Responding to Agency Avoidance of OIRA

Concerns have recently been raised that US federal agencies may sometimes avoid regulatory review by the White House Office of Information and Regulatory Affairs (OIRA). In this article, we assess the seriousness of such potential avoidance, and we recommend a framework for evaluating potential responses. After summarizing the system of presidential regulatory oversight through OIRA review, we analyze the incentives for agencies to cooperate with or avoid OIRA. We identify a wider array of agency avoidance tactics than has past scholarship, and a wider array of corresponding response options available to OIRA, the President, Congress, and the courts. We argue that, because the relationship between agencies and OIRA involves ongoing repeat player interactions, some of these avoidance tactics are less likely to occur (or to succeed) than has previously been alleged, and others are more likely; the difference depends significantly on how easy it is for OIRA to detect avoidance, and for OIRA, the courts, and others to respond. Further, we note that in this repeat player relationship, responses to agency avoidance tactics may induce further strategic moves and countermoves. Thus we further argue that the optimal response may not always be to try to eliminate the avoidance behavior; some avoidance may be worth tolerating where the benefits of trying to reduce agency avoidance would not justify the costs of response options and countermoves. We therefore conclude that responses to agency avoidance should be evaluated in a way similar to what OIRA asks of agencies evaluating proposed regulations: by weighing the pros and cons of alternative response options (including no action)

Аудит диагностики и лечения пневмоторакса в Учебной больнице АЛЬ-ШААБ.

Introduction. A pneumothorax is defined as the presence of air within the pleural cavity, it is classified as spontaneous primary or secondary and traumatic iatrogenic and non-iatrogenic. Despite having Sudan national protocol for the management of pneumothorax, there appears to be wide variation in clinical practice in diagnosis and management of pneumothorax Aims and objectives. The audit aims to study the initial management of primary and secondary pneumothorax at Al SHAAB teaching hospital. Method. Data collection was made from patients’ records with a diagnosis of pneumothorax Results. Fifty-five patients who were admitted to the chest department were enrolled. The majority of patients were between 25-45 years of age (40%), male with a female ratio of 3:1. The main presenting symptoms were cough 50 (94.4%) and shortness of breath 44(80%) followed by chest pain 20(36.4). Twenty patients (36.4) were a smoker and 35 (63,.6%) were a non-smoker. Pulmonary tuberculosis is the leading cause of pneumothorax 33(60,1%) and bronchial asthma 4(7.3%) while primary spontaneous were 9(16.4%). Clinically and radiologically the right side is more affected than the left side 34(61.8%) and 19(16.4%) respectively, pure pneumothorax in29 (52.7%) and hydropneumothorax in 26(37.3%). The size of pneumothorax is large in 25 (45.5%), medium18 (32.7), and small in 12(21.8%). Thirty-nine (70.9%) were managed with chest tube thoracostomy, 12 (21.8) by simple aspiration, and 4 (7.3%) responded to the observation of patients for two weeks. Conclusion. There is suboptimal compliance to the Sudan protocol in the management of pneumothorax. Recommendations. We recommended federal ministry of health to avail the protocol of diagnosis and management of pneumothorax in all emergency departments, also we recommended training of all registrars of chest medicine in the protocol of diagnosis and management of pneumothorax.Introducere. Un pneumotorax este definit ca prezența aerului în cavitatea pleurală, este clasificat ca spontan primar sau secundar și traumatic iatrogen și non-iatrogen. În ciuda faptului că există un protocol național Sudan pentru gestionarea pneumotoraxului, pare să existe o variație largă în practica clinică în diagnosticul și managementul pneumotoraxului. Scopuri si obiective. Auditul își propune să studieze managementul inițial al pneumotoraxului primar și secundar la spitalul didactic Al SHAAB. Metodă. Colectarea datelor s-a făcut din fișele pacienților cu diagnostic de pneumotorax Rezultate. Au fost înrolați cincizeci și cinci de pacienți care au fost internați în secția de piept. Majoritatea pacienților aveau vârste cuprinse între 25-45 de ani (40%), bărbați cu un raport feminin de 3:1. Principalele simptome de prezentare au fost tuse 50 (94,4%) și dificultăți de respirație 44 (80%) urmate de durere în piept 20 (36,4). Douăzeci de pacienți (36,4) au fost fumători și 35 (63,6%) au fost nefumători. Tuberculoza pulmonară este cauza principală a pneumotoraxului 33(60,1%) și a astmului bronșic 4(7,3%), în timp ce primar spontan au fost 9(16,4%). Clinic și radiologic partea dreaptă este mai afectată decât partea stângă 34(61,8%) și respectiv 19(16,4%), pneumotorax pur în 29 (52,7%) și hidropneumotorax în 26 (37,3%). Dimensiunea pneumotoraxului este mare la 25 (45,5%), medie18 (32,7) și mică la 12 (21,8%). Treizeci și nouă (70,9%) au fost tratați cu toracostomie cu tub toracic, 12 (21,8) prin aspirație simplă și 4 (7,3%) au răspuns la observarea pacienților timp de două săptămâni. Concluzie. Există o conformitate suboptimă la protocolul Sudan în gestionarea pneumotoraxului. Recomandări. Am recomandat Ministerului Federal al Sănătății să folosească protocolul de diagnostic și management al pneumotoraxului în toate departamentele de urgență, de asemenea, am recomandat instruirea tuturor registratorilor de medicină toracică în protocolul de diagnostic și management al pneumotoraxului.Введение. Пневмоторакс определяется как наличие воздуха в плевральной полости, он классифицируется как спонтанный первичный или вторичный, травматический ятрогенный и неятрогенный. Несмотря на наличие суданского национального протокола по лечению пневмоторакса, клиническая практика, повидимому, сильно различается в диагностике и лечении пневмоторакса. Цели и задачи. Аудит направлен на изучение начального лечения первичного и вторичного пневмоторакса в клинической больнице Альшааб. Метод. Сбор данных производился из историй болезни пациентов с диагнозом пневмоторакс. Полученные результаты. В исследование были включены 55 пациентов, госпитализированных в грудное отделение. Большинство пациентов были в возрасте от 25 до 45 лет (40%), мужчины с соотношением женщин 3:1. Основными симптомами были кашель 50 (94,4%) и одышка 44 (80%), сопровождаемая болью в груди 20 (36,4%). 20 пациентов (36,4) были курильщиками и 35 (63,6%) не курили. Туберкулез легких является ведущей причиной пневмоторакса 33 (60,1%) и бронхиальной астмы 4 (7,3%), тогда как первичный спонтанный - 9 (16,4%). Клинически и рентгенологически правая сторона больше поражена, чем левая 34 (61,8%) и 19 (16,4%) соответственно, чистый пневмоторакс у 29 (52,7%) и гидропневмоторакс у 26 (37,3%). Размер пневмоторакса большой у 25 (45,5%), средний у 18 (32,7) и малый у 12 (21,8%). Тридцать девять (70,9%) лечились с помощью плевральной торакостомии, 12 (21,8) — с помощью простой аспирации и 4 (7,3%) ответили на наблюдение за пациентами в течение двух недель.Вывод. Существует субоптимальное соблюдение суданского протокола при лечении пневмоторакса. Рекомендации. Мы рекомендовали федеральному министерству здравоохранения использовать протокол диагностики и лечения пневмоторакса во всех отделениях неотложной помощи, а также мы рекомендовали обучение всех регистраторов легочной медицины протоколу диагностики и лечения пневмоторакса

The relationship between vitamin D level and severity and control of bronchial asthma among adult Sudanese patients

Background: The aim of this study was to assess the relationship between vitamin D level and severity and control of bronchial asthma among adult Sudanese patients at Alshaab Teaching Hospital.Methods: This prospective cross-sectional study, conducted at Alshaab Teaching Hospital, Khartoum Sudan in the period from June to August 2015. Eighty-six asthmatic patients participated in the study after taking their consent. Demographic data were collected using structured questionnaire, the clinical parameters of asthma severity and control were measured according to the criteria of Global Strategy for Asthma Management and Prevention 2014 of the Global Initiative for Asthma (GINA). Airway limitation was assessed using Peak Flow Meter. Three ml of blood was taken from each patient to measure vitamin D (25(OH)D) using enzyme-linked immunosorbent assay (ELISA) and data were analyzed using the statistical package for social science (SPSS) version 20.Results: Normal serum 25(OH)D (30-50ng/ml) was found in only 2.3% of patients. The mean serum 25(OH)D level in patients with controlled asthma was 25.82±17.27ng/ml while in patients with uncontrolled asthma it was16.48±7.14ng/ml. (P value = 0.005). The mean serum 25(OH)D level in patients with severe asthma was 16.15±6.9ng/ml (P value = 0.151).Conclusions: There was a positive correlation between vitamin D level and bronchial asthma control and a negative correlation with bronchial asthma severity among the study group

Fast Back Projection Algorithm for Bi-Static SAR Using Polar Coordinates

Synthetic Aperture Radar (SAR) plays a significant role in geophysical studies and remote sensing applications. SAR inherits the benefits of imaging RADAR over the other optical sensors such as working in all weather conditions and working independently of sunlight. In addition to these benefits SAR generates a finer resolution 2-D image compared to conventional (real) aperture radar. Due to the sole merits of Ultrawideband-Ultrawidebeam (UWB) Bistatic SAR, this thesis introduces and analyzes a fast time domain algorithm for its image formation. This algorithm inherits the advantages of time-domain algorithms over frequency domain ones. It divides the full synthetic aperture into subapertures. Each subaperture generates a polar grid image. The key point is that the subaperture polar images have very low resolution in cross range (the angular direction); this means that they can be calculated on a pixel grid that is coarse in the angular direction. The final image is obtained by combining all subaperture polar images after converting them to the final high-resolution Cartesian image, in this conversion interpolation is used. Since the subaperture images contain far fewer pixels in cross range than the final image, far fewer operations are required to be executed as compared to Global Backprojection GBP. Due to using the polar grid, the proposed algorithm is named Bistatic Polar-FBP (Bi-PFBP). It is found that although for N×N scene image with N aperture positions the Bi-PFBP computational load is less by approximately a factor of √N as compared to GBP, the image quality generated by each one of them is almost the same

Fast Back Projection Algorithm for Bi-Static SAR Using Polar Coordinates

Synthetic Aperture Radar (SAR) plays a significant role in geophysical studies and remote sensing applications. SAR inherits the benefits of imaging RADAR over the other optical sensors such as working in all weather conditions and working independently of sunlight. In addition to these benefits SAR generates a finer resolution 2-D image compared to conventional (real) aperture radar. Due to the sole merits of Ultrawideband-Ultrawidebeam (UWB) Bistatic SAR, this thesis introduces and analyzes a fast time domain algorithm for its image formation. This algorithm inherits the advantages of time-domain algorithms over frequency domain ones. It divides the full synthetic aperture into subapertures. Each subaperture generates a polar grid image. The key point is that the subaperture polar images have very low resolution in cross range (the angular direction); this means that they can be calculated on a pixel grid that is coarse in the angular direction. The final image is obtained by combining all subaperture polar images after converting them to the final high-resolution Cartesian image, in this conversion interpolation is used. Since the subaperture images contain far fewer pixels in cross range than the final image, far fewer operations are required to be executed as compared to Global Backprojection GBP. Due to using the polar grid, the proposed algorithm is named Bistatic Polar-FBP (Bi-PFBP). It is found that although for N×N scene image with N aperture positions the Bi-PFBP computational load is less by approximately a factor of √N as compared to GBP, the image quality generated by each one of them is almost the same

Synthesis of Co3O4 Cotton-Like Nanostructures for Cholesterol Biosensor

The use of templates to assist and possess a control over the synthesis of nanomaterials has been an attractive option to achieve this goal. Here we have used sodium dodecyl sulfate (SDS) to act as a template for the low temperature synthesis of cobalt oxide (Co3O4) nanostructures. The use of SDS has led to tune the morphology, and the product was in the form of "cotton-like" nanostructures instead of connected nanowires. Moreover, the variation of the amount of the SDS used was found to affect the charge transfer process in the Co3O4. Using Co3O4 synthesized using the SDS for sensing of cholesterol was investigated. The use of the Co3O4 synthesized using the SDS was found to yield an improved cholesterol biosensor compared to Co3O4 synthesized without the SDS. The improvement of the cholesterol sensing properties upon using the SDS as a template was manifested in increasing the sensitivity and the dynamic range of detection. The results achieved in this study indicate the potential of using template assisted synthesis of nanomaterials in improving some properties, e. g., cholesterol sensing

Fabrication of Sensitive Potentiometric Cholesterol Biosensor Based on Co3O4 Interconnected Nanowires

Highly sensitive, selective, reliable and inexpensive cholesterol biosensors are highly demanded for the routine monitoring of cholesterol molecules in order to prevent heart failure incidents. In this study, Co3O4 nanostructures are synthesized using polyvinyl pyrrolidone surfactant as growth template by a low temperature aqueous chemical growth method. The morphology of nanostructures was investigated by scanning electron microscopy and X-ray diffraction techniques. The nanostructures exhibit interconnected nanowires like morphology with interconnected network of nanowires. The nanostructures of Co3O4 are polycrystalline. The cholesterol oxidase was physically adsorbed on the interconnected nanowires of Co3O4 for the chemical sensing of cholesterol molecules. The sensor device detected a wide range of cholesterol from 1×10−7 M to 1×10−3 M concentrations with sensitivity of −94.031 mV/decade. A detection limit of 0.035×10−7 M cholesterol concentration was observed and a fast response time of 10 s was also noticed. The fabricated device is highly stable, selective, sensitive, reproducible and repeatable. All the collected information about presented cholesterol biosensor indicates its potential application for the monitoring of cholesterol concentrations from human blood serum and real-life samples

Dopamine wide range detection sensor based on modified Co3O4 nanowires electrode

Ultra-thin cobalt oxide (Co3O4) nanowires grown on gold coated glass substrates by the hydrothermal chemical deposition and have been used as a wide range dopamine potentiometric sensor. An anionic surfactant ( sodium dodecylbenzenesulfonate) was used to achieve assisted growth procedure. Moreover, a polymeric membrane containing polyvinyl chloride as plasticized polymer, p-cyclodextrin as ionophore, and potassium tetrakis (4-chlorophenyl) borate as ionic additive were immobilized on the Co3O4 nanostructures through electrostatic adsorption method. X-ray diffraction, X-ray photoelectron spectroscopy, and scanning electron microscopy were used to characterize the electrodes while ultraviolet-visible absorption was used to investigate the band gap of the Co3O4 nanostructures. The structural characterization showed a cubic crystalline, pure phase, and nanowires morphology of the Co3O4. However, the morphology is altered when the surfactant concentration has been changed. The Co3O4 chemical modified electrodes were used in potentiometric measurements for dopamine in a 10(-2) M acetic acid/sodium acetate solution having a pH of 5.45. For dopamine range from 10(-9) M to 10(-2) M, the potential response of the sensor electrode was linear with a slope of 52 mV/decade. The wide range and high sensitivity of the modified Co3O4 nanowires based sensor for dopamine is attributed to the defects on the metal oxide that is dictated by the used surfactant along with the high surface area-to-volume ratio