Highest Priority In Terms Research Articles

Clarifying the Dioscoreabuchananii Benth. species complex: a new potentially extinct subspecies for South Africa.

The Dioscorea buchananii complex is shown to comprise three species, one of which is divided into two subspecies, based on morphological data. Two species, Dioscorea rupicola Kunth and Dioscorea multiloba Kunth, are endemic or subendemic to South Africa and of widespread occurrence in KwaZulu Natal. They differ markedly from each other in inflorescence and floral morphology and appear to be ecologically differentiated. The third species, Dioscorea buchananii Benth., is primarily found in southeastern tropical Africa, but a small number of specimens collected in South Africa in the late 19th and early 20th centuries are placed in an endemic subspecies, Dioscorea buchananii subsp. undatiloba (Baker) Wilkin. The latter taxon is a high priority in terms of rediscovery and conservation. Keys, descriptions, supporting information and illustrations are provided and made available online through eMonocot biodiversity informatics tools. Three nomenclatural acts are undertaken: two names are placed in synonymy and a new combination made.

How the Probability and Potential Clinical Significance of Pharmacokinetically Mediated Drug-Drug Interactions Are Assessed in Drug Development: Desvenlafaxine as an Example.

The avoidance of adverse drug-drug interactions (DDIs) is a high priority in terms of both the US Food and Drug Administration (FDA) and the individual prescriber. With this perspective in mind, this article illustrates the process for assessing the risk of a drug (example here being desvenlafaxine) causing or being the victim of DDIs, in accordance with FDA guidance. DDI studies for the serotonin-norepinephrine reuptake inhibitor desvenlafaxine conducted by the sponsor and published since 2009 are used as examples of the systematic way that the FDA requires drug developers to assess whether their new drug is either capable of causing clinically meaningful DDIs or being the victim of such DDIs. In total, 8 open-label studies tested the effects of steady-state treatment with desvenlafaxine (50-400 mg/d) on the pharmacokinetics of cytochrome (CYP) 2D6 and/or CYP 3A4 substrate drugs, or the effect of CYP 3A4 inhibition on desvenlafaxine pharmacokinetics. The potential for DDIs mediated by the P-glycoprotein (P-gp) transporter was assessed in in vitro studies using Caco-2 monolayers. Changes in area under the plasma concentration-time curve (AUC; CYP studies) and efflux (P-gp studies) were reviewed for potential DDIs in accordance with FDA criteria. Desvenlafaxine coadministration had minimal effect on CYP 2D6 and/or 3A4 substrates per FDA criteria. Changes in AUC indicated either no interaction (90% confidence intervals for the ratio of AUC geometric least-squares means [GM] within 80%-125%) or weak inhibition (AUC GM ratio 125% to < 200%). Coadministration with ketoconazole resulted in a weak interaction with desvenlafaxine (AUC GM ratio of 143%). Desvenlafaxine was not a substrate (efflux ratio < 2) or inhibitor (50% inhibitory drug concentration values > 250 μM) of P-gp. A 2-step process based on FDA guidance can be used first to determine whether a pharmacokinetically mediated interaction occurs and then to assess the potential clinical significance of the DDI. In the case of the drug tested in this series of studies, the potential for clinically meaningful DDIs mediated by CYP 2D6, CYP 3A4, or P-gp was found to be low.

Diagnosis, Management and Assessment of Adults with Joint Hypermobility Syndrome: A UK-Wide Survey of Physiotherapy Practice.

Joint hypermobility syndrome (JHS) is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. It is a relatively common cause of musculoskeletal pain but is generally understood to be under-recognized and poorly managed in clinical practice. The present study therefore aimed to identify how JHS is diagnosed, managed and assessed in routine physiotherapy practice. A survey tool was developed from similar physiotherapy surveys of musculoskeletal practice, a review of the literature, and consultation with researchers and clinicians. Paper copies of the final survey were sent to 201 randomly selected secondary care organizations across the UK and an electronic version was advertised through physiotherapy professional networks. A total of 66 responses (80% women) were received from physiotherapists, with a wide range of clinical experience. Only 32% of respondents reported that they had received formal training in JHS management. The Brighton diagnostic criteria for JHS were not often used (only 31% of respondents). The stated aims of physiotherapy and the specific interventions employed seem well matched, with a focus on advice, education, exercise and self-management. Although pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, suggesting a mismatch between what clinicians aim to achieve and what they measure. The results suggest that reported management strategies are broadly appropriate to long-term musculoskeletal conditions but additional training specific to JHS may be required, particularly in diagnosis and assessment.

Household food waste: the implications of consumer choice in food from purchase to disposal

Food and food-related waste is a high priority in terms of waste minimisation in New Zealand. Over the summer of 2012–2013, a survey of 147 participants was conducted on a range of views and practices related to environmental challenges and understandings. The survey, undertaken in Palmerston North, New Zealand, captured a wide socio-demographic. This article focuses on respondents’ food practices from purchase, to plate, to disposal and the environmental implications of these practices. The survey data have allowed an enriched understanding of both individual and structural level challenges as well as incentives towards improving environmental practices in relation to household food waste minimisation. The results indicated that, in keeping with other research in this area, food waste increases according to the number of individuals in a household, and in particular the number of younger people. Also, while the majority of participants were at least “somewhat concerned” about their households’ environmental impact, over three quarters of participant households put food waste into their rubbish bin. Some solutions and directions to further progress research, policy, and practice in this area are offered, and include the need for more direct and personalised communication regarding waste minimisation, along with the provision of kerbside food waste collections. It is clear that individual- or household-level changes are important and must be supported systemically by both local body and state level legislation and initiatives, if there is to be any substantial decline in food waste going to landfill.

Pre- and Postharvest Preventive Measures and Intervention Strategies to Control Microbial Food Safety Hazards of Fresh Leafy Vegetables

This review includes an overview of the most important preventive measures along the farm to fork chain to prevent microbial contamination of leafy greens. It also includes the technological and managerial interventions related to primary production, postharvest handling, processing practices, distribution, and consumer handling to eliminate pathogens in leafy greens. When the microbiological risk is already present, preventive measures to limit actual contamination events or pathogen survival are considered intervention strategies. In codes of practice the focus is mainly put on explaining preventive measures. However, it is also important to establish more focused intervention strategies. This review is centered mainly on leafy vegetables as the commodity identified as the highest priority in terms of fresh produce microbial safety from a global perspective. There is no unique preventive measure or intervention strategy that could be applied at one point of the food chain. We should encourage growers of leafy greens to establish procedures based on the HACCP principles at the level of primary production. The traceability of leafy vegetables along the chain is an essential element in ensuring food safety. Thus, in dealing with the food safety issues associated with fresh produce it is clear that a multidisciplinary farm to fork strategy is required.

A streamlined approach for the spatial allocation of fuel removals in wildland–urban interfaces

Major concerns are arising on the expansion of wildland–urban interfaces defined as zones where infrastructures and other man-made systems interact with undeveloped areas. Wildland–urban interfaces create an environment in which fire can easily spread from forest fuels to human settlements. In this context, there is a need to prevent fire spread by determining the sound allocation of fuel treatment (fuel removal). To this end, the Spatial Allocation Index was developed as a streamlined approach to determine where and what type of forest areas may be eligible for fuel removal in terms of fire suppression. This approach was developed as a case study example using forest landscapes located in the province of Taranto (Apulia region) in southern Italy. By using geostatistical techniques, we scaled up 210 data points of plot-level fuel load and developed maps for different forest types. These spatial predictions were combined with other landscape-level variables such as population density, urban density, and road density. Through our modelling approach we were able to determine the fuel model types and spatial allocations of wildland areas that are likely to be treated by fuel removal. Our results suggest that the predominant forest typology requiring treatment in the study area is the Mediterranean maquis (shrub-land), which covers 44 % of the wildland–urban interface landscape. The areas on the map where the Spatial Allocation Index reaches its maximum value are those with the highest priority in terms of fuel removal; i.e., the highest number of people, houses, and roads benefitting from wildfire suppression. By adopting this streamlined approach, forest managers and decision makers may avail of a fast and effective tool to improve efforts in landscape management and budgeting of financial resources.

Health, safety, and environmental risk assessment of steel production complex in central Iran using TOPSIS.

This research was carried out with the aim of presenting an environmental management plan for steel production complex (SPC) in central Iran. Following precise identification of the plant activities as well as the study area, possible sources of environmental pollution and adverse impacts on the air quality, water, soil, biological environment, socioeconomic and cultural environment, and health and safety of the employees were determined considering the work processes of the steel complex. Afterwards, noise, wastewater, and air pollution sources were measured. Subsequently, factors polluting the steel complex were identified by TOPSIS and then prioritized using Excel Software. Based on the obtained results, the operation of the furnaces in hot rolling process with the score 1, effluent derived from hot rolling process with the score 0.565, nonprincipal disposal and dumping of waste at the plant enclosure with the score 0.335, walking beam process with the score 1.483 respectively allocated themselves the highest priority in terms of air, water, soil and noise pollution. In terms of habitats, land cover and socioeconomic and cultural environment, closeness to the forest area and the existence of four groups of wildlife with the score 1.106 and proximity of villages and residential areas to the plant with the score 3.771 respectively enjoyed the highest priorities while impressibility and occupational accidents with the score 2.725 and cutting and welding operations with score 2.134 had the highest priority among health and safety criteria. Finally, strategies for the control of pollution sources were identified and Training, Monitoring and environmental management plan of the SPC was prepared.

작업관련성 손상·질병 발생과 손실비용에 따른 예방정책 우선순위 연구

As workplace incidents has been being declining in Korea, there is criticism of the effectiveness of occupational safety policy implementation. It is unknown that which policy target group needs to be targeted to yield effective injuries prevention. The purpose of this paper is to analyze and reveal the policy intervention group with a high priority in terms of industrial incident prevention and the related investment cost. A Policy Priority Model(PPM) is composed of 6 indicators regarding influences of both the incident reduction and the cost reduction. Z-score analyses are used to confirm the high policy priority area or policy target group. Overall, workplace with worker below 50 persons, construction site with the sales of more than a hundred million won, workplace with relatively small percentage of female employees and relatively higher percentage of older worker should be prioritized to reduce workplace injuries. This paper provides an analytic way that can be used to decide the policy priority workplace in order not only to reduce work-related injuries&illnesses and the related investment cost but to further lessen the related societal costs.

ESR statement on the stepwise development of imaging biomarkers

Development of imaging biomarkers is a structured process in which new biomarkers are discovered, verified, validated and qualified against biological processes and clinical end-points. The validation process not only concerns the determination of the sensitivity and specificity but also the measurement of reproducibility. Reproducibility assessments and standardisation of the acquisition and data analysis methods are crucial when imaging biomarkers are used in multicentre trials for assessing response to treatment. Quality control in multicentre trials can be performed with the use of imaging phantoms. The cost-effectiveness of imaging biomarkers also needs to be determined. A lot of imaging biomarkers are being developed, but there are still unmet needs—for example, in the detection of tumour invasiveness. Main Messages • Using imaging biomarkers to streamline drug discovery and disease progression is a huge advancement in healthcare. • The qualification and technical validation of imaging biomarkers pose unique challenges in that the accuracy, methods, standardisations and reproducibility are strictly monitored. • The clinical value of new biomarkers is of the highest priority in terms of patient management, assessing risk factors and disease prognosis.

Environmental policy implications of working from home: Modelling the impacts of land-use, infrastructure and socio-demographics

Working from home is generally perceived as an effective means of reducing energy use and associated pollution from commuter transport. In order to consider the merits of mechanisms and policies to support a change in behaviour that results in greater take-up of home working, this paper applies energy consumption per commute calculations and a logit model using a case study of Ireland. In marked contrast with larger countries, the energy consumption per commute is relatively low in Ireland. Nonetheless, the analysis indicates that, on average, at least an average net saving of 9.33kWh per day can be achieved where an individual converts to working from home, after deducting the home energy consumption associated with home working. We find that land use patterns, public transport networks, internet infrastructure, commute distances and socio-demographic characteristics can serve to influence rates of home working. Encouraging the higher and lower professional categories and those in the service sectors to work from home should be the highest priority in terms of energy and emissions reductions. Increased coverage of internet services and railway coverage will support higher rates of home working. Increased dispersion of residential, commercial and industrial areas serves to encourage greater home working.

Evaluating the Barriers to Point-of-Care Documentation for Nursing Staff

Point-of-care documentation has been identified as a patient safety measure for improving accuracy and timeliness of data. To evaluate the barriers that nurses and nurse aide/clinical technicians encounter for electronic point-of-care documentation, we conducted surveys on a telemetry unit at a southwestern Pennsylvania community hospital. Our first survey revealed that the location of the in-room computers, perceived lack of in-room computer reliability, Health Insurance Portability and Accountability Act/privacy concerns, and perceptions of the patients' response to charting on computers in patient rooms were all barriers to point-of-care documentation. Our second survey revealed that workflow priority issues were also a barrier to point-of-care documentation, as staff members did not rate documentation as a high priority in terms of delivering timely medical care. Changes in both nursing practices and hospital infrastructure may be needed if these barriers to point-of-care documentation are to be overcome.

Applying Importance-Performance Analysis to the Management of Health Care Services

Importance-performance analysis (IPA) is a strategic approach to measure users’ satisfaction and simply and functionally identify the strengths and the areas of improvement in a particular service. By first ascertaining the importance that users assign to the most relevant attributes of a service and subsequently evaluating the performance of each service, we can obtain a (Cartesian) graph with four quadrants. This graph allows an intuitive assessment of its operation and the implementation of appropriate recommendations for brand management. Therefore, IPA is widely used nowadays, especially in the health services. The present work is a part of a larger study that analyzes satisfaction among the professionals in the health services of Feira-Arouca, Portugal. In this sense, our main objective is to illustrate the considerable potential of IPA in health management in order to enable professionals and managers to identify some of the weaknesses of the health services and management of the Group Health Centers of Feira-Arouca. In this way, the study was based on 189 professionals working in the health sector. The results show that although financial accounting and the provisioning service are the two most important attributes, their performance is very low as compared to their importance. Simultaneously, representing the results on the basis of the classic model of IPA does not allow a clear and strategic interpretation and development of strategies. Thus, by applying a form of representation that was proposed more recently, we can reflect more deeply and improve the efficiency of service management. Consequently, the latter representation clarifies that financial accounting and the provisioning service have the highest priority in terms of management.

표본 추계학적 동적계획법을 사용한 한강수계 저수지 운영시스템 개발

한국수자원공사는 낙동강 및 금강수계에 대해 실시간 물관리 시스템을 개발하여 수계 내 다목적 댐의 효율적인 운영을 도모하였다. 본 연구에서는 이를 확장하여 최적화 기법인 표본 추계학적 동적계획법을 사용하여 한강수계 다목적댐의 효율적인 월말 목표저수량을 산정하고 이를 통해 실시간 물관리시스템의 효율을 극대화하고자 수행되었다. 수계 내 댐중 저수용량과 용수공급 측면에서 중요도가 높은 소양강댐, 충주댐, 화천댐 등 3개 댐만을 대상으로 모형을 개발하였으며 저수량 상태변수의 민감도 분석 결과를 통해 저수량 상태변수 개수를 설정하였다. 본 연구를 통해 제시된 최적화모형을 통한 운영률과 한국수자원공사의 운영목표수위에 의한 저수지 운영방식과 비교를 실시한 결과 연평균 37.22 MCM의 수계 내 요구용수 부족량 감소효과와 더불어 발전량 측면에서도 연간 171 GWh가 증가하는 것을 확인하였다. 또한 이수기 저수지 운영계획 시스템을 실제 적용한 결과 2007년~2008년 이수기 동안 전력생산, 수질개선 등을 위한 추가적인 용수공급이 가능하다는 것을 확인하였다. 이러한 실제 적용사례를 통해 SSDP 모형과 이수기 저수지운영 시스템의 그 유용성을 타진할 수 있었으며 다른 수계로 확장을 실시한다면 보다 합리적인 저수지 운영계획이 가능할 것으로 기대한다. Korea water resources corporation (K-Water) has developed the real-time water resources management system for the Nakdong and the Geum River basin to efficiently operate multi-purpose dams in the basins. This study has extended to the Han River basin for providing an effective ending target storage of a month to the real-time water resources management system using Sampling Stochastic Dynamic Programming (SSDP), consequently increasing the efficiency of the reservoir system. The optimization model were developed for three reservoirs, named Soyang, Chungju, and Hwacheon, with high priority in terms of the amounts of effective capacity and water supply for the basin. The number of storage state variable for each dam to set an optimization problem has been assigned from the results of sensitivity analysis. Compared with the K-water operating policy with the target water supply elevations, the optimization model suggested in this study showed that the shortfalls are decreased by 37.22 MCM/year for the required water demands in the basin, even increasing 171 GWh in hydro electronic power generation. In addition, the result of a reservoir operating system during the drawdown period applied to real situation demonstrates that additional releases for water quality or hydro electronic power generation would be possible during the drawdown period between 2007 and 2008. On the basis of these simulation results, the applicability of the SSDP model and the reservoir operating system is proved. Therefore, the more efficient reservoir operation can be achieved if the reservoir operating system is extended further to other Korean basins.

Solar sites assessment in Jordan using fuzzy logic

Due to the current increase in oil prices, economic growth, increasing population, and the growing energy demand in Jordan, the provision of reliable energy supply at reasonable cost is considered a crucial element of economic reform. The present study utilizes fuzzy logic to assess solar sites in Jordan and to decide which sites should be given the highest priority with respect to their benefits and costs. The criterion of evaluation using fuzzy logic is based on different parameters, i.e., solar resources, site capacity, site accessibility, soil condition, water availability, grid connection distance, land cost, land roughness, and wind speed. The results show that the Al Quwairah site has the highest benefit to cost ratio. Therefore, it should be given the highest priority in terms of erecting solar power technologies to achieve high power production capacity. The second and the third options are Ma’an and Wadi Rum, respectively.

Fuzzy sets analysis for ballast water treatment systems: best available control technology

An overview on various ballast water treatment (BWT) technologies aboard different types of ships is presented. These technologies are: (1) Filtration, (2) Cyclonic systems, (3) Heat treatment, (4) Chemical treatment, (5) Ultraviolet radiation, (6) Ultrasound, (7) Electroporation, and (8) Radiolysis. These technologies are proven technologies for BWT in the marine industry. The fuzzy sets methodology is used to perform a comparison among these different Ballast water systems to choose the best available control technology that should be given the highest priority in terms of development and research. The main objective of this paper is to determine the order in which ballast water systems should be given higher priority to be installed to tackle the world wide ballast water pollution problem. These systems are compared according to their benefits and cost. Based on the benefit to cost ratio, the results show that the filtration treatment appears to be the method that will provide the best combination of effective treatment and feasibility. The next two options are the use of ultraviolet and ultrasound. All these three options could be used to produce effective and reliable BWT with minimum cost and optimum benefits in terms of issues related to effectiveness, reliability, global benefits, and safety. The least options are radiolysis and chemical treatment due to their high costs and low safety factors. Also this study tries to clear the way for developing new and existing technology, and to provide a platform for successful treatment solution.

Fetal alcohol syndrome and developing craniofacial and dental structures – a review

Fetal alcohol syndrome (FAS) is a collection of signs and symptoms seen in children exposed to alcohol in the prenatal period. It is characterized mainly by a distinct pattern of craniofacial malformations, physical and mental retardation. However, with the increased incidence of FAS, there is a great variation in the clinical features of FAS. Narrative review. This review describes data from clinical and experimental studies, and in vitro models. Experimental studies have shown that alcohol has a direct toxic effect on the ectodermal and mesodermal cells of the developing embryo, particularly in the cells destined to give rise to dentofacial structures (i.e. cranial neural crest cells). Other effects, such as, abnormal pattern of cranial and mandibular growth and altered odontogenesis are described in detail. The exact mechanism by which alcohol induces its teratogenic effects remains still unknown. The possible mechanisms are outlined here, with an emphasis on the developing face and tooth. Possible future research directions and treatment strategies are also discussed. Early identification of children affected by prenatal alcohol exposure leads to interventions, services, and improved outcomes. FAS can be prevented with the elimination of alcohol consumption during pregnancy. We need to provide education, target high-risk groups, and make this issue a high priority in terms of public health.

Location-aware resource management in mobile ad hoc networks

We propose an innovative resource management scheme for TDMA based mobile ad hoc networks. Since communications between some important nodes in the network are more critical, they should be accepted by the net work with high priority in terms of network resource usage and quality of service (QoS) support. In this scheme, we design a location-aware bandwidth pre-reservation mechanism, which takes advantage of each mobile node's geographic location information to pre-reserve bandwidth for such high priority connections and thus greatly reduces potential scheduling conflicts for transmissions. In addition, an end-to-end bandwidth calculation and reservation algorithm is proposed to make use of the pre-reserved bandwidth. In this way, time slot collisions among different connections and in adjacent wireless links along a connection can be reduced so that more high priority connections can be accepted into the network without seriously hurting admissions of other connections. The salient feature of our scheme is the collaboration between the routing and MAC layer that results in the more efficient spatial reuse of limited resources, which demonstrates how cross-layer design leads to better performance in QoS support. Extensive simulations show that our scheme can successfully provide better communication quality to important nodes at a relatively low price. Finally, several design issues and future work are discussed.

Fetal Alcohol Spectrum Disorders: An Overview with Emphasis on Changes in Brain and Behavior

Fetal alcohol spectrum disorders constitute a major public health problem. This article presents an overview of important issues that surround these disorders and emphasizes the structural and neurobehavioral consequences associated with prenatal exposure to alcohol. Diagnostic criteria are discussed, and possible moderating factors for the range of outcomes are mentioned. In addition, the prevalence of fetal alcohol spectrum disorders is described, and estimates of the financial impact of these disorders are given. Heavy prenatal alcohol exposure can severely affect the physical and neurobehavioral development of a child. Autopsy and brain imaging studies indicate reductions and abnormalities in overall brain size and shape, specifically in structures such as the cerebellum, basal ganglia, and corpus callosum. A wide range of neuropsychological deficits have been found in children prenatally exposed to alcohol, including deficits in visuospatial functioning, verbal and nonverbal learning, attention, and executive functioning. These children also exhibit a variety of behavioral problems that can further affect their daily functioning. Children exposed to alcohol prenatally, with and without the physical features of fetal alcohol syndrome, display qualitatively similar deficits. Determining the behavioral phenotypes that result from heavy prenatal alcohol exposure is critical, because the identification of these children is crucial for early interventions. In addition, knowing which brain areas are involved might enable the development of better intervention strategies. However, intervention needs to go beyond the affected individual to prevent future cases. As evidenced by the staggering financial impact these disorders have on society, prevention efforts need to be aimed at high-risk groups, and this issue needs to be made a high priority in terms of public health.

Fuzzy sets programming to perform evaluation of solar systems in Jordan

This paper uses fuzzy set methodology to perform the comparison between different solar systems for various applications. The aim of the paper is to determine the order in which solar systems should be given higher priority to be used in Jordan. The systems considered are solar distillation, solar water heating, solar space heating and ventilation, solar water pumping, photovoltaics and solar electric power production. They were compared according to their benefits and costs. Based on benefit to cost ratios, the results show that solar distillation is found to be the best choice and should be given the highest priority in terms of research and development. It is followed by the solar pond for electric power production, then, solar water pumping followed by solar space heating and photovoltaics. Finally, solar water heating may not need further development.

Reflecting on the use of student portfolios

The use of portfolios in nursing has increased during recent years. We reflect upon the design and implementation of a portfolio for pre-registration nursing students in the School of Care Sciences1at the University of Glamorgan. The portfolio was introduced as the result of the need to address the theory–practice divide and to provide nurse students with the skills to maintain a professional profile upon registration.We also discuss other potential benefits associated with using the portfolio. These include the use of a portfolio as a focus for discussion between the student and their preceptor or personal tutor, a vehicle for the development of reflective skills and a means of assessment.We acknowledge that along with benefits, there are a number of potential problems and limitations in their use, for example, an increase in the workload for the student, preceptor and personal tutor. We include preliminary findings of an evaluation of our portfolio, revealing that both students and staff value the introduction of the portfolio, although currently it is not a high priority in terms of the course as a whole.