Biological Station, Michigan State University, Hickory Corners MI 49060 USA; Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing MI 48824 USA; Izaurralde, Roberto César [Department of Geographical Sciences, University of Maryland, College Park MD 20742 USA; Texas A& M AgriLife Research & Extension Center, Temple TX 76502 USA

2017-08-11

Agricultural residues are important sources of feedstock for a cellulosic biofuels industry that is being developed to reduce greenhouse gas emissions and improve energy independence. While the US Midwest has been recognized as key to providing maize stover for meeting near-term cellulosic biofuel production goals, there is uncertainty that such feedstocks can produce biofuels that meet federal cellulosic standards. Here, we conducted extensive site-level calibration of the Environmental Policy Integrated Climate (EPIC) terrestrial ecosystems model and applied the model at high spatial resolution across the US Midwest to improve estimates of the maximum production potential and greenhouse gas emissions expected from continuous maize residue-derived biofuels. A comparison of methodologies for calculating the soil carbon impacts of residue harvesting demonstrates the large impact of study duration, depth of soil considered, and inclusion of litter carbon in soil carbon change calculations on the estimated greenhouse gas intensity of maize stover-derived biofuels. Using the most representative methodology for assessing long-term residue harvesting impacts, we estimate that only 5.3 billion liters per year (bly) of ethanol, or 8.7% of the near-term US cellulosic biofuel demand, could be met under common no-till farming practices. However, appreciably more feedstock becomes available at modestly higher emissions levels, with potential for 89.0 bly of ethanol production meeting US advanced biofuel standards. Adjustments to management practices, such as adding cover crops to no-till management, will be required to produce sufficient quantities of residue meeting the greenhouse gas emission reduction standard for cellulosic biofuels. Considering the rapid increase in residue availability with modest relaxations in GHG reduction level, it is expected that management practices with modest benefits to soil carbon would allow considerable expansion of potential cellulosic

Impact of sampling strategy on stream load estimates in till landscape of the Midwest

Science.gov (United States)

Vidon, P.; Hubbard, L.E.; Soyeux, E.

2009-01-01

Accurately estimating various solute loads in streams during storms is critical to accurately determine maximum daily loads for regulatory purposes. This study investigates the impact of sampling strategy on solute load estimates in streams in the US Midwest. Three different solute types (nitrate, magnesium, and dissolved organic carbon (DOC)) and three sampling strategies are assessed. Regardless of the method, the average error on nitrate loads is higher than for magnesium or DOC loads, and all three methods generally underestimate DOC loads and overestimate magnesium loads. Increasing sampling frequency only slightly improves the accuracy of solute load estimates but generally improves the precision of load calculations. This type of investigation is critical for water management and environmental assessment so error on solute load calculations can be taken into account by landscape managers, and sampling strategies optimized as a function of monitoring objectives. ?? 2008 Springer Science+Business Media B.V.

RNAi-directed downregulation of vacuolar H(+ -ATPase subunit a results in enhanced stomatal aperture and density in rice.

Directory of Open Access Journals (Sweden)

Huiying Zhang

Full Text Available Stomatal movement plays a key role in plant development and response to drought and salt stress by regulating gas exchange and water loss. A number of genes have been demonstrated to be involved in the regulation of this process. Using inverse genetics approach, we characterized the function of a rice (Oryza sativa L. vacuolar H(+-ATPase subunit A (OsVHA-A gene in stomatal conductance regulation and physiological response to salt and osmotic stress. OsVHA-A was constitutively expressed in different rice tissues, and the fusion protein of GFP-OsVHA-A was exclusively targeted to tonoplast when transiently expressed in the onion epidermal cells. Heterologous expression of OsVHA-A was able to rescue the yeast mutant vma1Δ (lacking subunit A activity phenotype, suggesting that it partially restores the activity of V-ATPase. Meanwhile, RNAi-directed knockdown of OsVHA-A led to a reduction of vacuolar H(+-ATPase activity and an enhancement of plasma membrane H(+-ATPase activity, thereby increasing the concentrations of extracellular H(+ and intracellular K(+ and Na(+ under stress conditions. Knockdown of OsVHA-A also resulted in the upregulation of PAM3 (plasma membrane H(+-ATPase 3 and downregulation of CAM1 (calmodulin 1, CAM3 (calmodulin 3 and YDA1 (YODA, a MAPKK gene. Altered level of the ion concentration and the gene expression by knockdown of OsVHA-A probably resulted in expanded aperture of stomatal pores and increased stomatal density. In addition, OsVHA-A RNAi plants displayed significant growth inhibition under salt and osmotic stress conditions. Taken together, our results suggest that OsVHA-A takes part in regulating stomatal density and opening via interfering with pH value and ionic equilibrium in guard cells and thereby affects the growth of rice plants.

U.S. Department of Energy Zero Energy Ready Home Implementation

Energy Technology Data Exchange (ETDEWEB)

VonThoma, E. [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; Mosiman, G. [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership

2017-07-01

This report documents the process and outcomes involved in achieving the U.S. Department of Energy Zero Energy Ready Home (ZERH) program certification standards while helping homebuilders in Climate Zones 5 and 6 in the Upper Midwest achieve ZERH certification.

One-way coupling of an integrated assessment model and a water resources model: evaluation and implications of future changes over the US Midwest

Science.gov (United States)

Voisin, N.; Liu, L.; Hejazi, M.; Tesfa, T.; Li, H.; Huang, M.; Liu, Y.; Leung, L. R.

2013-11-01

An integrated model is being developed to advance our understanding of the interactions between human activities, terrestrial system and water cycle, and to evaluate how system interactions will be affected by a changing climate at the regional scale. As a first step towards that goal, a global integrated assessment model, which includes a water-demand model driven by socioeconomics at regional and global scales, is coupled in a one-way fashion with a land surface hydrology-routing-water resources management model. To reconcile the scale differences between the models, a spatial and temporal disaggregation approach is developed to downscale the annual regional water demand simulations into a daily time step and subbasin representation. The model demonstrates reasonable ability to represent the historical flow regulation and water supply over the US Midwest (Missouri, Upper Mississippi, and Ohio river basins). Implications for future flow regulation, water supply, and supply deficit are investigated using climate change projections with the B1 and A2 emission scenarios, which affect both natural flow and water demand. Although natural flow is projected to increase under climate change in both the B1 and A2 scenarios, there is larger uncertainty in the changes of the regulated flow. Over the Ohio and Upper Mississippi river basins, changes in flow regulation are driven by the change in natural flow due to the limited storage capacity. However, both changes in flow and demand have effects on the Missouri River Basin summer regulated flow. Changes in demand are driven by socioeconomic factors, energy and food demands, global markets and prices with rainfed crop demand handled directly by the land surface modeling component. Even though most of the changes in supply deficit (unmet demand) and the actual supply (met demand) are driven primarily by the change in natural flow over the entire region, the integrated framework shows that supply deficit over the Missouri River

Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

Science.gov (United States)

True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L

2014-07-01

The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

Forest Carbon Storage in the Northern Midwest, USA: A Bottom-Up Scaling Approach Combining Local Meteorological and Biometric Data With Regional Forest Inventories

Science.gov (United States)

Curtis, P. S.; Gough, C. M.; Vogel, C. S.

2005-12-01

Carbon (C) storage increasingly is considered an important part of the economic return of forestlands, making easily parameterized models for assessing current and future C storage important for both ecosystem and money managers. For the deciduous forests of the northern midwest, USA, detailed information relating annual C storage to local site characteristics can be combined with spatially extensive forest inventories to produce simple, robust models of C storage useful at a variety of scales. At the University of Michigan Biological Station (45o35`' N, 84o42`' W) we measured C storage, or net ecosystem production (NEP), in 65 forest stands varying in age, disturbance history, and productivity (site index) using biometric methods, and independently measured net C exchange at the landscape level using meteorological methods. Our biometric and meteorological estimates of NEP converged to within 1% of each other over five years, providing important confirmation of the robustness of these two approaches applied within northern deciduous forests (Gough et al. 2005). We found a significant relationship between NEP, stand age ( A, yrs), and site index ( Is, m), where NEP = 0.134 + 0.022 * (LN[ A* Is]) (r2 = 0.50, P database (ncrs2.fs.fed.us/4801/fiadb/) to estimate forest C storage at different scales across the upper midwest, Great Lakes region. Model estimates were validated against independent estimates of C storage for other forests in the region. At the local ecosystem-level (~1 km2) C storage averaged 1.52 Mg ha-1 yr-1. Scaling to the two-county area surrounding our meteorological and biometric study sites, average stand age decreased and site index increased, resulting in estimated storage of 1.62 Mg C ha-1 yr-1, or 0.22 Tg C yr-1 in the 1350 km2 of deciduous forest in this area. For the state of Michigan (31,537 km2 of deciduous forest), average uptake was estimated at 1.55 Mg C ha-1 yr-1, or 4.9 Tg C yr-1 total storage. For the three state region encompassing

Developing Flexible, Integrated Hydrologic Modeling Systems for Multiscale Analysis in the Midwest and Great Lakes Region

Science.gov (United States)

Hamlet, A. F.; Chiu, C. M.; Sharma, A.; Byun, K.; Hanson, Z.

2016-12-01

Physically based hydrologic modeling of surface and groundwater resources that can be flexibly and efficiently applied to support water resources policy/planning/management decisions at a wide range of spatial and temporal scales are greatly needed in the Midwest, where stakeholder access to such tools is currently a fundamental barrier to basic climate change assessment and adaptation efforts, and also the co-production of useful products to support detailed decision making. Based on earlier pilot studies in the Pacific Northwest Region, we are currently assembling a suite of end-to-end tools and resources to support various kinds of water resources planning and management applications across the region. One of the key aspects of these integrated tools is that the user community can access gridded products at any point along the end-to-end chain of models, looking backwards in time about 100 years (1915-2015), and forwards in time about 85 years using CMIP5 climate model projections. The integrated model is composed of historical and projected future meteorological data based on station observations and statistical and dynamically downscaled climate model output respectively. These gridded meteorological data sets serve as forcing data for the macro-scale VIC hydrologic model implemented over the Midwest at 1/16 degree resolution. High-resolution climate model (4km WRF) output provides inputs for the analyses of urban impacts, hydrologic extremes, agricultural impacts, and impacts to the Great Lakes. Groundwater recharge estimated by the surface water model provides input data for fine-scale and macro-scale groundwater models needed for specific applications. To highlight the multi-scale use of the integrated models in support of co-production of scientific information for decision making, we briefly describe three current case studies addressing different spatial scales of analysis: 1) Effects of climate change on the water balance of the Great Lakes, 2) Future

Air quality in bedded mono-slope beef barns

Science.gov (United States)

Bedded mono-slope barns are becoming more common in the upper Midwest. Because these are new facilities, little research has been published regarding environmental quality, building management and animal performance in these facilities. A team of researchers from South Dakota State University, USDA ...

Effect of date of termination of a winter cereal rye cover crop (Secale cereale) on corn seedling disease

Science.gov (United States)

Cover cropping is an expanding conservation practice that offers substantial benefits to soil protection, soil health, water quality, and potentially crop yields. Presently, winter cereals are the most widely used cover crops in the upper Midwest. However, winter cereal cover crops preceding corn, ...

The Veterans Health Administration’s Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans

Science.gov (United States)

2012-02-01

make it more difficult for veterans with PTSD to seek or maintain treatment. VHA provides treatment for PTSD at VHA hospitals , outpatient clinics ...measured in days of inpatient hospital care and outpatient clinic visits. A veteran may have had several outpatient visits on a sin- gle day, each...reproduce the same results precisely. The DSS system takes clinical and financial information from other VHA databases and uses algorithms that merge

Accounting for alfalfa N credits increases returns to corn production

Science.gov (United States)

Guidelines are relatively consistent across the Upper Midwest regarding the N benefit of alfalfa to the following grain crops. With higher corn yields and prices, however, some growers have questioned these guidelines and whether more N fertilizer is needed for first-year corn following a good stand...

7 CFR 1030.44 - Classification of producer milk.

Science.gov (United States)

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Classification of producer milk. 1030.44 Section 1030... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order Regulating Handling Classification of Milk § 1030.44 Classification of producer milk...

7 CFR 1030.14 - Other source milk.

Science.gov (United States)

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Other source milk. 1030.14 Section 1030.14 Agriculture... and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order Regulating Handling Definitions § 1030.14 Other source milk. See § 1000.14. ...

Rye cover crop increases earthworm populations and reduces losses of broadcast, fall-applied, fertilizers in surface runoff

Science.gov (United States)

Corn (Zea mays L.) silage and soybean [Glycine max (L.) Merr.] rotations in the US Upper Midwest leave minimal amounts of surface residues, which can contribute to soil degradation and a reduction in water quality. Planting cover crops after harvest can reduce these concerns, but their effectiveness...

7 CFR 1030.86 - Deduction for marketing services.

Science.gov (United States)

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1030.86 Section 1030... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1030.86...

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

Science.gov (United States)

Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

2016-01-01

Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

VA Suicide Prevention Applications Network: A National Health Care System-Based Suicide Event Tracking System.

Science.gov (United States)

Hoffmire, Claire; Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M

2016-11-01

The US Department of Veterans Affairs' Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA's medical records from October 1, 2010, to September 30, 2014-overall, by year, and by region. Data on suicide attempters in the VHA's medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision . Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA's medical records. Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA's medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems.

Utilizing the ECHO Model in the Veterans Health Affairs System: Guidelines for Setup, Operations and Preliminary Findings

Directory of Open Access Journals (Sweden)

Herschel Knapp

2015-06-01

Full Text Available Background: In 2011, the Veterans Health Administration (VHA consulted with the Project ECHO (Extension for Community Healthcare Outcomes team at the University of New Mexico, Albuquerque, to reproduce their successful model within the VHA. Methods: The VHA launched SCAN-ECHO (Specialty Care Access Network-Extension for Community Healthcare Outcomes, a multisite videoconferencing system to conduct live clinical consultations between specialists at a VHA Medical Center (hospital and primary care providers stationed at satellite VHA CBOCs (Community-Based Outpatient Clinic. Results: Analysis of the first three years rendered a mean attendee satisfaction of 89.53% and a consultation satisfaction score of 88.10%. About half of the SCAN-ECHO consultations resulted in patients receiving their treatment from their local primary care providers; the remaining half were referred to the VHA Medical Center when the treatment involved equipment or services not available at the CBOCs (e.g., MRI, surgery. Conclusion: This paper details the setup, operation logistics and preliminary findings, suggesting that SCAN-ECHO is a viable model for providing quality specialty clinical consultation service, prompter access to care, reduced commutes and continuing education. Additionally, the use of a secured Internet-based videoconferencing system that supports connectivity to multiple (mobile devices could expand the utilization of this service.

Influence of gender equity awareness on women's reproductive healthcare in rural areas of midwest China.

Science.gov (United States)

Wang, Lei; Cui, Ying; Zhang, Li; Wang, Chao; Jiang, Yan; Shi, Wei

2013-11-01

To investigate the impact of married women's gender equity awareness on use of reproductive healthcare services in rural China. The questionnaire-based study recruited 1500 married women who were aged 15-49years, had at least 1 pregnancy, and were living in rural Gansu, Qinghai, Shanxi, or Xinjiang, China, between October and December 2010. "Gender equity awareness" was quantified by responses to 7 statements, graded in accordance with a system scoring the strength of overall belief (≥19, strong; 15-18, moderate; and ≤14, weak). Only 383 women (26.3%) demonstrated high gender equity awareness. The percentage of women who received consistent prenatal care was highest in the group scoring 15 points or more (Pgender equity awareness is not strong in rural midwest China. There was a positive correlation between gender equity awareness and use of reproductive healthcare services. There should be an emphasis on various activities to educate women so that they can fully access reproductive healthcare. © 2013.

Partners in flight bird conservation plan for the Upper Great Lakes Plain (Physiographic Area 16)

Science.gov (United States)

Knutson, M.G.; Butcher, G.; Fitzgerald, J.; Shieldcastle, J.

2001-01-01

1 November 2001. Conservation of bird habitats is a major focus of effort by Partners in Flight, an international coalition of agencies, citizens, and other groups dedicated to 'keeping common birds common'. USGS worked on a planning team to publish a bird conservation plan for the Upper Great Lakes Plain ecoregion (PIF 16), which includes large portions of southern Wisconsin, southern Michigan and parts of Minnesota, Iowa, Illinois, Indiana, and Ohio. The conservation plan outlines specific habitat restoration and bird population objectives for the ecoregion over the next decade. The plan provides a context for on-the-ground conservation implementation by the US Fish and Wildlife Service, the USDA Natural Resources Conservation Service, the US Forest Service, states, and conservation groups. Citation: Knutson, M. G., G. Butcher, J. Fitzgerald, and J. Shieldcastle. 2001. Partners in Flight Bird Conservation Plan for The Upper Great Lakes Plain (Physiographic Area 16). USGS Upper Midwest Environmental Sciences Center in cooperation with Partners in Flight, La Crosse, Wisconsin. Download from website: http://www.blm.gov/wildlife/pifplans.htm. The Upper Great Lakes Plain covers the southern half of Michigan, northwest Ohio, northern Indiana, northern Illinois, southern Wisconsin, and small portions of southwest Minnesota and northwest Iowa. Glacial moraines and dissected plateaus are characteristic of the topography. Broadleaf forests, oak savannahs, and a variety of prairie communities are the natural vegetation types. A oDriftless Areao was not glaciated during the late Pleistocene and emerged as a unique area of great biological diversity. Priority bird species for the area include the Henslow's Sparrow, Sedge Wren, Bobolink, Golden-winged Warbler, Cerulean Warbler, Black-billed Cuckoo, and Red-headed Woodpecker. There are many large urban centers in this area whose growth and sprawl will continue to consume land. The vast majority of the presettlement forest and

Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration

OpenAIRE

Jay, Melanie; Mateo, Katrina F.; Squires, Allison P.; Kalet, Adina L.; Sherman, Scott E.

2016-01-01

Background Obesity affects 37?% of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10?% of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans? experiences with weight management and determine whether and how ...

Establishment and function of cover crops interseeded into corn

Science.gov (United States)

Cover crops can provide ecological services and improve the resiliency of annual cropping systems; however, cover crop use is low in corn (Zea mays L.)-soybean [Glycine max (L.) Merr.] rotations in the upper Midwest due to challenges with establishment. Our objective was to compare three planting me...

Examining the Intersections between Undergraduates' Engagement in Community Service and Development of Socially Responsible Leadership

Science.gov (United States)

Soria, Krista; Nobbe, June; Fink, Alex

2013-01-01

This paper examined relationships between students' engagement in community service in different contexts through classes, student organizations, work study, and on their own as well as their development of socially responsible leadership at a large, public, research university in the Upper Midwest. Results from the Multi-Institutional Study of…

7 CFR 1030.19 - Commercial food processing establishment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Commercial food processing establishment. 1030.19 Section 1030.19 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order Regulating Handling...

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

Directory of Open Access Journals (Sweden)

Joseph Lin

Full Text Available Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group and the other 25 underwent matrix rotation only (non-donut group. The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6% ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1% to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

PTSD: National Center for PTSD

Medline Plus

Full Text Available ... Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) VA Software Documentation Library (VDL) About VHA Learn about VHA ...

NACP MCI: CO2 Emissions Inventory, Upper Midwest Region, USA., 2007

Data.gov (United States)

National Aeronautics and Space Administration — ABSTRACT: This data set provides a bottom-up CO2 emissions inventory for the mid-continent region of the United States for the year 2007. The study was undertaken as...

NACP MCI: CO2 Emissions Inventory, Upper Midwest Region, USA., 2007

Data.gov (United States)

National Aeronautics and Space Administration — This data set provides a bottom-up CO2 emissions inventory for the mid-continent region of the United States for the year 2007. The study was undertaken as part of...

U-Pb Dating of Calcite to Constrain Basinal Brine Flux Events: An Example from the Upper Midwest USA

Science.gov (United States)

Rasbury, T.; Luczaj, J.

2017-12-01

Calcite forms in a variety of settings and can be the product of surface to deep basinal fluids. As such, this mineral can uniquely record details of the fluids responsible for its formation. The forms of calcium carbonates and their stratigraphic relationships from the thin section to the regional scale give important insights on pulses of fluids. A fundamental question is the age of such fluid pulses. While calcite excludes uranium (U) from its crystal structure, some is incorporated and depending on the U/Pb ratio, this provides an opportunity for radiometric dating. Calcite crystals of various sizes and crystal habits are found in Paleozoic carbonate rocks throughout the region from the western Michigan basin to the upper Mississippi valley. These are typically associated with Mississippi Valley-type (MVT) mineralization, including galena, sphalerite, and iron sulfides, but typically post-date the main MVT event. We have analyzed a variety of these calcites and find multiple generations of calcite, separated by tens of millions of years. The initial Pb isotope ratios are similar to the isotope ratios of nearby galena, strongly suggesting a genetic relationship. Our oldest ages are 200 Ma, and we find ages ranging into the Cenozoic. Based on the Paleozoic-hosted galena Pb-isotope isoscapes from the region, the fluids may have been sourced from both the Michigan and Illinois basins. An important and unanswered question is what would cause significant fluid movement out of the basins substantially after Appalachian orogenesis. Noble gas data from brines in the Michigan Basin have a mantle component and have been suggested to be responsible for recognized elevated temperatures across the basin (Ma et al., 2009). Multiple thermal events during the Paleozoic and Mesozoic eras may have an internal heat source related to reactivation of faults of the Keweenawan Rift system below the Michigan Basin. Perhaps a mantle heat source from below episodically fluxes into the

Women veterans' preferences for intimate partner violence screening and response procedures within the Veterans Health Administration.

Science.gov (United States)

Iverson, Katherine M; Huang, Kristin; Wells, Stephanie Y; Wright, Jason D; Gerber, Megan R; Wiltsey-Stirman, Shannon

2014-08-01

Intimate partner violence (IPV) is a significant health issue faced by women veterans, but little is known about their preferences for IPV-related care. Five focus groups were conducted with 24 women Veterans Health Administration (VHA) patients with and without a lifetime history of IPV to understand their attitudes and preferences regarding IPV screening and responses within VHA. Women veterans wanted disclosure options, follow-up support, transparency in documentation, and VHA and community resources. They supported routine screening for IPV and articulated preferences for procedural aspects of screening. Women suggested that these procedures could be provided most effectively when delivered with sensitivity and connectedness. Findings can inform the development of IPV screening and response programs within VHA and other healthcare settings. © 2014 Wiley Periodicals, Inc.

Cow- and herd-level risk factors for on-farm mortality in Midwest US dairy herds.

Science.gov (United States)

Shahid, M Q; Reneau, J K; Chester-Jones, H; Chebel, R C; Endres, M I

2015-07-01

The objectives of this study were to describe on-farm mortality and to investigate cow- and herd-level risk factors associated with on-farm mortality in Midwest US dairy herds using lactation survival analysis. We analyzed a total of approximately 5.9 million DHIA lactation records from 10 Midwest US states from January 2006 to December 2010. The cow-level independent variables used in the models were first test-day milk yield, milk fat percent, milk protein percent, fat-to-protein ratio, milk urea nitrogen, somatic cell score, previous dry period, previous calving interval, stillbirth, calf sex, twinning, calving difficulty, season of calving, parity, and breed. The herd-level variables included herd size, calving interval, somatic cell score, 305-d mature-equivalent milk yield, and herd stillbirth percentage. Descriptive analysis showed that overall cow-level mortality rate was 6.4 per 100 cow-years and it increased from 5.9 in 2006 to 6.8 in 2010. Mortality was the primary reason of leaving the herd (19.4% of total culls) followed by reproduction (14.6%), injuries and other (14.0%), low production (12.3%), and mastitis (10.5%). Risk factor analysis showed that increased hazard for mortality was associated with higher fat-to-protein ratio (>1.6 vs. 1 to 1.6), higher milk fat percent, lower milk protein percent, cows with male calves, cows carrying multiple calves, higher milk urea nitrogen, increasing parity, longer previous calving interval, higher first test-day somatic cell score, increased calving difficulty score, and breed (Holstein vs. others). Decreased hazard for mortality was associated with higher first test-day milk yield, higher milk protein, and shorter dry period. For herd-level factors, increased hazard for mortality was associated with increased herd size, increased percentage of stillbirths, higher somatic cell score, and increased herd calving interval. Cows in herds with higher milk yield had lower mortality hazard. Results of the study

CHUVAS, EROSIVIDADE, ERODIBILIDADE, USO DO SOLO E SUAS RELAÇÕES COM FOCOS EROSIVOS LINEARES NA ALTA BACIA DO RIO ARAGUAIA / Rainfall, erosivity, erodibility, land use and their relationships with erosion sites in the upper Araguaia River Basin

Directory of Open Access Journals (Sweden)

Silvando Carlos da Silva

2007-12-01

Full Text Available The intensive process of land occupation by farmers in the tropical savanna region of MidwestBrazil during the last three decades has promoted several environment impacts, such as theoccurrence of gully erosion processes as a consequence of intensive deforestation. Just in theUpper Araguaia River Basin, it was identified more than 300 large and medium gully features,which are related with the high natural susceptibility of the sandy soils; high erosivity and erodibility; inadequate land-use; lack of soil conservation practices; and a high annual rainfallindex during the rainy season. The objective of this research was to identify spatial relationshipsbetween rainfall distribution, erosivity, erodibility, land-use, and gully erosion distribution,which may support environmental planning actions related to land use conservation.Quantitative results show a high correlation between gully erosion distribution and higherosivity/erodibility and inadequate land-use.

PTSD: National Center for PTSD

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Veterans Health Administration Timely and Effective Care Data

Data.gov (United States)

U.S. Department of Health & Human Services — A list of VHA hospitals with timely and effective care (process of care) measure data. VHA collects this information through a Quality Improvement Organization...

Specialty oilseed crops provide an attractive source of pollen for beneficial insects

Science.gov (United States)

The continuing pollinator crisis is due, in part, to the lack of year-round floral resources. In intensive farming regions, such as the Upper Midwest (UMW) of the USA, natural and pastoral vegetation largely has been replaced by annual crops such as corn, soybean, and wheat. Neither the energy (nect...

Virtual Rural Community Development: Human Links That Sustain Web Links.

Science.gov (United States)

Bright, Larry K.; Evans, Wayne H.; Marmet, Kathy

Outmigration in the rural Upper Midwest prompted a group of citizens and University of South Dakota faculty to form the Center for the Advancement of Rural Communities (ARC). ARC considers how to stimulate traditionally competitive and isolated South Dakota peoples to collaborate for economic, social, educational, political, and cultural gains. As…

Nitrous oxide emissions from fertilized soil: Can we manage it?

Science.gov (United States)

Cropped fields in the upper Midwest have the potential to emit nitrous oxide (N2O) and nitric oxide (NO) gases resulting from soil transformation of nitrogen (N) fertilizers applied to crops such as corn and potatoes. Nitrous oxide is a potent greenhouse and also an important in ozone depleting che...

Cross-Cultural Competency Adaptability of Dental Hygiene Educators in Entry Level Dental Hygiene Programs

Science.gov (United States)

Engeswick, Lynnette Marie

2011-01-01

This study was conducted to discover the extent dental hygiene educators in 25 entry-level dental hygiene programs from the Upper Midwest demonstrate Emotional Resilience, Flexibility and Openness, Perceptual Acuity, and Personal Autonomy as they relate to their level of education and multicultural experiences. An additional purpose was to examine…

Water Quality Monitoring by Satellite

Science.gov (United States)

Journal of Chemical Education, 2004

2004-01-01

The availability of abundant water resources in the Upper Midwest of the United States is nullified by their contamination through heavy commercial and industrial activities. Scientists have taken the responsibility of detecting the water quality of these resources through remote-sensing satellites to develop a wide-ranging water purification plan…

Nonvariceal upper gastrointestinal bleeding

International Nuclear Information System (INIS)

Burke, Stephen J.; Weldon, Derik; Sun, Shiliang; Golzarian, Jafar

2007-01-01

Nonvariceal upper gastrointestinal bleeding (NUGB) remains a major medical problem even after advances in medical therapy with gastric acid suppression and cyclooxygenase (COX-2) inhibitors. Although the incidence of upper gastrointestinal bleeding presenting to the emergency room has slightly decreased, similar decreases in overall mortality and rebleeding rate have not been experienced over the last few decades. Many causes of upper gastrointestinal bleeding have been identified and will be reviewed. Endoscopic, radiographic and angiographic modalities continue to form the basis of the diagnosis of upper gastrointestinal bleeding with new research in the field of CT angiography to diagnose gastrointestinal bleeding. Endoscopic and angiographic treatment modalities will be highlighted, emphasizing a multi-modality treatment plan for upper gastrointestinal bleeding. (orig.)

Nonvariceal upper gastrointestinal bleeding

Energy Technology Data Exchange (ETDEWEB)

Burke, Stephen J.; Weldon, Derik; Sun, Shiliang [University of Iowa, Department of Radiology, Iowa, IA (United States); Golzarian, Jafar [University of Iowa, Department of Radiology, Iowa, IA (United States); University of Iowa, Department of Radiology, Carver College of Medicine, Iowa, IA (United States)

2007-07-15

Nonvariceal upper gastrointestinal bleeding (NUGB) remains a major medical problem even after advances in medical therapy with gastric acid suppression and cyclooxygenase (COX-2) inhibitors. Although the incidence of upper gastrointestinal bleeding presenting to the emergency room has slightly decreased, similar decreases in overall mortality and rebleeding rate have not been experienced over the last few decades. Many causes of upper gastrointestinal bleeding have been identified and will be reviewed. Endoscopic, radiographic and angiographic modalities continue to form the basis of the diagnosis of upper gastrointestinal bleeding with new research in the field of CT angiography to diagnose gastrointestinal bleeding. Endoscopic and angiographic treatment modalities will be highlighted, emphasizing a multi-modality treatment plan for upper gastrointestinal bleeding. (orig.)

Brief report: Comparison of methods to identify Iraq and Afghanistan war veterans using Department of Veterans Affairs administrative data.

Science.gov (United States)

Bangerter, Ann; Gravely, Amy; Cutting, Andrea; Clothier, Barb; Spoont, Michele; Sayer, Nina

2010-01-01

The Department of Veterans Affairs (VA) has made treatment and care of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans a priority. Researchers face challenges identifying the OIF/OEF population because until fiscal year 2008, no indicator of OIF/OEF service was present in the Veterans Health Administration (VHA) administrative databases typically used for research. In this article, we compare an algorithm we developed to identify OIF/OEF veterans using the Austin Information Technology Center administrative data with the VHA Support Service Center OIF/OEF Roster and veterans' self-report of military service. We drew data from two different institutional review board-approved funded studies. The positive predictive value of our algorithm compared with the VHA Support Service Center OIF/OEF Roster and self-report was 92% and 98%, respectively. However, this method of identifying OIF/OEF veterans failed to identify a large proportion of OIF/OEF veterans listed in the VHA Support Service Center OIF/OEF Roster. Demographic, diagnostic, and VA service use differences were found between veterans identified using our method and those we failed to identify but who were in the VHA Support Service Center OIF/OEF Roster. Therefore, depending on the research objective, this method may not be a viable alternative to the VHA Support Service Center OIF/OEF Roster for identifying OIF/OEF veterans.

Insights from advanced analytics at the Veterans Health Administration.

Science.gov (United States)

Fihn, Stephan D; Francis, Joseph; Clancy, Carolyn; Nielson, Christopher; Nelson, Karin; Rumsfeld, John; Cullen, Theresa; Bates, Jack; Graham, Gail L

2014-07-01

Health care has lagged behind other industries in its use of advanced analytics. The Veterans Health Administration (VHA) has three decades of experience collecting data about the veterans it serves nationwide through locally developed information systems that use a common electronic health record. In 2006 the VHA began to build its Corporate Data Warehouse, a repository for patient-level data aggregated from across the VHA's national health system. This article provides a high-level overview of the VHA's evolution toward "big data," defined as the rapid evolution of applying advanced tools and approaches to large, complex, and rapidly changing data sets. It illustrates how advanced analysis is already supporting the VHA's activities, which range from routine clinical care of individual patients--for example, monitoring medication administration and predicting risk of adverse outcomes--to evaluating a systemwide initiative to bring the principles of the patient-centered medical home to all veterans. The article also shares some of the challenges, concerns, insights, and responses that have emerged along the way, such as the need to smoothly integrate new functions into clinical workflow. While the VHA is unique in many ways, its experience may offer important insights for other health care systems nationwide as they venture into the realm of big data. Project HOPE—The People-to-People Health Foundation, Inc.

Upper Gastrointestinal (GI) Series

Science.gov (United States)

... standard barium upper GI series, which uses only barium a double-contrast upper GI series, which uses both air and ... evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that ...

PTSD: National Center for PTSD

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Midwest Growers’ Mail Survey of Contributors to Migrant Health and Nutrition

Science.gov (United States)

Kilanowski, Jill F.

2014-01-01

The purpose of this study was to solicit information from farm owners (growers), as representatives of their farm businesses, regarding descriptive information on migrant camp housing that may contribute to the health and nutritional status of employed workers and their families. This cross–sectional descriptive mail survey was sent to 802 growers in Indiana, Michigan, Ohio, and Pennsylvania via the US Postal Service. The growers were identified by an Internet search for licensed agricultural work camps in Midwest departments of agriculture. Response rate was 34%. Overall, growers reported a median of one migrant camp with 23 residents, employing workers seasonally for either 10 weeks or 6 months, with seven accompanying children on site. Individual kitchen appliances varied across the states, potentially influencing the preparation of healthy meals. Three themes were identified from the results. First, over one third of owners lacked or had limited knowledge about the health services available to migrant families. Second, migrant workers may have limited access to a variety of fresh produce for household meal preparation. Third, migrant children were unable to easily access public play areas, and families lacked recreational spaces in agricultural work camps. Play areas in migrant camps were mostly identified as open fields with little play equipment on site. Knowledge learned can influence future agricultural camp practices and the design of future research studies, and provide direction for grower education topics presented at agricultural conferences and by extension services. PMID:22994639

The Midwest Stream Quality Assessment—Influences of human activities on streams

Science.gov (United States)

Van Metre, Peter C.; Mahler, Barbara J.; Carlisle, Daren M.; Coles, James F.

2018-04-16

Healthy streams and the fish and other organisms that live in them contribute to our quality of life. Extensive modification of the landscape in the Midwestern United States, however, has profoundly affected the condition of streams. Row crops and pavement have replaced grasslands and woodlands, streams have been straightened, and wetlands and fields have been drained. Runoff from agricultural and urban land brings sediment and chemicals to streams. What is the chemical, physical, and biological condition of Midwestern streams? Which physical and chemical stressors are adversely affecting biological communities, what are their origins, and how might we lessen or avoid their adverse effects?In 2013, the U.S. Geological Survey (USGS) conducted the Midwest Stream Quality Assessment to evaluate how human activities affect the biological condition of Midwestern streams. In collaboration with the U.S. Environmental Protection Agency National Rivers and Streams Assessment, the USGS sampled 100 streams, chosen to be representative of the different types of watersheds in the region. Biological condition was evaluated based on the number and diversity of fish, algae, and invertebrates in the streams. Changes to the physical habitat and chemical characteristics of the streams—“stressors”—were assessed, and their relation to landscape factors and biological condition was explored by using mathematical models. The data and models help us to better understand how the human activities on the landscape are affecting streams in the region.

Veterans Health Administration Behavioral Health Data

Data.gov (United States)

U.S. Department of Health & Human Services — A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services...

The Eco-Behavioral Approach to Surveys and Social Accounts for Rural Communities: Exploratory Analyses and Interpretations of Roger G. Barker's Microdata from the Behavior Setting Survey of Midwest, Kansas in 1963-64.

Science.gov (United States)

Fox, Karl A.

The concept of behavior settings--the environments shaping individual behavior--was originated by Roger Barker in 1950 in connection with his community surveys in a small Kansas town, code-named Midwest. This book seeks to provide rural social scientists with an understanding of Barker's eco-behavioral approach and proposed adaptations of it to…

6th Annual Midwest Conference for Undergraduate Women in Physics, January 18-20, 2013, Urbana, Illinois

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Pitts, Kevin T. [University of Illinois at Urbana-Champaign

2016-04-28

This document is the program for the 6th Annual Midwest Conference for Undergraduate Women in Physics, which was held at the University of Illinois at Urbana-Champaign on January 18-20, 2013. The goals of the conference were to foster a culture in which undergraduate women are encouraged and supported to pursue, and also to succeed in, higher education in physics; to provide career information to students in physics and related fields; to give women the resources, motivation, and confidence to apply to graduate school and successfully complete a Ph.D. program in Physics; to provide information and dispel misconceptions about the application process for graduate school and the diverse employment opportunities in physics and related fields, enabling women to make more informed decisions about their goals and attain them; and to connect female physics students with successful female physicists to whom they can relate and who can act as inspirational role models and mentors.

Blogging in the Communication Technology Course

Science.gov (United States)

Platt, Carrie Anne

2011-01-01

This article describes an assignment that was developed for an undergraduate course on communication technologies taught at a public university in the Upper Midwest. The course focuses on the impact of new media technologies on traditional media industries and contemporary culture, and is taken by students majoring in journalism, public relations,…

An assessment of the relationship between emerald ash borer presence and landscape pattern

Science.gov (United States)

Susan J. Crocker; Dacia M. Meneguzzo

2009-01-01

Six years after its 2002 detection near Detroit, MI, the emerald ash borer (EAB) (Agrilus planipennis Fairmaire) has spread hundreds of miles across the Upper Midwest and Mid-Atlantic regions of the United States. Human-assisted transportation of infested ash materials is the primary mechanism of EAB dispersal over long distances. Natural spread...

Transforming Identities: The Transition From Teacher to Leader During Teacher Leader Preparation

Science.gov (United States)

Carver, Cynthia L.

2016-01-01

Since 1997, the Great Lakes Academy has provided leadership development for more than 800 teachers in a large metropolitan region of the Upper Midwest. Graduates of the 2-year program often describe their experience as transformative, life changing, and profound. To understand the meaning and impact of this transformation, the author used…

Using Calamity to Drive College Policy: President William Beardshear, Iowa State College, and the Challenge of Enrollment Growth, 1891-1902

Science.gov (United States)

Biggs, Douglas

2016-01-01

The six Land Grant colleges and universities across the upper Midwest (Wisconsin, Minnesota, Nebraska, North Dakota State, South Dakota State, and Iowa State) all faced unprecedented challenges in the 1890s. The economic depression brought on by the Panic of 1893 saw budget cutbacks and lean times, but the "McKinley Prosperity," combined…

“Lichens Lite?” chemical analysis of lichens for tracking 26 pollutants

Science.gov (United States)

Sarah Jovan; Susan Will-Wolf; Michael. Amacher

2015-01-01

Lichen chemistry can be used to estimate concentrations of environmental contaminants, ranging from heavy metals and fertilizers to polycyclic aromatic hydrocarbons, dioxins, pesticides, herbicides, and flame retardants. We conducted a pilot looking at 26 metals and nutrient anions in 5 widespread lichen species across the upper Midwest, including: As, Al, Ba, Ca, Cd,...

PTSD: National Center for PTSD

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Full Text Available ... About VHA Learn about VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice Guidelines Access and Quality Data Medical Inspector Patient Safety Organizations Administrative Clinical Quick Links Enter ZIP code ...

PTSD: National Center for PTSD

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Full Text Available ... Website Site Map Content Inventory Accessibility Privacy and Security Updating of Web Site Web Site Policies Important ... About VHA Learn about VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice ...

PTSD: National Center for PTSD

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Military sexual trauma among homeless veterans.

Science.gov (United States)

Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

2013-07-01

Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

Accelerating Research Impact in a Learning Health Care System: VA's Quality Enhancement Research Initiative in the Choice Act Era.

Science.gov (United States)

Kilbourne, Amy M; Elwy, A Rani; Sales, Anne E; Atkins, David

2017-07-01

Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice. With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA's transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act. QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations. QUERI's national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law's further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks. Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health.

Utilization of travel reimbursement in the Veterans Health Administration.

Science.gov (United States)

Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

2014-01-01

To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

"No One Really Knows What It Is That I Need": Learning a New Job at a Small Private College

Science.gov (United States)

Olson, Joann S.

2015-01-01

Colleges and universities are sites of learning, not only for tuition-paying students, but also for those employed by the institution. This qualitative study explored the workplace learning experiences of non-faculty staff at a small, faith-based private college in the upper Midwest who had recently changed jobs within the institution. Learning to…

A mathematical model; Un modelo matematico para el comportamiento de la radiosensibilidad medida con la viabilidad huevo-adulto de Drosophila melanogaster y D. simulans de Laguna Verde, Veracruz

Energy Technology Data Exchange (ETDEWEB)

Castillo M, J.A.; Pimentel P, A.E. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

2000-07-01

This work presents the results to define the adult egg viability behavior (VHA) of two species, Drosophila melanogaster and D. simulans obtained with the mathematical model proposed, as well as the respective curves. The data are the VHA result of both species coming from the vicinity of the Laguna Verde Nuclear Power plant (CNLV) comprise a 10 years collect period starting from 1987 until 1997. Each collect includes four series of data which are the VHA result obtained after treatment with 0, 4, 6 and 8 Gy of gamma rays. (Author)

A mathematical model

International Nuclear Information System (INIS)

Castillo M, J.A.; Pimentel P, A.E.

2000-01-01

This work presents the results to define the adult egg viability behavior (VHA) of two species, Drosophila melanogaster and D. simulans obtained with the mathematical model proposed, as well as the respective curves. The data are the VHA result of both species coming from the vicinity of the Laguna Verde Nuclear Power plant (CNLV) comprise a 10 years collect period starting from 1987 until 1997. Each collect includes four series of data which are the VHA result obtained after treatment with 0, 4, 6 and 8 Gy of gamma rays. (Author)

Computer vision for shoe upper profile measurement via upper and sole conformal matching

Science.gov (United States)

Hu, Zhongxu; Bicker, Robert; Taylor, Paul; Marshall, Chris

2007-01-01

This paper describes a structured light computer vision system applied to the measurement of the 3D profile of shoe uppers. The trajectory obtained is used to guide an industrial robot for automatic edge roughing around the contour of the shoe upper so that the bonding strength can be improved. Due to the specific contour and unevenness of the shoe upper, even if the 3D profile is obtained using computer vision, it is still difficult to reliably define the roughing path around the shape. However, the shape of the corresponding shoe sole is better defined, and it is much easier to measure the edge using computer vision. Therefore, a feasible strategy is to measure both the upper and sole profiles, and then align and fit the sole contour to the upper, in order to obtain the best fit. The trajectory of the edge of the desired roughing path is calculated and is then smoothed and interpolated using NURBS curves to guide an industrial robot for shoe upper surface removal; experiments show robust and consistent results. An outline description of the structured light vision system is given here, along with the calibration techniques used.

Upper GI Bleeding in Children

Science.gov (United States)

Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit blood ...

Estimating tree cavity distributions from historical FIA data

Science.gov (United States)

Mark D. Nelson; Charlotte. Roy

2012-01-01

Tree cavities provide important habitat features for a variety of wildlife species. We describe an approach for using historical FIA data to estimate the number of trees containing cavities during the 1990s in seven states of the Upper Midwest. We estimated a total of 280 million cavity-containing trees. Iowa and Missouri had the highest percentages of cavity-...

Watershed Scale Optimization to Meet Sustainable Cellulosic Energy Crop Demand

Energy Technology Data Exchange (ETDEWEB)

Chaubey, Indrajeet [Purdue Univ., West Lafayette, IN (United States); Cibin, Raj [Purdue Univ., West Lafayette, IN (United States); Bowling, Laura [Purdue Univ., West Lafayette, IN (United States); Brouder, Sylvie [Purdue Univ., West Lafayette, IN (United States); Cherkauer, Keith [Purdue Univ., West Lafayette, IN (United States); Engel, Bernard [Purdue Univ., West Lafayette, IN (United States); Frankenberger, Jane [Purdue Univ., West Lafayette, IN (United States); Goforth, Reuben [Purdue Univ., West Lafayette, IN (United States); Gramig, Benjamin [Purdue Univ., West Lafayette, IN (United States); Volenec, Jeffrey [Purdue Univ., West Lafayette, IN (United States)

2017-03-24

The overall goal of this project was to conduct a watershed-scale sustainability assessment of multiple species of energy crops and removal of crop residues within two watersheds (Wildcat Creek, and St. Joseph River) representative of conditions in the Upper Midwest. The sustainability assessment included bioenergy feedstock production impacts on environmental quality, economic costs of production, and ecosystem services.

PTSD: National Center for PTSD

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Full Text Available ... Interviewing Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) VA Software Documentation Library (VDL) About VHA Learn about VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical ...

76 FR 78739 - Agency Information Collection (Regulation on Application for Fisher Houses and Other Temporary...

Science.gov (United States)

2011-12-19

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0630] Agency Information Collection (Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application... INFORMATION: Title: Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher...

77 FR 50546 - Agency Information Collection: (PACT Patient Experiences Survey); Comment Request

Science.gov (United States)

2012-08-21

... Primary Care sites. This initiative supports the VHA's Universal Health Care Services Plan to redesign VHA... Health Administration Ambulatory Primary Care sites. The medical home provides accessible, coordinated... used by the VAAAHS PACT Demonstration Laboratory and the Ambulatory Care Service to evaluate the...

Reproductive dormancy in boll-weevil from populations of the midwest of Brazil.

Science.gov (United States)

Paula, D P; Claudino, D; Timbó, R V; Miranda, J E; Bemquerer, M P; Ribeiro, A C J; Sujii, E R; Fontes, E M G; Pires, C S S

2013-02-01

The boll weevil (Anthonomus grandis Boheman) (Coleoptera: Curculionidae) is an introduced pest in Brazil, which in 30 yr has successfully expanded to various eco-regions and became the most important pest of cotton (Gossypium hirsutum, Malvaceae). Given the limited knowledge about the adaptive mechanisms that allowed successful establishment of the pest population in a tropical region, in this work we studied the potential of the Midwest population of boll weevils to enter a reproductive dormancy and identified the importance of the feeding source for induction of dormancy. We investigated morphological and physiological characters as indicators of the dormancy. We also investigated the occurrence of reproductive dormancy in boll weevils populations from cotton farms of the Midwestern region of Brazil during the cotton and noncotton seasons of 2009 and 2010. The studies revealed that boll weevils entered facultative reproductive dormancy; however, unlike what has been observed for boll weevils from temperate and subtropical regions, the hypertrophy of fat body and hexamerin levels did not straightly correlated to reproductive dormancy. The food source and field conditions during early adult development were decisive factor for the induction of reproductive dormancy. The incidence of reproductive dormancy increased progressively as the phenology of cotton plant advanced, reaching approximately 90% at the end of the crop season. During the noncotton season, the boll weevil was predominantly found in reproductive dormancy, especially females; however, there is evidence of use of multiple adaptive strategies to colonize the next harvest.

Development and Implementation of the Midwest Geological Sequestration Consortium CO₂-Technology Transfer Center

Energy Technology Data Exchange (ETDEWEB)

Greenberg, Sallie E. [Univ. of Illinois, Champaign, IL (United States)

2015-06-30

In 2009, the Illinois State Geological Survey (ISGS), in collaboration with the Midwest Geological Sequestration Consortium (MGSC), created a regional technology training center to disseminate carbon capture and sequestration (CCS) technology gained through leadership and participation in regional carbon sequestration projects. This technology training center was titled and branded as the Sequestration Training and Education Program (STEP). Over the last six years STEP has provided local, regional, national, and international education and training opportunities for engineers, geologists, service providers, regulators, executives, K-12 students, K-12 educators, undergraduate students, graduate students, university and community college faculty members, and participants of community programs and functions, community organizations, and others. The goal for STEP educational programs has been on knowledge sharing and capacity building to stimulate economic recovery and development by training personnel for commercial CCS projects. STEP has worked with local, national and international professional organizations and regional experts to leverage existing training opportunities and provide stand-alone training. This report gives detailed information on STEP activities during the grant period (2009-2015).

Creating a culture of safety: why CEOs hold the key to improved outcomes.

Science.gov (United States)

Birk, Susan

2009-01-01

When the nonprofit VHA foundation, created by VHA Inc., Irving, Texas, embarked on a national patient safety initiative it looked first to outside industries, gathering information and ideas from pioneers in nuclear energy, aviation, the military and other innovation-rich fields known for safety excellence.

[Viral hepatitis A - possible diagnostic and therapeutic problems].

Science.gov (United States)

Husa, Petr; Husa, Petr

Viral hepatitis A (VHA) is the disease which has an ancient history. Reports of epidemic jaundice were described by Hippocrates in Greece during the 5th century B.C. Incidence of VHA in developed countries is dropping in last decades. What was once common disease is now very rare, usually emerging in local epidemies. With decreasing incidence of hepatitis A clinicians losing practical experiences with disease. Authors present possible diagnostic and therapeutic problems based on their experience with large epidemic of hepatitis A, which occurred in 2016-2017 in Brno area.Key words: hepatitis A (VHA) - hepatitis A virus (HAV).

Environmental and biological controls of urban tree transpiration in the Upper Midwest

Science.gov (United States)

Peters, E. B.; McFadden, J.; Montgomery, R.

2009-12-01

Urban trees provide a variety of ecosystem services to urban and suburban areas, including carbon uptake, climate amelioration, energy reduction, and stormwater management. Tree transpiration, in particular, modifies urban water budgets by providing an alternative pathway for water after rain events. The relative importance of environmental and biological controls on transpiration are poorly understood in urban areas, yet these controls are important for quantifying and scaling up the ecosystem services that urban trees provide at landscape and regional scales and predicting how urban ecosystems will respond to climate changes. The objectives of our study were to quantify the annual cycle of tree transpiration in an urban ecosystem and to determine how different urban tree species and plant functional types respond to environmental drivers. We continuously measured whole-tree transpiration using thermal dissipation sap flow at four urban forest stands that were broadly representative of the species composition and tree sizes found in a suburban residential neighborhood of Minneapolis-Saint Paul, Minnesota. A total of 40 trees, representing different species, plant functional types, successional stages, and xylem anatomy, were sampled throughout the 2007 and 2008 growing seasons (April-November). At each site we monitored soil moisture, air temperature, and relative humidity continuously, and we measured leaf area index weekly. Urban tree transpiration was strongly correlated with diurnal changes in vapor pressure deficit and photosynthetically active radiation and with seasonal changes in leaf area index. We found that plant functional type better explained species differences in transpiration per canopy area than either successional stage or xylem anatomy, largely due to differences in canopy structure between conifer and broad-leaf deciduous trees. We also observed inter-annual differences in transpiration rates due to a mid-season drought and longer growing season in 2007, compared with the cooler, wetter conditions in 2008. These results were scaled to estimate the relative contribution of each tree type at the scale of a suburban landscape. The findings of this study have implications for understanding the role of trees in managing urban water budgets and predicting the impacts of climate change on urban ecosystem services.

Assessment of multimodal freight bottlenecks and alleviation strategies for upper Midwest region.

Science.gov (United States)

2010-05-01

The freight that passes through the Mississippi Valley Region is high volume and has a substantial impact on the economy of the : region. According to the BTS-sponsored Commodity Flow Survey, trucks carried almost 2.5 billion tons of freight across t...

Applying Lean Six Sigma to improve medication management.

Science.gov (United States)

Nayar, Preethy; Ojha, Diptee; Fetrick, Ann; Nguyen, Anh T

2016-01-01

A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA's dual care policy; collect data and describe the current process for co-management of dual care veterans' medications; and draft recommendations to improve the current process for dual care medications co-management. Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. The findings of this project will be of value to VA providers and policy makers and health

Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

Science.gov (United States)

Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

2012-04-01

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Upper gastrointestinal bleeding.

Science.gov (United States)

Feinman, Marcie; Haut, Elliott R

2014-02-01

Upper gastrointestinal (GI) bleeding remains a commonly encountered diagnosis for acute care surgeons. Initial stabilization and resuscitation of patients is imperative. Stable patients can have initiation of medical therapy and localization of the bleeding, whereas persistently unstable patients require emergent endoscopic or operative intervention. Minimally invasive techniques have surpassed surgery as the treatment of choice for most upper GI bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 63355 - Proposed Information Collection (Regulation on Application for Fisher Houses and Other Temporary...

Science.gov (United States)

2011-10-12

... (Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application... information technology. Title: Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application, VA Forms 10-0408 and 10-0408a. OMB Control Number: 2900-0630. Type of Review...

Science Roles and Interactions in Adaptive Management of Large River Restoration Projects, Midwest United States

Science.gov (United States)

Jacobson, R. B.; Galat, D. L.; Smith, C. B.

2010-12-01

Most large-river restoration projects include formal or informal implementations of adaptive management strategies which acknowledge uncertainty and use scientific inquiry to learn and refine management options. Although the central role of science in reducing uncertainty is acknowledged in such projects, specific roles and interactions can vary widely, including how science relates to decision-making within the governance of these projects. Our objective is to present some structured generalizations about science roles and interactions as developed from the authors’ experiences in adaptive management of large river restoration in the Midwest United States. Scientific information may be introduced into decision making by scientists acting in any of the three roles common to adaptive management -- action agency representative, stakeholder, or science provider. We have observed that confusion and gridlock can arise when it is unclear if a scientist is acting as an advocate for a stakeholder or management position, or instead as an independent, “honest broker” of science. Although both advocacy and independence are proper and expected in public decision making, it is useful when scientists unambiguously identify their role. While complete scientific independence may be illusory, transparency and peer review can promote the ideal. Transparency comes from setting clear directions and objectives at the decision-making level and defining at the outset how learning will help assess progress and inform decisions. Independent peer reviews of proposals, study plans, and publications serve as a powerful tool to advance scientific independence, even if funding sources present a potential conflict of interest. Selection of experts for scientific advice and review often requires consideration of the balance between benefits of the “outside” expert (independent, knowledgeable but with little specific understanding of the river system), compared to those provided by the �

HIGH PREVALENCE OF AGENT ORANGE EXPOSURE AMONG THYROID CANCER PATIENTS IN THE NATIONAL VA HEALTHCARE SYSTEM.

Science.gov (United States)

Le, Karen T; Sawicki, Mark P; Wang, Marilene B; Hershman, Jerome M; Leung, Angela M

2016-06-01

Thyroid cancer is the most common endocrine malignancy and the most rapidly increasing cancer in the U.S. Little is known regarding the epidemiology and characteristics of patients with thyroid cancer within the national Veterans Health Administration (VHA) integrated healthcare system. The aim of this study was to further understand the characteristics of thyroid cancer patients in the VHA population, particularly in relation to Agent Orange exposure. This is a descriptive analysis of the VA (Veterans Affairs) Corporate Data Warehouse database from all U.S. VHA healthcare sites from October1, 1999, to December 31, 2013. Information was extracted for all thyroid cancer patients based on International Classification of Diseases-ninth revision diagnosis codes; histologic subtypes of thyroid cancer were not available. There were 19,592 patients (86% men, 76% white, 58% married, 42% Vietnam-era Veteran) in the VHA system with a diagnosis of thyroid cancer within this 14-year study period. The gender-stratified prevalence rates of thyroid cancer among the Veteran population during the study period were 1:1,114 (women) and 1:1,023 (men), which were lower for women but similar for men, when compared to the U.S. general population in 2011 (1:350 for women and 1:1,219 for men). There was a significantly higher proportion of self-reported Agent Orange exposure among thyroid cancer patients (10.0%), compared to the general VHA population (6.2%) (PAgent Orange exposure compared to the overall national VA patient population. T4 = thyroxine TCDD = 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin TSH = thyroid-stimulating hormone VA = Veterans Affairs VHA = Veterans Health Administration.

¿Es necesario investigar anticuerpos IgM contra el virus de la hepatitis A cuando el enzimograma hepático es normal? Is it necessary to investigate anti-hepatitis A virus (HAV IgM antibodies when the hepatic enzymogram is normal?

Directory of Open Access Journals (Sweden)

C. Coitinho

2007-09-01

Full Text Available La hepatitis por virus A (VHA es la más frecuente de las hepatitis virales en el mundo, especialmente en los países subdesarrollados. Donde esta enfermedad es endémica, se suelen realizar un gran número de estudios de laboratorio para confirmarla. El objetivo del presente trabajo fue evaluar la utilidad de investigar anticuerpos IgM anti hepatitis A (IgM anti-VHA para el diagnóstico de la VHA en pacientes con niveles séricos normales de aspartato y alanina aminotransferasas (AST/ALT. Todos los pacientes que concurrieron al laboratorio con solicitud de enzimograma hepático y anticuerpos IgM anti-VHA durante el período octubre 2005-marzo 2006 fueron evaluados en este estudio. Los datos clínicos más frecuentes fueron presunción de hepatitis e ictericia (27,5 y 12,7%. La determinación de IgM anti-VHA se realizó por ensayo inmunoenzimático de micropartículas (MEIA; la de enzimas hepáticas en un multianalizador. De los 158 pacientes estudiados, 84 tenían valores elevados de AST/ALT; dentro de este grupo, el 82% fue reactivo para IgM anti-VHA. Los 74 pacientes restantes mostraron niveles normales de AST/ALT y solo 7 de ellos, bajo control de evolución por VHA ya confirmada, fueron reactivos para IgM anti-VHA. El 49% de los pacientes IgM anti-VHA reactivos correspondió a menores de 10 años. De acuerdo con estas observaciones, sugerimos que los estudios de laboratorio para confirmar infección aguda por VHA deberían realizarse en forma secuencial, ya que es innecesaria la determinación de anticuerpos IgM anti-VHA cuando las aminotransferasas séricas son normales.Type A viral Hepatitis (HAV is the most frequent viral hepatitis around the world, especially in low income countries. In order to confirm this disease, a lot of laboratory tests are annually carried out where HAV is endemic. Our objective was to establish the utility of investigating anti-hepatitis A virus (HAV IgM antibodies for HAV diagnosis in patients with normal

The Midwest Regional Carbon Sequestration Partnership (MRCSP)

Energy Technology Data Exchange (ETDEWEB)

James J. Dooley; Robert Dahowski; Casie Davidson

2005-12-01

This final report summarizes the Phase I research conducted by the Midwest regional Carbon Sequestration Partnership (MRCSP). The Phase I effort began in October 2003 and the project period ended on September 31, 2005. The MRCSP is a public/private partnership led by Battelle with the mission of identifying the technical, economic, and social issues associated with implementation of carbon sequestration technologies in its seven state geographic region (Indiana, Kentucky, Maryland, Michigan, Ohio, Pennsylvania, and West Virginia) and identifying viable pathways for their deployment. It is one of seven partnerships that together span most of the U.S. and parts of Canada that comprise the U.S. Department of Energy's (DOE's) Regional Carbon Sequestration Program led by DOE's national Energy Technology Laboratory (NETL). The MRCSP Phase I research was carried out under DOE Cooperative Agreement No. DE-FC26-03NT41981. The total value of Phase I was $3,513,513 of which the DOE share was $2,410,967 or 68.62%. The remainder of the cost share was provided in varying amounts by the rest of the 38 members of MRCSP's Phase I project. The next largest cost sharing participant to DOE in Phase I was the Ohio Coal Development Office within the Ohio Air Quality Development Authority (OCDO). OCDO's contribution was $100,000 and was contributed under Grant Agreement No. CDO/D-02-17. In this report, the MRCSP's research shows that the seven state MRCSP region is a major contributor to the U. S. economy and also to total emissions of CO2, the most significant of the greenhouse gases thought to contribute to global climate change. But, the research has also shown that the region has substantial resources for sequestering carbon, both in deep geological reservoirs (geological sequestration) and through improved agricultural and land management practices (terrestrial sequestration). Geological reservoirs, especially deep saline reservoirs, offer the potential

Soluble adenylyl cyclase is an acid-base sensor in epithelial base-secreting cells.

Science.gov (United States)

Roa, Jinae N; Tresguerres, Martin

2016-08-01

Blood acid-base regulation by specialized epithelia, such as gills and kidney, requires the ability to sense blood acid-base status. Here, we developed primary cultures of ray (Urolophus halleri) gill cells to study mechanisms for acid-base sensing without the interference of whole animal hormonal regulation. Ray gills have abundant base-secreting cells, identified by their noticeable expression of vacuolar-type H(+)-ATPase (VHA), and also express the evolutionarily conserved acid-base sensor soluble adenylyl cyclase (sAC). Exposure of cultured cells to extracellular alkalosis (pH 8.0, 40 mM HCO3 (-)) triggered VHA translocation to the cell membrane, similar to previous reports in live animals experiencing blood alkalosis. VHA translocation was dependent on sAC, as it was blocked by the sAC-specific inhibitor KH7. Ray gill base-secreting cells also express transmembrane adenylyl cyclases (tmACs); however, tmAC inhibition by 2',5'-dideoxyadenosine did not prevent alkalosis-dependent VHA translocation, and tmAC activation by forskolin reduced the abundance of VHA at the cell membrane. This study demonstrates that sAC is a necessary and sufficient sensor of extracellular alkalosis in ray gill base-secreting cells. In addition, this study indicates that different sources of cAMP differentially modulate cell biology. Copyright © 2016 the American Physiological Society.

Clinical information seeking in traumatic brain injury: a survey of Veterans Health Administration polytrauma care team members.

Science.gov (United States)

Hogan, Timothy; Martinez, Rachael; Evans, Charlesnika; Saban, Karen; Proescher, Eric; Steiner, Monica; Smith, Bridget

2018-03-01

The polytraumatic nature of traumatic brain injury (TBI) makes diagnosis and treatment difficult. To (1) characterise information needs among Veterans Health Administration (VHA) polytrauma care team members engaged in the diagnosis and treatment of TBI; (2) identify sources used for TBI related information; and (3) identify barriers to accessing TBI related information. Cross-sectional online survey of 236 VHA polytrauma care team members. Most respondents (95.8%) keep at least somewhat current regarding TBI, but 31.5% need more knowledge on diagnosing TBI and 51.3% need more knowledge on treating TBI. Respondents use VHA affiliated sources for information, including local colleagues (81.7%), VHA offsite conferences/meetings (78.3%) and onsite VHA educational offerings (73.6%); however, limited time due to administrative responsibilities (50.9%), limited financial resources (50.4%) and patient care (50.4%) were prominent barriers. Medical librarians are in a unique position to develop information services, resources and other electronic tools that reflect the clinical context in which polytrauma care team members practice, and the different tasks they perform. Polytrauma care team members could benefit from additional information regarding the diagnosis and treatment of TBI. Addressing their information needs and supporting their information seeking requires a mulit-pronged approach to time and financial constraints. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil.

Science.gov (United States)

Freitas, Solange Zacalusni; Teles, Sheila Araújo; Lorenzo, Paulo Cesar; Puga, Marco Antonio Moreira; Tanaka, Tayana Serpa Ortiz; Thomaz, Danilo Yamamoto; Martins, Regina Maria Bringel; Druzian, Angelita Fernandes; Lindenberg, Andréa Siqueira Campos; Torres, Marina Sawada; Pereira, Sérgio A; Villar, Livia Melo; Lampe, Elisabete; Motta-Castro, Ana Rita Coimbra

2014-01-01

A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6). In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection), a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3%) and 3 (41.7%). The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

Examining Wrong Eye Implant Adverse Events in the Veterans Health Administration With a Focus on Prevention: A Preliminary Report.

Science.gov (United States)

Neily, Julia; Chomsky, Amy; Orcutt, James; Paull, Douglas E; Mills, Peter D; Gilbert, Christina; Hemphill, Robin R; Gunnar, William

2018-03-01

The study goals were to examine wrong intraocular lens (IOL) implant adverse events in the Veterans Health Administration (VHA), identify root causes and contributing factors, and describe system changes that have been implemented to address this challenge. This study represents collaboration between the VHA's National Center for Patient Safety (NCPS) and the National Surgery Office (NSO). This report includes 45 wrong IOL implant surgery adverse events reported to established VHA NCPS and NSO databases between July 1, 2006, and June 31, 2014. There are approximately 50,000 eye implant procedures performed each year in the VHA. Wrong IOL implant surgery adverse events are reported by VHA facilities to the NCPS and the NSO. Two authors (A.C. and J.N.) coded the reports for event type (wrong lens or expired lens) and identified the primary contributing factor (coefficient κ = 0.837). A descriptive analysis was conducted, which included the reported yearly event rate. The main outcome measure was the reported wrong IOL implant surgery adverse events. There were 45 reported wrong IOL implant surgery adverse events. Between 2011 and June 30, 2014, there was a significant downward trend (P = 0.02, R = 99.7%) at a pace of -0.08 (per 10,000 cases) every year. The most frequently coded primary contributing factor was incomplete preprocedure time-out (n = 12) followed by failure to perform double check of preprocedural calculations based upon original data and implant read-back at the time the surgical eye implant was performed (n = 10). Preventing wrong IOL implant adverse events requires diligence beyond performance of the preprocedural time-out. In 2013, the VHA has modified policy to ensure double check of preprocedural calculations and implant read-back with positive impact. Continued analysis of contributing human factors and improved surgical team communication are warranted.

Understanding and Applying Emotional Intelligence: A Qualitative Study of Tampa Veterans Administration Hospital Employees

Science.gov (United States)

Johnson, Brenda Webb

2017-01-01

Emotional intelligence (EI) has not been studied extensively within the Veterans' Health Administration (VHA). The VHA is the largest healthcare organization in America with over 360,000 employees and the organization invests heavily in competency development. The Tampa VA is a level 1 facility with over 5,000 employees in the Tampa Bay area. The…

VA Health Care: Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed

Science.gov (United States)

2016-09-01

their families , such as medallions and markers for headstones that signify veterans’ service. Page 3 GAO-16-803 VHA Organizational ... Research Oversight, and Chief Nursing Page 8 GAO-16-803 VHA Organizational Structure Officer. Also, the Chief Financial Officer and...VA HEALTH CARE Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed Report to

Reduced Gut Acidity Induces an Obese-Like Phenotype in Drosophila melanogaster and in Mice.

Directory of Open Access Journals (Sweden)

Wei-Sheng Lin

Full Text Available In order to identify genes involved in stress and metabolic regulation, we carried out a Drosophila P-element-mediated mutagenesis screen for starvation resistance. We isolated a mutant, m2, that showed a 23% increase in survival time under starvation conditions. The P-element insertion was mapped to the region upstream of the vha16-1 gene, which encodes the c subunit of the vacuolar-type H+-ATPase. We found that vha16-1 is highly expressed in the fly midgut, and that m2 mutant flies are hypomorphic for vha16-1 and also exhibit reduced midgut acidity. This deficit is likely to induce altered metabolism and contribute to accelerated aging, since vha16-1 mutant flies are short-lived and display increases in body weight and lipid accumulation. Similar phenotypes were also induced by pharmacological treatment, through feeding normal flies and mice with a carbonic anhydrase inhibitor (acetazolamide or proton pump inhibitor (PPI, lansoprazole to suppress gut acid production. Our study may thus provide a useful model for investigating chronic acid suppression in patients.

The reality of virtual learning for nurses in the largest integrated health care system in the nation.

Science.gov (United States)

Rick, Cathy; Kearns, Martha A; Thompson, Nancy A

2003-01-01

The health care network and hospital system within the Department of Veterans Affairs (VA), the Veterans Health Administration (VHA), provides employment to more than 56,000 nursing personnel and serves as clinical education site to countless other nursing and health professional students. Nurse administrators and educators are posed with the challenge of providing an environment in which each nurse is able to gain needed knowledge, learn new skills, and share and communicate this knowledge with other colleagues. The education of nurses improves the health status of veterans while also realizing individual professional enhancement. Regional and cultural diversity of the system present challenges to education, in both delivery and content. VHA's learning organizations, the Employee Education System and the Office of Special Projects, have maximized new technologies and information systems to provide innovative, virtual education opportunities, capitalizing on the benefits of informal and formal learning, thus moving VHA to the forefront in knowledge sharing and dissemination. The Virtual Learning Center, VA Knowledge Network, Learning Catalog, and VA Learning Online provide VHA's nurses with interactive, desktop virtual learning opportunities.

Programmering af applikationer med dSPACE real-time værktøjer

DEFF Research Database (Denmark)

Voigt, Kristian

1998-01-01

real-time direkte på et virkeligt system. Reguleringen af systemet sker vha. et DSP- og I/O-kort. En model af systemet opbygges vha. Matlab/Simulink fra firmaet The Mathworks. Modellen oversættes til C-kode vha. Real-Time Workshop fra firmaet The Mathworks. For at gøre C-koden hardwarespecifik bruges...... software fra hardwareleverandøren - dSPACE. Firmaet dSPACE har desuden levereret software til at monitorere real-time værdier i systemet, og software til at ændre på parametre i modellen i real-time.I brugervejledningens Appendix F findes et eksempel, der gennemgår hele forløbet med opstart af programmer...

Employing the church as a marketer of cancer prevention: a look at a health promotion project aimed to reduce colorectal cancer among African Americans in the Midwest.

Science.gov (United States)

Lumpkins, Crystal Y; Coffey, Candice R; Daley, Christine M; Greiner, K Allen

2013-01-01

Health promotion programs designed to address colorectal cancer disparities among African Americans are increasing. Unfortunately, this group still shoulders a disproportionate mortality burden in the United States; these numbers are also reflective of colorectal cancer (CRC) disparities in the Midwest. The purpose of this study was to extrapolate results from in-depth interviews and brief surveys on the effectiveness of the church as a social marketer of CRC-prevention messages. Results show that pastors believe the congregation has limited knowledge about CRC risk and prevention; they also believe the church can improve cancer-prevention communication among members and those affiliated with the church.

Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

Directory of Open Access Journals (Sweden)

Ferrández Oscar

2012-07-01

Full Text Available Abstract Background The increased use and adoption of Electronic Health Records (EHR causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI, which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity and precision (equivalent to positive predictive value metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches

Adaptation of Lean Six Sigma Methodologies for the Evaluation of Veterans Choice Program at 3 Urban Veterans Affairs Medical Centers.

Science.gov (United States)

Ball, Sherry L; Stevenson, Lauren D; Ladebue, Amy C; McCreight, Marina S; Lawrence, Emily C; Oestreich, Taryn; Lambert-Kerzner, Anne C

2017-07-01

The Veterans Health Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers. LSS techniques were used to assess data obtained through semistructured interviews with Veterans, staff, and providers to describe and evaluate the VCP process by identifying wastes and defects. The LSS methodology facilitated the process of targeting priorities for improvement and constructing suggestions to close identified gaps and inefficiencies. Identified key process wastes included inefficient exchange of clinical information between stakeholders in and outside of the VHA; poor dissemination of VCP programmatic information; shortages of VCP-participating providers; duplication of appointments; declines in care coordination; and lack of program adaptability to local processes. Recommendations for improvement were formulated using LSS. This evaluation illustrates how LSS can be utilized to assess a nationally mandated health care program. By focusing on stakeholder, staff, and Veteran perspectives, process defects in the VCP were identified and improvement recommendations were made. However, the current LSS language used is not intuitive in health care and similar applications of LSS may consider using new language and goals adapted specifically for health care.

Supply evaluation of a herbaceous and woody energy crop at three midwest regions

International Nuclear Information System (INIS)

English, B.C.; Dillivan, K.D.; Ojo, M.A.

1994-01-01

While substantial research has been conducted on the argronomic issues of biomass production and on the processes of converting biofuel crops into energy, little work has been completed analyzing the economic and physical impacts of biofuel production on an agriculturally based region. Acres currently devoted to traditional crops will be replaced by biomass crops if such a conversion proves to be economically attractive. These shifts could have impacts on local and regional levels of farm income, current farmland market values, commodity prices received, and the demand for and prices of farm level inputs. This paper examines the economic and physical ramifications of introducing biomass production to three Midwest regions centered in the following counties; Cass County, North Dakota, Olmsted County, Minnesota, and Orange County, Indiana. Using a regional linear programming model that maximizes net returns to producers subject to several constraints, a supply curve for biomass is developed for each of the three regions. The model predicts that at a plant gate price of $26, $40, and $52 per dry ton, biomass begins to enter into production in the Cass, Olmsted, and Orange Regions respectively. Prices of $28, $44, and $54 per dry ton of biomass are sufficient to supply a quantity necessary to operate a power plant requiring 5,000 dry tons per day in Cass, Olmsted, and Orange regions respectively. In the Olmsted and Orange regions, biomass production results in fertilizer being applied, however, in the Cass Region a slight increase in fertilizer use corresponds to biomass production

Perceived correlates of domain-specific physical activity in rural adults in the Midwest.

Science.gov (United States)

Chrisman, Matthew; Nothwehr, Faryle; Yang, Jingzen; Oleson, Jacob

2014-01-01

In response to calls for more specificity when measuring physical activity, this study examined perceived correlates of this behavior in rural adults separately by the domain in which this behavior occurs (ie, home care, work, active living, and sport). A cross-sectional survey was completed by 407 adults from 2 rural towns in the Midwest. The questionnaire assessed the perceived social and physical environment, including neighborhood characteristics, as well as barriers to being active. The Kaiser Physical Activity Survey captured domain-specific activity levels. The response rate was 25%. Multiple regression analyses were conducted to examine the associations between social and physical environment factors and domain-specific physical activity. Having a favorable attitude toward using government funds for exercise and activity-friendly neighborhood characteristic were positively associated with active living. Friends encouraging exercise was positively associated with participation in sport. Barriers were inversely associated with active living and sport. Total physical activity was positively associated with workplace incentives for exercise, favorable policy attitudes toward supporting physical education in schools and supporting the use of government funds for biking trails, and it was inversely associated with barriers. There were no factors associated with physical activity in the domains of work or home care. Correlates of physical activity are unique to the domain in which this behavior occurs. Programs to increase physical activity in rural adults should target policy attitudes, neighborhood characteristics, and social support from friends while also working to decrease personal barriers to exercise. © 2014 National Rural Health Association.

Community Health Worker Employer Survey: Perspectives on CHW Workforce Development in the Midwest.

Science.gov (United States)

Chaidez, Virginia; Palmer-Wackerly, Angela L; Trout, Kate E

2018-05-30

A statewide Community Health Worker Employer Survey was administered to various clinical, community, and faith-based organizations (n = 240) across a range of rural and urban settings in the Midwest. At least 80% of participants agreed or strongly agreed that items characterized as supervisory support were present in their work environment. Thirty-six percent of respondents currently employed CHWs, over half (51%) of survey respondents reported seeing the need to hire/work with more CHWs, and 44% saw the need for CHWs increasing in the future. Regarding CHW support, a majority of respondents indicated networking opportunities (63%), paid time for networking (80%), adequate time for supervision (75%), orientation training (78%), mandatory training (78%), ongoing training (79%), and paid time for training (82%). Open-ended responses to the question "In your organization, what needs could CHWs meet?" resulted in the largest number of respondents reporting mental health issues as a priority, followed by connecting people with services or resources, educating the public on preventive health, family support, and home care/visitations. Our findings suggest that respondents, who largely have supervisory or managerial roles, view workplace environments in Nebraska favorably, despite the fact that nearly two-thirds of respondents typically work well over 40 h per week. In addition, CHWs could help address mental and physical health needs in a variety of community and clinical settings through primary and secondary prevention activities, such as provision of health screenings, health and nutrition education, connecting people to resources and empowering community members through these activities and more.

Upper gastrointestinal bleeding in patients with CKD.

Science.gov (United States)

Liang, Chih-Chia; Wang, Su-Ming; Kuo, Huey-Liang; Chang, Chiz-Tzung; Liu, Jiung-Hsiun; Lin, Hsin-Hung; Wang, I-Kuan; Yang, Ya-Fei; Lu, Yueh-Ju; Chou, Che-Yi; Huang, Chiu-Ching

2014-08-07

Patients with CKD receiving maintenance dialysis are at risk for upper gastrointestinal bleeding. However, the risk of upper gastrointestinal bleeding in patients with early CKD who are not receiving dialysis is unknown. The hypothesis was that their risk of upper gastrointestinal bleeding is negatively linked to renal function. To test this hypothesis, the association between eGFR and risk of upper gastrointestinal bleeding in patients with stages 3-5 CKD who were not receiving dialysis was analyzed. Patients with stages 3-5 CKD in the CKD program from 2003 to 2009 were enrolled and prospectively followed until December of 2012 to monitor the development of upper gastrointestinal bleeding. The risk of upper gastrointestinal bleeding was analyzed using competing-risks regression with time-varying covariates. In total, 2968 patients with stages 3-5 CKD who were not receiving dialysis were followed for a median of 1.9 years. The incidence of upper gastrointestinal bleeding per 100 patient-years was 3.7 (95% confidence interval, 3.5 to 3.9) in patients with stage 3 CKD, 5.0 (95% confidence interval, 4.8 to 5.3) in patients with stage 4 CKD, and 13.9 (95% confidence interval, 13.1 to 14.8) in patients with stage 5 CKD. Higher eGFR was associated with a lower risk of upper gastrointestinal bleeding (P=0.03), with a subdistribution hazard ratio of 0.93 (95% confidence interval, 0.87 to 0.99) for every 5 ml/min per 1.73 m(2) higher eGFR. A history of upper gastrointestinal bleeding (Pupper gastrointestinal bleeding risk. In patients with CKD who are not receiving dialysis, lower renal function is associated with higher risk for upper gastrointestinal bleeding. The risk is higher in patients with previous upper gastrointestinal bleeding history and low serum albumin. Copyright © 2014 by the American Society of Nephrology.

Right upper quadrant pain

International Nuclear Information System (INIS)

Ralls, P.W.; Colletti, P.M.; Boswell, W.D. Jr.; Halls, J.M.

1984-01-01

Historically, assessment of acute right upper quadrant abdominal pain has been a considerable clinical challenge. While clinical findings and laboratory data frequently narrow the differential diagnosis, symptom overlap generally precludes definitive diagnosis among the various diseases causing acute right upper quadrant pain. Fortunately, the advent of newer diagnostic imaging modalities has greatly improved the rapidity and reliability of diagnosis in these patients. An additional challenge to the physician, with increased awareness of the importance of cost effectiveness in medicine, is to select appropriate diagnostic schema that rapidly establish accurate diagnoses in the most economical fashion possible. The dual goals of this discussion are to assess not only the accuracy of techniques used to evaluate patients with acute right upper quadrant pain, but also to seek out cost-effective, coordinated imaging techniques to achieve this goal

Upper plenum mixing in a BWR

International Nuclear Information System (INIS)

Alamgir, M.; Andersen, J.G.M.; Parameswaran, V.

1984-01-01

A model for the emergency core cooling injection into the upper plenum of a boiling water reactor has been formulated and implemented into the TRACB02 computer program. The model consists of a spray model and a submerged jet model. The submerged jet model is used when the spray nozzles are covered by a two-phase mixture, and the spray model is used when the nozzles are uncovered. The upper plenum model has been assessed by comparison to an upper plenum mixing test in the Steam Sector Test Facility. It is found that the model accurately predicts the phenomena in the upper plenum of a boiling water reactor

Translation of clinical practice guidelines for childhood obesity prevention in primary care mobilizes a rural Midwest community.

Science.gov (United States)

Gibson, S Jo

2016-03-01

The purpose of this project was to implement clinic system changes that support evidence-based guidelines for childhood obesity prevention. Adherence rates for prevention and screening of children in a rural Midwest primary care setting were used to measure the success of the program. Retrospective chart reviews reflected gaps in current practice and documentation. An evidence-based toolkit for childhood obesity prevention was used to implement clinic system changes for the identified gaps. The quality improvement approach proved to be effective in translating knowledge of obesity prevention guidelines into rural clinic practices with significant improvements in documentation of prevention measures that may positively impact the childhood obesity epidemic. Primary care providers, including nurse practitioners (NPs), are at the forefront of diagnosing, educating, and counseling children and families on obesity prevention and need appropriate resources and tools to deliver premier care. The program successfully demonstrated how barriers to practice, even with the unique challenges in a rural setting, can be overcome. NPs fulfill a pivotal primary care role and can provide leadership that may positively impact obesity prevention in their communities. ©2015 American Association of Nurse Practitioners.

Landing the job: A guide to successful transition.

Science.gov (United States)

Roberts, Julia

2014-08-28

Personal development plans (PDPs) guide individuals in personal and professional career enhancement ( Bullock and Jamieson 1998 ). While formats vary, the key component is self-analysis of strengths and weaknesses. This article describes a nurse administrator's successful use of a PDP to progress her career from a mid-level manager position at a small, rural hospital to a senior executive level position at the USA's second largest Veterans Health Administration (VHA) facility. The PDP used VHA's eight core leadership competencies: personal mastery, systems thinking, organisational stewardship, creative thinking, technical skills, interpersonal effectiveness, flexibility, and customer service. These core competencies mirror the VHA's 360° self-assessment tool supported by the National Center for Organization Development ( US Department of Veterans Affairs 2014 ).

Spatial and temporal variation of algal assemblages in six Midwest agricultural streams having varying levels of atrazine and other physicochemical attributes

Energy Technology Data Exchange (ETDEWEB)

Andrus, J. Malia, E-mail: andrusm@waterborne-env.com [Waterborne Environmental, Inc., 2001 South First Street, Suite 109, Champaign, IL 61820 (United States); Winter, Diane, E-mail: dwinter1@juno.com [Rhithron Associates, Inc., 33 Fort Missoula Rd., Missoula, MT 59804 (United States); Algal Analysis, LLC, Missoula, MT (United States); Scanlan, Michael, E-mail: mscanlan@maptech-inc.com [MapTech, Inc., 3154 State Street, Blacksburg, VA 24060 (United States); Sullivan, Sean, E-mail: ssullivan@rhithron.com [Rhithron Associates, Inc., 33 Fort Missoula Rd., Missoula, MT 59804 (United States); Bollman, Wease, E-mail: wbollman@rhithron.com [Rhithron Associates, Inc., 33 Fort Missoula Rd., Missoula, MT 59804 (United States); Waggoner, J.B., E-mail: jwaggoner@inovatia.com [Inovatia, Inc., 120 East Davis Street, Fayette, MO 65248 (United States); Hosmer, Alan J., E-mail: alan.hosmer@syngenta.com [Syngenta Crop Protection, LLC, 410 Swing Rd., Greensboro, NC 27419 (United States); Brain, Richard A., E-mail: richard.brain@syngenta.com [Syngenta Crop Protection, LLC, 410 Swing Rd., Greensboro, NC 27419 (United States)

2015-02-01

Potential effects of pesticides on stream algae occur alongside complex environmental influences; in situ studies examining these effects together are few, and have not typically controlled for collinearity of variables. We monitored the dynamics of periphyton, phytoplankton, and environmental factors including atrazine, and other water chemistry variables at 6 agricultural streams in the Midwest US from spring to summer of 2011 and 2012, and used variation partitioning of community models to determine the community inertia that is explained uniquely and/or jointly by atrazine and other environmental factors or groups of factors. Periphyton and phytoplankton assemblages were significantly structured by year, day of year, and site, and exhibited dynamic synchrony both between site–years and between periphyton and phytoplankton in the same site–year. The majority of inertia in the models (55.4% for periphyton, 68.4% for phytoplankton) was unexplained. The explained inertia in the models was predominantly shared (confounded) between variables and variable groups (13.3, 30.9%); the magnitude of inertia that was explained uniquely by variable groups (15.1, 18.3%) was of the order hydroclimate > chemistry > geography > atrazine for periphyton, and chemistry > hydroclimate > geography > atrazine for phytoplankton. The variables most influential to the assemblage structure included flow and velocity variables, and time since pulses above certain thresholds of nitrate + nitrite, total phosphorus, total suspended solids, and atrazine. Time since a ≥ 30 μg/L atrazine pulse uniquely explained more inertia than time since pulses ≥ 10 μg/L or daily or historic atrazine concentrations; this result is consistent with studies concluding that the effects of atrazine on algae typically only occur at ≥ 30 μg/L and are recovered from. - Highlights: • We monitored algal communities at 6 Midwest streams receiving atrazine in 2011 and 2012. • Partitioning of CCA models of

Spatial and temporal variation of algal assemblages in six Midwest agricultural streams having varying levels of atrazine and other physicochemical attributes

International Nuclear Information System (INIS)

Andrus, J. Malia; Winter, Diane; Scanlan, Michael; Sullivan, Sean; Bollman, Wease; Waggoner, J.B.; Hosmer, Alan J.; Brain, Richard A.

2015-01-01

Potential effects of pesticides on stream algae occur alongside complex environmental influences; in situ studies examining these effects together are few, and have not typically controlled for collinearity of variables. We monitored the dynamics of periphyton, phytoplankton, and environmental factors including atrazine, and other water chemistry variables at 6 agricultural streams in the Midwest US from spring to summer of 2011 and 2012, and used variation partitioning of community models to determine the community inertia that is explained uniquely and/or jointly by atrazine and other environmental factors or groups of factors. Periphyton and phytoplankton assemblages were significantly structured by year, day of year, and site, and exhibited dynamic synchrony both between site–years and between periphyton and phytoplankton in the same site–year. The majority of inertia in the models (55.4% for periphyton, 68.4% for phytoplankton) was unexplained. The explained inertia in the models was predominantly shared (confounded) between variables and variable groups (13.3, 30.9%); the magnitude of inertia that was explained uniquely by variable groups (15.1, 18.3%) was of the order hydroclimate > chemistry > geography > atrazine for periphyton, and chemistry > hydroclimate > geography > atrazine for phytoplankton. The variables most influential to the assemblage structure included flow and velocity variables, and time since pulses above certain thresholds of nitrate + nitrite, total phosphorus, total suspended solids, and atrazine. Time since a ≥ 30 μg/L atrazine pulse uniquely explained more inertia than time since pulses ≥ 10 μg/L or daily or historic atrazine concentrations; this result is consistent with studies concluding that the effects of atrazine on algae typically only occur at ≥ 30 μg/L and are recovered from. - Highlights: • We monitored algal communities at 6 Midwest streams receiving atrazine in 2011 and 2012. • Partitioning of CCA models of

HIV AND HCV COINFECTION: PREVALENCE, ASSOCIATED FACTORS AND GENOTYPE CHARACTERIZATION IN THE MIDWEST REGION OF BRAZIL

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Solange Zacalusni Freitas

2014-12-01

Full Text Available A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6. In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection, a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3% and 3 (41.7%. The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

Indicators of physical fitness in school children from the midwest region of São Paulo City

Directory of Open Access Journals (Sweden)

Maria Tereza Silveira Böhme

2010-08-01

Full Text Available The objectives of this study were: a to evaluate indicators of physical fitness in childrenand adolescents according to chronological age and gender; b to classify their performanceusing the PROESP-BR normative tables. A total of 3145 randomly selected school children (1590boys and 1555 girls, ranging in age from 7 to 16 years, were submitted to the following tests:distance covered in a 9-minute run, standing long jump test, medicine-ball throw, and 60-s situptest to measure abdominal muscle endurance. Significant differences were observed betweengenders at all chronological ages and also between boys of different chronological ages. In girls,no significant differences were observed between chronological ages, with performance tendingto stabilize at 11/12 years of age. Classification of the participants according to the PROESP-BRnormative tables showed that more than 50% of all subjects were below the 40th percentile in alltests, especially girls. The same tendency was observed when compared to other Brazilian studies.Considering mean values, it can be concluded that the school children studied, especially girls,presented a low level of physical fitness, thus indicating the need for health promotion programsin the midwest region of São Paulo City addressing physical activity.

High nitrate concentrations in some Midwest United States streams in 2013 after the 2012 drought

Science.gov (United States)

Van Metre, Peter C.; Frey, Jeffrey W.; Musgrove, MaryLynn; Nakagaki, Naomi; Qi, Sharon L.; Mahler, Barbara J.; Wieczorek, Michael; Button, Daniel T.

2016-01-01

Nitrogen sources in the Mississippi River basin have been linked to degradation of stream ecology and to Gulf of Mexico hypoxia. In 2013, the USGS and the USEPA characterized water quality stressors and ecological conditions in 100 wadeable streams across the midwestern United States. Wet conditions in 2013 followed a severe drought in 2012, a weather pattern associated with elevated nitrogen concentrations and loads in streams. Nitrate concentrations during the May to August 2013 sampling period ranged from nitrate concentrations at the 100 sites were compared with May to June concentrations predicted from a regression model developed using historical nitrate data. Observed concentrations for 17 sites, centered on Iowa and southern Minnesota, were outside the 95% confidence interval of the regression-predicted mean, indicating that they were anomalously high. The sites with a nitrate anomaly had significantly higher May to June nitrate concentrations than sites without an anomaly (means, 19.8 and 3.6 mg L−1, respectively) and had higher antecedent precipitation indices, a measure of the departure from normal precipitation, in 2012 and 2013. Correlations between nitrate concentrations and watershed characteristics and nitrogen and oxygen isotopes of nitrate indicated that fertilizer and manure used in crop production, principally corn, were the dominant sources of nitrate. The anomalously high nitrate levels in parts of the Midwest in 2013 coincide with reported higher-than-normal nitrate loads in the Mississippi River.

Fuzzy upper bounds and their applications

Energy Technology Data Exchange (ETDEWEB)

Soleimani-damaneh, M. [Department of Mathematics, Faculty of Mathematical Science and Computer Engineering, Teacher Training University, 599 Taleghani Avenue, Tehran 15618 (Iran, Islamic Republic of)], E-mail: soleimani_d@yahoo.com

2008-04-15

This paper considers the concept of fuzzy upper bounds and provides some relevant applications. Considering a fuzzy DEA model, the existence of a fuzzy upper bound for the objective function of the model is shown and an effective approach to solve that model is introduced. Some dual interpretations are provided, which are useful for practical purposes. Applications of the concept of fuzzy upper bounds in two physical problems are pointed out.

Familial autoimmunity and polyautoimmunity in 60 Brazilian Midwest patients with systemic sclerosis

Directory of Open Access Journals (Sweden)

Alex Magno Coelho Horimoto

Full Text Available ABSTRACT Introduction: Systemic sclerosis (SSc is a connective tissue disease of unknown etiology, characterized by a triad of vascular injury, autoimmunity and tissue fibrosis. It is known that a positive family history is the greatest risk factor already identified for the development of SSc in a given individual. Preliminary observation of a high prevalence of polyautoimmunity and of familial autoimmunity in SSc patients support the idea that different autoimmune phenotypes may share common susceptibility variants. Objectives: To describe the frequency of familial autoimmunity and polyautoimmunity in 60 SSc patients in the Midwest region of Brazil, as well as to report the main autoimmune diseases observed in this association of comorbidities. Methods: A cross-sectional study with recruitment of 60 consecutive patients selected at the Rheumatology Department, University Hospital, Medicine School, Federal University of Mato Grosso do Sul (FMUFMS, as well as interviews of their relatives during the period from February 2013 to March 2014. Results: A frequency of 43.3% of polyautoimmunity and of 51.7% of familial autoimmunity in SSc patients was found. Patients with the presence of polyautoimmunity and familial autoimmunity presented primarily the diffuse form of SSc, but this indicator did not reach statistical significance. The autoimmune diseases most frequently observed in polyautoimmunity patients were: Hashimoto's thyroiditis (53.8%, Sjögren's syndrome (38.5%, and inflammatory myopathy (11.5%. The main autoimmune diseases observed in SSc patients' relatives were: Hashimoto's thyroiditis (32.3%, rheumatoid arthritis (22.6%, and SLE (22.6%. The presence of more than one autoimmune disease in SSc patients did not correlate with disease severity or activity. Conclusions: From the high prevalence of coexisting autoimmune diseases found in SSc patients, we stress the importance of the concept of shared autoimmunity, in order to promote a

Novel and Lost Forests in the Upper Midwestern United States, from New Estimates of Settlement-Era Composition, Stem Density, and Biomass.

Science.gov (United States)

Goring, Simon J; Mladenoff, David J; Cogbill, Charles V; Record, Sydne; Paciorek, Christopher J; Jackson, Stephen T; Dietze, Michael C; Dawson, Andria; Matthes, Jaclyn Hatala; McLachlan, Jason S; Williams, John W

2016-01-01

EuroAmerican land-use and its legacies have transformed forest structure and composition across the United States (US). More accurate reconstructions of historical states are critical to understanding the processes governing past, current, and future forest dynamics. Here we present new gridded (8x8km) reconstructions of pre-settlement (1800s) forest composition and structure from the upper Midwestern US (Minnesota, Wisconsin, and most of Michigan), using 19th Century Public Land Survey System (PLSS), with estimates of relative composition, above-ground biomass, stem density, and basal area for 28 tree types. This mapping is more robust than past efforts, using spatially varying correction factors to accommodate sampling design, azimuthal censoring, and biases in tree selection. We compare pre-settlement to modern forests using US Forest Service Forest Inventory and Analysis (FIA) data to show the prevalence of lost forests (pre-settlement forests with no current analog), and novel forests (modern forests with no past analogs). Differences between pre-settlement and modern forests are spatially structured owing to differences in land-use impacts and accompanying ecological responses. Modern forests are more homogeneous, and ecotonal gradients are more diffuse today than in the past. Novel forest assemblages represent 28% of all FIA cells, and 28% of pre-settlement forests no longer exist in a modern context. Lost forests include tamarack forests in northeastern Minnesota, hemlock and cedar dominated forests in north-central Wisconsin and along the Upper Peninsula of Michigan, and elm, oak, basswood and ironwood forests along the forest-prairie boundary in south central Minnesota and eastern Wisconsin. Novel FIA forest assemblages are distributed evenly across the region, but novelty shows a strong relationship to spatial distance from remnant forests in the upper Midwest, with novelty predicted at between 20 to 60km from remnants, depending on historical forest

Novel and Lost Forests in the Upper Midwestern United States, from New Estimates of Settlement-Era Composition, Stem Density, and Biomass.

Directory of Open Access Journals (Sweden)

Simon J Goring

Full Text Available EuroAmerican land-use and its legacies have transformed forest structure and composition across the United States (US. More accurate reconstructions of historical states are critical to understanding the processes governing past, current, and future forest dynamics. Here we present new gridded (8x8km reconstructions of pre-settlement (1800s forest composition and structure from the upper Midwestern US (Minnesota, Wisconsin, and most of Michigan, using 19th Century Public Land Survey System (PLSS, with estimates of relative composition, above-ground biomass, stem density, and basal area for 28 tree types. This mapping is more robust than past efforts, using spatially varying correction factors to accommodate sampling design, azimuthal censoring, and biases in tree selection.We compare pre-settlement to modern forests using US Forest Service Forest Inventory and Analysis (FIA data to show the prevalence of lost forests (pre-settlement forests with no current analog, and novel forests (modern forests with no past analogs. Differences between pre-settlement and modern forests are spatially structured owing to differences in land-use impacts and accompanying ecological responses. Modern forests are more homogeneous, and ecotonal gradients are more diffuse today than in the past. Novel forest assemblages represent 28% of all FIA cells, and 28% of pre-settlement forests no longer exist in a modern context. Lost forests include tamarack forests in northeastern Minnesota, hemlock and cedar dominated forests in north-central Wisconsin and along the Upper Peninsula of Michigan, and elm, oak, basswood and ironwood forests along the forest-prairie boundary in south central Minnesota and eastern Wisconsin. Novel FIA forest assemblages are distributed evenly across the region, but novelty shows a strong relationship to spatial distance from remnant forests in the upper Midwest, with novelty predicted at between 20 to 60km from remnants, depending on historical

A Qualitative Evaluation of Web-Based Cancer Care Quality Improvement Toolkit Use in the Veterans Health Administration.

Science.gov (United States)

Bowman, Candice; Luck, Jeff; Gale, Randall C; Smith, Nina; York, Laura S; Asch, Steven

2015-01-01

Disease severity, complexity, and patient burden highlight cancer care as a target for quality improvement (QI) interventions. The Veterans Health Administration (VHA) implemented a series of disease-specific online cancer care QI toolkits. To describe characteristics of the toolkits, target users, and VHA cancer care facilities that influenced toolkit access and use and assess whether such resources were beneficial for users. Deductive content analysis of detailed notes from 94 telephone interviews with individuals from 48 VHA facilities. We evaluated toolkit access and use across cancer types, participation in learning collaboratives, and affiliation with VHA cancer care facilities. The presence of champions was identified as a strong facilitator of toolkit use, and learning collaboratives were important for spreading information about toolkit availability. Identified barriers included lack of personnel and financial resources and complicated approval processes to support tool use. Online cancer care toolkits are well received across cancer specialties and provider types. Clinicians, administrators, and QI staff may benefit from the availability of toolkits as they become more reliant on rapid access to strategies that support comprehensive delivery of evidence-based care. Toolkits should be considered as a complement to other QI approaches.

Veterans Experiencing Elder Abuse: Improving Care of a High-Risk Population About Which Little Is Known.

Science.gov (United States)

Makaroun, Lena K; Taylor, Laura; Rosen, Tony

2018-02-01

At least 10% of older adults experience abuse, neglect, or exploitation annually in the United States, and this problem is expected to grow as our population ages. Little is known about the prevalence and characteristics of elder abuse of veterans, but it is likely that this population is at high risk based on established elder abuse risk factors. Veterans who receive their care through the Veterans Health Administration (VHA) have a higher prevalence of poor psychological health, poor physical health, functional impairment, cognitive impairment, and social isolation than the general population. As the largest integrated healthcare system in the United States, the VHA has long been a leader in the development of innovative, integrated care programs for older adults. The VHA has another opportunity to lead by promoting research, clinical care, and education on elder abuse, furthering their mission of serving those who served. This article outlines the rationale for developing a research agenda for elder abuse in the VHA, as well as potential first steps toward understanding more about this complex problem affecting veterans. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Midwest Forensics Resource Center Project Summary June 2005

Energy Technology Data Exchange (ETDEWEB)

David Baldwin

2005-06-01

The mission of the MFRC Research and Development Program, is to provide technological advances in forensic science for the benefit of our regional partners as well as the forensic community at large. Key areas of forensic science need are identified through our interactions with our Midwest partners and our R&D advisory group, as well as through our participation in national meetings in forensic science. Under the sponsorship of the National Institute of Justice, the MFRC solicits proposals for the development of practical and useful technology, instrumentation, and methodology that address needs in areas related to forensic science and its application to operational crime laboratories. The MFRC facilitates proposal development by working to establish partnerships between researchers and our regional partners. The MFRC administers a peer-review of the proposals and then funds the selected projects at a cost of approximately $55,000 each, with a 12-month period of performance. The process for selection of these projects includes the following steps: (1) drafting of a call for proposals by MFRC staff, (2) review of the draft call by members of the R&D advisory committee, (3) review and approval of the call by NIJ, (4) issuance of the call to ISU, Ames Laboratory, regional partners, and research organizations, (5) receipt of proposals, (6) review of proposals by R&D advisory committee, (7) ranking and selection by MFRC staff using advisory committee reviews, with concurrence by NIJ, (8) notification of proposers, (9) receipt and review of progress reports by MFRC, (10) receipt and review of final reports by MFRC, R&D advisory committee, and NIJ. The decision to fund any specific project is based upon a peer-reviewed call-for-proposal system administered by the MFRC. The reviewers are crime laboratory specialists and scientists who are asked to rate the proposals on four criteria areas including: (1) relevance to the mission of the MFRC, (2) technical approach and

Evaluation of safety climate and employee injury rates in healthcare.

Science.gov (United States)

Cook, Jacqueline M; Slade, Martin D; Cantley, Linda F; Sakr, Carine J

2016-09-01

Safety climates that support safety-related behaviour are associated with fewer work-related injuries, and prior research in industry suggests that safety knowledge and motivation are strongly related to safety performance behaviours; this relationship is not well studied in healthcare settings. We performed analyses of survey results from a Veterans Health Administration (VHA) Safety Barometer employee perception survey, conducted among VHA employees in 2012. The employee perception survey assessed 6 safety programme categories, including management participation, supervisor participation, employee participation, safety support activities, safety support climate and organisational climate. We examined the relationship between safety climate from the survey results on VHA employee injury and illness rates. Among VHA facilities in the VA New England Healthcare System, work-related injury rate was significantly and inversely related to overall employee perception of safety climate, and all 6 safety programme categories, including employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate. Positive employee perceptions of safety climate in VHA facilities are associated with lower work-related injury and illness rates. Employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate were all associated with lower work-related injury rates. Future implications include fostering a robust safety climate for patients and healthcare workers to reduce healthcare worker injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Defense Health Care: DOD Needs to Clarify Policies Related to Occupational and Environmental Health Surveillance and Monitor Risk Mitigation Activities

Science.gov (United States)

2015-05-01

information on the types of illnesses that may result from an exposure. VBA officials told us that they have access to unclassified POEMS through a MESL...Environmental Monitoring Summaries USARCENT U.S. Army Central VA Department of Veterans Affairs VBA Veterans Benefits Administration VHA...Administration ( VBA ) and the Veterans Health Administration (VHA) to identify the ways in which OEHS data is being used, including its use in

Regional distribution of Paenibacillus larvae subspecies larvae, the causative organism of American foulbrood, in honey bee colonies of the Western United States.

Science.gov (United States)

Eischen, Frank A; Graham, R Henry; Cox, Robert

2005-08-01

We examined honey bee, Apis mellifera L., colonies pollinating almonds in California during February 2003 for Paenibacillus larvae subsp. Larvae, the causative organism of the virulent brood disease American foulbrood. Colonies originating from the Rocky Mountain area and California had significantly higher numbers (P bees, respectively) than colonies from the upper Midwest (1.28). Colonies from the northwestern, central, and southwestern United States had intermediate CFU or bacterial colony levels. Operations positive for P. larvae larvae were relatively uniform at approximately 70-80%, and no regional significant differences were found. Percentages of colonies with high CFUs (> or = 400 per 30 bees) differed significantly, with those from the Rocky Mountain region having 8.73% compared with those of the upper Midwest with 0%. The significance of CFU levels was evaluated by inoculating healthy colonies with diseased immatures and sampling adult bees. The number of CFUs detected per diseased immature was conservatively estimated to be approximately 399 CFUs per 30 adult bees. We defined this spore level as 1 disease equivalent. Based on this, 3.86% colonies in our survey had 1 or more disease equivalent number of P. larvae larvae CFUs. Operations with high P. larvae larvae spore levels in their colonies will likely observe American foulbrood if prophylaxis is not practiced diligently.

A break-even analysis for dementia care collaboration: Partners in Dementia Care.

Science.gov (United States)

Morgan, Robert O; Bass, David M; Judge, Katherine S; Liu, C F; Wilson, Nancy; Snow, A Lynn; Pirraglia, Paul; Garcia-Maldonado, Maurilio; Raia, Paul; Fouladi, N N; Kunik, Mark E

2015-06-01

Dementia is a costly disease. People with dementia, their families, and their friends are affected on personal, emotional, and financial levels. Prior work has shown that the "Partners in Dementia Care" (PDC) intervention addresses unmet needs and improves psychosocial outcomes and satisfaction with care. We examined whether PDC reduced direct Veterans Health Administration (VHA) health care costs compared with usual care. This study was a cost analysis of the PDC intervention in a 30-month trial involving five VHA medical centers. Study subjects were veterans (N = 434) 50 years of age and older with dementia and their caregivers at two intervention (N = 269) and three comparison sites (N = 165). PDC is a telephone-based care coordination and support service for veterans with dementia and their caregivers, delivered through partnerships between VHA medical centers and local Alzheimer's Association chapters. We tested for differences in total VHA health care costs, including hospital, emergency department, nursing home, outpatient, and pharmacy costs, as well as program costs for intervention participants. Covariates included caregiver reports of veterans' cognitive impairment, behavior problems, and personal care dependencies. We used linear mixed model regression to model change in log total cost post-baseline over a 1-year follow-up period. Intervention participants showed higher VHA costs than usual-care participants both before and after the intervention but did not differ significantly regarding change in log costs from pre- to post-baseline periods. Pre-baseline log cost (p ≤ 0.001), baseline cognitive impairment (p ≤ 0.05), number of personal care dependencies (p ≤ 0.01), and VA service priority (p ≤ 0.01) all predicted change in log total cost. These analyses show that PDC meets veterans' needs without significantly increasing VHA health care costs. PDC addresses the priority area of care coordination in the National Plan to Address Alzheimer

A case study of population health improvement at a Midwest regional hospital employer.

Science.gov (United States)

Long, D Adam; Sheehan, Paula

2010-06-01

This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

Angiography of the upper extremity

International Nuclear Information System (INIS)

Janevski, B.K.

1982-01-01

This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

Upper gastrointestinal bleeding - state of the art.

Science.gov (United States)

Szura, Mirosław; Pasternak, Artur

2014-01-01

Upper gastrointestinal (GI) bleeding is a condition requiring immediate medical intervention, with high associated mortality exceeding 10%. The most common cause of upper GI bleeding is peptic ulcer disease, which largely corresponds to the intake of NSAIDs and Helicobacter pylori infection. Endoscopy is the essential tool for the diagnosis and treatment of active upper GI hemorrhage. Endoscopic therapy together with proton pump inhibitors and eradication of Helicobacter pylori significantly reduces rebleeding rates, mortality and number of emergency surgical interventions. This paper presents contemporary data on the diagnosis and treatment of upper gastrointestinal bleeding.

Upper bounds of deformation in the Upper Rhine Graben from GPS data - First results from GURN (GNSS Upper Rhine Graben Network)

Science.gov (United States)

Masson, Frederic; Knoepfler, Andreas; Mayer, Michael; Ulrich, Patrice; Heck, Bernhard

2010-05-01

In September 2008, the Institut de Physique du Globe de Strasbourg (Ecole et Observatoire des Sciences de la Terre, EOST) and the Geodetic Institute (GIK) of Karlsruhe University (TH) established a transnational cooperation called GURN (GNSS Upper Rhine Graben Network). Within the GURN initiative these institutions are cooperating in order to establish a highly precise and highly sensitive network of permanently operating GNSS sites for the detection of crustal movements in the Upper Rhine Graben region. At the beginning, the network consisted of the permanently operating GNSS sites of SAPOS®-Baden-Württemberg, different data providers in France (e.g. EOST, Teria, RGP) and some further sites (e.g. IGS). In July 2009, the network was extended to the South when swisstopo (Switzerland) and to the North when SAPOS®-Rheinland-Pfalz joined GURN. Therefore, actually the GNSS network consists of approx. 80 permanently operating reference sites. The presentation will discuss the actual status of GURN, main research goals, and will present first results concerning the data quality as well as time series of a first reprocessing of all available data since 2002 using GAMIT/GLOBK (EOST working group) and the Bernese GPS Software (GIK working group). Based on these time series, the velocity as well as strain fields will be calculated in the future. The GURN initiative is also aiming for the estimation of the upper bounds of deformation in the Upper Rhine Graben region.

MARKETING MECHANISMS TO FACILITATE CO-EXISTENCE OF GM AND NON-GM CROPS

OpenAIRE

Henry, Benjamin; Wilson, William W.; Dahl, Bruce L.

2006-01-01

Development of genetically modified (GM) and specialty crops has had a great impact on the grain handling industry during recent years. Added costs associated with handling these crops have become an important issue for grain handlers. For this study, data were collected from a survey of elevators in the Upper Midwest. The information focused on segregation practices, time requirements, and costs. This study shows the different costs (grading and handling) associated with segregation practice...

Upper bounds on superpartner masses from upper bounds on the Higgs boson mass.

Science.gov (United States)

Cabrera, M E; Casas, J A; Delgado, A

2012-01-13

The LHC is putting bounds on the Higgs boson mass. In this Letter we use those bounds to constrain the minimal supersymmetric standard model (MSSM) parameter space using the fact that, in supersymmetry, the Higgs mass is a function of the masses of sparticles, and therefore an upper bound on the Higgs mass translates into an upper bound for the masses for superpartners. We show that, although current bounds do not constrain the MSSM parameter space from above, once the Higgs mass bound improves big regions of this parameter space will be excluded, putting upper bounds on supersymmetry (SUSY) masses. On the other hand, for the case of split-SUSY we show that, for moderate or large tanβ, the present bounds on the Higgs mass imply that the common mass for scalars cannot be greater than 10(11)  GeV. We show how these bounds will evolve as LHC continues to improve the limits on the Higgs mass.

Report on ticks collected in the Southeast and Mid-West regions of Brazil: analyzing the potential transmission of tick-borne pathogens to man

Directory of Open Access Journals (Sweden)

Figueiredo Luiz Tadeu Moraes

1999-01-01

Full Text Available Specimens of ticks were collected in 1993, 1996, 1997, and 1998, mostly from wild and domestic animals in the Southeast and Mid-West regions of Brazil. Nine species of Amblyommidae were identified: Anocentor nitens, Amblyomma cajennense, Amblyomma ovale, Amblyomma fulvum, Amblyomma striatum, Amblyomma rotundatum, Boophilus microplus, Boophilus annulatus, and Rhipicephalus sanguineus. The potential of these tick species as transmitters of pathogens to man was analyzed. A Flaviviridade Flavivirus was isolated from Amblyomma cajennense specimens collected from a sick capybara (Hydrochaeris hydrochaeris. Amblyomma cajennense is the main transmitter of Rickettsia rickettsii (=R. rickettsi, the causative agent of spotted fever in Brazil. Wild mammals, mainly capybaras and deer, infested by ticks and living in close contact with cattle, horses and dogs, offer the risk of transmission of wild zoonosis to these domestic animals and to man.

Upper atmosphere research at INPE

International Nuclear Information System (INIS)

Clemesha, B.R.

1984-01-01

Upper atmosphere research at INPE is mainly concerned with the chemistry and dynamics of the stratosphere, upper mesosphere and lower thermosphere, and the middle thermosphere. Experimental work includes lidar observations of the stratospheric aerosol, measurements of stratospheric ozone by Dobson spectrophotometers and by balloon and rocket-borne sondes, lidar measurements of atmospheric sodium, and photometric observations of O, O 2 , OH and Na emissions, including interferrometric measurements of the OI6300 emission for the purpose of determing thermospheric winds and temperature. The airglow observations also include measurements of a number of emissions produced by the precipitation of energetic neutral particles generated by charge exchange in the ring current. Some recent results of INPE's upper atmosphere program are presented. (Author) [pt

Geospatial assessment of bioenergy land use and its impacts on soil erosion in the U.S. Midwest.

Science.gov (United States)

SooHoo, William M; Wang, Cuizhen; Li, Huixuan

2017-04-01

Agricultural land use change, especially corn expansion since 2000s, has been accelerating to meet the growing bioenergy demand of the United States. This study identifies the environmentally sensitive lands (ESLs) in the U.S. Midwest using the distance-weighted Revised Universal Soil Loss Equation (RUSLE) associated with bioenergy land uses extracted from USDA Cropland Data Layers. The impacts of soil erosion to downstream wetlands and waterbodies in the river basin are counted in the RUSLE with an inverse distance weighting approach. In a GIS-ranking model, the ESLs in 2008 and 2011 (two representative years of corn expansion) are ranked based on their soil erosion severity in crop fields. Under scenarios of bioenergy land use change (corn to grass and grass to corn) on two land types (ESLs and non-ESLs) at three magnitudes (5%, 10% and 15% change), this study assesses the potential environmental impacts of bioenergy land use at a basin level. The ESL distributions and projected trends vary geographically responding to different agricultural conversions. Results support the idea of re-planting native prairie grasses in the identified High and Severe rank ESLs for sustainable bioenergy management in this important agricultural region. Copyright © 2016 Elsevier Ltd. All rights reserved.

Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

Science.gov (United States)

Page, Stephen J; Hill, Valerie; White, Susan

2013-06-01

To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

A Boundary Property for Upper Domination

KAUST Repository

AbouEisha, Hassan M.; Hussain, Shahid; Lozin, Vadim; Monnot, Jé rô me; Ries, Bernard; Zamaraev, Viktor

2016-01-01

An upper dominating set in a graph is a minimal (with respect to set inclusion) dominating set of maximum cardinality.The problem of finding an upper dominating set is generally NP-hard, but can be solved in polynomial time in some restricted graph

Ensayo de neutralización in vitro de aplicación en la evaluación de inmunógenos contra la hepatitis A, obtenidos mediante la tecnología de expresión en fagos filamentosos

Directory of Open Access Journals (Sweden)

Alicia Aguilar

2010-04-01

Full Text Available La inmunidad contra el virus de la hepatitis A (VHA se debe en primera instancia a la inducción de anticuerpos neutralizantes. Disponer de ensayos de neutralización es indispensable para evaluar nuevos candidatos vacunales contra este patógeno. En el presente trabajo se desarrolló un ensayo de neutralización in vitro que permitió evaluar la inmunogenicidad de mimotopos del VHA obtenidos mediante la tecnología de expresión en fagos al ser inmunizados ratones Balb/c. Diferentes diluciones de anticuerpos se incubaron con 103 o 102 Dosis Infecciosas en Cultivo de Tejidos 50% (DICT50 del clon citopático HM175/18f de VHA, y se inocularon en placas con células FRhK4. Después de 7 días de incubación el título neutralizante se determinó como el recíproco de la dilución del suero capaz de reducir la multiplicación viral al 50%. Tanto 103 como 102 DICT50 fueron neutralizadas por el anticuerpo monoclonal 7E7 y los sueros humanos (A12 y A31 positivos a anticuerpos anti-VHA. Los controles negativos del ensayo no neutralizaron al virus. Los títulos neutralizantes de los sueros de ratones inmunizados con fagos portadores de mimotopos de VHA oscilaron entre 4 y 16, mientras que los sueros preinmunes y los de ratones inmunizados con fago salvaje M13 no neutralizaron la infectividad viral. Este ensayo de neutralización resultó adecuado para la evaluación de los inmunógenos propuestos

The influence of trauma and patient characteristics on provider burnout in VA post-traumatic stress disorder specialty programmes.

Science.gov (United States)

Garcia, Hector A; McGeary, Cindy A; Finley, Erin P; McGeary, Donald D; Ketchum, Norma S; Peterson, Alan L

2016-03-01

Prolonged exposure (PE) and cognitive processing therapy (CPT) - post-traumatic stress disorder (PTSD) treatments now available at the Veterans Health Administration (VHA) - expose the provider to graphic traumatic material. Little is known about the impact of traumatic material on VHA providers. The purpose of this study was to examine the relationship between trauma content, patient characteristics, and burnout among VHA PTSD Clinical Team (PCT) providers. It was hypothesized that trauma content and patient characteristics would significantly predict burnout in this population. This cross-sectional study consisted of 137 participants. The sample was mostly female (67%), Caucasian (non-Hispanic; 81%), and married (70%) with a mean age of 44.3 years (SD = 11.3). Participants completed an electronic survey that assessed demographics, patient characteristics (i.e., anger, personality disorder, malingering), trauma content characteristics (e.g., killing of women and children) as well as burnout as measured by the Maslach Burnout Inventory-General Survey (MBI-GS; Maslach et al., 1996, Burnout inventory manual. Palo Alto: Consulting Psychologist Press). Over half of the study population reported being bothered by trauma content; however, trauma content did not predict burnout. Treating patients with personality disorders and suspected malingering predicted burnout in PCT providers. High numbers (77%) reported perceiving that emotional exhaustion impacted the quality of care they provided. These findings suggest an important role of burnout assessment, prevention, and treatment strategies at the VHA. This paper addresses the impact of provider burnout on perceived quality of care. This paper also addresses potential predictors of burnout in PCT settings. This paper outlines potential remedies to provider burnout in the VHA. © 2015 The British Psychological Society.

Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

Science.gov (United States)

Shay, Kenneth; Hyduke, Barbara; Burris, James F

2013-04-01

The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward.

Science.gov (United States)

Skelton, Felicia; Suda, Katie; Evans, Charlesnika; Trautner, Barbara

2018-01-11

Context Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

Creating a sampling frame for population-based veteran research: representativeness and overlap of VA and Department of Defense databases.

Science.gov (United States)

Washington, Donna L; Sun, Su; Canning, Mark

2010-01-01

Most veteran research is conducted in Department of Veterans Affairs (VA) healthcare settings, although most veterans obtain healthcare outside the VA. Our objective was to determine the adequacy and relative contributions of Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and Department of Defense (DOD) administrative databases for representing the U.S. veteran population, using as an example the creation of a sampling frame for the National Survey of Women Veterans. In 2008, we merged the VHA, VBA, and DOD databases. We identified the number of unique records both overall and from each database. The combined databases yielded 925,946 unique records, representing 51% of the 1,802,000 U.S. women veteran population. The DOD database included 30% of the population (with 8% overlap with other databases). The VHA enrollment database contributed an additional 20% unique women veterans (with 6% overlap with VBA databases). VBA databases contributed an additional 2% unique women veterans (beyond 10% overlap with other databases). Use of VBA and DOD databases substantially expands access to the population of veterans beyond those in VHA databases, regardless of VA use. Adoption of these additional databases would enhance the value and generalizability of a wide range of studies of both male and female veterans.

The influence of gender on suicidal ideation following military sexual trauma among Veterans in the Veterans Health Administration.

Science.gov (United States)

Monteith, Lindsey L; Bahraini, Nazanin H; Matarazzo, Bridget B; Gerber, Holly R; Soberay, Kelly A; Forster, Jeri E

2016-10-30

No studies have examined whether military sexual trauma, as measured and defined within the Veterans Health Administration (VHA), is associated with suicidal ideation among Veterans in VHA care, when taking prior suicide attempts into account. Research regarding the role of gender in this association is also limited. The present study examined: (1) whether military sexual trauma was associated with the presence of past-week suicidal ideation among 354 Veterans in VHA (310 men, 44 women); (2) whether gender moderated the association between military sexual trauma and suicidal ideation. Information regarding military sexual trauma, suicidal ideation, suicide attempt, and psychiatric diagnoses was obtained from self-report instruments and medical records. Adjusting for age, gender, combat, posttraumatic stress disorder, depressive disorders, negative affect, and lifetime suicide attempt, Veterans with military sexual trauma were significantly more likely to report suicidal ideation, compared to Veterans without military sexual trauma. Furthermore, the association between military sexual trauma and suicidal ideation was stronger for men compared to women. These results contribute to a growing literature identifying military sexual trauma as a risk factor for suicidal thoughts and behaviors among Veterans in VHA care and emphasize the importance of screening for suicidal ideation among survivors of military sexual trauma. Published by Elsevier Ireland Ltd.

A Clinical Nurse Leader (CNL) practice development model to support integration of the CNL role into microsystem care delivery.

Science.gov (United States)

Kaack, Lorraine; Bender, Miriam; Finch, Michael; Borns, Linda; Grasham, Katherine; Avolio, Alice; Clausen, Shawna; Terese, Nadine A; Johnstone, Diane; Williams, Marjory

The Veterans Health Administration (VHA) Office of Nursing Services (ONS) was an early adopter of Clinical Nurse Leader (CNL) practice, generating some of the earliest pilot data of CNL practice effectiveness. In 2011 the VHA ONS CNL Implementation & Evaluation Service (CNL I&E) piloted a curriculum to facilitate CNL transition to effective practice at local VHA settings. In 2015, the CNL I&E and local VHA setting stakeholders collaborated to refine the program, based on lessons learned at the national and local level. The workgroup reviewed the literature to identify theoretical frameworks for CNL practice and practice development. The workgroup selected Benner et al.'s Novice-to-Expert model as the defining framework for CNL practice development, and Bender et al.'s CNL Practice Model as the defining framework for CNL practice integration. The selected frameworks were cross-walked against existing curriculum elements to identify and clarify additional practice development needs. The work generated key insights into: core stages of transition to effective practice; CNL progress and expectations for each stage; and organizational support structures necessary for CNL success at each stage. The refined CNL development model is a robust tool that can be applied to support consistent and effective integration of CNL practice into care delivery. Published by Elsevier Inc.

The Veterans Affairs's Corporate Data Warehouse: Uses and Implications for Nursing Research and Practice.

Science.gov (United States)

Price, Lauren E; Shea, Kimberly; Gephart, Sheila

2015-01-01

The Department of Veterans Affairs Veterans Healthcare Administration (VHA) is supported by one of the largest integrated health care information systems in the United States. The VHA's Corporate Data Warehouse (CDW) was developed in 2006 to accommodate the massive amounts of data being generated from more than 20 years of use and to streamline the process of knowledge discovery to application. This article describes the developments in research associated with the VHA's transition into the world of Big Data analytics through CDW utilization. The majority of studies utilizing the CDW also use at least one other data source. The most commonly occurring topics are pharmacy/medications, systems issues, and weight management/obesity. Despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.

Risk management and market efficiency on the Midwest Independent System Operator electricity exchange

Science.gov (United States)

Jones, Kevin

Midwest Independent Transmission System Operator, Inc. (MISO) is a non-profit regional transmission organization (RTO) that oversees electricity production and transmission across thirteen states and one Canadian province. MISO also operates an electronic exchange for buying and selling electricity for each of its five regional hubs. MISO oversees two types of markets. The forward market, which is referred to as the day-ahead (DA) market, allows market participants to place demand bids and supply offers on electricity to be delivered at a specified hour the following day. The equilibrium price, known as the locational marginal price (LMP), is determined by MISO after receiving sale offers and purchase bids from market participants. MISO also coordinates a spot market, which is known as the real-time (RT) market. Traders in the real-time market must submit bids and offers by thirty minutes prior to the hour for which the trade will be executed. After receiving purchase and sale offers for a given hour in the real time market, MISO then determines the LMP for that particular hour. The existence of the DA and RT markets allows producers and retailers to hedge against the large fluctuations that are common in electricity prices. Hedge ratios on the MISO exchange are estimated using various techniques. No hedge ratio technique examined consistently outperforms the unhedged portfolio in terms of variance reduction. Consequently, none of the hedge ratio methods in this study meet the general interpretation of FASB guidelines for a highly effective hedge. One of the major goals of deregulation is to bring about competition and increased efficiency in electricity markets. Previous research suggests that electricity exchanges may not be weak-form market efficient. A simple moving average trading rule is found to produce statistically and economically significant profits on the MISO exchange. This could call the long-term survivability of the MISO exchange into question.

The Upper Atmosphere; Threshold of Space.

Science.gov (United States)

Bird, John

This booklet contains illustrations of the upper atmosphere, describes some recent discoveries, and suggests future research questions. It contains many color photographs. Sections include: (1) "Where Does Space Begin?"; (2) "Importance of the Upper Atmosphere" (including neutral atmosphere, ionized regions, and balloon and investigations); (3)…

Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial.

Science.gov (United States)

Dunning, James R; Cleland, Joshua A; Waldrop, Mark A; Arnot, Cathy F; Young, Ian A; Turner, Michael; Sigurdsson, Gisli

2012-01-01

Randomized clinical trial. To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain. Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain. Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (Ppain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (Pcervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome

Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

OpenAIRE

Wright, Brad; O'Shea, Amy M.J.; Glasgow, Justin M.; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

2016-01-01

Abstract Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals. The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals. Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient...

Diagnosis and treatment of upper limb apraxia

OpenAIRE

Dovern, A.; Fink, G. R.; Weiss, P. H.

2012-01-01

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

The ARMADA Project: Bringing Oceanography and the Arctic to the Midwest

Science.gov (United States)

Pazol, J.

2010-12-01

In the fall of 2009, I spent 6 weeks aboard the Coast Guard Icebreaker Healy on a mapping expedition in the Arctic Ocean, through participation in the University of Rhode Island's ARMADA Project. Because I grew up in the Midwest, went to college here, and teach in the Chicago suburbs, I had limited first-hand experience in oceanography, as did most of my students. During my time aboard the ship, I primarily served as a member of the mapping team, collecting bathymetric and seismic data. My other science activities included aiding geologists and acoustic engineers in dredging projects and deployment of under-ice recording devices. I collected water data, sent off weather balloons, and assisted marine mammal observers. For the ARMADA Project I kept an on-line journal, which had a far-reaching impact. Students in many schools kept track of my activities and communicated with me via e-mail. Colleagues and friends shared the journal through other media, such as Facebook. Several of my entries were published in blogs belonging to NOAA and the USGS. I received a grant for renting a satellite phone, and through it was able to make "Live from the Arctic" phone calls. After introductory PowerPoints I communicated with more than 420 students in 5 schools in 3 states. When I returned, I made a series of presentations about the Arctic and my adventures to hundreds of people and was featured in an educational magazine with a circulation of more than 90,000. I also participated in an in-depth mentoring program with a new teacher to help her succeed during the first years of her career. The results: My students and I now have a direct connection to the Arctic and to the fields of oceanography, acoustic engineering, and geology. On their own initiative, students have developed individual projects exploring aspects of my research. They have attended presentations from the Extreme Ice Center and have become involved in drilling issues in the Chukchi Sea. A group of students is

Eastern Iowa, Northwestern Illinois

Science.gov (United States)

1973-01-01

This view of the Mississippi and Iowa River Valleys (41.5N, 90.5W) shows the rich agricultural region of the upper midwest. Most of the farms occupy one statute mile squares bounded by roads that coincide with the section lines used in the township and range system of surveying practiced in the U.S. central plains, the heart of the great corn belt. Other crops grown in the region include oats, soybeans, hay and alfalfa.

Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration.

Science.gov (United States)

Jay, Melanie; Mateo, Katrina F; Squires, Allison P; Kalet, Adina L; Sherman, Scott E

2015-01-01

Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical

Building a framework to explore water-human interaction for sustainable agro ecosystems in US Midwest

Science.gov (United States)

Mishra, S. K.; Ding, D.; Rapolu, U.

2012-12-01

Human activity is intricately linked to the quality and quantity of water resources. Although many studies have examined water-human interaction, the complexity of such coupled systems is not well understood largely because of gaps in our knowledge of water-cycle processes which are heavily influenced by socio-economic drivers. On this context, this team has investigated connections among agriculture, policy, climate, land use/land cover, and water quality in Iowa over the past couple of years. To help explore these connections the team is developing a variety of cyber infrastructure tools that facilitate the collection, analysis and visualization of data, and the simulation of system dynamics. In an ongoing effort, the prototype system is applied to Clear Creek watershed, an agricultural dominating catchment in Iowa in the US Midwest, to understand water-human processes relevant to management decisions by farmers regarding agro ecosystems. The primary aim of this research is to understand the connections that exist among the agricultural and biofuel economy, land use/land cover change, and water quality. To help explore these connections an agent-based model (ABM) of land use change has been developed that simulates the decisions made by farmers given alternative assumptions about market forces, farmer characteristics, and water quality regulations. The SWAT model was used to simulate the impact of these decisions on the movement of sediment, nitrogen, and phosphorus across the landscape. The paper also demonstrate how through the use of this system researchers can, for example, search for scenarios that lead to desirable socio-economic outcomes as well as preserve water quantity and quality.

A Boundary Property for Upper Domination

KAUST Repository

AbouEisha, Hassan M.

2016-08-08

An upper dominating set in a graph is a minimal (with respect to set inclusion) dominating set of maximum cardinality.The problem of finding an upper dominating set is generally NP-hard, but can be solved in polynomial time in some restricted graph classes, such as P4-free graphs or 2K2-free graphs.For classes defined by finitely many forbidden induced subgraphs, the boundary separating difficult instances of the problem from polynomially solvable ones consists of the so called boundary classes.However, none of such classes has been identified so far for the upper dominating set problem.In the present paper, we discover the first boundary class for this problem.

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

Data.gov (United States)

U.S. Environmental Protection Agency — This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has...

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

Science.gov (United States)

This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

Impact of rural residence and health system structure on quality of liver care.

Directory of Open Access Journals (Sweden)

Catherine Rongey

Full Text Available Specialist physician concentration in urban areas can affect access and quality of care for rural patients. As effective drug treatment for hepatitis C (HCV becomes increasingly available, the extent to which rural patients needing HCV specialists face access or quality deficits is unknown. We sought to determine the influence of rural residency on access to HCV specialists and quality of liver care.The study used a national cohort of 151,965 Veterans Health Administration (VHA patients with HCV starting in 2005 and followed to 2009. The VHA's constant national benefit structure reduces the impact of insurance as an explanation for observed disparities. Multivariate cox proportion regression models for each quality indicator were performed.Thirty percent of VHA patients with HCV reside in rural and highly rural areas. Compared to urban residents, highly rural (HR 0.70, CI 0.65-0.75 and rural (HR 0.96, CI 0.94-0.97 residents were significantly less likely to access HCV specialty care. The quality indicators were more mixed. While rural residents were less likely to receive HIV screening, there were no significant differences in hepatitis vaccinations, endoscopic variceal and hepatocellular carcinoma screening between the geographic subgroups. Of note, highly rural (HR 1.31, CI 1.14-1.50 and rural residents (HR 1.06, CI 1.02-1.10 were more likely to receive HCV therapy. Of those treated for HCV, a third received therapy from a non-specialist provider.Rural patients have less access to HCV specialists, but this does not necessarily translate to quality deficits. The VHA's efforts to improve specialty care access, rural patient behavior and decentralization of HCV therapy beyond specialty providers may explain this contradiction. Lessons learned within the VHA are critical for US healthcare systems restructuring into accountable care organizations that acquire features of integrated systems.

Disproportionate Mental Health Burden Associated With Past-Year Intimate Partner Violence Among Women Receiving Care in the Veterans Health Administration.

Science.gov (United States)

Dichter, Melissa E; Sorrentino, Anneliese; Bellamy, Scarlett; Medvedeva, Elina; Roberts, Christopher B; Iverson, Katherine M

2017-12-01

Experience of intimate partner violence (IPV) can lead to mental health conditions, including anxiety, depression, and unhealthy substance use. Women seen in the Veterans Health Administration (VHA) face high rates of both IPV and mental health morbidity. This study aimed to identify associations between recent IPV experience and mental health diagnoses among women VHA patients. We examined medical records data for 8,888 female veteran and nonveteran VHA patients across 13 VHA facilities who were screened for past-year IPV between April, 2014 and April, 2016. Compared with women who screened negative for past-year IPV (IPV-), those who screened positive (IPV+; 8.7%) were more than twice as likely to have a mental health diagnosis, adjusted odds ratio (AOR) = 2.27, 95% confidence interval (CI) [1.95, 2.64]; or more than two mental health diagnoses, AOR = 2.29, 95% CI [1.93, 2.72]). Screening IPV+ was also associated with significantly higher odds of each type of mental health morbidity (AOR range = 1.85-3.19) except psychoses. Over half (53.5%) of the women who screened IPV+ had a mental health diagnosis, compared with fewer than one-third (32.6%) of those who screened IPV-. Each subtype of IPV (psychological, physical, and sexual violence) was significantly associated with having a mental health diagnosis (AOR range = 2.25-2.37) or comorbidity (AOR range = 2.17-2.78). Associations remained when adjusting for military sexual trauma and combat trauma among the veteran subsample. These findings highlight the mental health burden associated with past-year IPV among female VHA patients and underscore the need to address psychological and sexual IPV, in addition to physical violence. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Extensive upper respiratory tract sarcoidosis

Science.gov (United States)

Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

2016-01-01

Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea. PMID:27090537

DNA barcoding for conservation, seed banking and ecological restoration of Acacia in the Midwest of Western Australia.

Science.gov (United States)

Nevill, Paul G; Wallace, Mark J; Miller, Joseph T; Krauss, Siegfried L

2013-11-01

We used DNA barcoding to address an important conservation issue in the Midwest of Western Australia, working on Australia's largest genus of flowering plant. We tested whether or not currently recommended plant DNA barcoding regions (matK and rbcL) were able to discriminate Acacia taxa of varying phylogenetic distances, and ultimately identify an ambiguously labelled seed collection from a mine-site restoration project. Although matK successfully identified the unknown seed as the rare and conservation priority listed A. karina, and was able to resolve six of the eleven study species, this region was difficult to amplify and sequence. In contrast, rbcL was straightforward to recover and align, but could not determine the origin of the seed and only resolved 3 of the 11 species. Other chloroplast regions (rpl32-trnL, psbA-trnH, trnL-F and trnK) had mixed success resolving the studied taxa. In general, species were better resolved in multilocus data sets compared to single-locus data sets. We recommend using the formal barcoding regions supplemented with data from other plastid regions, particularly rpl32-trnL, for barcoding in Acacia. Our study demonstrates the novel use of DNA barcoding for seed identification and illustrates the practical potential of DNA barcoding for the growing discipline of restoration ecology. © 2013 John Wiley & Sons Ltd.

Upper gastrointestinal alterations in kidney transplant candidates.

Science.gov (United States)

Homse Netto, João Pedro; Pinheiro, João Pedro Sant'Anna; Ferrari, Mariana Lopes; Soares, Mirella Tizziani; Silveira, Rogério Augusto Gomes; Maioli, Mariana Espiga; Delfino, Vinicius Daher Alvares

2018-05-14

The incidence of gastrointestinal disorders among patients with chronic kidney disease (CKD) is high, despite the lack of a good correlation between endoscopic findings and symptoms. Many services thus perform upper gastrointestinal (UGI) endoscopy on kidney transplant candidates. This study aims to describe the alterations seen on the upper endoscopies of 96 kidney-transplant candidates seen from 2014 to 2015. Ninety-six CKD patients underwent upper endoscopic examination as part of the preparation to receive kidney grafts. The data collected from the patients' medical records were charted on Microsoft Office Excel 2016 and presented descriptively. Mean values, medians, interquartile ranges and 95% confidence intervals of the clinic and epidemiological variables were calculated. Possible associations between endoscopic findings and infection by H. pylori were studied. Males accounted for 54.17% of the 96 patients included in the study. Median age and time on dialysis were 50 years and 50 months, respectively. The most frequent upper endoscopy finding was enanthematous pangastritis (57.30%), followed by erosive esophagitis (30.20%). Gastric intestinal metaplasia and peptic ulcer were found in 8.33% and 7.30% of the patients, respectively. H. pylori tests were positive in 49 patients, and H. pylori infection was correlated only with non-erosive esophagitis (P = 0.046). Abnormal upper endoscopy findings were detected in all studied patients. This study suggested that upper endoscopy is a valid procedure for kidney transplant candidates. However, prospective studies are needed to shed more light on this matter.

Lathlike upper bainite in a silicon steel

International Nuclear Information System (INIS)

Liu Cheng; Zhao Zhenbo; Bhole, S.D.

2006-01-01

The morphology and mechanical properties of upper bainite formed isothermally at 400 deg. C for different holding times in a 1.83 wt.% silicon steel have been investigated by optical metallograph, X-ray diffraction and transmission electron microscopy (TEM). In the early stage of upper bainitic transformation, lathlike bainite whose individual lath ferrite is separated by the thin film type of retained austenite is obtained. As the isothermal holding times are increased, the blocky region consisting of retained austenite and martensite is also found. The stability of retained austenite in lathlike upper bainite is studied in relation to the isothermal treatment times, and the heat treatment conditions. The results show that an optimum combination of strength and ductility is attributed to the formation of bainitic ferrite (BF) and a large amount of thin film carbon-enriched retained austenite in the upper bainite

Upper Gastrointestinal Stent Insertion in Malignant and Benign Disorders

Science.gov (United States)

Kang, Hyoun Woo

2015-01-01

Upper gastrointestinal (GI) stents are increasingly being used to manage upper GI obstructions. Initially developed for palliative treatment of esophageal cancer, upper GI stents now play an emerging role in benign strictures of the upper GI tract. Because recurrent obstruction and stent-related complications are common, new modifications of stents have been implemented. Self-expandable metal stents (SEMS) have replaced older plastic stents. In addition, newly designed SEMS have been developed to prevent complications. This review provides an overview of the various types, indications, methods, complications, and clinical outcomes of upper GI stents in a number of malignant and benign disorders dividing the esophagus and gastroduodenum. PMID:26064817

Unsedated Flexible Upper Gastrointestinal Endoscopy: Need for ...

African Journals Online (AJOL)

Background: To determine the incidence of oxygen desaturation and whether routine oxygen monitoring is necessary during unsedated diagnostic flexible upper gastrointestinal endoscopy. Methods: A prospective study involving 54 consecutive in and out patients who had diagnostic upper gastrointestinal endoscopy at ...

Occupational upper airway disease: how work affects the nose

NARCIS (Netherlands)

Hox, V.; Steelant, B.; Fokkens, W.; Nemery, B.; Hellings, P. W.

2014-01-01

Chronic inflammation of the upper airways is common and can arbitrarily be divided into rhinitis and rhinosinusitis. Infection and allergy represent two well-characterized and most frequently diagnosed etiologies of upper airway inflammation. Persistent upper airway inflammation caused by agents

A STUDY ON UPPER GASTROINTESTINAL ENDOSCOPIC FINDINGS IN PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING

Directory of Open Access Journals (Sweden)

Salla Surya Prakasa Rao

2016-10-01

Full Text Available BACKGROUND Vomiting of blood almost always proximal to the ligament of Treitz is the upper gastrointestinal haemorrhage. The incidence of acute upper gastrointestinal haemorrhage has been estimated to be 50-100 per 1,00,000 person per year, with an annual hospitalization rate of approximately 100 per 1, 00,000 hospital admission. This study is to find out the prevalence of nature of lesion on Upper Gastrointestinal Endoscopy in patients admitted for Gastrointestinal bleeding. (UGI Bleed. MATERIALS AND METHODS Place of Study- Department of General Medicine, Andhra Medical College, Visakhapatnam, India. Type of Study- Prospective study. Period of Study- July 2015 to August 2016. RESULTS The Results Study on Endoscopic Findings in Upper Gastro Intestinal Bleed are 1. The peptic ulcer disease was the most common lesion found on endoscopy with prevalence of 54%. 2. Varices contributes second common lesion, next to peptic ulcer disease in UGI bleed with prevalence of 16%. 3. Minor UGI bleed was the commonest presentation. Majority of lesions (60% presented with minor UGI bleed, 28% lesions presented as moderate UGI bleed. Only 8% presented as major UGI bleed. 4. Varices account for the most common cause for major UGI bleed contributing 50%. 5. Gastric ulcer was commonest lesions accounting for 37 cases (37% among 72 cases having single acid peptic lesions on endoscopy. The second most common is duodenal ulcer (31%. 6. Multiple lesions were found in 10% of cases. Peptic ulcer lesions were found in 20% of total number of varices cases. CONCLUSION Peptic ulcer disease was found to be most common lesion causing UGI bleed, with most common presentation as minor UGI bleed and variceal bleed being most common cause of major UGI bleed.

Upper airway evaluation

International Nuclear Information System (INIS)

Hoffman, E.A.; Gefter, W.B.; Schnall, M.; Nordberg, J.; Listerud, J.; Lenkinski, R.E.

1988-01-01

The authors are evaluating upper-airway sleep disorders with magnetic resonance (MR) imaging and x-ray cine computed tomography (CT). Fixed structural anatomy is visualized with multisection spin-echo MR imaging, the dynamic component with cine CT. Unique aspects of the study are described in this paper

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

Directory of Open Access Journals (Sweden)

Seth Stake

2016-01-01

Full Text Available Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

Science.gov (United States)

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

A 12 years audit of upper gastrointestinal endoscopic procedures

International Nuclear Information System (INIS)

Khurram, M.; Khaar, H.B.; Hasan, Z.; Umar, M.; Javed, S.; Asghar, T.; Minhas, Z.; Akbar, A.; Atta, N.; Nassar, F.; Sultana, Q.; Pervaiz, A.; Masoom, A.

2003-01-01

Objective: Evaluation of upper gastrointestinal (GI) endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Results: Of the 8481 patients, 4935 (58.2%) were female and 3546 (41.8%) male. Mean patient age was 40.5 years. Dyspepsia (42.6%), upper GI bleed (32.8%), and evaluation of chronic liver disease (10.2%) were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value = 0.02. Conclusion: Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies. (author)

Decreasing Physical Inactivity in the Veterans Health Administration Employee Population.

Science.gov (United States)

Schult, Tamara M; Schmunk, Sandra K; Awosika, Ebi R

2016-12-01

The aim of this study was to describe a comprehensive approach to decrease physical inactivity in the Veterans Health Administration (VHA) employee population. The approach included (1) initiatives to decrease physical inactivity in the workplace; (2) two operational surveys to assess system-wide service provision; and (3) two national employee surveys. From 2010 to 2012, 86 employee fitness centers were completed in VA medical centers. A grants program (2010 to 2015) funded smaller projects designed to decrease physical inactivity in the workplace. Projects involved the provision of equipment to decrease sedentary behaviors, including stability balls, treadmill and sit-to-stand desks, stairwell projects, and funding for on-site fitness classes, bicycle racks, and outdoor par courses and walking paths among others. A comprehensive approach to decrease physical inactivity in VHA employees was successful. Overall, self-reported, age-adjusted physical inactivity in VHA employees decreased from 25.3% in 2010 to 16.1% in 2015.

PTSD Care Among Veterans With and Without Co-Occurring Substance Use Disorders.

Science.gov (United States)

Mansfield, Alyssa J; Greenbaum, Mark A; Schaper, Kim M; Banducci, Anne N; Rosen, Craig S

2017-06-01

This study examined whether a co-occurring substance use disorder contributed to disparities in receipt of Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) specialty care or psychotherapy. Logistic regression, controlling for sociodemographic characteristics, was used to examine predictors of PTSD care among 424,211 veterans with confirmed PTSD (two or more PTSD diagnosis encounters) who accessed care in a VHA facility between fiscal years 2009 and 2010. Overall, 16% of veterans had PTSD and a co-occurring substance use disorder diagnosis. In adjusted analyses, veterans with a co-occurring substance use disorder were more likely than veterans with PTSD alone to receive any outpatient PTSD specialty care and complete eight or more sessions of outpatient psychotherapy within 14 weeks, but they were less likely to be treated in inpatient PTSD specialty units. Co-occurring substance use disorders did not appear to hinder receipt of outpatient specialty PTSD treatment or of sufficient psychotherapy among VHA-enrolled veterans.

ACA Federal Upper Limits

Data.gov (United States)

U.S. Department of Health & Human Services — Affordable Care Act Federal Upper Limits (FUL) based on the weighted average of the most recently reported monthly average manufacturer price (AMP) for...

ON COMPUTING UPPER LIMITS TO SOURCE INTENSITIES

International Nuclear Information System (INIS)

Kashyap, Vinay L.; Siemiginowska, Aneta; Van Dyk, David A.; Xu Jin; Connors, Alanna; Freeman, Peter E.; Zezas, Andreas

2010-01-01

A common problem in astrophysics is determining how bright a source could be and still not be detected in an observation. Despite the simplicity with which the problem can be stated, the solution involves complicated statistical issues that require careful analysis. In contrast to the more familiar confidence bound, this concept has never been formally analyzed, leading to a great variety of often ad hoc solutions. Here we formulate and describe the problem in a self-consistent manner. Detection significance is usually defined by the acceptable proportion of false positives (background fluctuations that are claimed as detections, or Type I error), and we invoke the complementary concept of false negatives (real sources that go undetected, or Type II error), based on the statistical power of a test, to compute an upper limit to the detectable source intensity. To determine the minimum intensity that a source must have for it to be detected, we first define a detection threshold and then compute the probabilities of detecting sources of various intensities at the given threshold. The intensity that corresponds to the specified Type II error probability defines that minimum intensity and is identified as the upper limit. Thus, an upper limit is a characteristic of the detection procedure rather than the strength of any particular source. It should not be confused with confidence intervals or other estimates of source intensity. This is particularly important given the large number of catalogs that are being generated from increasingly sensitive surveys. We discuss, with examples, the differences between these upper limits and confidence bounds. Both measures are useful quantities that should be reported in order to extract the most science from catalogs, though they answer different statistical questions: an upper bound describes an inference range on the source intensity, while an upper limit calibrates the detection process. We provide a recipe for computing upper

Upper High School Students' Understanding of Electromagnetism

Science.gov (United States)

Saglam, Murat; Millar, Robin

2006-01-01

Although electromagnetism is an important component of upper secondary school physics syllabuses in many countries, there has been relatively little research on students' understanding of the topic. A written test consisting of 16 diagnostic questions was developed and used to survey the understanding of electromagnetism of upper secondary school…

The Development of the Flat-Knitted Shaped Uppers based on Ergonomics

Directory of Open Access Journals (Sweden)

Lu Zhiwen

2016-06-01

Full Text Available To achieve the efficiency and specification of the flat-knitted uppers design, the basic patterns of uppers are made from shoe lasts based on the research on the characteristics of human’s feet and wearability requirements on uppers. The knitting technology for half-shaped and fully shaped uppers was formed after the shear deformation of basic pattern and combination with flat knitting technology. As regards to the functional requirements on key parts of uppers, the structures of flat-knitted shaped uppers were intensively analysed and studied, dividing them into two categories (functional structure and decorative structure, discussing the knitting methods and advantages of different structure, and finally experimentally proving that the planar pattern of flat knitted uppers can apply to the design of flat-knitted uppers and achieve the combination of functionality and artistry of sneakers after combining with structural changes, with a great significance on the achievement of the efficient production of uppers and the enhancement of its commercial value.

Analysis of the upper-truncated Weibull distribution for wind speed

International Nuclear Information System (INIS)

Kantar, Yeliz Mert; Usta, Ilhan

2015-01-01

Highlights: • Upper-truncated Weibull distribution is proposed to model wind speed. • Upper-truncated Weibull distribution nests Weibull distribution as special case. • Maximum likelihood is the best method for upper-truncated Weibull distribution. • Fitting accuracy of upper-truncated Weibull is analyzed on wind speed data. - Abstract: Accurately modeling wind speed is critical in estimating the wind energy potential of a certain region. In order to model wind speed data smoothly, several statistical distributions have been studied. Truncated distributions are defined as a conditional distribution that results from restricting the domain of statistical distribution and they also cover base distribution. This paper proposes, for the first time, the use of upper-truncated Weibull distribution, in modeling wind speed data and also in estimating wind power density. In addition, a comparison is made between upper-truncated Weibull distribution and well known Weibull distribution using wind speed data measured in various regions of Turkey. The obtained results indicate that upper-truncated Weibull distribution shows better performance than Weibull distribution in estimating wind speed distribution and wind power. Therefore, upper-truncated Weibull distribution can be an alternative for use in the assessment of wind energy potential

Upper respiratory tract (image)

Science.gov (United States)

The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

GETDB: 104406 [GETDB

Lifescience Database Archive (English)

Full Text Available 104406 Link to Original y[*] w[*]; P{GawB}NP3193 / CyO, P{UAS-lacZ.UW14}UW14 52B5 L...ink to DGRC Genome Viewer: 104406 fus CG8207 Vha14 3193 2 FlyBase Insertion: P{GawB}NP3193 NP line. Received...uest - sg sg sg internal lethal - - - - - - Show 104406 DGRC Number 104406 Link t... to DGRC Genome Viewer: 104406 Related Genes fus CG8207 Vha14 Original Number 3193 Chr. 2 Comments FlyBase I

Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding.

Science.gov (United States)

Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

2015-05-28

To distinguish upper from lower gastrointestinal (GI) bleeding. Patient records between April 2011 and March 2014 were analyzed retrospectively (3296 upper endoscopy, and 1520 colonoscopy). Seventy-six patients had upper GI bleeding (Upper group) and 65 had lower GI bleeding (Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiver-operator characteristic (ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. Hemoglobin (P = 0.023), total protein (P = 0.0002), and lactate dehydrogenase (P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen (BUN) was higher in the Upper group than in the Lower group (P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vs lower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/dL, with a specificity of 93.0%. The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/dL.

Survey of upper extremity injuries among martial arts participants.

Science.gov (United States)

Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

2013-01-01

To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

Correlation of preadmission organic chemistry courses and academic performance in biochemistry at a midwest chiropractic doctoral program.

Science.gov (United States)

McRae, Marc P

2010-01-01

Organic chemistry has been shown to correlate with academic success in the preclinical years of medicine, dentistry, and graduate physiology. The purpose of this study is to examine the relationship between undergraduate organic chemistry grades and first-semester biochemistry grades at a Midwest chiropractic doctoral program. Students enrolled in a first-semester biochemistry course who had completed the prerequisite courses in organic chemistry offered at this same institution were entered into the study. The total grade for each of the three courses was calculated using the midterm and final exam raw scores with a weighting of 50% each. Analysis consisted of obtaining correlation coefficients between the total grades of organic 1 with biochemistry and organic 2 with biochemistry. Using the biochemistry total grade, the students were divided into quartiles and course grades for both organic chemistry 1 and 2 were calculated. For the 109 students in the study, the correlation coefficient between the biochemistry and organic chemistry 1 and biochemistry and organic chemistry 2 courses was r = 0.744 and r = 0.725, respectively. The difference in organic chemistry grades between those in the first and fourth quartiles was 63.2% and 86.9% for organic chemistry 1 (p organic chemistry 2 (p organic chemistry can be used as an indicator of future academic success in a chiropractic biochemistry course. Knowledge of such a relationship could prove useful to identify students who may potentially run into academic difficulty with first-year biochemistry.

Upper-Level Waves of Synoptic Scale at Midlatitudes

Science.gov (United States)

Rivest, Chantal

1990-01-01

Upper-level waves of synoptic scale are important dynamical entities at midlatitudes. They often induce surface cyclogenesis (cf. Peterssen and Smebye, 1971), and their life duration is typically longer than time scales for disruption by the ambient shear (Sanders, 1988). The objectives of the present thesis are to explain the maintenance and genesis of upper-level synoptic-scale waves in the midlatitude flow. We develop an analytical model of waves on generalized Eady basic states that have uniform tropospheric and stratospheric potential vorticity, but allow for the decay of density with height. The Eady basic state represents the limiting case of infinite stratospheric stability and constant density. We find that the Eady normal mode characteristics hold in the presence of realistic tropopause and stratosphere. In particular, the basic states studied support at the synoptic scale upper-level normal modes. These modes provide simple models for the dynamics of upper-level synoptic-scale waves, as waves supported by the large latitudinal gradients of potential vorticity at the tropopause. In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal mode solutions no longer exist, as was demonstrated in Green (1960). Disappearance of the normal mode solution when a parameter changes slightly represents a dilemma that we seek to understand. We examine what happens to the upper-level normal modes in the presence of tropospheric gradients of potential vorticity in a series of initial -value experiments. Our results show that the normal modes become slowly decaying quasi-modes. Mathematically the quasi-modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained

Mid-upper-arm-circumference and mid-upper-arm circumference z-score

DEFF Research Database (Denmark)

Rasmussen, J; Andersen, A; Fisker, A B

2012-01-01

Mid-upper-arm circumference (MUAC) is a simple method of assessing nutritional status in children above 6 months of age. In 2007 World Health Organization (WHO) introduced a MUAC z-score for children above 3 months of age. We evaluated whether MUAC or MUAC z-score had the best ability to identify...

Arterial variations of upper limb: a case report

Directory of Open Access Journals (Sweden)

Vollala V

2005-01-01

Full Text Available Variations of upper limb arteries are common and there are many reports about this subject. We report multiple variations in arterial pattern of upper extremity, which were encountered in a single cadaver.

Upper Limit for Regional Sea Level Projections

Science.gov (United States)

Jevrejeva, Svetlana; Jackson, Luke; Riva, Riccardo; Grinsted, Aslak; Moore, John

2016-04-01

With more than 150 million people living within 1 m of high tide future sea level rise is one of the most damaging aspects of warming climate. The latest Intergovernmental Panel on Climate Change report (AR5 IPCC) noted that a 0.5 m rise in mean sea level will result in a dramatic increase the frequency of high water extremes - by an order of magnitude, or more in some regions. Thus the flood threat to the rapidly growing urban populations and associated infrastructure in coastal areas are major concerns for society. Hence, impact assessment, risk management, adaptation strategy and long-term decision making in coastal areas depend on projections of mean sea level and crucially its low probability, high impact, upper range. With probabilistic approach we produce regional sea level projections taking into account large uncertainties associated with Greenland and Antarctica ice sheets contribution. We calculate the upper limit (as 95%) for regional sea level projections by 2100 with RCP8.5 scenario, suggesting that for the most coastlines upper limit will exceed the global upper limit of 1.8 m.

PWR upper/lower internals shield

Energy Technology Data Exchange (ETDEWEB)

Homyk, W.A. [Indian Point Station, Buchanan, NY (United States)

1995-03-01

During refueling of a nuclear power plant, the reactor upper internals must be removed from the reactor vessel to permit transfer of the fuel. The upper internals are stored in the flooded reactor cavity. Refueling personnel working in containment at a number of nuclear stations typically receive radiation exposure from a portion of the highly contaminated upper intervals package which extends above the normal water level of the refueling pool. This same issue exists with reactor lower internals withdrawn for inservice inspection activities. One solution to this problem is to provide adequate shielding of the unimmersed portion. The use of lead sheets or blankets for shielding of the protruding components would be time consuming and require more effort for installation since the shielding mass would need to be transported to a support structure over the refueling pool. A preferable approach is to use the existing shielding mass of the refueling pool water. A method of shielding was devised which would use a vacuum pump to draw refueling pool water into an inverted canister suspended over the upper internals to provide shielding from the normally exposed components. During the Spring 1993 refueling of Indian Point 2 (IP2), a prototype shield device was demonstrated. This shield consists of a cylindrical tank open at the bottom that is suspended over the refueling pool with I-beams. The lower lip of the tank is two feet below normal pool level. After installation, the air width of the natural shielding provided by the existing pool water. This paper describes the design, development, testing and demonstration of the prototype device.

Transfusion strategy for acute upper gastrointestinal bleeding.

Science.gov (United States)

Handel, James; Lang, Eddy

2015-09-01

Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.

Barriers, facilitators, and benefits of implementation of dialectical behavior therapy in routine care: results from a national program evaluation survey in the Veterans Health Administration.

Science.gov (United States)

Landes, Sara J; Rodriguez, Allison L; Smith, Brandy N; Matthieu, Monica M; Trent, Lindsay R; Kemp, Janet; Thompson, Caitlin

2017-12-01

National implementation of evidence-based psychotherapies (EBPs) in the Veterans Health Administration (VHA) provides important lessons on the barriers and facilitators to implementation in a large healthcare system. Little is known about barriers and facilitators to the implementation of a complex EBP for emotional and behavioral dysregulation-dialectical behavioral therapy (DBT). The purpose of this study was to understand VHA clinicians' experiences with barriers, facilitators, and benefits from implementing DBT into routine care. This national program evaluation survey measured site characteristics of VHA sites (N = 59) that had implemented DBT. DBT was most often implemented in general mental health outpatient clinics. While 42% of sites offered all four modes of DBT, skills group was the most frequently implemented mode. Fifty-nine percent of sites offered phone coaching in any form, yet only 11% of those offered it all the time. Providers were often provided little to no time to support implementation of DBT. Barriers that were difficult to overcome were related to phone coaching outside of business hours. Facilitators to implementation included staff interest and expertise. Perceived benefits included increased hope and functioning for clients, greater self-efficacy and compassion for providers, and ability to treat unique symptoms for clinics. There was considerable variability in the capacity to address implementation barriers among sites implementing DBT in VHA routine care. Mental health policy makers should note the barriers and facilitators reported here, with specific attention to phone coaching barriers.

Mental Health Service Utilization before and after Receipt of a Service-Connected Disability Award for PTSD: Findings from a National Sample.

Science.gov (United States)

Sripada, Rebecca K; Hannemann, Claire M; Schnurr, Paula P; Marx, Brian P; Pollack, Stacey J; McCarthy, John F

2018-04-17

To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Upper Eyelid Fractional CO2 Laser Resurfacing With Incisional Blepharoplasty.

Science.gov (United States)

Kotlus, Brett S; Schwarcz, Robert M; Nakra, Tanuj

2016-01-01

Laser resurfacing, performed at the same time as blepharoplasty, has most commonly been applied to the lower eyelid skin but can effectively be used on the upper eyelid to reduce rhytidosis and improve skin quality. The authors evaluate the safety and efficacy of this procedure. Fractional CO2 laser resurfacing was performed in conjunction with incisional upper blepharoplasty. The ultrapulsed laser energy was applied to the sub-brow skin, the upper medial canthal skin, and the pretarsal skin in 30 patients. Photos were obtained preoperatively and at 3 months. All patients demonstrated reduction in upper eyelid rhytidosis without any serious complications. Independent rhytidosis grading (0-4) showed a mean improvement of 42%. One patient experienced wound dehiscence that satisfactorily resolved without intervention. Upper eyelid laser resurfacing is effective and can be safely performed at the same time as upper blepharoplasty. This approach reduces or eliminates the need for medial incisions to address medial canthal skin redundancy and rhytidosis and it directly treats upper eyelid wrinkles on residual eyelid and infra-brow skin during blepharoplasty.

Upper urinary tract tumors

DEFF Research Database (Denmark)

Gandrup, Karen L; Nordling, Jørgen; Balslev, Ingegerd

2014-01-01

BACKGROUND: Computed tomography urography (CTU) is used widely in the work-up of patients with symptoms of urinary tract lesions. Preoperative knowledge of whether a tumor is invasive or non-invasive is important for the choice of surgery. So far there are no studies about the distinction...... of invasive and non-invasive tumors in ureter and renal pelvis based on the enhancement measured with Hounsfield Units. PURPOSE: To examine the value of CTU using split-bolus technique to distinguish non-invasive from invasive urothelial carcinomas in the upper urinary tract. MATERIAL AND METHODS: Patients...... obtained at CTU could distinguish between invasive and non-invasive lesions. No patients had a CTU within the last year before the examination that resulted in surgery. CONCLUSION: A split-bolus CTU cannot distinguish between invasive and non-invasive urothelial tumors in the upper urinary tract...

Work-Related Upper Limb Disorders: A Case Report

Directory of Open Access Journals (Sweden)

Zlatka Borisova Stoyneva

2015-03-01

Full Text Available In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud’s phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud’s phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed.

Visceral pain originating from the upper urinary tract

DEFF Research Database (Denmark)

Pedersen, Katja Venborg; Drewes, Asbjørn Mohr; Frimodt-Møller, Poul Christian

2010-01-01

Pain originating from the upper urinary tract is a common problem and stone colic is one of the most intense pain conditions that can be experienced in the clinic. The pain is difficult to alleviate and often leads to medical attention. In humans, pain mechanisms of the upper urinary tract pain...... are still poorly understood, which often leads to a trial and error approach in clinical pain management. Pain from the upper urinary tract seems to have all the characteristics of pure visceral pain, including referred pain with or without hyperalgesia/trophic changes in somatic tissues and viscero......-visceral hyperalgesia. However, further studies are needed to better understand these visceral pain mechanisms with regard to optimising pain management. This review gives an introduction to visceral pain in general and upper urinary tract pain in particular, with special reference to pain pathways and pharmacological...

Upper limits on the total cosmic-ray luminosity of individual sources

Energy Technology Data Exchange (ETDEWEB)

Anjos, R.C.; De Souza, V. [Instituto de Física de São Carlos, Universidade de São Paulo, São Paulo (Brazil); Supanitsky, A.D., E-mail: rita@ifsc.usp.br, E-mail: vitor@ifsc.usp.br, E-mail: supanitsky@iafe.uba.ar [Instituto de Astronomía y Física del Espacio (IAFE), CONICET-UBA, Buenos Aires (Argentina)

2014-07-01

In this paper, upper limits on the total luminosity of ultra-high-energy cosmic-rays (UHECR) E > 10{sup 18} eV) are determined for five individual sources. The upper limit on the integral flux of GeV--TeV gamma-rays is used to extract the upper limit on the total UHECR luminosity of individual sources. The correlation between upper limit on the integral GeV--TeV gamma-ray flux and upper limit on the UHECR luminosity is established through the cascading process that takes place during propagation of the cosmic rays in the background radiation fields, as explained in reference [1]. Twenty-eight sources measured by FERMI-LAT, VERITAS and MAGIC observatories have been studied. The measured upper limit on the GeV--TeV gamma-ray flux is restrictive enough to allow the calculation of an upper limit on the total UHECR cosmic-ray luminosity of five sources. The upper limit on the UHECR cosmic-ray luminosity of these sources is shown for several assumptions on the emission mechanism. For all studied sources an upper limit on the ultra-high-energy proton luminosity is also set.

Upper limits on the total cosmic-ray luminosity of individual sources

International Nuclear Information System (INIS)

Anjos, R.C.; De Souza, V.; Supanitsky, A.D.

2014-01-01

In this paper, upper limits on the total luminosity of ultra-high-energy cosmic-rays (UHECR) E > 10 18 eV) are determined for five individual sources. The upper limit on the integral flux of GeV--TeV gamma-rays is used to extract the upper limit on the total UHECR luminosity of individual sources. The correlation between upper limit on the integral GeV--TeV gamma-ray flux and upper limit on the UHECR luminosity is established through the cascading process that takes place during propagation of the cosmic rays in the background radiation fields, as explained in reference [1]. Twenty-eight sources measured by FERMI-LAT, VERITAS and MAGIC observatories have been studied. The measured upper limit on the GeV--TeV gamma-ray flux is restrictive enough to allow the calculation of an upper limit on the total UHECR cosmic-ray luminosity of five sources. The upper limit on the UHECR cosmic-ray luminosity of these sources is shown for several assumptions on the emission mechanism. For all studied sources an upper limit on the ultra-high-energy proton luminosity is also set

Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing".

Science.gov (United States)

Çağıcı, Can Alper

2017-11-16

Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Upper intestinal lipids regulate energy and glucose homeostasis.

Science.gov (United States)

Cheung, Grace W C; Kokorovic, Andrea; Lam, Tony K T

2009-09-01

Upon the entry of nutrients into the small intestine, nutrient sensing mechanisms are activated to allow the body to adapt appropriately to the incoming nutrients. To date, mounting evidence points to the existence of an upper intestinal lipid-induced gut-brain neuronal axis to regulate energy homeostasis. Moreover, a recent discovery has also revealed an upper intestinal lipid-induced gut-brain-liver neuronal axis involved in the regulation of glucose homeostasis. In this mini-review, we will focus on the mechanisms underlying the activation of these respective neuronal axes by upper intestinal lipids.

Preliminary stratigraphy and facies analysis of the Upper Cretaceous Kaguyak Formation, including a brief summary of newly discovered oil stain, upper Alaska Peninsula

Science.gov (United States)

Wartes, Marwan A.; Decker, Paul L.; Stanley, Richard G.; Herriott, Trystan M.; Helmold, Kenneth P.; Gillis, Robert J.

2013-01-01

The Alaska Division of Geological and Geophysical Surveys has an ongoing program aimed at evaluating the Mesozoic forearc stratigraphy, structure, and petroleum systems of lower Cook Inlet. Most of our field studies have focused on the Jurassic component of the petroleum system (this report). However, in late July and early August of 2012, we initiated a study of the stratigraphy and reservoir potential of the Upper Cretaceous Kaguyak Formation. The Kaguyak Formation is locally well exposed on the upper Alaska Peninsula (fig. 25) and was named by Keller and Reiser (1959) for a sequence of interbedded siltstone and sandstone of upper Campanian to Maastrichtian age that they estimated to be 1,450 m thick.Subsequent work by Detterman and Miller (1985) examined 900 m of section and interpreted the unit as the record of a prograding submarine fan.This interpretation of deep-water deposition contrasts with other Upper Cretaceous rocks exposed along the Alaska Peninsula and lower Cook Inlet that are generally described as nonmarine to shallow marine (Detterman and others, 1996; LePain and others, 2012).Based on foraminifera and palynomorphs from the COST No. 1 well, Magoon (1986) concluded that the Upper Cretaceous rocks were deposited in a variety of water depths and environments ranging from upper bathyal to nonmarine. During our recent fieldwork west and south of Fourpeaked Mountain, we similarly encountered markedly varying lithofacies in the Kaguyak Formation (fig. 25), and we also found oil-stained rocks that are consistent with the existence of an active petroleum system in Upper Cretaceous rocks on the upper Alaska Peninsula and in lower Cook Inlet. These field observations are summarized below.

Infantile lipofibromatosis of the upper limb

Energy Technology Data Exchange (ETDEWEB)

Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Chan, Mei-Yoke [KK Women' s and Children' s Hospital, Department of Paediatric Medicine, Singapore (Singapore); Walford, Norman [Tan Tock Seng Hospital, Department of Pathology, Singapore (Singapore)

2005-12-01

The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. (orig.)

UPPER FRASNIAN (UPPER DEVONIAN POLYGNATHUS AND ICRIODUS CONODONTS FROM THE BAHRAM FORMATION, HUR SECTION, KERMAN PROVINCE, SOUTHEASTERN IRAN

Directory of Open Access Journals (Sweden)

TAYEBEH AHMADI

2012-07-01

Full Text Available Conodont fauna from the Upper Devonian (Frasnian Bahram Formation at the Hur section, north of Kerman, southeast Iran, is dominated by species of Icriodus and Polygnathus. This fauna allowed discrimination of two biointervals from the Lower rhenana Zone to an Upper rhenana-linguiformis interval. The age of the lower part of the studied section is tentatively considered to be older than the Lower rhenana Zone. 

The gothic arch tracing and the upper canine teeth as guides in the positioning of upper posterior teeth.

Science.gov (United States)

el-Gheriani, A S; Davies, A L; Winstanley, R B

1989-09-01

The relationship between the position of the buccal cusps of the natural upper posterior teeth and the distance between the lateral arms of the Gothic arch tracing or the distance between the upper canine teeth has been found to be constant to within +/- 2 mm. This may be of value when setting up artificial teeth for denture patients, enabling them to be positioned close to the natural predecessors.

Upper entropy axioms and lower entropy axioms

International Nuclear Information System (INIS)

Guo, Jin-Li; Suo, Qi

2015-01-01

The paper suggests the concepts of an upper entropy and a lower entropy. We propose a new axiomatic definition, namely, upper entropy axioms, inspired by axioms of metric spaces, and also formulate lower entropy axioms. We also develop weak upper entropy axioms and weak lower entropy axioms. Their conditions are weaker than those of Shannon–Khinchin axioms and Tsallis axioms, while these conditions are stronger than those of the axiomatics based on the first three Shannon–Khinchin axioms. The subadditivity and strong subadditivity of entropy are obtained in the new axiomatics. Tsallis statistics is a special case of satisfying our axioms. Moreover, different forms of information measures, such as Shannon entropy, Daroczy entropy, Tsallis entropy and other entropies, can be unified under the same axiomatics

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use.

Science.gov (United States)

Nelson, Karin M; Helfrich, Christian; Sun, Haili; Hebert, Paul L; Liu, Chuan-Fen; Dolan, Emily; Taylor, Leslie; Wong, Edwin; Maynard, Charles; Hernandez, Susan E; Sanders, William; Randall, Ian; Curtis, Idamay; Schectman, Gordon; Stark, Richard; Fihn, Stephan D

2014-08-01

In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care clinics, we developed and validated a method to assess PCMH implementation. To create an index that measures the extent of PCMH implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. We conducted an observational study using data on more than 5.6 million veterans who received care at 913 VHA hospital-based and community-based primary care clinics and 5404 primary care staff from (1) VHA clinical and administrative databases, (2) a national patient survey administered to a weighted random sample of veterans who received outpatient care from June 1 to December 31, 2012, and (3) a survey of all VHA primary care staff in June 2012. Composite scores were constructed for 8 core domains of PACT: access, continuity, care coordination, comprehensiveness, self-management support, patient-centered care and communication, shared decision making, and team-based care. Patient satisfaction, rates of hospitalization and emergency department use, quality of care, and staff burnout. Fifty-three items were included in the PACT Implementation Progress Index (Pi2). Compared with the 87 clinics in the lowest decile of the Pi2, the 77 sites in the top decile exhibited significantly higher patient satisfaction (9.33 vs 7.53; P hospitalization rates for ambulatory care-sensitive conditions (4.42 vs 3.68 quarterly admissions for veterans 65 years or older per 1000 patients; P < .001), and lower emergency department use (188 vs 245 visits per 1000 patients; P < .001). The extent of PCMH implementation, as measured by the Pi2, was highly associated with important outcomes for both

Structures and immunolocalization of Na+, K+ -ATPase, Na+ /H+ exchanger 3 and vacuolar-type H+ -ATPase in the gills of blennies (Teleostei: Blenniidae) inhabiting rocky intertidal areas.

Science.gov (United States)

Uchiyama, M; Komiyama, M; Yoshizawa, H; Shimizu, N; Konno, N; Matsuda, K

2012-05-01

The structure and immunolocalization of the ion transporters Na(+) ,K(+) -ATPase (NKA), Na(+) /H(+) exchanger (NHE3) and vacuolar-type H(+) -ATPase (VHA) were examined in the gills of teleosts of the family Blenniidae, which inhabit rocky shores with vertical zonation in subtropical seas. These features were compared among the following species with different ecologies: the amphibious rockskipper blenny Andamia tetradactylus, the intertidal white-finned blenny Praealticus tanegasimae and the purely marine yaeyama blenny Ecsenius yaeyamaensis. Light and electron microscopic observations indicated that thick gill filaments were arranged close to each other and alternately on two hemibranches of a gill arch in the opercular space of A. tetradactylus. Many mucous cells (MC) and mitochondrion-rich cells (MRC) were present in the interlamellar regions of the gill filament. An immunohistochemical study demonstrated that numerous NKA, NHE3 and some VHA were located predominantly on presumed MRCs of gill filaments and at the base of the lamellae. Analyses using serial (mirror image) sections of the gills indicated that only a few NKA immunoreactive cells (IRC) were colocalized with VHA on some MRCs in the filaments. In the gills of P. tanegasimae, NKA- and NHE3-IRCs were observed in the interlamellar region of the filaments and at the base of the lamellae. VHA-IRCs were located sparsely on the lamellae and filaments. In the gills of E. yaeyamaensis, the lamellae and filaments were thin and straight, respectively. MCs were located at the tip as well as found scattered in the interlamellar region of gill filaments. NKA-, NHE3- and VHA-IRCs were moderately frequently observed in the filaments and rarely on the lamellae. This study shows that the structure and distribution of ion transporters in the gills differ among the three blennid species, presumably reflecting their different ecologies. © 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the

Traumatic upper cervical esophageal perforation in childhood with ...

African Journals Online (AJOL)

rae. The next step was an upper gastrointestinal series, in which posterior oropharyngeal and cervical esophageal perforation draining to the posterior mediastinum was detected (Fig. 1). Emergency laryngobronchoscopy and esophagoscopy were performed. The upper and lower airways were normal except mild laryngeal ...

A dichotomy for upper domination in monogenic classes

KAUST Repository

AbouEisha, Hassan M.; Hussain, Shahid; Lozin, Vadim V.; Monnot, Jé rô me; Ries, Bernard

2014-01-01

An upper dominating set in a graph is a minimal (with respect to set inclusion) dominating set of maximum cardinality. The problem of finding an upper dominating set is NP-hard for general graphs and in many restricted graph families. In the present

Invasive earthworms interact with abiotic conditions to influence the invasion of common buckthorn (Rhamnus cathartica).

Science.gov (United States)

Roth, Alexander M; Whitfeld, Timothy J S; Lodge, Alexandra G; Eisenhauer, Nico; Frelich, Lee E; Reich, Peter B

2015-05-01

Common buckthorn (Rhamnus cathartica L.) is one of the most abundant and ecologically harmful non-native plants in forests of the Upper Midwest United States. At the same time, European earthworms are invading previously glaciated areas in this region, with largely anecdotal evidence suggesting they compound the negative effects of buckthorn and influence the invasibility of these forests. Germination and seedling establishment are important control points for colonization by any species, and manipulation of the conditions influencing these life history stages may provide insight into why invasive species are successful in some environments and not others. Using a greenhouse microcosm experiment, we examined the effects of important biotic and abiotic factors on the germination and seedling establishment of common buckthorn. We manipulated light levels, leaf litter depth and earthworm presence to investigate the independent and interactive effects of these treatments on buckthorn establishment. We found that light and leaf litter depth were significant predictors of buckthorn germination but that the presence of earthworms was the most important factor; earthworms interacted with light and leaf litter to increase the number and biomass of buckthorn across all treatments. Path analysis suggested both direct and moisture-mediated indirect mechanisms controlled these processes. The results suggest that the action of earthworms may provide a pathway through which buckthorn invades forests of the Upper Midwest United States. Hence, researchers and managers should consider co-invasion of plants and earthworms when investigating invasibility and creating preemptive or post-invasion management plans.

Upper plenum dump during reflood in PWR loss-of-coolant accident

International Nuclear Information System (INIS)

Sudo, Yukio; Griffith, Peter.

1981-01-01

Upper plenum dump during reflood in a large break loww-of-coolant accident of PWR is studied with the emergency core coolant injection into the upper plenum in addition to the cold leg. Transient experiments were carried out by injecting water into the upper plenum and the simple analysis based on a one-dimensional model was done using the drift flux model in order to investigate the conditions under which water dump through the core occurs during reflood. The most significant result is an upper plenum dump occurs when the pressure (hydrostatic head) in the upper plenum is greater than that in the lower plenum. Under those circumstances the flow regime isco-current down flow in which the upper plenum is rapidly emptied. On the other hand, when the upper plenum pressure (hydrostatic head) is less than the lower plenum pressure (hydrostatic head), the co-current down flow is not realized but a counter-current flow occurs. With subcooled water injection to the upper plenum, co-current down flow is realized even when the upper plenum hydrostatic head is less than the lower plenum hydrostatic head. The importance of this effect varies according to the magnetude of water subcooling. (author)

Cerebral gas embolism due to upper gastrointestinal endoscopy

NARCIS (Netherlands)

ter Laan, Mark; Totte, Erik; van Hulst, Rob A.; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E.

Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of

Cerebral gas embolism due to upper gastrointestinal endoscopy

NARCIS (Netherlands)

ter Laan, Mark; Totte, Erik; van Hulst, Rob A.; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E.

2009-01-01

Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of

Upper limb injury in rugby union football: results of a cohort study.

Science.gov (United States)

Usman, Juliana; McIntosh, Andrew Stuart

2013-04-01

There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

Upper Domination: Towards a Dichotomy Through Boundary Properties

KAUST Repository

AbouEisha, Hassan M.

2017-07-14

An upper dominating set in a graph is a minimal dominating set of maximum cardinality. The problem of finding an upper dominating set is generally NP-hard. We study the complexity of this problem in finitely defined classes of graphs and conjecture that the problem admits a complexity dichotomy in this family. A helpful tool to study the complexity of an algorithmic problem is the notion of boundary classes. However, none of such classes has been identified so far for the upper dominating set problem. We discover the first boundary class for this problem and prove the dichotomy for monogenic classes.

Congenital upper eyelids ectropion in Down’s syndrome

Directory of Open Access Journals (Sweden)

Corredor-Osorio, Rafael

2017-02-01

Full Text Available Congenital bilateral ectropion of the upper eyelids is a rare, benign condition reported in ophthalmic literature. It is more frequently associated with Down’s syndrome, ichthyosis, and sporadic cases in newborns from black population. We report three cases of congenital bilateral upper eyelid ectropion associated with Down’s syndrome. Management of these patients usually requires medial and lateral canthoplasties, full-thickness pentagonal resection of the upper eyelids and placement of skin grafts. We present herein the evolution of one of these patients and we will discuss the mechanism of the eyelid ectropion and its treatment.

Prevalence of upper limb disorders among female librarians.

Science.gov (United States)

Pandy, R

2013-09-01

Work as a librarian involves exposure to potential risk factors for developing upper limb disorders. The prevalence of upper limb symptoms has, however, not previously been assessed in this occupational group. To estimate the 7-day and annual prevalence of self-reported neck and upper limb symptoms in librarians and to examine associations with specific tasks and ergonomic risk factors. A cross-sectional study using components of the standardized Nordic questionnaire. The study population consisted of librarians employed by a large local authority, and data collection was by means of a self-administered questionnaire. from studies on keyboard workers and on the general population were used as comparators. The 7-day prevalence of self-reported neck and upper limb pain in female librarians was 42% (95% confidence interval (CI) 33.7-50.5) and the annual prevalence was 65% (95% CI 56.6-72.8). The prevalence of reported wrist and hand pain increased with increased working involving a wide thumb-index span (P librarians was high, but there was insufficient evidence to confirm whether the prevalence was higher than in the general population or among keyboard workers. Working with a wide thumb-index span was associated with reporting upper limb symptoms.

in upper gastrointestinal endoscopy

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Sinan Uzman

2016-07-01

Full Text Available Introduction : There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE. Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE are few. Aim: To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times. Material and methods: This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy. The patients were divided into propofol and midazolam/meperidine groups. Randomization was generated by a computer. Cardiopulmonary side effects (hypotension, bradycardia, hypoxemia, procedure-related times (endoscopy time, awake time, time to hospital discharge, and patient and endoscopist satisfaction were compared between groups. Results: There was no significant difference between the groups with respect to the cost, endoscopy time, or demographic and clinical characteristics of the patients. Awake time and time to hospital discharge were significantly shorter in the propofol group (6.58 ±4.72 vs. 9.32 ±4.26 min, p = 0.030 and 27.60 ±7.88 vs. 32.00 ±10.54 min, p = 0.019. Hypotension incidence was significantly higher in the propofol group (12% vs. 0%, p = 0.027. The patient and endoscopist satisfaction was better with propofol. Conclusions : Propofol may be preferred to midazolam/meperidine sedation, with a shorter awake and hospital discharge time and better patient and endoscopist satisfaction. However, hypotension risk should be considered with propofol, and careful evaluation is needed, particularly in cardiopulmonary disorders.

Essential learning tools for continuing medical education for physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows: the Midwest Reproductive Symposium International.

Science.gov (United States)

Collins, Gretchen G; Jeelani, Roohi; Beltsos, Angeline; Kearns, William G

2018-04-01

Essential learning tools for continuing medical education are a challenge in today's rapidly evolving field of reproductive medicine. The Midwest Reproductive Symposium International (MRSi) is a yearly conference held in Chicago, IL. The conference is targeted toward physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows engaged in the practice of reproductive medicine. In addition to the scientific conference agenda, there are specific sessions for nurses, mental health professionals, and REI fellows. Unique to the MRSi conference, there is also a separate "Business Minds" session to provide education on business acumen as it is an important element to running a department, division, or private clinic.

Orthodontic intervention of an impacted upper left central incisor due ...

African Journals Online (AJOL)

A fixed orthodontic appliance was used to facilitate traction and correction of malalignement of the impacted upper left central incisor.Treatment outcome: Successful removal of the odontoma, full exposure of the crown of upper left central incisor and good alignment on the arch were achieved. Crowding on the upper and ...

Formation and dissociation of dust molecules in dusty plasma

Science.gov (United States)

Yan, Jia; Feng, Fan; Liu, Fucheng; Dong, Lifang; He, Yafeng

2016-09-01

Dust molecules are observed in a dusty plasma experiment. By using measurements with high spatial resolution, the formation and dissociation of the dust molecules are studied. The ion cloud in the wake of an upper dust grain attracts the lower dust grain nearby. When the interparticle distance between the upper dust grain and the lower one is less than a critical value, the two dust grains would form a dust molecule. The upper dust grain always leads the lower one as they travel. When the interparticle distance between them is larger than the critical value, the dust molecule would dissociate. Project supported by the National Natural Science Foundation of China (Grant Nos. 11205044 and 11405042), the Natural Science Foundation of Hebei Province, China (Grant Nos. A2011201006 and A2012201015), the Research Foundation of Education Bureau of Hebei Province, China (Grant No. Y2012009), the Program for Young Principal Investigators of Hebei Province, China, and the Midwest Universities Comprehensive Strength Promotion Project, China.

Improved Mars Upper Atmosphere Climatology

Science.gov (United States)

Bougher, S. W.

2004-01-01

The detailed characterization of the Mars upper atmosphere is important for future Mars aerobraking activities. Solar cycle, seasonal, and dust trends (climate) as well as planetary wave activity (weather) are crucial to quantify in order to improve our ability to reasonably depict the state of the Mars upper atmosphere over time. To date, our best information is found in the Mars Global Surveyor (MGS) Accelerometer (ACC) database collected during Phase 1 (Ls = 184 - 300; F10.7 = 70 - 90) and Phase 2 (Ls = 30 - 90; F10.7 = 90 - 150) of aerobraking. This database (100 - 170 km) consists of thermospheric densities, temperatures, and scale heights, providing our best constraints for exercising the coupled Mars General Circulation Model (MGCM) and the Mars Thermospheric General Circulation Model (MTGCM). The Planetary Data System (PDS) contains level 0 and 2 MGS Accelerometer data, corresponding to atmospheric densities along the orbit track. Level 3 products (densities, temperatures, and scale heights at constant altitudes) are also available in the PDS. These datasets provide the primary model constraints for the new MGCM-MTGCM simulations summarized in this report. Our strategy for improving the characterization of the Mars upper atmospheres using these models has been three-fold : (a) to conduct data-model comparisons using the latest MGS data covering limited climatic and weather conditions at Mars, (b) to upgrade the 15-micron cooling and near-IR heating rates in the MGCM and MTGCM codes for ad- dressing climatic variations (solar cycle and seasonal) important in linking the lower and upper atmospheres (including migrating tides), and (c) to exercise the detailed coupled MGCM and MTGCM codes to capture and diagnose the planetary wave (migrating plus non-migrating tidal) features throughout the Mars year. Products from this new suite of MGCM-MTGCM coupled simulations are being used to improve our predictions of the structure of the Mars upper atmosphere for the

Work-related upper limb “overuse” syndromes

DEFF Research Database (Denmark)

Jepsen, Jørgen Riis

2016-01-01

A previous review of historical descriptions and theories about the character and pathogenesis of writer’s cramp and other comparable chronic upper limb “overuse” work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case...... series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb...... disorders remain diagnostically challenging to clinicians and there is still a tendency to see many patients’ pain as a psychiatric problem when a standard physical examination does not explain the condition. This article describes reports of writer’s cramp and comparable occupational upper limb “overuse...

Upper limb treatment technigues for stroke survivors

Directory of Open Access Journals (Sweden)

Martyna Kornet

2017-03-01

It was considered that the most important elements of the treatment used in the rehabilitation of the paretic upper limb are: exercise matching the anti-spasm pattern, maintaining appropriate position for exercise that provide an approximation of the shoulder joint and the use of cross-facilitation. The study indicates that the treatment of a post stroke upper limb should be based on the: physiotherapy, kinesiotherapy and specific positioning - all of them corresponding to a given stage of the disease. The work also presents the most frequently used methods, especially highlighting: the Prorioceptive Neuromuscular Facilitation (PNF, Bobath, Brunnstrom, CIMT and OIT. It was also shown that in order to enhance the effects of a post-stroke upper limb rehabilitation, it should be extended by modern methods such as Mirror Therapy, Virtual Reality or Robot-assisted Therapy.

Hypnosis and upper digestive function and disease

Science.gov (United States)

Chiarioni, Giuseppe; Palsson, Olafur S; Whitehead, William E

2008-01-01

Hypnosis is a therapeutic technique that primarily involves attentive receptive concentration. Even though a small number of health professionals are trained in hypnosis and lingering myths and misconceptions associated with this method have hampered its widespread use to treat medical conditions, hypnotherapy has gained relevance as an effective treatment for irritable bowel syndrome not responsive to standard care. More recently, a few studies have addressed the potential influence of hypnosis on upper digestive function and disease. This paper reviews the efficacy of hypnosis in the modulation of upper digestive motor and secretory function. The present evidence of the effectiveness of hypnotherapy as a treatment for functional and organic diseases of the upper bowel is also summarized, coupled with a discussion of potential mechanisms of its therapeutic action. PMID:19009639

Percutaneous transsplenic varices embolization for upper gastrointestinal bleeding

International Nuclear Information System (INIS)

Zhang Qiang; Li Jingyu; Lu Junliang; Xu Liyang; Liu Tao

2010-01-01

Objective: To investigate the value of percutaneous transsplenic varices embolization (PTSVE) for treatment of upper gastrointestinal bleeding. Methods: Twenty cases with liver cirrhosis and portal hypertension suffered upper gastrointestinal bleeding. PTSVE was administered to them with hardener and coils. Among them, 8 cases had massive hepatocellular carcinoma (HCC) in right lobe; 10 cases with hepatocellular carcinoma had portal vein tumor thrombus and occlusion; the other two cases with liver cirrhosis had portal vein thrombosis. All of these cases were not suitable for percutaneous transhepatic varices embolization (PTHVE). PTSVE was performed under the guidance of fluoroscopy. Results: Technical success was achieved in 18 patients. A total of 35 gastric coronary veins were embolized. In all these cases, upper gastrointestinal bleeding stopped after PTSVE. There was no recurrence within 1 month follow-up. No serious complication occurred. Conclusion: PTSVE is a safe and efficient alternative treatment for upper gastrointestinal bleeding, especially for cases with portal vein occlusion or with massive HCC in right lobe of liver. (authors)

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Geomechanical Framework for Secure CO₂ Storage in Fractured Reservoirs and Caprocks for Sedimentary Basins in theMidwest United States

Energy Technology Data Exchange (ETDEWEB)

Sminchak, Joel [Battelle, Columbus, OH (United States)

2017-09-29

This report presents final technical results for the project Geomechanical Framework for Secure CO₂ Storage in Fractured Reservoirs and Caprocks for Sedimentary Basins in the Midwest United States (DE-FE0023330). The project was a three-year effort consisting of seven technical tasks focused on defining geomechanical factors for CO₂ storage applications in deep saline rock formations in Ohio and the Midwest United States, because geomechancial issues have been identified as a significant risk factor for large-scale CO₂ storage applications. A basin-scale stress-strain analysis was completed to describe the geomechanical setting for rock formations of Ordovician-Cambrian age in Ohio and adjacent areas of the Midwest United States in relation to geologic CO₂ storage applications. The tectonic setting, stress orientation-magnitude, and geomechanical and petrophysical parameters for CO₂ storage zones and caprocks in the region were cataloged. Ten geophysical image logs were analyzed for natural fractures, borehole breakouts, and drilling-induced fractures. The logs indicated mostly less than 10 fractures per 100 vertical feet in the borehole, with mostly N65E principal stress orientation through the section. Geophysical image logs and other logs were obtained for three wells located near the sites where specific models were developed for geomechanical simulations: Arches site in Boone County, Kentucky; Northern Appalachian Basin site in Chautauqua County, New York; and E-Central Appalachian Basin site in Tuscarawas County, Ohio. For these three wells, 9,700 feet of image logs were processed and interpreted to provide a systematic review of the distribution within each well of natural fractures, wellbore breakouts, faults, and drilling induced fractures. There were many borehole breakouts and drilling-induced tensile fractures but few natural fractures. Concentrated fractures were present at the Rome-basal sandstone

Upper lip changes and gingival exposure on smiling: vertical dimension analysis.

Science.gov (United States)

Miron, Hagai; Calderon, Shlomo; Allon, Dror

2012-01-01

Our objectives were to evaluate and quantify upper lip soft-tissue changes in the vertical dimensions both at rest and at maximum smile, and to examine the correlation between upper labial vestibular attachment height and maxillary gingival exposure on smiling. Seventy-two volunteers (36 men, 36 women) aged 20 to 40 (mean, 30.49 years) were recruited for this study. For each subject, 9 measurements of upper lip position and maxillary incisor crown height at rest and in maximum smile were recorded. A statistically significant sexual dimorphism was apparent in most of the measured variables. Relaxed external upper lip length was 3.1 mm shorter in the women than in the men. The mean maxillary central incisor display at rest was 1.78 mm greater in the women than in the men. A high smile line was 2.5 times more prevalent in the women. The upper lip was shortened by 30% in subjects with a high smile line compared with 23% in subjects with a low smile line. The following findings were observed in subjects with a high smile pattern: (1) short upper lip length, (2) low smiling/resting upper lip length ratio, (3) inferior attachment of the upper labial vestibule, and (4) prominent upper lip vermilion. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

Directory of Open Access Journals (Sweden)

Saleem Jason J

2011-11-01

Full Text Available Abstract Background Based on barriers to the use of computerized clinical decision support (CDS learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration's (VHA's colorectal cancer (CRC screening clinical reminder to compare against the VHA's current CRC reminder. Methods In a controlled simulation experiment, 12 primary care providers (PCPs used prototypes of the current and redesigned CRC screening reminder in a within-subject comparison. Quantitative measurements were based on a usability survey, workload assessment instrument, and workflow integration survey. We also collected qualitative data on both designs. Results Design enhancements to the VHA's existing CRC screening clinical reminder positively impacted aspects of usability and workflow integration but not workload. The qualitative analysis revealed broad support across participants for the design enhancements with specific suggestions for improving the reminder further. Conclusions This study demonstrates the value of a human-computer interaction evaluation in informing the redesign of information tools to foster uptake, integration into workflow, and use in clinical practice.

Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012.

Science.gov (United States)

Wright, Brad; OʼShea, Amy M J; Glasgow, Justin M; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

2016-09-01

Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals.The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals.Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals' observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects.We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005.Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured.

PA and NP productivity in the Veterans Health Administration.

Science.gov (United States)

Moran, Eileen A; Basa, Edesha; Gao, Jian; Woodmansee, Denni; Almenoff, Peter L; Hooker, Roderick S

2016-07-01

This study assessed the 2014 clinical productivity of 5,959 physician assistants (PAs) and nurse practitioners (NPs) in the US Department of Veterans Affairs' Veterans Health Administration (VHA). Total work relative value units divided by the direct clinical full-time equivalent measured annual productivity, and correlated factors were examined using weighted analysis of variance. PAs and NPs in adult primary care roles were more productive than those in other specialties. Both providers were more productive in rural than in nonrural settings and less productive in teaching than nonteaching hospitals. Men were slightly more productive than women but age and years of VHA employment were not correlates of productivity. PAs were more productive when their scope of practice allowed significant autonomy; NP productivity was unaffected by supervisory requirements. PAs and NPs are an important component of the VHA provider workforce, and their productivity correlates with a number of factors. More organizational research is necessary to better understand the contributing roles PAs and NPs provide in a rapidly evolving, vertically integrated, national health delivery system.

Correlation of Preadmission Organic Chemistry Courses and Academic Performance in Biochemistry at a Midwest Chiropractic Doctoral Program*

Science.gov (United States)

McRae, Marc P.

2010-01-01

Purpose: Organic chemistry has been shown to correlate with academic success in the preclinical years of medicine, dentistry, and graduate physiology. The purpose of this study is to examine the relationship between undergraduate organic chemistry grades and first-semester biochemistry grades at a Midwest chiropractic doctoral program. Methods: Students enrolled in a first-semester biochemistry course who had completed the prerequisite courses in organic chemistry offered at this same institution were entered into the study. The total grade for each of the three courses was calculated using the midterm and final exam raw scores with a weighting of 50% each. Analysis consisted of obtaining correlation coefficients between the total grades of organic 1 with biochemistry and organic 2 with biochemistry. Using the biochemistry total grade, the students were divided into quartiles and course grades for both organic chemistry 1 and 2 were calculated. Results: For the 109 students in the study, the correlation coefficient between the biochemistry and organic chemistry 1 and biochemistry and organic chemistry 2 courses was r = 0.744 and r = 0.725, respectively. The difference in organic chemistry grades between those in the first and fourth quartiles was 63.2% and 86.9% for organic chemistry 1 (p organic chemistry 2 (p organic chemistry can be used as an indicator of future academic success in a chiropractic biochemistry course. Knowledge of such a relationship could prove useful to identify students who may potentially run into academic difficulty with first-year biochemistry PMID:20480012

Vulnerabilities of national parks in the American Midwest to climate and land use changes

Science.gov (United States)

Stroh, Esther D.; Struckhoff, Matthew A.; Shaver, David; Karstensen, Krista A.

2016-06-08

Many national parks in the American Midwest are surrounded by agricultural or urban areas or are in highly fragmented or rapidly changing landscapes. An environmental stressor is a physical, chemical, or biological condition that affects the functioning or productivity of species or ecosystems. Climate change is just one of many stressors on park natural resources; others include urbanization, land use change, air and water pollution, and so on. Understanding and comparing the relative vulnerability of a suite of parks to projected climate and land use changes is important for region-wide planning. A vulnerability assessment of 60 units in the 13-state U.S. National Park Service Midwestern administrative region to climate and land use change used existing data from multiple sources. Assessment included three components: individual park exposure (5 metrics), sensitivity (5 metrics), and constraints to adaptive capacity (8 metrics) under 2 future climate scenarios. The three components were combined into an overall vulnerability score. Metrics were measures of existing or projected conditions within park boundaries, within 10-kilometer buffers surrounding parks, and within ecoregions that contain or intersect them. Data were normalized within the range of values for all assessed parks, resulting in high, medium, and low relative rankings for exposure, sensitivity, constraints to adaptive capacity, and overall vulnerability. Results are consistent with assessments regarding patterns and rates of climate change nationwide but provide greater detail and relative risk for Midwestern parks. Park overall relative vulnerability did not differ between climate scenarios. Rankings for exposure, sensitivity, and constraints to adaptive capacity varied geographically and indicate regional conservation planning opportunities. The most important stressors for the most vulnerable Midwestern parks are those related to sensitivity (intrinsic characteristics of the park) and

Projecting the long-term biogeochemical impacts of a diverse agroforestry system in the Midwest

Science.gov (United States)

Wolz, K. J.; DeLucia, E. H.; Paul, R. F.

2014-12-01

results illustrate the potential long-term biogeochemical impacts that can be generated by a land-use transition to a diverse agroforestry system in the Midwest.

[High risk factors of upper gastrointestinal bleeding after neurosurgical procedures].

Science.gov (United States)

Zheng, Kang; Wu, Gang; Cheng, Neng-neng; Yao, Cheng-jun; Zhou, Liang-fu

2005-12-21

To analyze high risk factors of postoperative upper gastrointestinal (GI) bleeding after neurosurgery so as to give guidance for prevention of GI bleeding. A questionnaire was developed to investigate the medical records of 1500 patients who were hospitalized and underwent neurosurgical operations in 1997. Logistic regression analysis was made. 1430 valid questionnaires were obtained. Postoperative upper GI bleeding occurred in 75 patients (5.24%). The incidence of upper GI bleeding were 6.64% (54/813) in the male patients and 3.40% (21/617) in the female persons (P = 0.007); 9.88% (41/415) in those aged > 50 and 3.35% in those aged hematoma, intraventricular hemorrhage, subdural hematoma, and extradural hematoma were 15.7%, 10.0%, 6.00%, and 2.94% respectively (P = 0.02). The incidence of upper GI bleeding of the patients with tumors of fourth ventricle of cerebrum, brainstem, cerebral hemisphere, and sellar hypothalamus were 15.79% (3/19), 7.89%, 5.71%, and 3.74% respectively. In the emergent cases, the incidence of upper GI bleeding was higher in those with hypertension. The incidence of upper GI bleeding was 5.46% in the patients undergoing adrenocortical hormone treatment, significantly higher than that in those who did not receive such treatment (2.13%). Patients who are at high risk of developing postoperative upper GI bleeding including that: age greater than 50 years; male; Glasgow Coma Score less than 10 pre and post operation; The lesion was located in brain stem and forth ventricle; Hypertensive cerebral hemorrhage; Intracerebral and intraventricular hemorrhagic brain trauma; Postoperative pneumonia, brain edema, encephalic high pressure, pyogenic infection of the central nervous system and other postoperative complications. The mortality of patients with postoperative upper GI bleeding was evidently higher than that of the patients without postoperative upper GI bleeding.

Endometrioid carcinoma of the upper urinary tract

Directory of Open Access Journals (Sweden)

Kulkarni Jagdeesh

2010-01-01

Full Text Available Herein, we report a second case of endometrioid carcinoma of the upper urinary tract presenting 17 years after hysterectomy for high grade adenocarcinoma of ovary. A 51-year-old nullipara presented to us with a complaint of hematuria. After complete work up, she underwent right radical nephro-ureterectomy with bladder cuff excision. The histology showed endometrioid carcinoma of upper urinary tract without any evidence of endometriosis.

System for cooling the upper wall of a nuclear reactor vessel

International Nuclear Information System (INIS)

Pailla, Henri; Schaller, Karl; Vidard, Michel.

1974-01-01

A system for cooling the upper wall of the main vessel of a fast neutron reactor is described. This vessel is suspended from an upper shield by the upper wall. It includes coils carrying a coolant which are immersed in an intermediate liquid bathing the wall and contained in a tank integral with the vessel. At least one of the two cooling and intermediate liquids is a liquid metal. The main vessel is contained in a safety vessel, the space between the main and safety vessels is occluded in its upper part by an insulating shield placed under the tank. There is a liquid metal seal between the upper wall and the upper shield under the tank. This system has been specially designed for sodium cooled fast neutron reactors [fr

Three-body segment musculoskeletal model of the upper limb

Directory of Open Access Journals (Sweden)

Valdmanová L.

2013-06-01

Full Text Available The main aim is to create a computational three-body segment model of an upper limb of a human body for determination of muscle forces generated to keep a given loaded upper limb position. The model consists of three segments representing arm, forearm, hand and of all major muscles connected to the segments. Muscle origins and insertions determination corresponds to a real anatomy. Muscle behaviour is defined according to the Hill-type muscle model consisting of contractile and viscoelastic element. The upper limb is presented by a system of three rigid bars connected by rotational joints. The whole limb is fixed to the frame in the shoulder joint. A static balance problem is solved by principle of virtual work. The system of equation describing the musculoskeletal system is overdetermined because more muscles than necessary contribute to get the concrete upper limb position. Hence the mathematical problem is solved by an optimization method searching the least energetically-consuming solution. The upper limb computational model is verified by electromyography of the biceps brachii muscle.

Evaluation of a model framework to estimate soil and soil organic carbon redistribution by water and tillage using 137Cs in two U.S. Midwest agricultural fields

Science.gov (United States)

Young, Claudia J.; Liu, Shuguang; Schumacher, Joseph A.; Schumacher, Thomas E.; Kaspar, Thomas C.; McCarty, Gregory W.; Napton, Darrell; Jaynes, Dan B.

2014-01-01

Cultivated lands in the U.S. Midwest have been affected by soil erosion, causing soil organic carbon (SOC) redistribution in the landscape and other environmental and agricultural problems. The importance of SOC redistribution on soil productivity and crop yield, however, is still uncertain. In this study, we used a model framework, which includes the Unit Stream Power-based Erosion Deposition (USPED) and the Tillage Erosion Prediction (TEP) models, to understand the soil and SOC redistribution caused by water and tillage erosion in two agricultural fields in the U.S. Midwest. This model framework was evaluated for different digital elevation model (DEM) spatial resolutions (10-m, 24-m, 30-m, and 56-m) and topographic exponents (m = 1.0–1.6 and n = 1.0–1.3) using soil redistribution rates from 137Cs measurements. The results showed that the aggregated 24-m DEM, m = 1.4 and n = 1.0 for rill erosion, and m = 1.0 and n = 1.0 for sheet erosion, provided the best fit with the observation data at both sites. Moreover, estimated average SOC redistributions were 1.3 ± 9.8 g C m− 2 yr− 1 in field site 1 and 3.6 ± 14.3 g C m− 2 yr− 1 in field site 2. Spatial distribution patterns showed SOC loss (negative values) in the eroded areas and SOC gain (positive value) in the deposition areas. This study demonstrated the importance of the spatial resolution and the topographic exponents to estimate and map soil redistribution and the SOC dynamics throughout the landscape, helping to identify places where erosion and deposition from water and tillage are occurring at high rates. Additional research is needed to improve the application of the model framework for use in local and regional studies where rainfall erosivity and cover management factors vary. Therefore, using this model framework can help to improve the information about the spatial distribution of soil erosion across agricultural landscapes and to gain a better understanding of SOC

Black breast cancer survivors experience greater upper extremity disability.

Science.gov (United States)

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

Assessing Upper-Level Winds on Day-of-Launch

Science.gov (United States)

Bauman, William H., III; Wheeler, Mark M.

2012-01-01

On the day-or-launch. the 45th Weather Squadron Launch Weather Officers (LWOS) monitor the upper-level winds for their launch customers to include NASA's Launch Services Program (LSP). During launch operations, the payload launch team sometimes asks the LWO if they expect the upper level winds to change during the countdown but the LWOs did not have the capability to quickly retrieve or display the upper-level observations and compare them to the numerical weather prediction model point forecasts. The LWOs requested the Applied Meteorology Unit (AMU) develop a capability in the form of a graphical user interface (GUI) that would allow them to plot upper-level wind speed and direction observations from the Kennedy Space Center Doppler Radar Wind Profilers and Cape Canaveral Air Force Station rawinsondes and then overlay model point forecast profiles on the observation profiles to assess the performance of these models and graphically display them to the launch team. The AMU developed an Excel-based capability for the LWOs to assess the model forecast upper-level winds and compare them to observations. They did so by creating a GUI in Excel that allows the LWOs to first initialize the models by comparing the O-hour model forecasts to the observations and then to display model forecasts in 3-hour intervals from the current time through 12 hours.

Upper mantle flow in the western Mediterranean

Energy Technology Data Exchange (ETDEWEB)

Panza, G F [Dipartimento di Scienze della Terra, Universita degli Studi di Trieste, Trieste (Italy) and Abdus Salam International Centre for Theoretical Physics, Trieste (Italy); Raykova, R [Geophysical Institute of BAS, Sofia (Bulgaria) and Istituto Nazionale di Geofisica e Vulcanologia, Sezione Bologna, Bologna (Italy); Carminati, E; Doglioni, C [Dipartimento di Scienze della Terra, Universita degli Studi di Trieste, Trieste (Italy)

2006-07-15

Two cross-sections of the western Mediterranean Neogene-to-present backarc basin are presented, in which geological and geophysical data of the Transmed project are tied to a new shear-wave tomography. Major results are i) the presence of a well stratified upper mantle beneath the older African continent, with a marked low-velocity layer between 130-200 km of depth; ii) the dilution of this layer within the younger western Mediterranean backarc basin to the north, and iii) the easterly raising of a shallower low-velocity layer from about 140 km to about 30 km in the Tyrrhenian active part of the backarc basin. These findings suggest upper mantle circulation in the western Mediterranean backarc basin, mostly easterly-directed and affecting the boundary between upper asthenosphere (LVZ) and lower asthenosphere, which undulates between about 180 km and 280 km. (author)

Upper mantle flow in the western Mediterranean

International Nuclear Information System (INIS)

Panza, G.F.; Raykova, R.; Carminati, E.; Doglioni, C.

2006-07-01

Two cross-sections of the western Mediterranean Neogene-to-present backarc basin are presented, in which geological and geophysical data of the Transmed project are tied to a new shear-wave tomography. Major results are i) the presence of a well stratified upper mantle beneath the older African continent, with a marked low-velocity layer between 130-200 km of depth; ii) the dilution of this layer within the younger western Mediterranean backarc basin to the north, and iii) the easterly raising of a shallower low-velocity layer from about 140 km to about 30 km in the Tyrrhenian active part of the backarc basin. These findings suggest upper mantle circulation in the western Mediterranean backarc basin, mostly easterly-directed and affecting the boundary between upper asthenosphere (LVZ) and lower asthenosphere, which undulates between about 180 km and 280 km. (author)

Upper limb position control in fibromyalgia

Directory of Open Access Journals (Sweden)

Bardal Ellen

2012-09-01

Full Text Available Abstract Background Motor problems are reported by patients with fibromyalgia (FM. However, the mechanisms leading to alterations in motor performance are not well understood. In this study, upper limb position control during sustained isometric contractions was investigated in patients with FM and in healthy controls (HCs. Methods Fifteen female FM patients and 13 HCs were asked to keep a constant upper limb position during sustained elbow flexion and shoulder abduction, respectively. Subjects received real-time visual feedback on limb position and both tasks were performed unloaded and while supporting loads (1, 2, and 3 kg. Accelerations of the dominant upper limb were recorded, with variance (SD of mean position and power spectrum analysis used to characterize limb position control. Normalized power of the acceleration signal was extracted for three frequency bands: 1–3 Hz, 4–7 Hz, and 8–12 Hz. Results Variance increased with load in both tasks (P 0.001 but did not differ significantly between patients and HCs (P > 0.17. Power spectrum analysis showed that the FM patients had a higher proportion of normalized power in the 1–3 Hz band, and a lower proportion of normalized power in the 8–12 Hz band compared to HCs (P 0.05. The results were consistent for all load conditions and for both elbow flexion and shoulder abduction. Conclusion FM patients exhibit an altered neuromuscular strategy for upper limb position control compared to HCs. The predominance of low-frequency limb oscillations among FM patients may indicate a sensory deficit.

The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

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Anouar Teriaky

2016-01-01

Full Text Available Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD, H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations.

Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.

Science.gov (United States)

Xu, Qingfu; Wischmeyer, Jareth; Gonzalez, Eduardo; Pichichero, Michael E

2017-07-01

We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. Nasopharyngeal (NP) samples were collected from 74 acute otitis media (AOM) infection-prone and 754 non-prone children during 2094 healthy visits, 673 viral URI visits and 631 AOM visits. Three otopathogens Streptococcus pneumoniae (Spn), Nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis (Mcat) were identified by culture. NP colonization rates of multiple otopathogens during health were significantly lower than during viral URI, and during URI they were lower than at onset of upper respiratory bacterial infection in both AOM infection-prone and non-prone children. AOM infection-prone children had higher polymicrobial colonization rates than non-prone children during health, viral URI and AOM. Polymicrobial colonization rates of AOM infection-prone children during health were equivalent to that of non-prone children during viral URI, and during viral URI were equivalent to that of non-prone during AOM infection. Spn colonization was positively associated with NTHi and Mcat colonization during health, but negatively during AOM infection. The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Development Of Sustainable Biobased Products And Bioenergy In Cooperation With The Midwest Consortium For Sustainable Biobased Products And Energy

Energy Technology Data Exchange (ETDEWEB)

Michael Ladisch; Randy Woodson

2009-03-18

Collaborative efforts of Midwest Consortium have been put forth to add value to distiller's grains by further processing them into fermentable sugars, ethanol, and a protein rich co-product consistent with a pathway to a biorenewables industry (Schell et al, 2008). These studies were recently published in the enclosed special edition (Volume 99, Issue 12) of Bioresource Technology journal. Part of them have demonstrated the utilization of distillers grains as additional feedstock for increased ethanol production in the current dry grind process (Kim et al., 2008a, b; Dien et al.,2008, Ladisch et al., 2008a, b). Results showed that both liquid hot water (LHW) pretreatment and ammonia fiber expansion (AFEX) were effective for enhancing digestibility of distiller's grains. Enzymatic digestion of distiller's grains resulted in more than 90% glucose yield under standard assay conditions, although the yield tends to drop as the concentration of dry solids increases. Simulated process mass balances estimated that hydrolysis and fermentation of distillers grains can increase the ethanol yield by 14% in the current dry milling process (Kim et al., 2008c). Resulting co-products from the modified process are richer in protein and oil contents than conventional distiller's grains, as determined both experimentally and computationally. Other research topics in the special edition include water solubilization of DDGS by transesterification reaction with phosphite esters (Oshel el al., 2008) to improve reactivity of the DDGS to enzymes, hydrolysis of soluble oligomers derived from DDGS using functionalized mesoporous solid catalysts (Bootsma et al., 2008), and ABE (acetone, butanol, ethanol) production from DDGS by solventogenic Clostridia (Ezeji and Blaschek, 2008). Economic analysis of a modified dry milling process, where the fiber and residual starch is extracted and fermented to produce more ethanol from the distillers grains while producing highly

Upper extremity sensorimotor control among collegiate football players.

Science.gov (United States)

Laudner, Kevin G

2012-03-01

Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.

Wenckebach upper rate response in single chamber pacemaker.

Science.gov (United States)

Barold, S S

2000-07-01

The Medtronic Minix pacemaker during normal function in the VVT mode was found to exhibit a Wenckenbach upper rate response similar to that of dual chamber devices. This behavior occurred only when the upper rate interval was longer than the pacemaker refractory period. In a single chamber device this response may simulate pacemaker malfunction.

A short overview of upper limb rehabilitation devices

Science.gov (United States)

Macovei, S.; Doroftei, I.

2016-08-01

As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings.

Science.gov (United States)

Diaz, Liege; Hernandez-Oquet, Rafael Enrique; Deshpande, Amar R; Moshiree, Baharak

2015-11-01

Studies describing the prevalence of upper gastrointestinal (GI) Crohn disease (CD) and its histopathologic changes have been inconsistent as a result of different definitions used for upper GI involvement, diverse populations, and varying indications for endoscopy. We reviewed the literature describing endoscopic findings and histologic lesions in gastric and duodenal mucosa of patients with established CD. PubMed, EMBASE, and the Cochrane Library were searched for gastroduodenal biopsy findings in patients with CD from 1970 to 2014. We included all retrospective and prospective studies in adults. We calculated the prevalence of the most common endoscopic and histopathological findings among patients with overall CD and upper GI CD. Of the 385 articles identified, 20 eligible studies were included. A total of 2511 patients had CD and 815 had upper GI CD. In the CD group, the most common histopathological finding was nonspecific gastric inflammation in 32% of patients, followed by gastric granuloma in 7.9%. Focal gastritis was prevalent in 30.9% of patients. In the upper GI CD group, gastric inflammation was present in 84% of patients, followed by duodenal inflammation in 28.2% and gastric granuloma in 23.2%. The most common gastric endoscopic finding in patients with CD was erythema in 5.9%, followed by erosions in 3.7%. Duodenal endoscopic findings included ulcers and erythema in 5.3% and 3.0% of patients, respectively. We found a prevalence of 34% for CD involving the upper GI tract across these 20 studies. Routine upper endoscopy with biopsies of the upper GI tract in the diagnostic workup of patients with CD can correctly classify the distribution and extent of the disease.

Hospital CEOs' priorities and perceptions regarding industry issues and the Virginia Hospital Association's activities.

Science.gov (United States)

McDermott, D R; Gerardo, E F; Duguid, D A; Cooning, P J

1991-01-01

Based on a survey of Virginia hospital CEOs, it was revealed that four industry issues are causing a high degree of concern, namely Medicare/Medicaid reimbursement policies, personnel shortages, indigent care, and increased operating expenses. Each of these issues will be discussed regarding the VHA's activities to devise possible solutions. Regarding Medicare, the VHA has worked closely with the American Hospital Association in their federal advocacy efforts encouraging members to write, call, and visit their Congressional representatives to persuade them to pass legislation increasing the Medicare budget. Regarding Medicaid, which is administered by each state and in Virginia involves a 50/50 sharing of the funding between the federal and state governments, the VHA has challenged what it believes to be an illegal hospital reimbursement system through the federal judicial system. While the process is continuing, the VHA is encouraged by the U.S. Supreme Court's decision (July 1990) affirming hospitals' and all other health care providers' right, to pursue via the judicial process their allegation that a state is violating federal law by setting inadequate and inequitable Medicaid reimbursement rates to hospitals. In order to address the personnel shortages issue, the VHA has actively addressed recruitment and retention challenges by establishing a Health Manpower Resource Center and hiring a full-time director. This office targets high school students, second-career adults, and current health care professionals through communication and education programs. The area of indigent care represents one of the VHA's most notable achievements to date. This entails the recent Virginia legislation creating the Indigent Care Trust Fund. This fund's initial amount is some $15 million and represents an approximate 60/40 contribution ratio involving both the State of Virginia and hospitals in Virginia. A formula has been developed for each hospital in Virginia to assess how

Common data items in seven European oesophagogastric cancer surgery registries: towards a European upper GI cancer audit (EURECCA Upper GI).

Science.gov (United States)

de Steur, W O; Henneman, D; Allum, W H; Dikken, J L; van Sandick, J W; Reynolds, J; Mariette, C; Jensen, L; Johansson, J; Kolodziejczyk, P; Hardwick, R H; van de Velde, C J H

2014-03-01

Seven countries (Denmark, France, Ireland, the Netherlands, Poland, Sweden, United Kingdom) collaborated to initiate a EURECCA (European Registration of Cancer Care) Upper GI project. The aim of this study was to identify a core dataset of shared items in the different data registries which can be used for future collaboration between countries. Item lists from all participating Upper GI cancer registries were collected. Items were scored 'present' when included in the registry, or when the items could be deducted from other items in the registry. The definition of a common item was that it was present in at least six of the seven participating countries. The number of registered items varied between 40 (Poland) and 650 (Ireland). Among the 46 shared items were data on patient characteristics, staging and diagnostics, neoadjuvant treatment, surgery, postoperative course, pathology, and adjuvant treatment. Information on non-surgical treatment was available in only 4 registries. A list of 46 shared items from seven participating Upper GI cancer registries was created, providing a basis for future quality assurance and research in Upper GI cancer treatment on a European level. Copyright © 2013 Elsevier Ltd. All rights reserved.

Progress of the ECRH Upper Launcher design for ITER

International Nuclear Information System (INIS)

Strauss, D.; Aiello, G.; Bruschi, A.; Chavan, R.; Farina, D.; Figini, L.; Gagliardi, M.; Garcia, V.; Goodman, T.P.; Grossetti, G.; Heemskerk, C.; Henderson, M.A.; Kasparek, W.; Krause, A.; Landis, J.-D.; Meier, A.; Moro, A.; Platania, P.; Plaum, B.; Poli, E.

2014-01-01

The design of the ITER ECRH system provides 20 MW millimeter wave power for central plasma heating and MHD stabilization. The system consists of an array of 24 gyrotrons with power supplies coupled to a set of transmission lines guiding the beams to the four upper and the equatorial launcher. The front steering upper launcher design described herein has passed successfully the preliminary design review, and it is presently in the final design stage. The launcher consists of a millimeter wave system and steering mechanism with neutron shielding integrated into an upper port plug with the plasma facing blanket shield module (in-vessel) and a set of ex-vessel waveguides connecting the launcher to the transmission lines. Part of the transmission lines are the ultra-low loss CVD torus diamond windows and a shutter valve, a miter bend section and the feedthroughs integrated in the plug closure plate. These components are connected by corrugated waveguides and form together the first confinement system (FCS). In-vessel, the millimeter-wave system includes a quasi-optical beam propagation system including four mirror sets and a front steering mirror. The millimeter wave system is integrated into a specifically optimized upper port plug providing structural stability to withstand plasma disruption forces and the high heat load from the plasma side with a dedicated blanket shield module. A recent update in the ITER interface definition has resulted in the recession of the upper port plug first wall panels, which is now integrated into the design. Apart from the millimeter wave system the upper port plug houses also a set of shield blocks which provide neutron shielding. An overview of the actual ITER ECRH Upper Launcher is given together with some highlights of the design

Interventional studies of the upper gastrointestinal tract

International Nuclear Information System (INIS)

Shapiro, B.; Gross, M.D.

1985-01-01

Nuclear Medicine studies of the upper gastrointestinal (GI) tract provide a means whereby physiologic and pathophysiologic features can be observed from a unique and noninvasive perspective. While nuclear medicine studies by their very nature lack the high spatial resolution of the radiographic approach, the data derived are readily quantitated and presented in numerical fashion to provide functional and dynamic information in which the influences of interventions may be observed. This chapter outlines the scope of such interventions in studies of the upper GI tract with emphasis on examinations for gastroesophageal reflux and gastric emptying. The interactions of nutrients, physical maneuvers of pharmacologic agents on nuclear medicine studies of the upper GI tract may be intentional to render a test more sensitive or to evaluate the effect of therapy, or may represent an unintentional side effect that must be taken into account if misinterpretation is to be avoided

LATERAL CEPHALOMETRIC RADIOGRAPHY FOR EVALUATION OF UPPER AIRWAY

Directory of Open Access Journals (Sweden)

Miesje Karmiati Purwanegara

2015-06-01

Full Text Available The influenced of respiration to dentocraniofacial growth and development is still controversial. The accurate radiologic examination is important factor for proper diagnosis. Deviation of upper airway (i.e. nasopharynx, oropharymx and nasal cavity could be evaluated by lateral and anteroposterior cephalometric projection technique. This paper explains several methods to evaluate upper respiratory tract by lateral radiograph.

Isolated primary lymphedema tarda of the upper limb.

Science.gov (United States)

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

The GCOS Reference Upper-Air Network (GRUAN)

Science.gov (United States)

Vömel, H.; Berger, F. H.; Immler, F. J.; Seidel, D.; Thorne, P.

2009-04-01

While the global upper-air observing network has provided useful observations for operational weather forecasting for decades, its measurements lack the accuracy and long-term continuity needed for understanding climate change. Consequently, the scientific community faces uncertainty on such key issues as the trends of temperature in the upper troposphere and stratosphere or the variability and trends of stratospheric water vapour. To address these shortcomings, and to ensure that future climate records will be more useful than the records to date, the Global Climate Observing System (GCOS) program initiated the GCOS Reference Upper Air Network (GRUAN). GRUAN will be a network of about 30-40 observatories with a representative sampling of geographic regions and surface types. These stations will provide upper-air reference observations of the essential climate variables, i.e. temperature, geopotential, humidity, wind, radiation and cloud properties using specialized radiosondes and complementary remote sensing profiling instrumentation. Long-term stability, quality assurance / quality control, and a detailed assessment of measurement uncertainties will be the key aspects of GRUAN observations. The network will not be globally complete but will serve to constrain and adjust data from more spatially comprehensive global observing systems including satellites and the current radiosonde networks. This paper outlines the scientific rationale for GRUAN, its role in the Global Earth Observation System of Systems, network requirements and likely instrumentation, management structure, current status and future plans.

Starting manufacturing phase of ITER upper ports

Energy Technology Data Exchange (ETDEWEB)

Utin, Yuri, E-mail: yuri.utin@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Fabritsiev, Sergey [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Giraud, Benoit; Guirao, Julio [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Koenig, Werner [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Kedrov, Igor; Kuzmin, Evgeny [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Levesy, Bruno; Martinez, Jean-Marc [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France); Prebeck, Markus [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Privalova, Elena [NTC Sintez, Efremov Inst., 189631 Metallostroy, St. Petersburg (Russian Federation); Ranzinger, Franz [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); Savrukhin, Petr [Russian Federation ITER Domestic Agency, Kurchatov sq.1, 123182 Moscow (Russian Federation); Schiller, Thomas [MAN Diesel & Turbo SE, Werftstrasse 17, Deggendorf (Germany); and others

2015-10-15

Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

Starting manufacturing phase of ITER upper ports

International Nuclear Information System (INIS)

Utin, Yuri; Alekseev, Alexander; Sborchia, Carlo; Choi, Changho; Albin, Vincent; Barabash, Vladimir; Davis, James; Fabritsiev, Sergey; Giraud, Benoit; Guirao, Julio; Koenig, Werner; Kedrov, Igor; Kuzmin, Evgeny; Levesy, Bruno; Martinez, Jean-Marc; Prebeck, Markus; Privalova, Elena; Ranzinger, Franz; Savrukhin, Petr; Schiller, Thomas

2015-01-01

Highlights: • The port plugs are attached to the ports with high-strength fasteners. • Tightening of the fasteners via inductive heating was tested. • A concept for the port/plug sealing with metal-type gaskets has progressed. • Manufacturing design of the Upper Ports is in progress. • A full-scale mock-up of double-wall part of the port stub extension is in manufacturing process – acceptable final tolerances are expected. - Abstract: The ITER Vacuum Vessel (VV) features upper, equatorial and lower ports. The upper and regular equatorial ports are occupied by the port plugs. Although the port design has been overall completed in the past, the design of some remaining interfaces was still in progress: in particular, the Sealing Flange package, which includes the high-vacuum seals and the plug fasteners. As the ITER construction phase has started, the procurement of the VV ports has been launched. The VV upper ports will be procured by the Russian Federation Domestic Agency. The main suppliers were selected and the manufacturing design of the first parts is in full progress now. Since the VV is classified at nuclear level N2, the design and manufacture of its components are to be compliant with the French RCC-MR code and regulations for nuclear pressure equipment in France. These regulations make a strong impact to the port design and manufacturing process.

Bilateral tumors of the upper urothelium

Directory of Open Access Journals (Sweden)

Đokić Milan

2006-01-01

Full Text Available Introduction: The incidence of tumors of the upper urothelium is high in our country, apart from their relation to specific regions (BEN and PBEN and their frequent bilateralism. Bilateral forms are present in significant percentage and are followed, in most cases, by renal failure, which speaks in favor of conservative surgery, if possible. Objective: The aim of the study was to present epidemiological, pathoanatomical and clinical characteristics of bilateral tumors of the upper urothelium and evaluate the Results of their treatment. Method: Our retrospective study analyzed 12 patients with bilateral tumors of the upper urothelium who were treated in the period from 1992 to 1996, according to their epidemiological, clinical, pathoanatomical and pathohistological characteristics, type of surgical treatment and relevant success. Results: In the observed period, bilateral tumors of the upper urothelium were found in 8.2% of our patients. In the group of 12 patients, 5 females and 7 males, 11 cases were from the region of Balkan Endemic Nephropathy (BEN. Renal failure was recorded in high percentage (66%. Radical surgical treatment - total nephroureterectomy was performed in 9 kidney units, and conservative operation in 15 units. Relapse significantly depended on tumor stage and grade, not on type of surgical treatment in the majority of cases. Five-year survival was 58.33%; major cause of death was associated with further evolution of tumor, recurrence and tumor dissemination, respectively, while renal failure complications were the cause of death in one case. Conclusion: The success of treatment mainly depends on tumor stage and grade and not on type of surgical Method in conservative treatment, but renal failure and its complications are an important risk factor in these patients.

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

Science.gov (United States)

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

Membrane-based ethylene/ethane separation: The upper bound and beyond

KAUST Repository

Rungta, Meha

2013-08-02

Ethylene/ethane separation via cryogenic distillation is extremely energy-intensive, and membrane separation may provide an attractive alternative. In this paper, ethylene/ethane separation performance using polymeric membranes is summarized, and an experimental ethylene/ethane polymeric upper bound based on literature data is presented. A theoretical prediction of the ethylene/ethane upper bound is also presented, and shows good agreement with the experimental upper bound. Further, two ways to overcome the ethylene/ethane upper bound, based on increasing the sorption or diffusion selectivity, is also discussed, and a review on advanced membrane types such as facilitated transport membranes, zeolite and metal organic framework based membranes, and carbon molecular sieve membranes is presented. Of these, carbon membranes have shown the potential to surpass the polymeric ethylene/ethane upper bound performance. Furthermore, a convenient, potentially scalable method for tailoring the performance of carbon membranes for ethylene/ethane separation based on tuning the pyrolysis conditions has also been demonstrated. © 2013 American Institute of Chemical Engineers.

MRI findings in the upper cervical spine of rheumatoid arthritis

International Nuclear Information System (INIS)

Kawaida, Hidefumi; Sakou, Takashi; Morizono, Yoshiyuki; Yoshikuni, Nagatoshi; Taketomi, Eiji; Hashiguchi, Masanao

1989-01-01

In 55 patients with rheumatoid arthritis associated with upper cervical spine abnormality, the presence or absence of medullary and upper cervical pressures was examined on sagittal MRI scans. Atlanto-dental anterior incomplete dislocation and horizontal dislocation were imaged concurrently with X-rays. For horizontal dislocation, an abnormal Redlund-Johnell value and a Ranawat value of 7 mm or less were always associated with medullary pressure as seen on MRI. For anterior incomplete dislocation, upper cervical pressure was always associated when a space available for the spinal cord was 13 mm or less or frequently associated when the atlanto-dental interval was 8 mm or more. Many of the patients with the upper cervical abnormalities complained of occipital or cervical pain. The pain was always encountered in patients with an abnormal Redlund-Johnell value. Roentgenography of the cervical spine confirmed MRI-proven medullary or upper cervical pressure, suggesting the potential of MRI in the treatment of rheumatoid arthritis. (Namekawa, K)

MRI findings in the upper cervical spine of rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Kawaida, Hidefumi; Sakou, Takashi; Morizono, Yoshiyuki; Yoshikuni, Nagatoshi; Taketomi, Eiji; Hashiguchi, Masanao

1989-04-01

In 55 patients with rheumatoid arthritis associated with upper cervical spine abnormality, the presence or absence of medullary and upper cervical pressures was examined on sagittal MRI scans. Atlanto-dental anterior incomplete dislocation and horizontal dislocation were imaged concurrently with X-rays. For horizontal dislocation, an abnormal Redlund-Johnell value and a Ranawat value of 7 mm or less were always associated with medullary pressure as seen on MRI. For anterior incomplete dislocation, upper cervical pressure was always associated when a space available for the spinal cord was 13 mm or less or frequently associated when the atlanto-dental interval was 8 mm or more. Many of the patients with the upper cervical abnormalities complained of occipital or cervical pain. The pain was always encountered in patients with an abnormal Redlund-Johnell value. Roentgenography of the cervical spine confirmed MRI-proven medullary or upper cervical pressure, suggesting the potential of MRI in the treatment of rheumatoid arthritis. (Namekawa, K).

EDs in the Midwest and South activate disaster plans as deadly tornadoes sweep through the region.

Science.gov (United States)

2012-05-01

Hospitals in the Midwest and South activated their disaster plans in early March to deal with a phalanx of powerful tornadoes that leveled several small towns and killed at least two dozen people. Some hospitals had to activate plans for both internal and external disasters as their own facilities were threatened. One small critical-access hospital in West Liberty, KY, sustained significant damage and had to evacuate its patients to another facility. All the hospitals credit their disaster plans and practice drills with helping them to manage the crisis as efficiently as possible. Morgan County ARH Hospital in West Liberty, KY, went for several days without an operational lab or radiology department, but staff kept the ED open for absolute emergencies. Margaret Mary Community Hospital (MMCH) in Batesville, IN, received six tornado victims, but it was prepared for many more. Administrators credit advanced warning of the storms with helping them to prepare effectively, as well as to coordinate their response with other hospitals in the area. As a level 1 trauma center, the University of Louisville Hospital in Louisville, KY, received all the most seriously injured patients in the region, even while the facility itself was under a tornado warning. Staff had to route families away from the glassed-in waiting room to the basement until the tornado warning had passed. At one point during the crisis, there were 90 patients in the hospital's ED even though the department is only equipped with 29 beds. Administrators at Huntsville Hospital in Huntsville, AL, encouraged colleagues to take advantage of smaller-scale emergencies to activate parts of their disaster plans, and to focus disaster preparation drills on their hospital's top hazard vulnerabilities.

[The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

Science.gov (United States)

Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

2009-11-01

To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines

OpenAIRE

Ga??zka-Franta, Anna; Jura-Szo?tys, Edyta; Sm??ka, Wojciech; Gawlik, Rados?aw

2016-01-01

Abstract Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardle...

An upper limb mathematical model of an oil palm harvester

Science.gov (United States)

Tumit, N. P.; Rambely, A. S.; BMT, Shamsul; Shahriman A., B.; Ng Y., G.; Deros, B. M.; Zailina, H.; Goh, Y. M.; Arumugam, Manohar; Ismail, I. A.; Abdul Hafiz A., R.

2014-09-01

The main purpose of this article is to develop a mathematical model of human body during harvesting via Kane's method. In this paper, a 2-D closed-kinematic biomechanical model that represents a harvesting movement is developed. The model of six segments consisted of upper right arm, right forearm, harvesting equipment, left forearm, upper left arm, and upper part of trunk. Finally, the inverse dynamic equations are represented in matrix form.

Upper cretaceous ammonite succession (Cenomanian - Coniacian) related to the upper Hondita and Loma Gorda Formations along the Bambuca creek, Aipe, Huila (Colombia, S.A.)

International Nuclear Information System (INIS)

Patarroyo, Pedro

2011-01-01

The Bambuca creek section (Aipe - Huila) shows a very good exposition of the upper Magdalena valley cretaceous deposits. To the upper part of the Hondita Formation were recollected acanthoceras sp. and rhynchostreon sp. of the upper Cenomanian. Related to the lower segment of the Loma Gorda Formation were found choffaticeras (c.) cf. segne, fagesia cf. catinus, neoptychites cf. andinus, mitonia gracilis, morrowitessp., nannovascoceras ? sp., quitmaniceras ? sp., benueites ? sp., paramammites ? sp. together with mytiloideskossmati, m. goppelnensis and anomia sp. of the lower Turonian. Following by hoplitoides sp. h. ingens,h. cf. lagiraldae, codazziceras ospinae, allocrioceras sp. that can be representing between the lower and middle Turonian. To the upper part of this segment were collected prionocycloceras sp. p. guayabanum, reesidites subtuberculatum, subprionotropis colombianus, mytiloides scupini, dydimotis sp., gauthiericerassp, anagaudryceras ? sp., eulophoceras jacobi, paralenticeras sieversi, hauericeras cf. madagascarensis, peroniceras (p.) subtricarinatum, forresteria (f.) sp, barroisiceras cf. onilahyense, ankinatsytes venezolanus, with upper Turonian to Coniacian. According to the related fauna it is not possible to establish the Cenomanian/Turonian and Turonian/Coniacian boundaries.

International Spinal Cord Injury Upper Extremity Basic Data Set

DEFF Research Database (Denmark)

Biering-Sørensen, F; Bryden, A; Curt, A

2014-01-01

OBJECTIVE: To develop an International Spinal Cord Injury (SCI) Upper Extremity Basic Data Set as part of the International SCI Data Sets, which facilitates consistent collection and reporting of basic upper extremity findings in the SCI population. SETTING: International. METHODS: A first draft...

Diagnosis and management of upper gastrointestinal bleeding in children.

Science.gov (United States)

Owensby, Susan; Taylor, Kellee; Wilkins, Thad

2015-01-01

Upper gastrointestinal bleeding is an uncommon but potentially serious, life-threatening condition in children. Rapid assessment, stabilization, and resuscitation should precede all diagnostic modalities in unstable children. The diagnostic approach includes history, examination, laboratory evaluation, endoscopic procedures, and imaging studies. The clinician needs to determine carefully whether any blood or possible blood reported by a child or adult represents true upper gastrointestinal bleeding because most children with true upper gastrointestinal bleeding require admission to a pediatric intensive care unit. After the diagnosis is established, the physician should start a proton pump inhibitor or histamine 2 receptor antagonist in children with upper gastrointestinal bleeding. Consideration should also be given to the initiation of vasoactive drugs in all children in whom variceal bleeding is suspected. An endoscopy should be performed once the child is hemodynamically stable. © Copyright 2015 by the American Board of Family Medicine.

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 ...

African Journals Online (AJOL)

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 cases. A.B Olokoba, L.B Olokoba, A.A.G Jimoh. Abstract. Background: Upper gastrointestinal tract bleeding refers to blood loss within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament ...

Upper limb function in adults with Duchenne muscular dystrophy

NARCIS (Netherlands)

B. Bartels (Bart); R.F. Pangalila (Robert); M.P. Bergen (Michael); N.A.M. Cobben (Nicolle); H.J. Stam (Henk); M.E. Roebroeck (Marij)

2011-01-01

textabstractTo determine upper limb function and associated factors in adults with Duchenne muscular dystrophy. Design: Cross-sectional study. Subjects: A sample of 70 men with Duchenne muscular dystrophy (age range 20-43 years). Methods: General motor function and, in particular, upper limb distal

Trends in Acute Nonvariceal Upper Gastrointestinal Bleeding in Dialysis Patients

Science.gov (United States)

Yang, Ju-Yeh; Lee, Tsung-Chun; Montez-Rath, Maria E.; Paik, Jane; Chertow, Glenn M.; Desai, Manisha

2012-01-01

Impaired kidney function is a risk factor for upper gastrointestinal (GI) bleeding, an event associated with poor outcomes. The burden of upper GI bleeding and its effect on patients with ESRD are not well described. Using data from the US Renal Data System, we quantified the rates of occurrence of and associated 30-day mortality from acute, nonvariceal upper GI bleeding in patients undergoing dialysis; we used medical claims and previously validated algorithms where available. Overall, 948,345 patients contributed 2,296,323 patient-years for study. The occurrence rates for upper GI bleeding were 57 and 328 episodes per 1000 person-years according to stringent and lenient definitions of acute, nonvariceal upper GI bleeding, respectively. Unadjusted occurrence rates remained flat (stringent) or increased (lenient) from 1997 to 2008; after adjustment for sociodemographic characteristics and comorbid conditions, however, we found a significant decline for both definitions (linear approximation, 2.7% and 1.5% per year, respectively; Pupper GI bleeding episodes and were more likely to receive blood transfusions during an episode. Overall 30-day mortality was 11.8%, which declined significantly over time (relative declines of 2.3% or 2.8% per year for the stringent and lenient definitions, respectively). In summary, despite declining trends worldwide, crude rates of acute, nonvariceal upper GI bleeding among patients undergoing dialysis have not decreased in the past 10 years. Although 30-day mortality related to upper GI bleeding declined, perhaps reflecting improvements in medical care, the burden on the ESRD population remains substantial. PMID:22266666

Upper limits from counting experiments with multiple pipelines

International Nuclear Information System (INIS)

Sutton, Patrick J

2009-01-01

In counting experiments, one can set an upper limit on the rate of a Poisson process based on a count of the number of events observed due to the process. In some experiments, one makes several counts of the number of events, using different instruments, different event detection algorithms or observations over multiple time intervals. We demonstrate how to generalize the classical frequentist upper limit calculation to the case where multiple counts of events are made over one or more time intervals using several (not necessarily independent) procedures. We show how different choices of the rank ordering of possible outcomes in the space of counts correspond to applying different levels of significance to the various measurements. We propose an ordering that is matched to the sensitivity of the different measurement procedures and show that in typical cases it gives stronger upper limits than other choices. As an example, we show how this method can be applied to searches for gravitational-wave bursts, where multiple burst-detection algorithms analyse the same data set, and demonstrate how a single combined upper limit can be set on the gravitational-wave burst rate.

Expanding Local Cancer Clinical Trial Options: Analysis of the Economic Impact of the Midwest Cancer Alliance in Kansas.

Science.gov (United States)

Gafford, J Atlee; Gurley-Calvez, Tami; Krebill, Hope; Lai, Sue Min; Christiadi; Doolittle, Gary C

2017-09-01

Patients benefit from receiving cancer treatment closer to home when possible and at high-volume regional centers when specialized care is required. The purpose of this analysis was to estimate the economic impact of retaining more patients in-state for cancer clinical trials and care, which might offset some of the costs of establishing broader cancer trial and treatment networks. Kansas Cancer Registry data were used to estimate the number of patients retained in-state for cancer care following the expansion of local cancer clinical trial options through the Midwest Cancer Alliance based at the University of Kansas Medical Center. The 2014 economic impact of this enhanced local clinical trial network was estimated in four parts: Medical spending was estimated on the basis of National Cancer Institute cost-of-care estimates. Household travel cost savings were estimated as the difference between in-state and out-of-state travel costs. Trial-related grant income was calculated from administrative records. Indirect and induced economic benefits to the state were estimated using an economic impact model. The authors estimated that the enhanced local cancer clinical trial network resulted in approximately $6.9 million in additional economic activity in the state in 2014, or $362,000 per patient retained in-state. This estimate includes $3.6 million in direct spending and $3.3 million in indirect economic activity. The enhanced trial network also resulted in 45 additional jobs. Retaining patients in-state for cancer care and clinical trial participation allows patients to remain closer to home for care and enhances the state economy.

Information Literacy in the Upper Secondary School

DEFF Research Database (Denmark)

Holm, Claus; Schreiber, Trine; Tønnesen, Pia Hvid

The discussion paper is a publication from the project Information Literacy in the Upper Secondary School. The project is a collaboration between the National Library of Education at the Danish School of Education, Aarhus University, and the Royal School of Library and Information Science....... The project is funded by Denmark's Electronic Research Library (DEFF). The discussion paper is published in connection with the conference Information Literacy in the Upper Secondary School on 22 April 2010. See video streaming from the conference etc. at www.dpu.dk/info....

Upper urinary tract carcinoma in Lynch syndrome cases.

Science.gov (United States)

Crockett, David G; Wagner, David G; Holmäng, Sten; Johansson, Sonny L; Lynch, Henry T

2011-05-01

Patients with Lynch syndrome are much more likely to have generally rare upper urinary tract urothelial carcinoma but not bladder urothelial carcinoma. While the risk has been quantified, to our knowledge there is no description of how this population of patients with Lynch syndrome and upper urinary tract cancer differs from the general population with upper urinary tract cancer. We obtained retrospective data on a cohort of patients with Lynch syndrome from the Hereditary Cancer Center in Omaha, Nebraska and compared the data to those on a control general population from western Sweden. These data were supplemented by a new survey about exposure to known risk factors. Of the patients with Lynch syndrome 91% had mutations in MSH2 rather than in MSH1 and 79% showed upper tract urothelial carcinoma a mean of 15.85 years after prior Lynch syndrome-type cancer. Median age at diagnosis was 62 years vs 70 in the general population (p Lynch syndrome 51% had urothelial carcinoma in the ureter while it occurred in the renal pelvis in 65% of the general population (p = 0.0013). Similar numbers of high grade tumors were found in the Lynch syndrome and general populations (88% and 74%, respectively, p = 0.1108). Upper urinary tract tumors develop at a younger age and are more likely to be in the ureter with an almost equal gender ratio in patients with Lynch syndrome. It has high grade potential similar to that in the general population. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Pattern of presentation and management of benign upper urinary ...

African Journals Online (AJOL)

Background: Upper urinary tract obstruction is a common cause of severe symptoms, recurrent urinary tract infection and deterioration or complete loss of renal function when intervention is not timely. Objective: To document the pattern of presentation and the management options for the benign upper urinary tract ...

Orofacial-cervical alterations in individuals with upper airway resistance syndrome

Directory of Open Access Journals (Sweden)

Pedro Wey Barbosa de Oliveira

Full Text Available ABSTRACT INTRODUCTION: Studies that assess the upper airways in sleep-related breathing disorders have been performed only in patients with obstructive sleep apnea syndrome who seek medical attention. Therefore, in addition to the need for population studies, there are no data on the orofacial-cervical physical examination in subjects with upper airway resistance syndrome. OBJECTIVES: To compare the orofacial-cervical examination between volunteers with upper airway resistance syndrome and without sleep-related breathing disorders. METHODS: Through questionnaires, physical measurements, polysomnography, and otorhinolaryngological evaluation, this study compared the orofacial-cervical physical examination, through a systematic analysis of the facial skeleton, mouth, throat, and nose, between volunteers with upper airway resistance syndrome and volunteers without sleep-related breathing disorders in a representative sample of the adult population of the city of São Paulo. RESULTS: There were 1042 volunteers evaluated; 49 subjects (5% were excluded as they did not undergo otorhinolaryngological evaluation, 381 (36% had apnea-hypopnea index > 5 events/hour, and 131 (13% had oxyhemoglobin saturation < 90%. Among the remaining 481 subjects (46%, 30 (3% met the criteria for the upper airway resistance syndrome definition and 53 (5% met the control group criteria. At the clinical evaluation of nasal symptoms, the upper airway resistance syndrome group had more oropharyngeal dryness (17% vs. 29.6%; p = 0.025 and septal deviation grades 1-3 (49.1% vs. 57.7%; p = 0.025 when compared to controls. In the logistic regression model, it was found that individuals from the upper airway resistance syndrome group had 15.6-fold higher chance of having nose alterations, 11.2-fold higher chance of being hypertensive, and 7.6-fold higher chance of complaining of oropharyngeal dryness when compared to the control group. CONCLUSION: Systematic evaluation of the facial

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

Science.gov (United States)

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Upper gastrointestinal bleeding caused by severe esophagitis: a unique clinical syndrome.

Science.gov (United States)

Guntipalli, Prathima; Chason, Rebecca; Elliott, Alan; Rockey, Don C

2014-12-01

We have recognized a unique clinical syndrome in patients with upper gastrointestinal bleeding who are found to have severe esophagitis. We aimed to more clearly describe the clinical entity of upper gastrointestinal bleeding in patients with severe esophagitis. We conducted a retrospective matched case-control study designed to investigate clinical features in patients with carefully defined upper gastrointestinal bleeding and severe esophagitis. Patient data were captured prospectively via a Gastrointestinal Bleeding Healthcare Registry, which collects data on all patients admitted with gastrointestinal bleeding. Patients with endoscopically documented esophagitis (cases) were matched with randomly selected controls that had upper gastrointestinal bleeding caused by other lesions. Epidemiologic features in patients with esophagitis were similar to those with other causes of upper gastrointestinal bleeding. However, hematemesis was more common in patients with esophagitis 86% (102/119) than in controls 55% (196/357) (p bleeding than those without cirrhosis. We have described a unique clinical syndrome in patients with upper gastrointestinal bleeding who have erosive esophagitis. This syndrome is manifest by typical clinical features and is associated with favorable outcomes.

A survey of medicinal plants around upper Songkhla lake, Thailand ...

African Journals Online (AJOL)

A survey of medicinal plants around upper Songkhla lake, Thailand. ... method of preparation, route of administration and properties of plants. ... Keywords: Medicinal plant, Ethnobotany, Traditional medicine, Upper Songkhla Lake, Thailand ...

Diagnosis and treatment of upper limb apraxia.

Science.gov (United States)

Dovern, A; Fink, G R; Weiss, P H

2012-07-01

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

"Ballistic Six" Upper-Extremity Plyometric Training for the Pediatric Volleyball Players.

Science.gov (United States)

Turgut, Elif; Cinar-Medeni, Ozge; Colakoglu, Filiz F; Baltaci, Gul

2017-09-19

The Ballistic Six exercise program includes commonly used upper-body exercises, and the program is recommended for overhead throwing athletes. The purpose of the current study was to investigate the effects of a 12-week the Ballistic Six upper-extremity plyometric training program on upper-body explosive power, endurance, and reaction time in pediatric overhead athletes. Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into 2 study groups: an intervention group (upper-extremity plyometric training in addition to the volleyball training; n = 14) and a control group (the volleyball training only; n = 14). All the participants were assessed before and after a 12-week training program for upper-body power, strength and endurance, and reaction time. Statistical comparison was performed using an analysis of variance test. Comparisons showed that after a 12-week training program, the Ballistic Six upper-body plyometric training program resulted in more improvements in an overhead medicine ball throwing distance and a push-up performance, as well as greater improvements in the reaction time in the nonthrowing arm when compared with control training. In addition, a 12-week training program was found to be effective in achieving improvements in the reaction time in the throwing arm for both groups similarly. Compared with regular training, upper-body plyometric training resulted in additional improvements in upper-body power and strength and endurance among pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

Assessment of Effect on LBLOCA PCT for Change in Upper Head Nodalization

International Nuclear Information System (INIS)

Kang, Dong Gu; Huh, Byung Gil; Yoo, Seung Hun; Bang, Youngseok; Seul, Kwangwon; Cho, Daehyung

2014-01-01

In this study, the best estimate plus uncertainty (BEPU) analysis of LBLOCA for original and modified nodalizations was performed, and the effect on LBLOCA PCT for change in upper head nodalization was assessed. In this study, the best estimate plus uncertainty (BEPU) analysis of LBLOCA for original and modified nodalizations was performed, and the effect on LBLOCA PCT for change in upper head nodalization was assessed. It is confirmed that modification of upper head nodalization influences PCT behavior, especially in the reflood phase. In conclusions, the modification of nodalization to reflect design characteristic of upper head temperature should be done to predict PCT behavior accurately in LBLOCA analysis. In the best estimate (BE) method with the uncertainty evaluation, the system nodalization is determined by the comparative studies of the experimental data. Up to now, it was assumed that the temperature of the upper dome in OPR-1000 was close to that of the cold leg. However, it was found that the temperature of the upper head/dome might be a little lower than or similar to that of the hot leg through the evaluation of the detailed design data. Since the higher upper head temperature affects blowdown quenching and peak cladding temperature in the reflood phase, the nodalization for upper head should be modified

Membraneous stenosis of the upper oesophagus ('webs')

International Nuclear Information System (INIS)

Koch, H.L.; Kurtz, B.

1981-01-01

Webs of the upper oesophagus are sail-like mucosal folds of unknown aetiology. Small, transverse webs on the anterior wall of the oesophagus are not uncommon incidental findings which are easily overlooked on routine examination. Extensive, circular membranes in the upper oesophagus, on the other hand, are rare; these may lead to severe difficulty with swallowing and may be associated with regurgitation. One example of a transverse, and three cases of circular webs are described, which caused stenosis and dysphagia and which, in some cases, were multiple. The aetiology is discussed. (orig.) [de

Collaborative Tools in Upper Secondary School - Why?

DEFF Research Database (Denmark)

Mathiasen, Helle; Degn, Hans-Peter; Bech, Christian Winther

2013-01-01

The paper will discuss potentials of digital media to support student engagement and student production in Danish upper secondary education with a specific focus on group work and collaboration. With the latest school reform, upper secondary education in Denmark has experienced an increased focus...... on the system theoretical approach will be described. Third, the findings from the qualitative, and quantitative studies will be presented. The paper concludes that the study demonstrates changes in the way group work is organised by the students using digital media, and a tendency to develop student engagement...

Numerical simulation on bake-out of the ITER diagnostic upper port plug

International Nuclear Information System (INIS)

Pak, S.; Pitcher, C.S.; Kalish, M.R.; Cheon, M.S.; Seon, C.R.; Lee, H.G.

2010-01-01

The diagnostic upper port plug in ITER is fixed to the upper port of the vacuum vessel as a cantilevered beam with bolts and forms a primary vacuum boundary. It needs to be baked out for outgassing before normal operation. This study calculated the required bake-out time and the transient thermal stress during baking for the diagnostic upper port plug. The calculation was done through numerical simulation. The analysis took into consideration the gradual temperature increase of working fluid. In order to look into the effect of radiation heat transfer from the upper port plug to the vacuum vessel port, the upper vacuum vessel port was included in this analysis.

Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.

Science.gov (United States)

McCarthy, John F; Bossarte, Robert M; Katz, Ira R; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M; Nielson, Christopher; Schoenbaum, Michael

2015-09-01

The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

Alarm symptoms of upper gastrointestinal cancer and contact to general practice

DEFF Research Database (Denmark)

Rasmussen, Sanne; Larsen, Pia Veldt; Svendsen, Rikke Pilsgaard

2015-01-01

INTRODUCTION: Survival of upper gastrointestinal (GI) cancer depends on early stage diagnosis. Symptom-based guidelines and fast-track referral systems have been implemented for use in general practice. To improve diagnosis of upper GI cancer, knowledge on prevalence of alarm symptoms...... between 1.1% ("repeated vomiting") and 3.4% ("difficulty swallowing"). Women had higher odds of experiencing "repeated vomiting" and "persistent and recent-onset abdominal pain", but lower odds of experiencing "upper GI bleeding". The proportion of people contacting their GP with each of the four specific...... alarm symptoms ranged from 24.3% ("upper GI bleeding") to 39.9% ("repeated vomiting"). For each combination of two specific alarm symptoms, at least 52% contacted their GP. CONCLUSION: The specific alarm symptoms of upper GI cancer are not very prevalent in the general population. The proportion of GP...

H.R.: a bill to grant the consent of the Congress to the Central Midwest Interstate Low-Level Radioactive Waste Compact. Introduced in the House of Representatives, Ninety-Ninth Congress, First Session, April 16, 1985

International Nuclear Information System (INIS)

Anon.

1985-01-01

The revised bill, after submission to the House Committees on Interior and Insular Affairs and on Energy and Commerce, grants the Central Midwest Interstate Compact for the regional management and disposal of low-level radioactive wastes. The amended bill applies to the states of Illinois and Kentucky, and outlines procedures for the affected states to cooperate in the transport and the siting and operation of storage facilities. A compact commission to administer the program will include voting members from each eligible state. The bill also specifies the rights and obligations of participants and requirements for joining or withdrawing from the compact and for terminating the compact. Other sections cover related laws, congressional review, and penalties for non-compliance

Microbes in the upper atmosphere and unique opportunities for astrobiology research.

Science.gov (United States)

Smith, David J

2013-10-01

Microbial taxa from every major biological lineage have been detected in Earth's upper atmosphere. The goal of this review is to communicate (1) relevant astrobiology questions that can be addressed with upper atmosphere microbiology studies and (2) available sampling methods for collecting microbes at extreme altitudes. Precipitation, mountain stations, airplanes, balloons, rockets, and satellites are all feasible routes for conducting aerobiology research. However, more efficient air samplers are needed, and contamination is also a pervasive problem in the field. Measuring microbial signatures without false positives in the upper atmosphere might contribute to sterilization and bioburden reduction methods for proposed astrobiology missions. Intriguingly, environmental conditions in the upper atmosphere resemble the surface conditions of Mars (extreme cold, hypobaria, desiccation, and irradiation). Whether terrestrial microbes are active in the upper atmosphere is an area of intense research interest. If, in fact, microbial metabolism, growth, or replication is achievable independent of Earth's surface, then the search for habitable zones on other worlds should be broadened to include atmospheres (e.g., the high-altitude clouds of Venus). Furthermore, viable cells in the heavily irradiated upper atmosphere of Earth could help identify microbial genes or enzymes that bestow radiation resistance. Compelling astrobiology questions on the origin of life (if the atmosphere synthesized organic aerosols), evolution (if airborne transport influenced microbial mutation rates and speciation), and panspermia (outbound or inbound) are also testable in Earth's upper atmosphere.

Spacesuit Soft Upper Torso Sizing Systems

Science.gov (United States)

Graziosi, David; Splawn, Keith

2011-01-01

The passive sizing system consists of a series of low-profile pulleys attached to the front and back of the shoulder bearings on a spacesuit soft upper torso (SUT), textile cord or stainless steel cable, and a modified commercial ratchet mechanism. The cord/cable is routed through the pulleys and attached to the ratchet mechanism mounted on the front of the spacesuit within reach of the suited subject. Upon actuating the ratchet mechanism, the shoulder bearing breadth is changed, providing variable upper torso sizing. The active system consists of a series of pressurizable nastic cells embedded into the fabric layers of a spacesuit SUT. These cells are integrated to the front and back of the SUT and are connected to an air source with a variable regulator. When inflated, the nastic cells provide a change in the overall shoulder bearing breadth of the spacesuit and thus, torso sizing. The research focused on the development of a high-performance sizing and actuation system. This technology has application as a suit-sizing mechanism to allow easier suit entry and more accurate suit fit with fewer torso sizes than the existing EMU (Extravehicular Mobility Unit) suit system. This advanced SUT will support NASA s Advanced EMU Evolutionary Concept of a two-sizes-fit-all upper torso for replacement of the current EMU hard upper torso (HUT). Both the passive and nastic sizing system approaches provide astronauts with real-time upper torso sizing, which translates into a more comfortable suit, providing enhanced fit resulting in improved crewmember performance during extravehicular activity. These systems will also benefit NASA by reducing flight logistics as well as overall suit system cost. The nastic sizing system approach provides additional structural redundancy over existing SUT designs by embedding additional coated fabric and uncoated fabric layers. Two sizing systems were selected to build into a prototype SUT: one active and one passive. From manned testing, it

Upper limb fractures in rugby in Huddersfield 1986-1990.

OpenAIRE

Eyres, K S; Abdel-Salam, A; Cleary, J

1991-01-01

Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported.

Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

Science.gov (United States)

Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

2018-06-01

Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.