Journal articles on the topic 'Milestone schedule'
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NAGAOKA, Hiroaki, Shuzo FURUSAKA, Hyeong Geun PARK, and Takashi KANETA. "SCHEDULE PLANNING AND MANAGEMENT WITH MILESTONE IN REPETITIVE CONSTRUCTION WORK." Journal of Architecture and Planning (Transactions of AIJ) 62, no. 492 (1997): 171–77. http://dx.doi.org/10.3130/aija.62.171_1.
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Sobel, Halle G., Rachel Swigris, Karen M. Chacko, Alison Landrey, Monica McNulty, Kaitlyn Vennard, Susan Michelle Nikels, Kathleen Suddarth, Edward N. Murphy, and Eva Aagaard. "Resident and Preceptor Perceptions of Preceptor Integration Into Resident Clinic Scheduling Templates." Journal of Graduate Medical Education 9, no. 4 (August 1, 2017): 497–502. http://dx.doi.org/10.4300/jgme-d-16-00609.1.
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ABSTRACT Background Some internal medicine residency programs on X+Y schedules have modified clinic preceptor schedules to mimic those of the resident cohort (resident matched). This is in contrast to a traditional model, in which preceptors supervise on the same half-day each week. Objective We assessed preceptor and resident perceptions of the 2 precepting models. Methods We surveyed 44 preceptors and 97 residents at 3 clinic sites in 2 academic medical centers. Two clinics used the resident-matched model, and 1 used a traditional model. Surveys were completed at 6 months and 1 year. We assessed resident and preceptor perceptions in 5 domains: relationships between residents and preceptors; preceptor familiarity with complex patients; preceptor ability to assess milestone achievements; ability to follow up on results; and quality of care. Results There was no difference in perceptions of interpersonal relationships or satisfaction with patient care. Preceptors in the resident-matched schedule reported they were more familiar with complex patients at both 6 months and 1 year, and felt more comfortable evaluating residents' milestone achievements at 6 months, but not at 1 year. At 1 year, residents in the resident-matched model perceived preceptors were more familiar with complex patients than residents in the traditional model. The ability to discuss patient results between clinic weeks was low in both models. Conclusions The resident-matched model increased resident and preceptor perceptions of familiarity with complex patients and early preceptor perceptions of comfort in assessment of milestone achievements.
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Koepke, M. E. "Factors influencing the commercialization of inertial fusion energy." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 379, no. 2189 (December 7, 2020): 20200020. http://dx.doi.org/10.1098/rsta.2020.0020.
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Managing the IFE pathway to fusion electricity will involve management of commericalization scope, schedule, cost and risk. The technology pathway to economical fusion power comprises the commercialization scope. Industry assumes commercialization risk in fielding its own pre-pilot plant research programme for this compact-fusion pathway without the benefit of a federally coordinated IFE research and development programme. The cost of commercializing the mass-production of inexpensive targets and insisting on high reliability, availability, maintainability and inspectability has a major impact on the economics of commercializing fusion power plants. Schedule vulnerability for inertial fusion energy arises from the sensitivity of time-based roadmap stages to uncertainties in the pace of scientific understanding and technology development, as well as to unexpected and inexplicable changes of the budgeting process. Rather than rely on a time-based roadmap, a milestone-based roadmap is maximally appropriate, especially for industry and investors who are particularly well-suited to taking the risks associated with reaching the target milestones provided by the government. Milestones must be identified and optimally sequenced and the necessary resources must be delineated. Progress on the above factors, since the outcomes of recent U.S., U.K. and EUROfusion roadmapping exercises were released, are reported. This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 2)’.
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Jimenez, Christopher A., Edward D. White, Gregory E. Brown, Jonathan D. Ritschel, Brandon M. Lucas, and Michael J. Seibel. "Using Pre-Milestone B Data to Predict Schedule Duration for Defense Acquisition Programs." Journal of Cost Analysis and Parametrics 9, no. 2 (May 3, 2016): 112–26. http://dx.doi.org/10.1080/1941658x.2016.1201024.
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Fisher, Wayne. "Macroergonomics in the Context of Vendor-Customer Technology Transfer." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 38, no. 12 (October 1994): 774–78. http://dx.doi.org/10.1177/154193129403801212.
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The transfer of a system-level product from vendor to customer typically requires that the customer change both business processes and organizational structures as part of the system implementation process. A macroergonomic approach was used to analyze the transfer of an image based check processing system to customer sites and identify opportunities to improve the transfer process. The analysis identified a lack of knowledge of the organizational, administrative and managerial changes that would be introduced by the new technology as a potential risk to the project implementation schedule. The analysis indicated that establishing a knowledge base covering five non-technical areas (general system familiarity, worksite preparation, human resources, operations and system support) and transferring that knowledge base to the customer's implementation team would minimize the potential schedule risk. A specialized consulting role was created to transfer the knowledge base to the customer's implementation team through a series of seminar sessions tied to specific implementation milestones. Each session focused on assisting the customer's implementation team in developing an action plan to allocate and schedule the resources necessary to carry the project through to the next milestone. The structure of the knowledge base and the presentation format for the consulting service were verified during initial trials at customer sites. A curriculum of classroom instruction and apprenticeship was then developed to train the consultants. Qualitative feedback from customers indicated that the service was perceived to provide value to the participants.
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Kashiwagi, Isaac, Dean Kashiwagi, and Len Gambla. "Application of the Best Value Approach in Procuring ERP Services in a Traditional ICT Environment." Journal for the Advancement of Performance Information and Value 10, no. 1 (March 13, 2020): 51–65. http://dx.doi.org/10.37265/japiv.v10i1.22.
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The ICT industry has struggled with performance for years. Tools, processes, and techniques have been developed in attempts to improve performance, however, the level of performance has not significantly improved. The Best Value Approach has been proposed to increase both the procurement and execution of ICT projects. This researches focus is to further test, explore and confirm the claims associated with the Best Value Approach and its applicability in the ICT industry. Using case study research, the Best Value Approach was used in the selection of an ERP vendor for a client organization. The research findings confirm the claims of the Best Value Approach to be accurate in terms of being simpler, quicker, lower costing, requiring little expertise from the client and delivering an understandable, non-technical plan including detailed schedule, milestone schedule, and schedule that identifies all stakeholder activity.
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Yi, Daekyoung, Eul-Bum Lee, and Junyong Ahn. "Onshore Oil and Gas Design Schedule Management Process Through Time-Impact Simulations Analyses." Sustainability 11, no. 6 (March 17, 2019): 1613. http://dx.doi.org/10.3390/su11061613.
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Korean oil and gas contractors have recently incurred significant losses due to improper engineering performance on EPC (engineering procurement and construction) projects in overseas markets. Several previous studies have verified the significant impact engineering has on EPC construction cost and project lifecycle. However, no literature has studied the time impact engineering has on EPC projects, representing a gap in the existing body of knowledge. To fill this gap, a Monte Carlo simulation was performed with the Pertmaster, Primavera risk analysis software for three sample onshore oil and gas projects. From said simulation of all major EPC critical activities, the authors found that the engineering phase is up to 10 times as impactful as the procurement and construction phases on the overall schedule duration. In assessing the engineering activities, the authors found the piping design activities to have the greatest impact on the overall schedule performance. Using these findings, the authors present a design schedule management process which minimizes the delays of project completion in EPC projects. Said process includes the following six steps: (1) Milestone management, (2) drawing status management, (3) productivity management of engineering, (4) interface management, (5) management of major vendor documents, and (6) work front management. The findings of this paper add to the body of knowledge by confirming the design phase to be the most impactful on the overall project schedule success. Furthermore, the presented design schedule management will aid industry with successfully executing the design phase in a timely manner, including examples from case study projects for a greater understanding.
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Utami Nilawati, Ni Ketut, and I. Gde Eka Dharsika. "Penerapan Manajemen Proyek Pada Tahap Pengendalian Waktu Pelaksanaan Proyek Soft Landscaping Jumeirah Resort Pecatu Graha Bali." Jurnal Ilmiah Vastuwidya 3, no. 1 (June 16, 2020): 01–05. http://dx.doi.org/10.47532/jiv.v3i1.94.
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Construction are increasingly needed in the implementation of projects, especially the existence of services that can control the main demands regarding the accuracy of quality, financial efficiency and time accuracy are very much needed. In implementing the Jumeirah Resort Pecatu Graha Bali Development Project, researchers focused their research on soft landscaping work. The role of project management in controlling the implementation time is to obtain a good way or technique to be applied so that limited resources can be managed so as to obtain effective and efficient results due to well-ordered arrangements.The "S" curve is one of the techniques for controlling project progress by using a combination of the "S" curve and the milestone. After looking at the schedule of plans and comparing with progress in the field, there are very significant delays in work on: (a) Groundcover work, when viewed from February 2019 time schedule groundcover work should have been completed, but progress data in the field in that month only reached 30.92%; (b) Shrubs work, if seen from March 2019 time schedule shrubs work should have been completed, but progress data in the field in that month only reached 35.86%; (c) Palms work, if seen from April 2019 time schedule palms work should have reached the final stage of work, but progress data in the field in that month only reached 43.69%. Factors causing the delay in work based on daily reports include: (a) Land not yet ready for planting because it is still waiting for civil works to be completed; (b) Delay in supply of types of plants: groundcover, shrubs and palms, because plants are imported from Java, especially in Malang areas.
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Worek, Franz, Horst Thiermann, Marianne Koller, and Timo Wille. "In Vitro Interaction of Organophosphono- and Organophosphorothioates with Human Acetylcholinesterase." Molecules 25, no. 13 (July 2, 2020): 3029. http://dx.doi.org/10.3390/molecules25133029.
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The implementation of the Chemical Weapons Convention (CWC) in 1997 was a milestone in the prohibition of chemical warfare agents (CWA). Yet, the repeated use of CWA underlines the ongoing threat to the population. Organophosphorus (OP) nerve agents still represent the most toxic CWA subgroup. Defensive research on nerve agents is mainly focused on the “classical five”, namely tabun, sarin, soman, cyclosarin and VX, although Schedule 1 of the CWC covers an unforeseeable number of homologues. Likewise, an uncounted number of OP pesticides have been produced in previous decades. Our aim was to determine the in vitro inhibition kinetics of selected organophosphono- and organophosphorothioates with human AChE, as well as hydrolysis of the agents in human plasma and reactivation of inhibited AChE, in order to derive potential structure–activity relationships. The investigation of the interactions of selected OP compounds belonging to schedule 1 (V-agents) and schedule 2 (amiton) of the CWC with human AChE revealed distinct structural effects of the P-alkyl, P-O-alkyl and N,N-dialkyl residues on the inhibitory potency of the agents. Irrespective of structural modifications, all tested V-agents presented as highly potent AChE inhibitors. The high stability of the tested agents in human plasma will most likely result in long-lasting poisoning in vivo, having relevant consequences for the treatment regimen. In conclusion, the results of this study emphasize the need to investigate the biological effects of nerve agent analogues in order to assess the efficacy of available medical countermeasures.
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Choi, Jaeh Yun, and Kyu Sung Lee. "An Automated Progress Tracking System for Industrial Facility Construction Projects." Advanced Materials Research 671-674 (March 2013): 2973–77. http://dx.doi.org/10.4028/www.scientific.net/amr.671-674.2973.
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As amount of information in construction industry is growing, the role of information system in project management is becoming increasingly important. With the emerging IT application to the advancing construction industry, construction project management system with advanced technology has been progressed vigorously to improve construction productivity and management efficiency. Recently, a web-based Project Management Information System (PMIS) is developed to support decision-making process by efficiently managing project related information generated from various discipline. Many firms are in the process of developing the PMIS system or already have been applied the system to various projects. However, PMIS is still in its early stage of development to be applied at industrial plant construction projects. With the complexity of the industrial plant projects, the industry practitioners need to be able to visualize the construction schedule information to manage the project efficiently. This study suggests methodologies for improving PMIS specialized for industrial plant piping construction projects to estimate the baseline schedule and performance measurement more accurately by developing a framework for the piping construction projects. By using this developed system, the researchers expect that piping construction projects will be more efficiently managed on a real-time basis through measuring progress of piping at each and every state of progress milestone and provide management with opportunities to forecast the level of efforts required to execute the remaining work scope in a timely manner.
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Verma, Garima, and Umesh Pathak. "Comparative study of knowledge and practices of childhood immunization among health care providers in Meerut, India." International Journal of Contemporary Pediatrics 4, no. 5 (August 23, 2017): 1658. http://dx.doi.org/10.18203/2349-3291.ijcp20173649.
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Background: Immunization laid a major milestone in preventive practices in childhood diseases and decreasing mortality rates. However, despite of such impressive immunization programme we are not able to achieve our targeted goals on time. Lack of awareness of immunization practices amongst our health care providers can be one of the reasons behind this.Methods: Total 300 participants were included in study divided into three groups A, B and C (pediatricians, allopathic practitioners and health providers at PHC respectively). A self-administered questionnaire in English comprising of questions related to knowledge and practices of immunization were given to all participants. Their responses were analyzed and assessed for level of knowledge in each field and then compared with other groups.Results: In the present study, nearly half of the participants were >50 yrs and it was observed that percentage of correct knowledge was decreasing with increasing age of participants. Correct immunization schedule was known by all the participants. Correct knowledge regarding immunization of unvaccinated child reporting at 1-2 years of age was maximum amongst group A and minimum amongst group C (P≤0.05). Correct knowledge about use of Refrigerator for vaccine storage and storage temperature of vaccine was also satisfactory in group A (92%) (p<0.001).Conclusions: After analyzing all responses we can fairly conclude from this study that overall knowledge of immunization practices amongst health care providers was not satisfactory which emphasizes on need of continuous training and supervision of health care providers dealing with immunization.
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Smith, Robert. "Tips and Lessons Learned for Conducting Safety Review Board Meetings." Journal of System Safety 56, no. 2 (December 1, 2020): 37–47. http://dx.doi.org/10.56094/jss.v56i2.22.
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At some point during a safety program’s lifecycle, presenting to an Independent Safety Review Board is likely. For the program representatives, including their safety lead, program manager, and supporting representatives (e.g., design engineers, software developers, test directors, etc.), this could be comparable to a full-scale audit on their program - and in some cases, it is! The fear that program representatives have with presenting to Safety Review Boards is the unknown. They may ask themselves:
What is going to be uncovered, or discovered?
Will they be able to provide sufficient responses to address questions and concerns and defend our safety assessments?
Will the Safety Review Board process delay the schedule?
Are they going to miss a test event milestone?
Will they make their Critical Design Review (CDR)?
Will they meet their certification process?
How much is this going to cost?
Why do they need to provide all of this Objective Quality Evidence (OQE)?
This paper provides tips and highlights what programs should do, and should not do, based on lessons learned to have successful Safety Review Board meetings. The end goal of any successful Safety Review Board meeting is to ensure the safety program processes and analytical artifacts are adequate and well-established to properly identify and assess safety risks for the personnel, equipment and environment that will be exposed to potential hazards during the system’s lifecycle.
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Dolata, MD, Wojciech K. "Megakariocytic Hypoplasia Due To TKIs In a CML Patient Can Be Overcome By TPO Receptor Agonist Eltrombopag." Blood 122, no. 21 (November 15, 2013): 5178. http://dx.doi.org/10.1182/blood.v122.21.5178.5178.
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Background Patients who develop severe thrombocytopenia while treated with TK inhibitors may be forced to stop them, face a worse prognosis, and eventually require a treatment with a bone marrow transplant. Eltrombopag is a TPO receptor agonist that stimulates megakaryocytic proliferation. Case 62-year-old man presented in October 2008 with splenomegaly and leukocytosis. The bone marrow biopsy was diagnostic of CML. Imatinib was started at 400 mg daily resulting in hematological response and resolution of splenomegaly, but severe thrombocytopenia necessitated 50 % dose reduction. Thrombocytopenia was not responsive to Prednisone, and a trial of platelets transfusions with the standard dose of Imatinib had to be stopped because of thrombocytopenia below 10 K and the risk of bleeding – reducing the dose of the TKI was improving the platelet count. Treatment with Dasatinib and with Nilotinib also necessitated 50 % dose reductions because of thrombocytopenia. These reduced TKI dosing resulted in the best Quantitative RT-PCR for bcr/abl product reduction level at – 1.01. Bone marrow biopsy in December 2010 showed no morphologic evidence of CML, and no dysplasia; it was normocellular marrow with erythroid hyperplasia and megakaryocytic hypoplasia. Cytogenetic analysis and FISH showed presence of the Philadelphia chromosome rearrangement. The patient declined the treatment with a Bone marrow transplant. In April 2011 a TPO agonist Eltrombopag 50 mg daily was started, given on two weeks on two weeks off schedule. As platelets remained adequate since then, the Nilotinib was escalated to the full dose of 400 mg twice daily. The patient tolerated the treatment well. Results The patient required about half-a-year support with Eltrombopag; after that it was discontinued as the platelet count remained above 40 K. No dose reduction of Nilotinib was necessary. In January 2012 the patient reached the milestone of Complete Cytogentic Response with the level of bcr/abl transcript minus 2 or less, which continued to decrease and now the patient is achieving a Major Molecular Response. Conclusion Treatment of CML with Tyrosine Kinase Inhibitors – Imatinib, Dasatinib, or Nilotinib in our patient – can be complicated by severe thrombocytopenia. These patients’ next treatment option may be a Bone marrow transplant. Limited use of Eltrombopag can improve thrombocytopenia, and allow these patients to continue TKIs with attainment of the treatment milestons. Disclosures: Off Label Use: Eltrombopag. It is used in thrombocytopenia, in ITP. In this presentation it was used to treat thrombocytopenia secondary to Thyrosine Kinase Inhibitors in Chronic Myelogenous Leukemia.
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Ananto, Gamawan. "“321” Program in Bandung State Polytechnic for Manufacturing for Better Operations Management Understanding." Advanced Materials Research 576 (October 2012): 685–89. http://dx.doi.org/10.4028/www.scientific.net/amr.576.685.
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In ‘Bandung State Polytechnic for Manufacturing’ (POLMAN) Bandung as a vocational education institution, Production Base Education (PBE) is already implemented for years. Through this concept students are doing practical jobs that inquired by real customer from industries, with the Quality-Cost-Delivery (QCD) necessity as well. The student practical program schedule is made structurally, combined with theory and other needed contents according the planned competency for each study program in 3 years (6 semesters). Therefore, so far 2 weeks for practical and 1 week theory alternately is arranged and ran well. Students will then learn all about process and transformation of raw material to product included assembly, but they seem not enough experienced in Operation Management and integrating the related manufacture activities. There are feedbacks that POLMAN graduates have adequate capability in technical matters like designing, machining, fabrication etc. but few skills in managing could still be improved. In 321 program idea, students will get the first 3 semesters for basic matters needed, the next 2 semesters in integrated continually project program and the last 1 semester for finalization and the additional enrichment items. With this program, students will more concern and get better understanding in project handling comprehensively, integrating all related planning, relevancies among one process to others in order handling and manufacture activities, and be realized in controlling the milestone of supply chain component entities like vendor, logistic, production, sales and customer. The consequences in market and project matter preparation of course has to be highly anticipated.
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Biruk, Sławomir, and Piotr Jaśkowski. "Selection of the Optimal Actions for Crashing Processes Duration to Increase the Robustness of Construction Schedules." Applied Sciences 10, no. 22 (November 12, 2020): 8028. http://dx.doi.org/10.3390/app10228028.
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Both the construction clients and the contractors want their projects delivered on time. Construction schedules, usually tight from the beginning, tend to expire as the progress of works is disturbed by materializing risks. As consequence, the project’s original milestones are delayed. To protect the due date and, at the same time, avoid changes to the logic of work, the manager needs to the project progress and, if delays occur, speed up processes not yet completed. The authors investigate the problem of selecting the optimal set of actions of responding to schedule delays. They put forward a simulation-based method of selecting schedule compression measures (speeding up processes) and determining the best moment to take such actions. The idea is explained using a simple case. The results confirm that it is possible to find an easily implementable schedule crashing mode to answer schedule disturbances. The proposed method enables minimizing the cost of schedule crashing actions and the cost of delays as well as increasing the robustness of the schedule by reducing differences between the actual and the as-planned process starts. It is intended as a decision support tool to help construction managers prepare better reactive schedules. The lowest costs are achieved if the acceleration measures are implemented with some time lag to the occurrence of delays.
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Alofi, Ahmed, Yasir Alhammadi, Dean Kashiwagi, and Kenneth Sullivan. "Upgrade the Saudi Arabian Procurement System Delivery Method." Journal for the Advancement of Performance Information and Value 7, no. 1 (December 1, 2015): 146. http://dx.doi.org/10.37265/japiv.v7i1.60.
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Saudi Arabia has had many issues in delivering mega construction projects, such as delays, high costs, and low customer satisfaction. Some studies show that around 70% of public projects in Saudi Arabia are delayed. One factor that might be causing these performance issues is the traditional low bid contracting system in Saudi Arabia, or the Saudi procurement system. In Saudi Arabia, owners select contractors based only upon the lowest price. This paper researched ways to modify the current Saudi procurement system and show quick and simple modifications that can be done to improve the low performance. This research proposes that by adding the clarification phase from the Performance Information Procurement System (PIPS) to the Saudi traditional procurement process could greatly improve construction performance. The clarification phase requires the selected contractor to submit a project scope, detailed and milestone schedule, potential risks that they do not control, and performance measurement before a contract is awarded. The PIPS system is one of the most successful systems around the world, which shows success rate of 98% in six different countries with risk and cost reduction up to 30%. The clarification phase has been identified as the most important step in the PIPS to ensuring a successful project. This paper conducted a survey among construction professionals in Saudi Arabia, including 157 engineers, 33 consultants 9 owners, 5 vendors, 13 academics, and 28 architects, in order to develop the public procurement system in Saudi Arabia. The participants work in government sectors with an interest in the Saudi Arabian procurement system. The survey confirmed that professionals in the Saudi construction industry believe that the procurement system should be changed and that the inclusion of the clarification phase to the procurement system is a way to improve the procurement system.
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Abuwarda, Zinab, and Tarek Hegazy. "Multi-dimensional optimization model for schedule fast-tracking without over-stressing construction workers." Canadian Journal of Civil Engineering 46, no. 12 (December 2019): 1160–73. http://dx.doi.org/10.1139/cjce-2018-0544.
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Fast-tracking is an important process to speed the delivery of construction projects. To support optimum fast-tracking decisions, this paper introduces a generic schedule optimization framework that integrates four schedule acceleration dimensions: linear activity crashing; discrete activity modes of execution; alternative network paths; and flexible activity overlapping. Because excessive schedule compression can lead to space congestion and overstressed workers, the optimization formulation uses specific variables and constraints to prevent simultaneous use of overlapping and crashing at the same activity segment. To handle complex projects with a variety of milestones, resource limits, and constraints, the framework has been implemented using the constraint programming (CP) technique. Comparison with a literature case study and further experimentation demonstrated the flexibility and superior performance of the proposed model. The novelty of the model stems from its integrated multi-dimensional formulation, its CP engine, and its ability to provide alternative fast-track schedules to strictly constrained projects without overstressing the construction workers.
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Shohreh Ghasemi, Reyhaneh Heydari, Faranak goodarzi, Fargol Mashhadi Akbar Boojar, Amirreza Dashti, and Mahmood Dashti. "A review of treatment plans for the biological clock of astronauts: A systematic review." Open Access Research Journal of Biology and Pharmacy 2, no. 2 (September 30, 2021): 007–15. http://dx.doi.org/10.53022/oarjbp.2021.2.2.0044.
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Since the start of civilization and even further back, humankind has been dreaming of flying. Recently, this dream has come true and reached beyond that and sends astronauts to outer space. However, by achieving this milestone, we encountered new problems that were new to humanity. One of the biggest problems is having a sleeping disorder and disruption of the biological clock. It is essential because having a sleep disorder makes astronauts unable to function at 100% capacity, and in outer space, it is dangerous. Some treatments for sleep disorders include drug therapy, such as Dexedrine, temazepam, modafinil, bupropion, melatonin, zolpidem, dextroamphetamine, light treatment, or a trickling sleep/wake schedule, according to NASA's guidelines. This study aimed to review the treatments for sleep disorders and disruption of the biological clock aimed at astronauts during space flights. We presented the different treatments and discussed and oriented the next prospect of research on sleep in space. Therefore, there will be guidelines for astronauts during their flights. Since the beginning of space travel, there have been many papers regarding space and weightlessness on the adverse effects on health. Studies have described the effect of space travel and the environment of microgravity on health. A few studies include both the short- and long-term effects of microgravity on the biological clock. With this new dawn and sending new astronauts to International Space Station (ISS) with NASA and SpaceX commercial Falcon 9 rocket, which opened a new horizon for spaceflights, it is even more important to consider the adverse effects microgravity on health. Purpose: This review aims to specifically analyze the biological clock, sleep deficiency, and circadian disorders. As we acknowledge, there is a sleep deficiency associated with complex microgravity environs and space missions before and after launch. Material and methods: Two researchers searched a thorough and detailed search of the PubMed database with the keywords mentioned below. The search was performed in November 2020 without any time limitations. We only included human studies and articles in the English language. Results: A total of 148 articles were found, and after going through titles, 77 articles were chosen for checking abstracts. Finally, only 12 manuscripts were accepted for data extraction. Conclusion: It is essential for health care involved in space travel providers to help pre-emptively identify problems that may prevent severe consequences during a microgravity environment. Sleep and circadian factors are the fundamental issues of human fatigue, and aviation schedules significantly impact both. We should admire a computerized fatigue model for having a better approach to studying the impact of scheduling.
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Alyoubi, Bader A. "The Effect of Knowledge Management Systems on Measuring Success Indicators for Saudi Arabia 2030." Research in World Economy 10, no. 4 (December 22, 2019): 31. http://dx.doi.org/10.5430/rwe.v10n4p31.
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Vision 2030 is designed to place the Kingdom of Saudi Arabia (KSA) as a trading and financial hub in the Middle East. Ninety-six strategic objectives are framed for Vision 2010. Whilst these objectives are very inspiring, challenges are seen in integrating them under a single unifying framework. Unless the diverse objectives are integrated, knowledge and learning of team members are brought on a common platform to measure the success indicators, achieving the vision would be difficult. Objective of the paper is to develop a KM model that will help to measure the success indicators of Vision 2030. A literature review helped to understand the barriers, processes, and methodology of KM frameworks. The findings indicate that Vision 2030 is wide in scope with 96 loosely connected strategic objectives. An overarching framework that links all these objectives and places them on a common platform is not evident. These inputs were used to design the KM Vision 2030 model that links all the objectives and helps to gather metrics from the objectives, and measure the success of the project. Some of the metrics that can be considered are linking objectives, milestone achievement, adhering to schedule and budget, economic and social impact on people and businesses, progress in positioning KSA as the leader of Middle East, and others. Some of these measures are qualitative, whilst others are quantitative, implying that a multimodal data collection and analysis method is needed. The model suggests institution of Knowledge Champions, Communities of Practice, big data analytics, knowledge assets development and sharing, and brings all the objectives on a transparent and usable platform. A pilot study in the form of a semi-structured interview and survey was administered to five experts in the field of KM and IT systems. Their findings indicate that big data analytics can play a major role in decision-making and in measuring the project success. The findings also speak of the need to connect the strategic objectives. Recommendations are made to refine the model.
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Panthi, Krishna Kanta. "Turnkey Contract - A Management Challenge under Himalayan Geological Condition." Hydro Nepal: Journal of Water, Energy and Environment 19 (July 26, 2016): 17–24. http://dx.doi.org/10.3126/hn.v19i0.15346.
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Himalayan geology poses special attention and tunneling challenges, which are associated to the engineering geological conditions in the rock mass. Completing tunneling project within scheduled contractual time is an issue to be carefully brainstormed and planned by a very competent project management team. This team work is especially a key demand for the projects built under turnkey contract having fixed performance guarantees, completion milestones and contract sum. This is because, delay in construction completion will bring huge contractual penalties and extra cost to the contractor and is, therefore, a management headache to the project team. Hydropower projects consisting long underground waterways system passing through varying geological ground conditions may hinder achieving targeted milestones due to uncertainty associated to the geological risks. This paper present Khimti I Hydropower Project (60 MW) that has 10 km long underground waterway system, one km long access tunnel, many construction Adits and an underground powerhouse. The project was constructed under a turnkey contract called KC2 contracts with main civil contractor responsible for both design and construction implementation of the project. The construction quality was guaranteed through several contractual performance tests listed under the KC2 contract. This article attempts to review on the way the geological ground condition has influenced in the completion milestone of the project and highlights on what are the key issues that must be carefully accessed before accepting a turnkey contract for hydropower project with long underground waterway systems.HYDRO Nepal JournalJournal of Water, Energy and EnvironmentIssue: 19Page: 17-24
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Rao, Prabhakar, and Seetha Ramaiah. "A CASE Study on Software Project Development Cost, Schedule & Effort Estimation." Asian Journal of Pharmaceutical and Clinical Research 10, no. 13 (April 1, 2017): 10. http://dx.doi.org/10.22159/ajpcr.2017.v10s1.19538.
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This paper theme is to provide a case study of Software Project Development cost, effort, and schedule estimation. From recent past, a remarkable research takes place in developing different techniques on software effort and cost estimation. Making estimation before start of any project is necessary to be able to plan and manage any project. The estimate is an intelligent guess for the project resources. Nowadays, software has become a major contributor to economic growth for any nation. Making an estimate before starting any software project is vital for the project managers and key stakeholders. Major project milestones such as project schedules, budgeting, resource allocation, and project delivery dates are set on theeffort and cost estimates. Thus, the reliability of the estimation leads any project success or otherwise fail. In this article, author’s idea is to work with function point analysis and include the concept of workforce scheduling in a better way while taking the decision in the contract phase. That leads to strengthening the relations between the developer and the customer. Basically, size is a main measured unit of the software project. Based on the size and other functionalities, the software managers estimate the total effort required to develop the project. From the effort and work schedule, the total cost can be estimated.
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Namestovski, Žolt, and Attila Kovari. "Framework for Preparation of Engaging Online Educational Materials—A Cognitive Approach." Applied Sciences 12, no. 3 (February 8, 2022): 1745. http://dx.doi.org/10.3390/app12031745.
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This study examines the process of creating successful, engaging, interactive, and activity-based online educational materials, while taking the cognitive aspects of learners into account. The quality of online educational materials has become increasingly important in the recent period, and it is crucial that content is created that allows our students to learn effectively and enjoyably. In this paper, we present the milestones of curriculum creation and the resulting model, the criteria of selecting online learning environments, technical requirements, and the content of educational videos, interactive contents, and other methodological solutions. In addition, we also introduce some principles of instructional design, as well as a self-developed model that can be used to create effective online learning materials and online courses. There was a need for a self-developed, milestone-based, practice-oriented model because the models examined so far were too general and inadequate to meet the needs of a decentralized developer team, who work on different schedules, with significant geographical distances between them and do not place enough emphasis on taking cognitive factors into account. In these processes, special attention should be paid to having a clear and user-friendly interface, support for individual learning styles, effective multimedia, ongoing assistance and tracking of students’ progress, as well as interactivity and responsive appearance.
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Kim, Myung-Hun, Eul-Bum Lee, and Han-Suk Choi. "A Forecast and Mitigation Model of Construction Performance by Assessing Detailed Engineering Maturity at Key Milestones for Offshore EPC Mega-Projects." Sustainability 11, no. 5 (February 27, 2019): 1256. http://dx.doi.org/10.3390/su11051256.
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The main subject of this research is to develop a forecast and mitigation model of schedule and cost performance during a detailed engineering stage of offshore engineering, procurement and construction (EPC) projects. The weight factors of major elements in detailed engineering completion rating index system (DECRIS) were measured using a fuzzy inference system (FIS) and an analytic hierarchy process (AHP). At five key engineering milestones, from an EPC contract being awarded to the start of construction, detailed engineering maturities were assessed in fourteen historical offshore EPC projects using the DECRIS model. DECRIS cutoff scores for successful project execution were defined at the key engineering milestones. A schedule and cost performance was forecasted and validated through comparison of DECRIS and other models using statistical confidence of a fuzzy set qualitative comparative analysis (fsQCA) and a regression analysis. As a mitigation method for engineering risks to EPC contractors, engineering resource enhancement is recommended for trade-off optimization of cost overrun using a Monte Carlo simulation. The main contribution of this research is that EPC contractors could continuously forecast construction costs and schedule performance utilizing the DECRIS model, and could review the adequacy of engineering resources, assessing the trade-off between said resources and cost/schedule risk mitigation.
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Klimek, M., and P. Łebkowski. "Heuristics for project scheduling with discounted cash flows optimisation." Bulletin of the Polish Academy of Sciences Technical Sciences 63, no. 3 (September 1, 2015): 613–22. http://dx.doi.org/10.1515/bpasts-2015-0072.
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Abstract The article presents the resource-constrained project scheduling problem with the maximisation of discounted cash flows from the contractor’s perspective: with cash outflows related to starting individual activities and with cash inflows for completing project stages (milestones). The authors propose algorithms for improving a forward active schedule by iterative one-unit right shifts of activities, taking into account different resource flow networks. To illustrate the algorithms and problem, a numerical example is presented. Finally, the algorithms are tested using standard test problems with additionally defined cash flows and contractual milestones.
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Castagnetti, Fausto, Gianantonio Rosti, Massimo Breccia, Antonella Gozzini, Fabio Stagno, Giovanna Rege Cambrin, Ivana Pierri, et al. "Alternating Nilotinib 400 mg twice daily and Imatinib 400 mg once daily as Frontline Treatment of Ph+ Chronic Myeloid Leukemia. A Phase 2 Multicentric Study of the GIMEMA CML Working Party." Blood 118, no. 21 (November 18, 2011): 453. http://dx.doi.org/10.1182/blood.v118.21.453.453.
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Abstract Abstract 453 Background: Imatinib (IM) 400 mg daily is the standard treatment for Ph+ Chronic Myeloid Leukemia (CML) in early Chronic Phase (ECP). Nilotinib (NIL) is a 2nd generation tyrosine kinase inhibitor (TKI) with superior efficacy to IM (phase 3 ENESTnd trial). NIL has been approved for the frontline treatment of CML in many countries. The treatment with more than one TKI, according to the principles of cancer polychemotherapy, may improve the response rates and may decrease the frequency of drug-resistance. The combination of different TKIs is potentially toxic, difficult to be explored in the ECP setting. The sequential administration of IM and NIL is worth to be investigated because a significant proportion of CML patients treated with a single TKI as monotherapy develops primary or secondary resistance. Aims: To evaluate the response (either cytogenetic and molecular) and the outcome of ECP Ph+ CML patients treated with the sequential administration of NIL and IM. Methods: A phase 2 study was conducted by the GIMEMA CML WP (ClinicalTrials.gov. NCT00769327). NIL was administered first because it has a more rapid therapeutic effect. Schedule: NIL 400 mg twice daily for 3 months; IM 400 mg daily for the next 3 months; then, NIL and IM turning every 3 months, for a total duration of 24 months (study core). The 3-month rotation schedule was respected, irrespectively of temporary discontinuations. The primary end-point was the Complete Cytogenetic Response (CCgR) rate at 12 months. If the conventional cytogenetic analysis resulted not evaluable, a FISH analysis was performed. If one of the 2 drugs was permanently discontinued for adverse event (AE), the patient remained in study, continuing the treatment with the other drug (except for cardiac AEs). Definitions: Major Molecular Response (MMR): BCR-ABL/ABL ratio < 0,1%IS; failure: according to 2009 ELN recommendations; event: failure, permanent discontinuation of both drug for any reason, patient refusal. All the analysis were performed according to the ITT principle. Results: 123 patients have been enrolled in 38 italian hematologic Centers; median age 56 years (range 18–84); 33% low, 45% intermediate and 22% high Sokal score; median follow-up 21 months (at least 12 months observation, 24 months by November 2011). The cumulative CCgR rate by 12 months was 87%; CCgR at each milestone: 68% at 3 months, 73% at 6 months, 67% at 12 months (primary efficacy variable). The cumulative MMR rate by 12 months was 82%, while the rates of MMR at 3, 6 and 12 months were 59%, 62% and 60%, respectively. The discrepancies between cumulative response rates and response at each timepoint were mainly due to the number of patients not evaluable at each timepoint (10% of cytogenetic analysis not evaluable at 12 months) and to protocol discontinuation in stable CCgR and/or MMR. The incidence of hematologic AEs was low. Non-hematologic AEs or lab abnormalities grade > 2 observed in >5 % of patients were as follows: NIL - skin rash, pruritus, bilirubin increase, transaminase increase, lipase increase; IM - fluid retention, periorbital edema. AEs were manageable with appropriate dose adaptations. Four patients (3%) showed a prolongation of the QTcF above 450 msec (none above 500 msec). At the end of the first 12 months, 95 patients (77%) remained on study: 6 and 3 on NIL and IM monotherapy, respectively, 86 on sequential treatment with both drugs; 15% of patients permanently reduced the NIL dose to 400 mg daily and 9% of patients permanently reduced the IM dose to 300 mg daily. During the first year, 28 patients (23%) experienced an event: 10 treatment failure (8%); 2 death in CP (2%); 16 refusal, protocol violation or AE (13%). Six out of the 10 patients who failed the treatment progressed to advanced phase (3 patients: detection of a T315I mutation). Conclusions: The cumulative response rates achieved with a sequential administration of NIL and IM seem to be superior to the historical data of IM alone. The response rates at each timepoint, lower than expected, were probably due to the high number of not evaluable patients and to the number of patients not continuing the study despite a stable CCgR/MMR. However, if compared to the excellent results of 2nd generation TKI as monotherapy in ECP CML (single and randomized trials), the present analysis do not support an alternating schedule of NIL and IM as frontline treatment of ECP CML. Acknowledgments: European LeukemiaNet, COFIN, Bologna University, BolognAIL Disclosures: Castagnetti: Novartis Pharma: Honoraria; Bristol-Myers Squibb: Honoraria. Rosti:Novartis: Consultancy; Bristol Myers Squibb: Consultancy; Novartis: Research Funding; Novartis: Honoraria; Bristol Myers Squibb: Honoraria. Soverini:Novartis: Consultancy; ARIAD: Consultancy; Bristol-Myers Squibb: Consultancy. Martinelli:Bristol-Myers Squibb: Consultancy; Novartis: Consultancy, Research Funding.
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Moselhi, Osama. "Schedule compression using the direct stiffness method." Canadian Journal of Civil Engineering 20, no. 1 (February 1, 1993): 65–72. http://dx.doi.org/10.1139/l93-007.
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This paper presents a new method for critical path (CPM) scheduling that optimizes project duration in order to minimize the project total cost. In addition, the method could be used to produce constrained schedules that accommodate contractual completion dates of projects and their milestones. The proposed method is based on the well-known "direct stiffness method" for structural analysis. The method establishes a complete analogy between the structural analysis problem with imposed support settlement and that of project scheduling with imposed target completion date. The project CPM network is replaced by an equivalent structure. The equivalence conditions are established such that when the equivalent structure is compressed by an imposed displacement equal to the schedule compression, the sum of all member forces represents the additional cost required to achieve such compression. To enable a comparison with the currently used methods, an example application from the literature is analyzed using the proposed method. The results are in close agreement with those obtained using current techniques. In addition, the proposed method has some interesting features: (i) it is flexible, providing a trade-off between required accuracy and computational effort, (ii) it is capable of providing solutions to CPM networks where dynamic programming may not be directly applicable, and (iii) it could be extended to treat other problems including the impact of delays and disruptions on schedule and budget of construction projects. Key words: construction scheduling, time–cost trade-off, project cost optimization, scheduling with constraints, project acceleration.
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Kala, Karthika, Binu Areekal, Reshmy Ravindran, and Safa Puliyakkadi. "Menstrual Practices among Rural High School Students in Thrissur - Central Kerala." Journal of Evidence Based Medicine and Healthcare 7, no. 50 (December 14, 2020): 2981–86. http://dx.doi.org/10.18410/jebmh/2020/609.
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BACKGROUND Adolescence is the transitional phase of growth and development between childhood and adulthood. Menstruation, which is a milestone event in a girl's reproductive life begins during this period and it is also one of the major causes of stress in this stage. Adequate knowledge and good menstrual practices can help in addressing this stress and also in preventing reproductive tract infections to a great extent. This study tries to assess the awareness with regard to menstrual practice and its determinants among adolescent girls in a rural area of Central Kerala. The study also aims to explore the social taboos related to menstrual practices. METHODS This cross-sectional study was conducted at two high schools in Thrissur district of Central Kerala. The study methodology involved visiting the selected schools and questions about menstrual practices were put to students individually ensuring adequate privacy, with the aid of a semi-structured interview schedule. 196 adolescent girls participated in the study. The data was coded and entered into MS excel. Further analysis was done using the software SPSS 16.0 version. RESULTS The percentage of girls using sanitary pad is 32.1 %, clothes were used by 12.2 % girls, and 55.6 % used either cloth or sanitary pad. Most of them disposed their sanitary pads by burning them (75.6 %), but 16.3 % threw their pads / clothes in the general waste, some flushed them in the toilet (8.1 %). 64.3 % of them washed and exposed their undergarments in the sun but 35.7 % washed and kept them inside their house. 84.7 % of girls were aware about menstruation at the time of menarche. In 58.7 % of cases the source of information was their mother. Regarding social taboos during menstruation, the most common one was inability to attend social or religious functions during menstruation (76 %) followed by restrictions in going out (9.7 %), and 7.7 % in food preparation. 7 % of girls had to sleep in a corner of the room while they were menstruating. Maternal education, family income and awareness regarding menstruation had statistically significant association with usage of sanitary pads. CONCLUSIONS Majority of the adolescent girls had awareness regarding menstruation. However, there were some who followed less than ideal practices when it comes to disposal of sanitary napkins / clothes and care of undergarments. The wrong concepts like menstruation is a ‘disease of impurity’ and menstruation occurs when ‘bad blood’ collects is still prevalent among the adolescent girls. It is of concern that the social taboos regarding menstruation are still widely embraced by the society. KEYWORDS Menstrual Practices, Menstrual Awareness, Kerala, Menstruation
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Anysz, Hubert, and Michał Krzemiński. "Cost approach to the flow-shop construction scheduling." E3S Web of Conferences 110 (2019): 02048. http://dx.doi.org/10.1051/e3sconf/201911002048.
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A flow-shop construction scheduling – especially for a higher number of tasks projected – requires the use of metaheuristic algorithms to find the optimal schedule. The criteria of optimality may vary as well as constraints assumed for the schedule. The paper presents base rules of the flow-shop scheduling as well as the methods of making the work of engaged brigades continuous. When the cost of work execution is analyzed, it can occur that the optimal schedule understood as providing the shortest total time of project execution or the shortest total slack times of working brigades is not the cheapest solution. The following cost generators are taken into account: a daily cost of each brigade (working or waiting for the work), the technology applied to work execution, penalties for not keeping the milestones. The model of a time-cost evaluation of the flow-shop time schedule is formulated, analyzed and discussed. For the illustration of the presented model, the exemplary flow-shop time schedule with some constraints assumed is analyzed with and without the lowest cost as a criterion of optimality.
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Kaur, Sukhvir. "Software Quality." INTERNATIONAL JOURNAL OF COMPUTERS & TECHNOLOGY 3, no. 1 (August 1, 2012): 127–31. http://dx.doi.org/10.24297/ijct.v3i1b.2753.
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In the given paper I present the information regarding quality metrics. Different quality factors can be imposing with relation to cost, schedule and rework. It’s very important to make quality assurance plans. For that you have to cover many milestones which can be represented in time sheets. The main characteristics of the quality models have covered in this paper
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Вельчев, Георгий Сергеевич. "Teaching and education Process in the Belev Diocesan Women's School." Церковный историк, no. 2(2) (August 15, 2019): 276–85. http://dx.doi.org/10.31802/chist.2019.2.2.015.
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Статья посвящена процессу воспитания и обучения воспитанниц Белёвского епархиального женского училища. Открытие епархиальных женских училищ на территории Российской империи стало важной вехой в развитии как духовного, так и светского образования. Несмотря на то, что эти учебные заведения были сословными, трудно переоценить значение появления женских училищ в жизни дореволюционного духовенства, доступное детям церковнои священнослужителей обучение в которых значительно поднимало уровень просвещения семей духовенства и несколько приближало его к интеллигенции. Эти учебные организации открывались преимущественно при женских монастырях, находящихся в ведении Святейшего Синода или под управлением местного епархиального архиерея: основой для училищ в большинстве случаев послужили монастырские приюты. Содержание этих учебных заведений осуществлялось за счёт средств, выделяемых епархией, а также индивидуальных пожертвований. Статус училища определялся возможностью устроить учебно-воспитательный процесс согласно Уставу епархиальных женских училищ, что, в свою очередь, во многом зависело от решения вопроса финансирования. Читатель узнает о внутреннем распорядке дня учащихся, о воспитании девочек в строго религиозно-нравственном направлении, о расписании ежедневных занятий, о изучаемых в училище предметах, о задаваемом на дом материале для самостоятельного изучения и об организация досуговой деятельности во внеучебное время воспитанниц. The article is devoted to the process of education and training of pupils of the Belevsky diocesan women's school. The opening of diocesan women's colleges in the Russian Empire was an important milestone in the development of both spiritual and secular education. Despite the fact that these educational institutions were estates, it is difficult to overestimate the importance of the emergence of women's schools in the life of pre-revolutionary clergy, whose education available to the children of clergy and clergy significantly raised the level of education of the clergy families and brought them somewhat closer to the intelligentsia. These educational establishments were set up mainly in the women's monasteries administered by the Holy Synod or under the direction of the local diocesan bishop: the foundation of these schools was in most cases provided by the monastic asylums. The maintenance of these schools was funded by the diocese, as well as by individual donations. The status of the school was determined by the possibility of organising the teaching and educational process in accordance with the Statutes of the diocese. The status of the school was determined by its ability to organise the educational process in accordance with the Statutes of the diocesan women's colleges, which, in turn, depended to a great extent on the solution of the problem of financing. The reader learns about the internal daily routine of students, the strictly religious and moral upbringing of girls, the daily schedule of classes, the subjects taught in the school, the homework given to them for self-study, and leisure activities organized for students outside of school hours.
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Nair, Sreekanth, Aarti Jagannathan, Suresh Kudumallige, Channaveerachari Naveen Kumar, and Jagadisha Thirthalli. "Need for micro-finance self-help groups among women family caregivers of persons with mental disability in rural India." Mental Health and Social Inclusion 22, no. 1 (February 12, 2018): 34–45. http://dx.doi.org/10.1108/mhsi-10-2017-0039.
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Purpose Micro-finance self-help groups empower caregivers to indulge in productive activities based on the local availability of resources to reduce their financial burden. The purpose of this paper is to assess the need for and feasibility of initiating micro-finance groups for the caregivers of persons with mental disability in a rural socio-economically backward community of Karnataka, India. Design/methodology/approach The design of the study was a cross-sectional survey, with mixed methodology design out of the eight localities where the Mental Health Public Health Centres (PHC) were running successfully in Konandur area, Thirthahalli Taluk, Karnataka, one PHC was selected using simple Random Sampling Design and a 5 kms radius from Konandur town was selected as the area of the survey (190 households). During door-to-door survey, if the family indicated that a particular member is mentally unwell, the GHQ-5 and Symptoms and Others checklist were administered on him/her and the women caregiver was interviewed using qualitative needs assessment schedule and Perceived Social Support Scale. Findings Ten persons/households with mental illness (5.26 per cent) were identified in the community. Themes of financial needs, capacity of the caregiver, community resources, need for the microfinance self-help groups, informational needs, social support, burn out, and stigma elicited in the interview were depicted in the form of a conceptual framework to understand the inter-connectedness between the various themes. Research limitations/implications This study is the first initiative in the field of micro-finance self-help groups for the persons with mental illness and families. The design of the study was a cross-sectional survey, which is found globally to be the most suited in conducting prevalence studies, as it provides accurate results for future studies as well as it is the first step to obtain accurate baseline values to later plan a prospective follow up study. The study used mixed methodology design. Though the sample size was small, the information collected from the participants in qualitative and quantitative method was triangulated and conceptual frameworks were developed. As this study is one of the first of its kind in the country, the results of this study from the stated sample can be considered as an important pilot for future longitudinal and cross-sectional studies to be planned in the community. Originality/value There is hardly any scientific literature which talks about the need for Micro-finance self-help groups for Persons with Disability, especially with person with mental disability. In order to initiate any Micro-finance SHG activities, it is essential to first undertake the need for and feasibility of initiating such micro-finance group activities in any given area. This study will be an important milestone in initiating any self-help group activity for caregivers of persons with mental disability, as it would help us understand the financial needs of the community, based on which a draft proposal to initiate micro-finance self-help group activities can be drawn up.
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Oguoma, Victor M., Nicole Wilson, Kim Mulholland, Mathuram Santosham, Paul Torzillo, Peter McIntyre, Heidi Smith-Vaughan, et al. "10-Valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine (PHiD-CV10) versus 13-valent pneumococcal conjugate vaccine (PCV13) as a booster dose to broaden and strengthen protection from otitis media (PREVIX_BOOST) in Australian Aboriginal children: study protocol for a randomised controlled trial." BMJ Open 10, no. 5 (May 2020): e033511. http://dx.doi.org/10.1136/bmjopen-2019-033511.
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IntroductionStreptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are major otitis media pathogens that densely co-colonise the nasopharynx and infect the middle ear of Australian Aboriginal infants from very early in life. Our co-primary hypotheses are that at 18 months of age infants receiving 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) compared with those receiving 13-valent pneumococcal conjugate vaccine (PCV13) as a booster at 12 months of age will have higher antibody levels to Haemophilus influenzae protein D and that infants receiving PCV13 will have higher antibody levels to PCV13-only serotypes 3, 6A and 19A.Methods and analysesOur randomised controlled trial will enrol 270 Aboriginal children at 12 months of age to a booster dose of either PHiD-CV10 or PCV13. Children who completed the three-dose primary course schedules of PHiD-CV10 at 2, 4, 6 months of age; PCV13 at 2, 4, 6 months of age; or a combination schedule of PHiD-CV10 at 1, 2, 4 months of age plus PCV13 at 6 months of age are eligible. The co-primary assessor-blinded outcomes when the infants are 18 months of age are as follows: (a) IgG geometric mean concentration (GMC) and proportion with IgG ≥100 EU/mL for protein D, and (b) IgG GMC and the proportion with IgG ≥0.35 µg/mL for pneumococcal serotypes 3, 6A and 19A. Secondary immunogenicity comparisons of six primary and booster dose schedules of 10 shared serotypes at 18 months of age, nasopharyngeal carriage, all forms of otitis media, hearing loss and developmental milestones at 18, 24, 30 and 36 months of age will be reported.Ethics and disseminationEthics committees of NT Department of Health, Menzies, WA Department of Health and WA Aboriginal Health approved the study. Results will be presented to communities, at conferences and published in peer-reviewed journals.Trial registration numberNCT01735084.
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Hsiao, Cheng-Ting, Fremen ChihChen Chou, Chih-Cheng Hsieh, Li Chun Chang, and Chih-Ming Hsu. "Developing a Competency-Based Learning and Assessment System for Residency Training: Analysis Study of User Requirements and Acceptance." Journal of Medical Internet Research 22, no. 4 (April 14, 2020): e15655. http://dx.doi.org/10.2196/15655.
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Background The increasingly complex medical environment highlights the importance of milestones and entrustable professional activities (EPAs) to realize the ideals of competency-based medical education (CBME). However, if enormous amounts of assessment results need to be compiled, the development of a digital system to manage, integrate, and synthesize learning and assessment data will be necessary. Furthermore, this system should be able to facilitate real-time assessment with feedback and therefore enhance users’ learning through coaching in the moment in the clinical workplace. Objective The main purpose of this study was to develop a competency-based electronic platform system to provide resident physicians with clinical assessments and learning in order to enhance the learning of trainees and reduce the burden of assessments. Methods A competency-based learning and assessment system (CBLAS) for residency training was designed, developed, and evaluated in this study. Opinion interviews and a focus group consensus meeting of key users, including trainees, clinical teachers, and administrative staff, were conducted as needs assessments. The structure of the CBLAS was designed according to the thematic analysis of needs assessments. Clinical teachers’ acceptance of using CBME assessments, according to the constructs of attitude, perceived usefulness, and perceived ease of use, was surveyed in the beginning and half a year after implementation of the CBLAS. Additionally, the satisfaction of using the CBLAS, according to information, system, and service qualities, was surveyed after implementation. Results The main functions of the CBLAS, including milestones, EPAs, learning portfolios, teacher/student feedback, e-books, learning materials, assessment progress tracking, and statistical analysis of assessment results, were designed and developed for responding to nine themes, which emerged from the needs assessments of the three user groups. Twenty clinical teachers responded to the CBME assessment acceptance surveys before and after CBLAS implementation, which revealed a significant improvement in the factor of “attitude” (P=.02) but no significant differences in the two factors of “usefulness” (P=.09) and “ease of use” (P=.58) for CBME assessments. Furthermore, satisfaction surveys were performed in 117 users, and 87.2% (102/117) were satisfied with the CBLAS in terms of information, system, and service qualities. There was no significant difference in satisfaction among different user groups. Conclusions The CBLAS is a user-centered platform that supports clinical teachers’ assessment exercises and residents’ learning, as well as administrative work for staff according to users’ needs assessments and operationalized features of CBME assessments. With the system, clinical teachers had a more positive attitude to conduct the assessment activities of milestones and EPAs and learners could arrange their study schedules to enhance their learning effectiveness. The CBLAS sheds light on how to effectively design and develop a digital system to execute milestone- and EPA-based assessments for enhancing competency-based education among residents, according to our experiences in Taiwan.
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Ulrich, Dale A., Meghann C. Lloyd, Chad W. Tiernan, Julia E. Looper, and Rosa M. Angulo-Barroso. "Effects of Intensity of Treadmill Training on Developmental Outcomes and Stepping in Infants With Down Syndrome: A Randomized Trial." Physical Therapy 88, no. 1 (January 1, 2008): 114–22. http://dx.doi.org/10.2522/ptj.20070139.
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Background and PurposeInfants with Down syndrome (DS) are consistently late walkers. The purpose of this investigation was to test the effects of individualized, progressively more intense treadmill training on developmental outcomes in infants with DS.SubjectsThirty infants born with DS were randomly assigned to receive lower-intensity, generalized treadmill training or higher-intensity, individualized training implemented by their parents in their homes.MethodsResearch staff members monitored implementation of training, physical growth, and onset of motor milestones of all infants on a monthly basis.ResultsInfants in the higher-intensity, individualized training group increased their stepping more dramatically over the course of training. Infants in the higher-intensity training group attained most of the motor milestones at an earlier mean age.Discussion and ConclusionTreadmill training of infants with DS is an excellent supplement to regularly scheduled physical therapy intervention for the purpose of reducing the delay in the onset of walking.
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Kaur, Tarminder. "AGENDA OF RURAL EMPLOYMENT THROUGH MGNREGA: A CASE OF HARYANA (INDIA)." International Journal of Research -GRANTHAALAYAH 9, no. 7 (August 5, 2021): 197–204. http://dx.doi.org/10.29121/granthaalayah.v9.i7.2021.4107.
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The paper is intended to comprehensively analyze the concern of Government for rural development and its various efforts to contain rural problems. Most of all the efforts since independence, MGNREGA is emerged as a milestone and unique initiative to tackle rural poverty through 100 days rural employment. An effort is done to assess the performance of MGNREGA through financial investments in last five years. The actual results have been seen in the form of observing the amount siphoned for labour budget out of total budgetary outlay. Further, to review the social implications, the disadvantaged sections of SCs (Scheduled Caste) and women are specifically considered as beneficiaries.
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Ko, Chien-Ho. "Production control in precast fabrication: considering demand variability in production schedules." Canadian Journal of Civil Engineering 38, no. 2 (February 2011): 191–99. http://dx.doi.org/10.1139/l10-123.
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On-time delivery is a key factor in the business success of precast fabricators. The greatest obstacle to achieving this goal is demand variability. The objective of this research is to develop a plan that continuously improves production control systems for precast fabrication. This plan involves a lead time estimation model (LTEM) and schedule adjustment principles. The LTEM is established to estimate the impact of demand variability. In the model, previous jobs are analyzed as indicators of customer behavior. Using the captured behavior, fabrication lead time can be estimated for forthcoming projects. Two principles are proposed to adjust the production schedule according to the estimated lead times. Two adjustment principles are designed to reduce the impact of demand variability: (1) start fabrication later relative to the required delivery dates and (2) shift production milestones backward to the end of the production process. The effectiveness of the developed improvement plan including LTEM and the adjustment principles were validated using a real precast fabricator. The proposed approach is one of the first studies to use historical data to estimate the impacts of demand variability based on customer behavior.
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Mejlænder-Larsen, Øystein. "A three-step process for reporting progress in detail engineering using BIM, based on experiences from oil and gas projects." Engineering, Construction and Architectural Management 26, no. 4 (May 20, 2019): 648–67. http://dx.doi.org/10.1108/ecam-12-2017-0273.
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Purpose Traditionally, progress in detail engineering in construction projects is reported based on estimates and manual input from the disciplines in the engineering team. Reporting progress on activities in an engineering schedule manually, based on subjective evaluations, is time consuming and can reduce accuracy, especially in larger and multi-disciplinary projects. How can progress in detail engineering be reported using BIM and connected to activities in an engineering schedule? The purpose of this paper is to introduce a three-step process for reporting progress in detail engineering using building information modeling (BIM) to minimize manual reporting and increase quality and accuracy. Design/methodology/approach The findings of this paper are based on the studies of experiences from the execution of projects in the oil and gas industry. Data are collected from an engineering, procurement and construction (EPC) contractor and two engineering contractors using case study research. Findings In the first step, control objects in building information models are introduced. Statuses are added to control objects to fulfill defined quality levels related to milestones. In the second step, the control objects with statuses are used to report visual progress and aggregated in an overall progress report. In the third step, overall progress from building information models are connected to activities in an engineering schedule. Originality/value Existing research works related to monitoring and reporting progress using a BIM focus on construction and not on detail engineering. The research demonstrates that actual progress in detail engineering can be visualized and reported through the use of BIM and extracted to activities in an engineering schedule through a three-step process.
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El-Sourady, Maie, Heidi Chen, Sara F. Martin, Joseph Ritchie, Katreece Ellis, Ashley Richeson, Don Moore, Mohana Karlekar, and Sumi Misra. "Effects of a Primary Palliative Care Educational System for Teaching Learners at Different Levels of Training." American Journal of Hospice and Palliative Medicine® 36, no. 8 (March 7, 2019): 675–81. http://dx.doi.org/10.1177/1049909119834854.
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Interest and appreciation for palliative care (PC) has resulted in increased demand for both PC services and education. The PC rotation has been shown to improve PC knowledge in medical students (MS) and internal medicine (IM) residents, and PC specialists stand poised to direct the primary PC education of learners at different levels of training. To concurrently teach learners of different levels of training on a busy PC service, we created an educational system that emphasizes management of learner schedules, organization of teaching activities, faculty development to improve teaching skills, and learner self-evaluation. Both MS and IM residents showed an improvement in self-assessed competence as well as increased comfort level with seriously ill patients after PC rotation. Careful adjustment of learner schedules has accommodated an increasing number of learners, while maintaining a low learner to faculty ratio. The PC educators face an exciting and daunting challenge as the number of patients with PC needs and the number of learners requesting PC experience grow. We continue to improve milestone-based PC assessment tools, to invest in faculty development, and to explore innovative ways to support PC educators as they strive to provide consistent PC education that is both useful for learners and can be incorporated into busy PC clinical practice.
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Tokatlián, Juan G. "The Miami Summit and Drugs: A Placid, Innocuous Conference?" Journal of Interamerican Studies and World Affairs 36, no. 3 (1994): 75–92. http://dx.doi.org/10.2307/166527.
Full textAbstract:
The Western Hemisphere summit, which has been called by President Bill Clinton and is scheduled to be held in Miami (FL) in December 1994, will no doubt prove to be yet another major milestone along the evolving path of inter-American relations. Nevertheless, the significance of this meeting has been muted by the scanty information and limited signals given out by the host country regarding the meeting's purpose and agenda. In some ways, the upcoming summit projects a double image: of an event that is both transcendental and superficial at one and the same time. At least two elements point in this direction. On the one hand, much like similar previous conferences in history, not all members of the Hemisphere will attend, since some nations - like Cuba - have not been invited, an aspect that will affect the nature, spirit, and scope of this long-awaited assemblage of the Americas.
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Tam, Constantine S., Stephen Opat, Gavin Cull, Judith Trotman, David Gottlieb, David Simpson, Paula Marlton, et al. "Twice Daily Dosing with the Highly Specific BTK Inhibitor, Bgb-3111, Achieves Complete and Continuous BTK Occupancy in Lymph Nodes, and Is Associated with Durable Responses in Patients (pts) with Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)." Blood 128, no. 22 (December 2, 2016): 642. http://dx.doi.org/10.1182/blood.v128.22.642.642.
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Abstract Introduction : BGB-3111 is a potent, highly specific and irreversible Bruton tyrosine kinase (BTK) inhibitor, with greater selectivity than ibrutinib (IB) for BTK vs. other TEC- and HER-family kinases. We previously reported that BGB-3111 320mg daily (the RP2D, given as a single or split dose) achieved plasma concentrations 6- to10-fold higher than that of IB 560mg QD. Complete BTK occupancy in peripheral blood mononuclear cells (PBMCs) was observed in all pts treated in the dose-escalation (DEsc) component of the Phase 1 trial, and preliminary data suggested that >90% blockade was achievable in lymph nodes (LN). We now report the results of BTK occupancy analyses in LN specimens from a dedicated pharmacodynamics (PD) cohort and update safety and efficacy in patients with CLL/SLL. Aims: (1)To determine BTK occupancy in LN samples from pts receiving either a daily or twice-daily regimen; and (2) to define the safety profile and activity of BGB-3111 in pts with relapsed/refractory (R/R) or previously untreated CLL/SLL. Methods: This Phase 1 trial included a DEsc component in pts with R/R B-cell malignancies, and disease-specific expansion cohorts (ECs), including CLL/SLL, at the RP2D (320mg daily, given either QD or as a split BID dose). Additionally, in a PD cohort, pts with R/R B-cell malignancies were assigned to BGB-3111 160mg BID vs 320mg QD, with paired LN biopsies at baseline and at day 3 (pre-dose), in order to determine BTK occupancy in LN at the time of trough drug exposure. Adverse events (AEs) are reported per CTCAE v4.03, and response according to the 2012 clarification of the International Workshop on CLL criteria (for CLL pts) or the 2014 Lugano Classification (for SLL pts). BTK occupancy was determined by competitive fluorescent probe assay. The data cut-off for this report was 10 June 2016. Results: BTK Occupancy: 30 pts were evaluated for LN BTK occupancy (CLL, n=9; DLBCL, n=3; FL, n=5; MCL, n=6; MZL, n=3; WM, n=4), 23 pts were enrolled in the PD cohort; 7 patients in other ECs (160mg BID) consented to optional paired LN biopsies. BTK occupancy in LN by dose/schedule is shown in Figure 1. Median occupancy was 99.5% (160mg BID, n=18) vs 94.4% (320mg QD, n=12) (p=0.002, Wilcoxon). The proportion of pts with >90% occupancy was 94% (160mg BID) vs 58% (320mg QD) (p=0.027, Fisher exact). Occupancy did not appear to differ amongst histologic subtypes. CLL/SLL Safety and Activity: As of 10 Jun 2016, 45 pts with CLL (n=42) or SLL (n=3) have been enrolled: 8 pts in DEsc (80mg QD [n=1], 160mg QD [n=2], 160mg BID [n=2], and 320mg QD [n=3]), and 37 in either the PD cohort or CLL/SLL EC (160mg BID, n=19; 320mg QD, n=18). 29 CLL/SLL pts are included in this analysis; 11 pts were excluded because of short (<12 weeks) follow-up, and 5 pts accrued at a single study site were excluded because of insufficient study documentation at baseline. Demographic and disease characteristics are shown in Table 1. BGB-3111 was well tolerated with 69% subjects reporting no drug related AE >Gr 1 severity within the first 12 weeks of therapy. The most frequent AEs of any attribution were petechiae/ bruising (38%), upper respiratory tract infection (31%, all Gr 1/2), diarrhea (28%, all Gr 1/2), fatigue (24%, all Gr 1/2), and cough (21%, all Gr 1/2). Three SAEs were assessed as possibly related to BGB-3111 (Gr 2 cardiac failure, Gr 2 pleural effusion and Gr 3 purpura, all n=1). The case of Gr 3 purpura was the only major bleeding event reported. Atrial fibrillation (Gr 2) occurred in one pt. Three pts had temporary dose interruption for AE, and one pt discontinued BGB-3111 for AE. After a median follow-up of 7.5 months (2.9-17.3 months), the response rate is 90% (26/29), with PR in 79% (23/29) and, PR-L in 10% (3/29), SD in 7% (2/29), and non-evaluable response in one pt who discontinued treatment prior to week 12. No instances of disease progression or Richter transformation have occurred. Conclusions: BGB-3111 is well-tolerated and highly active in R/R CLL/SLL. While trough BTK occupancy in lymph nodes was robust with either 320mg QD or 160mg BID dosing, complete and continuous occupancy (median 99.5%) was more frequently achieved with the 160mg PO BID regimen. Late stage clinical trials will determine if the optimized BTK occupancy with this regimen translates into improvements in disease control and reduced drug resistance. Figure. Figure. Disclosures Tam: janssen: Honoraria, Research Funding; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees. Opat:Roche: Consultancy, Honoraria, Other: Provision of subsidised drugs, Research Funding. Gottlieb:Indee: Membership on an entity's Board of Directors or advisory committees; Celgene: Research Funding; Abbvie: Membership on an entity's Board of Directors or advisory committees. Simpson:Celgene, Roche, Janssen: Honoraria; Amgen Pharmaceuticals: Research Funding. Anderson:Walter and Eliza Hall Institute of Medical Research: Other: Walter and Eliza Hall Institute of Medical Research receives milestone payments for the development of venetoclax. Kirschbaum:Beigene: Employment. Wang:Beigene: Employment. Xue:Beigene: Employment. Yang:BeiGene: Employment. Hedrick:Beigene: Employment. Seymour:Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie Inc.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Genentech: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees. Roberts:Genentech: Patents & Royalties: Employee of Walter and Eliza Hall Institute of Medical Research which receives milestone payments related to venetoclax; Janssen: Research Funding; Genentech: Research Funding; AbbVie: Research Funding; Servier: Research Funding.
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Pellegrini, Carlos A., and Martin Palavecino. "El sistema de médicos residentes: año 2020." Revista Argentina de Cirugía 112, no. 4 (December 1, 2020): 369–78. http://dx.doi.org/10.25132/raac.v112.n4.anpel.
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The present review of the last years in the training of human resources in surgery highlights the validity and vision for the future of Prof. Dr. Mario Brea’s speech. When he defines the residency system, we realize that the principles are the same, but adapted to the 21st century: ▪ Progressive training. ▪ Pre-established programs with modern curricula and comprehensive systems of evaluation. ▪ Promotion and allocation of more responsibilities: compliance with Milestones (or in the future with some other type of assessment such as Entrusted Professional Activities, EPAs). ▪ Direction, guidance and close supervision with the implementation of feedback as a pedagogical tool. Appropriate work environment and schedule: simulation as a protected environment for learning surgical and NTS skills; restrictive working hours to reduce medical error. ▪ Research and teaching: the publication of original papers should be encouraged since the early years of training as well as the relationship with junior residents to create a virtuous circle of professional training
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Garon, Julie, and Manish Patel. "The polio endgame: rationale behind the change in immunisation." Archives of Disease in Childhood 102, no. 4 (January 17, 2017): 362–65. http://dx.doi.org/10.1136/archdischild-2016-311171.
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The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort.
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Palombo, Claudia Nery Teixeira, Luciane Simões Duarte, Elizabeth Fujimori, and Áurea Tamami Minagawa Toriyama. "Use and records of child health handbook focused on growth and development." Revista da Escola de Enfermagem da USP 48, spe (August 2014): 59–66. http://dx.doi.org/10.1590/s0080-623420140000600009.
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Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.
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Plachinda, Paul, Julia Morgan, and Maria Coelho. "Towards Net Zero: Modeling Approach to the Right-Sized Facilities." Sustainability 15, no. 1 (December 22, 2022): 163. http://dx.doi.org/10.3390/su15010163.
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As the concentration of greenhouse gases (GHGs) in the atmosphere increases, the concerns about carbon emissions are growing. Several net-zero initiatives are taking place around the globe to achieve a balance between the GHGs put into the atmosphere and those taken out. While most efforts present a sectorized approach, this paper describes the importance of integrating information across different sectors for effective modeling of carbon emissions and holistic reduction opportunity analysis. Using the Idaho National Laboratory (INL) campus as a test case, this work provides a web-based tool for INL stakeholders to use when engaging in strategic planning to achieve carbon emissions reduction. This net-zero engineering support tool (NEST) uses historical data as foundational information for applying the modeling framework. Prediction of CO2 emissions throughout project completion integrates various approaches and schedules aimed at energy conservation, fleet decarbonization, and other GHG reduction activities. Using NEST, stakeholders can visualize carbon emissions, electricity consumption, and costs for decision making when planning the pathway for reaching carbon net zero. The INL’s initiative to transition into an EV fleet was used to demonstrate the developed framework and the advantages of using NEST. It was shown that electrifying different fossil-fueled campus vehicles before 2030 with aggressive replacement schedules require high annual capital expenditure (CAPEX), which may not be available. The tool allows decision makers to test different replacement schedules and prioritize those that yield CAPEX below a certain threshold while meeting target milestones. While the demonstration focused on vehicle electrification, the developed framework lays the foundation for further quantitative analysis of other GHG reduction activities.
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Peter, Beate, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, et al. "Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia." F1000Research 8 (March 11, 2019): 271. http://dx.doi.org/10.12688/f1000research.18062.1.
Full textAbstract:
Background: Speech or language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), an inborn error of metabolism with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the BBC from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were developmental milestones in communication, motor, and cognition. Outcomes in the treatment cohort were compared to typical children and the control child. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, and three had higher communication and personal-social skills, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12th February 2019).
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Peter, Beate, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, et al. "Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia." F1000Research 8 (February 6, 2020): 271. http://dx.doi.org/10.12688/f1000research.18062.3.
Full textAbstract:
Background: Speech and language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).
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Peter, Beate, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, et al. "Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia." F1000Research 8 (March 31, 2020): 271. http://dx.doi.org/10.12688/f1000research.18062.4.
Full textAbstract:
Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).
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Peter, Beate, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, et al. "Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia." F1000Research 8 (July 6, 2020): 271. http://dx.doi.org/10.12688/f1000research.18062.5.
Full textAbstract:
Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).
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Kisor, David F. "Collaboration to Meet a Therapeutic Need: The Development of Nelarabine." Clinical Medicine. Therapeutics 1 (January 2009): CMT.S2909. http://dx.doi.org/10.4137/cmt.s2909.
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The development of nelarabine as a therapeutic agent to treat various forms of hematologic malignancies spans more than 40 years. From the bench top to the bedside, basic scientists and clinical scientists in the pharmaceutical industry and academia collaborated with regulatory agencies to bring this drug to the market. Studies have demonstrated efficacy in treating T-cell leukemia and lymphoma and further work is ongoing as new dosing schedules of nelarabine and combinations with other chemotherapeutic agents are explored. This work is aimed at maximizing the therapeutic outcome while minimizing the potential neurotoxicity that has been identified with nelarabine. This brief review provides some of the “milestones” of development and presents a summary of the efforts of the pharmaceutical industry, academia, and government. Nelarabine, synthesized in the late 1970's as a prodrug of 9-β-D-arabinofuranosylguanine (ara-G), is still undergoing rigorous clinical evaluations in an effort to identify its optimal use.
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Peter, Beate, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, et al. "Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia." F1000Research 8 (September 5, 2019): 271. http://dx.doi.org/10.12688/f1000research.18062.2.
Full textAbstract:
Background: Speech or language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), an inborn error of metabolism with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the BBC from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were developmental milestones in communication, motor, and cognition. Outcomes in the treatment cohort were compared to typical children and the control child and to typically developing children represented in test norms and cases described in the literature . The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, and three had higher communication and personal-social skills, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12th February 2019).