Influenza vaccine refusal in Israeli young adults.

PubMed

Balicer, Ran D; Grotto, Itamar; Huerta, Michael; Levian, Yardena; Davidovitch, Nadav

2007-10-01

The purpose of this study was to identify correlates of noncompliance with influenza immunization among young adults and to determine the reasons leading to immunization refusal. Self-administered questionnaires were distributed in 10 military bases during two consecutive annual Israel Defense Force influenza vaccination campaigns. Multivariate logistic regression was performed to identify independent correlates. Of 2,000 questionnaires distributed over two seasons, 942 were completed and returned. Of those, 401 respondents were not vaccinated either because of medical contraindication or for administrative reasons. The remaining 541 respondents who reported either receiving the vaccine or refusing to receive it were analyzed. Risk groups for vaccine refusal included older age (17.9% vs. 3.5% refusal rate) and officer rank (25.9% vs. 13.8% refusal rate). The main reasons for vaccine refusal differed significantly between officers and nonofficers (chi2 = 7.587, p = 0.023). Officers refused mainly (60%) because of fear of possible vaccine adverse effects, whereas nonofficers refused mainly (44.2%) because of disbelief in the vaccine's efficacy in preventing illness. Officers serve as a negative role model in this case, and efforts directed toward dissemination of evidence-based information regarding vaccine-related adverse effects should be introduced to increase vaccination rates in this group.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Interior of a Biotechnology Refrigerator that preserves samples for use in (or after culturing in) the NASA Bioreactor. The unit is shown extracted from a middeck locker shell. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Biotechnology Refrigerator that preserves samples for use in (or after culturing in) the NASA Bioreactor. The unit is shown extracted from a middeck locker shell. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Biotechnology Refrigerator that preserves samples for use in (or after culturing in) the NASA Bioreactor. The unit is shown extracted from a middeck locker shell and with thermal blankets partially removed. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Close-up view of the interior of a NASA Bioreactor shows the plastic plumbing and valves (cylinders at right center) to control fluid flow. The rotating wall vessel is at top center. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

Degradability of Chlorinated Solvents in Landfill Environment

NASA Astrophysics Data System (ADS)

Wang, J. Y.; Litman, M.

2002-12-01

methane production, were monitored throughout the refuse decomposition process. At two different stages of refuse decomposition, active refuse decomposition representing young landfills and maturation phase representing aged landfills, anaerobic microbial cultures were derived from selected bioreactors and tested in serum bottles for their abilities to biodegrade target CAHs. Complementary to the bioreactor experiment, the serum bottle experiment was designed to investigate specific conditions that potentially control or limit the reductive dechlorination of CAHs in landfills. The conditions tested include 1) inhibited refuse methanogenesis, 2) enhanced methanogenic refuse decomposition, 3) presence of other organic carbons commonly found in landfills such as cellulose, lactate, ethanol, and acetate and 4) presence of yeast extract and humic acids which are commonly found in aged landfills. This research investigated the degradability, the degradation rate, and the extent of dechlorination of CAHs in a landfill ecosystem as the refuse decomposition progresses. The results can lead to a broader application of the intrinsic bioattenuation capacity of landfills. An in situ remedial strategy directly tackling the contaminant source can minimize the risk of future impact and achieve a significant saving in remediation cost. The information of contaminant fate in landfills can also help regulatory agencies formulate risk-based guidelines for post-closure monitoring programs and potential re-development projects.

Use of bioreactor landfill for nitrogen removal to enhance methane production through ex situ simultaneous nitrification-denitrification and in situ denitrification.

PubMed

Sun, Xiaojie; Zhang, Hongxia; Cheng, Zhaowen

2017-08-01

High concentrations of nitrate-nitrogen (NO 3 - -N) derived from ex situ nitrification phase can inhibit methane production during ex situ nitrification and in situ denitrification bioreactor landfill. A combined process comprised of ex situ simultaneous nitrification-denitrification (SND) in an aged refuse bioreactor (ARB) and in situ denitrification in a fresh refuse bioreactor (FRB) was conducted to reduce the negative effect of high concentrationsof NO 3 - -N. Ex situ SND can be achieved because NO 3 - -N concentration can be reduced and the removal rate of ammonium-nitrogen (NH 4 + -N) remains largely unchanged when the ventilation rate of ARB-A2 is controlled. The average NO 3 - -N concentrations of effluent were 470mg/L in ex situ nitrification ARB-A1 and 186mg/L in ex situ SND ARB-A2. The average NH 4 + -N removal rates of ARB-A1 and ARB-A2 were 98% and 94%, respectively. Based on the experimental data from week 4 to week 30, it is predicted that NH 4 + -N concentration in FRB-F1 of the ex situ nitrification and in situ denitrification process would reach 25mg/L after 63weeks, and about 40weeks for the FRB-F2 of ex situ SND and in situ denitrification process . Ex situ SND and in situ denitrification process can improve themethane production of FRB-F2. The lag phase time of methane production for the FRB-F2 was 11weeks. This phase was significantly shorter than the 15-week phases of FRB-F1 in ex situ nitrification and in situ denitrification process. A seven-week stabilizationphase was required to increase methane content from 5% to 50% for FRB-F2. Methane content in FRB-F1 did not reach 50% but reached the 45% peak after 20weeks. Copyright © 2017 Elsevier Ltd. All rights reserved.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Exterior view of the NASA Bioreactor Engineering Development Unit flown on Mir. The rotating wall vessel is behind the window on the face of the large module. Control electronics are in the module at left; gas supply and cooling fans are in the module at back. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

The heart of the bioreactor is the rotating wall vessel, shown without its support equipment. Volume is about 125 mL. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

Rotating Bioreactor

NASA Technical Reports Server (NTRS)

1988-01-01

The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues currently being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1996-01-01

Close-up view of the interior of a NASA Bioreactor shows the plastic plumbing and valves (cylinders at center) to control fluid flow. A fresh nutrient bag is installed at top; a flattened waste bag behind it will fill as the nutrients are consumed during the course of operation. The drive chain and gears for the rotating wall vessel are visible at bottom center center. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2010 CFR

2010-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2013 CFR

2013-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2011 CFR

2011-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2014 CFR

2014-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2012 CFR

2012-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

Bioreactor principles

NASA Technical Reports Server (NTRS)

2001-01-01

Cells cultured on Earth (left) typically settle quickly on the bottom of culture vessels due to gravity. In microgravity (right), cells remain suspended and aggregate to form three-dimensional tissue. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

Geographic clusters in underimmunization and vaccine refusal.

PubMed

Lieu, Tracy A; Ray, G Thomas; Klein, Nicola P; Chung, Cindy; Kulldorff, Martin

2015-02-01

Parental refusal and delay of childhood vaccines has increased in recent years and is believed to cluster in some communities. Such clusters could pose public health risks and barriers to achieving immunization quality benchmarks. Our aims were to (1) describe geographic clusters of underimmunization and vaccine refusal, (2) compare clusters of underimmunization with different vaccines, and (3) evaluate whether vaccine refusal clusters may pose barriers to achieving high immunization rates. We analyzed electronic health records among children born between 2000 and 2011 with membership in Kaiser Permanente Northern California. The study population included 154,424 children in 13 counties with continuous membership from birth to 36 months of age. We used spatial scan statistics to identify clusters of underimmunization (having missed 1 or more vaccines by 36 months of age) and vaccine refusal (based on International Classification of Diseases, Ninth Revision, Clinical Modification codes). We identified 5 statistically significant clusters of underimmunization among children who turned 36 months old during 2010-2012. The underimmunization rate within clusters ranged from 18% to 23%, and the rate outside them was 11%. Children in the most statistically significant cluster had 1.58 (P < .001) times the rate of underimmunization as others. Underimmunization with measles, mumps, rubella vaccine and varicella vaccines clustered in similar geographic areas. Vaccine refusal also clustered, with rates of 5.5% to 13.5% within clusters, compared with 2.6% outside them. Underimmunization and vaccine refusal cluster geographically. Spatial scan statistics may be a useful tool to identify locations with challenges to achieving high immunization rates, which deserve focused intervention. Copyright © 2015 by the American Academy of Pediatrics.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Astronaut John Blaha replaces an exhausted media bag and filled waste bag with fresh bags to continue a bioreactor experiment aboard space station Mir in 1996. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. This image is from a video downlink. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC).

Refusal of curative radiation therapy and surgery among patients with cancer.

PubMed

Aizer, Ayal A; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K; Hoffman, Karen E; Kim, Simon P; Martin, Neil E; Hu, Jim C; Trinh, Quoc-Dien; Nguyen, Paul L

2014-07-15

Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life-saving care. Copyright © 2014 Elsevier Inc. All rights reserved.

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aizer, Ayal A., E-mail: aaaizer@partners.org; Chen, Ming-Hui; Parekh, Arti

Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008.more » Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life

Size-fractionation and characterization of landfill leachate and the improvement of Cu{sup 2+} adsorption capacity in soil and aged refuse

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lou Ziyang; State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Tongji University, Shanghai 200092; Chai Xiaoli

2009-01-15

Leachate was collected from an anaerobic lagoon at Shanghai Laogang refuse landfill, the largest landfill in China, and the sample was separated into six fractions using micro-filtration membranes, followed by ultra-filtration membranes. Several parameters of the samples were measured, including chemical oxygen demand (COD), total organic carbon (TOC), total solids (TS), pH, total phosphate (TP), total nitrogen (TN), fixed solids (FS), NH{sub 4}{sup +}, orthophosphate, color, turbidity, and conductivity. These parameters were then quantitatively correlated with the molecular weight cutoff of the membrane used. Organic matter in the dissolved fraction (MW < 1 kDa) predominated in the leachate, accounting formore » 65% of TOC. Thermal infrared spectroscopy was used to characterize the filter residues. Asymmetric and symmetric stretching of methyl and methylene groups, and of functional groups containing nitrogen and oxygen atoms, were observed. In addition, the ability of two different samples to adsorb heavy metals was tested. Cu{sup 2+} was chosen as the representative heavy metal in this study, and the samples were soil; aged refuse, which had spent 8 years in a conventional sanitary landfill; and samples of soil and aged refuse treated for 48 h with leachate in the ratio of 5 g of sample per 50 ml of leachate. Cu{sup 2+} uptake by the raw soil was {approx}4.60 {mu}g/g, while uptake by the leachate-contacted soil and leachate-contacted aged refuse were 5.66 and 5.11 {mu}g/g, respectively. These results show that the organic matter in the leachate enhanced the capacity of aqueous solutions to adsorb Cu{sup 2+}.« less

Expedited Partner Therapy: Pharmacist Refusal of Legal Prescriptions.

PubMed

Borchardt, Lauren N; Pickett, Michelle L; Tan, Kevin T; Visotcky, Alexis M; Drendel, Amy L

2018-05-01

Expedited partner therapy (EPT) is an effective strategy for partner management of sexually transmitted infections. Some states, including Wisconsin, allow EPT prescriptions to be filled without a patient name. This study determined the refusal rates of nameless EPT prescriptions in Milwaukee pharmacies. In this cross-sectional study, 3 trained research assistants of different age, sex, and race posed as "patients" and visited 50 pharmacy locations from one pharmacy chain in Milwaukee County, WI, to fill nameless EPT prescriptions. A χ test was used to compare demographics of patients, pharmacists, and pharmacies. Multiple logistic regression was used to identify factors associated with prescription refusal. Twenty-nine (58%) of 50 nameless EPT prescriptions were refused. Univariate analysis showed that prescriptions were more likely to be refused if the pharmacy was in the suburbs (77%) compared with Milwaukee city (43%; P = 0.01), if the pharmacist was older than the patient (82%) compared with being younger (46%) or within the same age group (33%; P = 0.01 for both), and if the patient was white (78%) compared with nonwhite (47%; P = 0.03). Multivariable regression revealed significantly higher refusals for pharmacies located in the suburbs compared with the city (odds ratio, 5.3; 95% confidence interval, 1.4-20.3; P = 0.03) and in patients who were white compared with nonwhite (odds ratio: 4.8; 95% confidence interval, 1.2-19.8; P = 0.01). More than half of nameless EPT prescriptions were refused in Milwaukee county pharmacies, more frequently at suburban pharmacies and for white patients. Increased pharmacist education regarding EPT is essential to help combat the sexually transmitted infection crisis.

Dialysis patients refusing kidney transplantation: data from the Slovenian Renal Replacement Therapy Registry.

PubMed

Buturović-Ponikvar, Jadranka; Gubenšek, Jakob; Arnol, Miha; Bren, Andrej; Kandus, Aljoša; Ponikvar, Rafael

2011-06-01

Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease; nevertheless, some dialysis patients refuse to be transplanted. The aim of our registry-based, cross-sectional study was to compare kidney transplant candidates to dialysis patients refusing transplantation. Data were collected from the Slovenian Renal Replacement Therapy Registry database, as of 31 December 2008. Demographic and some RRT data were compared between the groups. There were 1448 dialysis patients, of whom 1343 were treated by hemodialysis and 105 by peritoneal dialysis (PD); 132 (9%) were on the waiting list for transplantation, 208 (14%) were preparing for enrollment (altogether 340 [23%] dialysis patients were kidney transplant candidates); 200 (13.7%) patients were reported to refuse transplantation, all ≤ 65 years of age; 345 (24%) were not enrolled due to medical contraindications, 482 (33%) due to age, and 82 (6%) due to other or unknown reasons. No significant difference was found in age, gender, or presence of diabetes between kidney transplant candidates vs. patients refusing transplantation (mean age 50.5 ± 13.9 vs. 51.3 ± 9.6 years, males 61% vs. 63%, diabetics 18% vs. 17%). The proportion of patients ≤ 65 years old who were refusing transplantation was 28% (187/661) for hemodialysis and 17% (13/79) for PD patients (P = 0.03). There is a considerable group of dialysis patients in Slovenia refusing kidney transplantation. Compared to the kidney transplant candidates, they are similar in age, gender and prevalence of diabetes. Patients treated by peritoneal dialysis refuse kidney transplantation less often than hemodialysis patients. © 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.

Bioreactor Scalability: Laboratory-Scale Bioreactor Design Influences Performance, Ecology, and Community Physiology in Expanded Granular Sludge Bed Bioreactors

PubMed Central

Connelly, Stephanie; Shin, Seung G.; Dillon, Robert J.; Ijaz, Umer Z.; Quince, Christopher; Sloan, William T.; Collins, Gavin

2017-01-01

Studies investigating the feasibility of new, or improved, biotechnologies, such as wastewater treatment digesters, inevitably start with laboratory-scale trials. However, it is rarely determined whether laboratory-scale results reflect full-scale performance or microbial ecology. The Expanded Granular Sludge Bed (EGSB) bioreactor, which is a high-rate anaerobic digester configuration, was used as a model to address that knowledge gap in this study. Two laboratory-scale idealizations of the EGSB—a one-dimensional and a three- dimensional scale-down of a full-scale design—were built and operated in triplicate under near-identical conditions to a full-scale EGSB. The laboratory-scale bioreactors were seeded using biomass obtained from the full-scale bioreactor, and, spent water from the distillation of whisky from maize was applied as substrate at both scales. Over 70 days, bioreactor performance, microbial ecology, and microbial community physiology were monitored at various depths in the sludge-beds using 16S rRNA gene sequencing (V4 region), specific methanogenic activity (SMA) assays, and a range of physical and chemical monitoring methods. SMA assays indicated dominance of the hydrogenotrophic pathway at full-scale whilst a more balanced activity profile developed during the laboratory-scale trials. At each scale, Methanobacterium was the dominant methanogenic genus present. Bioreactor performance overall was better at laboratory-scale than full-scale. We observed that bioreactor design at laboratory-scale significantly influenced spatial distribution of microbial community physiology and taxonomy in the bioreactor sludge-bed, with 1-D bioreactor types promoting stratification of each. In the 1-D laboratory bioreactors, increased abundance of Firmicutes was associated with both granule position in the sludge bed and increased activity against acetate and ethanol as substrates. We further observed that stratification in the sludge-bed in 1-D laboratory

School Refusal Assessment Scale-Revised: Factorial Invariance and Latent Means Differences across Gender and Age in Spanish Children

PubMed Central

Gonzálvez, Carolina; Inglés, Cándido J.; Kearney, Christopher A.; Vicent, María; Sanmartín, Ricardo; García-Fernández, José M.

2016-01-01

The aim of this study was to analyze the factorial invariance and latent means differences of the Spanish version of the School Refusal Assessment Scale-Revised for Children (SRAS-R-C) in a sample of 1,078 students (50.8% boys) aged 8–11 years (M = 9.63, SD = 1.12). The results revealed that the proposed model in this study, with a structure of 18 items divided into four factors (Negative Affective, Social Aversion and/or Evaluation, To Pursue Attention and Tangible Reinforcements), was the best-fit model with a tetra-factorial structure, remaining invariant across gender and age. Analysis of latent means differences indicated that boys and 11-year-old students scored highest on the Tangible Reinforcements subscale compared with their 8- and 9-year-old peers. On the contrary, for the subscales of Social Aversion and/or Evaluation and to Pursue Attention, the differences were significant and higher in younger age groups compared to 11-year-olds. Appropriate indexes of reliability were obtained for SRAS-R-C subscales (0.70, 0.79, 0.87, and 0.72). Finally, the founded correlation coefficients of scores of the SRAS-R-C revealed a predictable pattern between school refusal and positive/negative affect and optimism/pessimism. PMID:28082938

Bio-reactor chamber

NASA Technical Reports Server (NTRS)

Chandler, Joseph A. (Inventor)

1989-01-01

A bioreactor for cell culture is disclosed which provides for the introduction of fresh medium without excessive turbulent action. The fresh medium enters the bioreactor through a filter with a backwash action which prevents the cells from settling on the filter. The bioreactor is sealed and depleted medium is forced out of the container as fresh medium is added.

Risk factors associated with treatment refusal in lung cancer

PubMed Central

Suh, Won Na; Kong, Kyoung Ae; Han, Yeji; Kim, Soo Jung; Lee, Su Hwan; Ryu, Yon Ju; Lee, Jin Hwa; Shim, Sung Shine; Kim, Yookyung

2017-01-01

Background The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. Methods We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti‐cancer treatment and allowed only palliative care were classified into the non‐treatment group, while the remaining 468 who received anti‐cancer treatment were classified into the treatment group. Results The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage (P < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07–1.13), educational status lower than high school (OR 1.95, 95% CI 1.2–3.2), no history of surgery (OR 2.29, 95% CI 1.4–3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3–4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3–10.8) were significant factors for refusal of cancer treatment. Conclusion Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients. PMID:28627788

NASA Bioreactor Demonstration System

NASA Technical Reports Server (NTRS)

2002-01-01

Leland W. K. Chung (left), Director, Molecular Urology Therapeutics Program at the Winship Cancer Institute at Emory University, is principal investigator for the NASA bioreactor demonstration system (BDS-05). With him is Dr. Jun Shu, an assistant professor of Orthopedics Surgery from Kuming Medical University China. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. Credit: Emory University.

Risk factors associated with treatment refusal in lung cancer.

PubMed

Suh, Won Na; Kong, Kyoung Ae; Han, Yeji; Kim, Soo Jung; Lee, Su Hwan; Ryu, Yon Ju; Lee, Jin Hwa; Shim, Sung Shine; Kim, Yookyung; Chang, Jung Hyun

2017-09-01

The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti-cancer treatment and allowed only palliative care were classified into the non-treatment group, while the remaining 468 who received anti-cancer treatment were classified into the treatment group. The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage ( P < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07-1.13), educational status lower than high school (OR 1.95, 95% CI 1.2-3.2), no history of surgery (OR 2.29, 95% CI 1.4-3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3-4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3-10.8) were significant factors for refusal of cancer treatment. Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

NASA Bioreactor Schematic

NASA Technical Reports Server (NTRS)

2001-01-01

The schematic depicts the major elements and flow patterns inside the NASA Bioreactor system. Waste and fresh medium are contained in plastic bags placed side-by-side so the waste bag fills as the fresh medium bag is depleted. The compliance vessel contains a bladder to accommodate pressure transients that might damage the system. A peristolic pump moves fluid by squeezing the plastic tubing, thus avoiding potential contamination. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

An innovative combined on-site process for the remote rural solid waste treatment--a pilot scale case study in China.

PubMed

Li, Wen-Bing; Yao, Jun; Tao, Ping-Ping; Hu, Hong; Fang, Cheng-Ran; Shen, Dong-Sheng

2011-03-01

The aim of this study was to find a feasible method for the treatment of solid waste generated in the remote rural, where the transportation costs are prohibitive and the resources to construct and maintain conventional treatment plants are not available. This process, consisted of two types of simulated bioreactor landfill (one was recirculated bioreactor landfill, and the other was comprised of fresh and aged refuse reactor) and a soil infiltration system, was operated in ambient temperature for 180 days all together. After treated by the system of fresh and aged refuse reactor, the refuse and leachate reached a strongly degraded and stable state. The remaining leachate can be treated by the soil infiltration system, and 87.5 ± 2.1%, 98.6 ± 1.0% and 95.7 ± 1.7% were achieved by 60 cm soil depths for organic matter, ammonium nitrogen and total nitrogen removal, respectively. Copyright © 2010 Elsevier Ltd. All rights reserved.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Biotechnology Specimen Temperature Controller (BSTC) will cultivate cells until their turn in the bioreactor; it can also be used in culturing experiments that do not require the bioreactor. The BSTC comprises four incubation/refrigeration chambers individually set at 4 to 50 deg. C (near-freezing to above body temperature). Each chamber holds three rugged tissue chamber modules (12 total), clear Teflon bags holding 30 ml of growth media, all positioned by a metal frame. Every 7 to 21 days (depending on growth rates), an astronaut uses a shrouded syringe and the bags' needleless injection ports to transfer a few cells to a fresh media bag, and to introduce a fixative so that the cells may be studied after flight. The design also lets the crew sample the media to measure glucose, gas, and pH levels, and to inspect cells with a microscope. The controller is monitored by the flight crew through a 23-cm (9-inch) color computer display on the face of the BSTC. This view shows the BTSC with the front panel open. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Biotechnology Specimen Temperature Controller (BSTC) will cultivate cells until their turn in the bioreactor; it can also be used in culturing experiments that do not require the bioreactor. The BSTC comprises four incubation/refrigeration chambers individually set at 4 to 50 degreesC (near-freezing to above body temperature). Each chamber holds three rugged tissue chamber modules (12 total), clear Teflon bags holding 30 ml of growth media, all positioned by a metal frame. Every 7 to 21 days (depending on growth rates), an astronaut uses a shrouded syringe and the bags' needleless injection ports to transfer a few cells to a fresh media bag, and to introduce a fixative so that the cells may be studied after flight. The design also lets the crew sample the media to measure glucose, gas, and pH levels, and to inspect cells with a microscope. The controller is monitored by the flight crew through a 23-cm (9-inch) color computer display on the face of the BSTC. This view shows the BTSC with the front panel open. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Bioreactor Demonstration System (BDS) comprises an electronics module, a gas supply module, and the incubator module housing the rotating wall vessel and its support systems. Nutrient media are pumped through an oxygenator and the culture vessel. The shell rotates at 0.5 rpm while the irner filter typically rotates at 11.5 rpm to produce a gentle flow that ensures removal of waste products as fresh media are infused. Periodically, some spent media are pumped into a waste bag and replaced by fresh media. When the waste bag is filled, an astronaut drains the waste bag and refills the supply bag through ports on the face of the incubator. Pinch valves and a perfusion pump ensure that no media are exposed to moving parts. An Experiment Control Computer controls the Bioreactor, records conditions, and alerts the crew when problems occur. The crew operates the system through a laptop computer displaying graphics designed for easy crew training and operation. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. See No. 0101825 for a version with major elements labeled, and No. 0103180 for an operational schematic. 0101816

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Bioreactor Demonstration System (BDS) comprises an electronics module, a gas supply module, and the incubator module housing the rotating wall vessel and its support systems. Nutrient media are pumped through an oxygenator and the culture vessel. The shell rotates at 0.5 rpm while the irner filter typically rotates at 11.5 rpm to produce a gentle flow that ensures removal of waste products as fresh media are infused. Periodically, some spent media are pumped into a waste bag and replaced by fresh media. When the waste bag is filled, an astronaut drains the waste bag and refills the supply bag through ports on the face of the incubator. Pinch valves and a perfusion pump ensure that no media are exposed to moving parts. An Experiment Control Computer controls the Bioreactor, records conditions, and alerts the crew when problems occur. The crew operates the system through a laptop computer displaying graphics designed for easy crew training and operation. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. See No. 0101816 for a version without labels, and No. 0103180 for an operational schematic.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Bioreactor Demonstration System (BDS) comprises an electronics module, a gas supply module, and the incubator module housing the rotating wall vessel and its support systems. Nutrient media are pumped through an oxygenator and the culture vessel. The shell rotates at 0.5 rpm while the irner filter typically rotates at 11.5 rpm to produce a gentle flow that ensures removal of waste products as fresh media are infused. Periodically, some spent media are pumped into a waste bag and replaced by fresh media. When the waste bag is filled, an astronaut drains the waste bag and refills the supply bag through ports on the face of the incubator. Pinch valves and a perfusion pump ensure that no media are exposed to moving parts. An Experiment Control Computer controls the Bioreactor, records conditions, and alerts the crew when problems occur. The crew operates the system through a laptop computer displaying graphics designed for easy crew training and operation. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. See No. 0101823 for a version without labels, and No. 0103180 for an operational schematic.

NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Bioreactor Demonstration System (BDS) comprises an electronics module, a gas supply module, and the incubator module housing the rotating wall vessel and its support systems. Nutrient media are pumped through an oxygenator and the culture vessel. The shell rotates at 0.5 rpm while the irner filter typically rotates at 11.5 rpm to produce a gentle flow that ensures removal of waste products as fresh media are infused. Periodically, some spent media are pumped into a waste bag and replaced by fresh media. When the waste bag is filled, an astronaut drains the waste bag and refills the supply bag through ports on the face of the incubator. Pinch valves and a perfusion pump ensure that no media are exposed to moving parts. An Experiment Control Computer controls the Bioreactor, records conditions, and alerts the crew when problems occur. The crew operates the system through a laptop computer displaying graphics designed for easy crew training and operation. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. See No. 0101824 for a version with labels, and No. 0103180 for an operational schematic.

Bioreactor rotating wall vessel

NASA Technical Reports Server (NTRS)

2001-01-01

The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. Cell constructs grown in a rotating bioreactor on Earth (left) eventually become too large to stay suspended in the nutrient media. In the microgravity of orbit, the cells stay suspended. Rotation then is needed for gentle stirring to replenish the media around the cells.

Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal.

PubMed

Chi, Donald L

2014-07-01

The aim of this study was to examine caregivers' refusal of preventive medical and dental care for children. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.

Refusal to medical interventions.

PubMed

Palacios, G; Herreros, B; Pacho, E

2014-10-01

Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Bioreactor and methods for producing synchronous cells

NASA Technical Reports Server (NTRS)

Helmstetter, Charles E. (Inventor); Thornton, Maureen (Inventor); Gonda, Steve (Inventor)

2005-01-01

Apparatus and methods are directed to a perfusion culture system in which a rotating bioreactor is used to grow cells in a liquid culture medium, while these cells are attached to an adhesive-treated porous surface. As a result of this arrangement and its rotation, the attached cells divide, with one cell remaining attached to the substrate, while the other cell, a newborn cell is released. These newborn cells are of approximately the same age, that are collected upon leaving the bioreactor. The populations of newborn cells collected are of synchronous and are minimally, if at all, disturbed metabolically.

Refusal of medical treatment in the pediatric emergency service: analysis of reasons and aspects.

PubMed

Gündüz, Ramiz Coşkun; Halil, Halit; Gürsoy, Cüneyt; Çifci, Atilla; Özgün, Seher; Kodaman, Tuğba; Sönmez, Mehtap

2014-01-01

Refusal of treatment for acutely ill children is still an important problem in the emergency service. When families refuse medical treatment for their acutely ill children, healthcare professionals may attempt to provide information and negotiate with the family concerning treatment refusal and its possible adverse outcomes, and request consent for refusal of medical treatment. There is insufficient data about refusal of treatment in our country. The purpose of this study was to analyze the causes of treatment refusal in the pediatric emergency service. We collected data recorded on informed consent forms. During a 2-year-study period, 215 patients refused treatment recommended by acute health care professionals. The majorty of patients were in the 0-2 year age group. Hospitalization was the type of treatment most commonly refused; restrictions regarding family members staying with their children during hospitalization and admission to another hospital were the major reasons for refusal of treatment. Clarifying the reasons for treatment refusal may help us to overcome deficiencies, improve conditions, resolve problems and build confidence between healthcare providers and service users, increasing users' satisfaction in the future.

Caregivers Who Refuse Preventive Care for Their Children: The Relationship Between Immunization and Topical Fluoride Refusal

PubMed Central

2014-01-01

Objectives. The aim of this study was to examine caregivers’ refusal of preventive medical and dental care for children. Methods. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). Results. The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Conclusions. Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children. PMID:24832428

Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study.

PubMed

Repalust, Anja; Šević, Sandra; Rihtar, Stanko; Štulhofer, Aleksandar

2017-10-01

Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18-88 years (M age  = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96-3.03, p < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

Estimates and determinants of HPV non-vaccination and vaccine refusal in girls 12 to 14 y of age in Canada: Results from the Childhood National Immunization Coverage Survey, 2013

PubMed Central

Gilbert, Nicolas L.; Gilmour, Heather; Dubé, Ève; Wilson, Sarah E.; Laroche, Julie

2016-01-01

ABSTRACT Since the introduction of HPV vaccination programs in Canada in 2007, coverage has been below public health goals in many provinces and territories. This analysis investigated the determinants of HPV non-vaccination and vaccine refusal. Data from the Childhood National Immunization Coverage Survey (CNICS) 2013 were used to estimate the prevalence of HPV non-vaccination and parental vaccine refusal in girls aged 12–14 years, for Canada and the provinces and territories. Multivariate logistic regression was used to examine factors associated with non-vaccination and vaccine refusal, after adjusting for potential confounders. An estimated 27.7% of 12–14 y old girls had not been vaccinated against HPV, and 14.4% of parents reported refusing the vaccine. The magnitude of non-vaccination and vaccine refusal varied by province or territory and also by responding parent's country of birth. In addition, higher education was associated with a higher risk of refusal of the HPV vaccine. Rates of HPV non-vaccination and of refusal of the HPV vaccine differ and are influenced by different variables. These findings warrant further investigation. PMID:26942572

Bioreactor design concepts

NASA Technical Reports Server (NTRS)

Bowie, William

1987-01-01

Two parallel lines of work are underway in the bioreactor laboratory. One of the efforts is devoted to the continued development and utilization of a laboratory research system. That system's design is intended to be fluid and dynamic. The sole purpose of such a device is to allow testing and development of equipment concepts and procedures. Some of the results of those processes are discussed. A second effort is designed to produce a flight-like bioreactor contained in a double middeck locker. The result of that effort has been to freeze a particular bioreactor design in order to allow fabrication of the custom parts. The system is expected to be ready for flight in early 1988. However, continued use of the laboratory system will lead to improvements in the space bioreactor. Those improvements can only be integrated after the initial flight series.

Cells growing in NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

For 5 days on the STS-70 mission, a bioreactor cultivated human colon cancer cells, which grew to 30 times the volume of control specimens grown on Earth. This significant result was reproduced on STS-85 which grew mature structures that more closely match what are found in tumors in humans. Shown here, clusters of cells slowly spin inside a bioreactor. On Earth, the cells continually fall through the buffer medium and never hit bottom. In space, they are naturally suspended. Rotation ensures gentle stirring so waste is removed and fresh nutrient and oxygen are supplied. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

NASA Classroom Bioreactor

NASA Technical Reports Server (NTRS)

Scully, Robert

2004-01-01

Exploration of space provides a compelling need for cell-based research into the basic mechanisms that underlie the profound changes that occur in terrestrial life that is transitioned to low gravity environments. Toward that end, NASA developed a rotating bioreactor in which cells are cultured while continuously suspended in a cylinder in which the culture medium rotates with the cylinder. The randomization of the gravity vector accomplished by the continuous rotation, in a low shear environment, provides an analog of microgravity. Because cultures grown in bioreactors develop structures and functions that are much closer to those exhibited by native tissue than can be achieved with traditional culture methods, bioreactors have contributed substantially to advancing research in the fields of cancer, diabetes, infectious disease modeling for vaccine production, drug efficacy, and tissue engineering. NASA has developed a Classroom Bioreactor (CB) that is built from parts that are easily obtained and assembled, user-friendly and versatile. It can be easily used in simple school settings to examine the effect cultures of seeds or cells. An educational brief provides assembly instructions and lesson plans that describes activities in science, math and technology that explore free fall, microgravity, orbits, bioreactors, structure-function relationships and the scientific method.

Design challenges for space bioreactors

NASA Technical Reports Server (NTRS)

Seshan, P. K.; Petersen, G. R.

1989-01-01

The design of bioreactors for operation under conditions of microgravity presents problems and challenges. Absence of a significant body force such as gravity can have profound consequences for interfacial phenomena. Marangoni convection can no longer be overlooked. Many speculations on the advantages and benefits of microgravity can be found in the literature. Initial bioreactor research considerations for space applications had little regard for the suitability of the designs for conditions of microgravity. Bioreactors can be classified in terms of their function and type of operation. The complex interaction of parameters leading to optimal design and operation of a bioreactor is illustrated by the JSC mammalian cell culture system. The design of a bioreactor is strongly dependent upon its intended use as a production unit for cell mass and/or biologicals or as a research reactor for the study of cell growth and function. Therefore a variety of bioreactor configurations are presented in rapid summary. Following this, a rationale is presented for not attempting to derive key design parameters such as the oxygen transfer coefficient from ground-based data. A set of themes/objectives for flight experiments to develop the expertise for design of space bioreactors is then proposed for discussion. These experiments, carried out systematically, will provide a database from which engineering tools for space bioreactor design will be derived.

A comparison of refuse attenuation in laboratory and field scale lysimeters.

PubMed

Youcai, Zhao; Luochun, Wang; Renhua, Hua; Dimin, Xu; Guowei, Gu

2002-01-01

For this study, small and middle scale laboratory lysimeters, and a large scale field lysimeter in situ in Shanghai Refuse Landfill, with refuse weights of 187,600 and 10,800,000 kg, respectively, were created. These lysimeters are compared in terms of leachate quality (pH, concentrations of COD, BOD and NH3-N), refuse composition (biodegradable matter and volatile solid) and surface settlement for a monitoring period of 0-300 days. The objectives of this study were to explore both the similarities and disparities between laboratory and field scale lysimeters, and to compare degradation behaviors of refuse at the intensive reaction phase in the different scale lysimeters. Quantitative relationships of leachate quality and refuse composition with placement time show that degradation behaviors of refuse seem to depend heavily on the scales of the lysimeters and the parameters of concern, especially in the starting period of 0-6 months. However, some similarities exist between laboratory and field lysimeters after 4-6 months of placement because COD and BOD concentrations in leachate in the field lysimeter decrease regularly in a parallel pattern with those in the laboratory lysimeters. NH3-N, volatile solid (VS) and biodegradable matter (BDM) also gradually decrease in parallel in this intensive reaction phase for all scale lysimeters as refuse ages. Though the concrete data are different among the different scale lysimeters, it may be considered that laboratory lysimeters with sufficient scale are basically applicable for a rough simulation of a real landfill, especially for illustrating the degradation pattern and mechanism. Settlement of refuse surface is roughly proportional to the initial refuse height.

[Refusal of initiation of dialysis by elderly patients with chronic renal failure].

PubMed

Fujimaki, Hiroshi; Kasuya, Yutaka; Kawaguchi, Sachiko; Hara, Shino; Koga, Shiro; Takahashi, Tadao; Mizuno, Shoichi

2005-07-01

Refusal of dialysis is not uncommon in elderly patients with chronic renal failure. In this study, we retrospectively inspected our dealings with patients who refused our offer to initiate dialysis. In addition, we discussed how to grasp the meaning of this phenomenon. We treated 152 patients with advanced chronic renal failure aged 60 years and over at Tokyo Metropolitan Geriatric Hospital. The patients fulfilling the following two criteria were considered to be refusal cases. The first criterion was that an acceptance of the initiation of dialysis could not be obtained in spite of repeated counseling. The second criterion was that a definite outcome was precipitated by the development of severe uremic symptoms. In every refusal case, clinical characteristics and household members were surveyed. Verbal expressions of the reasons for refusal were retrieved from medical charts. The outcome was also studied. The two criteria were fulfilled in 7 cases. The male/female ratio was 5:2. The age was 78 +/- 7 years (mean +/- standard deviation). All but one cases were ambulatory, and all cases had normal cognitive function. Four cases were married, and the other cases had lost their partners. The number of household members was 3.9 +/- 1.8. We speculated that every case could maintain a good quality of life even after the initiation of dialysis. Representative expressions of the reasons for refusal were "I have already lived fully" and "I would prefer to accept death rather than dialysis". The outcome was urgent initiation of dialysis (five cases) and death (two cases). The time between initial counseling and the outcome was 115 +/- 37 days. Accepting or refusing dialysis therapy is a selection related to life or death. We must make an effort to obtain consent to initiating dialysis if patients are assessed as suitable for dialysis.

Implied consent refusal impact

DOT National Transportation Integrated Search

1991-09-01

This report examines the extent to which persons suspected of DWI refuse to take a chemical test as required by law, describes implied consent laws in 50 States, analyzes the relation of law features to refusal rate, and analyzes the characteristics ...

Long-term monitoring and prediction for settlement and composition of refuse in Shanghai Laogang Municipal Landfill.

PubMed

Jiangying, Liu; Dimin, Xu; Youcai, Zhao; Shaowei, Chen; Guojian, Li; Qi, Zhou

2004-09-01

Parameters about composition of refuse such as mass percentage of biodegradable matter, volatile solid, organic carbon, cellulose, total sugar, and settlement were monitored and analyzed in a large-scale experimental unit. The empirical formulas between composition and refuse age were established in terms of the data obtained from the experimental unit and verified by comparing with the corresponding parameters of refuse in the closed landfill units from 1991 until 1994 in the Shanghai Laogang Municipal Landfill. Furthermore, the long-term prediction for the composition of refuse was made, and it was predicted that the half-life is 7 to 11 years for biodegradable matter, 9 to 12 years for organic carbon or volatile solid, 7 to 16 years for cellulose, and 4 to 6 years for total sugar. In addition, a mathematical model, based on the mechanism of refuse biodegradation in the landfill, was developed to simulate the relationship between the settlement and the refuse age and manifests the secondary settlement potential. The mathematical model was proved not only to be reliable but also should be accurate for predicting the settlement of the landfill. The secondary settlement, which mainly results from the slow and gradual biodegradation of refuse, is linear with respect to the exponent of refuse age. Finally, according to the settlement model and empirical biodegradation formulas, it may be predicted that, 79.4% of biodegradable matter, 92.9% of total sugar, 72.7% of volatile solid and organic carbon, and 73.1% of cellulose will be biodegraded and that 79% of the maximum secondary settlement potential will occur before the Shanghai Laogang Municipal Landfill is in a high stabilization situation, i.e., approximately 21 years after final closure.

Prostate tumor grown in NASA Bioreactor

NASA Technical Reports Server (NTRS)

2001-01-01

This prostate cancer construct was grown during NASA-sponsored bioreactor studies on Earth. Cells are attached to a biodegradable plastic lattice that gives them a head start in growth. Prostate tumor cells are to be grown in a NASA-sponsored Bioreactor experiment aboard the STS-107 Research-1 mission in 2002. Dr. Leland Chung of the University of Virginia is the principal investigator. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. Credit: NASA and the University of Virginia.

Space bioreactor: Design/process flow

NASA Technical Reports Server (NTRS)

Cross, John H.

1987-01-01

The design of the space bioreactor stems from three considerations. First, and foremost, it must sustain cells in microgravity. Closely related is the ability to take advantage of the weightlessness and microgravity. Lastly, it should fit into a bioprocess. The design of the space bioreactor is described in view of these considerations. A flow chart of the bioreactor is presented and discussed.

Space Bioreactor Science Workshop

NASA Technical Reports Server (NTRS)

Morrison, Dennis R. (Editor)

1987-01-01

The first space bioreactor has been designed for microprocessor control, no gaseous headspace, circulation and resupply of culture medium, and a slow mixing in very low shear regimes. Various ground based bioreactors are being used to test reactor vessel design, on-line sensors, effects of shear, nutrient supply, and waste removal from continuous culture of human cells attached to microcarriers. The small (500 ml) bioreactor is being constructed for flight experiments in the Shuttle middeck to verify systems operation under microgravity conditions and to measure the efficiencies of mass transport, gas transfer, oxygen consumption, and control of low shear stress on cells. Applications of microcarrier cultures, development of the first space bioreactor flight system, shear and mixing effects on cells, process control, and methods to monitor cell metabolism and nutrient requirements are among the topics covered.

Paper for Publication in IOP: Conference Series Leachate Treatment using three Years Aged Lysimetric Bioreactor Models

NASA Astrophysics Data System (ADS)

Hartono, Djoko M.; Andari Kristanto, Gabriel; Gusniani Sofian, Irma; Fauzan, Ahmad; Mahdiana, Ghanis

2018-03-01

This study was conducted as a response to address the problem of land availability for Cipayung landfill that no longer able to accommodate waste generation Depok City and to protect water pollution in receiving water body. Law No. 8/2008 explained that local governments and cities are required to create a sanitary landfill as a final waste processing system to replace open dumping that had been done by almost all the final processing of waste in cities in Indonesia. Sanitary landfill is the final waste processing system that works best and is environmentally friendly. The sanitary landfill will generate leachate. Leachate is the result of precipitation, evaporation, surface runoff, water infiltration into the waste, and also including the water contained in the waste. The purpose of this study was to determine the utilization of leachate generated by three years aged reactor.This study use a modeling tools as bioreactor landfill tank or so called lysimetric, that made of the polymer material that susceptible to high heat and pressure. This bioreactor landfill tank has a diameter of 0.83 m, with a surface area of 0.54 m2 and a height of 2.02 m, with the examination duration of 115 days. This tank consists of several layer, such as sand layer, solid waste layer, water layer and piping system. These layer has 3 year aged. The In this research, leachate recirculation in bioreactor landfills was conducted with waste layered loading systems with percolation system. This research has been conducted since the beginning of 2016, sampling, field measurement and analysis of leachate and waste quality carried out for approximately 115 days of field measurements.Several parameter were measured such as pH, BOD, COD, nitrate, nitrite and TSS. From the analysis of the leachate quality parameters of pH, BOD, COD, nitrite, TSS, showed a reduction in the concentration of the three reactors. The concentration of parameters measured at the initial stage until the final stage, showed a

Aged refuse enhances anaerobic digestion of waste activated sludge.

PubMed

Zhao, Jianwei; Gui, Lin; Wang, Qilin; Liu, Yiwen; Wang, Dongbo; Ni, Bing-Jie; Li, Xiaoming; Xu, Rui; Zeng, Guangming; Yang, Qi

2017-10-15

In this work, a low-cost alternative approach (i.e., adding aged refuse (AR) into waste activated sludge) to significantly enhance anaerobic digestion of sludge was reported. Experimental results showed that with the addition dosage of AR increasing from 0 to 400 mg/g dry sludge soluble chemical oxygen demand (COD) increased from 1150 to 5240 mg/L at the digestion time of 5 d, while the maximal production of volatile fatty acids (VFA) increased from 82.6 to 183.9 mg COD/g volatile suspended solids. Although further increase of AR addition decreased the concentrations of both soluble COD and VFA, their contents in these systems with AR addition at any concentration investigated were still higher than those in the blank, which resulted in higher methane yields in these systems. Mechanism studies revealed that pertinent addition of AR promoted solubilization, hydrolysis, and acidogenesis processes and did not affect methanogenesis significantly. It was found that varieties of enzymes and anaerobes in AR were primary reason for the enhancement of anaerobic digestion. Humic substances in AR benefited hydrolysis and acidogenesis but inhibited methanogenesis. The effect of heavy metals in AR on sludge anaerobic digestion was dosage dependent. Sludge anaerobic digestion was enhanced by appropriate amounts of heavy metals but inhibited by excessive amounts of heavy metals. The relative abundances of microorganisms responsible for sludge hydrolysis and acidogenesis were also observed to be improved in the system with AR addition, which was consistent with the performance of anaerobic digestion. Copyright © 2017 Elsevier Ltd. All rights reserved.

School Refuser Child Identities

ERIC Educational Resources Information Center

Stroobant, Emma; Jones, Alison

2006-01-01

"School refuser" is an always-already negative child identity. The term is used to categorize children or adolescents who appear to dislike and fear school (or aspects of school) and persistently refuse to attend or attend very unwillingly. Given that school attendance is generally considered a necessary social good, regular and anxious…

Central Nervous System Disease, Education, and Race Impact Radiation Refusal in Pediatric Cancer Patients.

PubMed

Patel, Chirayu G; Stavas, Mark; Perkins, Stephanie; Shinohara, Eric T

2017-07-01

To investigate the determinants of radiation therapy refusal in pediatric cancer, we used the Surveillance, Epidemiology, and End Results registry to identify 24,421 patients who met the eligibility criteria, diagnosed between 1974 and 2012. Patients had any stage of cancer, were aged 0 to 19, and received radiation therapy or refused radiation therapy when it was recommended. One hundred twenty-eight patients (0.52%) refused radiation therapy when it was recommended. Thirty-two percent of patients who refused radiation therapy ultimately died from their cancer, at a median of 7 months after diagnosis (95% confidence interval, 3-11 mo), as compared with 29.0% of patients who did not refuse radiation therapy died from their cancer, at a median of 17 months after diagnosis (95% confidence interval, 17-18 mo). On multivariable analysis, central nervous system (CNS) site, education, and race were associated with radiation refusal. The odds ratio for radiation refusal for patients with CNS disease was 1.62 (P=0.009) as compared with patients without CNS disease. For patients living in a county with ≥10% residents having less than ninth grade education, the odds ratio for radiation refusal was 1.71 (P=0.008) as compared with patients living in a county with <10% residents having less than ninth grade education. Asian, Pacific Islander, Alaska Native, and American Indian races had an odds ratio of 2.12 (P=0.002) for radiation refusal as compared with black or white race. Although the radiation refusal rate in the pediatric cancer population is low, we show that CNS site, education level, and race are associated with a significant difference in radiation refusal.

Refusing to Treat Sexual Dysfunction in Sex Offenders.

PubMed

Douglas, Thomas

2017-01-01

This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal-refusal to offer abortion services-is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or neither is, and (2) critiquing two attempts to buttress it.

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

[Treatment Refusal in Pediatric Oncology].

PubMed

Špótová, A; Husáková, K; Hrašková, A; Mikesková, M; Puškáčová, J; Hederová, S; Jamárik, M; Rabenseifertová, E; Jalovecká, Z; Kolenová, A; Šubová, Z

2017-01-01

Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly against oncological treatment, potentially compromising their childrens rights for health care and to the chance for cure. In this paper, we report two cases of treatment refusal from our department and the impact of such decisions on the children themselves. Case no. 1 describes a child with retinoblastoma whose parents refused standard treatment in order to seek alternative treatment abroad. Case no. 2 describes a patient with a primary lymphoma of bone who received treatment by a court order after parental refusal. When parents refuse a treatment for potentially curable cancer, the medical team often focuses on the certainty of death without treatment. In the background, there is a smaller but still significant risk that - even if the treatment is eventually accepted or compelled - the child will still die from treatment-related complications or refractory disease, possibly with considerable suffering. The reasons for refusing a treatment vary. The entire medical team is tasked with trying to respectfully understand the reasoning behind the parents unwillingness to accept the treatment, in order to address all possible misunderstandings and to propose solutions that could be acceptable for the parents. In some situations however, it is necessary to resolve the dilemma by legal means in order to protect the life of the child.Key words: oncology - ethics - decision making - treatment refusal - legal guardians The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 7. 8. 2017Accepted: 7. 9. 2017.

PRACTICE REVIEW OF FIVE BIOREACTOR/RECIRCULATION LANDFILLS

EPA Science Inventory

Six bioreactor landfills were analyzed to provide a perspective of current practice and technical issues that differentiate bioreactor landfills from conventional landfills. Five of the bioreactor landfills were anaerobic and one was aerated. In one case, nearly identical cells e...

49 CFR 219.213 - Unlawful refusals; consequences.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Unlawful refusals; consequences. 219.213 Section 219.213 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... § 219.213 Unlawful refusals; consequences. (a) Disqualification. An employee who refuses to cooperate in...

Refusal of hemodialysis by hospitalized chronic kidney disease patients in Pakistan.

PubMed

Shafi, Salman Tahir; Saleem, Mohammad; Anjum, Roshina; Abdullah, Wajid; Shafi, Tahir

2018-01-01

In Pakistan, patients with chronic kidney disease (CKD) are commonly diagnosed at a late stage. There is little information about the refusal of hemodialysis by hospitalized CKD patients who need hemodialysis (HD) and reasons for acceptance and refusal among these patients. All patients with Stage V CKD who had medical indications to undergo HD and were hospitalized at a tertiary care facility over a six-month period were invited to participate in this study. Patients were surveyed regarding acceptance or refusing of HD and reasons for their decisions. Demographic, socioeconomic, and clinical characteristics of patients were compared between patients who accepted or refused HD. A total of 125 patients were included in the study. The mean age of the patients was 47.9 ±12.1 years. The mean duration of diagnosis of CKD was 2.5 ± 0.6 months. Of all patients, 72 (57.6%) agreed to do HD and 53 (42.4%) refused HD. Patients with arteriovenous fistula in place (27.1 vs. 9.1%, P 0.02) and those in the middle- or higher-income group (64.4% vs. 38.6%, p = 0.03) were more willing to undergo HD. Trust in doctor's advice (86.1%) was the most common reason for acceptance of HD. Frequency of HD per week (52.8%), lifelong and permanent nature of HD (50.9%), advice by family members or friends (37.7%), perception of poor quality of life on HD (35.8%), and fear of HD needles and complications during HD (33.9%) were the most common reasons for refusal. Refusal of HD is common among hospitalized CKD patients with medical indications to undergo HD, especially in lower income group.

Refusal of Recommended Chemotherapy for Ovarian Cancer: Risk Factors and Outcomes; a National Cancer Data Base Study.

PubMed

Wallace, Sumer K; Lin, Jeff F; Cliby, William A; Leiserowitz, Gary S; Tergas, Ana I; Bristow, Robert E

2016-05-01

To identify risk factors associated with refusal of recommended chemotherapy and its impact on patients with epithelial ovarian cancer (EOC). We identified patients in the National Cancer Data Base diagnosed with EOC from January 1998 to December 2011. Patients who refused chemotherapy were identified and compared with those who received recommended, multiagent chemotherapy. Univariate and multivariable analyses were performed using chi-square test with Bonferroni correction, binary logistic regression, log-rank test, and Cox proportional hazards modeling. The threshold for statistical significance was set at a P value of less than 0.05. From a cohort of 147,713 eligible patients, 2,707 refused chemotherapy. These patients were compared with 92,212 patients who received recommended multiagent chemotherapy. Older age, more medical comorbidities, not having insurance, and later year of diagnosis were directly and significantly associated with chemotherapy refusal when analyzed using multivariable logistic regression. In addition, lower-than-expected facility adherence to NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Ovarian Cancer, treatment at low-volume center, lower grade, and higher stage were all significantly and independently associated with chemotherapy refusal. Median overall survival of patients who received multiagent chemotherapy was significantly longer than that of those who refused chemotherapy (43 vs 4.8 months; P<.0005). After controlling for known patient, facility, and disease prognostic factors, chemotherapy refusal is significantly associated with increased risk of death. Refusal of recommended chemotherapy carries significant risk of early death from ovarian cancer. Our data demonstrate that the decision to refuse chemotherapy is multifactorial and, in addition to unalterable factors (eg, stage/grade, age), involves factors that can be changed, including facility type and payor. Efforts at addressing these discrepancies in

The Space Station integrated refuse management system

NASA Technical Reports Server (NTRS)

1988-01-01

The University of Central Florida's design of an Integrated Refuse Management System for the proposed International Space Station is addressed. Four integratable subsystems capable of handling an estimated Orbiter shortfall of nearly 40,000 lbs of refuse produced annually are discussed. The subsystems investigated were: (1) collection and transfer; (2) recycle and reuse; (3) advanced disposal; and (4) propulsion assist in disposal. Emphasis is placed on the recycling or reuse of those materials ultimately providing a source of Space Station refuse. Special consideration is given to various disposal methods capable of completely removing refuse from close proximity of the Space Station. There is evidence that pyrolysis is the optimal solution for disposal of refuse through employment of a Rocket Jettison Vehicle. Additionally, design considerations and specifications of the Refuse Management System are discussed. Optimal and alternate design solutions for each of the four subsystems are summarized. Finally, the system configuration is described and reviewed.

30 CFR 77.215-4 - Refuse piles; abandonment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; abandonment. 77.215-4 Section 77... MINES Surface Installations § 77.215-4 Refuse piles; abandonment. When a refuse pile is to be abandoned... refuse pile shall be abandoned in accordance with a plan submitted by the operator and approved by the...

Heart tissue grown in NASA Bioreactor

NASA Technical Reports Server (NTRS)

2001-01-01

Lisa Freed and Gordana Vunjak-Novakovic, both of the Massachusetts Institute of Technology (MIT), have taken the first steps toward engineering heart muscle tissue that could one day be used to patch damaged human hearts. Cells isolated from very young animals are attached to a three-dimensional polymer scaffold, then placed in a NASA bioreactor. The cells do not divide, but after about a week start to cornect to form a functional piece of tissue. Here, a transmission electron micrograph of engineered tissue shows a number of important landmarks present in functional heart tissue: (A) well-organized myofilaments (Mfl), z-lines (Z), and abundant glycogen granules (Gly); and (D) intercalcated disc (ID) and desmosomes (DES). The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). Credit: MIT

Heart tissue grown in NASA Bioreactor

NASA Technical Reports Server (NTRS)

2001-01-01

Lisa Freed and Gordana Vunjak-Novakovic, both of the Massachusetts Institute of Technology (MIT), have taken the first steps toward engineering heart muscle tissue that could one day be used to patch damaged human hearts. Cells isolated from very young animals are attached to a three-dimensional polymer scaffold, then placed in a NASA bioreactor. The cells do not divide, but after about a week start to cornect to form a functional piece of tissue. Functionally connected heart cells that are capable of transmitting electrical signals are the goal for Freed and Vunjak-Novakovic. Electrophysiological recordings of engineered tissue show spontaneous contractions at a rate of 70 beats per minute (a), and paced contractions at rates of 80, 150, and 200 beats per minute respectively (b, c, and d). The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. The Bioreactor is rotated to provide gentle mixing of fresh and spent nutrient without inducing shear forces that would damage the cells. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). Credit: NASA and MIT.

NASA Bioreactor tissue culture

NASA Technical Reports Server (NTRS)

1998-01-01

Dr. Lisa E. Freed of the Massachusetts Institute of Technology and her colleagues have reported that initially disc-like specimens tend to become spherical in space, demonstrating that tissues can grow and differentiate into distinct structures in microgravity. The Mir Increment 3 (Sept. 16, 1996 - Jan. 22, 1997) samples were smaller, more spherical, and mechanically weaker than Earth-grown control samples. These results demonstrate the feasibility of microgravity tissue engineering and may have implications for long human space voyages and for treating musculoskeletal disorders on earth. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

9 CFR 439.50 - Refusal of accreditation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ACCREDITATION OF NON-FEDERAL CHEMISTRY LABORATORIES § 439.50 Refusal of accreditation. Upon a determination by the Administrator, a laboratory will be refused accreditation for the following reasons: (a) A laboratory will be refused accreditation for failure to meet the requirements of § 439.5 or § 439.10 of this...

The space station integrated refuse management system

NASA Technical Reports Server (NTRS)

Anderson, Loren A.

1988-01-01

The design and development of an Integrated Refuse Management System for the proposed International Space Station was performed. The primary goal was to make use of any existing potential energy or material properties that refuse may possess. The secondary goal was based on the complete removal or disposal of those products that could not, in any way, benefit astronauts' needs aboard the Space Station. The design of a continuous living and experimental habitat in space has spawned the need for a highly efficient and effective refuse management system capable of managing nearly forty-thousand pounds of refuse annually. To satisfy this need, the following four integrable systems were researched and developed: collection and transfer; recycle and reuse; advance disposal; and propulsion assist in disposal. The design of a Space Station subsystem capable of collecting and transporting refuse from its generation site to its disposal and/or recycling site was accomplished. Several methods of recycling or reusing refuse in the space environment were researched. The optimal solution was determined to be the method of pyrolysis. The objective of removing refuse from the Space Station environment, subsequent to recycling, was fulfilled with the design of a jettison vehicle. A number of jettison vehicle launch scenarios were analyzed. Selection of a proper disposal site and the development of a system to propel the vehicle to that site were completed. Reentry into the earth atmosphere for the purpose of refuse incineration was determined to be the most attractive solution.

Predictors of condom use and refusal among the population of Free State province in South Africa

PubMed Central

2012-01-01

Background This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Methods Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT) were used for analysing two response variables ‘ever used condom’ and ‘ever refused condom’. Results Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by ‘knowledge of correct use of condom’, condom availability, young age, being single and higher education. ‘Perceived need’ for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one’s HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms). In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. Conclusions The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need for condom-use and

The Legal Ethical Backbone of Conscientious Refusal.

PubMed

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

22 CFR 40.6 - Basis for refusal.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Basis for refusal. 40.6 Section 40.6 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED General Provisions § 40.6 Basis for refusal. A visa can be refused...

21 CFR 211.50 - Sewage and refuse.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage and refuse. Sewage, trash, and other refuse in and from the building and immediate premises shall be...

Pediatric Depression: When Does Parental Refusal for Treatment Constitute Medical Neglect?

PubMed

Shapiro, Michael

2018-06-01

Depression is a common disorder in youth, and 10% to 15% of individuals have a lifetime prevalence by 18 years of age. Youth who receive treatment typically have a positive outcome, but many remain undiagnosed and untreated. 1 There is a dearth of literature on parental refusal to consent to treatment for pediatric depression and the circumstances under which such refusal could be considered medical neglect. In general, it appears that mental health diagnoses are rarely reported in cases of medical neglect. 2 . Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Medication Refusal: Resident Rights, Administration Dilemma.

PubMed

Haskins, Danielle R; Wick, Jeannette Y

2017-12-01

Occasionally, residents actively or passively refuse to take medications. Residents may refuse medication for a number of reasons, including religious beliefs, dietary restrictions, misunderstandings, cognitive impairment, desire to self-harm, or simple inconvenience. This action creates a unique situation for pharmacists and long-term facility staff, especially if patients have dementia. Residents have the legal right to refuse medications, and long-term care facilities need to employ a process to resolve disagreement between the health care team that recommends the medication and the resident who refuses it. In some cases, simple interventions like selecting a different medication or scheduling medications in a different time can address and resolve the resident's objection. If the medical team and the resident cannot resolve their disagreement, often an ethics consultation is helpful. Documenting the resident's refusal to take any or all medications, the health care team's actions and any other outcomes are important. Residents' beliefs may change over time, and the health care team needs to be prepared to revisit the issue as necessary.

ACOG Committee Opinion No. 306. Informed refusal.

PubMed

2004-12-01

Informed refusal is a fundamental component of the informed consent process. Informed consent laws have evolved to the "materiality or patient viewpoint" standard. A physician must disclose to the patient the risks, benefits, and alternatives that a reasonable person in the patient's position would want to know to make an informed decision. Throughout this process, the patient's autonomy, level of health literacy, and cultural background should be respected. The subsequent election by the patient to forgo an intervention that has been recommended by the physician constitutes informed refusal. Documentation of the informed refusal process is essential. It should include a notation that the need for the intervention, as well as risks, benefits, and alternatives to the intervention, and possible consequences of refusal, have been explained. The patient's reason for refusal also should be documented.

Legal briefing: conscience clauses and conscientious refusal.

PubMed

Pope, Thaddeus Mason

2010-01-01

This issue's "Legal Briefing" column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States. Healthcare providers' own moral beliefs have been obstructing and are expected to increasingly obstruct patients' access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs. There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing - on ethical, moral, or religious grounds healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse 2. Abortion: duty to provide 3. Contraception: right to refuse 4. Contraception: duty to provide 5. Sterilization: right to refuse 6. Fertility, HIV, vaccines

30 CFR 77.214 - Refuse piles; general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; general. 77.214 Section 77.214... Installations § 77.214 Refuse piles; general. (a) Refuse piles constructed on or after July 1, 1971, shall be..., tipples, or other surface installations and such piles shall not be located over abandoned openings or...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

Tissue grown in space in NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

For 5 days on the STS-70 mission, a bioreactor cultivated human colon cancer cells, such as the culture section shown here, which grew to 30 times the volume of control specimens grown on Earth. This significant result was reproduced on STS-85 which grew mature structures that more closely match what are found in tumors in humans. The two white circles within the tumor are part of a plastic lattice that helped the cells associate. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators.

Bioreactor design for tendon/ligament engineering.

PubMed

Wang, Tao; Gardiner, Bruce S; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B; Wang, Allan; Xu, Jiake; Smith, David W; Lloyd, David G; Zheng, Ming H

2013-04-01

Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a suitable culture environment, which mimics the dynamics of the in vivo environment for tendon/ligament maturation. For clinical settings, bioreactors also have the advantages of less-contamination risk, high reproducibility of cell propagation by minimizing manual operation, and a consistent end product. In this review, we identify the key components, design preferences, and criteria that are required for the development of an ideal bioreactor for engineering tendons and ligaments.

Designing electrical stimulated bioreactors for nerve tissue engineering

NASA Astrophysics Data System (ADS)

Sagita, Ignasius Dwi; Whulanza, Yudan; Dhelika, Radon; Nurhadi, Ibrahim

2018-02-01

Bioreactor provides a biomimetic ecosystem that is able to culture cells in a physically controlled system. In general, the controlled-parameters are temperature, pH, fluid flow, nutrition flow, etc. In this study, we develop a bioreactor that specifically targeted to culture neural stem cells. This bioreactor could overcome some limitations of conventional culture technology, such as petri dish, by providing specific range of observation area and a uniform treatment. Moreover, the microfluidic bioreactor, which is a small-controlled environment, is able to observe as small number of cells as possible. A perfusion flow is applied to mimic the physiological environment in human body. Additionally, this bioreactor also provides an electrical stimulation which is needed by neural stem cells. In conclusion, we found the correlation between the induced shear stress with geometric parameters of the bioreactor. Ultimately, this system shall be used to observe the interaction between stimulation and cell growth.

Colon tumor cells grown in NASA Bioreactor

NASA Technical Reports Server (NTRS)

2001-01-01

These photos compare the results of colon carcinoma cells grown in a NASA Bioreactor flown on the STS-70 Space Shuttle in 1995 flight and ground control experiments. The cells grown in microgravity (left) have aggregated to form masses that are larger and more similar to tissue found in the body than the cells cultured on the ground (right). The principal investigator is Milburn Jessup of the University of Texas M. D. Anderson Cancer Center. The NASA Bioreactor provides a low turbulence culture environment which promotes the formation of large, three-dimensional cell clusters. Due to their high level of cellular organization and specialization, samples constructed in the bioreactor more closely resemble the original tumor or tissue found in the body. NASA-sponsored bioreactor research has been instrumental in helping scientists to better understand normal and cancerous tissue development. In cooperation with the medical community, the bioreactor design is being used to prepare better models of human colon, prostate, breast and ovarian tumors. Cartilage, bone marrow, heart muscle, skeletal muscle, pancreatic islet cells, liver and kidney are just a few of the normal tissues being cultured in rotating bioreactors by investigators. Cell constructs grown in a rotating bioreactor on Earth (left) eventually become too large to stay suspended in the nutrient media. In the microgravity of orbit, the cells stay suspended. Rotation then is needed for gentle stirring to replenish the media around the cells. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC). Credit: NASA and University of Texas M. D. Anderson Cancer Center.

Process technology of luwak coffee through bioreactor utilization

NASA Astrophysics Data System (ADS)

Hadipernata, M.; Nugraha, S.

2018-01-01

Indonesia has an advantage in producing exotic coffee that is Luwak coffee. Luwak coffee is produced from the fermentation process in digestion of civet. Luwak coffee production is still limited due to the difficulty level in the use of civet animals as the only medium of Luwak coffee making. The research was conducted by developing technology of luwak coffee production through bioreactor utilization and addition the bacteria isolate from gastric of civet. The process conditions in the bioreactor which include temperature, pH, and bacteria isolate of civet are adjusted to the process that occurs in civet digestion, including peristaltic movement on the stomach and small intestine of the civet will be replaced by the use of propellers that rotate on the bioreactor. The result of research showed that proximat analysis data of artificial/bioreactor luwak coffee did not significant different with original luwak coffee. However, the original luwak coffee has higher content of caffeine compared to bioreactor luwak coffee. Based on the cuping test the bioreactor luwak coffee has a value of 84.375, while the original luwak coffee is 84.875. As the result, bioreactor luwak coffee has excellent taste that similiar with original luwak coffee taste.

Patient refusal of glaucoma surgery and associated factors in Lagos, Nigeria.

PubMed

Adekoya, Bola Josephine; Akinsola, Feyisayo B; Balogun, Bola Grace; Balogun, Modupe Medinat; Ibidapo, Olajumoke O

2013-01-01

To determine the prevalence of patient refusal of glaucoma surgery (GSR) and the associated factors in Lagos, Nigeria. A multicenter cross-sectional survey was conducted in Lagos state, Nigeria. Twelve centres were invited to participate, but data collection was completed in 10. Newly diagnosed glaucoma patients were recruited and interviewed from these sites over a four week period on prior awareness of glaucoma, surgery refusal, and reason(s) for the refusal. Presenting visual acuity was recorded from the patient files. The odds ratio and 95% confidence intervals (CI) were calculated. A total of 208 newly diagnosed glaucoma patients were recruited. Sixty-five (31.2%) patients refused surgery. Fear of surgery (31 (47.7%) patients), and fear of going blind (19 (29.2%) patients) were the most common reasons. The odds ratio of surgery refusal were marital status - not married versus married (2.0; 95% CI, 1.02-3.94), use of traditional medication - users versus non users (2.4; 95% CI, 1.1-5.2), perception of glaucoma causing blindness - no versus yes (3.7; 95% CI, 1.3-10.5), type of institution - government versus private (5.7; 95% CI, 1.3-25.1), and visual acuity in the better eye - normal vision versus visual impairment (2.3; 95% CI, 1.1-4.9). Age, gender, level of education, family history of glaucoma, and prior awareness of the diagnosis of glaucoma, were not significantly associated with surgery refusal. Perception of patients concerning glaucoma blindness was the strongest factor on multivariate analysis. GSR was relatively low in this study. Unmarried status, use of traditional medications, perception that glaucoma cannot cause blindness, government hospital patients, and good vision in the better eye were associated with GSR. These factors might help in the clinical setting in identifying appropriate individuals for targeted counseling, as well as the need for increased public awareness about glaucoma.

Bioreactor Design for Tendon/Ligament Engineering

PubMed Central

Wang, Tao; Gardiner, Bruce S.; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B.; Wang, Allan; Xu, Jiake

2013-01-01

Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a suitable culture environment, which mimics the dynamics of the in vivo environment for tendon/ligament maturation. For clinical settings, bioreactors also have the advantages of less-contamination risk, high reproducibility of cell propagation by minimizing manual operation, and a consistent end product. In this review, we identify the key components, design preferences, and criteria that are required for the development of an ideal bioreactor for engineering tendons and ligaments. PMID:23072472

Design considerations and challenges for mechanical stretch bioreactors in tissue engineering.

PubMed

Lei, Ying; Ferdous, Zannatul

2016-05-01

With the increase in average life expectancy and growing aging population, lack of functional grafts for replacement surgeries has become a severe problem. Engineered tissues are a promising alternative to this problem because they can mimic the physiological function of the native tissues and be cultured on demand. Cyclic stretch is important for developing many engineered tissues such as hearts, heart valves, muscles, and bones. Thus a variety of stretch bioreactors and corresponding scaffolds have been designed and tested to study the underlying mechanism of tissue formation and to optimize the mechanical conditions applied to the engineered tissues. In this review, we look at various designs of stretch bioreactors and common scaffolds and offer insights for future improvements in tissue engineering applications. First, we summarize the requirements and common configuration of stretch bioreactors. Next, we present the features of different actuating and motion transforming systems and their applications. Since most bioreactors must measure detailed distributions of loads and deformations on engineered tissues, techniques with high accuracy, precision, and frequency have been developed. We also cover the key points in designing culture chambers, nutrition exchanging systems, and regimens used for specific tissues. Since scaffolds are essential for providing biophysical microenvironments for residing cells, we discuss materials and technologies used in fabricating scaffolds to mimic anisotropic native tissues, including decellularized tissues, hydrogels, biocompatible polymers, electrospinning, and 3D bioprinting techniques. Finally, we present the potential future directions for improving stretch bioreactors and scaffolds. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:543-553, 2016. © 2016 American Institute of Chemical Engineers.

Teaching refusal skills to sexually active adolescents.

PubMed

Warzak, W J; Page, T J

1990-06-01

Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.

Pragmatic Transfer in Thai EFL Refusals

ERIC Educational Resources Information Center

Wannaruk, Anchalee

2008-01-01

Communication breakdowns can occur during cross-cultural communication due to different perceptions and interpretations of appropriateness and politeness. This study investigates similarities and differences between refusals in American English and Thai and incidences of pragmatic transfer by Thai EFL learners when making refusals. The…

30 CFR 77.215-1 - Refuse piles; identification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; identification. 77.215-1 Section... COAL MINES Surface Installations § 77.215-1 Refuse piles; identification. A permanent identification marker, at least six feet high and showing the refuse pile identification number as assigned by the...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

Schisandra lignans production regulated by different bioreactor type.

PubMed

Szopa, Agnieszka; Kokotkiewicz, Adam; Luczkiewicz, Maria; Ekiert, Halina

2017-04-10

Schisandra chinensis (Chinese magnolia vine) is a rich source of therapeutically relevant dibenzocyclooctadiene lignans with anticancer, immunostimulant and hepatoprotective activities. In this work, shoot cultures of S. chinensis were grown in different types of bioreactors with the aim to select a system suitable for the large scale in vitro production of schisandra lignans. The cultures were maintained in Murashige-Skoog (MS) medium supplemented with 3mg/l 6-benzylaminopurine (BA) and 1mg/l 1-naphthaleneacetic acid (NAA). Five bioreactors differing with respect to cultivation mode were tested: two liquid-phase systems (baloon-type bioreactor and bubble-column bioreactor with biomass immobilization), the gas-phase spray bioreactor and two commercially available temporary immersion systems: RITA ® and Plantform. The experiments were run for 30 and 60 days in batch mode. The harvested shoots were evaluated for growth and lignan content determined by LC-DAD and LC-DAD-ESI-MS. Of the tested bioreactors, temporary immersion systems provided the best results with respect to biomass production and lignan accumulation: RITA ® bioreactor yielded 17.86g/l (dry weight) during 60 day growth period whereas shoots grown for 30 days in Plantform bioreactor contained the highest amount of lignans (546.98mg/100g dry weight), with schisandrin, deoxyschisandrin and gomisin A as the major constituents (118.59, 77.66 and 67.86mg/100g dry weight, respectively). Copyright © 2017 Elsevier B.V. All rights reserved.

Refusal of treatment in obstetrics - A maternal-fetal conflict.

PubMed

Ohel, Iris; Iris, Ohel; Levy, Amalia; Amalia, Levy; Mazor, Moshe; Moshe, Mazor; Wiznitzer, Arnon; Arnon, Wiznitzer; Sheiner, Eyal; Eyal, Sheiner

2009-07-01

Clinical studies about the necessity of standard obstetric interventions raise questions, making refusal by pregnant women of treatment a legitimate choice. The present study was aimed at characterising patients refusing medical treatment during pregnancy and delivery, and to examine whether refusal of treatment in obstetrics is associated with adverse perinatal outcome. A population-based study, comparing patients who refused (1898) and did not refuse (164,064) medical intervention during pregnancy and delivery, was conducted. Deliveries occurred between the years 1988 and 2002 in a tertiary medical centre. Patients refusing medical intervention tended to be older (30.5 +/- 5.0 vs. 28.4 +/- 5.9, p < 0.001) and of higher parity (above parity 5: 52.5% vs. 32.4%; parity 1: 10.2% vs. 20.0%; p < 0.001) than the controls. Parturients refusing medical treatment experienced significantly higher rates of adverse perinatal outcome including low Apgar scores (less than 7, in 1 and 5 min: 12.4% vs. 4.4%, p < 0.001 and 1.9% vs. 0.6%, p < 0.001, respectively). Moreover, higher rates of perinatal mortality in general and intra-partum death, in particular, were documented among women refusing medical treatment (3.3% vs. 1.5%, p < 0.001; 0.8% vs. 0.1%, p < 0.001). When using a multiple logistic regression model of risk factors for perinatal mortality, refuse of treatment was an independent risk factor for perinatal mortality (OR = 1.5; 95% CI = 1.1-2.0; p = 0.010). Patients refusing a medically indicated intervention have higher rates of pregnancy- and labour- related complications. Refusal of treatment is an independent risk factor for perinatal mortality.

Clinostats and bioreactors.

PubMed

Klaus, D M

2001-06-01

The environment created on Earth within a clinostat or Rotating Wall Vessel (RWV) bioreactor is often referred to as "simulated microgravity". Both devices utilize constant reorientation to effectively nullify cumulative sedimentation of particles. Neither, however, can fully reproduce the concurrent lack of structural deformation, displacement of intercellular components and/or reduced mass transfer in the extracellular fluid that occur in actual weightlessness. Parameters including density, viscosity, and even container geometry must each be considered to determine the overall gravity-dependent effects produced by either a clinostat or the RWV bioreactor; in addition, the intended application of these two devices differs considerably. A state of particle "motionlessness" relative to the surrounding bulk fluid, which is nearly analogous to the extracellular environment encountered under weightless conditions, can theoretically be achieved through clinorotation. The RWV bioreactor, on the other hand, while similarly maintaining cells in suspension as they continually "fall" through the medium under 1 g conditions, can also purposefully induce a perfusion of nutrients to and waste from the culture. A clinostat, therefore, is typically used in an attempt to reproduce the quiescent, unstirred fluid conditions achievable on orbit; while the RWV bioreactor ideally creates a low shear, but necessarily mixed, fluid environment that is optimized for suspension culture and tissue growth. Other techniques for exploring altered inertial environments, such as freefall, neutral buoyancy and electromagnetic levitation, can also provide unique insight into how gravity affects biological systems. Ultimately, all underlying biophysical principles thought to give rise to gravity-dependent physiological responses must be identified and thoroughly examined in order to accurately interpret data from flight experiments or ground-based microgravity analogs.

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2013 CFR

2013-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2012 CFR

2012-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

Ways to say no: refusal skill strategies among urban adolescents.

PubMed

Nichols, Tracy R; Graber, Julia A; Brooks-Gunn, Jeanne; Botvin, Gilbert J

2006-01-01

To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer refusal skills. Differences were found by situation with students demonstrating greater use of Simple No in the smoking refusal and Alternatives in the shoplifting refusal. Nonverbal assertiveness was similar across situations and was associated with Declarative Statements, but only in the smoking refusal. Prevention programs should tailor refusal skills practice to cover multiple situations.

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

Two-liquid-phase bioreactors.

PubMed

Van Sonsbeek, H M; Beeftink, H H; Tramper, J

1993-09-01

The application of two liquid phases that are poorly miscible is a fascinating research topic for biocatalytical conversions because of the promising results. Motives for application include an increase of productivity and achievement of continuous processing, but new limitations arise, e.g., interfacial effects such as biocatalyst accumulation and loss of activity, medium component accumulation, and slow coalescence. Centrifuges, membranes, and immobilization are tools that can overcome part of the problems, but more fundamental knowledge about interfaces and coalescence is still necessary for successful application. For scaleup and further development of processes based on the obtained results, a choice must be made for the configuration of the experimental setup of a bioreactor. Aspects like aeration, shear stress, batch or continuous processing, and immobilization can play an important role. This review article describes these aspects and the proposals that have been made in recent years concerning two-liquid-phase bioreactors. It shows some adaptations to existing bioreactors, such as loop reactors and stirred-tank reactors.

Predictors of intensive care unit refusal in French intensive care units: a multiple-center study.

PubMed

Garrouste-Orgeas, Maité; Montuclard, Luc; Timsit, Jean-François; Reignier, Jean; Desmettre, Thibault; Karoubi, Philippe; Moreau, Delphine; Montesino, Laurent; Duguet, Alexandre; Boussat, Sandrine; Ede, Christophe; Monseau, Yannick; Paule, Thierry; Misset, Benoit; Carlet, Jean

2005-04-01

To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. Observational, prospective, multiple-center study. Four university hospitals and seven primary-care hospitals in France. None. Age, underlying diseases (McCabe score and Knaus class), dependency, hospital mortality, and ICU characteristics were recorded. The crude ICU refusal rate was 23.8% (137/574), with variations from 7.1% to 63.1%. The reasons for refusal were too well to benefit (76/137, 55.4%), too sick to benefit (51/137, 37.2%), unit too busy (9/137, 6.5%), and refusal by the family (1/137). In logistic regression analyses, two patient-related factors were associated with ICU refusal: dependency (odds ratio [OR], 14.20; 95% confidence interval [CI], 5.27-38.25; p < .0001) and metastatic cancer (OR, 5.82; 95% CI, 2.22-15.28). Other risk factors were organizational, namely, full unit (OR, 3.16; 95% CI, 1.88-5.31), center (OR, 3.81; 95% CI, 2.27-6.39), phone admission (OR, 0.23; 95% CI, 0.14-0.40), and daytime admission (OR, 0.52; 95% CI, 0.32-0.84). The Standardized Mortality Ratio was 1.41 (95% CI, 1.19-1.69) for immediately admitted patients, 1.75 (95% CI, 1.60-1.84) for refused patients, and 1.03 (95% CI, 0.28-1.75) for later-admitted patients. ICU refusal rates varied greatly across ICUs and were dependent on both patient and organizational factors. Efforts to define ethically optimal ICU admission policies might lead to greater homogeneity in refusal rates, although case-mix variations would be expected to leave an irreducible amount of variation across ICUs.

Effective Intervention for School Refusal Behaviour

ERIC Educational Resources Information Center

Nuttall, Clare; Woods, Kevin

2013-01-01

Evaluation of successful professional intervention for two case studies of female adolescents' school refusal behaviour is presented. Data gathered from the young person, professionals, and parents in each case are synthesised to propose a multi-level, ecologically situated model of intervention for school refusal behaviour. The proposed model…

Children of divorce: the differential diagnosis of contact refusal.

PubMed

Freeman, Bradley W

2011-07-01

Contact refusal is a common phenomenon that can occur during the course of, or after, divorce, which affects the relationship between a child and the parent. This article defines the concept of contact refusal and discusses the importance of its recognition. The concept is further narrowed to focus on the child as the one refusing contact, not the parent, which can happen as well. Various types of contact refusals are illustrated in the article through clinical vignettes, and an approach to categorizing the various types of contact refusal is presented. Copyright © 2011 Elsevier Inc. All rights reserved.

EVALUATION PLAN FOR TWO LARGE-SCALE LANDFILL BIOREACTOR TECHNOLOGIES

EPA Science Inventory

Abstract - Waste Management, Inc., is operating two long-term bioreactor studies at the Outer Loop Landfill in Louisville, KY, including facultative landfill bioreactor and staged aerobic-anaerobic landfill bioreactor demonstrations. A Quality Assurance Project Plan (QAPP) was p...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

The cost of refusing treatment and equality of outcome.

PubMed Central

Savulescu, J

1998-01-01

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. PMID:9752624

Role of Bioreactors in Microbial Biomass and Energy Conversion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Liang; Zhang, Biao; Zhu, Xun

Bioenergy is the world’s largest contributor to the renewable and sustainable energy sector, and it plays a significant role in various energy industries. A large amount of research has contributed to the rapidly evolving field of bioenergy and one of the most important topics is the use of the bioreactor. Bioreactors play a critical role in the successful development of technologies for microbial biomass cultivation and energy conversion. In this chapter, after a brief introduction to bioreactors (basic concepts, configurations, functions, and influencing factors), the applications of the bioreactor in microbial biomass, microbial biofuel conversion, and microbial electrochemical systems aremore » described. Importantly, the role and significance of the bioreactor in the bioenergy process are discussed to provide a better understanding of the use of bioreactors in managing microbial biomass and energy conversion.« less

School Refusal

ERIC Educational Resources Information Center

Wimmer, Mary

2008-01-01

School attendance is an ongoing concern for administrators, particularly in middle level and high school. Frequent absences affect student learning, test scores, and social development. Absenteeism is often the result of emotional disorders, such as anxiety or depression. Administrators who understand the causes of school refusal behavior and are…

Multifunctional Bioreactor System for Human Intestine Tissues

PubMed Central

2017-01-01

The three-dimensional (3D) cultivation of intestinal cells and tissues in dynamic bioreactor systems to represent in vivo intestinal microenvironments is essential for developing regenerative medicine treatments for intestinal diseases. We have previously developed in vitro human intestinal tissue systems using a 3D porous silk scaffold system with intestinal architectures and topographical features for the adhesion, growth, and differentiation of intestinal cells under static culture conditions. In this study, we designed and fabricated a multifunctional bioreactor system that incorporates pre-epithelialized 3D silk scaffolds in a dynamic culture environment for in vitro engineering of human intestine tissues. The bioreactor system allows for control of oxygen levels in perfusion fluids (aerobic simulated intestinal fluid (SIF), microaerobic SIF, and anaerobic SIF), while ensuring control over the mechanical and chemical microenvironments present in native human intestines. The bioreactor system also enables 3D cell culture with spatial separation and cultivation of cocultured epithelial and stromal cells. Preliminary functional analysis of tissues housed in the bioreactor demonstrated that the 3D tissue constructs survived and maintained typical phenotypes of intestinal epithelium, including epithelial tight junction formation, intestinal biomarker expression, microvilli formation, and mucus secretion. The unique combination of a dynamic bioreactor and 3D intestinal constructs offers utility for engineering human intestinal tissues for the study of intestinal diseases and discovery options for new treatments. PMID:29333491

Physicians' evaluations of patients' decisions to refuse oncological treatment

PubMed Central

van Kleffens, T; van Leeuwen, E

2005-01-01

Objective: To gain insight into the standards of rationality that physicians use when evaluating patients' treatment refusals. Design of the study: Qualitative design with indepth interviews. Participants: The study sample included 30 patients with cancer and 16 physicians (oncologists and general practitioners). All patients had refused a recommended oncological treatment. Results: Patients base their treatment refusals mainly on personal values and/or experience. Physicians mainly emphasise the medical perspective when evaluating patients' treatment refusals. From a medical perspective, a patient's treatment refusal based on personal values and experience is generally evaluated as irrational and difficult to accept, especially when it concerns a curative treatment. Physicians have a different attitude towards non-curative treatments and have less difficulty accepting a patient's refusal of these treatments. Thus, an important factor in the physician's evaluation of a treatment refusal is whether the treatment refused is curative or non-curative. Conclusion: Physicians mainly use goal oriented and patients mainly value oriented rationality, but in the case of non-curative treatment refusal, physicians give more emphasis to value oriented rationality. A consensus between the value oriented approaches of patient and physician may then emerge, leading to the patient's decision being understood and accepted by the physician. The physician's acceptance is crucial to his or her attitude towards the patient. It contributes to the patient's feeling free to decide, and being understood and respected, and thus to a better physician–patient relationship. PMID:15738431

20 CFR 401.70 - Appeals of refusals to correct records or refusals to allow access to records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... explaining the decision on your appeal. The time limit for making our decision after we receive your appeal... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Appeals of refusals to correct records or refusals to allow access to records. 401.70 Section 401.70 Employees' Benefits SOCIAL SECURITY...

In Situ Bioreactor

ScienceCinema

Blackwelder, Brad

2018-05-11

At Idaho National Laboratory, researchers have developed bioreactor technology that permits identification, bioremediation testing and treatment at the source using naturally occurring microbes to disarm contaminants.

Bioreactor Technology in Cardiovascular Tissue Engineering

NASA Astrophysics Data System (ADS)

Mertsching, H.; Hansmann, J.

Cardiovascular tissue engineering is a fast evolving field of biomedical science and technology to manufacture viable blood vessels, heart valves, myocar-dial substitutes and vascularised complex tissues. In consideration of the specific role of the haemodynamics of human circulation, bioreactors are a fundamental of this field. The development of perfusion bioreactor technology is a consequence of successes in extracorporeal circulation techniques, to provide an in vitro environment mimicking in vivo conditions. The bioreactor system should enable an automatic hydrodynamic regime control. Furthermore, the systematic studies regarding the cellular responses to various mechanical and biochemical cues guarantee the viability, bio-monitoring, testing, storage and transportation of the growing tissue.

The right not to be treated or to refuse treatment.

PubMed

Deutsch, E

1989-01-01

The corollary to the right to refuse treatment is the requirement that, in general, informed consent be obtained before treatment. The Declaration of Lisbon recognises this: "The patient has the right to accept or to refuse treatment after receiving adequate information." The information to be given to the patient is of three kinds, but a special problem in relation to the doctrine of informed refusal places a special duty on the doctor to inform the patient about the possible consequences of refusing treatment. Related topics, such as refusal in part, refusal by a parent or guardian, the novus actus interveniens, the living will, and contributory negligence are touched upon.

Factors Associated with School Refusal in Adolescents: Some Preliminary Results.

ERIC Educational Resources Information Center

Ficula, Teresa V.; And Others

School refusal, as differentiated from both school phobia and truancy, is a term used to denote emotionally-based avoidance of school. To identify factors associated with school refusal, 41 junior high and high school students (including special education school refusers, special education non-refusers, and a comparison group from a regular…

Effect of sudden addition of PCE and bioreactor coupling to ZVI filters on performance of fluidized bed bioreactors operated in simultaneous electron acceptor modes.

PubMed

Moreno-Medina, C U; Poggi-Varaldo, Hector M; Breton-Deval, L; Rinderknecht-Seijas, N

2017-11-01

The present work evaluated the effects of (i) feeding a water contaminated with 80 mg/L PCE to bioreactors seeded with inoculum not acclimated to PCE, (ii) coupling ZVI side filters to bioreactors, and (iii) working in different biological regimes, i.e., simultaneous methanogenic aeration and simultaneous methanogenic-denitrifying regimes, on fluidized bed bioreactor performance. Simultaneous electron acceptors refer to the simultaneous presence of two compounds operating as final electron acceptors in the biological respiratory chain (e.g., use of either O 2 or NO 3 - in combination with a methanogenic environment) in a bioreactor or environmental niche. Four lab-scale, mesophilic, fluidized bed bioreactors (bioreactors) were implemented. Two bioreactors were operated as simultaneous methanogenic-denitrifying (MD) units, whereas the other two were operated in partially aerated methanogenic (PAM) mode. In the first period, all bioreactors received a wastewater with 1 g chemical oxygen demand of methanol per liter (COD-methanol/L). In a second period, all the bioreactors received the wastewater plus 80 mg perchloroethylene (PCE)/L; at the start of period 2, one MD and one PAM were coupled to side sand-zero valent iron filters (ZVI). All bioreactors were inoculated with a microbial consortium not acclimated to PCE. In this work, the performance of the full period 1 and the first 60 days of period 2 is reported and discussed. The COD removal efficiency and the nitrate removal efficiency of the bioreactors essentially did not change between period 1 and period 2, i.e., upon PCE addition. On the contrary, specific methanogenic activity in PAM bioreactors (both with and without coupled ZVI filter) significantly decreased. This was consistent with a sharp fall of methane productivity in those bioreactors in period 2. During period 2, PCE removals in the range 86 to 97 % were generally observed; the highest removal corresponded to PAM bioreactors along with the

Reduced-Gravity Experiments Conducted to Help Bioreactor Development

NASA Technical Reports Server (NTRS)

Niederhaus, Charles E.; Nahra, Henry K.; Kizito, John P.

2004-01-01

The NASA Glenn Research Center and the NASA Johnson Space Center are collaborating on fluid dynamic investigations for a future cell science bioreactor to fly on the International Space Station (ISS). Project Manager Steven Gonda from the Cellular Biotechnology Program at Johnson is leading the development of the Hydrodynamic Focusing Bioreactor--Space (HFB-S) for use on the ISS to study tissue growth in microgravity. Glenn is providing microgravity fluid physics expertise to help with the design and evaluation of the HFB-S. These bioreactors are used for three-dimensional tissue culture, which cannot be done in ground-based labs in normal gravity. The bioreactors provide a continual supply of oxygen for cell growth, as well as periodic replacement of cell culture media with nutrients. The bioreactor must provide a uniform distribution of oxygen and nutrients while minimizing the shear stresses on the tissue culture.

[Refusal of treatments by an adult cancer patient].

PubMed

Dauchy, Sarah; Faivre, Jean-Christophe; Block, Véronique; Metzger, Maude; Salleron, Julia; Charles, Cécile; Adam, Virginie

2018-03-01

Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Drink refusal training as part of a combined behavioral intervention: Effectiveness and mechanisms of change

PubMed Central

Witkiewitz, Katie; Donovan, Dennis M.; Hartzler, Bryan

2012-01-01

Objective Many trials have demonstrated the effectiveness of cognitive behavioral interventions for alcohol dependence, yet few studies have examined why particular treatments are effective. This study was designed to evaluate whether drink refusal training was an effective component of a combined behavioral intervention (CBI) and whether change in self-efficacy was a mechanism of change following drink refusal training for individuals with alcohol dependence. Method The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. The goal of the current study was to examine whether a drink refusal skills training module, administered as part of a 16-week CBI (n=776; 31% female, 23% non-White, average age=44) predicted changes in drinking frequency and self-efficacy during and following the CBI, and whether changes in self-efficacy following drink refusal training predicted changes in drinking frequency up to one year following treatment. Results Participants (n=302) who received drink refusal skills training had significantly fewer drinking days during treatment (d=0.50) and up to one year following treatment (d=0.23). In addition the effect of the drink refusal skills training module on drinking outcomes following treatment was significantly mediated by changes in self-efficacy, even after controlling for changes in drinking outcomes during treatment (proportion mediated = 0.47). Conclusions Drink refusal training is an effective component of CBI and some of the effectiveness may be attributed to changes in client self-efficacy. PMID:22289131

Method of extracting coal from a coal refuse pile

DOEpatents

Yavorsky, Paul M.

1991-01-01

A method of extracting coal from a coal refuse pile comprises soaking the coal refuse pile with an aqueous alkali solution and distributing an oxygen-containing gas throughout the coal refuse pile for a time period sufficient to effect oxidation of coal contained in the coal refuse pile. The method further comprises leaching the coal refuse pile with an aqueous alkali solution to solubilize and extract the oxidized coal as alkali salts of humic acids and collecting the resulting solution containing the alkali salts of humic acids. Calcium hydroxide may be added to the solution of alkali salts of humic acid to form precipitated humates useable as a low-ash, low-sulfur solid fuel.

Denitrifying bioreactor clogging potential during wastewater treatment.

PubMed

Christianson, Laura E; Lepine, Christine; Sharrer, Kata L; Summerfelt, Steven T

2016-11-15

Chemoheterotrophic denitrification technologies using woodchips as a solid carbon source (i.e., woodchip bioreactors) have been widely trialed for treatment of diffuse-source agricultural nitrogen pollution. There is growing interest in the use of this simple, relatively low-cost biological wastewater treatment option in waters with relatively higher total suspended solids (TSS) and chemical oxygen demand (COD) such as aquaculture wastewater. This work: (1) evaluated hydraulic retention time (HRT) impacts on COD/TSS removal, and (2) assessed the potential for woodchip clogging under this wastewater chemistry. Four pilot-scale woodchip denitrification bioreactors operated for 267 d showed excellent TSS removal (>90%) which occurred primarily near the inlet, and that COD removal was maximized at lower HRTs (e.g., 56% removal efficiency and 25 g of COD removed per m 3 of bioreactor per d at a 24 h HRT). However, influent wastewater took progressively longer to move into the woodchips likely due to a combination of (1) woodchip settling, (2) clogging due to removed wastewater solids and/or accumulated bacterial growth, and (3) the pulsed flow system pushing the chips away from the inlet. The bioreactor that received the highest loading rate experienced the most altered hydraulics. Statistically significant increases in woodchip P content over time in woodchip bags placed near the bioreactor outlets (0.03 vs 0.10%P 2 O 5 ) and along the bioreactor floor (0.04 vs. 0.12%P 2 O 5 ) confirmed wastewater solids were being removed and may pose a concern for subsequent nutrient mineralization and release. Nevertheless, the excellent nitrate-nitrogen and TSS removal along with notable COD removal indicated woodchip bioreactors are a viable water treatment technology for these types of wastewaters given they are used downstream of a filtration device. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Factors associated with repeated refusal to participate in longitudinal population-based HIV surveillance in rural South Africa: an observational study, regression analyses

PubMed Central

Giordano, Katie; McGrath, Nuala; Snow, Rachel; Harlow, Siobán; Newell, Marie-Louise

2014-01-01

Background For many estimation purposes, individuals who repeatedly refuse to participate in longitudinal HIV surveillance pose a bigger threat to valid inferences than individuals who participate at least occasionally. We investigate the determinants of repeated refusal to consent to HIV testing in a population-based longitudinal surveillance in rural South Africa. Methods We used data from two years (2005 & 2006) of the annual HIV surveillance conducted by the Africa Centre for Health and Population Studies, linking the HIV surveillance data to demographic and socioeconomic data. The outcome for the analysis was “repeated refusal”. Demographic variables included sex, age, highest educational attainment, and place of residence. We also included a measure of wealth and the variable “ever had sex”. To compare the association of each variable with the outcome, unadjusted odds ratios and standard errors were estimated. Multivariable logistic regression was used to estimate adjusted odds ratios and their standard errors. Data were analyzed using STATA 10.0. Results Of 15,557 eligible individuals, 46% refused to test for HIV in both rounds. Males were significantly more likely than females to repeatedly refuse testing. Holding all other variables constant, individuals in the middle age groups were more likely to repeatedly refuse testing compared with younger and older age groups. The odds of repeated refusal increased with increasing level of education and relative wealth. People living in urban areas were significantly more likely to repeatedly refuse an HIV test than people living in peri-urban or rural areas. Compared to those who had ever had sex, both males and females who had not yet had sex were significantly more likely to refuse to participate. Conclusions The likelihood of repeated refusal to test for HIV in this longitudinal surveillance increases with education, wealth, urbanization, and primary sexual abstinence. Since the factors determining

Development of Fundamental Technologies for Micro Bioreactors

NASA Astrophysics Data System (ADS)

Sato, Kiichi; Kitamori, Takehiko

This chapter reviews the development of fundamental technologies required for microchip-based bioreactors utilizing living mammalian cells and pressure driven flow. The most important factor in the bioreactor is the cell culture. For proper cell culturing, continuous medium supply from a microfluidic channel and appropriate modification of the channel surface to accommodate cell attachment is required. Moreover, the medium flow rate should be chosen carefully, because shear stress affects cell activity. The techniques presented here could be applied to the development of micro bioreactors such as microlivers, pigment production by plant cells, and artificial insemination.

Parental Refusal of Childhood Vaccines and Medical Neglect Laws.

PubMed

Parasidis, Efthimios; Opel, Douglas J

2017-01-01

To examine the relation of vaccine refusal and medical neglect under child welfare laws. We used the Westlaw legal database to search court opinions from 1905 to 2016 and identified cases in which vaccine refusal was the sole or a primary reason in a neglect proceeding. We also delineated if religious or philosophical exemptions from required school immunizations were available at the time of adjudication. Our search yielded 9 cases from 5 states. Most courts (7 of 9) considered vaccine refusal to constitute neglect. In the 4 cases decided in jurisdictions that permitted religious exemptions, courts either found that vaccine refusal did not constitute neglect or considered it neglect only in the absence of a sincere religious objection to vaccination. Some states have a legal precedent for considering parental vaccine refusal as medical neglect, but this is based on a small number of cases. Each state should clarify whether, under its laws, vaccine refusal constitutes medical neglect.

Self-reporting and measurement of body mass index in adolescents: refusals and validity, and the possible role of socioeconomic and health-related factors.

PubMed

Chau, Nearkasen; Chau, Kénora; Mayet, Aurélie; Baumann, Michèle; Legleye, Stéphane; Falissard, Bruno

2013-09-08

Body mass index assessment using self-reported height and weight (BMIsr) can encounter refusals and under/over-reporting while for assessment with measured data (BMIm) refusals can be more frequent. This could relate to socioeconomic and health-related factors. We explored these issues by investigating numerous potential factors: gender, age, family structure, father's occupation, income, physical/sports activity, subjective weight perception, school performance, unhealthy behaviours, physical/psychological health, social relationships, living environment, having sustained violence, sexual abuse, and involvement in violence. The sample included 1559 adolescents from middle schools in north-eastern France. They completed a questionnaire including socioeconomic and health-related data, self-reported height/weight, measured height/weight, and weight perception (participation rate 94%). Data were analysed using logistic regression models. BMIsr encountered under-reporting (with change in BMI category, 11.8%), over-reporting (6.0%), and reporting refusals (3.6%). BMIm encountered more numerous refusals (7.9%). Reporting refusal was related to living with a single parent, low school performance, lack of physical/sports activity, sustained violence, poor psychological health, and poor social relationships (gender/age-adjusted odds ratios 1.95 to 2.91). Further to these factors, measurement refusal was related to older age, having divorced/separated parents, a father being a manual worker/inactive, insufficient family income, tobacco/cannabis use, involvement in violence, poor physical health, and poor living environment (1.30 to 3.68). Under-reporting was related to male gender, involvement in violence, poor psychological health, and overweight/obesity (as assessed with BMIm) (1.52 to 11). Over-reporting was related to male gender, younger age, alcohol consumption, and underweight (1.30 to 5.35). Weight perception was linked to reporting refusals and under

21 CFR 316.14 - Refusal to provide written recommendations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Refusal to provide written recommendations. 316.14... (CONTINUED) DRUGS FOR HUMAN USE ORPHAN DRUGS Written Recommendations for Investigations of Orphan Drugs § 316.14 Refusal to provide written recommendations. (a) FDA may refuse to provide written recommendations...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

Breath test refusals

DOT National Transportation Integrated Search

2007-11-01

The National Highway Traffic Safety Administration has found that the percentage of people who refuse to provide breath samples when arrested for Driving While Intoxicated (DWI) varies considerably across States, and this creates a concern in the cri...

Coal-cleaning plant refuse characterization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cavalet, J.R.; Torak, E.R.

1985-06-01

This report describes a study performed for the Electric Power Research Institute's Coal Cleaning Test Facility in Homer City, Pennsylvania. The purpose of the study was to design a standard methods for chemically and physically classifying refuse generated by physical coal cleaning and to construct a matrix that will accurately predict how a particular refuse will react to particular disposal methods - based solely on raw-coal characteristics and the process used to clean the coal. The value of such a classification system (which has not existed to this point) is the ability to design efficient and economical systems for disposingmore » of specific coal cleaning refuse. The report describes the project's literature search and a four-tier classification system. It also provides designs for test piles, sampling procedures, and guidelines for a series of experiments to test the classfication system and create an accurate, reliable predictive matrix. 38 refs., 39 figs., 35 tabs.« less

30 CFR 77.215-2 - Refuse piles; reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; reporting requirements. 77.215-2... COAL MINES Surface Installations § 77.215-2 Refuse piles; reporting requirements. (a) The proposed location of a new refuse pile shall be reported to and acknowledged in writing by the District Manager...

BIOREACTOR DESIGN - OUTER LOOP LANDFILL, LOUISVILLE, KY

EPA Science Inventory

Bioreactor field demonstration projects are underway at the Outer Loop Landfill in Louisville, KY, USA. The research effort is a cooperative research effort between US EPA and Waste Management Inc. Two primary kinds of municipal waste bioreactors are under study at this site. ...

BIOREACTOR LANDFILLS, THEORETICAL ADVANTAGES AND RESEARCH CHALLENGES

EPA Science Inventory

Bioreactor landfills are municipal solid waste landfills that utilize bulk liquids in an effort to accelerate solid waste degradation. There are few potential benefits for operating a MSW landfill as a bioreactor. These include leachate treatment and management, increase in the s...

Membrane Bioreactor With Pressure Cycle

NASA Technical Reports Server (NTRS)

Efthymiou, George S.; Shuler, Michael L.

1991-01-01

Improved class of multilayer membrane bioreactors uses convention forced by differences in pressure to overcome some of diffusional limitations of prior bioreactors. In reactor of new class, flow of nutrient solution reduces adverse gradients of concentration, keeps cells supplied with fresh nutrient, and sweeps away products faster than diffusion alone. As result, overall yield and rate of reaction increased. Pressures in sweeping gas and nutrient alternated to force nutrient liquid into and out of biocatalyst layer through hyrophilic membrane.

Hydrofocusing Bioreactor for Three-Dimensional Cell Culture

NASA Technical Reports Server (NTRS)

Gonda, Steve R.; Spaulding, Glenn F.; Tsao, Yow-Min D.; Flechsig, Scott; Jones, Leslie; Soehnge, Holly

2003-01-01

The hydrodynamic focusing bioreactor (HFB) is a bioreactor system designed for three-dimensional cell culture and tissue-engineering investigations on orbiting spacecraft and in laboratories on Earth. The HFB offers a unique hydrofocusing capability that enables the creation of a low-shear culture environment simultaneously with the "herding" of suspended cells, tissue assemblies, and air bubbles. Under development for use in the Biotechnology Facility on the International Space Station, the HFB has successfully grown large three-dimensional, tissuelike assemblies from anchorage-dependent cells and grown suspension hybridoma cells to high densities. The HFB, based on the principle of hydrodynamic focusing, provides the capability to control the movement of air bubbles and removes them from the bioreactor without degrading the low-shear culture environment or the suspended three-dimensional tissue assemblies. The HFB also provides unparalleled control over the locations of cells and tissues within its bioreactor vessel during operation and sampling.

16 CFR 1210.18 - Refusal of importation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Refusal of importation. 1210.18 Section 1210.18 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Certification Requirements § 1210.18 Refusal of importation. (a...

When a Wife Says "No": Wife Sexual Refusal as a Factor in Husband-Wife Homicides in Ghana.

PubMed

Adinkrah, Mensah

2017-11-01

In Ghana, wife sexual refusal is a key factor in uxoricides or husband-to-wife murders. Despite this, there is a dearth of systematic research that examines sexual strife as a precipitant of domestic violence and spousal murder. The present article addresses the current lack of research by systematically examining 25 cases of homicides and attempted homicides where wives were lethally and nonlethally assaulted by their husbands following the former's refusal to engage in husband-initiated sexual intercourse. A content analysis was conducted of all print and electronic media news items where a wife's refusal of sexual intercourse with a husband triggered lethal or aggravated violence. The results showed that the victims were aged 23 to 55 years old and were generally of low socioeconomic status. The assailants were aged 28 to 60 years old. Assailants used machetes, knives, and personal weapons to perpetrate the crimes, and extreme violence was a frequent feature of both lethal and nonlethal acts.

Persian Speakers' Use of Refusal Strategies across Politeness Systems

ERIC Educational Resources Information Center

Salmani Nodoushan, Mohammad Ali

2016-01-01

This study aimed at investigating the preferred refusal strategies in Persian. 3047 refusals collected by 108 field workers as well as 376 refusals collected through face to face interviews were analyzed and classified according to the descriptions proposed by Liao (1994) and Liao and Bresnahan (1996). The frequencies of the resulting direct and…

Do you feel powerless when a patient refuses medication?

PubMed

Carey, N; Jones, S L; O'Toole, A W

1990-10-01

1. Because a client legally has the right to refuse medication, the nurse can only recommend, advise, suggest, or urge the patient to comply. Consequently, it is important to understand the nurse's response to patient refusal of medication. 2. Overall, nurses were more apt to identify with indirect indicators than they were to identify words that address the concept directly (control and powerlessness). 3. The most common hazard identified in a medication refusal event was the potential for injury, and the individuals most at risk were the nurse giving the medication and other personnel on the unit. 4. The most prominent nursing response to medication refusal was counseling. Nearly all the nurse subjects believed that the medication refusal event negatively influenced nursing care, the patient/nurse interaction, and patient teaching.

Miami-Dade County Hydraulic Hybrid Refuse Truck Testing | Transportation

Science.gov Websites

Research | NREL Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Photo of garbage truck with view of lake and city in background. As hydraulic hybrid refuse vehicles, with 29 more on order. Photo courtesy of Parker Hannifin NREL is

Bioreactor technology for production of valuable algal products

NASA Astrophysics Data System (ADS)

Liu, Guo-Cai; Cao, Ying

1998-03-01

Bioreactor technology has long been employed for the production of various (mostly cheap) food and pharmaceutical products. More recently, research has been mainly focused on the development of novel bioreactor technology for the production of high—value products. This paper reports the employment of novel bioreactor technology for the production of high-value biomass and metabolites by microalgae. These high-value products include microalgal biomass as health foods, pigments including phycocyanin and carotenoids, and polyunsaturated fatty acids such as eicosapentaenoic acid and docosahexaenoic acid. The processes involved include heterotrophic and mixotrophic cultures using organic substrates as the carbon source. We have demonstrated that these bioreactor cultivation systems are particularly suitable for the production of high-value products from various microalgae. These cultivation systems can be further modified to improve cell densities and productivities by using high cell density techniques such as fed-batch and membrane cell recycle systems. For most of the microalgae investigated, the maximum cell concentrations obtained using these bioreactor systems in our laboratories are much higher than any so far reported in the literature.

BIOREACTOR LANDFILL DESIGN

EPA Science Inventory

Modern landfill design entails many elements including foundations, liner systems, leachate collection systems, stormwater control systems, slope stability considerations, leachate management systems, gas extraction systems, and capping and closure. The use of bioreactor technolo...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

Tissue grown in NASA Bioreactor

NASA Technical Reports Server (NTRS)

1998-01-01

Cells from kidneys lose some of their special features in conventional culture but form spheres replete with specialized cell microvilli (hair) and synthesize hormones that may be clinically useful. Ground-based research studies have demonstrated that both normal and neoplastic cells and tissues recreate many of the characteristics in the NASA bioreactor that they display in vivo. Proximal kidney tubule cells that normally have rich apically oriented microvilli with intercellular clefts in the kidney do not form any of these structures in conventional two-dimensional monolayer culture. However, when normal proximal renal tubule cells are cultured in three-dimensions in the bioreactor, both the microvilli and the intercellular clefts form. This is important because, when the morphology is recreated, the function is more likely also to be rejuvenated. The work is sponsored by NASA's Office of Biological and Physical Research. The bioreactor is managed by the Biotechnology Cell Science Program at NASA's Johnson Space Center (JSC).

The right to refuse treatment: a model act.

PubMed Central

1983-01-01

Although the right to refuse medical treatment is universally recognized as a fundamental principle of liberty, this right is not always honored. A refusal can be thwarted either because a patient is unable to competently communicate or because providers insist on continuing treatment. To help enhance the patient's right to refuse treatment, many states have enacted so-called "living will" or "natural death" statutes. We believe the time has come to move beyond these current legislative models, and we therefore propose a Model Act that clearly enunciates an individual's right to refuse treatment, does not limit its exercise to the terminally ill or to heroic measures, and provides a mechanism by which individuals can set forth their wishes in advance and designate another person to enforce them. PMID:6869647

Cell Separations in Microgravity and Development of a Space Bioreactor

NASA Technical Reports Server (NTRS)

Morrison, D. R.

1985-01-01

A bioreactor optimized for operations in space is now being developed. The current research is focused on determining the optimum cell-bead ratios, medium content and proper maintenance conditions required to keep living cell specimens alive and healthy for the entire flight. The bioreactor development project has recently added a microprocessor/computer to the JSC prototype for control and data analysis. Appropriate new technology is being combined with the current bioreactor designs and tested to determine what specific features must be included in the fabrication of a bioreactor designed to operate for STS demonstration tests. Considerations include: (1) circulation and resupply of culture media; (2) sensors required to monitor temperature, cell growth, mass transport, and oxygen consumption; and (3) inflight control of shear stress on cells, gas transfer in microgravity, diffusion, and intracellular transport. These data and results from the JSC prototype bioreactor test will be used for the design and construction of a small space bioreactor for the Orbiter middeck.

PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE

PubMed Central

FS, Vahidy; MH, Rahbar; AP, Lal; JC, Grotta; SI, Savitz

2012-01-01

Objective To determine factors associated with patients refusing IV t-PA for suspected acute ischemic stroke (AIS), and to compare the outcomes of patients who refused t-PA (RT) with those treated with t-PA. Methods Patients who were treated with and refused t-PA at our stroke center were identified retrospectively. Demographics, clinical presentation, and outcome measures were collected and compared. Clinical outcome was defined as excellent (mRS: 0–1), good (mRS: 0–2), and poor (mRS: 3–6). Results Over 7.5 years, thirty (4.2%) patients refused t-PA. There were no demographic differences between the treated and RT groups. The rate of RT decreased over time (OR 0.63, 95% CI 0.50 – 0.79). Factors associated with refusal included a later symptom onset to emergency department presentation time (OR 1.02, 95% CI 1.01 – 1.03), lower NIHSS (OR 1.11, 95% CI 1.03 – 1.18), a higher proportion of stroke mimics (OR 17.61, 95% CI 6.20 – 50.02) and shorter hospital stay (OR 1.32, 95% CI 1.09 – 1.61). Among patients who were subsequently diagnosed with ischemic stroke, only length of stay was significantly shorter for refusal patients (OR 1.37, 95% CI 1.06 – 1.78). After controlling for mild strokes and stroke mimics, clinical outcome was not different between the groups (OR 1.61, 95% CI 0.69 – 3.73). Conclusion The incidence of patients refusing t-PA has decreased over time, yet it may be a cause for t-PA under-utilization. Patients with milder symptoms were more likely to refuse t-PA. Refusal patients presented later to the hospital and had shorter hospital stays. One out six refusal patients (16.6%) had a stroke mimic. PMID:23227830

9 CFR 98.20 - Embryos refused entry.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

9 CFR 98.20 - Embryos refused entry.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

9 CFR 98.20 - Embryos refused entry.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

9 CFR 98.20 - Embryos refused entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

9 CFR 98.20 - Embryos refused entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

Primary care pediatricians' perceptions of vaccine refusal in europe.

PubMed

Grossman, Zachi; van Esso, Diego; Del Torso, Stefano; Hadjipanayis, Adamos; Drabik, Anna; Gerber, Andreas; Miron, Dan

2011-03-01

An electronic survey assessing primary care pediatricians' estimations and practices regarding parents' vaccination refusal was sent to 395 members of the European Academy of Pediatrics Research in Ambulatory Setting network, with a response rate of 87%. Of respondents who vaccinate in the clinic, 93% estimated the total vaccine refusal rate as <1%. Of all respondents, 69% prefer a shared decision-making approach to handle refusing parents.

Tapered bed bioreactor

DOEpatents

Scott, Charles D.; Hancher, Charles W.

1977-01-01

A vertically oriented conically shaped column is used as a fluidized bed bioreactor wherein biologically catalyzed reactions are conducted in a continuous manner. The column utilizes a packing material a support having attached thereto a biologically active catalytic material.

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

Why parents refuse childhood vaccination: a qualitative study using online focus groups

PubMed Central

2013-01-01

Background In high income countries, vaccine-preventable diseases have been greatly reduced through routine vaccination programs. Despite this success, many parents question, and a small proportion even refuse vaccination for their children. As no qualitative studies have explored the factors behind these decisions among Dutch parents, we performed a study using online focus groups. Methods In total, eight online focus groups (n = 60) which included Dutch parents with at least one child, aged 0–4 years, for whom they refused all or part of the vaccinations within the National Immunization Program (NIP). A thematic analysis was performed to explore factors that influenced the parents’ decisions to refuse vaccination. Results Refusal of vaccination was found to reflect multiple factors including family lifestyle; perceptions about the child’s body and immune system; perceived risks of disease, vaccine efficacy, and side effects; perceived advantages of experiencing the disease; prior negative experience with vaccination; and social environment. The use of online focus groups proved to be an effective qualitative research method providing meaningful data. Conclusion Information provided by the NIP turned out to be insufficient for this group of parents. More trust in the NIP and deliberate decisions might result from increased parental understanding of lifestyle and disease susceptibility, the impact of vaccinations on the immune system, and the relative risks of diseases and their vaccines. The public health institute should also inform parents that the NIP is recommended but non-mandatory. PMID:24341406

Design concepts for bioreactors in space

NASA Technical Reports Server (NTRS)

Seshan, P. K.; Peterson, G. R.; Beard, B.; Dunlop, E. H.

1986-01-01

Microbial food sources are becoming viable and more efficient alternatives to conventional food sources especially in the context of Closed Ecological Life Support Systems (CELSS) in space habitats. Since bioreactor designs for terrestrial operation will not readily apply to conditions of microgravity, there is an urgent need to learn about the differences. These differences cannot be easily estimated due to the complex nature of the mass transport and mixing mechanisms in fermenters. Therefore, a systematic and expeditious experimental program must be undertaken to obtain the engineering data necessary to lay down the foundations of designing bioreactors for microgravity. Two bioreactor design concepts presented represent two dissimilar approaches to grappling with the absence of gravity in space habitats and deserve to be tested for adoption as important components of the life support function aboard spacecrafts, space stations and other extra-terrestrial habitats.

Fluid mechanics of spinner-flask bioreactors

NASA Astrophysics Data System (ADS)

Sucosky, Philippe; Neitzel, G. Paul

2000-11-01

The dynamic environment within bioreactors used for in vitro tissue growth has been observed to affect the development of mammalian cells. Many studies have shown that moderate mechanical stress enhances growth of some tissues whereas high shear levels and turbulence seem to damage cells. In order to optimize the design and the operating conditions of bioreactors, it is important to understand the fluid-dynamic characteristics and to control the stress levels within these devices. The present research focuses on the characterization of the flow field within a spinner-flask bioreactor. The dynamic properties of the flow are investigated experimentally using particle-image velocimetry with a refractive-index-matched model. Phase-locked ensemble-averaging is employed to provide some information on the turbulence characteristics of the model culture medium in the vicinity of a model tissue construct.

Human cell culture in a space bioreactor

NASA Technical Reports Server (NTRS)

Morrison, Dennis R.

1988-01-01

Microgravity offers new ways of handling fluids, gases, and growing mammalian cells in efficient suspension cultures. In 1976 bioreactor engineers designed a system using a cylindrical reactor vessel in which the cells and medium are slowly mixed. The reaction chamber is interchangeable and can be used for several types of cell cultures. NASA has methodically developed unique suspension type cell and recovery apparatus culture systems for bioprocess technology experiments and production of biological products in microgravity. The first Space Bioreactor was designed for microprocessor control, no gaseous headspace, circulation and resupply of culture medium, and slow mixing in very low shear regimes. Various ground based bioreactors are being used to test reactor vessel design, on-line sensors, effects of shear, nutrient supply, and waste removal from continuous culture of human cells attached to microcarriers. The small Bioreactor is being constructed for flight experiments in the Shuttle Middeck to verify systems operation under microgravity conditions and to measure the efficiencies of mass transport, gas transfer, oxygen consumption and control of low shear stress on cells.

Cultivation of mammalian cells using a single-use pneumatic bioreactor system.

PubMed

Obom, Kristina M; Cummings, Patrick J; Ciafardoni, Janelle A; Hashimura, Yasunori; Giroux, Daniel

2014-10-10

Recent advances in mammalian, insect, and stem cell cultivation and scale-up have created tremendous opportunities for new therapeutics and personalized medicine innovations. However, translating these advances into therapeutic applications will require in vitro systems that allow for robust, flexible, and cost effective bioreactor systems. There are several bioreactor systems currently utilized in research and commercial settings; however, many of these systems are not optimal for establishing, expanding, and monitoring the growth of different cell types. The culture parameters most challenging to control in these systems include, minimizing hydrodynamic shear, preventing nutrient gradient formation, establishing uniform culture medium aeration, preventing microbial contamination, and monitoring and adjusting culture conditions in real-time. Using a pneumatic single-use bioreactor system, we demonstrate the assembly and operation of this novel bioreactor for mammalian cells grown on micro-carriers. This bioreactor system eliminates many of the challenges associated with currently available systems by minimizing hydrodynamic shear and nutrient gradient formation, and allowing for uniform culture medium aeration. Moreover, the bioreactor's software allows for remote real-time monitoring and adjusting of the bioreactor run parameters. This bioreactor system also has tremendous potential for scale-up of adherent and suspension mammalian cells for production of a variety therapeutic proteins, monoclonal antibodies, stem cells, biosimilars, and vaccines.

Nitrate Removal Rates in Denitrifying Bioreactors During Storm Flows

NASA Astrophysics Data System (ADS)

Pluer, W.; Walter, T.

2017-12-01

Field denitrifying bioreactors are designed to reduce excess nitrate (NO3-) pollution in runoff from agricultural fields. Field bioreactors saturate organic matter to create conditions that facilitate microbial denitrification. Prior studies using steady flow in lab-scale bioreactors showed that a hydraulic retention time (HRT) between 4 and 10 hours was optimal for reducing NO3- loads. However, during storm-induced events, flow rate and actual HRT fluctuate. These fluctuations have the potential to disrupt the system in significant ways that are not captured by the idealized steady-flow HRT models. The goal of this study was to investigate removal rate during dynamic storm flows of variable rates and durations. Our results indicate that storm peak flow and duration were not significant controlling variables. Instead, we found high correlations (p=0.004) in average removal rates between bioreactors displaying a predominantly uniform flow pattern compared with bioreactors that exhibited preferential flow (24.4 and 21.4 g N m-3 d-1, respectively). This suggests that the internal flow patterns are a more significant driver of removal rate than external factors of the storm hydrograph. Designing for flow patterns in addition to theoretical HRT will facilitate complete mixing within the bioreactors. This will help maximize excess NO3- removal during large storm-induced runoff events.

Prostate Cancer Patients' Refusal of Cancer-Directed Surgery: A Statewide Analysis

PubMed Central

Islam, K. M.

2015-01-01

Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients' decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients' well-being. PMID:25973276

20 CFR 229.81 - Refusal to accept vocational rehabilitation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... disabled employee refuses, without good reason, to accept vocational rehabilitation services available... in which the child refuses, without good reason, to accept such vocational rehabilitation services...

Correlates of HIV testing refusal among emergency department patients in the opt-out testing era.

PubMed

Setse, Rosanna W; Maxwell, Celia J

2014-05-01

Opt-out HIV screening is recommended by the CDC for patients in all healthcare settings. We examined correlates of HIV testing refusal among urban emergency department (ED) patients. Confidential free HIV screening was offered to 32,633 ED patients in an urban tertiary care facility in Washington, DC, during May 2007-December 2011. Demographic differences in testing refusals were examined using χ(2) tests and generalized linear models. HIV testing refusal rates were 47.7 % 95 % CI (46.7-48.7), 11.7 % (11.0-12.4), 10.7 % (10.0-11.4), 16.9 % (15.9-17.9) and 26.9 % (25.6-28.2) in 2007, 2008, 2009, 2010 and 2011 respectively. Persons 33-54 years of age [adjusted prevalence ratio (APR) 1.42, (1.36-1.48)] and those ≥ 55 years [APR 1.39 (1.31-1.47)], versus 33-54 years; and females versus males [APR 1.07 (1.02-1.11)] were more likely to refuse testing. Opt-out HIV testing is feasible and sustainable in urban ED settings. Efforts are needed to encourage testing among older patients and women.

Pervasive refusal syndrome. Three German cases provide further illustration.

PubMed

Jans, Thomas; Ball, Juliane; Preiss, Maike; Haberhausen, Michael; Warnke, Andreas; Renner, Tobias J

2011-09-01

Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

The right to refuse.

PubMed

Baston, Simon

2007-03-01

Accepting or refusing clinical treatment is an adult's right, and guidance for healthcare professionals on the issue is set out in the Reference Guide to Consent for Examination or Treatment ( Department of Health 2001 ).

A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children.

PubMed

Hubbard, Kristie L; Anderson, Sarah E; Curtin, Carol; Must, Aviva; Bandini, Linda G

2014-12-01

Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Evaluation of woodchip bioreactors for improved water quality

USDA-ARS?s Scientific Manuscript database

Woodchip bioreactors are gaining popularity with farmers because of their edge-of-field nitrate removal capabilities, which do not require changes in land management practices. However, limited research has been conducted to study the potential of these bioreactors to also reduce downstream transpor...

Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

ERIC Educational Resources Information Center

Nichols, Tracy R.; Birnel, Sara; Graber, Julia A.; Brooks-Gunn, Jeanne; Botvin, Gilbert J.

2010-01-01

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the…

Open source software to control Bioflo bioreactors.

PubMed

Burdge, David A; Libourel, Igor G L

2014-01-01

Bioreactors are designed to support highly controlled environments for growth of tissues, cell cultures or microbial cultures. A variety of bioreactors are commercially available, often including sophisticated software to enhance the functionality of the bioreactor. However, experiments that the bioreactor hardware can support, but that were not envisioned during the software design cannot be performed without developing custom software. In addition, support for third party or custom designed auxiliary hardware is often sparse or absent. This work presents flexible open source freeware for the control of bioreactors of the Bioflo product family. The functionality of the software includes setpoint control, data logging, and protocol execution. Auxiliary hardware can be easily integrated and controlled through an integrated plugin interface without altering existing software. Simple experimental protocols can be entered as a CSV scripting file, and a Python-based protocol execution model is included for more demanding conditional experimental control. The software was designed to be a more flexible and free open source alternative to the commercially available solution. The source code and various auxiliary hardware plugins are publicly available for download from https://github.com/LibourelLab/BiofloSoftware. In addition to the source code, the software was compiled and packaged as a self-installing file for 32 and 64 bit windows operating systems. The compiled software will be able to control a Bioflo system, and will not require the installation of LabVIEW.

Open Source Software to Control Bioflo Bioreactors

PubMed Central

Burdge, David A.; Libourel, Igor G. L.

2014-01-01

Bioreactors are designed to support highly controlled environments for growth of tissues, cell cultures or microbial cultures. A variety of bioreactors are commercially available, often including sophisticated software to enhance the functionality of the bioreactor. However, experiments that the bioreactor hardware can support, but that were not envisioned during the software design cannot be performed without developing custom software. In addition, support for third party or custom designed auxiliary hardware is often sparse or absent. This work presents flexible open source freeware for the control of bioreactors of the Bioflo product family. The functionality of the software includes setpoint control, data logging, and protocol execution. Auxiliary hardware can be easily integrated and controlled through an integrated plugin interface without altering existing software. Simple experimental protocols can be entered as a CSV scripting file, and a Python-based protocol execution model is included for more demanding conditional experimental control. The software was designed to be a more flexible and free open source alternative to the commercially available solution. The source code and various auxiliary hardware plugins are publicly available for download from https://github.com/LibourelLab/BiofloSoftware. In addition to the source code, the software was compiled and packaged as a self-installing file for 32 and 64 bit windows operating systems. The compiled software will be able to control a Bioflo system, and will not require the installation of LabVIEW. PMID:24667828

Factors related to treatment refusal in Taiwanese cancer patients.

PubMed

Chiang, Ting-Yu; Wang, Chao-Hui; Lin, Yu-Fen; Chou, Shu-Lan; Wang, Ching-Ting; Juang, Hsiao-Ting; Lin, Yung-Chang; Lin, Mei-Hsiang

2015-01-01

Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (≥10times) (p=0.016). Cancer patients who refuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

47 CFR 73.4005 - Advertising-refusal to sell.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

47 CFR 73.4005 - Advertising-refusal to sell.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

47 CFR 73.4005 - Advertising-refusal to sell.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

47 CFR 73.4005 - Advertising-refusal to sell.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

47 CFR 73.4005 - Advertising-refusal to sell.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

Disposable Bioreactors for Plant Micropropagation and Mass Plant Cell Culture

NASA Astrophysics Data System (ADS)

Ducos, Jean-Paul; Terrier, Bénédicte; Courtois, Didier

Different types of bioreactors are used at Nestlé R&D Centre - Tours for mass propagation of selected plant varieties by somatic embryogenesis and for large scale culture of plants cells to produce metabolites or recombinant proteins. Recent studies have been directed to cut down the production costs of these two processes by developing disposable cell culture systems. Vegetative propagation of elite plant varieties is achieved through somatic embryogenesis in liquid medium. A pilot scale process has recently been set up for the industrial propagation of Coffea canephora (Robusta coffee). The current production capacity is 3.0 million embryos per year. The pre-germination of the embryos was previously conducted by temporary immersion in liquid medium in 10-L glass bioreactors. An improved process has been developed using a 10-L disposable bioreactor consisting of a bag containing a rigid plastic box ('Box-in-Bag' bioreactor), insuring, amongst other advantages, a higher light transmittance to the biomass due to its horizontal design. For large scale cell culture, two novel flexible plastic-based disposable bioreactors have been developed from 10 to 100 L working volumes, validated with several plant species ('Wave and Undertow' and 'Slug Bubble' bioreactors). The advantages and the limits of these new types of bioreactor are discussed, based mainly on our own experience on coffee somatic embryogenesis and mass cell culture of soya and tobacco.

A versatile modular bioreactor platform for Tissue Engineering

PubMed Central

Schuerlein, Sebastian; Schwarz, Thomas; Krziminski, Steffan; Gätzner, Sabine; Hoppensack, Anke; Schwedhelm, Ivo; Schweinlin, Matthias; Walles, Heike

2016-01-01

Abstract Tissue Engineering (TE) bears potential to overcome the persistent shortage of donor organs in transplantation medicine. Additionally, TE products are applied as human test systems in pharmaceutical research to close the gap between animal testing and the administration of drugs to human subjects in clinical trials. However, generating a tissue requires complex culture conditions provided by bioreactors. Currently, the translation of TE technologies into clinical and industrial applications is limited due to a wide range of different tissue‐specific, non‐disposable bioreactor systems. To ensure a high level of standardization, a suitable cost‐effectiveness, and a safe graft production, a generic modular bioreactor platform was developed. Functional modules provide robust control of culture processes, e.g. medium transport, gas exchange, heating, or trapping of floating air bubbles. Characterization revealed improved performance of the modules in comparison to traditional cell culture equipment such as incubators, or peristaltic pumps. By combining the modules, a broad range of culture conditions can be achieved. The novel bioreactor platform allows using disposable components and facilitates tissue culture in closed fluidic systems. By sustaining native carotid arteries, engineering a blood vessel, and generating intestinal tissue models according to a previously published protocol the feasibility and performance of the bioreactor platform was demonstrated. PMID:27492568

Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States

PubMed Central

Phadke, Varun K.; Bednarczyk, Robert A.; Salmon, Daniel A.; Omer, Saad B.

2016-01-01

IMPORTANCE Parents hesitant to vaccinate their children may delay routine immunizations or seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this phenomenon. Improved understanding of the association between vaccine refusal and the epidemiology of these diseases is needed. OBJECTIVE To review the published literature to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles and pertussis, 2 vaccine-preventable diseases with recent US outbreaks. EVIDENCE REVIEW Search of PubMed through November 30, 2015, for reports of US measles outbreaks that have occurred since measles was declared eliminated in the United States (after January 1, 2000), endemic and epidemic pertussis since the lowest point in US pertussis incidence (after January 1, 1977), and for studies that assessed disease risk in the context of vaccine delay or exemption. FINDINGS We identified 18 published measles studies (9 annual summaries and 9 outbreak reports), which described 1416 measles cases (individual age range, 2 weeks-84 years; 178 cases younger than 12 months) and more than half (56.8%) had no history of measles vaccination. Of the 970 measles cases with detailed vaccination data, 574 cases were unvaccinated despite being vaccine eligible and 405 (70.6%) of these had nonmedical exemptions (eg, exemptions for religious or philosophical reasons, as opposed to medical contraindications; 41.8%of total). Among 32 reports of pertussis outbreaks, which included 10 609 individuals for whom vaccination status was reported (age range, 10 days-87 years), the 5 largest statewide epidemics had substantial proportions (range, 24%–45%) of unvaccinated or undervaccinated individuals. However, several pertussis outbreaks also occurred in highly vaccinated populations, indicating waning immunity. Nine reports (describing 12 outbreaks) provided detailed vaccination data on

Veterinary opinions on refusing euthanasia: justifications and philosophical frameworks.

PubMed

Yeates, J W; Main, D C J

2011-03-12

To obtain information on euthanasia decisions from practising veterinary surgeons, respondents were asked to estimate how often during their time in practice they had refused to euthanase a dog and how often they had wanted to refuse to euthanase a dog but not done so because of other pressures. For each, respondents were then asked to state their most common reasons for refusing/not refusing in free text. The responses of clinicians were considered in the light of established ethical concepts to produce an evidence-based ethical framework for decision making. In total, 58 practitioners responded. Common reasons given for decisions on whether to refuse euthanasia referred to the patient's interests, such as the possibility of treatment or rehoming, and the fear of other unacceptable outcomes for the dog. Other reasons were based on concern for owners' interests. Some respondents reported being pressured into euthanasia by clients and other veterinary surgeons. This gives insight into the ethical principles that explicitly underlie veterinary surgeons' euthanasia decisions and the resultant framework may be useful for discussing and teaching euthanasia.

The Relation between Students' Justice Experiences and Their School Refusal Behavior

ERIC Educational Resources Information Center

Donat, Matthias; Gallschütz, Christoph; Dalbert, Claudia

2018-01-01

In a cross-sectional questionnaire study with N = 1658 German students, aged between 12 and 17 years (M = 14.1, SD = 0.5), we investigated the relation of students' personal belief in a just world (BJW) to their school absenteeism and functions of school refusal behavior. In accordance with recent studies which identified negative relations…

Situation testing: the case of health care refusal.

PubMed

Després, C; Couralet, P-E

2011-04-01

Situation testing to assess physicians' refusal to provide healthcare is increasingly used in research studies. This paper aims to explain the relevance and limits of this method. Conducted in 2008-2009, this study was designed to assess the rate of healthcare refusal among several categories of private practitioners toward patients covered by the French public means-tested complementary health insurance (CMUc) when they requested a first appointment by phone. The other objectives were to study the determinants of healthcare refusal and assess the method. The study was conducted on a representative sample of Paris-based dentists and physicians in five categories: general practitioners, medical gynecologists, ophthalmologists, radiologists, and dentists. The method was based on two protocols. In the first scenario, an actor pretended to be a CMUc beneficiary and, in the second one, he did not give information about his health coverage but hinted at a low socioeconomic status. The two protocols were compared and procedures checking the relation between refusal and CMUc coverage were implemented in each of them. In the scenario in which the patient declared being a CMUc beneficiary, the results showed different refusal rates depending on the type of practitioner, physician, or dentist, their specialty, and whether or not, they charge more than the standard set fee. In the second scenario, refusal rates were much lower. The comparison of the two protocols seems to confirm the existence of discrimination based on CMUc affiliation rather than patients' socioeconomic status. The discussion presents the limits of situation testing, which remains an experimental instrument because it does not observe reality but reveals behaviors in situation. The findings cannot be extrapolated and are limited in time. The statistical analysis is only valid if the procedure followed is precise and applied consistently using a preset scenario. In addition, the discriminatory nature of the

[Refusal of nursing care, the legal perspective].

PubMed

Fisman, Jérôme

2016-10-01

The refusal of nursing care forms part of the freedom offered to anyone wanting to refuse, consciously and knowingly, any form of nursing care such as washing, the taking of medication or hospitalisation. However, limits are fixed by law as well as by case law. Are we totally free in the expression of our will? Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Salmonella Typhimurium grown in a rotating wall bioreactor

NASA Technical Reports Server (NTRS)

2003-01-01

Salmonella typhimurium appears green in on human intestinal tissue (stained red) cultured in a NASA rotating wall bioreactor. Dr. Cheryl Nickerson of Tulane University is studying the effects of simulated low-g on a well-known pathogen, Salmonella typhimurium, a bacterium that causes two to four million cases of gastrointestinal illness in the United States each year. While most healthy people recover readily, S. typhimurium can kill people with weakened immune systems. Thus, a simple case of food poisoning could disrupt a space mission. Using the NASA rotating-wall bioreactor, Nickerson cultured S. typhimurium in modeled microgravity. Mice infected with the bacterium died an average of three days faster than the control mice, indicating that S. typhimurium's virulence was enhanced by the bioreactor. Earlier research showed that 3 percent of the genes were altered by exposure to the bioreactor. Nickerson's work earned her a 2001 Presidential Early Career Award for Scientists and Engineers.

Upflow bioreactor with septum and pressure release mechanism

DOEpatents

Hansen, Conly L.; Hansen, Carl S.; Pack, Kevin; Milligan, John; Benefiel, Bradley C.; Tolman, C. Wayne; Tolman, Kenneth W.

2010-04-20

An upflow bioreactor includes a vessel having an inlet and an outlet configured for upflow operation. A septum is positioned within the vessel and defines a lower chamber and an upper chamber. The septum includes an aperture that provides fluid communication between the upper chamber and lower chamber. The bioreactor also includes means for releasing pressure buildup in the lower chamber. In one configuration, the septum includes a releasable portion having an open position and a closed position. The releasable portion is configured to move to the open position in response to pressure buildup in the lower chamber. In the open position fluid communication between the lower chamber and the upper chamber is increased. Alternatively the lower chamber can include a pressure release line that is selectively actuated by pressure buildup. The pressure release mechanism can prevent the bioreactor from plugging and/or prevent catastrophic damage to the bioreactor caused by high pressures.

28 CFR 549.65 - Refusal to accept treatment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Refusal to accept treatment. 549.65 Section 549.65 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.65 Refusal to accept treatment. (a) When, as a result of...

16 CFR § 1210.18 - Refusal of importation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Refusal of importation. § 1210.18 Section § 1210.18 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Certification Requirements § 1210.18 Refusal of importation. (a...

Fluidized-bed bioreactor process for the microbial solubiliztion of coal

DOEpatents

Scott, Charles D.; Strandberg, Gerald W.

1989-01-01

A fluidized-bed bioreactor system for the conversion of coal into microbially solubilized coal products. The fluidized-bed bioreactor continuously or periodically receives coal and bio-reactants and provides for the production of microbially solubilized coal products in an economical and efficient manner. An oxidation pretreatment process for rendering coal uniformly and more readily susceptible to microbial solubilization may be employed with the fluidized-bed bioreactor.

Simplified Bioreactor For Growing Mammalian Cells

NASA Technical Reports Server (NTRS)

Spaulding, Glenn F.

1995-01-01

Improved bioreactor for growing mammalian cell cultures developed. Designed to support growth of dense volumes of mammalian cells by providing ample, well-distributed flows of nutrient solution with minimal turbulence. Cells relatively delicate and, unlike bacteria, cannot withstand shear forces present in turbulent flows. Bioreactor vessel readily made in larger sizes to accommodate greater cell production quantities. Molding equipment presently used makes cylinders up to 30 centimeters long. Alternative sintered plastic techniques used to vary pore size and quantity, as necessary.

Streamlined bioreactor-based production of human cartilage tissues.

PubMed

Tonnarelli, B; Santoro, R; Adelaide Asnaghi, M; Wendt, D

2016-05-27

Engineered tissue grafts have been manufactured using methods based predominantly on traditional labour-intensive manual benchtop techniques. These methods impart significant regulatory and economic challenges, hindering the successful translation of engineered tissue products to the clinic. Alternatively, bioreactor-based production systems have the potential to overcome such limitations. In this work, we present an innovative manufacturing approach to engineer cartilage tissue within a single bioreactor system, starting from freshly isolated human primary chondrocytes, through the generation of cartilaginous tissue grafts. The limited number of primary chondrocytes that can be isolated from a small clinically-sized cartilage biopsy could be seeded and extensively expanded directly within a 3D scaffold in our perfusion bioreactor (5.4 ± 0.9 doublings in 2 weeks), bypassing conventional 2D expansion in flasks. Chondrocytes expanded in 3D scaffolds better maintained a chondrogenic phenotype than chondrocytes expanded on plastic flasks (collagen type II mRNA, 18-fold; Sox-9, 11-fold). After this "3D expansion" phase, bioreactor culture conditions were changed to subsequently support chondrogenic differentiation for two weeks. Engineered tissues based on 3D-expanded chondrocytes were more cartilaginous than tissues generated from chondrocytes previously expanded in flasks. We then demonstrated that this streamlined bioreactor-based process could be adapted to effectively generate up-scaled cartilage grafts in a size with clinical relevance (50 mm diameter). Streamlined and robust tissue engineering processes, as the one described here, may be key for the future manufacturing of grafts for clinical applications, as they facilitate the establishment of compact and closed bioreactor-based production systems, with minimal automation requirements, lower operating costs, and increased compliance to regulatory guidelines.

[Refusal of application to care in Alzheimer's disease and related diseases: establishment of a mobile unit hospital extra].

PubMed

Collignon, Julien; Rouch, Isabelle; Gonthier, Régis; Corbin-Seguin, Aude; Combe, Lorraine; Trombert-Paviot, Béatrice; Laurent, Bernard; Girtanner, Chantal

2013-03-01

Refusal of care and support in these patients with Alzheimer's disease and related illnesses at home is a cause of accelerated loss of autonomy and increases the risk of a crisis with early institutionalization. Factors contributing to the denial of care are poorly understood and very few epidemiological data exist. we compared age, diagnosis, level of severity of the disease, the type of behavioral, family status of 101 patients living in denial of care and support as seen by a mobile home (group UPEPc) to 136 control patients seen at the memory clinic (group CM). Patients living in denial of care appear to significantly low age [82/80.5, p<0.0001], with more advanced disease [average MMSE 18/22, p<0.0001], the presence family conflicts and behavioral disorders [delirious--hallucination, agitation--aggression, depression, apathy, p<0.05]. the profile of patients refusing home care is specific and it is important to educate GPs conditions that favor an obstacle to medicalization. The advantage of a mobile extramural to analyze risk factors for refusal of care and propose alternatives should be further investigated.

Multimembrane Bioreactor

NASA Technical Reports Server (NTRS)

Cho, Toohyon; Shuler, Michael L.

1989-01-01

Set of hydrophilic and hydrophobic membranes in bioreactor allows product of reaction to be separated, while nutrients fed to reacting cells and byproducts removed from them. Separation process requires no externally supplied energy; free energy of reaction sufficient. Membranes greatly increase productivity of metabolizing cells by continuously removing product and byproducts, which might otherwise inhibit reaction, and by continuously adding oxygen and organic nutrients.

Why Some Students Refuse Additional Learning Support: Transition at a Further Education College

ERIC Educational Resources Information Center

Smith, Andrew

2006-01-01

In a specialist further education college, it was recognised that students aged 16/17 transferring to vocational study after their compulsory schooling were refusing to take up their entitlement to additional learning support. This created a shortfall in the college's predicted units of funding; also, course managers reported that several of these…

Scale up of diesel oil biodegradation in a baffled roller bioreactor.

PubMed

Nikakhtari, Hossein; Song, Wanning; Kumar, Pardeep; Nemati, Mehdi; Hill, Gordon A

2010-05-01

Diesel oil is a suitable substance to represent petroleum contamination from accidental spills in operating and transportation facilities. Using a microbial culture enriched from a petroleum contaminated soil, biodegradation of diesel oil was carried out in 2.2, 55, and 220 L roller baffled bioreactors. The effects of bioreactor rotation speed (from 5 to 45 rpm) and liquid loading (from 18% to 73% of total volume) on the biodegradation of diesel oil were studied. In the small scale bioreactor (2.2L), the maximum rotation speed of 45 rpm resulted in the highest biodegradation rate with a first order biodegradation kinetic constant of 0.095 d(-1). In the larger scale bioreactors, rotation speed did not affect the biodegradation rate. Liquid loadings higher than 64% resulted in reduced biodegradation rates in the small scale bioreactor; however, in the larger roller bioreactors liquid loading did not affect the biodegradation rate. Biodegradation of diesel oil at 5 rpm and 73% loading is recommended for operating large scale roller baffled bioreactors. Under these conditions, high diesel oil concentrations up to 50 gL(-1) can be bioremediated at a rate of 1.61 gL(-1)d(-1). Copyright 2010 Elsevier Ltd. All rights reserved.

Fluidized-bed bioreactor system for the microbial solubilization of coal

DOEpatents

Scott, C.D.; Strandberg, G.W.

1987-09-14

A fluidized-bed bioreactor system for the conversion of coal into microbially solubilized coal products. The fluidized-bed bioreactor continuously or periodically receives coal and bio-reactants and provides for the production of microbially solubilized coal products in an economical and efficient manner. An oxidation pretreatment process for rendering coal uniformly and more readily susceptible to microbial solubilization may be employed with the fluidized-bed bioreactor. 2 figs.

A versatile modular bioreactor platform for Tissue Engineering.

PubMed

Schuerlein, Sebastian; Schwarz, Thomas; Krziminski, Steffan; Gätzner, Sabine; Hoppensack, Anke; Schwedhelm, Ivo; Schweinlin, Matthias; Walles, Heike; Hansmann, Jan

2017-02-01

Tissue Engineering (TE) bears potential to overcome the persistent shortage of donor organs in transplantation medicine. Additionally, TE products are applied as human test systems in pharmaceutical research to close the gap between animal testing and the administration of drugs to human subjects in clinical trials. However, generating a tissue requires complex culture conditions provided by bioreactors. Currently, the translation of TE technologies into clinical and industrial applications is limited due to a wide range of different tissue-specific, non-disposable bioreactor systems. To ensure a high level of standardization, a suitable cost-effectiveness, and a safe graft production, a generic modular bioreactor platform was developed. Functional modules provide robust control of culture processes, e.g. medium transport, gas exchange, heating, or trapping of floating air bubbles. Characterization revealed improved performance of the modules in comparison to traditional cell culture equipment such as incubators, or peristaltic pumps. By combining the modules, a broad range of culture conditions can be achieved. The novel bioreactor platform allows using disposable components and facilitates tissue culture in closed fluidic systems. By sustaining native carotid arteries, engineering a blood vessel, and generating intestinal tissue models according to a previously published protocol the feasibility and performance of the bioreactor platform was demonstrated. © 2017 The Authors. Biotechnology Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Study of shear rate in modified airlift nitrifying bioreactor].

PubMed

Jin, Ren-cun; Zheng, Ping

2006-06-01

The characteristics of shear rate in an airlift nitrifying bioreactor and its influencing factors were studied. The results showed that the shear rate was different in different sections of the bioreactor. With inlet gas flowrate at 430 approximately 2700 L x h(-1), the overall shear rate was (0.702 approximately 3.13) x 10(5) s(-1), shear rate in riser was (1.07 approximately 31.3) x 10(5) s(-1) and in gas-liquid separator was (1.12 approximately 25.0) x 10(5) s(-1), respectively. It indicates that the highest shear rates prevailed in the riser part of bioreactor. The operational variables and the bioreactor configurations exerted a significant influence on the shear level of the bioreactor. When inlet gas flowrate was raised from 1300 to 2700 L x h(-1), shear rate in riser and separator ascended first and then descended subsequently. The diameter of draft tube (d) was negatively correlated with shear rate. When the draft tube with diameter of 5.5 cm was installed, the shear rates in riser, separator and overall shear rate were 85.5%, 82.3% and 80.6%, respectively less as compared with that with diameter of 4.0 cm. The number of static mixers (N) was positively correlated with the shear rate. When d was set at 4.0 cm, with N of 10 and 39, the shear rates in riser were 6.14 and 7.97 times higher respectively, than that of conventional bioreactor. The ratio of maximum local shear rate to overall shear rate was 3.68 approximately 7.66, and the homogeneity of the shear field in airlift bioreactors could be improved if d and N were set at 5.5 cm and 10 approximately 13, respectively.

Oscillating Cell Culture Bioreactor

NASA Technical Reports Server (NTRS)

Freed, Lisa E.; Cheng, Mingyu; Moretti, Matteo G.

2010-01-01

To better exploit the principles of gas transport and mass transport during the processes of cell seeding of 3D scaffolds and in vitro culture of 3D tissue engineered constructs, the oscillatory cell culture bioreactor provides a flow of cell suspensions and culture media directly through a porous 3D scaffold (during cell seeding) and a 3D construct (during subsequent cultivation) within a highly gas-permeable closed-loop tube. This design is simple, modular, and flexible, and its component parts are easy to assemble and operate, and are inexpensive. Chamber volume can be very low, but can be easily scaled up. This innovation is well suited to work with different biological specimens, particularly with cells having high oxygen requirements and/or shear sensitivity, and different scaffold structures and dimensions. The closed-loop changer is highly gas permeable to allow efficient gas exchange during the cell seeding/culturing process. A porous scaffold, which may be seeded with cells, is fixed by means of a scaffold holder to the chamber wall with scaffold/construct orientation with respect to the chamber determined by the geometry of the scaffold holder. A fluid, with/without biological specimens, is added to the chamber such that all, or most, of the air is displaced (i.e., with or without an enclosed air bubble). Motion is applied to the chamber within a controlled environment (e.g., oscillatory motion within a humidified 37 C incubator). Movement of the chamber induces relative motion of the scaffold/construct with respect to the fluid. In case the fluid is a cell suspension, cells will come into contact with the scaffold and eventually adhere to it. Alternatively, cells can be seeded on scaffolds by gel entrapment prior to bioreactor cultivation. Subsequently, the oscillatory cell culture bioreactor will provide efficient gas exchange (i.e., of oxygen and carbon dioxide, as required for viability of metabolically active cells) and controlled levels of fluid

Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys.

PubMed

Reniers, Georges; Eaton, Jeffrey

2009-03-13

To assess the relationship between prior knowledge of one's HIV status and the likelihood to refuse HIV testing in populations-based surveys and explore its potential for producing bias in HIV prevalence estimates. Using longitudinal survey data from Malawi, we estimate the relationship between prior knowledge of HIV-positive status and subsequent refusal of an HIV test. We use that parameter to develop a heuristic model of refusal bias that is applied to six Demographic and Health Surveys, in which refusal by HIV status is not observed. The model only adjusts for refusal bias conditional on a completed interview. Ecologically, HIV prevalence, prior testing rates and refusal for HIV testing are highly correlated. Malawian data further suggest that amongst individuals who know their status, HIV-positive individuals are 4.62 (95% confidence interval, 2.60-8.21) times more likely to refuse testing than HIV-negative ones. On the basis of that parameter and other inputs from the Demographic and Health Surveys, our model predicts downward bias in national HIV prevalence estimates ranging from 1.5% (95% confidence interval, 0.7-2.9) for Senegal to 13.3% (95% confidence interval, 7.2-19.6) for Malawi. In absolute terms, bias in HIV prevalence estimates is negligible for Senegal but 1.6 (95% confidence interval, 0.8-2.3) percentage points for Malawi. Downward bias is more severe in urban populations. Because refusal rates are higher in men, seroprevalence surveys also tend to overestimate the female-to-male ratio of infections. Prior knowledge of HIV status informs decisions to participate in seroprevalence surveys. Informed refusals may produce bias in estimates of HIV prevalence and the sex ratio of infections.

A comparison of orbitally-shaken and stirred-tank bioreactors: pH modulation and bioreactor type affect CHO cell growth and protein glycosylation.

PubMed

Monteil, Dominique T; Juvet, Valentin; Paz, Jonathan; Moniatte, Marc; Baldi, Lucia; Hacker, David L; Wurm, Florian M

2016-09-01

Orbitally shaken bioreactors (OSRs) support the suspension cultivation of animal cells at volumetric scales up to 200 L and are a potential alternative to stirred-tank bioreactors (STRs) due to their rapid and homogeneous mixing and high oxygen transfer rate. In this study, a Chinese hamster ovary cell line producing a recombinant antibody was cultivated in a 5 L OSR and a 3 L STR, both operated with or without pH control. Effects of bioreactor type and pH control on cell growth and metabolism and on recombinant protein production and glycosylation were determined. In pH-controlled bioreactors, the glucose consumption and lactate production rates were higher relative to cultures grown in bioreactors without pH control. The cell density and viability were higher in the OSRs than in the STRs, either with or without pH control. Volumetric recombinant antibody yields were not affected by the process conditions, and a glycan analysis of the antibody by mass spectrometry did not reveal major process-dependent differences in the galactosylation index. The results demonstrated that OSRs are suitable for recombinant protein production from suspension-adapted animal cells. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1174-1180, 2016. © 2016 American Institute of Chemical Engineers.

Lime retention in anthracite coal-breaker refuse

Treesearch

Miroslaw M. Czapowskyj; Edward A. Sowa

1973-01-01

Hydrated lime was applied to extremely acid anthracite coal-breaker refuse at rates of 2.5 and 5.0 tons per acre. The lime raised the pH to neutral range, and this range was still in evidence 7 years after treatment. The pH readings decreased with the depth of the refuse profile, and below 9 inches they approximated those of the control plots. The 2.5-tons-of-lime-per-...

Denitrifying bioreactors for nitrate removal from tile drained cropland

USDA-ARS?s Scientific Manuscript database

Denitrification bioreactors are a promising technology for mitigation of nitrate-nitrogen (NO3-N) losses in subsurface drainage water. Bioreactors are constructed with carbon substrates, typically wood chips, to provide a substrate for denitrifying microorganisms. Researchers in Iowa found that for ...

ADVANCING THE FIELD EVALUATIONS AND APPLICATIONS OF LANDFILL BIOREACTORS

EPA Science Inventory

The US Environmental Protection Agency (EPA) is undertaking a long-term program to conduct field evaluations of landfill bioreactors. The near-term effort is focused on the development of appropriate monitoring strategies to ensure adequate control of the landfill bioreactors an...

38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Refusal of treatment by... VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking... informed that breaking an additional appointment will be deemed to be a refusal to accept VA treatment. If...

Potential bias in the bank: what distinguishes refusers, nonresponders and participants in a clinic-based biobank?

PubMed

Ridgeway, J L; Han, L C; Olson, J E; Lackore, K A; Koenig, B A; Beebe, T J; Ziegenfuss, J Y

2013-01-01

Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in terms of attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to electronic health record information, we compared patient characteristics and self-reported information among participants, nonresponders and refusers. We also compared reasons for nonparticipation between refusers and nonresponders to elucidate potential pathways to reduce nonparticipation and any uncovered bias. We mailed recruitment packets to 1,600 adult patients with upcoming appointments at Mayo Clinic (Rochester, Minn., USA) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 nonresponders and 26 refusers to collect self-reported information, including reasons for nonparticipation. Participants were asked to complete a mailed questionnaire. We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% nonresponse (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns, while nonresponders more often identified time constraints as the reason for nonparticipation. For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups

Fixed-bed bioreactor system for the microbial solubilization of coal

DOEpatents

Scott, C.D.; Strandberg, G.W.

1987-09-14

A fixed-bed bioreactor system for the conversion of coal into microbially solubilized coal products. The fixed-bed bioreactor continuously or periodically receives coal and bio-reactants and provides for the large scale production of microbially solubilized coal products in an economical and efficient manner. An oxidation pretreatment process for rendering coal uniformly and more readily susceptible to microbial solubilization may be employed with the fixed-bed bioreactor. 1 fig., 1 tab.

Predictors of Tobacco and Alcohol Refusal Efficacy for Urban and Rural African-American Adolescents

ERIC Educational Resources Information Center

Nasim, Aashir; Belgrave, Faye Z.; Corona, Rosalie; Townsend, Tiffany G.

2009-01-01

This study sought to determine the relative contributions of individual, family, peer, and community risk and promotive factors in explaining alcohol and tobacco refusal attitudes among 227 African-American adolescents (ages 12 to 17) from urban and rural areas. Hierarchical linear regression (HLR) results revealed differences in the predictive…

Modular bioreactor for the remediation of liquid streams and methods for using the same

DOEpatents

Noah, Karl S.; Sayer, Raymond L.; Thompson, David N.

1998-01-01

The present invention is directed to a bioreactor system for the remediation of contaminated liquid streams. The bioreactor system is composed of at least one and often a series of sub-units referred to as bioreactor modules. The modular nature of the system allows bioreactor systems be subdivided into smaller units and transported to waste sites where they are combined to form bioreactor systems of any size. The bioreactor modules further comprises reactor fill materials in the bioreactor module that remove the contaminants from the contaminated stream. To ensure that the stream thoroughly contacts the reactor fill materials, each bioreactor module comprises means for directing the flow of the stream in a vertical direction and means for directing the flow of the stream in a horizontal direction. In a preferred embodiment, the reactor fill comprises a sulfate reducing bacteria which is particularly useful for precipitating metals from acid mine streams.

43 CFR 15.4 - Refuse and polluting substances.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

43 CFR 15.4 - Refuse and polluting substances.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

43 CFR 15.4 - Refuse and polluting substances.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

43 CFR 15.4 - Refuse and polluting substances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

43 CFR 15.4 - Refuse and polluting substances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care

PubMed Central

Calanzani, Natalia; Higginson, Irene J; Koffman, Jonathan; Gomes, Barbara

2016-01-01

Background Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1) participation versus non-participation and 2) provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey. Methods Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18), identified through death registrations in London, England (response rate 39.3%). The informant of death (a relative in 95.3% of cases) was contacted 4–10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants. Findings The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52–8.00, ref: 20–49yrs) and female informants (AOR 1.70, 95%CI: 1.33–2.16). Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46–0.84, ref: home) and proxies other than spouses/partners (AORs 0.28 to 0.57). Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32–0.77). Refusal reasons were often multidimensional, most commonly study-related (36.0%), proxy-related and grief-related (25.1% each). One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920). Conclusions Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase

Plantform Bioreactor for Mass Micropropagation of Date Palm.

PubMed

Almusawi, Abdulminam H A; Sayegh, Abdullah J; Alshanaw, Ansam M S; Griffis, John L

2017-01-01

A novel protocol for the commercial production of date palm through micropropagation is presented. This protocol includes the use of a semisolid medium alternation or in combination with a temporary immersion system (TIS, Plantform bioreactor) in date palm micropropagation. The use of the Plantform bioreactor for date palm results in an improved multiplication rate, reduced micropropagation time, and improved weaning success. It also reduces the cost of saleable units and thus improves economic return for commercial micropropagation. The use of the Plantform bioreactor successfully addresses other hindrances that can occur during the scale-up of date palm micropropagation, including asynchrony of somatic embryos, limited maturation of somatic embryos, and highly variable germination frequencies of embryos.

Plant cell cultures: bioreactors for industrial production.

PubMed

Ruffoni, Barbara; Pistelli, Laura; Bertoli, Alessandra; Pistelli, Luisa

2010-01-01

The recent biotechnology boom has triggered increased interest in plant cell cultures, since a number of firms and academic institutions investigated intensively to rise the production of very promising bioactive compounds. In alternative to wild collection or plant cultivation, the production of useful and valuable secondary metabolites in large bioreactors is an attractive proposal; it should contribute significantly to future attempts to preserve global biodiversity and alleviate associated ecological problems. The advantages of such processes include the controlled production according to demand and a reduced man work requirement. Plant cells have been grown in different shape bioreactors, however, there are a variety of problems to be solved before this technology can be adopted on a wide scale for the production of useful plant secondary metabolites. There are different factors affecting the culture growth and secondary metabolite production in bioreactors: the gaseous atmosphere, oxygen supply and CO2 exchange, pH, minerals, carbohydrates, growth regulators, the liquid medium rheology and cell density. Moreover agitation systems and sterilization conditions may negatively influence the whole process. Many types ofbioreactors have been successfully used for cultivating transformed root cultures, depending on both different aeration system and nutrient supply. Several examples of medicinal and aromatic plant cultures were here summarized for the scale up cultivation in bioreactors.

Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital.

PubMed

Salam, Asma Abdus; Afshan, Gauhar

2016-01-01

Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information.

Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

PubMed Central

Salam, Asma Abdus; Afshan, Gauhar

2016-01-01

Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

Refuse leachate exposure causes changes of thyroid hormone level and related gene expression in female goldfish (Carassius auratus).

PubMed

Gong, Yufeng; Tian, Hua; Zhang, Xiaona; Dong, Yifei; Wang, Wei; Ru, Shaoguo

2016-12-01

To elucidate the potential thyroid disrupting effects of refuse leachate on females, female goldfish (Carassius auratus) were exposed to 0.5% diluted leachates from each step of a leachate treatment process (i.e. raw leachate before treatment, after membrane bioreactor treatment, and the final treated leachate) for 21days. Raw leachate exposure caused disturbances in the thyroid cascade of female fish, as evidenced by the elevated plasma 3,3',5-triiodo-l-thyronine (p<0.05) and thyroid-stimulating hormone (p<0.01) levels as well as up-regulated hepatic and gonadal type I deiodinase (p<0.01), type II deiodinase (p<0.01) and thyroid receptor (p<0.05) mRNA levels. Thyroid disrupting potency decreased markedly as raw leachate progressed through the "membrane bioreactor + reverse osmosis" treatment but could still be detected in the treated leachate. As our results indicated, thyroid system in female goldfish was more sensitive to leachate exposure than that of the male fish. Copyright © 2016 Elsevier B.V. All rights reserved.

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2011-10-01 2011-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2013-10-01 2012-10-01 true Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2012-10-01 2012-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2010-10-01 2010-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2014-10-01 2012-10-01 true Can a family be penalized if a parent refuses to...

Breath Test Refusals and Their Effect on DWI Prosecution

DOT National Transportation Integrated Search

2012-07-01

This report describes the design and results of a project aimed at estimating the rate that drivers : refuse to submit to a legally-requested breath alcohol concentration test, and the effect of such : refusals on the prosecution of DWI cases. The st...

Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse

Science.gov Websites

Trucks Virginia Cleans up With Natural Gas Refuse Trucks to someone by E-mail Share Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Facebook Tweet about Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Twitter Bookmark Alternative

Modular bioreactor for the remediation of liquid streams and methods for using the same

DOEpatents

Noah, K.S.; Sayer, R.L.; Thompson, D.N.

1998-06-30

The present invention is directed to a bioreactor system for the remediation of contaminated liquid streams. The bioreactor system is composed of at least one and often a series of sub-units referred to as bioreactor modules. The modular nature of the system allows bioreactor systems be subdivided into smaller units and transported to waste sites where they are combined to form bioreactor systems of any size. The bioreactor modules further comprises reactor fill materials in the bioreactor module that remove the contaminants from the contaminated stream. To ensure that the stream thoroughly contacts the reactor fill materials, each bioreactor module comprises means for directing the flow of the stream in a vertical direction and means for directing the flow of the stream in a horizontal direction. In a preferred embodiment, the reactor fill comprises a sulfate reducing bacteria which is particularly useful for precipitating metals from acid mine streams. 6 figs.

37 CFR 211.7 - Reconsideration procedure for refusals to register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CONGRESS COPYRIGHT OFFICE AND PROCEDURES MASK WORK PROTECTION § 211.7 Reconsideration procedure for... refusals to register copyright claims are applicable to requests to reconsider refusals to register mask...

Staying alive! Sensors used for monitoring cell health in bioreactors.

PubMed

O'Mara, P; Farrell, A; Bones, J; Twomey, K

2018-01-01

Current and next generation sensors such as pH, dissolved oxygen (dO) and temperature sensors that will help drive the use of single-use bioreactors in industry are reviewed. The current trend in bioreactor use is shifting from the traditional fixed bioreactors to the use of single-use bioreactors (SUBs). However as the shift in paradigm occurs there is now a greater need for sensor technology to play 'catch up' with the innovation of bioreactor technology. Many of the sensors still in use today rely on technology created in the 1960's such as the Clark-type dissolved oxygen sensor or glass pH electrodes. This is due to the strict requirements of sensors to monitor bioprocesses resulting in the use of traditional well understood methods, making it difficult to incorporate new sensor technology into industry. A number of advances in sensor technology have been achieved in recent years, a few of these advances and future research will also be discussed in this review. Copyright © 2017 Elsevier B.V. All rights reserved.

Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance

PubMed Central

Marcewicz, Lauren H.; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D.; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

2017-01-01

Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011–2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation. PMID:28054156

Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance.

PubMed

Marcewicz, Lauren H; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

2017-05-01

Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

Children with food refusal: an assessment of parental eating attitudes and their styles of coping with stress.

PubMed

Tan, Seda; Yilmaz, Ayse Esra; Karabel, Musemma; Kara, Semra; Aldemir, Seçil; Karabel, Duran

2012-05-01

In this study, we aimed to assess the eating attitudes and stress coping styles of parents whose children presented to the clinic complaining of food refusal. The parents of 31 children aged ≥3 years, presented to the clinic with the complaint of food refusal. The control group consisted of 30 healthy children with no prior history of food refusal, and their parents. In both groups, birth features, body mass indexes (BMIs), eating attitudes and stress coping styles of the parents were assessed. The parents of both groups were studied, in part utilizing the eating attitudes test (EAT), and the coping styles of stress scale (CSSS). Our study found that body weights and BMI values of the fathers in the study group were significantly lower than fathers in the control group. There was no significant difference in EAT scores between the two groups; however, where the children's body weight and height for age percentile was under 25%, the parents had significantly lower EAT scores. When CSSS scores were assessed, the optimistic approach score of the mother and the self-confident score of the father were found to be significantly high in both groups. The parental perception and definition of eating problems does not necessarily indicate the presence of an eating disorder in a child. In fact, the eating attitudes of the fathers were related to the low percentile weight and height values of the children, and a child's food refusal was not dependent on the stress coping style used by the parent. Copyright © 2012. Published by Elsevier B.V.

The Potential for Microalgae as Bioreactors to Produce Pharmaceuticals

PubMed Central

Yan, Na; Fan, Chengming; Chen, Yuhong; Hu, Zanmin

2016-01-01

As photosynthetic organisms, microalgae can efficiently convert solar energy into biomass. Microalgae are currently used as an important source of valuable natural biologically active molecules, such as carotenoids, chlorophyll, long-chain polyunsaturated fatty acids, phycobiliproteins, carotenoids and enzymes. Significant advances have been achieved in microalgae biotechnology over the last decade, and the use of microalgae as bioreactors for expressing recombinant proteins is receiving increased interest. Compared with the bioreactor systems that are currently in use, microalgae may be an attractive alternative for the production of pharmaceuticals, recombinant proteins and other valuable products. Products synthesized via the genetic engineering of microalgae include vaccines, antibodies, enzymes, blood-clotting factors, immune regulators, growth factors, hormones, and other valuable products, such as the anticancer agent Taxol. In this paper, we briefly compare the currently used bioreactor systems, summarize the progress in genetic engineering of microalgae, and discuss the potential for microalgae as bioreactors to produce pharmaceuticals. PMID:27322258

Refusal of Medical and Surgical Interventions by Older Persons with Advanced Chronic Disease

PubMed Central

Van Ness, Peter H.; O’Leary, John R.; Fried, Terri R.

2007-01-01

BACKGROUND Patients with advanced chronic disease are frequently offered medical and surgical interventions with potentially large trade-offs between benefits and burdens. Little is known about the frequency or outcomes of treatment refusal among these patients. OBJECTIVE To assess the frequency of, reasons for, factors associated with, and outcomes of treatment refusal among older persons with advanced chronic disease. DESIGN Observational cohort study. PARTICIPANTS Two hundred twenty-six community-dwelling persons with advanced cancer, chronic obstructive pulmonary disease, or congestive heart failure, interviewed at least every 4 months for up to 2 years. MEASUREMENTS Participants were asked if they had refused any treatments recommended by their physicians, and why. RESULTS Thirty-six of 226 patients (16%) reported refusing 1 or more medical or surgical treatments recommended by their physician. The most frequently refused interventions were cardiac catheterization and surgery. The most common reason for refusal was fear of side effects (41%). Treatment refusal was more frequent among patients who wanted prognostic information (10% vs 2%, p = .02) or estimated their own longevity at 2 years or less (18% vs 5%, p = .02). There was an increased risk of mortality among refusers compared with non-refusers (HR 1.98, 95% CI 1.02–3.86). CONCLUSIONS Refusal of medical and surgical interventions other than medications is common among persons with advanced chronic disease, and is associated with a greater desire for, and understanding of, prognostic information. PMID:17483977

Consent and refusal in dementia research: conceptual and practical considerations.

PubMed

Cohen-Mansfield, J

2003-01-01

This article discusses types of consent refusals, rates of refusal, factors that affect consent, and methods to increase rates of consent in elderly research participants and in those with dementia in particular. Refusals can be categorized according to several types: complete refusal, refusal that is time-contingent, partial refusal, and contingent agreement. Rates of consent vary greatly across studies of persons with dementia. This variation can also be affected by different methodologies of calculating rates, in addition to differences in content of studies, populations, and procedures. To warrant consent, a study must first be scientifically sound, with a high likelihood of advancing knowledge, and must provide maximal protection to participants. Consent rates are affected by the following factors: levels of anticipated risks and benefits of the study, relationships among the different caregivers involved in the care of the potential subject, the ability of the researcher to properly identify and locate the person who needs to provide consent, characteristics and attitudes of the person providing consent, and the method of obtaining consent, including timing, location, method of presentation, and type of consent requested. An understanding of these issues can assist the researcher in tailoring research procedures so as to maximize rates of consent. It also raises ethical issues that warrant further discussion concerning the process of obtaining consent from and for persons with dementia.

Start-up of membrane bioreactor and hybrid moving bed biofilm reactor-membrane bioreactor: kinetic study.

PubMed

Leyva-Díaz, J C; Poyatos, J M

2015-01-01

A hybrid moving bed biofilm reactor-membrane bioreactor (hybrid MBBR-MBR) system was studied as an alternative solution to conventional activated sludge processes and membrane bioreactors. This paper shows the results obtained from three laboratory-scale wastewater treatment plants working in parallel in the start-up and steady states. The first wastewater treatment plant was a MBR, the second one was a hybrid MBBR-MBR system containing carriers both in anoxic and aerobic zones of the bioreactor (hybrid MBBR-MBRa), and the last one was a hybrid MBBR-MBR system which contained carriers only in the aerobic zone (hybrid MBBR-MBRb). The reactors operated with a hydraulic retention time of 30.40 h. A kinetic study for characterizing heterotrophic biomass was carried out and organic matter and nutrients removals were evaluated. The heterotrophic biomass of the hybrid MBBR-MBRb showed the best kinetic performance in the steady state, with yield coefficient for heterotrophic biomass=0.30246 mg volatile suspended solids per mg chemical oxygen demand, maximum specific growth rate for heterotrophic biomass=0.00308 h(-1) and half-saturation coefficient for organic matter=3.54908 mg O2 L(-1). The removal of organic matter was supported by the kinetic study of heterotrophic biomass.

Refusing The Choice: Balancing Life and Work

NASA Astrophysics Data System (ADS)

Brooks, J.

2012-12-01

The Choice The intellect of man is forced to choose perfection of the life, or of the work, And if it take the second must refuse A heavenly mansion, raging in the dark. When all that story's finished, what's the news? In luck or out the toil has left its mark: That old perplexity an empty purse, Or the day's vanity, the night's remorse. William Butler Yeats William Yeats put forward The Choice that I feel too many scientists feel they must make. Too often, many choose to leave science. How do we refuse this choice and find balance between life and our careers? While I don't know the answer, I will share choices that have lead to not perfection but satisfaction in science careers and lives. The role of mentors, supportive spouses, the luck of the job, and flexibility in research directions have all contributed to being able to refuse to choose.

Production of recombinant adeno-associated vectors using two bioreactor configurations at different scales

PubMed Central

Negrete, Alejandro; Kotin, Robert M.

2007-01-01

The conventional methods for producing recombinant adeno-associated virus (rAAV) rely on transient transfection of adherent mammalian cells. To gain acceptance and achieve current good manufacturing process (cGMP) compliance, clinical grade rAAV production process should have the following qualities: simplicity, consistency, cost effectiveness, and scalability. Currently, the only viable method for producing rAAV in large-scale, e.g.≥1016 particles per production run, utilizes Baculovirus Expression Vectors (BEVs) and insect cells suspension cultures. The previously described rAAV production in 40 L culture using a stirred tank bioreactor requires special conditions for implementation and operation not available in all laboratories. Alternatives to producing rAAV in stirred-tank bioreactors are single-use, disposable bioreactors, e.g. Wave™. The disposable bags are purchased pre-sterilized thereby eliminating the need for end-user sterilization and also avoiding cleaning steps between production runs thus facilitating the production process. In this study, rAAV production in stirred tank and Wave™ bioreactors was compared. The working volumes were 10 L and 40 L for the stirred tank bioreactors and 5 L and 20 L for the Wave™ bioreactors. Comparable yields of rAAV, ~2e+13 particles per liter of cell culture were obtained in all volumes and configurations. These results demonstrate that producing rAAV in large scale using BEVs is reproducible, scalable, and independent of the bioreactor configuration. Keywords: adeno-associated vectors; large-scale production; stirred tank bioreactor; wave bioreactor; gene therapy. PMID:17606302

High-throughput miniaturized bioreactors for cell culture process development: reproducibility, scalability, and control.

PubMed

Rameez, Shahid; Mostafa, Sigma S; Miller, Christopher; Shukla, Abhinav A

2014-01-01

Decreasing the timeframe for cell culture process development has been a key goal toward accelerating biopharmaceutical development. Advanced Microscale Bioreactors (ambr™) is an automated micro-bioreactor system with miniature single-use bioreactors with a 10-15 mL working volume controlled by an automated workstation. This system was compared to conventional bioreactor systems in terms of its performance for the production of a monoclonal antibody in a recombinant Chinese Hamster Ovary cell line. The miniaturized bioreactor system was found to produce cell culture profiles that matched across scales to 3 L, 15 L, and 200 L stirred tank bioreactors. The processes used in this article involve complex feed formulations, perturbations, and strict process control within the design space, which are in-line with processes used for commercial scale manufacturing of biopharmaceuticals. Changes to important process parameters in ambr™ resulted in predictable cell growth, viability and titer changes, which were in good agreement to data from the conventional larger scale bioreactors. ambr™ was found to successfully reproduce variations in temperature, dissolved oxygen (DO), and pH conditions similar to the larger bioreactor systems. Additionally, the miniature bioreactors were found to react well to perturbations in pH and DO through adjustments to the Proportional and Integral control loop. The data presented here demonstrates the utility of the ambr™ system as a high throughput system for cell culture process development. © 2014 American Institute of Chemical Engineers.

Define of internal recirculation coefficient for biological wastewater treatment in anoxic and aerobic bioreactors

NASA Astrophysics Data System (ADS)

Rossinskyi, Volodymyr

2018-02-01

The biological wastewater treatment technologies in anoxic and aerobic bioreactors with recycle of sludge mixture are used for the effective removal of organic compounds from wastewater. The change rate of sludge mixture recirculation between bioreactors leads to a change and redistribution of concentrations of organic compounds in sludge mixture in bioreactors and change hydrodynamic regimes in bioreactors. Determination of the coefficient of internal recirculation of sludge mixture between bioreactors is important for the choice of technological parameters of biological treatment (wastewater treatment duration in anoxic and aerobic bioreactors, flow capacity of recirculation pumps). Determination of the coefficient of internal recirculation of sludge mixture requires integrated consideration of hydrodynamic parameter (flow rate), kinetic parameter (rate of oxidation of organic compounds) and physical-chemical parameter of wastewater (concentration of organic compounds). The conducted numerical experiment from the proposed mathematical equations allowed to obtain analytical dependences of the coefficient of internal recirculation sludge mixture between bioreactors on the concentration of organic compounds in wastewater, the duration of wastewater treatment in bioreactors.

Design of a novel bioreactor and application in vascular tissue engineering

NASA Astrophysics Data System (ADS)

Zhang, Zhi-Xiong; Xi, Ting-Fei; Wang, Ying-Jun; Chen, Xiao-Song; Zhang, Jian; Wang, Chun-Ren; Gu, Yong-Quan; Chen, Liang; Li, Jian-Xin; Chen, Bing

2008-11-01

Endothelial cells (ECs) detachment under high shear stress at the early period of transplantation resulted in thrombosis and occlusion. To solve this problem, we developed a novel bioreactor. The bioreactor mimicked the formation of pulsatile flow in physiological conditions. Human umbilical vein ECs were seeded onto the lumen of living tissue conduits grown within dog peritoneal cavity. The shear stress generated by the bioreactor was increased step by step from 1.5 ± 0.8 dyn/cm 2 to 5.3 ± 2.4 dyn/cm 2, and was applied to ECs after static culture for 2 days. The results showed that completely confluent monolayer ECs were elongated, and were oriented parallel to the flow direction. The bioreactor could provide good environment for formation of endothelium. Stepwise increase shear stress could strengthen cell-cell and cell-extracellular matrix. The flow conditions of the bioreactor play a key role to determine the quality of the ECs lining.

Potential Bias in the Bank: What Distinguishes Refusers, Non-responders and Participants in a Clinic-based Biobank?

PubMed Central

Ridgeway, Jennifer L; Han, Leona C; Olson, Janet E; Lackore, Kandace A; Koenig, Barbara A; Beebe, Timothy J; Ziegenfuss, Jeanette Y

2013-01-01

Background Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to Electronic Medical Record information, we compared patient characteristics and self-reported information among participants, non-responders, and refusers. We also compared reasons for non-participation between refusers and non-responders to elucidate potential pathways to reduce non-participation and any uncovered bias. Methods We mailed recruitment packets to 1600 adult patients with upcoming appointments at Mayo Clinic (Rochester, MN) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 non-responders and 26 refusers to collect self-reported information, including reasons for non-participation. Participants were asked to complete a mailed questionnaire. Results We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% non-response (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns while non-responders more often identified time constraints as the reason for non-participation. Conclusion For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation

Pyrosequence analysis of bacterial communities in aerobic bioreactors treating polycyclic aromatic hydrocarbon-contaminated soil

PubMed Central

Richardson, Stephen D.; Aitken, Michael D.

2011-01-01

Two aerobic, lab-scale, slurry-phase bioreactors were used to examine the biodegradation of polycyclic aromatic hydrocarbons (PAHs) in contaminated soil and the associated bacterial communities. The two bioreactors were operated under semi-continuous (draw-and-fill) conditions at a residence time of 35 days, but one was fed weekly and the other monthly. Most of the quantified PAHs, including high-molecular-weight compounds, were removed to a greater extent in the weekly-fed bioreactor, which achieved total PAH removal of 76%. Molecular analyses, including pyrosequencing of 16S rRNA genes, revealed significant shifts in the soil bacterial communities after introduction to the bioreactors and differences in the abundance and types of bacteria in each of the bioreactors. The weekly-fed bioreactor displayed a more stable bacterial community with gradual changes over time, whereas the monthly-fed bioreactor community was less consistent and may have been more strongly influenced by the influx of untreated soil during feeding. Phylogenetic groups containing known PAH-degrading bacteria previously identified through stable-isotope probing of the untreated soil were differentially affected by bioreactor conditions. Sequences from members of the Acidovorax and Sphingomonas genera, as well as the uncultivated ‘‘Pyrene Group 2’’ were abundant in the bioreactors. However, the relative abundances of sequences from the Pseudomonas, Sphingobium, and Pseudoxanthomonas genera, as well as from a group of unclassified anthracene degraders, were much lower in the bioreactors compared to the untreated soil. PMID:21369833

49 CFR 219.209 - Reports of tests and refusals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Reports of tests and refusals. 219.209 Section 219.209 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.209 Reports of tests and refusals. (...

A versatile miniature bioreactor and its application to bioelectrochemistry studies.

PubMed

Kloke, A; Rubenwolf, S; Bücking, C; Gescher, J; Kerzenmacher, S; Zengerle, R; von Stetten, F

2010-08-15

Often, reproducible investigations on bio-microsystems essentially require a flexible but well-defined experimental setup, which in its features corresponds to a bioreactor. We therefore developed a miniature bioreactor with a volume in the range of a few millilitre that is assembled by alternate stacking of individual polycarbonate elements and silicone gaskets. All the necessary supply pipes are incorporated as bore holes or cavities within the individual elements. Their combination allows for a bioreactor assembly that is easily adaptable in size and functionality to experimental demands. It allows for controlling oxygen transfer as well as the monitoring of dissolved oxygen concentration and pH-value. The system provides access for media exchange or sterile sampling. A mass transfer coefficient for oxygen (k(L)a) of 4.3x10(-3) s(-1) at a flow rate of only 15 ml min(-1) and a mixing time of 1.5s at a flow rate of 11 ml min(-1) were observed for the modular bioreactor. Single reactor chambers can be interconnected via ion-conductive membranes to form a two-chamber test setup for investigations on electrochemical systems such as fuel cells or sensors. The versatile applicability of this modular and flexible bioreactor was demonstrated by recording a growth curve of Escherichia coli (including monitoring of pH and oxygen) saturation, and also as by two bioelectrochemical experiments. In the first electrochemical experiment the use of the bioreactor enabled a direct comparison of electrode materials for a laccase-catalyzed oxygen reduction electrode. In a second experiment, the bioreactor was utilized to characterize the influence of outer membrane cytochromes on the performance of Shewanella oneidensis in a microbial fuel cell. Copyright 2010 Elsevier B.V. All rights reserved.

A narrative review of studies of refusal of psychotropic medication in acute inpatient psychiatric care.

PubMed

Owiti, J A; Bowers, L

2011-09-01

This paper offers a narrative review of the 22 studies of medication refusal in acute psychiatry. Because of varied definitions of medication refusal, diverse methodologies and few rigorous studies, it has not been possible to draw firm conclusions on the average rate of refusal of psychotropic medications in acute psychiatry. However, it is clear that medication refusal is common and leads to poor outcomes characterized by higher rates of seclusion, restraint, threats of, and actual, assaults and longer hospitalizations. There are no statistically significant differences between refusers and acceptors in gender, marital status and preadmission living arrangements. Although no firm conclusions on the influence of ethnicity, status at admission and diagnosis on refusal, the refusers are more likely to have higher number of previous hospitalizations and history of prior refusal. The review indicates that staff factors such as the use of temporary staff, lack of confidence in ward staff and ineffective ward structure are associated with higher rates of medication refusal. Comprehensive knowledge of why, and how, patients refuse medication is lacking. Research on medication refusal is still fragmented, of variable methodological quality and lacks an integrating model. © 2011 Blackwell Publishing.

Point of care experience with pneumococcal and influenza vaccine documentation among persons aged ≥65 years: high refusal rates and missing information.

PubMed

Brownfield, Elisha; Marsden, Justin E; Iverson, Patty J; Zhao, Yumin; Mauldin, Patrick D; Moran, William P

2012-09-01

Missed opportunities to vaccinate and refusal of vaccine by patients have hindered the achievement of national health care goals. The meaningful use of electronic medical records should improve vaccination rates, but few studies have examined the content of these records. In our vaccine intervention program using an electronic record with physician prompts, paper prompts, and nursing standing orders, we were unable to achieve national vaccine goals, due in large part to missing information and patient refusal. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

[The parents' experience of school refusal in adolescence].

PubMed

Bussard, Dewi; Harf, Aurélie; Sibeoni, Jordan; Radjack, Rahmeth; Benoit, Jean Pierre; Moro, Marie Rose

2015-01-01

While today's society places considerable importance on schooling and performances, school absenteeism is currently very high. One of the causes is anxiety-based school refusal. This phenomenon affects the adolescent but also has an impact on their family. Exploring the experience of the parents of teenagers presenting anxiety-based school refusal enables these families to be given better support. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

ERIC Educational Resources Information Center

Tolin, David F.; Whiting, Sara; Maltby, Nicholas; Diefenbach, Gretchen J.; Lothstein, Mary Anne; Hardcastle, Surrey; Catalano, Amy; Gray, Krista

2009-01-01

The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week…

49 CFR 219.209 - Reports of tests and refusals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Reports of tests and refusals. 219.209 Section 219... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.209 Reports of tests and refusals. (a)(1) A railroad that has experienced one or more events for...

Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

PubMed

Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

2016-01-01

Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

A comparison of bioreactors for culture of fetal mesenchymal stem cells for bone tissue engineering.

PubMed

Zhang, Zhi-Yong; Teoh, Swee Hin; Teo, Erin Yiling; Khoon Chong, Mark Seow; Shin, Chong Woon; Tien, Foo Toon; Choolani, Mahesh A; Chan, Jerry K Y

2010-11-01

Bioreactors provide a dynamic culture system for efficient exchange of nutrients and mechanical stimulus necessary for the generation of effective tissue engineered bone grafts (TEBG). We have shown that biaxial rotating (BXR) bioreactor-matured human fetal mesenchymal stem cell (hfMSC) mediated-TEBG can heal a rat critical sized femoral defect. However, it is not known whether optimal bioreactors exist for bone TE (BTE) applications. We systematically compared this BXR bioreactor with three most commonly used systems: Spinner Flask (SF), Perfusion and Rotating Wall Vessel (RWV) bioreactors, for their application in BTE. The BXR bioreactor achieved higher levels of cellularity and confluence (1.4-2.5x, p < 0.05) in large 785 mm(3) macroporous scaffolds not achieved in the other bioreactors operating in optimal settings. BXR bioreactor-treated scaffolds experienced earlier and more robust osteogenic differentiation on von Kossa staining, ALP induction (1.2-1.6×, p < 0.01) and calcium deposition (1.3-2.3×, p < 0.01). We developed a Micro CT quantification method which demonstrated homogenous distribution of hfMSC in BXR bioreactor-treated grafts, but not with the other three. BXR bioreactor enabled superior cellular proliferation, spatial distribution and osteogenic induction of hfMSC over other commonly used bioreactors. In addition, we developed and validated a non-invasive quantitative micro CT-based technique for analyzing neo-tissue formation and its spatial distribution within scaffolds. Copyright © 2010 Elsevier Ltd. All rights reserved.

LEACHATE NITROGEN CONCENTRATIONS AND BACTERIAL NUMBERS FROM TWO BIOREACTOR LANDFILLS

EPA Science Inventory

The U.S. EPA and Waste Management Inc. have entered into a cooperative research and development agreement (CRADA) to study landfills operated as bioreactors. Two different landfill bioreactor configurations are currently being tested at the Outer Loop landfill in Louisville, KY...

Enhancement of matrix production and cell proliferation in human annulus cells under bioreactor culture.

PubMed

Yang, Xinlin; Wang, Daidong; Hao, Jianrong; Gong, Meiqing; Arlet, Vincent; Balian, Gary; Shen, Francis H; Li, Xudong Joshua

2011-06-01

Tissue engineering is a promising approach for treatment of disc degeneration. Herein, we evaluated effects of rotating bioreactor culture on the extracellular matrix production and proliferation of human annulus fibrosus (AF) cells. AF cells were embedded into alginate beads, and then cultured up to 3 weeks in a rotating wall vessel bioreactor or a static vessel. By real-time reverse transcription-polymerase chain reaction, expression of aggrecan, collagen type I and type II, and collagen prolyl 4-hydroxylase II was remarkably elevated, whereas expression of matrix metalloproteinase 3 and a disintegrin and metalloproteinase with thrombospondin motifs 5 was significantly decreased under bioreactor. Biochemical analysis revealed that the levels of the whole cell-associated proteoglycan and collagen were approximately five- and twofolds in rotating bioreactor, respectively, compared to those in static culture. Moreover, AF cell proliferation was augmented in rotating bioreactor. DNA contents were threefolds higher in rotating bioreactor than that in static culture. Expression of the proliferating cell nuclear antigen was robustly enhanced in rotating bioreactor as early as 1 week. Our findings suggested that rotating bioreactor culture would be an effective technique for expansion of human annulus cells for tissue engineering driven treatment of disc degeneration.

Refusal of postoperative radiotherapy and its association with survival in head and neck cancer.

PubMed

Schwam, Zachary G; Husain, Zain; Judson, Benjamin L

2015-11-01

Administering postoperative radiotherapy (PORT) is associated with improved survival and slower disease progression in select head and neck cancer patients. Predictive factors for PORT refusal have not been described in this population. Retrospective analysis of 6127 head and neck cancer patients who received or refused PORT in the National Cancer Database (2003-2006) was performed. Statistical analysis included Chi-square, multivariable logistic regression, Kaplan-Meier, and Cox proportional hazards analysis. In total, 247 patients (4.0%) refused PORT. Three-year overall survival was 62.8% versus 53.4% for those who received and refused PORT, respectively. PORT refusers were more likely to have negative nodes than those who underwent PORT (37.4% versus 20.1%, p<.001). In multivariate analysis, predictive factors for refusing PORT included living far from the treatment facility (OR 1.92), having negative nodes (OR 2.14), and Charlson score of ⩾ 2 (OR 2.14) (all p ⩽.001). PORT refusal was associated with increased mortality (hazard ratio 1.20, p=.044). A significant proportion of head and neck cancer patients refused PORT; this was associated with compromised overall survival. Predictive factors for PORT refusal included socioeconomic, demographic, and pathologic variables. Elucidating root causes of refusal may lead to interventions that improve long-term outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Alternative Fuels Data Center: Fleet Application for Refuse Collection

Science.gov Websites

CNG - Compressed Natural Gas 1 Electric 1 Hybrid - CNG 1 Hybrid - LNG 1 Hydraulic hybrid 9 LNG - Liquified Natural Gas icon for refuse collection vehicle application Autocar ACMD-Xpert Hybrid - CNG Hybrid - Compressed Natural Gas LNG - Liquified Natural Gas icon for refuse collection vehicle application BYD All

Academic Self-Attributions for Success and Failure in Mathematics and School Refusal

ERIC Educational Resources Information Center

Gonzálvez, Carolina; Sanmartín, Ricardo; Vicent, María; Inglés, Cándido J.; Aparicio-Flores, M. Pilar; García-Fernández, José M.

2018-01-01

The aim of this research is twofold: to analyze the mean differences scores in mathematic self-attributions based on school refusal and to verify its predictive capability on high scores in school refusal. The Sydney Attribution Scale and the School Refusal Assessment Scale-Revised were administered to 1078 Spanish students (50.8% boys) aged…

[The refusal of nursing care by the families].

PubMed

Curchod, Claude; Fisher, Marion

2016-10-01

Caregiving is complex. While it is not easy to admit that the process can be refused by the patient, it is no easier when it is refused by the patient's family. Accepting this fact is however an essential stage in the relational and care processes. The family must therefore be supported by professionals in order to be able to make an enlightened choice. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Protein Expression in Insect and Mammalian Cells Using Baculoviruses in Wave Bioreactors.

PubMed

Kadwell, Sue H; Overton, Laurie K

2016-01-01

Many types of disposable bioreactors for protein expression in insect and mammalian cells are now available. They differ in design, capacity, and sensor options, with many selections available for either rocking platform, orbitally shaken, pneumatically mixed, or stirred-tank bioreactors lined with an integral disposable bag (Shukla and Gottschalk, Trends Biotechnol 31(3):147-154, 2013). WAVE Bioreactors™ were among the first disposable systems to be developed (Singh, Cytotechnology 30:149-158, 1999). Since their commercialization in 1999, Wave Bioreactors have become routinely used in many laboratories due to their ease of operation, limited utility requirements, and protein expression levels comparability to traditional stirred-tank bioreactors. Wave Bioreactors are designed to use a presterilized Cellbag™, which is attached to a rocking platform and inflated with filtered air provided by the bioreactor unit. The Cellbag can be filled with medium and cells and maintained at a set temperature. The rocking motion, which is adjusted through angle and rock speed settings, provides mixing of oxygen (and CO2, which is used to control pH in mammalian cell cultures) from the headspace created in the inflated Cellbag with the cell culture medium and cells. This rocking motion can be adjusted to prevent cell shear damage. Dissolved oxygen and pH can be monitored during scale-up, and samples can be easily removed to monitor other parameters. Insect and mammalian cells grow very well in Wave Bioreactors (Shukla and Gottschalk, Trends Biotechnol 31(3):147-154, 2013). Combining Wave Bioreactor cell growth capabilities with recombinant baculoviruses engineered for insect or mammalian cell expression has proven to be a powerful tool for rapid production of a wide range of proteins.

Bioreactors for removing methyl bromide following contained fumigations

USGS Publications Warehouse

Miller, L.G.; Baesman, S.M.; Oremland, R.S.

2003-01-01

Use of methyl bromide (MeBr) as a quarantine, commodity, or structural fumigant is under scrutiny because its release to the atmosphere contributes to the depletion of stratospheric ozone. A closed-system bioreactor consisting of 0.5 L of a growing culture of a previously described bacterium, strain IMB-1, removed MeBr (> 110 ??mol L-1) from recirculating air. Strain IMB-1 grew slowly to high cell densities in the bioreactor using MeBr as its sole carbon and energy source. Bacterial oxidation of MeBr produced CO2 and hydrobromic acid (HBr), which required continuous neutralization with NaOH for the system to operate effectively. Strain IMB-1 was capable of sustained oxidation of large amounts of MeBr (170 mmol in 46 d). In an open-system bioreactor (10-L fermenter), strain IMB-1 oxidized a continuous supply of MeBr (220 ??mol L-1 in air). Growth was continuous, and 0.5 mol of MeBr was removed from the air supply in 14 d. The specific rate of MeBr oxidation was 7 ?? 10-16 mol cell-1 h-1. Bioreactors such as these can therefore be used to remove large quantities of contaminant MeBr, which opens the possibility of biodegradation as a practical means for its disposal.

Aggregation of Culture Expanded Human Mesenchymal Stem Cells in Microcarrier-based Bioreactor.

PubMed

Yuan, Xuegang; Tsai, Ang-Chen; Farrance, Iain; Rowley, Jon; Ma, Teng

2018-03-15

Three-dimensional aggregation of human mesenchymal stem cells (hMSCs) has been used to enhance their therapeutic properties but current fabrication protocols depend on laboratory methods and are not scalable. In this study, we developed thermal responsive poly(N-isopropylacrylamide) grafted microcarriers (PNIPAM-MCs), which supported expansion and thermal detachment of hMSCs at reduced temperature (23.0 °C). hMSCs were cultured on the PNIPAM-MCs in both spinner flask (SF) and PBS Vertical-Wheel (PBS-VW) bioreactors for expansion. At room temperature, hMSCs were detached as small cell sheets, which subsequently self-assembled into 3D hMSC aggregates in PBS-VW bioreactor and remain as single cells in SF bioreactor owing to different hydrodynamic conditions. hMSC aggregates generated from the bioreactor maintained comparable immunomodulation and cytokine secretion properties compared to the ones made from the AggreWell ® . The results of the current study demonstrate the feasibility of scale-up production of hMSC aggregates in the suspension bioreactor using thermal responsive microcarriers for integrated cell expansion and 3D aggregation in a close bioreactor system and highlight the critical role of hydrodynamics in self-assembly of detached hMSC in suspension.

3D Printed Vascular Networks Enhance Viability in High-Volume Perfusion Bioreactor.

PubMed

Ball, Owen; Nguyen, Bao-Ngoc B; Placone, Jesse K; Fisher, John P

2016-12-01

There is a significant clinical need for engineered bone graft substitutes that can quickly, effectively, and safely repair large segmental bone defects. One emerging field of interest involves the growth of engineered bone tissue in vitro within bioreactors, the most promising of which are perfusion bioreactors. Using bioreactor systems, tissue engineered bone constructs can be fabricated in vitro. However, these engineered constructs lack inherent vasculature and once implanted, quickly develop a necrotic core, where no nutrient exchange occurs. Here, we utilized COMSOL modeling to predict oxygen diffusion gradients throughout aggregated alginate constructs, which allowed for the computer-aided design of printable vascular networks, compatible with any large tissue engineered construct cultured in a perfusion bioreactor. We investigated the effect of 3D printed macroscale vascular networks with various porosities on the viability of human mesenchymal stem cells in vitro, using both gas-permeable, and non-gas permeable bioreactor growth chamber walls. Through the use of 3D printed vascular structures in conjunction with a tubular perfusion system bioreactor, cell viability was found to increase by as much as 50% in the core of these constructs, with in silico modeling predicting construct viability at steady state.

3D Printed Vascular Networks Enhance Viability in High-Volume Perfusion Bioreactor

PubMed Central

Ball, Owen; Nguyen, Bao-Ngoc B.; Placone, Jesse K.; Fisher, John P.

2016-01-01

There is a significant clinical need for engineered bone graft substitutes that can quickly, effectively, and safely repair large segmental bone defects. One emerging field of interest involves the growth of engineered bone tissue in vitro within bioreactors, the most promising of which are perfusion bioreactors. Using bioreactor systems, tissue engineered bone constructs can be fabricated in vitro. However, these engineered constructs lack inherent vasculature and once implanted, quickly develop a necrotic core, where no nutrient exchange occurs. Here, we utilized COMSOL modeling to predict oxygen diffusion gradients throughout aggregated alginate constructs, which allowed for the computer-aided design of printable vascular networks, compatible with any large tissue engineered construct cultured in a perfusion bioreactor. We investigated the effect of 3D printed macroscale vascular networks with various porosities on the viability of human mesenchymal stem cells in vitro, using both gas-permeable, and non-gas permeable bioreactor growth chamber walls. Through the use of 3D printed vascular structures in conjunction with a tubular perfusion system bioreactor, cell viability was found to increase by as much as 50% in the core of these constructs, with in silico modeling predicting construct viability at steady state. PMID:27272210

Refusal skill ability: an examination of adolescent perceptions of effectiveness.

PubMed

Nichols, Tracy R; Birnel, Sara; Graber, Julia A; Brooks-Gunn, Jeanne; Botvin, Gilbert J

2010-06-01

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the second by a group of high school interns. Consistency with programming criteria was found for interns' ratings of several indicators of verbal and non-verbal assertiveness. However, a strategy previously defined by the program as effective was perceived as ineffective by adolescents while another deemed ineffective and problematic by intervention developers was viewed as effective. Interns endorsed presenting detailed and reasonable arguments as an effective refusal strategy while short, simple statements were deemed ineffective. This study suggests the importance of including adolescent perspectives in the design, delivery, and evaluation of drug prevention strategies.

COMPUTER SIMULATOR (BEST) FOR DESIGNING SULFATE-REDUCING BACTERIA FIELD BIOREACTORS

EPA Science Inventory

BEST (bioreactor economics, size and time of operation) is a spreadsheet-based model that is used in conjunction with public domain software, PhreeqcI. BEST is used in the design process of sulfate-reducing bacteria (SRB) field bioreactors to passively treat acid mine drainage (A...

DESIGNING SULFATE-REDUCING BACTERIA FIELD BIOREACTORS USING THE BEST MODEL

EPA Science Inventory

BEST (bioreactor economics, size and time of operation) is a spreadsheet-based model that is used in conjunction with a public domain computer software package, PHREEQCI. BEST is intended to be used in the design process of sulfate-reducing bacteria (SRB)field bioreactors to pas...

Data on insulin therapy refusal among type II diabetes mellitus patients in Mashhad, Iran.

PubMed

Mostafavian, Zahra; Ghareh, Sahar; Torabian, Farnaz; Yazdi, Mohammad Sarafraz; Khazaei, Mahmood Reza

2018-06-01

Insulin has been considered as a therapy option of last resort in type 2 diabetes (T2DM) management. Delay in insulin therapy is common in these patients. This study collected the data on the factors associated with insulin refusal in poorly controlled T2DM patients prior to insulin therapy. The data collected from two endocrinology outpatient clinics affiliated by Islamic Azad University of Mashhad, Iran (IAUM) from January 2016 to September 2017. Study population was adults with non-insulin-using type 2 diabetes mellitus who refused insulin therapy. A 17-items researcher made questionnaire was used to obtain demographic data and information toward causes of insulin refusal. Data were analyzed using SPPS V.16 with descriptive and analytical tests such as multiple logistic regressions. The data of 110 patients with T2DM was recorded in this study. The most prevalent cause of insulin therapy refusal was reported to be painful insulin injection (78.2%) followed by this item "I'm afraid of injecting myself with a needle" (74.5%). Regression analysis revealed that education level had a significant association with the item of "Injecting insulin is painful" (P=0.033, OR=0.357). Also age (P=0.025, OR=1.076) and disease duration (P=0.024, OR=0.231) were significantly associated with the question "taking insulin makes life less flexible". Several causes have been found regarding misconceptions about insulin therapy in T2DM patients. Specialized educational interventions are recommended for initiating successful insulin therapy in these patients.

Delay and refusal of human papillomavirus vaccine for girls, national immunization survey-teen, 2010.

PubMed

Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J

2014-03-01

Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.

A Flow Perfusion Bioreactor System for Vocal Fold Tissue Engineering Applications

PubMed Central

Heris, Hossein K.; Thomson, Scott L.; Taher, Rani; Kazemirad, Siavash; Sheibani, Sara; Li-Jessen, Nicole Y.K.; Vali, Hojatollah; Mongeau, Luc

2016-01-01

The human vocal folds (VFs) undergo complex biomechanical stimulation during phonation. The aim of the present study was to develop and validate a phono-mimetic VF flow perfusion bioreactor, which mimics the mechanical microenvironment of the human VFs in vitro. The bioreactor uses airflow-induced self-oscillations, which have been shown to produce mechanical loading and contact forces that are representative of human phonation. The bioreactor consisted of two synthetic VF replicas within a silicone body. A cell-scaffold mixture (CSM) consisting of human VF fibroblasts, hyaluronic acid, gelatin, and a polyethylene glycol cross-linker was injected into cavities within the replicas. Cell culture medium (CCM) was perfused through the scaffold by using a customized secondary flow loop. After the injection, the bioreactor was operated with no stimulation over a 3-day period to allow for cell adaptation. Phonation was subsequently induced by using a variable speed centrifugal blower for 2 h each day over a period of 4 days. A similar bioreactor without biomechanical stimulation was used as the nonphonatory control. The CSM was harvested from both VF replicas 7 days after the injection. The results confirmed that the phono-mimetic bioreactor supports cell viability and extracellular matrix proteins synthesis, as expected. Many scaffold materials were found to degrade because of challenges from phonation-induced biomechanical stimulation as well as due to biochemical reactions with the CCM. The bioreactor concept enables future investigations of the effects of different phonatory characteristics, that is, voice regimes, on the behavior of the human VF cells. It will also help study the long-term functional outcomes of the VF-specific biomaterials before animal and clinical studies. PMID:27537192

A Flow Perfusion Bioreactor System for Vocal Fold Tissue Engineering Applications.

PubMed

Latifi, Neda; Heris, Hossein K; Thomson, Scott L; Taher, Rani; Kazemirad, Siavash; Sheibani, Sara; Li-Jessen, Nicole Y K; Vali, Hojatollah; Mongeau, Luc

2016-09-01

The human vocal folds (VFs) undergo complex biomechanical stimulation during phonation. The aim of the present study was to develop and validate a phono-mimetic VF flow perfusion bioreactor, which mimics the mechanical microenvironment of the human VFs in vitro. The bioreactor uses airflow-induced self-oscillations, which have been shown to produce mechanical loading and contact forces that are representative of human phonation. The bioreactor consisted of two synthetic VF replicas within a silicone body. A cell-scaffold mixture (CSM) consisting of human VF fibroblasts, hyaluronic acid, gelatin, and a polyethylene glycol cross-linker was injected into cavities within the replicas. Cell culture medium (CCM) was perfused through the scaffold by using a customized secondary flow loop. After the injection, the bioreactor was operated with no stimulation over a 3-day period to allow for cell adaptation. Phonation was subsequently induced by using a variable speed centrifugal blower for 2 h each day over a period of 4 days. A similar bioreactor without biomechanical stimulation was used as the nonphonatory control. The CSM was harvested from both VF replicas 7 days after the injection. The results confirmed that the phono-mimetic bioreactor supports cell viability and extracellular matrix proteins synthesis, as expected. Many scaffold materials were found to degrade because of challenges from phonation-induced biomechanical stimulation as well as due to biochemical reactions with the CCM. The bioreactor concept enables future investigations of the effects of different phonatory characteristics, that is, voice regimes, on the behavior of the human VF cells. It will also help study the long-term functional outcomes of the VF-specific biomaterials before animal and clinical studies.

Effects of aeration frequency on leachate quality and waste in simulated hybrid bioreactor landfills.

PubMed

Ko, Jae Hac; Ma, Zeyu; Jin, Xiao; Xu, Qiyong

2016-12-01

Research has been conducted to investigate the effects of daily aeration frequency on leachate quality and waste settlement in simulated hybrid landfill bioreactors. Four laboratory-scale reactors were constructed and operated for about 10 months to simulate different bioreactor operations, including one anaerobic bioreactor and three hybrid bioreactors with different aeration frequencies (one, two, and four times per day). Chemical oxygen demand (COD) and biochemical oxygen demand (BOD 5 ) reduced more than 96% of the initial concentrations in all aerated bioreactors. The differences of COD and BOD 5 reductions among tested aeration frequencies were relatively small. For ammonia nitrogen, the higher aeration frequency (two or four times per day) resulted in the quicker reduction. Overall, the concentrations of heavy metals (Cr, Co, Cu, Mn, Ni, and Zn) decreased over time except Cd and Pb. The reduction of redox-sensitive metal concentrations (Mn, Co, Ni, and Cu) was greater in aerated bioreactors than in anaerobic bioreactor. Settlement of municipal solid waste (MSW) was enhanced with higher frequency of aeration events (four times per day). In recent years, hybird bioreactor landfill technology has gained a lot of attention. Appropriate aeration rate is crucial for hybrid bioreactor operation, but few studies have been done and different results were obtained. Research was conducted to investigate the effects of daily aeration frequency on leachate quality and waste settlement. Results indicated that aeration can effectively accelerate waste stabilization and remove organic carbon concentration and total nitrogen in the leachate.

Membrane bioreactors for the removal of anionic micropollutants from drinking water.

PubMed

Crespo, João G; Velizarov, Svetlozar; Reis, Maria A

2004-10-01

Biological treatment processes allow for the effective elimination of anionic micropollutants from drinking water. However, special technologies have to be implemented to eliminate the target pollutants without changing water quality, either by adding new pollutants or removing essential water components. Some innovative technologies that combine the use of membranes with the biological degradation of ionic micropollutants in order to minimize the secondary contamination of treated water include pressure-driven membrane bioreactors, gas-transfer membrane bioreactors and ion exchange membrane bioreactors.

A simple eccentric stirred tank mini-bioreactor: mixing characterization and mammalian cell culture experiments.

PubMed

Bulnes-Abundis, David; Carrillo-Cocom, Leydi M; Aráiz-Hernández, Diana; García-Ulloa, Alfonso; Granados-Pastor, Marisa; Sánchez-Arreola, Pamela B; Murugappan, Gayathree; Alvarez, Mario M

2013-04-01

In industrial practice, stirred tank bioreactors are the most common mammalian cell culture platform. However, research and screening protocols at the laboratory scale (i.e., 5-100 mL) rely primarily on Petri dishes, culture bottles, or Erlenmeyer flasks. There is a clear need for simple-easy to assemble, easy to use, easy to clean-cell culture mini-bioreactors for lab-scale and/or screening applications. Here, we study the mixing performance and culture adequacy of a 30 mL eccentric stirred tank mini-bioreactor. A detailed mixing characterization of the proposed bioreactor is presented. Laser induced fluorescence (LIF) experiments and computational fluid dynamics (CFD) computations are used to identify the operational conditions required for adequate mixing. Mammalian cell culture experiments were conducted with two different cell models. The specific growth rate and the maximum cell density of Chinese hamster ovary (CHO) cell cultures grown in the mini-bioreactor were comparable to those observed for 6-well culture plates, Erlenmeyer flasks, and 1 L fully instrumented bioreactors. Human hematopoietic stem cells were successfully expanded tenfold in suspension conditions using the eccentric mini-bioreactor system. Our results demonstrate good mixing performance and suggest the practicality and adequacy of the proposed mini-bioreactor. Copyright © 2012 Wiley Periodicals, Inc.

Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

PubMed

Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

2015-12-01

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

Development and Characterization of a Parallelizable Perfusion Bioreactor for 3D Cell Culture.

PubMed

Egger, Dominik; Fischer, Monica; Clementi, Andreas; Ribitsch, Volker; Hansmann, Jan; Kasper, Cornelia

2017-05-25

The three dimensional (3D) cultivation of stem cells in dynamic bioreactor systems is essential in the context of regenerative medicine. Still, there is a lack of bioreactor systems that allow the cultivation of multiple independent samples under different conditions while ensuring comprehensive control over the mechanical environment. Therefore, we developed a miniaturized, parallelizable perfusion bioreactor system with two different bioreactor chambers. Pressure sensors were also implemented to determine the permeability of biomaterials which allows us to approximate the shear stress conditions. To characterize the flow velocity and shear stress profile of a porous scaffold in both bioreactor chambers, a computational fluid dynamics analysis was performed. Furthermore, the mixing behavior was characterized by acquisition of the residence time distributions. Finally, the effects of the different flow and shear stress profiles of the bioreactor chambers on osteogenic differentiation of human mesenchymal stem cells were evaluated in a proof of concept study. In conclusion, the data from computational fluid dynamics and shear stress calculations were found to be predictable for relative comparison of the bioreactor geometries, but not for final determination of the optimal flow rate. However, we suggest that the system is beneficial for parallel dynamic cultivation of multiple samples for 3D cell culture processes.

Development and Characterization of a Parallelizable Perfusion Bioreactor for 3D Cell Culture

PubMed Central

Egger, Dominik; Fischer, Monica; Clementi, Andreas; Ribitsch, Volker; Hansmann, Jan; Kasper, Cornelia

2017-01-01

The three dimensional (3D) cultivation of stem cells in dynamic bioreactor systems is essential in the context of regenerative medicine. Still, there is a lack of bioreactor systems that allow the cultivation of multiple independent samples under different conditions while ensuring comprehensive control over the mechanical environment. Therefore, we developed a miniaturized, parallelizable perfusion bioreactor system with two different bioreactor chambers. Pressure sensors were also implemented to determine the permeability of biomaterials which allows us to approximate the shear stress conditions. To characterize the flow velocity and shear stress profile of a porous scaffold in both bioreactor chambers, a computational fluid dynamics analysis was performed. Furthermore, the mixing behavior was characterized by acquisition of the residence time distributions. Finally, the effects of the different flow and shear stress profiles of the bioreactor chambers on osteogenic differentiation of human mesenchymal stem cells were evaluated in a proof of concept study. In conclusion, the data from computational fluid dynamics and shear stress calculations were found to be predictable for relative comparison of the bioreactor geometries, but not for final determination of the optimal flow rate. However, we suggest that the system is beneficial for parallel dynamic cultivation of multiple samples for 3D cell culture processes. PMID:28952530

Expansion of Human Mesenchymal Stem Cells in a Microcarrier Bioreactor.

PubMed

Tsai, Ang-Chen; Ma, Teng

2016-01-01

Human mesenchymal stem cells (hMSCs) are considered as a primary candidate in cell therapy owing to their self-renewability, high differentiation capabilities, and secretions of trophic factors. In clinical application, a large quantity of therapeutically competent hMSCs is required that cannot be produced in conventional petri dish culture. Bioreactors are scalable and have the capacity to meet the production demand. Microcarrier suspension culture in stirred-tank bioreactors is the most widely used method to expand anchorage dependent cells in a large scale. Stirred-tank bioreactors have the potential to scale up and microcarriers provide the high surface-volume ratio. As a result, a spinner flask bioreactor with microcarriers has been commonly used in large scale expansion of adherent cells. This chapter describes a detailed culture protocol for hMSC expansion in a 125 mL spinner flask using microcarriers, Cytodex I, and a procedure for cell seeding, expansion, metabolic sampling, and quantification and visualization using microculture tetrazolium (MTT) reagent.

Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification.

PubMed

Kenney, Shannon R; Bailey, Genie L; Anderson, Bradley J; Stein, Michael D

2017-10-01

An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery. Copyright © 2017. Published by Elsevier Ltd.

[Research progress of in vivo bioreactor as vascularization strategies in bone tissue engineering].

PubMed

Zhang, Haifeng; Han, Dong

2014-09-01

To review the application and research progress of in vivo bioreactor as vascularization strategies in bone tissue engineering. The original articles about in vivo bioreactor that can enhance vascularization of tissue engineered bone were extensively reviewed and analyzed. The in vivo bioreactor can be created by periosteum, muscle, muscularis membrane, and fascia flap as well as biomaterials. Using in vivo bioreactor can effectively promote the establishment of a microcirculation in the tissue engineered bones, especially for large bone defects. However, main correlative researches, currently, are focused on animal experiments, more clinical trials will be carried out in the future. With the rapid development of related technologies of bone tissue engineering, the use of in vivo bioreactor will to a large extent solve the bottleneck limitations and has the potential values for clinical application.

A plea for uniform European definitions for organ donor potential and family refusal rates.

PubMed

Jansen, Nichon E; Haase-Kromwijk, Bernadette J J M; van Leiden, Hendrik A; Weimar, Willem; Hoitsma, Andries J

2009-11-01

Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of donor potential and refusal rates for organ donation in intensive care units. We found 14 articles pertinent to this study. There is an enormous diversity among the performed studies. The definitions of potential organ donors and family refusal differed substantially. We tried to re-calculate the refusal rates. This method failed because of the influence caused by the registered will on donation in the Donor Register. We therefore calculated the total refusal rate. This strategy was also less satisfactory considering possible influence of the legal consent system on the approach of family. Because of lack of uniform definitions, we can conclude that the refusal rates for organ donation can not be used for a sound comparison among countries. To be able to learn from well-performing countries, it is necessary to establish uniform definitions regarding organ donation and registration of all intensive care deaths.

Seasonal Patterns in Microbial Community Composition in Denitrifying Bioreactors Treating Subsurface Agricultural Drainage.

PubMed

Porter, Matthew D; Andrus, J Malia; Bartolerio, Nicholas A; Rodriguez, Luis F; Zhang, Yuanhui; Zilles, Julie L; Kent, Angela D

2015-10-01

Denitrifying bioreactors, consisting of water flow control structures and a woodchip-filled trench, are a promising approach for removing nitrate from agricultural subsurface or tile drainage systems. To better understand the seasonal dynamics and the ecological drivers of the microbial communities responsible for denitrification in these bioreactors, we employed microbial community "fingerprinting" techniques in a time-series examination of three denitrifying bioreactors over 2 years, looking at bacteria, fungi, and the denitrifier functional group responsible for the final step of complete denitrification. Our analysis revealed that microbial community composition responds to depth and seasonal variation in moisture content and inundation of the bioreactor media, as well as temperature. Using a geostatistical analysis approach, we observed recurring temporal patterns in bacterial and denitrifying bacterial community composition in these bioreactors, consistent with annual cycling. The fungal communities were more stable, having longer temporal autocorrelations, and did not show significant annual cycling. These results suggest a recurring seasonal cycle in the denitrifying bioreactor microbial community, likely due to seasonal variation in moisture content.

The Fluid Mechanics of a Wavy-Wall Bioreactor

NASA Astrophysics Data System (ADS)

Sucosky, Philippe; Bilgen, Bahar; Aleem, Alexander; Neitzel, Paul; Barabino, Gilda

2004-11-01

Bioreactors are devices used for the production of mammalian tissue in vitro. Although mixing has been shown to stimulate the growth of cartilage constructs, high shear-stress levels can damage the cells. In order to enhance mixing while minimizing shear, a wavy-wall bioreactor (WWB) featuring a sinusoidal internal profile has been designed. The turbulent hydrodynamic environment produced in this device is investigated experimentally using particle-image velocimetry. A model bioreactor made of acrylic and filled with an index-matching solution of zinc iodide is used to compensate for the refraction of light at the walls. The flow observed in different planes is shown to be periodic, spatially dependent, and dominated by mean-shear rather than Reynolds stresses in the vicinity of constructs. Finally, a comparison between the mean-shear stresses obtained in the WWB and in a standard spinner flask reveals similar stress levels near the construct walls.

Social Skills, Competence, and Drug Refusal Efficacy as Predictors of Adolescent Alcohol Use.

ERIC Educational Resources Information Center

Scheier, Lawrence M.; Botvin, Gilbert J.; Diaz, Tracy; Griffin, Kenneth W.

1999-01-01

Examines the extent to which assertiveness and related social skills, personal competence, and refusal efficacy predict alcohol involvement in adolescents. Males were at higher risk for poor refusal skills and reported higher alcohol involvement. Youth characterized by poor social skill development reported lower refusal efficacy, lower grades,…

Unique differentiation profile of mouse embryonic stem cells in rotary and stirred tank bioreactors.

PubMed

Fridley, Krista M; Fernandez, Irina; Li, Mon-Tzu Alice; Kettlewell, Robert B; Roy, Krishnendu

2010-11-01

Embryonic stem (ES)-cell-derived lineage-specific stem cells, for example, hematopoietic stem cells, could provide a potentially unlimited source for transplantable cells, especially for cell-based therapies. However, reproducible methods must be developed to maximize and scale-up ES cell differentiation to produce clinically relevant numbers of therapeutic cells. Bioreactor-based dynamic culture conditions are amenable to large-scale cell production, but few studies have evaluated how various bioreactor types and culture parameters influence ES cell differentiation, especially hematopoiesis. Our results indicate that cell seeding density and bioreactor speed significantly affect embryoid body formation and subsequent generation of hematopoietic stem and progenitor cells in both stirred tank (spinner flask) and rotary microgravity (Synthecon™) type bioreactors. In general, high percentages of hematopoietic stem and progenitor cells were generated in both bioreactors, especially at high cell densities. In addition, Synthecon bioreactors produced more sca-1(+) progenitors and spinner flasks generated more c-Kit(+) progenitors, demonstrating their unique differentiation profiles. cDNA microarray analysis of genes involved in pluripotency, germ layer formation, and hematopoietic differentiation showed that on day 7 of differentiation, embryoid bodies from both bioreactors consisted of all three germ layers of embryonic development. However, unique gene expression profiles were observed in the two bioreactors; for example, expression of specific hematopoietic genes were significantly more upregulated in the Synthecon cultures than in spinner flasks. We conclude that bioreactor type and culture parameters can be used to control ES cell differentiation, enhance unique progenitor cell populations, and provide means for large-scale production of transplantable therapeutic cells.

9 CFR 590.160 - Refusal, suspension, or withdrawal of service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INSPECTION ACT) Denial of Service § 590.160 Refusal, suspension, or withdrawal of service. (a) The... service. 590.160 Section 590.160 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE...) may refuse to provide or may withdraw inspection service under this part with respect to any plant if...

9 CFR 590.160 - Refusal, suspension, or withdrawal of service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSPECTION ACT) Denial of Service § 590.160 Refusal, suspension, or withdrawal of service. (a) The... service. 590.160 Section 590.160 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE...) may refuse to provide or may withdraw inspection service under this part with respect to any plant if...

Biodegradation of paint stripper solvents in a modified gas lift loop bioreactor.

PubMed

Vanderberg-Twary, L; Steenhoudt, K; Travis, B J; Hanners, J L; Foreman, T M; Brainard, J R

1997-07-05

Paint stripping wastes generated during the decontamination and decommissioning of former nuclear facilities contain paint stripping organics (dichloromethane, 2-propanol, and methanol) and bulk materials containing paint pigments. It is desirable to degrade the organic residues as part of an integrated chemical-biological treatment system. We have developed a modified gas lift loop bioreactor employing a defined consortium of Rhodococcus rhodochrous strain OFS and Hyphomicrobium sp. DM-2 that degrades paint stripper organics. Mass transfer coefficients and kinetic constants for biodegradation in the system were determined. It was found that transfer of organic substrates from surrogate waste into the air and further into the liquid medium in the bioreactor were rapid processes, occurring within minutes. Monod kinetics was employed to model the biodegradation of paint stripping organics. Analysis of the bioreactor process was accomplished with BIOLAB, a mathematical code that simulates coupled mass transfer and biodegradation processes. This code was used to fit experimental data to Monod kinetics and to determine kinetic parameters. The BIOLAB code was also employed to compare activities in the bioreactor of individual microbial cultures to the activities of combined cultures in the bioreactor. This code is of benefit for further optimization and scale-up of the bioreactor for treatment of paint stripping and other volatile organic wastes in bulk materials.

The Role of Bioreactors in Ligament and Tendon Tissue Engineering.

PubMed

Mace, James; Wheelton, Andy; Khan, Wasim S; Anand, Sanj

2016-01-01

Bioreactors are pivotal to the emerging field of tissue engineering. The formation of neotissue from pluripotent cell lineages potentially offers a source of tissue for clinical use without the significant donor site morbidity associated with many contemporary surgical reconstructive procedures. Modern bioreactor design is becoming increasingly complex to provide a both an expandable source of readily available pluripotent cells and to facilitate their controlled differentiation into a clinically applicable ligament or tendon like neotissue. This review presents the need for such a method, challenges in the processes to engineer neotissue and the current designs and results of modern bioreactors in the pursuit of engineered tendon and ligament.

Untreated oral cavity cancer: Long-term survival and factors associated with treatment refusal.

PubMed

Cheraghlou, Shayan; Kuo, Phoebe; Mehra, Saral; Yarbrough, Wendell G; Judson, Benjamin L

2018-03-01

Oral cavity cancer is the most common malignant disease of the head and neck. The natural course of the disease is poorly characterized and unavailable for patient consideration during initial treatment planning. Our primary objective was to outline this natural history, with a secondary aim of identifying predictors of treatment refusal. Retrospective review of adult patients with oral cavity cancer who refused surgery that was recommended by their physician in the National Cancer Database. Demographic, tumor, and survival variables were included in the analyses. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted. Patients who were older, uninsured, had government insurance, or had more advanced disease were more likely to go untreated. Survival among untreated patients was poor, but there was a small proportion of patients surviving long term. Five-year survival rates ranged from 31.1% among early-stage patients to 12.6% among stage 4 patients. Although the natural course of oral cavity cancer carries a poor prognosis, there are a number of patients with longer-than-expected survival. The survival estimates may provide supplemental information for patients deciding whether to pursue treatment. In addition to age and extent of disease, system factors such as insurance status and facility case volume are associated with a patient's likelihood of refusing treatment. 4. Laryngoscope, 128:664-669, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

A novel perfused rotary bioreactor for cardiomyogenesis of embryonic stem cells.

PubMed

Teo, Ailing; Mantalaris, Athanasios; Song, Kedong; Lim, Mayasari

2014-05-01

Developments in bioprocessing technology play an important role for overcoming challenges in cardiac tissue engineering. To this end, our laboratory has developed a novel rotary perfused bioreactor for supporting three-dimensional cardiac tissue engineering. The dynamic culture environments provided by our novel perfused rotary bioreactor and/or the high-aspect rotating vessel produced constructs with higher viability and significantly higher cell numbers (up to 4 × 10(5) cells/bead) than static tissue culture flasks. Furthermore, cells in the perfused rotary bioreactor showed earlier gene expressions of cardiac troponin-T, α- and β-myosin heavy chains with higher percentages of cardiac troponin-I-positive cells and better uniformity of sacromeric α-actinin expression. A dynamic and perfused environment, as provided by this bioreactor, provides a superior culture performance in cardiac differentiation for embryonic stem cells particularly for larger 3D constructs.

Numerical simulation of microcarrier motion in a rotating wall vessel bioreactor.

PubMed

Ju, Zhi-Hao; Liu, Tian-Qing; Ma, Xue-Hu; Cui, Zhan-Feng

2006-06-01

To analyze the forces of rotational wall vessel (RWV) bioreactor on small tissue pieces or microcarrier particles and to determine the tracks of microcarrier particles in RWV bioreactor. The motion of the microcarrier in the rotating wall vessel (RWV) bioreactor with both the inner and outer cylinders rotating was modeled by numerical simulation. The continuous trajectory of microcarrier particles, including the possible collision with the wall was obtained. An expression between the minimum rotational speed difference of the inner and outer cylinders and the microcarrier particle or aggregate radius could avoid collisions with either wall. The range of microcarrier radius or tissue size, which could be safely cultured in the RWV bioreactor, in terms of shear stress level, was determined. The model works well in describing the trajectory of a heavier microcarrier particle in rotating wall vessel.

Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

PubMed

Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

2017-11-01

Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

22 CFR 92.9 - Refusals of requests for notarial services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Refusals of requests for notarial services. 92.9 Section 92.9 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED... services should be refused only after the most careful deliberation. [22 FR 10858, Dec. 27, 1957, as...

Nano-ceramic composite scaffolds for bioreactor-based bone engineering.

PubMed

Lv, Qing; Deng, Meng; Ulery, Bret D; Nair, Lakshmi S; Laurencin, Cato T

2013-08-01

Composites of biodegradable polymers and bioactive ceramics are candidates for tissue-engineered scaffolds that closely match the properties of bone. We previously developed a porous, three-dimensional poly (D,L-lactide-co-glycolide) (PLAGA)/nanohydroxyapatite (n-HA) scaffold as a potential bone tissue engineering matrix suitable for high-aspect ratio vessel (HARV) bioreactor applications. However, the physical and cellular properties of this scaffold are unknown. The present study aims to evaluate the effect of n-HA in modulating PLAGA scaffold properties and human mesenchymal stem cell (HMSC) responses in a HARV bioreactor. By comparing PLAGA/n-HA and PLAGA scaffolds, we asked whether incorporation of n-HA (1) accelerates scaffold degradation and compromises mechanical integrity; (2) promotes HMSC proliferation and differentiation; and (3) enhances HMSC mineralization when cultured in HARV bioreactors. PLAGA/n-HA scaffolds (total number = 48) were loaded into HARV bioreactors for 6 weeks and monitored for mass, molecular weight, mechanical, and morphological changes. HMSCs were seeded on PLAGA/n-HA scaffolds (total number = 38) and cultured in HARV bioreactors for 28 days. Cell migration, proliferation, osteogenic differentiation, and mineralization were characterized at four selected time points. The same amount of PLAGA scaffolds were used as controls. The incorporation of n-HA did not alter the scaffold degradation pattern. PLAGA/n-HA scaffolds maintained their mechanical integrity throughout the 6 weeks in the dynamic culture environment. HMSCs seeded on PLAGA/n-HA scaffolds showed elevated proliferation, expression of osteogenic phenotypic markers, and mineral deposition as compared with cells seeded on PLAGA scaffolds. HMSCs migrated into the scaffold center with nearly uniform cell and extracellular matrix distribution in the scaffold interior. The combination of PLAGA/n-HA scaffolds with HMSCs in HARV bioreactors may allow for the generation of engineered

Optimization of denitrifying bioreactor performance with agricultural residue-based filter media

USDA-ARS?s Scientific Manuscript database

Denitrification bioreactors are a promising technology for mitigation of nitrate-nitrogen (NO3-N) losses in subsurface drainage water. Bioreactors are constructed with carbon substrates, typically wood chips, to provide a substrate for denitrifying microorganisms. Columns were packed with wood chips...

CASKAD. Manual Mixing in Bioreactor

NASA Image and Video Library

2013-10-05

ISS037-E-005692 (5 Oct. 2013) --- Russian cosmonaut Sergey Ryazanskiy, Expedition 37 flight engineer, prepares to manually mix samples in a Bioreactor for the CASKAD experiment in the Poisk Mini-Research Module 2 (MRM2) of the International Space Station.

CASKAD. Manual Mixing in Bioreactor

NASA Image and Video Library

2013-10-05

ISS037-E-005694 (5 Oct. 2013) --- Russian cosmonaut Sergey Ryazanskiy, Expedition 37 flight engineer, prepares to manually mix samples in a Bioreactor for the CASKAD experiment in the Poisk Mini-Research Module 2 (MRM2) of the International Space Station.

[Analysis of the refusal of the flu vaccination (REGRIVI study)].

PubMed

Méijome-Blanco, S; González-Cristobo, G; Regueiro-Martínez, A Á

2018-02-10

The objective of this study is to determine the reasons for refusing the flu vaccination in the Primary Care Health Centre of Vilanova de Arousa, Spain, as well as to evaluate the flu vaccination coverage after an educational intervention. A quasi-experimental before and after study was conducted after an educational intervention on a total of 73 people that included those Primary Care Health Centre patients from Vilanova de Arousa who had refused the flu vaccination in 2014, and who did not meet the exclusion criteria (death during 2014 and 2015 campaigns, non-acceptance of participation, vaccine registration mistakes, contraindication or no indication for the vaccine, inability to contact). After a brief educational intervention, vaccination data from those patients in the 2015 and 2016 campaigns were checked. A descriptive analysis of the variables under study was then carried out. Of the 73 patients initially included, 72 completed the study. The main reasons for refusing a vaccination were the concerns about the adverse effects and patient perception of good health. Vaccination coverage was 50.7% in 2015, and 48.6% in 2016. The reasons for refusing vaccination are approachable with a brief intervention since the refusal decreases by half in the long-term. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Geomorphic reclmation of a coal refuse pile

NASA Astrophysics Data System (ADS)

Hopkinson, L. C.; Quaranta, J.

2017-12-01

Geomorphic reclamation is a technique that may offer opportunities to improve mine reclamation in Central Appalachia. The design approach is based on constructing a steady-state, mature landform condition and takes into account the long-term climatic conditions, soil types, terrain grade, and vegetation. Geomorphic reclamation has been applied successfully in semi-arid regions but has not yet been applied in Central Appalachia. This work describes a demonstration study where geomorphic landforming techniques are being applied to a coarse coal refuse pile in southern West Virginia, USA. The reclamation design includes four geomorphic watersheds that radially drain runoff from the pile. Each watershed has one central draining channel and incorporates compound slope profiles similarly to naturally eroded slopes. Planar slopes were also included to maintain the impacted area. The intent is to alter the hydrology to decrease water quality treatment costs. The excavation cut and fill volumes are comparable to those of more conventional refuse pile reclamation designs. If proven successful then this technique can be part of a cost-effective solution to improve water quality at active and future refuse facilities, abandoned mine lands, bond forfeiture sites, landfills, and major earthmoving activities within the region.

Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

PubMed

Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

2008-07-01

To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p < .001). All patients deemed too sick for ICU admission had decisions to forego LST. These decisions were made without direct patient examination in two-thirds of refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

Bioreactor droplets from liposome-stabilized all-aqueous emulsions

NASA Astrophysics Data System (ADS)

Dewey, Daniel C.; Strulson, Christopher A.; Cacace, David N.; Bevilacqua, Philip C.; Keating, Christine D.

2014-08-01

Artificial bioreactors are desirable for in vitro biochemical studies and as protocells. A key challenge is maintaining a favourable internal environment while allowing substrate entry and product departure. We show that semipermeable, size-controlled bioreactors with aqueous, macromolecularly crowded interiors can be assembled by liposome stabilization of an all-aqueous emulsion. Dextran-rich aqueous droplets are dispersed in a continuous polyethylene glycol (PEG)-rich aqueous phase, with coalescence inhibited by adsorbed ~130-nm diameter liposomes. Fluorescence recovery after photobleaching and dynamic light scattering data indicate that the liposomes, which are PEGylated and negatively charged, remain intact at the interface for extended time. Inter-droplet repulsion provides electrostatic stabilization of the emulsion, with droplet coalescence prevented even for submonolayer interfacial coatings. RNA and DNA can enter and exit aqueous droplets by diffusion, with final concentrations dictated by partitioning. The capacity to serve as microscale bioreactors is established by demonstrating a ribozyme cleavage reaction within the liposome-coated droplets.

Bioreactor droplets from liposome-stabilized all-aqueous emulsions.

PubMed

Dewey, Daniel C; Strulson, Christopher A; Cacace, David N; Bevilacqua, Philip C; Keating, Christine D

2014-08-20

Artificial bioreactors are desirable for in vitro biochemical studies and as protocells. A key challenge is maintaining a favourable internal environment while allowing substrate entry and product departure. We show that semipermeable, size-controlled bioreactors with aqueous, macromolecularly crowded interiors can be assembled by liposome stabilization of an all-aqueous emulsion. Dextran-rich aqueous droplets are dispersed in a continuous polyethylene glycol (PEG)-rich aqueous phase, with coalescence inhibited by adsorbed ~130-nm diameter liposomes. Fluorescence recovery after photobleaching and dynamic light scattering data indicate that the liposomes, which are PEGylated and negatively charged, remain intact at the interface for extended time. Inter-droplet repulsion provides electrostatic stabilization of the emulsion, with droplet coalescence prevented even for submonolayer interfacial coatings. RNA and DNA can enter and exit aqueous droplets by diffusion, with final concentrations dictated by partitioning. The capacity to serve as microscale bioreactors is established by demonstrating a ribozyme cleavage reaction within the liposome-coated droplets.

Miniature Bioreactor System for Long-Term Cell Culture

NASA Technical Reports Server (NTRS)

Gonda, Steve R.; Kleis, Stanley J.; Geffert, Sandara K.

2010-01-01

A prototype miniature bioreactor system is designed to serve as a laboratory benchtop cell-culturing system that minimizes the need for relatively expensive equipment and reagents and can be operated under computer control, thereby reducing the time and effort required of human investigators and reducing uncertainty in results. The system includes a bioreactor, a fluid-handling subsystem, a chamber wherein the bioreactor is maintained in a controlled atmosphere at a controlled temperature, and associated control subsystems. The system can be used to culture both anchorage-dependent and suspension cells, which can be either prokaryotic or eukaryotic. Cells can be cultured for extended periods of time in this system, and samples of cells can be extracted and analyzed at specified intervals. By integrating this system with one or more microanalytical instrument(s), one can construct a complete automated analytical system that can be tailored to perform one or more of a large variety of assays.

Bioreactors for guiding muscle tissue growth and development.

PubMed

Dennis, R G; Smith, B; Philp, A; Donnelly, K; Baar, K

2009-01-01

Muscle tissue bioreactors are devices which are employed to guide and monitor the development of engineered muscle tissue. These devices have a modern history that can be traced back more than a century, because the key elements of muscle tissue bioreactors have been studied for a very long time. These include barrier isolation and culture of cells, tissues and organs after isolation from a host organism; the provision of various stimuli intended to promote growth and maintain the muscle, such as electrical and mechanical stimulation; and the provision of a perfusate such as culture media or blood derived substances. An accurate appraisal of our current progress in the development of muscle bioreactors can only be made in the context of the history of this endeavor. Modern efforts tend to focus more upon the use of computer control and the application of mechanical strain as a stimulus, as well as substrate surface modifications to induce cellular organization at the early stages of culture of isolated muscle cells.

Physician switching after drug request refusal.

PubMed

Lee, Doohee; Begley, Charles E

2011-10-01

Physician switching is a barometer of the quality of the relationship between a patient and a physician. Understanding the factors associated with physician switching in the context of direct-to-consumer advertising (DTCA) of prescription drugs has been largely unexamined. A total of 818 of 2,988 participants in a national telephone survey (27.4%) who had received DTCA reported asking their physician for a prescription drug, and 196 (24.0%) reported that their physician refused to prescribe the drug. Of those whose physicians refused, 13.9% (n = 27 of 194 with data) switched doctors. We found that individuals with regular medical-seeking behavior, full prescription drug coverage, with certain chronic conditions, and of African American origin were significantly more likely to switch physicians in this context.

PERFORMANCE OF NORTH AMERICAN BIOREACTOR LANDFILLS: II. CHEMICAL AND BIOLOGICAL CHARACTERISTICS

EPA Science Inventory

The objective of this research was to examine the performance of five North American bioreactor landfills. This paper represents the second of a two part series and addresses biological and chemical aspects of bioreactor performance including gas production and management, and l...

Visualizing medium and biodistribution in complex cell culture bioreactors using in vivo imaging.

PubMed

Ratcliffe, E; Thomas, R J; Stacey, A J

2014-01-01

There is a dearth of technology and methods to aid process characterization, control and scale-up of complex culture platforms that provide niche micro-environments for some stem cell-based products. We have demonstrated a novel use of 3d in vivo imaging systems to visualize medium flow and cell distribution within a complex culture platform (hollow fiber bioreactor) to aid characterization of potential spatial heterogeneity and identify potential routes of bioreactor failure or sources of variability. This can then aid process characterization and control of such systems with a view to scale-up. Two potential sources of variation were observed with multiple bioreactors repeatedly imaged using two different imaging systems: shortcutting of medium between adjacent inlet and outlet ports with the potential to create medium gradients within the bioreactor, and localization of bioluminescent murine 4T1-luc2 cells upon inoculation with the potential to create variable seeding densities at different points within the cell growth chamber. The ability of the imaging technique to identify these key operational bioreactor characteristics demonstrates an emerging technique in troubleshooting and engineering optimization of bioreactor performance. © 2013 American Institute of Chemical Engineers.

Regulation of mesenchymal stem cell 3D microenvironment: From macro to microfluidic bioreactors.

PubMed

Sart, Sébastien; Agathos, Spiros N; Li, Yan; Ma, Teng

2016-01-01

Human mesenchymal stem cells (hMSCs) have emerged as an important cell type in cell therapy and tissue engineering. In these applications, maintaining the therapeutic properties of hMSCs requires tight control of the culture environments and the structural cell organizations. Bioreactor systems are essential tools to achieve these goals in the clinical-scale expansion and tissue engineering applications. This review summarizes how different bioreactors provide cues to regulate the structure and the chemico-mechanical microenvironment of hMSCs with a focus on 3D organization. In addition to conventional bioreactors, recent advances in microfluidic bioreactors as a novel approach to better control the hMSC microenvironment are also discussed. These advancements highlight the key role of bioreactor systems in preserving hMSC's functional properties by providing dynamic and temporal regulation of in vitro cellular microenvironment. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Bioreactors as engineering support to treat cardiac muscle and vascular disease.

PubMed

Massai, Diana; Cerino, Giulia; Gallo, Diego; Pennella, Francesco; Deriu, Marco A; Rodriguez, Andres; Montevecchi, Franco M; Bignardi, Cristina; Audenino, Alberto; Morbiducci, Umberto

2013-01-01

Cardiovascular disease is the leading cause of morbidity and mortality in the Western World. The inability of fully differentiated, load-bearing cardiovascular tissues to in vivo regenerate and the limitations of the current treatment therapies greatly motivate the efforts of cardiovascular tissue engineering to become an effective clinical strategy for injured heart and vessels. For the effective production of organized and functional cardiovascular engineered constructs in vitro, a suitable dynamic environment is essential, and can be achieved and maintained within bioreactors. Bioreactors are technological devices that, while monitoring and controlling the culture environment and stimulating the construct, attempt to mimic the physiological milieu. In this study, a review of the current state of the art of bioreactor solutions for cardiovascular tissue engineering is presented, with emphasis on bioreactors and biophysical stimuli adopted for investigating the mechanisms influencing cardiovascular tissue development, and for eventually generating suitable cardiovascular tissue replacements.

Clinical scale rapid expansion of lymphocytes for adoptive cell transfer therapy in the WAVE® bioreactor

PubMed Central

2012-01-01

Background To simplify clinical scale lymphocyte expansions, we investigated the use of the WAVE®, a closed system bioreactor that utilizes active perfusion to generate high cell numbers in minimal volumes. Methods We have developed an optimized rapid expansion protocol for the WAVE bioreactor that produces clinically relevant numbers of cells for our adoptive cell transfer clinical protocols. Results TIL and genetically modified PBL were rapidly expanded to clinically relevant scales in both static bags and the WAVE bioreactor. Both bioreactors produced comparable numbers of cells; however the cultures generated in the WAVE bioreactor had a higher percentage of CD4+ cells and had a less activated phenotype. Conclusions The WAVE bioreactor simplifies the process of rapidly expanding tumor reactive lymphocytes under GMP conditions, and provides an alternate approach to cell generation for ACT protocols. PMID:22475724

MONITORING GUIDANCE FOR BIOREACTOR LANDFILLS

EPA Science Inventory

Experimental bioreactor landfill operations at operating Municipal Solid Waste (MSW) landfills can be approved under the research development and demonstration (RD&D) provisions of 30CFR 258.4. To provide a basis for consistent data collection for future decision-making in suppor...

MONITORING APPROACHES FOR BIOREACTOR LANDFILLS

EPA Science Inventory

Experimental bioreactor landfill operations at operating Municipal Solid Waste (MSW) landfills can be approved under the research development and demonstration (RD&D) provisions of 40 CFR 258.4. To provide a basis for consistent data collection for future decision-making in suppo...

21 CFR 514.110 - Reasons for refusing to file applications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the applicant and to receive communications on all matters pertaining to the application. (7) The... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Reasons for refusing to file applications. 514.110... Applications § 514.110 Reasons for refusing to file applications. (a) The date of receipt of an application for...

Pediatric Prehospital Refusal of Medical Assistance: Association with Suspected Abuse or Neglect.

PubMed

Mix, Felicia; Myers, Lucas A; Luke, Anuradha; Sztajnkrycer, Matthew D

2017-01-01

Unlike adult refusal of medical assistance (RMA), pediatric refusal is not initiated by the patient. This lack of autonomy may permit neglect by the guardian through denial of necessary treatment. The purpose of the current study was to determine whether pediatric RMA was associated with suspected abuse or neglect (SAN). This was a retrospective single EMS agency cross-sectional analysis of calls between January 1, 2011 and December 31, 2015 for patients <18 years of age resulting in RMA. Age- and complaint-matched control groups were generated from transported patients during the same time period. Recidivism was defined as 2 or more episodes of RMA involving a single patient during the study period. A total of 241 calls for service resulted in RMA during the study period, representing 12.7% of all pediatric calls. Information regarding SAN was available for 202 calls. Recidivism was noted in 8 patients (17 calls for service), resulting in 185 unique patients. Twenty-one RMA patients (11.4%) were identified as SAN. No difference in SAN status was noted between RMA patients and age-matched controls (21 vs. 24, p = 0.75) and complaint-matched controls (21 vs. 26, p = 0.53). No SAN was identified in the 8 recidivist patients when compared with the 177 non-recidivist patients (0 vs. 21, p = 0.60). Pediatric SAN patients are not uncommon users of EMS in our service area. Neither RMA nor recidivist RMA was associated with the presence of SAN within our patient population.

Blood Transfusion in Children: The Refusal of Jehovah's Witness Parents'.

PubMed

Conti, Adelaide; Capasso, Emanuele; Casella, Claudia; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Policino, Fabio; Terracciano, Lucia; Delbon, Paola

2018-01-01

In Italy, both parents have parental responsibility; as a general principle they have the power to give or withhold consent to medical procedures on their children, including consent for blood transfusion; however these rights are not absolute and exist only to promote the welfare of children. The Authors discuss ethical and legal framework for Jehovah's Witness parents' refusal of blood transfusion in Italy. They searched national judgments concerning Jehovah's Witness parents' refusal of blood transfusion - and related comments - in national legal databases and national legal journals, and literature on medical literature databases. In the case of Jehovah's Witness parents' refusal of blood transfusion for their child, Italian Courts adopt measures that prevents the parents from exercise their parental responsibility not in the child's best interest. In the event that refusal by the parents, outside of emergency situations, exposes the child's health to serious risk, health workers must proceed by notifying the competent authority, according also to the Italian Code of Medical Ethics. When the patient is a minor, the child's best interest always come first.

76 FR 29796 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Refuse...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-23

... for OMB Review; Comment Request; Refuse Piles and Impounding Structures, Recordkeeping and Reporting... Administration (MSHA) sponsored information collection request (ICR) titled, ``Refuse Piles and Impounding... to submit annual reports and certification on refuse piles and impoundments to the agency and to keep...

Review of nonconventional bioreactor technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turick, C.E.; Mcllwain, M.E.

1993-09-01

Biotechnology will significantly affect many industrial sectors in the future. Industrial sectors that will be affected include pharmaceutical, chemical, fuel, agricultural, and environmental remediation. Future research is needed to improve bioprocessing efficiency and cost-effectiveness in order to compete with traditional technologies. This report describes recent advances in bioprocess technologies and bioreactor designs and relates them to problems encountered in many industrial bioprocessing operations. The primary focus is directed towards increasing gas and vapor transfer for enhanced bioprocess kinetics as well as unproved by-product separation and removal. The advantages and disadvantages of various conceptual designs such as hollow-fiber, gas-phase, hyperbaric/hypobaric, andmore » electrochemical bioreactors are also discussed. Specific applications that are intended for improved bioprocesses include coal desulfurization, coal liquefaction, soil bioremediation, biomass conversion to marketable chemicals, biomining, and biohydrometallurgy as well as bioprocessing of gases and vapors.« less

Autonomy, religious values, and refusal of lifesaving medical treatment.

PubMed

Wreen, M J

1991-09-01

The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined.

Autonomy, religious values, and refusal of lifesaving medical treatment.

PubMed Central

Wreen, M J

1991-01-01

The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined. PMID:1941952

Electrical stimulation for enhanced denitrification in woodchip bioreactors: Opportunities and challenges

USDA-ARS?s Scientific Manuscript database

Woodchip bioreactors are being implemented for the removal of nitrates in groundwater and tile water drainage. However, low nitrate removals in denitrifying woodchip bioreactors have been observed for short hydraulic retention time (HRT) and low water temperature (< 10ºC). One potential approach to ...

Bioreactor design for successive culture of anchorage-dependent cells operated in an automated manner.

PubMed

Kino-Oka, Masahiro; Ogawa, Natsuki; Umegaki, Ryota; Taya, Masahito

2005-01-01

A novel bioreactor system was designed to perform a series of batchwise cultures of anchorage-dependent cells by means of automated operations of medium change and passage for cell transfer. The experimental data on contamination frequency ensured the biological cleanliness in the bioreactor system, which facilitated the operations in a closed environment, as compared with that in flask culture system with manual handlings. In addition, the tools for growth prediction (based on growth kinetics) and real-time growth monitoring by measurement of medium components (based on small-volume analyzing machinery) were installed into the bioreactor system to schedule the operations of medium change and passage and to confirm that culture proceeds as scheduled, respectively. The successive culture of anchorage-dependent cells was conducted with the bioreactor running in an automated way. The automated bioreactor gave a successful culture performance with fair accordance to preset scheduling based on the information in the latest subculture, realizing 79- fold cell expansion for 169 h. In addition, the correlation factor between experimental data and scheduled values through the bioreactor performance was 0.998. It was concluded that the proposed bioreactor with the integration of the prediction and monitoring tools could offer a feasible system for the manufacturing process of cultured tissue products.

The Refusal of Palliative Radiation in Metastatic Non-Small Cell Lung Cancer and Its Prognostic Implications.

PubMed

Stavas, Mark J; Arneson, Kyle O; Ning, Matthew S; Attia, Albert A; Phillips, Sharon E; Perkins, Stephanie M; Shinohara, Eric T

2015-06-01

Patients with metastatic non-small cell lung cancer (NSCLC) have limited survival. Population studies have evaluated the impact of radiation refusal in the curative setting; however, no data exist concerning the prognostic impact of radiation refusal in the palliative care setting. To investigate the patterns of radiation refusal in newly diagnosed patients with metastatic NSCLC. Patients with Stage IV NSCLC diagnosed between 1988 and 2010 were identified in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses were used to identify predictors for refusal of radiation and the impact of radiation and refusal on survival in the palliative setting. A total of 285,641 patients were initially included in the analysis. Palliative radiation was recommended in 42% and refused by 3.1% of patients. Refusal rates remained consistent across included years of study. On multivariate analysis, older, nonblack/nonwhite, unmarried females were more likely to refuse radiation (P < 0.001 in all cases). Median survival for patients refusing radiation was three months vs. five months for those receiving radiation and two months for those whom radiation was not recommended. Patients with metastatic NSCLC who refuse recommended palliative radiation have a poor survival. Radiation refusal or the recommendation against treatment can serve as a trigger for integrating palliative care services sooner and contributes greatly to prognostic awareness. Further investigation into this survival difference and the factors behind refusal are warranted. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Enhanced Denitrification in Roadside Ditches with Bioreactors

NASA Astrophysics Data System (ADS)

Pluer, W.; Schneider, R.; Walter, M. T.

2016-12-01

Nitrate (NO3) pollution remains a water quality problem in agriculture-dominated watersheds despite decades of research and concerted efforts. Excess NO3 causes eutrophication in estuarine and marine ecosystems far downstream of the pollution source. Denitrification reduces NO3 to inert dinitrogen gas; this process occurs naturally in saturated areas of the landscape but this rate cannot keep up with the runoff rate due to fertilizer and manure applications. Researchers developed denitrifying bioreactors as a solution to encourage denitrification at the field level. Denitrifying bioreactors remove NO3 at a significantly higher rate (>2 g N m-2 d-1) than natural systems such as wetlands (<0.5 g N m-2 d-1). Most current designs of denitrifying bioreactors necessitate connection with tile drainage as the inflow source of water and NO3. It also requires a portion of farmland (typically <1% of field area is needed) which farmers can be reluctant to relinquish. Meanwhile, road ditches commonly run along agricultural fields, channeling runoff and NO3 to surface water. Because the ditches are designed to avoid flooding, they channel water rapidly and minimize time and contact with soil microbes for denitrification (denitrification rates in ditches are typically <0.1 g N m-2 d-1). Modified denitrifying bioreactors placed in road ditches could provide high NO3 removal in already marginal land, especially at baseflow conditions. A pilot study of this shows instantaneous NO3 removal rates up to 110 g N m-2 d-1 in the first year. Continued results similar to this pilot study and wider application could significantly increase ditch denitrification and help mitigate NO3 pollution.

Using a Preventive Social Work Program for Reducing School Refusal

ERIC Educational Resources Information Center

Elsherbiny, Mohamed Mohamed

2017-01-01

This article describes a study aimed at solving the problem of school refusal by implementing a preventive program and raising the awareness of parents, social workers, and school personnel. The school children involved in this study were reported by their parents and school social workers to refuse to go to school, and according to the children's…

Quantitative analysis of microbial biomass yield in aerobic bioreactor.

PubMed

Watanabe, Osamu; Isoda, Satoru

2013-12-01

We have studied the integrated model of reaction rate equations with thermal energy balance in aerobic bioreactor for food waste decomposition and showed that the integrated model has the capability both of monitoring microbial activity in real time and of analyzing biodegradation kinetics and thermal-hydrodynamic properties. On the other hand, concerning microbial metabolism, it was known that balancing catabolic reactions with anabolic reactions in terms of energy and electron flow provides stoichiometric metabolic reactions and enables the estimation of microbial biomass yield (stoichiometric reaction model). We have studied a method for estimating real-time microbial biomass yield in the bioreactor during food waste decomposition by combining the integrated model with the stoichiometric reaction model. As a result, it was found that the time course of microbial biomass yield in the bioreactor during decomposition can be evaluated using the operational data of the bioreactor (weight of input food waste and bed temperature) by the combined model. The combined model can be applied to manage a food waste decomposition not only for controlling system operation to keep microbial activity stable, but also for producing value-added products such as compost on optimum condition. Copyright © 2013 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.

Factors Associated with Parental Refusal of Routine Vaccination in the Czech Republic.

PubMed

Dáňová, Jana; Šálek, Jiří; Kocourková, Aneta; Čelko, Alexander M

2015-12-01

Routine vaccination is one of the most important preventive methods which is responsible for the decreasing trend of morbidity and mortality of vaccine preventable infectious diseases, their complications and sequelae. The impact of vaccination on declining trend of these diseases is well known and confirmed by a large number of epidemiological studies. In the Czech Republic, there is high vaccination coverage in regards to most vaccine preventable diseases. However, during the last decade proportion of parents refusing routine vaccination of their children due to different factors is increasing. The presented study evaluates current situation in the Czech Republic and describes the most significant factors in parents decision making. The study was conducted between 1 July 2013 and 31 March 2014 as a questionnaire based survey (cross-sectional study). The questionnaire was created with multiple choice answers. Questions were addressed to parents or legal representatives of children aged 0-18 years. Types of questions were divided into several subgroups. The study was performed in the Czech Republic in two different districts of Prague and Zlín. In the sample size (n=480) we detected 11 parents who refused vaccination of 11 children (2.29%). The most often refused vaccines in the prevalence study were hexavaccine (1st dose) and measles, mumps and rubella vaccine (1st dose). The hexavaccine includes tetanic anatoxin, diphtheric anatoxin, acellular pertussis vaccine, conjugate vaccine against Haemophilus influenzae b, inactivated polio vaccine, and recombinant vaccine against viral hepatitis B. The measles, mumps, rubella vaccine contains live attenuated viruses of measles, mumps, rubella. We observed increasing trend of routine vaccination refusal in children during the last ten years (compared to situation in the year 2004, p<0.001). The most important factors associated with this progression were distrust to vaccination, fear of some vaccine components and fear of

Immunofluorescence Approach to the Study of the Ecology of Thermoplasma acidophilum In Coal Refuse Material

PubMed Central

Bohlool, B. B.; Brock, T. D.

1974-01-01

Specific immunofluorescence staining was applied to the study of the localization, distribution, and growth of Thermoplasma acidophilum in its natural habitat, the coal refuse pile. Different antigenic groups of T. acidophilum could be isolated from the same refuse pile, and the same antigenic groups were isolated from piles from different geographical areas. No correlation could be established between the antigenic groups and the pH or temperature of the habitats. Brightly fluorescing cells of T. acidophilum were detected on microscope slides buried in contact with the coal refuse material or immersed in the water in the stream draining a refuse pile. T. acidophilum grew when inoculated into either coal refuse material and/or an aqueous extract of coal refuse when incubated at its optimal temperature of 55 C, but not when incubated at room temperature or 37 C. The coal refuse pile appears to be a primary habitat for T. acidophilum. PMID:4602306

Use of ATP to characterize biomass viability in freely suspended and immobilized cell bioreactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gikas, P.; Livingston, A.G.

1993-12-01

This work describes investigations into the viability of cells growing on 3,4-dichloroaniline (34DCA). Two bio-reactors are employed for microbial growth, a continuous stirred tank (CST) bioreactor with a 2-L working volume, and a three-phase air lift (TPAL) bioreactor with a 3-L working volume. Experiments have been performed at several dilution rates between 0.027 and 0.115 h[sup [minus]1] in the CST bioreactor and between 0.111 and 0.500h[sup [minus]1] in the TPAL bioreactor. The specific ATP concentration was calculated at each dilution rate in the suspended biomass in both bioreactors as well as in the immobilized biomass in the TPAL bioreactor. Themore » cultures were inspected under an electron microscope to monitor compositional changes. Results from the CST bioreactor showed that the biomass-specific ATP concentration increases from 0.44 to 1.86 mg ATP g[sup [minus]1] dry weight (dw) as dilution rate increases from 0.027 to 0.115 h[sup [minus]1]. At this upper dilution rate the cells were washed out. The specific ATP concentration reached a limiting average value of 1.73 mg ATP g[sup [minus]1] dw, which is assumed to be the quantity of ATP in 100% viable biomass, In the TPAL bioreactor, the ATP level increased with dilution rat in both the immobilized and suspended biomass. The specific ATP concentration in the immobilized biomass increased from approximately 0.051 mg ATP g[sup [minus]1] dw at dilution rates between 0.111 and 0.200 h[sup [minus]1] to approximately 0.119 mg ATP g[sup [minus]1] dw at dilution rates between 0.300 and 0.500 h[sup [minus]1].« less

Replaceable Sensor System for Bioreactor Monitoring

NASA Technical Reports Server (NTRS)

Mayo, Mike; Savoy, Steve; Bruno, John

2006-01-01

A sensor system was proposed that would monitor spaceflight bioreactor parameters. Not only will this technology be invaluable in the space program for which it was developed, it will find applications in medical science and industrial laboratories as well. Using frequency-domain-based fluorescence lifetime technology, the sensor system will be able to detect changes in fluorescence lifetime quenching that results from displacement of fluorophorelabeled receptors bound to target ligands. This device will be used to monitor and regulate bioreactor parameters including glucose, pH, oxygen pressure (pO2), and carbon dioxide pressure (pCO2). Moreover, these biosensor fluorophore receptor-quenching complexes can be designed to further detect and monitor for potential biohazards, bioproducts, or bioimpurities. Biosensors used to detect biological fluid constituents have already been developed that employ a number of strategies, including invasive microelectrodes (e.g., dark electrodes), optical techniques including fluorescence, and membrane permeable systems based on osmotic pressure. Yet the longevity of any of these sensors does not meet the demands of extended use in spacecraft habitat or bioreactor monitoring. It was therefore necessary to develop a sensor platform that could determine not only fluid variables such as glucose concentration, pO2, pCO2, and pH but can also regulate these fluid variables with controlled feedback loop.

A novel aerobic sulfate reduction process in landfill mineralized refuse.

PubMed

Liu, Weijia; Long, Yuyang; Fang, Yuan; Ying, Luyao; Shen, Dongsheng

2018-05-08

It is thought that mineralized refuse could be excavated from almost-full landfill sites to provide space for the increasing burden of municipal solid waste. When excavating, however, the H 2 S emissions from the mineralized waste need to be considered carefully. In an attempt to understand how H 2 S emissions might change during this excavation process, we carried out a series of tests, including exposing anaerobic mineralized refuse to oxygen, isolating and determining possible functional bacteria, and characterizing the electron donors and/or acceptors. The results showed that H 2 S would be released when landfill mineralized refuse was exposed to oxygen (O 2 ), and could reach concentrations of 6 mg m -3 , which was 3 times the concentrations of H 2 S released from anaerobic mineralized refuse. Sulfur-metabolized microorganisms accounted for only 0.5% of the microbial functional bacteria (MFB) derived from the mineralized refuse when exposed to O 2 for 60 days, and SRB were not present. The MFB maintained H 2 S production by aerobic sulfate reduction using SO 4 2- and S 2 O 3 2- as electron acceptors, and sulfate-reducing rates of 16% and 55%, respectively, were achieved. Lactate and S 2 O 3 2- were the preferred electron donor and acceptor, respectively. By enhancing the carbon source and electron transfer, MFB may undergo strong aerobic sulfate reduction even at low abundances of sulfur-metabolized microorganisms. Copyright © 2018 Elsevier B.V. All rights reserved.

Use of bioreactors for culturing human retinal organoids improves photoreceptor yields.

PubMed

Ovando-Roche, Patrick; West, Emma L; Branch, Matthew J; Sampson, Robert D; Fernando, Milan; Munro, Peter; Georgiadis, Anastasios; Rizzi, Matteo; Kloc, Magdalena; Naeem, Arifa; Ribeiro, Joana; Smith, Alexander J; Gonzalez-Cordero, Anai; Ali, Robin R

2018-06-13

The use of human pluripotent stem cell-derived retinal cells for cell therapy strategies and disease modelling relies on the ability to obtain healthy and organised retinal tissue in sufficient quantities. Generating such tissue is a lengthy process, often taking over 6 months of cell culture, and current approaches do not always generate large quantities of the major retinal cell types required. We adapted our previously described differentiation protocol to investigate the use of stirred-tank bioreactors. We used immunohistochemistry, flow cytometry and electron microscopy to characterise retinal organoids grown in standard and bioreactor culture conditions. Our analysis revealed that the use of bioreactors results in improved laminar stratification as well as an increase in the yield of photoreceptor cells bearing cilia and nascent outer-segment-like structures. Bioreactors represent a promising platform for scaling up the manufacture of retinal cells for use in disease modelling, drug screening and cell transplantation studies.

Legislation and refusal of blood transfusion by a minor Jehovah-Witness in Belgium.

PubMed

Deneyer, M; Matthys, D; Ramet, J; Michel, L; Holsters, D; Vandenplas, Y

2011-01-01

The refusal of blood transfusion by Jehovah's Witnesses in critical situations constitutes an ethical and juridical dilemma. The refusal to receive blood products by Jehovah's Witnesses is based on biblical verses. Recurring arguments to sustain this refusal regard the right to self-determination and the right to freedom of faith. If minors are involved, the problem is rendered even more difficult as the parental authority over young children needs to be taken into account. When adolescents are concerned, the situation if even more ambiguous since adolescents might be considered as mature enough to provide autonomous consent. On the basis of three cases, the most frequent bottlenecks that can come up in paediatric emergency services are highlighted: (1) the refusal of a blood transfusion by the parents of a young child; (2) the refusal by an adolescent and (3) prior refusal based on a "No Blood"-document. Regarding minors, the law on patients' rights in Belgium contains safety mechanisms concerning the preservation of physical integrity. Therefore, a key responsibility has been assigned to the physician. A step-by-step plan and a synoptic diagram are presented.

Conscientious refusal in healthcare: the Swedish solution.

PubMed

Munthe, Christian

2017-04-01

The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination. Employee's requests to change work tasks are handled on a case-by-case basis within the frames of labour law, ensuring full voluntariness, and also employer's privilege regarding the organisation and direction of work, and duties of public institutions to provide services. Two complicating aspects of this solution related to the inclusion of 'alternative medical' service providers in a national health service, and professional insistence on conscientious refusal rights to accept legalised assisted dying are discussed. The latter is found to undermine the pragmatic reasons behind recent attempts by prolife groups to challenge the Swedish solution related to legal abortion in courts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Belief About Mandatory School Vaccinations and Vaccination Refusal Among Ohio Appalachian Parents: Do Demographic and Religious Factors, General Health, and Political Affiliation Play a Role?

PubMed

Krok-Schoen, Jessica L; Bernardo, Brittany M; Weier, Rory C; Peng, Juan; Katz, Mira L; Reiter, Paul L; Richardson, Morgan S; Pennell, Michael L; Tatum, Cathy M; Paskett, Electra D

2017-11-14

To examine how demographic, general health, religious, and political characteristics influenced beliefs about mandatory school vaccinations and history of vaccination refusal for children among Ohio Appalachian parents. In 2013 and 2014, baseline data were obtained from parents (n = 337) of girls aged 9-17 from 12 counties in rural Ohio Appalachia enrolled in the Community Awareness, Resources and Education (CARE II) Project. Multivariate logistic regression models were used to identify correlates of parental beliefs about mandatory school vaccinations and history of refusing a doctor-recommended vaccine for their child(ren). About 47% of parents agreed that parents should have the right to refuse mandatory school vaccinations for their child(ren). Participants who reported their political affiliation as Republican (OR = 2.45, 95% CI: 1.28-4.66) or Independent (OR = 3.31, 95% CI: 1.70-6.44) were more likely to agree that parents should have the right to refuse school-mandated vaccinations than parents who reported their political affiliation as Democrat. Approximately 39% of parents reported ever refusing a vaccine for their child(ren). Participants who were female (OR = 3.90, 95% CI: 1.04-14.58) and believed that parents should have the right to refuse mandatory school vaccinations (OR = 3.27, 95% CI: 1.90-5.62) were more likely to report ever refusing a vaccine for their child(ren). The study findings provide information to better understand factors related to vaccination refusal among parents in Appalachia Ohio that can be used to design interventions to improve vaccination uptake. © 2017 National Rural Health Association.

Reduced Differentiation Efficiency of Murine Embryonic Stem Cells in Stirred Suspension Bioreactors

PubMed Central

Taiani, Jaymi T.; Krawetz, Roman J.; zur Nieden, Nicole I.; Wu, Yiru Elizabeth; Kallos, Michael S.; Matyas, John R.

2010-01-01

The use of embryonic stem cells (ESCs) for regenerative medicine has generated increased attention due to the favorable attributes of these cells; namely, they are pluripotent and possess long-term self-renewal capacity. The initial aims of the present study were: (i) to use stirred suspension bioreactors to expand and differentiate ESCs into osteogenic and chondrogenic cell types and (ii) to explore if these ESC-derived cells influenced skeletal healing in an in vivo fracture model. We show that differentiation protocols used in static culture are insufficient when applied directly to suspension culture bioreactors. Moreover, when bioreactor-differentiated cells are transplanted into a burr-hole defect in bone, severe disruption of the bone architecture was noted at the fracture site, as determined by microcomputed tomography (microCT) imaging and histopathology. Further characterization of the bioreactor-differentiated cultures revealed that a subpopulation of cells in the resulting aggregates expressed the pluripotency marker Oct-4 in the nucleus. Nuclear Oct-4 expression persisted even after 30 days of culture in the absence of leukemia inhibitory factor (LIF). Remarkably, and unlike ESCs differentiated into skeletal cell types in static cultures, bioreactor-differentiated aggregates implanted subcutaneously into SCID mice formed teratomas. The development of effective ESC differentiation protocols for suspension bioreactors will require a more complete understanding of the environmental conditions within these culture systems and the influence that these conditions have on the regulation of pluripotency and differentiation in ESCs. PMID:19775198

A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.

PubMed

Real, Francis J; DeBlasio, Dominick; Beck, Andrew F; Ollberding, Nicholas J; Davis, David; Cruse, Bradley; Samaan, Zeina; McLinden, Daniel; Klein, Melissa D

Influenza vaccine hesitancy is common in the primary care setting. Though physicians can affect caregivers' attitudes toward vaccination, physicians report uneasiness discussing vaccine hesitancy. Few studies have targeted physician-patient communication training as a means to decrease vaccination refusal. An immersive virtual reality (VR) curriculum was created to teach pediatric residents communication skills when discussing influenza vaccine hesitancy. This pilot curriculum consisted of 3 VR simulations during which residents counseled graphical character representatives (avatars) who expressed vaccine hesitancy. Participants were randomized to the intervention (n = 24) or control (n = 21) group. Only residents in the intervention group underwent the VR curriculum. Impact of the curriculum was assessed through difference in influenza vaccine refusal rates between the intervention and control groups in the 3 months after the VR curriculum. Participants included postgraduate level (PL) 2 and PL3 pediatric residents. All eligible residents (n = 45) participated; the survey response rate was 100%. In patients aged 6 to 59 months, residents in the intervention group had a decreased rate of influenza vaccination refusal in the postcurriculum period compared to the control group (27.8% vs 37.1%; P = .03). Immersive VR may be an effective modality to teach communication skills to medical trainees. Next steps include evaluation of the curriculum in a larger, multisite trial. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Bioreactor Landfill Research and Demonstration Project Northern Oaks Landfill, Harrison, MI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, Xiando; Voice, Thomas; and Hashsham, Syed A.

2006-08-29

A bioreactor landfill cell with 1.2-acre footprint was constructed, filled, operated, and monitored at Northern Oaks Recycling and Disposal Facility (NORDF) at Harrison, MI. With a filled volume of 74,239 cubic yards, the cell contained approximately 35,317 tons of municipal solid waste (MSW) and 20,777 tons of cover soil. It was laid on the slope of an existing cell but separated by a geosynthetic membrane liner. After the cell reached a design height of 60 feet, it was covered with a geosynthetic membrane cap. A three-dimensional monitoring system to collect data at 48 different locations was designed and installed duringmore » the construction phase of the bioreactor cell. Each location had a cluster of monitoring devices consisting of a probe to monitor moisture and temperature, a leachate collection basin, and a gas sampling port. An increase in moisture content of the MSW in the bioreactor cell was achieved by pumping leachate collected on-site from various other cells, as well as recirculation of leachate from the bioreactor landfill cell itself. Three types of leachate injection systems were evaluated in this bioreactor cell for their efficacy to distribute pumped leachate uniformly: a leachate injection pipe buried in a 6-ft wide horizontal stone mound, a 15-ft wide geocomposite drainage layer, and a 60-ft wide geocomposite drainage layer. All leachate injection systems were installed on top of the compacted waste surface. The distribution of water and resulting MSW moisture content throughout the bioreactor cell was found to be similar for the three designs. Water coming into and leaving the cell (leachate pumped in, precipitation, snow, evaporation, and collected leachate) was monitored in order to carry out a water balance. Using a leachate injection rate of 26 – 30 gal/yard3, the average moisture content increased from 25% to 35% (wet based) over the period of this study. One of the key aspects of this bioreactor landfill study was to evaluate

Reasons for family refusal of ocular tissue donation.

PubMed

Hermann, K C; Pagnussato, F; Franke, C A; de Oliveira, M L B

2014-01-01

Corneal donations do not fill the transplant demand. The waiting list had 5512 individuals in Brazil and 143 in Rio Grande do Sul in December 2012. The aim of this study was to identify the reasons for family refusal of ocular tissues donation. This retrospective study analyzed interview records for ocular tissue procurement performed in a general, public university hospital located in Southern Brazil between January 2008 and December 2012. It identified the reasons of family refusal for ocular tissue donation. A total of 1010 interviews for ocular tissues procurement were performed. From these, 513 (50.79%) refused donation with the following reasons: 60 (11.69%) family members were unaware of the desire of the potential donor, 153 (29.82%) of potential donors spoke against donation in life, 113 (22.02%) family members were undecided about the donation, 156 (30.40%) family members were against donation, 3 (0.58%) family members were unhappy with the service, 11 (2.14%) family members were afraid of body release delay, 6 (1.16%) families expressed religious convictions against donation, and 11 (2.14%) family members wanted to keep the body intact. There are many reasons for ocular tissues donation refusal, and the knowledge provides better strategies for family interviews. In this study, most of the reasons, around 90%, can be related to lack of information or communication about the subject. Greater awareness of the population about the subject can be a good way to increase ocular tissue procurement indexes. Copyright © 2014 Elsevier Inc. All rights reserved.

School Refusal Behavior Associated with Separation Anxiety Disorder: A Cognitive-Behavioral Approach to Treatment

ERIC Educational Resources Information Center

Doobay, Alissa F.

2008-01-01

School refusal behavior can lead to disruptions in both educational attainment and social development. One of the common causes of school refusal behavior is separation anxiety disorder (SAD). Research suggests that children with SAD and school refusal behavior show an increased rate of psychiatric consultation and a decreased likelihood of…

Thinking beyond the Bioreactor Box: Incorporating Stream Ecology into Edge-of-Field Nitrate Management.

PubMed

Goeller, Brandon C; Febria, Catherine M; Harding, Jon S; McIntosh, Angus R

2016-05-01

Around the world, artificially drained agricultural lands are significant sources of reactive nitrogen to stream ecosystems, creating substantial stream health problems. One management strategy is the deployment of denitrification enhancement tools. Here, we evaluate the factors affecting the potential of denitrifying bioreactors to improve stream health and ecosystem services. The performance of bioreactors and the structure and functioning of stream biotic communities are linked by environmental parameters like dissolved oxygen and nitrate-nitrogen concentrations, dissolved organic carbon availability, flow and temperature regimes, and fine sediment accumulations. However, evidence of bioreactors' ability to improve waterway health and ecosystem services is lacking. To improve the potential of bioreactors to enhance desirable stream ecosystem functioning, future assessments of field-scale bioreactors should evaluate the influences of bioreactor performance on ecological indicators such as primary production, organic matter processing, stream metabolism, and invertebrate and fish assemblage structure and function. These stream health impact assessments should be conducted at ecologically relevant spatial and temporal scales. Bioreactors have great potential to make significant contributions to improving water quality, stream health, and ecosystem services if they are tailored to site-specific conditions and implemented strategically with land-based and stream-based mitigation tools within watersheds. This will involve combining economic, logistical, and ecological information in their implementation. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Tissue engineering bioreactor systems for applying physical and electrical stimulations to cells.

PubMed

Jin, GyuHyun; Yang, Gi-Hoon; Kim, GeunHyung

2015-05-01

Bioreactor systems in tissue engineering applications provide various types of stimulation to mimic the tissues in vitro and in vivo. Various bioreactors have been designed to induce high cellular activities, including initial cell attachment, cell growth, and differentiation. Although cell-stimulation processes exert mostly positive effects on cellular responses, in some cases such stimulation can also have a negative effect on cultured cells. In this review, we discuss various types of bioreactor and the positive and negative effects of stimulation (physical, chemical, and electrical) on various cultured cell types. © 2014 Wiley Periodicals, Inc.

Family Influences on Treatment Refusal in School-Linked Mental Health Services

ERIC Educational Resources Information Center

Keeley, Mary L.; Wiens, Brenda A.

2008-01-01

This study analyzed family influences on treatment refusal in school-linked mental health services (SLMHS). Specifically, it assessed whether levels of family cohesion, conflict, and organization were related to whether a family refused to initiate recommended treatment. Children (N = 133) referred for emotional and behavioral problems and their…

The Flow in a Model Rotating-Wall Bioreactor.

NASA Astrophysics Data System (ADS)

Smith, Marc K.; Neitzel, G. Paul

1997-11-01

Aggregates of mammalian cells can be grown on artificial polymer constructs in a reactor vessel in order to produce high-quality tissue for medical applications. The growth and differentiation of these cells is greatly affected by the fluid flow and mass transfer within the bioreactor. The surface shear stress on the constructs is an especially important quantity of interest. Here, we consider a bioreactor in the form of two concentric, independently-rotating cylinders with the axis of rotation in a horizontal plane. We shall examine the flow around a model tissue construct in the form of a disk fixed in the flow produced by the rotating walls of the bioreactor. Using CFD techniques, we shall determine the flow field and the surface shear stress distribution on the construct as a function of the wall velocities, the Reynolds number of the flow, and the construct size and position. The results will be compared to the PIV measurements of this system reported by Brown & Neitzel(1997 Meeting of the APS/DFD.).

Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2001-09-01

Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

Kinetics of heavy metal removal in a suspended and immobilized bioreactors

NASA Astrophysics Data System (ADS)

Kutty, S. R. M.; Ezechi, E. H.; Khaw, S. G.; Lai, C. L.; Isa, M. H.

2017-06-01

The capacity of microorganisms to remove heavy metal from wastewater has been a subject of diverse interest. Whereas some heavy metals are essential for effective microbial activity, some heavy metals could be toxic to the microorganisms at concentrations higher than their minimal inhibitory limit. The kinetics of Zn2+ removal from aqueous solution was evaluated in terms of substrate removal rate for two identical suspended and immobilized bioreactors. The suspended growth bioreactor was used as a control system (CS) and contains only biomass. The immobilized bioreactor (IB) contains both biomass and microwave incinerated rice husk ash (MIRHA). The bioreactors were operated at a fixed HRT of 29.1 hours, whereas Zn2+ influent concentration was varied in the range of 0.5, 1, 2, 5, 10 and 15 mg/L. At steady state conditions, the results show that Zn2+ removal was in the range of 72, 75, 72.5, 68.2, 70.3 and 58.7% for CS, whereas it was in the range of 88, 90, 83, 88.6, 86.2 and 83.7% for IB. The substrate removal rate was found as 1.1856 g/L.d for CS and 4.2693 g/L.d for IB. The results clearly show that Zn2+ removal was more favorable in IB, indicating that the performance of the bioreactor was enhanced by the addition of MIRHA.

State Right to Refuse Medication Laws and Procedures: Impact on Homicide and Suicide.

PubMed

Edwards, Griffin

2016-09-01

As part of the expansive overhaul of the mental health system that occurred in the latter half of the 20th Century, many states passed laws that allow, under certain conditions, voluntary and involuntarily committed patients to refuse medication. While some predicted the consequences of these laws would be dire, the effect on violent behavior remains untested. The aim is to decipher any differences state right to refuse medication laws may have on violence. Using the homicide rate of every US state between 1972 and 2001 (N = 1,479), and the suicide rate between 1981 and 2001 (N = 1,071). The study compares the difference in homicide/suicide rates before and after a law change to that same difference in a set of control states to estimate the effect of laws aimed at extending the right to refuse medication to both voluntary and involuntarily committed mental health patients. Laws designed to allow voluntarily committed patients to refuse medication are associated with a 0.8 increase in homicides per 100,000 of the state population while laws dictating an involuntarily committed patient's right to request refusal of medication are negative but statistically insignificant using standard t test. Laws designed to allow voluntarily committed patients to refuse medication have no statistically significant effect on suicides while laws dictating an involuntarily committed patient's right to request refusal of medication, specifically when the request is reviewed by independent mental health professionals, are associated with a statistically significant reduction in suicides. Allowing voluntarily committed patients to refuse medication may entice some to enter in-patient facilities, but the brief and optional exposure to medication and their side effects may actually discourage treatment and increase violence.

Method and Apparatus for a Miniature Bioreactor System for Long-Term Cell Culture

NASA Technical Reports Server (NTRS)

Kleis, Stanley J. (Inventor); Geffert, Sandra K. (Inventor); Gonda, Steve R. (Inventor)

2015-01-01

A bioreactor and method that permits continuous and simultaneous short, moderate, or long term cell culturing of one or more cell types or tissue in a laminar flow configuration is disclosed, where the bioreactor supports at least two laminar flow zones, which are isolated by laminar flow without the need for physical barriers between the zones. The bioreactors of this invention are ideally suited for studying short, moderate and long term studies of cell cultures and the response of cell cultures to one or more stressors such as pharmaceuticals, hypoxia, pathogens, or any other stressor. The bioreactors of this invention are also ideally suited for short, moderate or long term cell culturing with periodic cell harvesting and/or medium processing for secreted cellular components.

Sensing in tissue bioreactors

NASA Astrophysics Data System (ADS)

Rolfe, P.

2006-03-01

Specialized sensing and measurement instruments are under development to aid the controlled culture of cells in bioreactors for the fabrication of biological tissues. Precisely defined physical and chemical conditions are needed for the correct culture of the many cell-tissue types now being studied, including chondrocytes (cartilage), vascular endothelial cells and smooth muscle cells (blood vessels), fibroblasts, hepatocytes (liver) and receptor neurones. Cell and tissue culture processes are dynamic and therefore, optimal control requires monitoring of the key process variables. Chemical and physical sensing is approached in this paper with the aim of enabling automatic optimal control, based on classical cell growth models, to be achieved. Non-invasive sensing is performed via the bioreactor wall, invasive sensing with probes placed inside the cell culture chamber and indirect monitoring using analysis within a shunt or a sampling chamber. Electroanalytical and photonics-based systems are described. Chemical sensing for gases, ions, metabolites, certain hormones and proteins, is under development. Spectroscopic analysis of the culture medium is used for measurement of glucose and for proteins that are markers of cell biosynthetic behaviour. Optical interrogation of cells and tissues is also investigated for structural analysis based on scatter.

Generation of Neural Progenitor Spheres from Human Pluripotent Stem Cells in a Suspension Bioreactor.

PubMed

Yan, Yuanwei; Song, Liqing; Tsai, Ang-Chen; Ma, Teng; Li, Yan

2016-01-01

Conventional two-dimensional (2-D) culture systems cannot provide large numbers of human pluripotent stem cells (hPSCs) and their derivatives that are demanded for commercial and clinical applications in in vitro drug screening, disease modeling, and potentially cell therapy. The technologies that support three-dimensional (3-D) suspension culture, such as a stirred bioreactor, are generally considered as promising approaches to produce the required cells. Recently, suspension bioreactors have also been used to generate mini-brain-like structure from hPSCs for disease modeling, showing the important role of bioreactor in stem cell culture. This chapter describes a detailed culture protocol for neural commitment of hPSCs into neural progenitor cell (NPC) spheres using a spinner bioreactor. The basic steps to prepare hPSCs for bioreactor inoculation are illustrated from cell thawing to cell propagation. The method for generating NPCs from hPSCs in the spinner bioreactor along with the static control is then described. The protocol in this study can be applied to the generation of NPCs from hPSCs for further neural subtype specification, 3-D neural tissue development, or potential preclinical studies or clinical applications in neurological diseases.

Performance of an under-loaded denitrifying bioreactor with biochar amendment.

PubMed

Bock, Emily M; Coleman, Brady S L; Easton, Zachary M

2018-07-01

Denitrifying bioreactors are recently-established agricultural best management practices with growing acceptance in the US Midwest but less studied in other agriculturally significant regions, such as the US Mid-Atlantic. A bioreactor was installed in the Virginia Coastal Plain to evaluate performance in this geographically novel region facing challenges managing nutrient pollution. The 25.3 m 3 woodchip bed amended with 10% biochar (v/v) intercepted subsurface drainage from 6.5 ha cultivated in soy. Influent and effluent nitrate-nitrogen (NO 3 -N) and total phosphorus (TP) concentrations and flowrate were monitored intensively during the second year of operation. Bed surface fluxes of greenhouse gases (GHGs) nitrous oxide (N 2 O), methane (CH 4 ), and carbon dioxide (CO 2 ) were measured periodically with the closed dynamic chamber technique. The bioreactor did not have a statistically or environmentally significant effect on TP export. Cumulative NO 3 -N removal efficiency (9.5%) and average removal rate (0.56 ± 0.25 g m -3  d -1 ) were low relative to Midwest tile bioreactors, but comparable to installations in the Maryland Coastal Plain. Underperformance was attributed mainly to low NO 3 -N loading (mean 9.4 ± 4.4 kg ha -1 yr -1 ), although intermittent flow, periods of low HRT, and low pH (mean 5.3) also likely contributed. N removal rates were correlated with influent NO 3 -N concentration and temperature, but decreased with hydraulic residence time, indicating that removal was often N-limited. GHG emissions were similar to other bioreactors and constructed wetlands and not considered environmentally concerning. This study suggests that expectations of NO 3 -N removal efficiency developed from bioreactors receiving moderate to high NO 3 -N loading with influent concentrations exceeding 10-20 mg L -1 are unlikely to be met by systems where N-limitation becomes significant. Copyright © 2018 Elsevier Ltd. All rights reserved.

Design of well and groove microchannel bioreactors for cell culture.

PubMed

Korin, Natanel; Bransky, Avishay; Khoury, Maria; Dinnar, Uri; Levenberg, Shulamit

2009-03-01

Microfluidic bioreactors have been shown valuable for various cellular applications. The use of micro-wells/grooves bioreactors, in which micro-topographical features are used to protect sensitive cells from the detrimental effects of fluidic shear stress, is a promising approach to culture sensitive cells in these perfusion microsystems. However, such devices exhibit substantially different fluid dynamics and mass transport characteristics compared to conventional planar microchannel reactors. In order to properly design and optimize these systems, fluid and mass transport issues playing a key role in microscale bioreactors should be adequately addressed. The present work is a parametric study of micro-groove/micro-well microchannel bioreactors. Operation conditions and design parameters were theoretically examined via a numerical model. The complex flow pattern obtained at grooves of various depths was studied and the shear protection factor compared to planar microchannels was evaluated. 3D flow simulations were preformed in order to examine the shear protection factor in micro-wells, which were found to have similar attributes as the grooves. The oxygen mass transport problem, which is coupled to the fluid mechanics problem, was solved for various groove geometries and for several cell types, assuming a defined shear stress limitation. It is shown that by optimizing the groove depth, the groove bioreactor may be used to effectively maximize the number of cells cultured within it or to minimize the oxygen gradient existing in such devices. Moreover, for sensitive cells having a high oxygen demand (e.g., hepatocytes) or low endurance to shear (e.g., human embryonic stem cells), results show that the use of grooves is an enabling technology, since under the same physical conditions the cells cannot be cultured for long periods of time in a planar microchannel. In addition to the theoretical model findings, the culture of human foreskin fibroblasts in groove (30

Mathematical modeling and experimental testing of three bioreactor configurations based on windkessel models

PubMed Central

Ruel, Jean; Lachance, Geneviève

2010-01-01

This paper presents an experimental study of three bioreactor configurations. The bioreactor is intended to be used for the development of tissue-engineered heart valve substitutes. Therefore it must be able to reproduce physiological flow and pressure waveforms accurately. A detailed analysis of three bioreactor arrangements is presented using mathematical models based on the windkessel (WK) approach. First, a review of the many applications of this approach in medical studies enhances its fundamental nature and its usefulness. Then the models are developed with reference to the actual components of the bioreactor. This study emphasizes different conflicting issues arising in the design process of a bioreactor for biomedical purposes, where an optimization process is essential to reach a compromise satisfying all conditions. Two important aspects are the need for a simple system providing ease of use and long-term sterility, opposed to the need for an advanced (thus more complex) architecture capable of a more accurate reproduction of the physiological environment. Three classic WK architectures are analyzed, and experimental results enhance the advantages and limitations of each one. PMID:21977286

An economical bioreactor for evaluating biogas potential of particulate biomass.

PubMed

Wilkie, Ann C; Smith, P H; Bordeaux, F M

2004-03-01

An economical bioreactor designed for evaluating the biogas potential of particulate biomass is described. The bioreactor uses a simple stirring apparatus, called the Bordeaux stirrer, to enable gas-tight mixing of fermentation cultures. The apparatus consists of a low-rpm motor connected to a bent steel stir rod, which is placed in a length of flexible plastic tubing inserted through a rubber stopper in a gas-tight manner. This stirrer is suitable for providing intermittent or continuous mixing in bench-scale anaerobic cultures containing particulate biomass. The reactor system may be operated as a batch-fed or semi-continuously fed digester. This communication documents the advantages of the stirring apparatus, describes the details of reactor fabrication and operation, and outlines the type of experimental work for which the bioreactor is suitable.

Anaerobic digestion of citrus waste using two-stage membrane bioreactor

NASA Astrophysics Data System (ADS)

Millati, Ria; Lukitawesa; Dwi Permanasari, Ervina; Wulan Sari, Kartika; Nur Cahyanto, Muhammad; Niklasson, Claes; Taherzadeh, Mohammad J.

2018-03-01

Anaerobic digestion is a promising method to treat citrus waste. However, the presence of limonene in citrus waste inhibits anaerobic digestion process. Limonene is an antimicrobial compound and could inhibit methane forming bacteria that takes a longer time to recover than the injured acid forming bacteria. Hence, volatile fatty acids will be accumulated and methane production will be decreased. One way to solve this problem is by conducting anaerobic digestion process into two stages. The first step is aimed for hydrolysis, acidogenesis, and acetogenesis reactions and the second stage is aimed for methanogenesis reaction. The separation of the system would further allow each stage in their optimum conditions making the process more stable. In this research, anaerobic digestion was carried out in batch operations using 120 ml-glass bottle bioreactors in 2 stages. The first stage was performed in free-cells bioreactor, whereas the second stage was performed in both bioreactor of free cells and membrane bioreactor. In the first stage, the reactor was set into ‘anaerobic’ and ‘semi-aerobic’ conditions to examine the effect of oxygen on facultative anaerobic bacteria in acid production. In the second stage, the protection of membrane towards the cells against limonene was tested. For the first stage, the basal medium was prepared with 1.5 g VS of inoculum and 4.5 g VS of citrus waste. The digestion process was carried out at 55°C for four days. For the second stage, the membrane bioreactor was prepared with 3 g of cells that were encased and sealed in a 3×6 cm2 polyvinylidene fluoride membrane. The medium contained 40 ml basal medium and 10 ml liquid from the first stage. The bioreactors were incubated at 55°C for 2 days under anaerobic condition. The results from the first stage showed that the maximum total sugar under ‘anaerobic’ and ‘semi-aerobic’ conditions was 294.3 g/l and 244.7 g/l, respectively. The corresponding values for total volatile

Knowledge-based fault diagnosis system for refuse collection vehicle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, CheeFai; Juffrizal, K.; Khalil, S. N.

The refuse collection vehicle is manufactured by local vehicle body manufacturer. Currently; the company supplied six model of the waste compactor truck to the local authority as well as waste management company. The company is facing difficulty to acquire the knowledge from the expert when the expert is absence. To solve the problem, the knowledge from the expert can be stored in the expert system. The expert system is able to provide necessary support to the company when the expert is not available. The implementation of the process and tool is able to be standardize and more accurate. The knowledgemore » that input to the expert system is based on design guidelines and experience from the expert. This project highlighted another application on knowledge-based system (KBS) approached in trouble shooting of the refuse collection vehicle production process. The main aim of the research is to develop a novel expert fault diagnosis system framework for the refuse collection vehicle.« less

STATE OF THE PRACTICE FOR BIOREACTOR LANDFILLS - SUMMARY OF USEPA WORKSHOP ON BIOREACTOR LANDFILLS: SUMMARY

EPA Science Inventory

This is a summary of the Workshop on Landfill Bioreactors, held 9/6-7/2000 in Arlington, VA. The purpose of the workshop was to provide a forum to EPA, state and local governments, solid waste industry, and academic research representatives to exchange information and ideas on b...

Performance of high intensity fed-batch mammalian cell cultures in disposable bioreactor systems.

PubMed

Smelko, John Paul; Wiltberger, Kelly Rae; Hickman, Eric Francis; Morris, Beverly Janey; Blackburn, Tobias James; Ryll, Thomas

2011-01-01

The adoption of disposable bioreactor technology as an alternate to traditional nondisposable technology is gaining momentum in the biotechnology industry. Evaluation of current disposable bioreactors systems to sustain high intensity fed-batch mammalian cell culture processes needs to be explored. In this study, an assessment was performed comparing single-use bioreactors (SUBs) systems of 50-, 250-, and 1,000-L operating scales with traditional stainless steel (SS) and glass vessels using four distinct mammalian cell culture processes. This comparison focuses on expansion and production stage performance. The SUB performance was evaluated based on three main areas: operability, process scalability, and process performance. The process performance and operability aspects were assessed over time and product quality performance was compared at the day of harvest. Expansion stage results showed disposable bioreactors mirror traditional bioreactors in terms of cellular growth and metabolism. Set-up and disposal times were dramatically reduced using the SUB systems when compared with traditional systems. Production stage runs for both Chinese hamster ovary and NS0 cell lines in the SUB system were able to model SS bioreactors runs at 100-, 200-, 2,000-, and 15,000-L scales. A single 1,000-L SUB run applying a high intensity fed-batch process was able to generate 7.5 kg of antibody with comparable product quality. Copyright © 2011 American Institute of Chemical Engineers (AIChE).

Intelligent Bioreactor Management Information System (IBM-IS) for Mitigation of Greenhouse Gas Emissions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paul Imhoff; Ramin Yazdani; Don Augenstein

Methane is an important contributor to global warming with a total climate forcing estimated to be close to 20% that of carbon dioxide (CO2) over the past two decades. The largest anthropogenic source of methane in the US is 'conventional' landfills, which account for over 30% of anthropogenic emissions. While controlling greenhouse gas emissions must necessarily focus on large CO2 sources, attention to reducing CH4 emissions from landfills can result in significant reductions in greenhouse gas emissions at low cost. For example, the use of 'controlled' or bioreactor landfilling has been estimated to reduce annual US greenhouse emissions by aboutmore » 15-30 million tons of CO2 carbon (equivalent) at costs between $3-13/ton carbon. In this project we developed or advanced new management approaches, landfill designs, and landfill operating procedures for bioreactor landfills. These advances are needed to address lingering concerns about bioreactor landfills (e.g., efficient collection of increased CH4 generation) in the waste management industry, concerns that hamper bioreactor implementation and the consequent reductions in CH4 emissions. Collectively, the advances described in this report should result in better control of bioreactor landfills and reductions in CH4 emissions. Several advances are important components of an Intelligent Bioreactor Management Information System (IBM-IS).« less

Refusals in Chinese: How Do L1 and L2 Differ?

ERIC Educational Resources Information Center

Hong, Wei

2011-01-01

This article reports on an empirical study of refusal strategies in Chinese by native speakers (NS) and nonnative Chinese learners (NNS). Sixty subjects (perceived as "students") were to refuse an invitation by "the professor" to a Chinese New Year's party. The study found that the NS group produced 10 strategies, whereas the…

Removal of dichloromethane from waste gas streams using a hybrid bubble column/biofilter bioreactor

PubMed Central

2014-01-01

The performance of a hybrid bubble column/biofilter (HBCB) bioreactor for the removal of dichloromethane (DCM) from waste gas streams was studied in continuous mode for several months. The HBCB bioreactor consisted of two compartments: bubble column bioreactor removing DCM from liquid phase and biofilter removing DCM from gas phase. Effect of inlet DCM concentration on the elimination capacity was examined in the DCM concentration range of 34–359 ppm with loading rates ranged from 2.2 to 22.8 g/m3.h and constant total empty bed retention time (EBRT) of 200 s. In the equal loading rates, the elimination capacity and removal efficiency of the biofilter were higher than the corresponding values of the bubble column bioreactor. The maximum elimination capacity of the HBCB bioreactor was determined to be 15.7 g/m3.h occurred in the highest loading rate of 22.8 g/m3.h with removal efficiency of 69%. The overall mineralization portion of the HBCB bioreactor was in the range of 72-79%. The mixed liquor acidic pH especially below 5.5 inhibited microbial activity and decreased the elimination capacity. Inhibitory effect of high ionic strength was initiated in the mixed liquor electrical conductivity of 12.2 mS/cm. This study indicated that the HBCB bioreactor could benefit from advantages of both bubble column and biofilter reactors and could remove DCM from waste gas streams in a better manner. PMID:24406056

Biofabrication of customized bone grafts by combination of additive manufacturing and bioreactor knowhow.

PubMed

Costa, Pedro F; Vaquette, Cédryck; Baldwin, Jeremy; Chhaya, Mohit; Gomes, Manuela E; Reis, Rui L; Theodoropoulos, Christina; Hutmacher, Dietmar W

2014-09-01

This study reports on an original concept of additive manufacturing for the fabrication of tissue engineered constructs (TEC), offering the possibility of concomitantly manufacturing a customized scaffold and a bioreactor chamber to any size and shape. As a proof of concept towards the development of anatomically relevant TECs, this concept was utilized for the design and fabrication of a highly porous sheep tibia scaffold around which a bioreactor chamber of similar shape was simultaneously built. The morphology of the bioreactor/scaffold device was investigated by micro-computed tomography and scanning electron microscopy confirming the porous architecture of the sheep tibiae as opposed to the non-porous nature of the bioreactor chamber. Additionally, this study demonstrates that both the shape, as well as the inner architecture of the device can significantly impact the perfusion of fluid within the scaffold architecture. Indeed, fluid flow modelling revealed that this was of significant importance for controlling the nutrition flow pattern within the scaffold and the bioreactor chamber, avoiding the formation of stagnant flow regions detrimental for in vitro tissue development. The bioreactor/scaffold device was dynamically seeded with human primary osteoblasts and cultured under bi-directional perfusion for two and six weeks. Primary human osteoblasts were observed homogenously distributed throughout the scaffold, and were viable for the six week culture period. This work demonstrates a novel application for additive manufacturing in the development of scaffolds and bioreactors. Given the intrinsic flexibility of the additive manufacturing technology platform developed, more complex culture systems can be fabricated which would contribute to the advances in customized and patient-specific tissue engineering strategies for a wide range of applications.

37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... refusing to publish a statutory invention registration. 1.295 Section 1.295 Patents, Trademarks, and... decision finally refusing to publish a statutory invention registration. (a) Any requester who is dissatisfied with the final refusal to publish a statutory invention registration for reasons other than...

Optimizing T Cell Expansion in a Hollow-Fiber Bioreactor.

PubMed

Nankervis, Brian; Jones, Mark; Vang, Boah; Brent Rice, R; Coeshott, Claire; Beltzer, Jim

2018-01-01

Recent developments in regenerative medicine have precipitated the need to expand gene-modified human T cells to numbers that exceed the capacity of well-plate-based, and flask-based processes. This review discusses the changes in process development that are needed to meet the cell expansion requirements by utilizing hollow-fiber bioreactors . Maintenance of cell proliferation over long periods can become limited by unfilled demands for nutrients and oxygen and by the accumulation of waste products in the local environment. Perfusion feeding, improved gas exchange, and the efficient removal of lactate can increase the yield of T cells from an average of 10.8E +09 to more than 28E +09 in only 10 days. Aggressively feeding cells and actively keeping cells in the bioreactor improves gas exchange and metabolite management over semi-static methods. The ability to remove the environmental constraints that can limit cell expansion by using a two-chamber hollow-fiber bioreactor will be discussed.

Biodegradation of nonylphenol in a continuous packed-bed bioreactor.

PubMed

Soares, Ana; Guieysse, Benoit; Mattiasson, Bo

2003-06-01

A packed bed bioreactor, with 170 ml glass bead carriers and 130 ml medium, was tested for the removal of the endocrine disrupter, nonylphenol, with a Sphingomonas sp. The bioreactor was first continuously fed with medium saturated with nonylphenol in an attempt to simulate groundwater pollution. At best, nonylphenol was degraded by 99.5% at a feeding rate of 69 ml h(-1) and a removal rate of 4.3 mg nonylphenol day(-1), resulting in a 7.5-fold decrease in effluent toxicity according to the Microtox. The bioreactor was then fed with soil leachates at 69 ml h(-1) from artificially contaminated soil (1 g nonylphenol kg(-1) soil) and a real contaminated soil (0.19 g nonylphenol kg(-1) soil). Nonylphenol was always completely removed from the leachates of the two soils. It was removed by 99% from the artificial soil but only 62% from real contaminated soil after 18 and 20 d of treatment, respectively, showing limitation due to nonylphenol adsorption.

Application of multivariate analysis and mass transfer principles for refinement of a 3-L bioreactor scale-down model--when shake flasks mimic 15,000-L bioreactors better.

PubMed

Ahuja, Sanjeev; Jain, Shilpa; Ram, Kripa

2015-01-01

Characterization of manufacturing processes is key to understanding the effects of process parameters on process performance and product quality. These studies are generally conducted using small-scale model systems. Because of the importance of the results derived from these studies, the small-scale model should be predictive of large scale. Typically, small-scale bioreactors, which are considered superior to shake flasks in simulating large-scale bioreactors, are used as the scale-down models for characterizing mammalian cell culture processes. In this article, we describe a case study where a cell culture unit operation in bioreactors using one-sided pH control and their satellites (small-scale runs conducted using the same post-inoculation cultures and nutrient feeds) in 3-L bioreactors and shake flasks indicated that shake flasks mimicked the large-scale performance better than 3-L bioreactors. We detail here how multivariate analysis was used to make the pertinent assessment and to generate the hypothesis for refining the existing 3-L scale-down model. Relevant statistical techniques such as principal component analysis, partial least square, orthogonal partial least square, and discriminant analysis were used to identify the outliers and to determine the discriminatory variables responsible for performance differences at different scales. The resulting analysis, in combination with mass transfer principles, led to the hypothesis that observed similarities between 15,000-L and shake flask runs, and differences between 15,000-L and 3-L runs, were due to pCO2 and pH values. This hypothesis was confirmed by changing the aeration strategy at 3-L scale. By reducing the initial sparge rate in 3-L bioreactor, process performance and product quality data moved closer to that of large scale. © 2015 American Institute of Chemical Engineers.

Design of a flow perfusion bioreactor system for bone tissue-engineering applications.

PubMed

Bancroft, Gregory N; Sikavitsas, Vassilios I; Mikos, Antonios G

2003-06-01

Several different bioreactors have been investigated for tissue-engineering applications. Among these bioreactors are the spinner flask and the rotating wall vessel reactor. In addition, a new type of culture system has been developed and investigated, the flow perfusion culture bioreactor. Flow perfusion culture offers several advantages, notably the ability to mitigate both external and internal diffusional limitations as well as to apply mechanical stress to the cultured cells. For such investigation, a flow perfusion culture system was designed and built. This design is the outgrowth of important design requirements and incorporates features crucial to successful experimentation with such a system.

Microalgae-activated sludge treatment of molasses wastewater in sequencing batch photo-bioreactor.

PubMed

Tsioptsias, Costas; Lionta, Gesthimani; Samaras, Petros

2017-05-01

The aim of this work was the examination of the treatment potential of molasses wastewater, by the utilization of activated sludge and microalgae. The systems used included a sequencing batch bioreactor and a similar photo-bioreactor, favoring microalgae growth. The microalgae treatment of molasses wastewater mixture resulted in a considerable reduction in the total nitrogen content. A reduction in the ammonium and nitrate content was observed in the photo-bioreactor, while the effluent's total nitrogen consisted mainly of 50% organic nitrogen. The transformation of the nitrogen forms in the photo-bioreactor was attributed to microalgae activity, resulting in the production of a better quality effluent. Lower COD removal was observed for the photo-bioreactor than the control, which however increased, by the replacement of the anoxic phase by a long aeration period. The mechanism of nitrogen removal included both the denitrification process during the anoxic stage and the microalgae activities, as the replacement of the anoxic stage resulted in low total nitrogen removal capacities. A decrease in the photobioreactor performance was observed after 35 days of operation due to biofilm formation on the light tube surface, while the operation at higher temperature accelerated microalgae growth, resulting thus in the early failure of the photoreactor.

New Report Compares Performance of Compressed Natural Gas Refuse Haulers to

Science.gov Websites

Diesel-Powered Trucks Report Compares Performance of Compressed Natural Gas Refuse Haulers to Diesel-Powered Trucks For more information contact: e:mail: Public Affairs A new report that compares the performance of compressed natural gas (CNG) refuse haulers in New York City to similar diesel-powered trucks

A novel membrane distillation-thermophilic bioreactor system: biological stability and trace organic compound removal.

PubMed

Wijekoon, Kaushalya C; Hai, Faisal I; Kang, Jinguo; Price, William E; Guo, Wenshan; Ngo, Hao H; Cath, Tzahi Y; Nghiem, Long D

2014-05-01

The removal of trace organic compounds (TrOCs) by a novel membrane distillation-thermophilic bioreactor (MDBR) system was examined. Salinity build-up and the thermophilic conditions to some extent adversely impacted the performance of the bioreactor, particularly the removal of total nitrogen and recalcitrant TrOCs. While most TrOCs were well removed by the thermophilic bioreactor, compounds containing electron withdrawing functional groups in their molecular structure were recalcitrant to biological treatment and their removal efficiency by the thermophilic bioreactor was low (0-53%). However, the overall performance of the novel MDBR system with respect to the removal of total organic carbon, total nitrogen, and TrOCs was high and was not significantly affected by the conditions of the bioreactor. All TrOCs investigated here were highly removed (>95%) by the MDBR system. Biodegradation, sludge adsorption, and rejection by MD contribute to the removal of TrOCs by MDBR treatment. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Adipogenesis of human adipose-derived stem cells within three-dimensional hollow fiber-based bioreactors.

PubMed

Gerlach, Jörg C; Lin, Yen-Chih; Brayfield, Candace A; Minteer, Danielle M; Li, Han; Rubin, J Peter; Marra, Kacey G

2012-01-01

To further differentiate adipose-derived stem cells (ASCs) into mature adipocytes and create three-dimensional (3D) adipose tissue in vitro, we applied multicompartment hollow fiber-based bioreactor technology with decentral mass exchange for more physiological substrate gradients and integral oxygenation. We hypothesize that a dynamic 3D perfusion in such a bioreactor will result in longer-term culture of human adipocytes in vitro, thus providing metabolically active tissue serving as a diagnostic model for screening drugs to treat diabetes. ASCs were isolated from discarded human abdominal subcutaneous adipose tissue and then inoculated into dynamic 3D culture bioreactors to undergo adipogenic differentiation. Insulin-stimulated glucose uptake from the medium was assessed with and without TNF-alpha. 3D adipose tissue was generated in the 3D-bioreactors. Immunohistochemical staining indicated that 3D-bioreactor culture displayed multiple mature adipocyte markers with more unilocular morphologies as compared with two-dimensional (2D) cultures. Results of real-time polymerase chain reaction showed 3D-bioreactor treatment had more efficient differentiation in fatty acid-binding protein 4 expression. Repeated insulin stimulation resulted in increased glucose uptake, with a return to baseline between testing. Importantly, TNF-alpha inhibited glucose uptake, an indication of the metabolic activity of the tissue. 3D bioreactors allow more mature adipocyte differentiation of ASCs compared with traditional 2D culture and generate adipose tissue in vitro for up to 2 months. Reproducible metabolic activity of the adipose tissue in the bioreactor was demonstrated, which is potentially useful for drug discovery. We present here, to the best of our knowledge for the first time, the development of a coherent 3D high density fat-like tissue consisting of unilocular structure from primary adipose stem cells in vitro.

Adipogenesis of Human Adipose-Derived Stem Cells Within Three-Dimensional Hollow Fiber-Based Bioreactors

PubMed Central

Gerlach, Jörg C.; Lin, Yen-Chih; Brayfield, Candace A.; Minteer, Danielle M.; Li, Han; Rubin, J. Peter

2012-01-01

To further differentiate adipose-derived stem cells (ASCs) into mature adipocytes and create three-dimensional (3D) adipose tissue in vitro, we applied multicompartment hollow fiber-based bioreactor technology with decentral mass exchange for more physiological substrate gradients and integral oxygenation. We hypothesize that a dynamic 3D perfusion in such a bioreactor will result in longer-term culture of human adipocytes in vitro, thus providing metabolically active tissue serving as a diagnostic model for screening drugs to treat diabetes. ASCs were isolated from discarded human abdominal subcutaneous adipose tissue and then inoculated into dynamic 3D culture bioreactors to undergo adipogenic differentiation. Insulin-stimulated glucose uptake from the medium was assessed with and without TNF-alpha. 3D adipose tissue was generated in the 3D-bioreactors. Immunohistochemical staining indicated that 3D-bioreactor culture displayed multiple mature adipocyte markers with more unilocular morphologies as compared with two-dimensional (2D) cultures. Results of real-time polymerase chain reaction showed 3D-bioreactor treatment had more efficient differentiation in fatty acid-binding protein 4 expression. Repeated insulin stimulation resulted in increased glucose uptake, with a return to baseline between testing. Importantly, TNF-alpha inhibited glucose uptake, an indication of the metabolic activity of the tissue. 3D bioreactors allow more mature adipocyte differentiation of ASCs compared with traditional 2D culture and generate adipose tissue in vitro for up to 2 months. Reproducible metabolic activity of the adipose tissue in the bioreactor was demonstrated, which is potentially useful for drug discovery. We present here, to the best of our knowledge for the first time, the development of a coherent 3D high density fat-like tissue consisting of unilocular structure from primary adipose stem cells in vitro. PMID:21902468

Assessing the Risk of Prehospital Administration of Naloxone with Subsequent Refusal of Care.

PubMed

Levine, Michael; Sanko, Stephen; Eckstein, Marc

2016-01-01

EMS providers frequently encounter opioid-toxic patients who receive naloxone and then refuse further medical care. Older studies revealed this practice to be safe. In light of the evolving patterns of opioid abuse, this study attempted to determine the safety of this practice. This is a retrospective review of all patient encounters by the Los Angeles Fire Department (LAFD) between July 1, 2011-December 31, 2013. All LAFD patient encounters are stored electronically. These electronic records were reviewed for subjects who received naloxone had a documented respiratory rate (RR) less than 12, and subsequently refused transport. Data abstracted included name, social security number (SSN), date of birth (DOB), date of EMS encounter, age, and treatment rendered. The names, SSN, and DOB, as available, were supplied to the coroner's office. The Coroner's records were reviewed to determine if a patient with the same or similar name (e.g., Jon vs. Jonathan) had died within 24 hours, 30 days, or 6 months of the initial EMS encounter. The abstractor was blinded to the study hypothesis. 205 subjects were identified; the median (IQR) age was 41 (29-53) years. 27 (13%) were female. One subject (0.49%) died within 24 hours of the initial EMS encounter. The cause of death (COD) was coronary artery disease and heroin use. Two additional subjects (1. %) died within 30 days. One of these subjects died 6 days later; the COD is unknown. The other subject died 20 days after the EMS encounter; the COD was cardiovascular disease and liver cirrhosis. No additional subjects were identified at the 6 month follow up. A third subject died of a heroin overdose 16 months after the initial EMS encounter, but was beyond the pre-defined follow up period. The practice of receiving pre-hospital naloxone by paramedics and subsequently refusing care is associated with an extremely low short- and intermediate-term mortality. Despite an evolving pattern of opioid abuse, the results of this study

Long-term three-dimensional perfusion culture of human adult bone marrow mononuclear cells in bioreactors.

PubMed

Schmelzer, Eva; Finoli, Anthony; Nettleship, Ian; Gerlach, Jörg C

2015-04-01

The construction and long-term maintenance of three-dimensional in vitro bone marrow models is of great interest but still quite challenging. Here we describe the use of a multi-compartment hollow-fiber membrane based three-dimensional perfusion bioreactor for long-term culture of whole human bone marrow mononuclear cells. We also investigated bioreactors with incorporated open-porous foamed hydroxyapatite scaffolds, mimicking the in vivo bone matrix. Cells in bioreactors with and without scaffolds were cultured to 6 weeks and compared to Petri dish controls. Cells were analyzed for gene expression, surface markers by flow cytometry, metabolic activity, hematopoietic potential, viability, and attachment by immunocytochemistry. Cells in bioreactors were metabolic active during long-term culture. The percentages of hematopoietic stem cell and mature endothelial cell fractions were maintained in bioreactors. The expression of most of the analyzed genes stabilized and increased after long-term culture of 6 weeks. Compared to Petri dish culture controls, bioreactor perfusion culture improved in both the short and long-term, the colony formation unit capacity of hematopoietic progenitors. Cells attached to the ample surface area provided by hydroxyapatite scaffolds. The implementation of a hydroxyapatite scaffold did not influence colony formation capacity, percentages of cell type specific fractions, gene expression, cell viability or metabolic turnover when compared to control cells cultured in bioreactors without scaffolds. In conclusion, three-dimensional perfusion bioreactor culture enables long-term maintenance of primary human bone marrow cells, with hydroxyapatite scaffolds providing an in vivo-like scaffold for three-dimensional culture. © 2015 Wiley Periodicals, Inc.

Microbial ecology studies at two coal mine refuse sites in Illinois

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, R. M.; Cameron, R. E.

An investigation was made of the microflora associated with coal refuse at two abandoned mines in the midwestern United States. Information was gathered for both the edaphic and the biotic composition of the refuse material. Emphasis was placed on heterotrophic and autotrophic components as to numbers, kinds, and physiological groups. The presence of chemolithotrophs was also investigated. The relationship between abiotic and biotic components in regard to distribution of bacteria, fungi, and algae is discussed. Information presented in this report will be utilized in assessing trends and changes in microbial numbers and composition related to manipulations of the edaphic andmore » biotic ecosystem components associated with reclamation of the refuse piles.« less

Woodchip bioreactors effectively treat aquaculture effluent

USDA-ARS?s Scientific Manuscript database

Nutrients, in particular nitrogen and phosphorus, can create eutrophication problems in any watershed. Preventing water quality impairment requires controlling nutrients from both point-source and non-point source discharges. Woodchip bioreactors are one relatively new approach that can be utilized ...

A Microfluidic Bioreactor for Toxicity Testing of Stem Cell Derived 3D Cardiac Bodies.

PubMed

Christoffersson, Jonas; Bergström, Gunnar; Schwanke, Kristin; Kempf, Henning; Zweigerdt, Robert; Mandenius, Carl-Fredrik

2016-01-01

Modeling tissues and organs using conventional 2D cell cultures is problematic as the cells rapidly lose their in vivo phenotype. In microfluidic bioreactors the cells reside in microstructures that are continuously perfused with cell culture medium to provide a dynamic environment mimicking the cells natural habitat. These micro scale bioreactors are sometimes referred to as organs-on-chips and are developed in order to improve and extend cell culture experiments. Here, we describe the two manufacturing techniques photolithography and soft lithography that are used in order to easily produce microfluidic bioreactors. The use of these bioreactors is exemplified by a toxicity assessment on 3D clustered human pluripotent stem cells (hPSC)-derived cardiomyocytes by beating frequency imaging.

Integrating human stem cell expansion and neuronal differentiation in bioreactors

PubMed Central

Serra, Margarida; Brito, Catarina; Costa, Eunice M; Sousa, Marcos FQ; Alves, Paula M

2009-01-01

Background Human stem cells are cellular resources with outstanding potential for cell therapy. However, for the fulfillment of this application, major challenges remain to be met. Of paramount importance is the development of robust systems for in vitro stem cell expansion and differentiation. In this work, we successfully developed an efficient scalable bioprocess for the fast production of human neurons. Results The expansion of undifferentiated human embryonal carcinoma stem cells (NTera2/cl.D1 cell line) as 3D-aggregates was firstly optimized in spinner vessel. The media exchange operation mode with an inoculum concentration of 4 × 105 cell/mL was the most efficient strategy tested, with a 4.6-fold increase in cell concentration achieved in 5 days. These results were validated in a bioreactor where similar profile and metabolic performance were obtained. Furthermore, characterization of the expanded population by immunofluorescence microscopy and flow cytometry showed that NT2 cells maintained their stem cell characteristics along the bioreactor culture time. Finally, the neuronal differentiation step was integrated in the bioreactor process, by addition of retinoic acid when cells were in the middle of the exponential phase. Neurosphere composition was monitored and neuronal differentiation efficiency evaluated along the culture time. The results show that, for bioreactor cultures, we were able to increase significantly the neuronal differentiation efficiency by 10-fold while reducing drastically, by 30%, the time required for the differentiation process. Conclusion The culture systems developed herein are robust and represent one-step-forward towards the development of integrated bioprocesses, bridging stem cell expansion and differentiation in fully controlled bioreactors. PMID:19772662

Modeling energy consumption in membrane bioreactors for wastewater treatment in north Africa.

PubMed

Skouterisl, George; Arnot, Tom C; Jraou, Mouna; Feki, Firas; Sayadi, Sami

2014-03-01

Two pilot-scale membrane bioreactors were operated alongside a full-sized activated sludge plant in Tunisia in order to compare specific energy demand and treated water quality. Energy consumption rates were measured for the complete membrane bioreactor systems and for their different components. Specific energy demand was measured for the systems and compared with the activated sludge plant, which operated at around 3 kWh m(-3). A model was developed for each membrane bioreactor based on both dynamic and steady-state mass balances, microbial kinetics and stoichiometry, and energy balance. Energy consumption was evaluated as a function of mixed-liquor suspended solids concentration, net permeate fluxes, and the resultant treated water quality. This work demonstrates the potential for using membrane bioreactors in decentralised domestic water treatment in North Africa, at energy consumption levels similar or lower than conventional activated sludge systems, with the added benefit of producing treated water suitable for unrestricted crop irrigation.

Outsourcing in the public refuse collection sector: exploiting old certainties or exploring new possibilities?

PubMed

Gustafsson, Ove; Saksvik, Per Øystein

2005-01-01

An outsourcing process in a medium-size city, by Norwegian standards, provided the background for our study. In 1996, the city council decided to contract out the refuse collection in half of its total area (the western part of the city), and to let the public refuse collection enterprise continue to collect in the other half of the area. The public enterprise also participated in the competitive tender, without success, however. The bid submitted by the public refuse collection enterprise was used as the basis for a benchmarking process performed by the chief administrative officer of the city in May 1999. The process resulted in the requirement that the public enterprise downsize its number of refuse collectors by 27 per cent. The city thus acquired a more cost-effective refuse collection system both in the western part, now run by a private company, and in the rest of the city, where the collection remained the responsibility of the public enterprise, in its newly pared-down and reorganized version. Detectable changes in the refuse collectors' health status in the three-year period immediately following the outsourcing constitute our main focus in this study. We found that the downsizing and reorganization of the public enterprise had a negative impact on the refuse collectors' health status. One year after the downsizing, six of the 27 refuse collectors remaining in the public enterprise had been diagnosed with heart problems or musculoskeletal pains that were sufficiently serious to form the basis of their individual approaches to secure a disability pension, which all six were in the process of acquiring. The registered sick leave among the refuse collectors showed a dramatic increase during the same period. We found clear indications that the refuse collectors remaining in the employment of the public enterprise had no alternatives in the labour market. Although not the focus of this study, we found that the totality of costs and benefits, not only for the

Vaccine refusal and the endgame: walking the last mile first.

PubMed

Saint-Victor, Diane S; Omer, Saad B

2013-08-05

As multiple papers within this special issue illustrate, the dynamics of disease eradication are different from disease control. When it comes to disease eradication, 'the last mile is longest'. For social and ecological reasons such as vaccine refusal, further ending incidence of a disease when it has reached low levels is frequently complex. Issues of non-compliance within a target population often influence the outcome of disease eradication efforts. Past eradication efforts confronted such obstacles towards the tail end of the campaign, when disease incidence was lowest. This article provides a comparison of non-compliance within polio, measles and smallpox campaigns, demonstrating the tendency of vaccine refusal to rise as disease incidence falls. In order to overcome one of the most intractable challenges to eradication, future disease eradication efforts must prioritize vaccine refusal from the start, i.e. 'walk the last mile first'.

Responding to the refusal of care in the emergency department.

PubMed

Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

2014-01-01

The emergency department (ED) serves as the primary gateway for acute care and the source of health care of last resort. Emergency physicians are commonly expected to rapidly assess and treat patients with a variety of life-threatening conditions. However, patients do refuse recommended therapy, even when the consequences are significant morbidity and even mortality. This raises the ethical dilemma of how emergency physicians and ED staff can rapidly determine whether patient refusal of treatment recommendations is based on intact decision-making capacity and how to respond in an appropriate manner when the declining of necessary care by the patient is lacking a basis in informed judgment. This article presents a case that illustrates the ethical tensions raised by the refusal of life-sustaining care in the ED and how such situations can be approached in an ethically appropriate manner.

Bioreactor and process design for biohydrogen production.

PubMed

Show, Kuan-Yeow; Lee, Duu-Jong; Chang, Jo-Shu

2011-09-01

Biohydrogen is regarded as an attractive future clean energy carrier due to its high energy content and environmental-friendly conversion. It has the potential for renewable biofuel to replace current hydrogen production which rely heavily on fossil fuels. While biohydrogen production is still in the early stage of development, there have been a variety of laboratory- and pilot-scale systems developed with promising potential. This work presents a review of advances in bioreactor and bioprocess design for biohydrogen production. The state-of-the art of biohydrogen production is discussed emphasizing on production pathways, factors affecting biohydrogen production, as well as bioreactor configuration and operation. Challenges and prospects of biohydrogen production are also outlined. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Maternal refusal to consent to a cesarean delivery, stillbirth].

PubMed

Defline, A; Obadia, M; El Djerbi, A; Plevy, P; Lepercq, J

2014-01-01

The doctor-lawyer perspective that we discuss is a maternal refusal to consent to a cesarean delivery for a fetal indication in June 2011. Despite repeated information of the risks during a three-week hospitalization for pre-eclampsia, after being assured of the proper understanding of the seriousness of the situation by the patient and spouse, and after consideration to transfer to another hospital, the reiterated refusal led to a late fetal extraction resulting in term stillbirth. Copyright © 2013. Published by Elsevier Masson SAS.. All rights reserved.

Refusal of care: the physician-patient relationship and decisionmaking capacity.

PubMed

Simon, Jeremy R

2007-10-01

Problems of refusal of care, among the most common ethical dilemmas in the emergency department, are also often the most difficult to resolve, pitting 2 conflicting duties, that of helping patients and that of respecting their autonomy, against each other. Using a case presentation as a backdrop, this article offers a practical approach to patients who refuse treatment, including assessment of decisionmaking capacity but emphasizing the role of trust, communication, and compromise in these cases.

Jehovah's Witnesses and autonomy: honouring the refusal of blood transfusions.

PubMed

Bock, Gregory L

2012-11-01

This paper explores the scriptural and theological reasons given by Jehovah's Witnesses (JWs) to refuse blood transfusions. Julian Savulescu and Richard W Momeyer argue that informed consent should be based on rational beliefs and that the refusal of blood transfusions by JWs is irrational, but after examining the reasons given by JWs, I challenge the claim that JW beliefs are irrational. I also question whether we should give up the traditional notion of informed consent.

Continuous, packed-bed, enzymatic bioreactor production and stability of feruloyl soy glycerides

USDA-ARS?s Scientific Manuscript database

The synthesis of feruloyl soy glycerides was demonstrated on a pilot-scale (1 metric ton/year) in a continuous, four-column series, packed-bed, enzymatic bioreactor (herinafter referred to as the bioreactor). Ethyl ferulate and soybean oil were combined and converted at 3.5 kg/d over Candida antarti...

Using a Nonaversive Procedure to Decrease Refusals.

ERIC Educational Resources Information Center

Spooner, Fred; And Others

1990-01-01

A nonaversive technique was used to teach a severely handicapped woman to decrease her refusals. The technique employed precision teaching via precise daily measurement strategies, environmental analysis, and a focus on building appropriate behavior. (JDD)

A Multi-Paradigm Modeling Framework to Simulate Dynamic Reciprocity in a Bioreactor

PubMed Central

Kaul, Himanshu; Cui, Zhanfeng; Ventikos, Yiannis

2013-01-01

Despite numerous technology advances, bioreactors are still mostly utilized as functional black-boxes where trial and error eventually leads to the desirable cellular outcome. Investigators have applied various computational approaches to understand the impact the internal dynamics of such devices has on overall cell growth, but such models cannot provide a comprehensive perspective regarding the system dynamics, due to limitations inherent to the underlying approaches. In this study, a novel multi-paradigm modeling platform capable of simulating the dynamic bidirectional relationship between cells and their microenvironment is presented. Designing the modeling platform entailed combining and coupling fully an agent-based modeling platform with a transport phenomena computational modeling framework. To demonstrate capability, the platform was used to study the impact of bioreactor parameters on the overall cell population behavior and vice versa. In order to achieve this, virtual bioreactors were constructed and seeded. The virtual cells, guided by a set of rules involving the simulated mass transport inside the bioreactor, as well as cell-related probabilistic parameters, were capable of displaying an array of behaviors such as proliferation, migration, chemotaxis and apoptosis. In this way the platform was shown to capture not only the impact of bioreactor transport processes on cellular behavior but also the influence that cellular activity wields on that very same local mass transport, thereby influencing overall cell growth. The platform was validated by simulating cellular chemotaxis in a virtual direct visualization chamber and comparing the simulation with its experimental analogue. The results presented in this paper are in agreement with published models of similar flavor. The modeling platform can be used as a concept selection tool to optimize bioreactor design specifications. PMID:23555740

MONITORING APPROACHES FOR BIOREACTOR LANDFILLS - Report

EPA Science Inventory

Experimental bioreactor landfill operations at operating Municipal Solid Waste (MSW) landfills can be approved under the research development and demonstration (RD&D) provisions of 30CFR 258.4. To provide a basis for consistent data collection for future decision-making in suppor...

What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians.

PubMed

Pasman, H Roeline W; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-09-01

Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal. A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die. Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished. Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Suspension cell culture in microgravity and development of a space bioreactor

NASA Technical Reports Server (NTRS)

Morrison, Dennis R.

1987-01-01

NASA has methodically developed unique suspension type cell and recovery apparatus culture systems for bioprocess technology experiments and production of biological products in microgravity. The first space bioreactor has been designed for microprocessor control, no gaseous headspace, circulation and resupply of culture medium, and slow mixing in very low shear regimes. Various ground based bioreactors are being used to test reactor vessel design, on-line sensors, effects of shear, nutrient supply, and waste removal from continuous culture of human cells attached to microcarriers. The small (500 ml) bioreactor is being constructed for flight experiments in the Shuttle middeck to verify systems operation under microgravity conditions and to measure the efficiencies of mass transport, gas transfer, oxygen consumption, and control of low shear stress on cells.

21 CFR 1316.12 - Refusal to allow inspection with an administrative warrant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Refusal to allow inspection with an administrative warrant. 1316.12 Section 1316.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Inspections § 1316.12 Refusal to allow...

Computer control of a microgravity mammalian cell bioreactor

NASA Technical Reports Server (NTRS)

Hall, William A.

1987-01-01

The initial steps taken in developing a completely menu driven and totally automated computer control system for a bioreactor are discussed. This bioreactor is an electro-mechanical cell growth system cell requiring vigorous control of slowly changing parameters, many of which are so dynamically interactive that computer control is a necessity. The process computer will have two main functions. First, it will provide continuous environmental control utilizing low signal level transducers as inputs and high powered control devices such as solenoids and motors as outputs. Secondly, it will provide continuous environmental monitoring, including mass data storage and periodic data dumps to a supervisory computer.

Sunlight supply and gas exchange systems in microalgal bioreactor

NASA Technical Reports Server (NTRS)

Mori, K.; Ohya, H.; Matsumoto, K.; Furune, H.

1987-01-01

The bioreactor with sunlight supply system and gas exchange systems presented has proved feasible in ground tests and shows much promise for space use as a closed ecological life support system device. The chief conclusions concerning the specification of total system needed for a life support system for a man in a space station are the following: (1) Sunlight supply system - compactness and low electrical consumption; (2) Bioreactor system - high density and growth rate of chlorella; and (3) Gas exchange system - enough for O2 production and CO2 assimilation.

BIOREACTOR ECONOMICS, SIZE AND TIME OF OPERATION (BEST) COMPUTER SIMULATOR FOR DESIGNING SULFATE-REDUCING BACTERIA FIELD BIOREACTORS

EPA Science Inventory

BEST (bioreactor economics, size and time of operation) is an Excel™ spreadsheet-based model that is used in conjunction with the public domain geochemical modeling software, PHREEQCI. The BEST model is used in the design process of sulfate-reducing bacteria (SRB) field bioreacto...

Example study for granular bioreactor stratification: Three-dimensional evaluation of a sulfate-reducing granular bioreactor

PubMed Central

Hao, Tian-wei; Luo, Jing-hai; Su, Kui-zu; Wei, Li; Mackey, Hamish R.; Chi, Kun; Chen, Guang-Hao

2016-01-01

Recently, sulfate-reducing granular sludge has been developed for application in sulfate-laden water and wastewater treatment. However, little is known about biomass stratification and its effects on the bioprocesses inside the granular bioreactor. A comprehensive investigation followed by a verification trial was therefore conducted in the present work. The investigation focused on the performance of each sludge layer, the internal hydrodynamics and microbial community structures along the height of the reactor. The reactor substratum (the section below baffle 1) was identified as the main acidification zone based on microbial analysis and reactor performance. Two baffle installations increased mixing intensity but at the same time introduced dead zones. Computational fluid dynamics simulation was employed to visualize the internal hydrodynamics. The 16S rRNA gene of the organisms further revealed that more diverse communities of sulfate-reducing bacteria (SRB) and acidogens were detected in the reactor substratum than in the superstratum (the section above baffle 1). The findings of this study shed light on biomass stratification in an SRB granular bioreactor to aid in the design and optimization of such reactors. PMID:27539264

Efficacy of Bioremediation of Agricultural Runoff Using Bacterial Communities in Woodchip Bioreactors.

NASA Astrophysics Data System (ADS)

Mortensen, Z. H.; Leandro, M.; Silveus, J. M.

2016-12-01

California's agricultural sector is fundamental in the State's economic growth and is responsible for supplying a large portion of the country's produce. In order to meet the market's demand for crop production the region's agrarian landscape requires an abundance of nutrient rich irrigation. The resultant agricultural effluent is a source of increased nutrient content in California's watershed and groundwater systems, promoting eutrophication and contributing to negative impacts on local ecosystems and human health. Previous studies have examined the denitrification potential of woodchip bioreactors. However, research has been deficient regarding specific variables that may affect the remediation process. To evaluate the efficacy of woodchip bioreactors in remediating waters containing high nitrate concentrations, denitrification rates were examined and parameters such as temperature, laminar flow, and hydraulic residence times were measured to identify potential methods for increasing denitrification efficiency. By measuring the rate of denitrification in a controlled environment where potentially confounding factors can be manipulated, physical components affecting the efficiency of woodchip bioreactors were examined to assess effects. Our research suggests the implementation of woodchip bioreactors to treat agricultural runoff would significantly reduce the concentration of nitrate in agricultural effluent and contribute to the mitigation of negative impacts associated with agricultural irrigation. Future research should focus on the ability of woodchip bioreactors to successfully remediate other agricultural pollutants, such as phosphates and pesticides, to optimize the efficiency of the bioremediation process.

10 CFR 709.13 - Implications of refusal to take a polygraph examination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Implications of refusal to take a polygraph examination. 709.13 Section 709.13 Energy DEPARTMENT OF ENERGY COUNTERINTELLIGENCE EVALUATION PROGRAM CI Evaluation Protocols and Protection of National Security § 709.13 Implications of refusal to take a polygraph...

LANDFILL BIOREACTOR PERFORMANCE, SECOND INTERIM REPORT

EPA Science Inventory

A bioreactor landfill is a landfill that is operated in a manner that is expected to increase the rate and extent of waste decomposition, gas generation, and settlement compared to a traditional landfill. This Second Interim Report was prepared to provide an interpretation of fie...

Vaccine refusal and the endgame: walking the last mile first

PubMed Central

Saint-Victor, Diane S.; Omer, Saad B.

2013-01-01

As multiple papers within this special issue illustrate, the dynamics of disease eradication are different from disease control. When it comes to disease eradication, ‘the last mile is longest’. For social and ecological reasons such as vaccine refusal, further ending incidence of a disease when it has reached low levels is frequently complex. Issues of non-compliance within a target population often influence the outcome of disease eradication efforts. Past eradication efforts confronted such obstacles towards the tail end of the campaign, when disease incidence was lowest. This article provides a comparison of non-compliance within polio, measles and smallpox campaigns, demonstrating the tendency of vaccine refusal to rise as disease incidence falls. In order to overcome one of the most intractable challenges to eradication, future disease eradication efforts must prioritize vaccine refusal from the start, i.e. ‘walk the last mile first’. PMID:23798696

Impact of interventions for patients refusing emergency medical services transport.

PubMed

Alicandro, J; Hollander, J E; Henry, M C; Sciammarella, J; Stapleton, E; Gentile, D

1995-06-01

To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. Consecutive patients served by four suburban ambulance services who initially refused emergency medical services (EMS) transport to the hospital were prospectively enrolled. In phase 1 (control phase), all patients who initially refused medical attention or transport had an identifying data card completed. In phase 2 (documentation phase), out-of-hospital providers completed a similar data card that contained a checklist of high-risk criteria for a poor outcome if not transported. In phase 3 (intervention phase), a data card similar to that used in phase 2 was completed, and on-line medical control was contacted for all patients with high-risk criteria who refused transport. The primary endpoint was the percentage of patients transported to the hospital. A total of 361 patients were enrolled. Transport rate varied by phase: control, 17 of 144 (12%); documentation, 11 of 150 (7%); and intervention, 12 of 67 (18%) (chi-square, p = 0.023). Transport of high-risk patients improved with each intervention: control, two of 60 (3%); documentation, seven of 70 (10%); and intervention, 12 of 34 (35%) (chi-square, p = 0.00003). Transport of patients without high-risk criteria decreased with each intervention: control, 15 of 84 (18%); documentation, four of 80 (5%); and intervention, 0 of 33 (0%) (p = 0.0025). Of the 28 patients for whom medical control was contacted, 12 (43%) were transported to the hospital, and only three of these 12 patients (25%) were released from the ED. Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.

Treatment of N-Nitrosodimethylamine (NDMA) in Groundwater Using a Fluidized Bed Bioreactor

DTIC Science & Technology

2014-01-01

Nitrosodimethylamine ( NDMA ) in Groundwater Using a Fluidized Bed Bioreactor Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...Treatment of N-Nitrosodimethylamine ( NDMA ) in Groundwater Using a Fluidized Bed Bioreactor 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...21 5.6.1 NDMA and DMN

Mental health consequences of abortion and refused abortion.

PubMed

Watter, W W

1980-02-01

There is no scientific evidence to support the hypothesis put forth by Dr. Philip Ney in a recent article published in the Canadian Journal of Psychiatry that induced abortion is associated with an increase in child abuse. There are, however, numerous studies which support the contention that mandatory motherhood adversely affects the mental health of both the mother and the offspring. Studies conducted in Sweden, Scotland, and Czechoslovakia revealed that women who were refused abortions frequently experienced serious psychosocial difficulties for long periods of time following abortion refusal. Case controlled follow-up studies, conducted in Sweden and Czechoslovakia, of offspring born to women who were refused abortions demonstrated that a higher proportion of the unwanted children required psychiatric services, engaged in criminal behavior, and did less well in school than the controlled children. These studies have implications for the current Canadian law which permits a woman to obtain an abortion if pregnancy continuation will endanger her health. In view of the above statistical evidence, and the fact that mortality and morbidity are known to be lower for abortion than for childbirth, any person who denies a woman the right to have an abortion is increasing the risk that the health of the woman will be endangered. By law, therefore, all abortion requests should be honored.

Measuring Water in Bioreactor Landfills

NASA Astrophysics Data System (ADS)

Han, B.; Gallagher, V. N.; Imhoff, P. T.; Yazdani, R.; Chiu, P.

2004-12-01

Methane is an important greenhouse gas, and landfills are the largest anthropogenic source in many developed countries. Bioreactor landfills have been proposed as one means of abating greenhouse gas emissions from landfills. Here, the decomposition of organic wastes is enhanced by the controlled addition of water or leachate to maintain optimal conditions for waste decomposition. Greenhouse gas abatement is accomplished by sequestration of photosynthetically derived carbon in wastes, CO2 offsets from energy use of waste derived gas, and mitigation of methane emission from the wastes. Maintaining optimal moisture conditions for waste degradation is perhaps the most important operational parameter in bioreactor landfills. To determine how much water is needed and where to add it, methods are required to measure water within solid waste. However, there is no reliable method that can measure moisture content simply and accurately in the heterogeneous environment typical of landfills. While well drilling and analysis of solid waste samples is sometimes used to determine moisture content, this is an expensive, time-consuming, and destructive procedure. To overcome these problems, a new technology recently developed by hydrologists for measuring water in the vadose zone --- the partitioning tracer test (PTT) --- was evaluated for measuring water in solid waste in a full-scale bioreactor landfill in Yolo County, CA. Two field tests were conducted in different regions of an aerobic bioreactor landfill, with each test measuring water in ≈ 250 ft3 of solid waste. Tracers were injected through existing tubes inserted in the landfill, and tracer breakthrough curves were measured through time from the landfill's gas collection system. Gas samples were analyzed on site using a field-portable gas chromatograph and shipped offsite for more accurate laboratory analysis. In the center of the landfill, PTT measurements indicated that the fraction of the pore space filled with water

Using Descriptive Assessment in the Treatment of Bite Acceptance and Food Refusal

ERIC Educational Resources Information Center

Casey, Sean D.; Perrin, Christopher J.; Lesser, Aaron D.; Perrin, Stefanie H.; Casey, Cheryl L.; Reed, Gregory K.

2009-01-01

The feeding behaviors of two children who maintained failure to thrive diagnoses and displayed food refusal are assessed in their homes. Descriptive assessments are used to identify schedules of consequence provided by each child's care providers for bite acceptance and food refusal behaviors. Assessments reveal rich schedules of praise and access…

A symbiotic gas exchange between bioreactors enhances microalgal biomass and lipid productivities: taking advantage of complementary nutritional modes.

PubMed

Santos, C A; Ferreira, M E; da Silva, T Lopes; Gouveia, L; Novais, J M; Reis, A

2011-08-01

This paper describes the association of two bioreactors: one photoautotrophic and the other heterotrophic, connected by the gas phase and allowing an exchange of O(2) and CO(2) gases between them, benefiting from a symbiotic effect. The association of two bioreactors was proposed with the aim of improving the microalgae oil productivity for biodiesel production. The outlet gas flow from the autotrophic (O(2) enriched) bioreactor was used as the inlet gas flow for the heterotrophic bioreactor. In parallel, the outlet gas flow from another heterotrophic (CO(2) enriched) bioreactor was used as the inlet gas flow for the autotrophic bioreactor. Aside from using the air supplied from the auto- and hetero-trophic bioreactors as controls, one mixotrophic bioreactor was also studied and used as a model, for its claimed advantage of CO(2) and organic carbon being simultaneously assimilated. The microalga Chlorella protothecoides was chosen as a model due to its ability to grow under different nutritional modes (auto, hetero, and mixotrophic), and its ability to attain a high biomass productivity and lipid content, suitable for biodiesel production. The comparison between heterotrophic, autotrophic, and mixotrophic Chlorella protothecoides growth for lipid production revealed that heterotrophic growth achieved the highest biomass productivity and lipid content (>22%), and furthermore showed that these lipids had the most suitable fatty acid profile in order to produce high quality biodiesel. Both associations showed a higher biomass productivity (10-20%), when comparing the two separately operated bioreactors (controls) which occurred on the fourth day. A more remarkable result would have been seen if in actuality the two bioreactors had been inter-connected in a closed loop. The biomass productivity gain would have been 30% and the lipid productivity gain would have been 100%, as seen by comparing the productivities of the symbiotic assemblage with the sum of the two

Analysis of the efficiency of recombinant Escherichia coli strain cultivation in a gas-vortex bioreactor.

PubMed

Savelyeva, Anna V; Nemudraya, Anna A; Podgornyi, Vladimir F; Laburkina, Nadezhda V; Ramazanov, Yuriy A; Repkov, Andrey P; Kuligina, Elena V; Richter, Vladimir A

2017-09-01

The levels of aeration and mass transfer are critical parameters required for an efficient aerobic bioprocess, and directly depend on the design features of exploited bioreactors. A novel apparatus, using gas vortex for aeration and mass transfer processes, was constructed in the Center of Vortex Technologies (Novosibirsk, Russia). In this paper, we compared the efficiency of recombinant Escherichia coli strain cultivation using novel gas-vortex technology with conventional bioprocess technologies such as shake flasks and bioreactors with mechanical stirrers. We demonstrated that the system of aeration and agitation used in gas-vortex bioreactors provides 3.6 times higher volumetric oxygen transfer coefficient in comparison with mechanical bioreactor. The use of gas-vortex bioreactor for recombinant E. coli strain cultivation allows to increase the efficiency of target protein expression at 2.2 times for BL21(DE3)/pFK2 strain and at 3.5 times for auxotrophic C600/pRT strain (in comparison with stirred bioreactor). © 2016 International Union of Biochemistry and Molecular Biology, Inc.

Cultivation of Mycobacterium bovis BCG in bioreactors.

PubMed

Dietrich, Guido; Mollenkopf, Hans-Joachim; Weber, Heinz; Knapp, Bernhard; Diehl, Klaus-Dieter; Hess, Jürgen; Blackkolb, Friedrich; Bröker, Michael; Kaufmann, Stefan H E; Hundt, Erika

2002-07-03

The Mycobacterium bovis BCG vaccine for commercial use is classically produced as surface pellicles by culture on synthetic medium. Under these conditions, reproducibility of the cultures and quality assessment are hampered by slow growth of the bacilli, the formation of bacterial aggregates and a high proportion of dead bacilli after processing and final formulation of the vaccine. Here, we established dispersed cultures of M. bovis BCG in synthetic media in small-scale bioreactors. These cultures allow recording and adjusting of culture parameters and give rise to single bacilli with a high degree of live bacteria. In the murine model, bioreactor-grown M. bovis BCG exhibited slightly stronger replication and persistence than the vaccine produced under the classical conditions. The protective efficacy against challenge with M. tuberculosis was identical for both vaccine preparations.

Catalytic bioreactors and methods of using same

DOEpatents

Worden, Robert Mark; Liu, Yangmu Chloe

2017-07-25

Various embodiments provide a bioreactor for producing a bioproduct comprising one or more catalytically active zones located in a housing and adapted to keep two incompatible gaseous reactants separated when in a gas phase, wherein each of the one or more catalytically active zones may comprise a catalytic component retainer and a catalytic component retained within and/or thereon. Each of the catalytically active zones may additionally or alternatively comprise a liquid medium located on either side of the catalytic component retainer. Catalytic component may include a microbial cell culture located within and/or on the catalytic component retainer, a suspended catalytic component suspended in the liquid medium, or a combination thereof. Methods of using various embodiments of the bioreactor to produce a bioproduct, such as isobutanol, are also provided.

Containerized Wetland Bioreactor Evaluated for Perchlorate and Nitrate Degradation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dibley, V R; Krauter, P W

2004-12-02

The U.S. Department of Energy (DOE) and Lawrence Livermore Laboratory (LLNL) designed and constructed an innovative containerized wetlands (bioreactor) system that began operation in November 2000 to biologically degrade perchlorate and nitrate under relatively low-flow conditions at a remote location at Site 300 known as Building 854. Since initial start-up, the system has processed over 3,463,000 liters of ground water and treated over 38 grams of perchlorate and 148 kilograms of nitrate. Site 300 is operated by the University of California as a high-explosives and materials testing facility supporting nuclear weapons research. The 11-square mile site located in northern Californiamore » was added to the NPL in 1990 primarily due to the presence of elevated concentrations of volatile organic compounds (VOCs) in ground water. At the urging of the regulatory agencies, perchlorate was looked for and detected in the ground water in 1999. VOCs, nitrate and perchlorate were released into the soil and ground water in the Building 854 area as the result of accidental leaks during stability testing of weapons or from waste discharge practices that are no longer permitted at Site 300. Design of the wetland bioreactors was based on earlier studies showing that indigenous chlorate-respiring bacteria could effectively degrade perchlorate into nontoxic concentrations of chlorate, chlorite, oxygen, and chloride. Studies also showed that the addition of organic carbon would enhance microbial denitrification. Early onsite testing showed acetic acid to be a more effective carbon source than dried leaf matter, dried algae, or milk replacement starter; a nutrient and carbon source used in a Department of Defense phytoremediation demonstration. No inocula were added to the system. Groundwater was allowed to circulate through the bioreactor for three weeks to acclimate the wetland plants and to build a biofilm from indigenous flora. Using solar energy, ground water is pumped into

Mathematical modelling of cell layer growth in a hollow fibre bioreactor.

PubMed

Chapman, Lloyd A C; Whiteley, Jonathan P; Byrne, Helen M; Waters, Sarah L; Shipley, Rebecca J

2017-04-07

Generating autologous tissue grafts of a clinically useful volume requires efficient and controlled expansion of cell populations harvested from patients. Hollow fibre bioreactors show promise as cell expansion devices, owing to their potential for scale-up. However, further research is required to establish how to specify appropriate hollow fibre bioreactor operating conditions for expanding different cell types. In this study we develop a simple model for the growth of a cell layer seeded on the outer surface of a single fibre in a perfused hollow fibre bioreactor. Nutrient-rich culture medium is pumped through the fibre lumen and leaves the bioreactor via the lumen outlet or passes through the porous fibre walls and cell layer, and out via ports on the outer wall of the extra-capillary space. Stokes and Darcy equations for fluid flow in the fibre lumen, fibre wall, cell layer and extra-capillary space are coupled to reaction-advection-diffusion equations for oxygen and lactate transport through the bioreactor, and to a simple growth law for the evolution of the free boundary of the cell layer. Cells at the free boundary are assumed to proliferate at a rate that increases with the local oxygen concentration, and to die and detach from the layer if the local fluid shear stress or lactate concentration exceed critical thresholds. We use the model to predict operating conditions that maximise the cell layer growth for different cell types. In particular, we predict the optimal flow rate of culture medium into the fibre lumen and fluid pressure imposed at the lumen outlet for cell types with different oxygen demands and fluid shear stress tolerances, and compare the growth of the cell layer when the exit ports on the outside of the bioreactor are open with that when they are closed. Model simulations reveal that increasing the inlet flow rate and outlet fluid pressure increases oxygen delivery to the cell layer and, therefore, the growth rate of cells that are

The impact of municipal refuse utilization on energy and our environment

NASA Technical Reports Server (NTRS)

1978-01-01

The incinerator/boiler configuration is stressed as the most reliable method of waste utilization. It is also pointed out that the high cost of refuse disposal and the ever increasing cost of energy, have made this method attractive. A plan is outlined for operating a waste utilization plant. Community participation is encouraged in investigating the feasibility of refuse to energy facilities in their area.

Effects of Bioreactor Retention Time on Aerobic Microbial Decomposition of CELSS Crop Residues