Spinal cord injuries now occur in nearly one quarter of the casualties from the conflicts in Afghanistan and Iraq. We know our military treatment facilities are seriously challenged by these casualties for several reasons including co-morbidities associated with blast injuries and the lengthy rehabilitation required. We also now know medical treatments that promise to return the fractured bodies to approximate pre-injury function. Yet, we lack basic knowledge of the long-term outcomes defined as personally and socially meaningful by survivors and families who are seeking to heal the fractured relationships with valued communities. This gap limits our ability to deliver on the promise given by advances in battlefield trauma care and rehabilitation which is to enable a return to full lives in the community (Messinger 2010; Luborsky 1993, 1994a). Today s problem is that acute care treatments for the physical break are not matched by knowledge of how survivors continue life, conceptualize SCI and return to a full life. The US Surgeon General (DHHS 2004) faults the literatures narrow incident-based focus on acute medical events and neglect of ongoing processes after events; this narrowness neglects how people return to a valued life with disability(Verbrugge & Jette 1994). Yet, consensus is emerging that long-term outcomes are the next frontier (IOM 2005, WHO 2001) requiring us to ask new questions and use methods suited to cultural meanings and roles (Lysack et al 2007; Messinger 2010). An ample literature documents negative outcomes from inadequately treating the social and personal afflictions after SCI and other mobility loss. Thus, the hard earned knowledge of physical skills for living with altered bodies remains unmatched by societal practices to equip people with a culturally meaningful sense of community needed to thrive.

关键词：脊髓;创伤和损伤;康复技术;脊柱

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Preliminary Results: Accomplishments include initial and ongoing IRB review & approval of all initial submissions, protocol amendments, recruitment advertisements, serious adverse events reporting, and ongoing Richmond VAMC and off-site recruitment activities. We continue to submit to both McGuire and WRAMC IRBs. During Year-4, USMC Camp Lejeune and Richmond VAMC have been our most productive recruitment sites. The appropriate US Navy IRB agreed to accept the findings of the WRAMC IRB. Research assistant positions were reduced from 3 to 2 full time employees. Study procedures, recruitment, data management, and analyses have been refined through meetings, reviews, consultations, and through lessons learned during completed data collection efforts to date. Through 8/31/2012, two hundred and seven (207) subjects have been enrolled through RVAMC Polytrauma Network Site Clinic screening and Polytrauma Inpatient Rehabilitation Center, recruitment letters mailed, radio advertisements, posters in the clinics, and on-site enrollment at Fort Lee, VA, USMC Base Camp Lejeune, USMC Base Quantico, and Fort Lee, VA. Pending data analysis, most subjects appear to meet symptom criteria for PCS. Conclusions to Date: Enrollment has commenced and continues. Study personnel continue to work with the military partners to improve access to post-deployed service members. To ensure a sample representative of the target population, we continue to improve access to active duty service members at additional recruitment sites. At the time of this report, we have four active recruitment sites (see body of report). Due to now chronic radiology technician shortages at McGuire VAMC, Dr. Walker has cancelled plans for the proposed Diffusion Tensor Imaging sub-study. Any study outcomes (conclusions) await data analysis phase.

关键词：创伤性脑损伤;流行病学;康复技术

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Although fuel cell electric vehicles are still are in a pre-commercialization phase, hydrogen fuel cells currently are being used commercially in early market applications such as material handling and backup power. These early commercialization fuel cell deployments are helping improve hydrogen and fuel cell technologies and expanding their market potential. Fuel cell systems look particularly promising as replacements for batteries in material handling equipment (MHE, or more typically forklifts) in warehouse applications where operations extend for two or three shifts each day. In such applications, batteries generally need to be charged and replaced one or more times each day, which complicates logistics and increases overall labor costs. Fuel cell MHE have zero emissions, can operate for more than 12 hours without performance degradation, and can be fueled in minutes, making fuel cells an attractive alternative to conventional battery systems.

关键词：燃料电池；物料搬运设备；成本；评估；氢能

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The electrodes in Unitized Reversible Fuel Cell system with supported platinum carbon black are reported.However, the electrodes in the system is consist two internal modes; it is electrolyzer and fuel cell mode.A Unitized Reversible Fuel Cell has dual function electrodes are joined in the same cell to reduce the volume and improvement efficiency performance.The electrodes of Unitized Reversible Fuel Cells operating on hydrogen and oxygen which have as high as efficiency at most the applications.Therefore, This article is concentrated on the preparation of bifunctional electrodes as design and material with low platinum loading and supported by platinum carbon black and characterization by using scanning electron microscopy.As well as, survey the latest literature on bifunctional electrodes and electrocatalysts to identify the major problems occur in design of the URFC electrodes.

关键词：燃料电池；支持组合；可逆；催化剂层

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关键词：康复技术；创伤；心理学；医疗服务

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This thesis assesses drug-treatment quality in the three Afghan provinces of Kabul, Kandahar, and Badakhshan by evaluating the extent to which programs and centers meet United Nations Office on Drugs and Crime (UNODC) and World Health Organization (WHO) standards of care. The assessment is structured to show how recovery capital, institutional development, and community action sway an addict's ability to quit drugs successfully. In contextualizing the case studies, a social-economic and political framework is developed that reveals linkages among addiction, poverty, and drug trafficking. The most successful drug treatment programs follow UNODC/WHO standards, enrich community networks, invest in developing human capital, and adapt treatment protocols to Afghanistan's unique circumstances. Provinces with vibrant economic markets are the most effective at providing quality drug treatment because they are more socially invested in their communities. The thesis recommends that Afghanistan consider factors such as poverty, economic opportunity, governance, mental health, and education when tackling the narcotics trade. Social programs cannot exist in a weak governance system that tolerates violence. Properly caring for addicts and reducing the poverty rate will improve trust among partnerships, instill a sense of empowerment within the poor, create an outlet for social change, and give the community incentives to move away from the illicit drug market.

关键词：康复中心；药物成瘾；吸毒者；麻醉药品

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GAO identified 45 programs that supported employment for people with disabilities in fiscal year 2010, reflecting a fragmented system of services. The programs were administered by nine federal agencies and overseen by even more congressional committees. All programs overlapped with at least one other program in that they provided one or more similar employment service to a similar populationpeople with disabilities. The greatest overlap occurred in programs serving veterans and servicemembers (19 programs) and youth and young adults (5 programs). In addition, GAO identified seven programs that did not limit eligibility to any particular population and were potentially available to veterans and servicemembers or youth. Some overlapping programs, such as those with specific eligibility requirements, have less potential for duplicationproviding the same services to the same beneficiariesthan others. However, even when the potential for duplication of services is low, there may be inefficiencies associated with operating multiple programs that provide similar services to similar populations. Coordination across programs may help address fragmentation and potential duplication, but officials that GAO surveyed reported only limited coordination. However, among six selected programs that only serve people with disabilitiesincluding the Department of Educations Vocational Rehabilitation program and the Social Security Administrations Ticket to Work programofficials cited more consistent coordination.

关键词：康复技术；残疾人；退伍军人；服务人员

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The overall aim is to conduct preliminary evaluations of new rehabilitation strategies and new functional assessment methods for homonymous hemianopia (HH) and spatial neglect (SN), disabling visual and cognitive perception conditions that commonly occur as a result of severe traumatic brain injury (TBI) and stroke. Both HH and SN prevent detection of objects on the affected side, resulting in unsafe walking and driving. Using realistic tasks in virtual environments representative of everyday mobility challenges we are evaluating a novel optical device expansion prism (EP) glasses - combined with a new computerized perceptual-motor training regimen in helping people with HH and SN detect and avoid obstacles on the affected side. In the first year we have made good progress in developing the training software and preparing the functional assessments, and have started recruitment. Specifically, we (1) obtained all necessary IRB approvals; (2) made excellent progress in developing and testing the training program and training task suite; (3) made excellent progress in preparing the functional assessments in the driving simulator and virtual mall that will be used to evaluate performance without and without the prism glasses before and after training; (4) evaluated mobile eye tracking technologies that will be used for an outdoor walking task; (5) began recruitment; (6) collected pre-pilot data from participants who did not meet the study criteria, and (7) enrolled 3 participants for the main pilot study. Results from the first participant who has completed the protocol are promising showing significantly improved detection rates and collision judgments with the EP-glasses after training.

关键词：康复技术；脑;功能障碍;眼；光学仪器；创伤性脑损伤

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The National Renewable Energy Laboratory (NREL), in association with the U.S. Department of Energy's Office of Energy Efficiency and Renewable Energy (EERE), held a Biogas and Fuel Cells Workshop on June 11-13, 2012, in Golden, Colorado, to discuss biogas and waste-to-energy technologies for fuel cell applications. The meeting was spearheaded by the Fuel Cell Technologies Program in coordination with the Biomass Program. The overall objective was to identify opportunities for coupling renewable biomethane with highly efficient fuel cells to produce electricity; heat; combined heat and power (CHP); or combined heat, hydrogen and power (referred to as CHHP or trigeneration) for stationary or motive applications. The workshop focused on biogas sourced from wastewater treatment plants (WWTPs), landfills, and industrial facilities that generate or process large amounts of organic waste, including large biofuel production facilities (biorefineries).

关键词：燃料电池；直接能量转换；废水处理；沼气的过程

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An efficient method for utilising a two-dimensional camera to recognise hand gestures in three-dimensional space is described. The work is presented within the context of a recuperation aid for younger children with impaired movement of the upper limbs. The application is designed for use on a standard Android tablet device in the home, as part of an interactive storybook, so the algorithms are necessarily efficient. The hand movement recognition is achieved through the attachment of brightly coloured models to the child's fingers which serve the dual purpose of providing easily trackable elements of the image, and encouraging the child to regard the application as a game rather than a chore. The application promotes repeated use of specific hand skills identified by the medical profession to stimulate and assess rehabilitation of patients with impaired upper limb dexterity.

关键词：康复技术；残疾人；计算机视觉；跟踪

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