Sample records for aat augmentation therapy

  1. The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency

    PubMed Central

    Schmid, ST; Koepke, J; Dresel, M; Hattesohl, A; Frenzel, E; Perez, J; Lomas, DA; Miranda, E; Greulich, T; Noeske, S; Wencker, M; Teschler, H; Vogelmeier, C; Janciauskiene, S; Koczulla, AR

    2012-01-01

    Background The major concept behind augmentation therapy with human α1-antitrypsin (AAT) is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys)-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema. Objective To evaluate the short-term effects of augmentation therapy (Prolastin®) on plasma levels of AAT, C-reactive protein, and chemokines/cytokines. Materials and methods Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12) on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8), monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL). Results There were significant fluctuations in serum (but not in exhaled breath condensate) levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, and vascular endothelial growth factor within a week of augmentation therapy. In general, augmented individuals had higher AAT and lower serum levels of IL-8 than nonaugmented subjects. Prolastin added for 3 hours to neutrophils from protease inhibitor phenotype ZZ individuals in vitro reduced IL-8 release but showed no effect on cytokine/chemokine release from human bronchial epithelial cells. Conclusion Within a week, augmentation with Prolastin induced fluctuations in serum levels of AAT polymers and cytokine/chemokines but specifically lowered IL-8 levels. It remains to be determined whether these effects are related to the Prolastin preparation per se or to the therapeutic efficacy of augmentation with AAT. PMID:23055718

  2. Alpha-1 antitrypsin augmentation therapy decreases miR-199a-5p, miR-598 and miR-320a expression in monocytes via inhibition of NFκB.

    PubMed

    Hassan, Tidi; de Santi, Chiara; Mooney, Catherine; McElvaney, Noel G; Greene, Catherine M

    2017-10-23

    Alpha-1 antitrypsin (AAT) augmentation therapy involves infusion of plasma-purified AAT to AAT deficient individuals. Whether treatment affects microRNA expression has not been investigated. This study's objectives were to evaluate the effect of AAT augmentation therapy on altered miRNA expression in monocytes and investigate the mechanism. Monocytes were isolated from non-AAT deficient (MM) and AAT deficient (ZZ) individuals, and ZZs receiving AAT. mRNA (qRT-PCR, microarray), miRNA (miRNA profiling, qRT-PCR), and protein (western blotting) analyses were performed. Twenty one miRNAs were differentially expressed 3-fold between ZZs and MMs. miRNA validation studies demonstrated that in ZZ monocytes receiving AAT levels of miR-199a-5p, miR-598 and miR-320a, which are predicted to be regulated by NFκB, were restored to levels similar to MMs. Validated targets co-regulated by these miRNAs were reciprocally increased in ZZs receiving AAT in vivo and in vitro. Expression of these miRNAs could be increased in ZZ monocytes treated ex vivo with an NFκB agonist and decreased by NFκB inhibition. p50 and p65 mRNA and protein were significantly lower in ZZs receiving AAT than untreated ZZs. AAT augmentation therapy inhibits NFκB and decreases miR-199a-5p, miR-598 and miR-320a in ZZ monocytes. These NFκB-inhibitory properties may contribute to the anti-inflammatory effects of AAT augmentation therapy.

  3. [Alpha-1 antitrypsin deficiency. The experience of Pulido Valente Hospital with augmentation therapy].

    PubMed

    Alves Costa, Carla; Santos, Cristina

    2009-01-01

    Alpha-1 antitrypsin (AAT) is synthesised in the liver and has half-life of 4-5 days. AAT has antiprotease activity, with particular affinity for neutrophil elastase. Its deficiency leads to a lack of effective lung protection against activated neutrophil enzymes. Deficiency of AAT is a genetic disorder that occurs as a result of the inheritance of two protease inhibitor deficient alleles. Of the deficient alleles, Pi*Z is the most common, and the homozygous form Pi*ZZ results in the lowest serum levels, usually below 50 mg/ dl. The "protective threshold" is 80 mg/dl. Smoking increases the risk of emphysema. The current goal of augmentation therapy is to raise the plasma levels, above protective threshold and slow disease progression. The authors present the experience of the Day Care Hospital of the Pulido Valente Hospital with five male patients presenting emphysema due to AAT deficiency, receiving weekly intravenous treatment with Prolastin. We performed a clinical, respiratory functional and radiological evaluation between 2003 and 2007. The results point to a slower progression of the disease, with clinical and radiological stability and a reduced rate of FEV1 decline. Augmentation therapy is an expensive treatment and its use is lacking supportive evidence of efficacy by randomized controlled clinical trials. Evidence that it confers benefits is based on observational studies. Our experience is positive, showing clinical, radiological and functional benefits. The literature available points to a decrease in mortality, but we could not affirm so in our small population.

  4. Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

    PubMed Central

    Calvo, Paula; Fortuny, Joan R.; Guzmán, Sergio; Macías, Cristina; Bowen, Jonathan; García, María L.; Orejas, Olivia; Molins, Ferran; Tvarijonaviciute, Asta; Cerón, José J.; Bulbena, Antoni; Fatjó, Jaume

    2016-01-01

    Currently, one of the main objectives of human–animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6–month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre–program with post–program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre–session with post–session salivary cortisol and alpha–amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty–two institutionalized patients with chronic schizophrenia completed the 6–month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT–treatment group (n = 14) participated in twice–weekly 1–h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT–treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT–treatment group showed a significant improvement in negative symptomatology

  5. Therapeutics: Alpha-1 Antitrypsin Augmentation Therapy.

    PubMed

    Campos, Michael; Lascano, Jorge

    2017-01-01

    Subjects with alpha-1 antitrypsin deficiency who develop pulmonary disease are managed following general treatment guidelines, including disease management interventions. In addition, administration of intravenous infusions of alpha-1 proteinase inhibitor (augmentation therapy) at regular schedules is a specific therapy for individuals with AATD with pulmonary involvement.This chapter summarizes the manufacturing differences of commercially available formulations and the available evidence of the effects of augmentation therapy. Biologically, there is clear evidence of in vivo local antiprotease effects in the lung and systemic immunomodulatory effects. Clinically, there is cumulative evidence of slowing lung function decline and emphysema progression. The optimal dose of augmentation therapy is being revised as well as more individualized assessment of who needs this therapy.

  6. Combatting African Animal Trypanosomiasis (AAT) in livestock: The potential role of trypanotolerance.

    PubMed

    Yaro, M; Munyard, K A; Stear, M J; Groth, D M

    2016-07-30

    African Animal Trypanosomiasis (AAT) is endemic in at least 37 of the 54 countries in Africa. It is estimated to cause direct and indirect losses to the livestock production industry in excess of US$ 4.5 billion per annum. A century of intervention has yielded limited success, owing largely to the extraordinary complexity of the host-parasite interaction. Trypanotolerance, which refers to the inherent ability of some African livestock breeds, notably Djallonke sheep, N'Dama cattle and West African Dwarf goats, to withstand a trypanosomiasis challenge and still remain productive without any form of therapy, is an economically sustainable option for combatting this disease. Yet trypanotolerance has not been adequately exploited in the fight against AAT. In this review, we describe new insights into the genetic basis of trypanotolerance and discuss the potential of exploring this phenomenon as an integral part of the solution for AAT, particularly, in the context of African animal production systems. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Parents' acceptance and their children's choice of pet for animal-assisted therapy (A.A.T.) in 3- to 12-year-old children in the dental operatory -A questionnaire-based pilot study.

    PubMed

    Gupta, Nidhi; Yadav, Tushar

    2018-04-16

    To evaluate the parents' acceptance to therapy pets, child's most favoured pet, child's choice of soft toy as compared to live pet, and child's preference of his own pet versus therapy pet. Sixty-two children of age groups 3-6 year, 6-9 year, and 9-12 year were selected. The data from completed questionnaires were statistically analysed and subjected to z test, Chi-squared test with P value<0.05 considered as significant. The consent to the presence of pet was given by 41.47% parents of 9- to 12-year-old children, 34.15% parents of 6- to 9-year-old children and 24.39% parents of 3- to 6-year-old children. Children who chose dog as their preferred pet were 56.7%; those who chose cat as their preferred pet were 44%. A majority of 3-to 6-year-olds (63.15%) had dog & cat as their choice, while 6- to 9-year-olds (65.21%) & 9- to 12-year-olds (40%) preferred dogs over all others. Dog was the favourite pet of 46.8% children. More percentage of children wanted pet provided by clinic. Animal-Assisted Therapy (AAT) can prove to be a good behaviour management technique if more parents are made aware and informed about AAT; dog is one of the highly recommended pets for AAT, and therapy pet should be preferred over home pet. © 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Human Alpha-1-Antitrypsin (hAAT) therapy reduces renal dysfunction and acute tubular necrosis in a murine model of bilateral kidney ischemia-reperfusion injury

    PubMed Central

    Maicas, Nuria; van der Vlag, Johan; Bublitz, Janin; Florquin, Sandrine; Bakker-van Bebber, Marinka; Dinarello, Charles A.; Verweij, Vivienne; Masereeuw, Roos; Joosten, Leo A.

    2017-01-01

    Several lines of evidence have demonstrated the anti-inflammatory and cytoprotective effects of alpha-1-antitrypsin (AAT), the major serum serine protease inhibitor. The aim of the present study was to investigate the effects of human AAT (hAAT) monotherapy during the early and recovery phase of ischemia-induced acute kidney injury. Mild renal ischemia-reperfusion (I/R) injury was induced in male C57Bl/6 mice by bilateral clamping of the renal artery and vein for 20 min. hAAT (80 mg/kg, Prolastin®) was administered daily intraperitoneally (i.p.) from day -1 until day 7 after surgery. Control animals received the same amount of human serum albumin (hAlb). Plasma, urine and kidneys were collected at 2h, 1, 2, 3, 8 and 15 days after reperfusion for histological and biochemical analysis. hAAT partially preserved renal function and tubular integrity after induction of bilateral kidney I/R injury, which was accompanied with reduced renal influx of macrophages and a significant decrease of neutrophil gelatinase-associated lipocalin (NGAL) protein levels in urine and plasma. During the recovery phase, hAAT significantly decreased kidney injury molecule-1 (KIM-1) protein levels in urine but showed no significant effect on renal fibrosis. Although the observed effect size of hAAT administration was limited and therefore the clinical relevance of our findings should be evaluated carefully, these data support the potential of this natural protein to ameliorate ischemic and inflammatory conditions. PMID:28235038

  9. Complete Genome Sequence of Pseudomonas aeruginosa Phage AAT-1

    PubMed Central

    Andrade-Domínguez, Andrés

    2016-01-01

    Aspects of the interaction between phages and animals are of interest and importance for medical applications. Here, we report the genome sequence of the lytic Pseudomonas phage AAT-1, isolated from mammalian serum. AAT-1 is a double-stranded DNA phage, with a genome of 57,599 bp, containing 76 predicted open reading frames. PMID:27563032

  10. Mechanical stretching stimulates collagen synthesis via down-regulating SO2/AAT1 pathway

    PubMed Central

    Liu, Jia; Yu, Wen; Liu, Yan; Chen, Selena; Huang, Yaqian; Li, Xiaohui; Liu, Cuiping; Zhang, Yanqiu; Li, Zhenzhen; Du, Jie; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2016-01-01

    The aim of the study was to investigate the role of endogenous sulfur dioxide (SO2)/ aspartate aminotransferase 1 (AAT1) pathway in stretch-induced excessive collagen expression and its mechanism. The mechanical stretch downregulated SO2/AAT1 pathway and increased collagen I and III protein expression. Importantly, AAT1 overexpression blocked the increase in collagen I and III expression, transforming growth factor-β1 (TGF- β1) expression and phosphorylation of Smad2/3 induced by stretch, but AAT1 knockdown mimicked the increase in collagen I and III expression, TGF- β1 expression and phosphorylation of Smad2/3 induced by stretch. Mechanistically, SB431542, a TGF-β1/Smad2/3 inhibitor, eliminated excessive collagen I and III accumulation induced by AAT1 knockdown, stretch or stretch plus AAT1 knockdown. In a rat model of high pulmonary blood flow-induced pulmonary vascular collagen accumulation, AAT1 expression and SO2 content in lung tissues of rat were reduced in shunt rats with high pulmonary blood flow. Supplement of SO2 derivatives inhibited activation of TGF- β1/Smad2/3 pathway and alleviated the excessive collagen accumulation in lung tissues of shunt rats. The results suggested that deficiency of endogenous SO2/AAT1 pathway mediated mechanical stretch-stimulated abnormal collagen accumulation via TGF-β1/Smad2/3 pathway. PMID:26880260

  11. Complete Genome Sequence of Pseudomonas aeruginosa Phage AAT-1.

    PubMed

    Andrade-Domínguez, Andrés; Kolter, Roberto

    2016-08-25

    Aspects of the interaction between phages and animals are of interest and importance for medical applications. Here, we report the genome sequence of the lytic Pseudomonas phage AAT-1, isolated from mammalian serum. AAT-1 is a double-stranded DNA phage, with a genome of 57,599 bp, containing 76 predicted open reading frames. Copyright © 2016 Andrade-Domínguez and Kolter.

  12. The effects of upaB deletion and the double/triple deletion of upaB, aatA, and aatB genes on pathogenicity of avian pathogenic Escherichia coli.

    PubMed

    Zhu-Ge, Xiang-Kai; Pan, Zi-Hao; Tang, Fang; Mao, Xiang; Hu, Lin; Wang, Shao-Hui; Xu, Bin; Lu, Cheng-Ping; Fan, Hong-Jie; Dai, Jian-Jun

    2015-12-01

    Autotransporters (ATs) are associated with pathogenesis of Avian Pathogenic Escherichia coli (APEC). The molecular characterization of APEC ATs can provide insights about their relevance to APEC pathogenesis. Here, we characterized a conventional autotransporter UpaB in APEC DE205B genome. The upaB existed in 41.9 % of 236 APEC isolates and was predominantly associated with ECOR B2 and D. Our studies showed that UpaB mediates the DE205B adhesion in DF-1 cells, and enhances autoaggregation and biofilm formation of fimbria-negative E. coli AAEC189 (MG1655Δfim) in vitro. Deletion of upaB of DE205B attenuates the virulence in duck model and early colonization in the duck lungs during APEC systemic infection. Furthermore, double and triple deletion of upaB, aatA, and aatB genes cumulatively attenuated DE205B adhesion in DF-1 cells, accompanying with decreased 50 % lethal dose (LD50) in duck model and the early colonization in the duck lungs. However, DE205BΔupaB/ΔaatA/ΔaatB might "compensate" the influence of gene deletion by upregulating the expression of fimbrial adhesin genes yqiL, yadN, and vacuolating autotransporter vat during early colonization of APEC. Finally, we demonstrated that vaccination with recombinant UpaB, AatA, and AatB proteins conferred protection against colisepticemia caused by DE205B infection in duck model.

  13. Significant Effect of Valproate Augmentation Therapy in Patients With Schizophrenia

    PubMed Central

    Tseng, Ping-Tao; Chen, Yen-Wen; Chung, Weilun; Tu, Kun-Yu; Wang, Hung-Yu; Wu, Ching-Kuan; Lin, Pao-Yen

    2016-01-01

    Abstract Valproate is an anticonvulsant, which is also widely used for treating psychiatric disorders. Some clinical trials have demonstrated benefits of valproate augmentation therapy in schizophrenia. Previous meta-analysis showed inconsistent findings because of limited literature at that time. The aim of this study is to update the newer published data by conducting a meta-analysis of clinical efficacy of valproate augmentation therapy in patients with schizophrenia or schizoaffective disorder. Data sources include electronic research through platform of PubMed. Study eligibility criteria, participants, and interventions were as follows: the inclusion criteria included articles discussing comparisons of the treatment effect in schizophrenic patients treated with antipsychotic augmented with valproate and antipsychotics with/without placebo; articles on clinical trials in humans. The exclusion criteria were case reports or series and nonclinical trials. We compared the effect between antipsychotic treatment with valproate augmentation and antipsychotic monotherapy. Data from clinical trials were pooled by random-effects model, and possible confounding variables were examined through meta-regression and subgroup analysis. Data from 11 articles including 889 patients were included into current meta-analysis. We found patients treated with antipsychotics with valproate augmentation showed significantly more improvement in total psychopathology than those treated with antipsychotics only (P = 0.02). Results from open trials, but not from randomized controlled trials (P = 0.20), showed significant improvement (P = 0.01). In addition, the significance only persisted in the studies conducted with a shorter treatment duration (P < 0.001) rather than longer treatment duration (P = 0.23). There is no difference in the dropout rate between valproate augmentation and antipsychotic treatment only (P = 0.14). We could not perform a detailed meta

  14. The moral basis of animal-assisted therapy.

    PubMed

    Zamir, Tzachi

    2006-01-01

    Is nonhuman animal-assisted therapy (AAT) a form of exploitation? After exploring possible moral vindications of AAT and after establishing a distinction between "use" and "exploitation," the essay distinguishes between forms of animal-assisted therapy that are morally unobjectionable and those modes of it that ought to be abolished.

  15. Low Serum Alpha-1 Antitrypsin (AAT) in Family Members of Individuals with Autism Correlates with PiMZ Genotype

    PubMed Central

    Russo, Anthony J.; Neville, Lauren; Wroge, Christine

    2009-01-01

    Aim Deficiency of Alpha-1-antitrypsin (AAT) can be a genetic condition that increases the risk of developing liver, lung and possibly gastrointestinal disease. Since many autistic children also have gastrointestinal disorders, this study was designed to measure serum concentration of AAT and establish AAT genotypes in autistic children, age and gender matched non-autistic siblings, parents and controls. Subjects and Methods We used an indirect ELISA with monoclonal IgG to AAT to measure AAT serum concentrations in 71 members from 16 families of individuals with autism and 18 controls (no family history of autism). We used a duplex polymerase chain reaction to detect M, S and Z alleles for alpha-1 antitrypsin expression in 52 members of 12 of the above families. Results A significantly high number of autistic family members had lower than normal serum levels of AAT when compared to controls. Autistic children with regressive onset had significantly lower levels of AAT compared to controls, and a significant number of autistic children with low serum AAT also had hyperbilirubinemia, gastrointestinal disease and respiratory problems. We also found that a significantly high number of these individuals had the PiMZ genotype and correspondingly low levels of serum alpha-1 antitrypsin. Discussion Knowing that low levels of alpha-1 antitrypsin may be inherited, and that low levels of AAT may be associated with GI disease in autistic children, genotyping autistic children may help identify individuals susceptible to developing digestive problems. PMID:19652762

  16. Assessment of animal African trypanosomiasis (AAT) vulnerability in cattle-owning communities of sub-Saharan Africa.

    PubMed

    Holt, H R; Selby, R; Mumba, C; Napier, G B; Guitian, J

    2016-01-30

    Animal African trypanosomiasis (AAT) is one of the biggest constraints to livestock production and a threat to food security in sub-Saharan Africa. In order to optimise the allocation of resources for AAT control, decision makers need to target geographic areas where control programmes are most likely to be successful and sustainable and select control methods that will maximise the benefits obtained from resources invested. The overall approach to classifying cattle-owning communities in terms of AAT vulnerability was based on the selection of key variables collected through field surveys in five sub-Saharan Africa countries followed by a formal Multiple Correspondence Analysis (MCA) to identify factors explaining the variations between areas. To categorise the communities in terms of AAT vulnerability profiles, Hierarchical Cluster Analysis (HCA) was performed. Three clusters of community vulnerability profiles were identified based on farmers' beliefs with respect to trypanosomiasis control within the five countries studied. Cluster 1 communities, mainly identified in Cameroon, reported constant AAT burden, had large trypanosensitive (average herd size  = 57) communal grazing cattle herds. Livestock (cattle and small ruminants) were reportedly the primary source of income in the majority of these cattle-owning households (87.0%). Cluster 2 communities identified mainly in Burkina Faso and Zambia, with some Ethiopian communities had moderate herd sizes (average = 16) and some trypanotolerant breeds (31.7%) practicing communal grazing. In these communities there were some concerns regarding the development of trypanocide resistance. Crops were the primary income source while communities in this cluster incurred some financial losses due to diminished draft power. The third cluster contained mainly Ugandan and Ethiopian communities which were mixed farmers with smaller herd sizes (average = 8). The costs spent diagnosing and treating AAT were moderate

  17. Effectiveness of Animal Assisted Therapy after brain injury: A bridge to improved outcomes in CRT.

    PubMed

    Stapleton, Mary

    2016-06-18

    Animal Assisted Therapy (AAT) has been widely used as a complementary therapy in mental health treatment especially to remediate social skill deficits. The goal of AAT is to improve social, emotional, and cognitive functioning. The purpose of this article is to draw upon the literature on AAT and explore specific applications to cognitive rehabilitation therapy (CRT) and social skills training. This study provides a systematic review of most of the available literature on ATT and assesses that potential uses of ATT for brain injury rehabilitation. Although the efficacy of AAT is not currently well documented by rigorous research, (Kazin, 2010) anecdotal evidence suggests that brain injury survivors may benefit from the combination of AAT and cognitive rehabilitation techniques. Acquired Brain Injury (ABI) survivors with cognitive impairments can benefit from AAT as part of a comprehensive and holistic rehabilitation treatment plan.

  18. Augmentation therapy for alpha-1 antitrypsin deficiency: towards a personalised approach

    PubMed Central

    2013-01-01

    Background Intravenous augmentation therapy is the only specific treatment available for emphysema associated with alpha-1 antitrypsin deficiency. Despite large observational studies and limited interventional studies there remains controversy about the efficacy of this treatment due to the impracticality of conducting adequately powered studies to evaluate the rate of decline in lung function, due to the low prevalence and the slow progression of the disease. However, measurement of lung density by computed tomography is a more specific and sensitive marker of the evolution of emphysema and two small placebo-controlled clinical trials have provided evidence supporting a reduction in the rate of decline in lung density with augmentation therapy. The problem Where augmentation therapy has become available there has been little consideration of a structured approach to therapy which is often introduced on the basis of functional impairment at diagnosis. Data from registries have shown a great variability in the evolution of lung disease according to patient acquisition and the presence of recognised risk factors. Avoidance of risk factors may, in many cases, stabilise the disease. Since augmentation therapy itself will at best preserve the presenting level of lung damage yet require intravenous administration for life with associated costs, identification of patients at risk of continued rapid or long term progression is essential to select those for whom this treatment can be most appropriate and hence generally more cost-effective. This represents a major reconsideration of the current practice in order to develop a consistent approach to management world wide. Purpose of this review The current review assesses the evidence for efficacy of augmentation therapy and considers how the combination of age, physiological impairment, exacerbation history and rate of decline in spirometry and other measures of emphysema may be used to improve therapeutic decision making

  19. Animal-Assisted Therapy and Counseling Support for Women With Breast Cancer: An Exploration of Patient's Perceptions.

    PubMed

    White, Jennifer H; Quinn, Martina; Garland, Sheila; Dirkse, Dale; Wiebe, Patricia; Hermann, Madeline; Carlson, Linda E

    2015-09-01

    Animal-assisted therapy (AAT) interventions have been shown to assist in coping and improve patient responses to symptoms. Specifically, the presence of an animal has been found to lower anxiety and motivate participation in therapy. We aimed to explore the acceptability of and experience of AAT during individual breast cancer counseling sessions. Patients undertaking counseling with a therapy dog present were invited to participate in the study. Patients were individually interviewed and asked to reflect on their experiences of AAT. Data generation and analysis were concurrent. Transcripts were analyzed thematically using a process of constant comparison. Our sample included 8 female participants, 39 to 61 years old, at an average of 3 years post-breast cancer diagnosis. The majority of patients reported a positive experience with AAT. Themes that emerged around their counseling experience included benefits in the process of initiating counseling and benefits for greater engagement and personal disclosure. Incorporating AAT into the delivery of counseling for breast cancer patients appears to be feasible and acceptable at a patient level. From a clinical perspective, AAT promoted increased communication with health professionals. This is of clinical importance as a means to improve participation and engagement in therapy-important elements in therapeutic outcomes. However, further evaluation of the impact of AAT on specific patient outcomes and psychological morbidity is required. © The Author(s) 2015.

  20. Visually augmented targeted combination light therapy for acne vulgaris: a case report.

    PubMed

    Yazdi, Alireza; Lyons, Colin-William; Roberts, Niamh

    2017-10-31

    Acne vulgaris is a common skin disease. Pharmacological modalities for treatment are proven to be efficacious but have limitations. Light therapy for acne vulgaris has shown promise in previous studies. This case report and its accompanying images show how a novel approach of visually augmented high fluence light therapy has been used to good effect. A 26-year-old Caucasian woman with acne vulgaris resistant to treatment with topical therapy underwent three sessions of combination potassium titanyl phosphate laser (532 nm)/neodymium-doped: yttrium aluminum garnet laser (1064 nm) light therapy with visually augmented narrow spot size and high fluence. A 73% reduction in total inflammatory lesions was evident 6 months after the initial treatment. This case report illustrates that there may be utility in this novel approach of narrow spot size, magnification-assisted, high fluence targeted combination laser therapy for inflammatory acne.

  1. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

    PubMed

    Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

    2017-07-01

    New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

  2. New-generation diabetes management: glucose sensor-augmented insulin pump therapy.

    PubMed

    Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V

    2011-07-01

    Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management.

  3. Trypanosoma brucei eflornithine transporter AAT6 is a low-affinity low-selective transporter for neutral amino acids.

    PubMed

    Mathieu, Christoph; González Salgado, Amaia; Wirdnam, Corina; Meier, Stefan; Grotemeyer, Marianne Suter; Inbar, Ehud; Mäser, Pascal; Zilberstein, Dan; Sigel, Erwin; Bütikofer, Peter; Rentsch, Doris

    2014-10-01

    Amino acid transporters are crucial for parasite survival since the cellular metabolism of parasitic protozoa depends on the up-take of exogenous amino acids. Amino acid transporters are also of high pharmacological relevance because they may mediate uptake of toxic amino acid analogues. In the present study we show that the eflornithine transporter AAT6 from Trypanosoma brucei (TbAAT6) mediates growth on neutral amino acids when expressed in Saccharomyces cerevisiae mutants. The transport was electrogenic and further analysed in Xenopus laevis oocytes. Neutral amino acids, proline analogues, eflornithine and acivicin induced inward currents. For proline, glycine and tryptophan the apparent affinities and maximal transport rates increased with more negative membrane potentials. Proline-induced currents were dependent on pH, but not on sodium. Although proline represents the primary energy source of T. brucei in the tsetse fly, down-regulation of TbAAT6-expression by RNAi showed that in culture TbAAT6 is not essential for growth of procyclic form trypanosomes in the presence of glucose or proline as energy source. TbAAT6-RNAi lines of both bloodstream and procyclic form trypanosomes showed reduced susceptibility to eflornithine, whereas the sensitivity to acivicin remained unchanged, indicating that acivicin enters the cell by more than one transporter.

  4. The AAT1 locus is critical for the biosynthesis of esters contributing to 'ripe apple' flavour in 'Royal Gala' and 'Granny Smith' apples.

    PubMed

    Souleyre, Edwige J F; Chagné, David; Chen, Xiuyin; Tomes, Sumathi; Turner, Rebecca M; Wang, Mindy Y; Maddumage, Ratnasiri; Hunt, Martin B; Winz, Robert A; Wiedow, Claudia; Hamiaux, Cyril; Gardiner, Susan E; Rowan, Daryl D; Atkinson, Ross G

    2014-06-01

    The 'fruity' attributes of ripe apples (Malus × domestica) arise from our perception of a combination of volatile ester compounds. Phenotypic variability in ester production was investigated using a segregating population from a 'Royal Gala' (RG; high ester production) × 'Granny Smith' (GS; low ester production) cross, as well as in transgenic RG plants in which expression of the alcohol acyl transferase 1 (AAT1) gene was reduced. In the RG × GS population, 46 quantitative trait loci (QTLs) for the production of esters and alcohols were identified on 15 linkage groups (LGs). The major QTL for 35 individual compounds was positioned on LG2 and co-located with AAT1. Multiple AAT1 gene variants were identified in RG and GS, but only two (AAT1-RGa and AAT1-GSa) were functional. AAT1-RGa and AAT1-GSa were both highly expressed in the cortex and skin of ripe fruit, but AAT1 protein was observed mainly in the skin. Transgenic RG specifically reduced in AAT1 expression showed reduced levels of most key esters in ripe fruit. Differences in the ripe fruit aroma could be perceived by sensory analysis. The transgenic lines also showed altered ratios of biosynthetic precursor alcohols and aldehydes, and expression of a number of ester biosynthetic genes increased, presumably in response to the increased substrate pool. These results indicate that the AAT1 locus is critical for the biosynthesis of esters contributing to a 'ripe apple' flavour. © 2014 The Authors The Plant Journal © 2014 John Wiley & Sons Ltd.

  5. New-generation diabetes management: glucose sensor-augmented insulin pump therapy

    PubMed Central

    Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V

    2011-01-01

    Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management. PMID:21728731

  6. Is electroconvulsive therapy effective as augmentation in clozapine-resistant schizophrenia?

    PubMed

    Kittsteiner Manubens, Lucas; Lobos Urbina, Diego; Aceituno, David

    2016-10-14

    Clozapine is considered to be the most effective antipsychotic drug for patients with treatment resistant schizophrenia, but up to a third of the patients do not respond to this treatment. Various strategies have been tried to augment the effect of clozapine in non-responders, one of these strategies being electroconvulsive therapy. However, its efficacy and safety are not yet clear. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 55 studies, among them six randomized controlled trials addressing clozapine-resistant schizophrenia. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded electroconvulsive therapy probably augments response to clozapine in patients with treatment resistant schizophrenia, but it is not possible to determine if it leads to cognitive adverse effects because the certainty of the evidence is very low.

  7. Clinical utility of alpha-1 proteinase inhibitor in the management of adult patients with severe alpha-1 antitrypsin deficiency: a review of the current literature

    PubMed Central

    Parr, David G; Lara, Beatriz

    2017-01-01

    Alpha-1 antitrypsin (AAT) functions primarily to inhibit neutrophil elastase, and its deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD). The putative protective serum concentration is generally considered to be above a threshold of 11 μM/L, and therapeutic augmentation of AAT above this value is believed to retard the progression of emphysema. Several AAT preparations, all derived from human donor plasma, have been commercialized since approval by the US Food and Drug Administration (FDA) in 1987. Biochemical efficacy has been demonstrated by augmentation of pulmonary antiprotease activity, but demonstration of clinical efficacy in randomized, placebo-controlled trials has been hampered by the practical difficulties of performing conventional studies in a rare disease with a relatively long natural history. Computed tomography has been applied to measure lung density as a more specific and sensitive surrogate outcome measure of emphysema than physiologic indices, such as forced expiratory volume in 1 second, and studies consistently show a therapeutic reduction in the rate of lung density decline. However, convincing evidence of benefit using traditional clinical measures remains elusive. Intravenous administration of AAT at a dose of 60 mg/kg/week is the commonest regime in use and has well-documented safety and tolerability. International and national guidelines on the management of AAT deficiency recommend intravenous augmentation therapy to supplement optimized usual COPD treatment in patients with severe deficiency and evidence of lung function impairment. PMID:28769553

  8. Customized biomaterials to augment chondrocyte gene therapy.

    PubMed

    Aguilar, Izath Nizeet; Trippel, Stephen; Shi, Shuiliang; Bonassar, Lawrence J

    2017-04-15

    A persistent challenge in enhancing gene therapy is the transient availability of the target gene product. This is particularly true in tissue engineering applications. The transient exposure of cells to the product could be insufficient to promote tissue regeneration. Here we report the development of a new material engineered to have a high affinity for a therapeutic gene product. We focus on insulin-like growth factor-I (IGF-I) for its highly anabolic effects on many tissues such as spinal cord, heart, brain and cartilage. One of the ways that tissues store IGF-I is through a group of insulin like growth factor binding proteins (IGFBPs), such as IGFBP-5. We grafted the IGF-I binding peptide sequence from IGFBP-5 onto alginate in order to retain the endogenous IGF-I produced by transfected chondrocytes. This novel material bound IGF-I and released the growth factor for at least 30days in culture. We found that this binding enhanced the biosynthesis of transfected cells up to 19-fold. These data demonstrate the coordinated engineering of cell behavior and material chemistry to greatly enhance extracellular matrix synthesis and tissue assembly, and can serve as a template for the enhanced performance of other therapeutic proteins. The present manuscript focuses on the enhancement of chondrocyte gene therapy through the modification of scaffold materials to enhance the retention of targeted gene products. This study combined tissue engineering and gene therapy, where customized biomaterials augmented the action of IGF-I by enhancing the retention of protein produced by transfection of the IGF-I gene. This approach enabled tuning of binding of IGF-I to alginate, which increased GAG and HYPRO production by transfected chondrocytes. To our knowledge, peptide-based modification of materials to augment growth factor-targeted gene therapy has not been reported previously. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  9. Moving from Virtual Reality Exposure-Based Therapy to Augmented Reality Exposure-Based Therapy: A Review

    PubMed Central

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed “safely” to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user’s experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia. PMID:24624073

  10. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review.

    PubMed

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed "safely" to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user's experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia.

  11. Evaluation of the efficacy of animal-assisted therapy based on the reality orientation therapy protocol in Alzheimer's disease patients: a pilot study.

    PubMed

    Menna, Lucia Francesca; Santaniello, Antonio; Gerardi, Federica; Di Maggio, Annamaria; Milan, Graziella

    2016-07-01

    The aim of this study was to evaluate the efficacy of animal-assisted therapy (AAT) in elderly patients affected by Alzheimer's disease based on the formal reality orientation therapy (ROT) protocol. Our study was carried out at an Alzheimer's centre for 6 months. A homogeneous sample (age, Mini-Mental State Examination (MMSE), 15-item Geriatric Depression Scale (GDS)) of 50 patients was selected at random and successively. Patients were divided into three groups: (i) 20 patients received a course of AAT (AAT group) based on the ROT protocol; (ii) 20 patients were engaged exclusively in activities based on the ROT group; and (iii) 10 patients (control group) participated in no stimulations. MMSE and GDS were administered at time 0 (T0 ) and time 1 (T1 ) to all three groups. Differences within groups between T0 and T1 for GDS and MMSE scores were analyzed by Student's t-test. Differences between group means were analyzed using an anova test with the Bonferroni-Dunn test for post-hoc comparisons. Both the AAT group and ROT group had improved GDS scores and showed a slight improvement in terms of mood. On the GDS, the AAT group improved from 11.5 (T0 ) to 9.5 (T1 ), and the ROT group improved from 11.6 (T0 ) to 10.5 (T1 ). At the same time, a slight improvement in cognitive function, as measured by the MMSE, was observed. In the AAT group, mean MMSE was 20.2 at T0 and 21.5 at T1 , and in the ROT group, it was 19.9 at T0 and 20.0 at T1 . In the control group, the average values of both the GDS and MMSE remained unchanged. The Bonferroni-Dunn results showed statistically significant differences between groups, particularly between the AAT group and the other two (P < 0.001). Pet therapy interventions based on the formal ROT protocol were effective and, compared to the ROT, provided encouraging and statistically significant results. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  12. Attitudes to and beliefs about animal assisted therapy for children with disabilities.

    PubMed

    Yap, Esther; Scheinberg, Adam; Williams, Katrina

    2017-02-01

    This study assessed the attitudes and beliefs surrounding animal-assisted therapy (AAT) for the rehabilitation of children with disabilities at the Royal Children's Hospital (RCH), focusing specifically on cerebral palsy (CP), autism spectrum disorder (ASD) and acquired brain injury (ABI). This was an initial step to inform future AAT research and to understand the feasibility of interventions. An online survey asking participants their opinions about the inclusion of AAT, and potential barriers to its introduction in a tertiary hospital setting was advertised on the RCH Intranet from 3 March 2015 to 3 April 2015. A total of 128 participants responded to the survey request, from a range of specialties and departments. Almost all survey respondents reported that animal-assisted therapy would be helpful in the physical or behavioral management of children affected by CP (98%), ASD (99%) and ABI (96%), and 98% of survey respondents supported the inclusion of AAT in the RCH. Ninety-two percent recommended AAT in the inpatient setting and 52% of the respondents suggest that it should be administered as a pre-determined program with set activities. Additionally, qualitative responses provided suggestions that AAT should be used to provide comfort in high stress environments such as prior to medical and surgical procedures. The majority of staff are supportive of the inclusion of AAT in the RCH, indicating more research is needed to establish whether AAT is acceptable to children and families as part of their care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Staff Attitudes Regarding the Impact of a Therapy Dog Program on Military Behavioral Health Patients.

    PubMed

    Brisson, Sara; Dekker, Anthony H

    Human-animal interactions in the form of animal-assisted therapy (AAT) have become common in both civilian and military health care facilities. Evidence supports AAT as a beneficial therapeutic alternative for patients with physical disabilities and psychological disorders. Few studies have been conducted in the civilian health care setting to evaluate staff attitudes regarding the impact of an AAT program on behavioral health (BH) patients. To our knowledge, no research has examined staff attitudes on the impact and effectiveness of AAT on active-duty Servicemembers in a BH program at a military facility. At the completion of a year-long AAT dog program and after institutional review board exemption, an anonymous, six-question survey was used to examine staff attitudes (n = 29) regarding the impact and continuation of the program with military BH patients. Most staff members (86%) believed the AAT dog program had a positive impact on the BH patients, including improved patient mood, greater patient relaxation, improved patient attitude toward therapy, and increased social interactions among patients. All the staff reported a desire to continue the program at the military facility. Most BH staff thought the year-long AAT dog program had a positive impact on patients. All staff supported continuation of the program. 2017.

  14. α-1-Antitrypsin (AAT)–modified donor cells suppress GVHD but enhance the GVL effect: a role for mitochondrial bioenergetics

    PubMed Central

    Karoopongse, Ekapun; Lesnikova, Marina; Margineantu, Daciana; Welte, Tobias; Dinarello, Charles A.; Hockenbery, David; Janciauskiene, Sabina; Deeg, H. Joachim

    2014-01-01

    Hematopoietic cell transplantation is curative in many patients. However, graft-versus-host disease (GVHD), triggered by alloreactive donor cells, has remained a major complication. Here, we show an inverse correlation between plasma α-1-antitrypsin (AAT) levels in human donors and the development of acute GVHD in the recipients (n = 111; P = .0006). In murine models, treatment of transplant donors with human AAT resulted in an increase in interleukin-10 messenger RNA and CD8+CD11c+CD205+ major histocompatibility complex class II+ dendritic cells (DCs), and the prevention or attenuation of acute GVHD in the recipients. Ablation of DCs (in AAT-treated CD11c-DTR donors) decreased CD4+CD25+FoxP3+ regulatory T cells to one-third and abrogated the anti-GVHD effect. The graft-versus-leukemia (GVL) effect of donor cells (against A20 tumor cells) was maintained or even enhanced with AAT treatment of the donor, mediated by an expanded population of NK1.1+, CD49B+, CD122+, CD335+ NKG2D-expressing natural killer (NK) cells. Blockade of NKG2D significantly suppressed the GVL effect. Metabolic analysis showed a high glycolysis–high oxidative phosphorylation profile for NK1.1+ cells, CD4+CD25+FoxP3+ T cells, and CD11c+ DCs but not for effector T cells, suggesting a cell type–specific effect of AAT. Thus, via altered metabolism, AAT exerts effective GVHD protection while enhancing GVL effects. PMID:25224412

  15. Effects of animal-assisted therapy on concentration and attention span in patients with acquired brain injury: A randomized controlled trial.

    PubMed

    Gocheva, Vanya; Hund-Georgiadis, Margret; Hediger, Karin

    2018-01-01

    Previous studies have reported that brain-injured patients frequently suffer from cognitive impairments such as attention and concentration deficits. Numerous rehabilitation clinics offer animal-assisted therapy (AAT) to address these difficulties. The authors' aim was to investigate the immediate effects of AAT on the concentration and attention span of brain-injured patients. Nineteen patients with acquired brain injury were included in a randomized, controlled, within-subject trial. The patients alternately received 12 standard therapy sessions (speech therapy, physiotherapy, occupational therapy) and 12 paralleled AAT sessions with comparable content. A total of 429 therapy sessions was analyzed consisting of 214 AAT and 215 control sessions. Attention span and instances of distraction were assessed via video coding in Noldus Observer. The Mehrdimensionaler Befindlichkeitsbogen ([Multidimensional Affect Rating Scale] MDBF questionnaire; Steyer, Schwenkmezger, Notz, & Eid, 1997) was used to measure the patient's self-rated alertness. Concentration was assessed through Visual Analogue Scale (VAS) via self-assessment and therapist's ratings. The patients' attention span did not differ whether an animal was present or not. However, patients displayed more instances of distraction during AAT. Moreover, patients rated themselves more concentrated and alert during AAT sessions. Further, therapists' evaluation of patients' concentration indicated that patients were more concentrated in AAT compared with the control condition. Although the patients displayed more instances of distraction while in the presence of an animal, it did not have a negative impact on their attention span. In addition, patients reported to be more alert and concentrated when an animal was present. Future studies should examine other attentional processes such as divided attention and include neurobiological correlates of attention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids

    DTIC Science & Technology

    2008-08-01

    SUBJECT TERMS Cancer therapy by localized immune response, Magneto -rehological Fluids 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT...Metastasized Breast Cancer by Localized Therapy utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit Evrensel...2008 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy utilizing

  17. Mainstreaming animal-assisted therapy.

    PubMed

    Palley, Lori S; O'Rourke, P Pearl; Niemi, Steven M

    2010-01-01

    The term animal-assisted therapy (AAT) commonly refers to the presentation of an animal to one or more persons for the purpose of providing a beneficial impact on human health or well-being. AAT is an ideal example of "One Health" because of numerous studies and widespread testimonials indicating that many humans feel better in the presence of pets and other domesticated animals, and, conversely, that some of those creatures appear to respond positively to human company for their emotional and perhaps physical betterment. Many AAT studies have claimed a wide range of human health benefits, but much of the research is characterized by small-scale interventions among disparate fields, resulting in criticisms about weak study design or inconsistent methodology. Such criticisms contrast with the strongly held belief among many that interaction with friendly animals has a strong and innate value for the persons involved. Consequently the appeal of AAT in human medicine today may be generally characterized as a "push" by enthusiastic advocates rather than a "pull" by prescribing physicians. To fully integrate AAT into conventional medical practice as an accepted therapeutic modality, more convincing intervention studies are necessary to confirm its clinical merits, along with an understanding of the underlying mechanism of the human response to the company of friendly animals.

  18. Exploring the Impact of an Animal Assisted Therapy Dog upon the Emotional, Educational, and Social Actualization of Middle School Students Receiving Counseling Services

    ERIC Educational Resources Information Center

    Jenkins, Christie D.

    2009-01-01

    The purpose of this study was to examine animal assisted therapy (AAT) in the school setting. This study reviewed the potential social, emotional, and educational benefits that children and adolescents may gain from utilizing an animal assisted therapy dog. This study utilized The Relationship Inventory and The AAT (Animal Assisted Therapy)…

  19. Animal-Assisted Therapy for Post-traumatic Stress Disorder: Lessons from "Case Reports" in Media Stories.

    PubMed

    Altschuler, Eric L

    2018-01-01

    Post-traumatic stress disorder (PTSD) can follow war trauma, sexual abuse, other traumas, and even be experienced by commanders for the PTSD of their subordinates. Medications and counseling are sometimes not effective, so new treatments are needed. Some years ago, I suggested that animal-assisted therapy (AAT) (pet therapy) might be beneficial for PTSD. A large randomized controlled trial is underway of canine-assisted therapy for PTSD. Randomized controlled trials are most useful in assessing the efficacy of a medical intervention as these trials control for known and unknown biases. However, due to their very nature and rigorous requirements, knowledge gained from randomized controlled trials may need to be supplemented from other kinds of studies. Here, I note that media reports of AAT for PTSD may effectively function as case reports and suggest further studies: For PTSD, these demonstrate that (1) AAT can be dramatically effective in improving PTSD symptoms; (2) there is the potential for benefit from AAT by multiple different animals besides canines for PTSD; and (3) AAT may have a role in preventing suicide in patients with PTSD. © Association of Military Surgeons of the United States 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Alpha 1 antitrypsin to treat lung disease in alpha 1 antitrypsin deficiency: recent developments and clinical implications.

    PubMed

    Chapman, Kenneth R; Chorostowska-Wynimko, Joanna; Koczulla, A Rembert; Ferrarotti, Ilaria; McElvaney, Noel G

    2018-01-01

    Alpha 1 antitrypsin deficiency is a hereditary condition characterized by low alpha 1 proteinase inhibitor (also known as alpha 1 antitrypsin [AAT]) serum levels. Reduced levels of AAT allow abnormal degradation of lung tissue, which may ultimately lead to the development of early-onset emphysema. Intravenous infusion of AAT is the only therapeutic option that can be used to maintain levels above the protective threshold. Based on its biochemical efficacy, AAT replacement therapy was approved by the US Food and Drug administration in 1987. However, there remained considerable interest in selecting appropriate outcome measures that could confirm clinical efficacy in a randomized controlled trial setting. Using computed tomography as the primary measure of decline in lung density, the capacity for intravenously administered AAT replacement therapy to slow and modify the course of disease progression was demonstrated for the first time in the Randomized, Placebo-controlled Trial of Augmentation Therapy in Alpha-1 Proteinase Inhibitor Deficiency (RAPID) trial. Following these results, an expert review forum was held at the European Respiratory Society to discuss the findings of the RAPID trial program and how they may change the landscape of alpha 1 antitrypsin emphysema treatment. This review summarizes the results of the RAPID program and the implications for clinical considerations with respect to diagnosis, treatment and management of emphysema due to alpha 1 antitrypsin deficiency.

  1. Animal-assisted therapy for dementia: a review of the literature.

    PubMed

    Filan, Susan L; Llewellyn-Jones, Robert H

    2006-12-01

    Animal-assisted therapy (AAT) is gaining popularity as part of therapy programs in residential aged care facilities. Humans and pet dogs respond to quiet interaction with a lowering of blood pressure and an increase in neurochemicals associated with relaxation and bonding. These effects may be of benefit in ameliorating behavioral and psychological symptoms of dementia (BPSD). Medline, PsychInfo and CINAHL databases (1960-2005) were searched for papers on AAT or pets and dementia. Publications of controlled trials that measured the effect of AAT for dementia were reviewed. Several small studies suggest that the presence of a dog reduces aggression and agitation, as well as promoting social behavior in people with dementia. One study has shown that aquaria in dining rooms of dementia care units stimulate residents to eat more of their meals and to gain weight but is limited by the small number of facilities studied. There is preliminary evidence that robotic pets may provide pleasure and interest to people with dementia. Current literature suggests that AAT may ameliorate BPSD, but the duration of the beneficial effect has not been explored. The relative benefits of "resident" versus "visiting" pet dogs are unclear and are confounded by the positive effect of pet interaction on staff or caregivers. Further research on the potential benefits of AAT is recommended.

  2. Animal-Assisted Therapies for Youth with or at risk for Mental Health Problems: A Systematic Review.

    PubMed

    Hoagwood, Kimberly Eaton; Acri, Mary; Morrissey, Meghan; Peth-Pierce, Robin

    2017-01-01

    To systematically review experimental evidence about animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000-2015, and compared studies by animal type, intervention, and outcomes. Studies were included if used therapeutically for children and adolescents (≤21 years) with or at risk for a mental health problem; used random assignment or a waitlist comparison/control group; and included child-specific outcome data. Of 1,535 studies, 24 met inclusion criteria. Of 24 studies identified, almost half were randomized controlled trials, with 9 of 11 published in the past two years. The largest group addresses equine therapies for autism. Findings are generally promising for positive effects associated with equine therapies for autism and canine therapies for childhood trauma. The AAT research base is slim; a more focused research agenda is outlined.

  3. Efficacy of Animal-Assisted Therapy in Lowering Anxiety Symptoms of Adolescents in Schools

    ERIC Educational Resources Information Center

    Zents, Courtney E.

    2017-01-01

    Adolescence is marked by a period of stress with a portion of these individuals experiencing problems with anxiety. There are physical and psychological benefits of using animal-assisted therapy (AAT) for decreasing anxiety, however, the research on this is limited. The current study expands on the AAT literature by studying the additive effects…

  4. Impact of Animal Assisted Therapy Reading Instruction on Reading Performance of Homeschooled Students

    ERIC Educational Resources Information Center

    Smith, Kelly A.

    2010-01-01

    While animal assisted therapy (AAT) has been a successful part of treatment plans within the medical field for several decades, AAT has not been quantitatively researched as a viable instructional tool that can be used in conjunction with other reading intervention strategies. With over one-third of elementary school aged children experiencing…

  5. New advances in amblyopia therapy I: binocular therapies and pharmacologic augmentation.

    PubMed

    Kraus, Courtney L; Culican, Susan M

    2018-05-18

    Amblyopia therapy options have traditionally been limited to penalisation of the non-amblyopic eye with either patching or pharmaceutical penalisation. Solid evidence, mostly from the Pediatric Eye Disease Investigator Group, has validated both number of hours a day of patching and days per week of atropine use. The use of glasses alone has also been established as a good first-line therapy for both anisometropic and strabismic amblyopia. Unfortunately, visual acuity equalisation or even improvement is not always attainable with these methods. Additionally, non-compliance with prescribed therapies contributes to treatment failures, with data supporting difficulty adhering to full treatment sessions. Interest in alternative therapies for amblyopia treatment has long been a topic of interest among researchers and clinicians alike. Incorporating new technology with an understanding of the biological basis of amblyopia has led to enthusiasm for binocular treatment of amblyopia. Early work on perceptual learning as well as more recent enthusiasm for iPad-based dichoptic training have each generated interesting and promising data for vision improvement in amblyopes. Use of pharmaceutical augmentation of traditional therapies has also been investigated. Several different drugs with unique mechanisms of action are thought to be able to neurosensitise the brain and enhance responsiveness to amblyopia therapy. No new treatment has emerged from currently available evidence as superior to the traditional therapies in common practice today. But ongoing investigation into the use of both new technology and the understanding of the neural basis of amblyopia promises alternate or perhaps better cures in the future. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. A pilot study of cognitive behaviour therapy for panic disorder augmented by panic surfing.

    PubMed

    Lamplugh, Claire; Berle, David; Milicevic, Denise; Starcevic, Vladan

    2008-01-01

    This pilot study reports the outcome of cognitive behaviour therapy for panic disorder augmented by panic surfing. This treatment approach encourages acceptance of feelings rather than control of symptoms and anxiety, at the same time also targeting catastrophic misinterpretations, bodily vigilance and safety-seeking behaviours. Eighteen participants completed a brief group treatment for panic disorder incorporating psychoeducation, panic surfing, interoceptive exposure, graded exposure and cognitive restructuring. Significant improvements occurred over the course of this treatment and were maintained at a 1-month follow-up. Results suggest that cognitive behaviour therapy augmented by panic surfing may be effective in the treatment of panic disorder, but there is a need for controlled studies and investigation of the relative contribution of its various components. 2008 John Wiley & Sons, Ltd.

  7. D-Cycloserine Augmentation of Cognitive Behavioral Group Therapy of Social Anxiety Disorder: Prognostic and Prescriptive Variables

    PubMed Central

    Smits, Jasper A. J.; Hofmann, Stefan G.; Rosenfield, David; DeBoer, Lindsey B.; Costa, Paul T.; Simon, Naomi M.; O'Cleirigh, Conall; Meuret, Alicia E.; Marques, Luana; Otto, Michael W.; Pollack, Mark H.

    2014-01-01

    Objective The aim of the current study was to identify individual characteristics that (1) predict symptom improvement with group cognitive behavioral therapy (CBT) for social anxiety disorder (SAD; i.e., prognostic variables) or (2) moderate the effects of d-cycloserine vs. placebo augmentation of CBT for SAD (i.e., prescriptive variables). Method Adults with SAD (N=169) provided Liebowitz Social Anxiety Scale (LSAS) scores in a trial evaluating DCS augmentation of group CBT. Rate of symptom improvement during therapy and posttreatment symptom severity were evaluated using multilevel modeling. As predictors of these two parameters, we selected the range of variables assessed at baseline (demographic characteristics, clinical characteristics, personality traits). Using step-wise analyses, we first identified prognostic and prescriptive variables within each of these domains and then entered these significant predictors simultaneously in one final model. Results African American ethnicity and cohabitation status were associated with greater overall rates of improvement during therapy and lower posttreatment severity. Higher initial severity was associated with a greater improvement during therapy, but also higher posttreatment severity (the greater improvement was not enough to overcome the initial higher severity). D-cycloserine augmentation was evident only among individuals low in conscientiousness and high in agreeableness. Conclusions African American ethnicity, cohabitation status, and initial severity are prognostic of favorable CBT outcomes in SAD. D-cycloserine augmentation appears particularly useful for patients low in conscientiousness and high in agreeableness. These findings can guide clinicians in making decisions about treatment strategies and can help direct research on the mechanisms of these treatments. PMID:23937345

  8. Attention bias modification augments cognitive-behavioral group therapy for social anxiety disorder: a randomized controlled trial.

    PubMed

    Lazarov, Amit; Marom, Sofi; Yahalom, Naomi; Pine, Daniel S; Hermesh, Haggai; Bar-Haim, Yair

    2017-12-20

    Cognitive-behavioral group therapy (CBGT) is a first-line treatment for social anxiety disorder (SAD). However, since many patients remain symptomatic post-treatment, there is a need for augmenting procedures. This randomized controlled trial (RCT) examined the potential augmentation effect of attention bias modification (ABM) for CBGT. Fifty patients with SAD from three therapy groups were randomized to receive an 18-week standard CBGT with either ABM designed to shift attention away from threat (CBGT + ABM), or a placebo protocol not designed to modify threat-related attention (CBGT + placebo). Therapy groups took place in a large mental health center. Clinician and self-report measures of social anxiety and depression were acquired pre-treatment, post-treatment, and at 3-month follow-up. Attention bias was assessed at pre- and post-treatment. Patients randomized to the CBGT + ABM group, relative to those randomized to the CBGT + placebo group, showed greater reductions in clinician-rated SAD symptoms post-treatment, with effects maintained at 3-month follow-up. Group differences were not evident for self-report or attention-bias measures, with similar reductions in both groups. Finally, reduction in attention bias did not mediate the association between group and reduction in Liebowitz Social Anxiety Scale Structured Interview (LSAS) scores. This is the first RCT to examine the possible augmenting effect of ABM added to group-based cognitive-behavioral therapy for adult SAD. Training patients' attention away from threat might augment the treatment response to standard CBGT in SAD, a possibility that could be further evaluated in large-scale RCTs.

  9. Animal-Assisted Therapy in Elderly Patients: Evidence and Controversies in Dementia and Psychiatric Disorders and Future Perspectives in Other Neurological Diseases.

    PubMed

    Peluso, Silvio; De Rosa, Anna; De Lucia, Natascia; Antenora, Antonella; Illario, Maddalena; Esposito, Marcello; De Michele, Giuseppe

    2018-01-01

    Animal-assisted therapy (AAT) includes a set of nonpharmacological interventions aimed at improving human health through the use of trained or untrained animals. In recent decades, AAT has been trialed for different neurological and psychiatric disorders. In patients with dementia, interaction with animals seems to have a positive influence on aggressiveness and anxiety and to ameliorate quality of life and relationship skills. In psychiatric patients, AAT seems to increase motivation and self-esteem, improve prosocial conduct, and decrease behavioral problems. The aim of this study is to review the literature on AAT for elderly people with dementia and psychiatric disorders. Other fields of possible application for AAT are suggested.

  10. Assisted therapy with dogs in cancer services.

    PubMed

    2017-06-12

    Background [Figure: see text] Healthcare professionals are keen to find alternative therapies to reduce the stress of hospital admissions, especially in the treatment of cancer. Animal-assisted therapy (AAT) involves using animals to help improve patients' health and well-being, and can alleviate stressful situations.

  11. Animal-Assisted Therapies for Youth with or at Risk for Mental Health Problems: A Systematic Review

    ERIC Educational Resources Information Center

    Hoagwood, Kimberly Eaton; Acri, Mary; Morrissey, Meghan; Peth-Pierce, Robin

    2017-01-01

    To systematically review experimental evidence regarding animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000-2015, and compared studies by animal type, intervention, and outcomes. Studies were included if used therapeutically for…

  12. Research on benefits of canine-assisted therapy for adults in nonmilitary settings.

    PubMed

    Knisely, Janet S; Barker, Sandra B; Barker, Randolph T

    2012-01-01

    Research has examined the physiological and psychosocial impact of animal-assisted activities (AAA) and animal-assisted therapy (AAT). The current review article summarizes the benefits of AAA and AAT for hospitalized patients with medical disorders, psychiatric patients, and residents of nursing homes and long-term care facilities. The literature regarding inclusion of animals in business and organizational settings is also reviewed. Although there is clear evidence of improved physical and psychological health from AAA and AAT in the civilian population, there is a dearth of published findings of the evaluation of such benefits for military personnel.

  13. Impact of a Health Management Program on Healthcare Outcomes among Patients on Augmentation Therapy for Alpha 1-Antitrypsin Deficiency: An Insurance Claims Analysis.

    PubMed

    Campos, Michael A; Runken, Michael C; Davis, Angela M; Johnson, Michael P; Stone, Glenda A; Buikema, Ami R

    2018-04-01

    Alpha 1-antitrypsin deficiency (AATD) is a genetic disorder which reduces serum alpha 1-antitrypsin (AAT or alpha1-proteinase inhibitor, A1PI) and increases the risk of chronic obstructive pulmonary disease (COPD). Management strategies include intravenous A1PI augmentation, and, in some cases, a health management program (Prolastin Direct ® ; PD). This study compared clinical and economic outcomes between patients with and without PD program participation. This retrospective study included commercial and Medicare Advantage health insurance plan members with ≥ 1 claim with diagnosis codes for COPD and ≥ 1 medical or pharmacy claim including A1PI (on index date). Outcomes were compared between patients receiving only Prolastin ® or Prolastin ® -C (PD cohort) and patients who received a different brand without PD (Comparator cohort). Demographic and clinical characteristics were captured during 6 months pre-index. Post-index exacerbation episodes and healthcare utilization and costs were compared between cohorts. The study sample comprised 445 patients (n = 213 in PD cohort; n = 232 in Comparator cohort), with a mean age 55.5 years, 50.8% male, and 78.9% commercially insured. The average follow-up was 822 days (2.25 years), and the average time on A1PI was 747 days (2.04 years). Few differences were observed in demographic or clinical characteristics. Adjusting for differences in patient characteristics, the rate of severe exacerbation episodes was reduced by 36.1% in the PD cohort. Adjusted total annual all-cause costs were 11.4% lower, and adjusted mean respiratory-related costs were 10.6% lower in the PD cohort than the Comparator cohort. Annual savings in all-cause total costs in the PD cohort relative to the Comparator cohort was US$25,529 per patient, largely due to significantly fewer and shorter hospitalizations. These results suggest that comprehensive health management services may improve both clinical and economic outcomes among

  14. Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

    PubMed

    Key, Brenda L; Rowa, Karen; Bieling, Peter; McCabe, Randi; Pawluk, Elizabeth J

    2017-09-01

    A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from

  15. Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia.

    PubMed

    Richeson, Nancy E

    2003-01-01

    The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a pilot study, 15 nursing home residents with dementia participated in a daily AAT intervention for three weeks. Results showed statistically significant decreases in agitated behaviors and a statistically significant increase in social interaction pretest to post-test.

  16. Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids. Addendum

    DTIC Science & Technology

    2009-08-01

    Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit A. Evrensel...AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible... Magneto -rheological Fluid (MRF) iron nano-particles were synthesized using the reverse micelle technique and coated with poly(NIPAAm). The size

  17. Enhancing human-animal relationships through veterinary medical instruction in animal-assisted therapy and animal-assisted activities.

    PubMed

    Schaffer, Caroline Brunsman

    2008-01-01

    Instruction in animal-assisted therapy (AAT) and animal-assisted activities (AAAs) teaches veterinary medical students to confidently and assertively maximize the benefits and minimize the risks of this union of animals and people. Instruction in AAT/AAA also addresses requirements by the American Veterinary Medical Association Council on Education that accredited schools/colleges of veterinary medicine include in their standard curriculum the topics of the human-animal bond, behavior, and the contributions of the veterinarian to the overall public and professional health care teams. Entry-level veterinarians should be prepared to: (1) assure that animals who provide AAT/AAA are healthy enough to visit nursing homes, hospitals, or other institutions; (2) promote behavior testing that selects animals who will feel safe, comfortable, and connected; (3) advise facilities regarding infection control and ways to provide a safe environment where the animals, their handlers, and the people being visited will not be injured or become ill; and (4) advocate for their patients and show compassion for their clients when animals are determined to be inappropriate participants in AAT/AAA programs. This article presents AAT/AAA terminology, ways in which veterinarians can advocate for AAT/AAA, the advantages of being involved in AAT/AAA, a model AAT/AAA practicum from Tuskegee University's School of Veterinary Medicine (TUSVM), and examples of co-curricular activities in AAT/AAA by TUSVM's student volunteers.

  18. D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel A.; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.

    2010-01-01

    This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine (DCS), to augment cognitive-behavioral therapy (CBT) for anxiety disorders. The literature on behavioral theory of exposure-based therapies is provided, followed by a discussion of the role of DCS in enhancing extinction…

  19. Natural healers: a review of animal assisted therapy and activities as complementary treatment for chronic conditions.

    PubMed

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

    The primary objective of this review is to synthesize the existing literature on the use of animal-assisted therapy and activity (AAT/A) as complementary treatment among people living with chronic disease and to discuss the possible application of this practice among children living with HIV. Relevant databases were searched between March 10 and April 11, 2011, using the words: animal assisted therapy or treatment and chronic conditions or diseases. Thirty-one articles were found and 18 followed the inclusion and exclusion criteria. Research suggests that AAT/A is effective for different patient profiles, particularly children. Interaction with dogs has been found to increase positive behaviors, such as sensitivity and focus, in children with social disabilities. Decreased levels of pain have also been reported among child patients as a result of AAT/A. More research should be done in the area of children living with chronic diseases that require strict adherence to treatment, such as HIV, and on AAT/A's prospective use as an educational tool to teach children about the importance of self-care for their medical conditions.

  20. First light results from the HERMES spectrograph at the AAT

    NASA Astrophysics Data System (ADS)

    Sheinis, Andrew I.

    2016-08-01

    The High Efficiency and Resolution Multi Element Spectrograph, HERMES is a facility-class optical spectrograph for the AAT. It is designed primarily for Galactic Archeology, the first major attempt to create a detailed understanding of galaxy formation and evolution by studying the history of our own galaxy, the Milky Way. The goal of the Galactic Archeology with Hermes (GALAH) survey is to reconstruct the mass assembly history of the Milky Way, through a detailed spatially tagged abundance study of one million stars. The spectrograph is based at the Anglo Australian Telescope (AAT) and is fed by the existing 2dF robotic fiber positioning system. The spectrograph uses VPH-gratings to achieve a spectral resolving power of 28,000 in standard mode and also provides a high-resolution mode ranging between 40,000 to 50,000 using a slit mask. The GALAH survey requires a SNR greater than 100 for a star brightness of V=14. The total spectral coverage of the four channels is about 100nm between 370 and 1000nm for up to 392 simultaneous targets within the 2- degree field of view. Hermes was commissioned in late 2013, with the GALAH Pilot starting in parallel with the commissioning. The GALAH survey started in early 2014 is currently about 33% complete. We present a description of the motivating science; an overview the instrument; and a status report on GALAH Survey.

  1. Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior.

    PubMed

    Nurenberg, Jeffry R; Schleifer, Steven J; Shaffer, Thomas M; Yellin, Mary; Desai, Prital J; Amin, Ruchi; Bouchard, Axel; Montalvo, Cristina

    2015-01-01

    Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

  2. Combination therapy utilizing shRNA knockdown and an optimized resistant transgene for rescue of diseases caused by misfolded proteins.

    PubMed

    Li, Chengwen; Xiao, Pingjie; Gray, Steven James; Weinberg, Marc Scott; Samulski, R Jude

    2011-08-23

    Molecular knockdown of disease proteins and restoration of wild-type activity represent a promising but challenging strategy for the treatment of diseases that result from the accumulation of misfolded proteins (i.e., Huntington disease, amyotrophic lateral sclerosis, and α-1 antitrypsin deficiency). In this study we used alpha-1 antitrypsin (AAT) deficiency with the piZZ mutant phenotype as a model system to evaluate the efficiency of gene-delivery approaches that both silence the piZZ transcript (e.g., shRNA) and restore circulating wild-type AAT expression from resistant codon-optimized AAT (AAT-opt) transgene cassette using adeno-associated virus (AAV) vector delivery. After systemic injection of a self-complimentary AAV serotype 8 (scAAV8) vector encoding shRNA in piZZ transgenic mice, both mutant AAT mRNA in the liver and defected serum protein level were inhibited by 95%, whereas liver pathology, as monitored by dPAS and fibrosis staining, reversed. To restore blood AAT levels in AAV8/shRNA-treated mice, several strategies to restore functional AAT levels were tested, including using AAV AAT-opt transgene cassettes targeted to muscle and liver, or combination vectors carrying piZZ shRNA and AAT-opt transgenes separately, or a single bicistronic AAV vector. With these molecular approaches, we observed over 90% knockdown of mutant AAT with a 13- to 30-fold increase of circulating wild-type AAT protein from the shRNA-resistant AAT-opt cassette. The molecular approaches applied in this study can simultaneously prevent liver pathology and restore blood AAT concentration in AAT deficiencies. Based on these observations, similar gene-therapy strategies could be considered for any diseases caused by accumulation of misfolded proteins.

  3. Animal-assisted therapy with children suffering from insecure attachment due to abuse and neglect: a method to lower the risk of intergenerational transmission of abuse?

    PubMed

    Parish-Plass, Nancy

    2008-01-01

    Children suffering from insecure attachment due to severe abuse and/or neglect are often characterized by internal working models which, although perhaps adaptive within the original family situation, are inappropriate and maladaptive in other relationships and situations. Such children have a higher probability than the general population of becoming abusing or neglecting parents. Besides the usual goals of psychotherapy, an overall goal is to stop the cycle of abuse in which abused children may grow up to be abusing parents. Therapy with these children is complicated by their distrust in adults as well as difficulties in symbolization due to trauma during the preverbal stage. Animal-Assisted Therapy (AAT) provides avenues for circumventing these difficulties, as well as providing additional tools for reaching the inner world of the client. This article gives a brief background of the connection between insecure attachment and intergenerational transmission of abuse and neglect as well as a brief overview of the principles of AAT in a play therapy setting. A rationale for the use of AAT as a unique therapy technique for children having suffered from abuse and neglect is followed by a number of clinical examples illustrating AAT.

  4. Helping Children with Disabilities through Animal-Assisted Therapy

    ERIC Educational Resources Information Center

    Watts, Katie; Everly, Janet Stout

    2009-01-01

    The Delta Society defines animal-assisted therapy as "a goal-directed intervention in which an animal is incorporated as an integral part of the clinical healthcare treatment process." Unlike other animal-assisted activities, animal-assisted therapy, or AAT, is led by a professional such as a physical therapist, occupational therapist,…

  5. Antacid Therapy and Disease Progression in Patients with Idiopathic Pulmonary Fibrosis Who Received Pirfenidone.

    PubMed

    Kreuter, Michael; Spagnolo, Paolo; Wuyts, Wim; Renzoni, Elisabetta; Koschel, Dirk; Bonella, Francesco; Maher, Toby M; Kolb, Martin; Weycker, Derek; Kirchgässler, Klaus-Uwe; Costabel, Ulrich

    2017-01-01

    Gastroesophageal reflux disease is a potential risk factor for idiopathic pulmonary fibrosis (IPF) progression; however, the impact of antacid therapy (AAT) is under debate. To evaluate the effect of AAT on IPF progression in pirfenidone-treated patients. This post hoc analysis included patients with IPF who received pirfenidone in 3 trials (CAPACITY [PIPF-004/PIPF-006] and ASCEND [PIPF-016]). Pulmonary function, exercise tolerance, survival, hospitalizations, and adverse events (AEs) over 52 weeks were analyzed by baseline AAT use. Disease progression was defined as a decrease in forced vital capacity (FVC) of ≥10%, a decrease in 6-min walking distance of ≥50 m, or death over 1 year. Of 623 patients, 44% received AAT. No significant differences were found at 52 weeks (AAT versus non-AAT, respectively) in disease progression (24.9 vs. 30.6%; p = 0.12), all-cause mortality rate (2.9 vs. 4.0%; p = 0.47), IPF-related mortality rate (1.1 vs. 2.0%; p = 0.37), all-cause hospitalization rate (16.1 vs. 18.3%; p = 0.48), or mean change in percent FVC (-2.7 vs. -3.1%; p = 0.44). A relative, but not absolute, FVC decline of ≥10% favored AAT (15 vs. 22%; p = 0.03). Severe gastrointestinal AEs (3.7 vs. 0.9%; p = 0.015) and severe pulmonary infections (3.7 vs. 1.1%; p = 0.035) were more frequent with AAT. AAT and pirfenidone had outcomes comparable to those of pirfenidone alone in patients with IPF, underscoring the need for prospective trials to elucidate the role of AAT with or without antifibrotic drugs as a treatment for IPF. © 2017 The Author(s) Published by S. Karger AG, Basel.

  6. First light results from the Hermes spectrograph at the AAT

    NASA Astrophysics Data System (ADS)

    Sheinis, Andrew; Barden, Sam; Birchall, Michael; Carollo, Daniela; Bland-Hawthorn, Joss; Brzeski, Jurek; Case, Scott; Cannon, Russell; Churilov, Vladimir; Couch, Warrick; Dean, Robert; De Silva, Gayandhi; D'Orazi, Valentina; Farrell, Tony; Fiegert, Kristin; Freeman, Kenneth; Frost, Gabriella; Gers, Luke; Goodwin, Michael; Gray, Doug; Heald, Ron; Heijmans, Jeroen; Jones, Damien; Keller, Stephan; Klauser, Urs; Kondrat, Yuriy; Lawrence, Jon; Lee, Steve; Mali, Slavko; Martell, Sarah; Mathews, Darren; Mayfield, Don; Miziarski, Stan; Muller, Rolf; Pai, Naveen; Patterson, Robert; Penny, Ed; Orr, David; Shortridge, Keith; Simpson, Jeffrey; Smedley, Scott; Smith, Greg; Stafford, Darren; Staszak, Nicholas; Vuong, Minh; Waller, Lewis; Wylie de Boer, Elizabeth; Xavier, Pascal; Zheng, Jessica; Zhelem, Ross; Zucker, Daniel

    2014-07-01

    The High Efficiency and Resolution Multi Element Spectrograph, HERMES is an facility-class optical spectrograph for the AAT. It is designed primarily for Galactic Archeology [21], the first major attempt to create a detailed understanding of galaxy formation and evolution by studying the history of our own galaxy, the Milky Way. The goal of the GALAH survey is to reconstruct the mass assembly history of the of the Milky Way, through a detailed spatially tagged abundance study of one million stars. The spectrograph is based at the Anglo Australian Telescope (AAT) and is fed by the existing 2dF robotic fiber positioning system. The spectrograph uses VPH-gratings to achieve a spectral resolving power of 28,000 in standard mode and also provides a high-resolution mode ranging between 40,000 to 50,000 using a slit mask. The GALAH survey requires a SNR greater than 100 for a star brightness of V=14. The total spectral coverage of the four channels is about 100nm between 370 and 1000nm for up to 392 simultaneous targets within the 2 degree field of view. Hermes has been commissioned over 3 runs, during bright time in October, November and December 2013, in parallel with the beginning of the GALAH Pilot survey starting in November 2013. In this paper we present the first-light results from the commissioning run and the beginning of the GALAH Survey, including performance results such as throughput and resolution, as well as instrument reliability. We compare the abundance calculations from the pilot survey to those in the literature.

  7. Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial.

    PubMed

    Hermanides, J; Nørgaard, K; Bruttomesso, D; Mathieu, C; Frid, A; Dayan, C M; Diem, P; Fermon, C; Wentholt, I M E; Hoekstra, J B L; DeVries, J H

    2011-10-01

    To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with Type 1 diabetes (40 women) currently treated with multiple daily injections, age 18-65 years and HbA(1c) ≥ 8.2% (≥ 66 mmol/mol) to 26 weeks of treatment with either a sensor-augmented insulin pump (n = 44) (Paradigm(®) REAL-Time) or continued with multiple daily injections (n = 39). Change in HbA(1c) between baseline and 26 weeks, sensor-derived endpoints and patient-reported outcomes were assessed. The trial was completed by 43/44 (98%) patients in the sensor-augmented insulin pump group and 35/39 (90%) patients in the multiple daily injections group. Mean HbA(1c) at baseline and at 26 weeks changed from 8.46% (SD 0.95) (69 mmol/mol) to 7.23% (SD 0.65) (56 mmol/mol) in the sensor-augmented insulin pump group and from 8.59% (SD 0.82) (70 mmol/mol) to 8.46% (SD 1.04) (69 mmol/mol) in the multiple daily injections group. Mean difference in change in HbA(1c) after 26 weeks was -1.21% (95% confidence interval -1.52 to -0.90, P < 0.001) in favour of the sensor-augmented insulin pump group. This was achieved without an increase in percentage of time spent in hypoglycaemia: between-group difference 0.0% (95% confidence interval -1.6 to 1.7, P = 0.96). There were four episodes of severe hypoglycaemia in the sensor-augmented insulin pump group and one episode in the multiple daily injections group (P = 0.21). Problem Areas in Diabetes and Diabetes Treatment Satisfaction Questionnaire scores improved in the sensor-augmented insulin pump group. Sensor augmented pump therapy effectively lowers HbA(1c) in patients with Type 1 diabetes suboptimally controlled with multiple daily injections. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  8. Why Animal Assisted Therapy Is Important for Children and Youth

    ERIC Educational Resources Information Center

    Pitts, John L.

    2005-01-01

    Animal Assisted Therapy (AAT) and Activities (AAA) have become well established in traditional physiological and psychological medicine in North America. While positive animal interaction is nothing new (Egyptian, Greek, Roman, many eastern and western cultures), the beneficial calming effects of therapy have only been well documented in the…

  9. Caffeine Sodium Benzoate for Electroconvulsive Therapy Augmentation.

    PubMed

    Bozymski, Kevin M; Potter, Teresa G; Venkatachalam, Vasu; Pandurangi, Ananda K; Crouse, Ericka L

    2018-05-15

    Because of an ongoing manufacturer shortage of injectable caffeine sodium benzoate (CSB), patients at our health system were given CSB compounded in-house to increase seizure response during electroconvulsive therapy (ECT). Therefore, we aimed to evaluate its effectiveness and safety as an ECT augmentation agent. Medical records of patients who received compounded CSB at Virginia Commonwealth University Health System were reviewed to identify adults receiving it as part of an index ECT treatment course between June 2012 and December 2016. The primary outcome was change in electroencephalogram seizure duration from pre-caffeine session to initial caffeine session. Data were also collected on demographics, motor seizure duration, maximum heart rate, mean arterial pressure, and concurrent medication use for these sessions and the last caffeine session. Seven-one patients were included in the study, predominantly white females with a mean age of 58.6 years. The most common indication for ECT was major depressive disorder resistant to pharmacotherapy (71.8%), followed by catatonia associated with another mental disorder (19.7%). Electroencephalogram seizure duration increased by 24.1 seconds on average with first CSB use (P < 0.0001), allowing 24 more patients overall to achieve goal of at least 30 seconds (P < 0.0001). No clinically significant changes in maximum heart rate or mean arterial pressure were observed, nor did any patients require an abortive agent for prolonged seizure. Five patients (7%) discontinued CSB prematurely: 4 related to adverse effects and 1 secondary to ineffectiveness. We confirm results of prior studies of the utility of CSB and add that compounded CSB is effective for ECT augmentation, maintaining effectiveness throughout the index course with minimal safety concerns.

  10. The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes.

    PubMed

    Linder, Deborah E; Mueller, Megan K; Gibbs, Debra M; Siebens, Hannah C; Freeman, Lisa M

    Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.

  11. GNOSIS: a novel near-infrared OH suppression unit at the AAT

    NASA Astrophysics Data System (ADS)

    Trinh, C. Q.; Ellis, S. C.; Lawrence, J. S.; Horton, A. J.; Bland-Hawthorn, J.; Leon-Saval, S. G.; Bryant, J.; Case, S.; Colless, M.; Couch, W.; Freeman, K.; Gers, L.; Glazebrook, K.; Haynes, R.; Lee, S.; Löhmannsröben, H.-G.; Miziarski, S.; O'Byrne, J.; Rambold, W.; Roth, M. M.; Schmidt, B.; Shortridge, K.; Smedley, S.; Tinney, C. G.; Xavier, P.; Zheng, J.

    2012-09-01

    GNOSIS has provided the first on-telescope demonstration of a concept to utilize complex aperioidc fiber Bragg gratings to suppress the 103 brightest atmospheric hydroxyl emission doublets between 1.47-1.7 μm. The unit is designed to be used at the 3.9-meter Anglo-Australian Telescope (AAT) feeding the IRIS2 spectrograph. Unlike previous atmospheric suppression techniques GNOSIS suppresses the lines before dispersion. We present the results of laboratory and on-sky tests from instrument commissioning. These tests reveal excellent suppression performance by the gratings and high inter-notch throughput, which combine to produce high fidelity OH-free spectra.

  12. A cost-effectiveness analysis of sensor-augmented insulin pump therapy and automated insulin suspension versus standard pump therapy for hypoglycemic unaware patients with type 1 diabetes.

    PubMed

    Ly, Trang T; Brnabic, Alan J M; Eggleston, Andrew; Kolivos, Athena; McBride, Margaret E; Schrover, Rudolf; Jones, Timothy W

    2014-07-01

    To assess the cost-effectiveness of sensor-augmented insulin pump therapy with "Low Glucose Suspend" (LGS) functionality versus standard pump therapy with self-monitoring of blood glucose in patients with type 1 diabetes who have impaired awareness of hypoglycemia. A clinical trial-based economic evaluation was performed in which the net costs and effectiveness of the two treatment modalities were calculated and expressed as an incremental cost-effectiveness ratio (ICER). The clinical outcome of interest for the evaluation was the rate of severe hypoglycemia in each arm of the LGS study. Quality-of-life utility scores were calculated using the three-level EuroQol five-dimensional questionnaire. Resource use costs were estimated using public sources. After 6 months, the use of sensor-augmented insulin pump therapy with LGS significantly reduced the incidence of severe hypoglycemia compared with standard pump therapy (incident rate difference 1.85 [0.17-3.53]; P = 0.037). Based on a primary randomized study, the ICER per severe hypoglycemic event avoided was $18,257 for all patients and $14,944 for those aged 12 years and older. Including all major medical resource costs (e.g., hospital admissions), the ICERs were $17,602 and $14,289, respectively. Over the 6-month period, the cost per quality-adjusted life-year gained was $40,803 for patients aged 12 years and older. Based on the Australian experience evaluating new interventions across a broad range of therapeutic areas, sensor-augmented insulin pump therapy with LGS may be considered a cost-effective alternative to standard pump therapy with self-monitoring of blood glucose in hypoglycemia unaware patients with type 1 diabetes. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Animal-assisted therapy with farm animals for persons with psychiatric disorders.

    PubMed

    Berget, Bente; Braastad, Bjarne O

    2011-01-01

    Animal-assisted therapy (AAT) with farm animals for humans with psychiatric disorders may reduce depression and state anxiety, and increase self-efficacy, in many participants. Social support by the farmer appears to be important. Positive effects are best documented for persons with affective disorders or clinical depression. Effects may sometimes take a long time to be detectable, but may occur earlier if the participants are encouraged to perform more complex working skills. Progress must however be individually adapted allowing for flexibility, also between days. Therapists involved with mental health show a pronounced belief in the effects of AAT with farm animals, variation being related to type of disorder, therapist's sex and his/her experience with AAT. Research is still scarce and further research is required to optimize and individually adapt the design of farm animal-assisted interventions.

  14. Hypothalamic-pituitary-thyroid system activity during lithium augmentation therapy in patients with unipolar major depression

    PubMed Central

    Bschor, Tom; Baethge, Christopher; Adli, Mazda; Lewitzka, Ute; Eichmann, Uta; Bauer, Michael

    2003-01-01

    Objective Lithium augmentation is an established strategy in the treatment of refractory depression, but little is known about predictors of response and its mode of action. There is increasing evidence that low thyroid function indices within the normal range are associated with a poorer treatment response to antidepressants, but previous studies on the hypothalamic-pituitary-thyroid (HPT) system during lithium augmentation provide inconclusive results and have methodological limitations. This study aimed at exploring the role of thyroid function in lithium augmentation and used a prospective design that included a homogeneous sample of inpatients with unipolar major depressive disorder. Methods In 24 euthyroid patients with a major depressive episode who had not responded to antidepressant monotherapy of at least 4 weeks, we measured serum thyroid-stimulating hormone (TSH), total triiodothyronine (T3) and total thyroxine (T4) before (baseline) and during lithium augmentation therapy (follow-up). The time point of the endocrinological follow-up depended on the status of response, which was assessed weekly with the Hamilton Depression Rating Scale, 17-item version (HDRS17). Responders were reassessed immediately after response was determined, and non-responders after 4 weeks of lithium augmentation. Results There was a statistically significant change in thyroid system activity during lithium augmentation, with an increase of TSH levels and a decrease of peripheral T3 and T4 levels. However, there were no differences in any of the HPT hormones between responders and non-responders at baseline or at follow-up. Conclusions The decrease of thyroid system activity during lithium treatment reflects the well-established “antithyroid” properties of lithium. However, it appears that thyroid status does not predict response to lithium augmentation in euthyroid patients before treatment. PMID:12790161

  15. Ambient Assistive Technologies (AAT): socio-technology as a powerful tool for facing the inevitable sociodemographic challenges?

    PubMed

    Schülke, Astrid M; Plischke, Herbert; Kohls, Niko B

    2010-06-07

    Due to the socio-demographic change in most developed western countries, elderly populations have been continuously increasing. Therefore, preventive and assistive systems that allow elderly people to independently live in their own homes as long as possible will become an economical if not ethical necessity. These respective technologies are being developed under the term "Ambient Assistive Technologies" (AAT). The EU-funded AAT-project Ambient Lighting Assistance for an Ageing Population (ALADIN) has established the long-term goal to create an adaptive system capable of improving the residential lighting conditions of single living elderly persons also aiming at supporting the preservation of their independence.Results of an earlier survey revealed that the elderly perceived their current lighting situation as satisfactory, whereas interviewers assessed in-house lighting as too dark and risk-laden. The overall results of ALADIN showed a significant increase in well-being from the baseline final testing with the new adaptive lighting system.Positive results for wellbeing and life quality suggest that the outcome effects may be attributed to the introduction of technology as well as to social contacts arising from participating in the study. The technological guidance of the study supervisors, in particular, may have produced a strong social reactivity effect that was first observed in the famous Hawthorne experiments in the 1930s. As older adults seem to benefit both from meaningful social contacts as well as assistive technologies, the question arises how assistive technology can be socially embedded to be able to maximize positive health effects. Therefore ethical guidelines for development and use of new assistive technologies for handicapped/older persons have to be developed and should be discussed with regard to their applicability in the context of AAT.

  16. Augmentation of the posterior maxilla: a proposed hierarchy of treatment selection.

    PubMed

    Fugazzotto, Paul A

    2003-11-01

    Literature is reviewed that discusses treatment results following Cauldwel Luc approach sinus augmentation therapy or osteotome sinus augmentation therapy, with and without simultaneous implant placement. A hierarchy of treatment selection for the augmentation of the posterior maxilla, based upon quantity and position of residual alveolar bone crestal to the floor of the sinus, is proposed.

  17. Automatic Adaptation of Basal Insulin Using Sensor-Augmented Pump Therapy.

    PubMed

    Herrero, Pau; Bondia, Jorge; Giménez, Marga; Oliver, Nick; Georgiou, Pantelis

    2018-03-01

    People with insulin-dependent diabetes rely on an intensified insulin regimen. Despite several guidelines, they are usually impractical and fall short in achieving optimal glycemic outcomes. In this work, a novel technique for automatic adaptation of the basal insulin profile of people with diabetes on sensor-augmented pump therapy is presented. The presented technique is based on a run-to-run control law that overcomes some of the limitations of previously proposed methods. To prove its validity, an in silico validation was performed. Finally, the artificial intelligence technique of case-based reasoning is proposed as a potential solution to deal with variability in basal insulin requirements. Over a period of 4 months, the proposed run-to-run control law successfully adapts the basal insulin profile of a virtual population (10 adults, 10 adolescents, and 10 children). In particular, average percentage time in target [70, 180] mg/dl was significantly improved over the evaluated period (first week versus last week): 70.9 ± 11.8 versus 91.1 ± 4.4 (adults), 46.5 ± 11.9 versus 80.1 ± 10.9 (adolescents), 49.4 ± 12.9 versus 73.7 ± 4.1 (children). Average percentage time in hypoglycemia (<70 mg/dl) was also significantly reduced: 9.7 ± 6.6 versus 0.9 ± 1.2 (adults), 10.5 ± 8.3 versus 0.83 ± 1.0 (adolescents), 10.9 ± 6.1 versus 3.2 ± 3.5 (children). When compared against an existing technique over the whole evaluated period, the presented approach achieved superior results on percentage of time in hypoglycemia: 3.9 ± 2.6 versus 2.6 ± 2.2 (adults), 2.9 ± 1.9 versus 2.0 ± 1.5 (adolescents), 4.6 ± 2.8 versus 3.5 ± 2.0 (children), without increasing the percentage time in hyperglycemia. The present study shows the potential of a novel technique to effectively adjust the basal insulin profile of a type 1 diabetes population on sensor-augmented insulin pump therapy.

  18. Restless legs syndrome augmentation among Japanese patients receiving pramipexole therapy: Rate and risk factors in a retrospective study

    PubMed Central

    Takahashi, Masayoshi; Nishida, Shingo; Nakamura, Masaki; Kobayashi, Mina; Matsui, Kentaro; Ito, Eiki; Usui, Akira; Inoue, Yuichi

    2017-01-01

    To investigate the rate of and risk factors for restless legs syndrome (RLS) augmentation in Japanese patients receiving pramipexole (PPX) treatment. Records of 231 consecutive patients with idiopathic RLS who received PPX therapy for more than one month in a single sleep disorder center were analyzed retrospectively. Augmentation was diagnosed based on the Max Planck Institute criteria; associated factors were identified by logistic regression analysis. Mean age at PPX initiation was 60.6 ± 14.9 years and mean treatment duration was 48.5 ± 26.4 months. Augmentation was diagnosed in 21 patients (9.1%). Daily PPX dose and treatment duration were significantly associated with augmentation. By analyzing the receiver operating characteristic curve, a PPX dose of 0.375 mg/day was found to be the optimal cut-off value for predicting augmentation. After stratifying patients according to PPX treatment duration, at median treatment duration of 46 months, optimal cut-off values for daily doses were 0.375 and 0.500 mg/day for <46 months and ≥46 months of treatment, respectively. The RLS augmentation with PPX treatment in Japanese patients was occurred at rate of 9.1%, being quite compatible with previously reported rates in Caucasian patients. The symptom could appear within a relatively short period after starting the treatment in possibly vulnerable cases even with a smaller drug dose. Our results support the importance of keeping doses of PPX low throughout the RLS treatment course to prevent augmentation. PMID:28264052

  19. Insulin Therapy Improves Adeno-Associated Virus Transduction of Liver and Skeletal Muscle in Mice and Cultured Cells.

    PubMed

    Carrig, Sean; Bijjiga, Enoch; Wopat, Mitchell J; Martino, Ashley T

    2016-11-01

    Adeno-associated virus (AAV) gene transfer is a promising treatment for genetic abnormalities. Optimal AAV vectors are showing success in clinical trials. Gene transfer to skeletal muscle and liver is being explored as a potential therapy for some conditions, that is, α 1 -antitrypsin (AAT) disorder and hemophilia B. Exploring approaches that enhance transduction of liver and skeletal muscle, using these vectors, is beneficial for gene therapy. Regulating hormones as an approach to improve AAV transduction is largely unexplored. In this study we tested whether insulin therapy improves liver and skeletal muscle gene transfer. In vitro studies demonstrated that the temporary coadministration (2, 8, and 24 hr) of insulin significantly improves AAV2-CMV-LacZ transduction of cultured liver cells and differentiated myofibers, but not of lung cells. In addition, there was a dose response related to this improved transduction. Interestingly, when insulin was not coadministered with the virus but given 24 hr afterward, there was no increase in the transgene product. Insulin receptor gene (INSR) expression levels were increased 5- to 13-fold in cultured liver cells and differentiated myofibers when compared with lung cells. Similar INSR gene expression profiles occurred in mouse tissues. Insulin therapy was performed in mice, using a subcutaneously implanted insulin pellet or a high-carbohydrate diet. Insulin treatment began just before intramuscular delivery of AAV1-CMV-schFIX or liver-directed delivery of AAV8-CMV-schFIX and continued for 28 days. Both insulin augmentation therapies improved skeletal muscle- and liver-directed gene transduction in mice as seen by a 3.0- to 4.5-fold increase in human factor IX (hFIX) levels. The improvement was observed even after the insulin therapy ended. Monitoring insulin showed that insulin levels increased during the brief period of rAAV delivery and during the entire insulin augmentation period (28 days). This study demonstrates

  20. Animal-assisted therapy and loneliness in nursing homes: use of robotic versus living dogs.

    PubMed

    Banks, Marian R; Willoughby, Lisa M; Banks, William A

    2008-03-01

    Loneliness is a common problem in long-term care facilities (LTCF) and previous work has shown that animal-assisted therapy (AAT) can to some degree reverse loneliness. Here, we compared the ability of a living dog (Dog) and a robotic dog (AIBO) to treat loneliness in elderly patients living in LTCF. In comparison with a control group not receiving AAT, both the Dog and AIBO groups had statistically significant improvements in their levels of loneliness. As measured by a modified Lexington Attachment to Pets Scale (MLAPS), residents showed high levels of attachment to both the dog and AIBO. Subscale analysis showed that the AIBO group scored lower than the living dog on "animal rights/animal welfare" but not on "general attachment" or "people substituting." However, MLAPS measures did not correlate with changes in loneliness, showing that attachment was not the mechanism by which AAT decreases loneliness. We conclude that interactive robotic dogs can reduce loneliness in residents of LTCF and that residents become attached to these robots. However, level of attachment does not explain the decrease in loneliness associated with AAT conducted with either a living or robotic dog.

  1. Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial.

    PubMed

    Kootker, Joyce A; Rasquin, Sascha M C; Lem, Frederik C; van Heugten, Caroline M; Fasotti, Luciano; Geurts, Alexander C H

    2017-04-01

    To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety poststroke. Multicenter, assessor-blinded, randomized controlled trial. Ambulatory rehabilitation setting. Patients who had a Hospital Anxiety and Depression Scale-depression subscale (HADS-D) score >7 at least 3 months poststroke (N=61). Participants were randomly allocated to either augmented CBT or computerized cognitive training (CCT). The CBT intervention was based on the principles of recognizing, registering, and altering negative thoughts and cognitions. CBT was augmented with goal-directed real-life activity training given by an occupational or movement therapist. HADS-D was the primary outcome, and measures of participation and quality of life were secondary outcomes. Outcome measurements were performed at baseline, immediately posttreatment, and at 4- and 8-month follow-up. Analysis was performed with linear mixed models using group (CBT vs CCT) as the between-subjects factor and time (4 assessments) as the within-subjects factor. Mixed model analyses showed a significant and persistent time effect for HADS-D (mean difference, -4.6; 95% confidence interval, -5.7 to -3.6; P<.001) and for participation and quality of life in both groups. There was no significant group × time effect for any of the outcome measures. Our augmented CBT intervention was not superior to CCT for the treatment of mood disorders after stroke. Future studies should determine whether both interventions are better than natural history. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. D-cycloserine as an augmentation strategy of cognitive behavioral therapy for social anxiety disorder

    PubMed Central

    Hofmann, Stefan G.; Smits, Jasper A. J.; Rosenfield, David; Simon, Naomi; Otto, Michael W.; Meuret, Alicia E.; Marques, Luana; Fang, Angela; Tart, Candyce; Pollack, Mark H.

    2014-01-01

    OBJECTIVE To test whether d-cycloserine, a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, augments and accelerates a full course of comprehensive cognitive behavioral therapy (CBT) in medication-free adults with generalized social anxiety disorder. METHOD A randomized placebo-controlled efficacy-study conducted at Boston University, Massachusetts General Hospital, and Southern Methodist University between 9/2007 and 12/2011 of 169 medication-free adults with generalized social anxiety disorder; 144 completed treatment, and 131 completed the follow-up assessments. Patients were randomized to receive 50 mg of d-cycloserine or placebo 1 hour before each of 5 exposure sessions that were part of a 12-session cognitive behavioral group treatment. Response and remission status was determined at baseline, throughout treatment, post-treatment, and at 1, 3, and 6-month follow-up assessments rated by assessors who were blind to treatment condition. RESULTS D-cycloserine-augmented and placebo-augmented CBT were associated with similar completion rates (87% and 82%), response rates (79.3% and 73.3%), and remission rates (34.5% and 24.4%) at post-treatment that were largely maintained at follow-up. Although d-cycloserine was associated with a 24–33% faster rate of improvement in symptom severity and remission rates relative to placebo during the 12-week treatment phase, the groups did not differ in response and remission rates. CONCLUSIONS D-cycloserine did not augment a full course of comprehensive CBT for social anxiety disorder. TRIAL REGISTRATION http://www.ClinicalTrials.gov, ID# NCT00633984, http://www.clinicaltrials.gov/ct2/show/NCT00633984 PMID:23599046

  3. Nanoenzyme-Augmented Cancer Sonodynamic Therapy by Catalytic Tumor Oxygenation.

    PubMed

    Zhu, Piao; Chen, Yu; Shi, Jianlin

    2018-04-24

    Ultrasound (US)-triggered sonodynamic therapy (SDT) can solve the critical issue of low tissue-penetrating depth of traditional phototriggered therapies, but the SDT efficacy is still not satisfactorily high in combating cancer at the current stage. Here we report on augmenting the SDT efficacy based on catalytic nanomedicine, which takes the efficient catalytic features of nanoenzymes to modulate the tumor microenvironment (TME). The multifunctional nanosonosensitizers have been successfully constructed by the integration of a MnO x component with biocompatible/biodegradable hollow mesoporous organosilica nanoparticles, followed by conjugation with protoporphyrin (as the sonosensitizer) and cyclic arginine-glycine-aspartic pentapeptide (as the targeting peptide). The MnO x component in the composite nanosonosensitizer acts as an inorganic nanoenzyme for converting the tumor-overexpressed hydrogen peroxide (H 2 O 2 ) molecules into oxygen and enhancing the tumor oxygen level subsequently, which has been demonstrated to facilitate SDT-induced reactive oxygen species production and enhance SDT efficacy subsequently. The targeted accumulation of these composite nanosonosensitizers efficiently suppressed the growth of U87 tumor xenograft on nude mice after US-triggered SDT treatment. The high in vivo biocompatibility and easy excretion of these multifunctional nanosonosensitizers from the body have also been evaluated and demonstrated to guarantee their future clinical translation, and their TME-responsive T 1 -weighted magnetic resonance imaging capability provides the potential for therapeutic guidance and monitoring during SDT.

  4. Occupational therapists as dog handlers: the collective experience with animal-assisted therapy in Iraq.

    PubMed

    Fike, Lorie; Najera, Cecilia; Dougherty, David

    2012-01-01

    The first pair of US Army animal-assisted therapy (AAT) dogs deployed to Iraq in December 2007 with the 85th Medical Detachment Combat and Operational Stress Control unit. As of this writing, 6 dogs have deployed to Iraq and Afghanistan, offering Soldiers a small reminder of home. Army occupational therapists led the way in this endeavor as primary handlers; the path has been rocky but ultimately rewarding. This article depicts how occupational therapists used AAT and animal-assisted activities to help Soldiers cope with the stressors of living in a deployed environment. Challenges and lessons-learned, including anecdotal examples, are discussed.

  5. Augmenting Antidepressant Medication Treatment of Depressed Women with Emotionally Focused Therapy for Couples: A Randomized Pilot Study

    ERIC Educational Resources Information Center

    Denton, Wayne H.; Wittenborn, Andrea K.; Golden, Robert N.

    2012-01-01

    This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM +…

  6. Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case-control trial.

    PubMed

    Majić, Tomislav; Gutzmann, Hans; Heinz, Andreas; Lang, Undine E; Rapp, Michael A

    2013-11-01

    To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F1,48 = 6.43; p <0.05) and depression (F1,48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Inflammatory cytokine response to exercise in alpha-1-antitrypsin deficient COPD patients ‘on’ or ‘off’ augmentation therapy

    PubMed Central

    2014-01-01

    Background There is still limited information on systemic inflammation in alpha-1-antitrypsin-deficient (AATD) COPD patients and what effect alpha-1-antitrypsin augmentation therapy and/or exercise might have on circulating inflammatory cytokines. We hypothesized that AATD COPD patients on augmentation therapy (AATD + AUG) would have lower circulating and skeletal muscle inflammatory cytokines compared to AATD COPD patients not receiving augmentation therapy (AATD-AUG) and/or the typical non-AATD (COPD) patient. We also hypothesized that cytokine response to exercise would be lower in AATD + AUG compared to AATD-AUG or COPD subjects. Methods Arterial and femoral venous concentration and skeletal muscle expression of TNFα, IL-6, IL-1β and CRP were measured at rest, during and up to 4-hours after 50% maximal 1-hour knee extensor exercise in all COPD patient groups, including 2 additional groups (i.e. AATD with normal lung function, and healthy age-/activity-matched controls). Results Circulating CRP was higher in AATD + AUG (4.7 ± 1.6 mg/dL) and AATD-AUG (3.3 ± 1.2 mg/dL) compared to healthy controls (1.5 ± 0.3 mg/dL, p < 0.05), but lower in AATD compared to non-AATD-COPD patients (6.1 ± 2.6 mg/dL, p < 0.05). TNFα, IL-6 and IL-1β were significantly increased by 1.7-, 1.7-, and 4.7-fold, respectively, in non-AATD COPD compared to AATD COPD (p < 0.05), and 1.3-, 1.7-, and 2.2-fold, respectively, compared to healthy subjects (p < 0.05). Skeletal muscle TNFα was on average 3–4 fold greater in AATD-AUG compared to the other groups (p < 0.05). Exercise showed no effect on these cytokines in any of our patient groups. Conclusion These data show that AATD COPD patients do not experience the same chronic systemic inflammation and exhibit reduced inflammation compared to non-AATD COPD patients. Augmentation therapy may help to improve muscle efflux of TNFα and reduce muscle TNFα concentration, but showed no

  8. "Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study.

    PubMed

    Sachdeva, Virender; Mittal, Vaibhev; Gupta, Varun; Gunturu, Rekha; Kekunnaya, Ramesh; Chandrasekharan, Anjali; Chabblani, Preeti Patil; Rao, Harsha L

    2016-01-01

    To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia. This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.

  9. Indocyanine green-augmented diode laser therapy of telangiectatic leg veins: a randomized controlled proof-of-concept trial.

    PubMed

    Klein, Annette; Bäumler, Wolfgang; Koller, Michael; Shafirstein, Gal; Kohl, Elisabeth A; Landthaler, Michael; Babilas, Philipp

    2012-07-01

    Telangiectatic leg veins, which affect about 40-50% of adults, represent a frequent cosmetic rather than a medical problem. Besides sclerotherapy, various laser devices are common treatment options. However, complete clearance rates can only be achieved in a small number of patients. In this proof-of-concept study, the safety and efficacy of indocyanine green (ICG)-augmented diode laser therapy (808 nm) was evaluated for the treatment of telangiectatic leg veins. ICG (2 mg/kg body weight) was intravenously administered in 15 female patients (skin type II to III) with telangiectatic leg veins (measuring between 0.25 and 3 mm in diameter). Immediately after ICG injection, diode laser pulses with different radiant exposures (50-110 J/cm(2)) were applied as one single treatment. Safety and efficacy were assessed 1 and 3 months after treatment by a blinded investigator and the patient. Treatments with the pulsed dye laser (PDL) and the diode laser without ICG served as reference therapies. The safety of ICG application and diode laser treatment was excellent in all patients with no persisting side effects. Vessel clearance was dose-dependent. Diode laser treatment at radiant exposures between 100 and 110 J/cm(2) resulted in good vessel clearance, which even improved to excellent after the application of double pulses. Diode laser therapy without ICG and PDL treatment induced poor to moderate clearance of telangiectatic leg veins. ICG-augmented diode laser therapy has proved to be a safe and effective treatment option for telangiectatic leg veins. Copyright © 2012 Wiley Periodicals, Inc.

  10. Dual-Energy CT Imaging of Tumor Liposome Delivery After Gold Nanoparticle-Augmented Radiation Therapy

    PubMed Central

    Ashton, Jeffrey R.; Castle, Katherine D.; Qi, Yi; Kirsch, David G.; West, Jennifer L.; Badea, Cristian T.

    2018-01-01

    Gold nanoparticles (AuNPs) are emerging as promising agents for both cancer therapy and computed tomography (CT) imaging. AuNPs absorb x-rays and subsequently release low-energy, short-range photoelectrons during external beam radiation therapy (RT), increasing the local radiation dose. When AuNPs are near tumor vasculature, the additional radiation dose can lead to increased vascular permeability. This work focuses on understanding how tumor vascular permeability is influenced by AuNP-augmented RT, and how this effect can be used to improve the delivery of nanoparticle chemotherapeutics. Methods: Dual-energy CT was used to quantify the accumulation of both liposomal iodine and AuNPs in tumors following AuNP-augmented RT in a mouse model of primary soft tissue sarcoma. Mice were injected with non-targeted AuNPs, RGD-functionalized AuNPs (vascular targeting), or no AuNPs, after which they were treated with varying doses of RT. The mice were injected with either liposomal iodine (for the imaging study) or liposomal doxorubicin (for the treatment study) 24 hours after RT. Increased tumor liposome accumulation was assessed by dual-energy CT (iodine) or by tracking tumor treatment response (doxorubicin). Results: A significant increase in vascular permeability was observed for all groups after 20 Gy RT, for the targeted and non-targeted AuNP groups after 10 Gy RT, and for the vascular-targeted AuNP group after 5 Gy RT. Combining targeted AuNPs with 5 Gy RT and liposomal doxorubicin led to a significant tumor growth delay (tumor doubling time ~ 8 days) compared to AuNP-augmented RT or chemotherapy alone (tumor doubling time ~3-4 days). Conclusions: The addition of vascular-targeted AuNPs significantly improved the treatment effect of liposomal doxorubicin after RT, consistent with the increased liposome accumulation observed in tumors in the imaging study. Using this approach with a liposomal drug delivery system can increase specific tumor delivery of chemotherapeutics

  11. Animal assisted therapy and perception of loneliness in geriatric nursing home residents.

    PubMed

    Vrbanac, Zoran; Zecević, Iva; Ljubić, Marijana; Belić, Maja; Stanin, Damir; Bottegaro, Nika Brkljaca; Jurkić, Gabrijela; Skrlin, Branimir; Bedrica, Ljiljana; Zubcić, Damir

    2013-09-01

    Use of animals for therapeutic purposes, animal assisted therapy or AAT is a method for improving quality of life for long-term inpatients. The object of this paper was to evaluate dog companionship as a form of AAT and its effects on perception of loneliness in geriatric nursing home residents. The participants were involved in a six-month program of dog companionship three times weekly for 90 minutes. There were 21 residents included in the program, with a mean age of 80 years. Loneliness was measured by the short version of the UCLA Scale of loneliness. Comparison of test results before and after participation in the program showed that dog companionship reduces the perception of loneliness.

  12. Improvement of dose calculation in radiation therapy due to metal artifact correction using the augmented likelihood image reconstruction.

    PubMed

    Ziemann, Christian; Stille, Maik; Cremers, Florian; Buzug, Thorsten M; Rades, Dirk

    2018-04-17

    Metal artifacts caused by high-density implants lead to incorrectly reconstructed Hounsfield units in computed tomography images. This can result in a loss of accuracy in dose calculation in radiation therapy. This study investigates the potential of the metal artifact reduction algorithms, Augmented Likelihood Image Reconstruction and linear interpolation, in improving dose calculation in the presence of metal artifacts. In order to simulate a pelvis with a double-sided total endoprosthesis, a polymethylmethacrylate phantom was equipped with two steel bars. Artifacts were reduced by applying the Augmented Likelihood Image Reconstruction, a linear interpolation, and a manual correction approach. Using the treatment planning system Eclipse™, identical planning target volumes for an idealized prostate as well as structures for bladder and rectum were defined in corrected and noncorrected images. Volumetric modulated arc therapy plans have been created with double arc rotations with and without avoidance sectors that mask out the prosthesis. The irradiation plans were analyzed for variations in the dose distribution and their homogeneity. Dosimetric measurements were performed using isocentric positioned ionization chambers. Irradiation plans based on images containing artifacts lead to a dose error in the isocenter of up to 8.4%. Corrections with the Augmented Likelihood Image Reconstruction reduce this dose error to 2.7%, corrections with linear interpolation to 3.2%, and manual artifact correction to 4.1%. When applying artifact correction, the dose homogeneity was slightly improved for all investigated methods. Furthermore, the calculated mean doses are higher for rectum and bladder if avoidance sectors are applied. Streaking artifacts cause an imprecise dose calculation within irradiation plans. Using a metal artifact correction algorithm, the planning accuracy can be significantly improved. Best results were accomplished using the Augmented Likelihood Image

  13. Effectiveness of animal-assisted therapy: A systematic review of randomized controlled trials.

    PubMed

    Kamioka, Hiroharu; Okada, Shinpei; Tsutani, Kiichiro; Park, Hyuntae; Okuizumi, Hiroyasu; Handa, Shuichi; Oshio, Takuya; Park, Sang-Jun; Kitayuguchi, Jun; Abe, Takafumi; Honda, Takuya; Mutoh, Yoshiteru

    2014-04-01

    The objectives of this review were to summarize the evidence from randomized controlled trials (RCTs) on the effects of animal-assisted therapy (AAT). Studies were eligible if they were RCTs. Studies included one treatment group in which AAT was applied. We searched the following databases from 1990 up to October 31, 2012: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi Web, GHL, WPRIM, and PsycINFO. We also searched all Cochrane Database up to October 31, 2012. Eleven RCTs were identified, and seven studies were about "Mental and behavioral disorders". Types of animal intervention were dog, cat, dolphin, bird, cow, rabbit, ferret, and guinea pig. The RCTs conducted have been of relatively low quality. We could not perform meta-analysis because of heterogeneity. In a study environment limited to the people who like animals, AAT may be an effective treatment for mental and behavioral disorders such as depression, schizophrenia, and alcohol/drug addictions, and is based on a holistic approach through interaction with animals in nature. To most effectively assess the potential benefits for AAT, it will be important for further research to utilize and describe (1) RCT methodology when appropriate, (2) reasons for non-participation, (3) intervention dose, (4) adverse effects and withdrawals, and (5) cost. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Psychotherapy Augmentation through Preconscious Priming

    PubMed Central

    Borgeat, François; O’Connor, Kieron; Amado, Danielle; St-Pierre-Delorme, Marie-Ève

    2013-01-01

    Objective: To test the hypothesis that repeated preconscious (masked) priming of personalized positive cognitions could augment cognitive change and facilitate achievement of patients’ goals following a therapy. Methods: Twenty social phobic patients (13 women) completed a 36-weeks study beginning by 12 weeks of group behavioral therapy. After the therapy, they received 6 weeks of preconscious priming and 6 weeks of a control procedure in a randomized cross-over design. The Priming condition involved listening twice daily with a passive attitude to a recording of individualized formulations of appropriate cognitions and attitudes masked by music. The Control condition involved listening to an indistinguishable recording where the formulations had been replaced by random numbers. Changes in social cognitions were measured by the Social Interaction Self Statements Test (SISST). Results: Patients improved following therapy. The Priming procedure was associated with increased positive cognitions and decreased negative cognitions on the SISST while the Control procedure was not. The Priming procedure induced more cognitive change when applied immediately after the group therapy. Conclusion: An effect of priming was observed on social phobia related cognitions in the expected direction. This self administered addition to a therapy could be seen as an augmentation strategy. PMID:23508724

  15. Dr. Fluffy: An In-Depth Look at Animal-Assisted Therapy

    ERIC Educational Resources Information Center

    Grado, Elisabeth M.

    2011-01-01

    Animal-Assisted Therapy (AAT) is a fairly new practice whose underlying principles date back to the beginning of time. Man has always found companionship in animals, but now researchers, educators and therapists are finding that by drawing on that comfort, children and adults can attack physical, mental and emotional issues. The use of animals in…

  16. The use of Animal-Assisted Therapy in adolescents with acute mental disorders: A randomized controlled study.

    PubMed

    Stefanini, M C; Martino, A; Allori, P; Galeotti, F; Tani, F

    2015-02-01

    The aim of this study was to compare the effects of Animal-Assisted Therapy (AAT) with a standard treatment protocol in children and adolescents admitted to the psychiatry hospital for acute mental disorders. We used a methodology involving high quality standards for AAT research. A pre-post experimental design with a randomized controlled trial (RCT) in 34 hospitalized patients (17 treatment, 17 control) was carried out. The study focused on improvement in clinical status including, global functioning measured by the Children Global Assessment Scale (C GAS), format of care and ordinary school attendance measured by a rating scale. Our results indicate a statistically significant improvement in global functioning, reduction in format of care and increased ordinary school attendance in the treatment group, but not in the control group. Our results verify that AAT can have significant positive effects on therapeutic progress and the recovery process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Periodontal considerations for esthetics: edentulous ridge augmentation.

    PubMed

    Rosenberg, E S; Cutler, S A

    1993-01-01

    Edentulous ridge augmentation is a plastic surgical technique that is performed to improve patient esthetics when unsightly, deformed ridges exist. This article describes the etiology of ridge deformities and the many procedures that can be executed to achieve an esthetic, functional result. Historically, soft-tissue mucogingival techniques were described to augment collapsed ridges. Pedicle grafts, free soft-tissue grafts, and subepithelial connective tissue grafts are predictable forms of therapy. More recently, ridge augmentation techniques were developed that regenerate the lost periodontium. These include allografts, bioglasses, guided tissue regenerative procedures, and tissue expansion.

  18. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol.

    PubMed

    Kootker, Joyce A; Rasquin, Sascha M C; Smits, Peter; Geurts, Alexander C; van Heugten, Caroline M; Fasotti, Luciano

    2015-09-01

    Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients' goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions. © The Author(s) 2014.

  19. Effectiveness of sensor-augmented pump therapy in children and adolescents with type 1 diabetes in the STAR 3 study.

    PubMed

    Slover, Robert H; Welsh, John B; Criego, Amy; Weinzimer, Stuart A; Willi, Steven M; Wood, Michael A; Tamborlane, William V

    2012-02-01

    Maintenance of appropriate A1C values and minimization of hyperglycemic excursions are difficult for many pediatric patients with type 1 diabetes. Continuous glucose monitoring (CGM) sensor-augmented pump (SAP) therapy is an alternative to multiple daily injection (MDI) therapy in this population. Sensor-augmented pump therapy for A1C reduction (STAR 3) was a 1-yr trial that included 82 children (aged 7-12) and 74 adolescents (aged 13-18) with A1C values ranging from 7.4 to 9.5% who were randomized to either SAP or MDI therapy. Quarterly A1C values were obtained from all subjects. CGM studies were carried out at baseline, 6 months, and 12 months to quantify glycemic excursions [calculated as area under the glucose concentration-time curve (AUC)] and variability. In the SAP group, sensor compliance was recorded. Baseline A1C values were similar in subjects randomized to the SAP (8.26 ± 0.55%) and MDI groups (8.30 ± 0.53%). All subsequent A1C values showed significant (p < 0.05) treatment group differences favoring SAP therapy. Compared with the MDI group, subjects in the SAP group were more likely to meet age-specific A1C targets and had lower AUC values for hyperglycemia with no increased risk of hypoglycemia. Glucose variability improved in the SAP group compared to the MDI group. Children wore CGM sensors more often and were more likely to reach age-specific A1C targets than adolescents. SAP therapy allows both children and adolescents with marginally or inadequately controlled type 1 diabetes to reduce A1C values, hyperglycemic excursions, and glycemic variability in a rapid, sustainable, and safe manner. © 2011 John Wiley & Sons A/S.

  20. Improving PTSD Outcomes in OIF/OEF Returnees: A Randomized Clinical Trial of Hydrocortisone Augmentation of Prolonged Exposure Therapy

    DTIC Science & Technology

    2012-08-01

    Melissa D . Altman, PhD will ensure that the ratings are accomplished in a reasonable time frame, and make the results available to the PI and co...Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report. European Journal of Traumatology. 2010(1): 5643. d . Solutions to...Brief Assessment of Cognition in Schizophrenia (BACS): Symbol-Coding Category Fluency: Animal Naming Trail Making Test: Part A Timed paper

  1. Comparison of therapy augmentation and deviation rates from the recommended once-daily dosing regimen between LDX and commonly prescribed long-acting stimulants for the treatment of ADHD in youth and adults.

    PubMed

    Setyawan, Juliana; Hodgkins, Paul; Guérin, Annie; Gauthier, Geneviève; Cloutier, Martin; Wu, Eric; Erder, M Haim

    2013-10-01

    To compare therapy augmentation and deviation rates from the recommended once-daily dosing regimen in Attention Deficit Hyperactivity Disorder (ADHD) patients initiated on lisdexamfetamine (LDX) vs other once-daily Food and Drug Administration (FDA) approved stimulants. ADHD patients initiated on a long-acting ADHD stimulant medication (index medication) in/after 2007 were selected from a large U.S. administrative claims database. Patients were required to be persistent for ≥90 days and continuously enrolled in their healthcare plan for ≥12 months following treatment initiation date. Based on age and previous treatment status, patients were classified into treatment-naïve children and adolescents (6-17 years old), previously treated children and adolescents, treatment-naïve adults (≥18 years old), and previously treated adults. Furthermore, patients were classified into four mutually exclusive treatment groups, based on index medication: lisdexamfetamine (LDX), osmotic release methylphenidate hydrochloride long-acting (OROS MPH), other methylphenidate/dexmethylphenidate long-acting (MPH LA), and amphetamine/dextroamphetamine long-acting (AMPH LA). The average daily consumption was measured as the quantity of index medication supplied in the 12-month study period divided by the total number of days of supply. Therapy augmentation was defined as the use of another ADHD medication concomitantly with the index medication for ≥28 consecutive days. Therapy augmentation and deviation rates from the recommended once-daily dosing regimen were compared between treatment groups using multivariate logistic regression models. Compared to the other treatment groups, LDX patients were less likely to augment with another ADHD medication (range odds ratios [OR]; 1.28-3.30) and to deviate from the recommended once-daily dosing regimen (range OR; 1.73-4.55), except for previously treated adult patients, where therapy augmentation differences were not statistically

  2. Augmented post-remission therapy for a minimal residual disease-defined high-risk subgroup of children and young people with clinical standard-risk and intermediate-risk acute lymphoblastic leukaemia (UKALL 2003): a randomised controlled trial.

    PubMed

    Vora, Ajay; Goulden, Nick; Mitchell, Chris; Hancock, Jeremy; Hough, Rachael; Rowntree, Clare; Moorman, Anthony V; Wade, Rachel

    2014-07-01

    No randomised study has shown whether stratification of treatment by minimal residual disease (MRD) response improves outcome in children and young people with acute lymphoblastic leukaemia (ALL). We assessed whether children and young people with clinical standard and intermediate-risk ALL who have persistent MRD at the end of induction therapy benefit from augmented post-remission therapy. Between Oct 1, 2003, and June 30, 2011, we enrolled eligible patients aged 1-24 years and initially categorised them into clinical standard-risk, intermediate-risk, and high-risk groups on the basis of a combination of National Cancer Institute criteria, cytogenetics, and early morphological response to induction therapy. Clinical standard-risk and intermediate-risk patients with MRD of 0·01% or higher at day 29 of induction (MRD high risk) were randomly assigned (1:1) to standard therapy (treatment regimens A and B) or augmented post-remission therapy (regimen C). Compared with standard therapy, the augmented treatment regimen (regimen C) included an additional eight doses of pegylated asparaginase, 18 doses of vincristine, and escalated-dose intravenous methotrexate without folinic acid rescue during interim maintenance courses. Computer randomisation was used for treatment allocation and was balanced for sex, age (<10 years vs ≥10 years), and white blood cell count at diagnosis (<50 × 10(9)/L vs ≥50 × 10(9)/L) by minimisation. Patients, clinicians, and data analysts were not masked to treatment allocation. The primary outcomes were event-free survival and overall survival. Analyses were by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN07355119. 533 MRD high-risk patients were randomly assigned to receive standard (n=266) or augmented (n=267) post-remission therapy. After a median follow-up of 70 months (IQR 52-91), 5-year event-free survival was better in the augmented treatment group (89·6% [95% CI 85·9-93·3

  3. Novel Surgical Treatments for Gastroesophageal Reflux Disease: Systematic Review of Magnetic Sphincter Augmentation and Electric Stimulation Therapy

    PubMed Central

    Stanak, Michal; Erdos, Judit; Hawlik, Katharina; Birsan, Tudor

    2018-01-01

    Electric stimulation therapy (EST) and magnetic sphincter augmentation (MSA) represent novel methods for the surgical treatment of gastroesophageal reflux disease (GERD). The aim of this review was to assess the effectiveness and safety of EST and magnetic sphincter augmentation device (MSAD) comapred to laparoscopic fundoplication (LF) and proton pump inhibitor therapy (in case of EST). We performed a systematic literature search without restrictions on publication dates in five electronic databases (MEDLINE, EMBASE, the Cochrane library, PubMed, and Centre for Reviews and Dissemination), complemented by hand search, search in trial registries, and documentation provided by the manufacturers. No study passed inclusion criteria for analyzing EST effectiveness. Concerning safety, lead erosion through the esophagus and trocar perforation of the small bowel occurred in 2.4% of patients (in one study). Only the registry study fulfilled inclusion criteria for effectiveness analysis of MSAD. The crucial outcome of GERD-health-related quality of life (HRQL) score improved from 20 to 3 points in MSAD patients, and from 23 to 3.5 points in LF patients. However, the LF patients were in a more severe stage of the disease. The results yield indefinite conclusions about the use of both MSAD and EST. Clinical effectiveness and safety of both MSAD and EST are not sufficiently proven and are yet to be supported by high quality evidence from randomized controlled trials.

  4. A randomized clinical trial of alpha(1)-antitrypsin augmentation therapy.

    PubMed

    Dirksen, A; Dijkman, J H; Madsen, F; Stoel, B; Hutchison, D C; Ulrik, C S; Skovgaard, L T; Kok-Jensen, A; Rudolphus, A; Seersholm, N; Vrooman, H A; Reiber, J H; Hansen, N C; Heckscher, T; Viskum, K; Stolk, J

    1999-11-01

    We have investigated whether restoration of the balance between neutrophil elastase and its inhibitor, alpha(1)-antitrypsin, can prevent the progression of pulmonary emphysema in patients with alpha(1)-antitrypsin deficiency. Twenty-six Danish and 30 Dutch ex-smokers with alpha(1)-antitrypsin deficiency of PI*ZZ phenotype and moderate emphysema (FEV(1) between 30% and 80% of predicted) participated in a double-blind trial of alpha(1)-antitrypsin augmentation therapy. The patients were randomized to either alpha(1)-antitrypsin (250 mg/kg) or albumin (625 mg/kg) infusions at 4-wk intervals for at least 3 yr. Self-administered spirometry performed every morning and evening at home showed no significant difference in decline of FEV(1) between treatment and placebo. Each year, the degree of emphysema was quantified by the 15th percentile point of the lung density histogram derived from computed tomography (CT). The loss of lung tissue measured by CT (mean +/- SEM) was 2.6 +/- 0.41 g/L/yr for placebo as compared with 1.5 +/- 0.41 g/L/yr for alpha(1)-antitrypsin infusion (p = 0.07). Power analysis showed that this protective effect would be significant in a similar trial with 130 patients. This is in contrast to calculations based on annual decline of FEV(1) showing that 550 patients would be needed to show a 50% reduction of annual decline. We conclude that lung density measurements by CT may facilitate future randomized clinical trials of investigational drugs for a disease in which little progress in therapy has been made in the past 30 yr.

  5. Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial.

    PubMed

    Galovski, Tara E; Harik, Juliette M; Blain, Leah M; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas D

    2016-02-01

    Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory after treatment. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy [CPT]). Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. High-density lipoproteins potentiate α1-antitrypsin therapy in elastase-induced pulmonary emphysema.

    PubMed

    Moreno, Juan-Antonio; Ortega-Gomez, Almudena; Rubio-Navarro, Alfonso; Louedec, Liliane; Ho-Tin-Noé, Benoit; Caligiuri, Giuseppina; Nicoletti, Antonino; Levoye, Angelique; Plantier, Laurent; Meilhac, Olivier

    2014-10-01

    Several studies report that high-density lipoproteins (HDLs) can carry α1-antitrypsin (AAT; an elastase inhibitor). We aimed to determine whether injection of exogenous HDL, enriched or not in AAT, may have protective effects against pulmonary emphysema. After tracheal instillation of saline or elastase, mice were randomly treated intravenously with saline, human plasma HDL (75 mg apolipoprotein A1/kg), HDL-AAT (75 mg apolipoprotein A1-3.75 mg AAT/kg), or AAT alone (3.75 mg/kg) at 2, 24, 48, and 72 hours. We have shown that HDL-AAT reached the lung and prevented the development of pulmonary emphysema by 59.3% at 3 weeks (alveoli mean chord length, 22.9 ± 2.8 μm versus 30.7 ± 4.5 μm; P < 0.001), whereas injection of HDL or AAT alone only showed a moderate, nonsignificant protective effect (28.2 ± 4.2 μm versus 30.7 ± 5 μm [P = 0.23] and 27.3 ± 5.66 μm versus 30.71 ± 4.96 μm [P = 0.18], respectively). Indeed, protection by HDL-AAT was significantly higher than that observed with HDL or AAT (P = 0.006 and P = 0.048, respectively). This protective effect was associated (at 6, 24, and 72 h) with: (1) a reduction in neutrophil and macrophage number in the bronchoalveolar lavage fluid; (2) decreased concentrations of IL-6, monocyte chemoattractant protein-1, and TNF-α in both bronchoalveolar lavage fluid and plasma; (3) a reduction in matrix metalloproteinase-2 and matrix metalloproteinase-9 activities; and (4) a reduction in the degradation of fibronectin, a marker of tissue damage. In addition, HDL-AAT reduced acute cigarette smoke-induced inflammatory response. Intravenous HDL-AAT treatment afforded a better protection against elastase-induced pulmonary emphysema than AAT alone, and may represent a significant development for the management of emphysema associated with AAT deficiency.

  7. An Explorative Study Examining Augmentative and Alternative Communication Training in the Field of Music Therapy.

    PubMed

    Gadberry, Anita L; Sweeney, Alison

    2017-07-01

    Music therapists work with many people who require Augmentative and Alternative Communication (AAC). As communication goals are central to music therapy practice, many music therapists would benefit from training in AAC. The purpose of this survey study was to determine the state of AAC education for music therapists at the university level, how AAC is being used in music therapy sessions, and how practicing music therapists are trained in AAC. Music therapy faculty and credentialed music therapists in North America and Europe were invited to complete an online survey. Descriptive statistics were used to analyze survey data from each group of respondents. With regard to training in AAC at the university level, results indicate that almost half of music therapy faculty (44.66%) provided some training. The primary reason given for not providing training was a lack of educator knowledge in this area. Results indicate that a majority (81.77%) of music therapy clinicians are familiar with AAC and slightly over half (55.08%) reported that they work with clients who use AAC. Sixty-two percent of music therapists reported using AAC to promote expressive language, and 49% to increase receptive language. Over 80% of clinicians stated they would benefit from additional AAC training. Although a majority of music therapists are familiar with ACC, results indicate that ACC competency could be enhanced through university-level instruction and continuing professional development courses. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  8. Inhaled alpha 1-antitrypsin: gauging patient interest in a new treatment.

    PubMed

    Monk, Richard; Graves, Michael; Williams, Pamela; Strange, Charlie

    2013-08-01

    Given the high cost of plasma derived intravenous alpha 1-antitrypsin (AAT), a more efficient method of delivery to the lungs is desirable. Inhaled AAT has been shown feasible for the treatment of alpha 1-antitrypsin deficiency (AATD) and is currently in clinical trials. To better understand patient preferences about possible inhaled AAT therapy, a survey was conducted to explore patient attitudes. We conducted an email based survey of patients in the Alpha-1 Foundation Research Registry with AATD on intravenous AAT replacement. Respondents were asked to rate their interest in hypothetical nebulized or dry powder inhaled AAT. Respondents reported high levels of interest in both dried powder inhaler and nebulizer delivered inhaled AAT. The interest in dried powder inhaled was higher than interest in nebulized AAT (71% vs 64%, p = 0.0001). The interest in dried powder inhaled AAT was particularly high in respondents currently on bronchodilator therapy (p = 0.0053). Patients were just as likely to use or not use the product if it required 20% more out of pocket cost. There is a high level of patient interest in the development of a commercially available inhaled AAT replacement product.

  9. Use of Statins to Augment Progenitor Cell Function in Preclinical and Clinical Studies of Regenerative Therapy: a Systematic Review.

    PubMed

    Park, Angela; Barrera-Ramirez, Juliana; Ranasinghe, Indee; Pilon, Sophie; Sy, Richmond; Fergusson, Dean; Allan, David S

    2016-06-01

    statin therapy (1.2-fold to 35-fold improvement over controls) in all 7 studies. Our systematic review provides a foundation of encouraging results that support further study of statins in regenerative therapy to augment the number and/or function of MSCs used in cell-based repair and to augment the number and function of EPCs in vivo to repair damaged tissues. Larger studies are needed to ensure safety and confirm clinical benefits.

  10. An approach to analyzing a single subject's scores obtained in a standardized test with application to the Aachen Aphasia Test (AAT).

    PubMed

    Willmes, K

    1985-08-01

    Methods for the analysis of a single subject's test profile(s) proposed by Huber (1973) are applied to the Aachen Aphasia Test (AAT). The procedures are based on the classical test theory model (Lord & Novick, 1968) and are suited for any (achievement) test with standard norms from a large standardization sample and satisfactory reliability estimates. Two test profiles of a Wernicke's aphasic, obtained before and after a 3-month period of speech therapy, are analyzed using inferential comparisons between (groups of) subtest scores on one test application and between two test administrations for single (groups of) subtests. For each of these comparisons, the two aspects of (i) significant (reliable) differences in performance beyond measurement error and (ii) the diagnostic validity of that difference in the reference population of aphasic patients are assessed. Significant differences between standardized subtest scores and a remarkably better preserved reading and writing ability could be found for both test administrations using the multiple test procedure of Holm (1979). Comparison of both profiles revealed an overall increase in performance for each subtest as well as changes in level of performance relations between pairs of subtests.

  11. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality.

    PubMed

    Ben-Moussa, Maher; Rubo, Marius; Debracque, Coralie; Lange, Wolf-Gero

    2017-01-01

    The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. "DJINNI" is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient's state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup.

  12. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality

    PubMed Central

    Ben-Moussa, Maher; Rubo, Marius; Debracque, Coralie; Lange, Wolf-Gero

    2017-01-01

    The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. “DJINNI” is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient’s state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup. PMID:28503155

  13. Augmentation treatment in major depressive disorder: focus on aripiprazole

    PubMed Central

    Nelson, J Craig; Pikalov, Andrei; Berman, Robert M

    2008-01-01

    Major depressive disorder (MDD) is a disabling psychiatric condition for which effective treatment remains an outstanding need. Antidepressants are currently the mainstay of treatment for depression; however, almost two-thirds of patients will fail to achieve remission with initial treatment. As a result, a range of augmentation and combination strategies have been used in order to improve outcomes for patients. Despite the popularity of these approaches, limited data from double-blind, randomized, placebo-controlled studies are available to allow clinicians to determine which are the most effective augmentation options or which patients are most likely to respond to which options. Recently, evidence has shown that adjunctive therapy with atypical antipsychotics has the potential for beneficial antidepressant effects in the absence of psychotic symptoms. In particular, aripiprazole has shown efficacy as an augmentation option with standard antidepressant therapy in two, large, randomized, double-blind studies. Based on these efficacy and safety data, aripiprazole was recently approved by the FDA as adjunctive therapy for MDD. The availability of this new treatment option should allow more patients with MDD to achieve remission and, ultimately, long-term, successful outcomes. PMID:19183784

  14. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial.

    PubMed

    Ly, Trang T; Nicholas, Jennifer A; Retterath, Adam; Lim, Ee Mun; Davis, Elizabeth A; Jones, Timothy W

    2013-09-25

    Hypoglycemia is a critical obstacle to the care of patients with type 1 diabetes. Sensor-augmented insulin pump with automated low-glucose insulin suspension has the potential to reduce the incidence of major hypoglycemic events. To determine the incidence of severe and moderate hypoglycemia with sensor-augmented pump with low-glucose suspension compared with standard insulin pump therapy. A randomized clinical trial involving 95 patients with type 1 diabetes, recruited from December 2009 to January 2012 in Australia. Patients were randomized to insulin pump only or automated insulin suspension for 6 months. The primary outcome was the combined incidence of severe (hypoglycemic seizure or coma) and moderate hypoglycemia (an event requiring assistance for treatment). In a subgroup, counterregulatory hormone responses to hypoglycemia were assessed using the hypoglycemic clamp technique. Of the 95 patients randomized, 49 were assigned to the standard-pump (pump-only) therapy and 46 to the low-glucose suspension group. The mean (SD) age was 18.6 (11.8) years; duration of diabetes, 11.0 (8.9) years; and duration of pump therapy, 4.1 (3.4) years. The baseline rate of severe and moderate hypoglycemic events in the pump-only group was 20.7 vs 129.6 events per 100 patient months in the low-glucose suspension group. After 6 months of treatment, the event rates decreased from 28 to 16 in the pump-only group vs 175 to 35 in the low-glucose suspension group. The adjusted incidence rate per 100 patient-months was 34.2 (95% CI, 22.0-53.3) for the pump-only group vs 9.5 (95% CI, 5.2-17.4) for the low-glucose suspension group. The incidence rate ratio was 3.6 (95% CI, 1.7-7.5; P <.001). There was no change in glycated hemoglobin in either group: mean, 7.4 (95% CI, 7.2-7.6) to 7.4 (95% CI, 7.2-7.7) in the pump-only group vs mean, 7.6 (95%, CI, 7.4-7.9) to 7.5 (95% CI, 7.3-7.7) in the low-glucose suspension group. Counterregulatory hormone responses to hypoglycemia were not changed

  15. D-Cycloserine Augmentation of Exposure-Based Cognitive Behavior Therapy for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders: A Systematic Review and Meta-analysis of Individual Participant Data.

    PubMed

    Mataix-Cols, David; Fernández de la Cruz, Lorena; Monzani, Benedetta; Rosenfield, David; Andersson, Erik; Pérez-Vigil, Ana; Frumento, Paolo; de Kleine, Rianne A; Difede, JoAnn; Dunlop, Boadie W; Farrell, Lara J; Geller, Daniel; Gerardi, Maryrose; Guastella, Adam J; Hofmann, Stefan G; Hendriks, Gert-Jan; Kushner, Matt G; Lee, Francis S; Lenze, Eric J; Levinson, Cheri A; McConnell, Harry; Otto, Michael W; Plag, Jens; Pollack, Mark H; Ressler, Kerry J; Rodebaugh, Thomas L; Rothbaum, Barbara O; Scheeringa, Michael S; Siewert-Siegmund, Anja; Smits, Jasper A J; Storch, Eric A; Ströhle, Andreas; Tart, Candyce D; Tolin, David F; van Minnen, Agnes; Waters, Allison M; Weems, Carl F; Wilhelm, Sabine; Wyka, Katarzyna; Davis, Michael; Rück, Christian; Altemus, Margaret; Anderson, Page; Cukor, Judith; Finck, Claudia; Geffken, Gary R; Golfels, Fabian; Goodman, Wayne K; Gutner, Cassidy; Heyman, Isobel; Jovanovic, Tanja; Lewin, Adam B; McNamara, Joseph P; Murphy, Tanya K; Norrholm, Seth; Thuras, Paul

    2017-05-01

    Whether and under which conditions D-cycloserine (DCS) augments the effects of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders is unclear. To clarify whether DCS is superior to placebo in augmenting the effects of cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders and to evaluate whether antidepressants interact with DCS and the effect of potential moderating variables. PubMed, EMBASE, and PsycINFO were searched from inception to February 10, 2016. Reference lists of previous reviews and meta-analyses and reports of randomized clinical trials were also checked. Studies were eligible for inclusion if they were (1) double-blind randomized clinical trials of DCS as an augmentation strategy for exposure-based cognitive behavior therapy and (2) conducted in humans diagnosed as having specific phobia, social anxiety disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder, or posttraumatic stress disorder. Raw data were obtained from the authors and quality controlled. Data were ranked to ensure a consistent metric across studies (score range, 0-100). We used a 3-level multilevel model nesting repeated measures of outcomes within participants, who were nested within studies. Individual participant data were obtained for 21 of 22 eligible trials, representing 1047 of 1073 eligible participants. When controlling for antidepressant use, participants receiving DCS showed greater improvement from pretreatment to posttreatment (mean difference, -3.62; 95% CI, -0.81 to -6.43; P = .01; d = -0.25) but not from pretreatment to midtreatment (mean difference, -1.66; 95% CI, -4.92 to 1.60; P = .32; d = -0.14) or from pretreatment to follow-up (mean difference, -2.98, 95% CI, -5.99 to 0.03; P = .05; d = -0.19). Additional analyses showed that participants assigned to DCS were associated with lower symptom severity than those assigned to

  16. Expanding the Role of Maryland Community Colleges in K-12 Teacher Preparation: Benefits and Costs of Implementing the Associate of Arts in Teaching (AAT) Degree

    ERIC Educational Resources Information Center

    Frank, Jennifer Vest

    2012-01-01

    This study uses benefit-cost analysis to compare three alternative scenarios for implementing the Associate of Arts in Teaching (AAT) degree in Maryland community colleges. The first policy scenario is that community colleges retain their traditional role in K-12 teacher preparation by providing lower-division transfer courses and programs for…

  17. Tissue engineering for lateral ridge augmentation with recombinant human bone morphogenetic protein 2 combination therapy: a case report.

    PubMed

    Mandelaris, George A; Spagnoli, Daniel B; Rosenfeld, Alan L; McKee, James; Lu, Mei

    2015-01-01

    This case report describes a tissue-engineered reconstruction with recombinant human bone morphogenetic protein 2/acellular collagen sponge (rhBMP-2/ ACS) + cancellous allograft and space maintenance via Medpor Contain mesh in the treatment of a patient requiring maxillary and mandibular horizontal ridge augmentation to enable implant placement. The patient underwent a previously unsuccessful corticocancellous bone graft at these sites. Multiple and contiguous sites in the maxilla and in the mandibular anterior, demonstrating advanced lateral ridge deficiencies, were managed using a tissue engineering approach as an alternative to autogenous bone harvesting. Four maxillary and three mandibular implants were placed 9 and 10 months, respectively, after tissue engineering reconstruction, and all were functioning successfully after 24 months of follow-up. Histomorphometric analysis of a bone core obtained at the time of the maxillary implant placement demonstrated a mean of 76.1% new vital bone formation, 22.2% marrow/cells, and 1.7% residual graft tissue. Tissue engineering for lateral ridge augmentation with combination therapy requires further research to determine predictability and limitations.

  18. Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial.

    PubMed

    Melvin, Glenn A; Dudley, Amanda L; Gordon, Michael S; Klimkeit, Ester; Gullone, Eleonora; Taffe, John; Tonge, Bruce J

    2017-06-01

    This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11-16.5 years). Sixty-two participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide-attempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self-efficacy and clinician-rated global functioning); with gains largely maintained at 6-months and 1-year. Few participants were anxiety disorder free after acute treatment. During the follow-up period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between-group difference was greater adolescent-reported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates.

  19. Bardoxolone: augmenting the Yin in chronic kidney disease.

    PubMed

    Thomas, Merlin C

    2011-10-01

    Nrf-2 (NF-E2-related factor 2) is a regulator of anti-oxidant, anti-inflammatory and detoxification pathways. Coordinated augmentation of these key defence pathways via Nrf-2 signalling is being investigated for the treatment of chronic diseases, including diabetes and its complications. The first to reach commercial development is the triterpenoid, bardoxolone methyl. In recent clinical trial, bardoxolone rapidly improved kidney function on average by 5-10 ml/min within 4 weeks of therapy. Importantly, this improvement was sustained during one year of active treatment. This suggests that rather that overworking a failing system, bardoxolone appeared to safely augment renal function, at least to one year. If similar improvements in kidney function can be reproduced in the upcoming BEACON trial, it will represent a major advance on conventional therapy and new way to bring balance to the failing kidney.

  20. Gene Augmentation Therapy for a Missense Substitution in the cGMP-Binding Domain of Ovine CNGA3 Gene Restores Vision in Day-Blind Sheep

    PubMed Central

    Gootwine, Elisha; Abu-Siam, Mazen; Obolensky, Alexey; Rosov, Alex; Honig, Hen; Nitzan, Tali; Shirak, Andrey; Ezra-Elia, Raaya; Yamin, Esther; Banin, Eyal; Averbukh, Edward; Hauswirth, William W.; Ofri, Ron; Seroussi, Eyal

    2017-01-01

    Purpose Applying CNGA3 gene augmentation therapy to cure a novel causative mutation underlying achromatopsia (ACHM) in sheep. Methods Impaired vision that spontaneously appeared in newborn lambs was characterized by behavioral, electroretinographic (ERG), and histologic techniques. Deep-sequencing reads of an affected lamb and an unaffected lamb were compared within conserved genomic regions orthologous to human genes involved in similar visual impairment. Observed nonsynonymous amino acid substitutions were classified by their deleteriousness score. The putative causative mutation was assessed by producing compound CNGA3 heterozygotes and applying gene augmentation therapy using the orthologous human cDNA. Results Behavioral assessment revealed day blindness, and subsequent ERG examination showed attenuated photopic responses. Histologic and immunohistochemical examination of affected sheep eyes did not reveal degeneration, and cone photoreceptors expressing CNGA3 were present. Bioinformatics and sequencing analyses suggested a c.1618G>A, p.Gly540Ser substitution in the GMP-binding domain of CNGA3 as the causative mutation. This was confirmed by genetic concordance test and by genetic complementation experiment: All five compound CNGA3 heterozygotes, carrying both p.Arg236* and p.Gly540Ser mutations in CNGA3, were day-blind. Furthermore, subretinal delivery of the intact human CNGA3 gene using an adeno-associated viral vector (AAV) restored photopic vision in two affected p.Gly540Ser homozygous rams. Conclusions The c.1618G>A, p.Gly540Ser substitution in CNGA3 was identified as the causative mutation for a novel form of ACHM in Awassi sheep. Gene augmentation therapy restored vision in the affected sheep. This novel mutation provides a large-animal model that is valid for most human CNGA3 ACHM patients; the majority of them carry missense rather than premature-termination mutations. PMID:28282490

  1. Gene Augmentation Therapy for a Missense Substitution in the cGMP-Binding Domain of Ovine CNGA3 Gene Restores Vision in Day-Blind Sheep.

    PubMed

    Gootwine, Elisha; Abu-Siam, Mazen; Obolensky, Alexey; Rosov, Alex; Honig, Hen; Nitzan, Tali; Shirak, Andrey; Ezra-Elia, Raaya; Yamin, Esther; Banin, Eyal; Averbukh, Edward; Hauswirth, William W; Ofri, Ron; Seroussi, Eyal

    2017-03-01

    Applying CNGA3 gene augmentation therapy to cure a novel causative mutation underlying achromatopsia (ACHM) in sheep. Impaired vision that spontaneously appeared in newborn lambs was characterized by behavioral, electroretinographic (ERG), and histologic techniques. Deep-sequencing reads of an affected lamb and an unaffected lamb were compared within conserved genomic regions orthologous to human genes involved in similar visual impairment. Observed nonsynonymous amino acid substitutions were classified by their deleteriousness score. The putative causative mutation was assessed by producing compound CNGA3 heterozygotes and applying gene augmentation therapy using the orthologous human cDNA. Behavioral assessment revealed day blindness, and subsequent ERG examination showed attenuated photopic responses. Histologic and immunohistochemical examination of affected sheep eyes did not reveal degeneration, and cone photoreceptors expressing CNGA3 were present. Bioinformatics and sequencing analyses suggested a c.1618G>A, p.Gly540Ser substitution in the GMP-binding domain of CNGA3 as the causative mutation. This was confirmed by genetic concordance test and by genetic complementation experiment: All five compound CNGA3 heterozygotes, carrying both p.Arg236* and p.Gly540Ser mutations in CNGA3, were day-blind. Furthermore, subretinal delivery of the intact human CNGA3 gene using an adeno-associated viral vector (AAV) restored photopic vision in two affected p.Gly540Ser homozygous rams. The c.1618G>A, p.Gly540Ser substitution in CNGA3 was identified as the causative mutation for a novel form of ACHM in Awassi sheep. Gene augmentation therapy restored vision in the affected sheep. This novel mutation provides a large-animal model that is valid for most human CNGA3 ACHM patients; the majority of them carry missense rather than premature-termination mutations.

  2. Validating Above-cloud Aerosol Optical Depth Retrieved from MODIS using NASA Ames Airborne Sun-Tracking Photometric and Spectrometric (AATS and 4STAR) Measurements

    NASA Astrophysics Data System (ADS)

    Jethva, H. T.; Torres, O.; Remer, L. A.; Redemann, J.; Dunagan, S. E.; Livingston, J. M.; Shinozuka, Y.; Kacenelenbogen, M. S.; Segal-Rosenhaimer, M.

    2014-12-01

    Absorbing aerosols produced from biomass burning and dust outbreaks are often found to overlay the lower level cloud decks as evident in the satellite images. In contrast to the cloud-free atmosphere, in which aerosols generally tend to cool the atmosphere, the presence of absorbing aerosols above cloud poses greater potential of exerting positive radiative effects (warming) whose magnitude directly depends on the aerosol loading above cloud, optical properties of clouds and aerosols, and cloud fraction. In recent years, development of algorithms that exploit satellite-based passive measurements of ultraviolet (UV), visible, and polarized light as well as lidar-based active measurements constitute a major breakthrough in the field of remote sensing of aerosols. While the unprecedented quantitative information on aerosol loading above cloud is now available from NASA's A-train sensors, a greater question remains ahead: How to validate the satellite retrievals of above-cloud aerosols (ACA)? Direct measurements of ACA such as carried out by the NASA Ames Airborne Tracking Sunphotometer (AATS) and Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR) can be of immense help in validating ACA retrievals. In this study, we validate the ACA optical depth retrieved using the 'color ratio' (CR) method applied to the MODIS cloudy-sky reflectance by using the airborne AATS and 4STAR measurements. A thorough search of the historic AATS-4STAR database collected during different field campaigns revealed five events where biomass burning, dust, and wildfire-emitted aerosols were found to overlay lower level cloud decks observed during SAFARI-2000, ACE-ASIA 2001, and SEAC4RS-2013, respectively. The co-located satellite-airborne measurements revealed a good agreement (root-mean-square-error<0.1 for Aerosol Optical Depth (AOD) at 500 nm) with most matchups falling within the estimated uncertainties in the MODIS retrievals (-10% to +50%). An extensive validation of

  3. A novel Norrie disease pseudoglioma gene mutation, c.-1_2delAAT, responsible for Norrie disease in a Chinese family.

    PubMed

    Zhang, Xin-Yu; Jiang, Wei-Ying; Chen, Lu-Ming; Chen, Su-Qin

    2013-01-01

    To investigate the genetic findings and phenotypic characteristics of a Chinese family with Norrie disease (ND). Molecular genetic analysis and clinical examinations were performed on a Chinese family with ND. Mutations in the Norrie disease pseudoglioma (NDP) gene were detected by direct sequencing. Haplotypes were constructed and compared with the phenotypes in the family. Evolutionary comparisons and mutant open reading frame (ORF) prediction were also undertaken. Two family members with ocular manifestations were diagnosed with ND. No signs of sensorineural hearing loss were observed in either patient, while one of them showed signs of mild mental retardation. A novel heterozygous mutation in the NDP gene, c.-1_2delAAT, was detected in both patients. The mutation and the mutation bearing haplotype co-segregated with the ND phenotype in males and was transmitted from their mothers and/or grandmothers (II:2). The male without ND did not harbor the mutation. The mutation occurred at the highly conserved nucleotides. ORF finder predicted that the mutation would lead to the production of a truncated protein that lacks the first 11 N-terminal amino acids. A novel mutation, c.-1_2delAAT in the NDP gene, was identified in a Chinese family with ND. This mutation caused ND without obvious sensorineural hearing loss. Mental disorder was found in one but not the other patients. The clinical heterogeneity in the family indicated that other genetic variants and epigenetic factors may also play a role in the disease presentation.

  4. Augmentation and impulsive behaviors in restless legs syndrome: Coexistence or association?

    PubMed

    Heim, Beatrice; Djamshidian, Atbin; Heidbreder, Anna; Stefani, Ambra; Zamarian, Laura; Pertl, Marie-Theres; Brandauer, Elisabeth; Delazer, Margarete; Seppi, Klaus; Poewe, Werner; Högl, Birgit

    2016-07-05

    To assess the frequency of impulse control disorders (ICDs) in patients with restless legs syndrome (RLS) with and without augmentation under dopaminergic therapy in a case-control study. Augmentation and ICDs are both serious complications of dopaminergic treatment of RLS but little is known about possible associations between these drug-induced disorders. In total, 58 patients with idiopathic RLS diagnosed according to the International Restless Legs Syndrome Study Group criteria were recruited. Of these, 35 patients had augmentation. The frequency of ICD symptoms was assessed using semi-structural interviews. Demographic variables did not differ between patients with RLS with and without augmentation but those with augmentation took higher dopaminergic medication than patients without augmentation. Twenty-three patients with RLS (39.7%) had ICD symptoms, with 12 patients (20.7%) having definitive ICDs. Patients with augmentation had an increased risk of expressing ICD symptoms (p = 0.007, odds ratio 5.64, 95% confidence interval 1.59-20.02). Patients with RLS with augmentation have an almost 6-fold increased risk of exhibiting ICD symptoms. This implies that augmentation and ICDs are related and may share a common pathophysiology. Moreover, our results have clinical implications, suggesting that patients with RLS with augmentation should be screened for ICD symptoms. © 2016 American Academy of Neurology.

  5. Effectiveness of Aerobic Exercise as an Augmentation Therapy for Inpatients with Major Depressive Disorder: A Preliminary Randomized Controlled Trial.

    PubMed

    Shachar-Malach, Tal; Cooper Kazaz, Rena; Constantini, Naama; Lifschytz, Tzuri; Lerer, Bernard

    2015-01-01

    Physical exercise has been shown to reduce depressive symptoms when used in combination with antidepressant medication. We report a randomized controlled trial of aerobic exercise compared to stretching as an augmentation strategy for hospitalized patients with major depression. Male or female patients, 18-80 years, diagnosed with a Major Depressive Episode, were randomly assigned to three weeks of augmentation therapy with aerobic (n=6) or stretching exercise (n=6). Depression was rated, at several time points using the 21-item Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI) and other scales. According to the HAM-D, there were four (out of six) responders in the aerobic group, two of whom achieved remission, and none in the stretching group. According to the BDI, there were two responders in the aerobic group who were also remitters and none in the stretching group. The results of this small study suggest that aerobic exercise significantly improves treatment outcome when added to antidepressant medication. However, due to the small sample size the results must be regarded as preliminary and further studies are needed to confirm the findings.

  6. Augmented reality social story for autism spectrum disorder

    NASA Astrophysics Data System (ADS)

    Syahputra, M. F.; Arisandi, D.; Lumbanbatu, A. F.; Kemit, L. F.; Nababan, E. B.; Sheta, O.

    2018-03-01

    Augmented Reality is a technique that can bring social story therapy into virtual world to increase intrinsic motivation of children with Autism Spectrum Disorder(ASD). By looking at the behaviour of ASD who will be difficult to get the focus, the lack of sensory and motor nerves in the use of loads on the hands or other organs will be very distressing children with ASD in doing the right activities, and interpret and understand the social situation in determining a response appropriately. Required method to be able to apply social story on therapy of children with ASD that is implemented with Augmented Reality. The output resulting from this method is 3D animation (three-dimensional animation) of social story by detecting marker located in special book and some simple game which done by using leap motion controller which is useful in reading hand movement in real-time.

  7. Sensor-augmented pump therapy in very young children with type 1 diabetes: an efficacy and feasibility observational study.

    PubMed

    Frontino, Giulio; Bonfanti, Riccardo; Scaramuzza, Andrea; Rabbone, Ivana; Meschi, Franco; Rigamonti, Andrea; Battaglino, Roseila; Favalli, Valeria; Bonura, Clara; Sicignano, Sabrina; Gioia, Elisa; Zuccotti, Gian Vincenzo; Cerutti, Franco; Chiumello, Giuseppe

    2012-09-01

    Efficacy and feasibility of sensor-augmented pump (SAP) therapy were evaluated in very young children with type 1 diabetes (T1D). SAP (Dexcom [San Diego, CA] Seven Plus™ usage combined with insulin pump) therapy was retrospectively evaluated in 28 children (15 boys) younger than 7 years (mean age, 5.8 ± 1.2 years; range, 3-7 years), with T1D. Glycosylated hemoglobin (HbA1c) was evaluated at baseline and at the end of the study, as were efficacy and feasibility of the system, using a rating scale (with 3 being the most positive). SAP has been used for at least 6 months by 85% of patients, with an overall good satisfaction (92%). The greatest perceived benefit was the reduced fear of hypoglycemia (score of 3, 81%). HbA1c significantly improved only in patients with baseline HbA1c >7.5% (P = 0.026). SAP therapy is effective and feasible in preschool children with T1D. In patients with high HbA1c at baseline it provide a 0.9% decrease, sustained for at least 6 months.

  8. Human Augmentics: augmenting human evolution.

    PubMed

    Kenyon, Robert V; Leigh, Jason

    2011-01-01

    Human Augmentics (HA) refers to technologies for expanding the capabilities, and characteristics of humans. One can think of Human Augmentics as the driving force in the non-biological evolution of humans. HA devices will provide technology to compensate for human biological limitations either natural or acquired. The strengths of HA lie in its applicability to all humans. Its interoperability enables the formation of ecosystems whereby augmented humans can draw from other realms such as "the Cloud" and other augmented humans for strength. The exponential growth in new technologies portends such a system but must be designed for interaction through the use of open-standards and open-APIs for system development. We discuss the conditions needed for HA to flourish with an emphasis on devices that provide non-biological rehabilitation.

  9. Is ridge preservation/augmentation at periodontally compromised extraction sockets safe? A retrospective study.

    PubMed

    Kim, Jung-Ju; Ben Amara, Heithem; Schwarz, Frank; Kim, Hae-Young; Lee, Jung-Won; Wikesjö, Ulf M E; Koo, Ki-Tae

    2017-10-01

    This study aimed to evaluate the safety of ridge preservation/augmentation procedures when performed at compromised extraction sockets. Patients subject to ridge preservation/augmentation at periodontally compromised sockets at Seoul National University Dental Hospital (SNUDH) were evaluated in a chart review. Tooth extractions due to acute infection were not included in our study as chronically formed lesions are the only lesions that can be detected from radiographic images. If inflammatory symptoms persisted following ridge preservation/augmentation and antimicrobial and anti-inflammatory therapy, the patient was categorized as a re-infection case and implanted biomaterial removed. Of 10,060 patients subject to tooth extractions at SNUDH, 2011 through 2015, 297 cases meeting inclusion criteria were reviewed. The severity and type of lesions were not specific because extracting data was only done by radiographic images and chart records. The review identified eight patients exhibiting inflammatory symptoms that required additional antimicrobial and anti-inflammatory therapy. Within this group, re-infection occurred in two patients requiring biomaterials removal. The final safety rate for the ridge preservation/augmentation was 99.3%. None of the demographic factors, systemic conditions or choice of biomaterial affected the safety of ridge preservation/augmentation. Alveolar ridge preservation/augmentation at periodontally compromised sockets appears safe following thorough removal of infectious source. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Routine sensor-augmented pump therapy in type 1 diabetes: the INTERPRET study.

    PubMed

    Nørgaard, Kirsten; Scaramuzza, Andrea; Bratina, Natasa; Lalić, Nebojsa M; Jarosz-Chobot, Przemyslaw; Kocsis, Győző; Jasinskiene, Edita; De Block, Christophe; Carrette, Odile; Castañeda, Javier; Cohen, Ohad

    2013-04-01

    Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia. A 12-month observational study in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII), upon the introduction of continuous glucose monitoring (CGM), was conducted in 15 countries (in Europe and in Israel) to document the real-life use of SAP and assess which variables are associated with improvement in type 1 diabetes management. Data from 263 patients (38% male; mean age, 28.0 ± 15.7 years [range, 1-69 years]; body mass index, 23.3 ± 4.9 kg/m(2); diabetes duration, 13.9 ± 10.7 years; CSII duration, 2.6 ± 3 years) were collected. Baseline mean glycated hemoglobin A1c (HbA1c) was 8.1 ± 1.4%; 82% had suboptimal HbA1c (≥ 7%). The average sensor use for 12 months was 30% (range, 0-94%), and sensor use decreased with time (first 3 months, 37%; last 3 months, 27%). Factors associated with improvement in HbA1c after 12 months in patients with baseline HbA1c ≥ 7% were high baseline HbA1c (P<0.001), older age group (P<0.001), and more frequent sensor use (P = 0.047). Significantly less hospitalization, increased treatment satisfaction, and reduced fear of hypoglycemia were reported after 12 months of SAP. This is the largest and longest multicenter prospective observational study providing real-life data on SAP. These results are consistent with those of controlled trials showing the effectiveness of CGM in pump users.

  11. Patients and animal models of CNGβ1-deficient retinitis pigmentosa support gene augmentation approach

    PubMed Central

    Petersen-Jones, Simon M.; Occelli, Laurence M.; Winkler, Paige A.; Lee, Winston; Sparrow, Janet R.; Tsukikawa, Mai; Boye, Sanford L.; Chiodo, Vince; Capasso, Jenina E.; Becirovic, Elvir; Schön, Christian; Seeliger, Mathias W.; Levin, Alex V.; Hauswirth, William W.

    2017-01-01

    Retinitis pigmentosa (RP) is a major cause of blindness that affects 1.5 million people worldwide. Mutations in cyclic nucleotide-gated channel β 1 (CNGB1) cause approximately 4% of autosomal recessive RP. Gene augmentation therapy shows promise for treating inherited retinal degenerations; however, relevant animal models and biomarkers of progression in patients with RP are needed to assess therapeutic outcomes. Here, we evaluated RP patients with CNGB1 mutations for potential biomarkers of progression and compared human phenotypes with those of mouse and dog models of the disease. Additionally, we used gene augmentation therapy in a CNGβ1-deficient dog model to evaluate potential translation to patients. CNGB1-deficient RP patients and mouse and dog models had a similar phenotype characterized by early loss of rod function and slow rod photoreceptor loss with a secondary decline in cone function. Advanced imaging showed promise for evaluating RP progression in human patients, and gene augmentation using adeno-associated virus vectors robustly sustained the rescue of rod function and preserved retinal structure in the dog model. Together, our results reveal an early loss of rod function in CNGB1-deficient patients and a wide window for therapeutic intervention. Moreover, the identification of potential biomarkers of outcome measures, availability of relevant animal models, and robust functional rescue from gene augmentation therapy support future work to move CNGB1-RP therapies toward clinical trials. PMID:29202463

  12. Antidepressant response to aripiprazole augmentation associated with enhanced FDOPA utilization in striatum: a preliminary PET study

    PubMed Central

    Conway, Charles R.; Chibnall, John T.; Cumming, Paul; Mintun, Mark A.; Gebara, Marie Anne I.; Perantie, Dana C.; Price, Joseph L.; Cornell, Martha E.; McConathy, Jonathan E.; Gangwani, Sunil; Sheline, Yvette I.

    2014-01-01

    Several double blind, prospective trials have demonstrated an antidepressant augmentation efficacy of aripiprazole in depressed patients unresponsive to standard antidepressant therapy. Although aripiprazole is now widely used for this indication, and much is known about its receptor-binding properties, the mechanism of its antidepressant augmentation remains ill-defined. In vivo animal studies and in vitro human studies using cloned dopamine dopamine D2 receptors suggest aripiprazole is a partial dopamine agonist; in this preliminary neuroimaging trial, we hypothesized that aripiprazole’s antidepressant augmentation efficacy arises from dopamine partial agonist activity. To test this, we assessed the effects of aripiprazole augmentation on the cerebral utilization of 6-[18F]-fluoro-3,4-dihydroxy-L-phenylalanine (FDOPA) using positron emission tomography (PET). Fourteen depressed patients, who had failed 8 weeks of antidepressant therapy with selective serotonin reuptake inhibitors, underwent FDOPA PET scans before and after aripiprazole augmentation; eleven responded to augmentation. Whole brain, voxel-wise comparisons of pre- and post-aripiprazole scans revealed increased FDOPA trapping in the right medial caudate of augmentation responders. An exploratory analysis of depressive symptoms revealed that responders experienced large improvements only in putatively dopaminergic symptoms of lassitude and inability to feel. These preliminary findings suggest that augmentation of antidepressant response by aripiprazole may be associated with potentiation of dopaminergic activity. PMID:24468015

  13. A novel Norrie disease pseudoglioma gene mutation, c.-1_2delAAT, responsible for Norrie disease in a Chinese family

    PubMed Central

    Zhang, Xin-Yu; Jiang, Wei-Ying; Chen, Lu-Ming; Chen, Su-Qin

    2013-01-01

    AIM To investigate the genetic findings and phenotypic characteristics of a Chinese family with Norrie disease (ND). METHODS Molecular genetic analysis and clinical examinations were performed on a Chinese family with ND. Mutations in the Norrie disease pseudoglioma (NDP) gene were detected by direct sequencing. Haplotypes were constructed and compared with the phenotypes in the family. Evolutionary comparisons and mutant open reading frame (ORF) prediction were also undertaken. RESULTS Two family members with ocular manifestations were diagnosed with ND. No signs of sensorineural hearing loss were observed in either patient, while one of them showed signs of mild mental retardation. A novel heterozygous mutation in the NDP gene, c.-1_2delAAT, was detected in both patients. The mutation and the mutation bearing haplotype co-segregated with the ND phenotype in males and was transmitted from their mothers and/or grandmothers (II:2). The male without ND did not harbor the mutation. The mutation occurred at the highly conserved nucleotides. ORF finder predicted that the mutation would lead to the production of a truncated protein that lacks the first 11 N-terminal amino acids. CONCLUSION A novel mutation, c.-1_2delAAT in the NDP gene, was identified in a Chinese family with ND. This mutation caused ND without obvious sensorineural hearing loss. Mental disorder was found in one but not the other patients. The clinical heterogeneity in the family indicated that other genetic variants and epigenetic factors may also play a role in the disease presentation. PMID:24392318

  14. Towards Pervasive Augmented Reality: Context-Awareness in Augmented Reality.

    PubMed

    Grubert, Jens; Langlotz, Tobias; Zollmann, Stefanie; Regenbrecht, Holger

    2017-06-01

    Augmented Reality is a technique that enables users to interact with their physical environment through the overlay of digital information. While being researched for decades, more recently, Augmented Reality moved out of the research labs and into the field. While most of the applications are used sporadically and for one particular task only, current and future scenarios will provide a continuous and multi-purpose user experience. Therefore, in this paper, we present the concept of Pervasive Augmented Reality, aiming to provide such an experience by sensing the user's current context and adapting the AR system based on the changing requirements and constraints. We present a taxonomy for Pervasive Augmented Reality and context-aware Augmented Reality, which classifies context sources and context targets relevant for implementing such a context-aware, continuous Augmented Reality experience. We further summarize existing approaches that contribute towards Pervasive Augmented Reality. Based our taxonomy and survey, we identify challenges for future research directions in Pervasive Augmented Reality.

  15. Metabolic control after years of completing a clinical trial on sensor-augmented pump therapy.

    PubMed

    Quirós, Carmen; Giménez, Marga; Orois, Aida; Conget, Ignacio

    2015-11-01

    Sensor-augmented pump (SAP) therapy has been shown to be effective and safe for improving metabolic control in patients with type 1 diabetes mellitus (T1DM) in a number of trials. Our objective was to assess glycemic control in a group of T1DM patients on insulin pump or SAP therapy after years of participating in the SWITCH (Sensing With Insulin pump Therapy To Control HbA1c) trial and their return to routine medical monitoring. A retrospective, observational study of 20 patients who participated in the SWITCH trial at our hospital from 2008 to 2010. HbA1c values were compared at the start, during (at the end of the periods with/without SAP use - Sensor On/Sensor Off period respectively - of the cross-over design), and 3 years after study completion. HbA1c values of patients who continued SAP therapy (n=6) or only used insulin pump (n=14) were also compared. Twenty patients with T1DM (44.4±9.3 years, 60% women, baseline HbA1c level 8.43±0.55%) were enrolled into the SWITCH study). Three years after study completion, HbA1c level was 7.79±0.77 in patients on pump alone, with no significant change from the value at the end of the Off period of the study (7.85±0.57%; p=0.961). As compared to the end of the On period, HbA1c worsened less in patients who remained on SAP than in those on pump alone (0.18±0.42 vs. 0.55±0.71%; p=0.171), despite the fact that levels were similar at study start (8.41±0.60 vs. 8.47±0.45; p=0.831) and at the end of the On period (7.24±0.48 vs. 7.38±0.61; p=0.566). Frequency of CGM use in patients who continued SAP therapy was high (61.2% of the time in the last 3 months). Our study suggests that the additional benefit of SAP therapy achieved in a clinical trial may persist in the long term in routine clinical care of patients with T1DM. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. Coley's Lessons Remembered: Augmenting Mistletoe Therapy.

    PubMed

    Orange, Maurice; Reuter, Uwe; Hobohm, Uwe

    2016-12-01

    The following four observations point in the same direction, namely that there is an unleveraged potential for stimulating the innate immune system against cancer: (1) experimental treatments with bacterial extracts more than 100 years ago by Coley and contemporaries, (2) a positive correlation between spontaneous regressions and febrile infection, (3) epidemiological data suggesting an inverse correlation between a history of infection and the likelihood of developing cancer, and (4) our recent finding that a cocktail of pattern recognition receptor ligands (PRRLs) can eradicate solid tumors in cancer mice if applied metronomically. Because the main immunostimulating component of mistletoe extract (ME), mistletoe lectin, has been shown to be a PRRL as well, we suggest to apply ME in combination with additional PRRLs. Additional PRRLs can be found in approved drugs already on the market. Therefore, augmentation of ME might be feasible, with the aim of reattaining the old successes using approved drugs rather than bacterial extracts. © The Author(s) 2016.

  17. α-1 Antitrypsin Enhances Islet Engraftment by Suppression of Instant Blood-Mediated Inflammatory Reaction.

    PubMed

    Wang, Jingjing; Sun, Zhen; Gou, Wenyu; Adams, David B; Cui, Wanxing; Morgan, Katherine A; Strange, Charlie; Wang, Hongjun

    2017-04-01

    Islet cell transplantation has limited effectiveness because of an instant blood-mediated inflammatory reaction (IBMIR) that occurs immediately after cell infusion and leads to dramatic β-cell death. In intraportal islet transplantation models using mouse and human islets, we demonstrated that α-1 antitrypsin (AAT; Prolastin-C), a serine protease inhibitor used for the treatment of AAT deficiency, inhibits IBMIR and cytokine-induced inflammation in islets. In mice, more diabetic recipients reached normoglycemia after intraportal islet transplantation when they were treated with AAT compared with mice treated with saline. AAT suppressed blood-mediated coagulation pathways by diminishing tissue factor production, reducing plasma thrombin-antithrombin complex levels and fibrinogen deposition on islet grafts, which correlated with less graft damage and apoptosis. AAT-treated mice showed reduced serum tumor necrosis factor-α levels, decreased lymphocytic infiltration, and decreased nuclear factor (NF)-κB activation compared with controls. The potent anti-inflammatory effect of AAT is possibly mediated by suppression of c-Jun N-terminal kinase (JNK) phosphorylation. Blocking JNK activation failed to further reduce cytokine-induced apoptosis in β-cells. Taken together, AAT significantly improves islet graft survival after intraportal islet transplantation by mitigation of coagulation in IBMIR and suppression of cytokine-induced JNK and NF-κB activation. AAT-based therapy has the potential to improve graft survival in human islet transplantation and other cellular therapies on the horizon. © 2017 by the American Diabetes Association.

  18. Gluteal Augmentation With Intramuscular Implants in Patients With Human Immunodeficiency Virus With Lipoatrophy Related to the Use of Antiretroviral Therapy.

    PubMed

    Andrade, Guilherme Augusto; Coltro, Pedro Soler; Barros, Mário Eduardo; Müller Neto, Bruno Francisco; Lima, Renan Victor; Farina, Jayme Adriano

    2017-11-01

    Lipodystrophy syndrome associated with highly active antiretroviral therapy (HAART) may lead to low self-esteem and poor compliance with the drug treatment on patients infected with human immunodeficiency virus (HIV), which is a matter of concern for the health system. The aim of this study was to evaluate patients with HIV submitted to gluteal augmentation with intramuscular silicone implants to correct gluteal lipoatrophy related to the use of HAART. This is a retrospective evaluation of 10 patients submitted to gluteal augmentation with intramuscular silicone implant for correction of gluteal lipoatrophy related to the use of HAART, operated between 2012 and 2015. Postoperative complications and the degree of patient's satisfaction were analyzed. There were 3 postoperative complications including 1 case of surgical wound dehiscence and 2 cases of seroma. Six months after surgery, 8 patients had an excellent degree of satisfaction, and 2 patients had a good degree of satisfaction related to the procedure. Although this intervention does not offer functional advantages, it improves the body contour, increases patients' self-esteem, and helps them to accept their body image. These advantages can lead to higher compliance with prolonged HAART. Gluteal augmentation with intramuscular silicone implant can be a viable option to treat patients with HIV with gluteal lipoatrophy related to the use of HAART. The patients were satisfied with the outcomes of the procedure, and there were only minor self-limited postoperative complications.

  19. Impairment-oriented training or Bobath therapy for severe arm paresis after stroke: a single-blind, multicentre randomized controlled trial.

    PubMed

    Platz, T; Eickhof, C; van Kaick, S; Engel, U; Pinkowski, C; Kalok, S; Pause, M

    2005-10-01

    To study the effects of augmented exercise therapy time for arm rehabilitation as either Bobath therapy or the impairment-oriented training (Arm BASIS training) in stroke patients with arm severe paresis. Single blind, multicentre randomized control trial. Three inpatient neurorehabilitation centres. Sixty-two anterior circulation ischaemic stroke patients. Random assignment to three group: (A) no augmented exercise therapy time, (B) augmented exercise therapy time as Bobath therapy and (C) augmented exercise therapy time as Arm BASIS training. Fugl-Meyer arm motor score. Secondary measure: Action Research Arm Test (ARA). Ancillary measures: Fugl-Meyer arm sensation and joint motion/pain scores and the Ashworth Scale (elbow flexors). An overall effect of augmented exercise therapy time on Fugl-Meyer scores after four weeks was not corroborated (mean and 95% confidence interval (CI) of change scores: no augmented exercise therapy time (n=20) 8.8, 5.2-12.3; augmented exercise therapy time (n=40) 9.9, 6.8-13.9; p = 0.2657). The group who received the augmented exercise therapy time as Arm BASIS training (n=20) had, however, higher gains than the group receiving the augmented exercise therapy time as Bobath therapy (n=20) (mean and 95% CI of change scores: Bobath 7.2, 2.6-11.8; BASIS 12.6, 8.4-16.8; p = 0.0432). Passive joint motion/pain deteriorated less in the group who received BASIS training (mean and 95% CI of change scores: Bobath -3.2, -5.2 to -1.1; BASIS 0.1, -1.8-2.0; p = 0.0090). ARA, Fugl-Meyer arm sensation, and Ashworth Scale scores were not differentially affected. The augmented exercise therapy time as Arm BASIS training enhanced selective motor control. Type of training was more relevant for recovery of motor control than therapeutic time spent.

  20. Dioscin augments HSV-tk-mediated suicide gene therapy for melanoma by promoting connexin-based intercellular communication

    PubMed Central

    Li, Bin; Wu, Yingya; Liu, Xijuan; Tan, Yuhui; Du, Biaoyan

    2017-01-01

    Suicide gene therapy is a promising strategy against melanoma. However, the low efficiency of the gene transfer technique can limit its application. Our preliminary data showed that dioscin, a glucoside saponin, could upregulate the expression of connexins Cx26 and Cx43, major components of gap junctions, in melanoma cells. We hypothesized that dioscin may increase the bystander effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) through increasing the formation of gap junctions. Further analysis showed that dioscin indeed could increase the gap junctional intercellular communication in B16 melanoma cells, resulting in more efficient GCV-induced bystander killing in B16tk cells. By contrast, overexpression of dominant negative Cx43 impaired the cell-cell communication of B16 cells and subsequently weakened the bystander effect of HSV-tk/GCV gene therapy. In vivo, combination treatment with dioscin and GCV of tumor-bearing mice with 30% positive B16tk cells and 70% wild-type B16 cells caused a significant reduction in tumor volume and weight compared to treatment with GCV or dioscin alone. Taken together, these results demonstrated that dioscin could augment the bystander effect of the HSV-tk/GCV system through increasing connexin-mediated gap junction coupling. PMID:27903977

  1. Model-Based Sensor-Augmented Pump Therapy

    PubMed Central

    Grosman, Benyamin; Voskanyan, Gayane; Loutseiko, Mikhail; Roy, Anirban; Mehta, Aloke; Kurtz, Natalie; Parikh, Neha; Kaufman, Francine R.; Mastrototaro, John J.; Keenan, Barry

    2013-01-01

    Background In insulin pump therapy, optimization of bolus and basal insulin dose settings is a challenge. We introduce a new algorithm that provides individualized basal rates and new carbohydrate ratio and correction factor recommendations. The algorithm utilizes a mathematical model of blood glucose (BG) as a function of carbohydrate intake and delivered insulin, which includes individualized parameters derived from sensor BG and insulin delivery data downloaded from a patient’s pump. Methods A mathematical model of BG as a function of carbohydrate intake and delivered insulin was developed. The model includes fixed parameters and several individualized parameters derived from the subject’s BG measurements and pump data. Performance of the new algorithm was assessed using n = 4 diabetic canine experiments over a 32 h duration. In addition, 10 in silico adults from the University of Virginia/Padova type 1 diabetes mellitus metabolic simulator were tested. Results The percentage of time in glucose range 80–180 mg/dl was 86%, 85%, 61%, and 30% using model-based therapy and [78%, 100%] (brackets denote multiple experiments conducted under the same therapy and animal model), [75%, 67%], 47%, and 86% for the control experiments for dogs 1 to 4, respectively. The BG measurements obtained in the simulation using our individualized algorithm were in 61–231 mg/dl min–max envelope, whereas use of the simulator’s default treatment resulted in BG measurements 90–210 mg/dl min–max envelope. Conclusions The study results demonstrate the potential of this method, which could serve as a platform for improving, facilitating, and standardizing insulin pump therapy based on a single download of data. PMID:23567006

  2. Custom Titanium Ridge Augmentation Matrix (CTRAM): A Case Report.

    PubMed

    Connors, Christopher A; Liacouras, Peter C; Grant, Gerald T

    2016-01-01

    This is a case report of a custom titanium ridge augmentation matrix (CTRAM). Using cone beam computed tomography (CBCT), a custom titanium space-maintaining device was developed. Alveolar ridges were virtually augmented, a matrix was virtually designed, and the CTRAM was additively manufactured with titanium (Ti6Al4V). Two cases are presented that resulted in sufficient increased horizontal bone volume with successful dental implant placement. The CTRAM design allows for preoperative planning for increasing alveolar ridge dimensions to support dental implants, reduces surgical time, and prevents the need for a second surgical site to gain sufficient alveolar ridge bone volume for dental implant therapy.

  3. Dose timing of D-cycloserine to augment cognitive behavioral therapy for social anxiety: Study design and rationale.

    PubMed

    Hofmann, Stefan G; Carpenter, Joseph K; Otto, Michael W; Rosenfield, David; Smits, Jasper A J; Pollack, Mark H

    2015-07-01

    The use of D-cycloserine (DCS) as a cognitive enhancer to augment exposure-based cognitive-behavioral therapy (CBT) represents a promising new translational research direction with the goal to accelerate and optimize treatment response for anxiety disorders. Some studies suggest that DCS may not only augment extinction learning but could also facilitate fear memory reconsolidation. Therefore, the effect of DCS may depend on fear levels reported at the end of exposure sessions. This paper presents the rationale and design for a randomized controlled trial examining the relative efficacy of tailoring DCS administration based on exposure success (i.e. end fear levels) during a 5-session group CBT protocol for social anxiety disorder (n = 156). Specifically, tailored post-session DCS administration will be compared against untailored post-session DCS, untailored pre-session DCS, and pill placebo in terms of reduction in social anxiety symptoms and responder status. In addition, a subset of participants (n = 96) will undergo a fear extinction retention experiment prior to the clinical trial in which they will be randomly assigned to receive either DCS or placebo prior to extinguishing a conditioned fear. The results from this experimental paradigm will clarify the mechanism of the effects of DCS on exposure procedures. This study aims to serve as the first step toward developing an algorithm for the personalized use of DCS during CBT for social anxiety disorder, with the ultimate goal of optimizing treatment outcome for anxiety disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: A randomized, placebo-controlled pilot trial.

    PubMed

    Flanagan, Julianne C; Sippel, Lauren M; Wahlquist, Amy; Moran-Santa Maria, Megan M; Back, Sudie E

    2018-03-01

    Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition for which Prolonged Exposure (PE) therapy is highly efficacious. However, for some individuals, premature dropout and residual PTSD symptoms remain obstacles. The neuropeptide oxytocin is a promising candidate to enhance PE due to its ability to enhance 1) prosocial cognition and behavior, which are theorized to promote positive working alliance, and 2) extinction learning, which is the central mechanism of action underlying successful PE treatment. Despite a robust theoretical rationale, no studies to date have combined evidence-based psychotherapy for PTSD with oxytocin. This randomized, placebo-controlled, double-blind pilot trial examined the feasibility, safety, and preliminary efficacy of augmenting PE with oxytocin. Participants were 17 individuals with diverse index traumas. Participants self-administered intranasal oxytocin (40 IU) or matching placebo 45 min prior to each weekly PE therapy session. One adverse event occurred in the placebo group and three individuals dropped out (17.6%; 2 oxytocin group and 1 placebo group). The oxytocin group demonstrated lower PTSD and depression symptoms during PE, and had higher working alliance scores, although these differences did not reach statistical significance. Although preliminary, the findings support the feasibility of oxytocin combined with PE. Adequately powered studies are necessary to determine whether oxytocin enhances PE treatment outcomes and to examine potential mechanisms, such as accelerating extinction learning, enhancing early response, and preventing premature dropout. NCT03238924. Copyright © 2017. Published by Elsevier Ltd.

  5. Immune-based therapies.

    PubMed

    Lein, B

    1995-12-01

    Several immune-based HIV therapy studies presented at the Interscience Conference on Antimicrobial Agents Chemotherapy (ICAAC) are summarized. These studies involve the following therapies: HIV-IT, a gene therapy approach to augmenting the body's anti-HIV responses; interferon-alpha n3, a new formulation of alpha interferon with fewer toxicities; transfer of immune responses from one individual to another, also called passive immune therapy; and interleukin-2 (IL-2) in combination with protease inhibitors.

  6. Can augmented physiotherapy input enhance recovery of mobility after stroke? A randomized controlled trial.

    PubMed

    2004-08-01

    To discover if the provision of additional inpatient physiotherapy after stroke speeds the recovery of mobility. A multisite single-blind randomized controlled trial (RCT) comparing the effects of augmented physiotherapy input with normal input on the recovery of mobility after stroke. Three rehabilitation hospitals in North Glasgow, Scotland. Patients admitted to hospital with a clinical diagnosis of stroke, who were able to tolerate and benefit from mobility rehabilitation. We aimed to provide double the amount of physiotherapy to the augmented group. Primary outcomes were mobility milestones (ability to stand, step and walk), Rivermead Mobility Index (RMI) and walking speed. Seventy patients were recruited. The augmented therapy group received more direct contact with a physiotherapist (62 versus 35 minutes per weekday) and were more active (8.0% versus 4.8% time standing or walking) than normal therapy controls. The augmented group tended to achieve independent walking earlier (hazard ratio 1.48, 95% confidence interval 0.90-2.43; p=0.12) and had higher Rivermead Mobility Index scores at three months (mean difference 1.6; -0.1 to 3.3; p=0.068) but these differences did not reach statistical significance. There was no significant difference in any other outcome. A modest augmented physiotherapy programme resulted in patients having more direct physiotherapy time and being more active. The inability to show statistically significant changes in outcome measures could indicate either that this intervention is ineffective or that our study could not detect modest changes.

  7. Biomechanical and histological effects of augmented soft tissue mobilization therapy on achilles tendinopathy in a rabbit model.

    PubMed

    Imai, Kan; Ikoma, Kazuya; Chen, Qingshan; Zhao, Chunfeng; An, Kai-Nan; Gay, Ralph E

    2015-02-01

    Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury. This study was a non-human bench controlled research study using a rabbit model. Both Achilles tendons of 12 rabbits were injected with collagenase to produce tendon injury simulating Achilles tendinopathy. One side was then randomly allocated to receive ASTM, while the other received no treatment (control). ASTM was performed on the Achilles tendon on postoperative days 21, 24, 28, 31, 35, and 38. Tendons were harvested 10 days after treatment and examined with dynamic viscoelasticity and light microscopy. Cross-sectional area in the treated tendons was significantly greater than in controls. Storage modulus tended to be lower in the treated tendons but elasticity was not significantly increased. Loss modulus was significantly lower in the treated tendons. There was no significant difference found in tangent delta (loss modulus/storage modulus). Microscopy of control tendons showed that the tendon fibers were wavy and type III collagen was well stained. The tendon fibers of the augmented soft tissue mobilization treated tendons were not wavy and type III collagen was not prevalent. Biomechanical and histological findings showed that the Achilles tendons treated with ASTM had better recovery of biomechanical function than did control tendons. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  8. Dose Timing of D-cycloserine to Augment Cognitive Behavioral Therapy for Social Anxiety: Study Design and Rationale

    PubMed Central

    Carpenter, Joseph K.; Otto, Michael W.; Rosenfield, David; Smits, Jasper A. J.; Pollack, Mark H.

    2015-01-01

    The use of d-cycloserine (DCS) as a cognitive enhancer to augment exposure-based cognitive-behavioral therapy (CBT) represents a promising new translational research direction with the goal to accelerate and optimize treatment response for anxiety disorders. Some studies suggest that DCS may not only augment extinction learning but could also facilitate fear memory reconsolidation. Therefore, the effect of DCS may depend on fear levels reported at the end of exposure sessions. This paper presents the rationale and design for an ongoing randomized controlled trial examining the relative efficacy of tailoring DCS administration based on exposure success (i.e. end fear levels) during a 5-session group CBT protocol for social anxiety disorder (n = 156). Specifically, tailored post-session DCS administration will be compared against untailored post-session DCS, untailored pre-session DCS, and pill placebo in terms of reduction in social anxiety symptoms and responder status. In addition, a subset of participants (n = 96) will undergo a fear extinction retention experiment prior to the clinical trial in which they will be randomly assigned to receive either DCS or placebo prior to extinguishing a conditioned fear. The results from this experimental paradigm will clarify the mechanism of the effects of DCS on exposure procedures. This study aims to serve as the first step toward developing an algorithm for the personalized use of DCS during CBT for social anxiety disorder, with the ultimate goal of optimizing treatment outcome for anxiety disorders. ClinicalTrials.gov identifier: NCT02066792 PMID:26111923

  9. Restoring Segmental Biomechanics Through Nucleus Augmentation: An In Vitro Study.

    PubMed

    Pelletier, Matthew H; Cohen, Charles S; Ducheyne, Paul; Walsh, William R

    2016-12-01

    In vitro biomechanical laboratory study. The purpose of this study is to evaluate a mechanical treatment to create a degenerative motion segment and the ability of nucleus augmentation to restore biomechanics. In cases with an intact annulus fibrosus, the replacement or augmentation of the nucleus pulposus alone may provide a less invasive option to restore normal biomechanics and disk height when compared with spinal fusion or total disk replacement. Laboratory testing allows these changes to be fully characterized. However, without preexisting pathology, nucleus augmentation therapies are difficult to evaluate in vitro. The present study evaluated pure moment bending and compressive biomechanics in 3 states (n=6): (1) intact, (2) after creep loading and nucleus disruption to induce degenerative biomechanical changes, and (3) after nucleus augmentation through an injectable polymer (DiscCell). Neutral zone and ROM were increased in all modes of bending after the degenerative treatment. The most sensitive mode of bending was lateral bending, with intact ROM (20.0±2.9 degrees) increased to 22.3±2.6 degrees after degenerative treatment and reduced to 18.4±1.6 degrees after injection of the polymer. All bending ROM and NZ changes induced by the degenerative treatment were reversed by nucleus augmentation. This material was shown to be effective at altering motion segment biomechanics and restoring disk height during time zero tests. This technique may provide a model to examine the time zero performance of a nucleus augmentation device/material.

  10. The effect of a therapy dog on the communication skills of an adult with aphasia.

    PubMed

    LaFrance, Caroline; Garcia, Linda J; Labreche, Julianne

    2007-01-01

    Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

  11. Vascular mimicry in glioblastoma following anti-angiogenic and anti-20-HETE therapies.

    PubMed

    Angara, Kartik; Rashid, Mohammad H; Shankar, Adarsh; Ara, Roxan; Iskander, Asm; Borin, Thaiz F; Jain, Meenu; Achyut, Bhagelu R; Arbab, Ali S

    2017-09-01

    Glioblastoma (GBM) is one hypervascular and hypoxic tumor known among solid tumors. Antiangiogenic therapeutics (AATs) have been tested as an adjuvant to normalize blood vessels and control abnormal vasculature. Evidence of relapse exemplified in the progressive tumor growth following AAT reflects development of resistance to AATs. Here, we identified that GBM following AAT (Vatalanib) acquired an alternate mechanism to support tumor growth, called vascular mimicry (VM). We observed that Vatalanib induced VM vessels are positive for periodic acid-Schiff (PAS) matrix but devoid of any endothelium on the inner side and lined by tumor cells on the outer-side. The PAS+ matrix is positive for basal laminae (laminin) indicating vascular structures. Vatalanib treated GBM displayed various stages of VM such as initiation (mosaic), sustenance, and full-blown VM. Mature VM structures contain red blood cells (RBC) and bear semblance to the functional blood vessel-like structures, which provide all growth factors to favor tumor growth. Vatalanib treatment significantly increased VM especially in the core of the tumor, where HIF-1α was highly expressed in tumor cells. VM vessels correlate with hypoxia and are characterized by co-localized MHC-1+ tumor and HIF-1α expression. Interestingly, 20-HETE synthesis inhibitor HET0016 significantly decreased GBM tumors through decreasing VM structures both at the core and at periphery of the tumors. In summary, AAT induced resistance characterized by VM is an alternative mechanism adopted by tumors to make functional vessels by transdifferentiation of tumor cells into endothelial-like cells to supply nutrients in the event of hypoxia. AAT induced VM is a potential therapeutic target of the novel formulation of HET0016. Our present study suggests that HET0016 has a potential to target therapeutic resistance and can be combined with other antitumor agents in preclinical and clinical trials.

  12. Augmentation of Deglutitive Thyrohyoid Muscle Shortening by the Shaker Exercise

    PubMed Central

    Mepani, Rachel; Antonik, Stephen; Massey, Benson; Kern, Mark; Logemann, Jerilyn; Pauloski, Barbara; Rademaker, Alfred; Easterling, Caryn

    2010-01-01

    Earlier studies of the effect of 6 weeks of the Shaker Exercise have shown significant increase in UES opening and anterior excursion of larynx and hyoid during swallowing in patients with upper esophageal sphincter (UES) dysfunction, resulting in elimination of aspiration and resumption of oral intake. This effect is attributed to strengthening of the suprahyoid muscles, as evidenced by comparison of electromyographic changes in muscle fatigue before and after completion of the exercise regime. The effect of this exercise on thyrohyoid muscle shortening is unknown. Therefore the aim of this study was to determine the effect of the exercise on thyrohyoid muscle shortening. We studied 11 dysphagic patients with UES dysfunction. Six were randomized to traditional swallowing therapy and five to the Shaker Exercise. Videofluoroscopy was used to measure deglutitive thyrohyoid shortening before and after completion of assigned therapy regimen. Maximum thyrohyoid muscle shortening occurred at close temporal proximity to the time of maximal thyroid cartilage excursion. The percent change in thyrohyoid distance from initiation of deglutition to maximal anterior/superior hyoid excursion showed no statistically significant difference between the two groups prior to either therapy (p = 0.54). In contrast, after completion of therapy, the percent change in thyrohyoid distance in the Shaker Exercise group was significantly greater compared to the traditional therapy (p = 0.034). The Shaker Exercise augments the thyrohyoid muscle shortening in addition to strengthening the suprahyoid muscles. The combination of increased thyrohyoid shortening and suprahyoid strengthening contributes to the Shaker Exercise outcome of deglutitive UES opening augmentation. PMID:18685891

  13. Comparative study on treatment satisfaction and health perception in children and adolescents with type 1 diabetes mellitus on multiple daily injection of insulin, insulin pump and sensor-augmented pump therapy.

    PubMed

    Hussain, Tara; Akle, Mariette; Nagelkerke, Nico; Deeb, Asma

    2017-01-01

    Diabetes management imposes considerable demands on patients. Treatment method used has an impact on treatment satisfaction. We aim to examine the relationship between treatment satisfaction and health perception with the method used for treatment of type 1 diabetes mellitus in children and adolescents. We have interviewed patients with type 1 diabetes mellitus using questionnaires to assess treatment satisfaction and health perception. Patients were divided into three groups based on treatment used: multiple daily injection, insulin pump and sensor-augmented pump therapy. Comparison of scores was done between the groups. A total of 72 patients were enrolled (36 males). Mean age (standard deviation) was 11.4 (4.4) years and duration of diabetes of 4.9 (3.5) years. Mean (standard deviation) HbA1c was 8.1 (1.2). Median (range) duration of sensor use was 17.7 (3-30) days/month. Mean scale for treatment satisfaction and health perception questions was 25.3, 29.7 and 31.7 and 60, 79.7 and 81 for the multiple daily injection, pump and sensor-augmented pump, respectively (p = 0.00). Significant difference was seen between the multiple daily injection and both other groups. Sensor-augmented pump group scored higher than the pump group. However, the difference was not statistically significant. Duration of sensor use showed no correlation with treatment satisfaction. The method used for diabetes treatment has an impact on patients' satisfaction and health perception in children and adolescents with type 1 diabetes mellitus. Insulin pump users have a higher treatment satisfaction and better health perception than those on multiple daily injection. Augmenting pump therapy with sensor use adds value to treatment satisfaction without correlation with the duration of the sensors use.

  14. An Exploratory Study of Animal-Assisted Interventions Utilized by Mental Health Professionals

    ERIC Educational Resources Information Center

    O'Callaghan, Dana M.; Chandler, Cynthia K.

    2011-01-01

    This study implemented an exploratory analysis to examine how a sample of mental health professionals incorporates specific animal-assisted techniques into the therapeutic process. An extensive review of literature related to animal-assisted therapy (AAT) resulted in the identification of 18 techniques and 10 intentions for the practice of AAT in…

  15. Is Counseling Going to the Dogs? An Exploratory Study Related to the Inclusion of an Animal in Group Counseling with Adolescents

    ERIC Educational Resources Information Center

    Lange, Amber M.; Cox, Jane A.; Bernert, Donna J.; Jenkins, Christie D.

    2007-01-01

    Research has demonstrated that the use of animals in counseling provides beneficial effects to clients. This article presents literature on Animal-Assisted Therapy (AAT), and details an exploratory study that applied AAT in an adolescent anger management group. Consistent with other research, beneficial effects noted in this study included a…

  16. Secondary Breast Augmentation.

    PubMed

    Brown, Mitchell H; Somogyi, Ron B; Aggarwal, Shagun

    2016-07-01

    After studying this article, the participant should be able to: 1. Assess common clinical problems in the secondary breast augmentation patient. 2. Describe a treatment plan to correct the most common complications of breast augmentation. 3. Provide surgical and nonsurgical options for managing complications of breast augmentation. 4. Decrease the incidence of future complications through accurate assessment, preoperative planning, and precise surgical technique. Breast augmentation has been increasing steadily in popularity over the past three decades. Many of these patients present with secondary problems or complications following their primary breast augmentation. Two of the most common complications are capsular contracture and implant malposition. Familiarity and comfort with the assessment and management of these complications is necessary for all plastic surgeons. An up-to-date understanding of current devices and techniques may decrease the need to manage future complications from the current cohort of breast augmentation patients.

  17. Chin augmentation

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002986.htm Chin augmentation To use the sharing features on this page, please enable JavaScript. Chin augmentation is surgery to reshape or enhance the size ...

  18. Augmented reality in surgical procedures

    NASA Astrophysics Data System (ADS)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

    2008-02-01

    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  19. Switching and augmentation strategies for antipsychotic medications in acute-phase schizophrenia: latest evidence and place in therapy

    PubMed Central

    Hatta, Kotaro; Sugiyama, Naoya; Ito, Hiroto

    2018-01-01

    In terms of effectiveness of antipsychotics in schizophrenia, discrepancy often exists between results from double-blind randomized controlled trials and observations in emergency or acute-phase clinical practice. For instance, the antipsychotic switching strategy is not always applicable in emergency or acute-phase situations, and augmentation of another antipsychotic is occasionally done instead. In this review, we discuss strategies for early nonresponse to an antipsychotic drug such as switching and augmentation from the perspective of emergency and acute-phase treatment. We searched PubMed for the latest evidence on switching and augmentation strategies of antipsychotics for an emergency or acute-phase period. For risperidone and olanzapine, there is some evidence on switching and augmentation strategies in the management of acute-phase schizophrenia. There may be responders to olanzapine alone among early nonresponders to risperidone, whereas there may be few responders to risperidone alone among early nonresponders to olanzapine. However, there is still insufficient evidence at this time for application of these findings to routine clinical practice. For other antipsychotics, there is little evidence for their augmentation in acute-phase practice. We should be wary of polypharmacy, as multiple agents are too often prescribed by clinicians when not warranted. Considering current evidence, we propose how to switch antipsychotics in the acute phase of schizophrenia in routine practice. PMID:29854396

  20. Alpha-1 Antitrypsin Prevents the Development of Preeclampsia Through Suppression of Oxidative Stress.

    PubMed

    Feng, Yaling; Xu, Jianjuan; Zhou, Qin; Wang, Rong; Liu, Nin; Wu, Yanqun; Yuan, Hua; Che, Haisha

    2016-01-01

    Preeclampsia (PE) and its complications have become the leading cause of maternal and fetal morbidity and mortality in the world. And the development of PE is still barely predictable and thus challenging to prevent and manage clinically. Oxidative stress contributes to the development of the disease. Our previous study demonstrated that exogenous Alpha-1 antitrypsin (AAT) played a cytoprotective role in vascular endothelial cell by suppressing oxidative stress. In this study, we aim to investigate whether AAT contributes to the development of PE, and to identify the mechanism behind these effects. We found that AAT levels were significantly decreased in placenta tissues from women with PE compared that of healthy women. Notably, we demonstrate that AAT injection is able to relieve the high blood pressure and reduce urine protein levels in a dose-dependent manner in PE mice. In addition, our results showed that AAT injection exhibited an anti-oxidative stress role by significantly reducing PE mediated-upregulation of ROS, MMP9 and MDA, and increasing the levels of SOD, eNOS, and GPx with increased dosage of AAT. Furthermore, we found that AAT injection inactivated PE mediated activation of PAK/STAT1/p38 signaling. These findings were confirmed in human samples. In conclusion, our study suggests that exogenous AAT injection increases the antioxidants and suppresses oxidative stress, and subsequent prevention of PE development through inactivation of STAT1/p38 signaling. Thus, AAT would become a potential strategy for PE therapy.

  1. Augmenting computer networks

    NASA Technical Reports Server (NTRS)

    Bokhari, S. H.; Raza, A. D.

    1984-01-01

    Three methods of augmenting computer networks by adding at most one link per processor are discussed: (1) A tree of N nodes may be augmented such that the resulting graph has diameter no greater than 4log sub 2((N+2)/3)-2. Thi O(N(3)) algorithm can be applied to any spanning tree of a connected graph to reduce the diameter of that graph to O(log N); (2) Given a binary tree T and a chain C of N nodes each, C may be augmented to produce C so that T is a subgraph of C. This algorithm is O(N) and may be used to produce augmented chains or rings that have diameter no greater than 2log sub 2((N+2)/3) and are planar; (3) Any rectangular two-dimensional 4 (8) nearest neighbor array of size N = 2(k) may be augmented so that it can emulate a single step shuffle-exchange network of size N/2 in 3(t) time steps.

  2. An adaptive brain actuated system for augmenting rehabilitation

    PubMed Central

    Roset, Scott A.; Gant, Katie; Prasad, Abhishek; Sanchez, Justin C.

    2014-01-01

    For people living with paralysis, restoration of hand function remains the top priority because it leads to independence and improvement in quality of life. In approaches to restore hand and arm function, a goal is to better engage voluntary control and counteract maladaptive brain reorganization that results from non-use. Standard rehabilitation augmented with developments from the study of brain-computer interfaces could provide a combined therapy approach for motor cortex rehabilitation and to alleviate motor impairments. In this paper, an adaptive brain-computer interface system intended for application to control a functional electrical stimulation (FES) device is developed as an experimental test bed for augmenting rehabilitation with a brain-computer interface. The system's performance is improved throughout rehabilitation by passive user feedback and reinforcement learning. By continuously adapting to the user's brain activity, similar adaptive systems could be used to support clinical brain-computer interface neurorehabilitation over multiple days. PMID:25565945

  3. Long-Term Efficacy and Safety of Sensor Augmented Insulin Pump Therapy with Low-Glucose Suspend Feature in Patients with Type 1 Diabetes.

    PubMed

    Gómez, Ana María; Marín Carrillo, Lisseth Fernanda; Muñoz Velandia, Oscar Mauricio; Rondón Sepúlveda, Martín Alonso; Arévalo Correa, Carol M; Mora Garzón, Edwin; Cuervo Diaz, Maria Camila; Henao Carrillo, Diana Cristina

    2017-02-01

    Literature supports short-term efficacy and safety of Sensor Augmented Insulin Pump (SAP) therapy in patients with type 1 diabetes (T1D). However, no data are available showing long-term outcomes. Our study describes the long-term outcomes of SAP therapy with low-glucose suspend feature (SAP+LGS) in hypoglycemia in a Colombian population with T1D and hypoglycemia. A cohort study was conducted with T1D patients receiving SAP+LGS therapy who initiated this therapy because of hypoglycemia at San Ignacio University Hospital diabetes center in Bogotá, Colombia. Glycated hemoglobin (A1c) was assessed at least every 6 months, severe hypoglycemia (SH) and hypoglycemia unawareness (HU) incidence yearly. Adherence to therapy was also evaluated. One hundred eleven patients were included in the analysis. Total daily insulin dose was reduced during follow-up (mean difference -0.22 U/kg; 95% confidence interval [CI] -0.18 to -0.26; P < 0.001). A1c levels were reduced from a baseline value of 8.8% ± 1.9% to 7.5% ± 1.0% at 5 months (mean difference -1.3%; 95% CI -1.09 to -1.50; P < 0.001) and 7.1% ± 0.8% (mean difference -1.7%; 95% CI -1.59 to -1.90; P < 0.001) at the end of follow-up (47 months on average). The incidence of SH and HU episodes decreased significantly since the first year, and this effect was maintained over time (P < 0.001). SAP+LGS therapy in T1D patients with hypoglycemia led to a significant and sustained decrease in A1c during long periods of follow-up, as well as a significant reduction in SH and HU. Future randomized clinical trials are desired.

  4. Prevention of hypoglycemia by using low glucose suspend function in sensor-augmented pump therapy.

    PubMed

    Danne, Thomas; Kordonouri, Olga; Holder, Martin; Haberland, Holger; Golembowski, Sven; Remus, Kerstin; Bläsig, Sara; Wadien, Tanja; Zierow, Susanne; Hartmann, Reinhard; Thomas, Andreas

    2011-11-01

    Severe hypoglycemic episodes are a barrier for achieving optimal glycemic control. Sensor-augmented pump (SAP) therapy with insulin in combination with a novel mechanism of automatic insulin shutoff (low glucose suspend [LGS]) can be used to prevent and reduce hypoglycemia. In a prospective study, we investigated the effect of the LGS algorithm on the frequency of hypoglycemia in children and adolescents with type 1 diabetes under real-life conditions. Twenty-one patients with type 1 diabetes (10.8±3.8 years old, duration of diabetes 5.9±3.0 years, pump therapy for 3.7±1.7 years, glycated hemoglobin level 7.8±1.1%) from three pediatric centers used the Paradigm(®) Veo(™) system (Medtronic Minimed, Northridge, CA) during two subseqent time periods: SAP without LGS for 2 weeks and then SAP with LGS enabled for 6 weeks. The primary objective was to assess the frequency of hypoglycemic episodes when using the LGS feature with an insulin delivery shutoff of a maximum of 2 h at a sensor glucose level below 70 mg/dL (3.9 mmol/L). In total, 1,298 LGS alerts occurred (853 shorter than 5 min). Forty-two percent of LGS activations (>5 min) lasted less than 30 min, whereas 24% had a duration of 2 h. The number of hypoglycemic excursions (average/day) was reduced during SAP+LGS (<70 mg/L, 1.27±0.75 vs. 0.95±0.49, P=0.010; ≤40 mg/dL, 0.28±0.18 vs. 0.13±0.14, P=0.005) as was the time spent in hypoglycemia (average minutes/day, 101±68 vs. 58±33, P=0.002) without significant difference in the mean glucose level (145±23 vs. 148±19 mg/dL). No episodes of severe hyperglycemia or diabetic ketoacidosis were observed following LGS activation. The present investigation provides evidence that SAP with LGS reduces the frequency of hypoglycemia without compromising safety.

  5. Associations Between Medication Class and Subsequent Augmentation of Depression Treatment in Privately Insured US Adults.

    PubMed

    Ameli, Omid; Soria-Saucedo, Rene; Smith, Eric G; Cabral, Howard J; Soley-Bori, Marina; Kazis, Lewis E

    2017-06-01

    Treatment augmentation is an important clinical decision in the pharmacotherapy for depression, yet few studies have examined the rates of treatment augmentation by medication class. The aim of this study was to examine which initial pharmacotherapies for depression are more likely than others to result in subsequent treatment augmentation. This study is a retrospective cohort analysis of administrative data of 214,705 privately insured US adults between the age of 18 and 64 years who were diagnosed with a new episode of depression in 2009. Propensity score-adjusted logistic regression and Cox regression were used to model the effect of the class of initial monotherapy on treatment augmentation. Risk adjustors included depression severity, comorbidities, provider type, insurance, and demographic characteristics. The class of initial monotherapy and the health care provider type were the main independent variables of interest. The outcome was the augmentation of monotherapy. Thirty-four percent of individuals received treatment augmentation. Compared with selective serotonin reuptake inhibitor monotherapy, second-generation antipsychotics as the initial treatment were associated with significant increase in the likelihood of augmentation compared with the other classes (hazards ratio, 2.59; 95% confidence interval [CI], 2.51-2.68). This result was corroborated after propensity score adjustment (odds ratio, 2.85; 95% CI, 2.70-3.00) when comparing second-generation antipsychotics to the other classes of pharmacotherapy. The other significant predictor of treatment augmentation was the provider type. Mental health specialists were 27% more likely to augment a treatment compared with generalists (hazards ratio, 1.27; 95% CI, 1.25-1.30). The type of initial antidepressant therapy is associated with the chances of treatment augmentation. Second-generation antipsychotics progressed to augmentation more rapidly than the other classes.

  6. Optimizing the Use of Aripiprazole Augmentation in the Treatment of Major Depressive Disorder: From Clinical Trials to Clinical Practice

    PubMed Central

    Han, Changsu; Wang, Sheng-Min; Lee, Soo-Jung; Jun, Tae-Youn

    2015-01-01

    Major depressive disorder (MDD) is a recurrent, chronic, and devastating disorder leading to serious impairment in functional capacity as well as increasing public health care costs. In the previous decade, switching therapy and dose adjustment of ongoing antidepressants was the most frequently chosen subsequent treatment option for MDD. However, such recommendations were not based on firmly proven efficacy data from well-designed, placebo-controlled, randomized clinical trials (RCTs) but on practical grounds and clinical reasoning. Aripiprazole augmentation has been dramatically increasing in clinical practice owing to its unique action mechanisms as well as proven efficacy and safety from adequately powered and well-controlled RCTs. Despite the increased use of aripiprazole in depression, limited clinical information and knowledge interfere with proper and efficient use of aripiprazole augmentation for MDD. The objective of the present review was to enhance clinicians' current understanding of aripiprazole augmentation and how to optimize the use of this therapy in the treatment of MDD. PMID:26306301

  7. Pilot-optimal augmentation synthesis

    NASA Technical Reports Server (NTRS)

    Schmidt, D. K.

    1978-01-01

    An augmentation synthesis method usable in the absence of quantitative handling qualities specifications, and yet explicitly including design objectives based on pilot-rating concepts, is presented. The algorithm involves the unique approach of simultaneously solving for the stability augmentation system (SAS) gains, pilot equalization and pilot rating prediction via optimal control techniques. Simultaneous solution is required in this case since the pilot model (gains, etc.) depends upon the augmented plant dynamics, and the augmentation is obviously not a priori known. Another special feature is the use of the pilot's objective function (from which the pilot model evolves) to design the SAS.

  8. Augmenting the access grid using augmented reality

    NASA Astrophysics Data System (ADS)

    Li, Ying

    2012-01-01

    The Access Grid (AG) targets an advanced collaboration environment, with which multi-party group of people from remote sites can collaborate over high-performance networks. However, current AG still employs VIC (Video Conferencing Tool) to offer only pure video for remote communication, while most AG users expect to collaboratively refer and manipulate the 3D geometric models of grid services' results in live videos of AG session. Augmented Reality (AR) technique can overcome the deficiencies with its characteristics of combining virtual and real, real-time interaction and 3D registration, so it is necessary for AG to utilize AR to better assist the advanced collaboration environment. This paper introduces an effort to augment the AG by adding support for AR capability, which is encapsulated in the node service infrastructure, named as Augmented Reality Service (ARS). The ARS can merge the 3D geometric models of grid services' results and real video scene of AG into one AR environment, and provide the opportunity for distributed AG users to interactively and collaboratively participate in the AR environment with better experience.

  9. Practice comparisons between accelerated resolution therapy, eye movement desensitization and reprocessing and cognitive processing therapy with case examples.

    PubMed

    Hernandez, Diego F; Waits, Wendi; Calvio, Lisseth; Byrne, Mary

    2016-12-01

    Recent outcomes for Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy indicate that as many as 60-72% of patients retain their PTSD diagnosis after treatment with CPT or PE. One emerging therapy with the potential to augment existing trauma focused therapies is Accelerated Resolution Therapy (ART). ART is currently being used along with evidence based approaches at Fort Belvoir Community Hospital and by report has been both positive for clients as well as less taxing on professionals trained in ART. The following is an in-practice theoretical comparison of CPT, EMDR and ART with case examples from Fort Belvoir Community Hospital. While all three approaches share common elements and interventions, ART distinguishes itself through emphasis on the rescripting of traumatic events and the brevity of the intervention. While these case reports are not part of a formal study, they suggest that ART has the potential to augment and enhance the current delivery methods of mental health care in military environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Asialofetuin liposome-mediated human alpha1-antitrypsin gene transfer in vivo results in stationary long-term gene expression.

    PubMed

    Dasí, F; Benet, M; Crespo, J; Crespo, A; Aliño, S F

    2001-05-01

    The development of nonviral vectors for in vivo gene delivery to hepatocytes is an interesting topic in view of their safety and tremendous gene therapy potential. Since cationic liposomes and liposome uptake by receptor-mediated mechanisms could offer advantages in the efficacy of liposome-mediated gene transfer, we studied the effect of liposome charge (anionic vs. cationic) and the covalently coupled asialofetuin ligand on the liposome surface in mediating human alpha1-antitrypsin (hAAT) gene transfer to mice in vivo. The changes in liposome charge were made by adding the following lipids to the backbone liposomes: anionic phosphatidylserine, cationic N-[1-(2,3-dioleoyloxy)propyl]-N,N,N-trimethyl-ammonium methylsulfate or a lipopeptide synthesized from dipalmitoylphosphatidylethanolamine and covalently coupled to the cationic nuclear localization signal peptide. Two plasmids containing the hAAT gene were used: pTG7101, containing the complete genomic sequence of the human gene driven by the natural promoter, and p216, containing the human hAAT cDNA under the control of the CMV promoter. The results indicate that both untargeted anionic and cationic liposomes mediate plasma levels of hAAT that decline over time. However, asialofetuin liposomes increase the plasma levels of hAAT and can mediate long-term gene expression (>12 months) with stationary plasma levels of protein. Results from quantitative and qualitative reverse transcriptase polymerase chain reaction match those from protein plasma levels and confirm both the human origin of the message and the liver as source of the protein. The use of asialofetuin liposomes in hepatic gene therapy may both increase and prolong in vivo gene expression of hAAT and other clinically important genes.

  11. Histone deacetylase inhibitors augment doxorubicin-induced DNA damage in cardiomyocytes.

    PubMed

    Ververis, Katherine; Rodd, Annabelle L; Tang, Michelle M; El-Osta, Assam; Karagiannis, Tom C

    2011-12-01

    Histone deacetylase inhibitors have emerged as a new class of anticancer therapeutics with suberoylanilide hydroxamic acid (Vorinostat) and depsipeptide (Romidepsin) already being approved for clinical use. Numerous studies have identified that histone deacetylase inhibitors will be most effective in the clinic when used in combination with conventional cancer therapies such as ionizing radiation and chemotherapeutic agents. One promising combination, particularly for hematologic malignancies, involves the use of histone deacetylase inhibitors with the anthracycline, doxorubicin. However, we previously identified that trichostatin A can potentiate doxorubicin-induced hypertrophy, the dose-limiting side-effect of the anthracycline, in cardiac myocytes. Here we have the extended the earlier studies and evaluated the effects of combinations of the histone deacetylase inhibitors, trichostatin A, valproic acid and sodium butyrate on doxorubicin-induced DNA double-strand breaks in cardiomyocytes. Using γH2AX as a molecular marker for the DNA lesions, we identified that all of the broad-spectrum histone deacetylase inhibitors tested augment doxorubicin-induced DNA damage. Furthermore, it is evident from the fluorescence photomicrographs of stained nuclei that the histone deacetylase inhibitors also augment doxorubicin-induced hypertrophy. These observations highlight the importance of investigating potential side-effects, in relevant model systems, which may be associated with emerging combination therapies for cancer.

  12. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.

    PubMed

    Sagheb, K; Schiegnitz, E; Moergel, M; Walter, C; Al-Nawas, B; Wagner, W

    2017-12-01

    The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of the patients for the first time. In 17 patients, 21 different regions were augmented with an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany). For the augmentation, a mixture of autologous bone and deproteinized bovine bone mineral (DBBM) or autologous bone alone was used. Reentry with explantation of the TM and simultaneous implantation of 44 implants were performed after 6 months. Preoperative and 6-month postoperative cone beam computed tomographies (CBCT) were performed to measure the gained bone height. The success rate for the bone grafting procedure was 100%. Thirty-three percent of cases presented an exposure of the TM during the healing period. However, premature removal of these exposed meshes was not necessary. Exposure rate in augmentations performed with mid-crestal incisions was higher than in augmentations performed with a modified poncho incision (45.5 vs. 20%, p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on the exposure rate (p > 0.05). The mean vertical augmentation was 6.5 ± 1.7 mm, and the mean horizontal augmentation was 5.5 ± 1.9 mm. Implant survival rate after a mean follow-up of 12 ± 6 months after reentry was 100%. Within the limits of the retrospective character of this study, this study shows for the first time that individualized CAD-CAM TM provide a sufficient and safe augmentation technique

  13. In the Age of Breast Augmentation, Breast Reconstruction Provides an Opportunity to Augment the Breast.

    PubMed

    Zimmerman, Amanda L; Tugertimur, Bugra; Smith, Paul D; Kumar, Ambuj; Dayicioglu, Deniz

    2017-01-01

    Augmentation mammoplasty remains the most common cosmetic surgery procedure performed. The objective of this article is to evaluate the impact of augmented volume of the reconstructed breast in patients that undergo nipple-sparing mastectomy and patients previously augmented who undergo mastectomy with tissue expander/implant-based reconstruction. Patients undergoing skin-sparing mastectomy, nipple-sparing mastectomy, and mastectomy after previous augmentation followed by tissue expander/implant-based reconstruction between June 2011 and April 2015 by 2 surgeons at the same institution were included. Retrospective chart review of the patients identified using these criteria was performed to record patient characteristics, complications, breast volume, implant volume, and percentage change in volume at the time of reconstruction. Percentage change of breast volume was calculated using the formula (implant breast weight)/(breast weight) for skin-sparing and nipple-sparing mastectomy patients and (final breast implant weight - [breast weight + augmentation breast implant weight])/([breast weight + augmentation breast implant]) for patients undergoing mastectomy following previous augmentation. A total of 293 patients were included in the study with 63 patients who underwent nipple-sparing mastectomy, 166 patients who underwent skin-sparing mastectomy, and 64 patients who underwent previous augmentation with subsequent mastectomy. Mean percentage change in breast volume was 66% in the nipple-sparing mastectomy group, 15% for the right breast and 18% for the left breast in the skin-sparing mastectomy group, and 81% for the right breast and 72% for the left breast in the mastectomy following previous augmentation group. Complication rate for nipple-sparing mastectomy was 27%, mastectomy following previous augmentation was 20.3%, and skin-sparing mastectomy group was 18.7%. Patients who undergo nipple-sparing mastectomy or mastectomy following previous augmentation have

  14. Randomized trial of a dual-hormone artificial pancreas with dosing adjustment during exercise compared with no adjustment and sensor-augmented pump therapy.

    PubMed

    Jacobs, P G; El Youssef, J; Reddy, R; Resalat, N; Branigan, D; Condon, J; Preiser, N; Ramsey, K; Jones, M; Edwards, C; Kuehl, K; Leitschuh, J; Rajhbeharrysingh, U; Castle, J R

    2016-11-01

    To test whether adjusting insulin and glucagon in response to exercise within a dual-hormone artificial pancreas (AP) reduces exercise-related hypoglycaemia. In random order, 21 adults with type 1 diabetes (T1D) underwent three 22-hour experimental sessions: AP with exercise dosing adjustment (APX); AP with no exercise dosing adjustment (APN); and sensor-augmented pump (SAP) therapy. After an overnight stay and 2 hours after breakfast, participants exercised for 45 minutes at 60% of their maximum heart rate, with no snack given before exercise. During APX, insulin was decreased and glucagon was increased at exercise onset, while during SAP therapy, subjects could adjust dosing before exercise. The two primary outcomes were percentage of time spent in hypoglycaemia (<3.9 mmol/L) and percentage of time spent in euglycaemia (3.9-10 mmol/L) from the start of exercise to the end of the study. The mean (95% confidence interval) times spent in hypoglycaemia (<3.9 mmol/L) after the start of exercise were 0.3% (-0.1, 0.7) for APX, 3.1% (0.8, 5.3) for APN, and 0.8% (0.1, 1.4) for SAP therapy. There was an absolute difference of 2.8% less time spent in hypoglycaemia for APX versus APN (p = .001) and 0.5% less time spent in hypoglycaemia for APX versus SAP therapy (p = .16). Mean time spent in euglycaemia was similar across the different sessions. Adjusting insulin and glucagon delivery at exercise onset within a dual-hormone AP significantly reduces hypoglycaemia compared with no adjustment and performs similarly to SAP therapy when insulin is adjusted before exercise. © 2016 John Wiley & Sons Ltd.

  15. Augmented renal clearance is not a risk factor for mortality in Enterobacteriaceae bloodstream infections treated with appropriate empiric antimicrobials.

    PubMed

    Burnham, Jason P; Micek, Scott T; Kollef, Marin H

    2017-01-01

    The main objective of the study was to assess whether augmented renal clearance was a risk factor for mortality in a cohort of patients with Enterobacteriaceae sepsis, severe sepsis, or septic shock that all received appropriate antimicrobial therapy within 12 hours. Using a retrospective cohort from Barnes-Jewish Hospital, a 1,250-bed teaching hospital, we collected data on individuals with Enterobacteriaceae sepsis, severe sepsis, and septic shock who received appropriate initial antimicrobial therapy between June 2009 and December 2013. Clinical outcomes were compared according to renal clearance, as assessed by Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, sepsis classification, demographics, severity of illness, and comorbidities. We identified 510 patients with Enterobacteriaceae bacteremia and sepsis, severe sepsis, or septic shock. Sixty-seven patients (13.1%) were nonsurvivors. Augmented renal clearance was uncommon (5.1% of patients by MDRD and 3.0% by CKD-EPI) and was not associated with increased mortality. Our results are limited by the absence of prospective determination of augmented renal clearance. However, in this small cohort, augmented renal clearance as assessed by MDRD and CKD-EPI does not seem to be a risk factor for mortality in patients with Enterobacteriaceae sepsis. Future studies should assess this finding prospectively.

  16. [Augmentation technique on the proximal humerus].

    PubMed

    Scola, A; Gebhard, F; Röderer, G

    2015-09-01

    The treatment of osteoporotic fractures is still a challenge. The advantages of augmentation with respect to primary in vitro stability and the clinical use for the proximal humerus are presented in this article. In this study six paired human humeri were randomized into an augmented and a non-augmented group. Osteosynthesis was performed with a PHILOS plate (Synthes®). In the augmented group the two screws finding purchase in the weakest cancellous bone were augmented. The specimens were tested in a 3-part fracture model in a varus bending test. The augmented PHILOS plates withstood significantly more load cycles until failure. The correlation to bone mineral density (BMD) showed that augmentation could partially compensate for low BMD. The augmentation of the screws in locked plating in a proximal humerus fracture model is effective in improving the primary stability in a cyclic varus bending test. The targeted augmentation of two particular screws in a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality could be more effective in enhancing the primary stability of a proximal humerus locking plate because the effect of augmentation can be exploited more effectively limiting it to the degree required. The technique of augmentation is simple and can be applied in open and minimally invasive procedures. When the correct procedure is used, complications (cement leakage into the joint) can be avoided.

  17. Advances in biologic augmentation for rotator cuff repair

    PubMed Central

    Patel, Sahishnu; Gualtieri, Anthony P.; Lu, Helen H.; Levine, William N.

    2016-01-01

    Rotator cuff tear is a very common shoulder injury that often necessitates surgical intervention for repair. Despite advances in surgical techniques for rotator cuff repair, there is a high incidence of failure after surgery because of poor healing capacity attributed to many factors. The complexity of tendon-to-bone integration inherently presents a challenge for repair because of a large biomechanical mismatch between the tendon and bone and insufficient regeneration of native tissue, leading to the formation of fibrovascular scar tissue. Therefore, various biological augmentation approaches have been investigated to improve rotator cuff repair healing. This review highlights recent advances in three fundamental approaches for biological augmentation for functional and integrative tendon–bone repair. First, the exploration, application, and delivery of growth factors to improve regeneration of native tissue is discussed. Second, applications of stem cell and other cell-based therapies to replenish damaged tissue for better healing is covered. Finally, this review will highlight the development and applications of compatible biomaterials to both better recapitulate the tendon–bone interface and improve delivery of biological factors for enhanced integrative repair. PMID:27750374

  18. Advanced intellect-augmentation techniques

    NASA Technical Reports Server (NTRS)

    Engelbart, D. C.

    1972-01-01

    User experience in applying our augmentation tools and techniques to various normal working tasks within our center is described so as to convey a subjective impression of what it is like to work in an augmented environment. It is concluded that working-support, computer-aid systems for augmenting individuals and teams, are undoubtedly going to be widely developed and used. A very special role in this development is seen for multi-access computer networks.

  19. Effects of early augmentation of labour with amniotomy and oxytocin in nulliparous women: a meta-analysis.

    PubMed

    Fraser, W; Vendittelli, F; Krauss, I; Bréart, G

    1998-02-01

    To estimate the effects among nulliparae of early augmentation with amniotomy and oxytocin on caesarean delivery, and on other indicators of maternal and neonatal morbidity including transfusion. Apgar score < 7 at 5 minutes, and admission to the special care nursery. Meta-analysis. Published studies were identified through manual and computerised searches. Two unpublished studies were identified through direct communication with the investigators. Twelve trials were identified which compared a policy of early labour augmentation including amniotomy followed by oxytocin with a less active form of management. Two methodologically unacceptable studies were excluded. Studies were grouped according to whether they admitted only women with abnormal progress (therapy trials: n = 3) or accepted women with normal labour (prevention trials: n = 7). Unstratified analysis did not provide support for the hypothesis that early augmentation reduces the risk of caesarean section (typical odds ratio [OR] 0.9; 95% CI 0.7-1.1). The typical odds ratio for prevention trials was similar to that obtained in the unstratified analysis (typical OR 0.9, 95% CI 0.7-1.2). Although only a small number of women have been randomised in therapy trials, a trend toward a reduction in the rate of caesarean section with early intervention was seen in this group (typical OR 0.6, 95% CI 0.2-1.4). Early augmentation does not appear to provide benefit over a more conservative form of management in the context of care of nulliparous women with mild delays in the progress of labour. In the context of established delay in labour, an active policy of augmentation may reduce the risk of caesarean section. However, only three small trials have been performed in this context, and they do not have adequate power to allow firm conclusions to be drawn.

  20. The Status of RPE65 Gene Therapy Trials: Safety and Efficacy

    PubMed Central

    Pierce, Eric A.; Bennett, Jean

    2015-01-01

    Several groups have reported the results of clinical trials of gene augmentation therapy for Leber congenital amaurosis (LCA) because of mutations in the RPE65 gene. These studies have used subretinal injection of adeno-associated virus (AAV) vectors to deliver the human RPE65 cDNA to the retinal pigment epithelial (RPE) cells of the treated eyes. In all of the studies reported to date, this approach has been shown to be both safe and effective. The successful clinical trials of gene augmentation therapy for retinal degeneration caused by mutations in the RPE65 gene sets the stage for broad application of gene therapy to treat retinal degenerative disorders. PMID:25635059

  1. Augmented reality in neurosurgery

    PubMed Central

    Tagaytayan, Raniel; Kelemen, Arpad

    2016-01-01

    Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting. PMID:29765445

  2. Augmented reality in neurosurgery.

    PubMed

    Tagaytayan, Raniel; Kelemen, Arpad; Sik-Lanyi, Cecilia

    2018-04-01

    Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting.

  3. Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients

    PubMed Central

    Camardese, Giovanni; Leone, Beniamino; Serrani, Riccardo; Walstra, Coco; Di Nicola, Marco; Della Marca, Giacomo; Bria, Pietro; Janiri, Luigi

    2015-01-01

    Objectives We investigated the clinical benefits of bright light therapy (BLT) as an adjunct treatment to ongoing psychopharmacotherapy, both in unipolar and bipolar difficult-to-treat depressed (DTD) outpatients. Methods In an open-label study, 31 depressed outpatients (16 unipolar and 15 bipolar) were included to undergo 3 weeks of BLT. Twenty-five completed the treatment and 5-week follow-up. Main outcome measures Clinical outcomes were evaluated by the Hamilton Depression Rating Scale (HDRS). The Snaith–Hamilton Pleasure Scale and the Depression Retardation Rating Scale were used to assess changes in anhedonia and psychomotor retardation, respectively. Results The adjunctive BLT seemed to influence the course of the depressive episode, and a statistically significant reduction in HDRS scores was reported since the first week of therapy. The treatment was well-tolerated, and no patients presented clinical signs of (hypo)manic switch during the overall treatment period. At the end of the study (after 5 weeks from BLT discontinuation), nine patients (36%, eight unipolar and one bipolar) still showed a treatment response. BLT augmentation also led to a significant improvement of psychomotor retardation. Conclusion BLT combined with the ongoing pharmacological treatment offers a simple approach, and it might be effective in rapidly ameliorating depressive core symptoms of vulnerable DTD outpatients. These preliminary results need to be confirmed in placebo-controlled, randomized, double-blind clinical trial on larger samples. PMID:26396517

  4. Hyperbaric oxygen therapy augments the photodynamic action of methylene blue against bacteria in vitro

    NASA Astrophysics Data System (ADS)

    Bisland, S. K.; Dadani, F. N.; Chien, C.; Wilson, B. C.

    2007-02-01

    Photodynamic therapy (PDT) entails the combination of photosensitizer and light to generate cytotoxic molecules that derive from molecular oxygen (O II). The presence of sufficient O II within the target tissues is critical to the efficiency of PDT. This study investigates the use of hyperbaric oxygen therapy in combination with PDT (HOTPDT) to augment the photodynamic action of methylene blue (MB) or 5-aminolevulinic acid (ALA) against gram positive and gram negative bacterial strains in vitro. Staphylococcus aureus or Pseudomonas aeruginosa were grown in trypticase soy broth as planktonic cultures (~10 8/mL) or as established biofilms in 48 well plates (3 days old) at 32°C. Dark toxicity and PDT response in the presence or absence of HOT (2 atmospheres, 100% O II for 30, 60 or 120 min) was established for both MB (0-0.1 mM) and ALA (0- 1 mM) for a range of incubation times. The number of surviving colonies (CFU/mL) was plotted for each treatment groups. Light treatments (5, 10, 20 or 30 J/cm2) were conducted using an array of halogen bulbs with a red filter providing 90% transmittance over 600-800 nm at 21 mW/cm2. HOT increased the dark toxicity of MB (30 min, 0.1 mM) from < 0.2 log cell kill to 0.5 log cell kill. Dark toxicity of ALA (4 hr, 1 mM) was negligible and did not increase with HOT. For non-dark toxic concentrations of MB or ALA, (0.05 mM and 1 mM respectively) HOT-PDT enhanced the antimicrobial effect of MB against Staphylococcus aureus in culture by >1 and >2 logs of cell kill (CFU/mL) at 5 and 10 J/cm2 light dose respectively as compared to PDT alone. HOT-PDT also increased the anti-microbial effects of MB against Staphylococcus aureus biofilms compared to PDT, albeit less so (> 2 logs) following 10 J/cm2 light dose. Anti-microbial effects of PDT using ALA were not significant for either strain with or without HOT. These data suggest that HOTPDT may be useful for improving the PDT treatment of bacterial infections.

  5. Construction of a naturally occurring radioactive material project in the BeAAT hazardous waste facilities.

    PubMed

    Abuahmad, H

    2015-06-01

    This paper does not necessarily reflect the views of the International Commission on Radiological Protection. Naturally occurring radioactive material (NORM) is produced during exploration and production operations of subsidiaries of the Abu Dhabi National Oil Company (ADNOC) in the United Arab Emirates, and accumulates in drilling tubulars, plant equipment, and components. These NORM hazardous wastes need to be managed in such a way that they do not damage human health and the environment. The primary radionuclides of concern in the oil and gas industries are radium-226 and radium-228. These radioisotopes are the decay products of uranium and thorium isotopes that are present in subsurface formations from which hydrocarbons are produced. While uranium and thorium are largely immobile, radium is slightly more soluble and may become mobilised in the fluid phases of the formation (International Association of Oil & Gas Producers, 2008). In order to treat and dispose of NORM waste products safely, ADNOC's subsidiary 'TAKREER' is developing a new facility, on behalf of all ADNOC subsidiaries, within the existing Central Environmental Protection Facilities (BeAAT) in Ruwais city. The NORM plant is envisaged to treat, handle, and dispose of NORM waste in the forms of scale, sludge, and contaminated equipment. The NORM treatment facility will cover activities such as decontamination, volume reduction, NORM handling, and concrete immobilisation of NORM waste into packages for designated landfilling. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. [Augmentation with PMMA cement].

    PubMed

    Kühn, K-D; Höntzsch, D

    2015-09-01

    Cements based on polymethyl methacrylate (PMMA) can be used without any problem in a variety of clinical augmentations. Cement-related complications in surgical procedures involving PMMA cements, such as embolism, thermal necrosis, toxicity and hypersensitivity, are often due to other causes. Knowledge about the properties of the cement helps the user to safely employ PMMA cements in augmentations. High radio-opacity is required in vertebral body augmentations and this is provided in particular by zirconium dioxide. In vertebral body augmentations, a low benzoyl peroxide (BPO) content can considerably prolong the liquid dough phase. In augmentations with cement fillings in the region of a tumor, a high BPO content can specifically increase the peak temperature of the PMMA cement. In osteosynthetic augmentations with PMMA, necrosis is rare because heat development in the presence of metallic implants is low due to heat conduction via the implant. Larger cement fillings where there is no heat conduction via metal implants can exhibit substantially higher peak temperatures. The flow properties of PMMA cements are of particular importance for the user to allow optimum handling of PMMA cements. In patients with hypersensitivity to antibiotics, there is no need to avoid the use of PMMA as there are sufficient PMMA-based alternatives. The PMMA cements are local drug delivery systems and antibiotics, antiseptics, antimycotics and also cytostatics can be mixed with the cement. Attention must be paid to antagonistic and synergistic effects.

  7. Augmented reality: a review.

    PubMed

    Berryman, Donna R

    2012-01-01

    Augmented reality is a technology that overlays digital information on objects or places in the real world for the purpose of enhancing the user experience. It is not virtual reality, that is, the technology that creates a totally digital or computer created environment. Augmented reality, with its ability to combine reality and digital information, is being studied and implemented in medicine, marketing, museums, fashion, and numerous other areas. This article presents an overview of augmented reality, discussing what it is, how it works, its current implementations, and its potential impact on libraries.

  8. Analysis of glucose responses to automated insulin suspension with sensor-augmented pump therapy.

    PubMed

    Ly, Trang T; Nicholas, Jennifer A; Retterath, Adam; Davis, Elizabeth A; Jones, Timothy W

    2012-07-01

    The advent of sensor-augmented pump therapy with a low-glucose suspend (LGS) function (Medtronic Paradigm Veo System), allowing insulin to be automatically suspended for up to 2 h when sensor glucose falls below a preset threshold, has the potential to reduce the duration of hypoglycemia. In this article, we analyzed blood glucose profiles following a full 2-h insulin suspension activated by the LGS function, as well as examined different patterns of use among patients. Data from a cohort of participants using the Veo System for up to 6 months were analyzed to determine the time and duration of insulin suspension activated by the LGS function. We further evaluated overnight suspend events with no patient response occurring prior to 3:00 a.m., which allowed us to determine the pattern of sensor glucose values with no patient intervention during and after the period of insulin suspension. There were 3,128 LGS events during the 2,493 days evaluated. The median duration was 11.2 min, and 36% of events occurred overnight. There were 126 full 2-h suspend events that occurred overnight with no patient response, occurring before 3:00 a.m. For these events, the mean sensor glucose at the end of the 2-h suspend period was 99 ± 6 mg/dL ([means ± SE] 5.5 ± 0.3 mmol/L). The mean sensor glucose 2 h after insulin delivery resumed was 155 ± 10 mg/dL (8.6 ± 0.6 mmol/L). There were no episodes of severe hypoglycemia or diabetic ketoacidosis. Analyses of sensor glucose patterns following insulin suspension activated by LGS suggest that this technology is safe and unlikely to be associated with adverse outcomes.

  9. 2-Dimensional changes of the soft tissue profile of augmented and non-augmented human extraction sockets: a randomized pilot study.

    PubMed

    Flügge, Tabea; Nelson, Katja; Nack, Claudia; Stricker, Andres; Nahles, Susanne

    2015-04-01

    This study identified the soft tissue changes of the alveolar ridge at different time points within 12 weeks after tooth extraction with and without socket augmentation. In 38 patients with single tooth extractions, 40 sockets were augmented and 39 extraction sockets were not augmented. At 2, 4, 6, 8 and 12 weeks impressions were taken and casts digitized with a laser scanner. The horizontal and vertical changes were compared between augmented and non-augmented sites. A p-value <0.05 was considered statistically significant. The mean changes of augmented sockets were between 0.4 mm (2 weeks) and 0.8 mm (12 weeks). In non-augmented sockets changes of 0.7 mm (2 weeks) and of 1.0 mm (12 weeks) were demonstrated. The mean values differed significantly between the buccal and oral region (p < 0.01). Overall, there were significant differences of the mean dimensional changes regarding time (p < 0.01) and augmentation (p < 0.01). Augmented sockets showed less resorption within 4 weeks after extraction compared to non-augmented sockets. Non-augmented sockets showed a continuous dimensional loss with a great variation over 12 weeks whereas augmented sockets had the highest degree of resorption between 4 and 6 weeks. At 12 weeks a comparable resorption in augmented and non-augmented sockets was observed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Serotonin augmentation therapy by escitalopram has minimal effects on amyloid-β levels in early-stage Alzheimer's-like disease in mice.

    PubMed

    von Linstow, Christian Ulrich; Waider, Jonas; Grebing, Manuela; Metaxas, Athanasios; Lesch, Klaus Peter; Finsen, Bente

    2017-09-12

    Dysfunction of the serotonergic (5-HTergic) system has been implicated in the cognitive and behavioural symptoms of Alzheimer's disease (AD). Accumulation of toxic amyloid-β (Aβ) species is a hallmark of AD and an instigator of pathology. Serotonin (5-HT) augmentation therapy by treatment with selective serotonin reuptake inhibitors (SSRIs) in patients with AD has had mixed success in improving cognitive function, whereas SSRI administration to mice with AD-like disease has been shown to reduce Aβ pathology. The objective of this study was to investigate whether an increase in extracellular levels of 5-HT induced by chronic SSRI treatment reduces Aβ pathology and whether 5-HTergic deafferentation of the cerebral cortex could worsen Aβ pathology in the APP swe /PS1 ΔE9 (APP/PS1) mouse model of AD. We administered a therapeutic dose of the SSRI escitalopram (5 mg/kg/day) in the drinking water of 3-month-old APP/PS1 mice to increase levels of 5-HT, and we performed intracerebroventricular injections of the neurotoxin 5,7-dihydroxytryptamine (DHT) to remove 5-HTergic afferents. We validated the effectiveness of these interventions by serotonin transporter autoradiography (neocortex 79.7 ± 7.6%) and by high-performance liquid chromatography for 5-HT (neocortex 64% reduction). After 6 months of escitalopram treatment or housing after DHT-induced lesion, we evaluated brain tissue by mesoscale multiplex analysis and sections by IHC analysis. Amyloid-β-containing plaques had formed in the neocortex and hippocampus of 9-month-old APP/PS1 mice after 6 months of escitalopram treatment and 5-HTergic deafferentation. Unexpectedly, levels of insoluble Aβ42 were unaffected in the neocortex and hippocampus after both types of interventions. Levels of insoluble Aβ40 increased in the neocortex of SSRI-treated mice compared with those treated with vehicle control, but they were unaffected in the hippocampus. 5-HTergic deafferentation was without effect on the levels of

  11. Augmented Reality for the Improvement of Remote Laboratories: An Augmented Remote Laboratory

    ERIC Educational Resources Information Center

    Andujar, J. M.; Mejias, A.; Marquez, M. A.

    2011-01-01

    Augmented reality (AR) provides huge opportunities for online teaching in science and engineering, as these disciplines place emphasis on practical training and unsuited to completely nonclassroom training. This paper proposes a new concept in virtual and remote laboratories: the augmented remote laboratory (ARL). ARL is being tested in the first…

  12. Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges.

    PubMed

    Prakash, D; Campbell, B; Wajed, S

    2018-04-01

    Introduction Gastro-oesophageal reflux disease (GORD) is a common, chronic debilitating condition. Surgical management traditionally involves fundoplication. Magnetic sphincter augmentation (MSA) is a new definitive treatment. We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes. Methods MSA was introduced into NHS practice following successful acceptance of a cost-effective business plan and close observation of National Institute for Health and Care Excellence (NICE) recommendations for new procedures, including a carefully planned prospective data collection over a two-year follow-up period. Results Forty-seven patients underwent MSA over the 40-month period. Reflux health-related quality of life (GERD-HRQL) was significantly improved after the procedure and maintained at one- and two-year (P < 0.0001) follow-up. Drug dependency went from 100% at baseline to 2.6% and 8.7% after one and two years. High levels of patient satisfaction were reported. There were no adverse events. Conclusions MSA is highly effective in the treatment of uncomplicated GORD, with durable results and an excellent safety profile. This laparoscopic, minimally invasive procedure provides a good alternative for patients where surgical anatomy is unaltered. Our experience demonstrates that innovative technology can be incorporated into NHS practice with an acceptable business plan and compliance with NICE recommendations.

  13. Evaluation of the glycine transporter inhibitor Org 25935 as augmentation to cognitive-behavioral therapy for panic disorder: a multicenter, randomized, double-blind, placebo-controlled trial.

    PubMed

    Nations, Kari R; Smits, Jasper A J; Tolin, David F; Rothbaum, Barbara O; Hofmann, Stefan G; Tart, Candyce D; Lee, Allen; Schipper, Jacques; Sjogren, Magnus; Xue, Dixi; Szegedi, Armin; Otto, Michael W

    2012-05-01

    A growing body of evidence supports the efficacy of D-cycloserine (DCS), a partial agonist at the N-methyl-D-aspartate (NMDA) glutamate receptor, as augmentation to cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders. Org 25935 is a glycine transporter 1 inhibitor that acts to increase synaptic glycine levels and enhance NMDA-mediated glutamatergic activity. The aim of this study was to examine the efficacy of a glutamatergic compound other than DCS in a CBT augmentation paradigm. This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial for which participants were recruited from November 2008 through February 2010. Eligible adult patients diagnosed (DSM-IV) with panic disorder with or without agoraphobia (N = 40) were scheduled to receive 5 manualized CBT treatment sessions. Participants were randomly assigned to receive either a dose of Org 25935 (4 mg or 12 mg) or placebo 2 hours prior to the start of CBT sessions 3, 4, and 5. The primary endpoint was symptomatic change as measured by the Panic Disorder Severity Scale (PDSS) 1 week following the last CBT session. Although mean PDSS total scores decreased significantly from baseline to end of treatment in every group, no statistically significant benefit was observed for Org 25935 (4 or 12 mg) over placebo on the primary endpoint or on any secondary efficacy endpoint. Org 25935 showed no safety issues at either dose but was much better tolerated at the 4-mg dose level than at the 12-mg dose level. Org 25935 demonstrated no benefit over placebo in augmenting CBT for panic disorder. Study limitations and implications are discussed. clinicaltrials.gov Identifier: NCT00725725. © Copyright 2012 Physicians Postgraduate Press, Inc.

  14. Dynamic augmentation restores anterior tibial translation in ACL suture repair: a biomechanical comparison of non-, static and dynamic augmentation techniques.

    PubMed

    Hoogeslag, Roy A G; Brouwer, Reinoud W; Huis In 't Veld, Rianne; Stephen, Joanna M; Amis, Andrew A

    2018-02-03

    There is a lack of objective evidence investigating how previous non-augmented ACL suture repair techniques and contemporary augmentation techniques in ACL suture repair restrain anterior tibial translation (ATT) across the arc of flexion, and after cyclic loading of the knee. The purpose of this work was to test the null hypotheses that there would be no statistically significant difference in ATT after non-, static- and dynamic-augmented ACL suture repair, and they will not restore ATT to normal values across the arc of flexion of the knee after cyclic loading. Eleven human cadaveric knees were mounted in a test rig, and knee kinematics from 0° to 90° of flexion were recorded by use of an optical tracking system. Measurements were recorded without load and with 89-N tibial anterior force. The knees were tested in the following states: ACL-intact, ACL-deficient, non-augmented suture repair, static tape augmentation and dynamic augmentation after 10 and 300 loading cycles. Only static tape augmentation and dynamic augmentation restored ATT to values similar to the ACL-intact state directly postoperation, and maintained this after cyclic loading. However, contrary to dynamic augmentation, the ATT after static tape augmentation failed to remain statistically less than for the ACL-deficient state after cyclic loading. Moreover, after cyclic loading, ATT was significantly less with dynamic augmentation when compared to static tape augmentation. In contrast to non-augmented ACL suture repair and static tape augmentation, only dynamic augmentation resulted in restoration of ATT values similar to the ACL-intact knee and decreased ATT values when compared to the ACL-deficient knee immediately post-operation and also after cyclic loading, across the arc of flexion, thus allowing the null hypotheses to be rejected. This may assist healing of the ruptured ACL. Therefore, this study would support further clinical evaluation of dynamic augmentation of ACL repair.

  15. Can Atypical Antipsychotic Augmentation Reduce Subsequent Treatment Failure More Effectively Among Depressed Patients with a Higher Degree of Treatment Resistance? A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Wang, Hee Ryung; Woo, Young Sup; Ahn, Hyeong Sik; Ahn, Il Min; Kim, Hyun Jung; Bahk, Won-Myong

    2015-01-01

    Background: Atypical antipsychotic augmentation was demonstrated to be efficacious in treatment-resistant depression (TRD) in previous meta-analyses. We investigate whether there are differences in the effect size of atypical antipsychotic augmentation in major depressive disorder according to the degree of treatment resistance. Methods: A comprehensive search of four databases identified 11 randomized controlled trials. The 11 trials, which included 3 341 participants, were pooled using a random-effects meta-analysis. Results: Atypical antipsychotic augmentation of antidepressant therapy showed superior efficacy compared to antidepressant monotherapy in TRD in terms of both response and remission rates (response, risk ratio [RR] = 1.38, 95% confidence interval [CI] = 1.25 to 1.53; remission, RR = 1.62, 95% CI = 1.42 to 1.85). In addition, regarding response rates in the TRD trials, atypical antipsychotic augmentation exhibited significantly different effect sizes according to the degree of treatment resistance (TRD 1: RR = 1.24; TRD 2: RR = 1.37; TRD 2–4: RR = 1.58). In non-TRD trials, atypical antipsychotic augmentation failed to show superior efficacy over antidepressant monotherapy in terms of remission rates (RR = 0.89; 95% CI = 0.69 to 1.14). Atypical antipsychotic augmentation of antidepressant therapy exhibits greater effect size in patients with a higher degree of treatment resistance. Conclusions: This finding strengthens the rationale for considering atypical antipsychotic augmentation among depressed patients with multiple previous treatment failures in clinical practice. The efficacy of atypical antipsychotic augmentation for non-TRD seems to be different from that for TRD and, thus, further studies of non-TRD populations are needed. PMID:25770098

  16. Repeated vertebral augmentation for new vertebral compression fractures of postvertebral augmentation patients: a nationwide cohort study

    PubMed Central

    Liang, Cheng-Loong; Wang, Hao-Kwan; Syu, Fei-Kai; Wang, Kuo-Wei; Lu, Kang; Liliang, Po-Chou

    2015-01-01

    Purpose Postvertebral augmentation vertebral compression fractures are common; repeated vertebral augmentation is usually performed for prompt pain relief. This study aimed to evaluate the incidence and risk factors of repeat vertebral augmentation. Methods We performed a retrospective, nationwide, population-based longitudinal observation study, using the National Health Insurance Research Database (NHIRD) of Taiwan. All patients who received vertebral augmentation for vertebral compression fractures were evaluated. The collected data included patient characteristics (demographics, comorbidities, and medication exposure) and repeat vertebral augmentation. Kaplan–Meier and stratified Cox proportional hazard regressions were performed for analyses. Results The overall incidence of repeat vertebral augmentation was 11.3% during the follow-up until 2010. Patients with the following characteristics were at greater risk for repeat vertebral augmentation: female sex (AOR=1.24; 95% confidence interval [CI]: 1.10–2.36), advanced age (AOR=1.60; 95% CI: 1.32–2.08), diabetes mellitus (AOR=4.31; 95% CI: 4.05–5.88), cerebrovascular disease (AOR=4.09; 95% CI: 3.44–5.76), dementia (AOR=1.97; 95% CI: 1.69–2.33), blindness or low vision (AOR=3.72; 95% CI: 2.32–3.95), hypertension (AOR=2.58; 95% CI: 2.35–3.47), and hyperlipidemia (AOR=2.09; 95% CI: 1.67–2.22). Patients taking calcium/vitamin D (AOR=2.98; 95% CI: 1.83–3.93), bisphosphonates (AOR=2.11; 95% CI: 1.26–2.61), or calcitonin (AOR=4.59; 95% CI: 3.40–5.77) were less likely to undergo repeat vertebral augmentation; however, those taking steroids (AOR=7.28; 95% CI: 6.32–8.08), acetaminophen (AOR=3.54; 95% CI: 2.75–4.83), or nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR=6.14; 95% CI: 5.08–7.41) were more likely to undergo repeat vertebral augmentation. Conclusion We conclude that the incidence of repeat vertebral augmentation is rather high. An understanding of risk factors predicting repeat

  17. Reductive Augmentation of the Breast.

    PubMed

    Chasan, Paul E

    2018-06-01

    Although breast reduction surgery plays an invaluable role in the correction of macromastia, it almost always results in a breast lacking in upper pole fullness and/or roundness. We present a technique of breast reduction combined with augmentation termed "reductive augmentation" to solve this problem. The technique is also extremely useful for correcting breast asymmetry, as well as revising significant pseudoptosis in the patient who has previously undergone breast augmentation with or without mastopexy. An evolution of techniques has been used to create a breast with more upper pole fullness and anterior projection in those patients desiring a more round, higher-profile appearance. Reductive augmentation is a one-stage procedure in which a breast augmentation is immediately followed by a modified superomedial pedicle breast reduction. Often, the excision of breast tissue is greater than would normally be performed with breast reduction alone. Thirty-five patients underwent reductive augmentation, of which 12 were primary surgeries and 23 were revisions. There was an average tissue removal of 255 and 227 g, respectively, per breast for the primary and revision groups. Six of the reductive augmentations were performed for gross asymmetry. Fourteen patients had a previous mastopexy, and 3 patients had a previous breast reduction. The average follow-up was 26 months. Reductive augmentation is an effective one-stage method for achieving a more round-appearing breast with upper pole fullness both in primary breast reduction candidates and in revisionary breast surgery. This technique can also be applied to those patients with significant asymmetry. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  18. Augmented assessment as a means to augmented reality.

    PubMed

    Bergeron, Bryan

    2006-01-01

    Rigorous scientific assessment of educational technologies typically lags behind the availability of the technologies by years because of the lack of validated instruments and benchmarks. Even when the appropriate assessment instruments are available, they may not be applied because of time and monetary constraints. Work in augmented reality, instrumented mannequins, serious gaming, and similar promising educational technologies that haven't undergone timely, rigorous evaluation, highlights the need for assessment methodologies that address the limitations of traditional approaches. The most promising augmented assessment solutions incorporate elements of rapid prototyping used in the software industry, simulation-based assessment techniques modeled after methods used in bioinformatics, and object-oriented analysis methods borrowed from object oriented programming.

  19. Fighting cancers from within: augmenting tumor immunity with cytokine therapy.

    PubMed

    Pellegrini, Marc; Mak, Tak W; Ohashi, Pamela S

    2010-08-01

    The human immune system has successfully evolved to fight many pathogens. Through vaccination, we can harness and improve immune responses to eradicate infections. Despite this success, we are only now beginning to understand the natural tumor immune surveillance mechanisms and why, in some instances, our immune system fails to abrogate the development and growth of tumors. Encouraging results with the latest immunotherapies have renewed enthusiasm in the field. A central component of these therapies is the contribution of cytokines. Here we review our expanding knowledge of cytokine-induced effects as well as preclinical and clinical data that indicate adjuvant cytokine therapies may hold much promise in improving anti-tumor immunity. Further studies on optimal synergistic combinations, timing, duration and additional adjuvant therapies are required to realize the full potential of cytokines as immunotherapeutic agents. 2010 Elsevier Ltd. All rights reserved.

  20. The GW170817/GRB 170817A/AT 2017gfo Association: Some Implications for Physics and Astrophysics

    NASA Astrophysics Data System (ADS)

    Wang, Hao; Zhang, Fu-Wen; Wang, Yuan-Zhu; Shen, Zhao-Qiang; Liang, Yun-Feng; Li, Xiang; Liao, Neng-Hui; Jin, Zhi-Ping; Yuan, Qiang; Zou, Yuan-Chuan; Fan, Yi-Zhong; Wei, Da-Ming

    2017-12-01

    On 2017 August 17, a gravitational-wave event (GW170817) and an associated short gamma-ray burst (GRB 170817A) from a binary neutron star merger had been detected. The follow-up optical/infrared observations also identified the macronova/kilonova emission (AT 2017gfo). In this work, we discuss some implications of the remarkable GW170817/GRB 170817A/AT 2017gfo association. We show that the ∼1.7 s time delay between the gravitational-wave (GW) and GRB signals imposes very tight constraints on the superluminal movement of gravitational waves (i.e., the relative departure of GW velocity from the speed of light is ≤slant 4.3× {10}-16) or the possible violation of the weak equivalence principle (i.e., the difference of the gamma-ray and GW trajectories in the gravitational field of the galaxy and the local universe should be within a factor of ∼ 3.4× {10}-9). The so-called Dark Matter Emulators and a class of contender models for cosmic acceleration (“Covariant Galileon”) are ruled out as well. The successful identification of lanthanide elements in the macronova/kilonova spectrum also excludes the possibility that the progenitors of GRB 170817A are a binary strange star system. The high neutron star merger rate (inferred from both the local sGRB data and the gravitational-wave data) together with the significant ejected mass strongly suggest that such mergers are the prime sites of heavy r-process nucleosynthesis.

  1. Pedicle screw cement augmentation. A mechanical pullout study on different cement augmentation techniques.

    PubMed

    Costa, Francesco; Ortolina, Alessandro; Galbusera, Fabio; Cardia, Andrea; Sala, Giuseppe; Ronchi, Franco; Uccelli, Carlo; Grosso, Rossella; Fornari, Maurizio

    2016-02-01

    Pedicle screws with polymethyl methacrylate (PMMA) cement augmentation have been shown to significantly improve the fixation strength in a severely osteoporotic spine. However, the efficacy of screw fixation for different cement augmentation techniques remains unknown. This study aimed to determine the difference in pullout strength between different cement augmentation techniques. Uniform synthetic bones simulating severe osteoporosis were used to provide a platform for each augmentation technique. In all cases a polyaxial screw and acrylic cement (PMMA) at medium viscosity were used. Five groups were analyzed: I) only screw without PMMA (control group); II) retrograde cement pre-filling of the tapped area; III) cannulated and fenestrate screw with cement injection through perforation; IV) injection using a standard trocar of PMMA (vertebroplasty) and retrograde pre-filling of the tapped area; V) injection through a fenestrated trocar and retrograde pre-filling of the tapped area. Standard X-rays were taken in order to visualize cement distribution in each group. Pedicle screws at full insertion were then tested for axial pullout failure using a mechanical testing machine. A total of 30 screws were tested. The results of pullout analysis revealed better results of all groups with respect to the control group. In particular the statistical analysis showed a difference of Group V (p = 0.001) with respect to all other groups. These results confirm that the cement augmentation grants better results in pullout axial forces. Moreover they suggest better load resistance to axial forces when the distribution of the PMMA is along all the screw combining fenestration and pre-filling augmentation technique. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  2. Efficacy, Safety and Tolerability of Augmentative rTMS in Treatment of Major Depressive Disorder (MDD): A Prospective Cohort Study in Croatia.

    PubMed

    Filipcic, Igor; Milovac, Zeljko; Sucic, Strahimir; Gajsak, Tomislav; Filipcic, Ivona Simunovic; Ivezic, Ena; Aljinovic, Vjekoslav; Orgulan, Ivana; Penic, Sandra Zecevic; Bajic, Zarko

    2017-03-01

    An increasing body of research suggest that repetitive Transcranial Magnetic Stimulation (rTMS) is effective and safe treatment option for patients with major depressive disorder (MDD). The Psychiatric Hospital "Sveti Ivan" has the first TMS laboratory with rTMS and deep TMS (dTMS) in Croatia. The objective of this study was to assess the efficacy, safety and tolerability of augmentative rTMS treatment vs standard treatment in Croatian patients with major depressive disorder (MDD). Total of 93 MDD patients were enrolled; 41 of them were treated by augmentative rTMS and 52 were treated by standard (psychopharmacotherapy and psychotherapy) therapy only. We delivered rTMS to the left dorsolateral prefrontal cortex at 120% motor threshold (10 Hz, 4-second train duration), 3000 pulses per session using a figure-eight coil, minimum of 20 sessions during four weeks. Our key outcome was the change in Hamilton Depression Scale (HAM-D17) result from baseline to 4 th week. Our secondary outcomes were changes in Hamilton Anxiety (HAM-A) and WHOQOL-BREF scales. After four weeks the changes of HAM-D17 and HAM-A results were significantly different between the group of patients treated by augmentative rTMS (48% and 53% decrease, respectively) and the group of patients treated by the standard therapy alone (24% and 30% decrease) (P=0.004, P=0.007). Absolute benefit increase defined as the difference between rates of remission (HAM-D17 ≤7) in rTMS and control group was 33% (P=0.001). Number of patients needed to treat with rTMS in order to achieve remission in one patient was NNT=3. In a group of patients treated with augmentative rTMS 21/41 (51%), and in control group 17/52 (33%) were responders (P=0.071). It seems that augmentative treatment with rTMS is more effective on depression and anxiety symptoms than standard therapy in MDD with equal safety and tolerability. Randomized, controlled studies are required to verify this finding.

  3. Augmenting Human Performance in Remotely Piloted Aircraft.

    PubMed

    Gruenwald, Christina M; Middendorf, Matthew S; Hoepf, Michael R; Galster, Scott M

    2018-02-01

    An experiment in a program of research supporting the sense-assess-augment (SAA) framework is described. The objective is to use physiological measures to assess operator cognitive workload in remotely piloted aircraft (RPA) operations, and provide augmentation to assist the operator in times of high workload. In previous experiments, physiological measures were identified that demonstrate sensitivity to changes in workload. The current research solely focuses on the augmentation component of the SAA paradigm. This line of research uses a realistic RPA simulation with varying levels of workload. Recruited from the Midwest region were 12 individuals (6 women) to participate in the experiment. The subjects were trained to perform a surveillance task and a tracking task using RPAs. There was also a secondary task in which subjects were required to answer cognitive probes. A within subjects factorial design was employed with three factors per task. Subjective workload estimates were acquired using the NASA-TLX. Performance data were calculated using a composite scoring algorithm. Augmentation significantly improved performance and reduced workload in both tasks. In the surveillance task, augmentation increased performance from 573.78 to 679.04. Likewise, augmentation increased performance in the tracking task from 749.39 to 791.81. Augmentation was more beneficial in high workload conditions than low workload conditions. The increase in performance and decrease in workload associated with augmentation is an important and anticipated finding. This suggests that augmentation should only be provided when it is truly needed, especially if the augmentation requires additional assets and/or resources.Gruenwald CM, Middendorf MS, Hoepf MR, Galster SM. Augmenting human performance in remotely piloted aircraft. Aerosp Med Hum Perform. 2018; 89(2):115-121.

  4. Augmentation-related brain plasticity

    PubMed Central

    Di Pino, Giovanni; Maravita, Angelo; Zollo, Loredana; Guglielmelli, Eugenio; Di Lazzaro, Vincenzo

    2014-01-01

    Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyses the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain. Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools. Augmentation modifies function and structure of a number of areas, i.e., primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the sense of the self

  5. Confronting an Augmented Reality

    ERIC Educational Resources Information Center

    Munnerley, Danny; Bacon, Matt; Wilson, Anna; Steele, James; Hedberg, John; Fitzgerald, Robert

    2012-01-01

    How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself ? In this article, we seek to initiate a discussion that focuses on these questions, and…

  6. Advanced Intellect-Augmentation Techniques.

    ERIC Educational Resources Information Center

    Engelbart, D. C.

    This progress report covers a two-year project which is part of a program that is exploring the value of computer aids in augmenting human intellectual capability. The background and nature of the program, its resources, and the activities it has undertaken are outlined. User experience in applying augmentation tools and techniques to various…

  7. Coping Skills and Exposure Therapy in Panic Disorder and Agoraphobia: Latest Advances and Future Directions

    PubMed Central

    Meuret, Alicia E.; Wolitzky-Taylor, Kate B.; Twohig, Michael P.; Craske, Michelle G.

    2012-01-01

    Although cognitive-behavioral treatments for panic disorder have demonstrated efficacy, a considerable number of patients terminate treatment prematurely or remain symtpomatic. Cognitive and biobehavioral coping skills are taught to improve exposure therapy outcomes but evidence for an additive effect is largely lacking. Current methodologies used to study the augmenting effects of coping skills test the degree to which the delivery of coping skills enhances outcomes. However, they do not assess the degree to which acquisition of coping skills and their application during exposure therapy augment outcomes. We examine the extant evidence on the role of traditional coping skills in augmenting exposure for panic disorder, discuss the limitations of existing research, and offer recommendations for methodological advances. PMID:22440065

  8. Augmented growth inhibition of B16-BL6 melanoma by combined treatment with a selective matrix metalloproteinase inhibitor, MMI-166, and cytotoxic agents.

    PubMed

    Hojo, Kanji; Maki, Hideo; Sawada, Takuko Yamada; Maekawa, Ryuji; Yoshioka, Takayuki

    2002-01-01

    MMI-166 is a selective matrix metalloproteinase (MMP) inhibitor. The purpose of this study was to evaluate the antitumor efficacy of the combined treatment of MMI-166 with paclitaxel or carboplatin. Mice bearing B16-BL6 melanoma were treated p.o. with MMI-166 from 1 day after tumor inoculation. The mice were administered i.v. with either paclitaxel or carboplatin at the maximum tolerated dose (MTD). MMI-166 monotherapy inhibited in vivo growth of the B16-BL6 tumor to an extent similar to that of paclitaxel or carboplatin monotherapy. When MMI-166 was combined with paclitaxel or carboplatin, the antitumor efficacy was significantly (p < 0.01) augmented in comparison with either MMI-166 or each cytotoxic agent alone. The hematotoxicity study demonstrated that daily treatment with MMI-166 did not affect the blood cell number in the mice and more importantly the combination of MMI-166 with paclitaxel did not augment the hematotoxicity caused by paclitaxel. An in vitro cytotoxicity study showed that MMI-166 itself has neither direct cytotoxicity against B16-BL6 tumor cells nor does it augment the cytotoxicity of paclitaxel or carboplatin. These results indicate that augmented antitumor activity of the combination treatment was not simply due to the augmentation of direct cytotoxic activity, but was rather an additive effect of the antitumor activities of different mechanisms. They suggest the effectiveness of a combination therapy of MMI-166 with paclitaxel or carboplatin in clinical therapy.

  9. The Augmentation System Framework.

    ERIC Educational Resources Information Center

    Engelbart, Doug; Hooper, Kristina

    1986-01-01

    Augmentation systems are composed of things that will add to what the human is genetically endowed with in order to extend the net capabilities that a human or human organization can apply to the problems or goals of human society. A broad brush categorization of the components of an augmentation system includes three distinct though interacting…

  10. Cost-effectiveness of sensor-augmented pump therapy versus standard insulin pump therapy in patients with type 1 diabetes in Denmark.

    PubMed

    Roze, S; de Portu, S; Smith-Palmer, J; Delbaere, A; Valentine, W; Ridderstråle, M

    2017-06-01

    The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP+LGS versus CSII in patients with T1D was performed. Analyses were performed using the CORE Diabetes Model in two different patient cohorts in Denmark, one with hyperglycemia at baseline and one with increased risk for hypoglycemic events. Clinical input data were sourced from published literature. The analysis was performed over a lifetime time horizon from a societal perspective. Future costs and clinical outcomes were discounted at 3% per annum. In patients who were hyperglycemic at baseline the use of SAP+LGS versus CSII resulted in improved quality-adjusted life expectancy (12.44 versus 10.99 quality-adjusted life years [QALYs]) but higher mean lifetime costs (DKK 2,027,316 versus DKK 1,801,293) leading to an incremental cost-effectiveness ratio (ICER) of DKK 156,082 per QALY gained. For patients at increased risk for hypoglycemic events the ICER for SAP+LGS versus CSII was DKK 89,868 per QALY gained. The ICER for SAP+LGS versus CSII falls below commonly cited willingness-to-pay thresholds. Therefore, in Denmark, the use of SAP+LGS is likely to be considered cost-effective relative to CSII for patients with T1D who are either hyperglycemic, despite CSII use, or who experience frequent severe hypoglycemic events. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. ARSC: Augmented Reality Student Card--An Augmented Reality Solution for the Education Field

    ERIC Educational Resources Information Center

    El Sayed, Neven A. M.; Zayed, Hala H.; Sharawy, Mohamed I.

    2011-01-01

    Augmented Reality (AR) is the technology of adding virtual objects to real scenes through enabling the addition of missing information in real life. As the lack of resources is a problem that can be solved through AR, this paper presents and explains the usage of AR technology we introduce Augmented Reality Student Card (ARSC) as an application of…

  12. Augmented Reality-Guided Lumbar Facet Joint Injections.

    PubMed

    Agten, Christoph A; Dennler, Cyrill; Rosskopf, Andrea B; Jaberg, Laurenz; Pfirrmann, Christian W A; Farshad, Mazda

    2018-05-08

    The aim of this study was to assess feasibility and accuracy of augmented reality-guided lumbar facet joint injections. A spine phantom completely embedded in hardened opaque agar with 3 ring markers was built. A 3-dimensional model of the phantom was uploaded to an augmented reality headset (Microsoft HoloLens). Two radiologists independently performed 20 augmented reality-guided and 20 computed tomography (CT)-guided facet joint injections each: for each augmented reality-guided injection, the hologram was manually aligned with the phantom container using the ring markers. The radiologists targeted the virtual facet joint and tried to place the needle tip in the holographic joint space. Computed tomography was performed after each needle placement to document final needle tip position. Time needed from grabbing the needle to final needle placement was measured for each simulated injection. An independent radiologist rated images of all needle placements in a randomized order blinded to modality (augmented reality vs CT) and performer as perfect, acceptable, incorrect, or unsafe. Accuracy and time to place needles were compared between augmented reality-guided and CT-guided facet joint injections. In total, 39/40 (97.5%) of augmented reality-guided needle placements were either perfect or acceptable compared with 40/40 (100%) CT-guided needle placements (P = 0.5). One augmented reality-guided injection missed the facet joint space by 2 mm. No unsafe needle placements occurred. Time to final needle placement was substantially faster with augmented reality guidance (mean 14 ± 6 seconds vs 39 ± 15 seconds, P < 0.001 for both readers). Augmented reality-guided facet joint injections are feasible and accurate without potentially harmful needle placement in an experimental setting.

  13. Challenges associated with reentry maxillary sinus augmentation.

    PubMed

    Mardinger, Ofer; Moses, Ofer; Chaushu, Gavriel; Manor, Yifat; Tulchinsky, Ze'ev; Nissan, Joseph

    2010-09-01

    This study was a retrospective assessment of reentry sinus augmentation compared with sinus augmentation performed for the first time. There were 38 subjects who required sinus augmentation. The study group (17 patients, 21 sinuses) included subjects following failure of a previous sinus augmentation procedure that required reentry augmentation. The control group (21 patients, 21 sinuses) included subjects in which sinus augmentation was performed for the first time. Patients' medical files were reviewed. A preformed questionnaire was used to collect data regarding demographic parameters, medical and dental health history, habits, and intra- and postoperative data. Operative challenges in the study group included adhesions of the buccal flap to the Schneiderian membrane (62%, 13/21, P<.001), bony fenestration of the lateral wall with adhesions (71%, 15/21, P<.001), limited mobility of a clinical fibrotic Schneiderian membrane (71%, 15/21, P<.001), and increased incidence of membrane perforations (47%, 10/21, versus 9.5%, 2/21, P=.03). In the control group the Schneiderian membrane was thin and flexible. Sinus augmentation succeeded in all cases of both groups. Implant failure was significantly higher in the study group (11% versus 0%, P<.001). Clinical success of reentry sinus augmentation is predictable despite its complexity. Clinicians should be aware of anatomical changes caused by previous failure of this procedure. Patients should be informed about the lower success rate of implants when reentry sinus augmentation is required. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  14. A randomized, double-blind, placebo-controlled, dose-ranging study of lisdexamfetamine dimesylate augmentation for major depressive disorder in adults with inadequate response to antidepressant therapy

    PubMed Central

    Richards, Cynthia; Iosifescu, Dan V; Mago, Rajnish; Sarkis, Elias; Reynolds, James; Geibel, Brooke; Dauphin, Matthew

    2017-01-01

    Background: This randomized, double-blind, placebo-controlled study evaluated dose-response relationships of lisdexamfetamine dimesylate when used as augmentation for major depressive disorder in individuals exhibiting inadequate responses to antidepressant monotherapy. Methods: Eligible adults (18–65 years) were assigned to antidepressant monotherapy (escitalopram or venlafaxine extended-release) plus lisdexamfetamine dimesylate-matching placebo during an eight-week single-blind lead-in phase. Participants meeting randomization criteria were randomized (1:1:1:1:1) to eight weeks of lisdexamfetamine dimesylate (10, 30, 50, or 70 mg) or placebo while maintaining antidepressant therapy. Dose-responses for changes from augmentation baseline to week 16/early termination for Montgomery-Åsberg Depression Rating Scale total score (primary efficacy endpoint) and vital signs (systolic and diastolic blood pressure and pulse) were assessed using multiple comparisons procedures with modeling. Results: For Montgomery-Åsberg Depression Rating Scale total score change, no significant dose-responses were observed for any candidate dose-response curve (all p>0.10). In the dose-response evaluable population, least squares mean (90% confidence interval) treatment differences versus placebo for Montgomery-Åsberg Depression Rating Scale total score change at week 16 were −1.4 (−3.9, 1.2), 0.1 (−2.5, 2.7), −0.7 (−3.4, 2.0), and −0.9 (−3.5, 1.6) with 10, 30, 50, and 70 mg lisdexamfetamine dimesylate, respectively. For all vital sign parameters, lisdexamfetamine dimesylate exhibited significant dose-responses for all candidate dose-response curves (all p<0.10), with increases observed as lisdexamfetamine dimesylate dose increased; a linear relationship provided the best fit. Mean±standard deviation changes from augmentation baseline for systolic and diastolic blood pressure and pulse at week 16/early termination were −0.7±9.90 and −0.3±7.24 mm Hg and 0.2±10

  15. Does d-Cycloserine Augmentation of CBT Improve Therapeutic Homework Compliance for Pediatric Obsessive-Compulsive Disorder?

    PubMed

    Park, Jennifer M; Small, Brent J; Geller, Daniel A; Murphy, Tanya K; Lewin, Adam B; Storch, Eric A

    2014-07-01

    Clinical studies in adults and children with obsessive-compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome.

  16. Does d-Cycloserine Augmentation of CBT Improve Therapeutic Homework Compliance for Pediatric Obsessive–Compulsive Disorder?

    PubMed Central

    Park, Jennifer M.; Small, Brent J.; Geller, Daniel A.; Murphy, Tanya K.; Lewin, Adam B.; Storch, Eric A.

    2014-01-01

    Clinical studies in adults and children with obsessive–compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome. PMID:24999301

  17. Pet ownership and physical health.

    PubMed

    Matchock, Robert L

    2015-09-01

    Pet ownership and brief human-animal interactions can serve as a form of social support and convey a host of beneficial psychological and physiological health benefits. This article critically examines recent relevant literature on the pet-health connection. Cross-sectional studies indicate correlations between pet ownership and numerous aspects of positive health outcomes, including improvements on cardiovascular measures and decreases in loneliness. Quasi-experimental studies and better controlled experimental studies corroborate these associations and suggest that owning and/or interacting with a pet may be causally related to some positive health outcomes. The value of pet ownership and animal-assisted therapy (AAT), as a nonpharmacological treatment modality, augmentation to traditional treatment, and healthy preventive behavior (in the case of pet ownership), is starting to be realized. However, more investigations that employ randomized controlled trials with larger sample sizes and investigations that more closely examine the underlying mechanism of the pet-health effect, such as oxytocin, are needed.

  18. [Cement augmentation on the spine : Biomechanical considerations].

    PubMed

    Kolb, J P; Weiser, L; Kueny, R A; Huber, G; Rueger, J M; Lehmann, W

    2015-09-01

    Vertebral compression fractures are the most common osteoporotic fractures. Since the introduction of vertebroplasty and screw augmentation, the management of osteoporotic fractures has changed significantly. The biomechanical characteristics of the risk of adjacent fractures and novel treatment modalities for osteoporotic vertebral fractures, including pure cement augmentation by vertebroplasty, and cement augmentation of screws for posterior instrumentation, are explored. Eighteen human osteoporotic lumbar spines (L1-5) adjacent to vertebral bodies after vertebroplasty were tested in a servo-hydraulic machine. As augmentation compounds we used standard cement and a modified low-strength cement. Different anchoring pedicle screws were tested with and without cement augmentation in another cohort of human specimens with a simple pull-out test and a fatigue test that better reflects physiological conditions. Cement augmentation in the osteoporotic spine leads to greater biomechanical stability. However, change in vertebral stiffness resulted in alterations with the risk of adjacent fractures. By using a less firm cement compound, the risk of adjacent fractures is significantly reduced. Both screw augmentation techniques resulted in a significant increase in the withdrawal force compared with the group without cement. Augmentation using perforated screws showed the highest stability in the fatigue test. The augmentation of cement leads to a significant change in the biomechanical properties. Differences in the stability of adjacent vertebral bodies increase the risk of adjacent fractures, which could be mitigated by a modified cement compound with reduced strength. Screws that were specifically designed for cement application displayed greatest stability in the fatigue test.

  19. Indocyanine green-augmented diode laser therapy vs. long-pulsed Nd:YAG (1064 nm) laser treatment of telangiectatic leg veins: a randomized controlled trial.

    PubMed

    Klein, A; Buschmann, M; Babilas, P; Landthaler, M; Bäumler, W

    2013-08-01

    Telangiectatic leg veins (TLV) represent a common cosmetic problem. Near infrared lasers have been widely used in treatment because of their deeper penetration into the dermis, but with varying degrees of success, particularly because of different vessel diameters. Indocyanine green (ICG)-augmented diode laser treatment (ICG+DL) may present an alternative treatment option. This trial evaluates the efficacy of ICG+DL in the treatment of TLV and compares the safety and efficacy of therapy with the standard treatment, the long-pulsed neodymium-doped yttrium aluminium garnet (Nd:YAG) laser. In a prospective randomized controlled clinical trial, 29 study participants with TLV were treated with a Nd:YAG laser (λem = 1064 nm, 160-240 J cm(-2) , 65-ms pulse duration, 5-mm spot size) and ICG+DL (λem = 810 nm, 60-110 J cm(-2) , 48-87-ms pulse duration, 6-mm spot size; total ICG dose 4 mg kg(-1) ) in a side-by-side comparison in one single treatment setting that included histological examination in four participants. Two blinded investigators and the participants assessed clearance rate, cosmetic appearance and adverse events up to 3 months after treatment. According to both the investigators' and participants' assessment, clearance rates were significantly better after ICG+DL therapy than after Nd:YAG laser treatment (P < 0·05). On a 10-point scale indicating pain during treatment, participants rated ICG+DL therapy to be more painful (6·1 ± 2·0) than Nd:YAG laser (5·4 ± 2·0). ICG+DL therapy represents a new and promising treatment modality for TLV, with high clearance rates and a very good cosmetic outcome after one single treatment session. © 2013 British Association of Dermatologists.

  20. Hereditary alpha-1-antitrypsin deficiency and its clinical consequences.

    PubMed

    Fregonese, Laura; Stolk, Jan

    2008-06-19

    Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterized by low serum levels of AAT, the main protease inhibitor (PI) in human serum. The prevalence in Western Europe and in the USA is estimated at approximately 1 in 2,500 and 1 : 5,000 newborns, and is highly dependent on the Scandinavian descent within the population. The most common deficiency alleles in North Europe are PI Z and PI S, and the majority of individuals with severe AATD are PI type ZZ. The clinical manifestations may widely vary between patients, ranging from asymptomatic in some to fatal liver or lung disease in others. Type ZZ and SZ AATD are risk factors for the development of respiratory symptoms (dyspnoea, coughing), early onset emphysema, and airflow obstruction early in adult life. Environmental factors such as cigarette smoking, and dust exposure are additional risk factors and have been linked to an accelerated progression of this condition. Type ZZ AATD may also lead to the development of acute or chronic liver disease in childhood or adulthood: prolonged jaundice after birth with conjugated hyperbilirubinemia and abnormal liver enzymes are characteristic clinical signs. Cirrhotic liver failure may occur around age 50. In very rare cases, necrotizing panniculitis and secondary vasculitis may occur. AATD is caused by mutations in the SERPINA1 gene encoding AAT, and is inherited as an autosomal recessive trait. The diagnosis can be established by detection of low serum levels of AAT and isoelectric focusing. Differential diagnoses should exclude bleeding disorders or jaundice, viral infection, hemochromatosis, Wilson's disease and autoimmune hepatitis. For treatment of lung disease, intravenous alpha-1-antitrypsin augmentation therapy, annual flu vaccination and a pneumococcal vaccine every 5 years are recommended. Relief of breathlessness may be obtained with long

  1. Augmented Reality Comes to Physics

    NASA Astrophysics Data System (ADS)

    Buesing, Mark; Cook, Michael

    2013-04-01

    Augmented reality (AR) is a technology used on computing devices where processor-generated graphics are rendered over real objects to enhance the sensory experience in real time. In other words, what you are really seeing is augmented by the computer. Many AR games already exist for systems such as Kinect and Nintendo 3DS and mobile apps, such as Tagwhat and Star Chart (a must for astronomy class). The yellow line marking first downs in a televised football game2 and the enhanced puck that makes televised hockey easier to follow3 both use augmented reality to do the job.

  2. [Augmented antipsychotic therapy with pantogam active in patients with schizophrenia].

    PubMed

    Medvedev, V E; Frolova, V I; Gushanskaya, E V; Ter-Israelyan, A U

    2015-01-01

    to study the efficacy of the GABA-ergic drug pantogam active (D-, L-gopantenic acid) in patients with schizophrenia treated with typical neuroleptics and to assess the rate of treatment response and tolerability of the drug. A sample consisted of 70 patients with schizophrenia stratified into main (n=35) and control (n=35) groups. All patients received one of typical antipsychotics (haloperidol, zuclopenthixol, promazine or perphenazine). Patients of the main group received in addition pantogam active in dose of 1200-1800 mg daily. The maximum allowed dose of 1800 mg daily was used in 62.9% of the patients. The long-term combined therapy with the addition of D-, L-gopantenic acid (pantogam activ) allowed to achieve clinical improvement earlier (on 8th week in the main group versus 16th week in the control group). The frequency and severity of secondary negative symptoms associated with antipsychotic therapy were decreased as well. The high efficacy and tolerability of the combined therapy allow to improve quality of life in patients with schizophrenia and their compliance to treatment as well as to reduce costs of medical care.

  3. Reading Confidence with "Tail Waggin' Tutors"

    ERIC Educational Resources Information Center

    Loveridge, Stacy

    2017-01-01

    This report discusses the benefits of canine-assisted reading through the "Tail Waggin' Tutors" program at the Glen Burnie Regional Library in Anne Arundel County, Maryland. Presented are the two different types of therapy dog interactions, Animal-Assisted Therapy (AAT) and Animal-Assisted Activities (AAA). The first canine-assisted…

  4. The development of augmented video system on postcards

    NASA Astrophysics Data System (ADS)

    Chen, Chien-Hsu; Chou, Yin-Ju

    2013-03-01

    This study focuses on development of augmented video system on traditional picture postcards. The system will provide users to print out the augmented reality marker on the sticker to stick on the picture postcard, and it also allows users to record their real time image and video to augment on that stick marker. According dynamic image, users can share travel moods, greeting, and travel experience to their friends. Without changing in the traditional picture postcards, we develop augmented video system on them by augmented reality (AR) technology. It not only keeps the functions of traditional picture postcards, but also enhances user's experience to keep the user's memories and emotional expression by augmented digital media information on them.

  5. Living with sensor-augmented pump therapy in type 1 diabetes: adolescents' and parents' search for harmony.

    PubMed

    Rashotte, Judy; Tousignant, Kelley; Richardson, Christine; Fothergill-Bourbonnais, Frances; Nakhla, Meranda M; Olivier, Patricia; Lawson, Margaret L

    2014-08-01

    Adolescents have difficulty successfully sustaining use of continuous glucose monitoring even when it is introduced to experienced pump users. However, little is known about how adolescents and parents perceive and manage sensor-augmented pump therapy (SAPT) in daily life. The purpose of this study was to explore adolescents' and parents' daily experience of living with SAPT. We used an interpretive phenomenological study design. We conducted in-depth, digitally recorded interviews with 7 adolescents and 9 parents recruited through 1 Canadian pediatric diabetes program. Adolescents who participated were 13 to 17 years of age with type 1 diabetes mellitus and had experience (current or past) living with SAPT. Transcripts of the interviews were subjected to a thematic analysis guided by the procedure outlined by Colaizzi. The overarching theme, seeking harmony, reflected adolescents' and parents' daily struggles with balancing multiple tensions that arose from managing SAPT and harmonizing seemingly opposing choices that were brought to the fore, while also struggling to live with both wellness and chronic illness. Four themes constituted the struggle to find harmony living with diabetes managed with SAPT: struggling with hopes and expectations for SAPT, being ready for SAPT, living the burdens of continuous glucose monitoring and creating partnerships. Healthcare providers can facilitate adolescent and parental decision-making about the optimal timing for SAPT introduction. Success with SAPT requires exploration of adolescent and parental expectations for SAPT as well as the degree to which parents have previously fostered their adolescent's involvement in and responsibility for diabetes management. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. Inkjet-based biopatterning of SDF-1β augments BMP-2-induced repair of critical size calvarial bone defects in mice

    PubMed Central

    Herberg, Samuel; Kondrikova, Galina; Periyasamy-Thandavan, Sudharsan; Howie, R. Nicole; Elsalanty, Mohammed E.; Weiss, Lee; Campbell, Phil; Hill, William D.; Cray, James J.

    2014-01-01

    Background A major problem in craniofacial surgery is non-healing bone defects. Autologous reconstruction remains the standard of care for these cases. Bone morphogenetic protein-2 (BMP-2) therapy has proven its clinical utility, although non-targeted adverse events occur due to the high milligram-level doses used. Ongoing efforts explore the use of different growth factors, cytokines, or chemokines, as well as co-therapy to augment healing. Methods Here we utilize inkjet-based biopatterning to load acellular DermaMatrix delivery matrices with nanogram-level doses of BMP-2, stromal cell-derived factor-1β (SDF-1β), transforming growth factor-β1 (TGF-β1), or co-therapies thereof. We tested the hypothesis that bioprinted SDF-1β co-delivery enhances BMP-2 and TGF-β1-driven osteogenesis both in-vitro and in-vivo using a mouse calvarial critical size defect (CSD) model. Results Our data showed that BMP-2 bioprinted in low-doses induced significant new bone formation by four weeks post-operation. TGF-β1 was less effective compared to BMP-2, and SDF-1β therapy did not enhance osteogenesis above control levels. However, co-delivery of BMP-2 + SDF-1β was shown to augment BMP-2-induced bone formation compared to BMP-2 alone. In contrast, co-delivery of TGF-β1 + SDF-1β decreased bone healing compared to TGF-β1 alone. This was further confirmed in vitro by osteogenic differentiation studies using MC3T3-E1 pre-osteoblasts. Conclusions Our data indicates that sustained release delivery of a low-dose growth factor therapy using biopatterning technology can aid in healing CSD injuries. SDF-1β augments the ability for BMP-2 to drive healing, a result confirmed in vivo and in vitro; however, because SDF-1β is detrimental to TGF-β1-driven osteogenesis, its’ effect on osteogenesis is not universal. PMID:25016095

  7. Computerized tomography-assisted calculation of sinus augmentation volume.

    PubMed

    Krennmair, Gerald; Krainhöfner, Martin; Maier, Harald; Weinländer, Michael; Piehslinger, Eva

    2006-01-01

    This study was intended to calculate the augmentation volume for a sinus lift procedure based on cross-sectional computerized tomography (CT) scans for 2 different augmentation heights. Based on area calculations of cross-sectional CT scans, the volume of additional bone needed was calculated for 44 sinus lift procedures. The amount of bone volume needed to raise the sinus floor to heights of both 12 and 17 mm was calculated. To achieve a sinus floor height of 12 mm, it was necessary to increase the height by a mean of 7.2+/-2.1 mm (range, 3.0 to 10.5 mm), depending on the residual ridge height; to achieve a height of 17 mm, a mean of 12.4+/-2.0 mm (range, 8.5 to 15.5 mm) was required (P < .01). The calculated augmentation volume for an augmentation height of 12 mm was 1.7+/-.9 cm3; for an augmentation height of 17 mm, the volume required was 3.6+/-1.5 cm3. Increasing the height of the sinus lift by 5 mm, ie, from 12 mm to 17 mm augmentation height, increased the augmentation volume by 100%. A significant correlation was found between augmentation height and the calculated sinus lift augmentation volume (r = 0. 78, P < .01). Detailed preoperative knowledge of sinus lift augmentation volume is helpful as a predictive value in deciding on a donor site for harvesting autogenous bone and on the ratio of bone to bone substitute to use. Calculation of the augmentation size can help determine the surgical approach and thus perioperative treatment and the costs of the surgery for both patients and clinicians.

  8. RMS active damping augmentation

    NASA Technical Reports Server (NTRS)

    Gilbert, Michael G.; Scott, Michael A.; Demeo, Martha E.

    1992-01-01

    The topics are presented in viewgraph form and include: RMS active damping augmentation; potential space station assembly benefits to CSI; LaRC/JSC bridge program; control law design process; draper RMS simulator; MIMO acceleration control laws improve damping; potential load reduction benefit; DRS modified to model distributed accelerations; accelerometer location; Space Shuttle aft cockpit simulator; simulated shuttle video displays; SES test goals and objectives; and SES modifications to support RMS active damping augmentation.

  9. EFFECTS OF HOMEWORK COMPLIANCE ON COGNITIVE-BEHAVIORAL THERAPY WITH D-CYCLOSERINE AUGMENTATION FOR CHILDREN WITH OBSESSIVE COMPULSIVE DISORDER.

    PubMed

    Olatunji, Bunmi O; Rosenfield, David; Monzani, Benedetta; Krebs, Georgina; Heyman, Isobel; Turner, Cynthia; Isomura, Kayoko; Mataix-Cols, David

    2015-12-01

    The present study examined the effects of homework compliance on outcome from cognitive behavioral therapy (CBT) for children with obsessive-compulsive disorder (OCD) and the extent to which these effects differ as a function of augmentation of CBT with D-cycloserine (DCS). Twenty-seven youth with OCD were randomized to either 50 mg DCS or placebo (PBO) administered immediately after each of 10 CBT sessions, primarily consisting of exposure and ritual prevention (ERP). Independent evaluators assessed OCD severity using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at the start of each session. Compliance with between-session ERP assignments was also assessed at the start of each session using the Patient ERP Adherence Scale (PEAS). Greater homework compliance between the previous session and the current session was related to lower CY-BOCS at the current session. However, the relation between homework compliance and CY-BOCS varied by treatment condition. Higher homework compliance was related to lower CY-BOCS for participants in the DCS condition, but not for participants in the PBO condition. Furthermore, participants receiving DCS were estimated to have significantly lower CY-BOCS than those given PBO among those with the highest levels of homework compliance. DCS may more effectively facilitate the effects of CBT for youth with OCD when patients are compliant with prescribed homework. Theoretical and clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  10. Nonsteady-Flow Thrust Augmenting Ejectors

    NASA Technical Reports Server (NTRS)

    Foa, J. V.

    1979-01-01

    Ejector augmenters in which the transfer of mechanical energy from the primary to the secondary flow takes place through the work of interface pressure forces are investigated. Nonsteady flow processes are analyzed from the standpoint of energy transfer efficiency and a comparison of a rotary jet augmenter to an ejector is presented.

  11. Ethical issues in growth hormone therapy.

    PubMed

    Lantos, J; Siegler, M; Cuttler, L

    1989-02-17

    Pediatricians face clinical and ethical dilemmas about therapy to augment growth in short children who do not meet classic criteria for growth hormone (GH) deficiency. Biologic norms of health are unhelpful because of the uncertain relationship between stature, GH secretion, health, and disease. Instead, we suggest that GH therapy be evaluated from the perspective of cultural norms. We compare GH therapy for short normal children with currently accepted therapies for non--life-threatening pediatric conditions such as well-child care, cosmetic therapy, treatment of psychological problems, and invasive outpatient therapy for chronic conditions. Based on this analysis, we argue that the burdens of therapy, the uncertainty about long-term risks and benefits, the unclear therapeutic end point, and the implications for child health policy place routine GH therapy for children without documented deficiency of GH secretion outside current pediatric ethical norms. Such therapy is properly administered within a comprehensive clinical research protocol.

  12. Bone marrow endothelial progenitors augment atherosclerotic plaque regression in a mouse model of plasma lipid lowering

    PubMed Central

    Yao, Longbiao; Heuser-Baker, Janet; Herlea-Pana, Oana; Iida, Ryuji; Wang, Qilong; Zou, Ming-Hui; Barlic-Dicen, Jana

    2012-01-01

    The major event initiating atherosclerosis is hypercholesterolemia-induced disruption of vascular endothelium integrity. In settings of endothelial damage, endothelial progenitor cells (EPCs) are mobilized from bone marrow into circulation and home to sites of vascular injury where they aid endothelial regeneration. Given the beneficial effects of EPCs in vascular repair, we hypothesized that these cells play a pivotal role in atherosclerosis regression. We tested our hypothesis in the atherosclerosis-prone mouse model in which hypercholesterolemia, one of the main factors affecting EPC homeostasis, is reversible (Reversa mice). In these mice normalization of plasma lipids decreased atherosclerotic burden; however, plaque regression was incomplete. To explore whether endothelial progenitors contribute to atherosclerosis regression, bone marrow EPCs from a transgenic strain expressing green fluorescent protein under the control of endothelial cell-specific Tie2 promoter (Tie2-GFP+) were isolated. These cells were then adoptively transferred into atheroregressing Reversa recipients where they augmented plaque regression induced by reversal of hypercholesterolemia. Advanced plaque regression correlated with engraftment of Tie2-GFP+ EPCs into endothelium and resulted in an increase in atheroprotective nitric oxide and improved vascular relaxation. Similarly augmented plaque regression was also detected in regressing Reversa mice treated with the stem cell mobilizer AMD3100 which also mobilizes EPCs to peripheral blood. We conclude that correction of hypercholesterolemia in Reversa mice leads to partial plaque regression that can be augmented by AMD3100 treatment or by adoptive transfer of EPCs. This suggests that direct cell therapy or indirect progenitor cell mobilization therapy may be used in combination with statins to treat atherosclerosis. PMID:23081735

  13. STAR 3 randomized controlled trial to compare sensor-augmented insulin pump therapy with multiple daily injections in the treatment of type 1 diabetes: research design, methods, and baseline characteristics of enrolled subjects.

    PubMed

    Davis, Stephen N; Horton, Edward S; Battelino, Tadej; Rubin, Richard R; Schulman, Kevin A; Tamborlane, William V

    2010-04-01

    Sensor-augmented pump therapy (SAPT) integrates real-time continuous glucose monitoring (RT-CGM) with continuous subcutaneous insulin infusion (CSII) and offers an alternative to multiple daily injections (MDI). Previous studies provide evidence that SAPT may improve clinical outcomes among people with type 1 diabetes. Sensor-Augmented Pump Therapy for A1c Reduction (STAR) 3 is a multicenter randomized controlled trial comparing the efficacy of SAPT to that of MDI in subjects with type 1 diabetes. Subjects were randomized to either continue with MDI or transition to SAPT for 1 year. Subjects in the MDI cohort were allowed to transition to SAPT for 6 months after completion of the study. SAPT subjects who completed the study were also allowed to continue for 6 months. The primary end point was the difference between treatment groups in change in hemoglobin A1c (HbA1c) percentage from baseline to 1 year of treatment. Secondary end points included percentage of subjects with HbA1c < or =7% and without severe hypoglycemia, as well as area under the curve of time spent in normal glycemic ranges. Tertiary end points include percentage of subjects with HbA1c < or =7%, key safety end points, user satisfaction, and responses on standardized assessments. A total of 495 subjects were enrolled, and the baseline characteristics similar between the SAPT and MDI groups. Study completion is anticipated in June 2010. Results of this randomized controlled trial should help establish whether an integrated RT-CGM and CSII system benefits patients with type 1 diabetes more than MDI.

  14. Augmentation cystoplasty in neurogenic bladder

    PubMed Central

    Kocjancic, Ervin; Demirdağ, Çetin

    2016-01-01

    The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

  15. Is a synthetic augmentation in medial open wedge high tibial osteotomies superior to no augmentation in terms of bone-healing?

    PubMed

    Ferner, Felix; Dickschas, Joerg; Ostertag, Helmut; Poske, Ulrich; Schwitulla, Judith; Harrer, Joerg; Strecker, Wolf

    2016-01-01

    Medial open-wedge high tibial osteotomy (MOWHTO) is an established method to treat unicompartimental osteoarthritis of the knee joint. However, augmentation of the created tibial gap after osteotomy is controversially discussed. We performed a prospective investigation of 49 consecutive cases of MOWHTO at our department. Patients were divided into two groups: group A consisted of 19 patients while group B consisted of 30 patients. In group A, the augmentation of the opening gap after osteotomy was filled with a synthetic bone graft, whereas group B received no augmentation. As an indicator for bone healing we investigated the non-union rate in our study population and compared the non-union-rate between the two groups. The non-union rate was 28% in group A (five of 19 patients had to undergo revision) which received synthetic augmentation, while it was 3.3% in group B (one of 30 patients had to undergo revision) which received no augmentation. The difference between the groups was statistically significant (p-value 0.027). With regard to bone healing after MOWHTO, synthetic augmentation was not superior to no augmentation in terms of non-union rates after surgery. In fact, we registered a significantly higher rate of non-union after augmentation with synthetic bone graft. III. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Augmented Reality Comes to Physics

    ERIC Educational Resources Information Center

    Buesing, Mark; Cook, Michael

    2013-01-01

    Augmented reality (AR) is a technology used on computing devices where processor-generated graphics are rendered over real objects to enhance the sensory experience in real time. In other words, what you are really seeing is augmented by the computer. Many AR games already exist for systems such as Kinect and Nintendo 3DS and mobile apps, such as…

  17. Horizontal alveolar ridge augmentation using autologous press fit bone cylinders and micro-lag-screw fixation: technical note and initial experience.

    PubMed

    Streckbein, Philipp; Kähling, Christopher; Wilbrand, Jan-Falco; Malik, Christoph-Yves; Schaaf, Heidrun; Howaldt, Hans-Peter; Streckbein, Roland

    2014-07-01

    The use of autologous block bone grafts for horizontal alveolar ridge augmentation in dental implantology is a common surgical procedure. Typically, bone grafts are individually moulded. The aim of this paper is to introduce an innovative procedure in lateral bone augmentation, where the recipient side is adjusted to the graft, not vice versa as in common procedures. Our initial clinical experience of twenty-five consecutive cases is presented. Adjusted trephine drills were used to harvest partly cylindrical grafts from the retromolar region of the mandible. After preparing the recipient site with accurately fitting grinding drills, the bone grafts were transplanted. The horizontally compromised alveolar ridges were successfully augmented and treated with dental implants. No major complication occurred during transplantation, the healing period, and subsequent implant therapy in our experimental setting with 25 patients and 38 augmentation procedures. One out of twenty-five patients presented with temporary dysaesthesia of the inferior alveolar nerve. The new method presented is an effective treatment option for horizontal alveolar ridge augmentation prior to single implant installation. Further studies should evaluate the donor site morbidity and long-term outcome on a larger population. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Strategies and Challenges in Simultaneous Augmentation Mastopexy.

    PubMed

    Spring, Michelle A; Hartmann, Emily C; Stevens, W Grant

    2015-10-01

    Simultaneous breast augmentation and mastopexy is a common procedure often considered to be one of the most difficult cosmetic breast surgeries. One-stage augmentation mastopexy was initially described more than 50 years ago. The challenge lies in the fact that the surgery has multiple opposing goals: to increasing the volume of a breast, enhance the shape, and simultaneously decrease the skin envelope. Successful outcomes in augmentation can be expected with proper planning, technique, and patient education. This article focuses on common indications for simultaneous augmentation mastopexy, techniques for safe and effective combined procedures, challenges of the procedure, and potential complications. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: a double-blind controlled pilot study.

    PubMed

    Dias, Rodrigo S; Kerr-Corrêa, Florence; Moreno, Ricardo A; Trinca, Luzia A; Pontes, Anagloria; Halbe, Hans W; Gianfaldoni, Arlete; Dalben, Ivete S

    2006-01-01

    This study evaluated the augmentation of venlafaxine with hormone therapy in the treatment of postmenopausal depression. The hormones evaluated were estrogen (0.625 mg) in combination with medroxyprogesterone acetate (2.5 mg) and methyltestosterone (2.5 mg). Seventy-two menopausal women (mean age: 53.6 +/- 4.27 years) diagnosed with depression (Montgomery-Asberg Depression Rating Scale [MADRS] scores > or = 20) were treated with venlafaxine and one of the following hormone therapy combinations, in a double-blind regimen: estrogen + medroxyprogesterone + methyltestosterone (group 1, n = 20); estrogen + medroxyprogesterone acetate (group 2, n = 20); methyltestosterone only (group 3, n = 16); and no hormone therapy (group 4, n = 16). Study duration was 24 weeks. Primary efficacy outcome was remission according to the MADRS, whereas secondary efficacy measures included the Clinical Global Impression (CGI), Blatt-Kupperman Index, and Women's Health Questionnaire (WHQ). Forty-eight patients completed the study. All groups showed significant improvement from baseline. Group 3 demonstrated significant improvement on the MADRS compared with placebo (group 4) at weeks 20 (P = 0.048) and 24 (P = 0.030); effect size 8.04 (0.83; 15.26) (P = 0.029), but also had the highest dropout rate. Groups 1 and 3 had significant CGI improvement rates compared with placebo: 42.23% (P = 0.012) and 44.45% (P = 0.08), respectively. There were no differences in the WHQ or BKI scores among the groups. Methyltestosterone 2.5 mg had the highest effect size compared with placebo, but the high dropout rate prevented its efficacy from being determined. Estrogen plus medroxyprogesterone, combined with methyltestosterone or otherwise, demonstrated a trend toward increased efficacy of venlafaxine. Further larger-scale clinical trials are needed to elucidate the findings of this pilot study.

  20. Using non-invasive brain stimulation to augment motor training-induced plasticity

    PubMed Central

    Bolognini, Nadia; Pascual-Leone, Alvaro; Fregni, Felipe

    2009-01-01

    Therapies for motor recovery after stroke or traumatic brain injury are still not satisfactory. To date the best approach seems to be the intensive physical therapy. However the results are limited and functional gains are often minimal. The goal of motor training is to minimize functional disability and optimize functional motor recovery. This is thought to be achieved by modulation of plastic changes in the brain. Therefore, adjunct interventions that can augment the response of the motor system to the behavioural training might be useful to enhance the therapy-induced recovery in neurological populations. In this context, noninvasive brain stimulation appears to be an interesting option as an add-on intervention to standard physical therapies. Two non-invasive methods of inducing electrical currents into the brain have proved to be promising for inducing long-lasting plastic changes in motor systems: transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). These techniques represent powerful methods for priming cortical excitability for a subsequent motor task, demand, or stimulation. Thus, their mutual use can optimize the plastic changes induced by motor practice, leading to more remarkable and outlasting clinical gains in rehabilitation. In this review we discuss how these techniques can enhance the effects of a behavioural intervention and the clinical evidence to date. PMID:19292910

  1. A lifting surface theory for thrust augmenting ejectors

    NASA Technical Reports Server (NTRS)

    Bevilaqua, P. M.

    1977-01-01

    The circulation theory of airfoil lift has been applied to calculate the performance of thrust augmenting ejectors. The ejector shroud is considered to be 'flying' in the secondary velocity field induced by the entrainment of the primary jet, so that the augmenting thrust is viewed as analogous to the lift on an airfoil. Vortex lattice methods are utilized to compute the thrust augmentation from the force on the flaps. The augmentation is shown to be a function of the length and shape of the flaps, as well as their position and orientation. Predictions of this new theory are compared with the results of classical methods of calculating the augmentation by integration of the stream thrust.

  2. Chemosensitization as a Means to Augment Commercial Antifungal Agents

    PubMed Central

    Campbell, Bruce C.; Chan, Kathleen L.; Kim, Jong H.

    2012-01-01

    Antimycotic chemosensitization and its mode of action are of growing interest. Currently, use of antifungal agents in agriculture and medicine has a number of obstacles. Foremost of these is development of resistance or cross-resistance to one or more antifungal agents. The generally high expense and negative impact, or side effects, associated with antifungal agents are two further issues of concern. Collectively, these problems are exacerbated by efforts to control resistant strains, which can evolve into a treadmill of higher dosages for longer periods. This cycle in turn, inflates cost of treatment, dramatically. A further problem is stagnation in development of new and effective antifungal agents, especially for treatment of human mycoses. Efforts to overcome some of these issues have involved using combinations of available antimycotics (e.g., combination therapy for invasive mycoses). However, this approach has had inconsistent success and is often associated with a marked increase in negative side effects. Chemosensitization by natural compounds to increase effectiveness of commercial antimycotics is a somewhat new approach to dealing with the aforementioned problems. The potential for safe natural products to improve antifungal activity has been observed for over three decades. Chemosensitizing agents possess antifungal activity, but at insufficient levels to serve as antimycotics, alone. Their main function is to disrupt fungal stress response, destabilize the structural integrity of cellular and vacuolar membranes or stimulate production of reactive oxygen species, augmenting oxidative stress and apoptosis. Use of safe chemosensitizing agents has potential benefit to both agriculture and medicine. When co-applied with a commercial antifungal agent, an additive or synergistic interaction may occur, augmenting antifungal efficacy. This augmentation, in turn, lowers effective dosages, costs, negative side effects and, in some cases, countermands resistance

  3. Augmented reality in dentistry: a current perspective.

    PubMed

    Kwon, Ho-Beom; Park, Young-Seok; Han, Jung-Suk

    2018-02-21

    Augmentation reality technology offers virtual information in addition to that of the real environment and thus opens new possibilities in various fields. The medical applications of augmentation reality are generally concentrated on surgery types, including neurosurgery, laparoscopic surgery and plastic surgery. Augmentation reality technology is also widely used in medical education and training. In dentistry, oral and maxillofacial surgery is the primary area of use, where dental implant placement and orthognathic surgery are the most frequent applications. Recent technological advancements are enabling new applications of restorative dentistry, orthodontics and endodontics. This review briefly summarizes the history, definitions, features, and components of augmented reality technology and discusses its applications and future perspectives in dentistry.

  4. Augmenting breath regulation using a mobile driven virtual reality therapy framework.

    PubMed

    Abushakra, Ahmad; Faezipour, Miad

    2014-05-01

    This paper presents a conceptual framework of a virtual reality therapy to assist individuals, especially lung cancer patients or those with breathing disorders to regulate their breath through real-time analysis of respiration movements using a smartphone. Virtual reality technology is an attractive means for medical simulations and treatment, particularly for patients with cancer. The theories, methodologies and approaches, and real-world dynamic contents for all the components of this virtual reality therapy (VRT) via a conceptual framework using the smartphone will be discussed. The architecture and technical aspects of the offshore platform of the virtual environment will also be presented.

  5. Soft Tissue Augmentation Using Silk Gels: An In Vitro and In Vivo Study

    PubMed Central

    Etienne, Olivier; Schneider, Aurore; Kluge, Jonathan A.; Bellemin-Laponnaz, Claire; Polidori, Camille; Leisk, Gary G.; Kaplan, David L.; Garlick, Jonathan A.; Egles, Christophe

    2010-01-01

    Background Restoration of a three-dimensional shape with soft tissue augmentation is a challenge for surgical reconstruction and esthetic improvement of intraoral mucosa and perioral skin tissues. A connective tissue graft or free gingival graft, classically used for such indications, requires a donor site, which may lead to various clinical complications. Methods In this article, a new three-dimensional scaffold made of silk fibroin that could be of great interest for these indications was studied. Mechanical tests were conducted to characterize the physical properties of the materials. The biocompatibility of such scaffolds was positively assessed in vitro using a combination of immunostaining, 5-bromo-2′-deoxyuridine proliferation assays, and histologic staining. Finally, the shaped material was grafted subcutaneously in nude mice for a long-time implantation study. Results Human fibroblasts embedded in this material had a survival rate up to 68.4% and were able to proliferate and synthesize proteins. One month after subcutaneous implantation, the three-dimensional soft tissue augmentation was stable, and histologic analysis revealed revascularization of the area through the biomaterial. A mild inflammatory reaction disappeared after 12 weeks. Conclusion The results indicate that silk-gel material was able to create a lasting three-dimensional soft tissue augmentation and is a promising biomaterial for periodontal and maxillofacial therapies, either as a scaffold for cells or alone as a biomaterial. PMID:19905955

  6. Augmented Reality Tower Technology Assessment

    NASA Technical Reports Server (NTRS)

    Reisman, Ronald J.; Brown, David M.

    2009-01-01

    Augmented Reality technology may help improve Air Traffic Control Tower efficiency and safety during low-visibility conditions. This paper presents the assessments of five off-duty controllers who shadow-controlled' with an augmented reality prototype in their own facility. Initial studies indicated unanimous agreement that this technology is potentially beneficial, though the prototype used in the study was not adequate for operational use. Some controllers agreed that augmented reality technology improved situational awareness, had potential to benefit clearance, control, and coordination tasks and duties and could be very useful for acquiring aircraft and weather information, particularly aircraft location, heading, and identification. The strongest objections to the prototype used in this study were directed at aircraft registration errors, unacceptable optical transparency, insufficient display performance in sunlight, inadequate representation of the static environment and insufficient symbology.

  7. Carbon dioxide water-bath treatment augments peripheral blood flow through the development of angiogenesis.

    PubMed

    Xu, Yan-Jun; Elimban, Vijayan; Dhalla, Naranjan S

    2017-08-01

    In this study, we investigated the effects of CO 2 water-bath therapy on blood flow and angiogenesis in the ischemic hind limb, as well as some plasma angiogenic factors in peripheral ischemic model. The hind limb ischemia was induced by occluding the femoral artery for 2 weeks in rats and treated with or without CO 2 water-bath therapy at 37 °C for 4 weeks (20 min treatment every day for 5 days per week). The peak blood flow and minimal and mean blood flow in the ischemic skeletal muscle were markedly increased by the CO 2 water-bath therapy. This increase in blood flow was associated with development of angiogenesis in the muscle, as well as reduction in the ischemia-induced increase in plasma malondialdehyde levels. Although plasma vascular endothelial growth factor and nitric oxide levels were increased in animals with peripheral ischemia, the changes in these biomarkers were not affected by CO 2 water-bath therapy. These results suggest that augmentation of blood flow in the ischemic hind limb by CO 2 water-bath therapy may be due to the development of angiogenesis and reduction in oxidative stress.

  8. Novel Augmentation Strategies in Major Depression.

    PubMed

    Martiny, Klaus

    2017-04-01

    Hypothesis The hypotheses of all the four included studies share the common idea that it is possible to augment the effect of antidepressant drug treatment by applying different interventions and with each intervention attain a clinically meaningful better effect compared to a control condition, and with minor side effects, thus improving the short- and medium-term outcome in major depression. Procedures Study design The basic study design has been the double blind randomised controlled trial (RCT). In the light therapy study, all patients were treated with sertraline for the whole of the study duration. In the first five weeks of the study, patients were randomised to treatment with either 60 minutes of bright white or 30 minutes of dim red light (sham condition). In the four weeks follow-up period, patients were treated with sertraline alone. In the Pindolol study, all patients were treated with venlafaxine and randomised to augmentation with either active or placebo matching pindolol tablets. In the PEMF study patients were continued on ongoing medication and randomised to augmentation with active or inactive (sham) 30 minutes daily PEMF treatment on weekdays. In the Chronos study all patients were treated with duloxetine and randomized to either a combination of three wake therapies with daily bright light treatment and sleep time stabilisation (wake group) or to daily exercise of minimum 30 minutes as an active control intervention (exercise group). The Chronos study was divided into: (1) a one-week run-in phase where duloxetine were started (and continued for the whole 29 week study period), (2) a one-week inpatient intervention phase where patient in the wake group did three wake therapies (sleep abstinence for the whole night and the following day until evening) in combination with daily light therapy and guidance on sleep time stabilisation and patients in the exercise group started a daily exercise program, (3) a seven week continuation phase where

  9. Antidepressant augmentation with anti-inflammatory agents.

    PubMed

    Andrade, Chittaranjan

    2014-09-01

    Antidepressant augmentation strategies are commonly employed to treat depressed patients who do not respond to antidepressant monotherapy. Neuroinflammatory mechanisms have been implicated in depression, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been found effective in animal models of depression both in monotherapy and when used to augment antidepressant drugs. However, results with NSAIDs have been mixed in human observational studies, with both better and worse depression outcomes reported. Four small (pooled N = 160) randomized controlled trials suggest that celecoxib (200-400 mg/d) augmentation of antidepressant medication improves 4-6 week outcomes in major depressive disorder. There are no data, however, to support the use of celecoxib or other NSAIDs in antidepressant-resistant depression. There are also concerns about adverse events associated with NSAID treatment, and about pharmacodynamic drug interactions between these drugs and serotonin reuptake inhibitors. A reasonable conclusion for the present is that NSAID augmentation of antidepressants is, at best, a tentative approach in nonrefractory major depression. © Copyright 2014 Physicians Postgraduate Press, Inc.

  10. Psychiatric benefits of integrative therapies in patients with cancer.

    PubMed

    Cassileth, Barrie R

    2014-02-01

    Integrative oncology uses non-pharmacological adjuncts to mainstream care to manage physical, emotional, and psychological symptoms experienced by cancer survivors. Depression, anxiety, fatigue and pain are among the common, often burdensome symptoms that can occur in clusters, deplete patient morale, interfere with treatment plans, and hamper recovery. Patients already seek various modalities on their own to address a broad range of problems. Legitimate complementary therapies offered at major cancer institutions improve quality of life, speed recovery, and optimize patient support. They also augment the benefits of psychiatric interventions, due to their ability to increase self-awareness and improve physical and psychological conditioning. Further, these integrated therapies provide lifelong tools and develop skills that patients use well after treatment to develop self-care regimens. The active referral of patients to integrative therapies achieves three important objectives: complementary care is received from therapists experienced in working with cancer patients, visits become part of the medical record, allowing treatment teams to guide individuals in maximizing benefit, and patients are diverted from useless or harmful 'alternatives.' We review the reciprocal physical and psychiatric benefits of exercise, mind-body practices, massage, acupuncture, and music therapy for cancer survivors, and suggest how their use can augment mainstream psychiatric interventions.

  11. “Combined Occlusion and Atropine Therapy” Versus “Augmented Part-Time Patching” in Children with Refractory/Residual Amblyopia: A Pilot Study

    PubMed Central

    Sachdeva, Virender; Mittal, Vaibhev; Gupta, Varun; Gunturu, Rekha; Kekunnaya, Ramesh; Chandrasekharan, Anjali; Chabblani, Preeti Patil; Rao, Harsha L.

    2016-01-01

    Purpose: To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia. Methodology: This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. Results: There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. Conclusions: COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia. PMID:27162453

  12. CRUX: A compliant robotic upper-extremity exosuit for lightweight, portable, multi-joint muscular augmentation.

    PubMed

    Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Trombadore, James M; Teodorescu, Mircea; Agogino, Adrian; Kurniawan, Sri

    2017-07-01

    Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the user's movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the underlying complexity of the human body. In this paper, we present a compliant, robotic exosuit for upper extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible multi-joint design for portable augmentation. We also illustrate how CRUX maintains the full range of motion of the upper-extremities for its users while providing multi-DoF strength amplification to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

  13. From Augmentation Media to Meme Media.

    ERIC Educational Resources Information Center

    Tanaka, Yuzuru

    Computers as meta media are now evolving from augmentation media vehicles to meme media vehicles. While an augmentation media system provides a seamlessly integrated environment of various tools and documents, meme media system provides further functions to edit and distribute tools and documents. Documents and tools on meme media can easily…

  14. A Randomized Controlled Trial of Cognitive-Behavioral Therapy for Generalized Anxiety Disorder with Integrated Techniques from Emotion-Focused and Interpersonal Therapies

    ERIC Educational Resources Information Center

    Newman, Michelle G.; Castonguay, Louis G.; Borkovec, Thomas D.; Fisher, Aaron J.; Boswell, James F.; Szkodny, Lauren E.; Nordberg, Samuel S.

    2011-01-01

    Objective: Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems. Method: This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal…

  15. A Randomized Controlled Trial of Exposure Therapy and Cognitive Restructuring for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Dang, Suzanne T.; Mastrodomenico, Julie; Nixon, Reginald D. V.; Felmingham, Kim L.; Hopwood, Sally; Creamer, Mark

    2008-01-01

    Previous studies have reported that adding cognitive restructuring (CR) to exposure therapy does not enhance treatment gains in posttraumatic stress disorder (PTSD). This study investigated the extent to which CR would augment treatment response when provided with exposure therapy. The authors randomly allocated 118 civilian trauma survivors with…

  16. Stability-Augmentation Devices for Miniature Aircraft

    NASA Technical Reports Server (NTRS)

    Wood, RIchard M.

    2005-01-01

    Non-aerodynamic mechanical devices are under consideration as means to augment the stability of miniature autonomous and remotely controlled aircraft. Such aircraft can be used for diverse purposes, including military reconnaissance, radio communications, and safety-related monitoring of wide areas. The need for stability-augmentation devices arises because adverse meteorological conditions generally affect smaller aircraft more strongly than they affect larger aircraft: Miniature aircraft often become uncontrollable under conditions that would not be considered severe enough to warrant grounding of larger aircraft. The need for the stability-augmentation devices to be non-aerodynamic arises because there is no known way to create controlled aerodynamic forces sufficient to counteract the uncontrollable meteorological forces on miniature aircraft. A stability-augmentation device of the type under consideration includes a mass pod (a counterweight) at the outer end of a telescoping shaft, plus associated equipment to support the operation of the aircraft. The telescoping shaft and mass pod are stowed in the rear of the aircraft. When deployed, they extend below the aircraft. Optionally, an antenna for radio communication can be integrated into the shaft. At the time of writing this article, the deployment of the telescoping shaft and mass pod was characterized as passive and automatic, but information about the deployment mechanism(s) was not available. The feasibility of this stability-augmentation concept was demonstrated in flights of hand-launched prototype aircraft.

  17. Potential costs of breast augmentation mammaplasty.

    PubMed

    Schmitt, William P; Eichhorn, Mitchell G; Ford, Ronald D

    2016-01-01

    Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. Level III, economic and decision analysis study. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Breast augmentation surgery

    MedlinePlus

    ... the shape of your breasts. Talk with a plastic surgeon if you are considering breast augmentation. Discuss ... mammograms or breast x-rays before surgery. The plastic surgeon will do a routine breast exam. Several ...

  19. Applied Augmented Reality for High Precision Maintenance

    NASA Astrophysics Data System (ADS)

    Dever, Clark

    Augmented Reality had a major consumer breakthrough this year with Pokemon Go. The underlying technologies that made that app a success with gamers can be applied to improve the efficiency and efficacy of workers. This session will explore some of the use cases for augmented reality in an industrial environment. In doing so, the environmental impacts and human factors that must be considered will be explored. Additionally, the sensors, algorithms, and visualization techniques used to realize augmented reality will be discussed. The benefits of augmented reality solutions in industrial environments include automated data recording, improved quality assurance, reduction in training costs and improved mean-time-to-resolution. As technology continues to follow Moore's law, more applications will become feasible as performance-per-dollar increases across all system components.

  20. Auricular Acupressure Helps Alleviate Xerostomia in Maintenance Hemodialysis Patients: A Pilot Study.

    PubMed

    Yang, Guowen; Lin, Shaoqin; Wu, Yuchi; Zhang, Shangpeng; Wu, Xiuqing; Liu, Xusheng; Zou, Chuan; Lin, Qizhan

    2017-04-01

    Xerostomia is one of the most common complaints in maintenance hemodialysis (MHD) patients. This problem contributes to excess fluid intake and results in poor survival outcome. Based on Traditional Chinese Medicine (TCM) theory and literature studies, the authors have been practicing auricular acupressure therapy (AAT) to help patients with xerostomia. This pilot study was conducted to demonstrate the potential of AAT for xerostomia in MHD patients. Eligible subjects who agreed to participate in this study were recruited and provided with AAT for 4 weeks. The Summated Xerostomia Inventory (SXI), as well as measurement of inter-dialytic weight gain (IDWG), daily inter-dialytic weight gain (daily IDWG), percentage of inter-dialytic weight gain (IDWG%), blood pressure, and biochemical parameters, were completed at baseline and after a 4-week intervention. A total of 26 eligible participants were recruited. Of them, 10 men and 16 women (M age  = 52.92 ± 11.80 years; dialysis vintage 81.86 ± 46.05 months) completed the study. After the 4-week AAT intervention, the SXI scores were significantly decreased compared with baseline (from 10.08 ± 2.26 to 9.04 ± 2.14; p < 0.05). However, the IDWG, daily IDWG, IDWG%, blood pressure, and biochemical parameters did not change significantly after the intervention. This study provides preliminary evidence that AAT may be effective in reducing xerostomia intensity for MHD patients.

  1. Chin augmentation - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100009.htm Chin augmentation - series—Normal anatomy To use the sharing features ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  2. Breast augmentation - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100205.htm Breast augmentation - series—Normal anatomy To use the sharing features ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  3. Augmented reality-assisted skull base surgery.

    PubMed

    Cabrilo, I; Sarrafzadeh, A; Bijlenga, P; Landis, B N; Schaller, K

    2014-12-01

    Neuronavigation is widely considered as a valuable tool during skull base surgery. Advances in neuronavigation technology, with the integration of augmented reality, present advantages over traditional point-based neuronavigation. However, this development has not yet made its way into routine surgical practice, possibly due to a lack of acquaintance with these systems. In this report, we illustrate the usefulness and easy application of augmented reality-based neuronavigation through a case example of a patient with a clivus chordoma. We also demonstrate how augmented reality can help throughout all phases of a skull base procedure, from the verification of neuronavigation accuracy to intraoperative image-guidance. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Enhancing Education through Mobile Augmented Reality

    ERIC Educational Resources Information Center

    Joan, D. R. Robert

    2015-01-01

    In this article, the author has discussed about the Mobile Augmented Reality and enhancing education through it. The aim of the present study was to give some general information about mobile augmented reality which helps to boost education. Purpose of the current study reveals the mobile networks which are used in the institution campus as well…

  5. Augmented Reality as a Countermeasure for Sleep Deprivation.

    PubMed

    Baumeister, James; Dorrlan, Jillian; Banks, Siobhan; Chatburn, Alex; Smith, Ross T; Carskadon, Mary A; Lushington, Kurt; Thomas, Bruce H

    2016-04-01

    Sleep deprivation is known to have serious deleterious effects on executive functioning and job performance. Augmented reality has an ability to place pertinent information at the fore, guiding visual focus and reducing instructional complexity. This paper presents a study to explore how spatial augmented reality instructions impact procedural task performance on sleep deprived users. The user study was conducted to examine performance on a procedural task at six time points over the course of a night of total sleep deprivation. Tasks were provided either by spatial augmented reality-based projections or on an adjacent monitor. The results indicate that participant errors significantly increased with the monitor condition when sleep deprived. The augmented reality condition exhibited a positive influence with participant errors and completion time having no significant increase when sleep deprived. The results of our study show that spatial augmented reality is an effective sleep deprivation countermeasure under laboratory conditions.

  6. Media-Augmented Exercise Machines

    NASA Astrophysics Data System (ADS)

    Krueger, T.

    2002-01-01

    Cardio-vascular exercise has been used to mitigate the muscle and cardiac atrophy associated with adaptation to micro-gravity environments. Several hours per day may be required. In confined spaces and long duration missions this kind of exercise is inevitably repetitive and rapidly becomes uninteresting. At the same time, there are pressures to accomplish as much as possible given the cost- per-hour for humans occupying orbiting or interplanetary. Media augmentation provides a the means to overlap activities in time by supplementing the exercise with social, recreational, training or collaborative activities and thereby reducing time pressures. In addition, the machine functions as an interface to a wide range of digital environments allowing for spatial variety in an otherwise confined environment. We hypothesize that the adoption of media augmented exercise machines will have a positive effect on psycho-social well-being on long duration missions. By organizing and supplementing exercise machines, data acquisition hardware, computers and displays into an interacting system this proposal increases functionality with limited additional mass. This paper reviews preliminary work on a project to augment exercise equipment in a manner that addresses these issues and at the same time opens possibilities for additional benefits. A testbed augmented exercise machine uses a specialty built cycle trainer as both input to a virtual environment and as an output device from it using spatialized sound, and visual displays, vibration transducers and variable resistance. The resulting interactivity increases a sense of engagement in the exercise, provides a rich experience of the digital environments. Activities in the virtual environment and accompanying physiological and psychological indicators may be correlated to track and evaluate the health of the crew.

  7. Optimal control applied to a model for species augmentation.

    PubMed

    Bodine, Erin N; Gross, Louis J; Lenhart, Suzanne

    2008-10-01

    Species augmentation is a method of reducing species loss via augmenting declining or threatened populations with individuals from captive-bred or stable, wild populations. In this paper, we develop a differential equations model and optimal control formulation for a continuous time augmentation of a general declining population. We find a characterization for the optimal control and show numerical results for scenarios of different illustrative parameter sets. The numerical results provide considerably more detail about the exact dynamics of optimal augmentation than can be readily intuited. The work and results presented in this paper are a first step toward building a general theory of population augmentation, which accounts for the complexities inherent in many conservation biology applications.

  8. Type 2 diabetes impairs the ability of skeletal muscle pericytes to augment postischemic neovascularization in db/db mice.

    PubMed

    Hayes, Katherine L; Messina, Louis M; Schwartz, Lawrence M; Yan, Jinglian; Burnside, Amy S; Witkowski, Sarah

    2018-05-01

    Peripheral artery disease is an atherosclerotic occlusive disease that causes limb ischemia and has few effective noninterventional treatments. Stem cell therapy is promising, but concomitant diabetes may limit its effectiveness. We evaluated the therapeutic potential of skeletal muscle pericytes to augment postischemic neovascularization in wild-type and type 2 diabetic (T2DM) mice. Wild-type C57BL/6J and leptin receptor spontaneous mutation db/db T2DM mice underwent unilateral femoral artery excision to induce limb ischemia. Twenty-four hours after ischemia induction, CD45 - CD34 - CD146 + skeletal muscle pericytes or vehicle controls were transplanted into ischemic hindlimb muscles. At postoperative day 28, pericyte transplantation augmented blood flow recovery in wild-type mice (79.3 ± 5% vs. 61.9 ± 5%; P = 0.04), but not in T2DM mice (48.6% vs. 46.3 ± 5%; P = 0.51). Pericyte transplantation augmented collateral artery enlargement in wild-type (26.7 ± 2 μm vs. 22.3 ± 1 μm, P = 0.03), but not T2DM mice (20.4 ± 1.4 μm vs. 18.5 ± 1.2 μm, P = 0.14). Pericyte incorporation into collateral arteries was higher in wild-type than in T2DM mice ( P = 0.002). Unexpectedly, pericytes differentiated into Schwann cells in vivo. In vitro, Insulin increased Nox2 expression and decreased tubular formation capacity in human pericytes. These insulin-induced effects were reversed by N-acetylcysteine antioxidant treatment. In conclusion, T2DM impairs the ability of pericytes to augment neovascularization via decreased collateral artery enlargement and impaired engraftment into collateral arteries, potentially via hyperinsulinemia-induced oxidant stress. While pericytes show promise as a unique form of stem cell therapy to increase postischemic neovascularization, characterizing the molecular mechanisms by which T2DM impairs their function is essential to achieve their therapeutic potential.

  9. Recent Development of Augmented Reality in Surgery: A Review

    PubMed Central

    Vávra, P.; Zonča, P.; Ihnát, P.; El-Gendi, A.

    2017-01-01

    Introduction The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. Methods We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms “augmented reality” and “surgery.” Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. Conclusions The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice. PMID:29065604

  10. Recent Development of Augmented Reality in Surgery: A Review.

    PubMed

    Vávra, P; Roman, J; Zonča, P; Ihnát, P; Němec, M; Kumar, J; Habib, N; El-Gendi, A

    2017-01-01

    The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms "augmented reality" and "surgery." Results . The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice.

  11. Long-Term Cognitive and Behavioral Therapies, Combined with Augmentative Communication, Are Related to Uncinate Fasciculus Integrity in Autism

    ERIC Educational Resources Information Center

    Pardini, Matteo; Elia, Maurizio; Garaci, Francesco G.; Guida, Silvia; Coniglione, Filadelfo; Krueger, Frank; Benassi, Francesca; Gialloreti, Leonardo Emberti

    2012-01-01

    Recent evidence points to white-matter abnormalities as a key factor in autism physiopathology. Using Diffusion Tensor Imaging, we studied white-matter structural properties in a convenience sample of twenty-two subjects with low-functioning autism exposed to long-term augmentative and alternative communication, combined with sessions of cognitive…

  12. Augmented Reality for Close Quarters Combat

    ScienceCinema

    None

    2018-01-16

    Sandia National Laboratories has developed a state-of-the-art augmented reality training system for close-quarters combat (CQB). This system uses a wearable augmented reality system to place the user in a real environment while engaging enemy combatants in virtual space (Boston Dynamics DI-Guy). Umbra modeling and simulation environment is used to integrate and control the AR system.

  13. Age grouping to optimize augmentation success.

    PubMed

    Gordon, Robert W

    2010-05-01

    This article has described the different age groups that present for noninvasive injectable lip and perioral augmentation, as well as the breakdown of 3 subgroups that present within the 4 general age groups. With the fundamental understanding of these presenting groups and subgroups, the practicing augmenter will be able to better treatment plan and educate the patient on realistic and optimal aesthetic outcomes.

  14. Magnetohydrodynamic Augmentation of Pulse Detonation Rocket Engines (Preprint)

    DTIC Science & Technology

    2010-09-28

    augmentation of the thrust . Ejectors typically transfer energy between streams through shear stress between separate flow streams, where a portion of the...the opportunity to extract energy and apply it to a separate stream where the net thrust can be increased. With MHD augmentation , such as in the Pulse...with the PDRIME for separate or additional thrust augmentation . Results show potential performance gains under many flight and operating conditions

  15. CRUX: a Compliant Robotic Upper-Extremity eXosuit for Lightweight, Portable, Multi-DoF Muscular Augmentation

    NASA Technical Reports Server (NTRS)

    Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Teodorescu, Mircea; Kurniawan,Sri; Agogino, Adrian; Kurniawan, Sri

    2017-01-01

    Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the users movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the complexity of the underlying human body. In this paper, we present a compliant, robotic exosuit for upper-extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible design for portability. We also show how CRUX maintains full flexibility of the upper-extremities for its users while providing multi- DoF augmentative strength to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

  16. D-cycloserine Deters Reacquisition of Cocaine Self-Administration by Augmenting Extinction Learning

    PubMed Central

    Nic Dhonnchadha, Bríd Á; Szalay, Jonathan J; Achat-Mendes, Cindy; Platt, Donna M; Otto, Michael W; Spealman, Roger D; Kantak, Kathleen M

    2010-01-01

    Augmentation of cue exposure (extinction) therapy with cognitive-enhancing pharmacotherapy may offer an effective strategy to combat cocaine relapse. To investigate this possibility at the preclinical level, rats and squirrel monkeys were trained to self-administer cocaine paired with a brief visual cue. Lever pressing was subsequently extinguished by withholding cocaine injections while maintaining response-contingent presentations of the cue. The glycine partial agonist D-cycloserine (DCS; 15 and 30 mg/kg in rats, 3 and 10 mg/kg in monkeys) was evaluated for its effects on the rate of extinction and subsequent reacquisition of cocaine self-administration. Compared with vehicle, pretreatment with 30 mg/kg DCS 0.5 h before extinction training reduced the number of responses and latency to reach the extinction criterion in rats, but neither dose of DCS altered these measures in monkeys. In both species, pretreatment with the higher dose of DCS before extinction training significantly attenuated reacquisition of cocaine self-administration compared with either extinction training in the absence of DCS or DCS in the absence of explicit extinction. Furthermore, treatment with 30 mg/kg DCS accompanied by brief handling (a stress induction) immediately after but not 6 h after extinction training attenuated reacquisition of cocaine self-administration in rats. No adverse effects of 10 mg/kg DCS were evident in quantitative observational studies in monkeys. The results suggest that DCS augmented consolidation of extinction learning to deter reacquisition of cocaine self-administration in rats and monkeys. The results suggest that DCS combined with exposure therapy may constitute a rational strategy for the clinical management of cocaine relapse. PMID:19741593

  17. Yohimbine enhancement of exposure therapy for social anxiety disorder: a randomized controlled trial.

    PubMed

    Smits, Jasper A J; Rosenfield, David; Davis, Michelle L; Julian, Kristin; Handelsman, Pamela R; Otto, Michael W; Tuerk, Peter; Shiekh, Michael; Rosenfield, Ben; Hofmann, Stefan G; Powers, Mark B

    2014-06-01

    Preclinical and clinical trials suggest that yohimbine may augment extinction learning without significant side effects. However, previous clinical trials have only examined adults with specific phobias. Yohimbine has not yet been investigated in the augmentation of exposure therapy for other anxiety disorders. Adults (n = 40) with a DSM-IV diagnosis of social anxiety disorder were randomized to placebo or yohimbine HCl (10.8 mg) 1 hour before each of four exposure sessions. Outcome measures were collected at baseline, each treatment session, posttreatment, and 1-month follow-up. Yohimbine was well tolerated. Yohimbine augmentation, relative to placebo augmentation, resulted in faster improvement and better outcomes on self-report measures of social anxiety disorder severity (Liebowitz Social Anxiety Scale, d = .53) and depressed mood severity (Beck Depression Inventory, d = .37) but not on the clinician-rated measures (Clinical Global Impressions-Severity Scale, d = .09; Clinical Global Impressions-Improvement Scale, d = .25). Between-group differences on the Liebowitz Social Anxiety Scale were moderated by the level of fear reported at the end of an exposure exercise (end fear), such that the advantage of yohimbine over placebo was only evident among patients who reported low end fear. The results provide moderate support for yohimbine as a therapeutic augmentation strategy for exposure therapy in social anxiety disorder, one that may be especially effective when coupled with successful exposure experiences. Beneficial effects for yohimbine were readily evident for self-report measures but not for clinician-rated outcomes of social anxiety severity and improvement. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

  18. An experimental test of alternative population augmentation scenarios.

    PubMed

    Kronenberger, John A; Gerberich, Jill C; Fitzpatrick, Sarah W; Broder, E Dale; Angeloni, Lisa M; Funk, W Chris

    2018-01-19

    Human land use is fragmenting habitats worldwide and inhibiting dispersal among previously connected populations of organisms, often leading to inbreeding depression and reduced evolutionary potential in the face of rapid environmental change. To combat this augmentation of isolated populations with immigrants is sometimes used to facilitate demographic and genetic rescue. Augmentation with immigrants that are genetically and adaptively similar to the target population effectively increases population fitness, but if immigrants are very genetically or adaptively divergent, augmentation can lead to outbreeding depression. Despite well-cited guidelines for the best practice selection of immigrant sources, often only highly divergent populations remain, and experimental tests of these riskier augmentation scenarios are essentially nonexistent. We conducted a mesocosm experiment with Trinidadian guppies (Poecilia reticulata) to test the multigenerational demographic and genetic effects of augmenting 2 target populations with 3 types of divergent immigrants. We found no evidence of demographic rescue, but we did observe genetic rescue in one population. Divergent immigrant treatments tended to maintain greater genetic diversity, abundance, and hybrid fitness than controls that received immigrants from the source used to seed the mesocosms. In the second population, divergent immigrants had a slightly negative effect in one treatment, and the benefits of augmentation were less apparent overall, likely because this population started with higher genetic diversity and a lower reproductive rate that limited genetic admixture. Our results add to a growing consensus that gene flow can increase population fitness even when immigrants are more highly divergent and may help reduce uncertainty about the use of augmentation in conservation. © 2018 Society for Conservation Biology.

  19. Augmentation in the treatment of restless legs syndrome with transdermal rotigotine.

    PubMed

    Beneš, Heike; García-Borreguero, Diego; Ferini-Strambi, Luigi; Schollmayer, Erwin; Fichtner, Andreas; Kohnen, Ralf

    2012-06-01

    To assess the risk of augmentation under treatment with the transdermally delivered dopamine agonist rotigotine for restless legs syndrome (RLS). Experts in RLS augmentation retrospectively reviewed data from two double-blind, placebo-controlled 6-month trials (745 rotigotine and 214 placebo subjects, NCT00136045 and NCT00135993) and from two open-label 1-year trials (620 rotigotine subjects, NCT00498108 and NCT00263068). All study visits were systematically evaluated applying the Max Planck Institute (MPI) criteria for the diagnosis of both augmentation and clinically relevant augmentation. MPI criteria for augmentation were met on at least one visit by 8.2% of all subjects in the double-blind trials with 12 subjects meeting the criteria for clinically relevant augmentation: 11 under rotigotine (1.5%) and one under placebo treatment. In the open-label trials, 9.7% of all subjects met the MPI criteria for augmentation and 2.9% met the criteria for clinically relevant augmentation. None of the patients treated with rotigotine for up to 1.5 years (double-blind plus open-label trial) discontinued prematurely owing to augmentation. Neither could dose-dependency or a time pattern for clinically relevant augmentation episodes be detected. Our analyses suggest that the risk for clinically relevant augmentation for the duration of up to 18 months of rotigotine treatment is low. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management.

    PubMed

    Saxena, Roopali; Rida, Padmashree C G; Kucuk, Omer; Aneja, Ritu

    2016-06-01

    Cancer, referred to as the 'disease of civilization', continues to haunt humanity due to its dreadful manifestations and limited success of therapeutic interventions such as chemotherapy in curing the disease. Although effective, chemotherapy has repeatedly demonstrated inadequacy in disease management due to its debilitating side effects arising from its deleterious nonspecific effects on normal healthy cells. In addition, development of chemoresistance due to mono-targeting often results in cessation of chemotherapy. This urgently demands development and implementation of multitargeted alternative therapies with mild or no side effects. One extremely promising strategy that yet remains untapped in the clinic is augmenting chemotherapy with dietary phytochemicals or extracts. Ginger, depository of numerous bioactive molecules, not only targets cancer cells but can also mitigate chemotherapy-associated side effects. Consequently, combination therapy involving ginger extract and chemotherapeutic agents may offer the advantage of being efficacious with reduced toxicity. Here we discuss the remarkable and often overlooked potential of ginger extract to manage cancer, the possibility of developing ginger-based combinational therapies, and the major roadblocks along with strategies to overcome them in clinical translation of such inventions. We are optimistic that clinical implementation of such combination regimens would be a much sought after modality in cancer management. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog.

    PubMed

    Swall, Anna; Ebbeskog, Britt; Lundh Hagelin, Carina; Fagerberg, Ingegerd

    2017-12-01

    Living with Alzheimer's disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog. The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method. The main theme was "Using one's own resources and abilities as a human being", which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog. The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.

  2. 14 CFR 91.1061 - Augmented flight crews.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Augmented flight crews. 91.1061 Section 91...) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1061 Augmented flight crews. (a) No program manager may assign any flight...

  3. 14 CFR 91.1061 - Augmented flight crews.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Augmented flight crews. 91.1061 Section 91...) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1061 Augmented flight crews. (a) No program manager may assign any flight...

  4. Embedding Augmentative Communication within Early Childhood Classrooms.

    ERIC Educational Resources Information Center

    DiCarlo, Cynthia; Banajee, Meher; Stricklin, Sarintha Buras

    2000-01-01

    This article first describes various augmentative communication systems including sign language, picture symbols, and voice output communication devices. It then explains ways to embed augmentative communication within four types of early childhood classroom activities: (1) special or planned activities, (2) meal time, (3) circle time, and (4)…

  5. [Display technologies for augmented reality in medical applications].

    PubMed

    Eck, Ulrich; Winkler, Alexander

    2018-04-01

    One of the main challenges for modern surgery is the effective use of the many available imaging modalities and diagnostic methods. Augmented reality systems can be used in the future to blend patient and planning information into the view of surgeons, which can improve the efficiency and safety of interventions. In this article we present five visualization methods to integrate augmented reality displays into medical procedures and the advantages and disadvantages are explained. Based on an extensive literature review the various existing approaches for integration of augmented reality displays into medical procedures are divided into five categories and the most important research results for each approach are presented. A large number of mixed and augmented reality solutions for medical interventions have been developed as research prototypes; however, only very few systems have been tested on patients. In order to integrate mixed and augmented reality displays into medical practice, highly specialized solutions need to be developed. Such systems must comply with the requirements with respect to accuracy, fidelity, ergonomics and seamless integration into the surgical workflow.

  6. Complications Associated With the Use of Recombinant Human Bone Morphogenic Protein-2 in Ridge Augmentation: A Case Report.

    PubMed

    Dragonas, Panagiotis; Palin, Charles; Khan, Saba; Gajendrareddy, Praveen K; Weiner, Whitney D

    2017-10-01

    This case report aims to describe in detail a complication associated with resorption of regenerated bone following implant placement and ridge augmentation using recombinant human bone morphogenic protein-2 (rhBMP-2) in combination with allograft and xenograft. Bilateral maxillary sinus and ridge augmentation procedures were completed using rhBMP-2 combined with allograft and xenograft. Five months later, significant bone augmentation was achieved, which allowed for the placement of 4 implants. Upon stage 2 surgery, significant dehiscence was noted in all implants. Treatment steps to address this complication included implant removal, guided bone regeneration with xenograft only, and placement of new implants followed by soft-tissue grafting. At the time of publication, this patient is status 1½ years post case completion with maintenance of therapy outcomes. Off-label use of rhBMP-2 has gained significant acceptance in implant dentistry. However, there is limited evidence regarding the bone maturation process when rhBMP-2 is combined with other biomaterials. More research may be needed regarding the timing and process of bone healing in the presence of rhBMP-2, in an effort to avoid surgical complications.

  7. The Role and Impact of Animals with Pediatric Patients.

    PubMed

    Goddard, Anna Tielsch; Gilmer, Mary Jo

    2015-01-01

    Animal-facilitated therapy (AFT), more specifically known as animal-assisted therapy (AAT) or "pet therapy," has had an increased presence in the literature with a surge of recent research methodologies exploring this complementary alternative medicine (CAM) intervention. However, limited studies have been conducted in the pediatric population, with many articles anecdotal in nature. A literature review included primary data sources PubMed, PsychINFO, Medline, and CINAHL, and yielded positive and beneficial outcomes to be gained through AAT in the pediatric population. Primary outcome variables of decreased anxiety and pain are the most commonly reported results. Further research studies are indicated to include the effects of AFT with children with different diseases and diagnoses. Exploration of other psychosocial and physical variables, such as self-esteem, would be useful. Interdisciplinary strategies are needed to develop interventions to help reduce patient symptoms and treatment-associated stress, as well as to facilitate healing and wellness beyond traditional medical treatment plans. Complementary therapies are of continued interest to the health care community, especially for pediatric nurses. Effective use of animals to facilitate conversation, lead discussion, or break communication barriers has been demonstrated through both research and anecdotal reports.

  8. Augmented Reality in Architecture: Rebuilding Archeological Heritage

    NASA Astrophysics Data System (ADS)

    de la Fuente Prieto, J.; Castaño Perea, E.; Labrador Arroyo, F.

    2017-02-01

    With the development in recent years of augmented reality and the appearance of new mobile terminals and storage bases on-line, we find the possibility of using a powerful tool for transmitting architecture. This paper analyzes the relationship between Augmented Reality and Architecture. Firstly, connects the theoretical framework of both disciplines through the Representation concept. Secondly, describes the milestones and possibilities of Augmented Reality in the particular field of archaeological reconstruction. And lastly, once recognized the technology developed, we face the same analysis from a critical point of view, assessing their suitability to the discipline that concerns us is the architecture and within archeology.

  9. Normative Data for Interpreting the BREAST-Q: Augmentation

    PubMed Central

    Mundy, Lily R.; Homa, Karen; Klassen, Anne F.; Pusic, Andrea L.; Kerrigan, Carolyn L.

    2016-01-01

    Background The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome (PRO) instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. Methods Normative data were generated for the BREAST-Q Augmentation Module via the Army of Women (AOW), an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited via email, with women 18 years or older without a history of breast cancer or breast surgery invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. Results The preoperative BREAST-Q Augmentation Module was completed by 1,211 women. Mean age was 54 ±24 years, mean body mass index (BMI) was 27 ±6, and 39% (n=467) had a bra cup size ≥D. Mean scores were Satisfaction with Breasts (54 ±19), Psychosocial Well-being (66 ±20), Sexual Well-being (49 ±20), and Physical Well-being (86 ±15). Women with a BMI of 30 or greater and bra cup size D or greater had lower scores. In comparison to AOW scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. Conclusions The AOW normative data represent breast-related satisfaction and well-being in woman not actively seeking breast augmentation. This data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population. PMID:28350657

  10. Facial skeletal augmentation using hydroxyapatite cement.

    PubMed

    Shindo, M L; Costantino, P D; Friedman, C D; Chow, L C

    1993-02-01

    This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans.

  11. Diagnostic standards for dopaminergic augmentation of restless legs syndrome: report from a World Association of Sleep Medicine-International Restless Legs Syndrome Study Group consensus conference at the Max Planck Institute.

    PubMed

    García-Borreguero, Diego; Allen, Richard P; Kohnen, Ralf; Högl, Birgit; Trenkwalder, Claudia; Oertel, Wolfgang; Hening, Wayne A; Paulus, Walter; Rye, David; Walters, Arthur; Winkelmann, Juliane; Earley, Christopher J

    2007-08-01

    Augmentation of symptom severity is the main complication of dopaminergic treatment of restless legs syndrome (RLS). The current article reports on the considerations of augmentation that were made during a European Restless Legs Syndrome Study Group (EURLSSG)-sponsored Consensus Conference in April 2006 at the Max Planck Institute (MPI) in Munich, Germany, the conclusions of which were endorsed by the International RLS Study Group (IRLSSG) and the World Association of Sleep Medicine (WASM). The Consensus Conference sought to develop a better understanding of augmentation and generate a better operational definition for its clinical identification. Current concepts of the pathophysiology, clinical features, and therapy of RLS augmentation were evaluated by subgroups who presented a summary of their findings for general consideration and discussion. Recent data indicating sensitivity and specificity of augmentation features for identification of augmentation were also evaluated. The diagnostic criteria of augmentation developed at the National Institutes of Health (NIH) conference in 2002 were reviewed in light of current data and theoretical understanding of augmentation. The diagnostic value and criteria for each of the accepted features of augmentation were considered by the group. A consensus was then developed for a revised statement of the diagnostic criteria for augmentation. Five major diagnostic features of augmentation were identified: usual time of RLS symptom onset each day, number of body parts with RLS symptoms, latency to symptoms at rest, severity of the symptoms when they occur, and effects of dopaminergic medication on symptoms. The quantitative data available relating the time of RLS onset and the presence of other features indicated optimal augmentation criteria of either a 4-h advance in usual starting time for RLS symptoms or a combination of the occurrence of other features. A paradoxical response to changes in medication dose also indicates

  12. Inhaled 45-50% argon augments hypothermic brain protection in a piglet model of perinatal asphyxia.

    PubMed

    Broad, Kevin D; Fierens, Igor; Fleiss, Bobbi; Rocha-Ferreira, Eridan; Ezzati, Mojgan; Hassell, Jane; Alonso-Alconada, Daniel; Bainbridge, Alan; Kawano, Go; Ma, Daqing; Tachtsidis, Ilias; Gressens, Pierre; Golay, Xavier; Sanders, Robert D; Robertson, Nicola J

    2016-03-01

    Cooling to 33.5°C in babies with neonatal encephalopathy significantly reduces death and disability, however additional therapies are needed to maximize brain protection. Following hypoxia-ischemia we assessed whether inhaled 45-50% Argon from 2-26h augmented hypothermia neuroprotection in a neonatal piglet model, using MRS and aEEG, which predict outcome in babies with neonatal encephalopathy, and immunohistochemistry. Following cerebral hypoxia-ischemia, 20 Newborn male Large White piglets<40h were randomized to: (i) Cooling (33°C) from 2-26h (n=10); or (ii) Cooling and inhaled 45-50% Argon (Cooling+Argon) from 2-26h (n=8). Whole-brain phosphorus-31 and regional proton MRS were acquired at baseline, 24 and 48h after hypoxia-ischemia. EEG was monitored. At 48h after hypoxia-ischemia, cell death (TUNEL) was evaluated over 7 brain regions. There were no differences in body weight, duration of hypoxia-ischemia or insult severity; throughout the study there were no differences in heart rate, arterial blood pressure, blood biochemistry and inotrope support. Two piglets in the Cooling+Argon group were excluded. Comparing Cooling+Argon with Cooling there was preservation of whole-brain MRS ATP and PCr/Pi at 48h after hypoxia-ischemia (p<0.001 for both) and lower (1)H MRS lactate/N acetyl aspartate in white (p=0.03 and 0.04) but not gray matter at 24 and 48h. EEG background recovery was faster (p<0.01) with Cooling+Argon. An overall difference between average cell-death of Cooling versus Cooling+Argon was observed (p<0.01); estimated cells per mm(2) were 23.9 points lower (95% C.I. 7.3-40.5) for the Cooling+Argon versus Cooling. Inhaled 45-50% Argon from 2-26h augmented hypothermic protection at 48h after hypoxia-ischemia shown by improved brain energy metabolism on MRS, faster EEG recovery and reduced cell death on TUNEL. Argon may provide a cheap and practical therapy to augment cooling for neonatal encephalopathy. Copyright © 2015. Published by Elsevier Inc.

  13. Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report.

    PubMed

    Melham, T J; Sevier, T L; Malnofski, M J; Wilson, J K; Helfst, R H

    1998-06-01

    This clinical case report demonstrates the clinical effectiveness of a new form of soft tissue mobilization in the treatment of excessive connective tissue fibrosis (scar tissue) around an athlete's injured ankle. The scar tissue was causing the athlete to have pain with activity, pain on palpation of the ankle, decreased range of motion, and loss of function. Surgery and several months of conventional physical therapy failed to alleviate the athlete's symptoms. As a final resort, augmented soft tissue mobilization (ASTM) was administered. ASTM is an alternative nonsurgical treatment modality that is being researched at Performance Dynamics (Muncip, IN). ASTM is a process that uses ergonomically designed instruments that assist therapists in the rapid localization and effective treatment of areas exhibiting excessive soft tissue fibrosis. This is followed by a stretching and strengthening program. Upon the completion of 6 wk of ASTM therapy, the athlete had no pain and had regained full range of motion and function. This case report is an example of how a noninvasive augmented form of soft tissue mobilization (ASTM) demonstrated impressive clinical results in treating a condition caused by connective tissue fibrosis.

  14. SmartG: Spontaneous Malaysian Augmented Reality Tourist Guide

    NASA Astrophysics Data System (ADS)

    Kasinathan, Vinothini; Mustapha, Aida; Subramaniam, Tanabalan

    2016-11-01

    In effort to attract higher tourist expenditure along with higher tourist arrivals, this paper proposes a travel application called the SmartG, acronym for Spontaneous Malaysian Augmented Reality Tourist Guide, which operates by making recommendations to user based on the travel objective and individual budget constraints. The applications relies on augmented reality technology, whereby a three dimensional model is presented to the user based on input from real world environment. User testing returned a favorable feedback on the concept of using augmented reality in promoting Malaysian tourism.

  15. Design and Characterization of the 4STAR Sun-Sky Spectrometer with Results from 4- Way Intercomparison of 4STAR, AATS-14, Prede, and Cimel Photometers at Mauna Loa Observatory.

    NASA Astrophysics Data System (ADS)

    Flynn, C. J.; Dunagan, S. E.; Johnson, R. R.; Schmid, B.; Shinozuka, Y.; Ramachandran, S.; Livingston, J. M.; Russell, P. B.; Redemann, J.; Tran, A. K.; Holben, B. N.

    2008-12-01

    Uncertainties in radiative forcing of climate are still dominated by uncertainties in forcing by aerosols. Aerosols impact the radiation balance in three primary ways: the direct effect through scattering and absorption of radiation, the indirect effect by acting as cloud condensation nuclei affecting cloud optical depth and longevity, and the semi-direct effect affecting cloud formation and longevity through heating and thermodynamics. An active collaboration between the Pacific Northwest National Laboratory (PNNL), National Aeronautics and Space Administration (NASA) Ames Research Center (ARC), and NASA Goddard Space Flight Center (GSFC) is advancing new instrument concepts with application to reducing these aerosol uncertainties. The concept of 4STAR (Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research) combines airborne sun tracking capabilities of the Ames Airborne Tracking Sun Photometer (AATS-14) and Aeronet-like sky scanning capability with state-of-the-art monolithic spectrometry. The overall science goal for the new instruments is to improve knowledge of atmospheric constituents and their links to climate. The high-resolution spectral capability will improve retrievals of gas constituents (e.g., H2O, O3, and NO2) and thereby improve determination of aerosol properties as residual components of the total optical depth. The sky scanning capability will enable retrievals of aerosol type (via complex refractive index and shape) and aerosol size distribution extending to larger sizes than attainable by direct-beam sun photometry alone. Additional technical goals are to reduce instrument size, weight, and power requirements while increasing autonomy and component modularity to permit operation on a wide range of aircraft including unmanned aerial vehicles (UAVs). To investigate techniques to accomplish these goals, we developed a ground-based prototype, 4STAR-Ground. The 4STAR-Ground operating performance has been characterized in many tests

  16. Applying Augmented Reality in practical classes for engineering students

    NASA Astrophysics Data System (ADS)

    Bazarov, S. E.; Kholodilin, I. Yu; Nesterov, A. S.; Sokhina, A. V.

    2017-10-01

    In this article the Augmented Reality application for teaching engineering students of electrical and technological specialties is introduced. In order to increase the motivation for learning and the independence of students, new practical guidelines on Augmented Reality were developed in the application to practical classes. During the application development, the authors used software such as Unity 3D and Vuforia. The Augmented Reality content consists of 3D-models, images and animations, which are superimposed on real objects, helping students to study specific tasks. A user who has a smartphone, a tablet PC, or Augmented Reality glasses can visualize on-screen virtual objects added to a real environment. Having analyzed the current situation in higher education: the learner’s interest in studying, their satisfaction with the educational process, and the impact of the Augmented Reality application on students, a questionnaire was developed and offered to students; the study involved 24 learners.

  17. Augmented reality for anatomical education.

    PubMed

    Thomas, Rhys Gethin; John, Nigel William; Delieu, John Michael

    2010-03-01

    The use of Virtual Environments has been widely reported as a method of teaching anatomy. Generally such environments only convey the shape of the anatomy to the student. We present the Bangor Augmented Reality Education Tool for Anatomy (BARETA), a system that combines Augmented Reality (AR) technology with models produced using Rapid Prototyping (RP) technology, to provide the student with stimulation for touch as well as sight. The principal aims of this work were to provide an interface more intuitive than a mouse and keyboard, and to evaluate such a system as a viable supplement to traditional cadaver based education.

  18. Four-point injection technique for lip augmentation.

    PubMed

    Sahan, Ali; Funda, Tamer

    2018-06-01

    Lip augmentation procedures with hyaluronic acid dermal fillers have become increasingly popular worldwide because full lips are often considered beautiful and youthful. The goal of a lip augmentation procedure is to create smooth lips with adequate volume and a natural appearance. Various techniques for lip augmentation have been utilized and described. In the four-point injection technique, the lips were divided equally into right side and left side. Four entry points were made above the vermilion border for the upper lip and below the vermilion border for the lower lip. The filler was administered with a fanning technique through each entry point. Between January 2017 and November 2017, 50 female patients underwent a nonsurgical lip augmentation procedure with injectable fillers using this technique. Forty-five patients (90%) reported that they were satisfied or extremely satisfied with their lip enhancement procedure. No serious complications were observed. The advantages of this technique are reducing the risk of complications like erythema, edema, and vascular injuries, and providing easy access to injection sites.

  19. Cosmetic tourism for breast augmentation: a systematic review.

    PubMed

    Brightman, Louise; Ng, Sze; Ahern, Susannah; Cooter, Rodney; Hopper, Ingrid

    2017-12-03

    The medical tourism industry, and in particular cosmetic tourism for breast augmentation, is becoming an increasingly popular global phenomenon. The objective of this study is to determine the extent of medical literature and the patient risk profiles associated with cosmetic tourism for breast augmentation both locally and abroad. OVID MEDLINE, OVID Embase, Cochrane Central and Proquest electronic databases. The search was conducted through to April 2017. Studies pertaining entirely or partly to cosmetic tourism for breast augmentation were considered for inclusion. Exclusion criteria included non-English articles, studies relating to non-cosmetic or non-implant breast augmentation, and studies that did not separately report on findings associated with breast augmentation abroad. We identified 17 observational studies. Common destinations included Europe, South America and South East Asia. Infectious complications were common. Wound dehiscence and aesthetic dissatisfaction also featured. Catastrophic outcomes such as sepsis, intubation and ventilation, radical bilateral mastectomy, irreversible hypoxic brain injury and death were also reported. There were expectations that home country health systems would treat complications and provide non-medically indicated revision procedures. The burden on home country health systems was evident from a public health perspective. Determining the extent of cosmetic tourism for breast augmentation, including outcomes and complications, will help to inform Australian patients who this seek procedure abroad. Furthermore, it will aid in better understanding the health system implications and may help to guide future research and public health interventions both locally and internationally. © 2017 Royal Australasian College of Surgeons.

  20. Augmenting ejector endwall effects. [V/STOL aircraft

    NASA Technical Reports Server (NTRS)

    Porter, J. L.; Squyers, R. A.

    1979-01-01

    Rectangular inlet ejectors which had multiple hypermixing nozzles for their primary jets were investigated for the effects of endwall blowing on thrust augmentation performance. The ejector configurations tested had both straight wall and active boundary layer control type diffusers. Endwall flows were energized and controlled by simple blowing jets suitably located in the ejector. Both the endwall and boundary layer control diffuser blowing rates were varied to determine optimum performance. High area ratio diffusers with insufficient endwall blowing showed endwall separation and rapid degradation of thrust performance. Optimized values of diffuser boundary layer control and endwall nozzle blowing rates in an ejector augmenter were shown to achieve high levels of augmentation performance for maximum compactness.

  1. Space-based augmentation for global navigation satellite systems.

    PubMed

    Grewal, Mohinder S

    2012-03-01

    This paper describes space-based augmentation for global navigation satellite systems (GNSS). Space-based augmentations increase the accuracy and integrity of the GNSS, thereby enhancing users' safety. The corrections for ephemeris, ionospheric delay, and clocks are calculated from reference station measurements of GNSS data in wide-area master stations and broadcast via geostationary earth orbit (GEO) satellites. This paper discusses the clock models, satellite orbit determination, ionospheric delay estimation, multipath mitigation, and GEO uplink subsystem (GUS) as used in the Wide Area Augmentation System developed by the FAA.

  2. Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial.

    PubMed

    Beidel, Deborah C; Frueh, B Christopher; Neer, Sandra M; Bowers, Clint A; Trachik, Benjamin; Uhde, Thomas W; Grubaugh, Anouk

    2017-08-23

    Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up. Consistent with our hypothesis, VRET resulted in significant decreases on the Clinician Administered PTSD Scale and the PTSD Checklist-Military version for both groups. Also consistent with our hypothesis, significant decreases in social isolation occurred only for those participants who received the TMT group component. There were significant decreases for depression and anger for both groups, although these occurred after VRET and before group treatment. All treatment gains were maintained six-months later. Although not part of the original hypotheses, sleep was not improved by either intervention and remained problematic. The results support the use of VRET as an efficacious treatment for combat-related PTSD, but suggest that VRET alone does not result in optimal treatment outcomes across domains associated with PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Microsponges based novel drug delivery system for augmented arthritis therapy.

    PubMed

    Osmani, Riyaz Ali M; Aloorkar, Nagesh H; Ingale, Dipti J; Kulkarni, Parthasarathi K; Hani, Umme; Bhosale, Rohit R; Jayachandra Dev, Dandasi

    2015-10-01

    The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug-polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and particle size analysis, and evaluated for morphology, drug loading, in vitro drug release and ex vivo diffusion as well. There were no chemical interactions between drug and polymers used as revealed by compatibility studies outcomes. The drug polymer ratio reflected notable effect on drug content, encapsulation efficiency and particle size. SEM results revealed spherical microsponges with porous surface, and had 7.21 μm mean particle size. The microsponges were then incorporated in gel; which exhibited viscous modulus along with pseudoplastic behavior. In vitro drug release results depicted that microsponges with 1:2 drug-polymer ratio were more efficient to give extended drug release of 75.88% at the end of 8 h; while conventional formulation get exhausted incredibly earlier by releasing 81.11% drug at the end of 4 h only. Thus the formulated microsponge-based gel of diclofenac diethylamine would be a promising alternative to conventional therapy for safer and efficient treatment of arthritis and musculoskeletal disorders.

  4. The use of virtual reality-based therapy to augment poststroke upper limb recovery.

    PubMed

    Samuel, Geoffrey S; Choo, Min; Chan, Wai Yin; Kok, Stanley; Ng, Yee Sien

    2015-07-01

    Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient's disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts.

  5. Augmented Reality 2.0

    NASA Astrophysics Data System (ADS)

    Schmalstieg, Dieter; Langlotz, Tobias; Billinghurst, Mark

    Augmented Reality (AR) was first demonstrated in the 1960s, but only recently have technologies emerged that can be used to easily deploy AR applications to many users. Camera-equipped cell phones with significant processing power and graphics abilities provide an inexpensive and versatile platform for AR applications, while the social networking technology of Web 2.0 provides a large-scale infrastructure for collaboratively producing and distributing geo-referenced AR content. This combination of widely used mobile hardware and Web 2.0 software allows the development of a new type of AR platform that can be used on a global scale. In this paper we describe the Augmented Reality 2.0 concept and present existing work on mobile AR and web technologies that could be used to create AR 2.0 applications.

  6. Biological augmentation and tissue engineering approaches in meniscus surgery.

    PubMed

    Moran, Cathal J; Busilacchi, Alberto; Lee, Cassandra A; Athanasiou, Kyriacos A; Verdonk, Peter C

    2015-05-01

    The purpose of this review was to evaluate the role of biological augmentation and tissue engineering strategies in meniscus surgery. Although clinical (human), preclinical (animal), and in vitro tissue engineering studies are included here, we have placed additional focus on addressing preclinical and clinical studies reported during the 5-year period used in this review in a systematic fashion while also providing a summary review of some important in vitro tissue engineering findings in the field over the past decade. A search was performed on PubMed for original works published from 2009 to March 31, 2014 using the term "meniscus" with all the following terms: "scaffolds," "constructs," "cells," "growth factors," "implant," "tissue engineering," and "regenerative medicine." Inclusion criteria were the following: English-language articles and original clinical, preclinical (in vivo), and in vitro studies of tissue engineering and regenerative medicine application in knee meniscus lesions published from 2009 to March 31, 2014. Three clinical studies and 18 preclinical studies were identified along with 68 tissue engineering in vitro studies. These reports show the increasing promise of biological augmentation and tissue engineering strategies in meniscus surgery. The role of stem cell and growth factor therapy appears to be particularly useful. A review of in vitro tissue engineering studies found a large number of scaffold types to be of promise for meniscus replacement. Limitations include a relatively low number of clinical or preclinical in vivo studies, in addition to the fact there is as yet no report in the literature of a tissue-engineered meniscus construct used clinically. Neither does the literature provide clarity on the optimal meniscus scaffold type or biological augmentation with which meniscus repair or replacement would be best addressed in the future. There is increasing focus on the role of mechanobiology and biomechanical and

  7. Personalized augmented reality for anatomy education.

    PubMed

    Ma, Meng; Fallavollita, Pascal; Seelbach, Ina; Von Der Heide, Anna Maria; Euler, Ekkehard; Waschke, Jens; Navab, Nassir

    2016-05-01

    Anatomy education is a challenging but vital element in forming future medical professionals. In this work, a personalized and interactive augmented reality system is developed to facilitate education. This system behaves as a "magic mirror" which allows personalized in-situ visualization of anatomy on the user's body. Real-time volume visualization of a CT dataset creates the illusion that the user can look inside their body. The system comprises a RGB-D sensor as a real-time tracking device to detect the user moving in front of a display. In addition, the magic mirror system shows text information, medical images, and 3D models of organs that the user can interact with. Through the participation of 7 clinicians and 72 students, two user studies were designed to respectively assess the precision and acceptability of the magic mirror system for education. The results of the first study demonstrated that the average precision of the augmented reality overlay on the user body was 0.96 cm, while the results of the second study indicate 86.1% approval for the educational value of the magic mirror, and 91.7% approval for the augmented reality capability of displaying organs in three dimensions. The usefulness of this unique type of personalized augmented reality technology has been demonstrated in this paper. © 2015 Wiley Periodicals, Inc.

  8. VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

    PubMed Central

    Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

    2003-01-01

    Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphedema: one in the rabbit ear and the other in the mouse tail. In a rabbit model, following local phVEGF-C gene transfer, VEGFR-3 expression was significantly increased. This gene transfer led to a decrease in thickness and volume of lymphedema, improvement of lymphatic function demonstrated by serial lymphoscintigraphy, and finally, attenuation of the fibrofatty changes of the skin, the final consequences of lymphedema. The favorable effect of phVEGF-C on lymphedema was reconfirmed in a mouse tail model. Immunohistochemical analysis using lymphatic-specific markers: VEGFR-3, lymphatic endothelial hyaluronan receptor-1, together with the proliferation marker Ki-67 Ab revealed that phVEGF-C transfection potently induced new lymphatic vessel growth. This study, we believe for the first time, documents that gene transfer of phVEGF-C resolves lymphedema through direct augmentation of lymphangiogenesis. This novel therapeutic strategy may merit clinical investigation in patients with lymphedema. PMID:12618526

  9. Augmented reality based real-time subcutaneous vein imaging system

    PubMed Central

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  10. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

  11. Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy.

    PubMed

    Cho, Eugenia H; Shammas, Ronnie L; Phillips, Brett T; Greenup, Rachel A; Hwang, E Shelley; Hollenbeck, Scott T

    2017-06-01

    Breast augmentation with subglandular versus subpectoral implants may differentially impact the early detection of breast cancer and treatment recommendations. The authors assessed the impact of prior augmentation on the diagnosis and management of breast cancer in women undergoing mastectomy. Breast cancer diagnosis and management were retrospectively analyzed in all women with prior augmentation undergoing therapeutic mastectomy at the authors' institution from 1993 to 2014. Comparison was made to all women with no prior augmentation undergoing mastectomy in 2010. Subanalyses were performed according to prior implant placement. A total of 260 women with (n = 89) and without (n = 171) prior augmentation underwent mastectomy for 95 and 179 breast cancers, respectively. Prior implant placement was subglandular (n = 27) or subpectoral (n = 63) (For five breasts, the placement was unknown). Breast cancer stage at diagnosis (p = 0.19) and detection method (p = 0.48) did not differ for women with and without prior augmentation. Compared to subpectoral augmentation, subglandular augmentation was associated with the diagnosis of invasive breast cancer rather than ductal carcinoma in situ (p = 0.01) and detection by self-palpation rather than screening mammography (p = 0.03). Immediate two-stage implant reconstruction was the preferred reconstructive method in women with augmentation (p < 0.01). Breast cancer stage at diagnosis was similar for women with and without prior augmentation. Among women with augmentation, however, subglandular implants were associated with more advanced breast tumors commonly detected on palpation rather than mammography. Increased vigilance in breast cancer screening is recommended among women with subglandular augmentation. Therapeutic, III.

  12. S220. BLONANSERIN AUGMENTATION IN PATIENTS WITH SCHIZOPHRENIA – WHO IS BENEFITED FROM BLONANSERIN AUGMENTATION? AN OPEN-LABEL, PROSPECTIVE, MULTI-CENTER STUDY

    PubMed Central

    Bahk, Won-Myong; Kwon, Young Joon; Yoon, Bo-Hyun; Lee, Sang-Yeol; Lee, Kwanghun; Jon, Duk-In; Kim, Moon Doo; Lim, Eunsung

    2018-01-01

    Abstract Background Evidences for antipsychotic augmentation for schizophrenic patients with sub-optimal efficacy have been lacking although it has been widespread therapeutic strategy in clinical practice. The purpose of this study was to investigate the efficacy and tolerability of blonanserin augmentation with an atypical antipsychotics (AAPs) in schizophrenic patients. Methods A total of 100 patients with schizophrenia partially or completely unresponsive to treatment with an AAP recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to existing AAPs which were maintained during the study period. Efficacy was primarily evaluated using Positive and Negative Syndrome Scale (PANSS) at baseline, week 2, 4, 8, and 12. Predictors for PANSS response (≥20% reduction) was investigated. Results The PANSS total score was significantly decreased at 12 weeks after blonanserin augmentation (-21.0 ± 18.1, F=105.849, p<0.001). Response rate on PANSS at week 12 was 51.0%. Premature discontinuation was occurred in 17 patients (17.0%) and 4 patients among them discontinued the study due to adverse events. Nine patients experienced significant weight gain during the study. Response to blonanserin augmentation was associated with severe (PANSS>85) baseline symptom (OR=10.298, p=0.007) and higher dose (>600mg/day of chlorpromazine equivalent dose) of existing AAPs (OR=4.594, p=0.014). Discussion Blonanserin augmentation improved psychiatric symptoms of schizophrenic patients in cases of partial or non-responsive to an AAP treatment with favorable tolerability. Patients with severe symptom despite treatment with higher dose of AAP were benefited from this augmentation. These results suggested that blonanserin augmentation could be an effective strategy for specific patients with schizophrenia.

  13. Orion MPCV Continuum RCS Heating Augmentation Model Development

    NASA Technical Reports Server (NTRS)

    Hyatt, Andrew J.; White, Molly E.

    2014-01-01

    The reaction control system jets of the Orion Multi Purpose Crew Vehicle can have a significant impact on the magnitude and distribution of the surface heat flux on the leeside of the aft-body, when they are fired. Changes in surface heating are expressed in terms of augmentation factor over the baseline smooth body heating. Wind tunnel tests revealed heating augmentation factors as high as 13.0, 7.6, 2.8, and 5.8 for the roll, pitch down, pitch up, and yaw jets respectively. Heating augmentation factor models, based almost exclusively on data from a series of wind tunnel tests have been developed, for the purposes of thermal protection system design. The wind tunnel tests investigated several potential jet-to-freestream similarity parameters, and heating augmentation factors derived from the data showed correlation with the jet-to-freestream momentum ratio. However, this correlation was not utilized in the developed models. Instead augmentation factors were held constant throughout the potential trajectory space. This simplification was driven by the fact that ground to flight traceability and sting effects are not well understood. Given the sensitivity of the reaction control system jet heating augmentation to configuration, geometry, and orientation the focus in the present paper is on the methodology used to develop the models and the lessons learned from the data. The models that are outlined in the present work are specific to the aerothermal database used to design the thermal protection system for the Exploration Flight Test 1 vehicle.

  14. Adaptive multimodal interaction in mobile augmented reality: A conceptual framework

    NASA Astrophysics Data System (ADS)

    Abidin, Rimaniza Zainal; Arshad, Haslina; Shukri, Saidatul A'isyah Ahmad

    2017-10-01

    Recently, Augmented Reality (AR) is an emerging technology in many mobile applications. Mobile AR was defined as a medium for displaying information merged with the real world environment mapped with augmented reality surrounding in a single view. There are four main types of mobile augmented reality interfaces and one of them are multimodal interfaces. Multimodal interface processes two or more combined user input modes (such as speech, pen, touch, manual gesture, gaze, and head and body movements) in a coordinated manner with multimedia system output. In multimodal interface, many frameworks have been proposed to guide the designer to develop a multimodal applications including in augmented reality environment but there has been little work reviewing the framework of adaptive multimodal interface in mobile augmented reality. The main goal of this study is to propose a conceptual framework to illustrate the adaptive multimodal interface in mobile augmented reality. We reviewed several frameworks that have been proposed in the field of multimodal interfaces, adaptive interface and augmented reality. We analyzed the components in the previous frameworks and measure which can be applied in mobile devices. Our framework can be used as a guide for designers and developer to develop a mobile AR application with an adaptive multimodal interfaces.

  15. The use of virtual reality-based therapy to augment poststroke upper limb recovery

    PubMed Central

    Samuel, Geoffrey S; Choo, Min; Chan, Wai Yin; Kok, Stanley; Ng, Yee Sien

    2015-01-01

    Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient’s disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts. PMID:26243983

  16. Potential risks of using cement-augmented screws for spinal fusion in patients with low bone quality.

    PubMed

    Martín-Fernández, M; López-Herradón, A; Piñera, A R; Tomé-Bermejo, F; Duart, J M; Vlad, M D; Rodríguez-Arguisjuela, M G; Alvarez-Galovich, L

    2017-08-01

    Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. Although polymethyl methacrylate (PMMA)-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns because of the possible association between cement leakages (CLs) and other morbidities. To analyze potential complications related to the use of cement-augmented screws for spinal fusion and to investigate the effectiveness of using these screws in the treatment of patients with low bone quality. A retrospective single-center study. This study included 313 consecutive patients who underwent spinal fusion using a total of 1,780 cement-augmented screws. We analyzed potential complications related to the use of cement-augmented screws, including CL, vascular injury, infection, screw extraction problems, revision surgery, and instrument failure. There are no financial conflicts of interest to report. A total of 1,043 vertebrae were instrumented. Cement leakage was observed in 650 vertebrae (62.3%). There were no major clinical complications related to CL, but two patients (0.6%) had radicular pain related to CL at the S1 foramina. Of the 13 patients (4.1%) who developed deep infections requiring surgical debridement, two with chronic infections had possible spondylitis that required instrument removal. All patients responded well to antibiotic therapy. Revision surgery was performed in 56 patients (17.9%), most of whom had long construction. A total of 180 screws were removed as a result of revision. There were no problems with screw extraction. These results

  17. Regenerative periodontal therapy in mucogingival surgery for root coverage.

    PubMed

    Abitbol, T; Santi, E; Urbani, G

    1997-02-01

    This article illustrates the potential benefits of regenerative periodontal therapy in mucogingival surgery and esthetic dental treatment. Cases are described in which the treatment of soft-tissue recessions and root exposures are treated with surgical procedures where both clinical soft-tissue augmentation and the regeneration of periodontal attachment are obtained. Cases are also presented to illustrate the clinical application of guided tissue regeneration. Resorbable and nonresorbable barriers are placed over the root surface and bone and covered by the overlying flap, which allows the selective repopulation of the lesion by progenitor cells and the inhibition of a long junctional epithelium. Emphasis is placed on regenerative procedures in soft-tissue augmentation, particularly with respect to rationales, techniques, and indications.

  18. Virtual and augmented reality in the treatment of phantom limb pain: A literature review.

    PubMed

    Dunn, Justin; Yeo, Elizabeth; Moghaddampour, Parisah; Chau, Brian; Humbert, Sarah

    2017-01-01

    Phantom limb pain (PLP), the perception of discomfort in a limb no longer present, commonly occurs following amputation. A variety of interventions have been employed for PLP, including mirror therapy. Virtual Reality (VR) and augmented reality (AR) mirror therapy treatments have also been utilized and have the potential to provide an even greater immersive experience for the amputee. However, there is not currently a consensus on the efficacy of VR and AR therapy. The aim of this review is to evaluate and summarize the current research on the effect of immersive VR and AR in the treatment of PLP. A comprehensive literature search was conducted utilizing PubMed and Google Scholar in order to collect all available studies concerning the use of VR and/or AR in the treatment of PLP using the search terms "virtual reality," "augmented reality," and "phantom limb pain." Eight studies in total were evaluated, with six of those reporting quantitative data and the other two reporting qualitative findings. All studies located were of low-level evidence. Each noted improved pain with VR and AR treatment for phantom limb pain, through quantitative or qualitative reporting. Additionally, adverse effects were limited only to simulator sickness occurring in one trial for one patient. Despite the positive findings, all of the studies were confined purely to case studies and case report series. No studies of higher evidence have been conducted, thus considerably limiting the strength of the findings. As such, the current use of VR and AR for PLP management, while attractive due to the increasing levels of immersion, customizable environments, and decreasing cost, is yet to be fully proven and continues to need further research with higher quality studies to fully explore its benefits.

  19. No Effects of D-Cycloserine Enhancement in Exposure With Response Prevention Therapy in Panic Disorder With Agoraphobia: A Double-Blind, Randomized Controlled Trial.

    PubMed

    Hofmeijer-Sevink, Mieke Klein; Duits, Puck; Rijkeboer, Marleen M; Hoogendoorn, Adriaan W; van Megen, Harold J; Vulink, Nienke C; Denys, Damiaan A; van den Hout, Marcel A; van Balkom, Anton J; Cath, Danielle C

    2017-10-01

    D-cycloserine (DCS) is a partial N-methyl-D-aspartate receptor agonist that potentially augments response to exposure therapy in anxiety disorders by enhancing extinction learning. This randomized, double-blinded, placebo-controlled augmentation trial examined (1) the effectiveness of adding 125 mg of DCS to exposure therapy (before or directly after the first 6 treatment sessions) in patients with panic disorder with agoraphobia and (2) the effectiveness of DCS augmentation preceding exposure relative to DCS augmentation directly postexposure. Fifty-seven patients were allocated to 1 of 3 medication conditions (placebo and pre-exposure and postexposure DCS) as an addition to 6 exposure sessions within a 12-session exposure and response prevention protocol. The primary outcome measure was the mean score on the "alone" subscale of the Mobility Inventory (MI). No differences were found in treatment outcome between DCS and placebo, administered either pre-exposure or postexposure therapy, although at 3-month follow-up, the DCS postexposure group compared with DCS pre-exposure, exhibited greater symptom reduction on the MI-alone subscale. Ancillary analyses in specific subgroups (responders vs nonresponders, early vs late responders, severely vs mildly affected patients) did not reveal any between-group DCS versus placebo differences. Finally, the study did not find an effect of DCS relative to placebo to be specific for successful exposure sessions. This study does not find an effect of augmentation with DCS in patients with severe panic disorder and agoraphobia administered either pretreatment or directly posttreatment sessions. Moreover, no preferential effects are revealed in specific subgroups nor in successful exposure sessions. Yet, a small effect of DCS administration postexposure therapy cannot be ruled out, given the relatively small sample size of this study.

  20. Periodontal Therapy in Dogs Using Bone Augmentation Products Marketed for Veterinary Use.

    PubMed

    Angel, Molly

    Periodontal disease is extremely common in companion animal practice. Patients presenting for a routine oral examination and prophylaxis may be found to have extensive periodontal disease and attachment loss. Vertical bone loss is a known sequela to periodontal disease and commonly involves the distal root of the mandibular first molar. This case report outlines two dogs presenting for oral examination and prophylaxis with general anesthesia. Both patients did not have any clinical symptoms of periodontal disease other than halitosis. Both patients were diagnosed with three-walled vertical bone loss defects of one or both mandibular first molars utilizing dental radiography as well as periodontal probing, measuring, and direct visual inspection. These defects were consistent with periodontal disease index stage 4 (>50% attachment loss). The lesions were treated with appropriate root planing and debridement. Bone augmentation products readily available and marketed for veterinary use were then utilized to fill the defects to promote both the re-establishment of normal alveolar bone height and periodontal ligament reattachment to the treated surface. Follow-up assessment and owner dedication is critical to treatment outcome. Both patients' 6 mo follow-up examinations radiographically indicated bone repair and replacement with visible periodontal ligament space.

  1. 3D augmented reality with integral imaging display

    NASA Astrophysics Data System (ADS)

    Shen, Xin; Hua, Hong; Javidi, Bahram

    2016-06-01

    In this paper, a three-dimensional (3D) integral imaging display for augmented reality is presented. By implementing the pseudoscopic-to-orthoscopic conversion method, elemental image arrays with different capturing parameters can be transferred into the identical format for 3D display. With the proposed merging algorithm, a new set of elemental images for augmented reality display is generated. The newly generated elemental images contain both the virtual objects and real world scene with desired depth information and transparency parameters. The experimental results indicate the feasibility of the proposed 3D augmented reality with integral imaging.

  2. Pyriform Aperture Augmentation as An Adjunct to Rhinoplasty.

    PubMed

    Yaremchuk, Michael J; Vibhakar, Dev

    2016-01-01

    Skeletal deficiency in the central midface impacts nasal aesthetics. This lack of lower face projection can be corrected by alloplastic augmentation of the pyriform aperture. Creating convexity in the deficient midface will make the nose seem less prominent. Augmentation of the pyriform aperture is, therefore, often a useful adjunct during the rhinoplasty procedure. Augmenting the skeleton in this area can alter the projection of the nasal base, the nasolabial angle, and the vertical plane of the lip. The implant design and surgical techniques described here are extensions of others' previous efforts to improve paranasal aesthetics. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Gunner Goggles: Implementing Augmented Reality into Medical Education.

    PubMed

    Wang, Leo L; Wu, Hao-Hua; Bilici, Nadir; Tenney-Soeiro, Rebecca

    2016-01-01

    There is evidence that both smartphone and tablet integration into medical education has been lacking. At the same time, there is a niche for augmented reality (AR) to improve this process through the enhancement of textbook learning. Gunner Goggles is an attempt to enhance textbook learning in shelf exam preparatory review with augmented reality. Here we describe our initial prototype and detail the process by which augmented reality was implemented into our textbook through Layar. We describe the unique functionalities of our textbook pages upon augmented reality implementation, which includes links, videos and 3D figures, and surveyed 24 third year medical students for their impression of the technology. Upon demonstrating an initial prototype textbook chapter, 100% (24/24) of students felt that augmented reality improved the quality of our textbook chapter as a learning tool. Of these students, 92% (22/24) agreed that their shelf exam review was inadequate and 19/24 (79%) felt that a completed Gunner Goggles product would have been a viable alternative to their shelf exam review. Thus, while students report interest in the integration of AR into medical education test prep, future investigation into how the use of AR can improve performance on exams is warranted.

  4. Structural analysis of the alcohol acyltransferase protein family from Cucumis melo shows that enzyme activity depends on an essential solvent channel.

    PubMed

    Galaz, Sebastián; Morales-Quintana, Luis; Moya-León, María Alejandra; Herrera, Raúl

    2013-03-01

    Alcohol acyltransferases (AAT) play a key role in ester biosynthesis. In Cucumis melo var. cantalupensis, AATs are encoded by a gene family of four members (CmAAT1-4). CmAAT1, CmAAT3 and CmAAT4 are capable of synthesizing esters, with CmAAT1 the most active. CmAAT2 is inactive and has an Ala268 residue instead of a threonine which is present in all other active AATs, although the role of this residue is still unclear. The present work aims to understand the molecular mechanism involved in ester biosynthesis in melon fruit and to clarify the importance of the Ala268 residue. First, structural models for each protein were built by comparative modelling methodology. Afterwards, conformational interaction between the protein and several ligands, alcohols and acyl-CoAs was explored by molecular docking and molecular dynamics simulation. Structural analysis showed that CmAATs share a similar structure. Also, well-defined solvent channels were described in the CmAATs except for CmAAT2 which does not have a proper channel and instead has a small pocket around Ala268. Residues of the catalytic HxxxD motif interact with substrates within the solvent channel, with Ser363 also important. Strong binding interaction energies were described for the best substrate couple of each CmAAT (hexyl-, benzyl- and cinnamyl-acetate for CmAAT1, 3 and 4 respectively). CmAAT1 and CmAAT2 protein surfaces share similar electrostatic potentials; nevertheless the entrance channels for the substrates differ in location and electrostatic character, suggesting that Ala268 might be responsible for that. This could partly explain the major differences in activity reported for these two enzymes. © 2013 The Authors Journal compilation © 2013 FEBS.

  5. Augmentative & Alternative Communication

    ERIC Educational Resources Information Center

    Murphy, Patti

    2007-01-01

    There is no definitive recipe for augmentative and alternative communication (AAC) success, but its universal ingredients can be found at home. The main ones are: (1) Understanding that all children need to express themselves, however outgoing or shy they may be; (2) Willingness to embrace the technology that may help your child regardless of your…

  6. Augmented Thermal Bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1996-01-01

    The present invention is directed to an augmented thermal bus. In the present design a plurality of thermo-electric heat pumps are used to couple a source plate to a sink plate. Each heat pump is individually controlled by a model based controller. The controller coordinates the heat pumps to maintain isothermality in the source.

  7. Augmented thermal bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1993-01-01

    The present invention is directed to an augmented thermal bus. In the present design a plurity of thermo-electric heat pumps are used to couple a source plate to a sink plate. Each heat pump is individually controlled by a model based controller. The controller coordinates the heat pump to maintain isothermality in the source.

  8. Free gingival autograft for augmentation of keratinized tissue in apical to gingival recession – A case report

    PubMed Central

    Anand, Vishal; Gulati, Minkle; Rastogi, Pavitra; Dixit, Jaya

    2012-01-01

    Background The treatment of the mucogingival problem is one of the main objectives of the periodontal therapy. The insufficient or absent attached gingiva increases the risk of development of gingival recessions. Method One patient with Miller class II gingival recession and small vestibule depth in the frontal mandibular region was selected for treatment. Autogenous free gingival grafts harvested from the palatal mucosa were used to gain the attached gingiva. Result The initial healing completed in 2 weeks without complication. The augmentation of the attached gingival tissue using the free gingival graft technique led to gain of attached gingiva in the treated regions. Conclusion The limitations of the apical mucosal flap displacement for preparation of recipient site in situations with inadequate vestibule depth and small alveolar bone height require a graft with small width. The result from the presented case report with application of the free gingival graft indicates that it could be applied when augmentation of the attached gingiva tissue. PMID:25737851

  9. Microsponges based novel drug delivery system for augmented arthritis therapy

    PubMed Central

    Osmani, Riyaz Ali M.; Aloorkar, Nagesh H.; Ingale, Dipti J.; Kulkarni, Parthasarathi K.; Hani, Umme; Bhosale, Rohit R.; Jayachandra Dev, Dandasi

    2015-01-01

    The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug–polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and particle size analysis, and evaluated for morphology, drug loading, in vitro drug release and ex vivo diffusion as well. There were no chemical interactions between drug and polymers used as revealed by compatibility studies outcomes. The drug polymer ratio reflected notable effect on drug content, encapsulation efficiency and particle size. SEM results revealed spherical microsponges with porous surface, and had 7.21 μm mean particle size. The microsponges were then incorporated in gel; which exhibited viscous modulus along with pseudoplastic behavior. In vitro drug release results depicted that microsponges with 1:2 drug–polymer ratio were more efficient to give extended drug release of 75.88% at the end of 8 h; while conventional formulation get exhausted incredibly earlier by releasing 81.11% drug at the end of 4 h only. Thus the formulated microsponge-based gel of diclofenac diethylamine would be a promising alternative to conventional therapy for safer and efficient treatment of arthritis and musculoskeletal disorders. PMID:26594124

  10. Jet Propulsion with Special Reference to Thrust Augmenters

    NASA Technical Reports Server (NTRS)

    Schubauer, G B

    1933-01-01

    An investigation of the possibility of using thrust augmented jets as prime movers was carried out. The augmentation was to be effected by allowing the jet to mix with the surrounding air in the presence of bodies which deflect the air set in motion by the jet.

  11. [Association between oxytocin augmentation intervals and the risk of postpartum haemorrhage].

    PubMed

    Loscul, C; Chantry, A-A; Caubit, L; Deneux-Tharaux, C; Goffinet, F; Le Ray, C

    2016-09-01

    To study the association between the duration of oxytocin augmentation intervals and the risk of postpartum haemorrhage (PPH) among primiparous women in spontaneous labour. Retrospective cohort including primiparous women in spontaneous labour who received oxytocin during labour (n=454). Oxytocin augmentation intervals were dichotomized in intervals<20minutes and≥20minutes. Obstetrical and neonatal issues were analyzed according to the duration oxytocin augmentation intervals. The association between oxytocin augmentation intervals and PPH was analyzed using univariate and multivariate analysis. Oxytocin augmentation intervals were shorter than 20minutes for 43.8% of the study population. The rate of PPH was higher (9.1% vs 3.5%; P=0.014), and the use of sulprostone was more frequent (6.5% vs 3.5%; P=0.013) if oxytocin augmentation intervals were shorter than 20minutes in comparison with intervals≥20minutes. The association between oxytocin augmentation intervals and PPH remains significant after adjustment on other PPH risk factors (adjusted OR=3.48, 95% CI [1.45-8.34]). The rate of adverse neonatal issue, defined by arterial pH at birth≤7.10 and/or 5minutes score d'Apgar≤7, was higher if oxytocin augmentation intervals were<20minutes (12.1% vs 4.3%; P=0.002). Our study demonstrated an increased risk of PPH for primiparous women in spontaneous labour who received oxytocin with augmentation intervals shorter than 20minutes. Copyright © 2016. Published by Elsevier Masson SAS.

  12. Augmented microscopy with near-infrared fluorescence detection

    NASA Astrophysics Data System (ADS)

    Watson, Jeffrey R.; Martirosyan, Nikolay; Skoch, Jesse; Lemole, G. Michael; Anton, Rein; Romanowski, Marek

    2015-03-01

    Near-infrared (NIR) fluorescence has become a frequently used intraoperative technique for image-guided surgical interventions. In procedures such as cerebral angiography, surgeons use the optical surgical microscope for the color view of the surgical field, and then switch to an electronic display for the NIR fluorescence images. However, the lack of stereoscopic, real-time, and on-site coregistration adds time and uncertainty to image-guided surgical procedures. To address these limitations, we developed the augmented microscope, whereby the electronically processed NIR fluorescence image is overlaid with the anatomical optical image in real-time within the optical path of the microscope. In vitro, the augmented microscope can detect and display indocyanine green (ICG) concentrations down to 94.5 nM, overlaid with the anatomical color image. We prepared polyacrylamide tissue phantoms with embedded polystyrene beads, yielding scattering properties similar to brain matter. In this model, 194 μM solution of ICG was detectable up to depths of 5 mm. ICG angiography was then performed in anesthetized rats. A dynamic process of ICG distribution in the vascular system overlaid with anatomical color images was observed and recorded. In summary, the augmented microscope demonstrates NIR fluorescence detection with superior real-time coregistration displayed within the ocular of the stereomicroscope. In comparison to other techniques, the augmented microscope retains full stereoscopic vision and optical controls including magnification and focus, camera capture, and multiuser access. Augmented microscopy may find application in surgeries where the use of traditional microscopes can be enhanced by contrast agents and image guided delivery of therapeutics, including oncology, neurosurgery, and ophthalmology.

  13. Augmented REality Sandtables (ARESs) Impact on Learning

    DTIC Science & Technology

    2016-07-01

    Disclaimers The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized...The use of augmented reality ( AR ) to supplement training tools, specifically sand tables, can produce highly effective systems at relatively low...engagement and enhanced-scenario customization. The Augmented REality Sandtable ( ARES ) is projected to enhance training and retention of spatial

  14. Breakthrough Therapies: Cystic Fibrosis (CF) Potentiators and Correctors

    PubMed Central

    Solomon, George M.; Marshall, Susan G.; Ramsey, Bonnie W.; Rowe, Steven M.

    2015-01-01

    Cystic Fibrosis is caused by mutations in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene resulting in abnormal protein function. Recent advances of targeted molecular therapies and high throughput screening have resulted in multiple drug therapies that target many important mutations in the CFTR protein. In this review, we provide the latest results and current progress of CFTR modulators for the treatment of cystic fibrosis, focusing on potentiators of CFTR channel gating and Phe508del processing correctors for the Phe508del CFTR mutation. Special emphasis is placed on the molecular basis underlying these new therapies and emerging results from the latest clinical trials. The future directions for augmenting the rescue of Phe508del with CFTR modulators is also emphasized. PMID:26097168

  15. Transforming Polar Research with Google Glass Augmented Reality (Invited)

    NASA Astrophysics Data System (ADS)

    Ruthkoski, T.

    2013-12-01

    Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

  16. Transforming Polar Research with Google Glass Augmented Reality (Invited)

    NASA Astrophysics Data System (ADS)

    Ramachandran, R.; McEniry, M.; Maskey, M.

    2011-12-01

    Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

  17. Cost-effectiveness of sensor-augmented pump therapy in two different patient populations with type 1 diabetes in Italy.

    PubMed

    Nicolucci, A; Rossi, M C; D'Ostilio, D; Delbaere, A; de Portu, S; Roze, S

    2018-07-01

    Sensor-augmented pump therapy (SAP) combines real time continuous glucose monitoring (CGM) with Continuous Subcutaneous Insulin Infusion (CSII) and provides additional benefits beyond those provided by CSII alone. SAP with automated insulin suspension provides early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels are predicted to fall below a predefined threshold. Aim of this study was to assess the cost-effectiveness of SAP with automated insulin suspension versus CSII alone in type 1 diabetes. Cost-effectiveness analysis was performed using the CORE Diabetes Model. The analysis was performed in two different cohorts: one with high baseline HbA1c and one at elevated risk for hypoglycemic events. Clinical input data were sourced from published data. The analysis was conducted from a societal perspective over a lifetime time horizon; costs and clinical outcomes were discounted at 3% per year. In patients with poor glycemic control, SAP with automated insulin suspension resulted in improved discounted quality-adjusted life expectancy (QALY) versus CSII (12.44 QALYs vs. 10.99 QALYs) but higher mean total lifetime costs (€324,991 vs. €259,852), resulting in an incremental cost effectiveness ratio (ICER) of €44,982 per QALY gained. In patients at elevated risk for hypoglycemia, the ICER was €33,692 per QALY gained for SAP versus CSII. In Italy, the use of SAP with automated insulin suspension is associated with projected improvements in outcomes as compared to CSII. These benefits translate into an ICER usually considered as good value for money, particularly in patients at elevated risk of hypoglycemia. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  18. The Local Games Lab ABQ: Homegrown Augmented Reality

    ERIC Educational Resources Information Center

    Holden, Christopher

    2014-01-01

    Experiments in the use of augmented reality games formerly required extensive material resources and expertise to implement above and beyond what might be possible within the usual educational contexts. Currently, the more common availability of hardware in these contexts and the existence of easy-to-use, general purpose augmented reality design…

  19. α1-antitrypsin polymerizes in alveolar macrophages of smokers with and without α1-antitrypsin deficiency.

    PubMed

    Bazzan, Erica; Tinè, Mariaenrica; Biondini, Davide; Benetti, Riccardo; Baraldo, Simonetta; Turato, Graziella; Fagiuoli, Stefano; Sonzogni, Aurelio; Rigobello, Chiara; Rea, Federico; Calabrese, Fiorella; Foschino-Barbaro, Maria Pia; Miranda, Elena; Lomas, David A; Saetta, Marina; Cosio, Manuel G

    2018-05-12

    The deficiency of α 1 -antitrypsin (AAT) is secondary to misfolding and polymerization of the abnormal Z-AAT in liver cells and is associated with lung emphysema. Alveolar macrophages (AM) produce AAT, however it is not known if Z-AAT can polymerize in AM, further decreasing lung AAT and promoting lung inflammation. To investigate if AAT polymerizes in human AM and to study the possible relation between polymerization and degree of lung inflammation. Immunohistochemical analysis with 2C1 monoclonal antibody specific for polymerized AAT was performed in sections of: 9 lungs from individuals with AAT deficiency (AATD) and severe COPD, 35 smokers with normal AAT levels of which 24 with severe COPD and 11 without COPD, and 13 non-smokers. AM positive for AAT polymers were counted and expressed as percentage of total AM in lung. AAT polymerization was detected in [27(4-67)%] of AM from individuals with AATD but also in AM from smokers with normal AAT with [24(0-70)%] and without [24(0-60)%] COPD, but not in AM from non-smokers [0(0-1.5)%] (p<0.0001). The percentage of AM with polymerized AAT correlated with pack-years smoked (r=0.53,p=0.0001), FEV 1 /FVC (r=-0.41,p=0.005), Small Airways Disease (r=0.44,p=0.004), number of CD8+T-cells and neutrophils in alveolar walls (r=0.51,p=0.002; r=0.31,p=0.05 respectively). Polymerization of AAT in alveolar macrophages occurs in lungs of individuals with AATD but also in smokers with normal AAT levels with or without COPD. Our findings highlight the similarities in the pathophysiology of COPD in individuals with and without AATD, adding a potentially important step to the mechanism of COPD. Copyright © 2018. Published by Elsevier Inc.

  20. Augmented reality for breast imaging.

    PubMed

    Rancati, Alberto; Angrigiani, Claudio; Nava, Maurizio B; Catanuto, Giuseppe; Rocco, Nicola; Ventrice, Fernando; Dorr, Julio

    2018-06-01

    Augmented reality (AR) enables the superimposition of virtual reality reconstructions onto clinical images of a real patient, in real time. This allows visualization of internal structures through overlying tissues, thereby providing a virtual transparency vision of surgical anatomy. AR has been applied to neurosurgery, which utilizes a relatively fixed space, frames, and bony references; the application of AR facilitates the relationship between virtual and real data. Augmented breast imaging (ABI) is described. Breast MRI studies for breast implant patients with seroma were performed using a Siemens 3T system with a body coil and a four-channel bilateral phased-array breast coil as the transmitter and receiver, respectively. Gadolinium was injected as a contrast agent (0.1 mmol/kg at 2 mL/s) using a programmable power injector. Dicom formatted images data from 10 MRI cases of breast implant seroma and 10 MRI cases with T1-2 N0 M0 breast cancer, were imported and transformed into augmented reality images. ABI demonstrated stereoscopic depth perception, focal point convergence, 3D cursor use, and joystick fly-through. ABI can improve clinical outcomes, providing an enhanced view of the structures to work on. It should be further studied to determine its utility in clinical practice.

  1. Augmenting a Child's Reality: Using Educational Tablet Technology

    ERIC Educational Resources Information Center

    Tanner, Patricia; Karas, Carly; Schofield, Damian

    2014-01-01

    This study investigates the classroom integration of an innovative technology, augmented reality. Although the process of adding new technologies into a classroom setting can be daunting, the concept of augmented reality has demonstrated the ability to educate students and to assist with their comprehension of a procedural task. One half of the…

  2. Cost-Effectiveness of Sensor-Augmented Pump Therapy with Low Glucose Suspend Versus Standard Insulin Pump Therapy in Two Different Patient Populations with Type 1 Diabetes in France.

    PubMed

    Roze, Stéphane; Smith-Palmer, Jayne; Valentine, William; Payet, Vincent; de Portu, Simona; Papo, Natalie; Cucherat, Michel; Hanaire, Helene

    2016-02-01

    Sensor-augmented pump therapy (SAP) provides a useful adjunct relative to continuous subcutaneous insulin infusion (CSII) alone. It can provide early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels fall below a predefined threshold. The aim was to assess the cost-effectiveness of SAP with low glucose suspend (LGS) versus CSII alone in type 1 diabetes. Cost-effectiveness analysis was performed using the CORE Diabetes Model, using published clinical input data. The analysis was performed in two cohorts: one with uncontrolled glycated hemoglobin at baseline and one at elevated risk for hypoglycemic events. The analysis was conducted from a healthcare payer perspective over a lifetime time horizon; future costs and clinical outcomes were discounted at 4% per annum. In patients with uncontrolled glycated hemoglobin at baseline, SAP + LGS resulted in improved discounted quality-adjusted life expectancy (QALE) versus CSII (10.55 quality-adjusted life-years [QALYs] vs. 9.36 QALYs) but higher mean lifetime direct costs (€84,972 vs. €49,171) resulting in an incremental cost-effectiveness ratio (ICER) of €30,163 per QALY gained. In patients at elevated risk for hypoglycemia, the ICER was €22,005 per QALY gained for SAP + LGS versus CSII as lifetime costs were higher (€88,680 vs. €57,097), but QALE was also higher (18.46 QALYs vs. 18.30 QALYs). In France, projected improvements in outcomes with SAP + LGS versus CSII translated into an ICER generally considered as good value for money, particularly in patients who experience frequent and/or problematic hypoglycemic events.

  3. Functional Reflective Polarizer for Augmented Reality and Color Vision Deficiency

    DTIC Science & Technology

    2016-03-03

    Functional reflective polarizer for augmented reality and color vision deficiency Ruidong Zhu, Guanjun Tan, Jiamin Yuan, and Shin-Tson Wu* College...polarizer that can be incorporated into a compact augmented reality system. The design principle of the functional reflective polarizer is explained and...augment reality system is relatively high as compared to a polarizing beam splitter or a conventional reflective polarizer. Such a functional reflective

  4. Working alliance inventory applied to virtual and augmented reality (WAI-VAR): psychometrics and therapeutic outcomes

    PubMed Central

    Miragall, Marta; Baños, Rosa M.; Cebolla, Ausiàs; Botella, Cristina

    2015-01-01

    This study examines the psychometric properties of the Working Alliance Inventory-Short (WAI-S) adaptation to Virtual Reality (VR) and Augmented Reality (AR) therapies (WAI-VAR). The relationship between the therapeutic alliance (TA) with VR and AR and clinically significant change (CSC) is also explored. Seventy-five patients took part in this study (74.7% women, Mage = 34.41). Fear of flying and adjustment disorder patients received VR therapy, and cockroach phobia patients received AR therapy. Psychometric properties, CSC, one-way ANOVA, Spearman’s Correlations and Multiple Regression were calculated. The WAI-VAR showed a unidimensional structure, high internal consistency and adequate convergent validity. “Not changed” patients scored lower on the WAI-VAR than “improved” and “recovered” patients. Correlation between the WAI-VAR and CSC was moderate. The best fitting model for predicting CSC was a linear combination of the TA with therapist (WAI-S) and the TA with VR and AR (WAI-VAR), due to the latter variable slightly increased the percentage of variability accounted for in CSC. The WAI-VAR is the first validated instrument to measure the TA with VR and AR in research and clinical practice. This study reveals the importance of the quality of the TA with technologies in achieving positive outcomes in the therapy. PMID:26500589

  5. Working alliance inventory applied to virtual and augmented reality (WAI-VAR): psychometrics and therapeutic outcomes.

    PubMed

    Miragall, Marta; Baños, Rosa M; Cebolla, Ausiàs; Botella, Cristina

    2015-01-01

    This study examines the psychometric properties of the Working Alliance Inventory-Short (WAI-S) adaptation to Virtual Reality (VR) and Augmented Reality (AR) therapies (WAI-VAR). The relationship between the therapeutic alliance (TA) with VR and AR and clinically significant change (CSC) is also explored. Seventy-five patients took part in this study (74.7% women, M age = 34.41). Fear of flying and adjustment disorder patients received VR therapy, and cockroach phobia patients received AR therapy. Psychometric properties, CSC, one-way ANOVA, Spearman's Correlations and Multiple Regression were calculated. The WAI-VAR showed a unidimensional structure, high internal consistency and adequate convergent validity. "Not changed" patients scored lower on the WAI-VAR than "improved" and "recovered" patients. Correlation between the WAI-VAR and CSC was moderate. The best fitting model for predicting CSC was a linear combination of the TA with therapist (WAI-S) and the TA with VR and AR (WAI-VAR), due to the latter variable slightly increased the percentage of variability accounted for in CSC. The WAI-VAR is the first validated instrument to measure the TA with VR and AR in research and clinical practice. This study reveals the importance of the quality of the TA with technologies in achieving positive outcomes in the therapy.

  6. Management of augmentation of restless legs syndrome with rotigotine: a 1-year observational study.

    PubMed

    Trenkwalder, Claudia; Canelo, Monica; Lang, Michael; Schroeder, Hanna; Kelling, Daniela; Berkels, Reinhard; Schollmayer, Erwin; Heidbrede, Tanja; Benes, Heike

    2017-02-01

    The aim of this study is to assess the effect of switching to rotigotine transdermal patch on severity of restless legs syndrome (RLS) in patients who experienced acute augmentation with previous oral dopaminergics. In this 13-month observational study, adults with moderate-to-severe RLS and augmentation were switched to rotigotine per the physician's independent decision. Assessments included Clinical Global Impression severity score (CGI-1); (primary), treatment regimen for switching (secondary), RLS-6, International RLS Study Group Rating Scale (IRLS), and augmentation severity rating scale (ASRS). A total of 99 patients received rotigotine, of whom 46 completed observational period, and 43 were assessed for effectiveness. A total of 5 patients switched to rotigotine after a >1-day drug holiday, 23 switched overnight, 9 had an overlapping switch, and 6 received ongoing oral dopaminergics with rotigotine for ≥28 days. Of the 99 patients, 57 took concomitant RLS medications (excluding switching medications) on at least 1 day. At the final visit, median change in CGI-1 (Hodges-Lehman estimate [95% CI]) was -2.0 (-2.5, -1.50); 37 of the 43 patients improved by ≥1 CGI-1 category, and 16 of 43 were responders (≥50% improvement). RLS-6 and IRLS scores also improved. Patients had median ASRS of 0 at the final visit indicating "no worsening/occurrence of augmentation." ASRS item 1 showed a shift in mean time of symptom onset (24-h clock) from 12:38 (baseline) to 18:25 (final visit). Most common reasons for withdrawal of rotigotine were adverse events (26 patients) and lack of efficacy (14 patients). Switching from oral therapies to rotigotine was effective in improving RLS symptoms in 37 of the 43 patients (from the original population of 99 patients) who remained in the study over 13 months. ClinicalTrials.govNCT01386944. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Augmentative Communication for Children with Deaf-Blindness: Guidelines for Decision-Making.

    ERIC Educational Resources Information Center

    Cress, Cynthia J.; And Others

    This manual is intended to assist in developing augmentative communication systems for deaf-blind children. After a brief introduction, section II provides an overview of general augmentative communication systems and theory. Section III presents a general decision-making process for developing and selecting augmentative communication systems for…

  8. G-spot augmentation with autologous fat transplantation.

    PubMed

    Herold, Christian; Motamedi, Melodi; Hartmann, Uwe; Allert, Sixtus

    2015-01-01

    Lipofilling for G-spot augmentation is appealing because long-term persistence of the fat is expected to be very good. We report the case of a 29-year-old patient who requested G-spot augmentation to enhance sexual sensation. Autologous fat (8 cc) that was harvested from the trochanteric area was injected. Although there are few published data acknowledging the presence of the G-spot, the patient was satisfied with the procedure and no side effects occurred. Nevertheless, evaluation with standard questionnaires, such as Fragebogen zur Lebenszufriedenheit (FLZ) and Kurzfragebogen für sexuelle Probleme (KFSP-F), did not indicate the positive effects on subjective well-being and sexual parameters of a surgical G-spot augmentation. Studies comprising a larger series of patients are required before substantiated recommendations regarding the benefits and risks of this procedure will be possible.

  9. A Determinate Model of Thrust-Augmenting Ejectors

    NASA Astrophysics Data System (ADS)

    Whitley, N.; Krothapalli, A.; van Dommelen, L.

    1996-01-01

    A theoretical analysis of the compressible flow through a constant-area jet-engine ejector in which a primary jet mixes with ambient fluid from a uniform free stream is pursued. The problem is reduced to a determinate mathematical one by prescribing the ratios of stagnation properties between the primary and secondary flows. For some selections of properties and parameters more than one solution is possible and the meaning of these solutions is discussed by means of asymptotic expansions. Our results further show that while under stationary conditions the thrust-augmentation ratio assumes a value of 2 in the large area-ratio limit, for a free-stream Mach number greater than 0.6 very little thrust augmentation is left. Due to the assumptions made, the analysis provides idealized values for the thrust-augmentation ratio and the mass flux entrainment factor.

  10. "Spiral-Cap" ileocystoplasty for bladder augmentation and ureteric reimplant.

    PubMed

    Sawant, S Ajit; Tamhankar, Ashwin Sunil; Kumar, Vikash; Prakash, W Pawar; Gaurav, V Kasat; Bansal, Sumit

    2016-01-01

    To demonstrate the new technique of Spiral-cap ileocystoplasty for bladder augmentation and simultaneous ureteric reimplant. Seven patients with small capacity bladder and simultaneous lower ureteric involvement operated in single tertiary care institute over the last 5 years were included in this study. Spiral-cap ileocystoplasty was used in all the patients for bladder augmentation. Proximal part of the same ileal loop was used in isoperistaltic manner for ureteric reimplantation. Distal end of this ileal loop was intussuscepted into the pouch to decrease the incidence of reflux. Detubularized distal portion of the loop was reconfigured in spiral manner to augment the native bladder. Patients were analyzed for upper tract changes, serum creatinine, bladder capacity, and requirement of clean intermittent self-catheterization in follow-up over 5 years. There was no evidence of any urinary or bowel leak in the postoperative period. Recovery was equivalent with those treated with other methods of bladder augmentation. Follow-up ultrasonography showed good capacity bladder. Upper tracts were well preserved in follow-up. Urinary bladder and lower ureter pathologies were addressed simultaneously. Spiral-cap ileocystoplasty is a useful technique in patients who require simultaneous bladder augmentation and ureteric reimplant.

  11. Gold nanoparticles as a platform for creating a multivalent poly-SUMO chain inhibitor that also augments ionizing radiation.

    PubMed

    Li, Yi-Jia; Perkins, Angela L; Su, Yang; Ma, Yuelong; Colson, Loren; Horne, David A; Chen, Yuan

    2012-03-13

    Protein-protein interactions mediated by ubiquitin-like (Ubl) modifications occur as mono-Ubl or poly-Ubl chains. Proteins that regulate poly-SUMO (small ubiquitin-like modifier) chain conjugates play important roles in cellular response to DNA damage, such as those caused by cancer radiation therapy. Additionally, high atomic number metals, such as gold, preferentially absorb much more X-ray energy than soft tissues, and thus augment the effect of ionizing radiation when delivered to cells. In this study, we demonstrate that conjugation of a weak SUMO-2/3 ligand to gold nanoparticles facilitated selective multivalent interactions with poly-SUMO-2/3 chains leading to efficient inhibition of poly-SUMO-chain-mediated protein-protein interactions. The ligand-gold particle conjugate significantly sensitized cancer cells to radiation but was not toxic to normal cells. This study demonstrates a viable approach for selective targeting of poly-Ubl chains through multivalent interactions created by nanoparticles that can be chosen based on their properties, such as abilities to augment radiation effects.

  12. Augmented reality for personalized nanomedicines.

    PubMed

    Lee, Yugyung; Lee, Chi H

    As our understanding of onset and progress of diseases at the genetic and molecular level rapidly progresses, the potential of advanced technologies, such as 3D-printing, Socially-Assistive Robots (SARs) or augmented reality (AR), that are applied to personalized nanomedicines (PNMs) to alleviate pathological conditions, has become more prominent. Among advanced technologies, AR in particular has the greatest potential to address those challenges and facilitate the translation of PNMs into formidable clinical application of personalized therapy. As AR is about to adapt additional new methods, such as speech, voice recognition, eye tracing and motion tracking, to enable interaction with host response or biological systems in 3-D space, a combination of multiple approaches to accommodate varying environmental conditions, such as public noise and atmosphere brightness, will be explored to improve its therapeutic outcomes in clinical applications. For instance, AR glasses still being developed by Facebook or Microsoft will serve as new platform that can provide people with the health information they are interested in or various measures through which they can interact with medical services. This review has addressed the current progress and impact of AR on PNMs and its application to the biomedical field. Special emphasis is placed on the application of AR based PNMs to the treatment strategies against senior care, drug addiction and medication adherence. Published by Elsevier Inc.

  13. Collection and Analysis of Augmented Weigh-In-Motion Data

    DOT National Transportation Integrated Search

    1996-12-01

    Traffic loading data are essential for the planning and design of adequate and cost-effective highway pavements. Data from an augmented weigh-in-motion (WIM) system have been collected and analyzed. The augmented WIM systems, which comprise bending-p...

  14. A preliminary look at control augmented dynamic response of structures

    NASA Technical Reports Server (NTRS)

    Ryan, R. S.; Jewell, R. E.

    1983-01-01

    The augmentation of structural characteristics, mass, damping, and stiffness through the use of control theory in lieu of structural redesign or augmentation was reported. The standard single-degree-of-freedom system was followed by a treatment of the same system using control augmentation. The system was extended to elastic structures using single and multisensor approaches and concludes with a brief discussion of potential application to large orbiting space structures.

  15. Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges.

    PubMed

    Tsapkini, Kyrana; Frangakis, Constantine; Gomez, Yessenia; Davis, Cameron; Hillis, Argye E

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and family life call for the investigation of treatment alternatives. In this article, we present new data indicating that neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows some promise for maintaining or even improving language, at least temporarily, in PPA. The main aim of the present article is to determine whether tDCS plus spelling intervention is more effective than spelling intervention alone in treating written language in PPA. We also asked whether the effects of tDCS are sustained longer than the effects of spelling intervention alone. We present data from six PPA participants who underwent anodal tDCS or sham plus spelling intervention in a within-subject crossover design. Each stimulation condition lasted 3 weeks or a total of 15 sessions with a 2-month interval in between. Participants were evaluated on treatment tasks as well as on other language and cognitive tasks at 2-week and 2-month follow-up intervals after each stimulation condition. All participants showed improvement in spelling (with sham or tDCS). There was no difference in the treated items between the two conditions. There was, however, consistent and significant improvement for untrained items only in the tDCS plus spelling intervention condition. Furthermore, the improvement lasted longer in the tDCS plus spelling intervention condition compared to sham plus spelling intervention condition. Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function at least temporarily in PPA. The consistent finding of generalisation of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. However

  16. Potential Use of Augmented Reality in LIS Education

    ERIC Educational Resources Information Center

    Wójcik, Magdalena

    2016-01-01

    The subject of this article is the use of augmented reality technology in library and information science education. The aim is to determine the scope and potential uses of augmented reality in the education of information professionals. In order to determine the scope and forms of potential use of AR technology in LIS education a two-step…

  17. Augmented Reality, the Future of Contextual Mobile Learning

    ERIC Educational Resources Information Center

    Sungkur, Roopesh Kevin; Panchoo, Akshay; Bhoyroo, Nitisha Kirtee

    2016-01-01

    Purpose: This study aims to show the relevance of augmented reality (AR) in mobile learning for the 21st century. With AR, any real-world environment can be augmented by providing users with accurate digital overlays. AR is a promising technology that has the potential to encourage learners to explore learning materials from a totally new…

  18. An overview of current Navy programs to develop thrust augmenting ejectors

    NASA Technical Reports Server (NTRS)

    Green, K. A.

    1979-01-01

    The primary objective of Navy sponsored research in thrust augmentation is the development of an improved augmenter for V/STOL application. In support of this goal, a data base is being established to provide an accurate prediction capability for use in ejector design. A general technology development of ejectors and associated effects presently is split into the more specific areas of lift and control, since thrust augmenting ejectors may be suitable for both. Research areas examined include advanced diffuser and end wall design; advanced primary nozzles; analytic studies; augmenting reaction controls; and nozzle design.

  19. Computer Augmented Video Education.

    ERIC Educational Resources Information Center

    Sousa, M. B.

    1979-01-01

    Describes project CAVE (Computer Augmented Video Education), an ongoing effort at the U.S. Naval Academy to present lecture material on videocassette tape, reinforced by drill and practice through an interactive computer system supported by a 12 channel closed circuit television distribution and production facility. (RAO)

  20. Orthobiologics in the augmentation of osteoporotic fractures.

    PubMed

    Watson, J Tracy; Nicolaou, Daemeon A

    2015-02-01

    Many orthobiologic adjuvants are available and widely utilized for general skeletal restoration. Their use for the specific task of osteoporotic fracture augmentation is less well recognized. Common conductive materials are reviewed for their value in this patient population including the large group of allograft adjuvants categorically known as the demineralized bone matrices (DBMs). Another large group of alloplastic materials is also examined-the calcium phosphate and sulfate ceramics. Both of these materials, when used for the proper indications, demonstrate efficacy for these patients. The inductive properties of bone morphogenic proteins (BMPs) and platelet concentrates show no clear advantages for this group of patients. Systemic agents including bisphosphonates, receptor activator of nuclear factor κβ ligand (RANKL) inhibitors, and parathyroid hormone augmentation all demonstrate positive effects with this fracture cohort. Newer modalities, such as trace ion bioceramic augmentation, are also reviewed for their positive effects on osteoporotic fracture healing.

  1. Augmented Reality Imaging System: 3D Viewing of a Breast Cancer.

    PubMed

    Douglas, David B; Boone, John M; Petricoin, Emanuel; Liotta, Lance; Wilson, Eugene

    2016-01-01

    To display images of breast cancer from a dedicated breast CT using Depth 3-Dimensional (D3D) augmented reality. A case of breast cancer imaged using contrast-enhanced breast CT (Computed Tomography) was viewed with the augmented reality imaging, which uses a head display unit (HDU) and joystick control interface. The augmented reality system demonstrated 3D viewing of the breast mass with head position tracking, stereoscopic depth perception, focal point convergence and the use of a 3D cursor and joy-stick enabled fly through with visualization of the spiculations extending from the breast cancer. The augmented reality system provided 3D visualization of the breast cancer with depth perception and visualization of the mass's spiculations. The augmented reality system should be further researched to determine the utility in clinical practice.

  2. Effective augmentation of networked systems and enhancing pinning controllability

    NASA Astrophysics Data System (ADS)

    Jalili, Mahdi

    2018-06-01

    Controlling dynamics of networked systems to a reference state, known as pinning control, has many applications in science and engineering. In this paper, we introduce a method for effective augmentation of networked systems, while also providing high levels of pinning controllability for the final augmented network. The problem is how to connect a sub-network to an already existing network such that the pinning controllability is maximised. We consider the eigenratio of the augmented Laplacian matrix as a pinning controllability metric, and use graph perturbation theory to approximate the influence of edge addition on the eigenratio. The proposed metric can be effectively used to find the inter-network links connecting the disjoint networks. Also, an efficient link rewiring approach is proposed to further optimise the pinning controllability of the augmented network. We provide numerical simulations on synthetic networks and show that the proposed method is more effective than heuristic ones.

  3. Comparison of the hydrogeology and water quality of a ground-water augmented lake with two non-augmented lakes in northwest Hillsborough County, Florida

    USGS Publications Warehouse

    Metz, Patricia A.; Sacks, Laura A.

    2002-01-01

    The hydrologic effects associated with augmenting a lake with ground water from the Upper Floridan aquifer were examined in northwest Hillsborough County, Florida, from June 1996 through May 1999. The hydrogeology, ground-water flow patterns, water budgets, and water-quality characteristics were compared between a lake that has been augmented for more than 30 years (Round Lake) and two nearby nonaugmented lakes (Dosson Lake and Halfmoon Lake). Compared to the other study lakes, Round Lake is in a more leakage-dominated hydrogeologic setting. The intermediate confining unit is thin or highly breached, which increases the potential for vertical ground-water flow. Round Lake has the least amount of soft, organic lake-bottom sediments and the lake bottom has been dredged deeper and more extensively than the other study lakes, which could allow more leakage from the lake bottom. The area around Round Lake has experienced more sinkhole activity than the other study lakes. During this study, three sinkholes developed around the perimeter of the lake, which may have further disrupted the intermediate confining unit.Ground-water flow patterns around Round Lake were considerably different than the nonaugmented lakes. For most of the study, groundwater augmentation artificially raised the level of Round Lake to about 2 to 3 feet higher than the adjacent water table. As a result, lake water recharged the surficial aquifer around the entire lake perimeter, except during very wet periods when ground-water inflow occurred around part of the lake perimeter. The non-augmented lakes typically had areas of ground-water inflow and areas of lake leakage around their perimeter, and during wet periods, ground-water inflow occurred around the entire lake perimeter. Therefore, the area potentially contributing ground water to the non-augmented lakes is much larger than for augmented Round Lake. Vertical head loss within the surficial aquifer was greater at Round Lake than the other study

  4. Using Genetic Buffering Relationships Identified in Fission Yeast To Elucidate the Molecular Pathology of Tuberous Sclerosis

    DTIC Science & Technology

    2016-07-01

    5’-aat tat ttt ata tgg aat gag caa gta tgt ttt atc ata att gac cag ttc att tca agg acc ttc aaa aat ata cct acg aat tcg agc tcg ttt aaa c-3’), or...oTsc13 (5’-tta aga gtt cag att tgc ttt atg tgg tta ttc tgc tga agg tcc taa ttt att gac gtt gaa aaa taa agg cca cat agc gga tcc ccg ggt taa tta a-3...and oTsc14 (5’-ata aaa aaa att aat taa tga tgg caa ggc aca atc gta atc aat ctt tta att tag gac ttt tta tat gcc ctt atg gcg aat tcg agc tcg ttt aaa c

  5. Effect of bladder augmentation on VP shunt failure rates in spina bifida.

    PubMed

    Gonzalez, Dani O; Cooper, Jennifer N; McLeod, Daryl J

    2017-12-11

    Most patients with spina bifida require ventriculoperitoneal (VP) shunt placement. Some also require bladder augmentation, which may increase the risk of VP shunt malfunction and/or failure. The aim of this study was to assess whether bladder augmentation affects the rate of VP shunt failure in this population. Using the Pediatric Health Information System, we studied patients with spina bifida born between 1992 and 2014 who underwent VP shunt placement. Using conditional logistic regression, we compared age- and hospital-matched patients who did and did not undergo a bladder augmentation to determine their difference in rates of VP shunt failure. There were 4192 patients with spina bifida who underwent both surgical closure and VP shunt placement. Of these, 203 patients with bladder augmentation could be matched to 593 patients without bladder augmentation. VP shunt failure occurred within 2 years in 7.7% of patients, the majority of whom were in the group who underwent bladder augmentation (87%). After adjusting for confounders, undergoing bladder augmentation was independently associated with VP shunt failure (HR: 33.5, 95% CI: 13.15-85.44, p< 0.001). Bladder augmentation appears to be associated with VP shunt failure. Additional studies are necessary to better define this relationship and identify risk-reduction techniques.

  6. Fear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes.

    PubMed

    Smith, Noelle B; Doran, Jennifer M; Sippel, Lauren M; Harpaz-Rotem, Ilan

    2017-05-10

    Posttraumatic stress disorder (PTSD) is associated with alterations in critical brain regions such as the amygdala, hippocampus, and prefrontal cortex. This brief review has two objectives: (1) to discuss research examining extinction and reconsolidation processes as mechanisms in PTSD psychotherapy, and (2) present possibilities for augmenting extinction and reconsolidation within treatment through alterations to therapeutic interventions and novel approaches. A key component of many effective PTSD therapies is exposure, which involves intentional confrontation and processing of the traumatic memory. Our review suggests that extinction and reconsolidation processes underlie effective exposure-based treatment, but the neurobiological mechanisms of these processes in behavioral treatments for PTSD remains unclear. We argue that enhancing extinction and/or disrupting reconsolidation of a feared memory may improve the efficacy of existing treatments (e.g., increased change for limited/non-responders, faster/greater changes for responders), which can be done through multiple channels. Potential avenues for augmentation of the processes of extinction and reconsolidation in PTSD psychotherapies are reviewed, including behavioral modifications, pharmacotherapy agents, and the use of devices during therapy. We further suggest that investigations towards understanding the extent to which extinction and reconsolidation processes are necessary in effective PTSD psychotherapy is an important future direction for enhancing clinical care among PTSD populations. Published by Elsevier B.V.

  7. Macrophages are critical effectors of antibody therapies for cancer.

    PubMed

    Weiskopf, Kipp; Weissman, Irving L

    2015-01-01

    Macrophages are innate immune cells that derive from circulating monocytes, reside in all tissues, and participate in many states of pathology. Macrophages play a dichotomous role in cancer, where they promote tumor growth but also serve as critical immune effectors of therapeutic antibodies. Macrophages express all classes of Fcγ receptors, and they have immense potential to destroy tumors via the process of antibody-dependent phagocytosis. A number of studies have demonstrated that macrophage phagocytosis is a major mechanism of action of many antibodies approved to treat cancer. Consequently, a number of approaches to augment macrophage responses to therapeutic antibodies are under investigation, including the exploration of new targets and development of antibodies with enhanced functions. For example, the interaction of CD47 with signal-regulatory protein α (SIRPα) serves as a myeloid-specific immune checkpoint that limits the response of macrophages to antibody therapies, and CD47-blocking agents overcome this barrier to augment phagocytosis. The response of macrophages to antibody therapies can also be enhanced with engineered Fc variants, bispecific antibodies, or antibody-drug conjugates. Macrophages have demonstrated success as effectors of cancer immunotherapy, and further investigation will unlock their full potential for the benefit of patients.

  8. Augmenting Your Own Reality: Student Authoring of Science-Based Augmented Reality Games

    ERIC Educational Resources Information Center

    Klopfer, Eric; Sheldon, Josh

    2010-01-01

    Augmented Reality (AR) simulations superimpose a virtual overlay of data and interactions onto a real-world context. The simulation engine at the heart of this technology is built to afford elements of game play that support explorations and learning in students' natural context--their own community and surroundings. In one of the more recent…

  9. Antiplatelet therapy in PCI

    PubMed Central

    Fanaroff, Alexander; Rao, Sunil

    2018-01-01

    Platelets play a key role in mediating stent thrombosis, the major cause of ischemic events in the immediate period following percutaneous coronary intervention (PCI). For this reason, antiplatelet therapy, started at the time of PCI and continued for at least 30 days afterwards, is the cornerstone of antithrombotic therapy after PCI. However, the use of antiplatelet agents increase bleeding risk, with more potent antiplatelet agents further increasing bleeding risk. For this reason, balancing prevention of ischemic events with risk of bleeding is fundamental to the effective use of antiplatelet agents. In the past 5 years, potent and fast-acting P2Y12 inhibitors have been introduced, and have augmented the antiplatelet armamentarium available to interventional cardiologists. In this review, we review the preclinical and clinical data surrounding these new agents, and discuss the significant questions and controversies that still exist regarding the optimal antiplatelet strategy. PMID:28582206

  10. Augmented reality in intraventricular neuroendoscopy.

    PubMed

    Finger, T; Schaumann, A; Schulz, M; Thomale, Ulrich-W

    2017-06-01

    Individual planning of the entry point and the use of navigation has become more relevant in intraventricular neuroendoscopy. Navigated neuroendoscopic solutions are continuously improving. We describe experimentally measured accuracy and our first experience with augmented reality-enhanced navigated neuroendoscopy for intraventricular pathologies. Augmented reality-enhanced navigated endoscopy was tested for accuracy in an experimental setting. Therefore, a 3D-printed head model with a right parietal lesion was scanned with a thin-sliced computer tomography. Segmentation of the tumor lesion was performed using Scopis NovaPlan navigation software. An optical reference matrix is used to register the neuroendoscope's geometry and its field of view. The pre-planned ROI and trajectory are superimposed in the endoscopic image. The accuracy of the superimposed contour fitting on endoscopically visualized lesion was acquired by measuring the deviation of both midpoints to one another. The technique was subsequently used in 29 cases with CSF circulation pathologies. Navigation planning included defining the entry points, regions of interests and trajectories, superimposed as augmented reality on the endoscopic video screen during intervention. Patients were evaluated for postoperative imaging, reoperations, and possible complications. The experimental setup revealed a deviation of the ROI's midpoint from the real target by 1.2 ± 0.4 mm. The clinical study included 18 cyst fenestrations, ten biopsies, seven endoscopic third ventriculostomies, six stent placements, and two shunt implantations, being eventually combined in some patients. In cases of cyst fenestrations postoperatively, the cyst volume was significantly reduced in all patients by mean of 47%. In biopsies, the diagnostic yield was 100%. Reoperations during a follow-up period of 11.4 ± 10.2 months were necessary in two cases. Complications included one postoperative hygroma and one insufficient

  11. Advances in Mental Health Care: Five N = 1 Studies on the Effects of the Robot Seal Paro in Adults with Severe Intellectual Disabilities

    ERIC Educational Resources Information Center

    Wagemaker, Eline; Dekkers, Tycho J.; Agelink van Rentergem, Joost A.; Volkers, Karin M.; Huizenga, Hilde M.

    2017-01-01

    Background: The evidence base for psychological treatments for autism and mood disorders in people with moderate to severe intellectual disabilities (ID) is limited. Recent promising robot-based innovations in mental health care suggest that robot-based animal assisted therapy (AAT) could be useful to improve social skills and mood in people with…

  12. Vision-based augmented reality system

    NASA Astrophysics Data System (ADS)

    Chen, Jing; Wang, Yongtian; Shi, Qi; Yan, Dayuan

    2003-04-01

    The most promising aspect of augmented reality lies in its ability to integrate the virtual world of the computer with the real world of the user. Namely, users can interact with the real world subjects and objects directly. This paper presents an experimental augmented reality system with a video see-through head-mounted device to display visual objects, as if they were lying on the table together with real objects. In order to overlay virtual objects on the real world at the right position and orientation, the accurate calibration and registration are most important. A vision-based method is used to estimate CCD external parameters by tracking 4 known points with different colors. It achieves sufficient accuracy for non-critical applications such as gaming, annotation and so on.

  13. Patient-specific finite element modeling for femoral bone augmentation

    PubMed Central

    Basafa, Ehsan; Armiger, Robert S.; Kutzer, Michael D.; Belkoff, Stephen M.; Mears, Simon C.; Armand, Mehran

    2015-01-01

    The aim of this study was to provide a fast and accurate finite element (FE) modeling scheme for predicting bone stiffness and strength suitable for use within the framework of a computer-assisted osteoporotic femoral bone augmentation surgery system. The key parts of the system, i.e. preoperative planning and intraoperative assessment of the augmentation, demand the finite element model to be solved and analyzed rapidly. Available CT scans and mechanical testing results from nine pairs of osteoporotic femur bones, with one specimen from each pair augmented by polymethylmethacrylate (PMMA) bone cement, were used to create FE models and compare the results with experiments. Correlation values of R2 = 0.72–0.95 were observed between the experiments and FEA results which, combined with the fast model convergence (~3 min for ~250,000 degrees of freedom), makes the presented modeling approach a promising candidate for the intended application of preoperative planning and intraoperative assessment of bone augmentation surgery. PMID:23375663

  14. Pharmacological enhancement of behavioral therapy: focus on posttraumatic stress disorder.

    PubMed

    Choi, Dennis C; Rothbaum, Barbara O; Gerardi, Maryrose; Ressler, Kerry J

    2010-01-01

    Improved efficacy in the treatment of posttraumatic stress disorder (PTSD) and other anxiety disorders is urgently needed. Traditional anxiety treatments of hypnosis and psychodynamic therapy may be of some help, but uncontrolled studies lead to inconclusive results on the efficacy of these treatment techniques. There is a larger literature supporting the efficacy of cognitive-behavioral procedures with PTSD, including prolonged exposure therapy, eye movement desensitization and reprocessing, and anxiety management techniques. The cutting-edge technology of virtual reality-based exposure therapy for PTSD is particularly exciting. To further build on effective psychosocial treatments, current pharmacological augmentation approaches to emotional learning are being combined with psychotherapy. In particular, D-cycloserine, a partial NMDA agonist, has shown to be effective in facilitating the exposure/extinction therapy to improve the efficacy of treating anxiety disorders, and may guide the way for new pharmacological enhancements of behavioral therapy.

  15. Acanthamoeba keratitis in 194 patients: risk factors for bad outcomes and severe inflammatory complications.

    PubMed

    Carnt, Nicole; Robaei, Dana; Minassian, Darwin C; Dart, John K G

    2018-01-03

    To determine demographic and clinical features of patients with Acanthamoeba keratitis (AK) that are independent risk factors both for bad outcomes and for severe inflammatory complications (SIC). A retrospective audit of medical records of AK cases at Moorfields Eye Hospital from July 2000 to April 2012, including 12 earlier surgical cases. Cases with a bad outcome were defined as those having one or more of the following: corneal perforation, keratoplasty, other surgery (except biopsy), duration of antiamoebic therapy (AAT) ≥10.5 months (the 75th percentile of the whole cohort) and final visual acuity ≤20/80. SICs were defined as having scleritis and/or a stromal ring infiltrate. Multivariable analysis was used to identify independent risk factors for both bad outcomes and SICs. Records of 194 eyes (194 patients) were included, having bad outcomes in 93 (48%). Bad outcomes were associated with the presence of SIC, aged >34 years, corticosteroids used before giving AAT and symptom duration >37 days before AAT. The development of SIC was independently associated with aged >34 years, corticosteroids used before giving AAT and herpes simplex virus (HSV) keratitis treatment before AAT. The prompt diagnosis of AK, avoidance of a misdiagnosis of HSV keratitis and corticosteroid use before the exclusion of AK as a potential cause of keratitis are essential to the provision of a good outcome for patients and for the avoidance of SIC. Older age is an unmodifiable risk factor that may reflect differences in the immune response to AK in this patient subset. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. The Perception and Estimation of Egocentric Distance in Real and Augmented Reality Environments

    DTIC Science & Technology

    2008-05-01

    MICHELLE SAMS, PhD. Research Program Manager Director Training and Leader Development Technical review by Jennifer L. Solberg, U.S. Army Research...with augmented reality technology that are essential for determining the usefulness of current augmented reality (AR) for training and performance...determine perceived distance. 15. SUBJECT TERMS Augmented Environments, Augmented Reality, Dismounted Infantry, Training , Presence, distance perception

  17. Heating Augmentation for Short Hypersonic Protuberances

    NASA Technical Reports Server (NTRS)

    Mazaheri, Alireza R.; Wood, William A.

    2008-01-01

    Computational aeroheating analyses of the Space Shuttle Orbiter plug repair models are validated against data collected in the Calspan University of Buffalo Research Center (CUBRC) 48 inch shock tunnel. The comparison shows that the average difference between computed heat transfer results and the data is about 9:5%. Using CFD and Wind Tunnel (WT) data, an empirical correlation for estimating heating augmentation on short hyper- sonic protuberances (k/delta < 0.33) is proposed. This proposed correlation is compared with several computed flight simulation cases and good agreement is achieved. Accordingly, this correlation is proposed for further investigation on other short hypersonic protuberances for estimating heating augmentation.

  18. Heating Augmentation for Short Hypersonic Protuberances

    NASA Technical Reports Server (NTRS)

    Mazaheri, Ali R.; Wood, William A.

    2008-01-01

    Computational aeroheating analyses of the Space Shuttle Orbiter plug repair models are validated against data collected in the Calspan University of Buffalo Research Center (CUBRC) 48 inch shock tunnel. The comparison shows that the average difference between computed heat transfer results and the data is about 9.5%. Using CFD and Wind Tunnel (WT) data, an empirical correlation for estimating heating augmentation on short hypersonic protuberances (k/delta less than 0.3) is proposed. This proposed correlation is compared with several computed flight simulation cases and good agreement is achieved. Accordingly, this correlation is proposed for further investigation on other short hypersonic protuberances for estimating heating augmentation.

  19. Ribavirin Contributes to Hepatitis C Virus Suppression by Augmenting pDC Activation and Type 1 IFN Production.

    PubMed

    Wang, Yang; McGivern, David R; Cheng, Liang; Li, Guangming; Lemon, Stanley M; Niu, Junqi; Su, Lishan; Reszka-Blanco, Natalia J

    2015-01-01

    Ribavirin is used as a component of combination therapies for the treatment of chronic hepatitis C virus (HCV) infection together with pegylated interferon and/or direct-acting antiviral drugs. Its mechanism of action, however, is not clear. Direct antiviral activity and immunomodulatory functions have been implicated. Plasmacytoid dendritic cells (pDCs) are the principal source of type 1 interferon during viral infection. The interaction of pDCs with HCV-infected hepatocytes is the subject of intense recent investigation, but the effect of ribavirin on pDC activation has not been evaluated. In this study we showed that ribavirin augments toll-like receptors 7 and 9-mediated IFNα/β expression from pDCs and up-regulated numerous interferon-stimulated genes. Using the H77S.3 HCV infection and replication system, we showed that ribavirin enhanced the ability of activated pDCs to inhibit HCV replication, correlated with elevated induction of IFNα. Our findings provide novel evidence that ribavirin contributes to HCV inhibition by augmenting pDCs-derived type 1 IFN production.

  20. Ribavirin Contributes to Hepatitis C Virus Suppression by Augmenting pDC Activation and Type 1 IFN Production

    PubMed Central

    Wang, Yang; McGivern, David R; Cheng, Liang; Li, Guangming; Lemon, Stanley M; Niu, Junqi; Su, Lishan; Reszka-Blanco, Natalia J

    2015-01-01

    Ribavirin is used as a component of combination therapies for the treatment of chronic hepatitis C virus (HCV) infection together with pegylated interferon and/or direct-acting antiviral drugs. Its mechanism of action, however, is not clear. Direct antiviral activity and immunomodulatory functions have been implicated. Plasmacytoid dendritic cells (pDCs) are the principal source of type 1 interferon during viral infection. The interaction of pDCs with HCV-infected hepatocytes is the subject of intense recent investigation, but the effect of ribavirin on pDC activation has not been evaluated. In this study we showed that ribavirin augments toll-like receptors 7 and 9-mediated IFNα/β expression from pDCs and up-regulated numerous interferon-stimulated genes. Using the H77S.3 HCV infection and replication system, we showed that ribavirin enhanced the ability of activated pDCs to inhibit HCV replication, correlated with elevated induction of IFNα. Our findings provide novel evidence that ribavirin contributes to HCV inhibition by augmenting pDCs-derived type 1 IFN production. PMID:26274905

  1. A randomized controlled study of power posing before public speaking exposure for social anxiety disorder: No evidence for augmentative effects.

    PubMed

    Davis, Michelle L; Papini, Santiago; Rosenfield, David; Roelofs, Karin; Kolb, Sarah; Powers, Mark B; Smits, Jasper A J

    2017-12-01

    This manuscript details a randomized controlled study designed to test the efficacy of power posing (i.e., briefly holding postures associated with dominance and power) as an augmentative strategy for exposure therapy for social anxiety disorder (SAD). Seventy-three individuals diagnosed with SAD were assigned to one of three conditions: power posing, submissive posing, or rest (no posing) prior to participating in an exposure therapy session. Participants were assessed for between-group differences in pre- and post-manipulation salivary hormone levels, within-session subjective experiences of fear, and pre- and 1-week post-treatment SAD severity outcome measures. Though the intervention resulted in decreased SAD symptom severity one week later, analyses revealed no significant between-group differences on any tested variables. Accordingly, this study provides no evidence to suggest that power posing impacts hormone levels or exposure therapy outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Hypoglycemia and blood glucose fluctuations in the application of a sensor-augmented insulin pump.

    PubMed

    Luo, Pei; Cheng, Qianpeng; Chen, Bin; Li, Yang; Wu, Jinxiao; Zhang, Xingguang; Jiao, Xiumin; Zhao, Jing; Lv, Xiaofeng

    2013-12-01

    The purpose of this study was to understand the effect of sensor-augmented insulin pump (SAP) use on hypoglycemia and blood glucose (BG) fluctuations. Sixty patients with type 2 diabetes mellitus were randomly assigned to three groups of treatment with SAP, continuous subcutaneous insulin infusion (CSII), or multiple daily injection (MDI) therapy for 6 days. Parameters of glycemic control that were determined included mean BG concentration (MBG), SD of BG (SDBG), mean amplitude of glycemic excursions (MAGE), absolute means of daily differences (MODD), 24-h area under the curve at 10 h (AUC10), 24-h area under the curve at 3.9 h (AUC3.9), and Low Blood Glucose Index (LBGI). No significant differences were observed among the three groups in terms of MBG, SDBG, MAGE, or MODD at the beginning of treatment. The MBG, SDBG, MAGE, MODD, and total AUC10 of the SAP group improved over the 4 days of the intervention compared with the CSII and MDI groups; however, no significant differences were observed among the three groups in terms of total AUC3.9 and LBGI. Compared with CSII and MDI therapy, SAP therapy was able to rapidly lower mean BG and reduce BG level fluctuations with no increased risks of hypoglycemia.

  3. The status of augmented reality in laparoscopic surgery as of 2016.

    PubMed

    Bernhardt, Sylvain; Nicolau, Stéphane A; Soler, Luc; Doignon, Christophe

    2017-04-01

    This article establishes a comprehensive review of all the different methods proposed by the literature concerning augmented reality in intra-abdominal minimally invasive surgery (also known as laparoscopic surgery). A solid background of surgical augmented reality is first provided in order to support the survey. Then, the various methods of laparoscopic augmented reality as well as their key tasks are categorized in order to better grasp the current landscape of the field. Finally, the various issues gathered from these reviewed approaches are organized in order to outline the remaining challenges of augmented reality in laparoscopic surgery. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Global navigation satellite systems performance analysis and augmentation strategies in aviation

    NASA Astrophysics Data System (ADS)

    Sabatini, Roberto; Moore, Terry; Ramasamy, Subramanian

    2017-11-01

    In an era of significant air traffic expansion characterized by a rising congestion of the radiofrequency spectrum and a widespread introduction of Unmanned Aircraft Systems (UAS), Global Navigation Satellite Systems (GNSS) are being exposed to a variety of threats including signal interferences, adverse propagation effects and challenging platform-satellite relative dynamics. Thus, there is a need to characterize GNSS signal degradations and assess the effects of interfering sources on the performance of avionics GNSS receivers and augmentation systems used for an increasing number of mission-essential and safety-critical aviation tasks (e.g., experimental flight testing, flight inspection/certification of ground-based radio navigation aids, wide area navigation and precision approach). GNSS signal deteriorations typically occur due to antenna obscuration caused by natural and man-made obstructions present in the environment (e.g., elevated terrain and tall buildings when flying at low altitude) or by the aircraft itself during manoeuvring (e.g., aircraft wings and empennage masking the on-board GNSS antenna), ionospheric scintillation, Doppler shift, multipath, jamming and spurious satellite transmissions. Anyone of these phenomena can result in partial to total loss of tracking and possible tracking errors, depending on the severity of the effect and the receiver characteristics. After designing GNSS performance threats, the various augmentation strategies adopted in the Communication, Navigation, Surveillance/Air Traffic Management and Avionics (CNS + A) context are addressed in detail. GNSS augmentation can take many forms but all strategies share the same fundamental principle of providing supplementary information whose objective is improving the performance and/or trustworthiness of the system. Hence it is of paramount importance to consider the synergies offered by different augmentation strategies including Space Based Augmentation System (SBAS), Ground

  5. Patient Adherence Predicts Outcome from Cognitive Behavioral Therapy in Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Simpson, Helen Blair; Maher, Michael J.; Wang, Yuanjia; Bao, Yuanyuan; Foa, Edna B.; Franklin, Martin

    2011-01-01

    Objective: To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). Method: Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory…

  6. Applications of Mesenchymal Stem Cells in Sinus Lift Augmentation as a Dental Implant Technology.

    PubMed

    Parnia, Feridoun; Yazdani, Javad; Maleki Dizaj, Solmaz

    2018-01-01

    The potential application of stem cell biology in human dentistry is a new and emerging field of research. The objective of the current review was to study the efficiency of mesenchymal stem cells (MSCs) in sinus lift augmentation (SLA). A literature review was performed in PubMed Central using MeSH keywords such as sinus lift, MSCs, dental implants, and augmentation. The searches involved full-text papers written in English, published in the past 10 years (2007-2017). The review included in vitro and in vivo studies on the use of MSCs in SLA. Electronic searching provided 45 titles, and among them, 8 papers were chosen as suitable based on the inclusion requirements of this review. The reviewed studies have revealed the potential of MSCs in SLA. According to these papers, stem cell therapy combined with different biomaterials may considerably improve bone regeneration in previous steps of dental implantation and may veritably lead to efficient clinical usages in the recent future. However, the identification of an ideal source of stem cells as well as long-term studies is vital to assess the success rate of this technology. Further clinical trials are also needed to approve the potential of MSCs in SLA.

  7. Molecular phylogenetic trees - On the validity of the Goodman-Moore augmentation algorithm

    NASA Technical Reports Server (NTRS)

    Holmquist, R.

    1979-01-01

    A response is made to the reply of Nei and Tateno (1979) to the letter of Holmquist (1978) supporting the validity of the augmentation algorithm of Moore (1977) in reconstructions of nucleotide substitutions by means of the maximum parsimony principle. It is argued that the overestimation of the augmented numbers of nucleotide substitutions (augmented distances) found by Tateno and Nei (1978) is due to an unrepresentative data sample and that it is only necessary that evolution be stochastically uniform in different regions of the phylogenetic network for the augmentation method to be useful. The importance of the average value of the true distance over all links is explained, and the relative variances of the true and augmented distances are calculated to be almost identical. The effects of topological changes in the phylogenetic tree on the augmented distance and the question of the correctness of ancestral sequences inferred by the method of parsimony are also clarified.

  8. Parametric Investigation of Thrust Augmentation by Ejectors on a Pulsed Detonation Tube

    NASA Technical Reports Server (NTRS)

    Wilson, Jack; Sgondea, Alexandru; Paxson, Daniel E.; Rosenthal, Bruce N.

    2005-01-01

    A parametric investigation has been made of thrust augmentation of a 1 inch diameter pulsed detonation tube by ejectors. A set of ejectors was used which permitted variation of the ejector length, diameter, and nose radius, according to a statistical design of experiment scheme. The maximum augmentations for each ejector were fitted using a polynomial response surface, from which the optimum ejector diameters, and nose radius, were found. Thrust augmentations above a factor of 2 were measured. In these tests, the pulsed detonation device was run on approximately stoichiometric air-hydrogen mixtures, at a frequency of 20 Hz. Later measurements at a frequency of 40 Hz gave lower values of thrust augmentation. Measurements of thrust augmentation as a function of ejector entrance to detonation tube exit distance showed two maxima, one with the ejector entrance upstream, and one downstream, of the detonation tube exit. A thrust augmentation of 2.5 was observed using a tapered ejector.

  9. Research on Design of MUH Attitude Stability Augmentation Control System

    NASA Astrophysics Data System (ADS)

    Fan, Shigang

    2017-09-01

    Attitude stability augmentation control system with a lower cost need to be designed so that MUH (Mini Unmanned Helicopter) can adapt to different types of geographic environment and fly steadily although the weather may be bad. Attitude feedback was calculated mainly by filtering estimation within attitude acquisition module in this system. Stability augmentation can be improved mainly by PI. This paper will depict running principle and designing process of MUH attitude stability augmentation control system and algorithm that is considered as an important part in this system.

  10. HDAC inhibitors as cognitive enhancers in fear, anxiety and trauma therapy: where do we stand?

    PubMed Central

    Whittle, Nigel; Singewald, Nicolas

    2014-01-01

    A novel strategy to treat anxiety and fear-related disorders such as phobias, panic and PTSD (post-traumatic stress disorder) is combining CBT (cognitive behavioural therapy), including extinction-based exposure therapy, with cognitive enhancers. By targeting and boosting mechanisms underlying learning, drug development in this field aims at designing CBT-augmenting compounds that help to overcome extinction learning deficits, promote long-term fear inhibition and thus support relapse prevention. Progress in revealing the role of epigenetic regulation of specific genes associated with extinction memory generation has opened new avenues in this direction. The present review examines recent evidence from pre-clinical studies showing that increasing histone acetylation, either via genetic or pharmacological inhibition of HDACs (histone deacetylases) by e.g. vorinostat/SAHA (suberoylanilide hydroxamic acid), entinostat/MS-275, sodium butyrate, TSA (trichostatin A) or VPA (valproic acid), or by targeting HATs (histone acetyltransferases), augments fear extinction and, importantly, generates a long-term extinction memory that can protect from return of fear phenomena. The molecular mechanisms and pathways involved including BDNF (brain-derived neurotrophic factor) and NMDA (N-methyl-D-aspartate) receptor signalling are just beginning to be revealed. First studies in healthy humans are in support of extinction-facilitating effects of HDAC inhibitors. Very recent evidence that HDAC inhibitors can rescue deficits in extinction-memory-impaired rodents indicates a potential clinical utility of this approach also for exposure therapy-resistant patients. Important future work includes investigation of the long-term safety aspects of HDAC inhibitor treatment, as well as design of isotype(s)-specific inhibitors. Taken together, HDAC inhibitors display promising potential as pharmacological adjuncts to augment the efficacy of exposure-based approaches in anxiety and trauma therapy

  11. Percussive Augmenter of Rotary Drills (PARoD)

    NASA Technical Reports Server (NTRS)

    Badescu, Mircea; Bar-Cohen, Yoseph; Sherrit, Stewart; Bao, Xiaoqi; Chang, Zensheu; Donnelly, Chris; Aldrich, Jack

    2012-01-01

    Increasingly, NASA exploration mission objectives include sample acquisition tasks for in-situ analysis or for potential sample return to Earth. To address the requirements for samplers that could be operated at the conditions of the various bodies in the solar system, a piezoelectric actuated percussive sampling device was developed that requires low preload (as low as 10N) which is important for operation at low gravity. This device can be made as light as 400g, can be operated using low average power, and can drill rocks as hard as basalt. Significant improvement of the penetration rate was achieved by augmenting the hammering action by rotation and use of a fluted bit to provide effective cuttings removal. Generally, hammering is effective in fracturing drilled media while rotation of fluted bits is effective in cuttings removal. To benefit from these two actions, a novel configuration of a percussive mechanism was developed to produce an augmenter of rotary drills. The device was called Percussive Augmenter of Rotary Drills (PARoD). A breadboard PARoD was developed with a 6.4 mm (0.25 in) diameter bit and was demonstrated to increase the drilling rate of rotation alone by 1.5 to over 10 times. Further, a large PARoD breadboard with 50.8 mm diameter bit was developed and its tests are currently underway. This paper presents the design, analysis and preliminary test results of the percussive augmenter.

  12. Three New Alpha1-Antitrypsin Deficiency Variants Help to Define a C-Terminal Region Regulating Conformational Change and Polymerization

    PubMed Central

    Fra, Anna M.; Gooptu, Bibek; Ferrarotti, Ilaria; Miranda, Elena; Scabini, Roberta; Ronzoni, Riccardo; Benini, Federica; Corda, Luciano; Medicina, Daniela; Luisetti, Maurizio; Schiaffonati, Luisa

    2012-01-01

    Alpha1-antitrypsin (AAT) deficiency is a hereditary disorder associated with reduced AAT plasma levels, predisposing adults to pulmonary emphysema. The most common genetic AAT variants found in patients are the mildly deficient S and the severely deficient Z alleles, but several other pathogenic rare alleles have been reported. While the plasma AAT deficiency is a common trait of the disease, only a few AAT variants, including the prototypic Z AAT and some rare variants, form cytotoxic polymers in the endoplasmic reticulum of hepatocytes and predispose to liver disease. Here we report the identification of three new rare AAT variants associated to reduced plasma levels and characterize their molecular behaviour in cellular models. The variants, called Mpisa (Lys259Ile), Etaurisano (Lys368Glu) and Yorzinuovi (Pro391His), showed reduced secretion compared to control M AAT, and accumulated to different extents in the cells as ordered polymeric structures resembling those formed by the Z variant. Structural analysis of the mutations showed that they may facilitate polymerization both by loosening ‘latch’ interactions constraining the AAT reactive loop and through effects on core packing. In conclusion, the new AAT deficiency variants, besides increasing the risk of lung disease, may predispose to liver disease, particularly if associated with the common Z variant. The new mutations cluster structurally, thus defining a region of the AAT molecule critical for regulating its conformational state. PMID:22723858

  13. Acceleration-Augmented LQG Control of an Active Magnetic Bearing

    NASA Technical Reports Server (NTRS)

    Feeley, Joseph J.

    1993-01-01

    A linear-quadratic-gaussian (LQG) regulator controller design for an acceleration-augmented active magnetic bearing (AMB) is outlined. Acceleration augmentation is a key feature in providing improved dynamic performance of the controller. The optimal control formulation provides a convenient method of trading-off fast transient response and force attenuation as control objectives.

  14. [Constricted ear therapy with free auricular composite grafts].

    PubMed

    Liu, Tun; Zhang, Lian-sheng; Zhuang, Hong-xing; Zhang, Ke-yuan

    2004-03-01

    A simple and effective therapy for single side constricted ear. Transplanting normal side free composite auricular grafts to constricted ear (15 patients and 15 sides), then lengthening the helix, exposing the scapha, correcting deformity. The 15 patients composite grafts all survived. The helix has been lengthened, the scapha exposed, the normal ear reduced, the constricted ear augmented and two sides ear have become symmetry. This method is simple and results are satisfied.

  15. Graphene-augmented nanofiber scaffolds demonstrate new features in cells behaviour

    NASA Astrophysics Data System (ADS)

    Kazantseva, Jekaterina; Ivanov, Roman; Gasik, Michael; Neuman, Toomas; Hussainova, Irina

    2016-07-01

    Three-dimensional (3D) customized scaffolds capable to mimic a native extracellular matrix open new frontiers in cells manipulation and advanced therapy. The major challenge is in a proper substrate for in vitro models on engineered scaffolds, capable to modulate cells differentiation. Here for the first time we demonstrate novel design and functionality of the 3D porous scaffolds of aligned, self-assembled ceramic nanofibers of ultra-high anisotropy ratio (~107), augmented into graphene shells. This unique hybrid nano-network allows an exceptional combination of selective guidance stimuli of stem cells differentiation, immune reactions variations, and local immobilization of cancer cells, which was not available before. The scaffolds were shown to be able to direct human mesenchymal stem cells (important for stimulation of neuronal and muscle cells) preferential orientation, to suppress major inflammatory factors, and to localize cancer cells; all without additions of specific culture media. The selective downregulation of specific cytokines is anticipated as a new tool for understanding of human immune system and ways of treatment of associated diseases. The effects observed are self-regulated by cells only, without side effects, usually arising from use of external factors. New scaffolds may open new horizons for stem cells fate control such as towards axons and neurites regeneration (Alzheimer’s disease) as well as cancer therapy development.

  16. Nitric oxide donor augments antineoplastic effects of arginine deprivation in human melanoma cells.

    PubMed

    Mayevska, Oksana; Chen, Oleh; Karatsai, Olena; Bobak, Yaroslav; Barska, Maryna; Lyniv, Liliana; Pavlyk, Iuliia; Rzhepetskyy, Yuriy; Igumentseva, Natalia; Redowicz, Maria Jolanta; Stasyk, Oleh

    2017-06-15

    Anticancer therapy based on recombinant arginine-degrading enzymes has been proposed for the treatment of several types of malignant cells deficient in arginine biosynthesis. One of the predicted side effects of such therapy is restricted bioavailability of nitric oxide as arginine catabolic product. Prolonged NO limitation may lead to unwanted disturbances in NO-dependent vasodilation, cardiovascular and immune systems. This problem can be overcome by co-supplementation with exogenous NO donor. However, NO may potentially counteract anticancer effects of therapy based on arginine deprivation. In this study, we evaluate for the first time the effects of an exogenous NO donor, sodium nitroprusside, on viability and metastatic properties of two human melanoma cell lines SK-MEL-28 and WM793 under arginine-deprived conditions. It was revealed that NO did not rescue melanoma cells from specific effects evoked by arginine deprivation, namely decreased viability and induction of apoptosis, dramatically reduced motility, invasiveness and clonogenic potential. Moreover, sodium nitroprusside co-treatment augmented several of these antineoplastic effects. We report that a combination of NO-donor and arginine deprivation strongly and specifically impaired metastatic behavior of melanoma cells. Thus, sodium nitroprusside can be considered as an adjuvant for the more efficient treatment of malignant melanoma and possibly other tumors with arginine-degrading enzymes. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Augmented Reality Environments in Learning, Communicational and Professional Contexts in Higher Education

    ERIC Educational Resources Information Center

    Martín Gutiérrez, Jorge; Meneses Fernández, María Dolores

    2014-01-01

    This paper explores educational and professional uses of augmented learning environment concerned with issues of training and entertainment. We analyze the state-of-art research of some scenarios based on augmented reality. Some examples for the purpose of education and simulation are described. These applications show that augmented reality can…

  18. PMMA-hydroxyapatite composite material retards fatigue failure of augmented bone compared to augmentation with plain PMMA: in vivo study using a sheep model.

    PubMed

    Arabmotlagh, Mohammad; Bachmaier, Samuel; Geiger, Florian; Rauschmann, Michael

    2014-11-01

    Polymethylmethacrylate (PMMA) is the most commonly used void filler for augmentation of osteoporotic vertebral fracture, but the differing mechanical features of PMMA and osteoporotic bone result in overload and failure of adjacent bone. The aim of this study was to compare fatigue failure of bone after augmentation with PMMA-nanocrystalline hydroxyapatite (HA) composite material or with plain PMMA in a sheep model. After characterization of the mechanical properties of a composite material consisting of PMMA and defined amounts (10, 20, and 30% volume fraction) of HA, the composite material with 30% volume fraction HA was implanted in one distal femur of sheep; plain PMMA was implanted in the other femur. Native non-augmented bone served as control. Three and 6 months after implantation, the augmented bone samples were exposed to cyclic loading and the evolution of damage was investigated. The fatigue life was highest for the ovine native bone and lowest for bone-PMMA specimens. Bone-composite specimens showed significantly higher fatigue life than the respective bone-PMMA specimens in both 3- and 6-month follow-up groups. These results suggest that modification of mechanical properties of PMMA by addition of HA to approximate those of cancellous bone retards fatigue failure of the surrounding bone compared to augmented bone with plain PMMA. © 2014 Wiley Periodicals, Inc.

  19. Chest x-ray generation and data augmentation for cardiovascular abnormality classification

    NASA Astrophysics Data System (ADS)

    Madani, Ali; Moradi, Mehdi; Karargyris, Alexandros; Syeda-Mahmood, Tanveer

    2018-03-01

    Medical imaging datasets are limited in size due to privacy issues and the high cost of obtaining annotations. Augmentation is a widely used practice in deep learning to enrich the data in data-limited scenarios and to avoid overfitting. However, standard augmentation methods that produce new examples of data by varying lighting, field of view, and spatial rigid transformations do not capture the biological variance of medical imaging data and could result in unrealistic images. Generative adversarial networks (GANs) provide an avenue to understand the underlying structure of image data which can then be utilized to generate new realistic samples. In this work, we investigate the use of GANs for producing chest X-ray images to augment a dataset. This dataset is then used to train a convolutional neural network to classify images for cardiovascular abnormalities. We compare our augmentation strategy with traditional data augmentation and show higher accuracy for normal vs abnormal classification in chest X-rays.

  20. Flexible augmented reality architecture applied to environmental management

    NASA Astrophysics Data System (ADS)

    Correia, Nuno M. R.; Romao, Teresa; Santos, Carlos; Trabuco, Adelaide; Santos, Rossana; Romero, Luis; Danado, Jose; Dias, Eduardo; Camara, Antonio; Nobre, Edmundo

    2003-05-01

    Environmental management often requires in loco observation of the area under analysis. Augmented Reality (AR) technologies allow real time superimposition of synthetic objects on real images, providing augmented knowledge about the surrounding world. Users of an AR system can visualize the real surrounding world together with additional data generated in real time in a contextual way. The work reported in this paper was done in the scope of ANTS (Augmented Environments) project. ANTS is an AR project that explores the development of an augmented reality technological infrastructure for environmental management. This paper presents the architecture and the most relevant modules of ANTS. The system"s architecture follows the client-server model and is based on several independent, but functionally interdependent modules. It has a flexible design, which allows the transfer of some modules to and from the client side, according to the available processing capacities of the client device and the application"s requirements. It combines several techniques to identify the user"s position and orientation allowing the system to adapt to the particular characteristics of each environment. The determination of the data associated to a certain location involves the use of both a 3D Model of the location and the multimedia geo-referenced database.

  1. Indoor vs. Outdoor Depth Perception for Mobile Augmented Reality

    DTIC Science & Technology

    2009-03-01

    International Symposium on Mixed and Augmented Reality, pages 77–86, Sept. 2008. [12] M. A. Livingston, J. E. Swan II, J. L. Gabbard , T. H. Höllerer, D. Hix...D. Brown, Y. Baillot, J. L. Gabbard , and D. Hix. A perceptual matching technique for depth judgments in optical, see-through augmented reality. In

  2. Risk of intracranial hemorrhage and cerebrovascular accidents in non-small cell lung cancer brain metastasis patients.

    PubMed

    Srivastava, Geetika; Rana, Vishal; Wallace, Suzy; Taylor, Sarah; Debnam, Matthew; Feng, Lei; Suki, Dima; Karp, Daniel; Stewart, David; Oh, Yun

    2009-03-01

    Brain metastases confer significant morbidity and a poorer survival in non-small cell lung cancer (NSCLC). Vascular endothelial growth factor-targeted antiangiogenic therapies (AAT) have demonstrated benefit for patients with metastatic NSCLC and are expected to directly inhibit the pathophysiology and morbidity of brain metastases, yet patients with brain metastases have been excluded from most clinical trials of AAT for fear of intracranial hemorrhage (ICH). The underlying risk of ICH from NSCLC brain metastases is low, but needs to be quantitated to plan clinical trials of AAT for NSCLC brain metastases. Data from MD Anderson Cancer Center Tumor Registry and electronic medical records from January 1998 to March 2006 was interrogated. Two thousand one hundred forty-three patients with metastatic NSCLC registering from January 1998 to September 2005 were followed till March 2006. Seven hundred seventy-six patients with and 1,367 patients without brain metastases were followed till death, date of ICH, or last date of study, whichever occurred first. The incidence of ICH seemed to be higher in those with brain metastasis compared with those without brain metastases, in whom they occurred as result of cerebrovascular accidents. However, the rates of symptomatic ICH were not significantly different. All ICH patients with brain metastasis had received radiation therapy for them and had been free of anticoagulation. Most of the brain metastasis-associated ICH's were asymptomatic, detected during increased radiologic surveillance. The rates of symptomatic ICH, or other cerebrovascular accidents in general were similar and not significantly different between the two groups. In metastatic NSCLC patients, the incidence of spontaneous ICH appeared to be higher in those with brain metastases compared with those without, but was very low in both groups without a statistically significant difference. These data suggest a minimal risk of clinically significant ICH for NSCLC

  3. Hepatic-targeted RNA interference provides robust and persistent knockdown of alpha-1 antitrypsin levels in ZZ patients.

    PubMed

    Turner, Alice M; Stolk, Jan; Bals, Robert; Lickliter, Jason D; Hamilton, James; Christianson, Dawn R; Given, Bruce D; Burdon, Jonathan G; Loomba, Rohit; Stoller, James K; Teckman, Jeffery H

    2018-03-21

    Alpha-1 antitrypsin deficiency (AATD) is a genetic disorder causing pulmonary and liver disease. The PiZ mutation in AAT (SERPINA1) results in mis-folded AAT protein (Z-AAT) accumulating in hepatocytes, leading to fibrosis and cirrhosis. RNAi-based therapeutics silencing production of hepatic Z-AAT might benefit patients with AATD-associated liver disease. This study evaluated an RNAi therapeutic to silence production of AAT. Part A of this double-blind first-in-human study randomized 54 healthy volunteers (HVs) into single dose cohorts (two placebo: four active), receiving escalating doses of the investigational agent ARC-AAT from 0.38 to 8.0 mg/kg or placebo. Part B randomized 11 patients with PiZZ (homozygous for Z-AAT) genotype AATD, who received up to 4.0 mg/kg of ARC-AAT or placebo. Patients with baseline FibroScan® >11 kPa or forced expiratory volume in one second (FEV1) <60% were excluded. Assessments included safety, pharmacokinetics, and change in serum AAT concentrations. A total of 36 HVs received ARC-AAT and 18 received placebo (part A). Seven PiZZ individuals received ARC-AAT and four received placebo (part B). A dose response in serum AAT reduction was observed at doses ≥4 mg/kg with similar relative reductions in PiZZ patients and HVs at 4 mg/kg and a maximum reduction of 76.1% (HVs) vs. 78.8% (PiZZ) at this dose. The time it took for serum AAT to return to baseline was similar for HV and PiZZ. There were no notable differences between HV and PiZZ safety parameters. The study was terminated early because of toxicity findings related to the delivery vehicle (ARC-EX1) seen in a non-human primate study. PiZZ patients and HVs responded similarly to ARC-AAT. Deep and durable knockdown of hepatic AAT production based on observed reduction in serum AAT concentrations was demonstrated. Accumulation of abnormal proteins in the livers of patients with alpha-1 antitrypsin deficiency may lead to decreased liver function and potentially liver

  4. Video-augmented feedback for procedural performance.

    PubMed

    Wittler, Mary; Hartman, Nicholas; Manthey, David; Hiestand, Brian; Askew, Kim

    2016-06-01

    Resident programs must assess residents' achievement of core competencies for clinical and procedural skills. Video-augmented feedback may facilitate procedural skill acquisition and promote more accurate self-assessment. A randomized controlled study to investigate whether video-augmented verbal feedback leads to increased procedural skill and improved accuracy of self-assessment compared to verbal only feedback. Participants were evaluated during procedural training for ultrasound guided internal jugular central venous catheter (US IJ CVC) placement. All participants received feedback based on a validated 30-point checklist for US IJ CVC placement and validated 6-point procedural global rating scale. Scores in both groups improved by a mean of 9.6 points (95% CI: 7.8-11.4) on the 30-point checklist, with no difference between groups in mean score improvement on the global rating scale. In regards to self-assessment, participant self-rating diverged from faculty scoring, increasingly so after receiving feedback. Residents rated highly by faculty underestimated their skill, while those rated more poorly demonstrated increasing overestimation. Accuracy of self-assessment was not improved by addition of video. While feedback advanced the skill of the resident, video-augmented feedback did not enhance skill acquisition or improve accuracy of resident self-assessment compared to standard feedback.

  5. The augmenting action of banana tree juice on skeletal muscle contraction.

    PubMed

    Singh, Y N; Dryden, W F

    1990-01-01

    An extract obtained from juice expressed from the stem of the plantain banana tree (Musa sapientum L., var. paradisiaca) induces twitch augmentation in skeletal muscles. The mechanism of this action was investigated in the mouse hemi-diaphragm preparation. Directly evoked twitches and potassium induced (K+) contractures were both augmented by the extract. Twitch augmentation was partly dependent on extracellular Ca2+. The action on K(+)-contractures was unaffected by tetrodotoxin, but the rate of relaxation was enhanced in the absence of extracellular calcium (0[Ca2+]o). Muscle contracture induced by high concentrations of extract was also augmented in 0[Ca2+]o and in the presence of the Ca2(+)-channel blocking agent, nifedipine. The time course of the contracture was shortened in 0[Ca2+]o, but not by nifedipine. Nifedipine enhanced the augmenting effect of the extract on twitches but shortened the time-course of this action. In addition, a muscle contracture was superimposed on the twitching muscle at higher concentrations of nifedipine. Manganese, on the other hand, reduced or abolished the augmenting action of the extract. The results are consistent with an action of banana tree juice on the molecule responsible for excitation-contraction coupling in skeletal muscle, resulting in a labilization of intracellular Ca2+.

  6. Augmentation of machine structure to improve its diagnosability

    NASA Technical Reports Server (NTRS)

    Hsieh, L.

    1973-01-01

    Two methods of augmenting the structure of a sequential machine so that it is diagnosable are presented. The checkable (checking sequences) and repeated symbol distinguishing sequences (RDS) are discussed. It was found that as few as twice the number of outputs of the given machine is sufficient for constructing a state-output augmentation with RDS. Techniques for minimizing the number of states in resolving convergences and in resolving equivalent and nonreduced cycles are developed.

  7. Augmenting CPT to Improve Sleep Impairment in PTSD: A Randomized Clinical Trial

    PubMed Central

    Galovski, Tara E.; Mott, Juliette; Blain, Leah M.; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas

    2015-01-01

    Objective Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory following treatment for PTSD. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy; CPT). Method Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. Results After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Conclusion Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. Public Health Significance: This study suggests that hypnosis may be a viable treatment option in a stepped-care approach for treating sleep impairment in individuals suffering from PTSD. PMID:26689303

  8. Parametric Investigation of Thrust Augmentation by Ejectors on a Pulsed Detonation Tube

    NASA Technical Reports Server (NTRS)

    Wilson, Jack; Sgondea, Alexandru; Paxson, Daniel E.; Rosenthal, Bruce N.

    2006-01-01

    A parametric investigation has been made of thrust augmentation of a 1 in. diameter pulsed detonation tube by ejectors. A set of ejectors was used which permitted variation of the ejector length, diameter, and nose radius, according to a statistical design of experiment scheme. The maximum augmentation ratios for each ejector were fitted using a polynomial response surface, from which the optimum ratios of ejector diameter to detonation tube diameter, and ejector length and nose radius to ejector diameter, were found. Thrust augmentation ratios above a factor of 2 were measured. In these tests, the pulsed detonation device was run on approximately stoichiometric air-hydrogen mixtures, at a frequency of 20 Hz. Later measurements at a frequency of 40 Hz gave lower values of thrust augmentation. Measurements of thrust augmentation as a function of ejector entrance to detonation tube exit distance showed two maxima, one with the ejector entrance upstream, and one downstream, of the detonation tube exit. A thrust augmentation of 2.5 was observed using a tapered ejector.

  9. Alpha-1 Antitrypsin Attenuates M1 Microglia-Mediated Neuroinflammation in Retinal Degeneration

    PubMed Central

    Zhou, Tian; Huang, Zijing; Zhu, Xiaowei; Sun, Xiaowei; Liu, Yan; Cheng, Bing; Li, Mei; Liu, Yizhi; He, Chang; Liu, Xialin

    2018-01-01

    Neurodegenerative diseases are a set of disorders characterized by progressive neuronal death and are associated with microglia-mediated neuroinflammation. Recently, neuroinflammation is proposed as a promising therapeutic target for many neurodegenerative diseases. Alpha-1 antitrypsin (AAT) is recognized as a novel immunomodulatory agent in autoimmune diseases and transplantation, however, its impact on neuroinflammation and neurodegeneration remains unknown. This study aims to explore the effects of AAT on microglia-mediated neuroinflammation and retinal degeneration in rd1 mouse model. We found reduced expression of AAT in rd1 retina, and AAT supplement exhibited certain protective effect on retinal degeneration, presenting with increased amount of photoreceptor nuclei, and amplified wave amplitudes in electroretinogram analysis. Of note, AAT shifted microglia phenotype from pro-inflammatory M1 (CD16/CD32+, iNOS+) to anti-inflammatory M2 (CD206+, Arg1+) both in vivo and in vitro, underscoring the concept of immunomodulation on microglia polarization by AAT during neurodegeneration. Furthermore, AAT suppressed the activation of STAT1, promoted the expression of IRF4 while inhibited IRF8 expression, indicating the involvement of these signaling pathways in AAT immunomodulation. Collectively, our data provided evidence for a novel protective role of AAT through immunomodulation on microglia polarization. Attenuating neuroinflammation by AAT may be beneficial to retard neurodegeneration in rd1 mice. PMID:29899745

  10. Aromatase inhibitors augment nociceptive behaviors in rats and enhance the excitability of sensory neurons

    PubMed Central

    Robarge, Jason D.; Duarte, Djane B.; Shariati, Behzad; Wang, Ruizhong; Flockhart, David A.; Vasko, Michael R.

    2016-01-01

    Although aromatase inhibitors (AIs) are commonly used therapies for breast cancer, their use is limited because they produce arthralgia in a large number of patients. To determine whether AIs produce hypersensitivity in animal models of pain, we examined the effects of the AI, letrozole, on mechanical, thermal, and chemical sensitivity in rats. In ovariectomized (OVX) rats, administering a single dose of 1 or 5 mg/kg letrozole significantly reduced mechanical paw withdrawal thresholds, without altering thermal sensitivity. Repeated injection of 5 mg/kg letrozole in male rats produced mechanical, but not thermal, hypersensitivity that extinguished when drug dosing was stopped. A single dose of 5 mg/kg letrozole or daily dosing of letrozole or exemestane in male rats also augmented flinching behavior induced by intraplantar injection of 1000 nmol of adenosine 5′-triphosphate (ATP). To determine whether sensitization of sensory neurons contributed to AI-induced hypersensitivity, we evaluated the excitability of neurons isolated from dorsal root ganglia of male rats chronically treated with letrozole. Both small and medium-diameter sensory neurons isolated from letrozole-treated rats were more excitable, as reflected by increased action potential firing in response to a ramp of depolarizing current, a lower resting membrane potential, and a lower rheobase. However, systemic letrozole treatment did not augment the stimulus-evoked release of the neuropeptide calcitonin gene-related peptide (CGRP) from spinal cord slices, suggesting that the enhanced nociceptive responses were not secondary to an increase in peptide release from sensory endings in the spinal cord. These results provide the first evidence that AIs modulate the excitability of sensory neurons, which may be a primary mechanism for the effect of these drugs to augment pain behaviors in rats. PMID:27072527

  11. Prophylactic augmentation of the proximal femur: an investigation of two techniques.

    PubMed

    Raas, Christoph; Hofmann-Fliri, Ladina; Hörmann, Romed; Schmoelz, Werner

    2016-03-01

    Osteoporotic hip fractures are an increasing problem in an ageing population. They result in high morbidity, mortality and high socioeconomic costs. For patients with poor bone quality, prophylactic augmentation of the proximal femur might be an option for fracture prevention. In two groups of paired human femora the potential of limited polymethyl-methacrylate (PMMA) augmentation (11-15 ml) in a V-shape pattern and the insertion of a proximal femur nail antirotation (PFNA) blade were investigated. The testing was carried out pair wise simulating the single leg stand. The untreated femur in each pair served as control. An axial load was applied until failure. Load displacement parameters and temperature increase during the augmentation process were recorded. In the PMMA group no significant difference was found between the augmented and non-augmented specimen concerning load to failure (p = 0.35) and energy to failure (p = 0.9). A median temperature increase of 9.5 °C was observed in the augmented specimen. A significant correlation was found between the amount of applied PMMA and the temperature increase (Cor. Coef. = 0.82, p = 0.042). In the PFNA group, a significant decrease of load to failure and a non-significant decrease of energy to failure were observed (p = 0.037 and p = 0.075). Limited V-shaped PMMA augmentation and PFNA blade insertion did not show any improvement in failure load or energy to failure. Volumes of up to 15 ml PMMA did not cause a critical surface temperature increase.

  12. Is anastomotic urethroplasty is really superior than BMG augmented dorsal onlay urethroplasty in terms of outcomes and patient satisfaction: Our 4-year experience

    PubMed Central

    Choudhary, Anil Kumar; Jha, Nawal K.

    2015-01-01

    Introduction We analyzed the outcomes of augmented buccal mucosa graft (BMG) dorsal onlay urethroplasty and anastomotic urethroplasty in the management of urethral stricture. Methods: Patients having a stricture length more than 2 cm were treated by augmented BMG dorsal onlay urethroplasty; patients with a stricture length less than 2 cm were managed by excision and end-to-end anastomotic urethroplasty. The postoperative retrograde urethrogram, micturating cystourethrogram, and uroflowmetry were compared to preoperative values. The postoperative subjective symptoms and complications were recorded and analyzed. Results: In total, 90 patients were included in this study. Forty-five patients had an average stricture length of 5.9 cm; they underwent BMG augmented dorsal onlay urethroplasty. Of these, 7 (15.55%) patients came with recurrence, while 38 (84.44%) were asymptomatic, in the average follow-up period of 32.8 months. The next 45 patients underwent excision of the stricture and end-to-end anastomosis. Of these, 6 (13.33%) failed on therapy and the remaining 39 (86.66%) were asymptomatic during the average follow-up period of 28.4 months. Conclusion: The technique of BMG dorsal onlay is easy to do, it is very reliable, has high success rate, less postoperative complications and better patient satisfaction compared to anastomotic urethroplasty. Our study has its limitations. Recurrent cases of urethroplasty and hypospadias were excluded from this study. Recurrent stricture cases were eliminated to overcome bias. Cases of hypospadias are still best treated by axial or random penile skin flap as BMG augmentation cannot create a long urethral tube. Based on our 4-year experience, we recommend BMG augmented urethroplasty long and short segment stricture of the urethra. PMID:25624962

  13. Gold nanoparticles as a platform for creating a multivalent poly-SUMO chain inhibitor that also augments ionizing radiation

    PubMed Central

    Li, Yi-Jia; Perkins, Angela L.; Su, Yang; Ma, Yuelong; Colson, Loren; Horne, David A.; Chen, Yuan

    2012-01-01

    Protein-protein interactions mediated by ubiquitin-like (Ubl) modifications occur as mono-Ubl or poly-Ubl chains. Proteins that regulate poly-SUMO (small ubiquitin-like modifier) chain conjugates play important roles in cellular response to DNA damage, such as those caused by cancer radiation therapy. Additionally, high atomic number metals, such as gold, preferentially absorb much more X-ray energy than soft tissues, and thus augment the effect of ionizing radiation when delivered to cells. In this study, we demonstrate that conjugation of a weak SUMO-2/3 ligand to gold nanoparticles facilitated selective multivalent interactions with poly-SUMO-2/3 chains leading to efficient inhibition of poly-SUMO-chain-mediated protein-protein interactions. The ligand-gold particle conjugate significantly sensitized cancer cells to radiation but was not toxic to normal cells. This study demonstrates a viable approach for selective targeting of poly-Ubl chains through multivalent interactions created by nanoparticles that can be chosen based on their properties, such as abilities to augment radiation effects. PMID:22388745

  14. The Palatal Window for Treating an Incompletely Augmented Maxillary Sinus.

    PubMed

    Florio, Salvatore; Suzuki, Takanori; Cho, Sang-Choon

    2017-04-01

    Maxillary sinus augmentation through a lateral window is reported as one of the most predictable bone augmentation procedures before implant placement. The elevation of the membrane represents a delicate and crucial step that allows the creation of the space for the bone graft material. If the elevation is not completed, the regenerated bone might be inadequate for the implant placement. In this case, a new intervention will be necessary to complete the bone augmentation. Reaccessing from a lateral window, however, would be challenging due to thickness of the buccal boney wall because of the first grafting procedure; therefore, a different approach has to be used. The aim of this case report is to present the palatal window technique for treating incompletely augmented maxillary sinus. The detailed step-by-step diagnostic and surgical procedures are described, and the advantages and limitations of the technique are discussed through a review of the literature.

  15. Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study.

    PubMed

    Bao, Tian; Carender, Wendy J; Kinnaird, Catherine; Barone, Vincent J; Peethambaran, Geeta; Whitney, Susan L; Kabeto, Mohammed; Seidler, Rachael D; Sienko, Kathleen H

    2018-01-18

    Organization Test and Mini Balance Evaluation Systems Test scores than the control group. Significant improvement was also observed for Five Times Sit to Stand Test duration within the experimental group, but not in the control group. No significant improvements between the two groups were observed in the remaining clinical outcome measures. The findings of this study support the use of sensory augmentation devices by community-dwelling healthy older adults as balance rehabilitation tools, and indicate feasibility of telerehabilitation therapy with reduced input from clinicians.

  16. Percussive Augmenter of Rotary Drills (PARoD)

    NASA Technical Reports Server (NTRS)

    Badescu, Mircea; Hasenoehrl, Jennifer; Bar-Cohen, Yoseph; Sherrit, Stewart; Bao, Xiaoqi; Chang, Zensheu; Ostlund, Patrick; Aldrich, Jack

    2013-01-01

    Increasingly, NASA exploration mission objectives include sample acquisition tasks for in-situ analysis or for potential sample return to Earth. To address the requirements for samplers that could be operated at the conditions of the various bodies in the solar system, a piezoelectric actuated percussive sampling device was developed that requires low preload (as low as 10 N) which is important for operation at low gravity. This device can be made as light as 400 g, can be operated using low average power, and can drill rocks as hard as basalt. Significant improvement of the penetration rate was achieved by augmenting the hammering action by rotation and use of a fluted bit to provide effective cuttings removal. Generally, hammering is effective in fracturing drilled media while rotation of fluted bits is effective in cuttings removal. To benefit from these two actions, a novel configuration of a percussive mechanism was developed to produce an augmenter of rotary drills. The device was called Percussive Augmenter of Rotary Drills (PARoD). A breadboard PARoD was developed with a 6.4 mm (0.25 in) diameter bit and was demonstrated to increase the drilling rate of rotation alone by 1.5 to over 10 times. The test results of this configuration were published in a previous publication. Further, a larger PARoD breadboard with a 50.8 mm (2.0 in) diameter bit was developed and tested. This paper presents the design, analysis and test results of the large diameter bit percussive augmenter.

  17. Amisulpride Augmentation in Acute Catatonia.

    PubMed

    Arora, Manu; Banal, Rakesh; Praharaj, Samir K; Mahajan, Vivek

    Benzodiazepines are the first-line treatment of catatonia, but a substantial number of patients do not respond to them. Amisulpride is one of the atypical antipsychotic that has been effective for negative symptoms of schizophrenia. We examined the effect of augmentation of oral low doses of amisulpride with lorazepam on resolution of catatonic symptoms. Fifteen patients with catatonia were treated with a combination of oral lorazepam (2-4 mg) with amisulpride (100 mg). Catatonic symptoms were rated using the Bush Francis Catatonia Rating Scale at the baseline and daily thereafter. There was complete resolution of catatonic symptoms on the third day in all patients. There was significant reduction of the total Bush Francis Catatonia Rating Scale score over time (F = 181.38, P < 0.001) with a strong effect size (partial η = 0.96). Augmentation of lorazepam with low-dose amisulpride can be a reliable strategy for management of catatonia.

  18. Augmented reality building operations tool

    DOEpatents

    Brackney, Larry J.

    2014-09-09

    A method (700) for providing an augmented reality operations tool to a mobile client (642) positioned in a building (604). The method (700) includes, with a server (660), receiving (720) from the client (642) an augmented reality request for building system equipment (612) managed by an energy management system (EMS) (620). The method (700) includes transmitting (740) a data request for the equipment (612) to the EMS (620) and receiving (750) building management data (634) for the equipment (612). The method (700) includes generating (760) an overlay (656) with an object created based on the building management data (634), which may be sensor data, diagnostic procedures, or the like. The overlay (656) is configured for concurrent display on a display screen (652) of the client (642) with a real-time image of the building equipment (612). The method (700) includes transmitting (770) the overlay (656) to the client (642).

  19. Bone Grafting the Glenoid Versus Use of Augmented Glenoid Baseplates with Reverse Shoulder Arthroplasty.

    PubMed

    Jones, Richard B; Wright, Thomas W; Roche, Christopher P

    2015-12-01

    Large glenoid defects are a difficult reconstructive problem for surgeons performing reverse shoulder arthroplasty (rTSA). Options to address glenoid defects include eccentric reaming, bone grafting, and augmented glenoid baseplates. Augmented glenoid baseplates may provide a simpler, cost-effective, bone-preserving option compared to other techniques. No studies report the use of augmented baseplates to correct glenoid deformity in rTSA relative to the use of glenoid bone graft. We retrospectively reviewed 80 patients that received a primary rTSA and received either a structural bone graft or an augmented glenoid baseplate to address a significant glenoid defect. There were 39 patients in the augmented baseplate cohort and 41 patients in the bone graft cohort. The augmented baseplate cohort contained 24 8° posterior augment implants and 15 10° superior augment baseplates. The bone graft cohort consisted of 36 autograft humeral heads and 5 allograft femoral heads. The average follow-up for rTSA patients with an augmented baseplate was 28.3 ± 5.7 months, and the average follow-up for rTSA patients with glenoid bone graft was 34.1 ± 15.0 months. Each patient was scored preoperatively and at latest follow-up using the SST, UCLA, ASES, Constant, and SPADI metrics. Range of motion data was obtained as well. All patients demonstrated significant improvements in pain, ROM, and functional scores following treatment with rTSA using either augmented baseplates or glenoid bone graft to correct glenoid defects. The database contained no complications for the augmented glenoid baseplate cohort, and six complications (14.6%) for the glenoid bone graft cohort (including two glenoid loosenings and graft failures). Additionally, the augmented baseplate cohort showed a lower scapular notching rate of 10% as compared to the bone graft cohort which had a notching rate of 18.5%. The results of this study suggest that either augmented glenoid baseplates or glenoid bone graft can be

  20. Calcium Triglyceride Versus Polymethylmethacrylate Augmentation: A Biomechanical Analysis of Pullout Strength.

    PubMed

    Hickerson, Lindsay E; Owen, John R; Wayne, Jennifer S; Tuten, H Robert

    2013-01-01

    Biomechanical pullout study using calcium triglyceride (CTG) and polymethylmethacrylate (PMMA) for screw augmentation. Compare the biomechanical performance of CTG augmentation versus the gold standard, PMMA, in primary and revision models, using a pedicle screw pullout model. CTG is a novel form of bone augmentation with several reported biocompatible properties compared with PMMA. PMMA is the standard of care for pedicle screw augmentation in osteoporotic spine. Blocks of closed-cell rigid polyurethane foam of uniform density, representing subcortical layer in osteoporotic pedicle, were prepared according to ASTM standards. After the components of PMMA (n = 11) and CTG (n = 11) were individually mixed in a standardized fashion, 0.2 ml was injected from deep to superficial along a predrilled pilot hole followed by immediate insertion of the pedicle screw. An unaugmented group (n = 10) was also prepared. Blocks cured for 24 hrs, and screws were pulled out at a rate of 5 mm/min on materials testing equipment. For the revision model, the unaugmented group, after screw pullout, was augmented with 0.8 ml of PMMA (n = 5) or CTG (n = 5) as detailed above and screw pullout performed similarly. The mean pullout strengths (SD) for the intact models were as follows: unaugmented, 976.6 N (94.2 N); PMMA, 1,218.1 N (66.8 N); and CTG, 1,841.6 N (57.4 N). A one-way analysis of variance indicated a significant difference among the primary models (p < .0001). For the revision models, the pullout strength for PMMA was 1,939.2 N (108.9 N) and for CTG, 2,513.0 N (149.1 N), which were statistically different from each other (p < .0003). Stiffness of the constructs was increased with both PMMA and CTG augmentation over no augmentation (p < .0001) although no significant difference in stiffness was detected between the 2 forms of augmentation. We conclude that CTG augmentation of pedicle screws resulted in significantly higher axial pullout strength in primary (p < .0001) and revision

  1. Timing of PMMA cement application for pedicle screw augmentation affects screw anchorage.

    PubMed

    Schmoelz, Werner; Heinrichs, Christian Heinz; Schmidt, Sven; Piñera, Angel R; Tome-Bermejo, Felix; Duart, Javier M; Bauer, Marlies; Galovich, Luis Álvarez

    2017-11-01

    Cement augmentation is an established method to increase the pedicle screw (PS) anchorage in osteoporotic vertebral bodies. The ideal timing for augmentation when a reposition maneuver is necessary is controversial. While augmentation of the PS before reposition maneuver may increase the force applied it on the vertebrae, it bears the risk to impair PS anchorage, whereas augmenting the PS after the maneuver may restore this anchorage and prevent early screw loosening. The purpose of the present study was to evaluate the effect of cement application timing on PS anchorage in the osteoporotic vertebral body. Ten lumbar vertebrae (L1-L5) were used for testing. The left and right pedicles of each vertebra were instrumented with the same PS size and used for pairwise comparison of the two timing points for augmentation. For the reposition maneuver, the left PS was loaded axially under displacement control (2 × ±2 mm, 3 × ±6 mm, 3 × ±10 mm) to simulate a reposition maneuver. Subsequently, both PS were augmented with 2 ml PMMA cement. The same force as measured during the left PS maneuver was applied to the previously augmented right hand side PS [2 × F (±2 mm), 3 × F (±6 mm), 3 × F (±10 mm)]. Both PS were cyclically loaded with initial forces of +50 and -50 N, while the lower force was increased by 5 N every 100 cycles until total failure of the PS. The PS motion was measured with a 3D motion analysis system. After cyclic loading stress, X-rays were taken to identify the PS loosening mechanism. In comparison with PS augmented prior to the reposition maneuver, PS augmented after the reposition maneuver showed a significant higher number of load cycles until failure (5930 ± 1899 vs 3830 ± 1706, p = 0.015). The predominant loosening mechanism for PS augmented after the reposition maneuver was PS toggling with the attached cement cloud within the trabecular bone. While PS augmented prior to the reposition, maneuver showed a motion of

  2. Basic Perception in Head-worn Augmented Reality Displays

    DTIC Science & Technology

    2012-01-01

    Basic Perception in Head-worn Augmented Reality Displays Mark A. Livingston, Joseph L. Gabbard , J. Edward Swan II, Ciara M. Sibley, and Jane H...mark.livingston@nrl.navy.mil Joseph L. Gabbard Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA e-mail: jgabbard@vt.edu J...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 2 Livingston, Gabbard , et al. 1 Introduction For many first-time users of augmented reality

  3. D3D augmented reality imaging system: proof of concept in mammography.

    PubMed

    Douglas, David B; Petricoin, Emanuel F; Liotta, Lance; Wilson, Eugene

    2016-01-01

    The purpose of this article is to present images from simulated breast microcalcifications and assess the pattern of the microcalcifications with a technical development called "depth 3-dimensional (D3D) augmented reality". A computer, head display unit, joystick, D3D augmented reality software, and an in-house script of simulated data of breast microcalcifications in a ductal distribution were used. No patient data was used and no statistical analysis was performed. The D3D augmented reality system demonstrated stereoscopic depth perception by presenting a unique image to each eye, focal point convergence, head position tracking, 3D cursor, and joystick fly-through. The D3D augmented reality imaging system offers image viewing with depth perception and focal point convergence. The D3D augmented reality system should be tested to determine its utility in clinical practice.

  4. Adding to Leader-Follower Transactions: The Augmenting Effect of Charismatic Leadership

    DTIC Science & Technology

    1988-12-01

    leaders are able to influence and inspire followers on the basis of these values. The Augmenting Effect of Charismatic Leadership Two aspects of...III AD-A204 115 F r’ Adding to Leader -Follower Transactions: The Augmenting Effect of Charismatic Leadership David A. Waldman, Bernard M. Bass, and...OF NEW YORK m E L iLETI iA i .1’ Adding to Leader -Follower Transactions: The Augmenting Effect of Charismatic Leadership David A. Waldman, Bernard M

  5. Synergistic neuroprotective therapies with hypothermia

    PubMed Central

    Cilio, Maria Roberta; Ferriero, Donna M.

    2010-01-01

    summary Neuroprotection is a major health care priority, given the enormous burden of human suffering and financial cost caused by perinatal brain damage. With the advent of hypothermia as therapy for term hypoxic–ischemic encephalopathy, there is hope for repair and protection of the brain after a profound neonatal insult. However, it is clear from the published clinical trials and animal studies that hypothermia alone will not provide complete protection or stimulate the repair that is necessary for normal neurodevelopmental outcome. This review critically discusses drugs used to treat seizures after hypoxia–ischemia in the neonate with attention to evidence of possible synergies for therapy. In addition, other agents such as xenon, N-acetylcysteine, erythropoietin, melatonin and cannabinoids are discussed as future potential therapeutic agents that might augment protection from hypothermia. Finally, compounds that might damage the developing brain or counteract the neuroprotective effects of hypothermia are discussed. PMID:20207600

  6. Metformin as adjunct antituberculosis therapy.

    PubMed

    Singhal, Amit; Jie, Liu; Kumar, Pavanish; Hong, Gan Suay; Leow, Melvin Khee-Shing; Paleja, Bhairav; Tsenova, Liana; Kurepina, Natalia; Chen, Jinmiao; Zolezzi, Francesca; Kreiswirth, Barry; Poidinger, Michael; Chee, Cynthia; Kaplan, Gilla; Wang, Yee Tang; De Libero, Gennaro

    2014-11-19

    The global burden of tuberculosis (TB) morbidity and mortality remains immense. A potential new approach to TB therapy is to augment protective host immune responses. We report that the antidiabetic drug metformin (MET) reduces the intracellular growth of Mycobacterium tuberculosis (Mtb) in an AMPK (adenosine monophosphate-activated protein kinase)-dependent manner. MET controls the growth of drug-resistant Mtb strains, increases production of mitochondrial reactive oxygen species, and facilitates phagosome-lysosome fusion. In Mtb-infected mice, use of MET ameliorated lung pathology, reduced chronic inflammation, and enhanced the specific immune response and the efficacy of conventional TB drugs. Moreover, in two separate human cohorts, MET treatment was associated with improved control of Mtb infection and decreased disease severity. Collectively, these data indicate that MET is a promising candidate host-adjunctive therapy for improving the effective treatment of TB. Copyright © 2014, American Association for the Advancement of Science.

  7. Biomechanics of Polyhydroxyalkanoate Mesh-Augmented Single-Row Rotator Cuff Repairs.

    PubMed

    Tashjian, Robert Z; Kolz, Christopher W; Suter, Thomas; Henninger, Heath B

    Polyhydroxyalkanoate (PHA) mesh is a bioresorbable scaffold used to reinforce the suture-tendon interface in rotator cuff repairs (RCRs). We conducted a study of cyclic and ultimate failure properties of PHA mesh-augmented single-row RCRs and nonaugmented RCRs. Eight pairs of fresh-frozen cadaver humeri (6 male, 2 female) were tested. Mean (SD) age was 61 (9) years. The supraspinatus tendon was resected and reattached in a single-row configuration using 2 triple-loaded suture anchors and 6 simple stitches. The opposite humerus underwent RCR augmented with 2 strips of 13-mm × 23-mm PHA mesh. Humeri were mounted in an Instron load frame, cycled 1000 times to 1.0 MPa of effective stress, and loaded to failure. Construct gapping and ultimate failure loads/displacements were recorded. Paired t tests compared augmented and nonaugmented RCRs (P ≤ .05 was significant). There was no difference in gapping over 1000 cycles (P = .879). Mean (SD) failure load was higher for PHA mesh-augmented RCRs, 571 (173) N, than for nonaugmented (control) RCRs, 472 (120) N (P = .042), and failures were consistent within pairs because of tissue failure at the knots or anchor pullout. This technique for arthroscopic augmentation can be used to improve initial biomechanical repair strength in tears at risk for failure.

  8. Thrust Augmentation Measurements for a Pulse Detonation Engine Driven Ejector

    NASA Technical Reports Server (NTRS)

    Pal, S.; Santoro, Robert J.; Shehadeh, R.; Saretto, S.; Lee, S.-Y.

    2005-01-01

    Thrust augmentation results of an ongoing study of pulse detonation engine driven ejectors are presented and discussed. The experiments were conducted using a pulse detonation engine (PDE) setup with various ejector configurations. The PDE used in these experiments utilizes ethylene (C2H4) as the fuel, and an equi-molar mixture of oxygen and nitrogen as the oxidizer at an equivalence ratio of one. High fidelity thrust measurements were made using an integrated spring damper system. The baseline thrust of the PDE engine was first measured and agrees with experimental and modeling results found in the literature. Thrust augmentation measurements were then made for constant diameter ejectors. The parameter space for the study included ejector length, PDE tube exit to ejector tube inlet overlap distance, and straight versus rounded ejector inlets. The relationship between the thrust augmentation results and various physical phenomena is described. To further understand the flow dynamics, shadow graph images of the exiting shock wave front from the PDE were also made. For the studied parameter space, the results showed a maximum augmentation of 40%. Further increase in augmentation is possible if the geometry of the ejector is tailored, a topic currently studied by numerous groups in the field.

  9. Guidelines for the selection of optimal glenoid augment size for moderate to severe glenohumeral osteoarthritis.

    PubMed

    Sabesan, Vani; Callanan, Mark; Sharma, Vinay

    2014-07-01

    Total shoulder arthroplasty is technically demanding in regard to implantation of the glenoid component, especially in the setting of increased glenoid deformity and posterior glenoid wear. Augmented glenoid implants are an important and innovative option; however, there is little evidence accessible to surgeons to guide in the selection of the appropriate size augmented glenoid. Solid computer models of commercially available augmented glenoid components (+3, +5, +7) contained within the software allowed placement of the best fit glenoid component within the three-dimensional reconstruct of each patient's scapula. Peg perforation, amount of bone reamed, and amount of medialization were recorded for each augment size. There was strong correlation between the medialization of the joint line and the glenoid retroversion for each augmented component at neutral correction and correction to 6° of retroversion. At neutral, the range of retroversion that restored the anatomic joint line was -3° to -17° with use of the +3 augmented glenoid, -5° to -24° with the +5 augmented glenoid, and -9° to -31° with the +7 augmented glenoid. At 6° of retroversion, the range of retroversion that restored the anatomic joint line was -4° to -21° with use of the +3 augmented glenoid, -7° to -27° with the +5 augmented glenoid, and -9° to -34° with the +7 augmented glenoid. There was a strong correlation between glenoid retroversion and medialization for all augment sizes, supporting the recommendation for glenoid retroversion as the primary guide in selecting the amount of augmentation. Copyright © 2014. Published by Mosby, Inc.

  10. Radiation/Catalytic Augmented Combustion.

    DTIC Science & Technology

    1984-05-01

    interest to compare the experimental results for the solid bluff body with a thuoretical result. Using simple argtinieiiLs from fluid mechanics " one...responsibility through completion. Dr. A. E. Cerkanowlcz assisted in writing this final report. Experimental studies on catalytic augmented combustion...as well as with other combustion species, lead to ignition and sustained combustion via chain reactions. Simple combustion enhancement without

  11. Cognitive Behavioral Therapy for Anxiety in Children with Autism Spectrum Disorders: A Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Drahota, Amy; Sze, Karen; Har, Kim; Chiu, Angela; Langer, David A.

    2009-01-01

    Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or…

  12. Augmented Reality Implementation in Watch Catalog as e-Marketing Based on Mobile Aplication

    NASA Astrophysics Data System (ADS)

    Adrianto, D.; Luwinda, F. A.; Yesmaya, V.

    2017-01-01

    Augmented Reality is one of important methods to provide user with a better interactive user interface. In this research, Augmented Reality in Mobile Application will be applied to provide user with useful information related with Watch Catalogue. This research will be focused on design and implementation an application using Augmented Reality. The process model used in this research is Extreme Programming. Extreme Programming have a several steps which are planning, design, coding, and testing. The result of this research is Augmented Reality application based on Android. This research will be conclude that implementation of Augmented Reality based on Android in Watch Catalogue will help customer to collect the useful information related to the specific object of watch.

  13. Bibliography on augmentation of convective heat and mass transfer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bergles, A.E.; Webb, R.L.; Junkhan, G.H.

    1979-05-01

    Heat transfer augmentation has developed into a major specialty area in heat transfer research and development. A bibliography of world literature on augmentation is presented. The literature is classified into passive augmentation techniques, which require no external power, and active techniques, which do require external power. The fourteen techniques are grouped in terms of their application to the various modes of heat transfer. Mass transfer is included for completeness. Key words are included with each citation for technique/mode identification. The total number of publications cited is 1,967, including 75 surveys of various techniques and 42 papers on performance evaluation ofmore » passive techniques. Patents are not included as they will be the subject of a future topical report.« less

  14. An Argument Against Augmenting the Lagrangean for Nonholonomic Systems

    NASA Technical Reports Server (NTRS)

    Roithmayr, Carlos M.; Hodges, Dewey H.

    2009-01-01

    Although it is known that correct dynamical equations of motion for a nonholonomic system cannot be obtained from a Lagrangean that has been augmented with a sum of the nonholonomic constraint equations weighted with multipliers, previous publications suggest otherwise. An example has been proposed in support of augmentation and purportedly demonstrates that an accepted method fails to produce correct equations of motion whereas augmentation leads to correct equations; this paper shows that in fact the opposite is true. The correct equations, previously discounted on the basis of a flawed application of the Newton-Euler method, are verified by using Kane's method and a new approach to determining the directions of constraint forces. A correct application of the Newton-Euler method reproduces valid equations.

  15. Long-term stability of contour augmentation in the esthetic zone: histologic and histomorphometric evaluation of 12 human biopsies 14 to 80 months after augmentation.

    PubMed

    Jensen, Simon S; Bosshardt, Dieter D; Gruber, Reinhard; Buser, Daniel

    2014-11-01

    Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure. Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis. The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed. The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

  16. Cranial implant design using augmented reality immersive system.

    PubMed

    Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

    2007-01-01

    Software tools that utilize haptics for sculpting precise fitting cranial implants are utilized in an augmented reality immersive system to create a virtual working environment for the modelers. The virtual environment is designed to mimic the traditional working environment as closely as possible, providing more functionality for the users. The implant design process uses patient CT data of a defective area. This volumetric data is displayed in an implant modeling tele-immersive augmented reality system where the modeler can build a patient specific implant that precisely fits the defect. To mimic the traditional sculpting workspace, the implant modeling augmented reality system includes stereo vision, viewer centered perspective, sense of touch, and collaboration. To achieve optimized performance, this system includes a dual-processor PC, fast volume rendering with three-dimensional texture mapping, the fast haptic rendering algorithm, and a multi-threading architecture. The system replaces the expensive and time consuming traditional sculpting steps such as physical sculpting, mold making, and defect stereolithography. This augmented reality system is part of a comprehensive tele-immersive system that includes a conference-room-sized system for tele-immersive small group consultation and an inexpensive, easily deployable networked desktop virtual reality system for surgical consultation, evaluation and collaboration. This system has been used to design patient-specific cranial implants with precise fit.

  17. Therapeutic compositions and uses of alpha1-antitrypsin: a patent review (2012 - 2015).

    PubMed

    Lior, Yotam; Geyra, Assaf; Lewis, Eli C

    2016-05-01

    Identified as a circulating serine-protease inhibitor, the genetic deficiency of which predisposes to the development of lung emphysema, alpha1-antitrypsin (AAT) has recently been found to possess various anti-inflammatory and immunomodulatory activities outside the biochemical inhibition of serine-proteases. AAT is presently extracted from human plasma to supply life-long infusions to patients with genetic AAT deficiency. However, its newly appreciated functions point to extended therapeutic uses; these, alongside modified production attempts, represent a novel and dynamic niche of drug repurposing, set apart from addressing lung emphysema in AAT-deficient individuals. The review provides a comprehensive summary of patent-protected inventions in the field of novel clinical indications for AAT and innovations in AAT production. A molecule no longer patentable per se, presents with novel clinical applications; its mechanism still unfolding. While modified protein sequences are patentable and potentially superior, they are burdened by regulatory setbacks. Thus, recent approaches in the context of AAT appear in patents that describe combinations with other drugs, redefined clinical subclasses, and unique recombinant entities, carefully skirting saturated areas of AAT patentology. It will be fascinating to follow technologies and creative patenting as AAT navigates the trying trades of pharmaceutical industry towards an increasing lineup of unmet clinical needs.

  18. Calorie intake and patient outcomes in severe acute kidney injury: findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial

    PubMed Central

    2014-01-01

    Introduction Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes. Methods We performed a secondary analysis in 1456 patients from the RENAL trial. We measured the dose and evolution of DCI during treatment and analyzed its association with major clinical outcomes using multivariable logistic regression, Cox proportional hazards models, and time adjusted models. Results Overall, mean DCI during treatment in ICU was low at only 10.9 ± 9 Kcal/kg/day for non-survivors and 11 ± 9 Kcal/kg/day for survivors. Among patients with a lower DCI (below the median) 334 of 729 (45.8%) had died at 90-days after randomization compared with 316 of 727 (43.3%) patients with a higher DCI (above the median) (P = 0.34). On multivariable logistic regression analysis, mean DCI carried an odds ratio of 0.95 (95% confidence interval (CI): 0.91-1.00; P = 0.06) per 100 Kcal increase for 90-day mortality. DCI was not associated with significant differences in renal replacement (RRT) free days, mechanical ventilation free days, ICU free days and hospital free days. These findings remained essentially unaltered after time adjusted analysis and Cox proportional hazards modeling. Conclusions In the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes. Trial registration ClinicalTrials.gov number, NCT00221013 PMID:24629036

  19. Investigation of Thrust Augmentation and Acoustic Performance by Ejectors on PDE

    NASA Astrophysics Data System (ADS)

    Xu, Gui-yang; Weng, Chun-sheng; Li, Ning; Huang, Xiao-long

    2016-04-01

    Thrust augmentation and acoustic performance of a Pulse Detonation Engine (PDE) with ejector system is experimentally investigated. For these tests the LEjector/DEjector is varied from 1.18 to 4 and the axial placement of the ejector relative to the PDE exhaust is varied from an x/DPDE of -3 to 3. Results from the tests show that the optimum LEjector/DEjector based on thrust augmentation and Overall Sound Pressure Level (OASPL) is found to be 2.61. The divergent ejector performed the best based on thrust augmentation, while the reduction effect for OASPL and Peak Sound Pressure Level (PSPL) at 60° is most prominent for the convergent ejector. The optimum axial position based on thrust augmentation is determined to be x/DPDE = 2, while, x/DPDE = 0 based on OASPL and PSPL.

  20. Lung volume reduction surgery in patients with emphysema and alpha-1 antitrypsin deficiency.

    PubMed

    Stoller, James K; Gildea, Thomas R; Ries, Andrew L; Meli, Yvonne M; Karafa, Matthew T

    2007-01-01

    The role of lung volume reduction surgery (LVRS) for individuals with alpha-1 antitrypsin (AAT) deficiency is unclear. To assess the role of LVRS in individuals with severe deficiency of AAT, outcomes within the National Emphysema Treatment Trial were analyzed. Of 1218 randomized subjects, 16 (1.3%) had severe AAT deficiency (serum level < 80 mg/dL) and a consistent phenotype (when available). Characteristics of these 16 patients include 87.5% male; median serum AAT level, 55.5 mg/dL; age, 66 years; forced expiratory volume in 1 second (FEV1), 27% predicted; and 50% had upper-lobe-predominant emphysema. All 10 subjects randomized to LVRS underwent the procedure. Although the small number of subjects hampered statistical analysis, 2-year mortality was higher with surgery (20% versus 0%) than with medical treatment. Comparison of outcomes between the 10 AAT-deficient and the 554 AAT-replete subjects undergoing LVRS showed a greater increase in exercise capacity at 6 months in replete subjects and a trend toward lower and shorter duration FEV1 rise in deficient individuals. This study extends to 49 cases the published experience of LVRS in severe AAT deficiency. Although the small number of subjects precludes firm conclusions, trends of lower magnitude and duration of FEV1 rise after surgery in AAT-deficient versus AAT-replete subjects and higher mortality in deficient individuals randomized to surgery versus medical treatment suggest caution in recommending LVRS in AAT deficiency.

  1. Developing and Validating Practical Eye Metrics for the Sense-Assess-Augment Framework

    DTIC Science & Technology

    2015-09-29

    Sense-Assess-Augment ( SAA ) Framework. To better close the loop between the human and machine teammates AFRL’s Human Performance Wing and Human...Sense-Assess-Augment ( SAA ) framework, which is designed to sense a suite of physiological signals from the operator, use these signals to assess the...to use psychophysiological measures to improve human-machine teamwork (such as Biocybernetics or Augmented Cognition) the AFRL- SAA research program

  2. Motivational factors and psychological processes in cosmetic breast augmentation surgery.

    PubMed

    Solvi, Anette S; Foss, Kaja; von Soest, Tilmann; Roald, Helge E; Skolleborg, Knut C; Holte, Arne

    2010-04-01

    We investigated how and why prospective cosmetic breast augmentation patients decide to undergo such surgery. The results can offer important insights to plastic surgeons in addressing their patients' motives and expectations, and thereby avoiding potential patient dissatisfaction and disappointment. It is also a necessary first step to better understand the increasing tendency among women in the Western society to seek cosmetic breast augmentation. A qualitative, descriptive and phenomenological design was employed. Fourteen female prospective breast augmentation patients, aged 19-46 years, were recruited from a private plastic surgery clinic and interviewed in depth based on an informant-centred format. The interviews were tape-recorded, transcribed verbatim and coded and analysed phenomenologically using a QSR-N*Vivo software program. We detected four psychological processes associated with cosmetic breast augmentation surgery (create, improve, repair and restore). The data could further be categorised into one basic drive (femininity), six generating factors (appearance dissatisfaction, ideal figure, self-esteem, comments, clothes and sexuality) and five eliciting factors motivating the decision (media, knowledge of former patients, physicians, finances and romantic partner). These new insights into how and why women seek cosmetic breast augmentation may aid plastic surgeons in enhancing their communication with patients. This can be achieved by addressing the patient's psychological process and motives, and thereby better assist them in making the best decision possible in their particular situation. It may also lay the groundwork for future quantitative studies on the prevalence of certain motives for undergoing such surgery and, as such, help explain the increasing popularity of cosmetic breast-augmentation surgery. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study.

    PubMed

    Rothfeld, Alex; Pawlak, Amanda; Liebler, Stephenie A H; Morris, Michael; Paci, James M

    2018-04-01

    Patellar tendon repair with braided polyethylene suture alone is subject to knot slippage and failure. Several techniques to augment the primary repair have been described. Purpose/Hypothesis: The purpose was to evaluate a novel patellar tendon repair technique augmented with a knotless suture anchor internal brace with suture tape (SAIB). The hypothesis was that this technique would be biomechanically superior to a nonaugmented repair and equivalent to a standard augmentation with an 18-gauge steel wire. Controlled laboratory study. Midsubstance patellar tendon tears were created in 32 human cadaveric knees. Two comparison groups were created. Group 1 compared #2 supersuture repair without augmentation to #2 supersuture repair with SAIB augmentation. Group 2 compared #2 supersuture repair with an 18-gauge stainless steel cerclage wire augmentation to #2 supersuture repair with SAIB augmentation. The specimens were potted and biomechanically loaded on a materials testing machine. Yield load, maximum load, mode of failure, plastic displacement, elastic displacement, and total displacement were calculated for each sample. Standard statistical analysis was performed. There was a statistically significant increase in the mean ± SD yield load and maximum load in the SAIB augmentation group compared with supersuture alone (mean yield load: 646 ± 202 N vs 229 ± 60 N; mean maximum load: 868 ± 162 N vs 365 ± 54 N; P < .001). Group 2 showed no statistically significant differences between the augmented repairs (mean yield load: 495 ± 213 N vs 566 ± 172 N; P = .476; mean maximum load: 737 ± 210 N vs 697 ± 130 N; P = .721). Patellar tendon repair augmented with SAIB is biomechanically superior to repair without augmentation and is equivalent to repair with augmentation with an 18-gauge stainless steel cerclage wire. This novel patellar tendon repair augmentation is equivalent to standard 18-gauge wire augmentation at time zero. It does not require a second surgery for

  4. Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

    PubMed

    Oates, Jayson; Sharp, Gemma

    2017-10-01

    Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  5. AAtS over AeroMACS Technology Trials on the Airport Surface

    NASA Technical Reports Server (NTRS)

    Apaza, Rafael; Abraham, Biruk; Maeda, Toshihide

    2016-01-01

    Air-Ground component of SWIM; Enables enhanced two-way information exchanges between flight operators, aircrew, and ATSP (TFM); Used in all flight domains including pre-departure and post-arrival; Aircrew active in CDM; For strategic planning, advisory information; Not for command control (data voice) Wireless communications system for airport surface; Family member of Mobile WiMAX: (IEEE802.16e), Band 5091-5150 MHz, Bandwidth 5 MHz - TDDOFDMA - Adaptive Modulation and Coding - Quality of Service (QoS)

  6. Accelerated Spirometric Decline in New York City Firefighters With α1-Antitrypsin Deficiency

    PubMed Central

    Brantly, Mark; Izbicki, Gabriel; Hall, Charles; Shanske, Alan; Chavko, Robert; Santhyadka, Ganesha; Christodoulou, Vasilios; Weiden, Michael D.; Prezant, David J.

    2010-01-01

    Background: On September 11, 2001, the World Trade Center (WTC) collapse caused massive air pollution, producing variable amounts of lung function reduction in the New York City Fire Department (FDNY) rescue workforce. α1-Antitrypsin (AAT) deficiency is a risk factor for obstructive airway disease. Methods: This prospective, longitudinal cohort study of the first 4 years post-September 11, 2001, investigated the influence of AAT deficiency on adjusted longitudinal spirometric change (FEV1) in 90 FDNY rescue workers with WTC exposure. Workers with protease inhibitor (Pi) Z heterozygosity were considered moderately AAT deficient. PiS homozygosity or PiS heterozygosity without concomitant PiZ heterozygosity was considered mild deficiency, and PiM homozygosity was considered normal. Alternately, workers had low AAT levels if serum AAT was ≤ 20 μmol/L. Results: In addition to normal aging-related decline (37 mL/y), significant FEV1 decline accelerations developed with increasing AAT deficiency severity (110 mL/y for moderate and 32 mL/y for mild) or with low AAT serum levels (49 mL/y). Spirometric rates pre-September 11, 2001, did not show accelerations with AAT deficiency. Among workers with low AAT levels, cough persisted in a significant number of participants at 4 years post-September 11, 2001. Conclusions: FDNY rescue workers with AAT deficiency had significant spirometric decline accelerations and persistent airway symptoms during the first 4 years after WTC exposure, representing a novel gene-by-environment interaction. Clinically meaningful decline acceleration occurred even with the mild serum AAT level reductions associated with PiS heterozygosity (without concomitant PiZ heterozygosity). PMID:20634282

  7. CityGuideTour Toruń - tourist application using augmented reality

    NASA Astrophysics Data System (ADS)

    Węgrzyn, Magdalena; Mościcka, Albina

    2017-12-01

    The aim of the article is to show the possibilities of augmented reality in the fi eld of geodesy and cartography. It discusses the concept of augmented reality, its origins and development, as well as areas of the existing applications. The practical functioning of augmented reality in the area of geodesy and cartography is presented on the example of an application developed for the tourist city of Toruń, created with the use of CityGuideTour software. The principles of developing an application and the way it operates are also discussed. As a result, a fully operational bilingual application is available free of charge on the Web.

  8. Exposure Therapy for Fear of Spiders in an Adult with Learning Disabilities: A Case Report

    ERIC Educational Resources Information Center

    Cowdrey, Felicity A.; Walz, Linda

    2015-01-01

    The evidence-base for exposure therapy in people with learning disabilities experiencing specific phobias is sparse. This case study describes the assessment, formulation and treatment of spider phobia in a woman with learning disabilities using an exposure-based intervention augmented with mindfulness practice and bereavement work. To evaluate…

  9. On Location Learning: Authentic Applied Science with Networked Augmented Realities

    ERIC Educational Resources Information Center

    Rosenbaum, Eric; Klopfer, Eric; Perry, Judy

    2007-01-01

    The learning of science can be made more like the practice of science through authentic simulated experiences. We have created a networked handheld Augmented Reality environment that combines the authentic role-playing of Augmented Realities and the underlying models of Participatory Simulations. This game, known as Outbreak @ The Institute, is…

  10. Augmented Reality Learning Experiences: Survey of Prototype Design and Evaluation

    ERIC Educational Resources Information Center

    Santos, Marc Ericson C.; Chen, Angie; Taketomi, Takafumi; Yamamoto, Goshiro; Miyazaki, Jun; Kato, Hirokazu

    2014-01-01

    Augmented reality (AR) technology is mature for creating learning experiences for K-12 (pre-school, grade school, and high school) educational settings. We reviewed the applications intended to complement traditional curriculum materials for K-12. We found 87 research articles on augmented reality learning experiences (ARLEs) in the IEEE Xplore…

  11. Constructing Liminal Blends in a Collaborative Augmented-Reality Learning Environment

    ERIC Educational Resources Information Center

    Enyedy, Noel; Danish, Joshua A.; DeLiema, David

    2015-01-01

    In vision-based augmented-reality (AR) environments, users view the physical world through a video feed or device that "augments" the display with a graphical or informational overlay. Our goal in this manuscript is to ask "how" and "why" these new technologies create opportunities for learning. We suggest that AR is…

  12. Augmentation of Cognition and Perception Through Advanced Synthetic Vision Technology

    NASA Technical Reports Server (NTRS)

    Prinzel, Lawrence J., III; Kramer, Lynda J.; Bailey, Randall E.; Arthur, Jarvis J.; Williams, Steve P.; McNabb, Jennifer

    2005-01-01

    Synthetic Vision System technology augments reality and creates a virtual visual meteorological condition that extends a pilot's cognitive and perceptual capabilities during flight operations when outside visibility is restricted. The paper describes the NASA Synthetic Vision System for commercial aviation with an emphasis on how the technology achieves Augmented Cognition objectives.

  13. Radiative Augmented Combustion

    DTIC Science & Technology

    1988-03-01

    PbLFICE SY 7a NAME OF MONITORING ORGANIZATION M.L. ENERGIA , Inc. AFOSR/NA 6r. ADDRESS (City. State. anW ZIP Code) 7b. ADDRESS (City State, and ZIPCode...27 -00 N ’fPECTED 0 6I FOREWORD This is the Final Report on research on Radiative Augmented Combustion conducted at M. L. ENERGIA , Inc. It was a...the first two annual reports prior to this one. The entire research program was performed at ENERGIA , Inc., Princeton, New Jersey, with Dr. Moshe Lavid

  14. Prevalence of alpha-1 antitrypsin deficiency and allele frequency in patients with COPD in Brazil.

    PubMed

    Russo, Rodrigo; Zillmer, Laura Russo; Nascimento, Oliver Augusto; Manzano, Beatriz; Ivanaga, Ivan Teruaki; Fritscher, Leandro; Lundgren, Fernando; Miravitlles, Marc; Gondim, Heicilainy Del Carlos; Santos, Gildo; Alves, Marcela Amorim; Oliveira, Maria Vera; Souza, Altay Alves Lino de; Sales, Maria Penha Uchoa; Jardim, José Roberto

    2016-01-01

    To determine the prevalence of alpha 1-antitrypsin (AAT) deficiency (AATD), as well as allele frequency, in COPD patients in Brazil. This was a cross-sectional study involving 926 COPD patients 40 years of age or older, from five Brazilian states. All patients underwent determination of AAT levels in dried blood spot (DBS) samples by nephelometry. Those with DBS AAT levels ≤ 2.64 mg/dL underwent determination of serum AAT levels. Those with serum AAT levels of < 113 mg/dL underwent genotyping. In case of conflicting results, SERPINA1 gene sequencing was performed. Of the 926 COPD patients studied, 85 had DBS AAT levels ≤ 2.64 mg/dL, and 24 (2.6% of the study sample) had serum AAT levels of < 113 mg/dL. Genotype distribution in this subset of 24 patients was as follows: PI*MS, in 3 (12.5%); PI*MZ, in 13 (54.2%); PI*SZ, in 1 (4.2%); PI*SS, in 1 (4.2%); and PI*ZZ, in 6 (25.0%). In the sample as a whole, the overall prevalence of AATD was 2.8% and the prevalence of the PI*ZZ genotype (severe AATD) was 0.8. The prevalence of AATD in COPD patients in Brazil is similar to that found in most countries and reinforces the recommendation that AAT levels be measured in all COPD patients. Determinar a prevalência da deficiência de alfa 1-antitripsina (AAT), bem como a frequência alélica, em pacientes com DPOC no Brasil. Estudo transversal com 926 pacientes com DPOC, com 40 anos ou mais, oriundos de cinco estados brasileiros. Todos os pacientes foram submetidos a dosagem de AAT em amostras de sangue seco por meio de nefelometria. Aqueles em que a concentração de AAT no sangue seco foi ≤ 2,64 mg/dl foram submetidos a dosagem sérica de AAT. Aqueles em que a concentração sérica de AAT foi < 113 mg/dl foram submetidos a genotipagem. Quando os resultados foram discrepantes, foi realizado o sequenciamento do gene SERPINA1. Dos 926 pacientes com DPOC estudados, 85 apresentaram concentração de AAT em sangue seco ≤ 2,64 mg/dl, e 24 (2,6% da amostra) apresentaram

  15. The augmentation algorithm and molecular phylogenetic trees

    NASA Technical Reports Server (NTRS)

    Holmquist, R.

    1978-01-01

    Moore's (1977) augmentation procedure is discussed, and it is concluded that the procedure is valid for obtaining estimates of the total number of fixed nucleotide substitutions both theoretically and in practice, for both simulated and real data, and in agreement, for experimentally dense data sets, with stochastic estimates of the divergence, provided the restrictions on codon mutability resulting from natural selection are explicitly allowed for. Tateno and Nei's (1978) critique that the augmentation procedure has a systematic bias toward overestimation of the total number of nucleotide replacements is disputed, and a data analysis suggests that ancestral sequences inferred by the method of parsimony contain a large number of incorrectly assigned nucleotides.

  16. Human-in-the-loop evaluation of RMS Active Damping Augmentation

    NASA Technical Reports Server (NTRS)

    Demeo, Martha E.; Gilbert, Michael G.; Scott, Michael A.; Lepanto, Janet A.; Bains, Elizabeth M.; Jensen, Mary C.

    1993-01-01

    Active Damping Augmentation is the insertion of Controls-Structures Integration Technology to benefit the on-orbit performance of the Space Shuttle Remote Manipulator System. The goal is to reduce the vibration decay time of the Remote Manipulator System following normal payload maneuvers and operations. Simulation of Active Damping Augmentation was conducted in the realtime human-in-the-loop Systems Engineering Simulator at the NASA Johnson Space Center. The objective of this study was to obtain a qualitative measure of operational performance improvement from astronaut operators and to obtain supporting quantitative performance data. Sensing of vibratory motions was simulated using a three-axis accelerometer mounted at the end of the lower boom of the Remote Manipulator System. The sensed motions were used in a feedback control law to generate commands to the joint servo mechanisms which reduced the unwanted oscillations. Active damping of the Remote Manipulator System with an attached 3990 lb. payload was successfully demonstrated. Six astronaut operators examined the performance of an Active Damping Augmentation control law following single-joint and coordinated six-joint translational and rotational maneuvers. Active Damping Augmentation disturbance rejection of Orbiter thruster firings was also evaluated. Significant reductions in the dynamic response of the 3990 lb. payload were observed. Astronaut operators recommended investigation of Active Damping Augmentation benefits to heavier payloads where oscillations are a bigger problem (e.g. Space Station Freedom assembly operators).

  17. Detonation wave augmentation of gas turbines

    NASA Technical Reports Server (NTRS)

    Wortman, A.

    1984-01-01

    The results of a feasibility study that examined the effects of using detonation waves to augment the performance of gas turbines are reported. The central ideas were to reduce compressor requirements and to maintain high performance in jet engines. Gasdynamic equations were used to model the flows associated with shock waves generated by the detonation of fuel in detonator tubes. Shock wave attenuation to the level of Mach waves was found possible, thus eliminating interference with the compressor and the necessity of valves and seals. A preliminary parametric study of the performance of a compressor working at a 4:1 ratio in a conceptual design of a detonation wave augmented jet engine in subsonic flight indicated a clear superiority over conventional designs in terms of fuel efficiency and thrust.

  18. [CSE vs. augmented epidural anesthesia for cesarean section. Spinal and epidural anesthesia with bupivacaine 0.5% "isobar" require augmentation].

    PubMed

    Halter, F; Niesel, H C; Gladrow, W; Kaiser, H

    1998-09-01

    Incomplete anaesthesia is a major clinical problem both in single spinal and in single epidural anaesthesia. The clinical efficacy of epidural anaesthesia with augmentation (aEA) and combined epidural and spinal anesthesia (CSE) for cesarean section was investigated in a prospective randomized study on 45 patients. Anaesthesia extending up to Th5 was aimed for. Depending on the patient's height, epidural anaesthesia was administered with a dose of 18-22 ml 0.5% bupivacaine and spinal anaesthesia with a dose of 11-15 mg 0.5% bupivacaine. Augmentation was carried out in all cases in epidural anaesthesia, initially with 7.5 ml 1% Lidocaine with epinephrine 1:400,000, raised by 1.5 ml per missing segment. The epidural reinjection in CSE was carried out as necessary with 9.5-15 ml 1% lidocaine with epinephrine, depending on the height and difference from the segment Th5. The extension of anaesthesia achieved in epidural anaesthesia after an initial dose of 101.8 mg bupivacaine and augmenting dose of 99 mg lidocaine reached the segment Th5. The primary spinal anaesthesia dose up to 15 mg corresponding to height led to a segmental extension to a maximum of Th3 under CSE. Augmentation was necessary in 13 patients; in 5 cases because of inadequate extent of anaesthesia and 8 cases because of pain resulting from premature reversion. The augmenting dose required was 13.9 ml. Readiness for operation was attained after 19.8 min (aEA) and after 10.5 min (CSE). No patient required analgesics before delivery. The additional analgesic requirement during operation was 63.6% (aEA) and 39.1% (CSE). Taking into account pain in the area of surgery, the requirement of analgesics was 50% (aEA) vs. 17.4% (CSE). Antiemetics were required in 18.2 (aEA) and in 65.2% (CSE). The systolic blood pressure fell by 17.7% (aEA) and in 30.3% (CSE). The minimum systolic pressure was observed after 13.4 min in aEA, and after 9.5 min in CSE. The APGAR score and the umbilical pH did not show any

  19. Corticosteroids augment BRAF inhibitor vemurafenib induced lymphopenia and risk of infection.

    PubMed

    Sondermann, Wiebke; Griewank, Klaus G; Schilling, Bastian; Livingstone, Elisabeth; Leyh, Julia C; Rompoti, Natalia; Cosgarea, Ioana; Schimming, Tobias; Schadendorf, Dirk; Zimmer, Lisa; Hillen, Uwe

    2015-01-01

    We have previously demonstrated an impact of the BRAF inhibitor vemurafenib on patient lymphocyte counts. In the current study, the extent to which concomitant use of corticosteroids in BRAF inhibitor treated patients affects lymphocyte counts and predisposes to infection was investigated. A cohort of 102 patients receiving either the selective BRAF inhibitor vemurafenib or dabrafenib was analyzed. The amount of patients receiving either medication with or without systemic corticosteroids (dexamethasone) was determined and lymphocyte counts before and under therapy assessed. Additionally, the number and severity of infections occurring in these groups was analyzed. Vemurafenib treatment led to a considerable decrease in lymphocyte cell counts, with 62.3% of patients having lymphopenia. Dabrafenib treated patients only rarely demonstrated lymphopenia (12.5%). Dexamethasone co-administration further diminished lymphocyte counts. Lymphopenias were observed in 84.6% of patients receiving vemurafenib and dexamethasone. In our cohort, infections were noted in 9 patients, 4 of these were severe and 2 eventually fatal. All 9 cases with infections demonstrated lymphopenia, 8 of these had received dexamethasone and 7 of these a therapy with vemurafenib. Our findings demonstrate a significant lymphopenia in patients treated with the BRAF inhibitor vemurafenib, which is further augmented by dexamethasone and predisposes to infection. If validated in other studies, risk of infection should be considered when applying corticosteroids in combination with BRAF inhibitors, in particular vemurafenib.

  20. What is going on in augmented reality simulation in laparoscopic surgery?

    PubMed

    Botden, Sanne M B I; Jakimowicz, Jack J

    2009-08-01

    To prevent unnecessary errors and adverse results of laparoscopic surgery, proper training is of paramount importance. A safe way to train surgeons for laparoscopic skills is simulation. For this purpose traditional box trainers are often used, however they lack objective assessment of performance. Virtual reality laparoscopic simulators assess performance, but lack realistic haptic feedback. Augmented reality (AR) combines a virtual reality (VR) setting with real physical materials, instruments, and feedback. This article presents the current developments in augmented reality laparoscopic simulation. Pubmed searches were performed to identify articles regarding surgical simulation and augmented reality. Identified companies manufacturing an AR laparoscopic simulator received the same questionnaire referring to the features of the simulator. Seven simulators that fitted the definition of augmented reality were identified during the literature search. Five of the approached manufacturers returned a completed questionnaire, of which one simulator appeared to be VR and was therefore not applicable for this review. Several augmented reality simulators have been developed over the past few years and they are improving rapidly. We recommend the development of AR laparoscopic simulators for component tasks of procedural training. AR simulators should be implemented in current laparoscopic training curricula, in particular for laparoscopic suturing training.

  1. The effect of in situ augmentation on implant anchorage in proximal humeral head fractures.

    PubMed

    Unger, Stefan; Erhart, Stefanie; Kralinger, Franz; Blauth, Michael; Schmoelz, Werner

    2012-10-01

    Fracture fixation in patients suffering from osteoporosis is difficult as sufficient implant anchorage is not always possible. One method to enhance implant anchorage is implant/screw augmentation with PMMA-cement. The present study investigated the feasibility of implant augmentation with PMMA-cement to enhance implant anchorage in the proximal humerus. A simulated three part humeral head fracture was stabilised with an angular stable plating system in 12 pairs of humeri using six head screws. In the augmentation group the proximal four screws were treated with four cannulated screws, each augmented with 0.5ml of PMMA-cement, whereas the contra lateral side served as a non-augmented control. Specimens were loaded in varus-bending or axial-rotation using a cyclic loading protocol with increasing load magnitude until failure of the osteosynthesis occurred. Augmented specimens showed a significant higher number of load cycles until failure than non-augment specimens (varus-bending: 8516 (SD 951.6) vs. 5583 (SD 2273.6), P=0.014; axial-rotation: 3316 (SD 348.8) vs. 2050 (SD 656.5), P=0.003). Non-augmented specimens showed a positive correlation of load cycles until failure and measured bone mineral density (varus-bending: r=0.893, P=0.016; axial-rotation: r=0.753, P=0.084), whereas no correlation was present in augmented specimens (varus-bending: r=0,258, P=0.621; axial-rotation r=0.127, P=0.810). These findings suggest that augmentation of cannulated screws is a feasible method to enhance implant/screw anchorage in the humeral head. The improvement of screw purchase is increasing with decreasing bone mineral density. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Experimental Investigation of Turbojet Thrust Augmentation Using an Ejector

    DTIC Science & Technology

    2007-03-01

    mechanisms in which a particle can exchange energy. Thrust augmenting devices can be divided into two categories: ones that exchange net work or heat and...two categories from the energy equation discussion above. Thrust augmentation is achieved through turbulent entrainment where work and/or heat is...front sustained by compression waves from a trailing reaction zone. A deflagration wave is a subsonic flame front sustained by heat transfer

  3. Perform light and optic experiments in Augmented Reality

    NASA Astrophysics Data System (ADS)

    Wozniak, Peter; Vauderwange, Oliver; Curticapean, Dan; Javahiraly, Nicolas; Israel, Kai

    2015-10-01

    In many scientific studies lens experiments are part of the curriculum. The conducted experiments are meant to give the students a basic understanding for the laws of optics and its applications. Most of the experiments need special hardware like e.g. an optical bench, light sources, apertures and different lens types. Therefore it is not possible for the students to conduct any of the experiments outside of the university's laboratory. Simple optical software simulators enabling the students to virtually perform lens experiments already exist, but are mostly desktop or web browser based. Augmented Reality (AR) is a special case of mediated and mixed reality concepts, where computers are used to add, subtract or modify one's perception of reality. As a result of the success and widespread availability of handheld mobile devices, like e.g. tablet computers and smartphones, mobile augmented reality applications are easy to use. Augmented reality can be easily used to visualize a simulated optical bench. The students can interactively modify properties like e.g. lens type, lens curvature, lens diameter, lens refractive index and the positions of the instruments in space. Light rays can be visualized and promote an additional understanding of the laws of optics. An AR application like this is ideally suited to prepare the actual laboratory sessions and/or recap the teaching content. The authors will present their experience with handheld augmented reality applications and their possibilities for light and optic experiments without the needs for specialized optical hardware.

  4. Validating MODIS above-cloud aerosol optical depth retrieved from "color ratio" algorithm using direct measurements made by NASA's airborne AATS and 4STAR sensors

    NASA Astrophysics Data System (ADS)

    Jethva, Hiren; Torres, Omar; Remer, Lorraine; Redemann, Jens; Livingston, John; Dunagan, Stephen; Shinozuka, Yohei; Kacenelenbogen, Meloe; Segal Rosenheimer, Michal; Spurr, Rob

    2016-10-01

    We present the validation analysis of above-cloud aerosol optical depth (ACAOD) retrieved from the "color ratio" method applied to MODIS cloudy-sky reflectance measurements using the limited direct measurements made by NASA's airborne Ames Airborne Tracking Sunphotometer (AATS) and Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR) sensors. A thorough search of the airborne database collection revealed a total of five significant events in which an airborne sun photometer, coincident with the MODIS overpass, observed partially absorbing aerosols emitted from agricultural biomass burning, dust, and wildfires over a low-level cloud deck during SAFARI-2000, ACE-ASIA 2001, and SEAC4RS 2013 campaigns, respectively. The co-located satellite-airborne matchups revealed a good agreement (root-mean-square difference < 0.1), with most matchups falling within the estimated uncertainties associated the MODIS retrievals (about -10 to +50 %). The co-retrieved cloud optical depth was comparable to that of the MODIS operational cloud product for ACE-ASIA and SEAC4RS, however, higher by 30-50 % for the SAFARI-2000 case study. The reason for this discrepancy could be attributed to the distinct aerosol optical properties encountered during respective campaigns. A brief discussion on the sources of uncertainty in the satellite-based ACAOD retrieval and co-location procedure is presented. Field experiments dedicated to making direct measurements of aerosols above cloud are needed for the extensive validation of satellite-based retrievals.

  5. Validating MODIS Above-Cloud Aerosol Optical Depth Retrieved from Color Ratio Algorithm Using Direct Measurements Made by NASA's Airborne AATS and 4STAR Sensors

    NASA Technical Reports Server (NTRS)

    Jethva, Hiren; Torres, Omar; Remer, Lorraine; Redemann, Jens; Livingston, John; Dunagan, Stephen; Shinozuka, Yohei; Kacenelenbogen, Meloe; Segal Rozenhaimer, Michal; Spurr, Rob

    2016-01-01

    We present the validation analysis of above-cloud aerosol optical depth (ACAOD) retrieved from the color ratio method applied to MODIS cloudy-sky reflectance measurements using the limited direct measurements made by NASAs airborne Ames Airborne Tracking Sunphotometer (AATS) and Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR) sensors. A thorough search of the airborne database collection revealed a total of five significant events in which an airborne sun photometer, coincident with the MODIS overpass, observed partially absorbing aerosols emitted from agricultural biomass burning, dust, and wildfires over a low-level cloud deck during SAFARI-2000, ACE-ASIA 2001, and SEAC4RS 2013 campaigns, respectively. The co-located satellite-airborne match ups revealed a good agreement (root-mean-square difference less than 0.1), with most match ups falling within the estimated uncertainties associated with the MODIS retrievals (about -10 to +50 ). The co-retrieved cloud optical depth was comparable to that of the MODIS operational cloud product for ACE-ASIA and SEAC4RS, however, higher by 30-50% for the SAFARI-2000 case study. The reason for this discrepancy could be attributed to the distinct aerosol optical properties encountered during respective campaigns. A brief discussion on the sources of uncertainty in the satellite-based ACAOD retrieval and co-location procedure is presented. Field experiments dedicated to making direct measurements of aerosols above cloud are needed for the extensive validation of satellite based retrievals.

  6. An Analysis of Engagement in a Combination Indoor/Outdoor Augmented Reality Educational Game

    ERIC Educational Resources Information Center

    Folkestad, James; O'Shea, Patrick

    2011-01-01

    This paper describes the results of a qualitative analysis of video captured during a dual indoor/outdoor Augmented Reality experience. Augmented Reality is the layering of virtual information on top of the physical world. This Augmented Reality experience asked students to interact with the San Diego Museum of Art and the Botanical Gardens in San…

  7. Some tests on small-scale rectangular throat ejector. [thrust augmentation for V/STOL aircraft

    NASA Technical Reports Server (NTRS)

    Dean, W. N., Jr.; Franke, M. E.

    1979-01-01

    A small scale rectangular throat ejector with plane slot nozzles and a fixed throat area was tested to determine the effects of diffuser sidewall length, diffuser area ratio, and sidewall nozzle position on thrust and mass augmentation. The thrust augmentation ratio varied from approximately 0.9 to 1.1. Although the ejector did not have good thrust augmentation performance, the effects of the parameters studied are believed to indicate probable trends in thrust augmenting ejectors.

  8. Outcomes of rotator cuff augmentation surgery with autologous fascia lata.

    PubMed

    Rosales-Varo, A P; García-Espona, M A; Roda-Murillo, O

    To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients. The follow-up period lasted for one year post-intervention. We measured variables for tear type, functionality and pain, both baseline and at 6 and 12-month follow ups. We evaluated retear incidence in each group as well as each group's pain and functionality response. The improved pain levels in the non-graft group evolved gradually over time. Conversely, in the group with the augmentation grafts, average Constant-Murley shoulder outcome scores at six months were already above 10 and were maintained at 12 months. One retear occurred in the graft group and 2 in the group without grafts, thus presenting no significant differences. There were no significant changes in pain and function values at the one year follow up in either group. Our preliminary results regarding rotator cuff augmentation surgery with autologous fascia lata showed a significant improvement in pain levels after 6 months compared to the patients with no augmentation, who required 12 months to reach the same values. After a year of follow up, there were no differences between the mean Constant and pain scores in either intervention group The number of retears in the non-graft group was greater than that in the group with grafts although the difference was not significant. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Assessing the effectiveness of a 3-month day-and-night home closed-loop control combined with pump suspend feature compared with sensor-augmented pump therapy in youths and adults with suboptimally controlled type 1 diabetes: a randomised parallel study protocol

    PubMed Central

    Bally, Lia; Thabit, Hood; Tauschmann, Martin; Allen, Janet M; Hartnell, Sara; Wilinska, Malgorzata E; Exall, Jane; Huegel, Viki; Sibayan, Judy; Borgman, Sarah; Cheng, Peiyao; Blackburn, Maxine; Lawton, Julia; Elleri, Daniela; Leelarathna, Lalantha; Acerini, Carlo L; Campbell, Fiona; Shah, Viral N; Criego, Amy; Evans, Mark L; Dunger, David B; Kollman, Craig; Bergenstal, Richard M; Hovorka, Roman

    2017-01-01

    Introduction Despite therapeutic advances, many individuals with type 1 diabetes are unable to achieve tight glycaemic target without increasing the risk of hypoglycaemia. The objective of this study is to determine the effectiveness of a 3-month day-and-night home closed-loop glucose control combined with a pump suspend feature, compared with sensor-augmented insulin pump therapy in youths and adults with suboptimally controlled type 1 diabetes. Methods and analysis The study adopts an open-label, multi-centre, multi-national (UK and USA), randomised, single-period, parallel design and aims for 84 randomised patients. Participants are youths (6–21 years) or adults (>21 years) with type 1 diabetes treated with insulin pump therapy and suboptimal glycaemic control (glycated haemoglobin (HbA1c) ≥7.5% (58 mmol/mol) and ≤10% (86 mmol/mol)). Following a 4-week run-in period, eligible participants will be randomised to a 3-month use of automated closed-loop insulin delivery combined with pump suspend feature or to sensor-augmented insulin pump therapy. Analyses will be conducted on an intention-to-treat basis. The primary outcome is the time spent in the target glucose range from 3.9 to 10.0 mmol/L based on continuous glucose monitoring levels during the 3-month free-living phase. Secondary outcomes include HbA1c at 3 months, mean glucose, time spent below and above target; time with glucose levels <3.5 and <2.8 mmol/L; area under the curve when sensor glucose is <3.5 mmol/L, time with glucose levels >16.7 mmol/L, glucose variability; total, basal and bolus insulin dose and change in body weight. Participants’ and their families’ perception in terms of lifestyle change, daily diabetes management and fear of hypoglycaemia will be evaluated. Ethics and dissemination Ethics/institutional review board approval has been obtained. Before screening, all participants/guardians will be provided with oral and written information about the trial. The study

  10. Assessing the effectiveness of a 3-month day-and-night home closed-loop control combined with pump suspend feature compared with sensor-augmented pump therapy in youths and adults with suboptimally controlled type 1 diabetes: a randomised parallel study protocol.

    PubMed

    Bally, Lia; Thabit, Hood; Tauschmann, Martin; Allen, Janet M; Hartnell, Sara; Wilinska, Malgorzata E; Exall, Jane; Huegel, Viki; Sibayan, Judy; Borgman, Sarah; Cheng, Peiyao; Blackburn, Maxine; Lawton, Julia; Elleri, Daniela; Leelarathna, Lalantha; Acerini, Carlo L; Campbell, Fiona; Shah, Viral N; Criego, Amy; Evans, Mark L; Dunger, David B; Kollman, Craig; Bergenstal, Richard M; Hovorka, Roman

    2017-07-13

    Despite therapeutic advances, many individuals with type 1 diabetes are unable to achieve tight glycaemic target without increasing the risk of hypoglycaemia. The objective of this study is to determine the effectiveness of a 3-month day-and-night home closed-loop glucose control combined with a pump suspend feature, compared with sensor-augmented insulin pump therapy in youths and adults with suboptimally controlled type 1 diabetes. The study adopts an open-label, multi-centre, multi-national (UK and USA), randomised, single-period, parallel design and aims for 84 randomised patients. Participants are youths (6-21 years) or adults (>21 years) with type 1 diabetes treated with insulin pump therapy and suboptimal glycaemic control (glycated haemoglobin (HbA1c) ≥7.5% (58 mmol/mol) and ≤10% (86 mmol/mol)). Following a 4-week run-in period, eligible participants will be randomised to a 3-month use of automated closed-loop insulin delivery combined with pump suspend feature or to sensor-augmented insulin pump therapy. Analyses will be conducted on an intention-to-treat basis. The primary outcome is the time spent in the target glucose range from 3.9 to 10.0 mmol/L based on continuous glucose monitoring levels during the 3-month free-living phase. Secondary outcomes include HbA1c at 3 months, mean glucose, time spent below and above target; time with glucose levels <3.5 and <2.8 mmol/L; area under the curve when sensor glucose is <3.5 mmol/L, time with glucose levels >16.7 mmol/L, glucose variability; total, basal and bolus insulin dose and change in body weight. Participants' and their families' perception in terms of lifestyle change, daily diabetes management and fear of hypoglycaemia will be evaluated. Ethics/institutional review board approval has been obtained. Before screening, all participants/guardians will be provided with oral and written information about the trial. The study will be disseminated by peer-reviewed publications and conference

  11. Liver cell therapy and tissue engineering for transplantation.

    PubMed

    Vacanti, Joseph P; Kulig, Katherine M

    2014-06-01

    Liver transplantation remains the only definitive treatment for liver failure and is available to only a tiny fraction of patients with end-stage liver diseases. Major limitations for the procedure include donor organ shortage, high cost, high level of required expertise, and long-term consequences of immune suppression. Alternative cell-based liver therapies could potentially greatly expand the number of patients provided with effective treatment. Investigative research into augmenting or replacing liver function extends into three general strategies. Bioartificial livers (BALs) are extracorporeal devices that utilize cartridges of primary hepatocytes or cell lines to process patient plasma. Injection of liver cell suspensions aims to foster organ regeneration or provide a missing metabolic function arising from a genetic defect. Tissue engineering recreates the organ in vitro for subsequent implantation to augment or replace patient liver function. Translational models and clinical trials have highlighted both the immense challenges involved and some striking examples of success. Copyright © 2014. Published by Elsevier Inc.

  12. Thrust augmentation nozzle (TAN) concept for rocket engine booster applications

    NASA Astrophysics Data System (ADS)

    Forde, Scott; Bulman, Mel; Neill, Todd

    2006-07-01

    Aerojet used the patented thrust augmented nozzle (TAN) concept to validate a unique means of increasing sea-level thrust in a liquid rocket booster engine. We have used knowledge gained from hypersonic Scramjet research to inject propellants into the supersonic region of the rocket engine nozzle to significantly increase sea-level thrust without significantly impacting specific impulse. The TAN concept overcomes conventional engine limitations by injecting propellants and combusting in an annular region in the divergent section of the nozzle. This injection of propellants at moderate pressures allows for obtaining high thrust at takeoff without overexpansion thrust losses. The main chamber is operated at a constant pressure while maintaining a constant head rise and flow rate of the main propellant pumps. Recent hot-fire tests have validated the design approach and thrust augmentation ratios. Calculations of nozzle performance and wall pressures were made using computational fluid dynamics analyses with and without thrust augmentation flow, resulting in good agreement between calculated and measured quantities including augmentation thrust. This paper describes the TAN concept, the test setup, test results, and calculation results.

  13. Analysis of multinomial models with unknown index using data augmentation

    USGS Publications Warehouse

    Royle, J. Andrew; Dorazio, R.M.; Link, W.A.

    2007-01-01

    Multinomial models with unknown index ('sample size') arise in many practical settings. In practice, Bayesian analysis of such models has proved difficult because the dimension of the parameter space is not fixed, being in some cases a function of the unknown index. We describe a data augmentation approach to the analysis of this class of models that provides for a generic and efficient Bayesian implementation. Under this approach, the data are augmented with all-zero detection histories. The resulting augmented dataset is modeled as a zero-inflated version of the complete-data model where an estimable zero-inflation parameter takes the place of the unknown multinomial index. Interestingly, data augmentation can be justified as being equivalent to imposing a discrete uniform prior on the multinomial index. We provide three examples involving estimating the size of an animal population, estimating the number of diabetes cases in a population using the Rasch model, and the motivating example of estimating the number of species in an animal community with latent probabilities of species occurrence and detection.

  14. Stimulus augmenting and field dependence in children of alcoholic fathers.

    PubMed

    Hennecke, L

    1984-11-01

    The relationship between paternal alcoholism and two perceptual characteristics, stimulus augmenting and field dependence, was tested in boys and girls aged 10-12. Thirty children of alcoholic fathers, presumed at high risk for the disease because of its familial-genetic component, were compared with 30 children of nonalcoholic parents. Stimulus augmenting was measured by the Kinesthetic Figural After-Effect (KFA) test and field dependence by the Embedded Figures Test (EFT). It was reasoned that the consistent findings of field dependence in alcoholics could be a manifestation of brain damage and the consequent cognitive deficits often found in alcoholics. Thus it was proposed that field dependence would not differentiate the children of alcoholic fathers from those of nonalcoholics. No difference in field dependence was found between the groups, which supports other evidence that alcoholism can lead to field dependence. Since KFA scores revealed a significantly higher incidence of stimulus augmenters in the children of alcoholic fathers, it is proposed that stimulus augmenting is premorbid to alcoholism. It remains unclear, however, whether this phenomenon is due to an environmental or genetic factor.

  15. Construction of ontology augmented networks for protein complex prediction.

    PubMed

    Zhang, Yijia; Lin, Hongfei; Yang, Zhihao; Wang, Jian

    2013-01-01

    Protein complexes are of great importance in understanding the principles of cellular organization and function. The increase in available protein-protein interaction data, gene ontology and other resources make it possible to develop computational methods for protein complex prediction. Most existing methods focus mainly on the topological structure of protein-protein interaction networks, and largely ignore the gene ontology annotation information. In this article, we constructed ontology augmented networks with protein-protein interaction data and gene ontology, which effectively unified the topological structure of protein-protein interaction networks and the similarity of gene ontology annotations into unified distance measures. After constructing ontology augmented networks, a novel method (clustering based on ontology augmented networks) was proposed to predict protein complexes, which was capable of taking into account the topological structure of the protein-protein interaction network, as well as the similarity of gene ontology annotations. Our method was applied to two different yeast protein-protein interaction datasets and predicted many well-known complexes. The experimental results showed that (i) ontology augmented networks and the unified distance measure can effectively combine the structure closeness and gene ontology annotation similarity; (ii) our method is valuable in predicting protein complexes and has higher F1 and accuracy compared to other competing methods.

  16. Comparison of Water Vapor Measurements by Airborne Sun Photometer and Diode Laser Hygrometer on the NASA DC-8

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Livingston, J. M.; Schmid, Beat; Russell, P. B.

    In January-February 2003 the 14-channel NASA Ames Airborne Tracking Sunphotometer 30 (AATS) and the NASA Langley/Ames Diode Laser Hygrometer (DLH) were flown on the NASA DC-8 aircraft. AATS measured column water vapor on the aircraft-to-sun path, while DLH measured local water vapor in the free stream between the aircraft fuselage and an outboard engine cowling. The AATS and DLH measurements were compared for two DC-8 vertical profiles by differentiating the AATS column measurement and/or integrating the DLH local measurement over the altitude range of each profile (7.7-10 km and 1.2-12.5 km). These comparisons extend, for the first time, tests ofmore » AATS water vapor retrievals to altitudes >~6 km and column contents <0.1 g cm-2. To our knowledge this is the first time suborbital spectroscopic water vapor measurements using the 940-nm band have been tested in conditions so high and dry. For both profiles layer water vapor (LWV) from AATS and DLH were highly correlated, with r2 0.998, rms difference 7.2% and bias (AATS minus DLH) 0.9%. For water vapor densities AATS and DLH had r2 0.968, rms difference 27.6%, and bias (AATS minus DLH) -4.2%. These results compare favorably with previous comparisons of AATS water vapor to in situ results for altitudes <~6 km, columns ~0.1 to 5 g cm-2 and densities ~0.1 to 17 g m-3.« less

  17. Bladder augmentation and artificial sphincter implantation: urodynamic behavior and effects on continence.

    PubMed

    Rodó, Juan S; Cáceres, Freud A; Lerena, Javier R; Rossy, Enrica

    2008-02-01

    To quantify changes in bladder capacity, pressure and compliance after isolated bladder augmentation or augmentation associated with implantation of an artificial sphincter, and to compare the various types of augmentation. Preoperative and postoperative urodynamic studies were performed in a group of 38 patients (18 males and 20 females; age range 2-19 years), who underwent a type of bladder augmentation. The bladder improved in capacity in all patients (mean values: initial 137 ml, final 336 ml, individual increase 229 ml; 434%) except two, in which the augmentation was done with ureter. The mean pressure improved (initial 32 cm of H(2)O, final 14, decrease per patient 18 cm of H2O; 49%). The curve of compliance, progressively increasing typical of hyperreflexia and poor compliance, present in 70% of the cases preoperatively, improved in 78% cases postoperatively, although there were several different patterns. Urodynamic behavior was analyzed with regard to the tissue used for augmentation (ileum, ureter or sigmoid colon). In the sigmoid colon group, there were no significant differences in the urodynamic behavior of the bladder neo-reservoir in relation to the configuration used. With bladder augmentation comes an increase in bladder capacity, a reduction in pressure, and an improvement in compliance and continence. The level of change in capacity, pressure and compliance varies with the tissue used and the length and caliber of the insert. When the procedure is carried out using sigmoid colon tissue, there are no noteworthy differences among the various possible configurations.

  18. Evaluating Augmented Reality to Complete a Chain Task for Elementary Students with Autism

    ERIC Educational Resources Information Center

    Cihak, David F.; Moore, Eric J.; Wright, Rachel E.; McMahon, Don D.; Gibbons, Melinda M.; Smith, Cate

    2016-01-01

    The purpose of this study was to examine the effects of augmented reality to teach a chain task to three elementary-age students with autism spectrum disorders (ASDs). Augmented reality blends digital information within the real world. This study used a marker-based augmented reality picture prompt to trigger a video model clip of a student…

  19. Identification and treatment of augmentation in patients with restless legs syndrome: practical recommendations.

    PubMed

    Geyer, James; Bogan, Richard

    2017-09-01

    Restless legs syndrome (RLS) is a chronic disorder causing clinically significant discomfort to approximately 3% of adults. Although RLS was first identified centuries ago, our understanding of this disorder, its causes, and its treatments is still evolving. In particular, our knowledge of the potential negative effects of RLS treatments, including dopaminergic augmentation, continues to expand. Augmentation, which refers to a paradoxical treatment-related increase in RLS symptoms, has been associated with all three dopamine agonists approved for the treatment of RLS - rotigotine, pramipexole, and ropinirole. This review presents key information on prevention and treatment of dopaminergic augmentation from the recently published consensus-based guidelines issued by the International RLS Study Group task force in conjunction with the European RLS Study Group and the RLS Foundation for first-line treatment of RLS/Willis-Ekbom disease. If dopamine agonists are used to treat RLS, it is recommended that the dosage should be kept as low as possible without exceeding the maximum dose recommended for RLS treatment. As the frequency of augmentation with the rotigotine patch may only be slightly lower than that associated with pramipexole or ropinirole, medications that are effective and have little risk of augmentation, such as alpha-2-delta ligands, may be considered for initial RLS treatment. In addition, we present our clinical experience with treating patients with dopaminergic augmentation by highlighting 2 case studies and practical considerations when treating different patient populations. Applying current RLS augmentation diagnosis and treatment guidelines, as well as collecting detailed histories of worsening RLS symptoms, is critical for patient safety and effective management of RLS augmentation.

  20. Photo-activated porphyrin in combination with antibiotics: therapies against Staphylococci

    PubMed Central

    Dastgheyb, Sana S.; Eckmann, David M.; Composto, Russell J.

    2013-01-01

    Staphylococcal infections have become difficult to treat due to antibiotic insensitivity and resistance. Antimicrobial combination therapies may minimize acquisition of resistance and photodynamic therapy is an attractive candidate for these combinations. In this manuscript, we explore combined use of antibiotics and meso-tetra (4-aminophenyl) porphine (TAPP), a cationic porphyrin, for treatment of Staphylococcus aureus contamination. We characterize the antimicrobial activity of photoactivated TAPP and show that activity is largely lost in the presence of a radical scavenger. Importantly, TAPP can be reactivated with continued, albeit attenuated, antibacterial activity. We then show that the antimicrobial activity of illuminated TAPP is additive with chloramphenicol and tobramycin for Staphylococcus aureus and Escherichia coli, and synergistic for MRSA and Staphylococcus epidermidis. Chloramphenicol + methylene blue, another photosensitizer, also show additivity against Staphylococcus aureus. In contrast, ceftriaxone and vancomycin do not strongly augment the low level effects of TAPP against S. aureus. Eukaryotic cells exhibit a dose-dependent toxicity with illuminated TAPP. Our results suggest that even sub-minimum inhibitory concentration levels of photo-activated TAPP could be used to boost the activity of waning antibiotics. This may play an important role in treatments reliant on antibiotic controlled release systems where augmentation with photo-active agents could extend their efficacy. PMID:24148969

  1. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study.

    PubMed

    Jensen, Anders Torp; Jensen, Simon Storgård; Worsaae, Nils

    2016-06-01

    This retrospective clinical study aims to evaluate complications after augmentation of localized bone defects of the alveolar ridge. From standardized registrations, the following complications related to bone augmentation procedures were recorded: soft tissue dehiscence, infection, sensory disturbance, additional augmentation procedures needed, and early implant failure. A total of 223 patients (132 women, 91 men; mean age 23.5 years; range 17-65 years) with 331 bone defects had bone augmentation performed into which 350 implants were placed. Soft tissue dehiscence occurred in 1.7 % after GBR procedures, 25.9 % after staged horizontal ridge augmentation, and 18.2 % after staged vertical ridge augmentation. Infections were diagnosed in 2 % after GBR procedures, 12.5 % after sinus floor elevation (SFE) (transcrestal technique), 5 % after staged SFE, 11 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. Additional augmentation procedures were needed in 2 % after GBR procedures, 37 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. A total of six early implant failures occurred (1.7 %), four after GBR procedures (1.6 %), and two (12 %) after staged vertical ridge augmentation. Predictable methods exist to augment localized defects in the alveolar ridge, as documented by low complication rates and high early implant survival rates.

  2. [Subantral augmentation with porous titanium in experiment and clinic].

    PubMed

    Sirak, S V; Shchetinin, E V; Sletov, A A

    2016-01-01

    The article discusses the use of porous titanium for subantral augmentation. Experimental study was conducted on 12 yearling rams. Subantral augmentation using porous titanium was performed in 33 patients. In the control group consisting of 14 patients calcium phosphates and bone collagen based agents ("Bio-Оss" and "Collost") were used. In the main and control groups 46 and 32 implant were placed, respectively. Pilot histological and clinical studies proved that the granules of porous titanium are biocompatible with bone tissue, provide the optimal surface microrelief, thus creating good conditions for adhesion, expansion and migration of osteoforming cells, have negligible kinetics of resorption, are porous to ensure effective neovascularization of de novo formed bone tissue. Porous titanium is an effective alternative material for subantral bone augmentation for dental implantation and reconstructive operations on the maxillary sinus.

  3. Combination therapy strategies for improving PD-1 blockade efficacy: a new era in cancer immunotherapy.

    PubMed

    Chowdhury, P S; Chamoto, K; Honjo, T

    2018-02-01

    Programmed death 1 (PD-1) is an immune checkpoint molecule that negatively regulates T-cell immune function through the interaction with its ligand PD-L1. Blockage of this interaction unleashes the immune system to fight cancer. Immunotherapy using PD-1 blockade has led to a paradigm shift in the field of cancer drug discovery, owing to its durable effect against a wide variety of cancers with limited adverse effects. A brief history and development of PD-1 blockade, from the initial discovery of PD-1 to the recent clinical output of this therapy, have been summarized here. Despite its tremendous clinical success rate over other cancer treatments, PD-1 blockade has its own pitfall; a significant fraction of patients remains unresponsive to this therapy. The key to improve the PD-1 blockade therapy is the development of combination therapies. As this approach has garnered worldwide interest, here, we have summarized the recent trends in the development of PD-1 blockade-based combination therapies and the ongoing clinical trials. These include combinations with checkpoint inhibitors, radiation therapy, chemotherapy and several other existing cancer treatments. Importantly, FDA has approved PD-1 blockade agent to be used in combination with either CTLA-4 blockade or chemotherapy. Responsiveness to the PD-1 blockade therapy is affected by tumour and immune system-related factors. The role of the immune system, especially T cells, in determining the responsiveness has been poorly studied compared with those factors related to the tumour side. Energy metabolism has emerged as one of the important regulatory mechanisms for the function and differentiation of T cells. We have documented here the recent results regarding the augmentation of PD-1 blockade efficacy by augmenting mitochondrial energy metabolism of T cell. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  4. Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation.

    PubMed

    Garcia-Borreguero, Diego; Silber, Michael H; Winkelman, John W; Högl, Birgit; Bainbridge, Jacquelyn; Buchfuhrer, Mark; Hadjigeorgiou, Georgios; Inoue, Yuichi; Manconi, Mauro; Oertel, Wolfgang; Ondo, William; Winkelmann, Juliane; Allen, Richard P

    2016-05-01

    A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) in conjunction with the European Restless Legs Syndrome Study Group (EURLSSG) and the RLS Foundation (RLS-F) to develop evidence-based and consensus-based recommendations for the prevention and treatment of long-term pharmacologic treatment of dopaminergic-induced augmentation in restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force made the following prevention and treatment recommendations: As a means to prevent augmentation, medications such as α2δ ligands may be considered for initial RLS/WED treatment; these drugs are effective and have little risk of augmentation. Alternatively, if dopaminergic drugs are elected as initial treatment, then the daily dose should be as low as possible and not exceed that recommended for RLS/WED treatment. However, the physician should be aware that even low dose dopaminergics can cause augmentation. Patients with low iron stores should be given appropriate iron supplementation. Daily treatment by either medication should start only when symptoms have a significant impact on quality of life in terms of frequency and severity; intermittent treatment might be considered in intermediate cases. Treatment of existing augmentation should be initiated, where possible, with the elimination/correction of extrinsic exacerbating factors (iron levels, antidepressants, antihistamines, etc.). In cases of mild augmentation, dopamine agonist therapy can be continued by dividing or advancing the dose, or increasing the dose if there are breakthrough night-time symptoms. Alternatively, the patient can be switched to an α2δ ligand or rotigotine. For severe augmentation the patient can be switched either to an α2δ ligand or rotigotine, noting that rotigotine may also produce augmentation at higher doses with long-term use. In more severe cases of augmentation an opioid may be considered, bypassing α2δ ligands and rotigotine

  5. Removal of the intestinal mucosa: photochemical approach in bladder augmentation

    NASA Astrophysics Data System (ADS)

    Haselhuhn, Gregory D.; Kropp, Kenneth A.; Keck, Rick W.; Selman, Steven H.

    1995-03-01

    Experiments were undertaken to determine whether 5-aminoleuvinic acid in combination with light could be used as an adjunct to intestinal bladder augmentation with the aim of removing intestinal mucosa with subsequent re-epithelialization of the treated segment with urothelium. Histopathologic studies of so-treated intestinal segments used in bladder augmentation demonstrate the feasibility of this approach.

  6. Computer Augmented Learning; A Survey.

    ERIC Educational Resources Information Center

    Kindred, J.

    The report contains a description and summary of computer augmented learning devices and systems. The devices are of two general types programed instruction systems based on the teaching machines pioneered by Pressey and developed by Skinner, and the so-called "docile" systems that permit greater user-direction with the computer under student…

  7. Early augmented language intervention for children with developmental delays: potential secondary motor outcomes.

    PubMed

    Whitmore, Ani S; Romski, Mary Ann; Sevcik, Rose A

    2014-09-01

    This exploratory study examined the potential secondary outcome of an early augmented language intervention that incorporates speech-generating devices (SGD) on motor skill use for children with developmental delays. The data presented are from a longitudinal study by Romski and colleagues. Toddlers in the augmented language interventions were either required (Augmented Communication-Output; AC-O) or not required (Augmented Communication-Input; AC-I) to use the SGD to produce an augmented word. Three standardized assessments and five event-based coding schemes measured the participants' language abilities and motor skills. Toddlers in the AC-O intervention used more developmentally appropriate motor movements and became more accurate when using the SGD to communicate than toddlers in the AC-I intervention. AAC strategies, interventionist/parent support, motor learning opportunities, and physical feedback may all contribute to this secondary benefit of AAC interventions that use devices.

  8. The Increased Endogenous Sulfur Dioxide Acts as a Compensatory Mechanism for the Downregulated Endogenous Hydrogen Sulfide Pathway in the Endothelial Cell Inflammation

    PubMed Central

    Zhang, Da; Wang, Xiuli; Tian, Xiaoyu; Zhang, Lulu; Yang, Guosheng; Tao, Yinghong; Liang, Chen; Li, Kun; Yu, Xiaoqi; Tang, Xinjing; Tang, Chaoshu; Zhou, Jing; Kong, Wei; Du, Junbao; Huang, Yaqian; Jin, Hongfang

    2018-01-01

    Endogenous hydrogen sulfide (H2S) and sulfur dioxide (SO2) are regarded as important regulators to control endothelial cell function and protect endothelial cell against various injuries. In our present study, we aimed to investigate the effect of endogenous H2S on the SO2 generation in the endothelial cells and explore its significance in the endothelial inflammation in vitro and in vivo. The human umbilical vein endothelial cell (HUVEC) line (EA.hy926), primary HUVECs, primary rat pulmonary artery endothelial cells (RPAECs), and purified aspartate aminotransferase (AAT) protein from pig heart were used for in vitro experiments. A rat model of monocrotaline (MCT)-induced pulmonary vascular inflammation was used for in vivo experiments. We found that endogenous H2S deficiency caused by cystathionine-γ-lyase (CSE) knockdown increased endogenous SO2 level in endothelial cells and enhanced the enzymatic activity of AAT, a major SO2 synthesis enzyme, without affecting the expressions of AAT1 and AAT2. While H2S donor could reverse the CSE knockdown-induced increase in the endogenous SO2 level and AAT activity. Moreover, H2S donor directly inhibited the activity of purified AAT protein, which was reversed by a thiol reductant DTT. Mechanistically, H2S donor sulfhydrated the purified AAT1/2 protein and rescued the decrease in the sulfhydration of AAT1/2 protein in the CSE knockdown endothelial cells. Furthermore, an AAT inhibitor l-aspartate-β-hydroxamate (HDX), which blocked the upregulation of endogenous SO2/AAT generation induced by CSE knockdown, aggravated CSE knockdown-activated nuclear factor-κB pathway in the endothelial cells and its downstream inflammatory factors including ICAM-1, TNF-α, and IL-6. In in vivo experiment, H2S donor restored the deficiency of endogenous H2S production induced by MCT, and reversed the upregulation of endogenous SO2/AAT pathway via sulfhydrating AAT1 and AAT2. In accordance with the results of the in vitro experiment, HDX

  9. Polysomnographic record and successful management of augmentation in restless legs syndrome/Willis-Ekbom disease.

    PubMed

    Maestri, Michelangelo; Fulda, Stephany; Ferini-Strambi, Luigi; Zucconi, Marco; Marelli, Sara; Staedler, Claudio; Bassetti, Claudio L; Manconi, Mauro

    2014-05-01

    Dopamine agonists (DAs) represent the first-line treatment in restless legs syndrome (RLS); however, in the long term, a substantial proportion of patients will develop augmentation, which is a severe drug-related exacerbation of symptoms and the main reason for late DA withdrawal. Polysomnographic features and mechanisms underlining augmentation are unknown. No practice guidelines for management of augmentation are available. A clinical case series of 24 consecutive outpatients affected by RLS with clinically significant augmentation during treatment with immediate-release DA was performed. All patients underwent a full-night polysomnographic recording during augmentation. A switchover from immediate-release DAs (l-dopa, pramipexole, ropinirole, rotigotine) to the long-acting, extended-release formula of pramipexole was performed. Fifty percent of patients presented more than 15 periodic limb movements per hour of sleep during augmentation, showing longer sleep latency and shorter total sleep time than subjects without periodic limb movements. In all patients, resolution of augmentation was observed within two to four weeks during which immediate-release dopamine agonists could be completely withdrawn. Treatment efficacy of extended-release pramipexole has persisted, thus far, over a mean follow-up interval of 13 months. Pramipexole extended release could be an easy, safe, and fast pharmacological option to treat augmentation in patients with restless legs syndrome. As such it warrants further prospective and controlled investigations. This observation supports the hypothesis that the duration of action of the drug plays a key role in the mechanism of augmentation. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Endogenous Sulfur Dioxide: A New Member of Gasotransmitter Family in the Cardiovascular System

    PubMed Central

    Huang, Yaqian; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2016-01-01

    Sulfur dioxide (SO2) was previously regarded as a toxic gas in atmospheric pollutants. But it has been found to be endogenously generated from metabolism of sulfur-containing amino acids in mammals through transamination by aspartate aminotransferase (AAT). SO2 could be produced in cardiovascular tissues catalyzed by its synthase AAT. In recent years, studies revealed that SO2 had physiological effects on the cardiovascular system, including vasorelaxation and cardiac function regulation. In addition, the pathophysiological effects of SO2 were also determined. For example, SO2 ameliorated systemic hypertension and pulmonary hypertension, prevented the development of atherosclerosis, and protected against myocardial ischemia-reperfusion (I/R) injury and isoproterenol-induced myocardial injury. These findings suggested that endogenous SO2 was a novel gasotransmitter in the cardiovascular system and provided a new therapy target for cardiovascular diseases. PMID:26839635

  11. Endogenous Sulfur Dioxide: A New Member of Gasotransmitter Family in the Cardiovascular System.

    PubMed

    Huang, Yaqian; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2016-01-01

    Sulfur dioxide (SO2) was previously regarded as a toxic gas in atmospheric pollutants. But it has been found to be endogenously generated from metabolism of sulfur-containing amino acids in mammals through transamination by aspartate aminotransferase (AAT). SO2 could be produced in cardiovascular tissues catalyzed by its synthase AAT. In recent years, studies revealed that SO2 had physiological effects on the cardiovascular system, including vasorelaxation and cardiac function regulation. In addition, the pathophysiological effects of SO2 were also determined. For example, SO2 ameliorated systemic hypertension and pulmonary hypertension, prevented the development of atherosclerosis, and protected against myocardial ischemia-reperfusion (I/R) injury and isoproterenol-induced myocardial injury. These findings suggested that endogenous SO2 was a novel gasotransmitter in the cardiovascular system and provided a new therapy target for cardiovascular diseases.

  12. Transient Esotropia in the Child: Case Report and Review of the Literature

    PubMed Central

    Allegrini, Davide; Montesano, Giovanni; Fogagnolo, Paolo; Nocerino, Elisabetta; De Cillà, Stefano; Piozzi, Elena; Rossetti, Luca; Stefini, Massimo; Pece, Alfredo

    2017-01-01

    The aim of this report is to investigate the possible causes of acute acquired onset of transient esotropia (AATE) in children and to help to differentiate ophthalmoplegic migraine (OM) from accommodative spasm (AS). A case of an 8-year-old Caucasian female affected by AATE and diplopia is described. The day before AATE onset, the patient complained of slight headache without nausea and vomiting, with spontaneous resolution. AATE diagnosis is challenging. The most likely ophthalmological causes of AATE are AS and OM. In these cases it is important to evaluate the presence of both a familial history of recurrent headaches and an AATE associated with migraine, ptosis, nausea, and vomiting. A full ophthalmological evaluation and a thorough refractive examination in cycloplegia are mandatory to exclude ophthalmological causes. PMID:28559837

  13. Augmented renal clearance in the ICU: results of a multicenter observational study of renal function in critically ill patients with normal plasma creatinine concentrations*.

    PubMed

    Udy, Andrew A; Baptista, João P; Lim, Noelle L; Joynt, Gavin M; Jarrett, Paul; Wockner, Leesa; Boots, Robert J; Lipman, Jeffrey

    2014-03-01

    To describe the prevalence and natural history of augmented renal clearance in a cohort of recently admitted critically ill patients with normal plasma creatinine concentrations. Multicenter, prospective, observational study. Four, tertiary-level, university-affiliated, ICUs in Australia, Singapore, Hong Kong, and Portugal. Study participants had to have an expected ICU length of stay more than 24 hours, no evidence of absolute renal impairment (admission plasma creatinine < 120 µmol/L), and no history of prior renal replacement therapy or chronic kidney disease. Convenience sampling was used at each participating site. Eight-hour urinary creatinine clearances were collected daily, as the primary method of measuring renal function. Augmented renal clearance was defined by a creatinine clearance more than or equal to 130 mL/min/1.73 m. Additional demographic, physiological, therapeutic, and outcome data were recorded prospectively. Nine hundred thirty-two patients were admitted to the participating ICUs over the study period, and 281 of which were recruited into the study, contributing 1,660 individual creatinine clearance measures. The mean age (95% CI) was 54.4 years (52.5-56.4 yr), Acute Physiology and Chronic Health Evaluation II score was 16 (15.2-16.7), and ICU mortality was 8.5%. Overall, 65.1% manifested augmented renal clearance on at least one occasion during the first seven study days; the majority (74%) of whom did so on more than or equal to 50% of their creatinine clearance measures. Using a mixed-effects model, the presence of augmented renal clearance on study day 1 strongly predicted (p = 0.019) sustained elevation of creatinine clearance in these patients over the first week in ICU. Augmented renal clearance appears to be a common finding in this patient group, with sustained elevation of creatinine clearance throughout the first week in ICU. Future studies should focus on the implications for accurate dosing of renally eliminated pharmaceuticals

  14. Stability boundaries for command augmentation systems

    NASA Technical Reports Server (NTRS)

    Shrivastava, P. C.

    1987-01-01

    The Stability Augmentation System (SAS) is a special case of the Command Augmentation System (CAS). Control saturation imposes bounds on achievable commands. The state equilibrium depends only on the open loop dynamics and control deflection. The control magnitude to achieve a desired command equilibrium is independent of the feedback gain. A feedback controller provides the desired response, maintains the system equilibrium under disturbances, but it does not affect the equilibrium values of states and control. The saturation boundaries change with commands, but the location of the equilibrium points in the saturated region remains unchanged. Nonzero command vectors yield saturation boundaries that are asymmetric with respect to the state equilibrium. Except for the saddle point case with MCE control law, the stability boundaries change with commands. For the cases of saddle point and unstable nodes, the region of stability decreases with increasing command magnitudes.

  15. Behavior sensitivities for control augmented structures

    NASA Technical Reports Server (NTRS)

    Manning, R. A.; Lust, R. V.; Schmit, L. A.

    1987-01-01

    During the past few years it has been recognized that combining passive structural design methods with active control techniques offers the prospect of being able to find substantially improved designs. These developments have stimulated interest in augmenting structural synthesis by adding active control system design variables to those usually considered in structural optimization. An essential step in extending the approximation concepts approach to control augmented structural synthesis is the development of a behavior sensitivity analysis capability for determining rates of change of dynamic response quantities with respect to changes in structural and control system design variables. Behavior sensitivity information is also useful for man-machine interactive design as well as in the context of system identification studies. Behavior sensitivity formulations for both steady state and transient response are presented and the quality of the resulting derivative information is evaluated.

  16. Tests on Thrust Augmenters for Jet Propulsion

    NASA Technical Reports Server (NTRS)

    Jacobs, Eastman N; Shoemaker, James M

    1932-01-01

    This series of tests was undertaken to determine how much the reaction thrust of a jet could be increased by the use of thrust augmenters and thus to give some indication as to the feasibility of jet propulsion for airplanes. The tests were made during the first part of 1927 at the Langley Memorial Aeronautical Laboratory. A compressed air jet was used in connection with a series of annular guides surrounding the jet to act as thrust augmenters. The results show that, although it is possible to increase the thrust of a jet, the increase is not large enough to affect greatly the status of the problem of the application of jet propulsion to airplanes.

  17. Deformation-based augmented reality for hepatic surgery.

    PubMed

    Haouchine, Nazim; Dequidt, Jérémie; Berger, Marie-Odile; Cotin, Stéphane

    2013-01-01

    In this paper we introduce a method for augmenting the laparoscopic view during hepatic tumor resection. Using augmented reality techniques, vessels, tumors and cutting planes computed from pre-operative data can be overlaid onto the laparoscopic video. Compared to current techniques, which are limited to a rigid registration of the pre-operative liver anatomy with the intra-operative image, we propose a real-time, physics-based, non-rigid registration. The main strength of our approach is that the deformable model can also be used to regularize the data extracted from the computer vision algorithms. We show preliminary results on a video sequence which clearly highlights the interest of using physics-based model for elastic registration.

  18. Diffuser for augmenting a wind turbine

    DOEpatents

    Foreman, Kenneth M.; Gilbert, Barry L.

    1984-01-01

    A diffuser for augmenting a wind turbine having means for energizing the boundary layer at several locations along the diffuser walls is improved by the addition of a short collar extending radially outward from the outlet of the diffuser.

  19. Augmented Reality Simulations on Handheld Computers

    ERIC Educational Resources Information Center

    Squire, Kurt; Klopfer, Eric

    2007-01-01

    Advancements in handheld computing, particularly its portability, social interactivity, context sensitivity, connectivity, and individuality, open new opportunities for immersive learning environments. This article articulates the pedagogical potential of augmented reality simulations in environmental engineering education by immersing students in…

  20. 14 CFR 29.672 - Stability augmentation, automatic, and power-operated systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... power-operated systems. 29.672 Section 29.672 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Construction Control Systems § 29.672 Stability augmentation, automatic, and power-operated systems. If the functioning of stability augmentation or other automatic or power-operated system is necessary to show...