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This paper presents a streamlined and simplified framework to select the optimal corrosion-resistant reinforcement type and subsequently calculate the corresponding life-cycle costs for concrete bridge decks. Additionally, a design-oriented methodology that accounts for the effect of high-strength reinforcement, most notably reduced ductility and its implications on structural safety decision-making, is also included as part of the framework. The researchers developed a design-friendly high-strength reinforcement factor that is predicated on the net tensile strain of the high-strength reinforcement relative to the corresponding value of an equivalently designed bridge deck using conventional reinforcement. The framework provides two approaches for estimating life-cycle costs; the first adopts a theoretical present-value calculation from previous researchers, and the second serves as a simplified approach that directly superimposes material and repair costs over the intended service life. Example life-cycle cost estimates are then shown for a series of corrosion-resistant bar types including epoxy-coated; galvanized; stainless steel; and high-strength low-carbon, chromium (A1035) bars. A case study focusing on the ductility of high-strength reinforcement then provides further recommendations for implementing such bars into the larger framework. Lastly, two example bridge deck scenarios are highlighted to demonstrate the implementation of the proposed framework. The framework is designed to facilitate straightforward optimal design solutions for department of transportation (DOT) officials, consulting engineers, and others, for bridge deck applications where enhanced corrosion resistance is necessitated and access to more theoretical life-cycle cost methodologies is limited. [ABSTRACT FROM AUTHOR]

Antibiotic resistance poses an increasingly grave threat to the public health. Of pressing concern, rapid spread of carbapenem-resistance among multidrug-resistant (MDR) Gram-negative rods (GNR) is associated with few treatment options and high mortality rates. Current antibiotic susceptibility testing guiding patient management is performed in a standardized manner, identifying minimum inhibitory concentrations (MIC) in bacteriologic media, but ignoring host immune factors. Lacking activity in standard MIC testing, azithromycin (AZM), the most commonly prescribed antibiotic in the U.S., is never recommended for MDR GNR infection. Here we report a potent bactericidal action of AZM against MDR carbapenem-resistant isolates of Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. This pharmaceutical activity is associated with enhanced AZM cell penetration in eukaryotic tissue culture media and striking multi-log-fold synergies with host cathelicidin antimicrobial peptide LL-37 or the last line antibiotic colistin. Finally, AZM monotherapy exerts clear therapeutic effects in murine models of MDR GNR infection. Our results suggest that AZM, currently ignored as a treatment option, could benefit patients with MDR GNR infections, especially in combination with colistin.

The identification of competencies needed by hospitality managers has been investigated since the 1980s. In all of the competency research related to hospitality management, essential competencies include skills that can be classified as soft skills, yet a comprehensive list of these soft skills has not been identified. The purpose of this project is to have industry professionals rate the importance of soft skill competencies found in literature, and then reduce this list of competencies by completing a factor analysis. This study serves as the beginning for a comprehensive study of soft skills needed in entry-level hospitality management positions. doi:10.1057/thr.2009.22; published online 21 September 2009 Keywords: soft skills; employment competencies; technical skills; human relations skills; conceptual skills, INTRODUCTION Many times companies will discuss the knowledge, skills and abilities (KSAs) of their applicants because they are trying to select the 'best fit' for their company. Most companies will [...]

The purpose of this paper is to discuss an overview of the new updated PDGM 30-Day Medicare HHPPS rates for CY 2021. For Medicare covered home health services beginning January 1, 2021, this finalized rule titled “Medicare and Medicaid Programs: CY 2021 Home Health Prospective Payment System Rate Update” discusses the new changes for the HHPPS payment rates. This proposed CY 2021 rule includes the current changes from the 60-day to the 30-day episode payment rates, and the national per-visit rates for home health services. [ABSTRACT FROM AUTHOR]

Product template (PT) domains from fungal nonreducing polyketide synthases (NR-PKSs) are responsible for controlling the aldol cyclizations of poly-ß-ketone intermediates assembled during the catalytic cycle. Our ability to understand the high regioselective control that PT domains exert is hindered by the inaccessibility of intrinsically unstable poly-ß-ketones for in vitro studies. We describe here the crystallographic application of "atom replacement" mimetics in which isoxazole rings linked by thioethers mimic the alternating sites of carbonyls in the poly-ß-ketone intermediates. We report the 1.8-Å cocrystal structure of the PksA PT domain from aflatoxin biosynthesis with a heptaketide mimetic tethered to a stably modified 4'-phosphopantetheine, which provides important empirical evidence for a previously proposed mechanism of PT-catalyzed cyclization. Key observations support the proposed deprotonation at C4 of the nascent polyketide by the catalytic His1345 and the role of a protein-coordinated water network to selectively activate the C9 carbonyl for nucleophilic addition. The importance of the 4'-phosphate at the distal end of the pantetheine arm is demonstrated to both facilitate delivery of the heptaketide mimetic deep into the PT active site and anchor one end of this linear array to precisely meter C4 into close proximity to the catalytic His1345. Additional structural features, docking simulations, and mutational experiments characterize protein-substrate mimic interactions, which likely play roles in orienting and stabilizing interactions during the native multistep catalytic cycle. These findings afford a view of a polyketide "atom-replaced" mimetic in a NR-PKS active site that could prove general for other PKS domains. [ABSTRACT FROM AUTHOR]

The article offers information on Airport Roadway Sign Design Manual, January 2013 updated by Port Authority of New York and New Jersey which repeals the previously published manual in 1994, and includes agency guidelines for designing all new and replacement signs at airport facilities.

As a customer-focused industry, the attitudes and opinions of hospitality employees play an integral role in their interactions with customers, colleagues, and the overall work environment. As more employers utilize any number of measurement tools to predict success in job hires and promotions, two measurement tools, emotional intelligence and attachment styles, share multiple traits that could predict an employee's success within the company. This research presents the relationship between emotional intelligence and attachment styles that can assist human resources with the hiring process as well as help with leadership development of current employees. [ABSTRACT FROM AUTHOR]

There are many factors that determine leadership styles. One of the most important facets of leadership is understanding there are different leadership styles, which leadership style leaders use most often, and how or when to move from one style to another. There are five categories of leadership methodologies that most leaders fit into. Understanding which category the individual may be in can assist in identifying the strengths and weaknesses. This paper is about leadership styles, behaviors, and transforming into a leadership style that may best fit a given situation. The purpose of this paper is to report the findings of the relationship between management tendencies as it pertains to the leadership styles. As a leader, the individual may be more concerned for people versus the task performance. The leader's ability to adapt to different internal and external factors plays a major role in the performance and success of an organization. The method used to support the findings in this report derived from existing research and analysis of direct field data. Overall, the results reveal the majority of people fit into a team leadership role, but a few were on the borderline of being a socialite or an authoritarian. [ABSTRACT FROM AUTHOR]

The mechanistic details of many polyketide synthases (PKSs) remain elusive due to the instability of transient intermediates that are not accessible via conventional methods. Here we report an atom replacement strategy that enables the rapid preparation of polyketone surrogates by selective atom replacement, thereby providing key substrate mimetics for detailed mechanistic evaluations. Polyketone mimetics are positioned on the actinorhodin acyl carrier protein (actACP) to probe the underpinnings of substrate association upon nascent chain elongation and processivity. Protein NMR is used to visualize substrate interaction with the actACP, where a tetraketide substrate is shown not to bind within the protein, while heptaketide and octaketide substrates show strong association between helix II and IV. To examine the later cyclization stages, we extended this strategy to prepare stabilized cyclic intermediates and evaluate their binding by the actACP. Elongated monocyclic mimics show much longer residence time within actACP than shortened analogs. Taken together, these observations suggest ACP-substrate association occurs both before and after ketoreductase action upon the fully elongated polyketone, indicating a key role played by the ACP within PKS timing and processivity. These atom replacement mimetics offer new tools to study protein and substrate interactions and are applicable to a wide variety of PKSs. [ABSTRACT FROM AUTHOR]

As required by the Balanced Budget Act (BBA) of 1997 and its related amendments, Medicare began to reimburse home health agencies under the new Home Health Prospective Payment System (HHPPS) for services beginning October 1, 2000. Under HHPPS, all home health costs for services including medical supplies are paid using a basic unit of payment known as the 60-Day Episode. The payment amount was calculated using a national standardized rate, adjusted for the home health service case mix and a wage index based on the site of the service. For 60-Day Episodes beginning and ending in 2008, the Medicare HHPPS national standardized rate was updated by a new 153 case mix grouping, and a new non-routine medical supply payment was added to the nationalized standardized rate. For home health services beginning January 1, 2014, the new proposed rule titled "Medicare and Medicaid: Home Health Prospective Payment System Rate Update for CY 2014" (78 Federal Register Vol. 128) discusses the new updates to the HHPPS rates. This rule includes changes to the 60-day episode payment rates, the national per-visit rates, the low-utilization payment adjustment (LUPA) rates, the non-routine medical supplies (NRS) conversion factor, and the add-on LUPA payments. This rule further discusses the new requirements under the Affordable Care Act regarding rebasing adjustments to the national 60-day episode national standardized rate, the national per-visit rate, the low-utilization payment adjustments, and the non-routine medical supplies conversion factor. This paper discusses an overview of these new updated Medicare HHPPS rates for CY 2014. [ABSTRACT FROM AUTHOR]

The study was designed to determine what percentage of students enrolled in classes at a major southeastern university have interest in participating in study abroad programs. This study also sought to examine the perceptions of students toward study abroad programs and to determine what barriers may exist that prevents students from participating in study abroad programs. [ABSTRACT FROM AUTHOR]

End-of-life patients are increasingly cared for in the home by family, friends, or neighbors. There are known physical and psychological effects of caregiving, including symptoms of depression. Most studies of voluntary caregivers have focused on caregivers of dementia patients. The purpose of the study was to examine predictors of depression symptoms in hospice cancer caregivers. A secondary analysis used baseline assessment data of patients and caregivers from a larger study of patient-caregiver dyads from two large hospices. Wife caregiver, patient symptom global distress, and caregiver support satisfaction accounted for 13% of the variance in caregiver depression symptoms as measured by the 10-item Clinical Epidemiological Scale-Depression Scale (CES-D 10) (mean, 2.97 [SD, 2.15]) in the sample (n = 578). Approximately 38% of caregivers had CES-D 10 scores of 4 or greater, predictive for a diagnosis of depression, upon patient admission to hospice. Examining odds ratios, wife caregiver was positively predictive, and caregiver support satisfaction was negatively predictive of CES-D 10 scores of 4 or greater. The results support screening of caregivers for depression symptoms, the importance of support satisfaction, and the need to examine additional caregiver factors that may contribute to depression symptoms in caregivers of hospice cancer patients. [ABSTRACT FROM AUTHOR]

Vaginal vault prolapse is a major health care problem, and it is a late complication of hysterectomy. This condition occurs especially in elderly women, frequently associated with decrements in quality of life. The sacrospinous fixation is one of the surgical procedures used for the treatment of vaginal vault prolapse. Materials and methods: The study group consisted of 25 women who were diagnosed a vaginal vault or uterovaginal prolapse in which were performed a sacrospinous fixation at University Hospital Dr. José Eleuterio González from January 2005 to January 2008. The follow-up period was one year, and they were evaluated at 6 and 12 months after surgery through physical examination and a written questionnaire. Results: The mean age was 58 years and fourteen of the 25 patients had previous hysterectomies. A sacrospinous fixation, hysterectomy and an anterior or posterior repair were done in eleven patients, five women had a sacrospinous fixation and vaginal repair and in the rest of patients only a sacrospinous fixation was performed. The sacroespinous fixation had a high initial success rate of 92%, with 8% of recurrence of the prolapse. There was a significantly difference between after and before surgery in vault prolapse (p ≤0.004), cystocele (p ≤0.001), rectocele (p ≤0.001) and quality of life (p ≤0.000) Conclusion: Sacrospinous fixation is an efficient method of treatment for vaginal vault prolapse and it can be performed as a prophylactic procedure at the same time of vaginal hysterectomy in patients with uterovaginal prolapse. [ABSTRACT FROM AUTHOR]

Background: Overactive bladder has a significant effect on quality of life, reflected in social isolation and depression. Urinary urgency is defined as the urgent need to urinate, a characteristic symptom of overactive bladder syndrome. Antimuscarinics are the first line of treatment for urgency-frequency, but are associated with adverse effects that limit their use. Objective: To compare the results of 2 treatments: intravesical atropine sulphate vs. dimethylsulfoxide (DMSO). Both treatments were effective in evaluation of nocturia, bladder capacity, frequency, urinary urgency and scale in quality of life in our population of patients with overactive bladder. Methods: An experimental, longitudinal, prospective, comparative, randomized study was conducted of 14 women with overactive bladder diagnosis confirmed by urodynamics study at the University Hospital Dr. Jose Eleuterio Gonzalez. These women were divided into 2 groups. In group 1, n = 7 were applied 10 doses of 6.0 mg intravesical atropine sulphate diluted in 20 mL saline. In group 2, n = 7 were applied 10 doses of intravesical DMSO 50% (25 mL to 100% diluted in 25 mL of saline solution). Main variables were recorded as urinary frequency, nocturia, urinary urgency, bladder capacity before and after treatment with urodynamics and were evaluated with the quality of life survey OAB-q before and after of treatment. Results: There was a significant (p = 0.002) in urinary frequency in both groups after 10 doses of treatment, and nocturia decreased in both groups after 10 doses bladder (p = 0.003). No statistically significant changes were found when comparing the results of urinary frequency and nocturia 30 days after completion of treatment is to be inferred that the changes were maintained over 30 days after treatment. There was an increase of 99 mL in bladder capacity in the patient group treated with atropine sulfate, proven by urodynamic studies, with reduced urinary urgency by 86% in the DMSO group showed an increase of 85 mL in bladder capacity proven by urodynamic studies, with reduced urinary urgency by 86%. The OAB-q survey to assess the quality of life at baseline and after 7 days of treatment was repeated this survey with an average score of 0 to 35 points in both groups with an average of 12 points in group 1 and half from 23.7 points in group 2 when comparing two means using the Student t test was obtained (p = 0.18) not significant. Conclusions: Through the results of this study we conclude that the hypothesis is accepted clinical improvement work in relation to nocturia, bladder capacity, urgency, urinary frequency and quality of life through the use of Atropine Sulfate these results are comparable and in some respects superior to the results obtained using dimethyl sulfoxide 50%. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test an existing instrument to determine if patrons at a local wine festival exhibited homogeneous psychographic characteristics that included visitors' attitudes, interest, opinions, and personal preferences. During the "Vin de Mer" event at the 2009 Beaufort (NC) Wine and Food Festival, the researchers asked visitors to complete a survey instrument developed by researchers from Texas Tech University. Fifty-one (51) usable instruments were collected from individuals at this event. Using a multivariate general linear modeling technique, study findings indicated that patrons were homogeneous with regard to these psychographic characteristics when compared with certain demographic characteristics. Future research projects are planned for wineries, wine festivals, and wine shops. [ABSTRACT FROM AUTHOR]

The purpose of this project was to evaluate the relationship between depressive symptoms and symptom distress experienced by hospice patients with cancer. A total of 275 hospice patients with cancer were evaluated using the Memorial Symptom Assessment Scale (MSAS), the Center for Epidemiological Study-Depression (CES-D) Scale and a Demographic Data Form. Patients in the sample were mostly white and Christian with a variety of types of cancer with lung cancer being most common. Patients reported an average of 10 symptoms with fatigue, pain, dry mouth, drowsiness, loss of appetite and shortness of breath being reported most frequently. Among the most common symptoms, those with the highest intensity scores were pain and fatigue and with the highest distress scores were fatigue, pain, and shortness of breath. Depressive symptoms reached the cut-off score of 4 for 38% of patients indicating a likelihood of clinical depression. A moderate significant correlation (r = 0.45; P = .000) was found between CES-D scores and total number of symptoms - reported and with total symptom distress (r = 0.49; P = .000). Results underscore the continued need for a focus on symptoms in cancer patients, and further delineates the need to ameliorate depressive symptoms in order to enhance quality of life near the end of life. [ABSTRACT FROM AUTHOR]

This article describes how the strategic planning tool known as SWOT was used as a framework for case analysis of a public works project intended to enhance regional economic development in Tempe, Arizona. SWOT analysis is a process that identifies the strengths, weaknesses, opportunities and threats involved in a proposed project or business venture. SWOT analysis is a powerful technique for facilitating discussion and identifying key criteria and issues in situation analysis and problem solving. The idea behind the Tempe project was to create a focal point for the city that offered public recreational amenities as well as a potential tourist destination. The project aims to develop the dry riverbed of the Salt River into a lake, at a projected cost of $445 million.

Synchrotron X-ray absorption spectroscopy (XAS) is becoming an increasingly popular tool for the analysis of element speciation in complex natural mixtures such as soils and sediments. Identification of a particular mineral or amorphous solid in a heterogeneous mixture by XAS depends on the spectral uniqueness of the element in the bonding environment associated with a component, and on absorption effects from the components and the matrix. A suite of 27 common, Fe-bearing reference compounds, including sulfides, carbonates, phosphates, oxides, oxyhydroxides, and phyllosilicates, was analyzed to empirically assess the utility of X-ray absorption near-edge structure (XANES) and extended X-ray absorption fine structure (EXAFS) for identifying a particular Fe mineral (or class of minerals) in a soil or sediment mixture. We show that XANES spectral features are useful for distinguishing qualitatively among major mineral classes, but not necessarily for identifying minerals within classes. A practical detection limit (based on empirical mixtures) for most mineral classes is on the order of 5% of the total atomic Fe absorption, but detection limits vary depending on the spectral uniqueness of the components, the number of components, and the matrix. Calibration curves for Fe sulfide and non-sulfide (phyllosilicate ± oxide) component mixtures were made independently from the analyses of XANES and EXAFS fluorescence spectra of binary and ternary mineral mixtures (at 5% total Fe) in a quartz matrix to mimic natural sediments. Because of differences in sample and matrix absorption and fluorescence among sulfide and phyllosilicate minerals, apparent component fractions of pyrite derived from fits deviated significantly from linear binary mixtures. We show that corrections for non-linear fluorescence (as much as 20%) are particularly important for binary mineral mixtures with different densities and absorption characteristics (such as sulfides and phyllosilicates... [ABSTRACT FROM AUTHOR]

Interviews prostitutes in two municipalities in Jalisco (Central Mexico) which differed in measures of social control to determine their knowledge and beliefs about Acquired Immune Deficiency Syndrome (AIDS). Methodology; Clients; Discussion.