WorldWideScience

Sample records for volumes appropriately identified

  1. PATTERNS FOR IDENTIFYING APPROPRIATE KNOWLEDGE MANAGEMENT STRATEGIES IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Khadijeh Salmani

    2012-06-01

    Full Text Available Nowadays, striving to find an efficient way for developing or identifying appropriate knowledge management strategies in organizations has become so critical. Researchers and practitioners have attached great importance to information pyramids in organizations and have highlighted the lack of trained and skilled staff as a serious problem. On the other hand, having more flexibility at workplace, offering better service, and fulfilling customers' demands require a strategy for managing knowledge and its consequence. Knowledge management provides a wide range of different strategies and methods for identifying, creating, and sharing knowledge in organizations. This deep insight which consists of individual, organization’s experience, knowledge, and understanding helps organization respond to both internal and external stimuli and act in harmony. One fact which has seemingly achieved a consensus is the need for different strategies of knowledge management. Among the wide range of various and often unclear knowledge management strategies one can choose a strategy in a specific situation. The aim of this paper is to respond to strategic questions which emphasize competitive intelligence and internal knowledge retrieval system. The implications are discussed in detail.

  2. Identifying Appropriate Quantitative Study Designs for Library Research

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    Diane Lorenzetti

    2007-03-01

    Full Text Available This paper is concerned with the identification of quantitative study designs suitable for library research. Identifying a researchable question and selecting a research method best suited to it are key to the successful design and execution of any research project. Each research situation is unique, and each researcher must find the method that best suits both their situation and the question at hand. Following a brief discussion of issues related to question development, the author outlines a checklist that may assist the process of selecting study designs for quantitative research projects. When faced with options in terms of study design selection, pragmatic issues such as expertise, funding, time, and access to participants may influence this decision‐making process.

  3. Appropriateness of using a symbol to identify dementia and/or delirium: a systematic review.

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    Hines, Sonia; Abbey, Jenny; Wilson, Jacinda; Sacre, Sandy

    2009-01-01

    Alzheimer's Australia contracted the Dementia Collaborative Research Centre - Consumers, Carers and Social Research to conduct a systematic review to explore the appropriateness of a symbol for dementia.The concept of a symbol for people with dementia was an outcome of the Alzheimer's Australia National Consumer Summit on Dementia held in Canberra in October 2005. People living with dementia and their carers identified that a national symbol would be helpful in order to encourage appropriate treatment of people with dementia.Funding was provided as part of the Australian Government's Dementia Initiative to Alzheimer's Australia to work in collaboration with the Queensland University of Technology and Catholic Health Australia to explore, through research, the viability and potential impact of such a symbol in a range of care settings. The main objective of this systematic review was to evaluate any published and unpublished evidence regarding the appropriateness of developing a symbol for dementia and/or delirium, which could be used in a variety of settings to indicate that a person has dementia and/or delirium. A literature search was performed using the following databases: Ageline, APAIS Health, CINAHL, Dissertations and Theses Abstracts, Embase, MEDLINE, PsycEXTRAS, PsycINFO, PsycArticles, Current Contents, LegalTrac, Health and Society, Sociological Abstracts, Family and Society, CINCH, and Hein Online databases. The reference lists of articles retrieved were hand searched, as well as a range of literature from health, legal, ethical and emergency services. Grey literature was searched for using a number of Internet sites, and personal email communication with authors of relevant studies and known researchers in the field was initiated. Papers were retrieved if they provided information about attitudes or perceptions towards the appropriateness of symbols, identifiers or alerts used to inform others that someone has dementia, delirium and/or another medical

  4. Comparative assessment of genomic DNA extraction processes for Plasmodium: Identifying the appropriate method.

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    Mann, Riti; Sharma, Supriya; Mishra, Neelima; Valecha, Neena; Anvikar, Anupkumar R

    2015-12-01

    Plasmodium DNA, in addition to being used for molecular diagnosis of malaria, find utility in monitoring patient responses to antimalarial drugs, drug resistance studies, genotyping and sequencing purposes. Over the years, numerous protocols have been proposed for extracting Plasmodium DNA from a variety of sources. Given that DNA isolation is fundamental to successful molecular studies, here we review the most commonly used methods for Plasmodium genomic DNA isolation, emphasizing their pros and cons. A comparison of these existing methods has been made, to evaluate their appropriateness for use in different applications and identify the method suitable for a particular laboratory based study. Selection of a suitable and accessible DNA extraction method for Plasmodium requires consideration of many factors, the most important being sensitivity, cost-effectiveness and, purity and stability of isolated DNA. Need of the hour is to accentuate on the development of a method that upholds well on all these parameters.

  5. Identifying an appropriate Content Management System to develop Clinical Practice Guidelines: A perspective.

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    Reddy, Sandeep; Herring, Sally; Gray, Allison

    2015-12-03

    Clinical Practice Guidelines are widely used to inform and improve the quality and consistency of clinical practice. Developing and publishing Clinical Practice Guidelines is a complex task involving multiple components. Electronic Content Management Systems are increasingly employed to make this task more manageable. The Content Management System market offers a variety of options for publishing content on the Internet. However, there are limited products that comprehensively address the requirements of publishing Clinical Practice Guidelines. The authors are involved in publishing guidelines for remote clinical practitioners in Australia and present their perspective about identifying an appropriate Content Management System. Several elements essential to addressing their unique editing needs are defined in this article. Unfortunately, customisation is very expensive and laborious: few Content Management System providers can comprehensively meet the needs of Clinical Practice Guidelines publishing. Being pragmatic about the level of functionality a product can offer to support publication is essential.

  6. Antibiotic Resistances in Livestock: A Comparative Approach to Identify an Appropriate Regression Model for Count Data

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    Anke Hüls

    2017-05-01

    Full Text Available Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model and (ii to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate

  7. Identifying an appropriate measurement modeling approach for the Mini-Mental State Examination.

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    Rubright, Jonathan D; Nandakumar, Ratna; Karlawish, Jason

    2016-02-01

    The Mini-Mental State Examination (MMSE) is a 30-item, dichotomously scored test of general cognition. A number of benefits could be gained by modeling the MMSE in an item response theory (IRT) framework, as opposed to the currently used classical additive approach. However, the test, which is built from groups of items related to separate cognitive subdomains, may violate a key assumption of IRT: local item independence. This study aimed to identify the most appropriate measurement model for the MMSE: a unidimensional IRT model, a testlet response theory model, or a bifactor model. Local dependence analysis using nationally representative data showed a meaningful violation of the local item independence assumption, indicating multidimensionality. In addition, the testlet and bifactor models displayed superior fit indices over a unidimensional IRT model. Statistical comparisons showed that the bifactor model fit MMSE respondent data significantly better than the other models considered. These results suggest that application of a traditional unidimensional IRT model is inappropriate in this context. Instead, a bifactor model is suggested for future modeling of MMSE data as it more accurately represents the multidimensional nature of the scale. (PsycINFO Database Record

  8. The importance of appropriate partial volume correction for PET quantification in Alzheimer's disease

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    Thomas, Benjamin A.; Erlandsson, Kjell; Hutton, Brian F. [University College London, Institute of Nuclear Medicine, London (United Kingdom); Modat, Marc [University College London, Centre for Medical Image Computing, London (United Kingdom); Thurfjell, Lennart [GE Healthcare, Amersham (United Kingdom); Vandenberghe, Rik [Catholic University Leuven, Laboratory for Cognitive Neurology, Leuven (Belgium); University Hospitals Leuven, Neurology Department, Leuven (Belgium); Ourselin, Sebastien [University College London, Centre for Medical Image Computing, London (United Kingdom); University College London, Dementia Research Centre, London (United Kingdom)

    2011-06-15

    Alzheimer's disease (AD) is the most common form of dementia. Clinically, it is characterized by progressive cognitive and functional impairment with structural hallmarks of cortical atrophy and ventricular expansion. Amyloid plaque aggregation is also known to occur in AD subjects. In-vivo imaging of amyloid plaques is now possible with positron emission tomography (PET) radioligands. PET imaging suffers from a degrading phenomenon known as the partial volume effect (PVE). The quantitative accuracy of PET images is reduced by PVEs primarily due to the limited spatial resolution of the scanner. The degree of PVE is influenced by structure size, with smaller structures tending to suffer from more severe PVEs such as atrophied grey matter regions. The aims of this paper were to investigate the effect of partial volume correction (PVC) on the quantification of amyloid PET and to highlight the importance of selecting an appropriate PVC technique. An improved PVC technique, region-based voxel-wise (RBV) correction, was compared against existing Van-Cittert (VC) and Mueller-Gaertner (MG) methods using amyloid PET imaging data. Digital phantom data were produced using segmented MRI scans from a control subject and an AD subject. Typical tracer distributions were generated for each of the phantom anatomies. Also examined were 70 clinical PET scans acquired using [{sup 18}F]flutemetamol. Volume of interest (VOI) analysis was performed for corrected and uncorrected images. PVC was shown to improve the quantitative accuracy of regional analysis performed on amyloid PET images. Of the corrections applied, VC deconvolution demonstrated the worst recovery of grey matter values. MG PVC was shown to induce biases in some grey matter regions due to grey matter variability. In addition, white matter variability was shown to influence the accuracy of MG PVC in cortical grey matter and also cerebellar grey matter, a typical reference region for amyloid PET normalization in

  9. 28 CFR 1100.37 - Requirements to train appropriate personnel in identifying and protecting victims of severe forms...

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    2010-07-01

    ... appropriate DOJ and DOS personnel be trained in identifying victims of severe forms of trafficking in persons... services must provide initial training in the particular needs of victims of severe forms of trafficking in... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Requirements to train...

  10. Identifying the Most Appropriate Cultivar for Sustainability of Rice Production System Using Analytic Hierarchy Process (AHP

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    H. Moumenihelali

    2015-09-01

    Full Text Available In general, the ultimate goal of a sustainable system is to maximize the benefits of existing resources and to minimize the threats to the environment that occur due to the present conventional agricultural activities. Meanwhile, seed, as a rice cultivar in the present study, is presented as an important factor in sustainability. Therefore, identifying the most suitable cultivar of rice for sustaining the rice cultivation system is considered to be the main goal of the research. The population of the present study involves all specialists who have enough knowledge on components of sustainability and rice cultivars. To this end, 16 people were identified and studied through non-probability sampling method (purposeful and snowball. Face and content validity was used to determine the validity of the questionnaire. In addition, to assess the reliability, inconsistency ratio was used. Analytical Hierarchy Process (AHP technique was used in order to achieve the main objective, which is to identify the most suitable varieties for sustainable rice cultivation system. Expert Choice 2000 software was applied to calculate the data.The prerequisite of applying AHP technique is to consider the criteria (sustainability of rice cultivation system which include: economical, ecological, technical, social, and policy sustainability and their sub-criteria in the one hand, and decision alternatives (rice cultivars including: Hashemi, Tarom, Neda, Fajr, Khazar and Shirudi in the other hand. The results of prioritizing the criteria of rice cultivation stability showed that the economical (32%, ecological (23.9% and technical (21.1% stability are more important than the stability of social (14.8% and policy (8.3% aspects. Likewise, research findings showed that the cultivars of Hashemi (20.6% and Tarom (20.1% with a slight difference against each other are the most proper cultivars, respectively, in the sustainability of rice cultivation system.

  11. Tools to identify the men with prostate cancer most appropriate for active surveillance?

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    Robert H Getzenberg

    2014-02-01

    Full Text Available A great deal of effort is underway in order to identify those men with prostate cancer felicitous for active surveillance with greater precision than that afforded to us today. In the manuscript by Irshad et al. the authors evaluate a novel set of genes associated with senescence and aging as tools that can provide guidance regarding the indolent nature of an individual's prostate cancer with validation using both mRNA and protein analyses. While additional studies are required to understand the full impact of these findings, the innovative approach taken enhances our understanding of distinct phenotypes of prostate cancer.

  12. IDENTIFYING BOTTLENECKS FOR APPROPRIATE INFANT FEEDING IN URBAN SLUMS, ALIGARH CITY.

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    Saira Mehnaz

    2012-04-01

    Full Text Available Introduction: Urban population is increasing rapidly. Majority of these families are poor or landless farmers and labourers, who settle down in peri-urban areas, creating slums. Urban slums are thus growing at an alarming rate. The present study was carried out with the general objective of identifying factors which prevent access to health services. Objectives: 1. To determine the prevalence of stunting, wasting, and underweight in infants and young children. 2. To determine presence of certain micro-environmental and socioeconomic factors associated with poor nutritional status of infants and children. Methodology: Baseline study was carried out in Oct –Nov 2009 (as a part of another ongoing study and data was collected in 110 Mothers who had delivered children during the last one month. In Oct 2010 these families were visited again the infants were followed up. 39 families had shifted to another location or emigrated back to their parent state or village mostly in search of seasonal employment as reported by neighbours. One family refused to cooperate. . Two infants had died. Remaining 68 Mothers were interviewed in friendly informal manner after taking consent for study. Results: (35.4% study subjects had migrated to other areas, as reported by neighbours. Of the 68 mothers interviewed during follow up visit, previous baseline record showed that a majority were 20-30 years of age. , only 2 mothers (2.9% had exclusively breastfed for 6 months. 46 (67.6% said they had not been contacted by any health worker during the last 3 months. All 68 children were malnourished. Immunization status was poor and 94.1% children had suffered from some illness in the last one month. Conclusion: Migration is a problem which makes it difficult for providers to give continuity of care. Capacity building of the community can reduce the the bottlenecks leading to marginalization and exclusion of slum mothers from the mainstream urban health services.

  13. [A case of carbamate poisoning in which GCMS was useful to identify causal substance and to decide the appropriate treatment].

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    Kinoshita, H; Hirose, Y; Tanaka, T; Hori, Y; Nakajima, M; Fujisawa, M; Oseki, M

    2001-10-01

    We often have cases of insecticide poisoning where the patient is unconscious and the causal substances are unknown. We report an 83-year-old unconscious man who had apparently ingested several agricultural chemicals, possibly organophosphate or carbamate. According to his family, there were three kinds of containers of agricultural chemicals with their caps opened around him. When he was transferred to our hospital, he presented hypertension, hypersalivation, and muscle fasciculation. His pupils were markedly miotic. In order to identify the substances ingested we used a gas chromatographymass spectrometer (GCMS) using his gastric content. Within 30 minutes we were able to identify the causal substance as methomyl, one of the popular carbamates, thereby eliminating the need to use pralidoxime (PAM). GCMS makes it possible to identify unknown substances quickly and accurately and is therefore extremely useful in deciding the appropriate treatment.

  14. A combined GIS and stereo vision approach to identify building pixels in images and determine appropriate color terms

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    Philip James Bartie

    2011-05-01

    Full Text Available Color information is a useful attribute to include in a building's description to assist the listener in identifying the intended target. Often this information is only available as image data, and not readily accessible for use in constructing referring expressions for verbal communication. The method presented uses a GIS building polygon layer in conjunction with street-level captured imagery to provide a method to automatically filter foreground objects and select pixels which correspond to building facades. These selected pixels are then used to define the most appropriate color term for the building, and corresponding fuzzy color term histogram. The technique uses a single camera capturing images at a high frame rate, with the baseline distance between frames calculated from a GPS speed log. The expected distance from the camera to the building is measured from the polygon layer and refined from the calculated depth map, after which building pixels are selected. In addition significant foreground planar surfaces between the known road edge and building facade are identified as possible boundary walls and hedges. The output is a dataset of the most appropriate color terms for both the building and boundary walls. Initial trials demonstrate the usefulness of the technique in automatically capturing color terms for buildings in urban regions.

  15. A combined GIS and stereo vision approach to identify building pixels in images and determine appropriate color terms

    Directory of Open Access Journals (Sweden)

    Philip James Bartie

    2011-01-01

    Full Text Available Color information is a useful attribute to include in a building's description to assist the listener in identifying the intended target. Often this information is only available as image data, and not readily accessible for use in constructing referring expressions for verbal communication. The method presented uses a GIS building polygon layer in conjunction with street-level captured imagery to provide a method to automatically filter foreground objects and select pixels which correspond to building facades. These selected pixels are then used to define the most appropriate color term for the building, and corresponding fuzzy color term histogram. The technique uses a single camera capturing images at a high frame rate, with the baseline distance between frames calculated from a GPS speed log. The expected distance from the camera to the building is measured from the polygon layer and refined from the calculated depth map, after which building pixels are selected. In addition significant foreground planar surfaces between the known road edge and building facade are identified as possible boundary walls and hedges. The output is a dataset of the most appropriate color terms for both the building and boundary walls. Initial trials demonstrate the usefulness of the technique in automatically capturing color terms for buildings in urban regions.

  16. Delay-sensitive and delay-insensitive deconvolution perfusion-CT: similar ischemic core and penumbra volumes if appropriate threshold selected for each

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    Man, Fengyuan [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Patrie, James T.; Xin, Wenjun [University of Virginia, Department of Public Health Sciences, Charlottesville, VA (United States); Zhu, Guangming [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Military General Hospital of Beijing PLA, Department of Neurology, Beijing (China); Hou, Qinghua [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); The Second Affiliated Hospital of Guangzhou Medical University, Department of Neurology, Guangzhou (China); Michel, Patrik; Eskandari, Ashraf [Centre Hospitalier Universitaire Vaudois, Department of Neurology, Lausanne (Switzerland); Jovin, Tudor [University of Pittsburgh, Department of Neurology, Pittsburgh, PA (United States); Xian, Junfang; Wang, Zhenchang [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); Wintermark, Max [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Centre Hospitalier Universitaire Vaudois, Department of Radiology, Lausanne (Switzerland); Stanford University, Department of Radiology, Neuroradiology Division, Stanford, CA (United States)

    2015-03-07

    Perfusion-CT (PCT) processing involves deconvolution, a mathematical operation that computes the perfusion parameters from the PCT time density curves and an arterial curve. Delay-sensitive deconvolution does not correct for arrival delay of contrast, whereas delay-insensitive deconvolution does. The goal of this study was to compare delay-sensitive and delay-insensitive deconvolution PCT in terms of delineation of the ischemic core and penumbra. We retrospectively identified 100 patients with acute ischemic stroke who underwent admission PCT and CT angiography (CTA), a follow-up vascular study to determine recanalization status, and a follow-up noncontrast head CT (NCT) or MRI to calculate final infarct volume. PCT datasets were processed twice, once using delay-sensitive deconvolution and once using delay-insensitive deconvolution. Regions of interest (ROIs) were drawn, and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) in these ROIs were recorded and compared. Volume and geographic distribution of ischemic core and penumbra using both deconvolution methods were also recorded and compared. MTT and CBF values are affected by the deconvolution method used (p < 0.05), while CBV values remain unchanged. Optimal thresholds to delineate ischemic core and penumbra are different for delay-sensitive (145 % MTT, CBV 2 ml x 100 g{sup -1} x min{sup -1}) and delay-insensitive deconvolution (135 % MTT, CBV 2 ml x 100 g{sup -1} x min{sup -1} for delay-insensitive deconvolution). When applying these different thresholds, however, the predicted ischemic core (p = 0.366) and penumbra (p = 0.405) were similar with both methods. Both delay-sensitive and delay-insensitive deconvolution methods are appropriate for PCT processing in acute ischemic stroke patients. The predicted ischemic core and penumbra are similar with both methods when using different sets of thresholds, specific for each deconvolution method. (orig.)

  17. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    Science.gov (United States)

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  18. Novel genetic loci underlying human intracranial volume identified through genome-wide association

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    Adams, Hieab HH; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Rentería, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivières, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C; Blanken, Laura ME; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher RK; Cuellar-Partida, Gabriel; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Greven, Corina U; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liao, Jiemin; Liewald, David CM; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; Mazoyer, Bernard; McKay, David R; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L; Maniega, Susana Muñoz; Nho, Kwangsik; Nugent, Allison C; Olde Loohuis, Loes M; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Pütz, Benno; Rajan, Kumar B; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein MJ; Van Eijk, Kristel R; Van Erp, Theo GM; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Aggarwal, Neelum T; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Chen, Christopher; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Geus, Eco JC; De Jager, Philip L; de Zubicaray, Greig I; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Erk, Susanne; Espeseth, Thomas; Evans, Denis A; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald HH; Grabe, Hans J; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Hulshoff Pol, Hilleke E; Ikeda, Masashi; Ikram, M Kamran; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Longstreth, WT; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Katie L; McMahon, Francis J; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda WJH; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schofield, Peter R; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Srikanth, Velandai; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Turner, Jessica A; Tzourio, Christophe; Uitterlinden, Andre G; Valdés Hernández, Maria C; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic JA; Van Duijn, Cornelia M; Van Haren, Neeltje EM; Van 't Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Veltman, Dick J; Vernooij, Meike W; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, H Ronald; Zonderman, Alan B; Deary, Ian J; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G; De Craen, Anton JM; Wright, Margaret J; Launer, Lenore J; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stéphanie; Medland, Sarah E; Ikram, M Arfan; Thompson, Paul M

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five novel loci for intracranial volume and confirmed two known signals. Four of the loci are also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρgenetic=0.748), which indicated a similar genetic background and allowed for the identification of four additional loci through meta-analysis (Ncombined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, Parkinson’s disease, and enriched near genes involved in growth pathways including PI3K–AKT signaling. These findings identify biological underpinnings of intracranial volume and provide genetic support for theories on brain reserve and brain overgrowth. PMID:27694991

  19. High Volume Throughput Computing: Identifying and Characterizing Throughput Oriented Workloads in Data Centers

    CERN Document Server

    Zhan, Jianfeng; Sun, Ninghui; Wang, Lei; Jia, Zhen; Luo, Chunjie

    2012-01-01

    For the first time, this paper systematically identifies three categories of throughput oriented workloads in data centers: services, data processing applications, and interactive real-time applications, whose targets are to increase the volume of throughput in terms of processed requests or data, or supported maximum number of simultaneous subscribers, respectively, and we coins a new term high volume throughput computing (in short HVC) to describe those workloads and data center systems designed for them. We characterize and compare HVC with other computing paradigms, e.g., high throughput computing, warehouse-scale computing, and cloud computing, in terms of levels, workloads, metrics, coupling degree, data scales, and number of jobs or service instances. We also preliminarily report our ongoing work on the metrics and benchmarks for HVC systems, which is the foundation of designing innovative data center systems for HVC workloads.

  20. Hierarchical population monitoring of greater sage-grouse (Centrocercus urophasianus) in Nevada and California—Identifying populations for management at the appropriate spatial scale

    Science.gov (United States)

    Coates, Peter S.; Prochazka, Brian G.; Ricca, Mark A.; Wann, Gregory T.; Aldridge, Cameron; Hanser, Steven E.; Doherty, Kevin E; O'Donnell, Michael S.; Edmunds, David R.; Espinosa, Shawn P.

    2017-08-10

    Population ecologists have long recognized the importance of ecological scale in understanding processes that guide observed demographic patterns for wildlife species. However, directly incorporating spatial and temporal scale into monitoring strategies that detect whether trajectories are driven by local or regional factors is challenging and rarely implemented. Identifying the appropriate scale is critical to the development of management actions that can attenuate or reverse population declines. We describe a novel example of a monitoring framework for estimating annual rates of population change for greater sage-grouse (Centrocercus urophasianus) within a hierarchical and spatially nested structure. Specifically, we conducted Bayesian analyses on a 17-year dataset (2000–2016) of lek counts in Nevada and northeastern California to estimate annual rates of population change, and compared trends across nested spatial scales. We identified leks and larger scale populations in immediate need of management, based on the occurrence of two criteria: (1) crossing of a destabilizing threshold designed to identify significant rates of population decline at a particular nested scale; and (2) crossing of decoupling thresholds designed to identify rates of population decline at smaller scales that decouple from rates of population change at a larger spatial scale. This approach establishes how declines affected by local disturbances can be separated from those operating at larger scales (for example, broad-scale wildfire and region-wide drought). Given the threshold output from our analysis, this adaptive management framework can be implemented readily and annually to facilitate responsive and effective actions for sage-grouse populations in the Great Basin. The rules of the framework can also be modified to identify populations responding positively to management action or demonstrating strong resilience to disturbance. Similar hierarchical approaches might be beneficial

  1. Identifying priorities to improve paediatric in-hospital antimicrobial use by cross-sectional evaluation of prevalence and appropriateness of prescription.

    Science.gov (United States)

    Goycochea-Valdivia, Walter Alfredo; Moreno-Ramos, Francisco; Paño-Pardo, José Ramón; Aracil-Santos, Francisco Javier; Baquero-Artigao, Fernando; Del Rosal-Rabes, Teresa; Mellado-Peña, María José; Escosa-García, Luis

    2017-03-08

    Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP). AAP was defined as a correct indication plus an appropriate prescribing pattern (dose, spectrum and interval). Evaluation was performed using established antimicrobial guidelines. Other factors that may have a bearing on antimicrobial prescription were also analysed. A total of 171 patients were included. PAP was 49.7% (85/171) and AAP was 60.9% (91/161). The most common indications for antimicrobial use were antimicrobial prophylaxis (28.3%, 32/113) and pneumonia (8.2%, 8/113). Overall, 161 antimicrobials were prescribed (1.9 antimicrobials per patient): 55.3% (89/161) were empiric, 16.1% (26/161) were targeted and 28.6% (46/161) were prophylactic. Amoxicillin/clavulanate (8.2%, 14/171) and sulfamethoxazole/trimethoprim (8.2%, 14/171) were the most prescribed antimicrobials. The prescription of antifungals (11.7%, 20/171) and antivirals (1.8%, 3/171) was analysed. Major causes of inappropriate antibiotic use were prolonged prescriptions (21.7%, 35/161) and use of agents with an excessively broad coverage spectrum (21.1%, 34/161). PAP and AAP varied between wards and antimicrobials. Measurement of PAP and AAP offers valuable information for detecting priorities in hospital settings and monitoring antimicrobial usage prior to the development of antimicrobial stewardship programmes. In our setting, the main areas for improvement are duration of therapy and proper use of broad-spectrum antimicrobials. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Espa

  2. Using caregivers’ perceptions of rehabilitation services for children with Cerebral Palsy at public sector hospitals to identify the components of an appropriate service

    Directory of Open Access Journals (Sweden)

    G.M. Saloojee

    2011-02-01

    Full Text Available Despite  a  growing  body  of  evidence  favouring  a  family-centred approach to rehabilitation services for children with cerebral palsy (cp, the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA settings  remains unknown.  The  study  aimed  to  identify  key  components of  an appropriate  rehabilitation  service  which  would  meet  the  needs of children  with  CP  and  their  caregivers  at  SA  public  sector  hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20 questionnaire together with two open-endedquestions with  a  convenience  sample  of  caregivers attending therapy  at  CP  Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child,  and  practical  assistance  (handling  ideas  and suggestions,  assistive devices, food supplements, nappies, advice were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved.  Key components for  an  appropriate  therapy  service  include  caring  and respectful  attitudes,  hands-on  therapy,  handling  suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.

  3. Effective use of forensic science in volume crime investigations: identifying recurring themes in the literature.

    Science.gov (United States)

    Ludwig, Anika; Fraser, Jim

    2014-01-01

    New scientific, technological and legal developments, particularly the introduction of national databases for DNA and fingerprints, have led to increased use of forensic science in the investigation of crime. There is an assumption, and in some instances specific assertions, that such developments bring improvements either in broad criminal justice terms or more narrowly in terms of economic or practical efficiencies. The underlying presumption is that the new technological opportunities will be understood and effectively implemented. This research investigates whether such increases in activity have also been accompanied by improvements in the effective use of forensic science. A systematic review of thirty-six reports published (predominantly in England and Wales) since the 1980s, which have considered the use of forensic science in the investigation of volume crimes, was carried out. These reports have identified a number of recurrent themes that influenced how effectively forensic science was used in investigations. The themes identified included forensic knowledge and training of investigators, communication and information exchange between specialists and investigators, timeliness of forensic results, interagency relationships and deployment of crime scene examiner resources. The research findings suggest that these factors continue to hinder the effective use of forensic science despite technological advances and this paper considers their potential causes.

  4. Collaborative Appropriation

    DEFF Research Database (Denmark)

    Muller, Michael; Neureiter, Katja; Verdezoto, Nervo;

    2016-01-01

    Previous workshops and papers have examined how individual users adopt and adapt technologies to meet their own local needs, by “completing design through use.” However, there has been little systematic study of how groups of people engage collaboratively in these activities. This workshop opens ...... a discussion for these under-studied forms of collaborative appropriation, using a broad range of perspectives including empirical data, design explorations, research, and critique....

  5. Análise da apropriação do conceito de volume sob a perspectiva da teoria da atividade Analysis of the appropriation of the concept of volume by Activity Theory

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Gouvêa de Camargo Rodrigues

    2010-01-01

    Full Text Available De acordo com a Abordagem Histórico-Cultural e a Teoria da Atividade de Leontiev, apropriação de conceitos e desenvolvimento psíquico dos sujeitos são processos interligados. Com a intenção de compreendermos essa relação, desenvolvemos atividades orientadoras de ensino em uma 3ª série do Ensino Fundamental, trabalhando com o conceito de volume para investigar o processo de apropriação conceitual pelos alunos. Observamos que as ações das crianças são reveladoras do seu desenvolvimento psíquico, à medida que evidenciam a utilização dos conceitos geométricos como instrumentos orientadores na busca de soluções diante de situações desafiadoras. A apropriação se revela na mudança da relação do sujeito com o objeto, ou seja, quando ele deixa de agir por tentativa e erro ou repetição mecânica de procedimentos e age mediante reflexão e análise, o que exige mobilização de funções psíquicas superiores.According to the Historical and Cultural Approach and Leontiev's Activity Theory, the subjects' appropriation of concepts and psychic development are interlinked processes. Monitored learning activities on the concept of volume have been developed in a 3rd year primary school class to investigate the students' conceptual process. Children's activities revealed their psychic development as they used geometrical concepts such as monitoring instruments for the solution of challenging situations. Appropriation is revealed when there is a change in the relationship between subject and object, or rather, when the subject quits activities by trial and error or the mechanical repetition of procedures and acts according to reflection and analysis. The latter requires the mobilization of higher psychic functions.

  6. Job stress: an in-depth investigation based on the HSE questionnaire and a multistep approach in order to identify the most appropriate corrective actions.

    Science.gov (United States)

    De Sio, S; Cedrone, F; Greco, E; Di Traglia, M; Sanità, D; Mandolesi, D; Stansfeld, S A

    2016-01-01

    Psychosocial hazards and work-related stress have reached epidemic proportions in Europe. The Italia law introduced in 2008 the obligation for Italian companies to assess work related stress risk in order to protect their workers' safety and health. The purpose of our study was to propose an accurate measurement tool, using the HSE indicator tool, for more appropriate and significant work-related stress' prevention measures. The study was conducted on 204 visual display unit (VDU) operators: 106 male and 98 female. All subjects were administered the HSE questionnaire. The sample was studied through a 4 step process, using HSE analysis tool and a statistical analysis, based on the odds ratio calculation. The assessment model used demonstrated the presence of work related stress in VDU operators and additional "critical" aspects which had failed to emerge by the classical use of HSE analysis tool. The approach we propose allows to obtain a complete picture of the perception of work-related stress and can point out the most appropriate corrective actions.

  7. FLIS Procedures Manual. Document Identifier Code Input/Output Formats (Fixed Length). Volume 8.

    Science.gov (United States)

    2007-11-02

    4100.39-M DEFENSE LOGISTICS SERVICES CENTER Volume 8 74 WASHINGTON AVE N BATTLE CREEK MI 49017-3084 DLSC- VPH 1 April 1997 FOREWORD This is one of the...volume 1, chapter 1.6, or administrative comments and inquiries may be directed to DLSC- VPH . Service/Agency distribution is handled through...changes to DLSC- VPH . Content changes appearing on these pages are entered in bold-faced italic type. Comments or questions may be directed to DLSC- VPH . This

  8. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    NARCIS (Netherlands)

    Adams, Hieab H. H.; Hibar, Derrek P.; Chouraki, Vincent; Stein, Jason L.; Nyquist, Paul A.; Renteria, Miguel E.; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivieres, Sylvane; Beecham, Ashley H.; Jahanshad, Neda; Wittfeld, Katharine; Van der Lee, Sven J.; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S.; Armstrong, Nicola J.; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C.; Blanken, Laura M. E.; Blanton, Susan H.; Bohlken, Marc M.; Boks, Marco P.; Bralten, Janita; Brickman, Adam M.; Carmichael, Owen; Chakravarty, M. Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher R. K.; Cuellar-Partida, Gabriel; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L.; Gottesman, Rebecca F.; Greven, Corina U.; Grimm, Oliver; Griswold, Michael E.; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K.; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J.; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H.; Liao, Jiemin; Liewald, David C. M.; Lopez, Lorna M.; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A.; Mattheisen, Manuel; Mazoyer, Bernard; Mckay, David R.; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L.; Maniega, Susana Munoz; Nho, Kwangsik; Nugent, Allison C.; Loohuis, Loes M. Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Puetz, Benno; Rajan, Kumar B.; Ramasamy, Adaikalavan; Richards, Jennifer S.; Risacher, Shannon L.; Roiz-Santianez, Roberto; Rommelse, Nanda; Rose, Emma J.; Royle, Natalie A.; Rundek, Tatjana; Saemann, Philipp G.; Satizabal, Claudia L.; Schmaal, Lianne; Schork, Andrew J.; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V.; Sprooten, Emma; Strike, Lachlan T.; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein M. J.; Van Eijk, Kristel R.; Van Erp, Theo G. M.; Van Rooij, Daan; Walton, Esther; Westlye, Lars T.; Whelan, Christopher D.; Windham, Beverly G.; Winkler, Anderson M.; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R.; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P.; Agartz, Ingrid; Aggarwal, Neelum T.; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A.; Arepalli, Sampath; Assareh, Amelia A.; Barral, Sandra; Bastin, Mark E.; Becker, Diane M.; Becker, James T.; Bennett, David A.; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I.; Brodaty, Henry; Brouwer, Rachel M.; Brunner, Han G.; Buckner, Randy L.; Buitelaar, Jan K.; Bulayeva, Kazima B.; Cahn, Wiepke; Calhoun, Vince D.; Cannon, Dara M.; Cavalleri, Gianpiero L.; Chen, Christopher; Cheng, Ching -Yu; Cichon, Sven; Cookson, Mark R.; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E.; Czisch, Michael; Dale, Anders M.; Davies, Gareth E.; De Geus, Eco J. C.; De Jager, Philip L.; de Zubicaray, Greig I.; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L.; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C.; Duggirala, Ravi; Dyer, Thomas D.; Erk, Susanne; Espeseth, Thomas; Evans, Denis A.; Fedko, Iryna; Fernandez, Guillen; Ferrucci, Luigi; Fisher, Simon E.; Fleischman, Debra A.; Ford, Ian; Foroud, Tatiana M.; Fox, Peter T.; Francks, Clyde; Fukunaga, Masaki; Gibbs, J. Raphael; Glahn, David C.; Gollub, Randy L.; Goring, Harald H. H.; Grabe, Hans J.; Green, Robert C.; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K.; Hardy, John; Hartman, Catharina A.; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G.; Heslenfeld, Dirk J.; Ho, Beng-Choon; Hoekstra, Pieter J.; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Pol, Hilleke E. Hulshoff; Ikeda, Masashi; Ikram, M. Kamran; Jack, Clifford R.; Jenldnson, Mark; Johnson, Robert; Jonsson, Erik G.; Jukema, J. Wouter; Kahn, Rene S.; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S.; Kochunov, Peter; Kwok, John B.; Lawrie, Stephen M.; Lemaitre, Herve; Liu, Xinmin; Longo, Dan L.; Longstreth, W. T.; Lopez, Oscar L.; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S.; McDonald, Colm; McIntosh, Andrew M.; McMahon, Katie L.; McMahon, Francis J.; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W.; Morris, Derek W.; Mosley, Thomas H.; Muhleisen, Thomas W.; Mueller-Myhsok, Bertram; Nalls, Michael A.; Nauck, Matthias; Nichols, Thomas E.; Niessen, Wiro J.; Noethen, Markus M.; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L.; Ophoff, Roel A.; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W. J. H.; Pike, G. Bruce; Potkin, Steven G.; Psaty, Bruce M.; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L.; Romanczuk-Seiferth, Nina; Rotter, Jerome I.; Ryten, Mina; Sacco, Ralph L.; Sachdev, Perminder S.; Saykin, Andrew J.; Schmidt, Reinhold; Schofield, Peter R.; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M.; Smith, Colin; Smoller, Jordan W.; Soininen, Hindu.; Srikanth, Velandai; Steen, Vidar M.; Stott, David J.; Sussmann, Jessika E.; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W.; Traynor, Bryan J.; Troncoso, Juan; Turner, Jessica A.; Tzourio, Christophe; Uitterlinden, Andre G.; Hernandez, Maria C. Valdes; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic J. A.; Van Duijn, Cornelia M.; Van Haren, Neeltje E. M.; Van't Ent, Dennis; Van Tol, Marie Jose; Vardarajan, Badri N.; Veltman, Dick J.; Vernooij, Meike W.; Voelzke, Henry; Walter, Henrik; Wardlaw, Joanna M.; Wassink, Thomas H.; Weale, Michael E.; Weinberger, Daniel R.; Weiner, Michael W.; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y.; Wright, Clinton B.; Zielke, H. Ronald; Zonderman, Alan B.; Deary, Ian J.; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G.; De Craen, Anton J. M.; Wright, Margaret J.; Launer, Lenore J.; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stephanie; Medland, Sarah E.; Ikram, M. Arfan; Thompson, Paul M.

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously unk

  9. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    NARCIS (Netherlands)

    Adams, Hieab H. H.; Hibar, Derrek P.; Chouraki, Vincent; Stein, Jason L.; Nyquist, Paul A.; Renteria, Miguel E.; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivieres, Sylvane; Beecham, Ashley H.; Jahanshad, Neda; Wittfeld, Katharine; Van der Lee, Sven J.; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S.; Armstrong, Nicola J.; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C.; Blanken, Laura M. E.; Blanton, Susan H.; Bohlken, Marc M.; Boks, Marco P.; Bralten, Janita; Brickman, Adam M.; Carmichael, Owen; Chakravarty, M. Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher R. K.; Cuellar-Partida, Gabriel; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L.; Gottesman, Rebecca F.; Greven, Corina U.; Grimm, Oliver; Griswold, Michael E.; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K.; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J.; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H.; Liao, Jiemin; Liewald, David C. M.; Lopez, Lorna M.; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A.; Mattheisen, Manuel; Mazoyer, Bernard; Mckay, David R.; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L.; Maniega, Susana Munoz; Nho, Kwangsik; Nugent, Allison C.; Loohuis, Loes M. Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Puetz, Benno; Rajan, Kumar B.; Ramasamy, Adaikalavan; Richards, Jennifer S.; Risacher, Shannon L.; Roiz-Santianez, Roberto; Rommelse, Nanda; Rose, Emma J.; Royle, Natalie A.; Rundek, Tatjana; Saemann, Philipp G.; Satizabal, Claudia L.; Schmaal, Lianne; Schork, Andrew J.; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V.; Sprooten, Emma; Strike, Lachlan T.; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein M. J.; Van Eijk, Kristel R.; Van Erp, Theo G. M.; Van Rooij, Daan; Walton, Esther; Westlye, Lars T.; Whelan, Christopher D.; Windham, Beverly G.; Winkler, Anderson M.; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R.; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P.; Agartz, Ingrid; Aggarwal, Neelum T.; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A.; Arepalli, Sampath; Assareh, Amelia A.; Barral, Sandra; Bastin, Mark E.; Becker, Diane M.; Becker, James T.; Bennett, David A.; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I.; Brodaty, Henry; Brouwer, Rachel M.; Brunner, Han G.; Buckner, Randy L.; Buitelaar, Jan K.; Bulayeva, Kazima B.; Cahn, Wiepke; Calhoun, Vince D.; Cannon, Dara M.; Cavalleri, Gianpiero L.; Chen, Christopher; Cheng, Ching -Yu; Cichon, Sven; Cookson, Mark R.; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E.; Czisch, Michael; Dale, Anders M.; Davies, Gareth E.; De Geus, Eco J. C.; De Jager, Philip L.; de Zubicaray, Greig I.; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L.; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C.; Duggirala, Ravi; Dyer, Thomas D.; Erk, Susanne; Espeseth, Thomas; Evans, Denis A.; Fedko, Iryna; Fernandez, Guillen; Ferrucci, Luigi; Fisher, Simon E.; Fleischman, Debra A.; Ford, Ian; Foroud, Tatiana M.; Fox, Peter T.; Francks, Clyde; Fukunaga, Masaki; Gibbs, J. Raphael; Glahn, David C.; Gollub, Randy L.; Goring, Harald H. H.; Grabe, Hans J.; Green, Robert C.; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K.; Hardy, John; Hartman, Catharina A.; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G.; Heslenfeld, Dirk J.; Ho, Beng-Choon; Hoekstra, Pieter J.; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Pol, Hilleke E. Hulshoff; Ikeda, Masashi; Ikram, M. Kamran; Jack, Clifford R.; Jenldnson, Mark; Johnson, Robert; Jonsson, Erik G.; Jukema, J. Wouter; Kahn, Rene S.; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S.; Kochunov, Peter; Kwok, John B.; Lawrie, Stephen M.; Lemaitre, Herve; Liu, Xinmin; Longo, Dan L.; Longstreth, W. T.; Lopez, Oscar L.; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S.; McDonald, Colm; McIntosh, Andrew M.; McMahon, Katie L.; McMahon, Francis J.; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W.; Morris, Derek W.; Mosley, Thomas H.; Muhleisen, Thomas W.; Mueller-Myhsok, Bertram; Nalls, Michael A.; Nauck, Matthias; Nichols, Thomas E.; Niessen, Wiro J.; Noethen, Markus M.; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L.; Ophoff, Roel A.; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W. J. H.; Pike, G. Bruce; Potkin, Steven G.; Psaty, Bruce M.; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L.; Romanczuk-Seiferth, Nina; Rotter, Jerome I.; Ryten, Mina; Sacco, Ralph L.; Sachdev, Perminder S.; Saykin, Andrew J.; Schmidt, Reinhold; Schofield, Peter R.; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M.; Smith, Colin; Smoller, Jordan W.; Soininen, Hindu.; Srikanth, Velandai; Steen, Vidar M.; Stott, David J.; Sussmann, Jessika E.; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W.; Traynor, Bryan J.; Troncoso, Juan; Turner, Jessica A.; Tzourio, Christophe; Uitterlinden, Andre G.; Hernandez, Maria C. Valdes; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic J. A.; Van Duijn, Cornelia M.; Van Haren, Neeltje E. M.; Van't Ent, Dennis; Van Tol, Marie Jose; Vardarajan, Badri N.; Veltman, Dick J.; Vernooij, Meike W.; Voelzke, Henry; Walter, Henrik; Wardlaw, Joanna M.; Wassink, Thomas H.; Weale, Michael E.; Weinberger, Daniel R.; Weiner, Michael W.; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y.; Wright, Clinton B.; Zielke, H. Ronald; Zonderman, Alan B.; Deary, Ian J.; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G.; De Craen, Anton J. M.; Wright, Margaret J.; Launer, Lenore J.; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stephanie; Medland, Sarah E.; Ikram, M. Arfan; Thompson, Paul M.

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously unk

  10. Good Practice Chaplaincy: An Exploratory Study Identifying the Appropriate Skills, Attitudes and Practices for the Selection, Training and Utilisation of Chaplains.

    Science.gov (United States)

    Carey, Lindsay B; Rumbold, Bruce

    2015-08-01

    This article presents an overview of exploratory research regarding the skills, knowledge, attitudes and practices considered necessary for chaplains to be highly competent in providing holistic care to clients and staff. Utilising a qualitative methodology, two focus groups comprising Salvation Army chaplains and their managers provided data about their expectations of chaplaincy personnel and about the pastoral care interventions undertaken by chaplains. The results indicated that while there were some differences in opinion, nevertheless, in overall terms, there was general agreement between chaplains and their managers about particular personal and professional qualities necessary for chaplains to be considered appropriate and proficient. Evidence was also obtained indicating a need for change with regard to the organisational attitude and culture of The Salvation Army towards chaplaincy. Recommendations are presented concerning (1) the selection criteria for chaplaincy, (2) training and utilisation of chaplains plus (3) issues relating to organizational cultural change necessary to develop a future-ready chaplaincy more suitable for the twenty-first century.

  11. Building Quality Report Cards for Geriatric Care in The Netherlands: Using Concept Mapping to Identify the Appropriate "Building Blocks" from the Consumer's Perspective

    Science.gov (United States)

    Groenewoud, A. Stef; van Exel, N. Job A.; Berg, Marc; Huijsman, Robbert

    2008-01-01

    Purpose: This article reports on a study to identify "building blocks" for quality report cards for geriatric care. Its aim is to present (a) the results of the study and (b) the innovative step-by-step approach that was developed to arrive at these results. Design and Methods: We used Concept Mapping/Structured Conceptualization to…

  12. Identifying appropriate spatial scales for marine conservation and management using a larval dispersal model: The case of Concholepas concholepas (loco) in Chile

    Science.gov (United States)

    Garavelli, Lysel; Kaplan, David Michael; Colas, François; Stotz, Wolfgang; Yannicelli, Beatriz; Lett, Christophe

    2014-05-01

    Along the coast of Chile, fisheries targeting the marine gastropod Concholepas concholepas, commonly named “loco”, were highly valuable until the end of the 80s when catches declined significantly. Since the late 90s, a management plan based on territorial-user-rights areas has been implemented, with limited effect on stock recovery. More effective loco conservation and management is impeded by lack of information regarding connectivity via larval dispersal between these individually-managed areas. To develop a regional view of loco connectivity, we integrate loco life history information into a biophysical, individual-based larval dispersal model. This model is used to evaluate scales of loco connectivity and seasonality in connectivity patterns, as well as to partition the coast into largely disconnected subpopulations using a recently developed connectivity-matrix clustering algorithm. We find mean dispersal distances ranging from 170 to 220 km depending on release depth of larvae and planktonic larval duration. Settlement success levels depend quantitatively on the physical and biological processes included in the model, but connectivity patterns remain qualitatively similar. Model estimates of settlement success peak for larval release dates in late austral autumn, consistent with field results and with favorable conditions for larval coastal retention due to weak upwelling during austral autumn. Despite the relatively homogeneous Chilean coastline, distinct subpopulations with minimal connectivity between them are readily identifiable. Barriers to connectivity that are robust to changes in model configuration exist at 23°S and 29°S latitudes. These zones are all associated with important headlands and embayments of the Chilean coast.

  13. Evaluating the effectiveness of a training program that builds teachers' capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study.

    Science.gov (United States)

    Vieira, Marlene A; Gadelha, Ary A; Moriyama, Taís S; Bressan, Rodrigo A; Bordin, Isabel A

    2014-02-28

    In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers' ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers' capability in this area. To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers

  14. Evaluating the effectiveness of a training program that builds teachers’ capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study

    Science.gov (United States)

    2014-01-01

    Background In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers’ ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers’ capability in this area. Methods To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Results Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems

  15. Pleiotropic locus for emotion recognition and amygdala volume identified using univariate and bivariate linkage

    Science.gov (United States)

    Knowles, Emma E. M.; McKay, D. Reese; Kent, Jack W.; Sprooten, Emma; Carless, Melanie A.; Curran, Joanne E.; de Almeida, Marcio A. A.; Dyer, Thomas D.; Göring, Harald H. H.; Olvera, Rene; Duggirala, Ravi; Fox, Peter; Almasy, Laura; Blangero, John; Glahn, David. C.

    2014-01-01

    The role of the amygdala in emotion recognition is well established and separately each trait has been shown to be highly heritable, but the potential role of common genetic influences on both traits has not been explored. Here we present an investigation of the pleiotropic influences of amygdala and emotion recognition in a sample of randomly selected, extended pedigrees (N = 858). Using a combination of univariate and bivariate linkage we found a pleiotropic region for amygdala and emotion recognition on 4q26 (LOD = 4.34). Association analysis conducted in the region underlying the bivariate linkage peak revealed a variant meeting the corrected significance level (pBonferroni = 5.01×10−05) within an intron of PDE5A (rs2622497, Χ2 =16.67, p = 4.4×10−05) as being jointly influential on both traits. PDE5A has been implicated previously in recognition-memory deficits and is expressed in subcortical structures that are thought to underlie memory ability including the amygdala. The present paper extends our understanding of the shared etiology between amygdala and emotion recognition by showing that the overlap between the two traits is due, at least in part, to common genetic influences. Moreover, the present paper identifies a pleiotropic locus for the two traits and an associated variant, which localizes the genetic signal even more precisely. These results, when taken in the context of previous research, highlight the potential utility of PDE5-inhibitors for ameliorating emotion-recognition deficits in populations including, but not exclusively, those individuals suffering from mental or neurodegenerative illness. PMID:25322361

  16. Optical quantification of cellular mass, volume and density of circulating tumor cells identified in an ovarian cancer patient

    Directory of Open Access Journals (Sweden)

    Kevin Gregory Phillips

    2012-07-01

    Full Text Available Clinical studies have demonstrated that circulating tumor cells (CTCs are present in the blood of cancer patients with known metastatic disease across the major types of epithelial malignancies. Recent studies have shown that the concentration of CTCs in the blood is prognostic of overall survival in breast, prostate, colorectal and non-small cell lung cancer. This study characterizes CTCs identified using the high-definition (HD-CTC assay in an ovarian cancer patient with stage IIIC disease. We characterized the physical properties of 31 HD-CTCs and 50 normal leukocytes from a single blood draw taken just prior to the initial debulking surgery. We utilized a non-interferometric quantitative phase microscopy technique using brightfield imagery to measure cellular dry mass. Next we used a quantitative differential interference contrast microscopy technique to measure cellular volume. These techniques were combined to determine cellular dry mass density. We found that HD-CTCs were more massive than leukocytes: 33.6 ± 3.2 pg (HD-CTC compared to 18.7 ± 0.6 pg (leukocytes, p < 0.001; had greater volumes: 518.3 ± 24.5 fL (HD-CTC compared to 230.9 ± 78.5 fL (leukocyte, p<0.001; and possessed a decreased dry mass density with respect to leukocytes: 0.065 ± 0.006 pg/fL (HD-CTC compared to 0.085 ± 0.004 pg/fL (leukocyte, p < 0.006. Quantification of HD-CTC dry mass content and volume provide key insights into the fluid dynamics of cancer, and may provide the rationale for strategies to isolate, monitor or target CTCs based on their physical properties. The parameters reported here can also be incorporated into blood cell flow models to better understand metastasis.

  17. Inter-sport variability of muscle volume distribution identified by segmental bioelectrical impedance analysis in four ball sports

    Directory of Open Access Journals (Sweden)

    Yamada Y

    2013-04-01

    Full Text Available Yosuke Yamada,1,2 Yoshihisa Masuo,3 Eitaro Nakamura,4 Shingo Oda5 1Laboratory of Sports and Health Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Japan Society for the Promotion of Science, Tokyo, Japan; 3Waseda University Research Institute for Elderly Health, Saitama, Japan; 4Department of Sport Science, Kyoto Iken College of Medicine and Health, Kyoto, Japan; 5Faculty of Health and Well-being, Kansai University, Osaka, Japan Abstract: The aim of this study was to evaluate and quantify differences in muscle distribution in athletes of various ball sports using segmental bioelectrical impedance analysis (SBIA. Participants were 115 male collegiate athletes from four ball sports (baseball, soccer, tennis, and lacrosse. Percent body fat (%BF and lean body mass were measured, and SBIA was used to measure segmental muscle volume (MV in bilateral upper arms, forearms, thighs, and lower legs. We calculated the MV ratios of dominant to nondominant, proximal to distal, and upper to lower limbs. The measurements consisted of a total of 31 variables. Cluster and factor analyses were applied to identify redundant variables. The muscle distribution was significantly different among groups, but the %BF was not. The classification procedures of the discriminant analysis could correctly distinguish 84.3% of the athletes. These results suggest that collegiate ball game athletes have adapted their physique to their sport movements very well, and the SBIA, which is an affordable, noninvasive, easy-to-operate, and fast alternative method in the field, can distinguish ball game athletes according to their specific muscle distribution within a 5-minute measurement. The SBIA could be a useful, affordable, and fast tool for identifying talents for specific sports. Keywords: discriminant analysis, cluster and factor analysis, segmental bioelectrical impedance analysis, baseball, lacrosse

  18. Appropriate prescribing for older people

    NARCIS (Netherlands)

    Drenth - van Maanen, A.C.

    2013-01-01

    Appropriate prescribing is the result of pharmacotherapeutic decision-making to maximise the net health benefit of treatment, given the resources available. Several risk factors for inappropriate prescribing in older people have been identified, such as polypharmacy, impaired renal function, and

  19. Conceptualization and Appropriation

    DEFF Research Database (Denmark)

    Bossen, Claus; Dalsgård, Peter

    2005-01-01

    and system development. Second, we argue that the process of design extends far into the process of use and that much can be learned by looking at the process of appropriation of a new system. The problems of conceptualisation and appropriation point towards the need to critically examine the mangle...... of practice in which artefacts, actors and organizations intertwine...

  20. Appropriation of Information Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

    2008-01-01

    This paper explores the use of cognitive mapping for eliciting users' sensemaking during information system (IS) appropriation. Despite the potential usefulness of sensemaking, few studies in IS research use it as a theoretical lens to address IS appropriation. A possible reason for this may be t...... of the epistemological and methodological assumptions underlying cognitive mapping to ensure its validity and trustworthiness....

  1. Appropriability, services and reputation

    NARCIS (Netherlands)

    Dolfsma, W.A.

    2011-01-01

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

  2. Appropriability, services and reputation

    NARCIS (Netherlands)

    Dolfsma, W.A.

    2011-01-01

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

  3. Federal Logistics Information Systems. FLIS Procedures Manual. Document Identifier Code Input/Output Formats (Variable Length). Volume 9.

    Science.gov (United States)

    2007-11-02

    49017-3084 CH I CHANGE NO. 1 DoD 4100.39-M DoD 4100.39-M Volume 9 V DLSC- VPH 1 July 1997 _-’ FEDERAL LOGISTICS INFORMATION SYSTEM (FLIS) PROCEDURES...47 3053 UNIT OF ISSUE CONVERSION FACTOR 0005N H 02 QS 8472 FORMER UNIT OF ISSUE 0002A H 89 0211 OCCURS COUNTER/li/ 0001N H GV 2862 PHRASE CODE...16 0707 MANAGEMENT CONTROL DATA, COAST GUARD 0007X H 16 0443 EXPANSION FIELD 1 0001X H 47 3053 UNIT OF ISSUE CONVERSION FACTOR 0005N H 02 0S 8472

  4. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    Directory of Open Access Journals (Sweden)

    William A Copen

    Full Text Available In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured "ischemic core." The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI, but many authors suggest that maps of regional cerebral blood volume (CBV derived from computed tomography perfusion imaging (CTP can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume.58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: "objective absolute," i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9-2.5 mL/100 g, "objective relative," whose six thresholds (51%-60% were fractions of mean contralateral CBV, and "subjective," in which two radiologists (R1, R2 outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred.DWI was positive in 72% (42/58 of patients. CBV maps' sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156-699 mL for objective absolute thresholds, and 127-200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124 mL in individual patients. Inter-rater agreement

  5. A novel volume-age-KPS (VAK glioblastoma classification identifies a prognostic cognate microRNA-gene signature.

    Directory of Open Access Journals (Sweden)

    Pascal O Zinn

    Full Text Available BACKGROUND: Several studies have established Glioblastoma Multiforme (GBM prognostic and predictive models based on age and Karnofsky Performance Status (KPS, while very few studies evaluated the prognostic and predictive significance of preoperative MR-imaging. However, to date, there is no simple preoperative GBM classification that also correlates with a highly prognostic genomic signature. Thus, we present for the first time a biologically relevant, and clinically applicable tumor Volume, patient Age, and KPS (VAK GBM classification that can easily and non-invasively be determined upon patient admission. METHODS: We quantitatively analyzed the volumes of 78 GBM patient MRIs present in The Cancer Imaging Archive (TCIA corresponding to patients in The Cancer Genome Atlas (TCGA with VAK annotation. The variables were then combined using a simple 3-point scoring system to form the VAK classification. A validation set (N = 64 from both the TCGA and Rembrandt databases was used to confirm the classification. Transcription factor and genomic correlations were performed using the gene pattern suite and Ingenuity Pathway Analysis. RESULTS: VAK-A and VAK-B classes showed significant median survival differences in discovery (P = 0.007 and validation sets (P = 0.008. VAK-A is significantly associated with P53 activation, while VAK-B shows significant P53 inhibition. Furthermore, a molecular gene signature comprised of a total of 25 genes and microRNAs was significantly associated with the classes and predicted survival in an independent validation set (P = 0.001. A favorable MGMT promoter methylation status resulted in a 10.5 months additional survival benefit for VAK-A compared to VAK-B patients. CONCLUSIONS: The non-invasively determined VAK classification with its implication of VAK-specific molecular regulatory networks, can serve as a very robust initial prognostic tool, clinical trial selection criteria, and important step toward

  6. Appropriateness of Liver Biopsy

    OpenAIRE

    Thierry Poynard; Vlad Ratziu; Pierre Bedossa

    2000-01-01

    This review aims to discuss the appropriateness of liver biopsy in two frequent liver diseases, hepatitis C and alcoholic liver disease. The medical literature, published between 1965 and 1999, was reviewed by using MEDLINE. Only 0.1% of the publications were devoted specifically to the appropriateness of liver biopsy. Not all studies observed a significant agreement among doctors on the decision to use liver biopsy. Therefore, there is a possibility that hepatologists have significant, heter...

  7. Appropriation of Information Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

    2008-01-01

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

  8. Appropriate technology directories

    Energy Technology Data Exchange (ETDEWEB)

    Frankena, F.

    1984-01-01

    An alphabetical and annotated list of 107 directories of appropriate technologies includes the publications of numerous small firms and residential groups as well as government and industry sources. The references cover neighborhood, village, and community efforts to develop decentralized technologies. Some list private and public funding sources, while others deal with legal, technical, and social aspects of renewable and alternative technologies.

  9. Crowding as appropriation

    DEFF Research Database (Denmark)

    Thelle, Mikkel

    2016-01-01

    This article seeks to address the relation between crowds andpublic space as a question of appropriation. With the newliberal constitutions in Europe, several phenomena of crowdingemerge in major cities, of which Copenhagen is taken as anexample. By focusing on the crowd as an agglomeration ofbod...

  10. Media Appropriation and Explicitation

    Directory of Open Access Journals (Sweden)

    Tomas Laurenzo

    2016-12-01

    Full Text Available This paper presents a novel characterization of new media art together with an exploration of some key aspects of its practice: I propose that new media art’s defining characteristics are media appropriation and explicitation. With media appropriation I refer to the dialectal inscription into the art practice of the knowledge that allows for some particular technological production. I also propose that new media art’s language is constructed in part via the explicitation of certain aspects of more ‘traditional’ art, and that this explicitation allows for a construction of a new vocabulary. Examples of this are the explicitation of randomness, interaction, programming, or of the role that tools and instruments play, among others.

  11. Situational appropriation of information

    OpenAIRE

    2015-01-01

    Purpose In contrast to the interest of describing and managing the social processes of knowing, information science and information and knowledge management research have put less emphasis on discussing how particular information becomes usable and how it is used in different contexts and situations. The purpose of this paper is to address this major gap, and introduce and discuss the applicability of the notion of situational appropriation of information for shedding light on this particular...

  12. Whole-exome sequencing and imaging genetics identify functional variants for rate of change in hippocampal volume in mild cognitive impairment.

    Science.gov (United States)

    Nho, K; Corneveaux, J J; Kim, S; Lin, H; Risacher, S L; Shen, L; Swaminathan, S; Ramanan, V K; Liu, Y; Foroud, T; Inlow, M H; Siniard, A L; Reiman, R A; Aisen, P S; Petersen, R C; Green, R C; Jack, C R; Weiner, M W; Baldwin, C T; Lunetta, K; Farrer, L A; Furney, S J; Lovestone, S; Simmons, A; Mecocci, P; Vellas, B; Tsolaki, M; Kloszewska, I; Soininen, H; McDonald, B C; Farlow, M R; Ghetti, B; Huentelman, M J; Saykin, A J

    2013-07-01

    Whole-exome sequencing of individuals with mild cognitive impairment, combined with genotype imputation, was used to identify coding variants other than the apolipoprotein E (APOE) ε4 allele associated with rate of hippocampal volume loss using an extreme trait design. Matched unrelated APOE ε3 homozygous male Caucasian participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were selected at the extremes of the 2-year longitudinal change distribution of hippocampal volume (eight subjects with rapid rates of atrophy and eight with slow/stable rates of atrophy). We identified 57 non-synonymous single nucleotide variants (SNVs) which were found exclusively in at least 4 of 8 subjects in the rapid atrophy group, but not in any of the 8 subjects in the slow atrophy group. Among these SNVs, the variants that accounted for the greatest group difference and were predicted in silico as 'probably damaging' missense variants were rs9610775 (CARD10) and rs1136410 (PARP1). To further investigate and extend the exome findings in a larger sample, we conducted quantitative trait analysis including whole-brain search in the remaining ADNI APOE ε3/ε3 group (N=315). Genetic variation within PARP1 and CARD10 was associated with rate of hippocampal neurodegeneration in APOE ε3/ε3. Meta-analysis across five independent cross sectional cohorts indicated that rs1136410 is also significantly associated with hippocampal volume in APOE ε3/ε3 individuals (N=923). Larger sequencing studies and longitudinal follow-up are needed for confirmation. The combination of next-generation sequencing and quantitative imaging phenotypes holds significant promise for discovery of variants involved in neurodegeneration.

  13. Narrative self-appropriation

    DEFF Research Database (Denmark)

    Køster, Allan

    2017-01-01

    It is often emphasised that persons diagnosed with Borderline Personality Disorder [BPD] show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective BPD can be understood as an existential modality where the embodied self...... is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern “from behind”. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD...

  14. An appropriate data set size for digital soil mapping in Erechim, Rio Grande do Sul, Brazil Volume de dados adequado para o mapeamento digital de solos no município de Erechim, Rio Grande do Sul, Brasil

    Directory of Open Access Journals (Sweden)

    Alexandre ten Caten

    2013-04-01

    Full Text Available Digital information generates the possibility of a high degree of redundancy in the data available for fitting predictive models used for Digital Soil Mapping (DSM. Among these models, the Decision Tree (DT technique has been increasingly applied due to its capacity of dealing with large datasets. The purpose of this study was to evaluate the impact of the data volume used to generate the DT models on the quality of soil maps. An area of 889.33 km² was chosen in the Northern region of the State of Rio Grande do Sul. The soil-landscape relationship was obtained from reambulation of the studied area and the alignment of the units in the 1:50,000 scale topographic mapping. Six predictive covariates linked to the factors soil formation, relief and organisms, together with data sets of 1, 3, 5, 10, 15, 20 and 25 % of the total data volume, were used to generate the predictive DT models in the data mining program Waikato Environment for Knowledge Analysis (WEKA. In this study, sample densities below 5 % resulted in models with lower power of capturing the complexity of the spatial distribution of the soil in the study area. The relation between the data volume to be handled and the predictive capacity of the models was best for samples between 5 and 15 %. For the models based on these sample densities, the collected field data indicated an accuracy of predictive mapping close to 70 %.Informações digitais tornam possível um elevado grau de redundância das informações disponíveis para o ajuste de modelos preditores aplicados ao Mapeamento Digital de Solos (MDS. Entre esses modelos, a técnica de Árvores de Decisão (AD tem aplicação crescente, em razão da sua potência no tratamento de grandes volumes de dados. Objetivou-se com este trabalho avaliar o impacto do volume de dados utilizados para gerar os modelos por AD, na qualidade dos mapas de solos gerados pela técnica de MDS. Uma área de estudo com 889,33 km² foi escolhida na região do

  15. Romanian Special Forces: Identifying Appropriate Missions and Organizational Structure

    Science.gov (United States)

    2004-12-01

    WMD in terrorists’ possession represents the acme of terror, the Romanian SF Battalion should be prepared to contribute to CP efforts by conducting...Retrieved November 10, 2004, from http://gmr.mapn.ro/Arhiva_pdf/2003/ Revista -3.pdf Nastase, A. (Editor) (2002). Romania – NATO. Romania and the

  16. Appropriate schemata and building blocks

    Institute of Scientific and Technical Information of China (English)

    Yang Haijun; Li Minqiang

    2005-01-01

    Appropriate schemata as a novel concept to characterize building blocks are introduced, and then, the traits of appropriate schemata are presented. The effects of building blocks by search operators are analyzed. Hence, the experiments on RR-8X8 are employed to verify that appropriate schemata construct the building blocks. The validity of appropriate schemata and building blocks from the views of theory and practice is presented.

  17. Unauthorized Appropriations and Expiring Authorizations

    Science.gov (United States)

    2015-01-15

    health campaign on epilepsy ; Health Resources Services Administration seizure disorder demonstration projects in medically underserved areas; infant...Authorized: Indefinite Unauthorized FY 2015 Appropriations: Not Available American history for freedom : grants to institutions of higher education for...American Energy Freedom (secs. 1421 - 1423) * FY 2006 Appropriation Authorized: Indefinite Unauthorized FY 2015 Appropriations: Not Available A

  18. Military Construction: FY2017 Appropriations

    Science.gov (United States)

    2016-10-04

    and reserve components of the armed forces, military family housing construction and operations, the U.S. contribution to the NATO Security Investment...Appropriations Congressional Research Service 1 Introduction Military construction for active and reserve components of the armed forces, military...Rescinded appropriations may be applied against current year appropriations to reduce the new budget authority needed to satisfy requirements . The net

  19. Value Appropriation in Business Exchange

    DEFF Research Database (Denmark)

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

    2014-01-01

    Purpose – Value appropriation is a central, yet neglected aspect in business exchange research. The purpose of the paper is to generate an overview of research on active value appropriation in business exchange and provide the foundation for further research into value appropriation, as well as s...

  20. Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

    Science.gov (United States)

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

    2017-01-01

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

  1. Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

    Science.gov (United States)

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

    2017-01-01

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

  2. Appropriate Technology as Indian Technology.

    Science.gov (United States)

    Barry, Tom

    1979-01-01

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

  3. Chemical technology for appropriate development

    NARCIS (Netherlands)

    Van Brakel, J.

    1978-01-01

    'Chemical technology for appropriate development' is basicly a critical review of the literature. It gives a conceptual analysis of so called appropriate technology and the choice of production systems for less-development countries. The role of about 40 organizations active in this emerging field

  4. 24 CFR 100.143 - Appropriate corrective action.

    Science.gov (United States)

    2010-04-01

    ... violation, and adopting new policies as appropriate; (3) Identifying, and then training and/or disciplining the employees involved; (4) Developing outreach programs, marketing strategies, or loan products...

  5. The Appropriateness of Hierarchies (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2010-09-01

    Full Text Available In the early days of EBLIP, then referred to as evidence based librarianship (EBL, there were calls to strengthen our research base with "better" forms of evidence. These proposed better quality research methods were all quantitative and I admit myself to saying that ‚librarianship tends to reflect more qualitative, social sciences/humanities in its research methods and study types which tend to be less rigorous and more prone to bias‛ (Crumley and Koufogiannakis 2002, p.61. Although this was not meant to be a slight to qualitative research, I can see how it came across as one. Now, I would not put ‚less rigorous and more prone to bias‛ in that sentence, although the first half of the statement certainly still holds true. In our 2002 article, the general point that Ellen Crumley and I were trying to make is that a medical style research hierarchy is not a good fit for librarianship, where qualitative methods are generally more appropriate. At that time, we proposed a ‚core-centred approach to librarianship research‛ (p.68 rather than a hierarchical one, although this did not gain much traction within the EBLIP literature. We noted: ‚rather than relying on an evidence hierarchy, which is an artificial concept for librarians, Fig.3 suggests a core-centred approach. The types of studies that are likely to be conducted by librarians are placed near the centre, moving from a hierarchical to an encompassing model. … *This+ presents a more equitable view of a model for research in the profession‛ (p.67.Today I am even more resolved that it is time to remove the concept of a hierarchy of evidence from EBLIP. This concept is tied very closely to the medical model of evidence based medicine (EBM and is solely focused on quantitative research. Library and information studies (LIS is a social sciences discipline and as such is concerned mostly with questions of why we do things and how people function in the world. The actions of people

  6. Appropriateness Criteria for Active Surveillance of Prostate Cancer.

    Science.gov (United States)

    Cher, Michael L; Dhir, Apoorv; Auffenberg, Gregory B; Linsell, Susan; Gao, Yuqing; Rosenberg, Bradley; Jafri, S Mohammad; Klotz, Laurence; Miller, David C; Ghani, Khurshid R; Bernstein, Steven J; Montie, James E; Lane, Brian R

    2017-01-01

    The adoption of active surveillance varies widely across urological communities, which suggests a need for more consistency in the counseling of patients. To address this need we used the RAND/UCLA Appropriateness Method to develop appropriateness criteria and counseling statements for active surveillance. Panelists were recruited from MUSIC urology practices. Combinations of parameters thought to influence decision making were used to create and score 160 theoretical clinical scenarios for appropriateness of active surveillance. Recent rates of active surveillance among real patients across the state were assessed using the MUSIC registry. Low volume Gleason 6 was deemed highly appropriate for active surveillance whereas high volume Gleason 6 and low volume Gleason 3+4 were deemed appropriate to uncertain. No scenario was deemed inappropriate or highly inappropriate. Prostate specific antigen density, race and life expectancy impacted scores for intermediate and high volume Gleason 6 and low volume Gleason 3+4. The greatest degree of score dispersion (disagreement) occurred in scenarios with long life expectancy, high volume Gleason 6 and low volume Gleason 3+4. Recent rates of active surveillance use among real patients ranged from 0% to 100% at the provider level for low or intermediate biopsy volume Gleason 6, demonstrating a clear opportunity for quality improvement. By virtue of this work urologists have the opportunity to present specific recommendations from the panel to their individual patients. Community-wide efforts aimed at increasing rates of active surveillance and reducing practice and physician level variation in the choice of active surveillance vs treatment are warranted. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. SU-E-J-241: Wavelet-Based Temporal Feature Extraction From DCE-MRI to Identify Sub-Volumes of Low Blood Volume in Head-And-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    You, D; Aryal, M; Samuels, S; Eisbruch, A; Cao, Y [University of Michigan, Ann Arbor, MI (United States)

    2015-06-15

    Purpose: A previous study showed that large sub-volumes of tumor with low blood volume (BV) (poorly perfused) in head-and-neck (HN) cancers are significantly associated with local-regional failure (LRF) after chemoradiation therapy, and could be targeted with intensified radiation doses. This study aimed to develop an automated and scalable model to extract voxel-wise contrast-enhanced temporal features of dynamic contrastenhanced (DCE) MRI in HN cancers for predicting LRF. Methods: Our model development consists of training and testing stages. The training stage includes preprocessing of individual-voxel DCE curves from tumors for intensity normalization and temporal alignment, temporal feature extraction from the curves, feature selection, and training classifiers. For feature extraction, multiresolution Haar discrete wavelet transformation is applied to each DCE curve to capture temporal contrast-enhanced features. The wavelet coefficients as feature vectors are selected. Support vector machine classifiers are trained to classify tumor voxels having either low or high BV, for which a BV threshold of 7.6% is previously established and used as ground truth. The model is tested by a new dataset. The voxel-wise DCE curves for training and testing were from 14 and 8 patients, respectively. A posterior probability map of the low BV class was created to examine the tumor sub-volume classification. Voxel-wise classification accuracy was computed to evaluate performance of the model. Results: Average classification accuracies were 87.2% for training (10-fold crossvalidation) and 82.5% for testing. The lowest and highest accuracies (patient-wise) were 68.7% and 96.4%, respectively. Posterior probability maps of the low BV class showed the sub-volumes extracted by our model similar to ones defined by the BV maps with most misclassifications occurred near the sub-volume boundaries. Conclusion: This model could be valuable to support adaptive clinical trials with further

  8. Appropriateness of Percutaneous Coronary Intervention

    Science.gov (United States)

    Chan, Paul S.; Patel, Manesh R.; Klein, Lloyd W.; Krone, Ronald J.; Dehmer, Gregory J.; Kennedy, Kevin; Nallamothu, Brahmajee K.; Douglas Weaver, W.; Masoudi, Frederick A.; Rumsfeld, John S.; Brindis, Ralph G.; Spertus, John A.

    2012-01-01

    Context Despite the widespread use of percutaneous coronary intervention (PCI), the appropriateness of these procedures in contemporary practice is unknown. Objective To assess the appropriateness of PCI in the United States. Design, Setting, and Patients Multicenter, prospective study of patients within the National Cardiovascular Data Registry undergoing PCI between July 1, 2009, and September 30, 2010, at 1091 US hospitals. The appropriateness of PCI was adjudicated using the appropriate use criteria for coronary revascularization. Results were stratified by whether the procedure was performed for an acute (ST-segment elevation myocardial infarction, non–ST-segment elevation myocardial infarction, or unstable angina with high-risk features) or nonacute indication. Main Outcome Measures Proportion of acute and nonacute PCIs classified as appropriate, uncertain, or inappropriate; extent of hospital-level variation in inappropriate procedures. Results Of 500 154 PCIs, 355 417 (71.1%) were for acute indications (ST-segment elevation myocardial infarction, 103 245 [20.6%]; non–ST-segment elevation myocardial infarction, 105 708 [21.1%]; high-risk unstable angina, 146 464 [29.3%]), and 144 737 (28.9%) for nonacute indications. For acute indications, 350 469 PCIs (98.6%) were classified as appropriate, 1055 (0.3%) as uncertain, and 3893 (1.1%) as inappropriate. For nonacute indications, 72 911 PCIs (50.4%) were classified as appropriate, 54 988 (38.0%) as uncertain, and 16 838 (11.6%) as inappropriate. The majority of inappropriate PCIs for nonacute indications were performed in patients with no angina (53.8%), low-risk ischemia on noninvasive stress testing (71.6%), or suboptimal (≤1 medication) antianginal therapy (95.8%). Furthermore, although variation in the proportion of inappropriate PCI across hospitals was minimal for acute procedures, there was substantial hospital variation for nonacute procedures (median hospital rate for inappropriate PCI, 10

  9. Identifying Structure-Property Relationships Through DREAM.3D Representative Volume Elements and DAMASK Crystal Plasticity Simulations: An Integrated Computational Materials Engineering Approach

    Science.gov (United States)

    Diehl, Martin; Groeber, Michael; Haase, Christian; Molodov, Dmitri A.; Roters, Franz; Raabe, Dierk

    2017-03-01

    Predicting, understanding, and controlling the mechanical behavior is the most important task when designing structural materials. Modern alloy systems—in which multiple deformation mechanisms, phases, and defects are introduced to overcome the inverse strength-ductility relationship—give raise to multiple possibilities for modifying the deformation behavior, rendering traditional, exclusively experimentally-based alloy development workflows inappropriate. For fast and efficient alloy design, it is therefore desirable to predict the mechanical performance of candidate alloys by simulation studies to replace time- and resource-consuming mechanical tests. Simulation tools suitable for this task need to correctly predict the mechanical behavior in dependence of alloy composition, microstructure, texture, phase fractions, and processing history. Here, an integrated computational materials engineering approach based on the open source software packages DREAM.3D and DAMASK (Düsseldorf Advanced Materials Simulation Kit) that enables such virtual material development is presented. More specific, our approach consists of the following three steps: (1) acquire statistical quantities that describe a microstructure, (2) build a representative volume element based on these quantities employing DREAM.3D, and (3) evaluate the representative volume using a predictive crystal plasticity material model provided by DAMASK. Exemplarily, these steps are here conducted for a high-manganese steel.

  10. Identifying Structure-Property Relationships Through DREAM.3D Representative Volume Elements and DAMASK Crystal Plasticity Simulations: An Integrated Computational Materials Engineering Approach

    Science.gov (United States)

    Diehl, Martin; Groeber, Michael; Haase, Christian; Molodov, Dmitri A.; Roters, Franz; Raabe, Dierk

    2017-05-01

    Predicting, understanding, and controlling the mechanical behavior is the most important task when designing structural materials. Modern alloy systems—in which multiple deformation mechanisms, phases, and defects are introduced to overcome the inverse strength-ductility relationship—give raise to multiple possibilities for modifying the deformation behavior, rendering traditional, exclusively experimentally-based alloy development workflows inappropriate. For fast and efficient alloy design, it is therefore desirable to predict the mechanical performance of candidate alloys by simulation studies to replace time- and resource-consuming mechanical tests. Simulation tools suitable for this task need to correctly predict the mechanical behavior in dependence of alloy composition, microstructure, texture, phase fractions, and processing history. Here, an integrated computational materials engineering approach based on the open source software packages DREAM.3D and DAMASK (Düsseldorf Advanced Materials Simulation Kit) that enables such virtual material development is presented. More specific, our approach consists of the following three steps: (1) acquire statistical quantities that describe a microstructure, (2) build a representative volume element based on these quantities employing DREAM.3D, and (3) evaluate the representative volume using a predictive crystal plasticity material model provided by DAMASK. Exemplarily, these steps are here conducted for a high-manganese steel.

  11. Legislative Branch: FY2014 Appropriations

    Science.gov (United States)

    2013-11-25

    absence of appropriations, and pursuant to opinions issued in 1980 and early 1981 by then- Attorney General Benjamin Civiletti further clarifying the...future years. The Committees look forward to a report of progress being made by the Center’s fundraising program prior to hearings on its fiscal year

  12. Test Anxiety: Age Appropriate Interventions

    Science.gov (United States)

    Ross, David B.; Driscoll, Richard

    2006-01-01

    The presentation covers information on test anxiety reduction strategies from over thirty years of experience with clients of a variety of ages. Dr. Ross is from the College of Lake County. Dr. Driscoll is a private practitioner and Director of the American Test Anxieties Association. The purpose is to address age appropriate test anxiety…

  13. Art,authenticity and appropriation

    Institute of Scientific and Technical Information of China (English)

    James O.Young

    2006-01-01

    It is often suggested that artists from one culture(outsiders)cannot successfully employ styles,stories,motifs and other artistic content developed in the context of another culture.I call this suggestion the aesthetic handicap thesis and argue against it.Cultural appropriation can result in works of high aesthetic value.

  14. ACR Appropriateness Criteria Crohn Disease.

    Science.gov (United States)

    Kim, David H; Carucci, Laura R; Baker, Mark E; Cash, Brooks D; Dillman, Jonathan R; Feig, Barry W; Fowler, Kathryn J; Gage, Kenneth L; Noto, Richard B; Smith, Martin P; Yaghmai, Vahid; Yee, Judy; Lalani, Tasneem

    2015-10-01

    Crohn disease is a chronic inflammatory disorder involving the gastrointestinal tract, characterized by episodic flares and times of remission. Underlying structural damage occurs progressively, with recurrent bouts of inflammation. The diagnosis and management of this disease process is dependent on several clinical, laboratory, imaging, endoscopic, and histologic factors. In recent years, with the maturation of CT enterography, and MR enterography, imaging has played an increasingly important role in relation to Crohn Disease. In addition to these specialized examination modalities, ultrasound and routine CT have potential uses. Fluoroscopy, radiography, and nuclear medicine may be less beneficial depending on the clinical scenario. The imaging modality best suited to evaluating this disease may change, depending on the target population, severity of presentation, and specific clinical situation. This document presents seven clinical scenarios (variants) in both the adult and pediatric populations and rates the appropriateness of the available imaging options. They are summarized in a consolidated table, and the underlying rationale and supporting literature are presented in the accompanying narrative. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  15. Academic appropriation and Impact Indicators

    Directory of Open Access Journals (Sweden)

    Wilson López López

    2012-06-01

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

  16. A database of age-appropriate average MRI templates.

    Science.gov (United States)

    Richards, John E; Sanchez, Carmen; Phillips-Meek, Michelle; Xie, Wanze

    2016-01-01

    This article summarizes a life-span neurodevelopmental MRI database. The study of neurostructural development or neurofunctional development has been hampered by the lack of age-appropriate MRI reference volumes. This causes misspecification of segmented data, irregular registrations, and the absence of appropriate stereotaxic volumes. We have created the "Neurodevelopmental MRI Database" that provides age-specific reference data from 2 weeks through 89 years of age. The data are presented in fine-grained ages (e.g., 3 months intervals through 1 year; 6 months intervals through 19.5 years; 5 year intervals from 20 through 89 years). The base component of the database at each age is an age-specific average MRI template. The average MRI templates are accompanied by segmented partial volume estimates for segmenting priors, and a common stereotaxic atlas for infant, pediatric, and adult participants. The database is available online (http://jerlab.psych.sc.edu/NeurodevelopmentalMRIDatabase/).

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

    Directory of Open Access Journals (Sweden)

    Hossein Yousefi Manesh

    2013-01-01

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

  18. Appropriate technologies for environmental hygiene.

    Science.gov (United States)

    McGarry, M G

    1980-07-28

    Appropriate technologies for environmental hygiene usually centre on the delivery of adequate and accessible water supply, and proper treatment and disposal of excreta and refuse. In the face of the International Drinking Water and Sanitation Decade of 1981-90, several research efforts are under way in the developing countries to develop technologies and approaches for improving environmental hygiene in both rural areas and urban squatter settlements. These are discussed and include the technical development and field testing of infiltration galleries, low-cost slow and fast filtration processes for water treatment, handpumps, on-site excreta disposal using aqua-privy and compost toilets, and excreta treatment and refuse through composting with refuse, biogas generation, fish culture and use of excreta as crop fertilizer. The relevant technology 'hardware' is but one of several components necessary for effective delivery of services. The dearth of qualified manpower at all levels is described as being the major constraint to the Water and Sanitation Decade.

  19. Chemicals identified in feral and food animals: a data base. First annual report, October 1981. Volume I. Records 1-532

    Energy Technology Data Exchange (ETDEWEB)

    Cone, M.V.; Faust, R.A.; Baldauf, M.F. (comps.)

    1981-12-01

    This data file is a companion to Chemicals Identified in Human Biological Media, A Data Base, and follows basically the same format. The data base on human burden is in its third year of publication. This is the first annual report for the feral and food animal file. Data were obtained primarily from the open literature through manual searches (retrospective to 1979) of the journals listed in Appendix A. The data base now contains information on 60 different substances. Chemicals are listed by Chemical Abstracts Service (CAS) registry numbers and preferred names in Appendix B. For the user's convenience, cross-referenced chemical lists of CAS preferred and common names are provided in Appendix C. The animals, tissues, and body fluids found to be contaminated by these chemicals are listed in Appendix D. The data base is published annually in tabular format with indices and chemical listings that allow specific searching. A limited number of custom computer searches of the data base are available in special cases when the published format does not allow for retrieval of needed information.

  20. Appropriate roads for rural access

    CSIR Research Space (South Africa)

    Paige-Green, P

    2006-03-01

    Full Text Available plastic deformation. Deficiencies in any of these properties result in poor riding quality and high maintenance requirements as well as an increased loss of material from the road. It is thus essential that the best available material is used... of the specification illustrated in Figure 1 is the ability to identify potential problems associated with materials not meeting the specifications. This allows the implementer to make judgments regarding the consequences of using material outside...

  1. Use of unbound volumes of drug distribution in pharmacokinetic calculations.

    Science.gov (United States)

    Stepensky, David

    2011-01-18

    Volume of drug distribution is a primary pharmacokinetic parameter. This study assessed effects of drugs' plasma protein binding and tissue distribution on volume of drug distribution and identified the most appropriate ways for its calculation. Effects of the distribution factors on the unbound and total drug plasma concentrations and on the corresponding volumes of distribution were studied using pharmacokinetic modeling and simulation approach based on in vitro and in vivo concentration vs. time data of diazepam, a model drug with extensive plasma protein binding and tissue distribution. Pharmacokinetics of diazepam were appropriately described by three-compartment pharmacokinetic model that incorporated the processes of plasma protein binding and tissue permeation. According to this model, displacement of the drug from plasma proteins increases the unbound (but not the total) plasma concentrations and induces faster drug elimination from the body. The distribution pattern of the drug in the body and the time course of unbound (pharmacologically active) drug concentrations correlated with the unbound volumes of distribution, but not with the total volumes of distribution. In conclusion, unbound volumes of distribution appropriately describe the drug distribution pattern and the time course of unbound drug concentrations and are recommended for use as primary pharmacokinetic parameters in pharmaceutical research. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Increasing Coverage of Appropriate Vaccinations

    Science.gov (United States)

    Jacob, Verughese; Chattopadhyay, Sajal K.; Hopkins, David P.; Morgan, Jennifer Murphy; Pitan, Adesola A.; Clymer, John

    2016-01-01

    Context Population-level coverage for immunization against many vaccine-preventable diseases remains below optimal rates in the U.S. The Community Preventive Services Task Force recently recommended several interventions to increase vaccination coverage based on systematic reviews of the evaluation literature. The present study provides the economic results from those reviews. Evidence acquisition A systematic review was conducted (search period, January 1980 through February 2012) to identify economic evaluations of 12 interventions recommended by the Task Force. Evidence was drawn from included studies; estimates were constructed for the population reach of each strategy, cost of implementation, and cost per additional vaccinated person because of the intervention. Analyses were conducted in 2014. Evidence synthesis Reminder systems, whether for clients or providers, were among the lowest-cost strategies to implement and the most cost effective in terms of additional people vaccinated. Strategies involving home visits and combination strategies in community settings were both costly and less cost effective. Strategies based in settings such as schools and managed care organizations that reached the target population achieved additional vaccinations in the middle range of cost effectiveness. Conclusions The interventions recommended by the Task Force differed in reach, cost, and cost effectiveness. This systematic review presents the economic information for 12 effective strategies to increase vaccination coverage that can guide implementers in their choice of interventions to fit their local needs, available resources, and budget. PMID:26847663

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

    Directory of Open Access Journals (Sweden)

    R Ostovar

    2009-07-01

    .5% were considered as inappropriate. Also 22 cases (7.8% were considered as appropriate indications for drug therapy and none were found to be suitable for waiting and watching. There were 94 scenarios related to surgery that 75 scenarios (80% were grouped in appropriate and 8 scenarios (8.5% identified inappropriate. Conclusion: At the present time, due to the lack of scientific evidence for suitable decision-making in providing health services, methods based upon agreement, including the one used in the present study, and the use of treatment standards derived from similar studies, are amongst the most important measures taken to improve the standard of health, provide suitable health services, and to reduce unnecessary costs. In addition, RAM appropriateness method could be an ideal method in determining the appropriateness of health care and in reducing the rate of inappropriate services provided. The similarity of results derived from other studies performed by the RAND method in determining the appropriateness of benign prostatic hyperplasia treatment with the current study shows the validity and reliability of this method. Keywords: Appropriate criteria, Benign Prostatic Hyperplasia (BPH, Appraisal of Guidelines for Research and Evaluation (AGREE.

  4. Assessment of Appropriateness of Screening Community-Dwelling Older People to Prevent Functional Decline

    NARCIS (Netherlands)

    Drewes, Yvonne M.; Gussekloo, Jacobijn; van der Meer, Victor; Rigter, Henk; Dekker, Janny H.; Goumans, Marleen J. B. M.; Metsemakers, Job F. M.; van Overbeek, Riki; de Rooij, Sophia E.; Schers, Henk J.; Schuurmans, Marieke J.; Sturmans, Ferd; de Vries, Kerst; Westendorp, Rudi G. J.; Wind, Annet W.; Assendelft, Willem J. J.

    2012-01-01

    OBJECTIVES: To identify appropriate screening conditions, stratified according to age and vulnerability, to prevent functional decline in older people. DESIGN: A RAND/University of California at Los Angeles appropriateness method. SETTING: The Netherlands. PARTICIPANTS: A multidisciplinary panel of

  5. Veterans Medical Care: FY2011 Appropriations

    Science.gov (United States)

    2011-03-21

    employees receiving preventative occupational immunizations such as Hepatitis A&B and flu vaccinations. 49 Department of Veterans Affairs, FY2011...such as Hepatitis A&B and flu vaccinations. Veterans Medical Care: FY2011 Appropriations Congressional Research Service 20 Formulation of VHA’s...1,977,000 1,225,000 Emergency appropriations- Gulf Coast Hurricanes (P.L. 109-148) — — — — 198,265 — — 198,265 Emergency appropriations- Avian Flu

  6. Appropriateness and Effectiveness Perceptions of Conflict Strategies.

    Science.gov (United States)

    Canary, Daniel J.; Spitzberg, Brian H.

    1987-01-01

    Investigates how conflict strategies and communicator gender affect two properties of communicative competence, appropriateness and effectiveness, and how these properties are associated with interpersonal attraction. (SR)

  7. Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed.

    Science.gov (United States)

    Miller, Wayne L

    2016-08-01

    Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert clinicians of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in patients with chronic heart failure and help guide individualized, appropriate therapy-not all volume overload is the same. © 2016 American Heart Association, Inc.

  8. Correlation of Magnetic Resonance Imaging Tumor Volume with Histopathology

    Science.gov (United States)

    Turkbey, Baris; Mani, Haresh; Aras, Omer; Rastinehad, Ardeshir R.; Shah, Vijay; Bernardo, Marcelino; Pohida, Thomas; Daar, Dagane; Benjamin, Compton; McKinney, Yolanda L.; Linehan, W. Marston; Wood, Bradford J.; Merino, Maria J.; Choyke, Peter L.; Pinto, Peter A.

    2017-01-01

    Purpose The biology of prostate cancer may be influenced by the index lesion. The definition of index lesion volume is important for appropriate decision making, especially for image guided focal treatment. We determined the accuracy of magnetic resonance imaging for determining index tumor volume compared with volumes derived from histopathology. Materials and Methods We evaluated 135 patients (mean age 59.3 years) with a mean prostate specific antigen of 6.74 ng/dl who underwent multiparametric 3T endorectal coil magnetic resonance imaging of the prostate and subsequent radical prostatectomy. Index tumor volume was determined prospectively and independently by magnetic resonance imaging and histopathology. The ellipsoid formula was applied to determine histopathology tumor volume, whereas manual tumor segmentation was used to determine magnetic resonance tumor volume. Histopathology tumor volume was correlated with age and prostate specific antigen whereas magnetic resonance tumor volume involved Pearson correlation and linear regression methods. In addition, the predictive power of magnetic resonance tumor volume, prostate specific antigen and age for estimating histopathology tumor volume (greater than 0.5 cm3) was assessed by ROC analysis. The same analysis was also conducted for the 1.15 shrinkage factor corrected histopathology data set. Results There was a positive correlation between histopathology tumor volume and magnetic resonance tumor volume (Pearson coefficient 0.633, p <0.0001), but a weak correlation between prostate specific antigen and histopathology tumor volume (Pearson coefficient 0.237, p=0.003). On linear regression analysis histopathology tumor volume and magnetic resonance tumor volume were correlated (r2=0.401, p <0.00001). On ROC analysis AUC values for magnetic resonance tumor volume, prostate specific antigen and age in estimating tumors larger than 0.5 cm3 at histopathology were 0.949 (p <0.0000001), 0.685 (p=0.001) and 0.627 (p=0

  9. Developmentally Appropriate Practice: Myths and Facts.

    Science.gov (United States)

    Galen, Harlene

    1994-01-01

    Debunks various myths and misperceptions concerning developmentally appropriate practices. Developmental appropriateness is a philosophy, not a curriculum. Despite using alternative learning strategies such as guided play, teachers are in control, facilitate real academic learning, and build on what they already know. DAP is universal and can…

  10. Ghost-Story Telling: Keeping It Appropriate.

    Science.gov (United States)

    Weintraub, Jeff

    1996-01-01

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

  11. Using Appropriate Tools Strategically for Instruction

    Science.gov (United States)

    Sherman, Milan; Cayton, Charity

    2015-01-01

    Students' ability to use appropriate tools strategically is an important skill of mathematically proficient students (SMP 5, CCSSI 2010, p. 7). A parallel practice for teachers is using appropriate tools strategically for mathematics instruction. An important element of this practice is that the use of technology depends on the goals of…

  12. Volume Entropy

    CERN Document Server

    Astuti, Valerio; Rovelli, Carlo

    2016-01-01

    Building on a technical result by Brunnemann and Rideout on the spectrum of the Volume operator in Loop Quantum Gravity, we show that the dimension of the space of the quadrivalent states --with finite-volume individual nodes-- describing a region with total volume smaller than $V$, has \\emph{finite} dimension, bounded by $V \\log V$. This allows us to introduce the notion of "volume entropy": the von Neumann entropy associated to the measurement of volume.

  13. Teaching Physics Using Appropriate Technology Projects

    Science.gov (United States)

    Pearce, Joshua M.

    2007-03-01

    Appropriate technologies able to be easily and economically constructed from readily available materials by local craftspeople have a central role in the alleviation of poverty in the developing world. However, research and development of these technologies are generally apportioned relatively modest support by the developed world's institutions, in part because the operation of many of these appropriate technologies is dependent on relatively well-understood science accessible even to introductory college physics students. This paper describes a project-based assignment used to capitalize on this opportunity to motivate students to learn physics by offering them a chance to make concrete contributions to the optimization of appropriate technologies for sustainable development.

  14. Appropriate flow forecasting for reservoir operation

    NARCIS (Netherlands)

    Dong, Xiaohua

    2005-01-01

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

  15. Appropriation of Digital Competence in Teacher Education

    Directory of Open Access Journals (Sweden)

    Elen Instefjord

    2014-12-01

    Full Text Available The aim of the article is to explore opportunities for appropriation of digital competence in teacher education. Digital competence is knowledge, skills and attitudes required in order to use technology critically and reflectively in the process of building new knowledge. According to Wertsch learning to use a cultural artefact is characterized by two processes: mastery and appropriation. The article reports from a case study of two teacher education institutions. Findings indicate that the same challenges are found in both institutions: the conflict between mastery and appropriation, and between personal and educational use of technology, and the resistance towards technology among some teacher educators. The results signify that in order to create opportunities for appropriation of digital competence and encourage use of technology as part of pre-service teachers’ professional didactic competence, technology should be better integrated as pedagogical tools for teaching and learning in all subjects in the teacher education programmes.

  16. Appropriation of Digital Competence in Teacher Education

    Directory of Open Access Journals (Sweden)

    Elen Instefjord

    2015-11-01

    Full Text Available The aim of the article is to explore opportunities for appropriation of digital competence in teacher education. Digital competence is knowledge, skills and attitudes required in order to use technology critically and reflectively in the process of building new knowledge. According to Wertsch learning to use a cultural artefact is characterized by two processes: mastery and appropriation. The article reports from a case study of two teacher education institutions. Findings indicate that the same challenges are found in both institutions: the conflict between mastery and appropriation, and between personal and educational use of technology, and the resistance towards technology among some teacher educators. The results signify that in order to create opportunities for appropriation of digital competence and encourage use of technology as part of pre-service teachers’ professional didactic competence, technology should be better integrated as pedagogical tools for teaching and learning in all subjects in the teacher education programmes.

  17. 22 CFR 223.11 - Appropriate action.

    Science.gov (United States)

    2010-04-01

    ... influence, any oral or written communication to, the Agency on any matter of business for a period not to... such appearance or to accept any such communication; and (b) Taking other appropriate...

  18. Chautauqua notebook: appropriate technology on radio

    Energy Technology Data Exchange (ETDEWEB)

    Renz, B.

    1981-01-01

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

  19. Ways of art appropriation by the advertising

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Esteves

    2013-09-01

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

  20. The Ann Arbor Criteria for Appropriate Urinary Catheter Use in Hospitalized Medical Patients: Results Obtained by Using the RAND/UCLA Appropriateness Method.

    Science.gov (United States)

    Meddings, Jennifer; Saint, Sanjay; Fowler, Karen E; Gaies, Elissa; Hickner, Andrew; Krein, Sarah L; Bernstein, Steven J

    2015-05-05

    Interventions to reduce urinary catheter use involve lists of "appropriate" indications developed from limited evidence without substantial multidisciplinary input. Implementing these lists, however, is challenging given broad interpretation of indications, such as "critical illness." To refine criteria for appropriate catheter use-defined as use in which benefits outweigh risks-the RAND/UCLA Appropriateness Method was applied. After reviewing the literature, a 15-member multidisciplinary panel of physicians, nurses, and specialists in infection prevention rated scenarios for catheter use as appropriate, inappropriate, or of uncertain appropriateness by using a standardized, multiround rating process. The appropriateness of Foley catheters, intermittent straight catheters (ISCs), and external condom catheters for hospitalized adults on medical services was assessed in 299 scenarios, including urinary retention, incontinence, wounds, urine volume measurement, urine sample collection, and comfort. The scenarios included patient-specific issues, such as difficulty turning and catheter placement challenges. The panel rated 105 Foley scenarios (43 appropriate, 48 inappropriate, 14 uncertain), 97 ISC scenarios (15 appropriate, 66 inappropriate, 16 uncertain), and 97 external catheter scenarios (30 appropriate, 51 inappropriate, 16 uncertain). The refined criteria clarify that Foley catheters are appropriate for measuring and collecting urine only when fluid status or urine cannot be assessed by other means; specify that patients in the intensive care unit (ICU) need specific medical indications for catheters because ICU location alone is not an appropriate indication; and recognize that Foley and external catheters may be pragmatically appropriate to manage urinary incontinence in select patients. These new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.

  1. HPV status, cancer stem cell marker expression, hypoxia gene signatures and tumour volume identify good prognosis subgroups in patients with HNSCC after primary radiochemotherapy: A multicentre retrospective study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG)

    DEFF Research Database (Denmark)

    Linge, Annett; Lohaus, Fabian; Löck, Steffen

    2016-01-01

    carcinoma (HNSCC), who received primary radiochemotherapy (RCTx). MATERIALS AND METHODS: For 158 patients with locally advanced HNSCC of the oral cavity, oropharynx or hypopharynx who were treated at six DKTK partner sites, the impact of tumour volume, HPV DNA, p16 overexpression, p53 expression, CSC marker...... expression and hypoxia-associated gene signatures on outcome of primary RCTx was retrospectively analyzed. The primary endpoint of this study was loco-regional control (LRC). RESULTS: Univariate Cox regression revealed a significant impact of tumour volume, p16 overexpression, and SLC3A2 and CD44 protein......-negative group). Logistic modelling showed that inclusion of CD44 protein expression and p16 overexpression significantly improved the performance to predict LRC at 2years compared to the model with tumour volume alone. CONCLUSIONS: Tumour volume, HPV status, CSC marker expression and hypoxia gene...

  2. Effect of hospital volume on processes of breast cancer care: A National Cancer Data Base study.

    Science.gov (United States)

    Yen, Tina W F; Pezzin, Liliana E; Li, Jianing; Sparapani, Rodney; Laud, Purushuttom W; Nattinger, Ann B

    2017-05-15

    The purpose of this study was to examine variations in delivery of several breast cancer processes of care that are correlated with lower mortality and disease recurrence, and to determine the extent to which hospital volume explains this variation. Women who were diagnosed with stage I-III unilateral breast cancer between 2007 and 2011 were identified within the National Cancer Data Base. Multiple logistic regression models were developed to determine whether hospital volume was independently associated with each of 10 individual process of care measures addressing diagnosis and treatment, and 2 composite measures assessing appropriateness of systemic treatment (chemotherapy and hormonal therapy) and locoregional treatment (margin status and radiation therapy). Among 573,571 women treated at 1755 different hospitals, 38%, 51%, and 10% were treated at high-, medium-, and low-volume hospitals, respectively. On multivariate analysis controlling for patient sociodemographic characteristics, treatment year and geographic location, hospital volume was a significant predictor for cancer diagnosis by initial biopsy (medium volume: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.05-1.25; high volume: OR = 1.30, 95% CI = 1.14-1.49), negative surgical margins (medium volume: OR = 1.15, 95% CI = 1.06-1.24; high volume: OR = 1.28, 95% CI = 1.13-1.44), and appropriate locoregional treatment (medium volume: OR = 1.12, 95% CI = 1.07-1.17; high volume: OR = 1.16, 95% CI = 1.09-1.24). Diagnosis of breast cancer before initial surgery, negative surgical margins and appropriate use of radiation therapy may partially explain the volume-survival relationship. Dissemination of these processes of care to a broader group of hospitals could potentially improve the overall quality of care and outcomes of breast cancer survivors. Cancer 2017;123:957-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

  3. CRM AS INSTITUTION - IMAGINARY, LEGITIMACY AND APPROPRIATION

    Directory of Open Access Journals (Sweden)

    Christophe Benavent

    2009-10-01

    Full Text Available In this paper, we explore the idea that an IS could act as an institution in itself, if its legitimacy is well established, even the knowledge of the system is weak. This is in line with some theory of appropriation, and against the cognitive approach of the reason action theory. But we explore also one condition to gain legitimacy, which is that the system and proposed usage fit to the imaginary of the adopting population. Imaginary plays also a role along the appropriation process acting as a kind of pre-knowledge.

  4. Pragmatic Distance and Appropriateness of Utterance Politeness

    Institute of Scientific and Technical Information of China (English)

    吴丽丽

    2014-01-01

    The Politeness Principle proposed by Leech complements Grice ’ Cooperative Principle to a cer-tain extent in explaining the indirectness of language .However , the nature of politeness is its relativity . Determined by various factors such as social and cultural ones , the appropriateness of politeness at utter-ance level is affected by the appropriateness of the pragmatic distance between the participants .Different from the interpersonal relationships , pragmatic distance is calculated and determined in the process of communication varying with the variation of the communicative factors .Pragmatic distance is dynamic and can be maintained and altered by participants by using certain linguistic expressions to achieve the appro -priateness of politeness in communication .

  5. APPROPRIATE ALLOCATION OF CONTINGENCY USING RISK ANALYSIS METHODOLOGY

    Directory of Open Access Journals (Sweden)

    Andi Andi

    2004-01-01

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

  6. Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

    Science.gov (United States)

    Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

    2010-01-01

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

  7. Becoming Maya? Appropriation of the White Shaman.

    Science.gov (United States)

    Montejo, Victor D.

    1999-01-01

    The history of anthropology among the Maya consists of both the literal exploitation of archaeological finds and the appropriation of Maya culture and history by the Western academic world to construct distorted theories of the Maya past. In the ultimate disgrace, some Mayan priests are training White anthropologists to become shamans themselves…

  8. Teaching Rhythmic Gymnastics: A Developmentally Appropriate Approach.

    Science.gov (United States)

    Palmer, Heather C.

    This book is designed to guide teachers through the process of creating a developmentally appropriate rhythmic gymnastics program for children age 5-11. Rhythmic gymnastics programs develop fitness, inspire creativity, and allow all children to work at their own level. The book features 10 chapters in two parts. Part 1, "Getting Started on a…

  9. Becoming Maya? Appropriation of the White Shaman.

    Science.gov (United States)

    Montejo, Victor D.

    1999-01-01

    The history of anthropology among the Maya consists of both the literal exploitation of archaeological finds and the appropriation of Maya culture and history by the Western academic world to construct distorted theories of the Maya past. In the ultimate disgrace, some Mayan priests are training White anthropologists to become shamans themselves…

  10. Nationally Appropriate Mitigation Action: Understanding NAMA Cycle

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

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

  11. Teaching Rhythmic Gymnastics: A Developmentally Appropriate Approach.

    Science.gov (United States)

    Palmer, Heather C.

    This book is designed to guide teachers through the process of creating a developmentally appropriate rhythmic gymnastics program for children age 5-11. Rhythmic gymnastics programs develop fitness, inspire creativity, and allow all children to work at their own level. The book features 10 chapters in two parts. Part 1, "Getting Started on a…

  12. Identifying Activity

    CERN Document Server

    Lewis, Adrian S

    2009-01-01

    Identification of active constraints in constrained optimization is of interest from both practical and theoretical viewpoints, as it holds the promise of reducing an inequality-constrained problem to an equality-constrained problem, in a neighborhood of a solution. We study this issue in the more general setting of composite nonsmooth minimization, in which the objective is a composition of a smooth vector function c with a lower semicontinuous function h, typically nonsmooth but structured. In this setting, the graph of the generalized gradient of h can often be decomposed into a union (nondisjoint) of simpler subsets. "Identification" amounts to deciding which subsets of the graph are "active" in the criticality conditions at a given solution. We give conditions under which any convergent sequence of approximate critical points finitely identifies the activity. Prominent among these properties is a condition akin to the Mangasarian-Fromovitz constraint qualification, which ensures boundedness of the set of...

  13. Volume regulation in epithelia

    DEFF Research Database (Denmark)

    Larsen, Erik Hviid; Hoffmann, Else Kay

    2016-01-01

    function of iso-osmotic fluid transport that depends on Na+ recirculation. The causative relationship is discussed for a fluid-absorbing and a fluid-secreting epithelium of which the Na+ recirculation mechanisms have been identified. A large number of transporters and ion channels involved in cell volume...... regulation are cloned. The volume-regulated anion channel (VRAC) exhibiting specific electrophysiological characteristics seems exclusive to serve cell volume regulation. This is contrary to K+ channels as well as cotransporters and exchange mechanisms that may serve both transepithelial transport and cell...

  14. [Appropriate medication prescribing in older people].

    Science.gov (United States)

    Blain, H; Rambourg, P; Le Quellec, A; Ayach, L; Biboulet, P; Bismuth, M; Blain, A; Boulenger, J-P; Celton, B; Combe, B; Dauvilliers, Y; Davy, J-M; Geny, C; Hemmi, P; Hillaire-Buys, D; Jalabert, A; Jung, B; Leclercq, F; Léglise, M-S; Morel, J; Mourad, G; Ponrouch, M-P; Puisieux, F; Quantin, X; Quéré, I; Renard, E; Ribstein, J; Roch-Torreilles, I; Rolland, Y; Rosant, D; Terminet, A; Thuret, R; Villiet, M; Deshormières, N; Bourret, R; Bousquet, J; Jonquet, O; Millat, B

    2015-10-01

    Drug-induced adverse effects are one of the main avoidable causes of hospitalization in older people. Numerous lists of potentially inappropriate medications for older people have been published, as national and international guidelines for appropriate prescribing in numerous diseases and for different age categories. The present review describes the general rules for an appropriate prescribing in older people and summarizes, for the main conditions encountered in older people, medications that are too often under-prescribed, the precautions of use of the main drugs that induce adverse effects, and drugs for which the benefit to risk ratio is unfavourable in older people. All these data are assembled in educational tables designed to be printed in a practical pocket format and used in daily practice by prescribers, whether physicians, surgeons or pharmacists.

  15. Homeland Security Department: FY2006 Appropriations

    Science.gov (United States)

    2005-06-29

    continuing resolution.” e. P.L. 101-130, enacted after the Loma Prieta earthquake, appropriated $1.1 billion in supplemental funding for FY1990. In...cooperate with and assist DHS in any investigation or reinvestigation. The authorization would cease to be effective once the President has selected...that investigations for DHS security clearances are done in the most timely and efficient manner once the 9/11 Act reforms take effect .” (Congressional

  16. Is Bloom's Taxonomy Appropriate for Computer Science?

    OpenAIRE

    Johnson, Colin G.; Fuller, Ursula

    2007-01-01

    Bloom's taxonomy attempts to provide a set of levels of cognitive engagement with material being learned. It is usually presented as a generic framework. In this paper we outline some studies which examine whether the taxonomy is appropriate for computing, and how its application in computing might differ from its application elsewhere. We place this in the context of ongoing debates concerning graduateness and attempts to benchmark the content of a computing degree.

  17. Appropriate Use Criteria for Amyloid PET

    Science.gov (United States)

    Johnson, Keith A.; Minoshima, Satoshi; Bohnen, Nicolaas I.; Donohoe, Kevin J.; Foster, Norman L.; Herscovitch, Peter; Karlawish, Jason H.; Rowe, Christopher C.; Carrillo, Maria C.; Hartley, Dean M.; Hedrick, Saima; Mitchell, Kristi; Pappas, Virginia; Thies, William H.

    2013-01-01

    Positron Emission Tomography (PET) of brain amyloid-beta is a technology that is becoming more available, but its clinical utility in medical practice requires careful definition. In order to provide guidance to dementia care practitioners, patients and caregivers, the Alzheimer Association and the Society of Nuclear Medicine and Molecular Imaging convened the Amyloid Imaging Taskforce (AIT). The AIT considered a broad range of specific clinical scenarios in which amyloid PET could potentially be appropriately used. Peer-reviewed, published literature was searched to ascertain available evidence relevant to these scenarios, and the AIT developed a consensus of expert opinion. While empirical evidence of impact on clinical outcomes is not yet available, a set of specific Appropriate Use Criteria (AUC) were agreed upon that define the types of patients and clinical circumstances in which amyloid PET could be used. Both appropriate and inappropriate uses were considered and formulated, and are reported and discussed here. Because both dementia care and amyloid PET technology are in active development, these AUC will require periodic reassessment. Future research directions are also outlined, including diagnostic utility and patient-centered outcomes. PMID:23360977

  18. Inferring the drivers of discarding practices from observer data to identify appropriate fishery‐specific solutions

    DEFF Research Database (Denmark)

    Catchpole, Tom; Rochet, Marie‐Joëlle; Madsen, Niels

    2012-01-01

    Discard patterns are affected initially by catch compositions, which are determined by environmental factors, the fishing gear used, and fishing tactics, and finally by fishers, when they decide which parts of the catch to retain. An understanding of the drivers of discard practices is essential...... with associated quota that are above the MLS or minimum length landed. The model is applied to data from the full English observer programme and to French, Danish, Greek, and Spanish case study métiers. The proportionate contribution of the different categories is determined, the differences between métiers...

  19. Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries.

    Science.gov (United States)

    Filippi, Véronique; Richard, Fabienne; Lange, Isabelle; Ouattara, Fatoumata

    2009-06-01

    Near-miss cases often arrive in critical condition in referral hospitals in developing countries. Understanding the reasons why women arrive at these hospitals in a moribund state is crucial to the reduction of the incidence and case fatality of severe obstetric complications. This paper discusses how near-miss audits can empower the hospital teams to document and help reduce barriers to obstetric care in the most useful way and makes practical suggestions on interviews, analytical framework, ethical issues and staff motivation. Review of the evidence shows that case reviews and confidential enquiries appear particularly suitable to the understanding of delays. Criterion-based audits can also achieve this by establishing criteria for referral. However, hospital staff have limited intervention tools at their disposal to address barriers to emergency care at the community level. It is therefore important to involve the district management team and representatives of the community in auditing the health care seeking and treatment of women with near-miss complications.

  20. Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries

    OpenAIRE

    Filippi, V; Richard, F.; De Lange, I.; Ouattara,Fatoumata

    2009-01-01

    Near-miss cases often arrive in critical condition in referral hospitals in developing countries. Understanding the reasons why women arrive at these hospitals in a moribund state is crucial to the reduction of the incidence and case fatality of severe obstetric complications. This paper discusses how near-miss audits can empower the hospital teams to document and help reduce barriers to obstetric care in the most useful way and makes practical suggestions on interviews, analytical framework,...

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

    Directory of Open Access Journals (Sweden)

    Zdeněk Motlíček

    2015-01-01

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

  2. Stakeholder perspectives on appropriate forest management in the Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    Kearney, A.R.; Bradley, G. (Univ. of Washington, Seattle, WA (United States). Coll. of Forest Resources); Kaplan, R.; Kaplan, S. (Univ. of Michigan, Ann Arbor, MI (United States))

    1999-02-01

    One potential source of the controversy over forest management in the Pacific Northwest is differences in stakeholders' conceptualizations, or perspectives, on appropriate forest management. This study explores the nature of stakeholders' perspectives and identifies some of the differences and commonalities among them. Study participants included 23 individuals from 3 forest stakeholder groups: the USDA Forest Service, timber industry, and environmentalists. Participants' perspectives on appropriate forest management were assessed using a conceptual content cognitive map (3CM) task. Results indicate the existence of a wide range of concerns including issues related to the focus, setting, and process of management. The pattern of differences and similarities among stakeholder groups with respect to these concerns was found to be complex and to deviate substantially from common stereotypes. In addition, participants' perceptions of the other stakeholder groups were found to be highly stereotypical and were not supported by the data.

  3. The appropriate management of an appendiceal mucocele.

    Science.gov (United States)

    Lorenzon, Laura; De Dominicis, Chiara; Virgilio, Edoardo; Balducci, Genoveffa

    2015-03-16

    Appendicectomy is one of the most commonly performed surgical procedures. Appendiceal mucocele is a relative rare disease, but appropriate management is critical. Indeed, the intact removal of a mucocele represents a curative treatment; conversely, a rupture may result in the spread of epithelial cells throughout the peritoneal cavity (pseudomyxoma peritonei). We report a case of a 61-year-old woman, admitted to our department, who underwent resection of an appendiceal mucocele, focusing, in the discussion, on the clinical and surgical management of this disease. 2015 BMJ Publishing Group Ltd.

  4. [In-patient smoker? - Providing appropriate intervention].

    Science.gov (United States)

    Pamplona, Paula

    2007-01-01

    Tobacco use is the most avoidable cause of death. Other than provoking multiple diseases requiring hospitalisation, Tobacco Use is also a disease requiring management in the hospital setting, not only in terms of controlling the withdrawal symptoms of the patient, who has been abruptly prohibited from smoking, but also for fulfilling legislation which prohibits tobacco use in the health services, the only efficient way of preventing exposure of non-smokers to environmental tobacco smoke. Treating the in-patient smoker in an appropriate way also provides a window of opportunity for promoting not just a temporary but a complete smoking cessation.

  5. [Appropriateness prescribing and doctor's professional responsibility].

    Science.gov (United States)

    Massoni, F; Simeone, C; Luzi, E; Palla, C; Ricci, S

    2012-07-01

    The public health spending has now reached very significant levels, in this sense, the responsibility of the medical doctor assumes a significant importance in medical law. The aim of this paper is to analyze the profile of responsibilities of the medical doctor in the light of recent case law. The appropriateness of prescribing and risk assessment are, according to the authors, the real test on which to test the skill, prudence and diligence which are called prescribers. Guidelines can be a valuable tool for the professional help, knowing, however, limits application of the recommendations where to be reconciling with the prevailing protection of personal rights of the user.

  6. Food appropriation through large scale land acquisitions

    Science.gov (United States)

    Rulli, Maria Cristina; D'Odorico, Paolo

    2014-05-01

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

  7. Biochemical kinetics in changing volumes.

    Science.gov (United States)

    Pawłowski, Piotr H; Zielenkiewicz, Piotr

    2004-01-01

    The need of taking into account the change of compartment volume when developing chemical kinetics analysis inside the living cell is discussed. Literature models of a single enzymatic Michaelis-Menten process, glycolytic oscillations, and mitotic cyclin oscillations were tested with appropriate theoretical extension in the direction of volume modification allowance. Linear and exponential type of volume increase regimes were compared. Due to the above, in a growing cell damping of the amplitude, phase shift, and time pattern deformation of the metabolic rhythms considered were detected, depending on the volume change character. The performed computer simulations allow us to conclude that evolution of the cell volume can be an essential factor of the chemical kinetics in a growing cell. The phenomenon of additional metabolite oscillations caused by the periodic cell growth and division was theoretically predicted and mathematically described. Also, the hypothesis of the periodized state in the growing cell as the generalization of the steady-state was formulated.

  8. The Appropriateness Of Parental Involvement In The Job Search Process

    Directory of Open Access Journals (Sweden)

    Gary S. Insch

    2011-01-01

    Full Text Available This paper explores millennial job seekers and their parental involvement in the job search process. Preliminary work on a scale to measure the “appropriateness” of certain job search behaviors is reported. Ten parental job search behaviors are identified.  The appropriateness constructs of “mentoring” and “meddling” are developed and empirically tested. Results indicate that both meddling and mentoring are valid and initially useful constructs in examining the suitability of parental involvement in the job search process. The possible impact of parental involvement in the job search process is then discussed along with possible managerial responses.

  9. Appropriate Use of Drug Testing in Clinical Addiction Medicine.

    Science.gov (United States)

    Jarvis, Margaret; Williams, Jessica; Hurford, Matthew; Lindsay, Dawn; Lincoln, Piper; Giles, Leila; Luongo, Peter; Safarian, Taleen

    : Biological drug testing is a tool that provides information about an individual's recent substance use. Like any tool, its value depends on using it correctly; that is, on selecting the right test for the right person at the right time. This document is intended to clarify appropriate clinical use of drug testing in addiction medicine and aid providers in their decisions about drug testing for the identification, diagnosis, treatment, and recovery of patients with, or at risk for, addiction. The RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) process for combining scientific evidence with the collective judgment of experts was used to identify appropriate clinical practices and highlight areas where research is needed. Although consensus panels and expert groups have offered guidance on the use of drug testing for patients with addiction, very few addressed considerations for patients across settings and in different levels of care. This document will focus primarily on patients in addiction treatment and recovery, where drug testing is used to assess patients for a substance use disorder, monitor the effectiveness of a treatment plan, and support recovery. Inasmuch as the scope includes the recognition of addiction, which often occurs in general healthcare settings, selected special populations at risk for addiction visiting these settings are briefly included.

  10. Selecting appropriate cases when tracing causal mechanisms

    DEFF Research Database (Denmark)

    Beach, Derek; Pedersen, Rasmus Brun

    2016-01-01

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

  11. Installing an appropriate information security policy.

    Science.gov (United States)

    Gaunt, N

    1998-03-01

    Security of personal health care is of concern to patients, health care staff and informaticians alike. Nevertheless, their awareness of the appropriate measures for protection of such data have been found wanting. The development and implementation of an information and security policy in the health care environment must therefore take into account the attitudes of staff and their educational needs. The approach adopted in one large District General Hospital was to combine risk analysis with surveys of users attitudes to proposed measures and a participational approach to development of security procedures using an adaptation of the ETHICS soft systems methodology. As a result of several years of effort, a 'security culture' has begun to emerge in the organization. However, this can only be sustained by continual promotion of the policy and a willingness to adapt procedures to suit the operating environment.

  12. Public Space Design between Alienation and Appropriation

    DEFF Research Database (Denmark)

    Smith, Shelley; Steinø, Nicolai

    2014-01-01

    a barrier to the appropriation of public space by citizens, in particular when it comes to less conventional and new cultural practices – and this in turn becomes a barrier for both inclusion and for how we define and conceptualise space itself. This is problematic in a notion of public space as the space......Urban public space in a Western context has become increasingly functionalized and pre-determined. Designations for use, and by whom, have become more prolific – often in the name of practicality or safety – and have introduced more or less formalised codes of accepted behaviour. This represents...... of conceptualising, interpreting and materialising space. On the contrary, design has the capacity to foster uniformity and unambiguity, or to invite plurality and ambivalence. Using the practice of parkour as a vehicle for thought and exemplification, this paper takes its point of departure in alternative urban...

  13. Shoosing the appropriate size wind turbine

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

  14. Groundwater pollution: are we monitoring appropriate parameters?

    CSIR Research Space (South Africa)

    Tredoux, G

    2004-01-01

    Full Text Available . In the literature, divergent approaches have identified various sets of pollutants and pollution indicators. This paper discusses international and local trends in groundwater monitoring for baseline studies and on-going pollution detection monitoring for a variety...

  15. Appropriate medical care for persons in detention.

    Science.gov (United States)

    Idris, I

    2003-03-01

    The people who are in detention are screened by the Medical Officer of the Prison and if they are found to be unwell, these prisoners will be accommodated in the sickbay and medical treatment will be provided. If their sickness needs further investigations and management, they will be sent to the Government Hospital. If the prisoners are found to have infectious or contagious diseases, steps will be taken to prevent the spread of these diseases to other prisoners in the prison. Prisoners are given time to exercise to maintain good health and their clothing are regularly washed to make sure that they will not contract skin diseases, e.g. scabies, ringworm, etc. The Prison Department since 1989 has increasing numbers of HIV positive prisoners. The Department complies with this problem by sending staff for courses, lectures and seminars so that they will be able to handle these prisoners more efficiently in the prison. When these HIV/AIDS prisoners' condition turns bad, they are usually transferred to a Government Hospital. Another of the Prison Department's prominent medical problem among the prisoners is drug addiction. Staff trained with skill and techniques are counselors for the drug related prisoners. Realizing and in anticipation that the sickbays in the prisons are going to be full of HIV/AIDS prisoners and drug related prisoners, special attention will be given to more allocation to upgrade the sickbays in the prison. White attires will be provided to the sick prisoners in the sickbays so that they will look neat and clean. More doctors, medical assistants and nurses will be employed so that appropriate medical care or rather more appropriate medical care can be provided to the sick prisoners in the prisons. The Prison Department is in the process of privatizing medical care for prisoners in the prison and the Department is also trying to convert some prisons to be medical prisons so that adequate medical care can be given to the sick prisoners.

  16. Status Report on Nationally Appropriate Mitigation Actions (NAMAs). Mid-year update June 2013

    Energy Technology Data Exchange (ETDEWEB)

    Van Tilburg, X.; Bristow, S. [ECN Policy Studies, Amsterdam (Netherlands); Roeser, F.; Escalante, D.; Fekete, H. [Ecofys, Cologne (Germany)

    2013-06-15

    This mid-year update of the Annual Status Report on Nationally Appropriate Mitigation Actions, last published by Ecofys and ECN in November 2012, highlights recent trends in NAMA development and support and identifies where more progress is needed.

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

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

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

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

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

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

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

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

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

  20. (On)line dancing: choosing an appropriate distance education partner.

    Science.gov (United States)

    Menn, Mindy; Don Chaney, J

    2014-05-01

    Online-delivered distance education is a burgeoning component of professional development and continuing education. Distance education programs allow individuals to learn in a different location and/or at a different time from fellow learners, thereby increasing the flexibility and number of learning options. Selecting the "right" program for personal development from the ever-growing body of online-delivered education is an individualized decision that can become an overwhelming and challenging process. This Tool presents four important definitions for navigating distance education program description materials and outlines a five-step process to assist in identifying an appropriate program for personal development. The five-step process includes key questions and points to consider while conducting a candid self-assessment, identifying and investigating distance education programs, and then compiling information, comparing programs, and prioritizing a list of programs suitable for application. Furthermore, this Tool highlights important websites for distance education degree program reviews, accreditation information, and open educational resources.

  1. Financial Audit and Spending of Appropriations

    Directory of Open Access Journals (Sweden)

    Ivo Mijoč

    2013-07-01

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

  2. Institutional factors, government policies and appropriate technologies.

    Science.gov (United States)

    Watanabe, S

    1980-01-01

    Traditionally the use of inappropriate technologies in the developing countries has been explained by the existence of factor price distortions, e.g. the price of labor being artificially raised by labor legislation, and the price of capital being reduced by subsidies and unrealistic exchange rates. In reality the technological choice is often determined by economic conditions and the local sociocultural/political conditions. The institutional framework of the country may discourage the appropriate technology. The obstacles can be overcome when the following conditions are met: 1) a national consensus about the need for development efforts and importance of policy goals; 2) promising market prospects and/or an effective marketing system; and, 3) sufficient industrial competition in both home and international markets. Institutional problems come from the generation and diffusion of technologies from the supply side which are introduced to people who do not see the need for them. More emphasis on the marketing side ususally results in application of correct technology, especially where governments fund research and development projects and formulate their plans on the basis of a concrete investment or production plan and a clear idea about the target market. Land reforms and agricultural price policies are needed as well as the establishment of an efficient national administrative network.

  3. Is the 80% leak criterion always appropriate?

    Energy Technology Data Exchange (ETDEWEB)

    Haines, Harvey [Kiefner and Associates, Inc., Vienna, VA (United States); McNealy, Rick [Applus-RTD, Houston, TX (United States); Rosenfeld, M.J. [Kiefner and Associates, Inc., Worthington, OH (United States)

    2010-07-01

    For evaluating metal loss depth by corrosion, ASME B31G recommends 80% of the wall thickness as an upper limit. A pipeline can still be safe with deeper corrosion, but the main question is whether conservative criteria are necessary because of errors in corrosion depth measurement. Corrosion depths over 80% might be acceptable if the measurement error was well understood and if errors could be treated in a routine and practical manner. Measurement errors are well understood when published values exist for commercial ILI tools and errors can be reassessed during remediation using in-the-ditch measurements. In the case of low-pressure pipelines, the 80% recommendation seems to be overly conservative and restricts re-inspection intervals unnecessarily. Otherwise, 80% seems appropriate in view of the current ILI and manual pit gauge depth measurement technology, but if the accuracy of ILI inspections was improved, fewer immediate digs could be possible. Corrosion deeper than 80% seems to cause leaks by perforation rather than mechanical failure.

  4. Groundwater pollution: Are we monitoring appropriate parameters ...

    African Journals Online (AJOL)

    However, in practice groundwater quality monitoring is the main tool for timely ... quality is a specialised task for a hydrogeologist and a water quality monitoring expert. Although general prescriptions for waste management facilities exist these ... approaches have identified various sets of pollutants and pollution indicators.

  5. ACR Appropriateness Criteria®  Resectable Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Jones William E

    2012-09-01

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

  6. Aperiodic Volume Optics

    Science.gov (United States)

    Gerke, Tim D.

    Presented in this thesis is an investigation into aperiodic volume optical devices. The three main topics of research and discussion are the aperiodic volume optical devices that we call computer-generated volume holograms (CGVH), defects within periodic 3D photonic crystals, and non-periodic, but ordered 3D quasicrystals. The first of these devices, CGVHs, are designed and investigated numerically and experimentally. We study the performance of multi-layered amplitude computer-generated volume holograms in terms of efficiency and angular/frequency selectivity. Simulation results show that such aperiodic devices can increase diffraction efficiency relative to periodic amplitude volume holograms while maintaining angular and wavelength selectivity. CGVHs are also designed as voxelated volumes using a new projection optimization algorithm. They are investigated using a volumetric diffraction simulation and a standard 3D beam propagation technique as well as experimentally. Both simulation and experiment verify that the structures function according to their design. These represent the first diffractive structures that have the capacity for generating arbitrary transmission and reflection wave fronts and that provide the ability for multiplexing arbitrary functionality given different illumination conditions. Also investigated and discussed in this thesis are 3D photonic crystals and quasicrystals. We demonstrate that these devices can be fabricated using a femtosecond laser direct writing system that is particularly appropriate for fabrication of such arbitrary 3D structures. We also show that these devices can provide 3D partial bandgaps which could become complete bandgaps if fabricated using high index materials or by coating lower index materials with high index metals. Our fabrication method is particularly suited to the fabrication of engineered defects within the periodic or quasi-periodic systems. We demonstrate the potential for fabricating defects within

  7. Topological Active Volumes

    Directory of Open Access Journals (Sweden)

    Barreira N

    2005-01-01

    Full Text Available The topological active volumes (TAVs model is a general model for 3D image segmentation. It is based on deformable models and integrates features of region-based and boundary-based segmentation techniques. Besides segmentation, it can also be used for surface reconstruction and topological analysis of the inside of detected objects. The TAV structure is flexible and allows topological changes in order to improve the adjustment to object's local characteristics, find several objects in the scene, and identify and delimit holes in detected structures. This paper describes the main features of the TAV model and shows its ability to segment volumes in an automated manner.

  8. LTACH liaison aids appropriate level of care.

    Science.gov (United States)

    2011-10-01

    The long-term acute care liaison at Pennsylvania State University Milton S. Hershey Medical Center identifies patients eligible for a long-term acute care hospital (LTACH) stay and coordinates their transition. The LTACH liaison works with the case management and social work staffto identify patients early in the stay and give families information they can use to make an informed decision about a facility. The liaison follows up with the LTACH treatment team to ensure that they have all the information they need and feel comfortable about the treatment plan. As a result of the program, the hospital has increased the number of patients it transfers to LTACHs each month from about 18 to about 30.

  9. Counterhegemonic Acts: Appropriation as a Feminist Rhetorical Strategy.

    Science.gov (United States)

    Shugart, Helene A.

    1997-01-01

    Explores the rhetorical strategy of feminist appropriation to assess its function as a counterhegemonic tactic. Analyzes two appropriations: the Australian film "Shame" (appropriating "Shane") and Margaret Atwood's poems "Orpheus (1)" and "Eurydice" as a collective appropriation of the classical myth.…

  10. Renormalized Volume

    Science.gov (United States)

    Gover, A. Rod; Waldron, Andrew

    2017-09-01

    We develop a universal distributional calculus for regulated volumes of metrics that are suitably singular along hypersurfaces. When the hypersurface is a conformal infinity we give simple integrated distribution expressions for the divergences and anomaly of the regulated volume functional valid for any choice of regulator. For closed hypersurfaces or conformally compact geometries, methods from a previously developed boundary calculus for conformally compact manifolds can be applied to give explicit holographic formulæ for the divergences and anomaly expressed as hypersurface integrals over local quantities (the method also extends to non-closed hypersurfaces). The resulting anomaly does not depend on any particular choice of regulator, while the regulator dependence of the divergences is precisely captured by these formulæ. Conformal hypersurface invariants can be studied by demanding that the singular metric obey, smoothly and formally to a suitable order, a Yamabe type problem with boundary data along the conformal infinity. We prove that the volume anomaly for these singular Yamabe solutions is a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. Recently, Graham proved that the first variation of the volume anomaly recovers the density obstructing smooth solutions to this singular Yamabe problem; we give a new proof of this result employing our boundary calculus. Physical applications of our results include studies of quantum corrections to entanglement entropies.

  11. APpropriAteness of percutaneous Coronary interventions in patients with ischaemic HEart disease in Italy: the APACHE pilot study.

    Science.gov (United States)

    Leonardi, Sergio; Marino, Marcello; Crimi, Gabriele; Maiorana, Florinda; Rizzotti, Diego; Lettieri, Corrado; Bettari, Luca; Zuccari, Marco; Sganzerla, Paolo; Tresoldi, Simone; Adamo, Marianna; Ghiringhelli, Sergio; Sponzilli, Carlo; Pasquetto, Giampaolo; Pavei, Andrea; Pedon, Luigi; Bassan, Luciano; Bollati, Mario; Camisasca, Paola; Trabattoni, Daniela; Brancati, Marta; Poli, Arnaldo; Panciroli, Claudio; Lettino, Maddalena; Tarelli, Giuseppe; Tarantini, Giuseppe; De Luca, Leonardo; Varbella, Ferdinando; Musumeci, Giuseppe; De Servi, Stefano

    2017-09-05

    To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. Retrospective, pilot study. 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics. Proportion of patients who received appropriate PCI using validated appropriate use scores (ie, AUS≥7). Also, in patients with stable CAD, we examined adherence to the following European Society of Cardiology recommendations: (A) per cent of patients with complex coronary anatomy treated after heart team discussion; (B) per cent of fractional flow reserve-guided PCI for borderline stenoses in patients without documented ischaemia; (C) per cent of patients receiving guideline-directed medical therapy at the time of PCI as well as use of provocative test of ischaemia according to pretest probability (PTP) of CAD. Of the 401 mappable PCIs (91%), 38.7% (95% CI 33.9 to 43.6) were classified as appropriate, 47.6% (95% CI 42.7 to 52.6) as uncertain and 13.7% (95% CI 10.5% to 17.5%) as inappropriate. Median PTP in patients with stable CAD without known coronary anatomy was 69% (78% intermediate PTP, 22% high PTP). Ischaemia testing use was similar (p=0.71) in patients with intermediate (n=140, 63%) and with high PTP (n=40, 66%). In patients with stable CAD (n=352) guideline adherence to the three recommendations explored was: (A) 11%; (B) 25%; (C) 23%. AUS was higher in patients evaluated by the heart team as compared with patients who were not (7 (6.8) vs 5 (4.7); p=0.001). Use of heart team approaches and adherence to guideline recommendations on coronary revascularisation in a real-world setting is limited. This pilot study documents the feasibility of measuring appropriateness and guideline

  12. Accelerating Time-Varying Hardware Volume Rendering Using TSP Trees and Color-Based Error Metrics

    Science.gov (United States)

    Ellsworth, David; Chiang, Ling-Jen; Shen, Han-Wei; Kwak, Dochan (Technical Monitor)

    2000-01-01

    This paper describes a new hardware volume rendering algorithm for time-varying data. The algorithm uses the Time-Space Partitioning (TSP) tree data structure to identify regions within the data that have spatial or temporal coherence. By using this coherence, the rendering algorithm can improve performance when the volume data is larger than the texture memory capacity by decreasing the amount of textures required. This coherence can also allow improved speed by appropriately rendering flat-shaded polygons instead of textured polygons, and by not rendering transparent regions. To reduce the polygonization overhead caused by the use of the hierarchical data structure, we introduce an optimization method using polygon templates. The paper also introduces new color-based error metrics, which more accurately identify coherent regions compared to the earlier scalar-based metrics. By showing experimental results from runs using different data sets and error metrics, we demonstrate that the new methods give substantial improvements in volume rendering performance.

  13. Improving the radiologist-CAD interaction: designing for appropriate trust.

    Science.gov (United States)

    Jorritsma, W; Cnossen, F; van Ooijen, P M A

    2015-02-01

    Computer-aided diagnosis (CAD) has great potential to improve radiologists' diagnostic performance. However, the reported performance of the radiologist-CAD team is lower than what might be expected based on the performance of the radiologist and the CAD system in isolation. This indicates that the interaction between radiologists and the CAD system is not optimal. An important factor in the interaction between humans and automated aids (such as CAD) is trust. Suboptimal performance of the human-automation team is often caused by an inappropriate level of trust in the automation. In this review, we examine the role of trust in the radiologist-CAD interaction and suggest ways to improve the output of the CAD system so that it allows radiologists to calibrate their trust in the CAD system more effectively. Observer studies of the CAD systems show that radiologists often have an inappropriate level of trust in the CAD system. They sometimes under-trust CAD, thereby reducing its potential benefits, and sometimes over-trust it, leading to diagnostic errors they would not have made without CAD. Based on the literature on trust in human-automation interaction and the results of CAD observer studies, we have identified four ways to improve the output of CAD so that it allows radiologists to form a more appropriate level of trust in CAD. Designing CAD systems for appropriate trust is important and can improve the performance of the radiologist-CAD team. Future CAD research and development should acknowledge the importance of the radiologist-CAD interaction, and specifically the role of trust therein, in order to create the perfect artificial partner for the radiologist. This review focuses on the role of trust in the radiologist-CAD interaction. The aim of the review is to encourage CAD developers to design for appropriate trust and thereby improve the performance of the radiologist-CAD team. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd

  14. Digital Identifier Systems: Comparative Evaluation

    Directory of Open Access Journals (Sweden)

    Hamid Reza Khedmatgozar

    2015-02-01

    Full Text Available Identifier is one of the main elements in identifying an object in digital environment. Digital identifier systems were developed followed by a lot of problems such as violation of persistency and uniqueness of physical identifiers and URL in digital environment. These identifiers try to guarantee uniqueness and persistency of hostnames by using indirect names for Domain Name System (DNS. The main objective of this research is to identify qualified digital identifier system among other systems. To achieve the research objective, researchers have considered two major steps: first, identifying main criteria for distinguishing digital identifier based on literature review and focus group interview; and second, performing a comparative evaluation on common identifier systems in the world. Findings of first step demonstrated seven main criteria in three domains for distinguishing digital identifier systems: identifier uniqueness and persistency in the identifier features domain, digital identification, digital uniqueness, digital persistency and digital actionability in the digital coverage domain, and globality in the comprehensiveness of scope domain. In the second step, results of the comparative evaluation on common identifier systems indicated that six identifier systems, included, DOI, Handle, UCI, URN, ARK and PURL, are appropriate choices for using as a digital identifier system. Also, according to these results, three identification systems Including NBN, MARIAM and ISNI were identified as suitable choices for digital identification in certain specialized fields. According to many benefits of using these identifiers in important applied fields, such as, digital content chains and networks integration, digital right management, cross referencing, digital libraries and citation analysis, results of this study can help digital environment experts to diagnose digital identifier and their effective use in applied fields.

  15. Assessing appropriateness of antimicrobial therapy: in the eye of the interpreter.

    Science.gov (United States)

    DePestel, Daryl D; Eiland, Edward H; Lusardi, Katherine; Destache, Christopher J; Mercier, Renée-Claude; McDaneld, Patrick M; Lamp, Kenneth C; Chung, Thomas J; Hermsen, Elizabeth D

    2014-10-15

    To address the increase of drug-resistant bacteria and widespread inappropriate use of antimicrobials, many healthcare institutions have implemented antimicrobial stewardship programs to promote appropriate use of antimicrobials and optimize patient outcomes. However, a consensus definition of appropriate use is lacking. We conducted a multicenter observational study to compare 4 definitions of appropriateness--a study site-specific definition, use supported by susceptibility data, use supported by electronic drug information resources (Clinical Pharmacology/Micromedex), or study site principal investigator (PI) opinion-among patients receiving 1 or more of 13 identified antimicrobials. Data were collected for 262 patients. Overall, appropriateness with the 4 definitions ranged from 79% based on PI opinion to 94% based on susceptibility data. No single definition resulted in consistently high appropriate use for all target antimicrobials. For individual antimicrobials, the definitions with the highest rate of appropriate use were Clinical Pharmacology/Micromedex support (6 of 7 antimicrobials) and susceptibility data (5 of 7 antimicrobials). For specific indications, support from susceptibility data resulted in the highest rate of appropriate use (4 of 7 indications). Overall comparisons showed that appropriateness assessed by PI opinion differed significantly compared with other definitions when stratified by either target antimicrobial or indication. The significant variability in the rate of appropriate use highlights the difficulty in developing a standardized definition that can be used to benchmark judicious antimicrobial use.

  16. Appropriateness of lumbar spine magnetic resonance imaging in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, Francisco M. [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Research Department, Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Arana, Estanislao, E-mail: aranae@uv.es [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Servicio de Radiología, Fundación Instituto Valenciano de Oncología, Valencia (Spain); Fundación Instituto de Investigación en Servicios de Salud, Valencia (Spain); Royuela, Ana [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); CIBER Epidemiología y Salud Pública (CIBERESP) (Spain); Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, IRYCIS, Ctra. Colmenar Km. 9.1, 28034 Madrid (Spain); Cabrera, Alberto [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao, Vizcaya (Spain); Casillas, Carlos [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Instituto de Traumatología Unión de Mutuas, Av. del Lledó, C/Juan de Herrera, 27 12004 Castellón (Spain); and others

    2013-06-15

    Objectives: To determine the minimum percentage of lumbar spine magnetic resonance imaging (LSMRI) which are inappropriately prescribed in routine practice. Methods: LSMRI performed prospectively on 602 patients in 12 Radiology Services across 6 regions in Spain, were classified as “appropriate”, “uncertain” or “inappropriate” based on the indication criteria established by the National Institute for Clinical Excellence, the American College of Physicians and Radiology, and current evidence-based clinical guidelines. Studies on patients reporting at least one “red flag” were classified as “appropriate”. A logistic regression model was developed to identify factors associated with a higher likelihood of inappropriate LSMRI, including gender, reporting of referred pain, health care setting (private/public), and specialty of prescribing physician. Before performing the LSMRI, the radiologists also assessed the appropriateness of the prescription. Results: Eighty-eight percent of LSMRI were appropriate, 1.3% uncertain and 10.6% inappropriate. The agreement of radiologists’ assessment with this classification was substantial (k = 0.62). The odds that LSMRI prescriptions were inappropriate were higher for patients without referred pain [OR (CI 95%): 13.75 (6.72; 28.16)], seen in private practice [2.25 (1.20; 4.22)], by orthopedic surgeons, neurosurgeons or primary care physicians [2.50 (1.15; 5.56)]. Conclusion: Efficiency of LSMRI could be improved in routine practice, without worsening clinical outcomes.

  17. Are advertisements in dental journals supported by an appropriate evidence-base?

    Science.gov (United States)

    Chestnutt, Ivor G; Hardy, Robert

    2013-09-01

    Dental professionals are constantly exposed to advertisements in the dental literature. These promote products, either for use in the operatory or to recommend to patients. In an era of evidence-based practice, what references are provided to support claims made by the advertisers? This study aimed to determine if advertisements in four major dental journals, whose target audience is general dental practitioners, were supported by an appropriate evidence-base, readily accessible to readers. The 2010 printed volumes of the Australian Dental Journal, British Dental Journal, Dental Update and the Journal of the American Dental Association were hand searched to identify advertisements which made a claim of clinical benefit or superiority to competing products. Advertisements were categorized according to type of product being promoted and the availability, nature and number of any supporting references was recorded. Repeated advertisements were analyzed only once. A total of 390 advertisements were identified and 369 made a claim of benefit or superiority. When the 222 duplicates of the same advertisement were removed, 147 unique advertisements remained. Of these: 54 (37%) were advertisements related to dental devices for in-surgery use; 44 (30%) for dental materials, and 27 (18%) for dentifrices/medicaments. 113 (76.9%) advertisements offered no evidential support for claims made. Of the 34 advertisements that provided evidential support, only 20 provided a complete reference that could readily be sourced by an interested reader: 15 articles in refereed journals; 5 data on file; 3 in-house studies and combinations thereof. Four references were not accessible due to incomplete referencing. Two advertisements provided evidence that was not relevant to the product being advertised. The majority of advertisements in the dental literature do not provide an adequate evidence-base, readily available to readers, to support the claims being made. If evidence-based practice is

  18. ACR Appropriateness Criteria Review ACR Appropriateness Criteria® Occupational Lung Diseases.

    Science.gov (United States)

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

    2016-01-01

    Occupational lung disease is a category of disease entities characterized by a reaction of the lung parenchyma to inhaled aerosolized particles found in the environment. This document summarizes the imaging appropriateness data for silicosis, coal worker pneumoconiosis, and asbestosis. The main points of the document are that computed tomography is more sensitive than radiography, computed tomography without contrast generally suffices for evaluation, and fluorodeoxyglucose-positron emission tomography may have utility in patients with mesothelioma. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  19. [Nursing diagnoses and reports. An appropriate relationship?].

    Science.gov (United States)

    López Medina, Isabel M; Pancorbo Hidalgo, Pedro L; Sánchez Jurado, Laura I; Sánchez Criado, Vicente

    2003-03-01

    The objective of this study is to evaluate the use of nursing diagnosis in nursing discharge planning, according to NANDA taxonomy adapted to the model of V. Henderson. We have made a retrospective descriptive study analyzing 260 discharge care plan reports, from a county hospital of Jaén (Spain), during the period 1994-1998. We found 4.2 +/- 2.0 (average +/- standard deviation) nursing problems by discharge plan report. 62.4% of the problems were stated correctly as nursing diagnosis, with an average of 2.6 +/- 1.9 correct nursing diagnosis by report and 37.6% were incorrect nursing diagnosis, 1.6 +/- 1.1 by report as average. Most of the registered nursing problems (95.6%) were actual problems, present in the patients; a 4.3% were potential or high risk problems, and only one possible type nursing diagnosis was identified. After grouping the nursing problems according to the needs of the model of Virginia Henderson, we find that most of diagnosis cited were included in biological needs, and in smaller number to the psychosocial needs.

  20. The IRYSS-COPD appropriateness study: objectives, methodology, and description of the prospective cohort

    Directory of Open Access Journals (Sweden)

    Quintana José M

    2011-11-01

    Full Text Available Abstract Background Patients with chronic obstructive pulmonary disease (COPD often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these important gaps in clinical care, we created the IRYSS-COPD Appropriateness Study. Methods/Design The RAND/UCLA Appropriateness Methodology was used to identify appropriate and inappropriate scenarios for hospital admission for patients experiencing COPD exacerbations. These scenarios were then applied to a prospective cohort of patients attending the emergency departments (ED of 16 participating hospitals. Information was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up after admission or discharge home. While complete data were generally available at the time of ED admission, data were often missing at the time of decision making. Predefined assumptions were used to impute much of the missing data. Discussion The IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients.

  1. Point prevalence of appropriate antimicrobial therapy in a Dutch university hospital

    OpenAIRE

    Akhloufi, H.; Streefkerk, R. H.; Melles, D. C.; de Steenwinkel, J. E. M.; Schurink, C. A. M.; Verkooijen, R. P.; van der Hoeven, C. P.; Verbon, A.

    2015-01-01

    Antimicrobial stewardship teams have been shown to increase appropriate empirical antibiotic therapy and reduce medical errors and costs in targeted populations, but the effect in non-targeted populations is still unclear. The aim of this study was to determine the prevalence of inappropriate antibiotic use in a large university hospital and identify areas in which antimicrobial stewardship will be the most effective. In a point prevalence survey we assessed the appropriateness of antibiotic ...

  2. Developmentally Appropriate Technology in Early Childhood (DATEC) in Botswana: In-Service Teachers’ Perspectives

    OpenAIRE

    BOSE, Kabita

    2009-01-01

    Developmentally Appropriate Technology in Early Childhood (DATEC) aims to identify themost appropriate applications of Information and Communication Technology to support thedevelopment of children under eight years of age. Botswana has a unique spread ofpopulation density and deep-rooted socio-cultural values. There is a need to address thecompatibility of these aspects with the application of Information and CommunicationTechnology in the proposed Early Childhood Education programmes throug...

  3. The anterior cerebral artery is an appropriate arterial input function for perfusion-CT processing in patients with acute stroke

    Energy Technology Data Exchange (ETDEWEB)

    Wintermark, Max; Lau, Benison C.; Chien, Jeffrey; Arora, Sandeep [University of California, San Francisco, Department of Radiology, Neuroradiology Section, 505 Parnassus Avenue, Box 0628, San Francisco, CA (United States)

    2008-03-15

    Dynamic perfusion-CT (PCT) with deconvolution requires an arterial input function (AIF) for postprocessing. In clinical settings, the anterior cerebral artery (ACA) is often chosen for simplicity. The goals of this study were to determine how the AIF selection influences PCT results in acute stroke patients and whether the ACA is an appropriate default AIF. We retrospectively identified consecutive patients suspected of hemispheric stroke of less than 48 h duration who were evaluated on admission by PCT. PCT datasets were postprocessed using multiple AIF, and cerebral blood volume (CBV) and flow (CBF), and mean transit time (MTT) values were measured in the corresponding territories. Results from corresponding territories in the same patients were compared using paired t-tests. The volumes of infarct core and tissue at risk obtained with different AIFs were compared to the final infarct volume. Of 113 patients who met the inclusion criteria, 55 with stroke were considered for analysis. The MTT values obtained with an ''ischemic'' AIF tended to be shorter (P=0.055) and the CBF values higher (P=0.108) than those obtained using a ''nonischemic'' AIF. CBV values were not influenced by the selection of the AIF. No statistically significant difference was observed between the size of the PCT infarct core (P=0.121) and tissue at risk (P=0.178), regardless of AIF selection. In acute stroke patients, the selection of the AIF has no statistically significant impact of the PCT results; standardization of the PCT postprocessing using the ACA as the default AIF is adequate. (orig.)

  4. 45 CFR 605.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

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

  5. 7 CFR 15b.22 - Free appropriate public education.

    Science.gov (United States)

    2010-01-01

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

  6. 45 CFR 84.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

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

  7. 17 CFR 256.215 - Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

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

  8. Renormalized Volume

    CERN Document Server

    Gover, A Rod

    2016-01-01

    For any conformally compact manifold with hypersurface boundary we define a canonical renormalized volume functional and compute an explicit, holographic formula for the corresponding anomaly. For the special case of asymptotically Einstein manifolds, our method recovers the known results. The anomaly does not depend on any particular choice of regulator, but the coefficients of divergences do. We give explicit formulae for these divergences valid for any choice of regulating hypersurface; these should be relevant to recent studies of quantum corrections to entanglement entropies. The anomaly is expressed as a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. We show that the variation of these energy functionals is exactly the obstruction to solving a singular Yamabe type problem with boundary data along the...

  9. Produced Water Treatment Using Geothermal Energy from Oil and Gas Wells: An Appropriateness of Decommissioned Wells Index (ADWI) Approach

    Science.gov (United States)

    Kiaghadi, A.; Rifai, H. S.

    2016-12-01

    This study investigated the feasibility of harnessing geothermal energy from retrofitted oil and gas decommissioned wells to power desalination units and overcome the produced water treatment energy barrier. Previous studies using heat transfer models have indicated that well depth, geothermal gradient, formation heat conductivity, and produced water salt levels were the most important constraints that affect the achievable volume of treated water. Thus, the challenge of identifying which wells would be best suited for retrofit as geothermal wells was addressed by defining an Appropriateness of Decommissioned Wells Index (ADWI) using a 25 km x 25 km grid over Texas. Heat transfer modeling combined with fuzzy logic methodology were used to estimate the ADWI at each grid cell using the scale of Very Poor, Poor, Average, Good and Excellent. Values for each of the four constraints were extracted from existing databases and were used to select 20 representative values that covered the full range of the data. A heat transfer model was run for all the 160,000 possible combination scenarios and the results were regressed to estimate weighting coefficients that indicate the relative effect of well depth, geothermal gradient, heat conductivity, and produced water salt levels on the volume of treated water in Texas. The results indicated that wells located in cells with ADWI of "Average", "Good" or "Excellent" can potentially deliver 35,000, 106,000, or 240,000 L/day of treated water, respectively. Almost 98% of the cells in the Granite Wash, 97% in Eagle Ford Shale, 90% in Haynesville Shale, 79% in Permian Basin, and 78% in Barnett Shale were identified as better than "Average" locations; whereas, south of the Eagle Ford, southwestern Permian Basin, and the center of Granite Wash were "Excellent". Importantly, most of the locations with better than "Average" ADWI are within drought prone agricultural regions that would benefit from this resilient source of clean water.

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

    Data.gov (United States)

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

  11. German hospital database-allocation of patients to appropriate hospitals.

    Science.gov (United States)

    Schneider, Rita; Reiners, Christoph

    2010-06-01

    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

  12. Translation research: from accurate diagnosis to appropriate treatment

    Directory of Open Access Journals (Sweden)

    Pass Harvey I

    2004-10-01

    Full Text Available Abstract This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB and Health Insurance Portability and Accountability Act (HIPAA compliance, data standardization, sample procurement, quality control (QC, quality assurance (QA, data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease.

  13. Assessing medication packaging and labelling appropriateness in Sri Lanka.

    Science.gov (United States)

    Athuraliya, N; Walkom, E J; Dharmaratne, S; Robertson, J

    2016-01-01

    There is substantial evidence of poor dispensing practices with inadequate packaging and labelling of medicines, and limited advice on their usage in low and middle-income countries (LMICs). We examined the labelling and packaging of medicines identified during a survey of 1322 households in six regions of Sri Lanka between 2010 and 2013 conducted using the World Health Organization (WHO) methodology for household surveys. We compared medicines obtained from public and private sources and asked interviewees if they understood how to take the medicines. Packaging was considered adequate when the primary package was an envelope or closable container holding only one medicine. Adequate labels were legible and included medicine name, dose and expiration date. Interviewers assessed whether respondents knew how to take the medicines. Of 1322 households, 1253 households (94.8%) had at least one medicine; 84% were classified as western medicines and 16% traditional medicines. Of 5756 western medicines identified, 82.1% were adequately packaged, 43.3% adequately labelled and 41.4% both adequately packaged and labelled. Participants stated that they understood the label and knew how to take 96% of the medicines. Private medicine sources had more adequately packaged medicines than public sources (87.7% vs 73.5%; OR 2.58, 95% CI 2.23, 2.99) and more adequately labelled medicines (52.2% vs 27.4%; OR 2.90, 95% CI 2.57, 3.26). Inadequate packaging and labelling of medicines remain a concern in Sri Lanka. Commitment to Good Pharmacy Practices, investments in staff education and training and adequate dispensing resources (containers and labels), particularly in the public sector, are needed to address sub-optimal dispensing practices. Ageing populations with more chronic diseases requiring polypharmacy and complex medicine regimens increase the need for appropriately packaged and labelled medicines.

  14. Site Environmental Report for 2009, Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Suying

    2010-08-19

    Volume II of the Site Environmental Report for 2009 is provided by Ernest Orlando Lawrence Berkeley National Laboratory as a supplemental appendix to Volume I, which contains the body of the report. Volume II contains the environmental monitoring and sampling data used to generate summary results of routine and nonroutine sampling at the Laboratory, except for groundwater sampling data, which may be found in the reports referred to in Chapter 4 of Volume I. The results from sample collections are more comprehensive in Volume II than in Volume I: for completeness, all results from sample collections that began or ended in calendar year (CY) 2009 are included in this volume. However, the samples representing CY 2008 data have not been used in the summary results that are reported in Volume I. (For example, although ambient air samples collected on January 6, 2009, are presented in Volume II, they represent December 2008 data and are not included in Table 4-2 in Volume I.) When appropriate, sampling results are reported in both conventional and International System (SI) units. For some results, the rounding procedure used in data reporting may result in apparent differences between the numbers reported in SI and conventional units. (For example, stack air tritium results reported as < 1.5 Bq/m3 are shown variously as < 39 and < 41 pCi/m3. Both of these results are rounded correctly to two significant digits.)

  15. An appropriate tool for appetite testing and evaluation in young children in Benin

    NARCIS (Netherlands)

    Dossa, R.A.; Ategbo, E.A.; Raaij, van J.M.; Graaf, de C.; Hautvast, J.G.A.J.

    2002-01-01

    Appetite measurements were performed in 109 Beninese children aged 18–30 months to develop a tool for appetite evaluation in young children in nutritional intervention programmes. Two test foods were identified as appropriate for these children: a maize porridge (aklui) and rice (riz-au-gras). Ad li

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

    Science.gov (United States)

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

    2012-01-01

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

  17. Effects of Varied Levels of Treatment Integrity on Appropriate Toy Manipulation in Children with Autism

    Science.gov (United States)

    Groskreutz, Nicole C.; Groskreutz, Mark P.; Higbee, Thomas S.

    2011-01-01

    We assessed the effects of varying the treatment integrity of a prompting procedure on appropriate toy manipulation in two preschool-aged children with autism. Following an assessment to identify toys with high levels of inappropriate toy manipulation, each of three toys was associated with implementation of the prompting procedure at a different…

  18. Quality indicators to measure appropriate antibiotic use in hospitalized adults

    NARCIS (Netherlands)

    Bosch, C.M.A. van den; Geerlings, S.E.; Natsch, S.S.; Prins, J.M.; Hulscher, M.

    2015-01-01

    BACKGROUND: An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all

  19. Perspectives of Early Intervention Professionals about Culturally-Appropriate Practices.

    Science.gov (United States)

    Lee, Hwa; Ostrosky, Michaelene M.; Bennett, Tess; Fowler, Susan A.

    2003-01-01

    A survey of 123 early intervention professionals found they considered recommendations for providing culturally appropriate services important. However, multiple barriers often hindered implementation. Lack of time was the most common barrier to providing culturally appropriate practices, followed by lack of training and lack of materials.…

  20. APPROPRIATENESS OF GIFTED CHILDREN SOCIALIZATION IN CONTEMPORARY SOCIOCULTURAL CONDITIONS

    OpenAIRE

    Rimma Litvak; Tatyana Bondarchuk

    2012-01-01

    The article opens general appropriateness of one of the most important directions in working with gifted children that is socialization; it substantiates appropriateness as an axiom scheme, providing successfulness of the examined process; authors deduce about general outlook of gifted children socialization.

  1. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Consultation with appropriate officials; negotiation. 1261.403 Section 1261.403 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... appropriate officials; negotiation. (a) The authority pursuant to § 1261.402 to determine to forego...

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

    Directory of Open Access Journals (Sweden)

    Francesco Napolitano

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

  3. Military Construction: Analysis of the FY2012 Appropriation and Authorization

    Science.gov (United States)

    2011-07-13

    2055 are laid out in Table 2. The amounts shown are “new budget authority” ( NBA ), the new appropriations needed to fund the various accounts for...the years indicated. NBA is the total appropriation amount required for a given year minus reductions and rescissions mandated by subsequent

  4. 43 CFR 20.506 - Appropriations, legislation and lobbying.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Appropriations, legislation and lobbying. 20.506 Section 20.506 Public Lands: Interior Office of the Secretary of the Interior EMPLOYEE RESPONSIBILITIES AND CONDUCT Other Employee Conduct Provisions § 20.506 Appropriations, legislation and...

  5. Defense Authorization and Appropriations Bills: FY1970-FY2017

    Science.gov (United States)

    2017-01-18

    their numbers and votes, vetoes, substitutions, dates of final passage, and public law numbers. Significant definitions are also included. This...The appropriations bill actually enables the military departments and defense agencies to draw funds from the national treasury. Ideally , the... Ideally , after the authorization bill is passed, the appropriations bill goes through this same process. Although conceptually a sequential process

  6. Defense Authorization and Appropriations Bills: FY1970-FY2016

    Science.gov (United States)

    2016-04-20

    their numbers and votes, vetoes, substitutions, dates of final passage, and public law numbers. Significant definitions are also included. This report...The appropriations bill actually enables the military departments and defense agencies to draw funds from the national treasury. Ideally , the... Ideally , after the authorization bill is passed, the appropriations bill goes through this same process. Although conceptually a sequential process

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

    Science.gov (United States)

    Anderson, Stephen P.

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

  8. Developmentally Appropriate Discipline Practices of Elementary School Principals

    Science.gov (United States)

    Burnett, Donna Silva

    2010-01-01

    Research has indicated that developmentally appropriate practices (DAP) should be applied to manage behavioral problems in school age children. However, little evidence exists on the extent to which elementary school principals apply these practices appropriately in student discipline. The purpose of this phenomenological study was to explore how…

  9. 38 CFR 18.433 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

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

  10. Indigenous Thought, Appropriation, and Non-Aboriginal People

    Science.gov (United States)

    Haig-Brown, Celia

    2010-01-01

    In this article, I explore the question, "What is the relationship between appropriation of Indigenous thought and what might be called "deep learning" based in years of education in Indigenous contexts." Beginning with an examination of meanings ascribed to cultural appropriation, I bring texts from Gee on secondary…

  11. 16 CFR 614.1 - Appropriate proof of identity.

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

    2017-02-27

    Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities Nicole T. Carter Specialist in Natural Resources Policy...of Engineers: Water Resource Authorizations, Appropriations, and Activities Congressional Research Service Summary The U.S. Army Corps of...congressional attention because its water resource projects can have significant local and regional economic benefits and environmental effects

  13. Mathematics Preservice Teachers' Beliefs and Conceptions of Appropriate Technology Use

    Science.gov (United States)

    Wachira, Patrick; Keengwe, Jared; Onchwari, Grace

    2008-01-01

    Many preservice teachers report having had little exposure on the use of technology in the teaching and learning of mathematics. Without guidance on the appropriate use of technology, prospective teachers are left to form their own beliefs about what is appropriate technology use. This study assessed preservice teacher beliefs and conceptions of…

  14. Creative Commons and Appropriation: Implicit Collaboration in Digital Works

    Directory of Open Access Journals (Sweden)

    R. Lyle Skains

    2016-03-01

    Full Text Available Appropriation is a common practice in art and literature; electronic literature in particular lends itself readily to appropriation and collaboration, due to its multimodal and born-digital nature. This paper presents practice-based research examining the effects of digital appropriation on two works of digital fiction (a hyperfiction and an interactive fiction, demonstrating how it alters the creative writer’s typical process, as well as the resulting narrative itself. This practice of appropriation results in “implicit collaboration” between the digital creative writer and those whose work is appropriated, an arguable form of shared authorship. Questions regarding the ethics of this practice, including copyright concerns and authorship, are discussed.

  15. APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

    Directory of Open Access Journals (Sweden)

    Cornelia DUMITRU

    2015-07-01

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

  16. APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

    Directory of Open Access Journals (Sweden)

    Cornelia DUMITRU

    2015-12-01

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

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

    Science.gov (United States)

    Longhurst, Max L.

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

  18. VOLUMNECT: measuring volumes with Kinect

    Science.gov (United States)

    Quintino Ferreira, Beatriz; Griné, Miguel; Gameiro, Duarte; Costeira, João. Paulo; Sousa Santos, Beatriz

    2014-03-01

    This article presents a solution to volume measurement object packing using 3D cameras (such as the Microsoft KinectTM). We target application scenarios, such as warehouses or distribution and logistics companies, where it is important to promptly compute package volumes, yet high accuracy is not pivotal. Our application auto- matically detects cuboid objects using the depth camera data and computes their volume and sorting it allowing space optimization. The proposed methodology applies to a point cloud simple computer vision and image processing methods, as connected components, morphological operations and Harris corner detector, producing encouraging results, namely an accuracy in volume measurement of 8mm. Aspects that can be further improved are identified; nevertheless, the current solution is already promising turning out to be cost effective for the envisaged scenarios.

  19. Statement for the Subcommittee on Legislative Branch Appropriations of the House Committee on Appropriations, March 22, 1974.

    Science.gov (United States)

    Cooke, Eileen D.

    This statement by the American Library Association (ALA) for the Subcommittee on Legislative Appropriations of the House Committee on Appropriations endorses the Library of Congress request for funding in 1975 and requests that funding be increased for the Office of Superintendent of Documents for the same period. The value and importance of…

  20. Situating globality : African agency in the appropriation of global culture

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.; Dijk, van R.A.; Gewald, J.B.

    2004-01-01

    The papers in this volume were earlier presented at the conference 'Globalization and new questions of ownership', which was held in Leiden, The Netherlands, from 26-27 April 2002. The volume challenges the dominant view that globalization is a primary threat to African societies. Instead, it

  1. Situating globality : African agency in the appropriation of global culture

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.; Dijk, van R.A.; Gewald, J.B.

    2004-01-01

    The papers in this volume were earlier presented at the conference 'Globalization and new questions of ownership', which was held in Leiden, The Netherlands, from 26-27 April 2002. The volume challenges the dominant view that globalization is a primary threat to African societies. Instead, it emphas

  2. ACR Appropriateness Criteria(®) Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

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

    2017-05-01

    Upper gastrointestinal bleeding (UGIB) remains a significant cause of morbidity and mortality with mortality rates as high as 14%. This document addresses the indications for imaging UGIB that is nonvariceal and unrelated to portal hypertension. The four variants are derived with respect to upper endoscopy. For the first three, it is presumed that upper endoscopy has been performed, with three potential initial outcomes: endoscopy reveals arterial bleeding source, endoscopy confirms UGIB without a clear source, and negative endoscopy. The fourth variant, "postsurgical and traumatic causes of UGIB; endoscopy contraindicated" is considered separately because upper endoscopy is not performed. When endoscopy identifies the presence and location of bleeding but bleeding cannot be controlled endoscopically, catheter-based arteriography with treatment is an appropriate next study. CT angiography (CTA) is comparable with angiography as a diagnostic next step. If endoscopy demonstrates a bleed but the endoscopist cannot identify the bleeding source, angiography or CTA can be typically performed and both are considered appropriate. In the event of an obscure UGIB, angiography and CTA have been shown to be equivalent in identifying the bleeding source; CT enterography may be an alternative to CTA to find an intermittent bleeding source. In the postoperative or traumatic setting when endoscopy is contraindicated, primary angiography, CTA, and CT with intravenous contrast are considered appropriate. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to

  3. Appropriateness of cardiovascular care in elderly adult cancer survivors.

    Science.gov (United States)

    Cheung, Winson Y; Levin, Raisa; Setoguchi, Soko

    2013-01-01

    Research suggests that the quality of non-cancer-related care among cancer survivors (CS) is suboptimal. Secondary disease prevention is an important component of survivorship care that has not been previously evaluated. Our aims were (1) to assess the utilization of and adherence to medications and treatments for the secondary prevention of myocardial infarction (MI) in CS versus non-cancer patients (NCP) and (2) to compare temporal trends in cardiovascular care between these two patient cohorts. Linking data from Medicare, pharmacy assistance programs, and cancer registries, we calculated the percentage of individuals receiving preventive medications (statins, β-blockers, angiotensin-converting enzyme inhibitors) and revascularization interventions (angioplasty, stent, bypass surgery) within 90 days after acute MI in CS and propensity score-matched NCP. We assessed trends over time and determined predictors of appropriate preventive care using modified Poisson regression. We identified 1,119 CS and 7,886 NCP. Compared to NCP, more survivors received statins (38 vs. 31 %) and β-blockers (67 vs. 59 %), but fewer underwent bypass surgery (1.5 vs. 2.8 %) after MI. From 1997 to 2004, both survivors and NCP were increasingly prescribed medications to prevent future coronary events. Over the same time period, receipt of bypass surgery was significantly lower among survivors. Co-morbidities, such as depression and lung disease, and demographic factors, such as advanced age and female, were associated with underuse of preventive care among survivors when compared to NCP. Use of preventive medications and procedures has generally improved, but uptake of bypass surgery among CS still lags behind NCP.

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

    CSIR Research Space (South Africa)

    Duncker, Louiza C

    2014-11-01

    Full Text Available Sustainable development, which encompasses sustainable sanitation, is defined as development that is appropriate, has the specific objectives of accelerated growth, targeted interventions and community mobilisation to eradicate poverty and focuses...

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

    African Journals Online (AJOL)

    Determining the appropriate code in a South African business environment. ... that the use of clients' primary languages is a function of advisors' multilingual skills. ... As researchers, we are of the opinion that these results could impact on ...

  6. Evaluation of the appropriateness of certain grain production ...

    African Journals Online (AJOL)

    Evaluation of the appropriateness of certain grain production technologies for small-scale. ... South African Journal of Agricultural Extension. Journal Home ... The paper suggests a combination of both modern, high-input technologies and

  7. 18 CFR 367.2150 - Account 215, Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

    ... NATURAL GAS ACT Balance Sheet Chart of Accounts Proprietary Capital § 367.2150 Account 215, Appropriated... ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING...

  8. An audit tool for assessing the appropriateness of carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Feasby Thomas E

    2004-07-01

    Full Text Available Abstract Background To update appropriateness ratings for carotid endarterectomy using the best clinical evidence and to develop a tool to audit the procedure's use. Methods A nine-member expert panel drawn from all the Canadian Specialist societies that are involved in the care of patients with carotid artery disease, used the RAND Appropriateness Methodology to rate scenarios where carotid endarterectomy may be performed. A 9-point rating scale was used that permits the categorization of the use of carotid endarterectomy as appropriate, uncertain, or inappropriate. A descriptive analysis was undertaken of the final results of the panel meeting. A database and code were then developed to rate all carotid endarterectomies performed in a Western Canadian Health region from 1997 to 2001. Results All scenarios for severe symptomatic stenosis (70–99% were determined to be appropriate. The ratings for moderate symptomatic stenosis (50–69% ranged from appropriate to inappropriate. It was never considered appropriate to perform endarterectomy for mild stenosis (0–49% or for chronic occlusions. Endarterectomy for asymptomatic carotid disease was thought to be of uncertain benefit at best. The majority of indications for the combination of endarterectomy either prior to, or at time of coronary artery bypass grafting were inappropriate. The audit tool classified 98.0% of all cases. Conclusions These expert panel ratings, based on the best evidence currently available, provide a comprehensive and updated guide to appropriate use of carotid endarterectomy. The resulting audit tool can be downloaded by readers from the Internet and immediately used for hospital audits of carotid endarterectomy appropriateness.

  9. Myocardial perfusion imaging determination using an appropriate use smartphone application.

    Science.gov (United States)

    Mahajan, Ashish; Bal, Susan; Hahn, Harvey

    2015-02-01

    Inappropriate cardiac imaging has been a significant cost concern and cause of radiation burden to patients. To assess if a smartphone application (app) based on 2009 Appropriate Use Criteria (AUC) for Cardiac Radionuclide Imaging published by American College of Cardiology would be feasible at the point of order. We evaluated stress myocardial perfusion imaging (MPI) (N = 403) (mean age = 62.23 years; 47.89% males) over a 4 month period using a smartphone app to determine whether the study ordered was Appropriate, Inappropriate, or Uncertain per 2009 AUC. We also monitored the time needed to use the app to determine the level of appropriateness of each stress MPI. The results of the stress MPI were noted. Of the 403 stress MPIs evaluated, 267 (66.25%) were noted to be Appropriate, 118 (29.28%) were Inappropriate, and 13 (3.23%) were Uncertain, per AUC; 5 (1.25%) remained unclassified. Average time needed to use the app to assess each stress MPI for appropriateness was noted to be 44 (±9) seconds. Non-teaching physicians ordered 70 (38.89%) inappropriate stress MPIs as compared to 20 (23.53%) ordered by physicians on resident teaching service, and 28 (23.33%) by cardiologists (P = .0045). Among inappropriately ordered stress MPIs, 87 (42.65%) were ordered in females as compared to 31 (17.13%) in males (P stress MPIs among appropriately ordered were abnormal (reversible ischemia or fixed perfusion defect) as compared to 15 (12.17%) among inappropriately ordered stress MPIs (P = .0032). A free and convenient smartphone app provides an easy-to-use tool to assist physicians in determining the level of appropriateness of stress MPI in a time- and cost-effective manner at the point of order. The smartphone app may have potential to promote the usage of the AUC and possibly aid reduction of healthcare cost and ionizing radiation burden.

  10. Identifying parents with risky alcohol consumption habits in a paediatric unit - are screening and brief intervention appropriate methods?

    DEFF Research Database (Denmark)

    Bjerregaard, Lene B L; Gerke, Oke; Rubak, Sune Leisgaard Mørck

    2011-01-01

    child using motivational interviewing (MI) and screening for risky alcohol behaviour by Cut down, Annoyance from others, feel Guilty, Early-morning Craving (CAGE)-C. Data were analysed by descriptive statistics, and relationships were tested with a statistical significance level of 0.05, using SPSS...

  11. Factor analysis is more appropriate to identify overall dietary patterns associated with diabetes when compared with treelet transform analysis

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Dobson, A.; Soedamah-Muthu, S.S.; Mishra, G.D.

    2013-01-01

    Treelet transform (TT) is a proposed alternative to factor analysis for deriving dietary patterns. Before applying this method to nutrition data, further analyses are required to assess its validity in nutritional epidemiology. We aimed to compare dietary patterns from factor analysis and TT and the

  12. Identifying Potential Norovirus Epidemics in China via Internet Surveillance

    Science.gov (United States)

    Chen, Bin; Jiang, Tao; Cai, Gaofeng; Jiang, Zhenggang; Chen, Yongdi; Wang, Zhengting; Gu, Hua; Chai, Chengliang

    2017-01-01

    Background Norovirus is a common virus that causes acute gastroenteritis worldwide, but a monitoring system for norovirus is unavailable in China. Objective We aimed to identify norovirus epidemics through Internet surveillance and construct an appropriate model to predict potential norovirus infections. Methods The norovirus-related data of a selected outbreak in Jiaxing Municipality, Zhejiang Province of China, in 2014 were collected from immediate epidemiological investigation, and the Internet search volume, as indicated by the Baidu Index, was acquired from the Baidu search engine. All correlated search keywords in relation to norovirus were captured, screened, and composited to establish the composite Baidu Index at different time lags by Spearman rank correlation. The optimal model was chosen and possibly predicted maps in Zhejiang Province were presented by ArcGIS software. Results The combination of two vital keywords at a time lag of 1 day was ultimately identified as optimal (ρ=.924, Ptimes during the outbreak. In addition to Jiaxing Municipality, Hangzhou Municipality might have had some potential epidemics in the study time from the predicted model. Conclusions Although there are limitations with early warning and unavoidable biases, Internet surveillance may be still useful for the monitoring of norovirus epidemics when a monitoring system is unavailable. PMID:28790023

  13. Annual Status Report on Nationally Appropriate Mitigation Actions (NAMAs) 2013

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

    NAMAs are moving gradually from concept to concrete action. A fully functional and publicly available version of the UNFCCC NAMA registry was released on 16 October 2013, and the first dedicated fund for NAMA implementation was launched earlier this year. Countries with no previous NAMA activities engaged in NAMA development and new NAMAs emerged around the world. These are encouraging steps, although more evidence of finance and NAMA implementation is needed to establish NAMAs firmly as a mitigation mechanism and ease the emerging scepticism in some quarters. The reports begins with an overview of the latest statistics in NAMA development, drawing from the UNFCCC NAMA registry and the Ecofys NAMA Database. Currently, 40 NAMAs are included in the registry, and the database contains information on 82 NAMAs and 33 feasibility studies from 34 countries. This is followed by an analysis of areas in which progress is most needed to create widespread acceptance of the NAMA mechanism and implement actions that achieve significant GHG emissions reductions within the context of sustainable development. The chapter has four main sections, on: defining, financing, monitoring and operationalising NAMAs. The subsequent contributions on specific NAMA related topics are authored by different organisations. The Center for Clean Air Policy (CCAP) discusses the role of finance in advancing transformational NAMAs. The Energy research Centre of the Netherlands (ECN) takes a close look at the convergence in the structure and level of detail of current NAMA proposals. Ecofys defines transformational change and shows how transformational elements can be identified and incorporated into the design and implementation of a NAMA. GIZ highlights experiences and lessons learnt from applications of the NAMA Tool that has been presented and used as methodology for NAMA development in a variety of workshops and trainings all over the world. The Energy and Resources Institute (TERI) presents the

  14. Appropriate VTE prophylaxis is associated with lower direct medical costs.

    Science.gov (United States)

    Amin, Alpesh; Hussein, Mohamed; Battleman, David; Lin, Jay; Stemkowski, Stephen; Merli, Geno J

    2010-11-01

    To calculate and compare the direct medical costs of guideline-recommended prophylaxis with prophylaxis that does not fully adhere with guideline recommendations in a large, real-world population. Discharge records were retrieved from the US Premier Perspective™ database (January 2003-December 2003) for patients aged≥40 years with a primary diagnosis of cancer, chronic heart failure, lung disease, or severe infectious disease who received some form of thromboprophylaxis. Univariate analysis and multivariate regression modeling were performed to compare direct medical costs between discharges who received appropriate prophylaxis (correct type, dose, and duration based on sixth edition American College of Chest Physicians [ACCP] recommendations) and partial prophylaxis (not in full accordance with ACCP recommendations). Market segmentation analysis was used to compare costs stratified by hospital and patient characteristics. Of the 683 005 discharges included, 148,171 (21.7%) received appropriate prophylaxis and 534,834 (78.3%) received partial prophylaxis. The total direct unadjusted costs were $15,439 in the appropriate prophylaxis group and $17,763 in the partial prophylaxis group. After adjustment, mean adjusted total costs per discharge were lower for those receiving appropriate prophylaxis ($11,713; 95% confidence interval [CI], $11,675-$11,753) compared with partial prophylaxis ($13,369; 95% CI, $13,332-$13 406; Panalysis suggests that appropriate prophylaxis, in adherence with ACCP guidelines, is potentially cost-saving compared with partial prophylaxis in at-risk medical patients.

  15. Making appropriation 'stick': stabilizing politics in an 'inherently feminist' tool.

    Science.gov (United States)

    Hasson, Katie Ann

    2012-10-01

    This article examines how feminist politics are made to 'stick' to appropriated technologies in the context of a contemporary feminist women's health clinic in the US. Feminist clinics such as 'FemHealth', founded as part of 1970s women's health movements, put medical tools and knowledge into lay women's hands, making the appropriation of medical technologies a centerpiece of their political project. In the process, they rejected the authority of physicians and gave new politicized meanings to the tools they claimed as their own. As lay healthworkers at FemHealth continued the project of appropriation, they also continued to negotiate their dependence on physicians to perform tasks that required a medical license. Drawing on participant observation and interviews with healthworkers, I argue that struggles over the role and authority of physicians in this clinic play out through debates over two similar and competing tools used in the abortion procedure: the single-tooth tenaculum and the cervical stabilizer. Many healthworkers invested in the stabilizer as 'inherently feminist' in hopes that it would maintain its politics even when passed into physicians' hands. While appropriation depends on the ability of users to alter a technology's meanings, actors may feel invested in the new politics taken on by appropriated tools and work towards making those meanings persist, or 'stick'.

  16. Enlightening Volumes: Curve Fitting to Approximate Volumes

    Science.gov (United States)

    Buhl, David; O' Neal, Judy

    2008-01-01

    The current mantra in education is "technology, technology, technology." Many teachers and prospective teachers become frustrated with their lack of knowledge regarding the "appropriate" use of technology in the classroom. Prospective teachers need training in their education to understand how technology can be used "appropriately" in the…

  17. Identifying the Junction

    DEFF Research Database (Denmark)

    Hansen, Kim Toft

    2009-01-01

    of myth and realism, across the different modal views in the Old and New Testaments, to the related study of fantasy and crime fiction and the juncture of the two in Simon R. Green’s novel Hawk & Fisher – the first volume of a series in which logic and magic exist side by side. As a result this article...

  18. Novel genetic loci associated with hippocampal volume

    NARCIS (Netherlands)

    D.P. Hibar (Derrek); H.H.H. Adams (Hieab); N. Jahanshad (Neda); G. Chauhan (Ganesh); J.L. Stein; E. Hofer (Edith); M.E. Rentería (Miguel); J.C. Bis (Joshua); A. Arias-Vásquez (Alejandro); Ikram, M.K. (M. Kamran); S. Desrivières (Sylvane); M.W. Vernooij (Meike); L. Abramovic; S. Alhusaini (Saud); N. Amin (Najaf); M. Andersson (Micael); K. Arfanakis (Konstantinos); B. Aribisala (Benjamin); N.J. Armstrong (Nicola J.); L. Athanasiu (Lavinia); T. Axelsson (Tomas); A.H. Beecham (Ashley); A. Beiser (Alexa); M. Bernard (Manon); S.H. Blanton (Susan H.); M.M. Bohlken (Marc M.); M.P.M. Boks (Marco); L.B.C. Bralten (Linda); A.M. Brickman (Adam M.); Carmichael, O. (Owen); M.M. Chakravarty (M. Mallar); Q. Chen (Qiang); C.R.K. Ching (Christopher); V. Chouraki (Vincent); G. Cuellar-Partida (Gabriel); F. Crivello (Fabrice); A. den Braber (Anouk); Doan, N.T. (Nhat Trung); S.M. Ehrlich (Stefan); S. Giddaluru (Sudheer); A.L. Goldman (Aaron L.); R.F. Gottesman (Rebecca); O. Grimm (Oliver); M.D. Griswold (Michael); T. Guadalupe (Tulio); Gutman, B.A. (Boris A.); J. Hass (Johanna); U.K. Haukvik (Unn); D. Hoehn (David); A.J. Holmes (Avram); M. Hoogman (Martine); D. Janowitz (Deborah); T. Jia (Tianye); Jørgensen, K.N. (Kjetil N.); N. Karbalai (Nazanin); D. Kasperaviciute (Dalia); S. Kim (Shinseog); M. Klein (Marieke); B. Kraemer (Bernd); P.H. Lee (Phil); D.C. Liewald (David C.); L.M. Lopez (Lorna); M. Luciano (Michelle); C. MacAre (Christine); Marquand, A.F. (Andre F.); M. Matarin (Mar); R. Mather; M. Mattheisen (Manuel); McKay, D.R. (David R.); Milaneschi, Y. (Yuri); S. Muñoz Maniega (Susana); K. Nho (Kwangsik); A.C. Nugent (Allison); P. Nyquist (Paul); Loohuis, L.M.O. (Loes M. Olde); J. Oosterlaan (Jaap); M. Papmeyer (Martina); Pirpamer, L. (Lukas); B. Pütz (Benno); A. Ramasamy (Adaikalavan); Richards, J.S. (Jennifer S.); S.L. Risacher (Shannon); R. Roiz-Santiañez (Roberto); N. Rommelse (Nanda); S. Ropele (Stefan); E.J. Rose (Emma); N.A. Royle (Natalie); T. Rundek (Tatjana); P.G. Sämann (Philipp); Saremi, A. (Arvin); C.L. Satizabal (Claudia L.); L. Schmaal (Lianne); N.J. Schork (Nicholas); Shen, L. (Li); J. Shin (Jean); Shumskaya, E. (Elena); A.V. Smith (Albert Vernon); R. Sprooten (Roy); V.M. Strike (Vanessa); A. Teumer (Alexander); D. Tordesillas-Gutierrez (Diana); R. Toro (Roberto); D. Trabzuni (Danyah); S. Trompet (Stella); D. Vaidya (Dhananjay); J. van der Grond (Jeroen); S. van der Lee (Sven); Van Der Meer, D. (Dennis); M.M.J. Van Donkelaar (Marjolein M. J.); K.R. van Eijk (Kristel); T.G.M. van Erp (Theo G.); Van Rooij, D. (Daan); E. Walton (Esther); L.T. Westlye (Lars); C.D. Whelan (Christopher); B.G. Windham (B Gwen); A.M. Winkler (Anderson); K. Wittfeld (Katharina); G. Woldehawariat (Girma); A. Björnsson (Asgeir); Wolfers, T. (Thomas); L.R. Yanek (Lisa); Yang, J. (Jingyun); A.P. Zijdenbos; M.P. Zwiers (Marcel); I. Agartz (Ingrid); L. Almasy (Laura); D. Ames (David); Amouyel, P. (Philippe); O.A. Andreassen (Ole A.); S. Arepalli (Sampath); A.A. Assareh; S. Barral (Sandra); M.E. Bastin (Mark); Becker, D.M. (Diane M.); J.T. Becker; D.A. Bennett (David A.); J. Blangero (John); H. van Bokhoven (Hans); D.I. Boomsma (Dorret); H. Brodaty (Henry); R.M. Brouwer (Rachel); H.G. Brunner; M. Buckner; J.K. Buitelaar (Jan); K. Bulayeva (Kazima); W. Cahn (Wiepke); V.D. Calhoun Vince D. (V.); D.M. Cannon (Dara); G. Cavalleri (Gianpiero); Cheng, C.-Y. (Ching-Yu); S. Cichon (Sven); M.R. Cookson (Mark); A. Corvin (Aiden); B. Crespo-Facorro (Benedicto); J.E. Curran (Joanne); M. Czisch (Michael); A.M. Dale (Anders); G.E. Davies (Gareth); A.J. de Craen (Anton); E.J.C. de Geus (Eco); P.L. de Jager (Philip); G.I. de Zubicaray (Greig); I.J. Deary (Ian J.); S. Debette (Stéphanie); C. DeCarli (Charles); N. Delanty; C. Depondt (Chantal); A.L. DeStefano (Anita); A. Dillman (Allissa); S. Djurovic (Srdjan); D.J. Donohoe (Dennis); D.A. Drevets (Douglas); Duggirala, R. (Ravi); M.D. Dyer (Matthew); C. Enzinger (Christian); S. Erk; T. Espeseth (Thomas); Fedko, I.O. (Iryna O.); Fernández, G. (Guillén); L. Ferrucci (Luigi); S.E. Fisher (Simon); D. Fleischman (Debra); I. Ford (Ian); M. Fornage (Myriam); T. Foroud (Tatiana); P.T. Fox (Peter); C. Francks (Clyde); Fukunaga, M. (Masaki); Gibbs, J.R. (J. Raphael); D.C. Glahn (David); R.L. Gollub (Randy); H.H.H. Göring (Harald H.); R.C. Green (Robert C.); O. Gruber (Oliver); V. Gudnason (Vilmundur); S. Guelfi (Sebastian); Håberg, A.K. (Asta K.); N.K. Hansell (Narelle); J. Hardy (John); C.A. Hartman (C.); Hashimoto, R. (Ryota); K. Hegenscheid (Katrin); J. Heinz (Judith); S. Le Hellard (Stephanie); D.G. Hernandez (Dena); D.J. Heslenfeld (Dirk); Ho, B.-C. (Beng-Choon); P.J. Hoekstra (Pieter); W. Hoffmann (Wolfgang); A. Hofman (Albert); F. Holsboer (Florian); G. Homuth (Georg); N. Hosten (Norbert); J.J. Hottenga (Jouke Jan); M.J. Huentelman (Matthew); H.H. Pol; Ikeda, M. (Masashi); Jack, C.R. (Clifford R.); S. Jenkinson (Sarah); R. Johnson (Robert); Jönsson, E.G. (Erik G.); J.W. Jukema; R. Kahn; Kanai, R. (Ryota); I. Kloszewska (Iwona); Knopman, D.S. (David S.); P. Kochunov (Peter); Kwok, J.B. (John B.); S. Lawrie (Stephen); H. Lemaître (Herve); X. Liu (Xinmin); D.L. Longo (Dan L.); O.L. Lopez (Oscar L.); S. Lovestone (Simon); Martinez, O. (Oliver); J.-L. Martinot (Jean-Luc); V.S. Mattay (Venkata S.); McDonald, C. (Colm); A.M. McIntosh (Andrew); McMahon, F.J. (Francis J.); McMahon, K.L. (Katie L.); P. Mecocci (Patrizia); I. Melle (Ingrid); Meyer-Lindenberg, A. (Andreas); S. Mohnke (Sebastian); Montgomery, G.W. (Grant W.); D.W. Morris (Derek W); T.H. Mosley (Thomas H.); T.W. Mühleisen (Thomas); B. Müller-Myhsok (B.); M.A. Nalls (Michael); M. Nauck (Matthias); T.E. Nichols (Thomas); W.J. Niessen (Wiro); M.M. Nöthen (Markus); L. Nyberg (Lars); Ohi, K. (Kazutaka); R.L. Olvera (Rene); R.A. Ophoff (Roel); M. Pandolfo (Massimo); T. Paus (Tomas); Z. Pausova (Zdenka); B.W.J.H. Penninx (Brenda); Pike, G.B. (G. Bruce); S.G. Potkin (Steven); B.M. Psaty (Bruce); S. Reppermund; M. Rietschel (M.); J.L. Roffman (Joshua); N. Seiferth (Nina); J.I. Rotter (Jerome I.); M. Ryten (Mina); Sacco, R.L. (Ralph L.); P.S. Sachdev (Perminder); A.J. Saykin (Andrew); R. Schmidt (Reinhold); Schmidt, H. (Helena); C.J. Schofield (Christopher); Sigursson, S. (Sigurdur); Simmons, A. (Andrew); A. Singleton (Andrew); S.M. Sisodiya (Sanjay); Smith, C. (Colin); J.W. Smoller; H. Soininen (H.); V.M. Steen (Vidar); D.J. Stott (David J.); J. Sussmann (Jessika); A. Thalamuthu (Anbupalam); A.W. Toga (Arthur W.); B. Traynor (Bryan); J.C. Troncoso (Juan); M. Tsolaki (Magda); C. Tzourio (Christophe); A.G. Uitterlinden (André); Hernández, M.C.V. (Maria C. Valdés); M.P. van der Brug (Marcel); A. van der Lugt (Aad); N.J. van der Wee (Nic); N.E.M. van Haren (Neeltje E.); D. van 't Ent (Dennis); M.J.D. van Tol (Marie-José); B.N. Vardarajan (Badri); B. Vellas (Bruno); D.J. Veltman (Dick); H. Völzke (Henry); H.J. Walter (Henrik); J. Wardlaw (Joanna); A.M.J. Wassink (Annemarie); M.E. Weale (Michael); Weinberger, D.R. (Daniel R.); Weiner, M.W. (Michael W.); Wen, W. (Wei); E. Westman (Eric); T.J.H. White (Tonya); Wong, T.Y. (Tien Y.); Wright, C.B. (Clinton B.); R.H. Zielke (Ronald H.); A.B. Zonderman; N.G. Martin (Nicholas); C.M. van Duijn (Cock); M.J. Wright (Margaret); W.T. Longstreth Jr; G. Schumann (Gunter); H.J. Grabe (Hans Jörgen); B. Franke (Barbara); L.J. Launer (Lenore); S.E. Medland (Sarah Elizabeth); S. Seshadri (Sudha); P.M. Thompson (Paul); M.K. Ikram (Kamran)

    2017-01-01

    textabstractThe hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpi

  19. Novel genetic loci associated with hippocampal volume

    NARCIS (Netherlands)

    Hibar, Derrek P; Adams, Hieab H H; Jahanshad, Neda; Chauhan, Ganesh; Stein, Jason L; Hofer, Edith; Renteria, Miguel E; Bis, Joshua C; Arias-Vasquez, Alejandro; Ikram, M Kamran; Desrivières, Sylvane; Vernooij, Meike W; Abramovic, Lucija|info:eu-repo/dai/nl/34549072X; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beecham, Ashley H; Beiser, Alexa; Bernard, Manon; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P|info:eu-repo/dai/nl/286852071; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chen, Qiang; Ching, Christopher R K; Chouraki, Vincent; Cuellar-Partida, Gabriel; Crivello, Fabrice; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Gutman, Boris A; Hass, Johanna; Haukvik, Unn K; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Jørgensen, Kjetil N; Karbalai, Nazanin; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liewald, David C M; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre F; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; McKay, David R; Milaneschi, Yuri; Muñoz Maniega, Susana; Nho, Kwangsik; Nugent, Allison C; Nyquist, Paul; Loohuis, Loes M Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pirpamer, Lukas; Pütz, Benno; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Ropele, Stefan; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Saremi, Arvin; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Trompet, Stella; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Lee, Sven J; Van der Meer, Dennis; Van Donkelaar, Marjolein M J; Van Eijk, Kristel R|info:eu-repo/dai/nl/344497569; Van Erp, Theo G M; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Wittfeld, Katharina; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M|info:eu-repo/dai/nl/304811432; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke|info:eu-repo/dai/nl/250566370; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Craen, Anton J M; De Geus, Eco J C; De Jager, Philip L; De Zubicaray, Greig I; Deary, Ian J; Debette, Stéphanie; DeCarli, Charles; Delanty, Norman; Depondt, Chantal; DeStefano, Anita; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Enzinger, Christian; Erk, Susanne; Espeseth, Thomas; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Fornage, Myriam; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald H H; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Håberg, Asta K; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Huentelman, Matthew; Pol, Hilleke E Hulshoff|info:eu-repo/dai/nl/142348228; Ikeda, Masashi; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S|info:eu-repo/dai/nl/073778532; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Francis J; McMahon, Katie L; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W J H; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schmidt, Helena; Schofield, Peter R; Sigursson, Sigurdur; Simmons, Andrew; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Tsolaki, Magda; Tzourio, Christophe; Uitterlinden, Andre G; Hernández, Maria C Valdés; Van der Brug, Marcel; van der Lugt, Aad; van der Wee, Nic J A; Van Haren, Neeltje E M|info:eu-repo/dai/nl/271562161; van 't Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Vellas, Bruno; Veltman, Dick J; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, Ronald H; Zonderman, Alan B; Martin, Nicholas G; Van Duijn, Cornelia M; Wright, Margaret J; Longstreth, W T; Schumann, Gunter; Grabe, Hans J; Franke, Barbara; Launer, Lenore J; Medland, Sarah E; Seshadri, Sudha; Thompson, Paul M; Ikram, M Arfan

    2017-01-01

    The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hi

  20. Novel genetic loci associated with hippocampal volume

    NARCIS (Netherlands)

    D.P. Hibar (Derrek); H.H.H. Adams (Hieab); N. Jahanshad (Neda); G. Chauhan (Ganesh); J.L. Stein; E. Hofer (Edith); M.E. Rentería (Miguel); J.C. Bis (Joshua); A. Arias-Vásquez (Alejandro); Ikram, M.K. (M. Kamran); S. Desrivières (Sylvane); M.W. Vernooij (Meike); L. Abramovic; S. Alhusaini (Saud); N. Amin (Najaf); M. Andersson (Micael); K. Arfanakis (Konstantinos); B. Aribisala (Benjamin); N.J. Armstrong (Nicola J.); L. Athanasiu (Lavinia); T. Axelsson (Tomas); A.H. Beecham (Ashley); A. Beiser (Alexa); M. Bernard (Manon); S.H. Blanton (Susan H.); M.M. Bohlken (Marc M.); M.P.M. Boks (Marco); L.B.C. Bralten (Linda); A.M. Brickman (Adam M.); Carmichael, O. (Owen); M.M. Chakravarty (M. Mallar); Q. Chen (Qiang); C.R.K. Ching (Christopher); V. Chouraki (Vincent); G. Cuellar-Partida (Gabriel); F. Crivello (Fabrice); A. den Braber (Anouk); Doan, N.T. (Nhat Trung); S.M. Ehrlich (Stefan); S. Giddaluru (Sudheer); A.L. Goldman (Aaron L.); R.F. Gottesman (Rebecca); O. Grimm (Oliver); M.D. Griswold (Michael); T. Guadalupe (Tulio); Gutman, B.A. (Boris A.); J. Hass (Johanna); U.K. Haukvik (Unn); D. Hoehn (David); A.J. Holmes (Avram); M. Hoogman (Martine); D. Janowitz (Deborah); T. Jia (Tianye); Jørgensen, K.N. (Kjetil N.); N. Karbalai (Nazanin); D. Kasperaviciute (Dalia); S. Kim (Shinseog); M. Klein (Marieke); B. Kraemer (Bernd); P.H. Lee (Phil); D.C. Liewald (David C.); L.M. Lopez (Lorna); M. Luciano (Michelle); C. MacAre (Christine); Marquand, A.F. (Andre F.); M. Matarin (Mar); R. Mather; M. Mattheisen (Manuel); McKay, D.R. (David R.); Milaneschi, Y. (Yuri); S. Muñoz Maniega (Susana); K. Nho (Kwangsik); A.C. Nugent (Allison); P. Nyquist (Paul); Loohuis, L.M.O. (Loes M. Olde); J. Oosterlaan (Jaap); M. Papmeyer (Martina); Pirpamer, L. (Lukas); B. Pütz (Benno); A. Ramasamy (Adaikalavan); Richards, J.S. (Jennifer S.); S.L. Risacher (Shannon); R. Roiz-Santiañez (Roberto); N. Rommelse (Nanda); S. Ropele (Stefan); E.J. Rose (Emma); N.A. Royle (Natalie); T. Rundek (Tatjana); P.G. Sämann (Philipp); Saremi, A. (Arvin); C.L. Satizabal (Claudia L.); L. Schmaal (Lianne); N.J. Schork (Nicholas); Shen, L. (Li); J. Shin (Jean); Shumskaya, E. (Elena); A.V. Smith (Albert Vernon); R. Sprooten (Roy); V.M. Strike (Vanessa); A. Teumer (Alexander); D. Tordesillas-Gutierrez (Diana); R. Toro (Roberto); D. Trabzuni (Danyah); S. Trompet (Stella); D. Vaidya (Dhananjay); J. van der Grond (Jeroen); S. van der Lee (Sven); Van Der Meer, D. (Dennis); M.M.J. Van Donkelaar (Marjolein M. J.); K.R. van Eijk (Kristel); T.G.M. van Erp (Theo G.); Van Rooij, D. (Daan); E. Walton (Esther); L.T. Westlye (Lars); C.D. Whelan (Christopher); B.G. Windham (B Gwen); A.M. Winkler (Anderson); K. Wittfeld (Katharina); G. Woldehawariat (Girma); A. Björnsson (Asgeir); Wolfers, T. (Thomas); L.R. Yanek (Lisa); Yang, J. (Jingyun); A.P. Zijdenbos; M.P. Zwiers (Marcel); I. Agartz (Ingrid); L. Almasy (Laura); D. Ames (David); Amouyel, P. (Philippe); O.A. Andreassen (Ole A.); S. Arepalli (Sampath); A.A. Assareh; S. Barral (Sandra); M.E. Bastin (Mark); Becker, D.M. (Diane M.); J.T. Becker; D.A. Bennett (David A.); J. Blangero (John); H. van Bokhoven (Hans); D.I. Boomsma (Dorret); H. Brodaty (Henry); R.M. Brouwer (Rachel); H.G. Brunner; M. Buckner; J.K. Buitelaar (Jan); K. Bulayeva (Kazima); W. Cahn (Wiepke); V.D. Calhoun Vince D. (V.); D.M. Cannon (Dara); G. Cavalleri (Gianpiero); Cheng, C.-Y. (Ching-Yu); S. Cichon (Sven); M.R. Cookson (Mark); A. Corvin (Aiden); B. Crespo-Facorro (Benedicto); J.E. Curran (Joanne); M. Czisch (Michael); A.M. Dale (Anders); G.E. Davies (Gareth); A.J. de Craen (Anton); E.J.C. de Geus (Eco); P.L. de Jager (Philip); G.I. de Zubicaray (Greig); I.J. Deary (Ian J.); S. Debette (Stéphanie); C. DeCarli (Charles); N. Delanty; C. Depondt (Chantal); A.L. DeStefano (Anita); A. Dillman (Allissa); S. Djurovic (Srdjan); D.J. Donohoe (Dennis); D.A. Drevets (Douglas); Duggirala, R. (Ravi); M.D. Dyer (Matthew); C. Enzinger (Christian); S. Erk; T. Espeseth (Thomas); Fedko, I.O. (Iryna O.); Fernández, G. (Guillén); L. Ferrucci (Luigi); S.E. Fisher (Simon); D. Fleischman (Debra); I. Ford (Ian); M. Fornage (Myriam); T. Foroud (Tatiana); P.T. Fox (Peter); C. Francks (Clyde); Fukunaga, M. (Masaki); Gibbs, J.R. (J. Raphael); D.C. Glahn (David); R.L. Gollub (Randy); H.H.H. Göring (Harald H.); R.C. Green (Robert C.); O. Gruber (Oliver); V. Gudnason (Vilmundur); S. Guelfi (Sebastian); Håberg, A.K. (Asta K.); N.K. Hansell (Narelle); J. Hardy (John); C.A. Hartman (C.); Hashimoto, R. (Ryota); K. Hegenscheid (Katrin); J. Heinz (Judith); S. Le Hellard (Stephanie); D.G. Hernandez (Dena); D.J. Heslenfeld (Dirk); Ho, B.-C. (Beng-Choon); P.J. Hoekstra (Pieter); W. Hoffmann (Wolfgang); A. Hofman (Albert); F. Holsboer (Florian); G. Homuth (Georg); N. Hosten (Norbert); J.J. Hottenga (Jouke Jan); M.J. Huentelman (Matthew); H.H. Pol; Ikeda, M. (Masashi); Jack, C.R. (Clifford R.); S. Jenkinson (Sarah); R. Johnson (Robert); Jönsson, E.G. (Erik G.); J.W. Jukema; R. Kahn; Kanai, R. (Ryota); I. Kloszewska (Iwona); Knopman, D.S. (David S.); P. Kochunov (Peter); Kwok, J.B. (John B.); S. Lawrie (Stephen); H. Lemaître (Herve); X. Liu (Xinmin); D.L. Longo (Dan L.); O.L. Lopez (Oscar L.); S. Lovestone (Simon); Martinez, O. (Oliver); J.-L. Martinot (Jean-Luc); V.S. Mattay (Venkata S.); McDonald, C. (Colm); A.M. McIntosh (Andrew); McMahon, F.J. (Francis J.); McMahon, K.L. (Katie L.); P. Mecocci (Patrizia); I. Melle (Ingrid); Meyer-Lindenberg, A. (Andreas); S. Mohnke (Sebastian); Montgomery, G.W. (Grant W.); D.W. Morris (Derek W); T.H. Mosley (Thomas H.); T.W. Mühleisen (Thomas); B. Müller-Myhsok (B.); M.A. Nalls (Michael); M. Nauck (Matthias); T.E. Nichols (Thomas); W.J. Niessen (Wiro); M.M. Nöthen (Markus); L. Nyberg (Lars); Ohi, K. (Kazutaka); R.L. Olvera (Rene); R.A. Ophoff (Roel); M. Pandolfo (Massimo); T. Paus (Tomas); Z. Pausova (Zdenka); B.W.J.H. Penninx (Brenda); Pike, G.B. (G. Bruce); S.G. Potkin (Steven); B.M. Psaty (Bruce); S. Reppermund; M. Rietschel (M.); J.L. Roffman (Joshua); N. Seiferth (Nina); J.I. Rotter (Jerome I.); M. Ryten (Mina); Sacco, R.L. (Ralph L.); P.S. Sachdev (Perminder); A.J. Saykin (Andrew); R. Schmidt (Reinhold); Schmidt, H. (Helena); C.J. Schofield (Christopher); Sigursson, S. (Sigurdur); Simmons, A. (Andrew); A. Singleton (Andrew); S.M. Sisodiya (Sanjay); Smith, C. (Colin); J.W. Smoller; H. Soininen (H.); V.M. Steen (Vidar); D.J. Stott (David J.); J. Sussmann (Jessika); A. Thalamuthu (Anbupalam); A.W. Toga (Arthur W.); B. Traynor (Bryan); J.C. Troncoso (Juan); M. Tsolaki (Magda); C. Tzourio (Christophe); A.G. Uitterlinden (André); Hernández, M.C.V. (Maria C. Valdés); M.P. van der Brug (Marcel); A. van der Lugt (Aad); N.J. van der Wee (Nic); N.E.M. van Haren (Neeltje E.); D. van 't Ent (Dennis); M.J.D. van Tol (Marie-José); B.N. Vardarajan (Badri); B. Vellas (Bruno); D.J. Veltman (Dick); H. Völzke (Henry); H.J. Walter (Henrik); J. Wardlaw (Joanna); A.M.J. Wassink (Annemarie); M.E. Weale (Michael); Weinberger, D.R. (Daniel R.); Weiner, M.W. (Michael W.); Wen, W. (Wei); E. Westman (Eric); T.J.H. White (Tonya); Wong, T.Y. (Tien Y.); Wright, C.B. (Clinton B.); R.H. Zielke (Ronald H.); A.B. Zonderman; N.G. Martin (Nicholas); C.M. van Duijn (Cock); M.J. Wright (Margaret); W.T. Longstreth Jr; G. Schumann (Gunter); H.J. Grabe (Hans Jörgen); B. Franke (Barbara); L.J. Launer (Lenore); S.E. Medland (Sarah Elizabeth); S. Seshadri (Sudha); P.M. Thompson (Paul); M.K. Ikram (Kamran)

    2017-01-01

    textabstractThe hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpi

  1. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

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

    Directory of Open Access Journals (Sweden)

    Rafael Silveira e Silva

    2014-12-01

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

  3. ACR appropriateness criteria radiologic management of infected fluid collections.

    Science.gov (United States)

    Lorenz, Jonathan M; Al-Refaie, Waddah B; Cash, Brooks D; Gaba, Ron C; Gervais, Debra A; Gipson, Matthew G; Kolbeck, Kenneth J; Kouri, Brian E; Marshalleck, Francis E; Nair, Ajit V; Ray, Charles E; Hohenwalter, Eric J

    2015-08-01

    The best management of infected fluid collections depends on a careful assessment of clinical and anatomic factors as well as an up-to-date review of the published literature, to be able to select from a host of multidisciplinary treatment options. This article reviews conservative, radiologic, endoscopic, and surgical options and their best application to infected fluid collections as determined by the ACR Appropriateness Criteria Expert Panel on Interventional Radiology. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application, by the panel, of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  4. Investigation of Appropriate Refractory Material for Laboratory Electritic Resistrance Furnance

    Directory of Open Access Journals (Sweden)

    J.B Agboola

    2009-07-01

    Full Text Available There have been numerous efforts to increase the local content of furnaces; hence the choice of appropriate refractory material for lining of locally manufactured furnaces has remained a major concern. This research work investigates the choice of appropriate local refractory material for the lining of laboratory electric resistance furnace.Electric resistance furnaces are extensively used in the laboratory for heat treatment of metals and alloys. Refractory binders such as silicon carbide were experimented upon for strength and resistance to high temperature.The results obtained showed that Kankara fireclay containing 15% SiC ( 5.70 % linear shrinkage , 46.2% apparent porosity, 1.77gkm³ Bulk density, 18 cycles of spalling tests at 1300°C, 5.253KN/m² of cold strength has appropriate properties for producing grooved bricks for lining of laboratory electric resistance Furnace.

  5. Appropriate Algorithms for Nonlinear Time Series Analysis in Psychology

    Science.gov (United States)

    Scheier, Christian; Tschacher, Wolfgang

    Chaos theory has a strong appeal for psychology because it allows for the investigation of the dynamics and nonlinearity of psychological systems. Consequently, chaos-theoretic concepts and methods have recently gained increasing attention among psychologists and positive claims for chaos have been published in nearly every field of psychology. Less attention, however, has been paid to the appropriateness of chaos-theoretic algorithms for psychological time series. An appropriate algorithm can deal with short, noisy data sets and yields `objective' results. In the present paper it is argued that most of the classical nonlinear techniques don't satisfy these constraints and thus are not appropriate for psychological data. A methodological approach is introduced that is based on nonlinear forecasting and the method of surrogate data. In artificial data sets and empirical time series we can show that this methodology reliably assesses nonlinearity and chaos in time series even if they are short and contaminated by noise.

  6. ACR appropriateness criteria: Permanent source brachytherapy for prostate cancer.

    Science.gov (United States)

    Davis, Brian J; Taira, Al V; Nguyen, Paul L; Assimos, Dean G; D'Amico, Anthony V; Gottschalk, Alexander R; Gustafson, Gary S; Keole, Sameer R; Liauw, Stanley L; Lloyd, Shane; McLaughlin, Patrick W; Movsas, Benjamin; Prestidge, Bradley R; Showalter, Timothy N; Vapiwala, Neha

    To provide updated American College of Radiology (ACR) appropriateness criteria for transrectal ultrasound-guided transperineal interstitial permanent source brachytherapy. The ACR appropriateness criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Permanent prostate brachytherapy (PPB) is a treatment option for appropriately selected patients with localized prostate cancer with low to very high risk disease. PPB monotherapy remains an appropriate and effective curative treatment for low-risk prostate cancer patients demonstrating excellent long-term cancer control and acceptable morbidity. PPB monotherapy can be considered for select intermediate-risk patients with multiparametric MRI useful in evaluation of such patients. High-risk patients treated with PPB should receive supplemental external beam radiotherapy (EBRT) along with androgen deprivation. Similarly, patients with involved pelvic lymph nodes may also be considered for such combined treatment but reported long-term outcomes are limited. Computed tomography-based postimplant dosimetry completed within 60 days of PPB is essential for quality assurance. PPB may be considered for treatment of local recurrence after EBRT but is associated with an increased risk of toxicity. Updated appropriateness criteria for patient evaluation, selection, treatment, and postimplant dosimetry are given. These criteria are intended to be advisory only with the final responsibility for patient care residing with the treating

  7. Selecting appropriate absorbent products to treat urinary incontinence.

    Science.gov (United States)

    Payne, Drew

    2015-11-01

    Urinary incontinence can have a significant negative effect on a person's life, especially if left unmanaged and untreated. Continence assessment, often carried out by community nurses, is an important element in the management of a person's urinary incontinence, and so is the selection of appropriate absorbent incontinence pads. This article reviews: the causes and effects of urinary incontinence; how to derive the most appropriate information from a continence assessment; strategies for selecting incontinence pads for a person, on the basis of the results of the continence assessment; and some of the problems and risks associated with the use of incontinence pads.

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

    Science.gov (United States)

    Li, Fangyue; Wichmann, Knut; Otterpohl, Ralf

    2009-01-01

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

  9. Targeting Appropriate Interventions to Minimize Deterioration of Drinking-water Quality in Developing Countries

    OpenAIRE

    Trevett, Andrew F.; Carter, Richard C.

    2008-01-01

    In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified ‘disease risk index' (DRI) designed to identify communities or households that are ‘most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed. It is concluded that incorpor...

  10. FY2006 Supplemental Appropriations: Iraq and Other International Activities; Additional Katrina Hurricane Relief

    Science.gov (United States)

    2006-04-14

    supplemental2_2_16_06. pdf ]; (Hereafter cited as OMB, FY2006 Supplemental War Request.) DOD, FY2006 Supplemental Request - war. the major elements of the...fy2007/ pdf /appendix/mil.pdf]. CRS compared appropriated levels to those reported in DFAS reports and those reported in the FY2007 budget to identify a...Crisis. The crisis in Darfur began in February 2003, when two rebel groups emerged to challenge the National Islamic Front ( NIF ) government in Darfur

  11. Application of Appropriate Use Criteria for Initial Transthoracic Echocardiography in an Academic Outpatient Pediatric Cardiology Program.

    Science.gov (United States)

    Safa, Raya; Aggarwal, Sanjeev; Misra, Amrit; Kobayashi, Daisuke

    2017-08-01

    Transthoracic echocardiography (TTE) is a non-invasive diagnostic modality for children with suspected heart disease. The American College of Cardiology published Appropriate Use Criteria (AUC) for an initial outpatient pediatric TTE in 2014 to promote effective care and improve resource utilization. The objective was to determine the appropriateness of TTE per the published AUC in a single academic pediatric cardiology clinic as a baseline performance quality measure. The echocardiography database was used to identify initial outpatient TTE in children during January-March 2014. TTE indications (appropriate [A], may be appropriate [M], or rarely appropriate [R]) and findings (normal, incidental, or abnormal) were recorded. The effect of AUC and age groups on yield of abnormal TTE findings was analyzed. Of the 2166 screened studies, our study cohort consisted of 247 TTEs. Indications rated A, M, and R were found in 129, 27, and 90, respectively, and 1 was unclassifiable. Majority of TTE (n = 183) were normal, although incidental findings were noted in 32 and abnormal findings in 32 cases. Abnormal findings were noted in 26/129 of A, 2/27 of M, and 4/90 of R. Indications rated A were significantly associated with yield of abnormal TTE findings, adjusted by age group. Infants and adolescents were more likely to have abnormal TTE findings compared to young children. Recently published AUC were validated for initial TTE in the outpatient pediatric cardiology clinic. Appropriateness rated by AUC was highly associated with yield of abnormal TTE findings and worked best in infants and adolescent.

  12. Ovarian volume throughout life

    DEFF Research Database (Denmark)

    Kelsey, Thomas W; Dodwell, Sarah K; Wilkinson, A Graham

    2013-01-01

    cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n=59,994) we have generated and robustly validated the first model of ovarian volume from...... to about 2.8 mL (95% CI 2.7-2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis...

  13. Resolution analyses for selecting an appropriate airborne electromagnetic (AEM) system

    DEFF Research Database (Denmark)

    Christensen, N.B.; Lawrie, Ken

    2012-01-01

    Abstract. The choice of an appropriate airborne electromagnetic system for a given task should be based on a comparative analysis of candidate systems, consisting of both theoretical considerations and field studies including test lines. It has become common practice to quantify the system...

  14. APPROPRIATENESS OF GIFTED CHILDREN SOCIALIZATION IN CONTEMPORARY SOCIOCULTURAL CONDITIONS

    Directory of Open Access Journals (Sweden)

    Rimma Litvak

    2012-01-01

    Full Text Available The article opens general appropriateness of one of the most important directions in working with gifted children that is socialization; it substantiatesappropriateness as an axiom scheme, providing successfulness of the examined process; authors deduce about general outlook of gifted children socialization.

  15. Influence of test and person characteristics on nonparametric appropriateness measurement

    NARCIS (Netherlands)

    Meijer, Rob R.; Molenaar, Ivo W.; Sijtsma, Klaas

    1994-01-01

    Appropriateness measurement in nonparametric item response theory modeling is affected by the reliability of the items, the test length, the type of aberrant response behavior, and the percentage of aberrant persons in the group. The percentage of simulees defined a priori as aberrant responders tha

  16. Influence of Test and Person Characteristics on Nonparametric Appropriateness Measurement

    NARCIS (Netherlands)

    Meijer, Rob R; Molenaar, Ivo W; Sijtsma, Klaas

    1994-01-01

    Appropriateness measurement in nonparametric item response theory modeling is affected by the reliability of the items, the test length, the type of aberrant response behavior, and the percentage of aberrant persons in the group. The percentage of simulees defined a priori as aberrant responders tha

  17. The Appropriation of Fine Art into Contemporary Narrative Picturebooks

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

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

  18. Computer Series, 50: Choosing an Appropriate Computer Language.

    Science.gov (United States)

    Owen, G. Scott

    1984-01-01

    Discusses the brief history of microcomputers, offering some predictions about hardware trends. Gives explicit criteria for judging a computer language and discusses different programing languages in terms of what has been used in the past, and why, and what might be appropriate for the future. (JN)

  19. Assessing Students' Perceptions of Inappropriate and Appropriate Teacher Humor

    Science.gov (United States)

    Frymier, Ann Bainbridge; Wanzer, Melissa Bekelja; Wojtaszczyk, Ann M.

    2008-01-01

    This study replicated and extended a preliminary typology of appropriate and inappropriate teacher humor and advanced three explanations for differences in interpretations of teacher humor. Students were more likely to view teacher humor as inappropriate when it was perceived as offensive and when it demeaned students as a group or individually.…

  20. Developing an Appropriate Goalball Unit for Secondary Physical Education

    Science.gov (United States)

    Laughlin, Michael K.; Happel, Kathleen

    2016-01-01

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

  1. The Importance of Introductory Statistics Students Understanding Appropriate Sampling Techniques

    Science.gov (United States)

    Menil, Violeta C.

    2005-01-01

    In this paper the author discusses the meaning of sampling, the reasons for sampling, the Central Limit Theorem, and the different techniques of sampling. Practical and relevant examples are given to make the appropriate sampling techniques understandable to students of Introductory Statistics courses. With a thorough knowledge of sampling…

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

    Directory of Open Access Journals (Sweden)

    Anderson de Oliveira

    2014-11-01

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

  3. 40 CFR 24.08 - Selection of appropriate hearing procedures.

    Science.gov (United States)

    2010-07-01

    ... complex and are necessary to protect human health and the environment prior to development of a permanent... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Selection of appropriate hearing procedures. 24.08 Section 24.08 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL...

  4. Relations between the technological standards and technological appropriation

    Directory of Open Access Journals (Sweden)

    Carlos Alberto PRADO GUERRERO

    2010-06-01

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

  5. The Archive Effect: Appropriation Films and the Experience of History

    Science.gov (United States)

    Baron, Jaimie Rachel

    2010-01-01

    Since the beginning of cinema, filmmakers have appropriated previously shot visual-- and later audiovisual--documents and recontextualized them in their own films for various ends. Because these documents have generally derived from official state or commercial film archives, they have come to be referred to as "archival documents." Endowed with…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  7. Appropriate spiritual care by physicians: a theological perspective.

    Science.gov (United States)

    Pembroke, Neil Francis

    2008-12-01

    It is argued that when spiritual care by physicians is linked to the empirical research indicating the salutary effect on health of religious beliefs and practices an unintended degradation of religion is involved. It is contended that it is much more desirable to see support for the patient's spirituality as part of holistic care. A proposal for appropriate spiritual care by physicians is offered.

  8. Even Sewage Is a Resource...for "Appropriate Technology."

    Science.gov (United States)

    Hand, Marge

    1980-01-01

    Recounts highlights of a 1980 weekend course at Queens College Environmental Center (New York) focusing on lessons from history and other cultures in using overlooked resources to develop "Appropriate Technology." Practical and innovative energy alternatives discussed include solar energy, wind power, indoor hydroponic farming, shellfish…

  9. Antibiotic prescribing in dutch nursing homes: how appropriate is it?

    NARCIS (Netherlands)

    Buul, L.W. van; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.; Greeff, S.C. de; Natsch, S.S.; Steen, J.T. van der; Hertogh, C.M.P.M.

    2015-01-01

    OBJECTIVE: To investigate the appropriateness of decisions to prescribe or withhold antibiotics for nursing home (NH) residents with infections of the urinary tract (UTI), respiratory tract (RTI), and skin (SI). DESIGN: Prospective study. SETTING: Ten NHs in the central-west region of the Netherland

  10. Antibiotic prescribing in Dutch nursing homes: how appropriate is it?

    NARCIS (Netherlands)

    Buul, L.W. van; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Greeff, S.C. de; Natsch, S.; Steen, J.T. van der; Hertogh, C.M.P.M.

    2015-01-01

    Objective: To investigate the appropriateness of decisions to prescribe or withhold antibiotics for nursing home (NH) residents with infections of the urinary tract (UTI), respiratory tract (RTI), and skin (SI). Design: Prospective study. Setting: Ten NHs in the central-west region of the Netherland

  11. Improving appropriate medication use for older people in primary care

    NARCIS (Netherlands)

    Kwint, H.F.

    2013-01-01

    Clinical pharmacy interventions for older people with polypharmacy can be divided in dispensing services (aimed at support of medication management), e.g. multidose dispensing systems, and medication reviews (aimed at appropriateness of the pharmacotherapy. The objective of this thesis is to describ

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

    Science.gov (United States)

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

    2001-01-01

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

  13. Nurse telephone triage: good quality associated with appropriate decisions.

    NARCIS (Netherlands)

    Huibers, A.M.J.; Keizer, E.; Giesen, P.H.J.; Grol, R.P.T.M.; Wensing, M.J.P.

    2012-01-01

    Background Triage at out-of-hours GP cooperatives (GPCs) is aimed at determining medical urgency and guiding decisions. Both medical knowledge and communication skills are required for this complex task. Objective To explore the impact of quality of consultation and estimated urgency on the appropri

  14. 34 CFR 104.33 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

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

  15. Cultural Appropriation, Performance, and Agency in Mexicana Parent Involvement

    Science.gov (United States)

    Galindo, Rene; Medina, Christina

    2009-01-01

    Parental agency is examined in the creation of a dance performance by a group of Mexican immigrant mothers that combined a mixture of genres into an educational message. The "folklorico" performance resulted from a process of cultural appropriation involving linguistic, cultural, and experiential "translations." This process was concerned with…

  16. The Appropriation of Fine Art into Contemporary Narrative Picturebooks

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

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

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

    NARCIS (Netherlands)

    Hall, B.H.; Sena, V.

    2014-01-01

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

  18. Appropriate Language Assessment in Content and Language Integrated Learning

    Science.gov (United States)

    Morgan, Carol

    2006-01-01

    This article describes a small-scale research project in two schools using content and language integrated learning (CLIL), one English and one Austrian, where in both cases there had been considerable misgivings about appropriate forms of assessment to match the different kinds of language skill developed in the CLIL process. Teachers were…

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

    Science.gov (United States)

    Harper, Vernon B., Jr.

    2008-01-01

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

  20. 34 CFR 300.17 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ..., elementary school, or secondary school education in the State involved; and (d) Are provided in conformity... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education. 300.17 Section 300.17 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

  1. Improving appropriate medication use for older people in primary care

    NARCIS (Netherlands)

    Kwint, H.F.

    2013-01-01

    Clinical pharmacy interventions for older people with polypharmacy can be divided in dispensing services (aimed at support of medication management), e.g. multidose dispensing systems, and medication reviews (aimed at appropriateness of the pharmacotherapy. The objective of this thesis is to

  2. Percutaneous Coronary Intervention Utilization and Appropriateness across the United States.

    Directory of Open Access Journals (Sweden)

    Michael P Thomas

    Full Text Available Substantial geographic variation exists in percutaneous coronary intervention (PCI use across the United States. It is unclear the extent to which high PCI utilization can be explained by PCI for inappropriate indications. The objective of this study was to examine the relationship between PCI rates across regional healthcare markets utilizing hospital referral regions (HRRs and PCI appropriateness.The number of PCI procedures in each HRR was obtained from the 2010 100% Medicare limited data set. HRRs were divided into quintiles of PCI utilization with increasing rates of utilization progressing to quintile 5. NCDR CathPCI Registry® data were used to evaluate patient characteristics, appropriate use criteria (AUC, and outcomes across the HRR quintiles defined by PCI utilization with the study population restricted to HRRs where ≥ 80% of the PCIs were performed at institutions participating in the registry. PCI appropriateness was defined using 2012 AUC by the American College of Cardiology (ACC/American Heart Association (AHA/The Society for Cardiovascular Angiography and Interventions (SCAI.Our study cohort comprised of 380,981 patients treated at 178 HRRs. Mean PCI rates per 1,000 increased from 4.6 in Quintile 1 to 10.8 in Quintile 5. The proportion of non-acute PCIs was 27.7% in Quintile 1 increasing to 30.7% in Quintile 5. Significant variation (p < 0.001 existed across the quintiles in the categorization of appropriateness across HRRs of utilization with more appropriate PCI in lower utilization areas (Appropriate: Q1, 76.53%, Q2, 75.326%, Q3, 75.23%, Q4, 73.95%, Q5, 72.768%; Inappropriate: Q1 3.92%, Q2 4.23%, Q3 4.32%, Q4 4.35%, Q5 4.05%; Uncertain: Q1 8.29%, Q2 8.84%, Q3 8.08%, Q4 9.01%, Q5 8.93%; Not Mappable: Q1 11.26%, Q2 11.67%, Q3 12.37%, Q4 12.69%, Q5 14.34%. There was no difference in risk-adjusted mortality across quintiles of PCI utilization.Geographic regions with lower PCI rates have a higher proportion of PCIs performed

  3. Percutaneous Coronary Intervention Utilization and Appropriateness across the United States

    Science.gov (United States)

    Thomas, Michael P.; Parzynski, Craig S.; Curtis, Jeptha P.; Seth, Milan; Nallamothu, Brahmajee K.; Chan, Paul S.; Spertus, John A.; Patel, Manesh R.; Bradley, Steven M.; Gurm, Hitinder S.

    2015-01-01

    Background Substantial geographic variation exists in percutaneous coronary intervention (PCI) use across the United States. It is unclear the extent to which high PCI utilization can be explained by PCI for inappropriate indications. The objective of this study was to examine the relationship between PCI rates across regional healthcare markets utilizing hospital referral regions (HRRs) and PCI appropriateness. Methods The number of PCI procedures in each HRR was obtained from the 2010 100% Medicare limited data set. HRRs were divided into quintiles of PCI utilization with increasing rates of utilization progressing to quintile 5. NCDR CathPCI Registry® data were used to evaluate patient characteristics, appropriate use criteria (AUC), and outcomes across the HRR quintiles defined by PCI utilization with the study population restricted to HRRs where ≥ 80% of the PCIs were performed at institutions participating in the registry. PCI appropriateness was defined using 2012 AUC by the American College of Cardiology (ACC)/American Heart Association (AHA)/The Society for Cardiovascular Angiography and Interventions (SCAI). Results Our study cohort comprised of 380,981 patients treated at 178 HRRs. Mean PCI rates per 1,000 increased from 4.6 in Quintile 1 to 10.8 in Quintile 5. The proportion of non-acute PCIs was 27.7% in Quintile 1 increasing to 30.7% in Quintile 5. Significant variation (p < 0.001) existed across the quintiles in the categorization of appropriateness across HRRs of utilization with more appropriate PCI in lower utilization areas (Appropriate: Q1, 76.53%, Q2, 75.326%, Q3, 75.23%, Q4, 73.95%, Q5, 72.768%; Inappropriate: Q1 3.92%, Q2 4.23%, Q3 4.32%, Q4 4.35%, Q5 4.05%; Uncertain: Q1 8.29%, Q2 8.84%, Q3 8.08%, Q4 9.01%, Q5 8.93%; Not Mappable: Q1 11.26%, Q2 11.67%, Q3 12.37%, Q4 12.69%, Q5 14.34%). There was no difference in risk-adjusted mortality across quintiles of PCI utilization. Conclusions Geographic regions with lower PCI rates have a higher

  4. Gifted Students: How to Identify Them and Meet Their Needs

    Science.gov (United States)

    Genco, Susan L.

    2010-01-01

    The federal government has been making strides to make the term "appropriate" an inclusive term that recognizes and addresses the special learning needs of all students. In an effort to appropriately educate students who have been identified as "gifted," the New Jersey State Board of Education readopted Standards and Assessment…

  5. The Energy Forum of Sri Lanka: Working toward appropriate expertise

    Science.gov (United States)

    Nieusma, Dean

    Taking my cue from the knowledge base and practices comprising appropriate technology development, and building on politics of expertise scholarship, this dissertation develops the concept of appropriate expertise: the combination of social and technical competences required to address marginalization through technological interventions. The dissertation asks what appropriate expertise looks like "on the ground" in the context of development as practiced by an exceptional group of technology designers from the Energy Forum of Sri Lanka: What design goals did they strive toward? What challenges did they face? What strategies did they employ? In an effort to answer these questions, the dissertation looks at how these designers interacted across a range of contexts with a broad spectrum of people and institutions, each with its own expertise to draw upon. In particular, it looks at how they situated their work in a highly contoured field of social power, where different types of expertise were used as resources for reinforcing or resisting existing power relations. I use the concept relations of expertise to denote the structure of expert interactions across multiple contexts of activity. Although this concept links to broad political-economic conditions that order varied expert practices, my analytic focus is at a different level: the situated experiences of expert practitioners. By starting with ground-level practices and understandings, I argue that creating new relations of expertise---that is, changing the nature of the interactions among experts and between experts and those they work with---is the key way my informants worked to legitimate marginalized perspectives and thereby empower marginalized social groups around technology-development practices. Appropriate expertise enables the creation of appropriate technologies, but it does more. It enables the creation of new relations of expertise, both through inspiring new forms of interpersonal interaction

  6. MEDIA APPROPRIATIONS OF BLACK FEMINISM IN BRAZILIAN CONTEMPORANEITY

    Directory of Open Access Journals (Sweden)

    Telma Sueli Pinto Johnson

    2017-03-01

    Full Text Available RESUMO Este artigo examina apropriações midiáticas pelo feminismo negro baseadas em reflexões teórico-conceituais sobre a problemática da comunicação em sociedades midiatizadas e suas relações com a literacia midiática. O Instituto da Mulher Negra Geledés, fundado em 1998 no período da redemocratização brasileira, constitui-se no objeto de investigação. O movimento Geledés foi observado e mapeado em sua página no site de rede social Facebook, durante um período consecutivo de oito semanas em 2016, com o propósito de identificar modalidades de interações entre seus visitantes. A análise dedica-se, para além das postagens do Geledés, a apreender e compreender o que acontece na esfera da recepção quando se trata de tipos de usos, apropriações e produções de sentidos. Um construto metodológico baseado na Cartografia de Controvérsias (CC foi operacionalizado para analisar as interações dos actantes sociais do Geledés no Facebook, revelando predominância de interações passivas e elevado número de comentários participativos desqualificados sob a ótica do debate público racional.   PALAVRAS-CHAVE: Comunicação; Redes Sociais; Feminismo Negro; Literacia Midiática; Cartografia de Controvérsias.     ABSTRACT This article examines media appropriations by black feminism based on theoretical-conceptual reflections on the problem of communication in mediatized societies and their relations with media literacy. The Geledés Black Women's Institute, founded in 1998 in the period of Brazilian redemocratization, is the object of this research. The Geledés movement was observed and mapped on its page on the social networking site Facebook, during a consecutive period of eight weeks in 2016, with the purpose of identifying modalities of interactions among its visitors. The analysis is dedicated, in addition to the posts of the Geledés, to apprehend and to understand what happens in the sphere of the reception when

  7. Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: Predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Candan, Ozkan; Gecmen, Cetin; Bayam, Emrah; Guner, Ahmet; Celik, Mehmet; Doğan, Cem

    2017-06-01

    In this study, we investigated whether mechanical dispersion which reflects electrical abnormality and other echocardiographic and clinic parameters predict appropriate ICD shock in patients undergone ICD implantation for hypertrophic cardiomyopathy. Sixty-three patients who received ICD implantation for primary or secondary prevention were included in the study. Patients' clinical, electrocardiographic, 2D classic, and speckle tracking echocardiographic data were collected. Mechanical dispersion was defined as the standard deviation of time to peak negative strain in 18 left ventricular segments. Appropriate ICD therapy was defined as cardioversion or defibrillation due to ventricular tachycardia or fibrillation. Patients were divided into two groups as occurrence or the absence of appropriate ICD therapy. A total of 17 (26.9%) patients were observed to have an appropriate ICD therapy during follow-up periods. In patients who performed appropriate ICD therapy, a larger left atrial volume index, higher sudden cardiac death (SCD)-Risk Score, longer mechanical dispersion, and decreased global longitudinal peak strain (GLPS) were observed. In multivariate logistic regression analysis, including (GLPS, mechanical dispersion, LAVi, and SCD-Risk Score) was used to determine independent predictors of occurrence of appropriate ICD therapy during the follow-up. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be independent predictors of occurrence of appropriate ICD therapy. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be predictive for appropriate ICD therapy in patients receiving ICD implantation. Readily measurable mechanical dispersion and GLPS could be helpful to distinguish patients at high risk who could optimally benefit from ICD therapy. © 2017, Wiley Periodicals, Inc.

  8. Mean nuclear volume

    DEFF Research Database (Denmark)

    Mogensen, O.; Sørensen, Flemming Brandt; Bichel, P.

    1999-01-01

    We evaluated the following nine parameters with respect to their prognostic value in females with endometrial cancer: four stereologic parameters [mean nuclear volume (MNV), nuclear volume fraction, nuclear index and mitotic index], the immunohistochemical expression of cancer antigen (CA125...

  9. Textual appropriation: totalitarian violence in Shakespeare’s Macbeth and Textual appropriation: totalitarian violence in Shakespeare’s Macbeth and

    Directory of Open Access Journals (Sweden)

    Anna Stegh Camati

    2008-04-01

    Full Text Available Adaptations and vernacular appropriations on page and stage offer alternative readings of Shakespeare’s plays, mediated by heterogeneous forces of race, language and culture Appropriation can take multiple forms, as each generation attempts to redefine Shakespeare in contemporary terms in an ongoing process of mutation (Marsden 9. In an essay entitled “The Postcolonial/Postmodern Shakespeare”, Jyotsna Singh states that the postmodernist tendency to pluralize and decenter all totalizing assumptions of the centre has altered traditional values: “the Shakespearean text is no longer sacrosanct: instead it is invaded by heteroglossia, or multiplicity of styles and forms in the Bakhtinian sense, that disrupt the cultural authority of the official English Shakespeare” (Kerr et alii 39. Adaptations and vernacular appropriations on page and stage offer alternative readings of Shakespeare’s plays, mediated by heterogeneous forces of race, language and culture Appropriation can take multiple forms, as each generation attempts to redefine Shakespeare in contemporary terms in an ongoing process of mutation (Marsden 9. In an essay entitled “The Postcolonial/Postmodern Shakespeare”, Jyotsna Singh states that the postmodernist tendency to pluralize and decenter all totalizing assumptions of the centre has altered traditional values: “the Shakespearean text is no longer sacrosanct: instead it is invaded by heteroglossia, or multiplicity of styles and forms in the Bakhtinian sense, that disrupt the cultural authority of the official English Shakespeare” (Kerr et alii 39.

  10. Analysing Java Identifier Names

    OpenAIRE

    Butler, Simon

    2016-01-01

    Identifier names are the principal means of recording and communicating ideas in source code and are a significant source of information for software developers and maintainers, and the tools that support their work. This research aims to increase understanding of identifier name content types - words, abbreviations, etc. - and phrasal structures - noun phrases, verb phrases, etc. - by improving techniques for the analysis of identifier names. The techniques and knowledge acquired can be appl...

  11. Identifiability in stochastic models

    CERN Document Server

    1992-01-01

    The problem of identifiability is basic to all statistical methods and data analysis, occurring in such diverse areas as Reliability Theory, Survival Analysis, and Econometrics, where stochastic modeling is widely used. Mathematics dealing with identifiability per se is closely related to the so-called branch of ""characterization problems"" in Probability Theory. This book brings together relevant material on identifiability as it occurs in these diverse fields.

  12. Analytic torsion and symplectic volume

    DEFF Research Database (Denmark)

    McLellan, Brendan Donald Kenneth

    2013-01-01

    This article studies the abelian analytic torsion on a closed, oriented, quasi-regular Sasakian three-manifold and identifies this quantity as a specific multiple of the natural unit symplectic volume form on the moduli space of flat abelian connections. This identification effectively computes...... the analytic torsion explicitly in terms of Seifert data for a given quasi-regular Sasakian structure on a three-manifold....

  13. Disney animation: Global diffusion and local appropriation of culture

    Directory of Open Access Journals (Sweden)

    Souad Belkhyr

    2012-08-01

    Full Text Available Children’s media products reflect the cultural values of their producers as well as the social, political and economic conditions under which they were produced. Watching an animated feature, therefore, cannot be regarded as an innocent and simple act of consumption. It rather involves a complex process of coding/decoding and appropriating cultural meanings. The relation between structured patterns of global communication on the one hand, and the local conditions under which Disney cartoon products are marketed and consumed in the Arab world, on the other, can be perceived as the main axis of globalized diffusion and local appropriation of American cultural values and lifestyle. The consequences of which are difficult to foretell.

  14. What is the appropriate business continuity management staff size?

    Science.gov (United States)

    Walch, Damian; Merante, Jason

    2008-04-01

    This paper explores the question 'how many professionals does it take to build a resilient enterprise?' The paper describes the various segments of a comprehensive business continuity, disaster recovery and crisis management programme and then delves into the variables that determine the appropriate number of professionals required for the company. It is a thought-provoking examination that can help anybody in the `c-suite' examine their particular requirements, characteristics and culture to determine appropriate staffing levels. The reader will have a quantitative approach for determining the size and structure of a resilient enterprise which can provide a solid foundation for a programme that adapts and adjusts quickly and cost-effectively to disasters and events. It can also help build executive support for a programme management office which could ultimately increase the overall success of the programme.

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

    DEFF Research Database (Denmark)

    Martins, Bruno Oliveira

    2015-01-01

    institutions such as the European Parliament or the Court of Justice of the EU. In this chapter it is argued that the constitutional foundations of the EU play a decisive role in granting legitimacy to EU counter-terrorism law and policy and to ensuring its social acceptability. Combining sociological...... institutionalist theory with insights from the New Haven school, namely its societal and process-oriented conceptions of law, it crosses legal and political science traditions to explore the ways in which EU counter-terrorism law and policy acquire and maintain social appropriateness....... versus justice equation, on the issues of privacy and data protection, and on the broader respect for fundamental rights more generally. In this process, the legitimacy and the social appropriateness of some of these measures have been questioned, both at the societal level and before or by European...

  16. Appropriation and the uses of comics in information science literature

    Directory of Open Access Journals (Sweden)

    Valdir José Morigi

    2016-04-01

    Full Text Available Introduction: This article realizes the bibliographic mapping in the studies of Information Science, to demonstrate the development of comics in this area. Objective: Mapping studies about comics made in Information Science, showing their uses and appropriations in the dissemination's process of the collected results in this research. Methodology: Bibliographical research with qualitative-quantitative approach. Results: The comics are subject of research in Information Science from the perspective of the dissemination and interpretation of informatiom. Its use helps in the learning of the users and scholars shows its benefits. The studies demonstrate that the comics provide a mental effort because the visuals also allow learning. Studies also show that they can be used for research, where are showed the knowledge acquired in reading of comics, in other words, the knowledge without scientific basis. Conclusions: Concludes that some studies of Information Science determine which purposes the comics are appropriated by users.

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

    LENUS (Irish Health Repository)

    Robson, Michael

    2013-04-01

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

  18. Measuring Appropriate Antimicrobial Use: Attempts at Opening the Black Box.

    Science.gov (United States)

    Spivak, Emily S; Cosgrove, Sara E; Srinivasan, Arjun

    2016-12-15

    Indiscriminate antimicrobial use has plagued medicine since antibiotics were first introduced into clinical practice >70 years ago. Infectious diseases physicians and public health officials have advocated for preservation of these life-saving drugs for many years. With rising burden of antimicrobial-resistant organisms and Clostridium difficile infections, halting unnecessary antimicrobial use has become one of the largest public health concerns of our time. Inappropriate antimicrobial use has been quantified in various settings using numerous definitions; however, no established reference standard exists. With mounting national efforts to improve antimicrobial use, a consensus definition and standard method of measuring appropriate antimicrobial use is imperative. We review existing literature on systematic approaches to define and measure appropriate antimicrobial use, and describe a collaborative effort at developing standardized audit tools for assessing the quality of antimicrobial prescribing.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, G.

    1981-03-01

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

  20. Evaluating localized prostate cancer and identifying candidates for focal therapy.

    Science.gov (United States)

    Sartor, A Oliver; Hricak, Hedvig; Wheeler, Thomas M; Coleman, Jonathan; Penson, David F; Carroll, Peter R; Rubin, Mark A; Scardino, Peter T

    2008-12-01

    Can focal therapy successfully control prostate cancer? Also, if so, which patients should be considered eligible? With limited data available from relatively few patients, these questions are difficult to answer. At this writing, the most likely candidates for focal therapy are patients with low-risk, small-volume tumors, located in 1 region or sector of the prostate, who would benefit from early intervention. The difficulty lies in reliably identifying these men. The larger number of cores obtained in each needle biopsy session has increased both the detection of prostate cancer and the potential risk of overtreating many patients whose cancers pose very little risk to life or health. Urologists typically perform at least a 12-core template biopsy. Although the debate continues about the optimal template, laterally and peripherally directed biopsies have been shown to improve the diagnostic yield. However, as many as 25% of tumors arise anteriorly and can be missed with peripherally directed techniques. Prostate cancer tends to be multifocal, even in its earliest stages. However, the secondary cancers are usually smaller and less aggressive than the index cancer. They appear similar to the incidental cancers found in cystoprostatectomy specimens and appear to have little effect on prognosis in surgical series. When a single focus of cancer is found in 1 core, physicians rightly suspect that more foci of cancer are present in the prostate. Assessing the risk in these patients is challenging when determined by the biopsy data alone. To predict the presence of a very low-risk or "indolent" cancer, nomograms have been developed to incorporate clinical stage, Gleason grade, prostate-specific antigen levels, and prostate volume, along with the quantitative analysis of the biopsy results. Transperineal "mapping" or "saturation" biopsies have been advocated to detect cancers missed or underestimated by previous transrectal biopsies. This approach could provide the

  1. Diligence in determining the appropriate form of stationarity

    Directory of Open Access Journals (Sweden)

    André Heymans

    2014-02-01

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

  2. Disney animation: Global diffusion and local appropriation of culture

    OpenAIRE

    Souad Belkhyr

    2012-01-01

    Children’s media products reflect the cultural values of their producers and the social, political and economic conditions under which they were produced. Watching an animated feature, therefore, cannot be regarded as an innocent and simple act of consumption. It rather involves a complex process of coding/decoding and appropriating cultural meanings. The relation between structured patterns of communication under globalization, on one hand, and the local conditions under which Disney cartoon...

  3. Esthetic crown lengthening: appropriate diagnosis for achieving gingival balance.

    Science.gov (United States)

    Kao, Richard T; Dault, Scott; Frangadakis, Kenneth; Salehieh, J J

    2008-03-01

    A gummy smile poses a restorative challenge for dentists attempting to achieve ideal esthetics. Many have advocated the use of a gingivectomy or laser-assisted gingival contouring procedure. However, this simplistic approach can potentially create a mucogingival defect or a biological width violation. To avoid these periodontal-restorative complications, it is important during treatment planning to assess the anatomical relationship that resulted in the gummy smile and choose the appropriate surgical treatment to eliminate this condition.

  4. ACR Appropriateness Criteria(®) Radiologic Management of Mesenteric Ischemia.

    Science.gov (United States)

    Fidelman, Nicholas; AbuRahma, Ali F; Cash, Brooks D; Kapoor, Baljendra S; Knuttinen, M-Grace; Minocha, Jeet; Rochon, Paul J; Shaw, Colette M; Ray, Charles E; Lorenz, Jonathan M

    2017-05-01

    Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Recommended therapy for chronic mesenteric ischemia includes angioplasty with or without stent placement and, if an endovascular approach is not possible, surgical bypass or endarterectomy. The diagnosis of median arcuate ligament syndrome is controversial, but surgical release may be appropriate depending on the clinical situation. Venous mesenteric ischemia may respond to systemic anticoagulation alone. Transhepatic or transjugular superior mesenteric vein catheterization and thrombolytic infusion can be offered depending on the severity of symptoms, condition of the patient, and response to systemic anticoagulation. Adjunct transjugular intrahepatic portosystemic shunt creation can be considered for outflow improvement. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College

  5. Evaluating the appropriateness of electronic information resources for learning.

    Science.gov (United States)

    Saparova, Dinara; Nolan, Nathanial S

    2016-01-01

    Current US medical students have begun to rely on electronic information repositories-such as UpToDate, AccessMedicine, and Wikipedia-for their pre-clerkship medical education. However, it is unclear whether these resources are appropriate for this level of learning due to factors involving information quality, level of evidence, and the requisite knowledgebase. This study evaluated appropriateness of electronic information resources from a novel perspective: amount of mental effort learners invest in interactions with these resources and effects of the experienced mental effort on learning. Eighteen first-year medical students read about three unstudied diseases in the above-mentioned resources (a total of fifty-four observations). Their eye movement characteristics (i.e., fixation duration, fixation count, visit duration, and task-evoked pupillary response) were recorded and used as psychophysiological indicators of the experienced mental effort. Post reading, students' learning was assessed with multiple-choice tests. Eye metrics and test results constituted quantitative data analyzed according to the repeated Latin square design. Students' perceptions of interacting with the information resources were also collected. Participants' feedback during semi-structured interviews constituted qualitative data and was reviewed, transcribed, and open coded for emergent themes. Compared to AccessMedicine and Wikipedia, UpToDate was associated with significantly higher values of eye metrics, suggesting learners experienced higher mental effort. No statistically significant difference between the amount of mental effort and learning outcomes was found. More so, descriptive statistical analysis of the knowledge test scores suggested similar levels of learning regardless of the information resource used. Judging by the learning outcomes, all three information resources were found appropriate for learning. UpToDate, however, when used alone, may be less appropriate for first

  6. HOW TO SELECT APPROPRIATE HUMAN RESOURCE CONTROLLING INDICATORS

    OpenAIRE

    Monika Dugelova; Mariana Strenitzerova

    2015-01-01

    Human resource controlling represents a company’s strategic method to support its role is planning, checking, and managing—including information supplement for human resources department. Human resource controlling helps with optimization and transformation of human resource functions and with general human resource management. Our survey deals with the implementation of human resource controlling in information technology companies. The selection of appropriate human resource controlling too...

  7. Defense: FY2012 Budget Request, Authorization and Appropriations

    Science.gov (United States)

    2012-02-13

    Senate versions of the bill would have done). The ships for which most of the total cost is authorized in FY2012 include two Virginia -class submarines, a...New START Treaty: Central Limits and Key Provisions, by Amy F. Woolf . Defense: FY2012 Budget Request, Authorization and Appropriations...Missile Defense and Offensive Arms Reductions: A Review of the Historical Record, by Steven A. Hildreth and Amy F. Woolf . Defense: FY2012 Budget

  8. Appropriateness of colonoscopy: Diagnostic yield and safety in guidelines

    Institute of Scientific and Technical Information of China (English)

    Mario Grassini; Carlo Verna; Paolo Niola; Monica Navino; Edda Battaglia; Gabrio Bassotti

    2007-01-01

    AIM:To evaluate if the guidelines for the appropriateness of performing colonoscopy by American Society for Gastrointestinal Endoscopy (AGSE) and Italian Society of Digestive Endoscopy (SIED) yield a good diagnostic efficacy and do not present risks of missing important colonic pathologies in an Italian population sample.METHODS:A total of 1017 consecutive patients (560 men and 457 women; mean age 64.4 ± 16 years)referred to an open-access endoscopy unit for colonoscopy from July 2004 to May 2006 were evaluated according to ASGE and SIED guidelines for appropriateness of performing the procedure. Diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of colonoscopies performed.RESULTS:About 85.2% patients underwent colonoscopy that was considered appropriate based on at least one ASGE or SIED criterion,while it was considered inappropriate for 14.8% of patients. The diagnostic yield of colonoscopy was significantly higher for appropriate colonoscopies (26.94% vs 10.6%,P<0.001) than for inappropriate colonoscopies (5.3%). There was no missed colorectal cancer following the ASGE/SIED criteria.CONCLUSION:ASGE/SIED guidelines have shown a good diagnostic yield and the rate of missing relevant colonic pathologies seems very low. Unfortunately,the percentage of inappropriate referrals for colonoscopy in an open-access endoscopy system is still high,despite the number of papers published on the issue and the definition of international guidelines. Further steps are required to update and standardize the guidelines toincrease their diffusion and to promote educational programs for general practitioners.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-15

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

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

    Science.gov (United States)

    Eckel, Edward J

    2011-09-01

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

  11. ACR Appropriateness Criteria(®) Suspected Liver Metastases.

    Science.gov (United States)

    Kaur, Harmeet; Hindman, Nicole M; Al-Refaie, Waddah B; Arif-Tiwari, Hina; Cash, Brooks D; Chernyak, Victoria; Farrell, James; Grajo, Joseph R; Horowitz, Jeanne M; McNamara, Michelle M; Noto, Richard B; Qayyum, Aliya; Lalani, Tasneem; Kamel, Ihab R

    2017-05-01

    Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning). The optimization of imaging parameters is a vital factor in the success of either modality. PET/CT, intraoperative ultrasound are used to supplement CT and MRI. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Irrigation infrastructure and water appropriation rules for food security

    Science.gov (United States)

    Gohar, Abdelaziz A.; Amer, Saud A.; Ward, Frank A.

    2015-01-01

    In the developing world's irrigated areas, water management and planning is often motivated by the need for lasting food security. Two important policy measures to address this need are improving the flexibility of water appropriation rules and developing irrigation storage infrastructure. Little research to date has investigated the performance of these two policy measures in a single analysis while maintaining a basin wide water balance. This paper examines impacts of storage capacity and water appropriation rules on total economic welfare in irrigated agriculture, while maintaining a water balance. The application is to a river basin in northern Afghanistan. A constrained optimization framework is developed to examine economic consequences on food security and farm income resulting from each policy measure. Results show that significant improvements in both policy aims can be achieved through expanding existing storage capacity to capture up to 150 percent of long-term average annual water supplies when added capacity is combined with either a proportional sharing of water shortages or unrestricted water trading. An important contribution of the paper is to show how the benefits of storage and a changed water appropriation system operate under a variable climate. Results show that the hardship of droughts can be substantially lessened, with the largest rewards taking place in the most difficult periods. Findings provide a comprehensive framework for addressing future water scarcity, rural livelihoods, and food security in the developing world's irrigated regions.

  13. Appropriate and inappropriate referrals to a unit of conservative dentistry.

    Science.gov (United States)

    Burke, F J; Goodall, C A; Hayes, F

    1999-10-01

    Inappropriate referrals to secondary care are an unnecessary cost, notwithstanding the effect on waiting lists. It is essential therefore that only those patients whose referrals are appropriate are actually referred for secondary care. This project aimed to determine whether referrals to a unit of conservative dentistry are appropriate. The records of 120 consecutive new patient referrals who had been examined by one consultant in the unit of conservative dentistry at Glasgow Dental Hospital and School were obtained. A pro forma was designed on which synopses of the relevant clinical findings were written. These synopses were examined by four general dental practitioners (GDPs). A referral was considered appropriate if three or four of the GDPs considered it to be so, a referral was considered inappropriate if three or four of the GDPs concurred. Of the 120 cases examined, a majority of the GDP assessors agreed that 54 warranted referral, with 23 of these being referrals for toothwear. Agreement was not reached in 35 cases, while 31 referrals were considered inappropriate. Of the 31 cases which were considered inappropriate, 27 were thought to be within the scope of general practitioners. In conclusion, the results suggest that around one quarter of referrals to a unit of conservative dentistry are inappropriate. It would appear that a number of GDPs are unable or unwilling to treat a variety of simple conditions in practice and it may be that the development of referral guidelines is necessary to ensure that only those patients who merit a specialist opinion are referred for this service.

  14. The Concept of Appropriateness in Issuing Administrative Acts

    Directory of Open Access Journals (Sweden)

    Iulian Nedelcu

    2011-05-01

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

  15. Time for the Global Rollout of Endoscopic Lung Volume Reduction.

    Science.gov (United States)

    Koegelenberg, Coenraad F N; Slebos, Dirk-Jan; Shah, Pallav L; Theron, Johan; Dheda, Keertan; Allwood, Brian W; Herth, Felix J F

    2015-01-01

    Chronic obstructive pulmonary disease remains one of the most common causes of morbidity and mortality globally. The disease is generally managed with pharmacotherapy, as well as guidance about smoking cessation and pulmonary rehabilitation. Endoscopic lung volume reduction (ELVR) has been proposed for the treatment of advanced emphysema, with the aim of obtaining the same clinical and functional advantages of surgical lung volume reduction whilst potentially reducing risks and costs. There is a growing body of evidence that certain well-defined sub-groups of patients with advanced emphysema may benefit from ELVR, provided the selection criteria are met and a systematic approach is followed. ELVR devices, particularly unidirectional valves and coils, are currently being rolled out to many countries outside of the U.S.A. and Europe, although very few centres currently have the capacity to correctly evaluate and provide ELVR to prospective candidates. The high cost of these interventions underpins the need for careful patient selection to best identify those who may or may not benefit from ELVR-related procedures. The aim of this review is to provide the practicing pulmonologist with an overview of the practical aspects and current evidence for the use of the various techniques available, and to suggest an evidence-based approach for the appropriate use of these devices, particularly in emerging markets, where there should be a drive to develop and equip key specialised ELVR units.

  16. Developmentally Appropriate Technology in Early Childhood (DATEC in Botswana: In-Service Teachers’ Perspectives

    Directory of Open Access Journals (Sweden)

    Kabita BOSE

    2009-06-01

    Full Text Available Developmentally Appropriate Technology in Early Childhood (DATEC aims to identify themost appropriate applications of Information and Communication Technology to support thedevelopment of children under eight years of age. Botswana has a unique spread ofpopulation density and deep-rooted socio-cultural values. There is a need to address thecompatibility of these aspects with the application of Information and CommunicationTechnology in the proposed Early Childhood Education programmes throughout Botswana.The researcher felt that the views of the in-service teachers, (who are now students of theBachelor of Education Programme in the University of Botswana and have specialized inEarly Childhood Education, would be a valuable input towards an appropriate EarlyChildhood Education curriculum. Hence, a study was proposed to assess the views of theteachers, regarding DATEC in Botswana. Forty (40 fourth year students (Level 400 ofBachelor of Education (Primary Programme of University of Botswana, who specialised inearly years and have a good exposure to Information and Communication Technologyconstituted the sample. Their views were obtained from a semi-structured questionnaire.Both quantitative and qualitative approaches were used for analysis of data. The findings ofthe study showed that the respondents strongly believed that an integration of Informationand Communication Technology with the Early Childhood Education curriculum isnecessary to enhance an overall development of young children. Computers with relevantresources were thought to be the best Information and Communication Technologyapplications in Early Childhood Education for a developmentally appropriate programmethat would provide educational concepts, problem solving skills and creativity. However,they emphasised the need to make the technology socio-culturally compatible to citizens ofBotswana (Batswana to facilitate developmentally appropriate education of young children.The study

  17. Are factor analytical techniques used appropriately in the validation of health status questionnaires?

    DEFF Research Database (Denmark)

    de Vet, Henrica C W; Adér, Herman J; Terwee, Caroline B

    2005-01-01

    Factor analysis is widely used to evaluate whether questionnaire items can be grouped into clusters representing different dimensions of the construct under study. This review focuses on the appropriate use of factor analysis. The Medical Outcomes Study Short Form-36 (SF-36) is used as an example....... Articles were systematically searched and assessed according to a number of criteria for appropriate use and reporting. Twenty-eight studies were identified: exploratory factor analysis was performed in 22 studies, confirmatory factor analysis was performed in five studies and in one study both were...... of methods is crucial for correct interpretation of the results and verification of the conclusions. Our list of criteria may be useful for journal editors, reviewers and researchers who have to assess publications in which factor analysis is applied....

  18. Space use as an indicator of enclosure appropriateness in African wild dogs (Lycaon pictus).

    Science.gov (United States)

    Hunter, Sally C; Gusset, Markus; Miller, Lance J; Somers, Michael J

    2014-01-01

    A clear understanding of space use is required to more fully understand biological requirements of nonhuman animals in zoos, aid the design of exhibits, and maximize the animals' welfare. This study used electivity indexes to assess space use of two packs of African wild dogs (Lycaon pictus) and the appropriateness of two naturalistic, outdoor enclosures at the San Diego Zoo and Bronx Zoo. The results identified enclosure features that were both underutilized and overutilized. They suggest that replacing underutilized areas with features similar to areas that were overutilized may provide more preferred opportunities for the animals. Assessing space use of animals in human care may serve as an indicator of enclosure appropriateness and could have welfare implications. By looking at the possible reasons for area preferences, animal managers can get an idea of where improvements could be made. Designing future exhibits accordingly thus can provide possible welfare benefits for the animals concerned.

  19. Compatible fungi, suitable medium, and appropriate developmental stage essential for stable association of Dendrobium chrysanthum.

    Science.gov (United States)

    Hajong, Subarna; Kumaria, Suman; Tandon, Pramod

    2013-12-01

    Establishment of symbiotic association at the appropriate developmental stage helped maintain continued growth which is vital for the long-term ex vitro survival of the orchid. In the present study, symbiotic association was carried out using different developmental stages of Dendrobium chrysanthum and pathogenic Rhizoctonia isolates (obtained from orchids and non-orchid hosts) in different culture media. Isolate 2162 supported highest symbiotic germination on OMA-S (oat meal agar medium without nutrients + sucrose), whereas, stable symbiotic association with plantlets was obtained with isolate 4634 on OMA-NC (oat meal agar medium + cellulose). Isolate Dc-2S2 obtained from the host plant did not promote seed germination nor did it form association with protocorms or plantlets. This study, for the first time identifies a combination of compatible fungal isolate, suitable culture medium, and appropriate developmental stage at which symbiotic association in vitro can be deemed successful for the medicinally important orchid, D. chrysanthum.

  20. Determinants of appropriate child health and nutrition practices among women in rural Gambia.

    Science.gov (United States)

    Mwangome, Martha; Prentice, Andrew; Plugge, Emma; Nweneka, Chidi

    2010-04-01

    Health education and awareness involves providing knowledge about causes of illness and choices to promote a change in individual behaviour and, thus, improves survival of individuals. Studies have, however, shown that improved knowledge and awareness is not always translated into appropriate actions. This study aimed at exploring the factors determining mothers' choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practise what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare, when designing nutritional interventions.

  1. Mixing Appropriations and Private Financing to Meet Federal Energy Management Goals

    Energy Technology Data Exchange (ETDEWEB)

    Shonder, John A [ORNL

    2012-06-01

    This report compares several strategies for mixing appropriations and private financing in a typical federal agency that has identified $100 million in required energy conservation measures (ECMs) at its facilities. The analysis shows that in order to maximize savings and minimize overall life-cycle cost, the best strategy for the agency is to use private financing to fund as many of the ECMs as possible within the statutory maximum 25-year project term, beginning with the ECMs with the shortest paybacks. Available appropriations should either be applied to a privately financed project as a one-time payment from savings (i.e., as a buydown ) or used to directly fund longer-payback ECMs that cannot be included in the privately financed project.

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

    Science.gov (United States)

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

    2017-02-16

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

  3. How Important is the Use of Authentic Materials in Developing Appropri-ate and Effective Listening Skills

    Institute of Scientific and Technical Information of China (English)

    HAN Fei

    2013-01-01

    Listening plays a significant role in both the absorbing of knowledge and social communication, however, it has not re-ceived enough attention over the past few decades. In recent years, it has been debated whether there are any strategies in devel-oping appropriate and effective listening skills and whether to adopt the authentic materials in listening teaching. In this disserta-tion, the importance of authentic materials, adopting authentic materials in the listening instruction will be presented.

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

    Science.gov (United States)

    Volpicelli, Kathryn; Buttenheim, Alison M

    2016-11-01

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

  5. spatially identifying vulnerable areas

    African Journals Online (AJOL)

    System (SMDSS) to identify factors that make forest and game reserves vulnerable .... involve the creation of a Digital Elevation Model (DEM), Slope Settlement and ... Feature). Spatial. Analyst Tool. (Slope). Buffer Tool. Buffer Tool. Buffer Tool.

  6. ACR Appropriateness Criteria Low Back Pain.

    Science.gov (United States)

    Patel, Nandini D; Broderick, Daniel F; Burns, Judah; Deshmukh, Tejaswini K; Fries, Ian Blair; Harvey, H Benjamin; Holly, Langston; Hunt, Christopher H; Jagadeesan, Bharathi D; Kennedy, Tabassum A; O'Toole, John E; Perlmutter, Joel S; Policeni, Bruno; Rosenow, Joshua M; Schroeder, Jason W; Whitehead, Matthew T; Cornelius, Rebecca S; Corey, Amanda S

    2016-09-01

    Most patients presenting with uncomplicated acute low back pain (LBP) and/or radiculopathy do not require imaging. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their back pain. It is also considered for those patients presenting with red flags raising suspicion for serious underlying conditions, such as cauda equina syndrome, malignancy, fracture, and infection. Many imaging modalities are available to clinicians and radiologists for evaluating LBP. Application of these modalities depends largely on the working diagnosis, the urgency of the clinical problem, and comorbidities of the patient. When there is concern for fracture of the lumbar spine, multidetector CT is recommended. Those deemed to be interventional candidates, with LBP lasting for > 6 weeks having completed conservative management with persistent radiculopathic symptoms, may seek MRI. Patients with severe or progressive neurologic deficit on presentation and red flags should be evaluated with MRI. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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

    Science.gov (United States)

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

    2016-12-01

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

  8. MPCV Exercise Operational Volume Analysis

    Science.gov (United States)

    Godfrey, A.; Humphreys, B.; Funk, J.; Perusek, G.; Lewandowski, B. E.

    2017-01-01

    identified by determining which markers from the motion capture exceed the operational volume and by how much. A credibility assessment of this analysis was performed in accordance with NASA-STD-7009 prior to delivery to the MPCV program.

  9. Does mode mixing matter in EMD-based highlight volume methods for hydrocarbon detection? Experimental evidence

    Science.gov (United States)

    Xue, Ya-juan; Cao, Jun-xing; Du, Hao-kun; Zhang, Gu-lan; Yao, Yao

    2016-09-01

    Empirical mode decomposition (EMD)-based spectral decomposition methods have been successfully used for hydrocarbon detection. However, mode mixing that occurs during the sifting process of EMD causes the 'true' intrinsic mode function (IMF) to be extracted incorrectly and blurs the physical meaning of the IMF. We address the issue of how the mode mixing influences the EMD-based methods for hydrocarbon detection by introducing mode-mixing elimination methods, specifically ensemble EMD (EEMD) and complete ensemble EMD (CEEMD)-based highlight volumes, as feasible tools that can identify the peak amplitude above average volume and the peak frequency volume. Three schemes, that is, using all IMFs, selected IMFs or weighted IMFs, are employed in the EMD-, EEMD- and CEEMD-based highlight volume methods. When these methods were applied to seismic data from a tight sandstone gas field in Central Sichuan, China, the results demonstrated that the amplitude anomaly in the peak amplitude above average volume captured by EMD, EEMD and CEEMD combined with Hilbert transforms, whether using all IMFs, selected IMFs or weighted IMFs, are almost identical to each other. However, clear distinctions can be found in the peak frequency volume when comparing results generated using all IMFs, selected IMFs, or weighted IMFs. If all IMFs are used, the influence of mode mixing on the peak frequency volume is not readily discernable. However, using selected IMFs or a weighted IMFs' scheme affects the peak frequency in relation to the reservoir thickness in the EMD-based method. Significant improvement in the peak frequency volume can be achieved in EEMD-based highlight volumes using selected IMFs. However, if the weighted IMFs' scheme is adopted (i.e., if the undesired IMFs are included with reduced weights rather than excluded from the analysis entirely), the CEEMD-based peak frequency volume provides a more accurate reservoir thickness estimate compared with the other two methods. This

  10. [Appropriate cataract surgery training can promote work of blindness prevention].

    Science.gov (United States)

    Zhang, Mingzhi

    2014-03-01

    Cataract is the first blinding eye disease in the world and China. However, due to various reasons, cataract surgery rate (CSR) in China is much lower than in developed countries and even some developing countries. Properly and standardized training of cataract surgery for ophthalmologists from primary hospital and young eye doctors is one of the key point to improve CSR. For above, we had explored actively to establish an appropriate and suitable training model of cataract surgery. Ophthalmologist in primary hospital can provide high quality medical services to cataract patients in accordance with their own conditions after training and promote the sustainable development of blindness prevention work.

  11. A Pan-sharpening method appropriate to vegetation applications

    Institute of Scientific and Technical Information of China (English)

    Ying Zhang; Binbin He; Xiaowen Li

    2009-01-01

    An improved Pan-sharpening algorithm appropriate to vegetation applications is proposed to fuse a set of IKONOS panchromatic(PAN)and multispeetral image(MSI)data.The normalized difference vegetation index(NDVI)is introduced to evaluate the quality of fusion products.Compared with other methods such as principal component analysis(PCA),wavelet transform(WT),and curvelet transform(CT),this algorithm has a better trade-off between keeping the spatial and spectral information.The NDVI performances indicate that the fusion product of this method is more suitable for vegetation applications than the other methods.

  12. Narrative Intertextuality: How Pacheco Appropriates The Go-Between

    OpenAIRE

    2016-01-01

    This essay explores the role of rewriting in postmodern fiction, whether it goes under such names as appropriation, adaptation or the interaction between a hypotext and a hypertext. The core of the article is concerned with a minute comparison between H. P. Hartley’s novel The Go-Between (1953) and José Emilio Pacheco’s Las batallas en el desierto (1981). Similarities such as the role of a child/adult narrator, his infatuation with a mature woman, the traumatic experience it entails, how a di...

  13. Appropriate Contrast Enhancement Measures for Brain and Breast Cancer Images

    Directory of Open Access Journals (Sweden)

    Suneet Gupta

    2016-01-01

    Full Text Available Medical imaging systems often produce images that require enhancement, such as improving the image contrast as they are poor in contrast. Therefore, they must be enhanced before they are examined by medical professionals. This is necessary for proper diagnosis and subsequent treatment. We do have various enhancement algorithms which enhance the medical images to different extents. We also have various quantitative metrics or measures which evaluate the quality of an image. This paper suggests the most appropriate measures for two of the medical images, namely, brain cancer images and breast cancer images.

  14. [Appropriateness of referrals for magnetic resonance imaging in Latium, Italy].

    Science.gov (United States)

    Prota, Federica; Rosano, Aldo; San Martini, Elena; Cau, Norberto; Guasticchi, Gabriella

    2012-01-01

    Long wait times for access to Nuclear Magnetic resonance imaging (MRI) examinations are a concern and for this reason the project "Appropriateness of referrals for MRI examinations" has been launched in Latium (Italy). The aim of this preliminary study was to describe the main characteristics of MRI referrals in the region. Findings highlight a large variation in referral rates across the region, with 80% of MRI referrals being ordered by general practitioners and family pediatricians. The latter points to the possibility of inappropriate referrals for MRI imaging in Latium.

  15. Systematic review of appropriate cognitive assessment instruments used in clinical trials of schizophrenia, major depressive disorder and bipolar disorder.

    Science.gov (United States)

    Bakkour, Nadia; Samp, Jennifer; Akhras, Kasem; El Hammi, Emna; Soussi, Imen; Zahra, Fatma; Duru, Gérard; Kooli, Amna; Toumi, Mondher

    2014-05-30

    Cognitive dysfunction is increasingly recognized as a symptom in mental conditions including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BPD). Despite the many available cognitive assessment instruments, consensus is lacking on their appropriate use in clinical trials. We conducted a systematic literature review in Embase, PubMed/Medline and PsychINFO to identify appropriate cognitive function instruments for use in clinical trials of schizophrenia, MDD, and BPD. Instruments were identified from the articles. Instruments and articles were excluded if they did not address schizophrenia, MDD, or BPD. Instrument appropriateness was further assessed by the criteria of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative: test-retest reliability, utility, relationship to functional status, potential changeability to pharmacological agents, and tolerability and practicality for clinical trials. The database search yielded 173 articles describing 150 instruments used to assess cognitive function. Seventeen additional instruments were identified through Google and clinicaltrials.gov. Among all these, only 30 (18%) were deemed appropriate for use in the diseases of interest. Of these, 27 were studied in schizophrenia, one in MDD and two in BPD. These findings suggest the need for careful selection of appropriate cognitive assessment instruments, as not all may be valid in these disorders.

  16. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  17. Identifying Knowledge and Communication

    Directory of Open Access Journals (Sweden)

    Eduardo Coutinho Lourenço de Lima

    2006-12-01

    Full Text Available In this paper, I discuss how the principle of identifying knowledge which Strawson advances in ‘Singular Terms and Predication’ (1961, and in ‘Identifying Reference and Truth-Values’ (1964 turns out to constrain communication. The principle states that a speaker’s use of a referring expression should invoke identifying knowledge on the part of the hearer, if the hearer is to understand what the speaker is saying, and also that, in so referring, speakers are attentive to hearers’ epistemic states. In contrasting it with Russell’s Principle (Evans 1982, as well as with the principle of identifying descriptions (Donnellan 1970, I try to show that the principle of identifying knowledge, ultimately a condition for understanding, makes sense only in a situation of conversation. This allows me to conclude that the cooperative feature of communication (Grice 1975 and reference (Clark andWilkes-Gibbs 1986 holds also at the understanding level. Finally, I discuss where Strawson’s views seem to be unsatisfactory, and suggest how they might be improved.

  18. Volume Regulated Channels

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjær

    - serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...... of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume......, controlled cell death and cellular migration. Volume regulatory mechanisms has long been in focus for regulating cellular proliferation and my thesis work have been focusing on the role of Cl- channels in proliferation with specific emphasis on ICl, swell. Pharmacological blockage of the ubiquitously...

  19. HOW TO SELECT APPROPRIATE HUMAN RESOURCE CONTROLLING INDICATORS

    Directory of Open Access Journals (Sweden)

    Monika Dugelova

    2015-09-01

    Full Text Available Human resource controlling represents a company’s strategic method to support its role is planning, checking, and managing—including information supplement for human resources department. Human resource controlling helps with optimization and transformation of human resource functions and with general human resource management. Our survey deals with the implementation of human resource controlling in information technology companies. The selection of appropriate human resource controlling tools is the most important part of implementation. This article deals with the problem of human resource indicators selection as the most frequently used human resource controlling tool. Many international authors have solved the problem of performance appraisal measurement, and there are numerous demonstrations on how to choose key performance indicators. Our motivation to draft the complex methodology of human resource indicators selection is based on non-existing solution among the authors. To solve the problem and find appropriate methodology, we use the methods comparison, abstraction, and concretization. The result is a creation of the right human resource indicators selection in line with human resource controlling aim. We use the Balanced Scorecard, Deloitte human resource strategy framework, and partial solution of Kleinhempel (2010. These results constitute the basis for our future research and for drafting the whole methodology of human resource controlling implementation in information technology companies.

  20. Drama: an appropriate tool in development support communication.

    Science.gov (United States)

    Moyo, F F

    1997-01-01

    Because it supports progress, drama embodies development and, thus, can be used to support development communication. In fact, drama is the most appropriate medium for effecting change for development because it 1) involves interpersonal communication; 2) broadens the meaning of development; 3) challenges assumptions, demands accountability, suggests remedies, and evaluates the totality of performance; 4) exploits the politics of possibility; 5) is inherently dialogue; 6) allows the target community to participation during the exposition, the conflict, and the resolution; 7) is easy to assimilate; and 8) provides access to any medium. Drama is especially appropriate in South Africa because children carry on a tradition of play-acting, South Africans exhibit politeness to strangers that makes them passively aggressive in resisting change, it allows the temporary removal of cultural barriers among members of households, and it resembles the oral tradition that was pervasive in the culture. Drama can impart greater legitimacy to topics originating from the community or fuse a totally new concept with local culture. It can be used as a tool to criticize political mismanagement, comment on social problems, question culture, debate religious matters, examine economic society, assist educational programs, assist health efforts, raise people's awareness about conservation, and help spread technological advancements. Drama allows more to be done than said and allows communities to be involved in development efforts.

  1. Appropriating religion: understanding religion as an object of science

    Directory of Open Access Journals (Sweden)

    Donald Wiebe

    1999-01-01

    Full Text Available In this paper, the author focuses on the study of religion as a scientific project, for it is the scientific interest in religion which has constituted the grounds for admitting the study of religion into the curriculum of the modern Western university. Despite that academic legitimation, however, the study of religion in the setting of the modern research university is not held in high esteem relative to the other sciences. It if the scientific study of religion is to be legitimately ensconced in the modern research university, the notion of religion will have to be wholly appropriated by science; only then will we be able to establish a conceptual foundation from which to make valid knowledge claims about religion on a level commensurate with the pronouncements of the natural and social sciences. Indeed, to go one step further, given the hold on the concept of religion by those committed to the humanistic study of religion, we might need to talk here not of the appropriation but of expropriation of religion by science—that is, of wresting ownership of the concept from the humanists by using it solely as a taxonomic device to differentiate and explain a peculiar range of human behaviour demonstrated in religious practices.

  2. Initiatives to improve appropriate antibiotic prescribing in primary care.

    Science.gov (United States)

    Harris, Diane J

    2013-11-01

    Influencing clinicians' prescribing behaviour is important because inappropriate use and overuse of antibiotics are major drivers of antibiotic resistance. A systematic review of interventions for promoting prudent prescribing of antibiotics by general practitioners suggests that multifaceted interventions will maximize acceptability. This article reports how this type of approach has been used successfully in Derbyshire, UK over the last 4 years. The range of interventions that have been used includes educational meetings (both open group events and others targeted at higher prescribers in the surgery) using a supportive and guiding ethos; the provision of support materials aimed at empowering avoidance or delayed antibiotic prescribing, where appropriate, and improving patients' knowledge and confidence in self-management; and the production of different treatment guidelines incorporating key messages with evidence, indicating where antibiotics are unlikely to be of benefit. Education on antibiotics in schools was a novel approach, which was developed in North Derbyshire to increase public awareness of the appropriate treatment for common illnesses without using antibiotics.

  3. Appropriate methodologies for empirical bioethics: it's all relative.

    Science.gov (United States)

    Ives, Jonathan; Draper, Heather

    2009-05-01

    In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached.

  4. Disney animation: Global diffusion and local appropriation of culture

    Directory of Open Access Journals (Sweden)

    Souad Belkhyr

    2012-08-01

    Full Text Available Children’s media products reflect the cultural values of their producers and the social, political and economic conditions under which they were produced. Watching an animated cartoon, therefore, cannot be regarded as an innocent and simple act of consumption. It rather involves a complex process of coding/decoding and appropriating cultural meanings. Disney films are not only global means of entertainment but they can also function as an ideological apparatus. In an era of globalisation where the boundaries and divisions between entertainment and materiel consumption are blurred, Arab audiences are faced with a one-way flow of seemingly alien ideas and values that are disseminated through Disney stories, images and narratives. The relation between structured patterns of communication under globalization, on one hand, and the local conditions under which Disney cartoon products are marketed and consumed in the Arab world, on the other, can be understood as the main axis of globalised diffusion and localised appropriation of American cultural values and lifestyle among Arab societies

  5. Global Microbial Identifier

    DEFF Research Database (Denmark)

    Wielinga, Peter; Hendriksen, Rene S.; Aarestrup, Frank Møller

    2017-01-01

    microbial identifier (GMI) initiative, aims to build a database of whole microbial genome sequencing data linked to relevant metadata, which can be used to identify microorganisms, their communities and the diseases they cause. It would be a platform for storing whole genome sequencing (WGS) data......) will likely also enable a much better understanding of the pathogenesis of the infection and the molecular basis of the host response to infection. But the full potential of these advances will only transpire if the data in this area become transferable and thereby comparable, preferably in open......-source systems. There is therefore an obvious need to develop a global system of whole microbial genome databases to aggregate, share, mine and use microbiological genomic data, to address global public health and clinical challenges, and most importantly to identify and diagnose infectious diseases. The global...

  6. Identifying learning styles.

    Science.gov (United States)

    Hughes, Grace

    2016-12-14

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The article explored different learning styles and outlined some of the models that can be used to identify them. It discussed the limitations of these models, indicating that although they can be helpful in identifying a student's preferred learning style, this is not 'fixed' and might change over time. Learning is also influenced by other factors, such as culture and age.

  7. Precision volume measurement system.

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Erin E.; Shugard, Andrew D.

    2004-11-01

    A new precision volume measurement system based on a Kansas City Plant (KCP) design was built to support the volume measurement needs of the Gas Transfer Systems (GTS) department at Sandia National Labs (SNL) in California. An engineering study was undertaken to verify or refute KCP's claims of 0.5% accuracy. The study assesses the accuracy and precision of the system. The system uses the ideal gas law and precise pressure measurements (of low-pressure helium) in a temperature and computer controlled environment to ratio a known volume to an unknown volume.

  8. Stress management techniques in childhood and adolescence. Relaxation training, meditation, hypnosis, and biofeedback: appropriate clinical applications.

    Science.gov (United States)

    Smith, M S; Womack, W M

    1987-11-01

    Many childhood and adolescent stress-related symptoms have a psychophysiological component that involves muscular tension and/or autonomic nervous system dysfunction. Examples of this include recurrent headache, chest pain, abdominal pain, syncope, and dizziness. After a careful medical and psychosocial evaluation, the clinician may identify many patients who are appropriate for the application of stress reduction techniques such as progressive muscular relaxation, meditation, biofeedback, and relaxation/mental imagery (self-hypnosis). This review describes these techniques and their application with selected children and adolescents.

  9. Features for culturally appropriate avatars for behavior-change promotion in at-risk populations

    Directory of Open Access Journals (Sweden)

    Lisetti C

    2009-09-01

    Full Text Available We explore how avatars can be used as social orthotics defined as therapeutic computer-based social companions aimed at promoting healthy behaviors. We review some of the health interventions deployed in helping at-risk populations along with some of the unique advantages that computer-based interventions can add to face-to-face interventions. We posit that artificial intelligence has rendered possible the creation of culturally appropriate dialog-agents for interventions and we identify specific features for social avatars that are important - if not necessary - when applied to the domain of social orthotic systems for health promotion.

  10. Targeting appropriate interventions to minimize deterioration of drinking-water quality in developing countries.

    Science.gov (United States)

    Trevett, Andrew F; Carter, Richard C

    2008-06-01

    In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified 'disease risk index' (DRI) designed to identify communities or households that are 'most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed. It is concluded that incorporating a simple appraisal tool, such as the proposed DRI, into a community water-supply programme would be useful in shaping the overall strategy requiring only a minimum of organizational learning.

  11. Appropriateness of carotid plaque and intima-media thickness assessment in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Alessi Alexandre

    2008-10-01

    Full Text Available Abstract Objectives To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors. Methods 555 patients (220 men; 67.06 ± 12.44 years were included in the study. 120 patients (21.62% presented carotid plaque: 108 (19.45% in patients with at least one risk factor and 12 (2.1% in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057 and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001. There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067. Carotid plaque was more frequent in patients with CAD (p = 0.0002, diabetes (p = 0.024 and hypertension (p = 0.036. Conclusion Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.

  12. Identifying and Managing Risk.

    Science.gov (United States)

    Abraham, Janice M.

    1999-01-01

    The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

  13. Identifying Nursing's Future Leaders.

    Science.gov (United States)

    Gunning, Carolyn S.; Hawken, Patty L.

    1990-01-01

    A study determined that encouraging and supporting students in professional activities while they were still in school would lead those students to participate in professional nursing organizations after they graduated. Organized nursing needs to identify the factors that influence nurses to join organizations and concentrate on these factors to…

  14. Improving Student Success by Understanding Reasons for, Types of, and Appropriate Responses to Stressors Affecting Asian Graduate Students in Canada

    Science.gov (United States)

    Kim, Andrew

    2015-01-01

    An increasing number of university students in Canada are from East Asian countries and enrolled in graduate programs. For these students, unique factors may contribute to a stressful study environment, which in turn can impact academic performance. This article draws on literature to identify five such factors and appropriate coping strategies:…

  15. Early Head Growth: Relation with IQ at 8 Years and Determinants in Term Infants of Low and Appropriate Birthweight

    Science.gov (United States)

    Lira, Pedro I. C.; Eickmann, Sophie H.; Lima, Marilia C.; Amorim, Rosemary J.; Emond, Alan M.; Ashworth, Ann

    2010-01-01

    Aim: To investigate the relation between head growth at different periods and IQ at 8 years, and to identify factors associated with more rapid head growth. Method: Two parallel cohorts of term low birthweight (LBW) and appropriate birthweight (ABW) infants were enrolled at birth in northeast Brazil. Anthropometric measurements were made at birth,…

  16. Diagnosis of ADHD in Adults: What Is the Appropriate "DSM-5" Symptom Threshold for Hyperactivity-Impulsivity?

    Science.gov (United States)

    Solanto, Mary V.; Wasserstein, Jeanette; Marks, David J.; Mitchell, Katherine J.

    2012-01-01

    Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal "DSM-IV" criteria for ADHD combined or predominantly inattentive subtypes based on a structured…

  17. Diagnosis of ADHD in Adults: What Is the Appropriate "DSM-5" Symptom Threshold for Hyperactivity-Impulsivity?

    Science.gov (United States)

    Solanto, Mary V.; Wasserstein, Jeanette; Marks, David J.; Mitchell, Katherine J.

    2012-01-01

    Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal "DSM-IV" criteria for ADHD combined or predominantly inattentive subtypes based on a structured…

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    from the Electronic Patient Journal of OUH and Odense Pharmaco-Epidemiological Database. Guideline criteria for omalizumab treatment were used to evaluate the appropriateness of omalizumab candidate selection, and the Asthma Control Test (ACT) to assess the clinical effects of omalizumab at weeks 16...... to guidelines, and the clinical effect of omalizumab treatment over time. Design: We performed a retrospective observational study on adult patients with asthma treated with omalizumab during 2006-2015 at the Department of Respiratory Medicine at Odense University Hospital (OUH), Denmark. Data were obtained...... and 52 from treatment initiation. Results: During the observation period, 24 patients received omalizumab, but only 10 patients (42%) fulfilled criteria recommended by international guidelines. The main reasons for not fulfilling the criteria were inadequately reduced lung function, insufficient number...

  19. The appropriateness of a proton pump inhibitor prescription.

    LENUS (Irish Health Repository)

    Moran, N

    2014-11-01

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

  20. A study for watermark methods appropriate to medical images.

    Science.gov (United States)

    Cho, Y; Ahn, B; Kim, J S; Kim, I Y; Kim, S I

    2001-06-01

    The network system, including the picture archiving and communication system (PACS), is essential in hospital and medical imaging fields these days. Many medical images are accessed and processed on the web, as well as in PACS. Therefore, any possible accidents caused by the illegal modification of medical images must be prevented. Digital image watermark techniques have been proposed as a method to protect against illegal copying or modification of copyrighted material. Invisible signatures made by a digital image watermarking technique can be a solution to these problems. However, medical images have some different characteristics from normal digital images in that one must not corrupt the information contained in the original medical images. In this study, we suggest modified watermark methods appropriate for medical image processing and communication system that prevent clinically important data contained in original images from being corrupted.

  1. Optimal price subsidies for appropriate malaria testing and treatment behaviour

    DEFF Research Database (Denmark)

    Hansen, K. S.; Lesner, T. H.; Østerdal, L. P.

    2016-01-01

    of presumptive diagnosis. A global subsidy on artemisinin-based combination therapy (ACT) has recently been suggested to increase access to the most effective malaria treatment. Methods: Following the recommendation by World Health Organization that parasitological testing should be performed before treatment......, ACT medicines, and cheap, less effective anti-malarials are sold. Assuming that the individual has certain beliefs of the accuracy of the RDT and the probability that the fever is malaria, the model predicts the diagnosis-treatment behaviour of the individual. Subsidies on RDTs and ACT are introduced...... to incentivize appropriate behaviour: choose an RDT before treatment and purchase ACT only if the test is positive. Results: Solving the model numerically suggests that a combined subsidy on both RDT and ACT is cost minimizing and improves diagnosis-treatment behaviour of individuals. For certain beliefs...

  2. The importance of applying an appropriate data partitioning

    CERN Document Server

    Dimitrov, Gancho; The ATLAS collaboration

    2015-01-01

    In this presentation are described specific technical solutions put in place in various database applications of the ATLAS experiment at LHC where we make use of several partitioning techniques available in Oracle 11g. With the broadly used range partitioning and its option of automatic interval partitioning we add our own logic in PLSQL procedures and scheduler jobs to sustain data sliding windows in order to enforce various data retention policies. We also make use of the new Oracle 11g reference partitioning in the ATLAS Nightly Build System to achieve uniform data segmentation. However the most challenging was to segment the data of the new ATLAS Distributed Data Management system, which resulted in tens of thousands list type partitions and sub-partitions. Partition and sub-partition management, index strategy, statistics gathering and queries execution plan stability are important factors when choosing an appropriate physical model for the application data management. The so-far accumulated knowledge wi...

  3. AN EFFECTIVE ENGLISH CLASS WITH APPROPRIATE TECHNIQUES AND STRATEGIES

    Directory of Open Access Journals (Sweden)

    Vahidije Kadiu

    2016-09-01

    Full Text Available Teaching is considered to be one of the most important aspects for the future of the human beings. The fact that teaching is an art based on techniques and strategies is very important. The aim of this paper is to study the appropriate techniques and strategies for an effective English class. To achieve this, a survey was conducted at “Asim Vokshi secondary school. The main instrument used was a questionnaire. It was conducted on 70 students and 70 teachers. According to the results of the survey, many teachers believe that during an English class, different techniques and strategies should be included such as: cooperation, control of the class, and motivation. They also stressed the fact that four skills should be co-related for an effective class.  The most important finding was related to the students. According to them, the best way to learn the English language was by writing.

  4. Cultural Appropriations; Ethnic-Racial Representations; Black Press

    Directory of Open Access Journals (Sweden)

    Maria Angélica Zubaran

    2015-12-01

    Full Text Available This paper investigates the exchange and circulation of ideas in the black diaspora, particularly in the newspaper The Example, mapping and discussing the ethnic-racial and gender representations constructed in the narratives produced by the editors of this newspaper, during the campaign for the construction of a monument to the “Black Mother”. The aim is to analyze how the newspaper’s editors have appropriated texts that circulated in other newspapers about the campaign to the monument of the “Black Mother”, adapted them to their own interests and given them new meanings. From the theoretical approach of Cultural Studies, we understand the black press as a cultural artifact that not only informs but also produces discourses and representations that contribute to the formation of black subjectivities and identities.

  5. Narrative Intertextuality: How Pacheco Appropriates The Go-Between

    Directory of Open Access Journals (Sweden)

    Jorge Alcázar

    2016-01-01

    Full Text Available This essay explores the role of rewriting in postmodern fiction, whether it goes under such names as appropriation, adaptation or the interaction between a hypotext and a hypertext. The core of the article is concerned with a minute comparison between H. P. Hartley’s novel The Go-Between (1953 and José Emilio Pacheco’s Las batallas en el desierto (1981. Similarities such as the role of a child/adult narrator, his infatuation with a mature woman, the traumatic experience it entails, how a distant past is recreated, the clash of opposite social classes, the narrative thematics of music, as well as other minor details are brought to the fore.

  6. Understanding the Concept of Nationally Appropriate Mitigation Action

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

    discusses institutional arrangements, under the Convention, for providing financing to develop and implement NAMAs. The chapter also briefly discusses the different financial sources for implementing NAMAs, and concludes by explaining the concept of incremental cost in this specific context.......This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept...... and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman’s terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA...

  7. The tricks plants use to reach appropriate light

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The perception of ambient light signals that produce a relevant response to ensure exposure to appropriate levels of light energy is vital for plants. In response to this, intricate molecular mechanisms to mediate light signaling have evolved in plants. Among the responses induced by light, seedling extension is a determining event for plant survival in darkness, especially in the initial stage of plant growth. Here we review previous studies and recent progress towards an understanding of light signaling that regulates seedling elongation. We focus on the three regions of the sunlight spectrum that primarily control seedling elongation, namely red/far-red light, blue/UV-A light and UV-B light, and summarize the four signaling pathways that correspond to the three effective spectra.

  8. Optimal price subsidies for appropriate malaria testing and treatment behaviour

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Lesner, Tine Hjernø; Østerdal, Lars Peter

    2016-01-01

    , ACT medicines, and cheap, less effective anti-malarials are sold. Assuming that the individual has certain beliefs of the accuracy of the RDT and the probability that the fever is malaria, the model predicts the diagnosis-treatment behaviour of the individual. Subsidies on RDTs and ACT are introduced...... to incentivize appropriate behaviour: choose an RDT before treatment and purchase ACT only if the test is positive. RESULTS: Solving the model numerically suggests that a combined subsidy on both RDT and ACT is cost minimizing and improves diagnosis-treatment behaviour of individuals. For certain beliefs......BACKGROUND: Malaria continues to be a serious public health problem particularly in Africa. Many people infected with malaria do not access effective treatment due to high price. At the same time many individuals receiving malaria drugs do not suffer from malaria because of the common practice...

  9. Appropriate Strategies for Rural Houses In Northwest China

    Institute of Scientific and Technical Information of China (English)

    HE Quan; LIU Jia-ping; LU Xiao-hui; YANG Liu

    2009-01-01

    To avoid the old road of urban development with high consumption and high pollution,this paper took the houses in a village near Yinchuan(a typical city of Northwest China)as an exemplary proiect to explore the appropriate strategies in the arid cold climate for the sustainable devdopment in rural undeveloped areas Northwest China.Firstly,all houses were designed according to the principles of passive solar heating.Second-ly,optimized biomass energy technologies such as biogas pit and straw gasification stove were utilized for cooking or heating.Last but not the least important,the ecological building materials such as earth,straw bale,fly ash were used to construct houses,which improves the indoor thermal comfort and meanwhile lowers the negative impact on the environment.Low costs,easy accessibility and habitants'inclination were taken into account in the process of design.

  10. Appropriate electromagnetic techniques for imaging geothermal fracture zones

    Energy Technology Data Exchange (ETDEWEB)

    Groom, R.; Walker, P. [PetRos EiKon Incorporated, Ontario (Canada)

    1996-05-01

    Electromagnetic surface detection of fracture zones has often been approached by using the magnetotelluric method. This technique suffers greatly from the quantity and scale of the conductive inhomogeneities lying above the fracture zones. Additionally, it suffers from the inherent inability to focus the source on the target. There are no such source focusing capabilities in magnetotellurics. Accordingly, the quantity of magnetotelluric data required to resolve targets in such complex conditions can make the technique inefficient and insufficient from a cost perspective. When attempting to reveal a subsurface structure and image it, the basic physical responses at hand must be kept in mind, and the appropriate source must be utilized, which most effectively illuminates the target. A further advantage to controlled sources is that imaging techniques may be used to accentuate the response due to knowledge and control of the source.

  11. Generating Context-Appropriate Word Orders in Turkish

    CERN Document Server

    Hoffman, B

    1994-01-01

    Turkish has considerably freer word order than English. The interpretations of different word orders in Turkish rely on information that describes how a sentence relates to its discourse context. To capture the syntactic features of a free word order language, I present an adaptation of Combinatory Categorial Grammars called {}-CCGs (set-CCGs). In {}-CCGs, a verb's subcategorization requirements are relaxed so that it requires a set of arguments without specifying their linear order. I integrate a level of information structure, representing pragmatic functions such as topic and focus, with {}-CCGs to allow certain pragmatic distinctions in meaning to influence the word order of a sentence in a compositional way. Finally, I discuss how this strategy is used within an implemented generation system which produces Turkish sentences with context-appropriate word orders in a simple database query task.

  12. Popularising and appropriating engineering knowledge: an opportunity for innovation

    Directory of Open Access Journals (Sweden)

    Diana Cristina Ramírez Martínez

    2011-10-01

    Full Text Available Developing disciplines in Colombia, such as engineering, is a fundamental element in developing technological development and innovation. Such discipline generating knowledge and research represents input which must support approaches made to Colombia’s social and economic problems. The present article recognises scientific journals’ role as a support mechanism by controlling the quality of such input, aimed at strengthening technological developments and innovation. It describes the role of broadcasting knowledge and developing engineering, clearly showing the support which it has received in Colombia and the journals’ role as an element for strengthening innovation; in the paper “Ingeniería e Investigation” Journal is emphasised, describing its trajectory from its creation to how it has acquired its present day scientific and technological maturity. Some challenges and perspectives are then proposed for broadcasting and appropriating knowledge from journals.

  13. Heterologous expression of membrane proteins: choosing the appropriate host.

    Directory of Open Access Journals (Sweden)

    Florent Bernaudat

    Full Text Available BACKGROUND: Membrane proteins are the targets of 50% of drugs, although they only represent 1% of total cellular proteins. The first major bottleneck on the route to their functional and structural characterisation is their overexpression; and simply choosing the right system can involve many months of trial and error. This work is intended as a guide to where to start when faced with heterologous expression of a membrane protein. METHODOLOGY/PRINCIPAL FINDINGS: The expression of 20 membrane proteins, both peripheral and integral, in three prokaryotic (E. coli, L. lactis, R. sphaeroides and three eukaryotic (A. thaliana, N. benthamiana, Sf9 insect cells hosts was tested. The proteins tested were of various origins (bacteria, plants and mammals, functions (transporters, receptors, enzymes and topologies (between 0 and 13 transmembrane segments. The Gateway system was used to clone all 20 genes into appropriate vectors for the hosts to be tested. Culture conditions were optimised for each host, and specific strategies were tested, such as the use of Mistic fusions in E. coli. 17 of the 20 proteins were produced at adequate yields for functional and, in some cases, structural studies. We have formulated general recommendations to assist with choosing an appropriate system based on our observations of protein behaviour in the different hosts. CONCLUSIONS/SIGNIFICANCE: Most of the methods presented here can be quite easily implemented in other laboratories. The results highlight certain factors that should be considered when selecting an expression host. The decision aide provided should help both newcomers and old-hands to select the best system for their favourite membrane protein.

  14. Heterologous expression of membrane proteins: choosing the appropriate host.

    Science.gov (United States)

    Bernaudat, Florent; Frelet-Barrand, Annie; Pochon, Nathalie; Dementin, Sébastien; Hivin, Patrick; Boutigny, Sylvain; Rioux, Jean-Baptiste; Salvi, Daniel; Seigneurin-Berny, Daphné; Richaud, Pierre; Joyard, Jacques; Pignol, David; Sabaty, Monique; Desnos, Thierry; Pebay-Peyroula, Eva; Darrouzet, Elisabeth; Vernet, Thierry; Rolland, Norbert

    2011-01-01

    Membrane proteins are the targets of 50% of drugs, although they only represent 1% of total cellular proteins. The first major bottleneck on the route to their functional and structural characterisation is their overexpression; and simply choosing the right system can involve many months of trial and error. This work is intended as a guide to where to start when faced with heterologous expression of a membrane protein. The expression of 20 membrane proteins, both peripheral and integral, in three prokaryotic (E. coli, L. lactis, R. sphaeroides) and three eukaryotic (A. thaliana, N. benthamiana, Sf9 insect cells) hosts was tested. The proteins tested were of various origins (bacteria, plants and mammals), functions (transporters, receptors, enzymes) and topologies (between 0 and 13 transmembrane segments). The Gateway system was used to clone all 20 genes into appropriate vectors for the hosts to be tested. Culture conditions were optimised for each host, and specific strategies were tested, such as the use of Mistic fusions in E. coli. 17 of the 20 proteins were produced at adequate yields for functional and, in some cases, structural studies. We have formulated general recommendations to assist with choosing an appropriate system based on our observations of protein behaviour in the different hosts. Most of the methods presented here can be quite easily implemented in other laboratories. The results highlight certain factors that should be considered when selecting an expression host. The decision aide provided should help both newcomers and old-hands to select the best system for their favourite membrane protein. © 2011 Bernaudat et al.

  15. [Prescription appropriateness: Indication of citicoline in Primary Care].

    Science.gov (United States)

    Padilla Luz, A; Reyes Rodríguez, J F; Gómez Rodríguez de Acuña, A; González Gómez, C M; Álvarez Dorta, I; Pérez Cánovas, M E

    2015-01-01

    The economic situation has made it necessary to optimize resources by adjusting the pharmaceutical expenditure. Citicoline was (2011) the 10th drug by rank of billed amount. Its approved indications are stroke (acute and sub-acute) and head injury, but not cognitive decline associated with age, the presumed indication for most of its use. To assess the conditions of use of citicoline in the Health Area of Tenerife, in order to detect deviations from the indications of use as stipulated in the prescribing information sheet and the pattern of prescription, with emphasis on the analysis of its use in dementia where currently it has no indication or evidence to support it. Cross-sectional study of prescription-indication. A 680 patient sample, segmented by reference hospital (error±5%; CI: 0.95%; P=0.5) was taken from the 4036 patients with a prescription of citicoline billed during august-october 2011 (obtained from the prescription database program, Farmacanarias). We found that 123 patients (18.1%) had an appropriate indication. By including the prescription regimen, 28 patients (4.1%) had adequate indication and dose levels, and in only 2 patients (0.2%) an appropriate indication, dosage and duration were found. "The correct prescription-indication" of citicoline is inappropiate in almost all patients studied. Impact actions are needed in order to optimize prescription, improve patient safety by reducing potential interactions, and the occurrence of adverse effects, and improve efficiency by promoting savings. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Optimal price subsidies for appropriate malaria testing and treatment behaviour.

    Science.gov (United States)

    Hansen, Kristian Schultz; Lesner, Tine Hjernø; Østerdal, Lars Peter

    2016-11-04

    Malaria continues to be a serious public health problem particularly in Africa. Many people infected with malaria do not access effective treatment due to high price. At the same time many individuals receiving malaria drugs do not suffer from malaria because of the common practice of presumptive diagnosis. A global subsidy on artemisinin-based combination therapy (ACT) has recently been suggested to increase access to the most effective malaria treatment. Following the recommendation by World Health Organization that parasitological testing should be performed before treatment and ACT prescribed to confirmed cases only, it is investigated in this paper if a subsidy on malaria rapid diagnostic tests (RDTs) should be incorporated. A model is developed consisting of a representative individual with fever suspected to be malaria, seeking care at a specialized drug shop where RDTs, ACT medicines, and cheap, less effective anti-malarials are sold. Assuming that the individual has certain beliefs of the accuracy of the RDT and the probability that the fever is malaria, the model predicts the diagnosis-treatment behaviour of the individual. Subsidies on RDTs and ACT are introduced to incentivize appropriate behaviour: choose an RDT before treatment and purchase ACT only if the test is positive. Solving the model numerically suggests that a combined subsidy on both RDT and ACT is cost minimizing and improves diagnosis-treatment behaviour of individuals. For certain beliefs, such as low trust in RDT accuracy and strong belief that a fever is malaria, subsidization is not sufficient to incentivize appropriate behaviour. A combined subsidy on both RDT and ACT rather than a single subsidy is likely required to improve diagnosis-treatment behaviour among individuals seeking care for malaria in the private sector.

  17. Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

    Science.gov (United States)

    Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

    2010-06-01

    Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

  18. Appropriate Polypharmacy and Medicine Safety: When Many is not Too Many.

    Science.gov (United States)

    Cadogan, Cathal A; Ryan, Cristín; Hughes, Carmel M

    2016-02-01

    The use of multiple medicines (polypharmacy) is increasingly common in middle-aged and older populations. Ensuring the correct balance between the prescribing of 'many' drugs and 'too many' drugs is a significant challenge. Clinicians are tasked with ensuring that patients receive the most appropriate combinations of medications based on the best available evidence, and that medication use is optimised according to patients' clinical needs (appropriate polypharmacy). Historically, polypharmacy has been viewed negatively because of the associated medication safety risks, such as drug interactions and adverse drug events. More recently, polypharmacy has been identified as a risk factor for under-prescribing, such that patients do not receive necessary medications and this can also pose risks to patients' safety and well-being. The negative connotations that have long been associated with the term polypharmacy could potentially be acting as a driving factor for under-prescribing, whereby clinicians are reluctant to prescribe necessary medicines for patients who are already receiving 'many' medicines. It is now recognised that the prescribing of 'many' medicines can be entirely appropriate in patients with several chronic conditions and that the risks of adverse drug events that have been associated with polypharmacy may be greatly reduced when patients' clinical context is taken into consideration. In this article, we outline the current perspectives on polypharmacy and make the case for adopting the term 'appropriate polypharmacy' in differentiating between the prescribing of 'many' drugs and 'too many' drugs. We also outline the inherent challenges in doing so and provide recommendations for future clinical practice and research.

  19. Variable volume combustor

    Energy Technology Data Exchange (ETDEWEB)

    Ostebee, Heath Michael; Ziminsky, Willy Steve; Johnson, Thomas Edward; Keener, Christopher Paul

    2017-01-17

    The present application provides a variable volume combustor for use with a gas turbine engine. The variable volume combustor may include a liner, a number of micro-mixer fuel nozzles positioned within the liner, and a linear actuator so as to maneuver the micro-mixer fuel nozzles axially along the liner.

  20. Partial Volume Correction in Quantitative Amyloid Imaging

    Science.gov (United States)

    Su, Yi; Blazey, Tyler M.; Snyder, Abraham Z.; Raichle, Marcus E.; Marcus, Daniel S.; Ances, Beau M.; Bateman, Randall J.; Cairns, Nigel J.; Aldea, Patricia; Cash, Lisa; Christensen, Jon J.; Friedrichsen, Karl; Hornbeck, Russ C.; Farrar, Angela M.; Owen, Christopher J.; Mayeux, Richard; Brickman, Adam M.; Klunk, William; Price, Julie C.; Thompson, Paul M.; Ghetti, Bernardino; Saykin, Andrew J.; Sperling, Reisa A.; Johnson, Keith A.; Schofield, Peter R.; Buckles, Virginia; Morris, John C.; Benzinger, Tammie. LS.

    2014-01-01

    Amyloid imaging is a valuable tool for research and diagnosis in dementing disorders. As positron emission tomography (PET) scanners have limited spatial resolution, measured signals are distorted by partial volume effects. Various techniques have been proposed for correcting partial volume effects, but there is no consensus as to whether these techniques are necessary in amyloid imaging, and, if so, how they should be implemented. We evaluated a two-component partial volume correction technique and a regional spread function technique using both simulated and human Pittsburgh compound B (PiB) PET imaging data. Both correction techniques compensated for partial volume effects and yielded improved detection of subtle changes in PiB retention. However, the regional spread function technique was more accurate in application to simulated data. Because PiB retention estimates depend on the correction technique, standardization is necessary to compare results across groups. Partial volume correction has sometimes been avoided because it increases the sensitivity to inaccuracy in image registration and segmentation. However, our results indicate that appropriate PVC may enhance our ability to detect changes in amyloid deposition. PMID:25485714

  1. Formal and informal appropriation mechanisms: the role of openness and innovativeness

    NARCIS (Netherlands)

    Zobel, Ann-Kristin; Lokshin, Boris; Hagedoorn, John

    2016-01-01

    This paper analyses how firms’ degree of openness and innovativeness influence their use of formal and informal appropriation mechanisms. Patents, trademarks, copyrights, and design rights are formal appropriation mechanisms. Secrecy, lead-time, and complexity are examples of informal appropriation

  2. Volume Regulated Channels

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjær

    of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume...... but are also essential for a number of physiological processes such as proliferation, controlled cell death, migration and endocrinology. The thesis have been focusing on two Channels, namely the swelling activated Cl- channel (ICl, swell) and the transient receptor potential Vanilloid (TRPV4) channel. I: Cl......- serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...

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

    Directory of Open Access Journals (Sweden)

    Gezahegn Tesfaye

    2014-09-01

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

  4. Tools for measuring patient safety in primary care settings using the RAND/UCLA appropriateness method.

    Science.gov (United States)

    Bell, Brian G; Spencer, Rachel; Avery, Anthony J; Campbell, Stephen M

    2014-06-05

    The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and develop a 'toolkit' of feasible patient safety measures for general practices in England. A RAND/UCLA Appropriateness Method exercise was conducted with a panel of international experts in general practice patient safety. Statements were developed from an extensive systematic literature review of patient safety in general practice. We used standard RAND/UCLA Appropriateness Method rating methods to identify necessary items for assessing patient safety in general practice, framed in terms of the Structure-Process-Outcome taxonomy. Items were included in the toolkit if they received an overall panel median score of ≥ 7 with agreement (no more than two panel members rating the statement outside a 3-point distribution around the median). Of 205 identified statements, the panel rated 101 as necessary for assessing the safety of general practices. Of these 101 statements, 73 covered structures or organisational issues, 22 addressed processes and 6 focused on outcomes. We developed and tested tools that can lead to interventions to improve safety outcomes in general practice. This paper reports the first attempt to systematically develop a patient safety toolkit for general practice, which has the potential to improve safety, cost effectiveness and patient experience, in any healthcare system.

  5. Appropriate wastewater treatment systems for developing countries: criteria and indictor assessment in Thailand.

    Science.gov (United States)

    Singhirunnusorn, W; Stenstrom, M K

    2009-01-01

    This paper presents a comprehensive approach with factors to select appropriate wastewater treatment systems in developing countries in general and Thailand in particular. Instead of focusing merely on the technical dimensions, the study integrates the social, economic, and environmental concerns to develop a set of criteria and indicators (C&I) useful for evaluating appropriate system alternatives. The paper identifies seven elements crucial for technical selection: reliability, simplicity, efficiency, land requirement, affordability, social acceptability, and sustainability. Variables are organized into three hierarchical elements, namely: principles, criteria, and indicators. The study utilizes a mail survey to obtain information from Thai experts-academicians, practitioners, and government officials-to evaluate the C&I list. Responses were received from 33 experts on two multi-criteria analysis inquiries-ranking and rating-to obtain evaluative judgments. Results show that reliability, affordability, and efficiency are among the most important elements, followed by sustainability and social acceptability. Land requirement and simplicity are low in priority with relatively inferior weighting. A number of criteria are then developed to match the contextual environment of each particular condition. A total of 14 criteria are identified which comprised 64 indicators. Unimportant criteria and indicators are discarded after careful consideration, since some of the indicators are local or site specific.

  6. An Experience of the Transfer of Appropriate Technology from Fiji to Kenya; The 1987 ISIS-WICCE Exchange Programme on Women and Appropriate Technology.

    Science.gov (United States)

    Bolabola, Cema

    1987-01-01

    The author describes the 1987 exchange program "Women and Appropriate Technology." The program concentrated on appropriate technology in relation to rural women. She also describes a pilot appropriate technology project carried out in Kenya that involved the construction of three community buildings (a laundry and two bathrooms). (CH)

  7. Random Cell Identifiers Assignment

    Directory of Open Access Journals (Sweden)

    Robert Bestak

    2012-01-01

    Full Text Available Despite integration of advanced functions that enable Femto Access Points (FAPs to be deployed in a plug-and-play manner, the femtocell concept still cause several opened issues to be resolved. One of them represents an assignment of Physical Cell Identifiers (PCIs to FAPs. This paper analyses a random based assignment algorithm in LTE systems operating in diverse femtocell scenarios. The performance of the algorithm is evaluated by comparing the number of confusions for various femtocell densities, PCI ranges and knowledge of vicinity. Simulation results show that better knowledge of vicinity can significantly reduce the number of confusions events.

  8. Choosing appropriate temporal and spatial scales for ecological restoration

    Indian Academy of Sciences (India)

    J Baird Callicott

    2002-07-01

    Classic ecological restoration seems tacitly to have taken the Clementsian ``balance of nature” paradigm for granted: plant succession terminates in a climax community which remains at equilibrium until exogenously disturbed after which the process of succession is restarted until the climax is reached. Human disturbance is regarded as unnatural and to have commenced in the Western Hemisphere at the time of European incursion. Classic ecological restoration thus has a clear and unambiguous target and may be conceived as aiming to foreshorten the natural processes that would eventually lead to the climax of a given site, which may be determined by its state at ``settlement”. According to the new ``flux of nature” paradigm in ecology a given site has no telos and is constantly changing. Human disturbance is ubiquitous and long-standing, and at certain spatial and temporal scales is ``incorporated”. Any moment in the past 10,000 years that may be selected as a benchmark for restoration efforts thus appears to be arbitrary. Two prominent conservationists have therefore suggested that the ecological conditions in North America at the Pleistocene–Holocene boundary, prior to the anthropogenic extinction of the Pleistocene megafauna, be the target for ecological restoration. That suggestion explicitly assumes evolutionary temporal scales and continental spatial scales as the appropriate frame of reference for ecological restoration. However, ecological restoration should be framed in ecological spatio-temporal scales, which may be defined temporally in reference to ecological processes such as disturbance regimes and spatially in reference to ecological units such as landscapes, ecosystems, and biological provinces. Ecological spatio-temporal scales are also useful in achieving a scientifically defensible distinction between native and exotic species, which plays so central a role in the practice of ecological restoration and the conservation of biodiversity

  9. Adventure Time and the case Natasha Allegri: appropriation of cultural goods, fan art and new productive cycle television/ internet

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Baptista Reis

    2012-12-01

    Full Text Available This article endeavours in identifying the narrative and artistic relationships contained in the Natasha Allegri’s case and her gender swapped fan art version of the characters of the animated cartoon, of the north american cable network Cartoon Network, Adventure Time. The work focuses on the production circuit of fan art and appropriation of the narrative and characters of the animated cartoon by blogs and virtual communities through the influence of Allegri’s creation and the official appropriation by the producers and broadcasters of Adventure Time.

  10. Colombian initiatives in the Social Appropriation of Science and Technology: tendencies and challenges for a broader understanding of these dynamics.

    Science.gov (United States)

    Pérez-Bustos, Tania; Franco Avellaneda, Manuel; Lozano Borda, Marcela; Falla, Sigrid; Papagayo, Diana

    2012-03-01

    Is aimed at broadening Colombia's understanding of the social appropriation of science and technology, particularly the types of actors who promote initiatives in this sphere. Using a chain referral sampling methodology, a hundred such initiatives in Colombia were identified and documented, which were promoted by civil society, the State, business, the research community and mediators. The article further analyzes these iniciatives and indicates the challenges they represent, especially in breaking down the traditional approach to the social appropriation of science and technology in Colombia and replacing it with more participative strategies.

  11. [Appropriateness of ketorolac use in a trauma hospital].

    Science.gov (United States)

    Angeles González-Fernández, M

    2009-06-01

    To evaluate the suitability of ketorolac and non-steroidal anti-inflamatory drugs (NSAIDs) and other analgesic drugs currently used in the hospital. We have followed the steps to develop a PDCA cycle (plan, do, check, act) or quality improvement cycle. The quality problem was analysed using an Ishikawa diagram. We defined both qualitative quality indicators, those that measure prescription quality, and quantitative ones (defined daily dose, DDD/100BDs), which measure drug consumption, being the objectives to achieve. The study was conducted in all patients admitted to the hospital and who were admitted to orthopaedic and trauma surgery and plastic surgery departments with unit-dose dispensing systems. The strategy used was to give information to physicians through meetings and documentation. Finally, the results were analysed and compared with the initial objectives. The study was performed on 260 patients in the first study period and 292 in the second. Qualitative indicators: intravenous ketorolac use or =65 years old at dose < or =60 mg/day it increased 27.7% (p<0.05). Quantitative indicators: in the second study period, ketorolac use decreased (plastic surgery department: 61.8 DDD/100BDs to 14.8), whereas tramadol, ibuprofen and metamizole increased (plastic surgery department: 0 to 14.1 in tramadol, 8.7 to 48.6 in ibuprofen and 50.1 to 71 in metamizole). Appropriateness of ketorolac, NSAIDs and tramadol use has been achieved, thus improving patient safety. Strategies have been effective.

  12. Liver transplantation in adults:Choosing the appropriate timing

    Institute of Scientific and Technical Information of China (English)

    Maria; Siciliano; Lucia; Parlati; Federica; Maldarelli; Massimo; Rossi; Stefano; Ginanni; Corradini

    2012-01-01

    Liver transplantation is indicated in patients with acute liver failure,decompensated cirrhosis,hepatocellular carcinoma and rare liver-based genetic defects that trigger damage of other organs.Early referral to a transplant center is crucial in acute liver failure due to the high mortality with medical therapy and its unpredictable evolution.Referral to a transplant center should be considered when at least one complication of cirrhosis occurs during its natural history.However,because of the shortage of organ donors and the short-term mortality after liver transplantation on one hand and the possibility of managing the complications of cirrhosis with other treatments on the other,patients are carefully selected by the transplant center to ensure that transplantation is indicated and that there are no medical,surgical and psychological contraindications.Patients approved for transplantation are placed on the transplant waiting list and prioritized according to disease severity.Thus,the appropriate timing of transplantation depends on recipient disease severity and,although this is still a matter of debate,also on donor quality.These two variables are known to determine the "transplant benefit"(i.e.,when the expected patient survival is better with,than without,transplantation) and should guide donor allocation.

  13. Understanding the concept of nationally appropriate mitigation action

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S.; Desgain, D.

    2013-05-15

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman's terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA and related MRV and financing issues have evolved through the different COPs. The second chapter clarifies the understanding of NAMAs in the context of the global temperature goal, and moves on to discuss the legal nature and scope of NAMAs. The chapter subsequently analyses the diversity of NAMAs submitted by developing countries to the UNFCCC, and ends by proposing a structure for formal submission of a NAMA. The third chapter specifically addresses the concept of measurement, reporting and verification (MRV), and describes the implications for countries implementing the MRV requirements. The last chapter discusses institutional arrangements, under the Convention, for providing financing to develop and implement NAMAs. The chapter also briefly discusses the different financial sources for implementing NAMAs, and concludes by explaining the concept of incremental cost in this specific context. (Author)

  14. Producing Appropriation: Negotiating Islam-Sunda in Terebang Sejak

    Directory of Open Access Journals (Sweden)

    Neneng Yanti Khozanatu Lahpan

    2015-04-01

    Full Text Available This article is an ethnographic account of my research on negotiating Islam and Sunda in Islamic Sundanese music. By taking special case of Terebang Sejak, I draw my attention on the issue based on my fieldwork in Cikeusal village, TasikMalaya, West Java. Observations and interviews are the main tools I used in gathering information. By presenting particularity of Terebang Sejak, this paper aims to present complexity and negotiations that are formed from the interaction between Islam and Sunda in the music in the village. In this context, presenting the idea of the truism of marginalizing Islam on local culture is in accordance with the idea of Indonesian modernity, which has parallelism with the mission of modernist Islam. While many scholars describe Islam in Indonesia with the idea of syncretism to depict the religion as ‘not really Islam’, in this article I provide different interpretation of localizing Islam by which people produce their own interpretation and appropriation in response to social and political changes in their environs. This interpretation will contribute to new understanding in addressing the particularity of meanings based on local knowledge, among Cikeusal people that forms what coded as ‘identity’ of being Muslim-Sunda. Here, Islamic text of Kitab Mulud in the music has played an agentive role to acknowledge the music as Islamic, thus continues to be part of ritual. 

  15. Is antibiotic dosing appropriate for renal function in older adults?

    Institute of Scientific and Technical Information of China (English)

    T.S.Dharmarajan; RanganathanRajendran; MarilouCorpuz; EdwardP.Norkus

    2000-01-01

    A retrospective observational study was used to detennine if antibiotic dosing practices in older adults were adjusted for age or disease related changes in renal function in 196 patients, 17 to 99 years, hospitalized for urosepsis or pneumonia. Appropriate or inappropriate antibiotic dosing, based on ereatinine clearance, was assessed in three groups categorized by age and renal function. Duration of antibiotic therapy (iv, oral and total) was statistically equivalent across the three age groups. Older patients had significantly higher serum BUN (P<0.0000), creatinine (P=0.0078), renal impairment (P<0.000), and hospital deaths (P<0.000) compared to the young. Older adults were prescribed inappropriately higher antibiotic dosages significantly more often (P<0.000) than the young. The very old, prescribed excessive antibiotic doses (P=0.005) not adjusted for renal status, had an increased rate of Clostridium difficile colitis infection (P=0.014). In conclusion, excessive antibiotic dosing, not adjusted for ereatinine clearance, occurs in the elderly and we believe that it is correctable.

  16. Bibliometrics: tracking research impact by selecting the appropriate metrics

    Science.gov (United States)

    Agarwal, Ashok; Durairajanayagam, Damayanthi; Tatagari, Sindhuja; Esteves, Sandro C; Harlev, Avi; Henkel, Ralf; Roychoudhury, Shubhadeep; Homa, Sheryl; Puchalt, Nicolás Garrido; Ramasamy, Ranjith; Majzoub, Ahmad; Ly, Kim Dao; Tvrda, Eva; Assidi, Mourad; Kesari, Kavindra; Sharma, Reecha; Banihani, Saleem; Ko, Edmund; Abu-Elmagd, Muhammad; Gosalvez, Jaime; Bashiri, Asher

    2016-01-01

    Traditionally, the success of a researcher is assessed by the number of publications he or she publishes in peer-reviewed, indexed, high impact journals. This essential yardstick, often referred to as the impact of a specific researcher, is assessed through the use of various metrics. While researchers may be acquainted with such matrices, many do not know how to use them to enhance their careers. In addition to these metrics, a number of other factors should be taken into consideration to objectively evaluate a scientist's profile as a researcher and academician. Moreover, each metric has its own limitations that need to be considered when selecting an appropriate metric for evaluation. This paper provides a broad overview of the wide array of metrics currently in use in academia and research. Popular metrics are discussed and defined, including traditional metrics and article-level metrics, some of which are applied to researchers for a greater understanding of a particular concept, including varicocele that is the thematic area of this Special Issue of Asian Journal of Andrology. We recommend the combined use of quantitative and qualitative evaluation using judiciously selected metrics for a more objective assessment of scholarly output and research impact. PMID:26806079

  17. Who owns urban waste? Appropriation conflicts in emerging countries.

    Science.gov (United States)

    Cavé, Jérémie

    2014-09-01

    Managing solid waste in developing cities is not an easy task and many public policies have failed to bring the expected results. It is here argued that comprehending the solid waste handling in the South implies reconsidering the proper definition of waste. Where does the product end and where does rubbish begin? The answer to this question is far from being obvious. Solid waste appears as a blurred concept. Such a thorny issue is all the more relevant today, as municipal solid waste management approaches in the developing world are being reformulated: dumping sites are banned, sanitary landfills are imposed, and separate collection is being introduced. The current sector transformations are here analysed through a novel theoretical analysis combined with an original qualitative and quantitative empirical work. Through two case-studies of one-million inhabitant cities from emerging countries, it is shown that if appropriation conflicts arise that is because the urban solid waste deposit in Southern countries can be defined as an impure public good. This issue does not only involve private service operators and informal wastepickers; several other actors covet the urban solid waste deposit's cream, that is, recyclable items. In emerging countries, huge industrial groups are starting to target domestic recyclable waste as an alternative for raw materials, which costs are increasing ever more. © The Author(s) 2014.

  18. Chin tuck for prevention of aspiration: effectiveness and appropriate posture.

    Science.gov (United States)

    Ra, Jong Yun; Hyun, Jung Keun; Ko, Kyung Rok; Lee, Seong Jae

    2014-10-01

    Chin tuck has been has been widely used to prevent aspiration in the patients with dysphagia. This study was performed to investigate the effectiveness and the degree of optimal neck flexion of chin tuck. Ninety-seven patients who showed aspiration in the videofluoroscopic swallow study (VFSS). Participants were grouped into the effective (patients who showed effect with chin tuck) and ineffective group (those who did not show effect with chin tuck). VFSS was performed in neutral and chin tuck position and findings were compared between the groups. Severity of aspiration was assessed by the point penetration-aspiration scale. Duration of dysphagic symptoms, history of tracheostomy, and other possible contributing factors were also compared. Neck flexion angle was measured to find appropriate posture in which aspiration was prevented with chin tuck. Aspiration was reduced or eliminated in only 19 patients (19.6 %) with chin tuck. Oral transit time, pharyngeal delayed time and pharyngeal transit time were significantly shortened in both groups (p neck flexion was required to achieve an effect with chin tuck. The effectiveness of chin tuck was less than anticipated. Patients without residue in pyriform sinus were more likely to benefit from chin tuck. Sufficient neck flexion was important in chin tuck to prevent aspiration.

  19. Traditional architecture, building materials and appropriate modernity in Chilean cities

    Energy Technology Data Exchange (ETDEWEB)

    Cartes, I.A. [Universidad del Bio-Bio, Dept. of Planning and Urban Design, Concepcion (Chile)

    1998-09-01

    This paper discusses and analyses new buildings, inspired by traditional models of architecture, that propose energy savings and the use of local material revalidating the urban image of Chilean cities. However, as this paper demonstrates this adoption of traditional models, with their subsequent emphasis in ecological measures, such adoption is still intuitive and not a major principle of design. Therefore, isolated examples of modern buildings deal in an appropriate manner with their climate and geographical context. This kind of urban development contradicts the image of the country, which has been perceived by the international community as one of the most emergent economies. Consequently, central and local governments know that they have to aim a more environmental development in order to balance an explosive, and sometimes uncontrolled, way of building our cities. The conclusions stress the importance of creating common patterns of design for achieving better performances of buildings, owing to the fact that traditional models have been inherited and already exist as valid references. Especially, if Chile is to pursue both economical and sustainable development. (Author)

  20. Is duodenal biopsy appropriate in areas endemic for Helicobacter pylori?

    Science.gov (United States)

    Sahin, Abdurrahman; Cihangiroglu, Gulcin; Bilgic, Yilmaz; Calhan, Turan; Cengiz, Mustafa

    2017-01-01

    The primary reason for obtaining duodenal biopsy sample is to diagnose celiac disease. Helicobacter pylori (H. pylori) and drug injury are common causes of duodenitis. The aim of this retrospective study was to explore effects of H. pylori and drugs on duodenal mucosa. Duodenal biopsy samples of patients who underwent upper gastrointestinal endoscopy (UGIE) between February 2014 and December 2014 were retrospectively examined. Clinical symptoms, referral indications, endoscopic findings, H. pylori status, and drug history were recorded. Duodenal biopsy findings were compared based on presence of H. pylori and drug history. Of 2389 patients who underwent UGIE, 206 had duodenal biopsy. Eight patients (3.9%) were diagnosed with celiac disease. After excluding cases with celiac disease, 76 patients of remaining 198 patients (36.9%) had duodenal histopathological abnormality. H. pylori was found in 95 (47.9%) patients. Drug usage was less common (42%). Of patients who had histopathological duodenitis, 59% were H. pylori-infected. Rate of duodenitis was higher in H. pylori (+) group than in H. pylori (-) group (45% vs 27.1%; odds ratio, 2.4; 95% confidence interval, 1.3-4.4; p=0.005). There was no difference between groups regarding drug use in terms of histopathological duodenitis. H. pylori is the major contributor to duodenitis in high prevalence regions. Serological testing may be more appropriate before performing duodenal biopsy in patients with suspected celiac disease.

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

    Directory of Open Access Journals (Sweden)

    F. Boukadi

    2012-01-01

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

  2. Appropriate model selection methods for nonstationary generalized extreme value models

    Science.gov (United States)

    Kim, Hanbeen; Kim, Sooyoung; Shin, Hongjoon; Heo, Jun-Haeng

    2017-04-01

    Several evidences of hydrologic data series being nonstationary in nature have been found to date. This has resulted in the conduct of many studies in the area of nonstationary frequency analysis. Nonstationary probability distribution models involve parameters that vary over time. Therefore, it is not a straightforward process to apply conventional goodness-of-fit tests to the selection of an appropriate nonstationary probability distribution model. Tests that are generally recommended for such a selection include the Akaike's information criterion (AIC), corrected Akaike's information criterion (AICc), Bayesian information criterion (BIC), and likelihood ratio test (LRT). In this study, the Monte Carlo simulation was performed to compare the performances of these four tests, with regard to nonstationary as well as stationary generalized extreme value (GEV) distributions. Proper model selection ratios and sample sizes were taken into account to evaluate the performances of all the four tests. The BIC demonstrated the best performance with regard to stationary GEV models. In case of nonstationary GEV models, the AIC proved to be better than the other three methods, when relatively small sample sizes were considered. With larger sample sizes, the AIC, BIC, and LRT presented the best performances for GEV models which have nonstationary location and/or scale parameters, respectively. Simulation results were then evaluated by applying all four tests to annual maximum rainfall data of selected sites, as observed by the Korea Meteorological Administration.

  3. Evaluating the Appropriateness and Use of Domain Critical Errors

    Directory of Open Access Journals (Sweden)

    Chad W. Buckendahl

    2012-10-01

    Full Text Available The consequences associated with the uses and interpretations of scores for many credentialing testing programs have important implications for a range of stakeholders. Within licensure settings specifically, results from examination programs are often one of the final steps in the process of assessing whether individuals will be allowed to enter practice. This article focuses on the concept of domain critical errors and suggests a framework for considering their use in practice. Domain critical errors are defined here as knowledge, skills, abilities, or judgments that are essential to the definition of minimum qualifications in a testing program's pass-'fail decision-making process. Using domain critical errors has psychometric and policy implications, particularly for licensure programs that are mandatory for entry-level practice. Because these errors greatly influence pass-'fail decisions, the measurement community faces an ongoing challenge to promote defensible practices while concurrently providing assessment literacy development about the appropriate design and use of testing methods like domain critical errors.

  4. Bibliometrics: tracking research impact by selecting the appropriate metrics.

    Science.gov (United States)

    Agarwal, Ashok; Durairajanayagam, Damayanthi; Tatagari, Sindhuja; Esteves, Sandro C; Harlev, Avi; Henkel, Ralf; Roychoudhury, Shubhadeep; Homa, Sheryl; Puchalt, Nicolás Garrido; Ramasamy, Ranjith; Majzoub, Ahmad; Ly, Kim Dao; Tvrda, Eva; Assidi, Mourad; Kesari, Kavindra; Sharma, Reecha; Banihani, Saleem; Ko, Edmund; Abu-Elmagd, Muhammad; Gosalvez, Jaime; Bashiri, Asher

    2016-01-01

    Traditionally, the success of a researcher is assessed by the number of publications he or she publishes in peer-reviewed, indexed, high impact journals. This essential yardstick, often referred to as the impact of a specific researcher, is assessed through the use of various metrics. While researchers may be acquainted with such matrices, many do not know how to use them to enhance their careers. In addition to these metrics, a number of other factors should be taken into consideration to objectively evaluate a scientist's profile as a researcher and academician. Moreover, each metric has its own limitations that need to be considered when selecting an appropriate metric for evaluation. This paper provides a broad overview of the wide array of metrics currently in use in academia and research. Popular metrics are discussed and defined, including traditional metrics and article-level metrics, some of which are applied to researchers for a greater understanding of a particular concept, including varicocele that is the thematic area of this Special Issue of Asian Journal of Andrology. We recommend the combined use of quantitative and qualitative evaluation using judiciously selected metrics for a more objective assessment of scholarly output and research impact.

  5. A community assessment model appropriate for the Iranian community.

    Directory of Open Access Journals (Sweden)

    Kourosh Holakouie Naieni

    2014-03-01

    Full Text Available Community assessment is one of the core competencies for public health professionals; mainly because it gives them a better understanding of the strengths and drawbacks of their jurisdictions. We planned to recognize an appropriate model that provides a conceptual framework for the Iranian community.This study was conducted in Tehran, during 2009-2010 and consisted of two parts: a review of the literature and qualitative interview with selected experts as well as focus group discussion with health field staff. These steps were done to develop a conceptual framework: planning for a steering committee, forming a working committee, re-viewing community assessment models and projects, preparing the proposed model draft, in-depth interview and focused group discussions with national experts, finalizing the draft, and preparing the final model.Three different models published and applied routinely in different contexts. The 2008 North Carolina Community Assessment model was used as a reference. Ten national and 18 international projects were compared to the reference and one and six projects were completely compatible with this model, respectively.Our final proposed model takes communities through eight steps to complete a collaborative community assessment: form a community assessment team, solicit community participation and gain inter-sectoral collaboration, establish a working committee, empower the community, collect and analyze community's primary and secondary statistics, solicit community input to select health priorities, evaluate the community assessment and develop the community assessment document, an develop the community action plans.

  6. Towards the Amplituhedron Volume

    CERN Document Server

    Ferro, Livia; Orta, Andrea; Parisi, Matteo

    2015-01-01

    It has been recently conjectured that scattering amplitudes in planar N=4 super Yang-Mills are given by the volume of the (dual) amplituhedron. In this paper we show some interesting connections between the tree-level amplituhedron and a special class of differential equations. In particular we demonstrate how the amplituhedron volume for NMHV amplitudes is determined by these differential equations. The new formulation allows for a straightforward geometric description, without any reference to triangulations. Finally we discuss possible implications for volumes related to generic N^kMHV amplitudes.

  7. Unsteady flow volumes

    Energy Technology Data Exchange (ETDEWEB)

    Becker, B.G.; Lane, D.A.; Max, N.L.

    1995-03-01

    Flow volumes are extended for use in unsteady (time-dependent) flows. The resulting unsteady flow volumes are the 3 dimensional analog of streamlines. There are few examples where methods other than particle tracing have been used to visualize time varying flows. Since particle paths can become convoluted in time there are additional considerations to be made when extending any visualization technique to unsteady flows. We will present some solutions to the problems which occur in subdivision, rendering, and system design. We will apply the unsteady flow volumes to a variety of field types including moving multi-zoned curvilinear grids.

  8. Bronchoscopic lung volume reduction

    Directory of Open Access Journals (Sweden)

    M. I. Polkey

    2006-12-01

    Full Text Available Surgical lung volume reduction can improve exercise performance and forced expiratory volume in one second in patients with emphysema. However, the procedure is associated with a 5% mortality rate and a nonresponse rate of 25%. Accordingly, interest has focused on alternative ways of reducing lung volume. Two principle approaches are used: collapse of the diseased area using blockers placed endobronchially and the creation of extrapulmonary pathways. Preliminary data from the former approach suggest that it can be successful and that the magnitude of success is related to reduction in dynamic hyperinflation.

  9. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  10. Spacecraft Habitable Volume: Results of an Interdisciplinary Workshop

    Science.gov (United States)

    Fitts, David J.; Connolly, Janis; Howard, Robert

    2011-01-01

    NASA's Human Exploration Framework Team posed the question: "Is 80 cubic meters per person of habitable volume acceptable for a proposed Deep Space Habitat?" The goal of the workshop was to address the "net habitable volume" necessary for long-duration human spaceflight missions and identify design and psychological issues and mitigations. The objectives were: (1) Identify psychological factors -- i.e., "stressors" -- that impact volume and layout specifications for long duration missions (2) Identify mitigation strategies for stressors, especially those that can be written as volume design specifications (3) Identify a forward research roadmap -- i.e., what future work is needed to define and validate objective design metrics? (4) Provide advisories on the human factors consequences of poor net habitable volume allocation and layout design.

  11. Savannah River Site Approved Site Treatment Plan, 2001 Annual Update (Volumes I and II)

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2001-04-30

    The Compliance Plan Volume (Volume I) identifies project activity scheduled milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

  12. Selection of appropriate template for spatial normalization of brain images: tensor based morphometry

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Sung; Lee, Dong Soo; Kim, Yu Kyeong; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2004-07-01

    Although there have been remarkable advances in spatial normalization techniques, the differences in the shape of the hemispheres and the sulcal pattern of brains relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques. T1 SPGR MR images in 16 elderly male normal volunteers (>55 y. mean age: = 61.8 {+-} 3.5 y) were spatially normalized onto the age/gender specific Korean templates, and the Caucasian MNI template and the extent of the deformations were compared. These particular subjects were never included in the development of the templates. First , the images were matched into the templates using an affine transformation to eliminate the global difference between the templates and source images. Second the affine registration was followed by an estimation of nonlinear deformation. Determinants of the Jacobian matrices of the nonlinear deformation were then calculated for every voxel to estimate the regional volume change during the nonlinear transformation Jacobian determinant images highlighted the great magnitude of the relative local volume changes obtained when the elderly brains were spatially normalized onto the young/midlife male or female templates. They reflect the enlargement of CSF space in the lateral ventricles, sylvian fissures and cisterna magna, and the shrinkage of the cortex noted mainly in frontal, insular and lateral temporal cortexes, and the cerebellums in the aged brains. In the Jacobian determinant images, a regional shrinkage of the brain in the left middle prefrontal cortex was observed in addition to the regional expansion in the ventricles and sylvian fissures, which may be due to the age differences between the template and source images. The regional anatomical difference between template and source images could impose an extreme deformation of the source images during the spatial normalization and therefore. Individual brains should be placed into the appropriate

  13. Surveying the Process of Physical Development of Sahand New Town and Defining Appropriate Districts for Its Future Development

    Directory of Open Access Journals (Sweden)

    M. Pourjafar

    2012-01-01

    appropriate ecological capabilities. The main goal of this study is defining the best direction for city development that has the least short-time and longtime bad effects. Research method is descriptive and analytical method and data have been collected from library and observational study. Sahand is a new town in East Azerbaijan which was constructed about two decades ago for controlling the extreme growth of Tabriz and for attracting the extra population of this metropolis. Sahand new town is 20 kilometers far away from Tabriz and it became a town in 2007. It has a population of about 16000 and a population of about 90000 was forecasted for this town at its master plan. The area of allocated lands for this town is about 12650 hectare and it is situated on the hillside of Sahand Mountain. According to the process of ecological capability assessment in this research, for assessing the ecological capability of each region, we have to identify a lot of natural resources parameters. In order to provide these resources for assessment, they must become to land identification and resource maps. Subsequently, this information will be used as different information layers for assessing. Also, the information and the requirements for this model of ecological capability assessment were arranged according to the criteria of ecologic model (urban, rural and industrial development model.In the next stage, given the systematic method and also applying software applications such as GIS, data layers were analyzed, integrated and overlaid by AHP technique. Then, the final map of ecological capability of case study region was produced. This map was produced according to privileging two groups of lands, quiet appropriate and rather appropriate lands. Eventually, the final map of ecological capability of case study region was produced by overlaying the maps of these two kinds of lands with regard to both groups. So, the appropriate land for future development of Sahand new town was determined.4

  14. Free volume under shear

    Science.gov (United States)

    Maiti, Moumita; Vinutha, H. A.; Sastry, Srikanth; Heussinger, Claus

    2015-10-01

    Using an athermal quasistatic simulation protocol, we study the distribution of free volumes in sheared hard-particle packings close to, but below, the random-close packing threshold. We show that under shear, and independent of volume fraction, the free volumes develop features similar to close-packed systems — particles self-organize in a manner as to mimick the isotropically jammed state. We compare athermally sheared packings with thermalized packings and show that thermalization leads to an erasure of these structural features. The temporal evolution in particular the opening-up and the closing of free-volume patches is associated with the single-particle dynamics, showing a crossover from ballistic to diffusive behavior.

  15. Integers annual volume 2013

    CERN Document Server

    Landman, Bruce

    2014-01-01

    ""Integers"" is a refereed online journal devoted to research in the area of combinatorial number theory. It publishes original research articles in combinatorics and number theory. This work presents all papers of the 2013 volume in book form.

  16. Renormalized Volumes with Boundary

    CERN Document Server

    Gover, A Rod

    2016-01-01

    We develop a general regulated volume expansion for the volume of a manifold with boundary whose measure is suitably singular along a separating hypersurface. The expansion is shown to have a regulator independent anomaly term and a renormalized volume term given by the primitive of an associated anomaly operator. These results apply to a wide range of structures. We detail applications in the setting of measures derived from a conformally singular metric. In particular, we show that the anomaly generates invariant (Q-curvature, transgression)-type pairs for hypersurfaces with boundary. For the special case of anomalies coming from the volume enclosed by a minimal hypersurface ending on the boundary of a Poincare--Einstein structure, this result recovers Branson's Q-curvature and corresponding transgression. When the singular metric solves a boundary version of the constant scalar curvature Yamabe problem, the anomaly gives generalized Willmore energy functionals for hypersurfaces with boundary. Our approach ...

  17. Environmental chemistry: Volume A

    Energy Technology Data Exchange (ETDEWEB)

    Yen, T.F.

    1999-08-01

    This is an extensive introduction to environmental chemistry for engineering and chemical professionals. The contents of Volume A include a brief review of basic chemistry prior to coverage of litho, atmo, hydro, pedo, and biospheres.

  18. Juvenile wood volume and its proportion to stem volume vs. selected biometric features of Scots pine (Pinus sylvestris L. trees

    Directory of Open Access Journals (Sweden)

    Arkadiusz Tomczak

    2011-01-01

    Full Text Available The aim of the study was to determine whether there is a correlation between breast height diameter, tree height and stem total volume of Scots pines, on the one hand, and volume and proportion of juvenile wood, on the other. The investigations comprised pure pine stands of the IInd, IIIrd, IVth and Vth age classes developed in conditions of fresh mixed coniferous forest. A distinct curvilinear correlation was found between volume and proportion of juvenile wood in tree stems and breast height diameter, height and stem total volume. Because of high values of determination coefficients (R2, which characterised the above-mentioned correlations, it seems appropriate to use these regularities to assess the quality of the timber raw material regarding the proportions of its volume and juvenile wood in stems of Scots pine trees.

  19. De Minimis Thresholds for Federal Building Metering Appropriateness

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, Jordan W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-03-31

    The U.S. Department of Energy (DOE) is required by statute and Presidential Memorandum to establish guidelines for agencies to meter their Federal buildings for energy (electricity, natural gas, and steam) and water. See 42 U.S.C. § 8253(e). DOE issued guidance in February 2006 on the installation of electric meters in Federal buildings. A recent update to the 2006 guidance accounts for more current metering practices within the Federal Government. The updated metering guidance specifies that all Federal buildings shall be considered “appropriate” for energy or water metering unless identified for potential exclusion. In developing the updated guidance to carry out the statue, Congress also directed DOE to (among other things) establish exclusions from the metering requirements based on the de minimis quantity of energy use of a Federal building, industrial process, or structure. This paper discusses the method used to identify de minimis values.

  20. [Behavioral approach to facilitate appropriate use of antibiotics].

    Science.gov (United States)

    Matsushita, Osamu; Higuchi, Kazuko; Ishii, Noriko; Negayama, Kiyoshi; Taminato, Tomohiko

    2008-11-01

    Many hospitals have infection control education programs to facilitate the appropriate use of antimicrobial agents. Even with these efforts, however, it is not rare to encounter irregular prescriptions. In order to solve this discrepancy between knowledge and actual behavior, we chose an alternative approach to improve the decision making process. Recent advances in information technology have made it possible to not only instantly integrate various bacterial examination results using a computer, but to simultaneously carry out the statistical analyses at a much lower cost. We employed a client-server system to accomplish these tasks in Kagawa University Hospital. By connecting CCD camera-equipped microscopes to the system directly, image uploading has become a single-clicking job. Various microbial examination data were automatically transferred to the system once they became available in analytical devices such as BacT/ALERT 3D, VITEK, and an MIC analyzer. These data were presented to hospital doctors in well-designed web windows without delay. By removing psychological barriers to access laboratory examination data, statistics, and relevant information, more doctors seemed to independently follow scientific processes to choose antimicrobial agents. The daily behavior of hospital doctors has also been influenced by the system, e. g., pasting the microscopic images onto clinical records, or starting Gram staining in their own wards. These subtle but fundamental changes will eventually alter the way they make prescription decisions. The computer system was also useful for the infection control team to monitor and detect nosocomial infections, which has become essential to carry out its daily activities.

  1. Selecting appropriate bedding to reduce locomotion problems in broilers

    Directory of Open Access Journals (Sweden)

    ICL Almeida Paz

    2010-09-01

    Full Text Available Two experiments were carried out at the Poultry Sector of the School of Agrarian Sciences of the Federal University of Grande Dourados to evaluate the incidence of leg problems in broilers reared on two distinct types of bedding material: rice husks or wood shavings, both new and reused. In both trials, a randomized experimental design was applied in factorial arrangement (2 x 2 x 2 using two genetic strains (Cobb® or Ross®; two sexes (male or female, and two litter materials (rice husks or wood shavings. In each trial 1080 one day pullets were reared equally divided in the treatments. The birds were placed in 4.5 m² boxes at a density of 10 birds m-2. All birds were fed diets with equal nutritional density, and water was offered ad libitum. Feeds were divided in three phases: starter diet (1 - 21 days, grower diet (22 - 35 days, and finisher diet (36 - 45 days. On day 45, fifty birds were randomly selected in each experiment to evaluate flock leg problems. The following parameters were analyzed: gait score, incidence of valgus and varus disorder, footpad dermatitis, femoral degeneration, tibial dyschondroplasia, and spondylolisthesis. Ambient temperature during rearing and litter caking and moisture content were recorded in four boxes per treatment. The analytical hierarchy process was used to organize the data into specific criteria. Several criteria, related to the attributes that were determinant according to the statistical analysis, were chosen in order to provide the best input to the process. Results indicated that new wood-shavings bedding was the most appropriate bedding to prevent locomotion problems, followed by new rice husks, reused wood shavings, and reused rice husks. However, when leg problems were associated to sex and genetic strain, male Ross birds strain presented less problems when reared on new rice husks, followed by new wood shavings

  2. Selection of an appropriately simple storm runoff model

    Directory of Open Access Journals (Sweden)

    A. I. J. M. van Dijk

    2009-09-01

    Full Text Available Alternative conceptual storm runoff models, including several published ones, were evaluated against storm flow time series for 260 catchments in Australia (23–1902 km2. The original daily streamflow data was separated into baseflow and storm flow components and from these, event rainfall and storm flow totals were estimated. For each tested model structure, the number of free parameters was reduced in stages. The appropriate balance between simplicity and explanatory power was decided based on Aikake's Final Prediction Error Criterion and evidence of parameter equivalence. The majority of catchments showed storm recession half-times in the order of a day, with more rapid drainage in dry catchments. Overland and channel travel time did not appear to be an important driver of storm flow recession. A storm runoff model with two free parameters (one related to storm event size, the other to antecedent baseflow and a fixed initial loss of 12 mm provided the optimal model structure. The optimal model had some features similar to the Soil Conservation Service Curve Number technique, but performed an average 12 to 19% better. The non-linear relationship between event rainfall and event runoff may be associated with saturated area expansion during storms and/or the relationship between storm event size and peak rainfall intensity. Antecedent baseflow was a strong predictor of runoff response. A simple conceptual relationship between groundwater storage and saturated catchment area proved adequate and produced realistic estimates of saturated area of <0.1% for the driest and >5% for the wettest catchments.

  3. Cambridge Polytrauma Pathway: Are we making appropriately guided decisions?

    Science.gov (United States)

    Wynell-Mayow, William; Guevel, Borna; Quansah, Benjamin; O'Leary, Ronan; Carrothers, Andrew D

    2016-10-01

    Addenbrooke's Hospital, the Major Trauma Centre for the East of England Trauma Network, received 1070 major trauma patients between 1st January and 31st December 2014. In order to improve care, an audit was performed of 59 patients meeting our own selection criteria for orthopaedic polytrauma between 1st January 2013 and 31st December 2013. The Cambridge Polytrauma Pathway was devised through NCEPOD guidelines, literature review, internal and external discussion. It facilitates provision of best practice Early Appropriate Care, encompassing - multidisciplinary consultant decisions around the patient in our Neurological and Trauma Critical Care Unit, early full body trauma CT scans, serial measurements of lactate and fibrinogen levels, and out-of-hours orthopaedic theatre reserved for life-and-limb threatening injuries. Re-audit was conducted of 15 patients meeting selection criteria, admitted between 1st October 2014 and 31st March 2015. Significant improvements in recording of lactate and fibrinogen were demonstrated, both on admission (lactate - p<0.000, fibrinogen - p=0.015), and preoperatively (lactate - p=0.003, fibrinogen - p=0.030). Time to trauma CT was unchanged (p=0.536) with a median time to CT of 0.53h at re-audit (IQR 0.48-0.75). The number of patients receiving definitive orthopaedic intervention out-of-hours reduced from 8 to zero (p=0.195). The approach of facilitating management decisions to be made at early daytime MDT meetings has been adopted. It is anticipated that this pathway will improve outcomes in orthopaedic polytrauma patients and it is recommended that either the GOS-E, or the EQ-5D scoring systems be introduced to assess this. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  4. Generalized Partial Volume

    DEFF Research Database (Denmark)

    Darkner, Sune; Sporring, Jon

    2011-01-01

    Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV). Their theoret......Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV...

  5. Assessing medication packaging and labelling appropriateness in Sri Lanka

    OpenAIRE

    Athuraliya, N.; Walkom, E. J.; Dharmaratne, S.; Robertson, J.

    2016-01-01

    Background There is substantial evidence of poor dispensing practices with inadequate packaging and labelling of medicines, and limited advice on their usage in low and middle-income countries (LMICs). We examined the labelling and packaging of medicines identified during a survey of 1322 households in six regions of Sri Lanka between 2010 and 2013 conducted using the World Health Organization (WHO) methodology for household surveys. We compared medicines obtained from public and private sour...

  6. 18 CFR 367.4360 - Account 436, Appropriations of retained earnings.

    Science.gov (United States)

    2010-04-01

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

  7. Reachable volume RRT

    KAUST Repository

    McMahon, Troy

    2015-05-01

    © 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.

  8. On the Use of MCDM Technique for Identifying Key Technology: A case of Auto Company

    National Research Council Canada - National Science Library

    Aliakbar Mazlomi; osnah bt. Mohd. Yusuff

    2011-01-01

    .... Moreover, identifying strategic technology is main part of strategydevelopment. This article tries to apply MCDM methods in finding key strategic technologies from identified technologies from in order to provide appropriate technology strategy...

  9. Identifying Relevant Studies in Software Engineering

    DEFF Research Database (Denmark)

    Zhang, He; Ali Babar, Muhammad; Tell, Paolo

    2011-01-01

    Context: Systematic literature review (SLR) has become an important research methodology in software engineering since the introduction of evidence-based software engineering (EBSE) in 2004. One critical step in applying this methodology is to design and execute appropriate and effective search....... Objective: The main objective of the research reported in this paper is to improve the search step of undertaking SLRs in software engineering (SE) by devising and evaluating systematic and practical approaches to identifying relevant studies in SE. Method: We have systematically selected and analytically...

  10. Appropriate Tealeaf Harvest Timing Determination Referring Fiber Content in Tealeaf Derived from Ground based Nir Camera Images

    Directory of Open Access Journals (Sweden)

    Kohei Arai

    2015-08-01

    Full Text Available Method for most appropriate tealeaves harvest timing with the reference to the fiber content in tealeaves which can be estimated with ground based Near Infrared (NIR camera images is proposed. In the proposed method, NIR camera images of tealeaves are used for estimation of nitrogen content and fiber content in tealeaves. The nitrogen content is highly correlated to Theanine (amid acid content in tealeaves. Theanine rich tealeaves taste good. Meanwhile, the age of tealeaves depend on fiber content. When tealeaves are getting old, then fiber content is increased. Tealeaf shape volume also is increased with increasing of fiber content. Fiber rich tealeaves taste not so good, in general. There is negative correlation between fiber content and NIR reflectance of tealeaves. Therefore, tealeaves quality of nitrogen and fiber contents can be estimated with NIR camera images. Also, the shape volume of tealeaves is highly correlated to NIR reflectance of tealeaf surface. Therefore, not only tealeaf quality but also harvest amount can be estimated with NIR camera images. Experimental results show the proposed method works well for estimation of appropriate tealeaves harvest timing with fiber content in the tealeaves in concern estimated with NIR camera images.

  11. Estimating the volume of Alpine glacial lakes

    Science.gov (United States)

    Cook, S. J.; Quincey, D. J.

    2015-12-01

    Supraglacial, moraine-dammed and ice-dammed lakes represent a potential glacial lake outburst flood (GLOF) threat to downstream communities in many mountain regions. This has motivated the development of empirical relationships to predict lake volume given a measurement of lake surface area obtained from satellite imagery. Such relationships are based on the notion that lake depth, area and volume scale predictably. We critically evaluate the performance of these existing empirical relationships by examining a global database of glacial lake depths, areas and volumes. Results show that lake area and depth are not always well correlated (r2 = 0.38) and that although lake volume and area are well correlated (r2 = 0.91), and indeed are auto-correlated, there are distinct outliers in the data set. These outliers represent situations where it may not be appropriate to apply existing empirical relationships to predict lake volume and include growing supraglacial lakes, glaciers that recede into basins with complex overdeepened morphologies or that have been deepened by intense erosion and lakes formed where glaciers advance across and block a main trunk valley. We use the compiled data set to develop a conceptual model of how the volumes of supraglacial ponds and lakes, moraine-dammed lakes and ice-dammed lakes should be expected to evolve with increasing area. Although a large amount of bathymetric data exist for moraine-dammed and ice-dammed lakes, we suggest that further measurements of growing supraglacial ponds and lakes are needed to better understand their development.

  12. Evaluation of gallbladder volume and contraction index with three-dimensional ultrasonography in healthy dogs.

    Science.gov (United States)

    Rahmani, Vahideh; Molazem, Mohammad; Jamshidi, Shahram; Vali, Yasamin; Hanifeh, Mohsen

    2015-09-01

    Three-dimensional (3D) ultrasonography has been shown to be an accurate and appropriate tool for measurement of gallbladder volume in humans. Therefore, we applied this novel technique for the first time to study fasting and postprandial gallbladder volume in 10 healthy dogs and compared the results with those of 2-dimensional (2D) ultrasonography. Fasting gallbladder volumes determined by 3D ultrasonography were significantly higher than corresponding volumes determined by 2D ultrasonography (Pcompared with the fasting state using 3D ultrasonography (Pdogs in this study. It is suggested that 3D ultrasonography can be used to accurately estimate gallbladder volume and contractility.

  13. Decision Analysis System for Selection of Appropriate Decontamination Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Ebadian, M.A.; Boudreaux, J.F.; Chinta, S.; Zanakis, S.H.

    1998-01-01

    The principal objective for designing Decision Analysis System for Decontamination (DASD) is to support DOE-EM's endeavor to employ the most efficient and effective technologies for treating radiologically contaminated surfaces while minimizing personnel and environmental risks. DASD will provide a tool for environmental decision makers to improve the quality, consistency, and efficacy of their technology selection decisions. The system will facilitate methodical comparisons between innovative and baseline decontamination technologies and aid in identifying the most suitable technologies for performing surface decontamination at DOE environmental restoration sites.

  14. Annual Review of Anthropology, Volume 5.

    Science.gov (United States)

    Siegel, Bernard J., Ed.; And Others

    Seventeen articles focus on current research interests of anthropologists. The volume is part of a five-year project designed to identify interesting directions in physical, linguistic, archaeological, social, and cultural anthropology. Covering a wide range of anthropological subjects, the articles discuss a history of physical anthropology,…

  15. Annual Review of Anthropology, Volume 5.

    Science.gov (United States)

    Siegel, Bernard J., Ed.; And Others

    Seventeen articles focus on current research interests of anthropologists. The volume is part of a five-year project designed to identify interesting directions in physical, linguistic, archaeological, social, and cultural anthropology. Covering a wide range of anthropological subjects, the articles discuss a history of physical anthropology,…

  16. Use of manual alveolar recruitment maneuvers to eliminate atelectasis artifacts identified during thoracic computed tomography of healthy neonatal foals.

    Science.gov (United States)

    Lascola, Kara M; Clark-Price, Stuart C; Joslyn, Stephen K; Mitchell, Mark A; O'Brien, Robert T; Hartman, Susan K; Kline, Kevin H

    2016-11-01

    OBJECTIVE To evaluate use of single manual alveolar recruitment maneuvers (ARMs) to eliminate atelectasis during CT of anesthetized foals. ANIMALS 6 neonatal Standardbred foals. PROCEDURES Thoracic CT was performed on spontaneously breathing anesthetized foals positioned in sternal (n = 3) or dorsal (3) recumbency when foals were 24 to 36 hours old (time 1), 4 days old (time 2), 7 days old (time 3), and 10 days old (time 4). The CT images were collected without ARMs (all times) and during ARMs with an internal airway pressure of 10, 20, and 30 cm H2O (times 2 and 3). Quantitative analysis of CT images measured whole lung and regional changes in attenuation or volume with ARMs. RESULTS Increased attenuation and an alveolar pattern were most prominent in the dependent portion of the lungs. Subjectively, ARMs did not eliminate atelectasis; however, they did incrementally reduce attenuation, particularly in the nondependent portion of the lungs. Quantitative differences in lung attenuation attributable to position of foal were not identified. Lung attenuation decreased significantly (times 2 and 3) and lung volume increased significantly (times 2 and 3) after ARMs. Changes in attenuation and volume were most pronounced in the nondependent portion of the lungs and at ARMs of 20 and 30 cm H2O. CONCLUSIONS AND CLINICAL RELEVANCE Manual ARMs did not eliminate atelectasis but reduced attenuation in nondependent portions of the lungs. Positioning of foals in dorsal recumbency for CT may be appropriate when pathological changes in the ventral portion of the lungs are suspected.

  17. ICU-based rehabilitation and its appropriate metrics.

    Science.gov (United States)

    Gosselink, Rik; Needham, Dale; Hermans, Greet

    2012-10-01

    Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early rehabilitation of ICU patients has recently been identified as an important focus for interdisciplinary ICU teams. However, the amount of rehabilitation performed in ICUs is often inadequate. The scope of the review is to discuss recent developments in application of assessment tools and rehabilitation in critically ill patients within an interdisciplinary approach. ICU-based rehabilitation has become an important evidence-based component in the management of patients with critical illness. The assessment and evidence-based treatment of these patients should include a focus on prevention and treatment of deconditioning (muscle weakness, joint stiffness, impaired functional performance) and weaning failure (respiratory muscle weakness) to identify targets for rehabilitation. A variety of modalities for assessment and early ICU rehabilitation are supported by emerging clinical research and must be implemented according to the stage of critical illness, comorbidities, and consciousness and cooperation of the patient. Daily evaluation of every critically ill patient should include evaluation of the need for bedrest and immobility, and assessment of the potential for early rehabilitation interventions. Early ICU rehabilitation is an interdisciplinary team responsibility, involving physical therapists, occupational therapists, nurses and medical staff.

  18. Which Metrics Are Appropriate to Describe the Value of New Cancer Therapies?

    Directory of Open Access Journals (Sweden)

    Peter Johnson

    2015-01-01

    Full Text Available Patients with certain cancers are treated with curative intent, but for others the results are less favorable and different therapeutic approaches are needed. Early data suggest that new therapies, which modulate immune responses to cancers, may have potential for long-term survival in a proportion of cases. Therefore, it is timely to consider whether metrics generally used to describe the medical value of therapies for patients with common solid tumors remain appropriate for therapies with curative potential. Literature reviews were conducted to define how various stakeholders describe cure in oncology and to identify the endpoints used in clinical trials for selected solid tumors. The results showed that “cure” is described using various terms that can be divided broadly into lack of disease progression, eradication of cancerous cells, and survival. The review of trial endpoints showed frequent use of median overall survival (OS and progression- and response-related endpoints. Because these endpoints were mainly described in the context of chemotherapies that are not generally curative, they may not adequately capture outcomes of new therapeutic modalities with potential for long-term survival. More appropriate endpoints may include mean OS, cure fraction, and OS rate at landmark time points.

  19. An appropriate tool for appetite testing and evaluation in young children in Benin.

    Science.gov (United States)

    Dossa, R A M; Ategbo, E A D; van Raaij, J M A; de Graaf, C; Hautvast, J G A J

    2002-04-01

    Appetite measurements were performed in 109 Beninese children aged 18-30 months to develop a tool for appetite evaluation in young children in nutritional intervention programmes. Two test foods were identified as appropriate for these children: a maize porridge (aklui) and rice (riz-au-gras). Ad libitum intakes of the foods served after an overnight fast according to a standardized offering procedure were measured on 3 days. The children's habitual intakes were measured during 3 consecutive days not overlapping with the days when the test meals were provided. Energy intake from the test foods was comparable to breakfast energy intake which was 0.8-1.0 MJ, representing 21% of total daily energy intake. Energy intake from aklui was significantly correlated with daily intake (r=0.41, n=38, pappetite test as calculated from the triplicate measurements was 40% for aklui and 25% for riz-au-gras. This reproducibility is better than that of the habitual breakfast intake (43-45%). In conclusion, the appetite test used in our studies can be considered as an appropriate tool in appetite evaluations.

  20. Age-appropriate services for people diagnosed with young onset dementia (YOD): a systematic review.

    Science.gov (United States)

    Mayrhofer, Andrea; Mathie, Elspeth; McKeown, Jane; Bunn, Frances; Goodman, Claire

    2017-06-16

    Literature agrees that post-diagnostic services for people living with young onset dementia (YOD) need to be age-appropriate, but there is insufficient evidence of 'what works' to inform service design and delivery. To provide an evidence base of age-appropriate services and to review the perceived effectiveness of current interventions. We undertook a systematic review including all types of research relating to interventions for YOD. We searched PubMed, CINHAL Plus, SCOPUS, EBSCO Host EJS, Social Care Online and Google Scholar, hand-searched journals and carried out lateral searches (July-October 2016). Included papers were synthesised qualitatively. Primary studies were critically appraised. Twenty articles (peer-reviewed [n = 10], descriptive accounts [n = 10]) discussing 195 participants (persons diagnosed with YOD [n = 94], caregivers [n = 91] and other [n = 10]) were identified for inclusion. Services enabled people with YOD to remain living at home for longer. However, service continuity was compromised by short-term project-based commissioning and ad-hoc service delivery. The evidence on the experience of living with YOD is not matched by research and the innovation needed to mitigate the impact of YOD. The inclusion of people with YOD and their caregivers in service design is critical when planning support in order to delay institutional care.

  1. Analysis of volatile organic compounds in compost samples: A potential tool to determine appropriate composting time.

    Science.gov (United States)

    Zhu, Fengxiang; Pan, Zaifa; Hong, Chunlai; Wang, Weiping; Chen, Xiaoyang; Xue, Zhiyong; Yao, Yanlai

    2016-12-01

    Changes in volatile organic compound contents in compost samples during pig manure composting were studied using a headspace, solid-phase micro-extraction method (HS-SPME) followed by gas chromatography with mass spectrometric detection (GC/MS). Parameters affecting the SPME procedure were optimized as follows: the coating was carbon molecular sieve/polydimethylsiloxane (CAR/PDMS) fiber, the temperature was 60°C and the time was 30min. Under these conditions, 87 compounds were identified from 17 composting samples. Most of the volatile components could only be detected before day 22. However, benzenes, alkanes and alkenes increased and eventually stabilized after day 22. Phenol and acid substances, which are important factors for compost quality, were almost undetectable on day 39 in natural compost (NC) samples and on day 13 in maggot-treated compost (MC) samples. Our results indicate that the approach can be effectively used to determine the composting times by analysis of volatile substances in compost samples. An appropriate composting time not only ensures the quality of compost and reduces the loss of composting material but also reduces the generation of hazardous substances. The appropriate composting times for MC and NC were approximately 22days and 40days, respectively, during the summer in Zhejiang.

  2. SLSF loop handling system. Volume I. Structural analysis. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, H.; Cowie, A.; Ma, D.

    1978-10-01

    SLSF loop handling system was analyzed for deadweight and postulated dynamic loading conditions, identified in Chapters II and III in Volume I of this report, using a linear elastic static equivalent method of stress analysis. Stress analysis of the loop handling machine is presented in Volume I of this report. Chapter VII in Volume I of this report is a contribution by EG and G Co., who performed the work under ANL supervision.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  4. Which Metric Is More Appropriate to Evaluate Researchers?

    Directory of Open Access Journals (Sweden)

    Majid Khadem-Rezayian

    2015-06-01

    Full Text Available Iranian medical universities choose their best researchers in each field annually. The protocols of this process have been modified quite often, but the changes were not fundamental and did not lead to all-inclusive evaluation tools. The recent article in Asia Pacific Journal of Medical Toxicology, which proposes a scoring scale for evaluation of scientist's impact called "360-degree researcher evaluation score" (1, not only opens a new window for detailed evaluation of researchers' products and creations, but also provides a basic platform for promoting the research. In community medicine, there is a strict view to primarily address upstream causes of health problems while we look for solutions for downstream ones (2. It seems that this view has been considered in the designing process of this new scale, as for example, some neglected criteria which build capacity for science production (upstream causes of low science production are taken into account.   We really appreciate the holistic view of the scale, but we believe that following suggestions would help to improve its utility: In "science development" domain: It seems that the parameter of "number of downloads of articles" is not an appropriate criterion, because some journals do not report this measure. Besides, its value in scholarly communication is still under debate and it can be easily manipulated by the researcher himself (3. In calculating scores for journal articles, the calculation method is based on dividing impact factor (IF by 30. Many journals have low IFs of just 0.1 or 0.2 and this calculation can make too many decimals. However, the good news is that with this method of calculation, there is more emphasis on the design of the study than the IF of the publishing journal. In "economic impact" domain: The measurement method is based on "ranking in institution". As some parameters only receives 1 score at maximum and there may be several staff members in one department, the

  5. Exegesis seeking appropriation; appropriation seeking exegesis: Re-reading 2 Samuel 13:1−22 in search of redemptive masculinities

    Directory of Open Access Journals (Sweden)

    Gerald West

    2013-09-01

    Full Text Available Exegesis in the traditional sense is concerned with generating as much (scientific detail about a biblical text as possible. Whilst the two primary modes of biblical exegesis � socio-historical and literary-semiotic � do this differently, they share a common concern for the detail of the text as an ancient artefact. Critical distance is a key concept here, with the exegetes bracketing (for a moment their own contexts and concerns. However, such bracketing is impossible to sustain, and so the exegetes� interests (shaped by their contexts and concerns �leak� into the act of exegesis. Most exegetes today recognise this leakage, and whilst some still view such leakage as contaminating the exegesis, others, including the tradition of African biblical scholarship, actively identify the contextual concerns they bring to the task of exegesis, both respecting the detail of the text and desiring to be accountable to their contexts in which the Bible is a significant text. This article explored some of the dimensions of forms of exegesis that actively seek appropriation, using 2 Samuel 13:1�22 as an example. In this case, the article analysed the contextual shift from a focus on women as the victims of sexual violence to an emerging emphasis on masculinities. Reading the same text from these different contextual concerns �activates� particular details of the text, and so both draw on different elements of the text and thus guides the gaze of exegesis.

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

    Directory of Open Access Journals (Sweden)

    Kabbara WK

    2015-04-01

    Full Text Available Wissam K Kabbara,1 Wijdan H Ramadan,1 Peggy Rahbany,2 Souhaila Al-Natour3 1Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon; 2Children’s National Medical Center, Washington, DC, USA; 3Medex Pharmaceutical Company, Beirut, Lebanon Background: Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged.Objective: The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia in diabetic and nondiabetic patients.Methods: A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin were identified. Patients were mainly recruited from internal medicine floors and intensive care units.Results: The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%, followed by levofloxacin (42.4% and moxifloxacin (7.6%. Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%, followed by ciprofloxacin (39.0% and moxifloxacin (33.3%. In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was

  7. What's in a Name? The Impact of Accurate Staphylococcus pseudintermedius Identification on Appropriate Antimicrobial Susceptibility Testing.

    Science.gov (United States)

    Limbago, Brandi M

    2016-03-01

    Bacteria in the Staphylococcus intermedius group, including Staphylococcus pseudintermedius, often encode mecA-mediated methicillin resistance. Reliable detection of this phenotype for proper treatment and infection control decisions requires that these coagulase-positive staphylococci are accurately identified and specifically that they are not misidentified as S. aureus. As correct species level bacterial identification becomes more commonplace in clinical laboratories, one can expect to see changes in guidance for antimicrobial susceptibility testing and interpretation. The study by Wu et al. in this issue (M. T. Wu, C.-A. D. Burnham, L. F. Westblade, J. Dien Bard, S. D. Lawhon, M. A. Wallace, T. Stanley, E. Burd, J. Hindler, R. M. Humphries, J Clin Microbiol 54:535-542, 2016, http://dx.doi.org/10.1128/JCM.02864-15) highlights the impact of robust identification of S. intermedius group organisms on the selection of appropriate antimicrobial susceptibility testing methods and interpretation.

  8. Increasing the Understanding and Demonstration of Appropriate Affection in Children with Asperger Syndrome: A Pilot Trial

    Directory of Open Access Journals (Sweden)

    Kate Sofronoff

    2011-01-01

    Full Text Available The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability. It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study.

  9. Increasing the Understanding and Demonstration of Appropriate Affection in Children with Asperger Syndrome: A Pilot Trial

    Science.gov (United States)

    Sofronoff, Kate; Eloff, Johann; Sheffield, Jeanie; Attwood, Tony

    2011-01-01

    The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability). It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study. PMID:22937243

  10. Increasing the understanding and demonstration of appropriate affection in children with asperger syndrome: a pilot trial.

    Science.gov (United States)

    Sofronoff, Kate; Eloff, Johann; Sheffield, Jeanie; Attwood, Tony

    2011-01-01

    The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability). It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study.

  11. Live ultrasound volume reconstruction using scout scanning

    Science.gov (United States)

    Meyer, Amelie; Lasso, Andras; Ungi, Tamas; Fichtinger, Gabor

    2015-03-01

    Ultrasound-guided interventions often necessitate scanning of deep-seated anatomical structures that may be hard to visualize. Visualization can be improved using reconstructed 3D ultrasound volumes. High-resolution 3D reconstruction of a large area during clinical interventions is challenging if the region of interest is unknown. We propose a two-stage scanning method allowing the user to perform quick low-resolution scouting followed by high-resolution live volume reconstruction. Scout scanning is accomplished by stacking 2D tracked ultrasound images into a low-resolution volume. Then, within a region of interest defined in the scout scan, live volume reconstruction can be performed by continuous scanning until sufficient image density is achieved. We implemented the workflow as a module of the open-source 3D Slicer application, within the SlicerIGT extension and building on the PLUS toolkit. Scout scanning is performed in a few seconds using 3 mm spacing to allow region of interest definition. Live reconstruction parameters are set to provide good image quality (0.5 mm spacing, hole filling enabled) and feedback is given during live scanning by regularly updated display of the reconstructed volume. Use of scout scanning may allow the physician to identify anatomical structures. Subsequent live volume reconstruction in a region of interest may assist in procedures such as targeting needle interventions or estimating brain shift during surgery.

  12. Volumes of chain links

    CERN Document Server

    Kaiser, James; Rollins, Clint

    2011-01-01

    Agol has conjectured that minimally twisted n-chain links are the smallest volume hyperbolic manifolds with n cusps, for n at most 10. In his thesis, Venzke mentions that these cannot be smallest volume for n at least 11, but does not provide a proof. In this paper, we give a proof of Venzke's statement. The proof for n at least 60 is completely rigorous. The proof for n between 11 and 59 uses a computer calculation, and can be made rigorous for manifolds of small enough complexity, using methods of Moser and Milley. Finally, we prove that the n-chain link with 2m or 2m+1 half-twists cannot be the minimal volume hyperbolic manifold with n cusps, provided n is at least 60 or |m| is at least 8, and we give computational data indicating this remains true for smaller n and |m|.

  13. HARNESSING BIG DATA VOLUMES

    Directory of Open Access Journals (Sweden)

    Bogdan DINU

    2014-04-01

    Full Text Available Big Data can revolutionize humanity. Hidden within the huge amounts and variety of the data we are creating we may find information, facts, social insights and benchmarks that were once virtually impossible to find or were simply inexistent. Large volumes of data allow organizations to tap in real time the full potential of all the internal or external information they possess. Big data calls for quick decisions and innovative ways to assist customers and the society as a whole. Big data platforms and product portfolio will help customers harness to the full the value of big data volumes. This paper deals with technical and technological issues related to handling big data volumes in the Big Data environment.

  14. Identifying pelagic ecosystem indicators for management

    DEFF Research Database (Denmark)

    Trenkel, Verena; Hintzen, Niels; Rindorf, Anna

    2013-01-01

    When exploiting fish populations under the ecosystem approach, aiming for MSY is not necessarily sufficient to ensure wider ecosystem sustainability. All of the large stocks of pelagic fish are managed through harvest control rules based on an MSY approach. Ensuring good environmental status...... will probably require further constraints to be imposed by management. Most of the current paradigm with regards to GES for fisheries has been based on demersal fish. Pelagic fisheries and fish are operationally and biologically respectively different. We use the example of applying the ecosystem approach...... to pelagic fisheries to further explore the setting of management objectives. The objectives were identified through a participatory process including industry, management, scientist and NGO representatives. These objectives were used to identify appropriate driver, pressure and state indicators. The links...

  15. Identifying pelagic ecosystem indicators for management

    DEFF Research Database (Denmark)

    Trenkel, Verena; Hintzen, Niels; Rindorf, Anna

    2013-01-01

    to pelagic fisheries to further explore the setting of management objectives. The objectives were identified through a participatory process including industry, management, scientist and NGO representatives. These objectives were used to identify appropriate driver, pressure and state indicators. The links......When exploiting fish populations under the ecosystem approach, aiming for MSY is not necessarily sufficient to ensure wider ecosystem sustainability. All of the large stocks of pelagic fish are managed through harvest control rules based on an MSY approach. Ensuring good environmental status...... will probably require further constraints to be imposed by management. Most of the current paradigm with regards to GES for fisheries has been based on demersal fish. Pelagic fisheries and fish are operationally and biologically respectively different. We use the example of applying the ecosystem approach...

  16. Selecting appropriate animal models and experimental designs for endocrine disruptor research and testing studies.

    Science.gov (United States)

    Stokes, William S

    2004-01-01

    Evidence that chemicals in the environment may cause developmental and reproductive abnormalities in fish and wildlife by disrupting normal endocrine functions has increased concern about potential adverse human health effects from such chemicals. US laws have now been enacted that require the US Environmental Protection Agency (EPA) to develop and validate a screening program to identify chemicals in food and water with potential endocrine-disrupting activity. EPA subsequently proposed an Endocrine Disruptor Screening Program that uses in vitro and in vivo test systems to identify chemicals that may adversely affect humans and ecologically important animal species. However, the endocrine system can be readily modulated by many experimental factors, including diet and the genetic background of the selected animal strain or stock. It is therefore desirable to minimize or avoid factors that cause or contribute to experimental variation in endocrine disruptor research and testing studies. Standard laboratory animal diets contain high and variable levels of phytoestrogens, which can modulate physiologic and behavioral responses similar to both endogenous estrogen as well as exogenous estrogenic chemicals. Other studies have determined that some commonly used outbred mice and rats are less responsive to estrogenic substances than certain inbred mouse and rat strains for various estrogen-sensitive endpoints. It is therefore critical to select appropriate biological models and diets for endocrine disruptor studies that provide optimal sensitivity and specificity to accomplish the research or testing objectives. An introduction is provided to 11 other papers in this issue that review these and other important laboratory animal experimental design considerations in greater detail, and that review laboratory animal and in vitro models currently being used or evaluated for endocrine disruptor research and testing. Selection of appropriate animal models and experimental design

  17. Appropriate pressure-transmitting media for cryogenic experiment in the diamond anvil cell up to 10 GPa

    Science.gov (United States)

    Tateiwa, Naoyuki; Haga, Yoshinori

    2010-03-01

    We evaluated the qualities of pressure-transmitting media by the ruby fluorescence method at room temperature, 77 and 4.2 K in the diamond anvil cell (DAC) up to 10 GPa in order to find appropriate media for the low temperature experiment. Investigations were done on fourteen kinds of media: a 1:1 mixture by volume of Fluorinert FC-70 and FC-77, Daphne 7373 and 7474, NaCl, silicon oil (polydimethylsiloxane), vaselin, 2-propanol, glycerin, a 1:1 mixture by volume of n-pentane and isopentane, a 4:1 mixture by volume of methanol and ethanol, petroleum ether, nitrogen, argon and helium. We discuss the non-hydrostatic effects of the pressure in the media from the broadening effect of the ruby R1 fluorescence line. At the low temperature region, the non-hydrostatic effects develop continuously with increasing pressure from the low-pressure region in the all media. We reveal the relative strengths of the non-hydrostatic effects appeared in the media at 77K.

  18. Stability of methylprednisolone sodium succinate in small volumes of 5% dextrose and 0. 9% sodium chloride injections

    Energy Technology Data Exchange (ETDEWEB)

    Townsend, R.J.; Puchala, A.H.; Nail, S.L.

    1981-09-01

    The stability of methylprednisolone sodium succinate in small volumes of 5% dextrose and 0.9% sodium chloride injections was studied. Vials of methylprednisolone sodium succinate (125-3000 mg) were reconstituted and added to 50- and 100-ml volumes of the two diluents. These piggyback solutions were visually inspected for the development of haze over a 24-hour period. A nephelometer was used to quantitate the development of turbidity with time. The effect of pH on haze formation was investigated, and infrared spectroscopy was used to identify the haze. Nephelometer readings were found to correlate well with visual inspections. The haze was identified as being formed by the precipitation of free methylprednisolone. The rate of change of turbidity was directly related to the pH. A 1.4-3.2 percentage-point increase in the free methylprednisolone concentration secondary to hydrolysis over the 24-hour period was noted. The duration of stability was variable among the investigated lots and concentrations. Nineteen of the 24 admixtures stored at room temperature remained stable and free of visible haze for at least 12 hours after preparation. For all dosage strengths of methylprednisolone sodium succinate studied, these data indicate that solutions can be made stable for at least 12 hours by selecting the appropriate volume of diluent.

  19. Historical volume estimation and a structured method for calculating habitable volume for in-space and surface habitats

    Science.gov (United States)

    Simon, M.; Bobskill, M. R.; Wilhite, A.

    2012-11-01

    Habitable volume is an important spacecraft design figure of merit necessary to determine the required size of crewed space vehicles, or habitats. In order to design habitats for future missions and properly compare the habitable volumes of future habitat designs with historical spacecraft, consistent methods of both defining the required amount of habitable volume and estimating the habitable volume for a given layout are required. This paper provides a brief summary of historical habitable volume requirements and describes the appropriate application of requirements to various types of missions, particularly highlighting the appropriate application for various gravity environments. Then the proposed "Marching Grid Method", a structured automatic, numerical method to calculate habitable volume for a given habitat design, is described in detail. This method uses a set of geometric Boolean tests applied to a discrete set of points within the pressurized volume to numerically estimate the functionally usable and accessible space that comprises the habitable volume. The application of this method to zero gravity and nonzero gravity environments is also discussed. This proposed method is then demonstrated by calculating habitable volumes using two conceptual-level layouts of habitat designs, one for each type of gravity environment. These include the US Laboratory Module on ISS and the Scenario 12.0 Pressurized Core Module from the recent NASA Lunar Surface Systems studies. Results of this study include a description of the effectiveness of this method for various resolutions of the investigated grid, and commentary highlighting the use of this method to determine the overall utility of interior configurations for automatically evaluating interior layouts.

  20. The volume of a soliton

    Energy Technology Data Exchange (ETDEWEB)

    Adam, C., E-mail: adam@fpaxp1.usc.es [Departamento de Física de Partículas, Universidad de Santiago de Compostela and Instituto Galego de Física de Altas Enerxias (IGFAE), E-15782 Santiago de Compostela (Spain); Haberichter, M. [School of Mathematics, Statistics and Actuarial Science, University of Kent, Canterbury, CT2 7NF (United Kingdom); Wereszczynski, A. [Institute of Physics, Jagiellonian University, Lojasiewicza 11, Kraków (Poland)

    2016-03-10

    There exists, in general, no unique definition of the size (volume, area, etc., depending on dimension) of a soliton. Here we demonstrate that the geometric volume (area etc.) of a soliton is singled out in the sense that it exactly coincides with the thermodynamical or continuum-mechanical volume. In addition, this volume may be defined uniquely for rather arbitrary solitons in arbitrary dimensions.

  1. Large-volume results in SU(2) with adjoint fermions

    CERN Document Server

    Del Debbio, Luigi; Pica, Claudio; Patella, Agostino; Rago, Antonio; Roman, Sabin

    2014-01-01

    Taming finite-volume effects is a crucial ingredient in order to identify the existence of IR fixed points. We present the latest results from our numerical simulations of SU(2) gauge theory with 2 Dirac fermions in the adjoint representation on large volumes. We compare with previous results, and extrapolate to thermodynamic limit when possible.

  2. Large-volume results in SU(2) with adjoint fermions

    DEFF Research Database (Denmark)

    Del Debbio, Luigi; Lucini, Biagio; Pica, Claudio;

    2013-01-01

    Taming finite-volume effects is a crucial ingredient in order to identify the existence of IR fixed points. We present the latest results from our numerical simulations of SU(2) gauge theory with 2 Dirac fermions in the adjoint representation on large volumes. We compare with previous results, an...

  3. Is empiric therapy with fluconazole appropriate for esophageal candidiasis?

    Science.gov (United States)

    Sajith, Kattiparambil Gangadharan; Dutta, Amit Kumar; Sahni, Rani Diana; Esakimuthu, Saritha; Chacko, Ashok

    2014-03-01

    We studied the prevalence of fluconazole resistance in esophageal candidiasis. Patients with suspected esophageal candidiasis during gastroscopy underwent culture of white plaques. Minimum inhibitory concentration (MIC) >64 μg/mL of fluconazole for Candida was indicative of resistance. Sensitivity of itraconazole was tested in a subset of resistant strains. Sixty-five patients were included. Mean (SD) age was 50.03 (13.5) years and 67.7 % were males. Predisposing factors for candidiasis were found in 42 (64.6 %) patients. C. albicans was identified in 64 (97.4 %) patients and C. glabrata in one patient. Fluconazole resistance was seen in 38 (59.4 %) patients with C. albicans and also in the one patient with C. glabrata. All the fluconazole resistant isolates of C. albicans had MIC >128 μg/mL suggesting very high resistance. Twelve patients with fluconazole resistance had itraconazole resistance as well. The study shows a high rate of fluconazole resistance in patients with esophageal candidiasis.

  4. Determining the Most Appropriate Classification Methods for Water Quality

    Science.gov (United States)

    Gürsoy, Önder

    2016-10-01

    Assessing water resources’ quality and also monitoring them have attracted lots of attention in the recent years. Remote sensing has been growing widely in the last decade and its resources are very usable when it comes to water resources management. In this study, by using remote sensing technology, satellite images that have 350 to 1050 nanometres wavelength band sensors are used to determine the quality of the Kizilirmak River's water. Through the river's resources, ground based spectral measurements are made to identify the quality differences of the water at the test spots that have been determined before. In this context at Imranli, where the river contacts civilization for the first time, which is located in Sivas city of Turkey, samples are gathered in order to do ground based spectroradiometer measurements. These samples are gathered simultaneously with the image acquiring time of CHRIS Proba satellite. Spectral signatures that are obtained from ground measurements are used as reference data in order to classify CHRIS Proba satellite's hyperspectral images over the study area. Satellite images are classified based on Chemical Oxygen Demand (COD), Turbidity and Electrical Conductivity (EC) attributes. As a result, interpretations obtained from classified CHRIS Proba satellite hyperspectral images of the study area are presented. Spectras are readied for Matched Filtering and Spectral Angle Mapper methods for determining the best classification method.

  5. Mitigation and adaptation cost assessment: Concepts, methods and appropriate use

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    The present report on mitigation and adaptation costs addresses the complex issue of identifying synergies and tradeoffs between national priorities and mitigation policies, an issue that requires the integration of various disciplines so as to provide a comprehensive overview of future development trends, available technologies and economic policies. Further, the report suggests a new conceptual framework for treating the social aspects in assessing mitigation and adaptation costs in climate change studies. The impacts of certain sustainability indicators such as employment and poverty reduction on mitigation costing are also discussed in the report. Among the topics to be considered by over 120 distinguished international experts, are the elements of costing methodologies at both the micro and macro levels. Special effort will be made to include the impacts of such parameters as income, equity, poverty, employment and trade. Hence, the contents of this report are highly relevant to the authors of the Third Working Group in the development of the TAR. The report contains a chapter on Special Issues and Problems Related to Cost Assessment for Developing Countries. This chapter will provide valuable background in the further development of these concepts in the TAR because it is an area that has not received due attention in previous work. (au)

  6. Finding the Truth in Medical Imaging: Painting the Picture of Appropriateness for Magnetic Resonance Imaging in Canada.

    Science.gov (United States)

    Vanderby, Sonia; Peña-Sánchez, Juan Nicolás; Kalra, Neil; Babyn, Paul

    2015-11-01

    Questions about the appropriateness of medical imaging exams, particularly related to magnetic resonance exams, have arisen in recent years. However, the prevalence of inappropriate imaging in Canada is unclear as inappropriate exam proportion estimates are often based on studies from other countries. Hence, we sought to compare and summarize Canadian studies related to magnetic resonance imaging appropriateness. We completed a systematic literature search identifying studies related to magnetic resonance appropriateness in Canada published between 2003 and 2013. Two researchers independently searched and evaluated the literature available. Articles that studied or discussed magnetic resonance appropriateness in Canada were selected based on titles, abstracts, and, where necessary, full article review. Articles relating solely to other modalities or countries were excluded, as were imaging appropriateness guidelines and reviews. Fourteen articles were included: 8 quantitative studies and 6 editorials/commentaries. The quantitative studies reported inappropriate proportions of magnetic resonance exams ranging from 2%-28.5%. Our review also revealed substantial variations among study methods and analyses. Common topics identified among editorials/commentaries included reasons for obtaining imaging in general and for selecting a specific modality, consequences of inappropriate imaging, factors contributing to demand, and suggested means of mitigating inappropriate medical imaging use. The available studies do not support the common claim that 30% of medical imaging exams in Canada are inappropriate. The actual proportion of inappropriate magnetic resonance exams has not yet been established conclusively in Canada. Further research, particularly on a widespread national scale, is needed to guide healthcare policies. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  7. Identifying the Physical Properties of Showers That Influence User Satisfaction to Aid in Developing Water-Saving Showers

    Directory of Open Access Journals (Sweden)

    Minami Okamoto

    2015-07-01

    Full Text Available This research was conducted with the goal of clarifying the required conditions of water-saving showerheads. In order to this, the research analyzes the mutual relationship between water usage flow, the level of satisfaction and the physical properties of spray of showerheads. The physical properties of spray were measured using physical properties test apparatus of standard or scheme for water-saving showerheads issued in several water-saving countries, and satisfaction evaluation data was acquired through bathing experiments. The evaluated showerheads were separated into three groups according to usage water flow and the level of satisfaction. The relationships between usage water flow, the level of satisfaction and physical properties were compared. The results identified that Spray Force and Spray Force-per-Hole were physical properties that influence usage water flow. Spray force-per-hole, water volume ratio in Spray Patterns within φ 100 and φ 150, Temperature Drop and Spray Angle were identified as physical properties that influenced the level of satisfaction. The level of satisfaction and usage water flow has a spurious correlation through the physical properties of Spray Force-per-Hole and Temperature Drop. It is possible to improve the level of satisfaction independent of amount of water usage through designs that set an appropriate value for water volume ratio and Spray Angle for Spray Patterns within φ 100 and φ 150.

  8. Design for volume reduction

    NARCIS (Netherlands)

    Wever, R.; Boks, C.; Stevels, A.

    2007-01-01

    Traditionally packaging design-for-sustainability (DfS) strongly focuses on resource conservation and material recycling. The type and amount of materials used has been the driver in design. For consumer electronics (CE) products this weight-based approach is too limited; a volume-based approach is

  9. Introduction to the Volume.

    Science.gov (United States)

    Emihovich, Catherine; Schroder, Barbara; Panofsky, Carolyn P.

    1999-01-01

    Introduces a volume that examines the issue of critical thinking and whether or not it is culturally specific, discussing recent research on the subject. The papers focus on critical thinking and culture, historical consciousness and critical thinking, critical thinking as cultural-historical practice, culture and the development of critical…

  10. Ways to Develop College Students’Awareness of Appropriateness in Oral Communication

    Institute of Scientific and Technical Information of China (English)

    李晓莉

    2014-01-01

    Appropriateness is very important in oral communication. By analyzing the problems in oral communication, this arti-cle puts forward some efficient ways to raise college students’awareness of appropriateness in oral communication.

  11. Identification of appropriate temporal scales of dominant low flow indicators in the Main River, Germany

    NARCIS (Netherlands)

    Demirel, M.C.; Booij, Martijn J.; Servat, Eric; Demuth, Siegfried; Dezetter, Alain; Daniell, Trevor

    2010-01-01

    Models incorporating the appropriate temporal scales of dominant indicators for low flows are assumed to perform better than models with arbitrary selected temporal scales. In this paper, we investigate appropriate temporal scales of dominant low flow indicators: precipitation (P), evapotranspiratio

  12. Assessment of global flood exposures - developing an appropriate approach

    Science.gov (United States)

    Millinship, Ian; Booth, Naomi

    2015-04-01

    Increasingly complex probabilistic catastrophe models have become the standard for quantitative flood risk assessments by re/insurance companies. On the one hand, probabilistic modelling of this nature is extremely useful; a large range of risk metrics can be output. However, they can be time consuming and computationally expensive to develop and run. Levels of uncertainty are persistently high despite, or perhaps because of, attempts to increase resolution and complexity. A cycle of dependency between modelling companies and re/insurers has developed whereby available models are purchased, models run, and both portfolio and model data 'improved' every year. This can lead to potential exposures in perils and territories that are not currently modelled being largely overlooked by companies, who may then face substantial and unexpected losses when large events occur in these areas. We present here an approach to assessing global flood exposures which reduces the scale and complexity of approach used and begins with the identification of hotspots where there is a significant exposure to flood risk. The method comprises four stages: i) compile consistent exposure information, ii) to apply reinsurance terms and conditions to calculate values exposed, iii) to assess the potential hazard using a global set of flood hazard maps, and iv) to identify potential risk 'hotspots' which include considerations of spatially and/or temporally clustered historical events, and local flood defences. This global exposure assessment is designed as a scoping exercise, and reveals areas or cities where the potential for accumulated loss is of significant interest to a reinsurance company, and for which there is no existing catastrophe model. These regions are then candidates for the development of deterministic scenarios, or probabilistic models. The key advantages of this approach will be discussed. These include simplicity and ability of business leaders to understand results, as well as

  13. Fact Sheet: Selected Highlights of the FY2017 Military Construction Appropriations Bills

    Science.gov (United States)

    2016-08-18

    Division A: MILCON/VA, Division B: Zika Response Appropriations, and Division C: Zika Vector Control), removing the T-HUD portion for H.R. 2577, passed the...contained four divisions: (1) Division A: MILCON/VA, (2) Division B: Zika Response and Preparedness Appropriations, (3) Division C: Zika Vector Control...Appropriations Act, 2017; Division B as the Zika Response Appropriations Act, 2016; and Division C as the Zika Vector Control Act. The House passed the

  14. FY2017 Defense Appropriations Fact Sheet: Selected Highlights of H.R. 5293 and S. 3000

    Science.gov (United States)

    2016-06-17

    FY2017 Defense Appropriations Fact Sheet: Selected Highlights of H.R. 5293 and S . 3000 Pat Towell Specialist in U.S. Defense Policy and Budget...Appropriations Fact Sheet: Selected Highlights of H.R. 5293 and S . 300 Congressional Research Service Summary This Fact Sheet summarizes selected...Appropriations Committee on May 26, 2016 ( S . 3000). Congressional action on the FY2017 defense appropriations act has been fundamentally shaped by the

  15. How Do Value Creation and Competition Determine Whether a Firm Appropriates Value?

    OpenAIRE

    Glenn MacDonald; Michael D. Ryall

    2004-01-01

    How does competition among economic actors determine the value that each is able to appropriate? We provide a formal, general framework within which this question can be posed and answered, and then provide several results. Chief among them is a condition that is both required for, and guarantees, value appropriation. We apply our methodology to (i) assess the familiar notion that uniqueness, inimitability, and competition imply value appropriation, and (ii) determine the value appropriation ...

  16. Lanthanum additions and the toughness of ultra-high strength steels and the determination of appropriate lanthanum additions

    Energy Technology Data Exchange (ETDEWEB)

    Garrison, Warren M. [Department of Metallurgical Engineering and Materials Science, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213 (United States)]. E-mail: wmg@andrew.cmu.edu; Maloney, James L. [Timken Company, 1835 Dueber Avenue S.W., Canton, OH 44706-0930 (United States)

    2005-08-25

    Studies of commercial heats of AF1410 steel suggest that under appropriate conditions additions of rare-earth elements can significantly enhance fracture toughness. This improvement in toughness is not due to an extremely low inclusion volume fraction but is apparently due to the formation of larger and more widely spaced inclusions. The purpose of this work is to discuss our experience in using rare-earth additions to laboratory scale vacuum induction melted and subsequently vacuum arc remelted heats of ultra-high strength steels to achieve inclusion distributions similar to those observed in commercial heats modified with lanthanum additions. The results indicate that lanthanum additions of 0.015 wt.% to low sulfur steels which have been well deoxidized using carbon-vacuum deoxidation can result in lanthanum rich inclusions which are similar in size, volume fraction and spacing to those obtained in commercially produced heats of ultra-high strength steel to which lanthanum has been added. The heat of steel to which lanthanum additions of 0.015 wt.% were made had significantly higher toughness than did the heat of the same steel in which the sulfur had been gettered as small and closely spaced particles of MnS and which had an inclusion volume fraction similar to that of the heat modified by the addition of 0.015 wt.% lanthanum. This improvement in toughness was attributed to an increase in inclusion spacing. An addition of 0.06 wt.% lanthanum was excessive. Such an addition of lanthanum resulted in a huge volume fraction of large cuboidal inclusions which primarily contain lanthanum and oxygen and which are extremely detrimental to toughness.

  17. 41 CFR 60-300.84 - Responsibilities of appropriate employment service delivery system.

    Science.gov (United States)

    2010-07-01

    ... appropriate employment service delivery system. 60-300.84 Section 60-300.84 Public Contracts and Property... of appropriate employment service delivery system. By statute, appropriate employment service... referrals. The employment service delivery systems shall provide OFCCP, upon request, information...

  18. 29 CFR 103.30 - Appropriate bargaining units in the health care industry.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Appropriate bargaining units in the health care industry... Appropriate Bargaining Units § 103.30 Appropriate bargaining units in the health care industry. (a) This... such by either Joint Committee on Accreditation of Healthcare Organizations or by Commission...

  19. 20 CFR 404.1537 - What we mean by appropriate treatment.

    Science.gov (United States)

    2010-04-01

    ... mean by appropriate treatment. By appropriate treatment, we mean treatment for drug addiction or... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What we mean by appropriate treatment. 404... your treatment plan. These settings range from outpatient counseling services through a variety...

  20. 20 CFR 416.937 - What we mean by appropriate treatment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What we mean by appropriate treatment. 416... FOR THE AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.937 What we mean by appropriate treatment. By appropriate treatment, we mean treatment for...

  1. Processes of spatial appropriation and social inequalities in the Historic Center of Puebla

    Directory of Open Access Journals (Sweden)

    Alfonso Alvarez Moura

    2016-12-01

    Full Text Available Linking forms of intervention in the city and processes of socio- spatial appropriation in the historic center of Puebla. We discuss specific caseloads of dispossession - appropriating space that delve into social inequalities. With all this, we intend to verify the relationship between the use made of the Historical Center and social appropriation class that is the subject

  2. Increased intracranial volume in Parkinson's disease

    DEFF Research Database (Denmark)

    Krabbe, Katja; Karlsborg, Merete; Hansen, Andreas

    2005-01-01

    BACKGROUND: Parkinson's disease (PD) and multiple system atrophy (MSA) are neurodegenerative diseases that can be difficult to diagnose and distinguish from each other. STUDY AIMS AND METHODS: Patients with PD and MSA and controls were studied with magnetic resonance imaging (MRI) using tissue...... segmentation and outlining of regions in order to identify regional volume changes that might be useful in the diagnosis of the two diseases. RESULTS: Patients with PD had significantly larger intracranial volumes (ICVs) and significantly smaller putaminal and sustantia nigra volumes than controls. MSA...... or compensatory responses to early CNS damage. Atrophy of the amygdala in MSA patients has not been demonstrated with MR before. It might explain why these patients can have hyposmia. The putaminal atrophy found in the PD group may be a trait of the later stages of PD. Segmentation of the substantia nigra can...

  3. Appropriate antivenom doses for six types of envenomations caused by snakes in taiwan

    Directory of Open Access Journals (Sweden)

    C Chieh-Fan

    2009-01-01

    Full Text Available Six of the 15 species of venomous snakes found in Taiwan are responsible for most of the clinically significant envenomations in the country. These species are: Trimeresurus mucrosquamatus, Trimeresurus stejnegeri, Naja atra, Bungarus multicinctus, Deinagkistrodon acutus and Daboia russelii siamensis, which together can be subdivided into three groups based on their venom effects. Primary treatment consists of rapid administration of appropriate antivenoms. The present study aimed to identify a proper dose of antivenom for each snake group as well as to describe hemorrhagic, neurotoxic, and mixed effects of their venoms. A retrospective chart review identified 72 snakebite cases referred to an emergency department. Data on epidemiology, examination findings, snake identification, treatment, antivenom dose and complications were collected. After excluding 14 patients, data from 58 victims were analyzed. Most studied cases were male (86%. Significantly higher doses of antivenom were administered against neurotoxic envenomations (mean dose: three vials compared with the other two (p < 0.05. Moreover, patients affected by neurotoxic bites were more likely to develop blurred vision and other complications (p < 0.05. Multivariate logistic regression analysis indicated that neurotoxic envenomation was a risk factor for complications (OR: 8.84, 95% CI: 1.06-73.73. Neurotoxic envenomations and complication occurrence were positively correlated with antivenom dosage. In conclusion, patients affected by neurotoxic envenomations received higher doses of antivenom than others whereas incidence of complications was associated with higher antivenom doses.

  4. Right Ventricular Volumes and Systolic Function by Cardiac Magnetic Resonance and the Impact of Sex, Age, and Obesity in a Longitudinally Followed Cohort Free of Pulmonary and Cardiovascular Disease: The Framingham Heart Study.

    Science.gov (United States)

    Foppa, Murilo; Arora, Garima; Gona, Philimon; Ashrafi, Arman; Salton, Carol J; Yeon, Susan B; Blease, Susan J; Levy, Daniel; O'Donnell, Christopher J; Manning, Warren J; Chuang, Michael L

    2016-03-01

    Cardiac magnetic resonance is uniquely well suited for noninvasive imaging of the right ventricle. We sought to define normal cardiac magnetic resonance reference values and to identify the main determinants of right ventricular (RV) volumes and systolic function using a modern imaging sequence in a community-dwelling, longitudinally followed cohort free of clinical cardiovascular and pulmonary disease. The Framingham Heart Study Offspring cohort has been followed since 1971. We scanned 1794 Offspring cohort members using steady-state free precession cardiac magnetic resonance and identified a reference group of 1336 adults (64±9 years, 576 men) free of prevalent cardiovascular and pulmonary disease. RV trabeculations and papillary muscles were considered cavity volume. Men had greater RV volumes and cardiac output before and after indexation to body size (all P<0.001). Women had higher RV ejection fraction than men (68±6% versus 64±7%; P<0.0001). RV volumes and cardiac output decreased with advancing age. There was an increase in raw and height-indexed RV measurements with increasing body mass index, but this trend was weakly inverted after indexation of RV volumes to body surface area. Sex, age, height, body mass index, and heart rate account for most of the variability in RV volumes and function in this community-dwelling population. We report sex-specific normative values for RV measurements among principally middle-aged and older adults. RV ejection fraction is greater in women. RV volumes increase with body size, are greater in men, and are smaller in older people. Body surface area seems to be appropriate for indexation of cardiac magnetic resonance-derived RV volumes. © 2016 American Heart Association, Inc.

  5. Postoperative volume balance

    DEFF Research Database (Denmark)

    Frost, H; Mortensen, C.R.; Secher, Niels H.

    2017-01-01

    In healthy humans, stroke volume (SV) and cardiac output (CO) do not increase with expansion of the central blood volume by head-down tilt or administration of fluid. Here, we exposed 85 patients to Trendelenburg's position about one hour after surgery while cardiovascular variables were determined...... non-invasively by Modelflow. In Trendelenburg's position, SV (83 ± 19 versus 89 ± 20 ml) and CO (6·2 ± 1·8 versus 6·8 ± 1·8 l/min; both Pheart rate (75 ± 15 versus 76 ± 14 b min(-1) ) and mean arterial pressure were unaffected (84 ± 15 versus 84 ± 16 mmHg). For the 33 patients......, determination of SV and/or CO in Trendelenburg's position can be used to evaluate whether a patient is in need of IV fluid as here exemplified after surgery....

  6. Modeling Approach for Estimating Co-Produced Water Volumes and Saltwater Disposal Volumes in Oklahoma

    Science.gov (United States)

    Murray, K. E.

    2016-12-01

    Management of produced fluids has become an important issue in Oklahoma because large volumes of saltwater are co-produced with oil and gas, and disposed into saltwater disposal wells at high rates. Petroleum production increased from 2009-2015, especially in central and north-central Oklahoma where the Mississippian and Hunton zones were redeveloped using horizontal wells and dewatering techniques that have led to a disproportional increase in produced water volumes. Improved management of co-produced water, including desalination for beneficial reuse and decreased saltwater disposal volumes, is only possible if spatial and temporal trends can be defined and related to the producing zones. It is challenging to quantify the volumes of co-produced water by region or production zone because co-produced water volumes are generally not reported. Therefore, the goal of this research is to estimate co-produced water volumes for 2008-present with an approach that can be replicated as petroleum production shifts to other regions. Oil and gas production rates from subsurface zones were multiplied by ratios of H2O:oil and H2O:gas for the respective zones. Initial H2O:oil and H2O:gas ratios were adjusted/calibrated, by zone, to maximize correlation of county-scale produced H2O estimates versus saltwater disposal volumes from 2013-2015. These calibrated ratios were then used to compute saltwater disposal volumes from 2008-2012 because of apparent data gaps in reported saltwater disposal volumes during that timeframe. This research can be used to identify regions that have the greatest need for produced water treatment systems. The next step in management of produced fluids is to explore optimal energy-efficient strategies that reduce deleterious effects.

  7. Select Papers. Volume 1

    Science.gov (United States)

    2011-08-01

    non- uniform rational B-splines (NURBS), 127 and BRL-CAD TM format. This dual-package development allowed for rapid development of components ...next generation of scientists and engineers. A fundamental component of our outreach program is to provide students research experiences at ARL...summer intern. There, I ran Volume Based Morphometry , an application of Statistical Parametric Mapping that was new to the Hirsch lab. I

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

    Science.gov (United States)

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

    2015-11-14

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

  9. Impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Chul-Gyu Kim; Sungho Jo; Jae Sun Kim

    2012-01-01

    AIM:To evaluate the impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy (PD) for periampullary tumors in South Korea.METHODS:Periampullary cancer patients who underwent PD between 2005 and 2008 were analyzed from the database of the Health Insurance Review and Assessment Service of South Korea.A total of 126 hospitals were divided into 5 categories,each similar in terms of surgical volume for each category.We used hospital mortality as a quality indicator,which was defined as death during the hospital stay for PD,and calculated adjusted mortality through multivariate logistic models using several confounder variables.RESULTS:A total of eligible 4975 patients were enrolled in this study.Average annual surgical volume of hospitals was markedly varied,ranging from 215 PDs in the very-high-volume hospital to < 10 PDs in the verylow-volume hospitals.Admission route,type of medical security,and type of operation were significantly different by surgical volume.The overall hospital mortality was 2.1% and the observed hospital mortality by surgical volume showed statistical difference.Surgical volume,age,and type of operation were independent risk factors for hospital death,and adjusted hospital mortality showed a similar difference between hospitals with observed mortality.The result of the HosmerLemeshow test was 5.76 (P =0.674),indicating an acceptable appropriateness of our regression model.CONCLUSION:The higher-volume hospitals showed lower hospital mortality than the lower-volume hospitals after PD in South Korea,which were clarified through the nationwide database.

  10. Small-Volume Injections: Evaluation of Volume Administration Deviation From Intended Injection Volumes.

    Science.gov (United States)

    Muffly, Matthew K; Chen, Michael I; Claure, Rebecca E; Drover, David R; Efron, Bradley; Fitch, William L; Hammer, Gregory B

    2017-10-01

    In the perioperative period, anesthesiologists and postanesthesia care unit (PACU) nurses routinely prepare and administer small-volume IV injections, yet the accuracy of delivered medication volumes in this setting has not been described. In this ex vivo study, we sought to characterize the degree to which small-volume injections (≤0.5 mL) deviated from the intended injection volumes among a group of pediatric anesthesiologists and pediatric postanesthesia care unit (PACU) nurses. We hypothesized that as the intended injection volumes decreased, the deviation from those intended injection volumes would increase. Ten attending pediatric anesthesiologists and 10 pediatric PACU nurses each performed a series of 10 injections into a simulated patient IV setup. Practitioners used separate 1-mL tuberculin syringes with removable 18-gauge needles (Becton-Dickinson & Company, Franklin Lakes, NJ) to aspirate 5 different volumes (0.025, 0.05, 0.1, 0.25, and 0.5 mL) of 0.25 mM Lucifer Yellow (LY) fluorescent dye constituted in saline (Sigma Aldrich, St. Louis, MO) from a rubber-stoppered vial. Each participant then injected the specified volume of LY fluorescent dye via a 3-way stopcock into IV tubing with free-flowing 0.9% sodium chloride (10 mL/min). The injected volume of LY fluorescent dye and 0.9% sodium chloride then drained into a collection vial for laboratory analysis. Microplate fluorescence wavelength detection (Infinite M1000; Tecan, Mannedorf, Switzerland) was used to measure the fluorescence of the collected fluid. Administered injection volumes were calculated based on the fluorescence of the collected fluid using a calibration curve of known LY volumes and associated fluorescence.To determine whether deviation of the administered volumes from the intended injection volumes increased at lower injection volumes, we compared the proportional injection volume error (loge [administered volume/intended volume]) for each of the 5 injection volumes using a linear

  11. Patients' appropriateness, acceptability, usability and preferences for pharmaceutical preparations: Results from a literature review on clinical evidence.

    Science.gov (United States)

    Drumond, Nélio; van Riet-Nales, Diana A; Karapinar-Çarkit, Fatma; Stegemann, Sven

    2017-04-15

    Patients play an important role in achieving the desired therapeutic outcomes, as they are frequently responsible for their own medication management. To facilitate drug administration and overcome medication issues, the patients' needs and preferences should be considered in the pharmaceutical drug product design. With the aim to evaluate the current state of evidence for patient appropriateness, acceptability, usability and preference for aspects of this design, a literature search was performed. Comparative clinical studies that assessed such endpoints for different patient populations were included and summarized descriptively. The search identified 45 publications that met the inclusion criteria. A detailed analysis of the studies identified two main areas investigating either packaging design (n=10) or dosage form design (n=35). Studies on packaging design showed preferences for wing top and screw cap openings, push-through blisters and suppositories with slide system. Additionally, child-resistant containers should be avoided concerning specific patient populations. Regarding dosage form design, sprinkles and minitablets were the most preferred in studies involving young patients, while preferences varied considerably depending on route of administration and geographical region in studies with adult patients. Review of the methodology used in the studies revealed that ten studies had used well-defined protocols and observational endpoints to investigate patient appropriateness. Studies focusing on methodology for testing the appropriateness and usability of drug products by patients were not found. In conclusion, more interdisciplinary scientific efforts are required to develop and increase research in understanding patient needs and preferences.

  12. Appropriate Arrangement of Nori Aquafarming Grounds in the Ariake Sea on the Basis of Convective Dispersion Simulation Model

    Science.gov (United States)

    Tabata, Toshinori; Hiramatsu, Kazuaki; Harada, Masayoshi; Shiraishi, Hideto; Shuto, Toshio

    This study investigated appropriate arrangement of nori aquafarming grounds from the view point of nori growth in the Ariake Sea coastal waters. Databases of the sea-bed topography and nori aquafarming grounds were constructed using GIS. Then the tidal currents and salinity in the Ariake Sea were simulated using a two-dimensional depth-integrated model, which was developed by integrating the three-dimensional continuity, momentum, and diffusion equations. The wetting and drying scheme was also introduced to account for the appearance and disappearance of tidal flats. The velocities and directions of the simulated tidal currents, salinity, and tidal land appearance were in good agreement with observed data. Five scenarios considered by the Fukuoka Prefectural Government were introduced in the simulation model to identify the most appropriate arrangement. An experimental formula for nitrogen assimilation kinetics in the nori body was introduced to evaluate the simulation results for the five scenarios. The scenarios with a reduced density of aquafarming grounds had increased nori growth, suggesting that the arrangement of the aquafarming grounds affected the nori growth. The simulation results were used to identify the most appropriate arrangement of aquafarming grounds.

  13. The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases : The Neuromodulation Appropriateness Consensus Committee

    NARCIS (Netherlands)

    Deer, Timothy R.; Mekhail, Nagy; Provenzano, David; Pope, Jason; Krames, Elliot; Leong, Michael; Levy, Robert M.; Abejon, David; Buchser, Eric; Burton, Allen; Buvanendran, Asokumar; Candido, Kenneth; Caraway, David; Cousins, Michael; de Jongste, Micheal; Diwan, Sudhir; Eldabe, Sam; Gatzinsky, Kliment; Foreman, Robert D.; Hayek, Salim; Kim, Philip; Kinfe, Thomas; Kloth, David; Kumar, Krishna; Rizvi, Syed; Lad, Shivanand P.; Liem, Liong; Linderoth, Bengt; Mackey, Sean; McDowell, Gladstone; McRoberts, Porter; Poree, Lawrence; Prager, Joshua; Raso, Lou; Rauck, Richard; Russo, Marc; Simpson, Brian; Slavin, Konstantin; Staats, Peter; Stanton-Hicks, Michael; Verrills, Paul; Wellington, Joshua; Williams, Kayode; North, Richard

    Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended

  14. The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases : The Neuromodulation Appropriateness Consensus Committee

    NARCIS (Netherlands)

    Deer, Timothy R.; Mekhail, Nagy; Provenzano, David; Pope, Jason; Krames, Elliot; Leong, Michael; Levy, Robert M.; Abejon, David; Buchser, Eric; Burton, Allen; Buvanendran, Asokumar; Candido, Kenneth; Caraway, David; Cousins, Michael; de Jongste, Micheal; Diwan, Sudhir; Eldabe, Sam; Gatzinsky, Kliment; Foreman, Robert D.; Hayek, Salim; Kim, Philip; Kinfe, Thomas; Kloth, David; Kumar, Krishna; Rizvi, Syed; Lad, Shivanand P.; Liem, Liong; Linderoth, Bengt; Mackey, Sean; McDowell, Gladstone; McRoberts, Porter; Poree, Lawrence; Prager, Joshua; Raso, Lou; Rauck, Richard; Russo, Marc; Simpson, Brian; Slavin, Konstantin; Staats, Peter; Stanton-Hicks, Michael; Verrills, Paul; Wellington, Joshua; Williams, Kayode; North, Richard

    2014-01-01

    Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended approp

  15. The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases : The Neuromodulation Appropriateness Consensus Committee

    NARCIS (Netherlands)

    Deer, Timothy R.; Mekhail, Nagy; Provenzano, David; Pope, Jason; Krames, Elliot; Leong, Michael; Levy, Robert M.; Abejon, David; Buchser, Eric; Burton, Allen; Buvanendran, Asokumar; Candido, Kenneth; Caraway, David; Cousins, Michael; de Jongste, Micheal; Diwan, Sudhir; Eldabe, Sam; Gatzinsky, Kliment; Foreman, Robert D.; Hayek, Salim; Kim, Philip; Kinfe, Thomas; Kloth, David; Kumar, Krishna; Rizvi, Syed; Lad, Shivanand P.; Liem, Liong; Linderoth, Bengt; Mackey, Sean; McDowell, Gladstone; McRoberts, Porter; Poree, Lawrence; Prager, Joshua; Raso, Lou; Rauck, Richard; Russo, Marc; Simpson, Brian; Slavin, Konstantin; Staats, Peter; Stanton-Hicks, Michael; Verrills, Paul; Wellington, Joshua; Williams, Kayode; North, Richard

    2014-01-01

    Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended approp

  16. Achieving appropriate design for developing world heath care: the case of a low-cost autoclave for primary health clinics.

    Science.gov (United States)

    Cho, Hallie S; Tao, Gregory D; Winter, Amos

    2012-01-01

    In developing world health clinics, incidence of surgical site infection is 2 to 10 times higher than in developed world hospitals. This paper identifies lack of availability of appropriately designed, low-cost autoclaves in developing world health clinics as a major contributing factor to the dramatic gap in surgical site infection rates. The paper describes the process of developing a low-cost autoclave that addresses the unique challenges faced by developing world primary health clinics and discusses how appropriateness of design was determined. The resulting pressure cooker-based autoclave design was fabricated and tested against the CDC specifications. Twelve partnering clinics in Nepal trialed these autoclaves from July until December 2012.

  17. Environmental Report 1996, Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Harrach, R.J.

    1996-01-01

    This is Volume 2 of the Lawrence Livermore National Laboratory`s (LLNL`s) annual Environmental Report 1996, prepared for the US Department of Energy. Volume 2 supports Volume 1 summary data and is essentially a detailed data report that provides individual data points, where applicable. Volume 2 includes information on monitoring of air, air effluents, sewerable water, surface water, ground water, soil and sediment, vegetation and foodstuff, environmental radiation, and quality assurance.

  18. REFLECTION AND REFRACTION, VOLUME 2.

    Science.gov (United States)

    KLAUS, DAVID J.; AND OTHERS

    THIS VOLUME 2 OF A TWO-VOLUME SET PROVIDES AUTOINSTRUCTION IN PHYSICS. THE UNITS COVERED IN THIS VOLUME ARE (1) REFLECTION OF LIGHT, (2) PHOTOMETRY, (3) POLARIZATION, (4) REFRACTION OF LIGHT, (5) SNELL'S LAW, (6) LENSES, FOCUS, AND FOCAL POINTS, (7) IMAGE FORMATION, AND (8) ABERRATIONS, THE EYE, AND MAGNIFICATION. THE INTRODUCTION AND UNITS ON…

  19. Calculus Students' Understanding of Volume

    Science.gov (United States)

    Dorko, Allison; Speer, Natasha M.

    2013-01-01

    Researchers have documented difficulties that elementary school students have in understanding volume. Despite its importance in higher mathematics, we know little about college students' understanding of volume. This study investigated calculus students' understanding of volume. Clinical interview transcripts and written responses to volume…

  20. What makes a successful volume crime investigator?

    OpenAIRE

    2011-01-01

    This exploratory study sought to understand the role of volume crime investigators in the modern era. It attempted to gain officers` perceptions on the attributes required to be a successful at the role. In addition, the research sought to understand how modern investigators thought success should be defined and measured in relation to individual investigator performance. Chapter One explored previous research relating to police investigators and success, and identified the main research que...

  1. Autonomous Rendezvous and Docking Conference, volume 1

    Science.gov (United States)

    1990-01-01

    This document consists of the presentation submitted at the Autonomous Rendezvous and Docking (ARD) Conference. It contains three volumes: ARD hardware technology; ARD software technology; and ARD operations. The purpose of this conference is to identify the technologies required for an on orbit demonstration of the ARD, assess the maturity of these technologies, and provide the necessary insight for a quality assessment of the programmatic management, technical, schedule, and cost risks.

  2. Autonomous Rendezvous and Docking Conference, volume 3

    Science.gov (United States)

    1990-01-01

    This document consists of the presentation submitted at the Autonomous Rendezvous and Docking (ARD) Conference. The document contains three volumes: ARD hardware technology; ARD software technology; and ARD operations. The purpose of this conference is to identify the technologies required for an on orbit demonstration of ARD, assess the maturity of these technologies, and provide the necessary insight for a quality assessment of programmatic management, technical, schedule, and cost risks.

  3. Could the WHO model list of essential medicines do more for the safe and appropriate use of injections?

    Science.gov (United States)

    Logez, Sophie M D; Hutin, Yvan J F; Holloway, Kathleen; Gray, Robin; Hogerzeil, Hans V

    2004-10-01

    A national drug policy addressing the safe and appropriate use of injections is an important element to prevent overuse and unsafe use of injections. Because the World Health Organization World Health Organization Model List of Essential Medicines is a keystone of national drug policies, the authors examined the way it addresses injection practices. They reviewed the 11th World Health Organization Model List of Essential Medicines to collect information on (1) injectable medicines, (2) diluents, and (3) the recommendations regarding the procurement of injection devices. Of 306 active ingredients on the list, 135 (44%) are mentioned in injectable form. Of these, 41 (30%) need diluents for reconstitution. The list does not mention the need to procure appropriate diluents, injection devices, and safety boxes in quantities that match the quantities of injectable medicines. In addition, the list provides limited information that can be used to forecast the needs of injection devices to administer the injectable medicines that are included in the list. Future revisions of the World Health Organization Model List of Essential Medicines should attempt to reduce the number of injectable formulations on the basis of evidence. In addition, the list should specify that when injectable medicines are being supplied, diluents, single-use syringes, and safety boxes should be supplied. The volume of syringes needed for administration should be specified for each injectable medication on the list to facilitate the forecasting of the needs of injection devices.

  4. Volume variation of Gruneisen parameters of fcc transition metals

    Indian Academy of Sciences (India)

    C V Pandya; P R Vyas; T C Pandya; V B Gohel

    2002-02-01

    The volume variation of the Gruneisen parameters of ten fcc transition metals, up to 40% compression, has been studied on the basis of a model approach proposed by Antonov et al. The results are reasonably good for six metals except for Rh, Ag, Au and Ni when compared with available experimental and other theoretical values. The model requires an appropriate modification for Rh, Ag, Au and Ni.

  5. Constrained Appropriations

    DEFF Research Database (Denmark)

    Wildermuth, Norbert

    2008-01-01

    , that is disparities in the capacity of young Brazilian's to reconfigure and integrate the meanings of ‘external' cultural forms and media texts and to integrate them within local culture and their own identities, is another concrete dimension. However, more than merely describing and typifying some of the distinctive...... cultures of media consumption which unify and divide Brazil's (urban) youth, attention is also given to an  understanding of the relationship between young people and media, as developed in concrete attempts to increase the cultural competences of young, ‘disprivileged' media consumers. The contribution...

  6. Appropriate Pupilness

    DEFF Research Database (Denmark)

    Kofoed, Jette

    2008-01-01

    The analytical focus in this article is on how social categories intersect in daily school life and how intersections intertwine with other empirically relevant categories such as normality, pupilness and (in)appropriatedness. The point of empirical departure is a daily ritual where teams...... for football are selected. The article opens up for a microanalysis of everyday practices at the margins and at the core of what this article terms `pupilness'. The concept of intersectionality is suggested as a useful analytical tool to understand the multiple activities of pupils in everyday school life...

  7. CPD Appropriations

    Data.gov (United States)

    Department of Housing and Urban Development — The datasets are the full-year allocations for HUD's Office of Community Planning and Development (CPD) formula programs: Community Development Block Grants (CDBG);...

  8. Volume of an Industrial Autoclave

    Directory of Open Access Journals (Sweden)

    Nicholas Madaffari

    2010-01-01

    Full Text Available We were able to determine the volume of an industrial autoclave sterilization tank using a technique learned in calculus. By measuring the dimensions of the tank and roughly estimating the equation of curvature at the ends of the tank, we were able to revolve half of the end of the tank around the x axis to get its fluid volume. Adding the two volumes of the ends and the volume of the cylindrical portion on the tank yielded the total volume.

  9. Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center

    Science.gov (United States)

    Zakaria, Hazem M; Stauffer, John A; Raimondo, Massimo; Woodward, Timothy A; Wallace, Michael B; Asbun, Horacio J

    2016-01-01

    AIM To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed. RESULTS One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7.8%), pancreatic neuroendocrine tumors (n = 7, 6.8%), and miscellaneous (n = 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively. CONCLUSION Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach. PMID:27721927

  10. Data Identifiers and Citations Enable Reproducible Science

    Science.gov (United States)

    Tilmes, C.

    2011-12-01

    Modern science often involves data processing with tremendous volumes of data. Keeping track of that data has been a growing challenge for data center. Researchers who access and use that data don't always reference and cite their data sources adequately for consumers of their research to follow their methodology or reproduce their analyses or experiments. Recent research has led to recommendations for good identifiers and citations that can help address this problem. This paper will describe some of the best practices in data identifiers, reference and citation. Using a simplified example scenario based on a long term remote sensing satellite mission, it will explore issues in identifying dynamic data sets and the importance of good data citations for reproducibility. It will describe the difference between granule and collection level identifiers, using UUIDs and DOIs to illustrate some recommendations for developing identifiers and assigning them during data processing. As data processors create data products, the provenance of the input products and precise steps that led to their creation are recorded and published for users of the data to see. As researchers access the data from an archive, they can use the provenance to help understand the genesis of the data, which could have effects on their usage of the data. By citing the data on publishing their research, others can retrieve the precise data used in their research and reproduce the analyses and experiments to confirm the results. Describing the experiment to a sufficient extent to reproduce the research enforces a formal approach that lends credibility to the results, and ultimately, to the policies of decision makers depending on that research.

  11. Light Propagation Volumes

    OpenAIRE

    Mikulica, Tomáš

    2016-01-01

    Cílem diplomové práce je popsat různé metody výpočtu globálního osvětlení scény včetně techniky Light Propagation Volumes. Pro tuto metodu jsou podrobně popsány všechny tři kroky výpočtu: injekce, propagace a vykreslení. Dále je navrženo několik vlastních rozšíření zlepšující grafickou kvalitu metody. Části návrhu a implementace jsou zaměřeny na popis scény, zobrazovacího systému, tvorby stínů, implementace metody Light Propagation Volumes a navržených rozšíření. Práci uzavírá měření, porovná...

  12. Factors Impacting Habitable Volume Requirements: Results from the 2011 Habitable Volume Workshop

    Science.gov (United States)

    Simon, M.; Whitmire, A.; Otto, C.; Neubek, D. (Editor)

    2011-01-01

    This report documents the results of the Habitable Volume Workshop held April 18-21, 2011 in Houston, TX at the Center for Advanced Space Studies-Universities Space Research Association. The workshop was convened by NASA to examine the factors that feed into understanding minimum habitable volume requirements for long duration space missions. While there have been confinement studies and analogs that have provided the basis for the guidance found in current habitability standards, determining the adequacy of the volume for future long duration exploration missions is a more complicated endeavor. It was determined that an improved understanding of the relationship between behavioral and psychosocial stressors, available habitable and net habitable volume, and interior layouts was needed to judge the adequacy of long duration habitat designs. The workshop brought together a multi-disciplinary group of experts from the medical and behavioral sciences, spaceflight, human habitability disciplines and design professionals. These subject matter experts identified the most salient design-related stressors anticipated for a long duration exploration mission. The selected stressors were based on scientific evidence, as well as personal experiences from spaceflight and analogs. They were organized into eight major categories: allocation of space; workspace; general and individual control of environment; sensory deprivation; social monotony; crew composition; physical and medical issues; and contingency readiness. Mitigation strategies for the identified stressors and their subsequent impact to habitat design were identified. Recommendations for future research to address the stressors and mitigating design impacts are presented.

  13. The available lexicon: A tool for selecting appropriate vocabulary to teach a foreign language

    Directory of Open Access Journals (Sweden)

    Antonio Manuel Ávila Muñoz

    2017-01-01

    Full Text Available This study aims to provide foreign language professionals with a sound methodology for selecting a suitable lexicon apropos of their students’ level in the language. The justification of said selection is, herein, rooted in a cognitive argument: If we are able to observe the manner in which words are organized within the mind, we will be better able to select the words needed for the natural process of communication. After analyzing over lists of lexical availability compiled by previous analyses, this study puts forth a glossary filtered by way of an objective procedure based on the mathematical concept known as Fuzzy Expected Value. I begin first by rigorously defining the concept of lexical availability and then thoroughly examining and explaining the manner in which I have obtained the results. Next, I employ the cognitive theory of prototypes to expound upon the organizational apparatus which arranges words within speakers’ minds. Subsequently, and in accordance with objective criteria, a lexical selection is proposed. To end, I contemplate and muse upon the significance of a program that would enable us to identify the most appropriate vocabulary according to the students’ level of linguistic competence. In order to further substantiate this study, it will be juxtaposed with the specific notions outlined by the curriculum of The Cervantes Institute. Moreover, it will relate to the teaching levels proposed by the American Council on the Teaching of Foreign Languages (ACTFL and Common European Framework of Reference for Languages (CEFR.

  14. Toward appropriate criteria in medication adherence assessment in older persons: Position Paper.

    Science.gov (United States)

    Giardini, Anna; Martin, Maria Teresa; Cahir, Caitriona; Lehane, Elaine; Menditto, Enrica; Strano, Maria; Pecorelli, Sergio; Monaco, Alessandro; Marengoni, Alessandra

    2016-06-01

    Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.

  15. Selecting appropriate energy efficiency indicators for the Thai Energy Conservation Promotion Programme. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Eichhammer, W.; Gruber, E.; Cremer, C.

    2000-06-01

    In 1992 the Thai Government passed the Energy Conservation Promotion (ECP) Act to improve energy efficiency in Thai industry and commerce. The Thai-German Energy Efficiency Promotion Project (ENEP) is supporting the Department of Energy Development and Promotion (DEDP) in its effort to implement the Energy Conservation Program for large buildings and designated factories. About 4000 buildings and factories under the Compulsory Program, have to report every 6 months their energy consumption data to DEDP. Every 3 years energy audits have to be conducted by registered energy consultants, to identify energy saving opportunities, to set saving targets and to recommend energy conservation measures. Investments in energy efficient technologies are subsidized from an Energy Conservation Fund. Data from the energy consumption reports and the energy audit reports are collected in DEDP's database for further processing. The database is structured according to the Thai Standard Industrial Classification. In order to exploit the wealth of information provided by the auditing procedure the objective of the present work carried out by the consultant FhG-ISI for DEDP/BERC on behalf of the German Gesellschaft fuer Technische Zusammenarbeit (GTZ) was to recommend an appropriate set of energy efficiency indicators. This indicator set should allow DEDP to extract from the energy consumption reports, energy audit reports and other sources, useful statistical information to monitor and improve energy efficiency in Thailand. (orig.)

  16. Induction of appropriate Th-cell phenotypes: cellular decision-making in heterogeneous environments.

    Science.gov (United States)

    van den Ham, H-J; Andeweg, A C; de Boer, R J

    2013-11-01

    Helper T (Th)-cell differentiation is a key event in the development of the adaptive immune response. By the production of a range of cytokines, Th cells determine the type of immune response that is raised against an invading pathogen. Th cells can adopt many different phenotypes, and Th-cell phenotype decision-making is crucial in mounting effective host responses. This review discusses the different Th-cell phenotypes that have been identified and how Th cells adopt a particular phenotype. The regulation of Th-cell phenotypes has been studied extensively using mathematical models, which have explored the role of regulatory mechanisms such as autocrine cytokine signalling and cross-inhibition between self-activating transcription factors. At the single cell level, Th responses tend to be heterogeneous, but corrections can be made soon after T-cell activation. Although pathogens and the innate immune system provide signals that direct the induction of Th-cell phenotypes, these instructive mechanisms could be easily subverted by pathogens. We discuss that a model of success-driven feedback would select the most appropriate phenotype for clearing a pathogen. Given the heterogeneity in the induction phase of the Th response, such a success-driven feedback loop would allow the selection of effective Th-cell phenotypes while terminating incorrect responses.

  17. Nonlinear model of a distribution transformer appropriate for evaluating the effects of unbalanced loads

    Science.gov (United States)

    Toman, Matej; Štumberger, Gorazd; Štumberger, Bojan; Dolinar, Drago

    Power packages for calculation of power system transients are often used when studying and designing electromagnetic power systems. An accurate model of a distribution transformer is needed in order to obtain realistic values from these calculations. This transformer model must be derived in such a way that it is applicable when calculating those operating conditions appearing in practice. Operation conditions where transformers are loaded with nonlinear and unbalanced loads are especially challenging. The purpose of this work is to derive a three-phase transformer model that is appropriate for evaluating the effects of nonlinear and unbalanced loads. A lumped parameter model instead of a finite element (FE) model is considered in order to ensure that the model can be used in power packages for the calculation of power system transients. The transformer model is obtained by coupling electric and magnetic equivalent circuits. The magnetic equivalent circuit contains only three nonlinear reluctances, which represent nonlinear behaviour of the transformer. They are calculated by the inverse Jiles-Atherton (J-A) hysteresis model, while parameters of hysteresis are identified using differential evolution (DE). This considerably improves the accuracy of the derived transformer model. Although the obtained transformer model is simple, the simulation results show good agreement between measured and calculated results.

  18. ‘Machinic Trajectories’: Appropriated Devices as Post-Digital Drawing Machines

    Directory of Open Access Journals (Sweden)

    Andres Wanner

    2014-12-01

    Full Text Available This article presents a series of works called Machinic Trajectories, consisting of domestic devices appropriated as mechanical drawing machines. These are contextualized within the post-digital discourse, which integrates messy analog conditions into the digital realm. The role of eliciting and examining glitches for investigating a technology is pointed out. Glitches are defined as short-lived, unpremeditated aesthetic results of a failure; they are mostly known as digital phenomena, but I argue that the concept is equally applicable to the output of mechanical machines. Three drawing machines will be presented: The Opener, The Mixer and The Ventilator. In analyzing their drawings, emergent patterns consisting of unpremeditated visual artifacts will be identified and connected to irregularities of the specific technologies. Several other artists who work with mechanical and robotic drawing machines are introduced, to situate the presented works and reflections in a larger context of practice and to investigate how glitch concepts are applicable to such mechanical systems. 

  19. Ability of community-based prostate cancer screening to target an appropriate and underserved population

    Science.gov (United States)

    Moss, Jared; Heidel, Eric; Johnson, Jason; Powell, Chase; Dittrich, Erin; Rawn, Susan; Terry, Paul D; Goldman, Mitchell; Waters, W Bedford; White, Wesley M

    2015-01-01

    Screening is not universally beneficial due to over- and under-diagnosis, and false positives that beget additional testing and associated adverse events and expense. We examined data from all men who participated in a mass community prostate cancer screening between May 2009 and September 2010. The data contained information regarding patient demographics, family history of prostate cancer, lower urinary tract symptoms, prior history of prostate cancer, most recent digital rectal examination, and the presence of an established relationship with a physician. Current American Urological Association screening recommendations were then applied to determine the appropriateness of our outreach effort. A total of 438 men (mean age 66.5 years) underwent screening. A total of 106 (24.2%) patients in our study met contemporary criteria for screening. Of these men, the vast majority was well educated, well insured, and well informed about the need for prostate cancer screening. Based on these data, mass community-based prostate cancer screening does not appear to identify and screen at-risk men. Future efforts at mass screening should more carefully target men most likely to benefit. PMID:26140266

  20. Reasons for Not Intensifying Medications: Differentiating “Clinical Inertia” from Appropriate Care

    Science.gov (United States)

    Shewchuk, Richard; Qu, Haiyan; Williams, Jessica H.; Estrada, Carlos A.; Ovalle, Fernando; Allison, Jeroan J.

    2007-01-01

    Background “Clinical inertia” has been defined as inaction by physicians caring for patients with uncontrolled risk factors such as blood pressure. Some have proposed that it accounts for up to 80% of cardiovascular events, potentially an important quality problem. However, reasons for so-called clinical inertia are poorly understood. Objective To derive an empiric conceptual model of clinical inertia as a subset of all clinical inactions from the physician perspective. Methods We used Nominal Group panels of practicing physicians to identify reasons why they do not intensify medications when seeing an established patient with uncontrolled blood pressure. Measurements and Main Results We stopped at 2 groups (N = 6 and 7, respectively) because of the high degree of agreement on reasons for not intensifying, indicating saturation. A third group of clinicians (N = 9) independently sorted the reasons generated by the Nominal Groups. Using multidimensional scaling and hierarchical cluster analysis, we translated the sorting results into a cognitive map that represents an empirically derived model of clinical inaction from the physician’s perspective. The model shows that much inaction may in fact be clinically appropriate care. Conclusions/Recommendations Many reasons offered by physicians for not intensifying medications suggest that low rates of intensification do not necessarily reflect poor quality of care. The empirically derived model of clinical inaction can be used as a guide to construct performance measures for monitoring clinical inertia that better focus on true quality problems. PMID:17957346