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Combined arthroscopic TFCC debridement and wafer resection of the distal ulna in wrists with triangular fibrocartilage complex tears and positive ulnar variance.  


Because a certain percentage of patients with positive ulnar variance experience incomplete pain relief after triangular fibrocartilage complex (TFCC) debridement alone, we prospectively evaluated the feasibility and efficacy of combining arthroscopic TFCC debridement with arthroscopic wafer resection in such wrists as part of the same surgical procedure. We enrolled 12 patients between July 1998 and July 2000 and performed both subjective and objective assessment at follow-up with a minimum of 6 months and an average of 14 months. Seven posttraumatic and 5 degenerative tears were identified. Preoperative ulnar variance with a pronated grip x-ray averaged 2 mm and ranged between 1 and 4 mm. At final review 8 patients experienced complete pain relief and 4 experienced only minimal symptoms. The ulnocarpal stress test failed to elicit pain in any wrist. Nine patients were very satisfied, and 3 were satisfied. Grip strength improved 8 kg (36%). This procedure should be considered in the treatment of ulnar wrist pain when TFCC tears and positive ulnar variance coexist. PMID:11721249

Tomaino, M M; Weiser, R W



Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft.  


Background?A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC. Technique?The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment. Patients and Methods?We report on nine patients with a mean age of 42. Median follow-up was 13 months. Results?The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. Conclusions?This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag. PMID:25709873

Bain, Gregory I; Eng, Kevin; Lee, Yu Chao; Mcguire, Duncan; Zumstein, Matthias



Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft.  


An acute injury to the triangular fibrocartilage complex (TFCC) with avulsion of the foveal attachment can produce distal radioulnar joint (DRUJ) instability. The avulsed TFCC is translated distally so the footprint will be bathed in synovial fluid from the DRUJ and will become covered in synovitis. If the TFCC fails to heal to the footprint, then persistent instability can occur. The authors describe a surgical technique indicated for the treatment of persistent instability of the DRUJ due to foveal detachment of the TFCC. The procedure utilizes a loop of palmaris longus tendon graft passed through the ulnar aspect of the TFCC and into an osseous tunnel in the distal ulna to reconstruct the foveal attachment. This technique provides stability of the distal ulna to the radius and carpus. We recommend this procedure for chronic instability of the DRUJ due to TFCC avulsion, but recommend that suture repair remain the treatment of choice for acute instability. An arthroscopic assessment includes the trampoline test, hook test, and reverse hook test. DRUJ ballottement under arthroscopic vision details the direction of instability, the functional tear pattern, and unmasks concealed tears. If the reverse hook test demonstrates a functional instability between the TFCC and the radius, then a foveal reconstruction is contraindicated, and a reconstruction that stabilizes the radial and ulnar aspects of the TFCC is required. The foveal reconstruction technique has the advantage of providing a robust anatomically based reconstruction of the TFCC to the fovea, which stabilizes the DRUJ and the ulnocarpal sag. PMID:24694387

Bain, Gregory I; McGuire, Duncan; Lee, Yu Chao; Eng, Kevin; Zumstein, Matthias



A Newer Technique of Distal Ulna Reconstruction Using Proximal Fibula and TFCC Reconstruction Using Palmaris Longus Tendon following Wide Resection of Giant Cell Tumour of Distal Ulna.  


Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone metaepiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-year-old male. This technique of distal radioulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year followup. PMID:24455371

Mariappan, Elango; Mohanen, Pragash; Moses, Justin



A Newer Technique of Distal Ulna Reconstruction Using Proximal Fibula and TFCC Reconstruction Using Palmaris Longus Tendon following Wide Resection of Giant Cell Tumour of Distal Ulna  

PubMed Central

Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone metaepiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-year-old male. This technique of distal radioulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year followup. PMID:24455371

Mariappan, Elango; Mohanen, Pragash; Moses, Justin



Complexity in the Treatment of Naming Deficits  

ERIC Educational Resources Information Center

Purpose: This article discusses a novel approach for treatment of lexical retrieval deficits in aphasia in which treatment begins with complex, rather than simple, lexical stimuli. This treatment considers the semantic complexity of items within semantic categories, with a focus on their featural detail. Method and Results: Previous work on…

Kiran, Swathi



Complexity in Language Learning and Treatment  

ERIC Educational Resources Information Center

Purpose: To introduce a Clinical Forum focused on the Complexity Account of Treatment Efficacy (C. K. Thompson, L. P. Shapiro, S. Kiran, & J. Sobecks, 2003), a counterintuitive but effective approach for treating language disorders. This approach espouses training "complex" structures to promote generalized improvement of simpler, linguistically…

Thompson, Cynthia K.



Ulnar-sided wrist pain. II. Clinical imaging and treatment  

PubMed Central

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. PMID:20012039

Watanabe, Atsuya; Souza, Felipe; Vezeridis, Peter S.; Blazar, Philip



Multifunctional carbon nanohorn complexes for cancer treatment.  


Multifunctional carbon nanohorn (CNH) complexes were synthesized using oxidized CNH, magnetite (MAG) nanoparticles, and polyethyleneimine (PEI). The ferromagnetic MAG nanoparticles were loaded onto CNH (MAG-CNH) using iron(II) acetate and subsequent heat treatment. Chemical functionalization of the MAG-CNH complexes with PEI improved their water-dispersibility and allowed further conjugation with a fluorophore. The application of an external magnetic field significantly intensified the targeted vectorization of CNH complexes into human cervical cancer (HeLa) cells. Following cell uptake, laser irradiation of the cells showed a significant enhancement in the photothermal effects of CNHs leading to cell death. We have confirmed that the photothermal properties and ferromagnetic characteristics of CNH complexes show efficient cell elimination. The present study is an essential step toward the development of an innovative cancer therapy and a highly sensitive detection of cancer cells at the single-cell level. PMID:25319234

Chechetka, Svetlana A; Pichon, Benoit; Zhang, Minfang; Yudasaka, Masako; Bégin-Colin, Sylvie; Bianco, Alberto; Miyako, Eijiro



Treatment of complex sleep apnea syndrome.  


Patients with complex sleep apnea syndrome (CompSAS) present with features of obstructive sleep apnea syndrome but demonstrate not only instability of upper airway tone (leading to classic obstructive apneas and hypopneas) but also unstable, chemosensitive ventilatory control leading to repetitive central apneas or periodic breathing during sleep. The central apneas often become most apparent after application of continuous positive airway pressure (CPAP) to alleviate upper airway obstruction; patients continue to have fragmented sleep and repetitive desaturations as a result of central apneas and hypopneas. In some patients, central apneas appear to abate over time as a result of some form of adaptation to CPAP. How often this occurs is uncertain, however, and many patients with CompSAS require treatment that combines stabilization of the upper airway obstruction with treatment of respiratory center dysfunction. Adaptive servo-ventilation, which provides both a minimum pressure to hold the airway open and a precisely calculated ventilatory assist to minimize cyclic hypoventilation and hyperventilation, has emerged as a leading treatment. Noninvasive ventilation using bilevel positive airway pressure in the spontaneous-timed mode also may regulate ventilation in some patients with CompSAS. There is anecdotal evidence that CompSAS may be successfully treated using combined PAP therapy with oxygen, carbon dioxide, or the addition of dead space, but data are not sufficient to routinely recommend these methods. PMID:18782506

Ku?niar, Tomasz J; Morgenthaler, Timothy I



[Artemisia absinthium L. in complex treatment of inflammatory periodontal disease].  


The effectiveness of Artemisia absinthium L. in complex treatment of inflammatory periodontal disease was assessed in the study by ELIZA evaluation of PGE2 in mixed saliva. Microcirculation in periodontal tissues was also assessed by means of laser Doppler flowmetry. It was found out that complex treatment involving Artemisia absinthium L. improves microcirculation in periodontal tissues and reduces inflammation. PMID:23011328

Krechina, E K; Belorukov, V V



Surgical Treatment and Rehabilitation of Combined Complex Ligament Injuries  

PubMed Central

This article is a description of the surgical treatment and rehabilitation of combined complex ligament injuries. A background will be provided, and information on the combined complex knee injuries, selected aspects of surgical treatments, and rehabilitation strategies will be presented. Combined complex ligament injuries are devastating injuries and are not very common compared to other knee injuries. No meta-analysis or systematic review studies exist regarding the best treatments for these patients. This article's emphasis is on the stages in the rehabilitation program with documentation of the scientific and clinical rationale for the treatment techniques in each stage. Treatment interventions are described and documented with the limited evidence available in treating these patients. Guidelines for treatment, surgery, and a clinical protocol for treating patients with combined complex ligament injuries are provided for the practicing clinician to use as a template for treating these complicated patients. PMID:21509123

Romeyn, Richard L.; Jennings, Jason




Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. NORTHEAST VIEW OF THE WASTE WATER TREATMENT COMPLEX FOR THE PRIMARY AND 22 BAR MILLS. - U.S. Steel Duquesne Works, Auxiliary Buildings & Shops, Along Monongahela River, Duquesne, Allegheny County, PA


Multidisciplinary and Multistage Treatment of Complex Facial Trauma: Case Report  

Microsoft Academic Search

.   The improved performance of modern automobiles often results in higher driving speeds, rendering traffic accidents much more\\u000a devastating. Many of our facially injured patients require multidisciplinary and multistage treatment, which is often both\\u000a sophisticated and radical. We present a patient with complex facial trauma, discuss his injury characteristics and the multistage\\u000a treatment performed, and review the literature.

Rafael M. Nagler; Mica Peled; Dov Laufer



Mechanism-based treatment in complex regional pain syndromes.  


Complex regional pain syndromes (CRPS) are multifactorial disorders with complex aetiology and pathogenesis. Management of CRPS is challenging, partly because of a lack of clinical data regarding the efficacy of the various therapies, and partly because successful treatment of CRPS requires a multidisciplinary, patient-tailored approach. The pain in CRPS is often described as typical 'burning' neuropathic pain, and is accompanied by a variety of sensory, motor and autonomic signs and symptoms. Because research into therapies specifically in CRPS has been scarce, treatment for these syndromes has been largely based on therapeutic strategies adapted from neuropathic pain states; however, increased understanding of the pathogenesis of CRPS has provided the opportunity to develop mechanism-based treatments. The interactions between the multiple pathophysiological mechanisms that contribute to the development, progression and maintenance of CRPS remain poorly understood. This Review describes the challenges in linking the current theories and knowledge of pathophysiological mechanisms to the mode of actions of the different treatment approaches. We discuss the current treatment strategies for CRPS, including pharmacotherapy, sympathetic ganglion block interventions, psychological support, physiotherapy and occupational therapy, and establish the concept of mechanism-based treatment for CRPS. PMID:25134708

Gierthmühlen, Janne; Binder, Andreas; Baron, Ralf



76 FR 39110 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Register Volume 76, Number 128 (Tuesday, July...Treatment of Certain Complex Diagnostic Laboratory...permitted to bill for complex laboratory tests under...Amendment certificate number of the laboratory performing...Treatment of Certain Complex Diagnostic...



[Pantogam active in the complex treatment of dystonic hyperkineses].  


Efficacy of pantogam active in the complex treatment of facial and cervical dystonic hyperkineses was studied in 37 patients (25 women, 12 men) with dystonic torticollis, blepharospasm, oromandibular dystonia with illness duration more than 6 months. In these patients, the previous treatment had no positive effect. Pantogam active was prescribed in dose 900-1800 mg/day during 12 weeks. Efficacy was assessed with the TWSTRS, the HADS and the CGI-I. Pantogam active as add-on to basic treatment led to the reduction of severity in dystonic hyperkineses on the average 2-2,5 months from baseline. The best effect was seen in patients with short disease duration. The prescription of this drug allowed to increase the dose of drugs traditionally used in treatment of dystonia (clonazepam, cyclodole, tiapridal, baclofen) due to the decrease of their side-effects. PMID:21389940

Katunina, E A; Malykhina, E A; Avanesova, O V; Makarova, A A; Abdurakhmanova, E K; Gridiakin, V I



Constructed wetland treatment system for upper blackfoot mining complex  

SciTech Connect

A combined passive oxidation/sedimentation (pre-treatment) and constructed wetland (polishing) system has been designed and installed to treat mine drainage at the inactive Upper Blackfoot River Mining Complex northeast of Lincoln, MT. The system is designed to treat up to 100 gpm flow with moderate heavy metal concentrations (25 to 95 mg/L Zn; lower concentrations of Pb, Cu, and As), moderate Fe concentrations (< 100 mg/L), and periodic high acidity (pH 2.6 to 3.5). The treatment scheme is flexible to accommodate a wide range of flows, metal concentrations, and acidity in order to gain cost-efficiencies and to meet restrictive discharge standards for the environmentally-sensitive Blackfoot River watershed. The wetland treatment system presently is undergoing start-up testing and initial tuning and will be operational during summer, 1996. Conceptual and engineering designs are presented along with preliminary data.

Sanders, F.S.



Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder  

PubMed Central

Background Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole for the treatment of acute mania. These could also be useful in the treatment of bipolar depression, but only limited data exists so far to support the use of quetiapine monotherapy or the olanzapine-fluoxetine combination. Some, but not all, anticonvulsants possess a broad spectrum of effectiveness, including mixed dysphoric and rapid-cycling forms. Lamotrigine may be effective in the treatment of depression but not mania. Antidepressant use is controversial. Guidelines suggest their cautious use in combination with an antimanic agent, because they are supposed to induce switching to mania or hypomania, mixed episodes and rapid cycling. Conclusion The first-line psychosocial intervention in BD is psychoeducation, followed by cognitive-behavioral therapy. Other treatment options include Electroconvulsive therapy and transcranial magnetic stimulation. There is a gap between the evidence base, which comes mostly from monotherapy trials, and clinical practice, where complex treatment regimens are the rule. PMID:17925035

Fountoulakis, Konstantinos N; Vieta, Eduard; Siamouli, Melina; Valenti, Marc; Magiria, Stamatia; Oral, Timucin; Fresno, David; Giannakopoulos, Panteleimon; Kaprinis, George S



Treatment of complex neurovascular lesions: an interdisciplinary angio suite approach  

PubMed Central

Objective: The objective of this study was to analyse our initial experience using an interdisciplinary angio suite approach to neurosurgical treatment of complex neurovascular lesions and expound technical feasibility and possible applications. Subjects: Six out of 451 patients with cranial or spinal neurovascular lesions were surgically treated in the angio suite (biplane angiographic system) during a 28-month observation period. Clinical baseline data, radiological and intraoperative findings as well as clinical and radiological outcome were assessed. Results: A ventral spinal perimedullary arteriovenous malformation, a ventral spinal perimedullary fistula, two diffuse frontal dural arteriovenous fistulas, a multifocal temporal arteriovenous malformation and a partially embolized fronto-temporo-basal dural arteriovenous fistula were successfully treated with angiographically confirmed complete occlusion and unimpaired neurological condition of the patients at the 12-month follow up. Conclusion: This study demonstrates the feasibility of this approach and points out possible indications, namely ventrally located spinal lesions and diffuse, deep seated cranial lesions. PMID:24409203

Breyer, Tobias; Wrede, Karsten H.; Stein, Klaus-Peter; Wanke, Isabel; Grams, Astrid E.; Gizewski, Elke R.; Schlamann, Marc; Forsting, Michael; Sandalcioglu, I. Erol; Sure, Ulrich



Surimi wash water treatment for protein recovery: effect of chitosan–alginate complex concentration and treatment time on protein adsorption  

Microsoft Academic Search

Chitosan (Chi), a protein recovery agent for the treatment of aqueous food processing streams, appears to work by mechanical entrapment and electrostatic interaction of chitosan amino groups with anionic groups on proteins. Chitosan effectiveness for recovering soluble proteins from surimi wash water (SWW) is increased by complexation with alginate (Alg) and by adjusting complex concentration and treatment time. Flocculation at

Singgih Wibowo; Gonzalo Velazquez; Vivek Savant; J. Antonio Torres



Investigating the reproducibility of a complex multifocal radiosurgery treatment  

NASA Astrophysics Data System (ADS)

Stereotactic radiosurgery has become a widely used technique to treat solid tumors and secondary metastases of the brain. Multiple targets can be simultaneously treated with a single isocenter in order to reduce the set-up time to improve patient comfort and workflow. In this study, a 5-arc multifocal RapidArc treatment was delivered to multiple PRESAGE® dosimeters in order to explore the repeatability of the treatment. The three delivery measurements agreed well with each other, with less than 3% standard deviation of dose in the target. The deliveries also agreed well with the treatment plan, with gamma passing rates greater than 90% (5% dose-difference, and 2 mm distance-to-agreement criteria). The optical-CT PRESAGE® system provided a reproducible measurement for treatment verification, provided measurements were made immediately following treatment.

Niebanck, M.; Juang, T.; Newton, J.; Adamovics, J.; Wang, Z.; Oldham, M.



CyberKnife® radiosurgery in the treatment of complex skull base tumors: analysis of treatment planning parameters  

PubMed Central

Background Tumors of the skull base pose unique challenges to radiosurgical treatment because of their irregular shapes, proximity to critical structures and variable tumor volumes. In this study, we investigate whether acceptable treatment plans with excellent conformity and homogeneity can be generated for complex skull base tumors using the Cyberknife® radiosurgical system. Methods At Georgetown University Hospital from March 2002 through May 2005, the CyberKnife® was used to treat 80 patients with 82 base of skull lesions. Tumors were classified as simple or complex based on their proximity to adjacent critical structures. All planning and treatments were performed by the same radiosurgery team with the goal of minimizing dosage to adjacent critical structures and maximizing target coverage. Treatments were fractionated to allow for safer delivery of radiation to both large tumors and tumors in close proximity to critical structures. Results The CyberKnife® treatment planning system was capable of generating highly conformal and homogeneous plans for complex skull base tumors. The treatment planning parameters did not significantly vary between spherical and non-spherical target volumes. The treatment parameters obtained from the plans of the complex base of skull group, including new conformity index, homogeneity index and percentage tumor coverage, were not significantly different from those of the simple group. Conclusion Our data indicate that CyberKnife® treatment plans with excellent homogeneity, conformity and percent target coverage can be obtained for complex skull base tumors. Longer follow-up will be required to determine the safety and efficacy of fractionated treatment of these lesions with this radiosurgical system. PMID:17173702

Collins, Sean P; Coppa, Nicholas D; Zhang, Ying; Collins, Brian T; McRae, Donald A; Jean, Walter C



Diagnosis and treatment of injuries to the posterolateral ligament complex.  


Posterolateral corner (PLC) injuries are an often unrecognized and disabling injury that frequently accompanies other ligamentous disruptions. The spectrum of injury severity and heterogeneity of treatment options have made comparison of outcomes difficult. Several clinical studies and reviews have focused on the outcomes and treatment algorithms of knee dislocations or multiligamentous knee injuries. There is, however, a paucity of data in the literature analyzing the clinical outcomes and treatment recommendations of isolated PLC injuries or PLC injuries in combination with a single cruciate ligament tear. Furthermore, to our knowledge there is no review that analyzes the different repair or reconstructive techniques and assesses the clinical outcomes of these techniques. PMID:21980873

Rue, John-Paul; Kilcoyne, Kelly; Dickens, Jonathan; Kluk, Matthew



[Complex diagnosis and treatment of hepatic echinococcosis in childhood].  


In dependence of size, localization, observed complications and associated forms of disease, the clinical symptomatology is characterized whith a different view. Three stages are made out during the illness. Infrequently associated and complicated forms of disease are special interest. Surgical treatment is the basic method of treatment in hydatidosis. It's specificity at children keeps special because of age. The surgery of the hydatidosis has been simpified and except for some cases. Surgical procedurs is great variability of pathology amond hydatid cyst, logically a inform treatment can not be recommended. Surgical approaches were: 1. Conservative methods--leaving of pericyst in situ; or 2. Radical methods--total pericystectomy of liver resection. Modern surgical treatments must be individualized for each cases. PMID:15584458

Kalinova, K



Modern Palliative Radiation Treatment: Do Complexity and Workload Contribute to Medical Errors?  

SciTech Connect

Purpose: To examine whether treatment workload and complexity associated with palliative radiation therapy contribute to medical errors. Methods and Materials: In the setting of a large academic health sciences center, patient scheduling and record and verification systems were used to identify patients starting radiation therapy. All records of radiation treatment courses delivered during a 3-month period were retrieved and divided into radical and palliative intent. 'Same day consultation, planning and treatment' was used as a proxy for workload and 'previous treatment' and 'multiple sites' as surrogates for complexity. In addition, all planning and treatment discrepancies (errors and 'near-misses') recorded during the same time frame were reviewed and analyzed. Results: There were 365 new patients treated with 485 courses of palliative radiation therapy. Of those patients, 128 (35%) were same-day consultation, simulation, and treatment patients; 166 (45%) patients had previous treatment; and 94 (26%) patients had treatment to multiple sites. Four near-misses and 4 errors occurred during the audit period, giving an error per course rate of 0.82%. In comparison, there were 10 near-misses and 5 errors associated with 1100 courses of radical treatment during the audit period. This translated into an error rate of 0.45% per course. An association was found between workload and complexity and increased palliative therapy error rates. Conclusions: Increased complexity and workload may have an impact on palliative radiation treatment discrepancies. This information may help guide the necessary recommendations for process improvement for patients who require palliative radiation therapy.

D'Souza, Neil, E-mail: [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Holden, Lori [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Robson, Sheila [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)] [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)



[Hemosorption in the complex treatment of acute myocardial infarction].  


Hemosorption was used in 41 cases of acute myocardial infarction. It improved blood rheologic properties and central hemodynamic parameters, and had a good clinical effect, reducing complications and mortality rates. Therefore hemosorption can be recommended as part of combined treatment for acute myocardial infarction. PMID:3795700

Korochkin, I M; Aniskov, A E; Fandeev, A V



Boundary treatments for 2D elliptic mesh generation in complex geometries  

Technology Transfer Automated Retrieval System (TEKTRAN)

This paper presents a boundary treatment method for 2D elliptic mesh generation in complex geometries. Corresponding to Neumann- Dirichlet boundary conditions (sliding boundary conditions), the proposed method aims at achieving orthogonal and smooth nodal distribution along irregular boundaries. In ...


Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods  

EPA Science Inventory

Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...


Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods - slides  

EPA Science Inventory

Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...


[The clinic, diagnosis, complex treatment of diabetic polyneuropathy].  


Distal symmetric sensory-motor diabetic polyneuropathy (DPN)--the most common variant of diabetic neuropathy, which is expressed by more than 50% of patients with diabetes mellitus (DM) 1 and type 2. The pathogenesis of DPN is the damaging effect of chronic hyperglycemia. Based on this key trends in the pathogenetic treatment of DPN are the normal levels of blood glucose, improved tissue perfusion and oxygen consumption, improve the rheological properties of blood, to restore normal energy balance, reducing the severity of oxidative stress. PMID:23350148

Terent'eva, N V



Complex Trait-Treatment-Interaction analysis: A powerful approach for analysing individual differences in experimental designs  

Microsoft Academic Search

Complex Trait-Treatment-Interaction (CTTI) analysis is introduced as a new and highly efficient statistical approach for analysing individual differences in experimental designs. CTTI analysis enables the researcher to investigate the combined effects of several personality traits and several treatments on a dependent variable. Thus, the hypothesis can be tested that a specific relationship between some aspect of human behavior and some

Detlev Leutner; Thomas Rammsayer



A Uniform-Complexity Treatment of Encryption and Zero-Knowledge  

Microsoft Academic Search

We provide a treatment of encryption and zero-knowledge in terms of uniform complexitymeasures. This treatment is appropriate for cryptographic settings modeled by probabilisticpolynomial-time machines. Our uniform treatment allows to construct secure encryptionschemes and zero-knowledge proof systems (for all I NP) using only uniform complexity assumptions.We show that uniform variants of the two definitions of security, presented in the pioneeringwork of

Oded Goldreich



An efficient immersed boundary treatment for complex moving object  

NASA Astrophysics Data System (ADS)

An efficient immersed boundary treatment for simulation of flexible moving body immersed in fluid is presented. The level set signed distance function is used to indicate body surface. A simple mapping strategy is proposed to avoid costly signed distance re-initialization computations. The strategy is efficient for both rigid and deformable structures, and can be extended to 3-D case easily. With the use of signed distance function, reconstruction of flow variables on a body surface can be easily implemented through linear, bilinear or quadratic interpolation. In order to suppress the pressure oscillations caused by the role conversion of forcing points and fluid points, a modified interpolation scheme is presented by introducing a dynamic weight term to the fluid point. Together with local grid refinement and using larger time step, the pressure oscillations can be effectively diminished by the modified interpolation scheme. The proposed method is validated by 2-D numerical simulations on a uniform flow past a fixed cylinder, in-line and transversely oscillating cylinders, a flapping wing, a 3-D simulation on a uniform flow past a rectangle plane with an initial attack angle and a moving anguilliform swimmer. Present numerical results are compared with other CFD solutions as well as experimental results.

Liu, Cheng; Hu, Changhong



Quantification of beam complexity in intensity-modulated radiation therapy treatment plans  

SciTech Connect

Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites. Methods: The authors evaluated the beam complexity scores for 65 step-and-shoot IMRT plans from three sites (prostate, head and neck, and spine) and 26 volumetric-modulated arc therapy (VMAT) plans for the prostate. On the basis of the beam apertures and monitor unit weights of all segments, the authors calculated the mean aperture area, extent of aperture shape irregularity, and degree of beam modulation for each beam. Then the beam complexity values were averaged to obtain the complexity metrics of the IMRT plans. The authors studied the correlation between the beam complexity metrics and the quality assurance (QA) results. Finally, the effects of treatment planning parameters on beam complexity were studied. Results: The beam complexity scores were not uniform among the prostate IMRT beams from different gantry angles. The lateral beams had larger monitor units and smaller shape irregularity, while the anterior-posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest aperture irregularity, beam modulation, and normalized monitor units; the head and neck IMRT plans had large beam irregularity and beam modulation; and the spine stereotactic radiation therapy plans often had small beam apertures, which may have been associated with the relatively large discrepancies between planned and QA measured doses. There were weak correlations between the beam complexity scores and the measured dose errors. The prostate VMAT beams showed greater complexity than the prostate step-and-shoot IMRT beams. In the treatment planning process, the beam complexity increased as the minimum segment area decreased and as the number of optimization iterations and the maximum number of segments increased. Conclusions: The proposed metrics were effective in characterizing the beam complexity of different disease sites and for different treatment modalities. Efforts should be made to reduce the unnecessary complexity of IMRT beams to minimize the radiation dose uncertainties.

Du, Weiliang, E-mail:; Cho, Sang Hyun; Zhang, Xiaodong; Kudchadker, Rajat J. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)] [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)] [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)



Treating complex trauma among veterans: three stage-based treatment models.  


This article addresses the issue of complex trauma in veterans and treatments for symptom presentations resulting from complex trauma exposure. While various definitions have been proposed for complex trauma, the clinical issues related to it are relevant for veterans as they are at risk for cumulative trauma exposures such as multiple combat deployments and military sexual trauma. Several treatments were either developed to address and/or implemented with complex trauma. This article discusses three of these treatments that share a stage-based approach, focusing on the present (e.g., skills training and psychoeducation), which can then be followed, if needed, with a past-focused (e.g., exposure-based) treatment: Dialectical Behavior Therapy (Linehan, 1993), Seeking Safety (Najavits, 2002), Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy (Cloitre, Cohen, & Koenen, 2006). This article also discusses what is currently being done to address symptom presentations resulting from complex trauma exposure and challenges and possible solutions to implementing this care. PMID:23529776

Landes, Sara J; Garovoy, Natara D; Burkman, Kristine M



Bioadhesive tablets containing cyclodextrin complex of itraconazole for the treatment of vaginal candidiasis.  


Itraconazole (ITR) is commonly used in the treatment of Candida infections. It has a nephrotoxic effect and low bioavailability in patients who suffer from renal insufficiency, and its poor solubility in water makes ITR largely unavailable. Cyclodextrins (CyDs) are used to form inclusion complexes with drugs to improve their aqueous solubility and to reduce their side effects. In this study, ITR was complexed with ?-cyclodextrin (?-CyD), hydroxypropyl-?-cyclodextrin (HP-?-CyD), methyl-?-cyclodextrin (Met-?-CyD) and sulphobutyl ether-?-cyclodextrin (SBE7-?-CyD) to increase its water solubility and to reduce the side effects of the drug without decreasing antifungal activity. Complex formation between ITR and CyDs was evaluated using SEM, (1)H NMR and XRD studies. The antifungal activity of the complexes was analyzed on Candida albicans strains, and the susceptibility of the strains was found to be higher for the ITR-SBE7-?-CyD complex than for the complexes that were prepared with other CyDs. Vaginal bioadhesive sustained release tablet formulations were developed using the ITR-SBE7-?-CyD inclusion complex to increase the residence time of ITR in the vagina, thereby boosting the efficacy of the treatment. The swelling, matrix erosion and bioadhesion properties of formulations and the drug release rate of these tablets were analyzed, and the most therapeutically effective vaginal formulation was determined. PMID:24857873

Cevher, Erdal; Açma, Ay?e; Sinani, Genada; Aksu, Buket; Zloh, Mire; Mülaz?mo?lu, Lütfiye



Optimisation of complex water supply systems with water quality, hydraulic and treatment plant aspects  

Microsoft Academic Search

A model for optimal operation of a complex water supply system for drinking water and with water quality, hydraulic and desalination treatment plants developed by Cohen and others has been applied to a realistic regional network, in which water quality is defined by salinity, magnesium and sulphur. The model considers the hydraulics of the network, including pump stations, boosters and

Dani Cohen; Uri Shamir; Gideon Sinai



Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms  

ERIC Educational Resources Information Center

This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.



New Biocatalyst with Multiple Enzymatic Activities for Treatment of Complex Food Wastewaters  

Microsoft Academic Search

Summary The cells of filamentous fungus R. oryzae entrapped in the polyvinyl alcohol cryogel are capable of producing various extracellular hydrolytic enzymes (proteases, amylases, li- pases) and are used for the treatment of complex wastewaters of food industry. Five types of media simulating the wastewater of various food enterprises were treated under batch conditions for 600 h. Fats containing mostly

Elena Efremenko; Olga Senko; Dinara Zubaerova; Elena Podorozhko; Vladimir Lozinsky


Noninvasive treatments for pediatric complex regional pain syndrome: a focused review.  


This is a review of current literature of noninvasive treatments for pediatric complex regional pain syndrome (CRPS). There are a variety of noninvasive approaches to the treatment of pain, but few pediatric-focused studies have been published in regard to CRPS. In comparison with adult CRPS, there is a greater need for behavioral approaches in children to enable coping with difficult symptoms. Current gaps in knowledge include mechanisms triggering CRPS, pediatric-focused diagnostic criteria, validated tests that are diagnostically specific, definitive treatment protocols, age-based medication recommendations, and validation of specific noninvasive treatments in pediatric populations. Intensive multidisciplinary treatment is supported by high recovery rates and a family-centered approach that allows continuation of goals into the community environment. PMID:24780851

Katholi, Benjamin R; Daghstani, Suzanne S; Banez, Gerard A; Brady, Kimberly K



The potential of sarcospan in adhesion complex replacement therapeutics for the treatment of muscular dystrophy  

PubMed Central

Three adhesion complexes span the sarcolemma and facilitate critical connections between the extracellular matrix and the actin cytoskeleton: the dystrophin- and utrophin-glycoprotein complexes and ?7?1 integrin. Loss of individual protein components results in a loss of the entire protein complex and muscular dystrophy. Muscular dystrophy is a progressive, lethal wasting disease characterized by repetitive cycles of myofiber degeneration and regeneration. Protein replacement therapy offers a promising approach for the treatment of muscular dystrophy. Recently, we demonstrated that sarcospan facilitates protein-protein interactions amongst the adhesion complexes and is an important therapeutic target. Here, we review current protein replacement strategies, discuss the potential benefits of sarcospan expression, and identify important experiments that must be addressed for sarcospan to move to the clinic. PMID:23601082

Marshall, Jamie L.; Kwok, Yukwah; McMorran, Brian; Baum, Linda G.; Crosbie-Watson, Rachelle H.



Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria  

PubMed Central

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region. PMID:22121361

Aikins, Elfleda Angelina; daCosta, Oluranti Olatokunbo; Onyeaso, Chukwudi Ochi; Isiekwe, Michael Chukwudi



[An ontogenic conception of complex multilevel treatment of psychosomatic disorders in children].  


The author suggests a conception that considers the etiopathogenesis of psychogenic psychosomatic disorders as a chain of interacting factors. The main patterns of it are stressful life events, personality, psychotype, somatotype, systemic/organic deficit. Mechanisms of stable pathological state join this chain into a "vicious circle" of psychosomatosis. Based on the ontogenetic approach, the author suggests a 5-level system of the complex (psychosomatic) treatment of these disorders. The system integrates pharmacological treatment, neuropsychological correction, syndromal psychological correction of alexithymia and emotional sphere, modification of behavior and personality-oriented psychotherapy. PMID:23739511

Shevchenko, Iu S



Intrinsic brain networks normalize with treatment in pediatric complex regional pain syndrome.  


Pediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning). Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects). These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects. PMID:25379449

Becerra, Lino; Sava, Simona; Simons, Laura E; Drosos, Athena M; Sethna, Navil; Berde, Charles; Lebel, Alyssa A; Borsook, David



Intrinsic brain networks normalize with treatment in pediatric complex regional pain syndrome  

PubMed Central

Pediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning). Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects). These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects. PMID:25379449

Becerra, Lino; Sava, Simona; Simons, Laura E.; Drosos, Athena M.; Sethna, Navil; Berde, Charles; Lebel, Alyssa A.; Borsook, David



[Pathophysiological grounds of reamberin application in complex treatment of disintegrated factures of pelvic bones].  


The investigation showed that reamberin application in the complex treatment of patients with severe disintegrated fractures of pelvic bones is pathogenetically grounded. Despite polyetiological origin of critical conditions in the organism in this case, all these have a common pathophysiological basis of three main processes: hypoxia, intoxication, and immunosuppression. Succinic acid, which is contained in reamberin, is a substrate antihypoxant that stimulates the synthesis of restorative equivalents in the cell. A modifying effect of succinic acid on the processes of tissue metabolism, including cell respiration, LPO/AOS system, and synthesis of proteins, is the basis of pathophysiological ground of reamberin application in a complex treatment of patients with disintegrated fractures of pelvic bones. PMID:24400388

Slastin, S S; Dorovskikh, V A; Shapovalenko, N S; Zakharova, F A



Factors that lessen the burden of treatment in complex patients with chronic conditions: a qualitative study  

PubMed Central

Purpose Patients with multiple chronic conditions (multimorbidity) often require ongoing treatment and complex self-care. This workload and its impact on patient functioning and well-being are, together, known as treatment burden. This study reports on factors that patients with multimorbidity draw on to lessen perceptions of treatment burden. Patients and methods Interviews (n=50) and focus groups (n=4 groups, five to eight participants per group) were conducted with patients receiving care in a large academic medical center or an urban safety-net hospital. Interview data were analyzed using qualitative framework analysis methods, and themes and subthemes were used to identify factors that mitigate burden. Focus groups were held to confirm these findings and clarify any new issues. This study was part of a larger program to develop a patient-reported measure of treatment burden. Results Five major themes emerged from the interview data. These included: 1) problem-focused strategies, like routinizing self-care, enlisting support of others, planning for the future, and using technology; 2) emotion-focused coping strategies, like maintaining a positive attitude, focusing on other life priorities, and spirituality/faith; 3) questioning the notion of treatment burden as a function of adapting to self-care and comparing oneself to others; 4) social support (informational, tangible, and emotional assistance); and 5) positive aspects of health care, like coordination of care and beneficial relationships with providers. Additional subthemes arising from focus groups included preserving autonomy/independence and being proactive with providers. Conclusion Patients attempt to lessen the experience of treatment burden using a variety of personal, social, and health care resources. Assessing these factors in tandem with patient perceptions of treatment burden can provide a more complete picture of how patients fit complex self-care into their daily lives. PMID:24672228

Ridgeway, Jennifer L; Egginton, Jason S; Tiedje, Kristina; Linzer, Mark; Boehm, Deborah; Poplau, Sara; de Oliveira, Djenane Ramalho; Odell, Laura; Montori, Victor M; Eton, David T



Treatment of Complex Fistula in Ano with Cable-Tie Seton: A Prospective Case Series  

PubMed Central

Objective. To determine the fecal incontinence and recurrence rate in patients with complex fistula in ano managed with cable tie seton at a tertiary care teaching hospital. Methods. This is a prospective case series of patients with complex anal fistula i.e. recurrent fistula or encircling >30% of external anal sphincter, managed with cable tie seton from March 2003 to March 2009. Patients were seen in the clinic after 72 hours of seton insertion under anesthesia and then every other week. Each time the cable-tie was tightened if found loose without anesthesia and incontinence was inquired according to wexner's score. Results. Seventy nine patients were treated during the study period with the age (mean ± standard deviation) of 41 ± 10.6 years and. The seton was tightened with a median of six times (3–15 times range). Complete healing was achieved in 11.2 ± 5.7 weeks. All the patients were followed for a minimum period of one year and none of the patients had any incontinence. Recurrence was found in 4 (5%) patients. Conclusion. The cable tie seton is safe, cost effective and low morbidity option for the treatment of complex fistulae-in-ano. It can, therefore, be recommended as the standard of treatment for complex fistulae-in-ano requiring the placement of a seton. PMID:22084768

Memon, Ayaz Ahmad; Murtaza, Ghulam; Azami, Rizwan; Zafar, Hasnain; Chawla, Tabish; Laghari, Altaf Ali



The operative treatment of complex pilon fractures: A strategy of soft tissue control  

PubMed Central

Background: Pilon fractures are challenging to manage because of the complexity of the injury pattern and the risk of significant complications. The soft tissue injury and handling of the soft tissue envelope are crucial in pilon fracture outcomes. The purpose of this study was to evaluate the early rate of complications using the strategy of “soft tissue control” for operative treatment of complex pilon fractures. Materials and Methods: 36 complex pilon fractures were treated with the “soft tissue control” strategy. Patients followed the standard staged protocol, anterolateral approach to the distal tibia, the “no-touch” technique and incisional negative pressure wound therapy for pilon fractures. Patients were examined clinically at 2-3 weeks and then 8 weeks for complications associated with the surgical technique. Results: All fractures were AO/OTA (Orthopaedic Trauma Association) type C fractures (61% C3, 22% C2 and 16% C1). Only one patient developed superficial infection and resolved with antibiotics and local wound care. None developed deep infection. Conclusions: The strategy of soft tissue control for treatment of pilon fractures resulted in relatively low incidence of early wound complications in patients with complex pilon fractures. PMID:24133309

He, Xianfeng; Hu, Yong; Ye, Penghan; Huang, Lei; Zhang, Feng; Ruan, Yongping



Pulsed radiofrequency treatment of complex regional pain syndrome: A case series  

PubMed Central

BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy) have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS). Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF) has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS. METHODS: The present report describes three cases in which patients diagnosed with lower extremity CRPS type I obtained substantial and lasting intervals of pain relief following PRF of the lumbar sympathetic chain. Over a period of four years, 14 fluoroscopically guided procedures using PRF lesioning of the lumbar sympathetic chain at L2, L3 and L4 were performed in three individuals with CRPS type I of the lower limb. Outcome measures included pre- and post-treatment self-reported pain and medication requirements. RESULTS: Substantial pain relief (>50%) was achieved in 91.7% of PRF applications at three months and 83.3% at six months, with some treatments resulting in persistent relief well beyond 12 months. Medication use decreased to a comparable degree, with discontinuation of opiates after all but three treatments. CONCLUSIONS: PRF lesioning of the lumbar sympathetic chain can be an effective treatment for patients with CRPS type I of the lower extremity, with the potential to provide ?6 months of substantial pain relief. PMID:24945285

Djuric, Vlad



Emerging treatments for complex perianal fistula in Crohn’s disease  

PubMed Central

Complex perianal fistulas have a negative impact on the quality of life of sufferers and should be treated. Correct diagnosis, characterization and classification of the fistulas are essential to optimize treatment. Nevertheless, in the case of patients whose fistulas are associated with Crohn’s disease, complete closure is particularly difficult to achieve. Systemic medical treatments (antibiotics, thiopurines and other immunomodulatory agents, and, more recently, anti-tumor necrosis factor-? agents such as infliximab) have been tried with varying degrees of success. Combined medical (including infliximab) and less aggressive surgical therapy (drainage and seton placement) offer the best outcomes in complex Crohn’s fistulas while more aggressive surgical procedures such as fistulotomy or fistulectomy may increase the risk of incontinence. This review will focus on emerging novel treatments for perianal disease in Crohn’s patients. These include locally applied infliximab or tacrolimus, fistula plugs, instillation of fibrin glue and the use of adult expanded adipose-derived stem cell injection. More well-designed controlled studies are required to confirm the effectiveness of these emerging treatments. PMID:19750568

Taxonera, Carlos; Schwartz, David A; García-Olmo, Damián



Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study  

PubMed Central

Background In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis. Results We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusions Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients. PMID:24224077

Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; Veltman, Dick J.; Hoogendoorn, Adriaan W.; van Balkom, Anton J. L. M.; Draijer, Nel



Cutting through the Complexities of mTOR for the Treatment of Stroke  

PubMed Central

On a global basis, at least 15 million individuals suffer some form of a stroke every year. Of these individuals, approximately 800,000 of these cerebrovascular events occur in the United States (US) alone. The incidence of stroke in the US has declined from the third leading cause of death to the fourth, a result that can be attributed to multiple factors that include improved vascular disease management, reduced tobacco use, and more rapid time to treatment in patients that are clinically appropriate to receive recombinant tissue plasminogen activator. However, treatment strategies for the majority of stroke patients are extremely limited and represent a critical void for care. A number of new therapeutic considerations for stroke are under consideration, but it is the mammalian target of rapamycin (mTOR) that is receiving intense focus as a potential new target for cerebrovascular disease. As part of the phosphoinositide 3-kinase (PI 3-K) and protein kinase B (Akt) cascade, mTOR is an essential component of mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2) to govern cell death involving apoptosis, autophagy, and necroptosis, cellular metabolism, and gene transcription. Vital for the consideration of new therapeutic strategies for stroke is the ability to understand how the intricate and complex pathways of mTOR signaling sometimes lead to disparate clinical outcomes. PMID:24712647

Maiese, Kenneth



Value and limitations of adenosine in the diagnosis and treatment of narrow and broad complex tachycardias.  


The diagnostic and therapeutic potential of intravenous adenosine was studied in 64 patients during 92 episodes of regular sustained tachycardia. In 40 patients who had narrow complex tachycardias (QRS less than 0.12 s) adenosine (2.5-25 mg) restored sinus rhythm in 25 with junctional tachycardias (46 of 48 episodes) and produced atrioventricular block to reveal atrial or sinus tachycardia in 15. In 24 patients with broad complex tachycardias (QRS greater than or equal to 0.12 s) adenosine terminated the tachycardias in six patients and revealed atrial or sinus arrhythmias in four. The tachycardias persisted in 14 patients despite doses up to 20 mg, but adenosine allowed the diagnosis of ventricular tachycardia with retrograde atrial activation in two patients by producing transient ventriculoatrial dissociation. Diagnosis based on adenosine induced atrioventricular nodal block was correct in all patients with narrow complex tachycardias and in 92% of those with broad complex tachycardias, compared with correct electrocardiographic diagnoses in 90% and 75% respectively. Adenosine gave diagnostic information additional to the electrocardiogram in 25%. The response to adenosine in broad complex tachycardias identified those of supraventricular origin with 90% sensitivity, 93% specificity, and 92% predictive accuracy. Adenosine restored sinus rhythm in all patients with junctional reentrant tachycardias, but in 10 (35%) the arrhythmias recurred within two minutes. Symptomatic side effects (dyspnoea, chest pain, flushing, headache) were reported by 40 (63%) patients and, although transient, were severe in 23 (36%). There were ventricular pauses of over 2 s in 16% of patients, the longest pause being 6.1 s. Adenosine is of value in the diagnosis and treatment of narrow and broad complex tachycardias, but its use is limited by symptomatic side effects, a tenfold range in minimal effective dosage, occasional action at sites other than the atrioventricular node, and early recurrence or arrhythmia. PMID:2789911

Rankin, A C; Oldroyd, K G; Chong, E; Rae, A P; Cobbe, S M



Ferrous sulfate versus iron polymaltose complex for treatment of iron deficiency anemia in children.  


We assessed the clinical response and side effects of Ferrous sulfate (FS) and Iron polymaltose complex (IPC) in 118 children with Iron deficiency anemia (IDA). Subjects were randomized to receive therapy with either oral IPC (Group A, n=59) or oral FS (Group B, n=59); all were given elemental iron in three divided doses of 6 mg/kg/day. One hundred and six children could be followed up; 53 in each group. Children who received ferrous sulfate were having higher hemoglobin level, and less residual complaints as compared to those who had received iron polymaltose complex. Our study suggests ferrous sulfate has a better clinical response and less significant adverse effects during treatment of IDA in children. PMID:19430060

Bopche, Ankur Vikas; Dwivedi, Rashmi; Mishra, Rakesh; Patel, G S



Treatment of the Atrophic Upper Jaw: Rehabilitation of Two Complex Cases  

PubMed Central

In reconstructive surgery, the fresh frozen homologous bone (FFB) represents a valid alternative to the autologous bone, because FFB allows bone regeneration thanks to its osteoinductive and osteoconductive properties. The purpose of this work is to describe the surgical-implant-prosthetic treatment of two complex cases using FFB. In particular, fresh frozen homologous bone grafts were used to correct the severe atrophy of the maxilla, and, then, once the graft integration was obtained, implant therapy was performed and implants placed in native bone were immediately loaded. PMID:23984108

Borgonovo, Andrea Enrico; Marchetti, Andrea; Vavassori, Virna; Censi, Rachele; Boninsegna, Ramon



Treatment of Complex Regional Pain Syndrome (CRPS) using low dose naltrexone (LDN).  


Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome, which involves glial activation and central sensitization in the central nervous system. Here, we describe positive outcomes of two CRPS patients, after they were treated with low-dose naltrexone (a glial attenuator), in combination with other CRPS therapies. Prominent CRPS symptoms remitted in these two patients, including dystonic spasms and fixed dystonia (respectively), following treatment with low-dose naltrexone (LDN). LDN, which is known to antagonize the Toll-like Receptor 4 pathway and attenuate activated microglia, was utilized in these patients after conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms. PMID:23546884

Chopra, Pradeep; Cooper, Mark S



[Efficiency of groprinosine in the complex treatment of acute virus hepatitis B].  


35 patients with acute virus hepatitis of average severity were examined. They developed after short-term improvement of general state a negative dynamics of clinical and laboratory indexes. 21 patients have received traditional treatment, 14 patients additionally were prescribed groprinosine in a dose of 50 mg/kg daily per/os within 5-10 days. It was shown, that addition of gropfmosme to complex therapy positively influenced on the disease's course, promoted a rapid regress of clinical symptoms, normalization of biochemical indexes of liver's functions and decreased days of hospitalization. PMID:15724621

Karimov, I Z



Innovative processing and hydrometallurgical treatment methods for complex antimony ores and concentrates. Part I  

Microsoft Academic Search

The largest Russian antimony ore deposits are reviewed analytically. The present-day physicochemical methods (nuclear quadrupole\\u000a resonance, X-ray electron spectroscopy, multinuclear (13C, 15N, 31P) NMR) are used to develop innovative technologies. The innovative process for treatment of Au-Sbores of the Sarylakhsky\\u000a and Sentachansky deposits is described. Selective agents for antimonite flotation from complex Au-Sb-ores are considered.\\u000a Sodium dimethyldithiocarbamate performance in antimony

P. M. Solozhenkin; A. N. Alekseev



Staged Mucosal Advancement Flap versus Staged Fibrin Sealant in the Treatment of Complex Perianal Fistulas  

PubMed Central

Background. In this prospective randomised study, the staged mucosal advancement flap is compared with staged fibrin sealant application in the treatment of perianal fistulas. Methods. All patients with high complex cryptoglandular fistulas were randomised to closure of the internal opening by a mucosal advancement flap (MF) or injection with fibrin sealant (FS) after treatment with setons. Recurrence rate and incontinence disorders were explored. Results. The MF group (5 females and 10 males) with a median age of 51 years and a median followup of 52 months. The FS group (4 females and 11 males) with a median age of 45 years and a median followup of 49 months. Three (20%) patients of the MF group had a recurrent fistula compared to 9 (60%) of the FS group (P = 0.03). No new continence disorders developed. Conclusion. Staged FS injection has a much lower success rate compared to MF. PMID:21808642

van der Hagen, S. J.; Baeten, C. G.; Soeters, P. B.; van Gemert, W. G.



Increasing complexity: which drug class to choose for treatment of hypertension in the elderly?  

PubMed Central

Treatment of hypertension in the elderly is expected to become more complex in the coming decades. Based on the current landscape of clinical trials, guideline recommendations remain inconclusive. The present review discusses the latest evidence derived from studies available in 2013 and investigates optimal blood pressure (BP) and preferred treatment substances. Three common archetypes are discussed that hamper the treatment of hypertension in the very elderly. In addition, this paper presents the current recommendations of the NICE 2011, JNC7 2013-update, ESH/ESC 2013, CHEP 2013, JNC8 and ASH/ISH guidelines for elderly patients. Advantages of the six main substance classes, namely diuretics, beta-blockers (BBs), calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and direct renin inhibitors (DRIs) are discussed. Medical and economic implications of drug administration in the very elderly are presented. Avoidance of treatment-related adverse effects has become increasingly relevant. Current substance classes are equally effective, with similar effects on cardiovascular outcomes. Selection of substances should therefore also be based on collateral advantages of drugs that extend beyond BP reduction. The combination of ACEIs and diuretics appears to be favorable in managing systolic/diastolic hypertension. Diuretics are a preferred and cheap combination drug, and the combination with CCBs is recommended for patients with isolated systolic hypertension. ACEIs and CCBs are favorable for patients with dementia, while CCBs and ARBs imply substantial cost savings due to high adherence. PMID:24711696

Kaiser, Edelgard Anna; Lotze, Ulrich; Schäfer, Hans Hendrik



[Complex treatment of a large radicular cyst due to traumatic dental injury--a case report].  


A 28-year-old male came to the clinic for control visit and scaling. Panoramic radiograph was taken before any treatment. The radiograph revealed a large size periapical lesion extending from the lower right first premolar to the lower left canine. History of dental trauma in childhood was recorded. The asymptomatic, injured teeth were not treated by dentist. Upon clinical examination a discolored lower right central incisor and more teeth with pulpal necrosis were found. After the endodontic treatments a cystostomy was performed. Obturator was used by the patient in the healing period. The success of complex treatment is proven by the highly recovered bone forming shown during the regular recalls. For the correct diagnosis and planning of the complete treatment dentist should be careful on general- and dental anamnesis and complete clinical and radiographic examination. Small clinical signs and pathoses should alert the dentist. This case is a reminder that the careful anamnesis, clinical examination and early diagnosis of any pathosis are very important. PMID:24812750

Demeter, Andrea; Bogdán, Sándor; Tóth, Zsuzsanna; Nemes, Júlia



Limb salvage treatment for Gollop-Wolfgang complex (femoral bifurcation, complete tibial hemimelia, and hand ectrodactyly).  


We reported the findings from three patients with Gollop-Wolfgang complex and demonstrated the results of five limb salvage treatments for this condition. All three femoral bifurcations were accompanied by ipsilateral complete tibial hemimelia. Two patients showed contralateral complete or partial tibial hemimelia, and one patient had hand ectrodactyly. The five limb salvage treatments included resection of the anteromedial bifurcated femur in three limbs, foot centralization in five limbs, tibiofibular fusion in one limb with partial tibial hemimelia, fibular transfer (Brown's procedure) in three limbs with complete tibial hemimelia, and callus distraction lengthening in one limb. The duration from the first operation to the final follow-up ranged from 3.5 to 5.4 years. None of the three knees treated by fibular transfer achieved a successful functional result, but all of the knees were ultimately able to withstand weight bearing. Early knee disarticulation and resection of the protruded bifurcated femur, followed by fitting of a modern prosthesis is likely to be the best treatment for patients with Gollop-Wolfgang syndrome. We note that limb salvage treatment is an alternative in patients who opt to retain their feet and refuse amputation. PMID:23660549

Wada, Akifusa; Nakamura, Tomoyuki; Fujii, Toshio; Urano, Noriko; Yanagida, Haruhisa; Takamura, Kazuyuki; Taketa, Mayuki; Oketani, Yutaka; Kubota, Hideaki



Minimization of round-off error and treatment of single phase and separated components in conventional and complex columns  

E-print Network

MINIMIZATION OF ROUND-OFF ERROR AND TREATMENT OF SINGLE PHASE AND SEPARATED COMPONENTS IN CONVENTIONAL AND COMPLEX COLUMNS A Thesis By Andrew Jacobs Weisenfelder Submitted to the Graduate School of the Agricultural and Mechanical College... of Texas in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE May 1961 MaJor SubJect: Chemical Engineering MINIMIZATION OF ROUND-OFF ERROR AND TREATMENT OF SINGLE PHASE AND SEPARATED COMPONENTS IN CONVENTIONAL AND COMPLEX...

Weisenfelder, Andrew J



Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review  

PubMed Central

Introduction Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown. Method A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results Only six studies with one or more cognitive behavior therapy (CBT) treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results. PMID:25563302

Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.



Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study  

ERIC Educational Resources Information Center

Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel



Effect of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder in children  

PubMed Central

We investigated the effects of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder (ADHD) in children. Forty-seven male children (7–13 yr old), who were clinically diagnosed with ADHD at the Balance Brain Center in Seoul, Korea, were included in this study. The complex treatment consisted of visual and auditory stimuli, core muscle exercise, targeting ball exercise, ocular motor exercise, and visual motor integration. All subjects completed the complex treatment for 60 min/day, 2–3 times/week for more than 12 weeks. Data regarding visual and auditory reaction time and cognitive function were obtained using the Neurosync program, Stroop Color-Word Test, and test of nonverbal intelligence (TONI) at pre- and post-treatment. The complex treatment significantly decreased the total reaction time, while it increased the number of combo actions on visual and auditory stimuli (P< 0.05). The Stroop color, word, and color-word scores were significantly increased at post-treatment compared to the scores at pretreatment (P< 0.05). There was no significant change in the TONI scores, although a tendency toward an increase in these scores was observed. In conclusion, complex treatment using visual and auditory stimuli alleviated the symptoms of ADHD and improved cognitive function in children. In addition, visual and auditory function might be possible indicators for demonstrating effective ADHD intervention. PMID:24278878

Park, Mi-Sook; Byun, Ki-Won; Park, Yong-Kyung; Kim, Mi-Han; Jung, Sung-Hwa; Kim, Hong



Enhancement of Auditory Fear Conditioning after Housing in a Complex Environment Is Attenuated by Prior Treatment with Amphetamine  

ERIC Educational Resources Information Center

Prior exposure to drugs of abuse has been shown to occlude the structural plasticity associated with living in a complex environment. Amphetamine treatment may also occlude some cognitive advantages normally associated with living in a complex environment. To test this hypothesis we examined the influence of prior exposure to amphetamine on fear…

Briand, Lisa A.; Robinson, Terry E.; Maren, Stephen



Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator  

E-print Network

#12;Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue 75 751 4646; E-mail: Short title: Ultrasound-responsive t-PA nano complexes Key words: t-PA, thrombolytic therapy, gelatin, metal ions, ultrasound #12;1 ABSTRACT This study

Takada, Shoji


Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology  

PubMed Central

Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation. PMID:25684970

Zhou, Chuan-Guo; Wei, Bao-Jie; Gao, Kun; Dai, Ding-Ke; Zhai, Ren-You



THE JOURNAL OF CHEMICAL PHYSICS 135, 094304 (2011) "Adiabatic-hindered-rotor" treatment of the parahydrogen-water complex  

E-print Network

THE JOURNAL OF CHEMICAL PHYSICS 135, 094304 (2011) "Adiabatic-hindered-rotor" treatment of the parahydrogen-water complex Tao Zeng,1 Hui Li,2 Robert J. Le Roy,1 and Pierre-Nicholas Roy1,a) 1 Department 1 September 2011) Inspired by a recent successful adiabatic-hindered-rotor treatment

Le Roy, Robert J.


Study of edema reduction patterns during the treatment phase of complex decongestive physiotherapy for extremity lymphedema.  


Shortening the treatment phase of complex decongestive physiotherapy (CDP) is extremely important both for individual patients and medical economics. In 83 patients with stage II unilateral secondary extremity lymphedema (31 upper extremities and 52 lower extremities), the daily changes in the volume of affected extremities during the treatment phase of CDP were prospectively investigated. For the upper extremity lymphedemas, the biggest change was seen between days 1 (100% residual edema rate) and 2 (46.0 +/- 2.7%; mean +/- SD) of therapy with a 54.0% reduction (p < 0.0001). Between days 2 and 3 (38.0 +/- 2.6%) of therapy, there was an 8.0% reduction (p < 0.05). From days 3 to 6 of therapy, slight changes ranging from 0.2 to 3.2%/day were seen. For the lower extremity lymphedemas, the biggest change was seen between days 1 (100%) and 2 (44.5 +/- 2.1%) of therapy with a 55.5% reduction (p < 0.0001). Between days 2 and 3 (33.5 +/- 2.6%) of therapy, there was an 11.0% reduction (p < 0.001). The daily volume changes from days 4 to 6 were slight, ranging from 0.1 to 1.0%/day. During the treatment phase of CDP, the largest volume changes were seen soon after the start of therapy. PMID:18720915

Yamamoto, T; Todo, Y; Kaneuchi, M; Handa, Y; Watanabe, K; Yamamoto, R



Bee Venom Pharmacopuncture: An Effective Treatment for Complex Regional Pain Syndrome  

PubMed Central

Objectives: Treating complex regional pain syndrome (CRPS) is difficult because it still does not have a recommended therapy. A 29-year-old man was diagnosed with CRPS after surgery on his 4th and 5th left toes 7 years ago. Though he had undergone diverse pain treatment, the symptoms persisted, so he visited Dunsan Korean Medicine Hospital of Daejeon University. This case report presents results on the effect of bee venom pharmacopuncture in treating patient with CRPS. Methods: Bee venom pharmacopuncture (BVP), 0.15 to 0.4 mL dosage, was administered at GB43. The treatment was applied each week for a total 14 times. The symptoms were evaluated using a numeric rating scale (NRS) and the dosage of pain medicine. Results: On the first visit, he was taking an anticonvulsant, a trycyclic antidepressant, and an analgesic. On the NRS the worst pain in the toes received a score of 8. He also complained of severe pain and hypersensitivity when the 4th and the 5th toes were touched just slightly. Other complaint included dyspepsia, rash, and depression. After treatment, on the NRS, the score for toe pain was 0, and he no longer needed to take pain medication. During the 4-months follow-up period, he has remained without pain; neither have additional symptoms appeared nor adverse events occurred. Conclusion: BVP may have potential benefits for treating patients with CRPS. PMID:25780722

Kim, Jong-Min; Jeon, Hyung-Joon; Kim, Hyun-Ji; Cho, Chong-Kwan; Yoo, Hwa-Seung



Treatment of computer addicts with complex co-morbid psychiatric disorders.  


Computer technology is expanding at an exponential rate, and its effect on society and individuals is being observed in many locations and by many professionals. Computer-addictive behavior is characterized by excessive and inappropriate use of the computer that has repercussions on an individual's real life obligations and relationships. Currently, these unanticipated consequences have been variously classified as computer addiction, Internet addiction disorder, problematic internet use, pathological internet use, and as a new symptom to be added to other psychiatric conditions. Mounting evidence indicates that those who are vulnerable to these problems suffer from multiple co-morbid psychiatric disorders. The problem is further complicated because computer usage is so pervasive in our society that the aim of treatment cannot be abstinence. It must be treated as an eating disorder where the goal is to normalize computer activities in order to survive. Assessment of each patient consists of the measurement of problematic computer behavior and definition of the expectations they have for the effects of these activities. Because of the complexity of these patients' problems, treatment needs to be multidisciplinary and include cognitive behavior therapy, psychotropic medication, family therapy, and case managers. Teamwork is emphasized. Also, regular assessments at 3-month intervals are important both for the patient and the team. The aim of the treatment is to help the patient manage the inappropriate behavior and still be able to use the technology. PMID:19178219

Orzack, M H; Orzack, D S



A 10-year analysis of the "Amsterdam" protocol in the treatment of zygomatic complex fractures.  


Despite many publications on the epidemiology, incidence and aetiology of zygomatic complex (ZC) fractures there is still a lack of information about a consensus in its treatment. The aim of the present study is to investigate retrospectively the Amsterdam protocol for surgical treatment of ZC fractures. The 10 years results and complications are presented. The study population consisted of 236 patients (170 males, 66 females, 210 ZC fractures, 26 solitary zygomatic arch fractures) with a mean age of 39.3 (SD: ±15.6) years (range 4-87 years). The mean cause of injury was traffic accident followed by violence and fall. A total of 225 plates and 943 screws were used. Twenty-eight patients presented with complications, including wound infection (9 patients) and transient paralysis of the facial nerve (one patient). Seven patients (2.8%) needed surgical retreatment of whom four patients needed secondary orbital floor reconstruction as these patients developed enophthalmos and diplopia. In conclusion this report provides important data for reaching a consensus for the treatment of these types of fractures. PMID:23375533

Forouzanfar, Tymour; Salentijn, Erik; Peng, Gina; van den Bergh, Bart



Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions  

PubMed Central

Purpose The workload of health care and its impact on patient functioning and well-being is known as treatment burden. The purpose of this study was to finalize a conceptual framework of treatment burden that will be used to inform a new patient-reported measure of this construct. Patients and methods Semi-structured interviews were conducted with 50 chronically ill patients from a large academic medical center (n=32) and an urban safety-net hospital (n=18). We coded themes identifying treatment burden, with the themes harmonized through discussion between multiple coders. Four focus groups, each with five to eight participants with chronic illness, were subsequently held to confirm the thematic structure that emerged from the interviews. Results Most interviewed patients (98%) were coping with multiple chronic conditions. A preliminary conceptual framework using data from the first 32 interviews was evaluated and was modified using narrative data from 18 additional interviews with a racially and socioeconomically diverse sample of patients. The final framework features three overarching themes with associated subthemes. These themes included: 1) work patients must do to care for their health (eg, taking medications, keeping medical appointments, monitoring health); 2) challenges/stressors that exacerbate perceived burden (eg, financial, interpersonal, provider obstacles); and 3) impacts of burden (eg, role limitations, mental exhaustion). All themes and subthemes were subsequently confirmed in focus groups. Conclusion The final conceptual framework can be used as a foundation for building a patient self-report measure to systematically study treatment burden for research and analytical purposes, as well as to promote meaningful clinic-based dialogue between patients and providers about the challenges inherent in maintaining complex self-management of health. PMID:25848328

Eton, David T; Ridgeway, Jennifer L; Egginton, Jason S; Tiedje, Kristina; Linzer, Mark; Boehm, Deborah H; Poplau, Sara; Ramalho de Oliveira, Djenane; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T



Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma  

PubMed Central

Narrative exposure therapy (NET) is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD) as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011). An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the lifeline is laid. The lifeline is made up of a rope, with flowers (happy events), stones (traumatic events), sometimes candles (grief), or recently also sticks for aggressive acts (NET for offenders; see Stenmark, Cuneyt Guzey, Elbert, & Holen, 2014). These symbols are laid down along the rope, in chronological order. Subsequently, in the subsequent therapy sessions the lifeline is processed in chronological order, giving attention to all the important events a person has experienced in his or her life, both the adverse as well as the pleasurable ones. The narration ends with a written testimony. To date, there is good evidence NET is effective in the treatment of PTSD patients, with support from 18 RCTs (N=950). For culturally diverse populations, NET is recommended as the most evidence-based trauma treatment, besides culturally adapted CBT. NET has been investigated in different populations in Africa, Europe, and Asia. In Asia, research has been carried out in Sri Lanka as well as in China. In China, NET was conducted and investigated with survivors of the Sichuan earthquake (Zang, Hunt, & Cox, 2013, 2014). NET is understandable, even appealing and also supportive for patients with multiple trauma. In this presentation, the treatment principles and the practice of NET will be explained. PMID:25511727

Jongedijk, Ruud A.



Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma.  


Narrative exposure therapy (NET) is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD) as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011). An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the lifeline is laid. The lifeline is made up of a rope, with flowers (happy events), stones (traumatic events), sometimes candles (grief), or recently also sticks for aggressive acts (NET for offenders; see Stenmark, Cuneyt Guzey, Elbert, & Holen, 2014). These symbols are laid down along the rope, in chronological order. Subsequently, in the subsequent therapy sessions the lifeline is processed in chronological order, giving attention to all the important events a person has experienced in his or her life, both the adverse as well as the pleasurable ones. The narration ends with a written testimony. To date, there is good evidence NET is effective in the treatment of PTSD patients, with support from 18 RCTs (N=950). For culturally diverse populations, NET is recommended as the most evidence-based trauma treatment, besides culturally adapted CBT. NET has been investigated in different populations in Africa, Europe, and Asia. In Asia, research has been carried out in Sri Lanka as well as in China. In China, NET was conducted and investigated with survivors of the Sichuan earthquake (Zang, Hunt, & Cox, 2013, 2014). NET is understandable, even appealing and also supportive for patients with multiple trauma. In this presentation, the treatment principles and the practice of NET will be explained. PMID:25511727

Jongedijk, Ruud A



Endovascular treatment of complex dural arteriovenous fistula using the dual-microcatheter technique.  


A 71-year-old woman presented with headache and dilated vessels on CTA. Angiography demonstrated a complex dural arteriovenous fistula with retrograde cortical venous hypertension, supplied by branches of internal and external carotids bilaterally into a fistulous pouch paralleling the left transverse and sigmoid sinuses, which was occluded at the jugular bulb. The patient refused treatment and was lost to follow-up, returning with sudden confusion and hemianopsia from left temporo-occipital hemorrhage. Transvenous endovascular embolization was performed using the dual-microcatheter technique with a combination of coiling and Onyx copolymer, completely occluding the sinus and fistula while preserving normal venous drainage. The video can be found here: . PMID:24983721

Levitt, Michael R; Osbun, Joshua W; Nerva, John D; Kim, Louis J



Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy  

PubMed Central

Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

Ivanenko, Anna



Complex diagnostic and treatment issues in psychotic symptoms associated with narcolepsy.  


Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

Moturi, Sricharan; Ivanenko, Anna



Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis  

PubMed Central

A cohort of family members with various chronic diseases including Crohn’s disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. PMID:25852293

Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas



Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis.  


A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. PMID:25852293

Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas



The use of TPA in combination with alcohol in the treatment of the recurrent complex hydrocele  

PubMed Central

A hydrocele is an abnormal collection of serous fluid in the space between the parietal and visceral layers of the tunica vaginalis. Hydrocele is the most common cause of painless scrotal swelling which affects about 1% of men. Generally, adult hydroceles are idiopathic in origin; however, inguinal surgery, varicocelectomy, infection, trauma and a patent processus vaginalis are each associated with the subsequent development of a hydrocele. Surgical removal of hydroceles is the gold standard of care. However, multiple cases have reported high success rates (ranging from 85% to 96%) using a combination of aspiration and sclerotherapy. We present a case of a patient with recurring complex hydrocele and effective treatment utilizing a combination of thrombolytic therapy, catheter drainage and subsequent alcohol ablation. PMID:25024803

Metcalfe, Michael J.; Spouge, Rebecca J.; Spouge, David J.; Hoag, Chris C.



Interval hypoxic training in complex treatment of Helicobacter pylori-associated peptic ulcer disease.  


This study was aimed to demonstrate the efficacy of interval hypoxic training (IHT) in complex treatment of Helicobacter pylori-associated duodenal peptic ulcer disease (DPUD) by parameters of aerobic metabolism and indexes of heart rate variability (HRV). Eighty patients with H. pylori-associated DPUD were included into the study, mean age 32+/-1.8 yrs, duration of the disease up to 10 years (66.3 %). IHT was modulated using Frolov's hypoxicator (TDI-01) for 30 days after standard eradication therapy. Daily hypoxic sessions consisted of three one-minute sessions, one two-minute, and one three-minute sessions separated by one-minute intervals of room-air breathing. Use of IHT resulted in more efficient elimination of clinical symptoms, histological hallmarks of inflammation and signs of oxidative stress in glandulocytes of the gastric mucosa as determined by 4-hydroxynonenal accumulation. Moderate prooxidant activity of IHT was demonstrated by the increased level of TBARS and oxidatively modified products, normalization of hydroperoxides, middle mass molecules and atherogenic beta-lipoproteins with simultaneous increase in catalase activity and mild decline of SOD activity. Therefore, IHT appeared to be accompanied by higher intensity of redox reactions and enhanced regeneratory processes in cells and tissues. Significant increase in HRV was also noted. Such changes were associated with reduction of inflammation signs and modulation of the autonomic homeostasis in DPUD patients. In general, use of IHT in complex treatment of H. pylori in DPUD patients can be recommended to increase resistance to oxidative stress and to modulate autonomic balance and oxidative homeostasis. PMID:20532252

Semen, Khrysyna O; Yelisyeyeva, Olha P; Kaminskyy, Danylo V; Cherkas, Andriy P; Zarkovic, Kamelija; Lutsyk, O; Cipak, Ana; Jaganjac, Morana; Zarkovic, Neven



Coupled variable selection for regression modeling of complex treatment patterns in a clinical cancer registry.  


For determining a manageable set of covariates potentially influential with respect to a time-to-event endpoint, Cox proportional hazards models can be combined with variable selection techniques, such as stepwise forward selection or backward elimination based on p-values, or regularized regression techniques such as component-wise boosting. Cox regression models have also been adapted for dealing with more complex event patterns, for example, for competing risks settings with separate, cause-specific hazard models for each event type, or for determining the prognostic effect pattern of a variable over different landmark times, with one conditional survival model for each landmark. Motivated by a clinical cancer registry application, where complex event patterns have to be dealt with and variable selection is needed at the same time, we propose a general approach for linking variable selection between several Cox models. Specifically, we combine score statistics for each covariate across models by Fisher's method as a basis for variable selection. This principle is implemented for a stepwise forward selection approach as well as for a regularized regression technique. In an application to data from hepatocellular carcinoma patients, the coupled stepwise approach is seen to facilitate joint interpretation of the different cause-specific Cox models. In conditional survival models at landmark times, which address updates of prediction as time progresses and both treatment and other potential explanatory variables may change, the coupled regularized regression approach identifies potentially important, stably selected covariates together with their effect time pattern, despite having only a small number of events. These results highlight the promise of the proposed approach for coupling variable selection between Cox models, which is particularly relevant for modeling for clinical cancer registries with their complex event patterns. PMID:25345575

Schmidtmann, I; Elsäßer, A; Weinmann, A; Binder, H



Treatment with at Homeopathic Complex Medication Modulates Mononuclear Bone Marrow Cell Differentiation  

PubMed Central

A homeopathic complex medication (HCM), with immunomodulatory properties, is recommended for patients with depressed immune systems. Previous studies demonstrated that the medication induces an increase in leukocyte number. The bone marrow microenvironment is composed of growth factors, stromal cells, an extracellular matrix and progenitor cells that differentiate into mature blood cells. Mice were our biological model used in this research. We now report in vivo immunophenotyping of total bone marrow cells and ex vivo effects of the medication on mononuclear cell differentiation at different times. Cells were examined by light microscopy and cytokine levels were measured in vitro. After in vivo treatment with HCM, a pool of cells from the new marrow microenvironment was analyzed by flow cytometry to detect any trend in cell alteration. The results showed decreases, mainly, in CD11b and TER-119 markers compared with controls. Mononuclear cells were used to analyze the effects of ex vivo HCM treatment and the number of cells showing ring nuclei, niche cells and activated macrophages increased in culture, even in the absence of macrophage colony-stimulating factor. Cytokines favoring stromal cell survival and differentiation in culture were induced in vitro. Thus, we observe that HCM is immunomodulatory, either alone or in association with other products. PMID:19736221

Cesar, Beatriz; Abud, Ana Paula R.; de Oliveira, Carolina C.; Cardoso, Francolino; Bernardi, Raffaello Popa Di; Guimarães, Fernando S. F.; Gabardo, Juarez; de Freitas Buchi, Dorly



Tailoring fly ash activated with bentonite as adsorbent for complex wastewater treatment  

NASA Astrophysics Data System (ADS)

Used as adsorbent, alkali fly ash represents a low cost solution for advanced wastewater treatment. The alkali treatment raises sustainability issues therefore, in this research we aim to replace alkali fly ash with washed fly ash (FAw). For improving the adsorption capacity of washed fly ash, bentonite powder (B) was added, as a natural adsorbent with a composition almost identical to the fly ash. The new adsorbent was characterized by AFM, XRD, FTIR, SEM, EDS and the surface energy was evaluated by contact angle measurements. For understanding the complex adsorption process on this mixed substrate, preliminary tests were developed on synthetic wastewaters containing a single pollutant system (heavy metal), binary (two-heavy metals) and ternary (dye and two heavy metals) systems. Experiments were done on synthetic wastewaters containing methylene blue, cadmium and copper, using FAw, B and their powder mixtures. The pseudo-second order kinetics could well model all the processes, indicating a good adsorbent material which can be used for the pollutants removal from wastewater. After adsorption the substrates loaded with pollutants, annealed at 500 °C can be reused for padding in stone blocks.

Visa, Maria



Behavioural and EEG effects of chronic rapamycin treatment in a mouse model of tuberous sclerosis complex.  


Tuberous Sclerosis Complex (TSC) is a multisystem genetic disorder caused by mutation in either Tsc1 or Tsc2 genes that leads to the hyper activation of the mTOR pathway, a key signalling pathway for synaptic plasticity. TSC is characterized by benign tumors arising in different organs and severe neuropsychiatric symptoms, such as epilepsy, intellectual disability, autism, anxiety and depressive behaviour. Rapamycin is a potent inhibitor of mTOR and its efficacy in treating epilepsy and neurological symptoms remains elusive. In a mouse model in which Tsc1 has been deleted in embryonic telencephalic neural stem cells, we analyzed anxiety- and depression-like behaviour by elevated-plus maze (EPM), open-field test (OFT), forced-swim test (FST) and tail-suspension test (TST), after chronic administration of rapamycin. In addition, spectral analysis of background EEG was performed. Rapamycin-treated mutant mice displayed a reduction in anxiety- and depression-like phenotype, as shown by the EPM/OFT and FST, respectively. These results were inline with EEG power spectra outcomes. The same effects of rapamycin were observed in wild-type mice. Notably, in heterozygous animals we did not observe any EEG and/or behavioural variation after rapamycin treatment. Together these results suggest that both TSC1 deletion and chronic rapamycin treatment might have a role in modulating behaviour and brain activity, and point out to the potential usefulness of background EEG analysis in tracking brain dysfunction in parallel with behavioural testing. PMID:23159330

Cambiaghi, Marco; Cursi, Marco; Magri, Laura; Castoldi, Valerio; Comi, Giancarlo; Minicucci, Fabio; Galli, Rossella; Leocani, Letizia



[Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].  


The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders. PMID:19145827

Tkachov, A V



Treatment of Atopic Dermatitis with a Combination of Allergen-Specific Immunotherapy and a Histamine-Immunoglobulin Complex  

Microsoft Academic Search

Background: Allergic responses to common environmental agents are believed to be involved in the development of atopic dermatitis, but clinical usefulness of allergen-specific immunotherapy in the treatment of atopic dermatitis is controversial. We performed a pilot study to evaluate the clinical usefulness of combined treatment with allergen-specific immunotherapy and a histamine-immunoglobulin complex in patients with atopic dermatitis. Methods: Twenty patients

Dong-Ho Nahm; Eun So Lee; Han-Jung Park; Hyoun-Ah Kim; Gil-Soon Choi; Sook-Yeong Jeon



Erythrocytes: Better Tolerance of Iron Polymaltose Complex Compared with Ferrous Sulphate in the Treatment of Anaemia.  


BackgroundAbsolute iron deficiency, irrespective of aetiology, remains a major and worldwide cause of morbidity. After correction of the causative lesion, reconstitution of haemoglobin level and body iron stores is traditionally achieved with oral administration of ferrous salts. The latter have significant gastrointestinal tract side-effects that, in the short-term, may impair compliance. With protracted administration these products can cause lipid peroxidation which, in turn, may accelerate atherogenesis. An alternative formulation is an iron polymaltose complex where animal data supported a promoting effect of glycerophosphate. Setting and Trial Design This was a single-centre, open, randomised, multidose four treatment parallel group study. A standard dose of ferric polymaltose complex with two differing levels of glycerophosphate was compared with an equivalent amount of iron supplied as ferrous sulphate in anaemic volunteer blood donors. The endpoints were rate of haemoglobin rise and re-expansion of body iron stores reflected in blood ferritin concentration, as well as percentage saturation of transferrin. Secondary observations were changes in the proportion of hypochromic red cells during the course of treatment, erythropoietin levels and tolerability of the two formulations. Results Outcome in the rat model suggested that the utilisation of iron from polymaltose might be enhanced by glycerophosphate. However, in donors this difference was not evident and, accordingly, the data from the three polymaltose groups combined and compared to those receiving ferrous sulphate. The rate at which haemoglobin level improved, red cell indices returned to normal, and the number of hypochromic and microcytic red cells fell was not significantly different between the groups. Similarly the serum iron, percentage saturation of transferrin and red cell ferritin were comparable. In contrast the serum ferritin levels were higher for those receiving ferrous sulphate. Additionally, side-effects were significantly more frequently encountered with the latter preparation. Conclusion These data demonstrate that the addition of glycerophosphate, observed to be beneficial in rats, did not occur in humans. Secondly, in the blood donors, equivalent amounts of iron provided as the polymaltose, with or without glycerophosphate or ferrous sulphate, corrected haemoglobin concentration and morphologically abnormal erythropoiesis at comparable rates. Similarly iron stores are replenished to an equivalent extent as seen in the matching percentage saturation of transferrin and red cell ferritin levels. Interestingly, there is a discrepancy in the serum ferritin which is higher with the salt and this may reflect oxidative stress. Thirdly, corresponding efficacy can be achieved with better patient tolerance for the complex. Finally it is postulated that the iron polymaltose complex formulation more closely approximates the way in which enterocytes handle dietary iron and thus physiologic regulatory mechanisms would be expected to reciprocally slow down absorption as stores expand. Logically, therefore and, if confirmed, the latter finding suggests that this formulation may have a potential role in longer-term supplementation programmes. PMID:11399604

Jacobs, PETER; Wood, LUCILLE; Bird, ARTHUR R.



Heart Failure with a Normal Ejection Fraction: Treatments for a Complex Syndrome?  

PubMed Central

Opinion statement Heart failure with a normal ejection fraction (HFNEF) now comprises more than 50% of all patients with heart failure. As the population ages, HFNEF will continue to be a growing public health problem. Recent studies highlight the heterogeneity of this syndrome with regards to underlying pathophysiologic mechanisms. It has been recognized that multiple physiologic domains of cardiovascular function are abnormal in afflicted subjects resulting in a reduced reserve capacity which contributes in an integrated fashion to produce the observed phenotype. Additionally, the realization that differing aspects of this syndrome (e.g. exercise limitations, pulmonary edema and labile blood pressure) likely each have distinct physiologic causes further adds to the complexity. As a result of the heterogeneous nature of the pathophysiologic processes and comorbid illnesses in this population, there is a wide range of clinical outcomes. Accordingly, appreciation of the global nature of HFNEF will ideally better inform optimal design for future diagnostic and therapeutic strategies. Completed clinical trials have not resulted in any evidence-based treatments available for improving survival. Given the disappointing results of these investigations, there has been renewed interest in developing interventions that target underlying comorbidities and peripheral mechanisms. Additionally, non-pharmacologic interventions such as diet and exercise have shown promise in early, small clinical investigations. Finally, methods to more rationally subgroup patients in order to identify cohorts who could respond to targeted intervention are essential. Recognizing the success achieved in the treatment of systolic heart failure, or heart failure with a reduced ejection fraction (HFREF) by addressing neurohormonal and renal mechanisms, new therapies for HFNEF may be achieved by a similar shift in attention away from the heart. PMID:22660923

Bernard, Samuel; Maurer, Mathew S.



Changes in Brain Complexity during Valproate Treatment in Patients with Partial Epilepsy  

Microsoft Academic Search

Objective: The effect of valproate (VPA) on human electroencephalography (EEG) was studied using nonlinear dynamics analysis to investigate changes in brain complexity. Methods: We propose a spatial linear mode complexity (SLMC) measure to quantify the complexity of spatial linear modes in multichannel EEGs. Nine patients with complex partial seizures who had not previously been exposed to antiepileptic drugs (AEDs) were

Jae-Moon Kim; Ki-Young Jung; Chung-Mi Choi



MA THELU -18/02/2010 J Medical Virology 1 IRES Complexity before IFN-alpha treatment and  

E-print Network

MA THELU - 18/02/2010 J Medical Virology 1 IRES Complexity before IFN-alpha treatment and Evolution in "Journal of Medical Virology 2007;79(3):242-53" DOI : 10.1002/jmv.20792 #12;MA THELU - 18/02/2010 J Medical Virology 2 INTRODUCTION Hepatitis C Virus (HCV) is one of the major causative agent of chronic hepatitis

Boyer, Edmond


Six-month outcomes of an integrated assertive community treatment team serving adults with complex behavioral health and housing needs.  


Assertive community treatment (ACT) and integrated dual disorders treatment (IDDT) have individually proven effective for treatment of adults with complex behavioral health and housing needs. This study evaluated the effectiveness of an ACT team that delivered integrated care consistent with IDDT principles. Participants included 60 adults with a history of chronic homelessness and co-occurring mental health and substance use disorders. Measures assessing mental health, substance use, and residential stability were completed at intake to the program and then 6 months later. Participants reported statistically significant improvements in mental health symptomatology and residential stability over time, although there were no changes in substance use. Findings support the effectiveness of the intervention for improving mental health and housing stability among adults with complex behavioral health and housing needs. Fidelity data support the notion that multiple evidence-based interventions can be integrated while still maintaining adequate fidelity to individual components. PMID:24346225

Young, M Scott; Barrett, Blake; Engelhardt, Mark A; Moore, Kathleen A



Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study  

PubMed Central

Background: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Results: Thirty-two patients (20 female, 12 male, age 26–85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. Conclusion: We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment. PMID:23185121

Eton, David T; Ramalho de Oliveira, Djenane; Egginton, Jason S; Ridgeway, Jennifer L; Odell, Laura; May, Carl R; Montori, Victor M



Computer-aided patch planning for treatment of complex coarctation of the aorta  

NASA Astrophysics Data System (ADS)

Between five and eight percent of all children born with congenitally malformed hearts suffer from coarctations of the aorta. Some severe coarctations can only be treated by surgical repair. Untreated, this defect can cause serious damage to organ development or even lead to death. Patch repair requires open surgery. It can affect patients of any age: newborns with severe coarctation and/or hypoplastic aortic arch as well as older patients with late diagnosis of coarctation of the aorta. Another patient group are patients of varying age with re-coarctation of the aorta or hypoplastic aortic arch after surgical and/or interventional repair. If anatomy is complex and interventional treatment by catheterization, balloon angioplasty or stent placement is not possible, surgery is indicated. The choice of type of surgery depends not only on the given anatomy but also on the experience the surgical team has with each method. One surgical approach is patch repair. A patch of a suitable shape and size is sewed into the aorta to expand the aortic lumen at the site of coarctation. At present, the shape and size of the patch are estimated intra-operatively by the surgeon. We have developed a software application that allows planning of the patch pre-operatively on the basis of magnetic resonance angiographic data. The application determines the diameter of the coarctation and/or hypoplastic segment and constructs a patch proposal by calculating the difference to the normal vessel diameter pre-operatively. Evaluation of MR angiographic datasets from 12 test patients with different kinds of aortic arch stenosis shows a divergence of only (1.5+/-1.2) mm in coarctation diameters between manual segmentations and our approach, with comparable time expenditure. Following this proposal the patch can be prepared and adapted to the patient's anatomy pre-operatively. Ideally, this leads to shorter operation times and a better long-term outcome with a reduced rate of residual stenosis and re-stenosis and aneurysm formation.

Rietdorf, Urte; Riesenkampff, Eugénie; Kuehne, Titus; Huebler, Michael; Meinzer, Hans-Peter; Wolf, Ivo



Formulation, characterization and evaluation of cyclodextrin-complexed bendamustine-encapsulated PLGA nanospheres for sustained delivery in cancer treatment.  


Abstract PLGA nanospheres are considered to be promising drug carrier in the treatment of cancer. Inclusion complex of bendamustine (BM) with epichlorohydrin beta cyclodextrin polymer was prepared by freeze-drying method. Phase solubility study revealed formation of AL type complex with stability constant (Ks?=?645?M(-1)). This inclusion complex was encapsulated into PLGA nanospheres using solid-in-oil-in-water (S/O/W) technique. The particle size and zeta potential of PLGA nanospheres loaded with cyclodextrin-complexed BM were about 151.4?±?2.53?nm and?-?31.9?±?(-3.08)?mV. In-vitro release study represented biphasic release pattern with 20% burst effect and sustained slow release. DSC studies indicated that inclusion complex incorporated in PLGA nanospheres was not in a crystalline state but existed in an amorphous or molecular state. The cytotoxicity experiment was studied in Z-138 cells and IC50 value was found to be 4.3?±?0.11?µM. Cell viability studies revealed that the PLGA nanospheres loaded with complex exerts a more pronounced effect on the cancer cells as compared to the free drug. In conclusion, PLGA nanospheres loaded with inclusion complex of BM led to sustained drug delivery. The nanospheres were stable after 3 months of storage conditions with slight change in their particle size, zeta potential and entrapment efficiency. PMID:25391288

Gidwani, Bina; Vyas, Amber



Transdermal delivery of the in situ hydrogels of curcumin and its inclusion complexes of hydroxypropyl-?-cyclodextrin for melanoma treatment.  


Curcumin (Cur) is a hydrophobic polyphenol with diverse pharmacological effects, especially for cancer treatment. However, its weak water solubility and stability was the major obstacle for the formulation research of Cur. The complexation of Cur and hydroxypropyl-?-cyclodextrin (HP-?-CD) was done by grinding. The increasing solubility of Cur was achieved due to complexation and the photochemical stability of Cur was improved. The inclusion of Cur could happen when two ends of Cur were embedded into the cavity of the HP-?-CD rings. The in situ hydrogels (ISGs) of Cur and its inclusion complexes were prepared using poloxamers 407 and 188 as the matrix. The extent of drug's in vitro release from the ISGs depended on the dissolution of drugs. Both of the ISGs had transdermal effect and cytotoxicity on B16-F10 cells. However, the effects of the ISGs containing Cur inclusion complexes were much higher than those of Cur ISGs because of the improved Cur solubility in the former. The cytotoxicity of Cur on melanoma cells was related to blocking of cellular proliferation in the G2/M stage followed by cellular apoptosis. The ISGs of Cur inclusion complexes are a promising formulation for melanoma treatment. PMID:24746691

Sun, Yunbo; Du, Lina; Liu, Yangpu; Li, Xin; Li, Miao; Jin, Yiguang; Qian, Xiaohong



Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization  

NASA Astrophysics Data System (ADS)

As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions.

Deufel, Christopher L.; Furutani, Keith M.



[Complex pathogenetic treatment schemes of vascular dyscirculatory disorders in the remote period after exposure to low dose radiation].  


Complex studies including modern methods of investigation of structures and functions of nervous system: electroencephalograsphy (EEG), coherent analysis, neuropsychological study and methods of neuroimaging were performed in 517 participants in liquidation of consequences of the accident (LCA) at the Chernobyl NPP in 1986-1987. Dyscirculatory metabolic encephalopathy was revealed to be the main pathology with the etiological mechanism based on dyscirculatorhypoxic and metabolic disorders. Complexity of the revealed symptoms testified to an early organism aging in remote periods after exposure to low dose radiation. Pathogenetic schemes were developed for treatment of dyscirculatory encephalopathy in liquidators, which include drugs improving blood supply, antiaggregants, antioxidants and metabolites of the brains in various combinations. Taking into consideration that early appearance of vascular dyscirculatory disorders observed in liquidators is the sign of early aging of the organism, geroprotectors were added to treatment schemes. PMID:25507773



[Complex pathogenetic treatment schemes of vascular dyscirculatory disorders in the remote period after exposure to low dose radiation].  


Complex studies including modern methods of investigation of structures and functions of nervous system: electroencephalograsphy (EEG), coherent analysis, neuropsychological study and methods of neuroimaging were performed in 517 participants in liquidation of consequences of the accident (LCA) at the Chernobyl NPP in 1986-1987. Dyscirculatory metabolic encephalopathy was revealed to be the main pathology with the etiological mechanism based on dyscirculatorhypoxic and metabolic disorders. Complexity of the revealed symptoms testified to an early organism aging in remote periods after exposure to low dose radiation. Pathogenetic schemes were developed for treatment of dyscirculatory encephalopathy in liquidators, which include drugs improving blood supply, antiaggregants, antioxidants and metabolites of the brains in various combinations. Taking into consideration that early appearance of vascular dyscirculatory disorders observed in liquidators is the sign of early aging of the organism, geroprotectors were added to treatment schemes. PMID:25434175

Holodova, N B; Zhavoronkova, L A; Ryzhov, B N



Technology Evaluation for the Big Spring Water Treatment System at the Y-12 National Security Complex, Oak Ridge, Tennessee  

SciTech Connect

The Y-12 National Security Complex (Y-12 Complex) is an active manufacturing and developmental engineering facility that is located on the U.S. Department of Energy (DOE) Oak Ridge Reservation. Building 9201-2 was one of the first process buildings constructed at the Y-12 Complex. Construction involved relocating and straightening of the Upper East Fork Poplar Creek (UEFPC) channel, adding large quantities of fill material to level areas along the creek, and pumping of concrete into sinkholes and solution cavities present within the limestone bedrock. Flow from a large natural spring designated as ''Big Spring'' on the original 1943 Stone & Webster Building 9201-2 Field Sketch FS6003 was captured and directed to UEFPC through a drainpipe designated Outfall 51. The building was used from 1953 to 1955 for pilot plant operations for an industrial process that involved the use of large quantities of elemental mercury. Past operations at the Y-12 Complex led to the release of mercury to the environment. Significant environmental media at the site were contaminated by accidental releases of mercury from the building process facilities piping and sumps associated with Y-12 Complex mercury handling facilities. Releases to the soil surrounding the buildings have resulted in significant levels of mercury in these areas of contamination, which is ultimately transported to UEFPC, its streambed, and off-site. Bechtel Jacobs Company LLC (BJC) is the DOE-Oak Ridge Operations prime contractor responsible for conducting environmental restoration activities at the Y-12 Complex. In order to mitigate the mercury being released to UEFPC, the Big Spring Water Treatment System will be designed and constructed as a Comprehensive Environmental Response, Compensation, and Liability Act action. This facility will treat the combined flow from Big Spring feeding Outfall 51 and the inflow now being processed at the East End Mercury Treatment System (EEMTS). Both discharge to UEFPC adjacent to Bldg. 9201-2. The EEMTS treats mercury-contaminated groundwater that collects in sumps in the basement of Bldg. 9201-2. A pre-design study was performed to investigate the applicability of various treatment technologies for reducing mercury discharges at Outfall 51 in support of the design of the Big Spring Water Treatment System. This document evaluates the results of the pre-design study for selection of the mercury removal technology for the treatment system.

Becthel Jacobs Company LLC



CdS thin films obtained by thermal treatment of cadmium(II) complex precursor deposited by MAPLE technique  

Microsoft Academic Search

Thin films of [Cd{SSi(O–But)3}(S2CNEt2)]2, precursor for semiconducting CdS layers, were deposited on silicon substrates by Matrix-Assisted Pulsed Laser Evaporation (MAPLE) technique. Structural analysis of the obtained films by Fourier transform infrared spectroscopy (FTIR) confirmed the viability of the procedure. After the deposition of the coordination complex, the layers are manufactured by appropriate thermal treatment of the system (thin film and

Andrei Rotaru; Anna Mietlarek-Kropidlowska; Catalin Constantinescu; Nicu Scarisoreanu; Marius Dumitru; Michal Strankowski; Petre Rotaru; Valentin Ion; Cristina Vasiliu; Barbara Becker; Maria Dinescu



Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.  


The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity. PMID:21240739

Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel



Use of rotation thromboelastometry (ROTEM) to achieve successful treatment of polytrauma with fibrinogen concentrate and prothrombin complex concentrate.  


Goal-directed coagulation therapy is essential in the management of trauma patients with severe bleeding. Due to the complex nature of coagulation disorders in trauma, a quick and reliable diagnostic tool is essential. We report a severely injured multiple trauma patient who received haemostatic therapy with coagulation factor concentrates, guided by rotational thromboelastometry (ROTEM). Initial therapy consisted of fibrinogen concentrate (Haemocomplettan P), as maximum clot firmness in the ROTEM analyses was low, whereas clotting time was normal. Later on, prothrombin complex concentrate was given to optimise thrombin generation. This approach enabled extended emergency hemihepatectomy to be performed without using fresh frozen plasma. As the EXTEM maximum clot firmness showed good clot quality, no platelets were transfused despite low platelet counts. This case shows the potential success of treatment using both fibrinogen concentrate and prothrombin complex concentrate, not only in restoring haemostasis but also in minimising requirement for transfusion of allogeneic blood products. PMID:19995349

Schöchl, H; Forster, L; Woidke, R; Solomon, C; Voelckel, W



Typicality of Inanimate Category Exemplars in Aphasia Treatment: Further Evidence for Semantic Complexity  

ERIC Educational Resources Information Center

Purpose: The typicality treatment approach on improving naming was investigated within 2 inanimate categories ("furniture" and "clothing") using a single-subject experimental design across participants and behaviors in 5 patients with aphasia. Method: Participants received a semantic feature treatment to improve naming of either typical or…

Kiran, Swathi



Strength and Formability Improvement of Al-Cu-Mn Aluminum Alloy Complex Parts by Thermomechanical Treatment with Sheet Hydroforming  

NASA Astrophysics Data System (ADS)

Normally, the strength and formability of aluminum alloys can be increased largely by severe plastic deformation and heat treatment. However, many plastic deformation processes are more suitable for making raw material, not for formed parts. In this article, an experimental study of the thermomechanical treatment by using the sheet hydroforming process was developed to improve both mechanical strength and formability for aluminum alloys in forming complex parts. The limiting drawing ratio, thickness, and strain distribution of complex parts formed by sheet hydroforming were investigated to study the formability and sheet-deformation behavior. Based on the optimal formed parts, the tensile strength, microhardness, grain structure, and strengthening precipitates were analyzed to identify the strengthening effect of thermomechanical treatment. The results show that in the solution state, the limiting drawing ratio of cylindrical parts could be increased for 10.9% compared with traditional deep drawing process. The peak values of tensile stress and microhardness of formed parts are 18.0% and 12.5% higher than that in T6 state. This investigation shows that the thermomechanical treatment by sheet hydroforming is a potential method for the products manufacturing of aluminum alloy with high strength and good formability.

Chen, Yi-Zhe; Liu, Wei; Yuan, Shi-Jian



Dose calculation methodology for irradiation treatment of complex-shaped foods  

E-print Network

of the treated product falls within some specified range. The Monte Carlo electron transport simulation and computer tomography (CT) scan technology were used to predict the dose distribution in complex shaped foods, an apple phantom composed of paraffin wax...

Kim, Jongsoon



[Nutricional support in the complex treatment of a patient with esophageal spasm].  


In the presented clinical case the theme of the need for an integrated therapeutic intervention has been disclosed, including nutritional support on the various links of the pathogenesis of esophagospasm to the effectiveness of the patient's treatment. PMID:23947167

Firsova, L D; Ianova, O B; Vasnev, O S; Kostiuchenko, L N; Pichugina, I M; Efremov, L I



The effect of heme oxygenase-1 complexed with collagen on MSC performance in the treatment of diabetic ischemic ulcer.  


Diabetic ischemic ulcer is an intractable diabetic complication. Bone marrow mesenchymal stem cells (BMSCs) have great potential in variety of tissue repair. In fact, poor cell viability and tolerance limit their ability for tissue repair. In addition, it is difficult for stem cells to home and locate to the lesion. In this study, we explore whether over-expression of heme oxygenase-1 (HO-1) in BMSCs complexed with collagen play an important role in treatment of diabetic ischemic ulcers. In vitro, over-expression of HO-1 promoted the proliferation and paracrine activity of BMSCs and the conditioned medium of BMSCs accelerated HUVECs migration and proliferation. These processes were closely related to Akt signaling pathway and were not dependent on Erk signaling pathway. In vivo, in order to make BMSCs directly act on the wound, we choose a solid collagen as a carrier, BMSCs were planted into it, ischemic wounds of diabetic mice were covered with the complex of BMSCs and collagen. The results indicate that the complex of HO-1-overexpressing BMSCs and collagen biomaterials can significantly promote angiogenesis and wound healing. These preclinical findings open new perspectives for the treatment of diabetic foot ulcers. PMID:23059006

Hou, Chunli; Shen, Lei; Huang, Qiang; Mi, Jianhong; Wu, Yangxiao; Yang, Mingcan; Zeng, Wen; Li, Li; Chen, Wen; Zhu, Chuhong



Preliminary application of hybrid operation in the treatment of carotid artery stenosis in patients with complex ischemic cerebrovascular diseases  

PubMed Central

Along with the recent development of intraluminal interventional techniques and correlated imaging methods, one-stop hybrid operation has become a new focus in clinical settings. The aim of this study is to discuss the clinical significance of the one-stop hybrid endarterectomy surgery in the treatment of complex ischemic cerebrovascular diseases. In this study, clinical data from 10 patients with complex ischemic cerebrovascular diseases (including multi-vessel severe stenosis of the internal extracranial carotid artery, single vessel series stenosis of the internal extracranial carotid artery, in-stent restenosis, complete occlusion of the common carotid or the internal carotid artery) admitted to Beijing Xuanwu Hospital and Liaocheng Brain Hospital, were retrospectively analyzed. All enrolled subjects underwent three types of hybrid operations. The clinical efficacy of this surgery was subsequently assessed in this clinical trial. The results indicated that no related surgical complications were noted during the perioperative period. Intraoperative and postoperative imaging revealed no signs of vascular stenosis, the blood supply recovered, and clinical symptoms were alleviated. The follow-up lasted for 6 to 12 months. Imaging re-examination showed no evidence of re-stenosis and good blood circulation was present in the recanalized blood vessels. Favorable treatment efficacy was achieved. The intracranial blood supply was significantly improved postoperatively. In conclusion, one-stop hybrid operation plays an important role in treating complex stenosis cerebrovascular diseases. PMID:25197423

Zhang, Liyong; Xing, Tao; Geng, Fenyang; Du, Lixin; Wang, Jiyue



Time-dependent reduction of structural complexity of the buccal epithelial cell nuclei after treatment with silver nanoparticles.  


Recent studies have suggested that silver nanoparticles (AgNPs) may affect cell DNA structure in in vitro conditions. In this paper, we present the results indicating that AgNPs change nuclear complexity properties in isolated human epithelial buccal cells in a time-dependent manner. Epithelial buccal cells were plated in special tissue culture chamber / slides and were kept at 37°C in an RPMI 1640 cell culture medium supplemented with L-glutamine. The cells were treated with colloidal silver nanoparticles suspended in RPMI 1640 medium at the concentration 15 mg L?¹. Digital micrographs of the cell nuclei in a sample of 30 cells were created at five different time steps: before the treatment (controls), immediately after the treatment, as well as 15 , 30 and 60 min after the treatment with AgNPs. For each nuclear structure, values of fractal dimension, lacunarity, circularity, as well as parameters of grey level co-occurrence matrix (GLCM) texture, were determined. The results indicate time-dependent reduction of structural complexity in the cell nuclei after the contact with AgNPs. These findings further suggest that AgNPs, at concentrations present in today's over-the-counter drug products, might have significant effects on the cell genetic material. PMID:24118045

Pantic, I; Paunovic, J; Perovic, M; Cattani, C; Pantic, S; Suzic, S; Nesic, D; Basta-Jovanovic, G



Treatment with at Homeopathic Complex Medication Modulates Mononuclear Bone Marrow Cell Differentiation  

Microsoft Academic Search

A homeopathic complex medication (HCM), with immunomodulatory properties, is recom- mended for patients with depressed immune systems. Previous studies demonstrated that the medication induces an increase in leukocyte number. The bone marrow microenvironment is composed of growth factors, stromal cells, an extracellular matrix and progenitor cells that differentiate into mature blood cells. Mice were our biological model used in this

Beatriz Cesar; Ana Paula; R. Abud; Carolina C. de Oliveira; Francolino Cardoso; Raffaello Popa Di Bernardi; Fernando S. F. Guimaraes; Juarez Gabardo; Dorly de Freitas Buchi



Complex I Disorders: Causes, Mechanisms, and Development of Treatment Strategies at the Cellular Level  

ERIC Educational Resources Information Center

Mitochondrial oxidative phosphorylation (OXPHOS) represents the final step in the conversion of nutrients into cellular energy. Genetic defects in the OXPHOS system have an incidence between 1:5,000 and 1:10,000 live births. Inherited isolated deficiency of the first complex (CI) of this system, a multisubunit assembly of 45 different proteins,…

Valsecchi, Federica; Koopman, Werner J. H.; Manjeri, Ganesh R.; Rodenburg, Richard J.; Smeitink, Jan A. M.; Willems, Peter H. G. M.



Felodipine ?-cyclodextrin complex as an active core for time delayed chronotherapeutic treatment of hypertension.  


The present research work deals with the development of a time delayed chronotherapeutic formulation of felodipine (FD) aimed at rapid drug release after a desired lag time in the management of hypertension. The developed system comprises a drug core embedded within a swellable layer and coated with an insoluble, water permeable polymeric system. FD cyclodextrin complex was used as an active core while ethyl cellulose was used as an effective coating layer. Dissolution studies of the complex revealed that there was a 3-fold increase in dissolution of the complex compared to plain FD. This dissolution enhancement and rapid drug release resulted from FD amorphisation, as confirmed by XRD, DSC and SEM studies. FTIR and ¹H NMR studies confirmed the complex formation between FD and cyclodextrin based on the observed hydrogen bond interactions. FD release was adequately adjusted by using a pH independent polymer, i.e., ethyl cellulose, along with dibutyl phthalate as plasticizer. Influence of formulation variables like polymer viscosity, plasticizer concentration, super disintegrant concentration in the swellable layer and percent coating weight gain was investigated to characterize the lag time. Upon permeation of water, the core tablet swelled, resulting in the rupture of the coating layer, followed by rapid drug release. The developed formulation of FD showed a lag time of 5-7 h, which is desirable for chronotherapeutic application. PMID:23470351

Pagar, Kunal P; Vavia, Pradeep R



Clinical Application of Estimating Hepatitis B Virus Quasispecies Complexity by Massive Sequencing: Correlation between Natural Evolution and On-Treatment Evolution  

PubMed Central

Aim To evaluate HBV quasispecies (QA) complexity in the preCore/Core regions in relation to HBeAg status, and explore QA changes under natural evolution and nucleoside analogue (NUC) treatment. Methods Ultra-deep pyrosequencing of HBV preCore/Core regions in 30 sequential samples (baseline [diagnosis], treatment-free, and treatment-nonresponse) from 10 retrospectively selected patients grouped according to HBeAg status over time: HBeAg+ (N?=?4), HBeAg- (N?=?2), and fluctuating HBeAg (transient seroreversion/seroconversion pattern) (N?=?4). QA complexity was defined by Shannon entropy, mutation frequency, nucleotide diversity, and mutation frequency of amino acids (MfAA) in preCore and Core. Results The QA was less complex in HBeAg+ than in HBeAg- or fluctuating HBeAg. High complexity in preCore was associated with decreased viral replication (preCore MfAA negatively correlated with HBV-DNA, p?=?0.005). QA complexity in the treatment-free period negatively correlated with values seen during treatment. Specific variants were mainly selected in the Core region in HBeAg- and fluctuating HBeAg patients, suggesting higher immune pressure than in HBeAg+. Conclusions The negative correlation between QA natural evolution and on-treatment evolution indicates the importance of pre-treatment QA study to predict QA changes in NUC nonresponders. Study of QA complexity could be useful for managing HBV infection. PMID:25393280

Homs, Maria; Caballero, Andrea; Gregori, Josep; Tabernero, David; Quer, Josep; Nieto, Leonardo; Esteban, Rafael; Buti, Maria; Rodriguez-Frias, Francisco



Early Tibiotalocalcaneal Arthrodesis Intramedullary Nail for Treatment of a Complex Tibial Pilon Fracture (AO/OTA 43-C).  


Management of severely comminuted, complete articular tibial pilon fractures (AO/OTA 43-C) remains a challenge, with few treatment options providing good clinical outcomes. Open reduction and internal fixation of the tibial plafond, tibiotalar arthrodesis, and salvage hindfoot reconstruction procedures are all associated with surgical complications and functional limitations. In this report, we present a case of a complex pilon fracture in a patient with multiple medical comorbidities and socioeconomic disadvantages that was successfully and acutely treated with a retrograde tibiotalocalcaneal hindfoot arthrodesis nail. At final follow-up examination, the patient had decreased pain, a stable plantigrade foot, and could ambulate with normal shoes without any assistive devices. PMID:25156100

Hsu, Andrew R; Szatkowski, Jan P



Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.  

ERIC Educational Resources Information Center

This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

Williams, Mary Beth; Sommer, John F., Jr.


Treatment of complex dissociative disorders: a comparison of interventions reported by community therapists versus those recommended by experts.  


There is a paucity of empirical data to assist clinicians in choosing interventions to use with patients with complex dissociative disorder (DD; i.e., dissociative identity disorder and dissociative disorder not otherwise specified) at different stages in treatment. This study compared interventions used by a sample of international outpatient therapists treating DD clients in the 1st 2 stages of treatment with those recommended by expert DD therapists. There were many similarities between therapists' and experts' interventions, including the use of several emotion regulation and dissociation-focused interventions. However, community therapists reported significantly less focus on relationally oriented interventions, teaching and using grounding and containment skills, and stabilizing patients after revictimization by alleged perpetrators. This study has important implications for the development and implementation of training opportunities for DD therapists. PMID:25365637

Myrick, Amie C; Chasson, Gregory S; Lanius, Ruth A; Leventhal, Barry; Brand, Bethany L



A two-portal posterior endoscopic approach in the treatment of a complex talus fracture: a case report.  


The two-portal hindfoot endoscopy is a relatively new technique that is becoming increasingly popular. It gives excellent access to the posterior ankle compartment, the subtalar joint, and extra-articular structures. We report a 24-year-old man with a complex talus fracture involving the posterior part of the talar body and posterolateral process. He was treated endoscopically, with a two-portal posterior approach to the hindfoot. This approach allowed a better visualization and treatment of accompanying pathologies. Combined excision of the posterolateral process and fixation of the fracture was performed with the two-portal hindfoot endoscopy, which has not been previously described to our knowledge. The two-portal posterior endoscopic approach can be an attractive treatment alternative for the posterior part fractures of the talus, which can in turn, be a new indication for this technique. PMID:19767553

Ogut, Tahir; Seyahi, Aksel; Aydingoz, Onder; Bilsel, Nafiz



Prophylactic nitric oxide treatment reduces incidence of bovine respiratory disease complex in beef cattle arriving at a feedlot.  


Bovine respiratory disease complex (BRDc), is a challenging multi-factorial health issue caused by viral/bacterial pathogens and stressors linked with the transport and mixing of cattle, negatively impacting the cattle feedlot industry. Nitric oxide (NO) is a naturally occurring molecule with antimicrobial attributes. This study tests whether NO can prevent the symptoms associated with BRDc. Eighty-five, crossbred, multiple-sourced, commingled commercial weaned beef calves were monitored and scored for temperature, white blood count, clinical score, hematology, cortisol levels and neutrophil/lymphocyte ratio. NO treatment or placebo were given once on arrival to the stockyard. After one week 87.5% of sick animals were from the control while 12.5% from treatment groups and after two weeks 72% and 28% respectively. Treatment was shown to be safe, causing neither distress nor adverse effects on the animals. These data show that NO treatment on arrival to the feedlot significantly decreased the incidence of BRDc in this study. PMID:23850382

Regev-Shoshani, G; Church, J S; Cook, N J; Schaefer, A L; Miller, C



Use of clobazam for the treatment of refractory complex partial seizures  

Microsoft Academic Search

Clobazam (CLB) add-on therapy was attempted in 183 patients with intractable complex partial seizures in whom conventional benzodiazepines had been successfully discontinued before initiation of CLB. Although complete remission was initially achieved in 61, tolerance developed in almost half (49.2%) within the first 3 months, whereas 23 out of 31 patients (74.2%) who remained seizure free for the first 3




Value and limitations of adenosine in the diagnosis and treatment of narrow and broad complex tachycardias  

Microsoft Academic Search

The diagnostic and therapeutic potential of intravenous adenosine was studied in 64 patients during 92 episodes of regular sustained tachycardia. In 40 patients who had narrow complex tachycardias (QRS less than 0.12 s) adenosine (2.5-25 mg) restored sinus rhythm in 25 with junctional tachycardias (46 of 48 episodes) and produced atrioventricular block to reveal atrial or sinus tachycardia in 15.

A C Rankin; K G Oldroyd; E Chong; A P Rae; S M Cobbe



Density functional treatment of water-carbon dioxide van der Waals complex  

SciTech Connect

LCGTO-LSD and LCGTO-NLSD methods have been tested for the study of water-carbon dioxide weakly bound binary complex. Different local and nonlocal exchange-correlation energy functionals and many grid radial points have been used. Results show that both nonlocal corrections and a large number of radial points in the grid are mandatory for well reproducing then experimental data. 19 refs., 1 fig., 2 tabs.

Abashkin, Y.; Mele, F.; Russo, N.; Toscano, M. [Universita della Calabria, Arcavacata di Rende (Italy)



[Effectiveness of cycloferon in complex treatment of brucellosis patients with lesions of the scrotum].  


The article presents the results of urological examination (spermograms and data of ultrasound examination) of 22 patients with chronic brucellosis and diseases of the scrotum (6 patients with orchitis, 16 with orchiepididymitis) before and after conventional therapy (10 patients) and combined treatment with the inclusion of cycloferon (2 courses of 5 intramuscular injection [0.25 g] with an interval of 10 days)--12 patients. It is shown that the administration of cycloferon leads to more effective relief of intoxication symptoms and inflammation in the testes and appendages (reduction of scrotal wall thickness, size of testes and/or adjuncts, and the incidence and severity of hydrocele), and has a positive effect on spermatogenesis (reduction of semen viscosity, the number of white blood cells in semen, sperm agglutination associated with the formation of sperm antibodies in most patients after treatment), as well as reduces the number of exacerbations of chronic orchitis/orchiepididymitis by 2.4 times. PMID:23342613

Evdokimov, A V; Anashchenko, A V; Liapina, E P; Shul'diakov, A A; Glubochko, P V; Petrenko, N A



[Application of durable regional intraarterial chemotherapy in complex of treatment of unresectable locally spread rectal cancer].  


There in the clinic the method of treatment of inoperable locally spread cancer recti was elaborated, which consists of durable catheterization of superior rectal artery, securing possibility of conduction of several courses of chemotherapy. Using the method of treatment elaborated 33 patients suffering cancer recti were treated in 1996-2006 period. In 29 of them catheterization of superior rectal artery was done during formation of colostoma in conditions of progressing ileus. Partial regression and stabilization of the cancer recti tumor, confirmed by data of roentgenoscopy, colonofibroscopy, computer tomography, were noted in 28 patients. In 2 patients significant tumoral regression was achieved, what have permitted to perform radical operative intervention in some time. Complications, connected with the method application, were absent. PMID:16821369

Bondar, H V; Borota, O V; Kiiashko, O Iu



Typicality of Inanimate Category Exemplars in Aphasia Treatment: Further Evidence for Semantic Complexity  

PubMed Central

Purpose The typicality treatment approach on improving naming was investigated within two inanimate categories (furniture and clothing) using a single subject experimental design across participants and behaviors in five patients with aphasia. Method Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results Results indicated that two out of four patients trained on naming of atypical examples demonstrated generalization to naming untrained typical examples. One patient showed trends towards generalization but did not achieve criterion. Further, four out of four patients trained on typical examples demonstrated no generalized naming to untrained atypical examples within the category. Also, analysis of errors indicated an evolution of errors as a result of treatment, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Conclusions These results extend our previous findings (Kiran & Thompson, 2003) to patients with nonfluent aphasia and to inanimate categories such as furniture and clothing. Additionally, the results provide support for the claim that training atypical examples is a more efficient method to facilitating generalization to untrained items within a category than training typical examples (Kiran, 2007). PMID:18695023

Kiran, Swathi



Studies of zinc phthalocyanine/magnetic fluid complex as a bifunctional agent for cancer treatment  

NASA Astrophysics Data System (ADS)

The present study introduces a new class of material that allows the combined action of photodynamic therapy (PDT) and hyperthermia (HPT) therapies, designed to work in a synergetic way when used in vivo, with an expected enhancement in tumor damaging after minimum drug doses and based on heat dissipation and/or light photosensitization. With this purpose, we have investigated the spectroscopic and photophysical properties of the complex zinc phthalocyanine/magnetic fluid (ZnPC/MF) in homogeneous medium (ethanol). Our findings clearly indicate that the spectroscopic properties of ZnPC as a photosensitizer associated or not with MF present similar behavior working efficiently as a PDT drug.

Oliveira, D. M.; Macaroff, P. P.; Ribeiro, K. F.; Lacava, Z. G. M.; Azevedo, R. B.; Lima, E. C. D.; Morais, P. C.; Tedesco, A. C.



Early adjunct treatment with topical lidocaine results in improved pain and function in a patient with complex regional pain syndrome.  


Complex regional pain syndrome (CRPS) is a pain disorder characterized by sensory, motor, trophic and autonomic dysfunction. The hallmark of the disorder is pain out of proportion of the inciting event. CRPS is difficult for clinicians to manage as there is no gold standard for diagnosis or treatment. Patients with CRPS are at risk of developing contractures, tissue atrophy, joint dislocation and severe chronic pain. While CRPS is thought to be due to peripheral and central nervous system dysfunction, there is limited understanding of the pathophysiology of CRPS. The proposed mechanisms are multifactorial and consequently, so are the proposed treatments. These treatments can be invasive, such as intrathecal drug delivery or sympathectomy, which have poor evidence for efficacy. Thus, highlighting the need for a safe, effective, and early intervention. We present a case of topical 5% lidocaine ointment as a non-invasive, inexpensive and effective adjunct treatment in the management of pain in a spinal cord injured patient presenting with early CRPS. The clinically important effect of topical lidocaine for reducing severe allodynia allowed the patient to participate in rehabilitation strategies to further manage the debilitating consequences of her CRPS, including decreased range of motion (ROM) and function. The immediate pain relief from topical lidocaine allowed the patient to tolerate physical therapy sessions directed at her CRPS. A successful outcome was measured subjectively and objectively by our patient's reduction in symptoms and improvement in ROM and function, respectively. This case study provides preliminary support for improved pain and functional outcome with early adjunct treatment of CRPS with topical lidocaine. PMID:25247913

Hanlan, Amy K L; Mah-Jones, Dianna; Mills, Patricia B



Analysis of unilateral complex orbital fractures with a new treatment algorithm.  


The aim of this study is to investigate preoperative and postoperative properties, the management of unilateral complex orbital fractures, and to offer an algorithm for orbital fractures. For this research study, 248 patients with orbital trauma were evaluated according to an offered algorithm. Diplopia, enophthalmos, dystopia, infraorbital nerve dysfunction, and ocular movement limitations were documented for clinical assessment. Orbital rim displacement and an orbital volume check with computed tomography (CT) were used for indication of surgery. The injured orbital volume was compared with the healthy orbital volume in the preoperative and postoperative periods. In total, 58 patients required operations among the 248 patients, according to the algorithm. The preoperative mean injured orbital volume measurements of the operated patients were statistically different than the healthy orbital volume measurements (30.13 cm(3) ± 2.69 cm(3) and 27.15 cm(3) ± 1.29 cm(3), respectively). In the postoperative period, there was no difference between the injured and healthy orbital volume. In conclusion, an algorithm may facilitate the approach to unilateral complex orbital fractures. Ophthalmic examination, rim displacement, and the measurement of orbital volume using computed tomography are key points of orbital fractures with regard to management. PMID:25234601

Karamese, Mehtap; Akda?, Osman; Selimo?lu, Muhammed Nebil; Koplay, Tugba Gun; Bakbak, Berker; Koplay, Mustafa; Tosun, Zekeriya



Alternative Techniques for Treatment of Complex Below-the Knee Arterial Occlusions in Diabetic Patients With Critical Limb Ischemia  

SciTech Connect

The purpose of this study was to describe alternative endovascular (EV) techniques and assess their feasibility and efficacy in minimizing failure rates in limb salvage for the treatment of complex below-the knee (BTK) occlusions that could not be crossed with a conventional antegrade access. Between December 2007 and November 2010, 1,035 patients (557 male) underwent EV treatment for critical limb ischemia in our institution. In 124 (12% [83 male], mean age 68.2 {+-} 0.5 years) patients, transfemoral antegrade revascularization attempt failed, and an alternative approach was used. Follow-up was performed at 1 and 6 months. Results were compared with 56 patients treated between November 2002 and November 2007, in whom conventional technique was unsuccessful and unconventional techniques were not adopted. Technical success was achieved in 119 (96%) patients. The limb-salvage rates were 96.8% and 83% at 1- and 6-month follow-up, respectively. Sixteen (12.9%) and 33 (26.6%) patients underwent reintervention at 1- and 6-month follow-up, respectively. Transcutaneous oxygen tension increased at 1 month (44.7 {+-} 1.1 vs. 15.7 {+-} 0.8 mmHg; p < 0.001) and remained stable at follow-up. Twenty (16.1%) patients required major amputation. Thirteen (10.4%) patients died during follow-up. In our previous experience, percutaneous transluminal angioplasty failure, amputation, and death rates were 10.9, 39.2, and 23.2%, respectively. Alternative techniques allowed a significant decrease of major amputation and death rates (p = 0.0001 and p = 0.02, respectively). The use of alternative techniques seems feasible in case of a failed antegrade BTK revascularization attempt and could minimize failure rates in the treatment of complex occlusions while providing satisfying clinical success rates at 6 months.

Gandini, Roberto [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy); Uccioli, Luigi [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy); Spinelli, Alessio; Del Giudice, Costantino, E-mail:; Ros, Valerio Da; Volpi, Tommaso [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy); Meloni, Marco [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy); Simonetti, Giovanni [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)



Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach.  


Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room-angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical-endovascular technique in a hybrid operating room-angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24916414

Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H



Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach.  


Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room-angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical-endovascular technique in a hybrid operating room-angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24903968

Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H



Multiple treatment comparison meta-analyses: a step forward into complexity  

PubMed Central

The use of meta-analysis has become increasingly useful for clinical and policy decision making. A recent development in meta-analysis, multiple treatment comparison (MTC) meta-analysis, provides inferences on the comparative effectiveness of interventions that may have never been directly evaluated in clinical trials. This new approach may be confusing for clinicians and methodologists and raises specific challenges relevant to certain areas of medicine. This article addresses the methodological concepts of MTC meta-analysis, including issues of heterogeneity, choice of model, and adequacy of sample sizes. We address domain-specific challenges relevant to disciplines of medicine, including baseline risks of patient populations. We conclude that MTC meta-analysis is a useful tool in the context of comparative effectiveness and requires further study, as its utility and transparency will likely predict its uptake by the research and clinical community. PMID:21750628

Mills, Edward J; Bansback, Nick; Ghement, Isabella; Thorlund, Kristian; Kelly, Steven; Puhan, Milo A; Wright, James



"In reality, it is complex and difficult": UK nurses' perspectives on "treatment as prevention" within HIV care.  


Globally, clinical guidelines for HIV treatment are being altered to reflect new research showing that successful treatment with antiretroviral therapies (ART) can prevent the onward transmission of HIV. As a result, health care services are being challenged to find ways to roll out "treatment as prevention" (TasP) as a public health measure. In theory, TasP requires individuals to start ART as soon as they are diagnosed - for public health reasons - which may be some time before ART for that individual is required for clinical reasons. There is currently little research on the acceptability of TasP from a patient or provider perspective. This paper reports findings from a qualitative study that sought to explore UK nurses' views and experiences of TasP in HIV care. Ten HIV specialist nurses, purposively selected from across the country, were interviewed. Results suggest that, although positive about TasP in principle, nurses hold several reservations about its implementation in practice. Perceived benefits of TasP include reassurance for patients that their loved ones are protected and that immediate care is available. Concerns include the possibility of sexual dis-inhibition or coercion within sexual relationships. In the UK context, decisions around TasP are still being made on a highly individualised patient by patient basis, within a philosophy of holistic care and partnership working. As such, the research participants called for more resources to support information giving, risk assessment and decision-making. The results show that translating a public health treatment approach into individual patient care is complex, potentially time-consuming and may alter traditional provider-patient dynamics. The findings from this study suggest that in-depth research is needed to understand better the patient, community and provider experience as TasP becomes more widely rolled out. PMID:25650545

Evans, Catrin; Bennett, Juliet; Croston, Michelle; Brito-Ault, Nathaniel; Bruton, Jane



Synthesis and Biological Evaluation of Novel Folic Acid Receptor-Targeted, ?-Cyclodextrin-Based Drug Complexes for Cancer Treatment  

PubMed Central

Drug targeting is an active area of research and nano-scaled drug delivery systems hold tremendous potential for the treatment of neoplasms. In this study, a novel cyclodextrin (CD)-based nanoparticle drug delivery system has been assembled and characterized for the therapy of folate receptor-positive [FR(+)] cancer. Water-soluble folic acid (FA)-conjugated CD carriers (FACDs) were successfully synthesized and their structures were confirmed by 1D/2D nuclear magnetic resonance (NMR), matrix-assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS), high performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FTIR), and circular dichroism. Drug complexes of adamatane (Ada) and cytotoxic doxorubicin (Dox) with FACD were readily obtained by mixed solvent precipitation. The average size of FACD-Ada-Dox was 1.5–2.5 nm. The host-guest association constant Ka was 1,639 M?1 as determined by induced circular dichroism and the hydrophilicity of the FACDs was greatly enhanced compared to unmodified CD. Cellular uptake and FR binding competitive experiments demonstrated an efficient and preferentially targeted delivery of Dox into FR-positive tumor cells and a sustained drug release profile was seen in vitro. The delivery of Dox into FR(+) cancer cells via endocytosis was observed by confocal microscopy and drug uptake of the targeted nanoparticles was 8-fold greater than that of non-targeted drug complexes. Our docking results suggest that FA, FACD and FACD-Ada-Dox could bind human hedgehog interacting protein that contains a FR domain. Mouse cardiomyocytes as well as fibroblast treated with FACD-Ada-Dox had significantly lower levels of reactive oxygen species, with increased content of glutathione and glutathione peroxidase activity, indicating a reduced potential for Dox-induced cardiotoxicity. These results indicate that the targeted drug complex possesses high drug association and sustained drug release properties with good biocompatibility and physiological stability. The novel FA-conjugated ?-CD based drug complex might be promising as an anti-tumor treatment for FR(+) cancer. PMID:23658721

Yin, Juan-Juan; Sharma, Sonali; Shumyak, Stepan P.; Wang, Zhi-Xin; Zhou, Zhi-Wei; Zhang, Yangde; Guo, Peixuan; Li, Chen-Zhong; Kanwar, Jagat R.; Yang, Tianxin; Mohapatra, Shyam S.; Liu, Wanqing; Duan, Wei; Wang, Jian-Cheng; Li, Qi; Zhang, Xueji; Tan, Jun; Jia, Lee; Liang, Jun; Wei, Ming Q.; Li, Xiaotian; Zhou, Shu-Feng



A boundary collocation meshfree method for the treatment of Poisson problems with complex morphologies  

NASA Astrophysics Data System (ADS)

A new meshfree method based on a discrete transformation of Green's basis functions is introduced to simulate Poisson problems with complex morphologies. The proposed Green's Discrete Transformation Method (GDTM) uses source points that are located along a virtual boundary outside the problem domain to construct the basis functions needed to approximate the field. The optimal number of Green's functions source points and their relative distances with respect to the problem boundaries are evaluated to obtain the best approximation of the partition of unity condition. A discrete transformation technique together with the boundary point collocation method is employed to evaluate the unknown coefficients of the solution series via satisfying the problem boundary conditions. A comprehensive convergence study is presented to investigate the accuracy and convergence rate of the GDTM. We will also demonstrate the application of this meshfree method for simulating the conductive heat transfer in a heterogeneous materials system and the dissolved aluminum ions concentration in the electrolyte solution formed near a passive corrosion pit.

Soghrati, Soheil; Mai, Weijie; Liang, Bowen; Buchheit, Rudolph G.



Pyrosequencing demonstrated complex microbial communities in a membrane filtration system for a drinking water treatment plant.  


Microbial community composition in a pilot-scale microfiltration plant for drinking water treatment was investigated using high-throughput pyrosequencing technology. Sequences of 16S rRNA gene fragments were recovered from raw water, membrane tank particulate matter, and membrane biofilm, and used for taxonomic assignments, estimations of diversity, and the identification of potential pathogens. Greater bacterial diversity was observed in each sample (1,133-1,731 operational taxonomic units) than studies using conventional methods, primarily due to the large number (8,164-22,275) of sequences available for analysis and the identification of rare species. Betaproteobacteria predominated in the raw water (61.1%), while Alphaproteobacteria were predominant in the membrane tank particulate matter (42.4%) and membrane biofilm (32.8%). The bacterial community structure clearly differed for each sample at both the genus and species levels, suggesting that different environmental and growth conditions were generated during membrane filtration. Moreover, signatures of potential pathogens including Legionella, Pseudomonas, Aeromonas, and Chromobacterium were identified, and the proportions of Legionella and Chromobacterium were elevated in the membrane tank particulate matter, suggesting a potential threat to drinking water treated by membrane filtration. PMID:21502735

Kwon, Soondong; Moon, Eunjeong; Kim, Taek-Seung; Hong, Seungkwan; Park, Hee-Deung



Impact of reclamation treatment on the biological activity of soils of the solonetz complex in Western Siberia  

NASA Astrophysics Data System (ADS)

The abundance and activity of the soil microflora were studied in a field experiment with the use of green manure crops to assess the impact of reclamation measures on the biological activity of soils of the solonetz complex. The number of microorganisms in the plow soil horizon increased in the background of the green fallows as compared to the black ones. Coefficients of mineralization, immobilization, and transformation of organic compounds were calculated for different variants of the soil treatment. The value of the mineralization coefficient indicates the intense decomposition of the green manure that entered the soil. In the first year, peas were actively decomposed, while oats, in the second year (aftereffect). The activity of the soil enzymes (invertase, urease, and catalase) was determined. A close relationship between the catalase activity and the intensity of the microbiological processes in the soils was revealed.

Berezin, L. V.; Khamova, O. F.; Paderina, E. V.; Gindemit, A. M.



The complexity of biosorption treatments for oxyanions in a multi-element mine effluent.  


Selenium (Se) is a contaminant in effluents from coal mines and coal-fired power stations, where it is encountered as the oxyanion selenate (SeO4(2-), hereafter Se(VI)). Se(VI) can be removed from solution with Fe-treated biosorbents, but the efficacy of these treatments in effluents with multiple contaminants is unclear. This study investigates the interactions between Se(VI) and the oxyanions SO4(2-) and NO3(-). We produce a sustainable biosorbent, Gracilaria Modified Biochar (GMB), by treating a waste product generated after the commercial extraction of agar from cultivated seaweeds with ferric chloride (FeCl3) and converting it to biochar through pyrolysis. We then test interactions between Se(VI) and competing oxyanions in mock solutions and a real-world mine effluent with high concentrations of SO4(2-) and NO3(-). GMB immediately removed 98% of the Se(VI) from the mock solution, but only 3% from the mine effluent with the same initial Se(VI) concentration. Notably, 83-89% of the Se(VI) was removed by GMB when concentrations of Se(VI) and SO4(2-) were less than or equimolar in mock solutions. Higher concentrations of SO4(2-) reduced the uptake of Se(VI). There was no interference from NO3(-) on the biosorption of Se(VI). GMB is a successful biosorbent for Se(VI), however, high concentrations of SO4(2-) will compromise the biosorption of Se(VI). PMID:25590609

Johansson, Charlotte L; Paul, Nicholas A; de Nys, Rocky; Roberts, David A



Relativistic treatment of the interactions of electromagnetic probes with complex nuclei  

NASA Astrophysics Data System (ADS)

The interactions of electromagnetic probes with nuclei are studied. In the first part of this thesis the relationship between relativistic and nonrelativistic approaches to nucleon knock-out reactions is investigated. The relativistic amplitudes for the proton knock-out reactions (/gamma,p) and (e,/ e/sp/prime p) on nuclei are reduced to the nonrelativistic forms using an effective Pauli reduction scheme. The reductions are carried out to second order in the inverse nucleon mass. It is found that the interaction Hamiltonians appearing in the nonrelativistic amplitude have significant dependence on the vector and scalar mean nuclear potentials. These strong medium modifications are absent in traditional nonrelativistic calculations. Detailed comparisons show that these modifications are crucial to understanding the differences between relativistic and nonrelativistic models. These differences are also examined through reduction of the relativistic Hamiltonian for the first reaction via the Foldy- Wouthuysen transformation. Similar medium modifications are obtained in this case as well. We discuss the implications of these medium modifications for the consistency of existing non-relativistic calculations. In the second part of this thesis, a relativistic model for photoproduction of ? mesons from complex nuclei is developed. The model is used to study the exclusive reaction A(/gamma,/eta p)A-1, leading to discrete final states in the residual nucleus. Inclusive reactions A(/gamma,/eta)X in which the ? meson is the only detected particle are also studied. The ingredients of the model are: (i) the nucleon wavefunctions are solutions of the Dirac wave equation with the appropriate scalar and vector strong potentials, (ii) the ? meson is described by solutions of the Klein-Gordon equation with appropriate optical potentials, and (iii) the interactions between the fields are introduced through a covariant effective Lagrangian. The amplitudes are used to calculate the observables for the exclusive and inclusive reactions on different target nuclei. The energy region where the S11(1535) resonance dominates the reaction is specified. This is the best energy region for using the ? photoproduction reactions to study the properties of the above resonance in the nuclear medium. The region of phase space where the reaction has its largest cross section is also determined. Comparison with the existing nonrelativistic calculations is carried out. Detailed comparison of the inclusive reactions with the available data show that, in the energy regions studied, the quasifree ? production is the main contributing process to inclusive ? photoproduction reactions.

Hedayatipoor, Mohammad


Oral Curcuminoid C3 Complex® in the Treatment of Moderate to Severe Psoriasis Vulgaris: A Prospective Clinical Trial  

PubMed Central

Background There is a need for safe, inexpensive and effective psoriasis therapies. Many anecdotal accounts of patients’ successful treatment with the alternative medicine curcumin exist. Objective To determine the safety and efficacy of oral curcumin in psoriasis patients. Methods A phase II, open-label, Simon’s two-stage trial of 4.5g/d of oral Curcuminoid C3 Complex® in plaque psoriasis patients. Endpoints included improvement in Physicians Global Assessment, Psoriasis Area and Severity Index, and safety endpoints throughout the study. Results The intention to treat analysis response rate was 2/12 (95% CI: 2%, 48%) and both responders achieved a PASI 75. There were no study-related adverse events that necessitated subject withdrawal. Limitations Small sample size and lack of placebo group. Conclusion The response rate was low and possibly due to a placebo effect or the natural history of psoriasis. Large placebo-controlled studies are necessary prior to recommending oral curcumin as a psoriasis treatment. PMID:18249471

Kurd, Shanu Kohli; Smith, Nana; VanVoorhees, Abby; Troxel, Andrea B; Badmaev, Vladimir; Seykora, John T; Gelfand, Joel M



Everolimus in the treatment of subependymal giant cell astrocytomas, angiomyolipomas, and pulmonary and skin lesions associated with tuberous sclerosis complex  

PubMed Central

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder caused by inactivating mutations in either the TSC1 or TSC2 genes. It is characterized by the development of multiple, benign tumors in several organs throughout the body. Lesions occur in the brain, kidneys, heart, liver, lungs, and skin and result in seizures and epilepsy, mental retardation, autism, and renal and pulmonary organ system dysfunction, as well as other complications. Elucidation of the molecular pathways and etiological factors responsible for causing TSC has led to a paradigm shift in the management and treatment of the disease. TSC1 or TSC2 mutations lead to constitutive upregulation of the mammalian target of rapamycin pathway, which affects many cellular processes involved in tumor growth. By targeting mammalian target of rapamycin with everolimus, an orally active rapamycin derivative, clinically meaningful and statistically significant reductions in tumor burden have been achieved for the main brain (subependymal giant cell astrocytoma) and renal manifestations (angiomyolipoma) associated with TSC. This review provides an overview of TSC, everolimus, and the clinical trials that led to its approval for the treatment of TSC-associated subependymal giant cell astrocytoma and renal angiomyolipoma. PMID:24143074

Franz, David Neal



Thoracic sympathetic block for the treatment of complex regional pain syndrome type I: a double-blind randomized controlled study.  


Pain relief in complex regional pain syndrome (CRPS) remains a major challenge, in part due to the lack of evidence-based treatment trials specific for this condition. We performed a long-term randomized, double-blinded active-control study to evaluate the efficacy of thoracic sympathetic block (TSB) for upper limb type I CRPS. The study objective was to evaluate the analgesic effect of TSB in CRPS. Patients with CRPS type I were treated with standardized pharmacological and physical therapy and were randomized to either TSB or control procedure as an add-on treatment. Clinical data, pain intensity, and interference (Brief Pain Inventory), pain dimensions (McGill Pain Questionnaire [MPQ]), neuropathic characteristics (Neuropathic Pain Symptom Inventory [NPSI]), mood, upper limb function (Disabilities of Arm, Shoulder and Hand), and quality of life were assessed before, and at 1 month and 12 months after the procedure. Thirty-six patients (19 female, 44.7 ± 11.1 years of age) underwent the procedure (17 in the TSB group). Average pain intensity at 1 month was not significantly different after TSB (3.5 ± 3.2) compared to control procedure (4.8 ± 2.7; P=0.249). At 12 months, however, the average pain item was significantly lower in the TSB group (3.47 ± 3.5) compared to the control group (5.86 ± 2.9; P=0.046). Scores from the MPQ, evoked-pain symptoms subscores (NPSI), and depression scores (Hospital Anxiety and Depression Scale) were significantly lower in the TSB group compared to the control group at 1 and at 12 months. Other measurements were not influenced by the treatment. Quality of life was only slightly improved by TSB. No major adverse events occurred. Larger, multicentric trials should be performed to confirm these original findings. PMID:25149143

de Oliveira Rocha, Roberto; Teixeira, Manoel Jacobsen; Yeng, Lin Tchia; Cantara, Mirlene Gardin; Faria, Viviane Gentil; Liggieri, Victor; Loduca, Adrianna; Müller, Barbara Maria; Souza, Andrea C M S; de Andrade, Daniel Ciampi



Oral treatment of pressure ulcers with polaprezinc (zinc L-carnosine complex): 8-week open-label trial.  


Polaprezinc (zinc L-carnosine complex) is a tablet commonly prescribed for gastric ulcers in Japan. Recently, we reported the effects of polaprezinc on pressure ulcer healing at 4-week follow-up. We aimed to further evaluate the efficacy and safety of polaprezinc in 8-week treatment for chronic pressure ulcers. Patients with stage II-IV pressure ulcers for ? 8 weeks received 150 mg/day polaprezinc (containing 116 mg L-carnosine and 34 mg zinc) per os for a maximum of 8 weeks. We measured the severity of pressure ulcers weekly using the Pressure Ulcer Scale for Healing (PUSH) score and monitored blood biochemistry. Fourteen patients (nine men; 68.4?±?11.8 years) were enrolled. Pressure ulcer stages were II (one patient; 7 %), III (nine; 64 %), and IV (four; 29 %). The PUSH score improved significantly from 8.1 [95 % CI, 6.0-10.3] at baseline to -1.4 [-4.0 to 1.1] after 8 weeks (P?treatment of pressure ulcers and could be a candidate for their oral treatment. PMID:24691900

Sakae, Kensaku; Yanagisawa, Hiroyuki



Treatment Adjustment and Medication Adherence for Complex Patients With Diabetes, Heart Disease, and Depression: A Randomized Controlled Trial  

PubMed Central

PURPOSE Medication nonadherence, inconsistent patient self-monitoring, and inadequate treatment adjustment exacerbate poor disease control. In a collaborative, team-based, care management program for complex patients (TEAMcare), we assessed patient and physician behaviors (medication adherence, self-monitoring, and treatment adjustment) in achieving better outcomes for diabetes, coronary heart disease, and depression. METHODS A randomized controlled trial was conducted (2007–2009) in 14 primary care clinics among 214 patients with poorly controlled diabetes (glycated hemoglobin [HbA1c] ?8.5%) or coronary heart disease (blood pressure >140/90 mm Hg or low-density lipoprotein cholesterol >130 mg/dL) with coexisting depression (Patient Health Questionnaire-9 score ?10). In the TEAMcare program, a nurse care manager collaborated closely with primary care physicians, patients, and consultants to deliver a treat-to-target approach across multiple conditions. Measures included medication initiation, adjustment, adherence, and disease self-monitoring. RESULTS Pharmacotherapy initiation and adjustment rates were sixfold higher for antidepressants (relative rate [RR] = 6.20; P <.001), threefold higher for insulin (RR = 2.97; P <.001), and nearly twofold higher for antihypertensive medications (RR = 1.86, P <.001) among TEAMcare relative to usual care patients. Medication adherence did not differ between the 2 groups in any of the 5 therapeutic classes examined at 12 months. TEAMcare patients monitored blood pressure (RR = 3.20; P <.001) and glucose more frequently (RR = 1.28; P = .006). CONCLUSIONS Frequent and timely treatment adjustment by primary care physicians, along with increased patient self-monitoring, improved control of diabetes, depression, and heart disease, with no change in medication adherence rates. High baseline adherence rates may have exerted a ceiling effect on potential improvements in medication adherence. PMID:22230825

Lin, Elizabeth H. B.; Von Korff, Michael; Ciechanowski, Paul; Peterson, Do; Ludman, Evette J.; Rutter, Carolyn M.; Oliver, Malia; Young, Bessie A.; Gensichen, Jochen; McGregor, Mary; McCulloch, David K.; Wagner, Edward H.; Katon, Wayne J.



An investigation of multidisciplinary complex health care interventions - steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis  

PubMed Central

Background The Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model. Discussion The collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment. Summary An integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level. PMID:22524586



Effects of iron polymaltose complex, ferrous fumarate and ferrous sulfate treatments in anemic pregnant rats, their fetuses and placentas.  


Although oral iron preparations are widely prescribed to prevent and to treat iron deficiency anemia in pregnancy, comparative data on their effects to the mother, fetus and placenta are limited. In this study, the effects of oral iron polymaltose complex (IPC), ferrous fumarate (FF) and ferrous sulfate (FS) were compared in anemic pregnant rats, their fetuses and placentas. Hematological variables and oxidative stress markers in the liver, heart and kidneys of the dams and fetuses as well as the markers for oxidative stress, inflammation and hypoxia in placentas were assessed. Pregnancy outcome was measured by number of fetuses, and by neonate and placental weight. All therapies were comparably effective in correcting anemia. FS and FF, but not IPC, resulted in liver damage in dams and oxidative stress in dams, fetuses and placentas. FS group presented the highest catalase and GPx levels in dams, fetuses and placentas. IPC, but not FF or FS, restored normal TNF-? and IL6 expression levels in placentas whereas FS-treated animals presented the highest cytokine levels, suggesting a local inflammatory reaction. Anemia-induced high levels of HIF-1? were partially lowered by IPC and FF but further elevated by FS. Most of the negative effects associated with IDA were resolved by IPC treatment. Especially FS treatment was found to elicit hepatic damage in the dams, oxidative stress in the dams, fetuses and placenta as well as inflammation and high levels of HIF-1? in the placenta. Pregnancy outcome of FFand FS-treated animals was worse than that of IPC-treated animals. PMID:23547731

Toblli, Jorge E; Cao, Gabriel; Oliveri, Leda; Angerosa, Margarita



2-Deoxy-D-glucose treatment changes the Golgi apparatus architecture without blocking synthesis of complex lipids.  


The classic Golgi apparatus organization, an arrangement of highly ordered cisternal stacks with tubular-vesicular membrane specializations on both sides, is the functional image of a continuous flow of contents and membranes with input, metabolization, and output in a dynamic steady state. In response to treatment with 2-deoxy-D-glucose (2-DG), which lowers the cellular ATP level by about 70 % within minutes, this organization is rapidly replaced by tubular-glomerular membrane convolutes described as Golgi networks and bodies. 2-DG is a non-metabolizable glucose analogue and competitive inhibitor of glycolysis, which has become attractive in the context of therapeutic approaches for several kinds of tumors specifically targeting glycolysis in cancer. With the question of whether the functions of the Golgi apparatus in lipid synthesis would be influenced by the 2-DG-induced Golgi apparatus reorganization, we focused on lipid metabolism within the Golgi bodies. For this, we applied a fluorophore-labeled short-chain ceramide (BODIPY-Cer) in various combinations with 2-DG treatment to HepG2 cell cultures and followed uptake, enrichment and metabolization to higher ordered lipids. The cellular ATP status in each experiment was controlled with a bioluminescence assay, and the response of the Golgi apparatus was tracked by immunostaining of the trans-Golgi network protein TGN46. For electron microscopy, the fluorescent BODIPY-Cer signals were converted into electron-dense precipitates by photooxidation of diaminobenzidine (DAB); DAB precipitates labeled trans-Golgi areas in control cultures but also compartments at the periphery of the Golgi bodies formed in response to 2-DG treatment, thus indicating that concentration of ceramide takes place in spite of the Golgi apparatus reorganization. Lipid analyses by thin-layer chromatography (TLC) performed in parallel showed that BODIPY-Cer is not only concentrated in compartments of the 2-DG-induced Golgi bodies but is partly metabolized to BODIPY-sphingomyelin. Both, uptake and condensation of BODIPY-Cer and its conversion to complex lipids indicate that functions of the Golgi apparatus in the cellular lipid metabolism persist although the classic Golgi apparatus organization is abolished. PMID:25422148

Ranftler, Carmen; Meisslitzer-Ruppitsch, Claudia; Stangl, Herbert; Röhrl, Clemens; Fruhwürth, Stefanie; Neumüller, Josef; Pavelka, Margit; Ellinger, Adolf



Ab Initio Treatment of the Chemical Reaction Precursor Complex Cl(2P)-HF. 1. Three-Dimensional Diabatic Potential Energy Surfaces  

E-print Network

Ab Initio Treatment of the Chemical Reaction Precursor Complex Cl(2P)-HF. 1. Three-Dimensional Diabatic Potential Energy Surfaces Anna V. Fishchuk, Paul E. S. Wormer, and Ad van der Avoird* TheoreticalVed: October 10, 2005; In Final Form: December 22, 2005 The three adiabatic potential surfaces of the Cl(2P


The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: a pilot study.  


Periodontal disease (PD) is induced by a complex microbiota, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (together called the red complex), which triggers intense inflammatory reaction. Down syndrome (DS) individuals demonstrate a high prevalence of PD compared with those who are otherwise chromosomally normal (euploids). This pilot study aimed to evaluate the effect of non-surgical periodontal treatment in DS chronic periodontitis patients on clinical and microbiological parameters. Patients with chronic periodontitis, 23 DS and 12 euploids (control group), were submitted to non-surgical mechanical periodontal treatment, followed by maintenance for 45 days. Clinical parameters after periodontal treatment were similar in diseased and healthy sites, independent of the genetic background. Diseased sites of DS and control patients harbored similar levels of P. gingivalis and T. forsythia at baseline, but significantly higher levels of T. denticola were found in DS patients. Increased levels of P. gingivalis at healthy sites were found in DS individuals. Non-surgical periodontal therapy decreased the levels of red complex microorganisms and improved the tested clinical parameters of diseased sites in both groups. However, the levels of red complex bacteria were higher in diseased sites of DS patients after the periodontal treatment. We conclude in this pilot study that, although the mechanical periodontal treatment seemed to be effective in DS subjects over a short-term period, the red complex bacteria levels did not decrease significantly in diseased sites, as occurred in controls. Therefore, for DS patients, it seems that the conventional non-surgical periodontal therapy should be improved by utilizing adjuvants to reduce the presence of periodontopathogens. PMID:25367612

Tanaka, M H; Rodrigues, T O; Finoti, L S; Teixeira, S R L; Mayer, M P A; Scarel-Caminaga, R M; Giro, E M A



Treatment of nickel containing industrial effluents with a hybrid process comprising of polymer complexation–ultrafiltration–electrolysis  

Microsoft Academic Search

A process was studied at the laboratory level and on a pre-industrial pilot for pollutant removal from industrial waste waters containing nickel cations. Five successive steps are involved: (1) complexation of the metal by means of polymeric ligands; (2) ultrafiltration of the complex, which produced a purified effluent and a concentrated metal complex solution; (3) decomplexation by acidification; (4) ultrafiltration

P. Baticle; C. Kiefer; N. Lakhchaf; O. Leclerc; M. Persin; J. Sarrazin



The sweet spot of forward osmosis: Treatment of produced water, drilling wastewater, and other complex and difficult liquid streams  

E-print Network

The sweet spot of forward osmosis: Treatment of produced water, drilling wastewater, and other treated by forward osmosis. · Forward osmosis treatment of drilling mud and produced water was evaluated November 2013 Accepted 6 November 2013 Available online xxxx Keywords: Forward osmosis Wastewater treatment


Control point analysis comparison for 3 different treatment planning and delivery complexity levels using a commercial 3-dimensional diode array.  


To investigate the use of "Control Point Analysis" (Sun Nuclear Corporation, Melbourne, FL) to analyze and compare delivered volumetric-modulated arc therapy (VMAT) plans for 3 different treatment planning complexity levels. A total of 30 patients were chosen and fully anonymized for the purpose of this study. Overall, 10 lung stereotactic body radiotherapy (SBRT), 10 head-and-neck (H&N), and 10 prostate VMAT plans were generated on Pinnacle(3) and delivered on a Varian linear accelerator (LINAC). The delivered dose was measured using ArcCHECK (Sun Nuclear Corporation, Melbourne, FL). Each plan was analyzed using "Sun Nuclear Corporation (SNC) Patient 6" and "Control Point Analysis." Gamma passing percentage was used to assess the differences between the measured and planned dose distributions and to assess the role of various control point binning combinations. Of the different sites considered, the prostate cases reported the highest gamma passing percentages calculated with "SNC Patient 6" (97.5% to 99.2% for the 3%, 3mm) and "Control Point Analysis" (95.4% to 98.3% for the 3%, 3mm). The mean percentage of passing control point sectors for the prostate cases increased from 51.8 ± 7.8% for individual control points to 70.6 ± 10.5% for 5 control points binned together to 87.8 ± 11.0% for 10 control points binned together (2%, 2-mm passing criteria). Overall, there was an increasing trend in the percentage of sectors passing gamma analysis with an increase in the number of control points binned together in a sector for both the gamma passing criteria (2%, 2mm and 3%, 3mm). Although many plans passed the clinical quality assurance criteria, plans involving the delivery of high Monitor Unit (MU)/control point (SBRT) and plans involving high degree of modulation (H&N) showed less delivery accuracy per control point compared with plans with low MU/control point and low degree of modulation (prostate). PMID:24480374

Abdellatif, Ady; Gaede, Stewart



Reversal of brain metabolic abnormalities following treatment of AIDS dementia complex with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine): a PET-FDG study  

SciTech Connect

Brain glucose metabolism was evaluated in four patients with acquired immunodeficiency syndrome (AIDS) dementia complex using (/sup 18/F)fluorodeoxyglucose (FDG) and positron emission tomography (PET) scans at the beginning of therapy with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine), and later in the course of therapy. In two patients, baseline, large focal cortical abnormalities of glucose utilization were reversed during the course of therapy. In the other two patients, the initial PET study did not reveal pronounced focal alterations, while the post-treatment scans showed markedly increased cortical glucose metabolism. The improved cortical glucose utilization was accompanied in all patients by immunologic and neurologic improvement. PET-FDG studies can detect cortical metabolic abnormalities associated with AIDS dementia complex, and may be used to monitor the metabolic improvement in response to AZT treatment.

Brunetti, A.; Berg, G.; Di Chiro, G.; Cohen, R.M.; Yarchoan, R.; Pizzo, P.A.; Broder, S.; Eddy, J.; Fulham, M.J.; Finn, R.D.



Pain exposure physical therapy may be a safe and effective treatment for longstanding complex regional pain syndrome type 1: a case series  

Microsoft Academic Search

Objective: To determine if treatment of longstanding complex regional pain syndrome type 1, focusing on functional improvement only while neglecting pain, results in clinical improvement of this syndrome.Design: Prospective description of a case series of 106 patients.Setting: Outpatient clinic for rehabilitation.Interventions: Physical therapy of the affected limb directed at a functional improvement only while neglecting the pain, was performed following

Jan-Willem Ek; Jan C van Gijn; Han Samwel; Jan van Egmond; Frank PAJ Klomp; Robert TM van Dongen



Vibrational spectra, normal coordinate treatment and simulation of the vibrational spectra of piperazine glyoxime and its Co(III) complex  

NASA Astrophysics Data System (ADS)

Newly synthesized Co(III) complexes of piperazine glyoxime (PGO) are examined from the vibrational spectroscopy point of view. A complete interpretation of the vibrational spectra of both the ligand and the complex has been carried out on the basis of normal coordinate analysis. A valence force field has been developed for both of the compounds. The vibrational spectra of the compounds are simulated by a visual basic program prepared to run on an MS Excel data sheet.

Özpozan, T.; Küçükusta, D.; Büyükmumcu, Z.



Theoretical treatment of double photoionization of helium using a B-spline implementation of exterior complex scaling  

SciTech Connect

Calculations of absolute triple differential and single differential cross sections for helium double photoionization are performed using an implementation of exterior complex scaling in B-splines. Results for cross sections, well-converged in partial waves, are presented and compared with both experiment and earlier theoretical calculations. These calculations establish the practicality and effectiveness of the complex B-spline approach to calculations of double ionization of atomic and molecular systems.

McCurdy, C. William; Horner, Daniel A.; Rescigno, Thomas N.; Martin, Fernando



Tautomerism and metal complexation of 2-acylmethyl-2-oxazolines: a combined synthetic, spectroscopic, crystallographic and theoretical treatment.  


A synthetic, structural and theoretical investigation into the solid-state, solution and gas phase structure(s) of six 2-acylmethyl-4,4-dimethyl-2-oxazolines is reported. Four of these materials, viz.?-[(4,5-dihydro-4,4-dimethyl-2-oxazolyl)methylene]benzenemethanol (3a), ?-[(4,5-dihydro-4,4-dimethyl-2-oxazolyl)methylene]-(4-nitrobenzene)methanol (3b), 1-(4,5-dihydro-4,4-dimethyl-2-oxazolyl)-3,3-dimethyl-1-buten-2-ol (3d) and (E)-1-phenyl-2-((3aR)-3,3a,8,8a-tetrahydro-2H-indeno[1,2-d]oxazol-2-ylidene)ethanone (3f) have been characterised in the solid-state by single crystal X-ray diffraction studies. These data represent the first solid-state structural studies of this class of compounds and details the first synthesis and full characterisation of chiral derivative 3f. All four of these materials are shown to exist in the solid phase in the enamine tautomeric form (e.g., 3a is best described as 2-[4,4-dimethyl-2-oxazolidinylidene]-1-phenylethanone) and it is suggested (NMR, IR) that this isomeric form is likely also retained in solution (e.g., CDCl3) as the more stable isomer. An investigation of the relative gas phase stabilities of the three possible (i.e., the (Z)-enol, keto and enamine) isomers of all five compounds by DFT at the B3LYP/6-311G(d) level of theory confirms the latter as the most stable form. The energy differences between the enamine and keto tautomers have been calculated to be the lowest for derivative 3d. These results are compared and contrasted with the previously reported NMR studies of such compounds which have identified the keto form as being a minor (albeit solution) tautomer. Equilibrium solution tautomer distributions for 3d are found to be solvent dependent. The protonated form of 3a, isolated as the HSO4(-) salt (i.e.4a), has been further characterised in the solid state by single crystal X-ray diffraction. These data represent the first example of a protonated oxazoline to be structurally elucidated and confirms that upon protonation, the keto (oxazoline) tautomer is the energetically favoured form in the solid-state. This observation is further supported by DFT studies for the gas phase protonated forms of such materials. Further DFT (B3LYP/6-311G(d)) calculations employing the SM8 or SMD solvation models were then applied to address the observed solution isomeric distribution for 3d; these results corroborate the gas phase theoretical treatment and also yield values that predict the higher solution stability of the enamine form as observed, although they fail to account for the existence of the keto form as a minor solution state tautomer. To access the availability of an enol-form, via hypothetical de-protonation to the enolate, compound 3a was treated with hydrated Cu(NO3)2 in EtOH solution. The resulting isolated green-coloured product (5), the first metal derivative of this entire class of ligands, is best described (IR, X-ray diffraction) as a coordinated enolate complex, i.e., Cu(3a-H)2. Complex 5 crystallizes in the P21/c space group with four molecules in the unit cell. The coordination geometry around the formal Cu(2+) metal centre is determined to be highly distorted square planar in nature (?4 = 0.442). TD-DFT is used to give a reasonable explanation for the intensity of the absorbance band observed in the visible region for solutions of 5. These latter experiments strongly suggest that the title class of compounds may have considerable potential as ligands in coordination chemistry and/or metal-mediated catalysis. PMID:23591452

Jones, Roderick C; Herasymchuk, Khrystyna; Mahdi, Tayseer; Petrov, Anna; Resanovi?, Sanja; Vaughan, Douglas G; Lough, Alan J; Quail, J Wilson; Koivisto, Bryan D; Wylie, R Stephen; Gossage, Robert A



Analysis of lignin-carbohydrate and lignin-lignin linkages after hydrolase treatment of xylan-lignin, glucomannan-lignin and glucan-lignin complexes from spruce wood.  


Xylan-lignin (XL), glucomannan-lignin (GML) and glucan-lignin (GL) complexes were isolated from spruce wood, hydrolyzed with xylanase or endoglucanase/?-glucosidase, and analyzed by analytical pyrolysis and 2D-NMR. The enzymatic hydrolysis removed most of the polysaccharide moieties in the complexes, and the lignin content and relative abundance of lignin-carbohydrate linkages increased. Analytical pyrolysis confirmed the action of the enzymatic hydrolysis, with strong decreases of levoglucosane and other carbohydrate-derived products. Unexpectedly it also revealed that the hydrolase treatment alters the pattern of lignin breakdown products, resulting in higher amounts of coniferyl alcohol. From the anomeric carbohydrate signals in the 2D-NMR spectra, phenyl glycoside linkages (undetectable in the original complexes) could be identified in the hydrolyzed GML complex. Lower amounts of glucuronosyl and benzyl ether linkages were also observed after the hydrolysis. From the 2D-NMR spectra of the hydrolyzed complexes, it was concluded that the lignin in GML is less condensed than in XL due to its higher content in ?-O-4' ether substructures (62 % of side chains in GML vs 53 % in XL) accompanied by more coniferyl alcohol end units (16 vs 13 %). In contrast, the XL lignin has more pinoresinols (11 vs 6 %) and dibenzodioxocins (9 vs 2 %) than the GML (and both have ~13 % phenylcoumarans and 1 % spirodienones). Direct 2D-NMR analysis of the hydrolyzed GL complex was not possible due to its low solubility. However, after sample acetylation, an even less condensed lignin than in the GML complex was found (with up to 72 % ?-O-4' substructures and only 1 % pinoresinols). The study provides evidence for the existence of structurally different lignins associated to hemicelluloses (xylan and glucomannan) and cellulose in spruce wood and, at the same time, offers information on some of the chemical linkages between the above polymers. PMID:24531838

Du, Xueyu; Pérez-Boada, Marta; Fernández, Carmen; Rencoret, Jorge; del Río, José C; Jiménez-Barbero, Jesús; Li, Jiebing; Gutiérrez, Ana; Martínez, Angel T



Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial  

PubMed Central

Background Traditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis. Methods and design In a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ?40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy-effectiveness continuum. Discussion This trial is the first to compare the effectiveness of a complex Ayurvedic intervention with a complex conventional intervention in a Western medical setting in patients with knee osteoarthritis. During the trial design, aspects of efficacy and effectiveness were discussed. The resulting design is a compromise between rigor and pragmatism. Trial registration NCT01225133 PMID:23701973



[Dynamics of various electrophysiologic indices in patients with mild acute closed craniocerebral injuries during complex treatment using reflexotherapy].  


An analysis of 117 cases of acute closed craniocerebral trauma (CCCT) of a mild degree, the time-course of the EEG, EchoEG and REG findings in the process of treatment has shown that mild CCCT was expressed clinically in CSF hypertension, as well as vegetovascular and asthenoneurotic syndromes. The detection at the early stages of the injury of the leading clinical syndrome contributes to the conduction of purposeful therapeutic measures. A positive time-course of some electrophysiological parameters indicates the normalization of vegetovascular dysfunctions under the impact of acupuncture, which permits the use of this method in the multiple modality treatment of CCCT in the acute period. PMID:4050229

Petelin, L S; Go?denko, V S; Biblina, I M



The Role of Semantic Complexity in Treatment of Naming Deficits: Training Semantic Categories in Fluent Aphasia by Controlling Exemplar Typicality  

Microsoft Academic Search

The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and

Swathi Kiran; Cynthia K. Thompson



Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation?  


The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included. PMID:23561417

Souki, Bernardo Quiroga; Figueiredo, Daniel Santos Fonseca; Lima, Izabella Lucas de Abreu; Oliveira, Dauro Douglas; Miguel, José Augusto Mendes



Thermal treatment effects imposed on solid DNA cationic lipid complex with hexadecyltrimethylammonium chloride, observed by variable angle spectroscopic ellipsometry  

NASA Astrophysics Data System (ADS)

DNA cationic lipid complexes are materials of properties required for applications in organic electronics and optoelectronics. Often, their thermal stability demonstrated by thermogravimetry is cited in the literature as important issue. However, little is known about processes occurring in heated solid DNA cationic lipid complexes. In frame of this work, thin films of Deoxyribonucleic acid-hexadecyltrimethylammonium chloride (DNA-CTMA) were deposited on silicon wafers. Samples were thermally annealed, and simultaneously, their optical functions were measured by spectroscopic ellipsometry. At lower temperatures, thermal expansion coefficient of solid DNA-CTMA was negative, but at higher temperatures positive. Thermally induced modification of absorption spectrum in UV-vis was observed. It occurred at a range of temperatures higher than this of DNA denaturation in solution. The observed phenomenon was irreversible, at least in time scale of the experiment (one day).

Nizio?, Jacek



Novel nanocrystalline Ga–Al–Zn complex oxide: catalyst for simultaneous treatment of NPAC and lean NO x  

Microsoft Academic Search

Nanocrystalline Ga–Al–Zn complex-oxide (designated here as nano-GAZ) has been successfully synthesized using hydrothermal method. Using TEM, BET, FTIR, DTA–TGA, and XRD, synthesized nano-GAZ particles are shown as high-surface-area nanoparticles comprising typical spinel crystal structures. The nano-GAZ catalyst was tested as a new deNPAC catalyst, using pyridine as the model NPAC compound. The reaction results show that pyridine could be completely

S. C. Shen; K. Hidajat; L. E. Yu; S. Kawi



Efficacy of Amphotericin B Lipid Complex in the Treatment of Invasive Fungal Infections in Immunosuppressed Paediatric Patients  

Microsoft Academic Search

The safety and efficacy of amphotericin B lipid complex (ABLC) were evaluated in a retrospective study of 46 paediatric patients\\u000a with invasive infections. The study included a large proportion of patients who were refractory to or intolerant of conventional\\u000a antifungal therapy. The mean age of the children was 9.7?4.8 years. Primary underlying conditions included mainly haematopoietic\\u000a stem cell transplantation, leukaemia

R. Herbrecht; A. Auvrignon; E. Andrès; R. Guillemain; A. Suc; D. Eyer; C. Pailler; V. Letscher-Bru; G. Leverger; G. Schaison



Treatment of complex intracranial aneurysms using flow-diverting silk® stents. An analysis of 32 consecutive patients.  


This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms. PMID:25496683

Buyukkaya, Ramazan; Kocaeli, Hasan; Yildirim, Nalan; Cebeci, Hakan; Erdogan, Cüneyt; Hakyemez, Bahattin



Formation and characterization of lactoferrin\\/pectin electrostatic complexes: Impact of composition, pH and thermal treatment  

Microsoft Academic Search

Protein–polysaccharide complexes may be used for the development of delivery systems with applications in several industries. In the present work, the interaction of lactoferrin (LF, 0.2wt%) with a High-Methoxyl pectin (0.005–0.15wt%) in aqueous solutions was studied at different pH values (2–7) and temperatures (30–90 °C) at low ionic strength. ?-potential and light-scattering techniques were used to provide information about the electrical

Carlos Bengoechea; Owen G. Jones; Antonio Guerrero; David Julian McClements



[Preperitoneal suprainguinal access with prosthesis of the anterior abdominal wall in treatment of complex forms of incarcerated inguinal hernias].  


The article describes a non-typical access to treatment of gigantic incarcerated inguinal hernias. Preperitoneal suprainguinal access allows solution of the main task of operative aid in this pathology: inspection of the strangulated organs, safe dissection of the incarcerating ring and prosthesis of the anterior abdominal wall. This method in many aspects is comparable with traditional methods of hernioplasty, but the postoperative quality of life is much better. PMID:20552796

Fedoseev, A V; Leonchenko, S V; Faber, M I; Murav'ev, S Iu



Complex decisions for first-line and maintenance treatment of advanced wild-type non-small cell lung cancer.  


Until recently, the first-line treatment of advanced non-small cell lung cancer (NSCLC) required minimal clinical decision making. Patients who were eligible for chemotherapy received a platinum-based doublet, and 5-year survival rates were poor. With the advent of molecularly targeted agents and better tolerated chemotherapies-namely, bevacizumab, erlotinib, and pemetrexed-new therapeutic opportunities have emerged. Some of the strategies that have proven to be successful for the treatment of patients with NSCLC are targeting of the vascular endothelial growth factor, use of maintenance chemotherapy for patients without progression of disease after initial therapy, and tailoring of cytotoxic agents specific to the histology of an individual patient's cancer. Each approach has been independently shown to improve overall survival, but integrating the data from a number of complicated trials into the "best" approach for patients remains challenging. This review attempts to address three fundamental questions clinicians face in choosing first-line and maintenance treatment for advanced NSCLC, particularly nonsquamous histology: Is pemetrexed or a taxane agent better for combination with platinum therapy? Should bevacizumab be used, and is it beneficial when added to pemetrexed chemotherapy? When is maintenance therapy indicated, and which agent is best? PMID:25660158

Gentzler, Ryan D; Johnson, Melissa L



Comparative study of tolerability and efficacy of iron protein succinylate versus iron hydroxide polymaltose complex in the treatment of iron deficiency in children.  


One-hundred children, 48 males and 52 females, mean age +/- SD 39.9 +/- 28.2 months (range 12 to 113) with sideropenia or sideropenic anemia were randomly divided into 2 groups of 50 patients each (groups A and B) and were treated with iron protein succinylate (group A) or iron hydroxide polymaltose complex (group B). Patients of both groups received 4 mg/kg elemental iron, maximally 80 mg daily, for 2 months. Side-effects of therapy and laboratory values (RBC, hematocrit, hemoglobin, MCV, serum iron, total iron binding capacity, and ferritin) were registered before treatment, 30 days after the beginning of therapy as well as after 60 days in order to evaluate tolerability and efficacy of the drugs. Both drugs were well tolerated and showed only few adverse reactions, which were comparable in severity and frequency. Iron protein succinylate led not only to a faster increase of hemoglobin, hematocrit, MCV, serum iron, and ferritin than iron hydroxide polymaltose complex, but the laboratory values remained higher in group A than in B even after 2 months of treatment. PMID:9660039

Haliotis, F A; Papanastasiou, D A



Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.  


Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. PMID:24249260

Sarkozy, Clémentine; Terré, Christine; Jardin, Fabrice; Radford, Isabelle; Roche-Lestienne, Catherine; Penther, Dominique; Bastard, Christian; Rigaudeau, Sophie; Pilorge, Sylvain; Morschhauser, Franck; Bouscary, Didier; Delarue, Richard; Farhat, Hassan; Rousselot, Philippe; Hermine, Olivier; Tilly, Hervé; Chevret, Sylvie; Castaigne, Sylvie



Treatment of complex medical emergencies in a forward deployed setting: a case of out-of-hospital cardiac arrest.  


The Joint Trauma System in Afghanistan, while designed for the care of injured patients, can provide timely, multimodal, coordinated care for nontraumatic medical emergencies as patients are evacuated from theater. To illustrate this, a case of out-of-hospital cardiac arrest is presented. The patient was able to receive all recommended components of postcardiac arrest care in a timely, coordinated manner at four different medical treatment facilities and while traveling over 8,600 miles with critical care provided en route. PMID:24491623

Clifton, Guy T; Willis, Scott L; Peterson, Wylan C



Intramedullary Allograft Fibula as a Reduction and Fixation Tool for Treatment of Complex Proximal Humerus Fractures with Diaphyseal Extension.  


SUMMARY:: In this study, we present a novel technique for reduction and fixation of complex, unstable, proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while making the surgical procedure technically more manageable, and allows for early postoperative motion. In the first part of this study, we describe in detail the indications and surgical technique applied to these fractures. In the second part, we review the clinical and radiographic outcomes of these patients. Using this new technique, we have achieved an excellent union rate with minimal incidence of complications when treating these challenging fractures. PMID:23681414

Berkes, Marschall B; Little, Milton Tm; Lazaro, Lionel E; Cymerman, Rachel M; Pardee, Nadine C; Helfet, David L; Dines, Joshua S; Lorich, Dean G



Functional outcome of arthroscopic assisted fixation of distal radius fractures  

PubMed Central

Background: Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures. Materials and Methods: We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months). Results: Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score. Conclusion: The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures. PMID:23798761

Khanchandani, Prakash; Badia, Alejandro



The Auditory Brain-Stem Response to Complex Sounds: A Potential Biomarker for Guiding Treatment of Psychosis  

PubMed Central

Cognitive deficits limit psychosocial functioning in schizophrenia. For many patients, cognitive remediation approaches have yielded encouraging results. Nevertheless, therapeutic response is variable, and outcome studies consistently identify individuals who respond minimally to these interventions. Biomarkers that can assist in identifying patients likely to benefit from particular forms of cognitive remediation are needed. Here, we describe an event-related potential (ERP) biomarker – the auditory brain-stem response (ABR) to complex sounds (cABR) – that appears to be particularly well-suited for predicting response to at least one form of cognitive remediation that targets auditory information processing. Uniquely, the cABR quantifies the fidelity of sound encoded at the level of the brainstem and midbrain. This ERP biomarker has revealed auditory processing abnormalities in various neurodevelopmental disorders, correlates with functioning across several cognitive domains, and appears to be responsive to targeted auditory training. We present preliminary cABR data from 18 schizophrenia patients and propose further investigation of this biomarker for predicting and tracking response to cognitive interventions. PMID:25352811

Tarasenko, Melissa A.; Swerdlow, Neal R.; Makeig, Scott; Braff, David L.; Light, Gregory A.



Human immunodeficiency virus replication in AIDS patients with Mycobacterium avium complex bacteremia: a case control study. California Collaborative Treatment Group.  


The development of opportunistic infections and the administration of vaccines have been associated with transient increases of human immunodeficiency virus (HIV) RNA plasma levels in HIV-infected patients. To determine the relationship between Mycobacterium avium complex (MAC) bacteremia and HIV RNA levels, HIV RNA levels in patients who developed MAC bacteremia (cases) were compared with levels in patients who remained free of MAC disease (controls). Cases and controls were matched for CD4 cell count, prophylaxis against MAC disease, antiretroviral therapy, and duration of follow-up. Mean baseline HIV RNA levels were 4.8 log10 copies/mL in cases and 4.6 log10 copies/mL in controls (P = 0.22). HIV RNA levels increased by a median of 0.4 log in cases but not controls at the time of MAC bacteremia (P = 0.01). In AIDS patients, the onset of MAC bacteremia is associated with a modest but significant increase in serum HIV RNA levels. Increased HIV replication may contribute to the higher mortality associated with MAC bacteremia. PMID:9498437

Havlir, D V; Haubrich, R; Hwang, J; Dunne, M W; Currier, J; Forthal, D; Torriani, F; Richman, D D; McCutchan, J A



A curative treatment option for Complex Regional Pain Syndrome (CRPS) Type I: dorsal root entry zone operation (report of two cases).  


Complex Regional Pain Syndrome Type I (CRPS-I) is a debated health problem concerning its pathophysiology and treatment strategies. A 12-year-old boy and a 35-year-old woman were diagnosed with CRPS-I at different times. They had previously undergone various types of interventions with no success. After one year of follow-up and observation, DREZ lesioning operation was performed. Afterwards, both cases had transient lower extremity ataxia. The first case was followed for 60 months with no recurrence and total cure. The second case was pain-free until the 6th month, when she required psychological support; she was followed for 33 months with partial satisfactory outcome. Although not a first-line option, DREZ lesioning procedure can be chosen and may be a curative option in selected cases of CRPS-I who are unresponsive to conventional therapies. PMID:24535809

Kanpolat, Yucel; Al-Beyati, Eyyub; Ugur, Hasan Caglar; Akpinar, Gokhan; Kahilogullari, Gokmen; Bozkurt, Melih



[Treatment with stellate ganglion block, continuous epidural block and ulnar nerve block of a patient with postherpetic neuralgia who developed complex regional pain syndrome (CRPS)].  


We present a case of a 46-year-old female patient with systemic lupus erythematosus who developed herpes zoster of the right eighth cervical nerve. Her whole right forearm, hand and the first through fifth fingers were coated with some gel and protected against pain. She had been suffering from continuous and spasmodic burning pain, hyperalgesia, allodynia, drop in skin temperature, sudmotor disturbance, edema, constructure of the joints, muscle atrophy and bone atrophy of her right upper extremity probably due to postherpetic neuralgia (PHN) associated with complex regional pain syndrome (CRPS). She received right stellate ganglion block (SGB), continuous cervical epidural block and right ulnar nerve block. Reduction of pain and edema as well as improvement in mobility of each joint of her right upper extremity was observed. We suspect that SGB, continuous cervical epidural block and ulnar nerve block are effective and useful alternative treatments in a patient with PHN associated with CRPS of the eighth cervical nerve. PMID:11424478

Mizuno, J; Sugimoto, S; Ikeda, M; Kamakura, T; Machida, K; Kusume, S



The Ilizarov method for the treatment of complex tibial fractures and non-unions in a mass casualty setting: the 2005 earthquake in Pakistan.  


We report our experience in treating victims of the recent earthquake disaster in Pakistan. Our experience was based on two humanitarian missions to Islamabad: one in October 2005, 10 days after the earthquake, and the second in January 2006. The mission consisted of a team of orthopaedic surgeons and a second team of plastic surgeons. The orthopaedic team bought all the equipment for application of Ilizarov external fixators. We treated patients who had already received basic treatment in the region of the disaster and subsequently had been evacuated to Islamabad. During the first visit, we treated 12 injured limbs in 11 patients. Four of these patients were children. All cases consisted of complex multifragmentary fractures associated with severe crush injuries. All fractures involved the tibia, which were treated with Ilizarov external fixators. Nine fractures were type 3b open injuries. Eight were infected requiring debridement of infected bone and acute shortening. During a second visit, we reviewed all patients treated during our first mission. In addition, we treated 13 new patients with complex non-unions. Eight of these patients were deemed to be infected. All patients had previous treatment with monolateral fixators as well as soft tissue coverage procedures, except one patient who had had an IEF applied by another team. All these patients had revision surgery with circular frames. All patients from both groups were allowed to fully weight-bear post-operatively, after a short period of elevation to allow the flaps to take. Overall, all fractures united except one case who eventually had an amputation. Four patients had a corticotomy and lengthening, and three of them had a successful restoration of limb length. The fourth patient was the one with the eventual amputation. PMID:25764152

Tilkeridis, Konstantinos; Chari, Basavraj; Cheema, Nusrat; Tryfonidis, Marios; Khaleel, Arshad



IL-2/anti-IL-2 antibody complex treatment inhibits the development but not the progression of herpetic stromal keratitis.  


The IL-2/anti-IL-2 Ab immunocomplex has recently been shown to expand the naturally occurring pool of CD4(+)Foxp3(+) regulatory T cells (Tregs). In this study, we show that administration of the IL-2/anti-IL-2 Ab immunocomplex to C57BL/6 mice, prior to corneal HSV-1 infection, significantly increased the pool of Foxp3(+) Tregs when measured at early time points postinfection. Increased numbers of Foxp3(+) Tregs on days 2 and 4 postinfection resulted in a marked reduction in the development of severe herpetic stromal keratitis (HSK). When compared with corneas from the control group, corneas from the immunocomplex-treated group showed a significant reduction in the amount of infectious virus on day 2 but not on day 4 postinfection. Reduced viral load was associated with a 2-fold increase in NK cell numbers in corneas from the immunocomplex-treated group of mice. Moreover, a dramatic reduction in the influx of CD4 T cells in inflamed corneas was determined on days 7 and 16 postinfection in the immunocomplex-treated group of infected mice. Immunocomplex treatment given on days 5, 6, and 7 postinfection significantly increased Foxp3(+) Tregs in draining lymph nodes and in the spleen but failed to reduce the severity of HSK. In terms of the influx of CD4 T cells and granulocytes into inflamed corneas, no significant differences were noted between both groups of mice on day 16 postinfection. Our findings demonstrate that increasing Foxp3(+) Tregs early but not late postinfection in secondary lymphoid tissues is more efficacious in controlling the severity of HSK. PMID:25411200

Gaddipati, Subhash; Estrada, Kathleen; Rao, Pushpa; Jerome, Andrew David; Suvas, Susmit



Actinide immobilization in the subsurface environment by in-situ treatment with a hydrolytically unstable organophosphorus complexant: Uranyl uptake by calcium phytate  

SciTech Connect

In addition to naturally occurring uranium and thorium, actinide ions exist in the subsurface environment as a result of accidental releases and intentional disposal practices associated with nuclear weapons production. These species present a significant challenge to cost-effective remediation of contaminated environments. An attractive approach to decreasing the probability of actinide migration in the subsurface is to transform the ions into a less mobile form by remote treatment. We have under development a process which relies on a polyfunctional organophosphorus complexant to sequester the mobile metal ions by complexation/cation exchange in the near term, and to subsequently decompose, transforming the actinides into insoluble phosphate mineral forms in the long term. Studies to date include identification of a suitable organophosphorus reagent, profiling of its decomposition kinetics, verification of the formation of phosphate mineral phases upon decomposition of the reagent, and extensive comparison of the actinide uptake ability of the calcium salt of the reagent as compared with hydroxyapatite. In this report, we briefly describe the process with focus on the cation exchange behavior of the calcium salt of the organophosphorus sequestrant.

Nash, K.L.; Jensen, M.P.; Schmidt, M.A.



Comparison of Efficacy, Tolerability, and Cost of Iron Polymaltose Complex With Ferrous Sulphate in the Treatment of Iron Deficiency Anemia in Pregnant Women  

PubMed Central

Background The efficacy of iron polymaltose complex (IPC) in the treatment of iron deficiency anemia (IDA) during pregnancy has not been well established, and the evidence is inconclusive. Aims The aim of the study was to compare efficacy, safety, compliance, and cost-effectiveness of IPC with ferrous sulphate (FS) in pregnant patients. Settings and Designs The randomized, double-blind, parallel-group study was conducted in the Department of Pharmacology in collaboration with the Department of Obstetrics and Gynaecology Postgraduate Institute of Medical Education and Research, Chandigarh, India. Methods One hundred pregnant women aged 20–40 years at14 to 27 weeks' gestation, with hemoglobin (Hb) < 9 g/dL, and serum ferritin < 12 mcg/L, were classified into 2 groups. One group received IPC (100 mg elemental iron), and the other group received FS (120 mg elemental iron) daily for 8 weeks. At Week 0 and Week 8, Hb, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron, and serum ferritin were measured. Compliance with study medication was determined by pill counting at each visit. Cost minimization analysis was done to compare the costs of the 2 treatments. Statistical Analysis Data are expressed as mean ± SD. Paired and unpaired ‘t’ test were used to analyze differences within groups and between groups. Chi-square (x2) test was used to analyze primary efficacy parameters and adverse drug reactions (ADR). Results Statistically significant increases in Hb, PCV, MCV, MCH, MCHC, serum iron, and serum ferritin levels were seen at the end of 8 weeks of treatment in both groups. The overall adverse effects were more common in the FS group compared with the IPC group [41 (78%) vs 15 (31%), P < .001]. The compliance rate was significantly (P < .05) higher for the IPC (91%) group than for the FS (87%) group. The average total cost (direct + indirect) of treatment of anemia was comparable between the 2 groups. Conclusion The results of the present study suggest that IPC can be considered as a useful alternative formulation for the treatment of IDA during pregnancy for those patients who cannot tolerate other iron preparations (ferrous form); this is an important finding, as compliance is a significant concern during pregnancy. PMID:17435611

Saha, Lekha; Pandhi, Promila; Gopalan, Sarala; Malhotra, Samir; Saha, Pradip kumar



Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach  

PubMed Central

Background Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. Objective The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. Methods We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. Results The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels. Conclusions The descriptions of the treatment rationale for Balance, the alcohol intervention reported herein, provides an intervention blueprint that will aid in interpreting the results from future program evaluations. It will ease comparisons of program rationales across interventions, and may assist intervention development. By putting just-in-time therapy within a complete theoretical and practical context, including the tunnel delivery strategy and the self-regulation perspective, we have contributed to an understanding of how multiple delivery strategies in eHealth interventions can be combined. Additionally, this is a call for action to improve the reporting practices within eHealth research. Possible ways to achieve such improvement include using a systematic and structured approach, and for intervention reports to be published after peer-review and separately from evaluation reports. PMID:23612478

Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny



Complications of mammalian target of rapamycin inhibitor anticancer treatment among patients with tuberous sclerosis complex are common and occasionally life-threatening.  


The aim of this study was to evaluate the most common adverse events (AEs) linked to everolimus therapy, a mammalian target of rapamycin (mTOR) inhibitor, in children and adolescents with tuberous sclerosis complex (TSC) hospitalized in one medical center. The study group included 18 patients with a diagnosis of subependymal giant cell astrocytoma or renal angiomyolipoma related to TSC. The median duration of therapy was 15 months. All clinical symptoms and laboratory abnormalities including complete blood count, fasting lipid profile, glucose level, and liver and kidney function tests were analyzed as potential AEs. The most common AEs of everolimus therapy were laboratory abnormalities (100% of patients) and infection complications (83 episodes in 15 patients). Infectious episodes of pharyngitis (67%), diarrhea (44%), stomatitis (39%), and bronchitis (39%) were the most common infections. They were mostly mild or moderate in severity (grade 1-2). In two cases, life-threatening conditions related to mTOR inhibitor treatment were encountered. The first was classified as grade 4 pleuropneumonia and Streptococcus pneumoniae sepsis, whereas the second was classified as death related to AE (grade 5) Escherichia coli sepsis. The most common laboratory abnormalities were hypercholesterolemia (13/18 patients - 72%) and hypertriglyceridemia (12/18 patients - 66%). Neutropenia (12/18 patents - 66%) and anemia (8/18 patients - 44%) were the most common hematologic toxicities. Everolimus treatment in TSC patients may lead to life-threatening outcomes, including sepsis and death. Long-lasting effects of everolimus treatment in the context of high incidences of different laboratory abnormalities found in TSC patients are another subject that should be researched further. PMID:25719621

Trelinska, Joanna; Dachowska, Iwona; Kotulska, Katarzyna; Fendler, Wojciech; Jozwiak, Sergiusz; Mlynarski, Wojciech



Therapeutic Response of Vitamin A, Vitamin B Complex, Essential Fatty Acids (EFA) and Vitamin E in the Treatment of Phrynoderma: A Randomized Controlled Study  

PubMed Central

Background: In the treatment of phrynoderma, various nutrients have been tried in different dosages and routes with variable therapeutic outcomes. Aims: The present study was undertaken to compare the efficacy of various nutrients in the treatment of phrynoderma. Settings and Design: An open label randomized controlled study was conducted in the out-patient department of Dermatology in a tertiary care hospital. Material and Methods: The patients were divided into group of five and each patient received one of the five regimens [10 injections of Vitamin A 1 lakh units, intramuscularly (IM) on alternate day, 10 injections of Vitamin B complex, 2cc IM on alternate day, 2 table spoon of safflower oil, two times daily with meals, Tab Vitamin E 400mg once daily, and only topical keratolytic (salicylic acid 3% ointment) two times daily] respectively. The first four regimens also received topical keratolytic. The primary outcome measured was therapeutic response at the end of regimen. The response was graded based on the percentage of flattening and decrease in number of lesions. Less than 25% improvement was graded as poor, 26-50% improvement as moderate, 51-75% improvement as good, and more than 75% improvement as excellent response. In the statistical analysis, comparison was done using Chi-square and Fisher’s exact test. Results: A total of 125 patients were included in the study with 25 patients each in five regimen groups. There were 79 (63.2%) males and 46 (36.8%) females with a ratio of 1.72:1. The age of the patients ranged from 3 to 26 years with mean of 10.1±4.3 years. Out of 125 patients, 105 completed the study. In regimen 1 and 2, significant number of patients showed good to excellent response whereas significant number of patients in remaining regimen showed moderate to poor response with a p value of <0.05. The therapeutic response to Vitamin A and Vitamin B complex therapy was significantly better than other regimens. Conclusion: Intramuscular injections of Vitamin A or Vitamin B are effective in the treatment of phrynoderma. Addition of topical keratolytics helps in faster clearance of keratotic lesions. PMID:24596740

S., Ragunatha; Kumar V., Jagannath; S.B., Murugesh; M., Ramesh; G., Narendra; Kapoor, Meenakshi



Space Complexity Algorithms & Complexity  

E-print Network

Space Complexity Algorithms & Complexity Space Complexity Nicolas Stroppa Patrik Lambert - CA313@Dublin City University. 2008-2009. December 4, 2008 #12;Space Complexity Hierarchy of problems #12;Space Complexity NP-intermediate Languages If P = NP, then are there languages which neither in P

Way, Andy


Increased Survivorship and Altered Cytokine Profile from Treatment of Influenza A H1N1-Infected Mice with Ekybion: A Drug Complex of Natural Extracts and Inorganic Compounds.  


Ekybion is a drug complex of 16 natural extracts and inorganic compounds designed to treat a variety of respiratory pathogens of bacterial and viral origin. It is licensed throughout Europe for the treatment of respiratory tract infections from equine parainfluenza type 3 and equine herpes virus type 1 in equine stables. The purpose of this paper was to test the efficacy of Ekybion on a well-developed animal model of influenza A infection and determine a mode of action. Experiments were performed with Balb/c mice infected with a lethal dose of influenza A/PR/8/34 H1N1 virus and treated with nebulized Ekybion every 8?h in a time-dependant or dose-dependant fashion. These experiments showed that mice treated prior to infection with Ekybion had a higher survival rates (~46%) compared with untreated animals (~0%). Paradoxically, these mice showed no significant difference in lung virus titer or weight loss. There was, however, a decrease in the level of GM-CSF, IL-6, and G-CSF cytokines in the lungs of Ekybion-treated, infected mice. It is possible that decreases in proinflammatory cytokines may have contributed to increased survivorship in Ekybion-treated influenza-infected mice. PMID:20981272

Lupfer, Christopher; Besnouin, Didier; Tepper, Samuel E; Maselko, Maciej; Patton, Kristin M; Pastey, Manoj



Intravenous regional guanethidine blockade in the treatment of post-traumatic complex regional pain syndrome type 1 (algodystrophy) of the hand.  


A total of 57 patients, aged between 23 and 86 years, with complex regional pain syndrome (CRPS) type 1 nine weeks after an isolated closed fracture of the distal radius, was randomised to receive either serial intravenous regional blockade (IVRB) with 15 mg of guanethidine in 30 ml of 0.5% prilocaine or serial IVRB with 30 ml of normal saline at weekly intervals until the tenderness in their fingers had resolved or they had received a maximum of four IVRBs. The analgesic efficacy was assessed at 24 hours, 48 hours and one week after each procedure by the dolorimetry ratio and verbal pain scores, and at intervals up to six months after the fracture. There was no significant difference in the number of IVRBs administered or in finger tenderness, stiffness or grip strength between the two groups. The guanethidine group experienced more pain in the affected hand (p = 0.025) and at six months had more vasomotor instability (p < 0.0001) compared with the control group. IVRB using guanethidine offers no significant analgesic advantage over a normal saline placebo block in the treatment of early CRPS type 1 of the hand after fracture of the distal radius. It does not improve the outcome of this condition and may delay the resolution of vasomotor instability when compared with the placebo. PMID:12002497

Livingstone, J A; Atkins, R M



Increased Survivorship and Altered Cytokine Profile from Treatment of Influenza A H1N1-Infected Mice with Ekybion: A Drug Complex of Natural Extracts and Inorganic Compounds  

PubMed Central

Ekybion is a drug complex of 16 natural extracts and inorganic compounds designed to treat a variety of respiratory pathogens of bacterial and viral origin. It is licensed throughout Europe for the treatment of respiratory tract infections from equine parainfluenza type 3 and equine herpes virus type 1 in equine stables. The purpose of this paper was to test the efficacy of Ekybion on a well-developed animal model of influenza A infection and determine a mode of action. Experiments were performed with Balb/c mice infected with a lethal dose of influenza A/PR/8/34 H1N1 virus and treated with nebulized Ekybion every 8?h in a time-dependant or dose-dependant fashion. These experiments showed that mice treated prior to infection with Ekybion had a higher survival rates (~46%) compared with untreated animals (~0%). Paradoxically, these mice showed no significant difference in lung virus titer or weight loss. There was, however, a decrease in the level of GM-CSF, IL-6, and G-CSF cytokines in the lungs of Ekybion-treated, infected mice. It is possible that decreases in proinflammatory cytokines may have contributed to increased survivorship in Ekybion-treated influenza-infected mice. PMID:20981272

Lupfer, Christopher; Besnouin, Didier; Tepper, Samuel E.; Maselko, Maciej; Patton, Kristin M.; Pastey, Manoj



In vitro and in vivo anticancer properties of a Calcarea carbonica derivative complex (M8) treatment in a murine melanoma model  

PubMed Central

Background Melanoma is the most aggressive form of skin cancer and the most rapidly expanding cancer in terms of worldwide incidence. Chemotherapeutic approaches to treat melanoma have had only marginal success. Previous studies in mice demonstrated that a high diluted complex derived from Calcarea carbonica (M8) stimulated the tumoricidal response of activated lymphocytes against B16F10 melanoma cells in vitro. Methods Here we describe the in vitro inhibition of invasion and the in vivo anti-metastatic potential after M8 treatment by inhalation in the B16F10 lung metastasis model. Results We found that M8 has at least two functions, acting as both an inhibitor of cancer cell adhesion and invasion and as a perlecan expression antagonist, which are strongly correlated with several metastatic, angiogenic and invasive factors in melanoma tumors. Conclusion The findings suggest that this medication is a promising non-toxic therapy candidate by improving the immune response against tumor cells or even induce direct dormancy in malignancies. PMID:20338038



Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Vitamin B Complex in the Treatment of Nocturnal Leg Cramps in Elderly Patients with Hypertension  

Microsoft Academic Search

Nocturnal leg cramps is a common and troublesome problem in elderly individuals, and their etiology is unknown. Treatment with quinine is a common practice, but the effectiveness of the drug is doubtful and adverse drug effects are common. This randomized, double-blind, placebo-controlled study was conducted to evaluate the safety and efficacy of vitamin B complex capsules (fursulthiamine 50 mg, hydroxocobalamin

Paul Chan; Tsuei-Yuen Huang; Yi-Jen Chen; Wen-Pin Huang; Yu-Chi Liu



Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study)  

PubMed Central

Introduction In vitamin K antagonist (VKA)-treated patients with severe hemorrhage, guidelines recommend prompt VKA reversal with prothrombin complex concentrate (PCC) and vitamin K. The aim of this observational cohort study was to evaluate the impact of guideline concordant administration of PCC and vitamin K on seven-day mortality. Methods Data from consecutive patients treated with PCC were prospectively collected in 44 emergency departments. Type of hemorrhage, coagulation parameters, type of treatment and seven-day mortality mortality were recorded. Guideline-concordant administration of PCC and vitamin K (GC-PCC-K) were defined by at least 20 IU/kg factor IX equivalent PCC and at least 5 mg of vitamin K performed within a predefined time frame of eight hours after admission. Multivariate analysis was used to assess the effect of appropriate reversal on seven-day mortality in all patients and in those with intracranial hemorrhage (ICH). Results Data from 822 VKA-treated patients with severe hemorrhage were collected over 14 months. Bleeding was gastrointestinal (32%), intracranial (32%), muscular (13%), and “other” (23%). In the whole cohort, seven-day mortality was 13% and 33% in patients with ICH. GC-PCC-K was performed in 38% of all patients and 44% of ICH patients. Multivariate analysis showed a two-fold decrease in seven-day mortality in patients with GC-PCC-K (odds ratio (OR)?=?2.15 (1.20 to 3.88); P?=?0.011); this mortality reduction was also observed when only ICH was considered (OR?=?3.23 (1.53 to 6.79); P?=?0.002). Conclusions Guideline-concordant VKA reversal with PCC and vitamin K within eight hours after admission was associated with a significant decrease in seven-day mortality. PMID:24762166



[Relative bioavailability and penetration of glucosamine after topical treatment by Hondroxid Maximum transdermal glucosamine complex in comparison with oral, injectable routes in experiment on the rats].  


A comparison of the relative bioavailability and intensity of penetration of glucosamine sulfate in oral, injection and topical administration of the dosage form Hondroxid Maximum as a cream containing micellar system for transdermal delivery of glucosamine in the experiment by Sprague-Dawley rats was carried out. On the base on the pharmacokinetic profiles data of glucosamine in rat blood plasma with daily administration in 3 times a day for 1 week by cream Hondroxid Maximum 400 mg/kg and the single injection solution of 4% Glucosamine sulfate 400 mg/kg was found that the relative bioavailability was 61.6%. Calculated penetration rate of glucosamine in the plasma through the rats skin in 4 hours, equal to 26.9 ?g/cm2 x h, and the penetration of glucosamine through the skin into the plasma after a single dose of cream in 4 hours was 4.12%. Comparative analysis of literature and experimental data and calculations based on them suggest that medicine Hondroxid Maximum, cream with transdermal glucosamine complex in the treatment in accordance with the instructions can provide an average concentration of glucosamine in the synovial fluid of an inflamed joint in the range (0.7 - 1.5) ?g/ml, much higher than the concentration of endogenous glucosamine human synovial joint fluid (0.02 - 0.07 ?g/ml). By theoretical calculations taking into account experimental data it is shown that the medicine Hondroxid Maximum can reach the bioavailability level of the modern injection forms and exceed the bioavailability level of modern oral forms of glucosamine up to 2 times. PMID:25739190



Treatment and Recovery  


... Shopping cart Contact Us DVBIC Defense and Veterans Brain Injury Center Main menu Service Members & Veterans Family & Friends ... Materials Research DVBIC Locations Press Treatment and Recovery Brain injury treatment is a complex field of medical rehabilitation. ...


[The influence of C-taurine antioxidant complex on biochemical blood parameters in the process of treatment of patients with diabetes mellitus of type II with nonproliferative diabetic retinopathy].  


The purpose of this investigation is to study the effect of C- taurine complex of antioxidants on blood biochemical parameters in the process of treatment of patients with diabetes mellitus of type II with NPDR. 68 patients (136 eyes) were enrolled in the study. The monitoring of the patient lasted for 3 months. The character of changes of the basic visual functions has been examined. The patients were divided into 2 groups (main and control). Treatment of patients with main group conducted antioxidant complex Taurine + Vitamin C for 42 days. namely. Thus, we have revealed antioxidant activity of the combination of taurine and vitamin C with positive effect on the indexes of carbohydrate, lipid metabolism and hepatoprotective characteristics in patients with diabetes mellitus type II with NPDR. Taking into consideration the peculiarities of correlation relationships between functional, clinical and biochemical parameters and the results of experimental studies on animal it is acceptable to use Taurine complex + Vitamin C as part of conservative treatment of patients with diabetes mellitus type II with NPDR. PMID:24632640

Lekishvili, S E



Incontinence Treatment: Surgical Treatments  


... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ... changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures or devices Tips ...


Synthesis, structural characterization and cytotoxic activity of ternary copper(II)-dipeptide-phenanthroline complexes. A step towards the development of new copper compounds for the treatment of cancer.  


In the search for new compounds with antitumor activity, coordination complexes with different metals are being studied by our group. This work presents the synthesis and characterization of six copper complexes with general stoichiometry [Cu(L-dipeptide)(phen)]·nH2O (were phen=1,10-phenanthroline) and their cytotoxic activities against tumor cell lines. To characterize these systems, analytical and spectroscopic studies were performed in solid state (by UV-visible, IR, X-ray diffraction) including the crystal structure of four new complexes (of the six complexes studied): [Cu(Ala-Phe)(phen)]·4H2O, [Cu(Phe-Ala)(phen)]·4H2O, [Cu(Phe-Val)(phen)]·4.5H2O and [Cu(Phe-Phe)(phen)]·3H2O. In all of them, the copper ion is situated in a distorted squared pyramidal environment. The phen ligand is perpendicular to the dipeptide, therefore exposed and potentially available for interaction with biological molecules. In addition, for all the studied complexes, structural information in solution using EPR and UV-visible spectroscopies were obtained, showing that the coordination observed in solid state is maintained. The lipophilicity, DNA binding and albumin interaction were also studied. Biological experiments showed that all the complexes induce cell death in the cell lines: HeLa (human cervical adenocarcinoma), MCF-7 (human metastatic breast adenocarcinoma) and A549 (human lung epithelial carcinoma). Among the six complexes, [Cu(Ala-Phe)(phen)] presents the lowest IC50 values. Taken together all these data we hypothesize that [Cu(Ala-Phe)(phen)] may be a good candidate for further studies in vivo. PMID:25033418

Iglesias, Sebastián; Alvarez, Natalia; Torre, María H; Kremer, Eduardo; Ellena, Javier; Ribeiro, Ronny R; Barroso, Rafael P; Costa-Filho, Antonio J; Kramer, M Gabriela; Facchin, Gianella



Principles of Treatment Addiction treatment must assist the individual with  

E-print Network

TREATMENT Principles of Treatment Addiction treatment must assist the individual with 1. stopping in the family, at work and in society. Guidelines of Effective Treatment Viewing addiction as a complex of using a variety of approaches in addiction treatment. Behavioral therapies such as individual and group

Polly, David


Complex trauma to the shoulder girdle, including the proximal humerus, the clavicle, and the scapula: current concepts in diagnosis and treatment.  


Fractures to the shoulder girdle are common injuries in an aging population. Many techniques and theories lie behind the treatment of such injuries. Knowledge and understanding of current concepts for diagnosing and treating proximal humeral, clavicular, and scapular fractures and the theory behind them will help surgeons make informed decisions with regard to patient care. PMID:25745900

Mighell, Mark A; Hatzidakis, Armodios M; Otto, Randall J; Watson, J Tracy; Cottrell, Benjamin J; Cusick, Michael C; Pappou, Ioannis P



Case files of the medical toxicology fellowship at the toxikon consortium in Chicago: cocaine-associated wide-complex dysrhythmias and cardiac arrest - treatment nuances and controversies.  


A 19-year-old woman was brought by ambulance to the emergency department (ED) from a police holding cell. Less than 3 hours earlier, the patient had been a passenger in a car stopped for a traffic violation. As the police officer approached the car, the patient was noted to hurriedly stuff 2 plastic bags containing a white powdery substance into her mouth. On questioning, it was reported that the packets contained cocaine. Less than an hour after being taken to the police station, the patient was witnessed to have a generalized seizure. What is the pharmacological basis of acute cocaine intoxication? What are the cardiovascular manifestations of acute cocaine intoxication? What is the basis for using sodium bicarbonate in cocaine-induced wide-complex dysrhythmias? What is the basis for the use of lidocaine in cocaine-induced wide-complex dysrhythmias? Is there any evidence for the use of amiodarone to treat cocaine-induced wide-complex dysrhythmias? PMID:19031381

Kalimullah, Ejaaz A; Bryant, Sean M



Synthesis and characterization of Cu(II), Co(II) and Ni(II) complexes of a number of sulfadrug azodyes and their application for wastewater treatment.  


The azodye ligand (HL(1)) was synthesized from the coupling of sulfaguanidine diazonium salt with 2,4-dihydroxy-benzaldehyde while the two ligands, HL(2) and HL(3), were prepared by the coupling of sulfadiazine diazonium salt with salicylaldehyde (HL(2)) and 2,4-dihydroxy-benzaldehyde (HL(3)). The prepared ligands were characterized by elemental analysis, IR, (1)H NMR and mass spectra. Cu(II), Co(II) and Ni(II) complexes of the prepared ligands have been synthesized and characterized by various spectroscopic techniques like IR, UV-Visible as well as magnetic and thermal (TG and DTA) measurements. It was found that all the ligands behave as a monobasic bidentate which coordinated to the metal center through the azo nitrogen and ?-hydroxy oxygen atoms in the case of HL(1) and HL(3). HL(2) coordinated to the metal center through sulfonamide oxygen and pyrimidine nitrogen. The applications of the prepared complexes in the oxidative degradation of indigo carmine dye exhibited good catalytic activity in the presence of H2O2 as an oxidant. The reactions followed first-order kinetics and the rate constants were determined. The degradation reaction involved the catalytic action of the azo-dye complexes toward H2O2 decomposition, which can lead to the generation of HO radicals as a highly efficient oxidant attacking the target dye. The detailed kinetic studies and the mechanism of these catalytic reactions are under consideration in our group. PMID:24239761

El-Baradie, K; El-Sharkawy, R; El-Ghamry, H; Sakai, K



Prosthodontic treatment in a partially edentulous patient with a complex medical history of epilepsy and deep vein thrombosis: a case report.  


This report describes the prosthodontic rehabilitation of a partially edentulous patient by means of a maxillary implant-supported removable dental prosthesis and mandibular telescopic crown prosthesis. Due to the patient's contributory medical history for epilepsy and deep vein thrombosis, clinical management considerations are outlined along with an evidence-based, medically oriented treatment sequence concerning the surgical and prosthodontic stages of the case. PMID:21519555

Kosyfaki, Panagiota; Woerner, Wolf; Att, Wael



Multimodal treatment of pain.  


Chronic pain is a complex disorder with extensive overlap in sensory and limbic pathways. It needs systemic therapy in addition to focused local treatment. This article discusses treatment modalities other than surgical and interventional approaches and also discusses the literature regarding these treatment modalities, including pharmacotherapy, physical and occupational therapy, psychological approaches including cognitive behavior therapy, and other adjunctive treatments like yoga and tai chi. PMID:25240667

Mathews, Manu



An effective pre-treatment method for the determination of short-chain fatty acids in a complex matrix by derivatization coupled with headspace single-drop microextraction.  


We have developed a sample preparation method involving derivatization combined with headspace single-drop microextraction (HS-SDME) for the determination of short-chain fatty acids (SCFAs) in complex matrices. The derivatization of SCFAs was conducted using the BF3/ethanol method prior to HS-SDME. The HS-SDME extraction conditions for the derivatization products (ethyl esters) of SCFAs were optimized using 1.0?L of dibutylphthalate (DBP), 1000rpm stirring speed, 30% (w/v) NaCl, 20min extraction time, and 7mL of sample solution in a 12mL vial. Quantitative determination of ethyl esters was performed using gas chromatography (GC). Linear calibration curves and excellent reproducibility were obtained using these optimized extraction conditions. Compared with our previous work, the significantly lower detection limits (0.11, 0.017, 0.0060, and 0.0024?g/mL for C2 to C5 SCFAs, respectively) indicate that this new method is suitable for quantitative analysis of SCFAs in complex matrices, such as the RuO4 oxidation products of kerogen or asphaltene. PMID:24388413

Chen, Yuan; Li, Yun; Xiong, Yongqiang; Fang, Chenchen; Wang, Xiaotao



A comparison between intravenous iron polymaltose complex (Ferrum Hausmann) and oral ferrous fumarate in the treatment of iron deficiency anaemia in pregnancy.  


Anaemia is the most common medical disorder in pregnancy with iron deficiency anaemia accounting for the majority of cases. Over 90% of the iron deficiency anaemia is due to red cell iron deficiency associated with depleted iron stores and deficient intake. The two main modalities of treating iron deficiency anaemia are oral or parenteral iron. Ferrous Hausmann (iron dextrin) is the latest iron preparation which can be used for intravenous parenteral administration as a total dose infusion. This study compares the efficacy of Ferrum Hausmann with oral ferrous fumarate therapy in the treatment of iron deficiency anaemia in pregnancy. Our study shows that treatment with intravenous Ferrum Hausmann (iron dextrin) resulted in a significantly better level and rate of increase of haemoglobin (p<0.001). Serum ferritin, which is the best indicator of iron stores, was significantly higher (p<0.001) in the intravenous group. Other indices of iron status such as serum iron, serum transferrin and zinc protoporphyrin also showed a significant improvement in the intravenous group compared to those given oral iron. The results suggest that intravenous iron as a total dose infusion is able to replenish iron stores more efficiently, completely and at a faster rate than oral iron therapy, thus providing the fuel for stimulation of full erythopoiesis compared to oral iron. There were also no reports of any adverse reactions with intravenous iron dextrin, whereas there were a considerable proportion of women on oral iron therapy who reported side effects. In conclusion, intravenous iron therapy with Ferrous Hausmann (iron dextrin) is a suitable, effective and safe alternative to oral iron therapy in the treatment of iron deficiency anaemia in pregnancy. PMID:9508353

Singh, K; Fong, Y F; Kuperan, P



Land Treatment Digital Library  

USGS Publications Warehouse

The Land Treatment Digital Library (LTDL) was created by the U.S. Geological Survey to catalog legacy land treatment information on Bureau of Land Management lands in the western United States. The LTDL can be used by federal managers and scientists for compiling information for data-calls, producing maps, generating reports, and conducting analyses at varying spatial and temporal scales. The LTDL currently houses thousands of treatments from BLM lands across 10 states. Users can browse a map to find information on individual treatments, perform more complex queries to identify a set of treatments, and view graphs of treatment summary statistics.

Pilliod, David S.; Welty, Justin L.



The complex role of personality in cancer treatment: impact of dependency-detachment on health status, distress, and physician-patient relationship.  


Personality traits have been associated with positive and negative adjustment to a cancer diagnosis. No studies have assessed trait dependency and detachment and their relationship to health, distress, and the doctor-patient relationship in patients undergoing radiation treatment for cancer. Fifty adults (32 women; mean [SD], 60.32 [12.74] years) undergoing radiation treatment for a variety of cancers completed measures of dependency and detachment, doctor-patient relationship, physical health, somatization, anxiety, and depression. Overdependence scores were positively and significantly correlated with patients' anxiety and negatively and significantly correlated with the physician-patient relationship. Detachment scores were positively and significantly correlated with pain, somatization, depression, and anxiety and marginally associated with lower health-related quality of life. These preliminary findings support the construct validity and clinical utility of trait dependency and detachment testing with oncology patients and suggest that detachment is associated with poorer quality of life and higher psychological distress, whereas dependency is associated with poorer doctor-patient relationships after a cancer diagnosis. PMID:25756708

Porcerelli, John H; Bornstein, Robert F; Porcerelli, Daniel; Arterbery, V Elayne



A modified posteromedial approach combined with extensile anterior for the treatment of complex tibial pilon fractures (AO/OTA 43-C).  


The anterior approaches that have been described for open reduction internal fixation of multifragmentary pilon fractures are designed to reconstruct the comminuted and impacted anterior articular surface onto a stable posterior column. Thus, reduction of the posterior column, particularly proper length, is critical. There are differing opinions of how best to surgically approach the posterior pilon fracture. There is also no clear indication as to the timing of both anterior and posterior reconstructions. Our objectives were (1) to develop a more midline posterior approach that might provide better visualization of the posterior aspect of the posterior column and juxtametaphyseal/diaphyseal parts of the tibia, first on the cadaver and then with patients, and (2) to use this as part of a combined posterior and anterior approach during the same anesthesia for complex tibial pilon fractures (AO/OTA 43-C) in a preliminary study of 6 patients. PMID:24857906

Assal, Mathieu; Ray, Adrien; Fasel, Jean H D; Stern, Richard



Packaged Waste Treatment  

NASA Technical Reports Server (NTRS)

This Jacksonville, Florida, apartment complex has a wastewater treatment system which clears the water, removes harmful microorganisms and reduces solid residue to ash. It is a spinoff from spacecraft waste management and environmental control technology.



Improved Prevention, Screening & Treatment

Cancers develop through a complex interplay between genetic and environmental factors. By identifying and understanding this process, we can often develop preventive interventions or use tailored screening and treatment approaches for individuals at increased risk of developing cancer.


Deperturbation treatment of the A?+1-b?3 complex of NaRb and prospects for ultracold molecule formation in X?+1(v=0;J=0)  

NASA Astrophysics Data System (ADS)

High resolution Fourier transform spectra (FTS) of laser induced fluorescence (LIF) of C?+1;D?1?A?+1-b?3 and A?+1-b?3?X?+1 transitions in Na85Rb and Na87Rb were obtained. An analysis of the direct LIF spectra together with the rotational relaxation satellites provided highly accurate rovibronic term values for (4?J?163) of the A?+1-b?3 complex, covering about 1950 mostly singlet levels 0?vA?49 and a considerable number (>360) of the predominantly triplet b?0,13 sublevels. The direct deperturbation analysis of the singlet-triplet A-b complex was performed by means of the inverted channel-coupling approach with Hund’s coupling case a basis functions. The electronic matrix elements of the model 4×4 Hamiltonian were defined as piecewise analytical functions of the internuclear distance. Besides the Born-Oppenheimer potential energy curves of the mutually perturbed states and the off-diagonal spin-orbit (SO) A-b coupling function, the SO splitting of the b?3 state was determined due to the pronounced electronic-rotation interaction between the b?03 and b?13 components observed for high J levels. Overall, 24 mass-invariant fitting parameters have been required to reproduce about 2300 experimental term values of both isotopomers with a standard deviation of 0.012cm-1 , which is consistent with the uncertainty of the FTS experiment. An analytical mapping procedure based on a reduced variable representation of the radial coordinate was used to diminish the computational effort for the uniform finite-difference grid solution of the coupled-channel equations. The derived nonadiabatic A-b wave functions were used to evaluate the A?+1-b?3-D?1 , a?+3 , X?+1 rovibronic transition probabilities. The relative intensity distributions predicted for the D?A-b and A-b?X LIF progressions agree with their experimental counterparts within the accuracy of the measurements. The calculated A-b-a , X transition probabilities were applied for simulation of the stimulated Raman a?A-b?X processes, which can lead to efficient formation of ultracold NaRb molecules in the ground level vX=0 ; JX=0 .

Docenko, O.; Tamanis, M.; Ferber, R.; Pazyuk, E. A.; Zaitsevskii, A.; Stolyarov, A. V.; Pashov, A.; Knöckel, H.; Tiemann, E.



[Control of generalized chronic periodontitis combined with calcium-antagonist-related gingival overgrowth by a complex periodontal-endodontic-prosthodontic treatment. Case report].  


To day a relatively high percentage of elderly population of the industrialized world suffers with different cardiovascular diseases and are on permanent antihypertensive therapy. One of the most frequently used drugs is the calcium channel blockers prescribed against high blood pressure. The most common oral side effect of these drugs is the gingival enlargement that might develop even on otherwise healthy gingiva. The incidence of chronic periodontitis in this age group is also high and the Ca antagonist medication in those individuals might substantially modify the clinical course of periodontal inflammation leading to gingival enlargement and hypertrophic pocket wall. The case presented here is a 52 years old hypertonic woman with a long history of Ca-antagonist therapy and generalized chronic periodontitis combined with gingival hyperplasia. After the change of medication the 1,5 years comprehensive periodontal endodontic and prosthodontic therapy restored patient's periodontal health and provided complex dental rehabilitation. Nevertheless, only regular periodontal supportive therapy could ensure predictable outcome and guarantee long lasting periodontal health. PMID:22308953

Szánto, Erika; Gera, István



Established treatments of psoriasis  

Microsoft Academic Search

Psoriasis is a complex disease with a spectrum of clinical manifestations. Psoriasis may express as a few coin-sized erythemato-squamous plaques up to widespread disease covering the entire body surface (erythrodermic psoriasis). Psoriasis may present as a few stable plaques or unstable disease, rapidly relapsing after treatment. Some patients may respond excellently to topical treatments whereas other patients may be difficult

Wijnand H. P. M. Vissers



A Prospective Study on the Initial Results of a Low Profile Ulna Shortening Osteotomy System  

PubMed Central

Extra-articular ulna shortening osteotomy, in principle, is an accepted treatment option for symptomatic degenerative and traumatic triangular fibrocartilage complex (TFCC) tears. Despite the benefits of this surgical approach, potential disadvantages include risk of nonunion, soft tissue irritation, and the need for future hardware removal. A recently introduced low profile ulna shortening system was designed to decrease these potential complications. A single-surgeon prospective study was performed to evaluate this system. Ten consecutive patients undergoing ulna shortening for ulnar-sided wrist pain compatible with TFCC pathology participated in the study. Subjective, objective, and radiographic assessments were performed preoperatively and up to 24 weeks postoperatively. Based on visual analog scale (VOS) ratings (0 to 10), pain scores significantly improved (p?

Howard, Susan B.; Gulkin, Daniel



Complex Numbers  

NSDL National Science Digital Library

This is a short study guide from the University of Maryland's Physics Education Research Group on introducing, interpreting, and using complex numbers. Mathematical equations are included to help students understand the nature of complex numbers.



[Treatment of acute pancreatitis].  


The experience with the treatment of 482 patients with acute pancreatitis under the conditions of a central district hospital is presented. An outline for the conservative treatment depending upon the severity of the patient's status, when admitted to a surgical department, is suggested. 80 cases were operated upon; most of them with destructive forms of pancreatitis and with complications of the disease. The success of the treatment of acute pancreatitis depends upon complex, intensive conservative treatment rendered in due time. Total lethality was 6.2%, the postoperative one-32.5%. PMID:695204

Guzeev, A I



Hyperbaric treatment  

NASA Technical Reports Server (NTRS)

Viewgraphs on hyperbaric treatment are presented. Topics covered include: hyperbaric treatment - purpose; decompression sickness; sources of decompression sickness; physical description; forms of decompression sickness; hyperbaric treatment of decompression sickness; and duration of treatment.

Amoroso, Michael T.



Complex Numbers  

NSDL National Science Digital Library

The objective of this lesson is to gain a better understanding of complex numbers and their graphs Situation: The Swiss Mathemation, Jean Robert Argand developed a means to graphically represent complex numbers. This led to solving problems related to altenating electrical current, which provides current day luxuries. Could you do the same? Current Knowledge: Use your knowledge of complex number and the coordinate system and with your partner, ...

Mrs. Pierce



Controlling complexity  

SciTech Connect

Complex systems have the property that many competing behaviors are possible, and the system tends to alternate among them. In fact, the ability of a complex system to access many different states, combined with its sensitivity, offers great flexibility in manipulating the system`s dynamics to select a desired behavior. By understanding dynamically how some of the complex features arise, we show that it is indeed possible to control a complex system`s behavior. This is illustrated by using the noisy double rotor map as a paradigm. {copyright} {ital 1995} {ital The} {ital American} {ital Physical} {ital Society}.

Poon, L.; Grebogi, C. [Institute for Plasma Research, University of Maryland, College Park, Maryland 20742 (United States)] [Institute for Plasma Research, University of Maryland, College Park, Maryland 20742 (United States)



Designing Complexity  

ERIC Educational Resources Information Center

This article considers the nature of complexity and design, as well as relationships between the two, and suggests that design may have much potential as an approach to improving human performance in situations seen as complex. It is developed against two backgrounds. The first is a world view that derives from second order cybernetics and radical…

Glanville, Ranulph



[Complex therapy of patients with vertebral radiculopathies].  


The author determined efficiency of application of no-steroid anti-inflammatory medication, Revmoxicam as well as phonophoresis with Khondrasil ointment in the complex therapy of patients with vertebral radiculopaties. The use of the proposed complex treatment enables the regression of neurological symptoms and allows improving considerably results of the treatment of patients with vertebral radiculopaties. PMID:20455450

Zhdanova, V M



Complex regional pain syndrome  

Microsoft Academic Search

Opinion statement  Complex regional pain syndrome (CRPS) is a heterogeneous disorder that falls in the spectrum of neuropathic pain disorders.\\u000a It is maintained by abnormalities throughout the neuraxis (the peripheral, autonomic, and central nervous systems). The pathophysiology\\u000a of CRPS is not fully known. There are no scientifically well-established treatments. The diagnostic criteria for CRPS at this\\u000a time are purely clinical, and

Ok Yung Chung; Stephen P. Bruehl



Complexity International  

NSDL National Science Digital Library

Complexity International (CI) is an electronic journal devoted to "the field of complex systems, the generation of complex behaviour from the interaction of multiple parallel processes." The journal covers a wide variety of topics, including genetic algorithms, neural networks, and chaos theory. Because much of the focus is based on technological imitation of biological processes, some of the papers are closely tied to the life sciences. Volumes are added to on a continual basis as papers are accepted. Due to the lengthy acceptance process, it is especially useful that the CI Web site offers drafts of current submissions.


Carney Complex  


... a complex procedure with financial, physical, and emotional factors for couples to consider before starting. For more information, talk with an assisted reproduction specialist at a fertility clinic. How common is ...


Complex Networks  

NASA Astrophysics Data System (ADS)

1. Introduction; Part I. Random Network Models: 2. The Erdos-Renyi models; 3. Observations in real-world networks; 4. Models for complex networks; 5. Growing network models; Part II. Structure and Robustness of Complex Networks: 6. Distances in scale-free networks - the ultra small world; 7. Self-similarity in complex networks; 8. Distances in geographically embedded networks; 9. The network's structure - the generating function method; 10. Percolation on complex networks; 11. Structure of random directed networks - the bow tie; 12. Introducing weights - bandwidth allocation and multimedia broadcasting; Part III. Network Function - Dynamics and Applications: 13. Optimization of the network structure; 14. Epidemiological models; 15. Immunization; 16. Thermodynamic models on networks; 17. Spectral properties, transport, diffusion and dynamics; 18. Searching in networks; 19. Biological networks and network motifs; Part IV. Appendices; References; Index.

Cohen, Reuven; Havlin, Shlomo



Complex Numbers  

NSDL National Science Digital Library

Written by Tony R. Kuphaldt and Jason Starck, this chapter of All About Circuit's second volume on Alternating Current describes complex numbers: "In order to successfully analyze AC circuits, we need to work with mathematical objects and techniques capable of representing these multi-dimensional quantities. Here is where we need to abandon scalar numbers for something better suited: complex numbers." In addition to the introduction and credits to contributors, the chapter has seven sections: Vectors and AC waveforms, Simple vector addition, Complex vector addition, Polar and rectangular notation, Complex number arithmetic, More on AC "polarity," and Some examples with AC circuits. Each section has clear illustrations and a concise, bulleted review of what was covered at the end.

Kuphaldt, Tony R.


Glaucoma Treatments  


... for Change Get Involved Research Grants Special Events Glaucoma Treatments In this section you will find information on current treatments for glaucoma, including drugs and laser and conventional surgery… Treatments ...


Incontinence Treatment: Newer Treatment Options  


... Personal Stories Who We Are Contact Us Donate Incontinence Treatment: Newer Treatment Options Jump to Topic Lifestyle changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures ...



Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. VIEW OF SEWAGE TREATMENT PLANT (BLDG. 769) SOUTH OF STORAGE SHED (BLDG 773). SECURITY FENCE EAST OF SEWAGE TREATMENT PLANT. - Vandenberg Air Force Base, Space Launch Complex 3, Sewage Treatment Plant, Napa & Alden Roads, Lompoc, Santa Barbara County, CA


Complex Clouds  

Atmospheric Science Data Center

... View Larger Image The complex structure and beauty of polar clouds are highlighted by these images acquired by the Multi-angle ... cyclonic circulation over the Southern Indian Ocean, to the north of Enderbyland, East Antarctica. The image at left was created by ...



Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations.  


Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns. PMID:25550665

Woitzik, Erin; deGraauw, Chris; Easter, Brock



Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations  

PubMed Central

Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns. PMID:25550665

Woitzik, Erin; deGraauw, Chris; Easter, Brock



COMPLEX NUMBERS 1. Definition of complex numbers  

E-print Network

COMPLEX NUMBERS 1. Definition of complex numbers Complex conjugate, Magnitude Operations Addition, multiplication, reciprocal number 2. Representation of complex numbers in polar complex variable #12;2.2.A Complex numbers #12;#12;3 #12;4 #12;In short, Anytime we write Ae j we

La Rosa, Andres H.


Time complexity and gate complexity  

NASA Astrophysics Data System (ADS)

We formulate and investigate the simplest version of time-optimal quantum computation theory (TO-QCT), where the computation time is defined by the physical one and the Hamiltonian contains only one- and two-qubit interactions. This version of TO-QCT is also considered as optimality by sub-Riemannian geodesic length. The work has two aims: One is to develop a TO-QCT itself based on a physically natural concept of time, and the other is to pursue the possibility of using TO-QCT as a tool to estimate the complexity in conventional gate-optimal quantum computation theory (GO-QCT). In particular, we investigate to what extent is true the following statement: Time complexity is polynomial in the number of qubits if and only if gate complexity is also. In the analysis, we relate TO-QCT and optimal control theory (OCT) through fidelity-optimal computation theory (FO-QCT); FO-QCT is equivalent to TO-QCT in the limit of unit optimal fidelity, while it is formally similar to OCT. We then develop an efficient numerical scheme for FO-QCT by modifying Krotov’s method in OCT, which has a monotonic convergence property. We implemented the scheme and obtained solutions of FO-QCT and of TO-QCT for the quantum Fourier transform and a unitary operator that does not have an apparent symmetry. The former has a polynomial gate complexity and the latter is expected to have an exponential one which is based on the fact that a series of generic unitary operators has an exponential gate complexity. The time complexity for the former is found to be linear in the number of qubits, which is understood naturally by the existence of an upper bound. The time complexity for the latter is exponential in the number of qubits. Thus, both the targets seem to be examples satisfyng the preceding statement. The typical characteristics of the optimal Hamiltonians are symmetry under time reversal and constancy of one-qubit operation, which are mathematically shown to hold in fairly general situations.

Koike, Tatsuhiko; Okudaira, Yosuke



Managing Complexity  

SciTech Connect

Physical analogs have shown considerable promise for understanding the behavior of complex adaptive systems, including macroeconomics, biological systems, social networks, and electric power markets. Many of today’s most challenging technical and policy questions can be reduced to a distributed economic control problem. Indeed, economically-based control of large-scale systems is founded on the conjecture that the price-based regulation (e.g., auctions, markets) results in an optimal allocation of resources and emergent optimal system control. This paper explores the state of the art in the use physical analogs for understanding the behavior of some econophysical systems and to deriving stable and robust control strategies for them. In particular we review and discussion applications of some analytic methods based on the thermodynamic metaphor according to which the interplay between system entropy and conservation laws gives rise to intuitive and governing global properties of complex systems that cannot be otherwise understood.

Chassin, David P.; Posse, Christian; Malard, Joel M.



Leishmaniasis Treatment  


... message, please visit this page: About . Parasites - Leishmaniasis Parasites Home Share Compartir Treatment Before considering treatment, the ... applies to some (not all) types of the parasite found in parts of Latin America: certain types ...


Salmonellosis Treatment  


... more information on enabling JavaScript. Salmonellosis Skip Content Marketing Share this: Main Content Area Treatment Salmonella infections usually resolve in 5-7 days and most do not require treatment other ...


Water Treatment  

NSDL National Science Digital Library

Water treatment on a large scale enables the supply of clean drinking water to communities. In this activity, learners develop methods to clean a polluted water sample, describe components of a water treatment process, and learn how humans impact Earth's freshwater supply. The activity simulates methods used in real water treatment including aeration, coagulation, sedimentation, filtration and disinfection. This activity would be an excellent adjunct to a guided tour of a local water treatment plant.

New Jersey



[Treatment of fistulizing Crohn's disease].  


The treatment of fistulating Crohn's disease should include a combined medical and surgical approach and should be defined on an individual basis. Asymptomatic enteroenteric fistulas usually require no treatment, but internal fistulas (gastrocolic, duodenocolic, enterovesical) that cause severe or persistent symptoms require surgical intervention. While low asymptomatic anal-introital fistula may not need surgical treatment, in case of a symptomatic enterovaginal fistula surgery is usually required. There are no controlled-randomized trials to assess the effect of medical treatment for non-perianal fistulating Crohn's disease. The incidence of perianal fistulae varies according to the location of the disease, with its occurrence varying between 21-23%. The diagnostic approach should include an examination under anesthesia, endoscopy, and either MRI or EUS before the treatment begins. Asymptomatic simple perianal fistulas require no treatment. The presence of a perianal abscess should be ascertained and if present should be drained urgently. In case of a complex perianal disease, seton placement should also be recommended. Antibiotics (metronidazole and ciprofloxacine) are useful for treating complex perianal disease, however, when discontinued, most of the fistulas relapse. The current consensus suggests that azathioprine/6-mercaptopurine is the first line medical therapy for complex perianal disease, which is always given in combination with surgical therapy (seton, fistulotomy/fistulectomy). Anti TNF-alpha agents (infliximab and adalimumab) should be used as a second choice medical treatment. In refractory and extensive complex perianal disease a diverting stoma or proctectomy should be performed. PMID:24471302

Tonki?, Ante; Borzan, Vladimir



[Complex injuries associated with somnambulism].  


Up to 3% of adults walk in their sleep and some perform complex behaviours. Treatment recommendations for sleepwalking are inconsistent. This case report describes a 64-year-old man who climbed out of a 2nd floor toilet window during somnambulism. He fell 6-8 meters and fractured the tibia, fibula, cervical columna, lumbal columna, calcaneus, costae and suffered a pneumothorax. Evidence to support sleepwalking treatment is lacking and besides benzodiazepines, prevention is the preferred treatment choice according to the literature. PMID:21156113

Sillesen, Nanna Hylleholt; Nielsen, Lisa Toft; Bonde, Christian



MR arthrography of the wrist: controversies and concepts.  


Magnetic resonance arthrography (MRA) has become the preferred modality for imaging patients with internal derangement of the wrist. However, several aspects of MRA use need to be clarified before a standardized approach to the imaging of internal derangement of the wrist can be developed. The objective of the study is to evaluate the efficiency of different magnetic resonance (MR) sequences in the detection of lesions of the triangular fibrocartilage complex (TFCC) and scapholunate and lunotriquetral ligaments on direct MRA. Thirty-one consecutive direct magnetic resonance arthrographic examinations of the wrist using a wrist surface coil were performed for the assessment of the TFCC and intrinsic ligaments on a 1.5-T MR imaging system (Signa; 16 channel, Excite, GE Healthcare, Milwaukee, WI, USA). All patients had wrist pain, and in six cases, there was associated clinical carpal instability. The presence, location, and extent of TFCC, scapholunate ligament (SLL), and lunotriquetral ligament (LTL) lesions on T1 fat-saturated, multiplanar gradient recalled (MPGR) and short tau inversion recovery (STIR) images were identified, compared, and analyzed. Forty-one lesions of the TFCC, SLL, and LTL were visualized on contrast-sensitive (T1 fat-saturated) images in 23/31 (74.2%) patients. Twenty-one lesions of the TFCC and intrinsic ligaments were visualized on noncontrast-sensitive (MPGR and STIR) images (15 tears of the TFCC and six tears of the SLL and LTL). All of these lesions were seen on T1 fat-saturated images; 48.8% (20/41) lesions seen on T1 fat-saturated images (eight tears of TFCC and 12 tears of SLL and LTT) were not seen on MPGR and/or STIR images. Superior contrast resolution, joint distention, and the flow of contrast facilitate the diagnosis of lesions of the TFCC and intrinsic ligaments on contrast-sensitive sequences making MRA the preferred modality for imaging internal derangements of the wrist. Little agreement exists regarding the value and location of perforations of the intrinsic ligaments given that both traumatic and degenerative perforations may be symptomatic. Noncommunicating defects of the ulnar attachments of the triangular fibrocartilage (TFC), tears of the dorsal segment of the SLL, and defects at the lunate attachment of the SLL have a higher likelihood of being symptomatic and caused by trauma rather than by degenerative perforation. Although no consensus exists, it would appear that most arthrographies should be started with a radiocarpal injection. Injection into the distal radioulnar joint should be added if no communicational defects are visualized following radiocarpal injection in patients with ulnar-sided wrist pain. PMID:19048349

Maizlin, Zeev V; Brown, Jacqueline A; Clement, Jason J; Grebenyuk, Julia; Fenton, David M; Smith, Donna E; Jacobson, Jon A



3. Complex Numbers 17 3 Complex Numbers  

E-print Network

3. Complex Numbers 17 3 Complex Numbers Law and Order Life is unfair: The quadratic equation x2 - 1 solutions to the equation. This is how complex numbers could have been invented. More formally, complex numbers a and b are called respectively the real part and imagi- nary part of the complex number z

Givental, Alexander


Treatment goals: response and nonresponse  

PubMed Central

Psychiatric symptomatology is often subjective, but it can be partly made more objective for the purposes of evaluation. Esquirol was the first modern psychiatrist to stress the need for a scientific approach to treatment evaluation. The kinetics of treatment is complex because different components of the clinical picture improve at a different pace. Assessment of treatment requires prior definition of end point, response, and nonresponse. Response is influenced by several factors, such as placebo effect, diagnostic category and subtypes, and patient heterogeneity. Treatment response may be predicted from clinical and biological parameters. This article lists the main causes of nonresponse, and suggests how to remedy them. PMID:22034465

Macher, Jean-Paul; Crocq, Marc-Antoine



Optimization of Activated Sludge Wastewater Treatment System  

Microsoft Academic Search

Wastewater treatment plants (WWTP) are complex systems that incorporate a large number of biological, physicochemical and biochemical processes. The activated-sludge process is a biological method of wastewater treatment not only for the removal of organic matter but also for nitrification and nitrogen removal by biological denitrification. In this project, a model based on activated sludge wastewater treatment systems was carried

SUI Hong; LI Xin-gang; XU Shi-min; QIU Duan


Cosmic Complexity  

NASA Technical Reports Server (NTRS)

What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and neutrons, liberating a little energy and creating complexity. Then, the expanding universe cooled some more, and neutrons and protons, no longer kept apart by immense temperatures, found themselves unstable and formed helium nuclei. Then, a little more cooling, and atomic nuclei and electrons were no longer kept apart, and the universe became transparent. Then a little more cooling, and the next instability began: gravitation pulled matter together across cosmic distances to form stars and galaxies. This instability is described as a "negative heat capadty" in which extracting energy from a gravitating system makes it hotter -- clearly the 2nd law of thermodynamics does not apply here! (This is the physicist's part of the answer to e e cummings' question: what is the wonder that's keeping the stars apart?) Then, the next instability is that hydrogen and helium nuclei can fuse together to release energy and make stars burn for billions of years. And then at the end of the fuel source, stars become unstable and explode and liberate the chemical elements back into space. And because of that, on planets like Earth, sustained energy flows support the development of additional instabilities and all kinds of complex patterns. Gravitational instability pulls the densest materials into the core of the Earth, leaving a thin skin of water and air, and makes the interior churn incessantly as heat flows outwards. And the heat from the sun, received mostly near the equator and flowing towards the poles, supports the complex atmospheric and oceanic circulations. And because or that, the physical Earth is full of natural chemical laboratories, concentrating elements here, mixing them there, raising and lowering temperatures, ceaselessly experimenting with uncountable events where new instabilities can arise. At least one of them was the new experiment called life. Now that we know that there are at least as many planets as there are stars, it is hard to imagine that nature's ceasess experimentation would not be able to produce life elsewhere

Mather, John C.



Window treatments  

SciTech Connect

This book includes basic material as well as information the professional needs for designing appropriate window treatments for residential and nonresidential buildings: site, orientation, climate, energy efficiency, sound-proofing, privacy, protection, view, ventilation and interior and exterior aesthetics. Also includes a guide to the window treatment industry, a list of manufacturers, distributors, and retailers, information on window treatment fibers and fabrics, three glossaries, an extensive bibliography, and over 800 illustrations.

Nielson, K.J.



Wastewater Treatment  

NSDL National Science Digital Library

This lesson introduces students to the basics of wastewater treatment. Topics include the variety of materials that enter the wastewater system, septic tanks, and municpal treatment systems. Students can review online resources that describe the processes of wastewater treatment and septic tank operation in detail, and listen to a National Publc Radio (NPR) show that discusses the use of treated wastewater to make snow at a ski resort in Maine. The lesson includes an activity in which students participate in virtual tours of wastewater treatment facilities and answer questions about what they see.

Mark Laposata


Enhanced Analgesic Properties and Reduced Ulcerogenic Effect of a Mononuclear Copper(II) Complex with Fenoprofen in Comparison to the Parent Drug: Promising Insights in the Treatment of Chronic Inflammatory Diseases  

PubMed Central

Analgesic and ulcerogenic properties have been studied for the copper(II) coordination complex of the nonsteroidal anti-inflammatory drug Fenoprofen and imidazole [Cu(fen)2(im)2] (Cu: copper(II) ion; fen: fenoprofenate anion from Fenoprofen, im: imidazole). A therapeutic dose of 28?mg/kg was tested for [Cu(fen)2(im)2] and 21?mg/kg was employed for Fenoprofen calcium, administered by oral gavage in female mice to compare the therapeutic properties of the new entity. The acetic acid induced writhing test was employed to study visceral pain. The percentage of inhibition in writhing and stretching was 78.9% and 46.2% for the [Cu(fen)2(im)2] and Fenoprofen calcium, respectively. This result indicates that the complex could be more effective in diminishing visceral pain. The formalin test was evaluated to study the impact of the drugs over nociceptive and inflammatory pain. The complex is a more potent analgesic on inflammatory pain than the parent drug. Ulcerogenic effects were evaluated using a model of gastric lesions induced by hypothermic-restraint stress. Fenoprofen calcium salt caused an ulcer index of about 79?mm2 while the one caused by [Cu(fen)2(im)2] was 22?mm2. The complex diminished the development of gastric mucosal ulcers in comparison to the uncomplexed drug. Possible mechanisms of action related to both therapeutic properties have been discussed. PMID:25050353

Gumilar, Fernanda; Boeris, Mónica; Toso, Ricardo; Minetti, Alejandra



Enhanced analgesic properties and reduced ulcerogenic effect of a mononuclear copper(II) complex with fenoprofen in comparison to the parent drug: promising insights in the treatment of chronic inflammatory diseases.  


Analgesic and ulcerogenic properties have been studied for the copper(II) coordination complex of the nonsteroidal anti-inflammatory drug Fenoprofen and imidazole [Cu(fen)2(im)2] (Cu: copper(II) ion; fen: fenoprofenate anion from Fenoprofen, im: imidazole). A therapeutic dose of 28 mg/kg was tested for [Cu(fen)2(im)2] and 21 mg/kg was employed for Fenoprofen calcium, administered by oral gavage in female mice to compare the therapeutic properties of the new entity. The acetic acid induced writhing test was employed to study visceral pain. The percentage of inhibition in writhing and stretching was 78.9% and 46.2% for the [Cu(fen)2(im)2] and Fenoprofen calcium, respectively. This result indicates that the complex could be more effective in diminishing visceral pain. The formalin test was evaluated to study the impact of the drugs over nociceptive and inflammatory pain. The complex is a more potent analgesic on inflammatory pain than the parent drug. Ulcerogenic effects were evaluated using a model of gastric lesions induced by hypothermic-restraint stress. Fenoprofen calcium salt caused an ulcer index of about 79 mm(2) while the one caused by [Cu(fen)2(im)2] was 22 mm(2). The complex diminished the development of gastric mucosal ulcers in comparison to the uncomplexed drug. Possible mechanisms of action related to both therapeutic properties have been discussed. PMID:25050353

Agotegaray, Mariela; Gumilar, Fernanda; Boeris, Mónica; Toso, Ricardo; Minetti, Alejandra



SCFA lead lab technical assistance at Oak Ridge Y-12 nationalsecurity complex: Evaluation of treatment and characterizationalternatives of mixed waste soil and debris at disposal area remedialaction DARA solids storage facility (SSF)  

SciTech Connect

On July 17-18, 2002, a technical assistance team from the U.S. Department of Energy (DOE) Subsurface Contaminants Focus Area (SCFA) met with the Bechtel Jacobs Company Disposal Area Remedial Action (DARA) environmental project leader to review treatment and characterization options for the baseline for the DARA Solids Storage Facility (SSF). The technical assistance request sought suggestions from SCFA's team of technical experts with experience and expertise in soil treatment and characterization to identify and evaluate (1) alternative treatment technologies for DARA soils and debris, and (2) options for analysis of organic constituents in soil with matrix interference. Based on the recommendations, the site may also require assistance in identifying and evaluating appropriate commercial vendors.

Hazen, Terry



[Principles of wound treatment].  


New techniques and devices have revolutionized the treatment of wounds during the last years. For the treatment of wounds we have nowadays a great variety of new gadgets, tools and methods. Complex wounds require specific skills, given the fact that a great number of different promising methods are on the market to enable an optimal wound management. Well educated "wound experts" are required to overcome the problems of very complicated and chronic wound problems. The importance of an interdisciplinary team increases while facing the problems of special wound disorders such as a diabetic food, food ulcers or the problems of open abdomen in case of severe peritonitis. In this overview the main principles of modern wound treatment are outlined. The aim of this article is to present a good summary of wound judgement and treatment for the practioner. Increasingly important is it to point out the situation of complexe wounds which should be judgded and treated with the help of a "wound expert". PMID:18075140

Bruhin, A; Metzger, J



Treatment of mycobacterial infections.  


Treatment of mycobacterial infections differs from that of other bacterial diseases due to several properties possessed by the mycobacteria and the host. A hallmark of mycobacteria is the complex lipid-rich cell envelope that protects the organism from both the host response and antimycobacterial therapy. In addition, mycobacteria are facultative intracellular parasites which generally cause a more chronic type of disease. These properties add greater constraints to efficient therapy. To be effective, drugs must be able to penetrate the host macrophage and preferably have reduced toxicity and be effective at low doses to allow prolonged therapy. The author presents the general properties of the pathogen/host relationship in mycobacterial infections, in addition to the therapeutic choices available and the mechanisms of action involved in treatment. The evolution of technology for antimycobacterial therapy is illustrated by a discussion of new strategies being developed for the treatment of mycobacterial infections. PMID:11288520

Barrow, W W



ICD Complex Operations and Maintenance Plan  

SciTech Connect

This Operations and Maintenance (O&M) Plan describes how the Idaho National Laboratory (INL) conducts operations, winterization, and startup of the Idaho CERCLA Disposal Facility (ICDF) Complex. The ICDF Complex is the centralized INL facility responsible for the receipt, storage, treatment (as necessary), and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation waste.

Gibson, P. L.




PubMed Central

Ionic lanthanum has been used to study transepithelial ion permeation in in vitro rabbit gallbladder and intestine (ileum) by adding 1 mM La3+ to only the mucosal bathing solution. Transepithelial fluid transport electrical potential differences (p.d.), and resistances were measured. During La3+ treatment the gallbladder's rate of active solute-coupled fluid transport remained constant, the resistance increased, and the 2:1 NaCl diffusion p.d. decreased. Mucosa-to-serosa fluxes of 140La3+ were measured and indicate a finite permeability of the gallbladder to La3+. La3+ also increased the transepithelial resistance and p d. of ileum. Electron microscopic examination of La3+-treated gallbladder showed: (a) good preservation of the fine structure, (b) electron-opaque lanthanum precipitates in almost every lateral intercellular space, most frequently near the apical end of the lateral spaces close to or within the junctional complex, (c) lanthanum among the subjacent muscle and connective tissue layers, and (d) lanthanum filling almost the entire length of so-called "tight" junctions. No observations were made which unequivocally showed the penetration of lanthanum into the gallbladder cells. Electron micrographs of similar La3+-treated ilea showed lanthanum deposits penetrating the junctional complexes. These results coupled with other physiological studies indicate that the low resistance pathway for transepithelial ion permeation in gallbladder and ileum is through the tight junctions A division of salt-transporting epithelia into two main groups, those with "leaky" junctional complexes and those with tight junctional complexes, has been proposed. PMID:5040861

Machen, Terry E.; Erlij, David; Wooding, F. B. P.



Spin-orbit treatment of UV-vis absorption spectra and photophysics of rhenium(I) carbonyl-bipyridine complexes: MS-CASPT2 and TD-DFT analysis.  


The lowest-lying spectral transitions in [ReX(CO)(3)(bpy)] (X = Cl, Br, I; bpy = 2,2'-bipyridine) complexes were calculated by means of spin-orbit time-dependent density functional theory (SO-TD-DFT) and spin-orbit multistate complete active space second-order perturbation theory (SO-MS-CASPT2). Computational results are compared with absorption spectra measured in different solvents and used to qualitatively explain the temperature dependence of the phosphorescence decay parameters that were measured for the whole series of complexes. Spin-orbit excited-state calculations interpret their electronic absorption spectra as arising from a bunch of spin mixed states with a singlet component of only 50-90% (depending on the halide), and attribute the phosphorescence decay to thermal population of spin-mixed states with a substantial singlet character. PMID:22817529

Heydová, Radka; Gindensperger, Etienne; Romano, Roberta; Sýkora, Jan; Vl?ek, Antonín; Záliš, Stanislav; Daniel, Chantal



Water Treatment  

NSDL National Science Digital Library

This web site showcases Lenntech's Complete Water treatment and Air filtration solutions. This company designs, manufactures and installs complete air and water treatment system solutions. Lenntech proclaims, "Our wide range of technologies and extended know-how in all water-related sectors will guarantee you a cost-efficient solution meeting your water quality requirements." Whether or not you're looking to purchase one of these fine water treatment systems, the site will still provide beneficial resources about how said systems operate.


Sewage Treatment  

NASA Technical Reports Server (NTRS)

A million gallon-a-day sewage treatment plant in Huntington Beach, CA converts solid sewage to activated carbon which then treats incoming waste water. The plant is scaled up 100 times from a mobile unit NASA installed a year ago; another 100-fold scale-up will be required if technique is employed for widespread urban sewage treatment. This unique sewage-plant employed a serendipitous outgrowth of a need to manufacture activated carbon for rocket engine insulation. The process already exceeds new Environmental Protection Agency Standards Capital costs by 25% compared with conventional secondary treatment plants.



Scabies: Treatment  


... message, please visit this page: About . Parasites - Scabies Parasites Home Share Compartir Treatment On This Page Suggested ... Cases Publications Information For: Institutions Travelers Related Links Parasites A-Z Index Parasites Glossary Neglected Tropical Diseases ...


Medication Treatments  


... Information How is the FMR1 mutation related to Fragile X-associated disorders? What causes it? How many people ... approved any drugs specifically for the treatment of Fragile X or its symptoms. But in many cases, medications ...


Syphilis Treatment  


... is easy to cure in its early stages. Penicillin, an antibiotic, injected into the muscle, is the ... treatment for syphilis. If you are allergic to penicillin, your healthcare provider may give you another antibiotic ...


Wastewater Treatment.  

ERIC Educational Resources Information Center

Presents the 1978 literature review of wastewater treatment. This review covers: (1) process application; (2) coagulation and solids separation; (3) adsorption; (4) ion exchange; (5) membrane processes; and (6) oxidation processes. A list of 123 references is also presented. (HM)

Zoltek, J., Jr.; Melear, E. L.



Treatment Options  


... amount of FFP needed can overload the circulatory system and stress the heart. Other complications of treatment ... XI deficiency. They are also used to help control excessive menstrual bleeding. Antifibrinolytic drugs can be administered ...


Scabies Treatment  


... Chest & Lungs Chronic Conditions Developmental Disabilities Ear, Nose & Throat Emotional Problems Fever Genitals & Urinary Tract Head, Neck & Nervous System Obesity Skin Treatments View all Injuries & Emergencies Sports Injuries Vaccine Preventable Diseases Diphtheria Haemophilus ...


Norovirus Treatment  


... Norovirus Infection, National Institutes of Health NoroCORE Food Virology Treatment Recommend on Facebook Tweet Share Compartir There ... Norovirus Infection, National Institutes of Health NoroCORE Food Virology File Formats Help: How do I view different ...


Therapeutic Doll Making in Art Psychotherapy for Complex Trauma  

ERIC Educational Resources Information Center

Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

Stace, Sonia M.



Antitumor effects of electrochemical treatment  

PubMed Central

Electrochemical treatment is an alternative modality for tumor treatment based on the application of a low intensity direct electric current to the tumor tissue through two or more platinum electrodes placed within the tumor zone or in the surrounding areas. This treatment is noted for its great effectiveness, minimal invasiveness and local effect. Several studies have been conducted worldwide to evaluate the antitumoral effect of this therapy. In all these studies a variety of biochemical and physiological responses of tumors to the applied treatment have been obtained. By this reason, researchers have suggested various mechanisms to explain how direct electric current destroys tumor cells. Although, it is generally accepted this treatment induces electrolysis, electroosmosis and electroporation in tumoral tissues. However, action mechanism of this alternative modality on the tumor tissue is not well understood. Although the principle of Electrochemical treatment is simple, a standardized method is not yet available. The mechanism by which Electrochemical treatment affects tumor growth and survival may represent more complex process. The present work analyzes the latest and most important research done on the electrochemical treatment of tumors. We conclude with our point of view about the destruction mechanism features of this alternative therapy. Also, we suggest some mechanisms and strategies from the thermodynamic point of view for this therapy. In the area of Electrochemical treatment of cancer this tool has been exploited very little and much work remains to be done. Electrochemical treatment constitutes a good therapeutic option for patients that have failed the conventional oncology methods. PMID:23592904

González, Maraelys Morales; Zamora, Lisset Ortíz; Cabrales, Luis Enrique Bergues; Sierra González, Gustavo Victoriano; de Oliveira, Luciana Oliveira; Zanella, Rodrigo; Buzaid, Antonio Carlos; Parise, Orlando; Brito, Luciana Macedo; Teixeira, Cesar Augusto Antunes; Gomes, Marina das Neves; Moreno, Gleyce; Feo da Veiga, Venicio; Telló, Marcos; Holandino, Carla



Integrated nonthermal treatment system study  

SciTech Connect

This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)



Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna  

PubMed Central

Background?Dorsal instability of the distal ulna can lead to chronic wrist pain and loss of function. Structural changes to the dorsal radioulnar ligaments (DRUL) of the triangular fibrocartilage complex (TFCC) and the dorsal capsule around the ulnar head with or without foveal detachment can lead to volar subluxation of the distal radius e.g., dorsal instability of the distal ulna. Purpose?Is to evaluate the post-operative results of reinstituting distal radioulnar joint (DRUJ) stability through reefing of the dorsal capsule and dorsal radioulnar ligaments, with and without a foveal reattachment of the TFCC. Methods?A total of 37 patients were included in this retrospective study. Diagnosis and treatment was based strictly on dry wrist arthroscopy. In 17 patients isolated reefing of the DRUL and their collateral tissue extension was performed. In 20 patients an additional foveal reinsertion was performed. Postoperative results were evaluated with the DASH questionnaire, VAS scores, grip strength and range of motion. These findings were extrapolated in the Mayo wrist score. The two subgroups were compared. Results?Mayo wrist scores of the whole population had a mean of 73. There was no difference between the group that was treated with reefing of the DRUL only and the group that was treated with a combined foveal reinsertion. Conclusion?This relatively simple 'dorsal reefing' procedure, with foveal reinsertion when indicated, is a reliable method to restore volar-dorsal DRUJ stability with a significant decrease in pain sensation, good DASH scores and restoration of functional grip strength and ROM. Type of Study/Level of Evidence?Therapeutic, Level IV. PMID:24436811

Kouwenhoven, S.T.P.; de Jong, T.; Koch, A.R.




EPA Science Inventory

The biological treatment of a complex petrochemical wastewater containing high concentrations of organic chlorides, nitrates, and amines was initially studied using a sequence of anaerobic methanogenesis and oxygen activated sludge. Bench-scale and pilot-plant treatability studie...


The effects of infrared laser therapy and weightbath traction hydrotherapy as components of complex physical treatment in disorders of the lumbar spine: a controlled pilot study with follow-up  

NASA Astrophysics Data System (ADS)

Introduction: The therapeutic modalities available for the conservative management of chronic lumbar pain included infrared laser therapy and underwater traction, which usefulness is not universally acknowledged. This study was intended to ascertain any beneficial impact of infrared laser therapy and weightbath treatment on the clinical parameters and quality of life of patients with lumbar discopathy. Material and methods: The study population comprised 54 randomised subjects. I. group of 18 patents received only infrared laser therapy to lumbar region and painful Valley points. II. group of 18 subjects each received underwater traction therapy of lumbar spine with add-on McKenzie exercise and iontophoresis. The remaining III. group treated with exercise and iontophoresis, served as control. VAS, Oswestry index, SF36 scores, range of motion, neurological findings and thermography were monitored to appraise therapeutic afficacy in lumbar discopathy. A CT or MRI scan was done at baseline and after 3 months follow-up. Result:Infrared laser therapy and underwater traction for discopathy achieved significant improvement of all study parameters, which was evident 3 months later. Among the controls, significant improvement of only a single parameter was seen in patients with lumbar discopathy. Conclusions: Infrared laser therapy and underwater traction treatment effectively mitigate pain, muscle spasms, enhance joint flexibility, and improve the quality of life of patients with lumbar discopathy.

Oláh, Csaba; Oláh, Mihály; Demeter, Béla; Jancsó, Zoltán; Páll, Valéria; Bender, Tamás



[Proliferative vitreoretinopathy: curative treatment].  


Proliferative vitreoretinopathy (PVR), which causes contractile fibrocellular membranes that may prevent retinal reattachment, remains one of the most severe complications of rhegmatogenous retinal detachment (RD), with an incidence of 5-11%, and one of the most frequent causes of surgical failure (50-75%). Its severity is due to the complexity of the surgery required to treat patients, and to its uncertain anatomic and functional prognosis. Curative treatment of PVR includes vitrectomy, sometimes associated with phacoemulsification or scleral buckling; systematic peeling of epiretinal membranes, occasionally retinectomy; and systematic retinopexy by endolaser photocoagulation. The current preferred internal tamponade is silicone oil. Silicone oils of various densities are undergoing comparative studies. PMID:24997865

Chiquet, C; Rouberol, F



Acetic acid treatment in S. cerevisiae creates significant energy deficiency and nutrient starvation that is dependent on the activity of the mitochondrial transcriptional complex Hap2-3-4-5  

PubMed Central

Metabolic pathways play an indispensable role in supplying cellular systems with energy and molecular building blocks for growth, maintenance and repair and are tightly linked with lifespan and systems stability of cells. For optimal growth and survival cells rapidly adopt to environmental changes. Accumulation of acetic acid in stationary phase budding yeast cultures is considered to be a primary mechanism of chronological aging and induction of apoptosis in yeast, which has prompted us to investigate the dependence of acetic acid toxicity on extracellular conditions in a systematic manner. Using an automated computer controlled assay system, we investigated and model the dynamic interconnection of biomass yield- and growth rate-dependence on extracellular glucose concentration, pH conditions and acetic acid concentration. Our results show that toxic concentrations of acetic acid inhibit glucose consumption and reduce ethanol production. In absence of carbohydrates uptake, cells initiate synthesis of storage carbohydrates, trehalose and glycogen, and upregulate gluconeogenesis. Accumulation of trehalose and glycogen, and induction of gluconeogenesis depends on mitochondrial activity, investigated by depletion of the Hap2-3-4-5 complex. Analyzing the activity of glycolytic enzymes, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), pyruvate kinase (PYK), and glucose-6-phosphate dehydrogenase (G6PDH) we found that while high acetic acid concentration increased their activity, lower acetic acids concentrations significantly inhibited these enzymes. With this study we determined growth and functional adjustment of metabolism to acetic acid accumulation in a complex range of extracellular conditions. Our results show that substantial acidification of the intracellular environment, resulting from accumulation of dissociated acetic acid in the cytosol, is required for acetic acid toxicity, which creates a state of energy deficiency and nutrient starvation. PMID:23050242

Kitanovic, Ana; Bonowski, Felix; Heigwer, Florian; Ruoff, Peter; Kitanovic, Igor; Ungewiss, Christin; Wölfl, Stefan



The Mycobacterium avium complex.  

PubMed Central

Mycobacterium avium complex (MAC) disease emerged early in the epidemic of AIDS as one of the common opportunistic infections afflicting human immunodeficiency virus-infected patients. However, only over the past few years has a consensus developed about its significance to the morbidity and mortality of AIDS. M. avium was well known to mycobacteriologists decades before AIDS, and the MAC was known to cause disease, albeit uncommon, in humans and animals. The early interest in the MAC provided a basis for an explosion of studies over the past 10 years largely in response to the role of the MAC in AIDS opportunistic infection. Molecular techniques have been applied to the epidemiology of MAC disease as well as to a better understanding of the genetics of antimicrobial resistance. The interaction of the MAC with the immune system is complex, and putative MAC virulence factors appear to have a direct effect on the components of cellular immunity, including the regulation of cytokine expression and function. There now is compelling evidence that disseminated MAC disease in humans contributes to both a decrease in the quality of life and survival. Disseminated disease most commonly develops late in the course of AIDS as the CD4 cells are depleted below a critical threshold, but new therapies for prophylaxis and treatment offer considerable promise. These new therapeutic modalities are likely to be useful in the treatment of other forms of MAC disease in patients without AIDS. The laboratory diagnosis of MAC disease has focused on the detection of mycobacteria in the blood and tissues, and although the existing methods are largely adequate, there is need for improvement. Indeed, the successful treatment of MAC disease clearly will require an early and rapid detection of the MAC in clinical specimens long before the establishment of the characteristic overwhelming infection of bone marrow, liver, spleen, and other tissue. Also, a standard method of susceptibility testing is of increasing interest and importance as new effective antimicrobial agents are identified and evaluated. Antimicrobial resistance has already emerged as an important problem, and methods for circumventing resistance that use combination therapies are now being studied. Images PMID:8358707

Inderlied, C B; Kemper, C A; Bermudez, L E



Sewage Treatment  

NASA Technical Reports Server (NTRS)

Stennis Space Center's aquaculture research program has led to an attractive wastewater treatment for private homes. The system consists of a septic tank or tanks for initial sewage processing and a natural secondary treatment facility for further processing of septic tanks' effluent, consisting of a narrow trench, which contains marsh plants and rocks, providing a place for microorganisms. Plants and microorganisms absorb and digest, thus cleansing partially processed wastewater. No odors are evident and cleaned effluent may be discharged into streams or drainage canals. The system is useful in rural areas, costs about $1,900, and requires less maintenance than mechanical systems.



On State Complexes and Special Cube Complexes  

ERIC Educational Resources Information Center

This thesis presents the first steps toward a classification of non-positively curved cube complexes called state complexes. A "state complex" is a configuration space for a "reconfigurable system," i.e., an abstract system in which local movements occur in some discrete manner. Reconfigurable systems can be used to describe, for example,…

Peterson, Valerie J.



Audits for advanced treatment dosimetry  

NASA Astrophysics Data System (ADS)

Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

Ibbott, G. S.; Thwaites, D. I.



Surface Treatment  

NASA Technical Reports Server (NTRS)

A simple surface treatment process is provided which offers a high performance surface for a variety of applications at low cost. This novel surface treatment, which is particularly useful for Ti-6Al-4V alloys, is achieved by forming oxides on the surface with a two-step chemical process and without mechanical abrasion. First, after solvent degreasing, sulfuric acid is used to generate a fresh titanium surface. Next, an alkaline perborate solution is used to form an oxide on the surface. This acid-followed-by-base treatment is cost effective and relatively safe to use in commercial applications. In addition, it is chromium-free, and has been successfully used with a sol-gel coating to afford a strong adhesive bond that exhibits excellent durability after the bonded specimens have been subjected to a harsh 72 hour water boil immersion. Phenylethynyl containing adhesives were used to evaluate this surface treatment with a novel coupling agent containing both trialkoxysilane and phenylethynyl groups. 8 Claims, 16 Drawing Sheets

Park, Cheol (Inventor); Lowther, Sharon E. (Inventor); St.Clair, Terry L. (Inventor)



Wastewater Treatment  

NSDL National Science Digital Library web site for the water industry contains links to many sites for detailed information on industrial and municipal wastewater treatment plants as well as water supply and transmission. Also find information on current news releases, expos, conferences and much more.


Cryptosporidium: Treatment  


... symptoms may return if the immune status worsens. Related Treatment Links The Medical Letter's - " Drugs for Parasitic Diseases [PDF - 29 KB - 1 page] Nitazoxanide Fact Sheet Print page Get email updates Listen to audio/Podcast Contact Us: Centers for Disease Control and Prevention 1600 ...


Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol.  


Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia. PMID:18496477

Deutsch, Stephen I; Rosse, Richard B; Connor, Julie M; Burket, Jessica A; Murphy, Mary E; Fox, Fiona J



Implications of the IFRS goodwill accounting treatment  

Microsoft Academic Search

Purpose – This paper aims to critically examine the change in accounting treatment for goodwill pursuant to international financial reporting standards (IFRSs) by reference to the Australian reporting regime. Design\\/methodology\\/approach – The paper discusses and compares the former Australian and the new IFRS treatments for goodwill. This comparison focuses on the advantages and potential complexities of the new method, with

Graeme Wines; Ron Dagwell; Carolyn Windsor



Complexity analysis of angiogenesis vasculature  

NASA Astrophysics Data System (ADS)

Tumor vasculature has a high degree of irregularity as compared to normal vasculature. The quantification of the morphometric complexity in tumor images can be useful in diagnosis. Also, it is desirable in several other medical applications to have an automated complexity analysis to aid in diagnosis and prognosis under treatment. e.g. in diabetic retinopathy and in arteriosclerosis. In addition, prior efforts at segmentation of the tumor vasculature using matched filtering, template matching and splines have been hampered by the irregularity of these vessels. We try to solve both problems by introducing a novel technique for vessel detection, followed by a tracing-independent complexity analysis based on a combination of ideas. First, the vessel cross-sectional profile is modeled using a continuous and everywhere differentiable family of super-Gaussian curves. This family generates rectangular profiles that can accurately localize the vessel boundaries in microvasculature images. Second, a robust non-linear regression algorithm based on M-estimators is used to estimate the parameters that optimally characterize the vessel"s shape. A framework for the quantitative analysis of the complexity of the vasculature based on the vessel detection is presented. A set of measures that quantify the complexity are proposed viz. Squared Error, Entropy-based and Minimum Description Length-based Shape Complexities. They are completely automatic and can deal with complexities of the entire vessel unlike existing tortuousity measures which deal only with vessel centerlines. The results are validated using carefully constructed phantom and real image data with ground truth information from an expert observer.

Mahadevan, Vijay; Tyrell, James A.; Tong, Ricky T.; Brown, Edward B.; Jain, Rakesh K.; Roysam, Badrinath



Antimicrobials Treatment  

NASA Astrophysics Data System (ADS)

The use of antimicrobials is a common practice for preservation of foods. Incorporation, in a food recipe, of chemical antimicrobials towards inhibition of spoilage and pathogenic micro-organisms results in the compositional modification of food. This treatment is nowadays undesirable for the consumer, who likes natural products. Scientific community reflecting consumers demand for natural antimicrobials has made efforts to investigate the possibility to use natural antimicrobials such us bacteriocins and essential oils of plant origin to inhibit microbial growth.

Drosinos, Eleftherios H.; Skandamis, Panagiotis N.; Mataragas, Marios


[Diagnosis and treatment of acute paraproctitis].  


The results of treatment of 399 patients with various forms of acute paraproctitis are discussed. Comparative evaluation of therapeutic methods applied in the clinic is made. The authors suggest a complex method of treatment in which they use thermography with fluid crystals in topical diagnosis of abscesses of the pararectal fatty tissue and apply papain in combination with medium-frequency ultrasound for the treatment of perineal wounds. This method led to recovery of 97.4% of patients. PMID:7616699

Smirnov, V E; Lavreshin, P M; Vartanov, I E; Gobedzhishvili, V K



Neurologic manifestations of tuberous sclerosis complex  

Microsoft Academic Search

Tuberous sclerosis complex (TSC) is a multiorgan disorder that primarily affects the brain, skin, and kidneys. Recent advances\\u000a have elucidated the genetics of this complex, which has helped lead to an increased understanding of the basic neurobiology\\u000a of this disorder. There is both phenotypic and geneotypic heterogeneity. The treatment of epilepsy remains a major challenge\\u000a in these patients, and there

William M. McClintock



Fixation of atmospheric carbon dioxide by ruthenium complexes bearing an NHC-based pincer ligand: formation of a methylcarbonato complex and its methylation.  


A methylcarbonato ruthenium complex was prepared by capture of CO2 from air using the (CNC)(bpy)Ru scaffold. The methylcarbonato complex was relatively inert to decarboxylation. Treatments with methylating reagents released dimethylcarbonate. PMID:25711491

Arikawa, Yasuhiro; Nakamura, Takuo; Ogushi, Shinji; Eguchi, Kazushige; Umakoshi, Keisuke



Neuropathic pain after dental treatment.  


The head and neck regions are the most common sites of the human body to be involved in chronic pain conditions. Neuropathic pain is a chronic pain condition, and refers to all pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral or central nervous system (CNS). Trigeminal neuralgia, atypical odontalgia (phantom tooth pain), burning mouth syndrome, traumatic neuropathies, postherpetic neuralgias and complex regional pain syndrome are neuropathic pain conditions in the orofacial region that can be encountered in pain and dental clinics. The majority of the time this problem is misdiagnosed by the dentist, which can lead to unnecessary treatments. These treatments may include endodontic treatment and extraction of the tooth or teeth in the region. In this review, only post-traumatic peripheral pain neuropathies seen after dental treatments will be discussed. PMID:23588863

T?nastepe, Neslihan; Oral, Koray



Bench-to-bedside review: The evaluation of complex interventions in critical care  

Microsoft Academic Search

Complex interventions, such as the introduction of medical emergency teams or an early goal-directed therapy protocol, are developed from a number of components that may act both independently and inter-dependently. There is an emerging body of literature advocating the use of integrated complex interventions to optimise the treatment of critically ill patients. As with any other treatment, complex interventions should

Anthony Delaney; Derek C Angus; Rinaldo Bellomo; Peter Cameron; D James Cooper; Simon Finfer; David A Harrison; David T Huang; John A Myburgh; Sandra L Peake; Michael C Reade; Steve AR Webb; Donald M Yealy



Discrete Morse Complexes  

Microsoft Academic Search

We investigate properties of the set of discrete Morse functions on a simplicial complex as defined by Forman. It is not difficult to see that the pairings of discrete Morse functions of a finite simplicial complex again form a simplicial complex, the discrete Morse complex. It turns out that several known results from combinatorial topology and enumerative combinatorics, which previously

Manoj K. Chari; Michael Joswig



Complexes of clusters and complexes of stars  

E-print Network

Most star complexes are in fact complexes of stars, clusters and gas clouds; term "star complexes" was introduced as general one disregarding the preferential content of a complex. Generally the high rate of star formation in a complex is accompanied by the high number of bound clusters, including massive ones, what was explained by the high gas pressure in such regions. However, there are also complexes, where clusters seems to be more numerous in relation to stars than in a common complex. The high rate of clusters - but not isolated stars - formation seems to be typical for many isolated bursts of star formation, but deficit of stars might be still explained by the observational selection. The latter cannot, however, explain the complexes or the dwarf galaxies, where the high formation rate of only stars is observed. The possibility of the very fast dissolution of parental clusters just in such regions should itself be explained. Some difference in the physical conditions (turbulence parameters ?) within the initial gas supercloud might be a reason for the high or low stars/clusters number ratio in a complex.

Yu. N. Efremov



Treatment of Cachexia in Oncology  

PubMed Central

Cachexia is a complex metabolic syndrome associated with many chronic or end-stage diseases, especially cancer, and is characterized by loss of muscle with or without loss of fat mass. The management of cachexia is a complex challenge that should address the different causes underlying this clinical event with an integrated or multimodal treatment approach targeting the different factors involved in its pathophysiology. The purpose of this article was to review the current medical treatment of cancer-related cachexia, in particular focusing on combination therapy and ongoing research. Among the treatments proposed in the literature for cancer-related cachexia, some proved to be ineffective, namely, cyproheptadine, hydrazine, metoclopramide, and pentoxifylline. Among effective treatments, progestagens are currently considered the best available treatment option for cancer-related cachexia, and they are the only drugs approved in Europe. Drugs with a strong rationale that have failed or have not shown univocal results in clinical trials so far include eicosapentaenoic acid, cannabinoids, bortezomib, and anti-TNF-alpha MoAb. Several emerging drugs have shown promising results but are still under clinical investigation (thalidomide, selective cox-2 inhibitors, ghrelin mimetics, insulin, oxandrolone, and olanzapine). To date, despite several years of coordinated efforts in basic and clinical research, practice guidelines for the prevention and treatment of cancer-related muscle wasting are lacking, mainly because of the multifactorial pathogenesis of the syndrome. From all the data presented, one can speculate that one single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. PMID:21218002

Tazi, EM; Errihani, H



Treatment of cachexia in oncology.  


Cachexia is a complex metabolic syndrome associated with many chronic or end-stage diseases, especially cancer, and is characterized by loss of muscle with or without loss of fat mass. The management of cachexia is a complex challenge that should address the different causes underlying this clinical event with an integrated or multimodal treatment approach targeting the different factors involved in its pathophysiology. The purpose of this article was to review the current medical treatment of cancer-related cachexia, in particular focusing on combination therapy and ongoing research. Among the treatments proposed in the literature for cancer-related cachexia, some proved to be ineffective, namely, cyproheptadine, hydrazine, metoclopramide, and pentoxifylline. Among effective treatments, progestagens are currently considered the best available treatment option for cancer-related cachexia, and they are the only drugs approved in Europe. Drugs with a strong rationale that have failed or have not shown univocal results in clinical trials so far include eicosapentaenoic acid, cannabinoids, bortezomib, and anti-TNF-alpha MoAb. Several emerging drugs have shown promising results but are still under clinical investigation (thalidomide, selective cox-2 inhibitors, ghrelin mimetics, insulin, oxandrolone, and olanzapine). To date, despite several years of coordinated efforts in basic and clinical research, practice guidelines for the prevention and treatment of cancer-related muscle wasting are lacking, mainly because of the multifactorial pathogenesis of the syndrome. From all the data presented, one can speculate that one single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. PMID:21218002

Tazi, Em; Errihani, H



Sewage Treatment  

NASA Technical Reports Server (NTRS)

In the early 1970's, National Space Technology Laboratories discovered that water hyacinths literally thrive on sewage; they absorb and digest nutrients and minerals from wastewater, converting sewage effluents to clean water. They offer a means of purifying water at a fraction of the cost of a conventional sewage treatment plant, and provide a bonus value in byproducts. Hyacinths must be harvested at intervals; the harvested plants are used as fertilizers, high-protein animal feed and a source of energy. Already serving a number of small towns, the "aquaculture" technique has significantly advanced with its adoption by a major U.S. city.



Hyper Space Complex Number  

E-print Network

A new kind of numbers called Hyper Space Complex Numbers and its algebras are defined and proved. It is with good properties as the classic Complex Numbers, such as expressed in coordinates, triangular and exponent forms and following the associative and commutative laws of addition and multiplication. So the classic Complex Number is developed from in complex plane with two dimensions to in complex space with N dimensions and the number system is enlarged also.

Shanguang Tan



Complex partial status epilepticus in a child.  


Complex partial status epilepticus (SE) has been reported rarely in children. We describe the clinical case of a 14 year-old girl with complex partial seizures (CPS) since age 10 who developed a complex partial SE probably because she was not adherent to treatment. The neurologic examination and computed tomography scan were normal. During the SE she received diazepam and phenytoin and became free of the seizures after 5 minutes. The ictal EEG showed spikes and slow waves over the right temporal region. PMID:7487537

Silva, D F; Zanoteli, E; Lima, M M; Anghinah, R; Lima, J G



Bypasses and Reconstruction for Complex Brain Aneurysms  

PubMed Central

Microsurgery for brain aneurysms is a current relevant technique, as advances in endovascular and stent-assisted coiling have not solved many of the difficulties inherent in the management of complex brain aneurysms. The following review highlights the importance of microsurgical bypass techniques for the management of complex cerebrovascular aneurysms and emphasizes, through two clinical cases, the technical difficulties and indications for bypass surgery. These cases demonstrate that in selected scenarios, bypass microsurgery still offers the only viable treatment for complex aneurysms. PMID:25624977

da Silva, Harley Brito; Messina-Lopez, Mario; Sekhar, Laligam N.



[Prophylaxis and treatment of periimpalntitis].  


Ultrasonic Vector System (Dürr Dental, Germany) is the best means for complex treatment of peri-implantitis. The therapeutic effect of the system proved anti-inflammatory and regenerative impact of calcium hydroxyapatite on the soft tissue around the implant. The effectiveness of the result provided full, persistent and safe removal of bacteria, dental plaque, infected granulation tissue; the possibility of regular monitoring, prevention of re-infection of pathological pockets, without damaging the hard and soft tissues around the implant, the implant itself and artificial fragile crown, securing superb cleaning and polishing of the implant surface, which is an important condition for the further reduction and inactivation of pathogenic bacteria population. Healing peri-implantitis pockets at the expense of using conventional oral hygiene is not possible. Tools of carbon fiber in combination with a suspension Vector Fluid Polish and the Vector machine successfully accomplish the function of disinfection and polishing. The aim of the research was to present the results of peri-implantitis treatment with a new ultrasonic device Ultrasonic Vector System. Surgical treatment (21% of patients) was atraumatic. The risk of infection was decreased and necessary conditions were created for a significant acceleration of the tissue healing process. Relying on the successful results we recommend Vector- therapy before surgical procedures. Complex treatment was repeated depending on the clinical manifestations of inflammation around the implant. To prevent peri-implantitis, and get timely diagnosis of unwanted changes, and to maintain implants and the soft tissues around them in a healthy condition, the patients were strongly recommended to visit the dentist 3-4 times a year. They were offered professional oral hygiene and accessible parts of the implants with the help of a Vector machine. Relying on the results of the research we conducted during the treatment of peri-implantitis, we have seen the "magic" efficiency and the need to apply the «Vector» system into the complex treatment of this disease. PMID:24099810

Mandzhavidze, N; Vadachkoriia, N; Gumberidze, N



Protein Complexes in Bacteria  

PubMed Central

Large-scale analyses of protein complexes have recently become available for Escherichia coli and Mycoplasma pneumoniae, yielding 443 and 116 heteromultimeric soluble protein complexes, respectively. We have coupled the results of these mass spectrometry-characterized protein complexes with the 285 “gold standard” protein complexes identified by EcoCyc. A comparison with databases of gene orthology, conservation, and essentiality identified proteins conserved or lost in complexes of other species. For instance, of 285 “gold standard” protein complexes in E. coli, less than 10% are fully conserved among a set of 7 distantly-related bacterial “model” species. Complex conservation follows one of three models: well-conserved complexes, complexes with a conserved core, and complexes with partial conservation but no conserved core. Expanding the comparison to 894 distinct bacterial genomes illustrates fractional conservation and the limits of co-conservation among components of protein complexes: just 14 out of 285 model protein complexes are perfectly conserved across 95% of the genomes used, yet we predict more than 180 may be partially conserved across at least half of the genomes. No clear relationship between gene essentiality and protein complex conservation is observed, as even poorly conserved complexes contain a significant number of essential proteins. Finally, we identify 183 complexes containing well-conserved components and uncharacterized proteins which will be interesting targets for future experimental studies. PMID:25723151

Caufield, J. Harry; Abreu, Marco; Wimble, Christopher; Uetz, Peter



Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment  

PubMed Central

Background Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle. Methods This review focuses on the epidemiology, pathophysiology, causes, presentation, diagnosis, complications, management, and anesthetic considerations related to rhabdomyolysis. Results Any form of muscle damage––and by extension any entity that causes muscle damage––can initiate rhabdomyolysis. One of the most important treatment goals when rhabdomyolysis is suspected is avoiding acute kidney injury. Conclusion All clinicians should be aware of common causes, diagnosis, and treatment options.

Torres, Patrick A.; Helmstetter, John A.; Kaye, Adam M.; Kaye, Alan David



The metabolic syndrome - background and treatment  

PubMed Central

The metabolic syndrome (MBS) is characterised by a clustering of cardiovascular and metabolic risk factors. This syndrome is now widely recognised as a distinct pathological entity, and it is receiving a great deal of attention in the medical literature but also in the lay press. Globally speaking, persons with MBS have a clustering of the following risk factors: [List: see text] MBS is associated with important cardio/cerebrovascular and metabolic risks. Prevention and treatment are therefore of great importance. Preventive measures involving lifestyle are mandatory. In addition, MBS patients require pharmacological treatment, usually for the rest of their lives. Complex patterns of drug treatment will be required, since all the different, heterogenous pathophysiological problems will require appropriate treatment. After an introduction to MBS, this article provides an extensive and critical review of the drug treatment of this complex pathological entity. ImagesFigure 2 PMID:25696664

van Zwieten, P.A.



Evolution of biological complexity  

PubMed Central

To make a case for or against a trend in the evolution of complexity in biological evolution, complexity needs to be both rigorously defined and measurable. A recent information-theoretic (but intuitively evident) definition identifies genomic complexity with the amount of information a sequence stores about its environment. We investigate the evolution of genomic complexity in populations of digital organisms and monitor in detail the evolutionary transitions that increase complexity. We show that, because natural selection forces genomes to behave as a natural “Maxwell Demon,” within a fixed environment, genomic complexity is forced to increase. PMID:10781045

Adami, Christoph; Ofria, Charles; Collier, Travis C.



Neural networks and dynamic complex systems  

SciTech Connect

We describe the use of neural networks for optimization and inference associated with a variety of complex systems. We show how a string formalism can be used for parallel computer decomposition, message routing and sequential optimizing compilers. We extend these ideas to a general treatment of spatial assessment and distributed artificial intelligence. 34 refs., 12 figs.

Fox, G.; Furmanski, Wojtek; Ho, Alex; Koller, J.; Simic, P.; Wong, Isaac



Computational complexity of the quantum separability problem  

Microsoft Academic Search

Ever since entanglement was identified as a computational and cryptographic resource, researchers have sought efficient ways to tell whether a givendensity matrix represents an unentangled, or separable, state. This paper gives the first systematic and com- prehensive treatment of this (bipartite) quantum separability problem, focusing on its deterministic (as opposed to randomized) computational complexity. First, I review the one-sided tests

Lawrence M. Ioannou



Electronic Structures of Transition-Metal Complexes  

Microsoft Academic Search

The empirically determined values of the parameter Dq, which in transition-metal complexes, measure the influence of the ligands on the metal d-orbitals are interpreted theoretically. A quantitative treatment of ``the magnetic criterion of the bond type,'' is given. Values of Slater-Condon parameters for transition metal ions are tabulated.

L. E. Orgel



Brain metastasis and treatment  

PubMed Central

Despite major therapeutic advances in the management of patients with systemic malignancies, management of brain metastases remains a significant challenge. These patients often require multidisciplinary care that includes surgical resection, radiation therapy, chemotherapy, and targeted therapies. Complex decisions about the sequencing of therapies to control extracranial and intracranial disease require input from neurosurgeons, radiation oncologists, and medical/neuro-oncologists. With advances in understanding of the biology of brain metastases, molecularly defined disease subsets and the advent of targeted therapy as well as immunotherapeutic agents offer promise. Future care of these patients will entail tailoring treatment based on host (performance status and age) and tumor (molecular cytogenetic characteristics, number of metastases, and extracranial disease status) factors. Considerable work involving preclinical models and better clinical trial designs that focus not only on effective control of tumor but also on quality of life and neurocognition needs to be done to improve the outcome of these patients. PMID:25580268

Ahluwalia, Manmeet S.; Vogelbaum, Michael V.; Chao, Samuel T.



Osteopathic Manipulative Treatment  

PubMed Central

Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

Campbell, Shannon M.; Walkowski, Stevan



Periodontal Treatments and Procedures  


... Comprehensive Periodontal Evaluation Periodontal Treatments and Procedures Non-Surgical Periodontal Treatments Gum Graft Surgery Laser Treatment for Gum Disease Regenerative Procedures Dental Crown ...


[Experience of treatment of diabetic foot syndrome].  


In The Clinic of Cathedra of The Catastrophes Medicine, Military Medicine, Anesthesiology and Reanimatology in 2010 - 2013 yrs 53 patients, ageing 23-65 yrs, were treated for diabetic foot syndrome (DFS) of neuropathic and mixed forms. Diagnostic-treatment algorithm was proposed for determination of level and degree of a circulation and neuropathic disorders, introduction of which have promoted optimization of surgical and local treatment, improvement of the complex treatment results in patients, suffering DFS. A new method of treatment application, using combined preparation of hyaluronic acid with the sodium succinic, have permitted to achieve a complete healing of the ulcer defect. PMID:25252415

Pertsov, V I; Ponomarenko, O V



Oligocyclopentadienyl transition metal complexes  

SciTech Connect

Synthesis, characterization, and reactivity studies of oligocyclopentadienyl transition metal complexes, namely those of fulvalene, tercyclopentadienyl, quatercyclopentadienyl, and pentacyclopentadienyl(cyclopentadienyl) are the subject of this account. Thermal-, photo-, and redox chemistries of homo- and heteropolynuclear complexes are described.

de Azevedo, Cristina G.; Vollhardt, K. Peter C.



Quantum Complex Minkowski Space  

E-print Network

The complex Minkowski phase space has the physical interpretation of the phase space of the scalar massive conformal particle. The aim of the paper is the construction and investigation of the quantum complex Minkowski space.

Grzegorz Jakimowicz; Anatol Odzijewicz



Complex Elliptic Pendulum  

E-print Network

This paper briefly summarizes previous work on complex classical mechanics and its relation to quantum mechanics. It then introduces a previously unstudied area of research involving the complex particle trajectories associated with elliptic potentials.

Carl M. Bender; Daniel W. Hook; Karta Kooner



Compliance with treatment in adult patients with cystic fibrosis  

Microsoft Academic Search

BACKGROUND: Patients with chronic disease comply with about 50% of their treatment. The complex and time consuming daily drug regimens needed in the care of adult patients with cystic fibrosis encourage non-compliance with prescribed treatments. Understanding the reasons for, and the extent of, non-compliance is essential for a realistic appraisal of the patient's condition and sensible planning of future treatment

S. P. Conway; M. N. Pond; T. Hamnett; A. Watson



Assessment and Treatment of Personality Disorders: A Behavioral Perspective  

ERIC Educational Resources Information Center

Personality disorders are complex and highly challenging to treatment providers; yet, for clients with these problems, there exist very few treatment options that have been supported by research. Given the lack of empirically-supported therapies for personality disorders, it can be difficult to make treatment decisions for this population. The…

Nelson-Gray, Rosemery O.; Lootens, Christopher M.; Mitchell, John T.; Robertson, Christopher D.; Hundt, Natalie E.; Kimbrel, Nathan A.



Tuberous Sclerosis Complex Diagnostic Criteria Update: Recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference  

PubMed Central

BACKGROUND Tuberous sclerosis complex is highly variable in clinical presentation and findings. Disease manifestations continue to develop over the lifetime of an affected individual. Accurate diagnosis is fundamental to implementation of appropriate medical surveillance and treatment. Although significant advances have been made in the past 15 years in the understanding and treatment of tuberous sclerosis complex, current clinical diagnostic criteria have not been critically evaluated or updated since the last clinical consensus conference in 1998. METHODS The 2012 International Tuberous Sclerosis Complex Consensus Group, comprising 79 specialists from 14 countries, was organized into 12 subcommittees, each led by a clinician with advanced expertise in tuberous sclerosis complex and the relevant medical subspecialty. Each subcommittee focused on a specific disease area with important diagnostic implications and was charged with reviewing prevalence and specificity of disease-associated clinical findings and their impact on suspecting and confirming the diagnosis of tuberous sclerosis complex. RESULTS Clinical features of tuberous sclerosis complex continue to be a principal means of diagnosis. Key changes compared with 1998 criteria are the new inclusion of genetic testing results and reducing diagnostic classes from three (possible, probable, and definite) to two (possible, definite). Additional minor changes to specific criterion were made for additional clarification and simplification. CONCLUSIONS The 2012 International Tuberous Sclerosis Complex Diagnostic Criteria provide current, updated means using best available evidence to establish diagnosis of tuberous sclerosis complex in affected individuals. PMID:24053982

Northrup, Hope; Krueger, Darcy A.




Microsoft Academic Search

We introduce and study a family of simplicial complexes associated to an arbitrary finite root system and a nonnegative integer parameter m. For m = 1, our construction specializes to the (simplicial) generalized associahedra or, equivalently, to the cluster complexes for the cluster algebras of finite type. Our computation of the face numbers and h-vectors of these complexes produces the



Complex numbers Quaternions  

E-print Network

Complex numbers Quaternions Imaginary numbers and Quaternions Katrin Leschke University of Leicester June 29, 2010 Katrin Leschke Imaginary numbers and Quaternions #12;Complex numbers Quaternions Imaginary numbers and Quaternions #12;Complex numbers Quaternions Vectors in 2d­space A vector in 2d


Minimal atomic complexes  

Microsoft Academic Search

We define minimal atomic complexes and irreducible complexes, and we prove that they are the same. The irreducible complexes admit homological characterizations that make them easy to recognize. These concepts apply both to spaces and to spectra. On the spectrum level, our characterizations allow us to show that such familiar spectra as ko, eo2, and BoP at the prime 2,

A. J. Baker; J. P. May



Complex fuzzy soft multisets  

NASA Astrophysics Data System (ADS)

In this paper we combine two definitions, namely fuzzy soft multiset and complex fuzzy set to construct the definition of a complex fuzzy soft multiset and study its properties. In other words, we study the extension of a fuzzy soft multiset from real numbers to complex numbers. We also introduce its basic operations, namely complement, union and intersection. Some examples are given.

Alkouri, Abd Ulazeez M.; Salleh, Abdul Razak



Stochastic Complexity and Modeling  

Microsoft Academic Search

As a modification of the notion of algorithmic complexity, the stochastic complexity of a string of data, relative to a class of probabilistic models, is defined to be the fewest number of binary digits with which the data can be encoded by taking advantage of the selected models. The computation of the stochastic complexity produces a model, which may be

Jorma Rissanen



[Proliferative vitreoretinopathy: prophylactic treatment].  


Proliferative vitreoretinopathy (PVR) is a complex process. It causes contractile fibrocellular membranes that may prevent retinal reattachment. PVR therefore remains one of the most severe complications of rhegmatogenous retinal detachment (RD), with an incidence of 5-11%, and is among the most frequent causes of surgical failure (50-75%). Its severity derives from the complexity of the surgery required to treat patients and from its uncertain anatomic and functional prognosis. The first step in preventing PVR is to identify patients at risk by means of clinical and/or biological factors such as the characteristics of retinal tears (large size, number) and detachment (preexisting PVR, extent), and the use of cryotherapy. Surgeons must therefore adapt their surgical approach to the risk of PVR. The study of animal models and the natural history of the condition in humans demonstrate the importance of early antiproliferative treatment in the early stage of the disease. Combining 5-fluoro-uracil and heparin in the vitrectomy infusion lowers the rate of postoperative PVR onset in patients with PVR risk factors. The evaluation of new molecules and new dosages will lead to a decisive step in the fight against PVR. PMID:25012973

Chiquet, C; Rouberol, F



From Quantum Query Complexity to State Complexity  

E-print Network

State complexity of quantum finite automata is one of the interesting topics in studying the power of quantum finite automata. It is therefore of importance to develop general methods how to show state succinctness results for quantum finite automata. One such method is presented and demonstrated in this paper. In particular, we show that state succinctness results can be derived out of query complexity results.

Shenggen Zheng; Daowen Qiu



Complex-I-ty in aging.  


The role of mitochondrial complex I in aging has been studied in both C. elegans and Drosophila, where RNAi knock down of specific complex I subunits has been shown to extend lifespan. More recently, studies in Drosophila have shown that an increase in mitochondrial activity, including complex I-like activity, can also slow aging. In this review, we discuss this apparent paradox. Improved maintenance of mitochondrial activity, mitochondrial homeostasis, may be responsible for lifespan extension in both cases. Decreased electron transport chain activity caused by reducing complex I subunit expression prompts an increase in stress response signaling that leads to enhanced mitochondrial homeostasis during aging. Increased complex I activity, as well as mitochondrial biogenesis, is expected to both directly counteract the decline in mitochondrial health that occurs during aging and may also increase cellular NAD(+) levels, which have been linked to mitochondrial homeostatic mechanisms through activation of sirtuins. We suggest that manipulations that increase or decrease complex I activity both converge on improved mitochondrial homeostasis during aging, resulting in prolonged lifespan. PMID:24961226

Hur, Jae H; Stork, Devon A; Walker, David W



Imprinted Polymers in Wastewater Treatment  

SciTech Connect

In wastewater treatment, a method that specifically recognizes a variety of impurities in a flexible manner would be useful for treatment facilities with varying needs. Current purification techniques (i.e. bacteria, oxidation, reduction, precipitation and filtration) are nonspecific and difficult to control in complex mixtures. Heavy metal removal is particularly important in improving the efficiency of wastewater treatment, as they inhibit or even destroy the bacteria used for filtration. Imprinting polymerization is a technique that allows for the efficient removal of specific compounds and has been used in purification of enantiomers. It has potential to be applied in wastewater systems with the impurities acting as the template for the imprinting polymerization. The polymer with the bound impurities intact can then be removed via precipitation. After removal of the impurity the polymer can be reused. Data for the imprinting polymerization of polyacrylates and polyacrylamides for several metal complexes will be presented. Imprinting polymerization in combination with emulsion polymerization to improve the removal of hydrophobic contaminants will be described. Removal efficiencies will be presented and compared with conventional wastewater treatment methods.

Eastman, Christopher; Goodrich, Scott; Gartner, Isabelle; Mueller, Anja



Treatment Option Overview (Neuroblastoma)  


... are different types of treatment for patients with neuroblastoma. Different types of treatment are available for patients ... patients who have not started treatment. Children with neuroblastoma should have their treatment planned by a team ...


Amblyopia: Lazy Eye Treatment  


... Sun Eye Health News Consumer Alerts Amblyopia: Lazy Eye Treatment Tweet Lazy eye correction or treatment should ... Lazy Eye Diagnosis Amblyopia: Lazy Eye Treatment Lazy eye patch treatment If refractive amblyopia is a problem, ...


Heat Treatment Assistant Professor  

E-print Network

treatment. Residual stresses and decarburisation. 2 #12;Surface Hardening Case carburising, nitriding resistance-stabilising treatment and high temperature resistance-precipitation hardening, surface treatmentHeat Treatment R. Manna Assistant Professor Centre of Advanced Study Department of Metallurgical

Cambridge, University of


Treatment for HIV  


... and Public Home » Treatment » Treatment Decisions and HIV HIV/AIDS HIV/AIDS HIV/AIDS Home For Veterans ... here Enter ZIP code here Treatment Decisions and HIV for Veterans and the Public Treatment for HIV: ...


Posterior crossbite - treatment and stability  

PubMed Central

Posterior crossbite is defined as an inadequate transversal relationship of maxillary and mandibular teeth. Even when eliminating the etiologic factors, this malocclusion does not have a spontaneous correction, and should be treated with maxillary expansion as early as possible. This treatment aims at providing a better tooth/skeletal relationship, thereby improving masticatory function, and establishing a symmetrical condyle/fossa relationship. Should posterior crossbite not be treated early, it may result in skeletal changes, demanding a more complex approach. Additionally, an overcorrection expansion protocol should be applied in order to improve the treatment stability. Although the literature has reported a high rate of relapse after maxillary expansion, the goal of this study was to demonstrate excellent stability of the posterior crossbite correction 21 years post treatment. PMID:22666850

de ALMEIDA, Renato Rodrigues; de ALMEIDA, Marcio Rodrigues; OLTRAMARI-NAVARRO, Paula Vanessa Pedron; CONTI, Ana Cláudia de Castro Ferreira; NAVARRO, Ricardo de Lima; MARQUES, Henry Victor Alves



Finite Neutrosophic Complex Numbers  

E-print Network

In this book for the first time the authors introduce the notion of real neutrosophic complex numbers. Further the new notion of finite complex modulo integers is defined. For every $C(Z_n)$ the complex modulo integer $i_F$ is such that $2F_i = n - 1$. Several algebraic structures on $C(Z_n)$ are introduced and studied. Further the notion of complex neutrosophic modulo integers is introduced. Vector spaces and linear algebras are constructed using these neutrosophic complex modulo integers.

W. B. Vasantha Kandasamy; Florentin Smarandache



Complex Correspondence Principle  

SciTech Connect

Quantum mechanics and classical mechanics are distinctly different theories, but the correspondence principle states that quantum particles behave classically in the limit of high quantum number. In recent years much research has been done on extending both quantum and classical mechanics into the complex domain. These complex extensions continue to exhibit a correspondence, and this correspondence becomes more pronounced in the complex domain. The association between complex quantum mechanics and complex classical mechanics is subtle and demonstrating this relationship requires the use of asymptotics beyond all orders.

Bender, Carl M.; Meisinger, Peter N. [Department of Physics, Washington University, St. Louis, Missouri 63130 (United States); Hook, Daniel W. [Theoretical Physics, Imperial College London, London SW7 2AZ (United Kingdom); Wang Qinghai [Department of Physics, National University of Singapore, Singapore 117542 (Singapore)



[Complex treatment of lumbosacral radiculoischemia using manual therapy].  


A total of 200 patients with discogenic lumbosacral radiculoischemias were investigated and treated. The radiculoischemia was most common in the 5th lumbar radiculus with less frequent involvement of the 1st sacral radiculus. The isolate affliction of the latter was seldom. This is the first experience of treating these patients with manual therapy and postisometric myorelaxation. Besides, the therapy comprised a number of other interventions: drugs (vasodilators, anticholinesterase, dehydrating, group B vitamins), balneo- and fangotherapy, electrostimulation using "Myoton-2" device. The therapy yielded positive results which were verified electroneuromyographically. PMID:2750375

Drobinski?, A D; Kozelkin, A A



Trauma-focused CBT for youth with complex trauma  

PubMed Central

Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.



The Oriented Graph Complexes  

NASA Astrophysics Data System (ADS)

The oriented graph complexes are complexes of directed graphs without directed cycles. They govern, for example, the quantization of Lie bialgebras and infinite dimensional deformation quantization. Similar to the ordinary graph complexes GC n introduced by Kontsevich they come in two essentially different versions, depending on the parity of n. It is shown that, surprisingly, the oriented graph complex is quasi-isomorphic to the ordinary commutative graph complex of opposite parity GC n-1, up to some known classes. This yields in particular a combinatorial description of the action of on Lie bialgebras, and shows that a cycle-free formality morphism in the sense of Shoikhet can be constructed rationally without reference to configuration space integrals. Curiously, the obstruction class in the oriented graph complex found by Shoikhet corresponds to the well known theta graph in the ordinary graph complex.

Willwacher, Thomas



A consistent modelling methodology for secondary settling tanks in wastewater treatment  

E-print Network

A consistent modelling methodology for secondary settling tanks in wastewater treatment Stefan on a consistent modelling methodology (CMM) of complex real processes in wastewater treatment by utilizing both as a case since this is one of the most complex processes in a wastewater treatment plant and the simulation

Bürger, Raimund


Child health in complex emergencies.  

PubMed Central

Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care. PMID:16501716

Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu



Definitions Algebra of complex numbers  

E-print Network

Definitions Algebra of complex numbers Polar coordinates form of complex numbers Check your knowledge Review of Complex Numbers Definitions, Algebra of complex numbers, Polar coordinates Review of Complex Numbers #12;Definitions Algebra of complex numbers Polar coordinates form of complex numbers Check

Lega, Joceline


Oral insulin delivery systems based on complexation polymer hydrogels  

E-print Network

with poly(ethylene glycol) (P(MAA-g-EG)) for oral dosage forms of insulin is reviewed. The complexation for diabetic patients. Key words: Oral ­ Insulin ­ Peptides ­ Proteins ­ Delivery ­ Complexation hydrogels. J and proteins. Peptides and pro- teins are generally administered parenterally for systemic treatment because

Peppas, Nicholas A.


Surprising Titanium Complexes Bearing 2-Pyrazolato Ligands: Synthesis, Structure, and  

E-print Network

Surprising Titanium Complexes Bearing 2-Pyrazolato Ligands: Synthesis, Structure, and Molecular the synthesis and characterization of several homoleptic pz com- plexes of titanium(IV). These species complexes should be common in early to middle transition metals. Treatment of tetrakis(dimethylamido)titanium

Schlegel, H. Bernhard


Treatment planning considerations in older adults.  


The older patient often presents with clinically challenging dental problems combined with complex medical, social, psychological, and financial barriers to oral health. Through careful consideration, the clinician can design a thoughtfully sequenced treatment plan that addresses dental conditions and facilitates improved oral health. Several models serve to guide the clinician with this endeavor. Treatment planning for a medically complex patient with xerostomia and dementia involves a great deal of uncertainty, which may be attenuated by flexibility and good communication with the patient and all involved parties. PMID:25201539

Oong, Ella M; An, Gregory K



Medical Treatments for Sexual Problems in Women  

Microsoft Academic Search

\\u000a Cancer today is more of a chronic than a fatal disease: the improving survival rates increase the likelihood of long survival\\u000a after the diagnosis. Unfortunately, cancer treatment is the most frequent cause of premature iatrogenic menopause and psychosexual\\u000a dysfunction. Therefore, an increasing number of cancer survivors have to cope with both the consequences of cancer treatment\\u000a per se, the complex

Alessandra Graziottin; Audrey Serafini


Taurid meteor complex  

NASA Astrophysics Data System (ADS)

Structure of the autumnal part of the Taurid meteor complex based on photographic, radio and video meteor orbits is investigated and presented. Potential filaments or sub-streams to be associated with the complex were searched for utilizing the Southworth-Hawkins D-criterion. Altogether fourteen filaments or sub-streams associated with the complex were separated, with the length of the complex exceeding 100 degrees. Central part of the complex is formed by four the most dense filaments, the Northern and Southern Taurids, Southern Piscids and Omicron Orionids. The most probable bodies genetically related to the complex besides 2P/Encke are 2005 UY6, 2005 TF50 and 2007 RU17.

Bu?ek, M.; Porub?an, V.



Hypergraph coloring complexes.  


The aim of this paper is to generalize the notion of the coloring complex of a graph to hypergraphs. We present three different interpretations of those complexes-a purely combinatorial one and two geometric ones. It is shown, that most of the properties, which are known to be true for coloring complexes of graphs, break down in this more general setting, e.g., Cohen-Macaulayness and partitionability. Nevertheless, we are able to provide bounds for the [Formula: see text]- and [Formula: see text]-vectors of those complexes which yield new bounds on chromatic polynomials of hypergraphs. Moreover, though it is proven that the coloring complex of a hypergraph has a wedge decomposition, we provide an example showing that in general this decomposition is not homotopy equivalent to a wedge of spheres. In addition, we can completely characterize those hypergraphs whose coloring complex is connected. PMID:23483700

Breuer, Felix; Dall, Aaron; Kubitzke, Martina



Formation of interpolymer complexes  

Microsoft Academic Search

Interpolymer complex formations of poly(methacrylic acid) (PMAA) or poly(acrylic acid) (PAA) with oligocations as well as poly(ethylene oxide) (PEO), and poly-(N-vinyl-2-pyrrolidone of various chain lengths were studied. For the case of complexation between PMAA and oligocations, the standard free energy change for the complexation ?G° was found to be linearly dependent on the number of interacting sites, n. The stability

Eishun Tsuchida; Yoshihito Osada; Hiroyuki Ohno



Quantum Computational Complexity  

E-print Network

This article surveys quantum computational complexity, with a focus on three fundamental notions: polynomial-time quantum computations, the efficient verification of quantum proofs, and quantum interactive proof systems. Properties of quantum complexity classes based on these notions, such as BQP, QMA, and QIP, are presented. Other topics in quantum complexity, including quantum advice, space-bounded quantum computation, and bounded-depth quantum circuits, are also discussed.

John Watrous



Complexity and schizophrenia.  


Complexity estimators have been broadly utilized in schizophrenia investigation. Early studies reported increased complexity in schizophrenia patients, associated with a higher variability or "irregularity" of their brain signals. However, further investigations showed reduced complexities, thus introducing a clear divergence. Nowadays, both increased and reduced complexity values are reported. The explanation of such divergence is a critical issue to understand the role of complexity measures in schizophrenia research. Considering previous arguments a complementary hypothesis is advanced: if the increased irregularity of schizophrenia patients' neurophysiological activity is assumed, a "natural" tendency to increased complexity in EEG and MEG scans should be expected, probably reflecting an abnormal neuronal firing pattern in some critical regions such as the frontal lobes. This "natural" tendency to increased complexity might be modulated by the interaction of three main factors: medication effects, symptomatology, and age effects. Therefore, young, medication-naïve, and highly symptomatic (positive symptoms) patients are expected to exhibit increased complexities. More importantly, the investigation of these interacting factors by means of complexity estimators might help to elucidate some of the neuropathological processes involved in schizophrenia. PMID:22507763

Fernández, Alberto; Gómez, Carlos; Hornero, Roberto; López-Ibor, Juan José



Mathematics and complex systems.  


Contemporary researchers strive to understand complex physical phenomena that involve many constituents, may be influenced by numerous forces, and may exhibit unexpected or emergent behavior. Often such "complex systems" are macroscopic manifestations of other systems that exhibit their own complex behavior and obey more elemental laws. This article proposes that areas of mathematics, even ones based on simple axiomatic foundations, have discernible layers, entirely unexpected "macroscopic" outcomes, and both mathematical and physical ramifications profoundly beyond their historical beginnings. In a larger sense, the study of mathematics itself, which is increasingly surpassing the capacity of researchers to verify "by hand," may be the ultimate complex system. PMID:17947574

Foote, Richard



Trimethylacetate nickel complexes  

Microsoft Academic Search

The present review is devoted to the chemistry of trimethylacetate NiII complexes with various nitrogen-containing ligands. Pathways of formation of complexes containing the Ni2(?-OH2)(?-OOCCMe3)2 and Ni2(?-OOCCMe3)4 fragments are discussed. Pathways of degradation of the nine-nuclear complex Ni9(HOOCCMe3)4(?4-OH)3(?3-OH)3)3(?4-OOCCMe3)12 under the action of primary amines (aniline or propargylamine) as well as the process of dehydration ofN-phenyl-o-phenylenediamine up to the bischelate mononuclear complex

I. L. Eremenko; S. E. Nefedov; A. A. Sidorov; I. I. Moiseev



Underground Coal Thermal Treatment  

SciTech Connect

The long-term objective of this work is to develop a transformational energy production technology by insitu thermal treatment of a coal seam for the production of substitute natural gas (SNG) while leaving much of the coalâ??s carbon in the ground. This process converts coal to a high-efficiency, low-GHG emitting gas fuel. It holds the potential of providing environmentally acceptable access to previously unusable coal resources. This topical report discusses the development of experimental capabilities, the collection of available data, and the development of simulation tools to obtain process thermo-chemical and geo-thermal parameters in preparation for the eventual demonstration in a coal seam. It also includes experimental and modeling studies of CO{sub 2} sequestration. Efforts focused on: â?¢ Constructing a suite of three different coal pyrolysis reactors. These reactors offer the ability to gather heat transfer, mass transfer and kinetic data during coal pyrolysis under conditions that mimic in situ conditions (Subtask 6.1). â?¢ Studying the operational parameters for various underground thermal treatment processes for oil shale and coal and completing a design matrix analysis for the underground coal thermal treatment (UCTT). This analysis yielded recommendations for terms of targeted coal rank, well orientation, rubblization, presence of oxygen, temperature, pressure, and heating sources (Subtask 6.2). â?¢ Developing capabilities for simulating UCTT, including modifying the geometry as well as the solution algorithm to achieve long simulation times in a rubblized coal bed by resolving the convective channels occurring in the representative domain (Subtask 6.3). â?¢ Studying the reactive behavior of carbon dioxide (CO{sub 2}) with limestone, sandstone, arkose (a more complex sandstone) and peridotite, including mineralogical changes and brine chemistry for the different initial rock compositions (Subtask 6.4). Arkose exhibited the highest tendency of participating in mineral reactions, which can be attributed to the geochemical complexity of its initial mineral assemblage. In experiments with limestone, continuous dissolution was observed with the release of CO{sub 2} gas, indicated by the increasing pressure in the reactor (formation of a gas chamber). This occurred due to the lack of any source of alkali to buffer the solution. Arkose has the geochemical complexity for permanent sequestration of CO{sub 2} as carbonates and is also relatively abundant. The effect of including NH{sub 3} in the injected gas stream was also investigated in this study. Precipitation of calcite and trace amounts of ammonium zeolites was observed. A batch geochemical model was developed using Geochemists Workbench (GWB). Degassing effect in the experiments was corrected using the sliding fugacity model in GWB. Experimental and simulation results were compared and a reasonable agreement between the two was observed.

P. Smith; M. Deo; E. Eddings; A. Sarofim; K. Gueishen; M. Hradisky; K. Kelly; P. Mandalaparty; H. Zhang



Finding the missing heritability of complex diseases  

PubMed Central

Genome-wide association studies have identified hundreds of genetic variants associated with complex human diseases and traits, and have provided valuable insights into their genetic architecture. Most variants identified so far confer relatively small increments in risk, and explain only a small proportion of familial clustering, leading many to question how the remaining, ‘missing’ heritability can be explained. Here we examine potential sources of missing heritability and propose research strategies, including and extending beyond current genome-wide association approaches, to illuminate the genetics of complex diseases and enhance its potential to enable effective disease prevention or treatment. PMID:19812666

Manolio, Teri A.; Collins, Francis S.; Cox, Nancy J.; Goldstein, David B.; Hindorff, Lucia A.; Hunter, David J.; McCarthy, Mark I.; Ramos, Erin M.; Cardon, Lon R.; Chakravarti, Aravinda; Cho, Judy H.; Guttmacher, Alan E.; Kong, Augustine; Kruglyak, Leonid; Mardis, Elaine; Rotimi, Charles N.; Slatkin, Montgomery; Valle, David; Whittemore, Alice S.; Boehnke, Michael; Clark, Andrew G.; Eichler, Evan E.; Gibson, Greg; Haines, Jonathan L.; Mackay, Trudy F. C.; McCarroll, Steven A.; Visscher, Peter M.



Visual Complexity: A Review  

ERIC Educational Resources Information Center

The idea of visual complexity, the history of its measurement, and its implications for behavior are reviewed, starting with structuralism and Gestalt psychology at the beginning of the 20th century and ending with visual complexity theory, perceptual learning theory, and neural circuit theory at the beginning of the 21st. Evidence is drawn from…

Donderi, Don C.



Complex rectangular transforms  

Microsoft Academic Search

While deriving rectangular transforms Agarwal and cooley have used polynomial factors with real integer coefficients which resulted in real convolution matrices. In this paper, it is shown that the use of polynomial factors with complex integer coefficients yields new algorithms with complex convolution matrices, which require less number of multiplications than rectangular transforms. The paper outlines the derivation of the

V. Reddy; N. Reddy



Negotiating Complex Contracts  

Microsoft Academic Search

Work to date on computational models of negotiation has focused almost exclusively on defining contracts consisting of one or a few independent issues and tractable contract spaces. Many real-world contracts, by contrast, are much more complex, consisting of multiple inter-dependent issues and intractably large contract spaces. This paper describes a simulated annealing based approach appropriate for negotiating such complex contracts

Mark Klein; Peyman Faratin; Hiroki Sayama; Yaneer Bar-Yam




EPA Science Inventory

The enormous complexity of ecosystems is generally obvious under even the most cursory examination. In the modern world, this complexity is further augmented by the linkage of ecosystems to economic and social systems through the human use of the environment for technological pu...


Complex systems and valuation  

Microsoft Academic Search

Ecological and economic systems are undeniably complex. Whereas a goal of delineating ‘ecosystem services’ is to make readily apparent some of the important ways in which ecosystems underpin human welfare, insights are also gained by appreciating the nonlinear dynamic properties of ecosystems. In this paper, we review some of the relevant characteristics of complex systems. Ecosystems and economic systems share

Karin E. Limburg; Robert V. O'neill; Robert Costanza; Stephen Farber



Complexity and Relations  

ERIC Educational Resources Information Center

A central feature of complexity is that it is based on non-linear, recursive relations. However, in most current accounts of complexity such relations, while non-linear, are based on the reductive relations of a Newtonian onto-epistemological framework. This means that the systems that are emergent from the workings of such relations are a…

Lancaster, Jeanette Elizabeth



Tailoring Recursion for Complexity  

Microsoft Academic Search

We design functional algebras that characterize various complexity classes of global functions. For this purpose, classical schemata from recursion theory are tailored for capturing complexity. In particular we present a functional analog of first-order logic and describe algebras of the functions computable in nondeterministic logarithmic space, deterministic and nondeterministic polynomial time, and for the functions computable by $\\\\mathrm{AC}^1$-circuits.

Erich Grädel; Yuri Gurevich



U1A Complex  


Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.




U1A Complex  

SciTech Connect

Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.




Bacterial formate hydrogenlyase complex  

PubMed Central

Under anaerobic conditions, Escherichia coli can carry out a mixed-acid fermentation that ultimately produces molecular hydrogen. The enzyme directly responsible for hydrogen production is the membrane-bound formate hydrogenlyase (FHL) complex, which links formate oxidation to proton reduction and has evolutionary links to Complex I, the NADH:quinone oxidoreductase. Although the genetics, maturation, and some biochemistry of FHL are understood, the protein complex has never been isolated in an intact form to allow biochemical analysis. In this work, genetic tools are reported that allow the facile isolation of FHL in a single chromatographic step. The core complex is shown to comprise HycE (a [NiFe] hydrogenase component termed Hyd-3), FdhF (the molybdenum-dependent formate dehydrogenase-H), and three iron-sulfur proteins: HycB, HycF, and HycG. A proportion of this core complex remains associated with HycC and HycD, which are polytopic integral membrane proteins believed to anchor the core complex to the cytoplasmic side of the membrane. As isolated, the FHL complex retains formate hydrogenlyase activity in vitro. Protein film electrochemistry experiments on Hyd-3 demonstrate that it has a unique ability among [NiFe] hydrogenases to catalyze production of H2 even at high partial pressures of H2. Understanding and harnessing the activity of the FHL complex is critical to advancing future biohydrogen research efforts. PMID:25157147

McDowall, Jennifer S.; Murphy, Bonnie J.; Haumann, Michael; Palmer, Tracy; Armstrong, Fraser A.; Sargent, Frank



Performance Improvement Assuming Complexity  

ERIC Educational Resources Information Center

Individual performers, work teams, and organizations may be considered complex adaptive systems, while most current human performance technologies appear to assume simple determinism. This article explores the apparent mismatch and speculates on future efforts to enhance performance if complexity rather than simplicity is assumed. Included are…

Rowland, Gordon



Bacterial formate hydrogenlyase complex.  


Under anaerobic conditions, Escherichia coli can carry out a mixed-acid fermentation that ultimately produces molecular hydrogen. The enzyme directly responsible for hydrogen production is the membrane-bound formate hydrogenlyase (FHL) complex, which links formate oxidation to proton reduction and has evolutionary links to Complex I, the NADH:quinone oxidoreductase. Although the genetics, maturation, and some biochemistry of FHL are understood, the protein complex has never been isolated in an intact form to allow biochemical analysis. In this work, genetic tools are reported that allow the facile isolation of FHL in a single chromatographic step. The core complex is shown to comprise HycE (a [NiFe] hydrogenase component termed Hyd-3), FdhF (the molybdenum-dependent formate dehydrogenase-H), and three iron-sulfur proteins: HycB, HycF, and HycG. A proportion of this core complex remains associated with HycC and HycD, which are polytopic integral membrane proteins believed to anchor the core complex to the cytoplasmic side of the membrane. As isolated, the FHL complex retains formate hydrogenlyase activity in vitro. Protein film electrochemistry experiments on Hyd-3 demonstrate that it has a unique ability among [NiFe] hydrogenases to catalyze production of H2 even at high partial pressures of H2. Understanding and harnessing the activity of the FHL complex is critical to advancing future biohydrogen research efforts. PMID:25157147

McDowall, Jennifer S; Murphy, Bonnie J; Haumann, Michael; Palmer, Tracy; Armstrong, Fraser A; Sargent, Frank



Head Lice: Treatment  


... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...


Body Lice Treatment  


... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...


Pubic "Crab" Lice Treatment  


... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...


Treatment Option Overview (Retinoblastoma)  


... larger tumors. This treatment is a type of laser therapy. Chemotherapy Chemotherapy is a cancer treatment that uses ... chemoreduction, other treatments may include radiation therapy, cryotherapy, laser therapy , or regional chemotherapy . Systemic chemotherapy may also be ...


Reliable modeling of complex behavior  

SciTech Connect

The status of modeling for large-strain plasticity is assessed, and this overview is used to emphasize some general points concerning modeling in Materials Science. While a physical foundation is essential in order to achieve generality and some measure of confidence in extrapolations, phenomenological constraint is equally crucial to achieve reliability and predictive value in descriptions of the macroscopic behavior despite the enormous complexity of the underlying physics. Many details that may be of interest in modeling the physical foundation lose importance in the integration to an overall materials response, which depends on few parameters and is quite reproducible. From this point of view, the current understanding of large-strain plasticity is adequate in many respects. However, some problems are highlighted in which more quantitative modeling results would impact the reliability and generality of macroscopic properties descriptions, and which seem amenable to treatment with current techniques and resources. 21 refs., 6 figs., 1 tab.

Kocks, U.F.



ICDF Complex Remedial Action Report  

SciTech Connect

This Idaho CERCLA Disposal Facility (ICDF) Remedial Action Report has been prepared in accordance with the requirements of Section 6.2 of the INEEL CERCLA Disposal Facility Remedial Action Work Plan. The agency prefinal inspection of the ICDF Staging, Storage, Sizing, and Treatment Facility (SSSTF) was completed in June of 2005. Accordingly, this report has been developed to describe the construction activities completed at the ICDF along with a description of any modifications to the design originally approved for the facility. In addition, this report provides a summary of the major documents prepared for the design and construction of the ICDF, a discussion of relevant requirements and remedial action objectives, the total costs associated with the development and operation of the facility to date, and identification of necessary changes to the Agency-approved INEEL CERCLA Disposal Facility Remedial Action Work Plan and the ICDF Complex Operations and Maintenance Plan.

W. M. Heileson



[Role of enterosorbents in treatment of complicated varicose disease].  


Results of treatment of 43 patients, suffering varicose disease, complicated by trophic disorders, were analyzed. To the patients a complex was prescribed, including sorpents, angioprotectors, locally - ointments. There were operated 14 patients. PMID:25252553

Biliaieva, O O; Korzhyk, N P; Myronov, O M; Balins'ka, M I; Iemets', V V



Water Treatment Process  

NSDL National Science Digital Library

In this activity students can follow a drop of water from the source through the treatment process. Stop at each treatment point and unscramble the words to show where the water is along the treatment path. Click on each treatment point on the image to view the unscrambled answer and a little information about that treatment point. The treatment points are: coagulation, sedimentation, filtration, disinfection, and storage.


Indexing Distributed Complex Data for Complex Queries  

Microsoft Academic Search

Peer-to-peer networks are becoming a common form of online data exchange. Querying data, mostly files, using keywords on peer-to-peer networks is well-known. But users cannot perform many types of queries on complex data and on many of the attributes of the data on such networks other than mostly exact-match queries. We introduce a distributed hashing-based index for enabling more powerful

Egemen Tanin; Aaron Harwood; Hanan Samet



Peripheral Facial Palsy: Etiology, Diagnosis and Treatment  

Microsoft Academic Search

Treatment options for peripheral facial palsy (PFP) are an often discussed problem in neurologic practice. Following a short description of the complex anatomy of the seventh cranial nerve we therefore review possible etiologies in the context of leading clinical signs, with idiopathic PFP or Bell’s palsy (BP) being most frequent. A rather typical clinical course of BP allows to focus

Gudrun Roob; Franz Fazekas; Hans-Peter Hartung



Locus of Control in Alcoholics Undergoing Treatment.  

ERIC Educational Resources Information Center

Alcoholism is a complex behavior pattern. Social learning theory, which is concerned with the analysis of why individuals behave in certain ways and the effects of reinforcement patterns in their behaviors, offers an alternative to traditional treatments of alcoholics. Among alcoholics, drinking is a control issue. Locus of control is viewed as a…

Haley, Shirley C.


Endometriosis: insights into its pathogenesis and treatment.  


Clinical and basic science research in endometriosis has been severely hampered by the lack of accurate noninvasive diagnostic tools. The advent of powerful genomic and proteomic technology may help elucidate the etiology and pathophysiology of this complex and enigmatic disease and open new avenues for diagnosis and treatment. Genomic techniques have demonstrated that certain gene products are abnormally expressed in endometriotic tissues. PMID:15455323

Azarani, Arezou; Osias, Joelle; Berker, Bulent; Nezhat, Ceana; Nezhat, Camran



Bipolar Disorder in Adolescence: Diagnosis and Treatment.  

ERIC Educational Resources Information Center

Due to developmental issues and overlapping symptoms with other disorders, diagnosing bipolar disorder in adolescents is often a confusing and complex process. This article highlights diagnostic criteria, symptoms and behaviors, and the differential diagnosis process. Treatment options are also discussed. (Contains 17 references.) (GCP)

Wilkinson, Great Buyck; Taylor, Priscilla; Holt, Jan R.



Correction of Posterior Crossbites: Diagnosis and Treatment  

Microsoft Academic Search

The correction of posterior crossbites is more complex than it appears. To develop an appropriate treatment plan, it is first necessary to determine if: (1) there is a functional jaw shift on closing; (2) the crossbite is unilateral or bilateral; (3) it is dental, skeletal, or a combination of both; and (4) it is related only to the maxilla or

Robert E. Binder



Why Adoptees Search: An Existential Treatment Perspective.  

ERIC Educational Resources Information Center

Frames the adult adoptee's search for biological roots in an existential treatment perspective. This perspective is proposed as a practical approach to understanding the complexities of the adoption experience and an adoptee's desire to search. Reviews adoption practices, existential perspectives (e.g., death), and clinical implications. Provides…

Jago Krueger, Mary J.; Hanna, Fred J.



Treatment plan optimization using linear programming.  


Linear programming is a versatile mathematical tool for optimizing radiation therapy treatment plans. For planning purposes, dose constraint points, possible treatment beams, and an objective function are defined. Dose constraint points are specified in and about the target volume and normal structures with minimum and maximum dose values assigned to each point. A linear objective function is designed that defines the goal of optimization. A list of potential treatment beams is defined by energy, angle, and wedge selection. Then, linear programming calculates the relative weights of all the potential beams such that the objective function is optimized and doses to all constraint points are within the prescribed limits. Historically, linear programming has been used to improve conventional treatment techniques. It can also be used to create sophisticated, complex treatment plans suitable for delivery by computer-controlled therapy techniques. PMID:2046598

Rosen, I I; Lane, R G; Morrill, S M; Belli, J A



Sustainable treatment of landfill leachate  

NASA Astrophysics Data System (ADS)

Landfill leachate is a complex liquid that contains excessive concentrations of biodegradable and non-biodegradable products including organic matter, phenols, ammonia nitrogen, phosphate, heavy metals, and sulfide. If not properly treated and safely disposed, landfill leachate could be an impending source to surface and ground water contamination as it may percolate throughout soils and subsoils, causing adverse impacts to receiving waters. Lately, various types of treatment methods have been proposed to alleviate the risks of untreated leachate. However, some of the available techniques remain complicated, expensive and generally require definite adaptation during process. In this article, a review of literature reported from 2008 to 2012 on sustainable landfill leachate treatment technologies is discussed which includes biological and physical-chemical techniques, respectively.

Kamaruddin, Mohamad Anuar; Yusoff, Mohd. Suffian; Aziz, Hamidi Abdul; Hung, Yung-Tse



Selenophene transition metal complexes  

SciTech Connect

This research shows that selenophene transition metal complexes have a chemistry that is similar to their thiophene analogs. Selenophene coordination has been demonstrated and confirmed by molecular structure in both the {eta}{sup 5}- and the {eta}{sup 1}(Se)-coordination modes. The reaction chemistry of selenophene complexes closely resembles that of the analogous thiophene complexes. One major difference, however, is that selenophene is a better donor ligand than thiophene making the selenophene complexes more stable than the corresponding thiophene complexes. The {sup 77}Se NMR chemical shift values for selenophene complexes fall within distinct regions primarily depending on the coordination mode of the selenophene ligand. In the final paper, the C-H bond activation of {eta}{sup 1}(S)-bound thiophenes, {eta}{sup 1}(S)-benzothiophene and {eta}{sup 1}(Se)-bound selenophenes has been demonstrated. The deprotonation and rearrangement of the {eta}{sup 1}(E)-bound ligand to the carbon bound L-yl complex readily occurs in the presence of base. Reprotonation with a strong acid gives a carbene complex that is unreactive towards nucleophilic attack at the carbene carbon and is stable towards exposure to air. The molecular structure of [Cp(NO)(PPh{sub 3})Re(2-benzothioenylcarbene)]O{sub 3}SCF{sub 3} was determined and contains a Re-C bond with substantial double bond character. Methyl substitution for the thienylcarbene or selenylcarbene gives a carbene that rearranges thermally to give back the {eta}{sup 1}(E)-bound complex. Based on these model reactions, a new mechanism for the H/D exchange of thiophene over the hydrodesulfurization catalyst has been proposed.

White, C.J.



Complexity and robustness  

PubMed Central

Highly optimized tolerance (HOT) was recently introduced as a conceptual framework to study fundamental aspects of complexity. HOT is motivated primarily by systems from biology and engineering and emphasizes, (i) highly structured, nongeneric, self-dissimilar internal configurations, and (ii) robust yet fragile external behavior. HOT claims these are the most important features of complexity and not accidents of evolution or artifices of engineering design but are inevitably intertwined and mutually reinforcing. In the spirit of this collection, our paper contrasts HOT with alternative perspectives on complexity, drawing on real-world examples and also model systems, particularly those from self-organized criticality. PMID:11875207

Carlson, J. M.; Doyle, John



Controllability of Complex Systems  

NASA Astrophysics Data System (ADS)

We review recent work on controllability of complex systems. We also discuss the interplay of our results with questions of synchronization, and point out key directions of future research.[4pt] Work done in collaboration with Yang-Yu Liu, Center for Complex Network Research and Departments of Physics, Computer Science and Biology, Northeastern University and Center for Cancer Systems Biology, Dana-Farber Cancer Institute; and Albert-László Barabási, Center for Complex Network Research and Departments of Physics, Computer Science and Biology, Northeastern University; Center for Cancer Systems Biology, Dana-Farber Cancer Institute; and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School.

Slotine, Jean-Jacques



Mobile multiwave lidar complexes  

SciTech Connect

Multiwave mobile lidar complexes (MLCs) are designed and developed. A number of vehicle-based MLCs are built. The set of complex lidar probing data obtained with the help of MLCs is synchronised in space and time, covers a large area (the operation range of an MLC is 15 km), and is based on a unified methodological approach. The results of probing contain information on the concentration and physical nature of atmospheric aerosol, chemical composition of the gaseous phase of the atmosphere, wind and turbulence. The obtained data form the basis for a complex analysis of the ecological situation and prognosis of its development. (laser applications and other topics in quantum electronics)

Boreysho, A S; Konyaev, M A; Morozov, A V; Pikulik, A V; Savin, A V; Trilis, A V; Chakchir, S Ya [Institute of Laser Instruments and Technologies, D F Ustinov 'VOENMEKh' Baltic State Technical University, St Petersburg (Russian Federation); Boiko, N I; Vlasov, Yu N; Nikitaev, S P; Rozhnov, A V [Administration of the Commander of Radiation, Chemical and Biological Defence Corps of the Armed Forces of the Russian Federation (Russian Federation)



Complex intuitionistic fuzzy sets  

NASA Astrophysics Data System (ADS)

This paper presents a new concept of complex intuitionistic fuzzy set (CIFS) which is generalized from the innovative concept of a complex fuzzy set (CFS) by adding the non-membership term to the definition of CFS. The novelty of CIFS lies in its ability for membership and non-membership functions to achieve more range of values. The ranges of values are extended to the unit circle in complex plane for both membership and non-membership functions instead of [0, 1] as in the conventional intuitionistic fuzzy functions. We define basic operations namely complement, union, and intersection on CIFSs. Properties of these operations are derived.

Alkouri, Abdulazeez (Moh'd. Jumah) S.; Salleh, Abdul Razak



Honors problem 1: Complex numbers. Arithmetic of complex numbers  

E-print Network

Honors problem 1: Complex numbers. Arithmetic of complex numbers Recall that the complex numbers identify the complex numbers with the set of linear polynomials with real coefficients). The numbers as a subset of the complex numbers by identifying the real number a with a+0i. The imaginary numbers

Leininger, Christopher J.


Honors problem 1: Complex numbers. Arithmetic of complex numbers  

E-print Network

Honors problem 1: Complex numbers. Arithmetic of complex numbers Recall that the complex numbers we can identify the complex numbers with the set of linear polynomials with real coefficients as a subset of the complex numbers by identifying the real number a with a + 0i. The imaginary numbers

Leininger, Christopher J.


Wastewater treatment of pulp and paper industry: a review.  


Pulp and paper industries generate varieties of complex organic and inorganic pollutants depending upon the type of the pulping process. A state-of-art of treatment processes and efficiencies of various wastewater treatment is presented and critically reviewed in this paper. Process description, source of wastewater and their treatment is discussed in detail. Main emphasis is given to aerobic and anaerobic wastewater treatment. In pulp and paper mill wastewater treatment aerobic treatment includes activated sludge process, aerated lagoons and aerobic biological reactors. UASB, fluidized bed, anaerobic lagoon and anaerobic contact reactors are the main technologies for anaerobic wastewater treatment. It is found that the combination of anaerobic and aerobic treatment processes is much efficient in the removal of soluble biodegradable organic pollutants. Color can be removed effectively by fungal treatment, coagulation, chemical oxidation, and ozonation. Chlorinated phenolic compounds and adsorable organic halides (AOX) can be efficiently reduced by adsorption, ozonation and membrane filtration techniques. PMID:23033705

Kansal, Ankur; Siddiqui, Nihalanwar; Gautam, Ashutosh



The Trimeric Model: A New Model of Periodontal Treatment Planning  

PubMed Central

Treatment of periodontal disease is a complex and multidisciplinary procedure, requiring periodontal, surgical, restorative, and orthodontic treatment modalities. Several authors attempted to formulate models for periodontal treatment that orders the treatment steps in a logical and easy to remember manner. In this article, we discuss two models of periodontal treatment planning from two of the most well-known textbook in the specialty of periodontics internationally. Then modify them to arrive at a new model of periodontal treatment planning, The Trimeric Model. Adding restorative and orthodontic interrelationships with periodontal treatment allows us to expand this model into the Extended Trimeric Model of periodontal treatment planning. These models will provide a logical framework and a clear order of the treatment of periodontal disease for general practitioners and periodontists alike. PMID:25177662

Tarakji, Bassel



Cytarabine Lipid Complex Injection  


Cytarabine lipid complex is used to treat lymphomatous meningitis (a type of cancer in the covering of ... to take.tell your doctor if you have meningitis. Your doctor will probably not want you to ...


A complex legacy  

NASA Astrophysics Data System (ADS)

In his tragically short life, Alan Turing helped define what computing machines are capable of, and where they reach inherent limits. His legacy is still felt every day, in areas ranging from computational complexity theory to cryptography and quantum computing.

Moore, Cristopher



Pigment-protein complexes  

SciTech Connect

The photosynthetically-active pigment protein complexes of procaryotes and eucaryotes include chlorophyll proteins, carotenochlorophyll proteins, and biliproteins. They are either integral components or attached to photosynthetic membranes. Detergents are frequently required to solubilize the pigment-protein complexes. The membrane localization and detergent solubilization strongly suggest that the pigment-protein complexes are bound to the membranes by hydrophobic interactions. Hydrophobic interactions of proteins are characterized by an increase in entropy. Their bonding energy is directly related to temperature and ionic strength. Hydrophobic-interaction chromatography, a relatively new separation procedure, can furnish an important method for the purification of pigment-protein complexes. Phycobilisome purification and properties provide an example of the need to maintain hydrophobic interactions to preserve structure and function.

Siegelman, H W



Complex System Classification  

E-print Network

The use of terms such as “Engineering Systems”, “System of systems” and others have been coming into greater use over the past decade to denote systems of importance but with implied higher complexity than for the term ...

Magee, Christopher



STRUCTURAL BIOLOGY: Complex II Is Complex Too  

NSDL National Science Digital Library

Access to the article is free, however registration and sign-in are required. In aerobic eukaryotic cells, the respiratory chain of enzymes in the inner mitochondrial membrane transfers electrons from NADH and succinate to molecular oxygen, in the process producing the energy-rich molecule ATP. Hederstedt explains in his Perspective that the crystal structure of bacterial SQR (equivalent to mitochondrial complex II) reveals how the arrangement of redox centers in this enzyme enables electrons to be transferred to ubiquinone while minimizing production of reactive oxygen species that could damage tissues (Yankovskaya et al.).

Lars Hederstedt (Lund University; Department of Cell and Organism Biology)



Complex Networks and Graphs  

NSDL National Science Digital Library

Students learn about complex networks and how to represent them using graphs. They also learn that graph theory is a useful mathematical tool for studying complex networks in diverse applications of science and engineering, such as neural networks in the brain, biochemical reaction networks in cells, communication networks, such as the internet, and social networks. Topics covered include set theory, defining a graph, as well as defining the degree of a node and the degree distribution of a graph.



Complex mediums education  

Microsoft Academic Search

A simple electromagnetic medium is described by the constitutive relations D equals (epsilon) E,B equals (mu) H,J equals (sigma) E, where all the electromagnetic parameters, the permittivity (epsilon) , the permeability (mu) , and the conductivity (sigma) are scalar constants. All other electromagnetic mediums are complex mediums. A sub-class of complex mediums are layered mediums which are piece-wise simple mediums.

Dikshitulu K. Kalluri



Complex Numbers and Trigonometry  

NSDL National Science Digital Library

Complex numbers have applications in many applied sciences. This online text begins with an introduction to trigonometry, which serves as a starting point for additional discussion about complex numbers (also known as imaginary numbers). The drawings and figures are the only notable downside to this excellent resource, because many of them are somewhat crude; however, they are still fairly easy to follow. The book can be read online or downloaded for offline viewing.

Alexanderson, Gerald L.


Design approaches for taming complexity  

Microsoft Academic Search

We examine the essential characteristics of system complexity and simplicity and we describe a set of general design heuristics to address complexity. We distinguish inherent, irreducible complexity from perceived complexity. We illustrate a little theory of complexity with examples drawn from ultra-large-scale systems: telephony, the Internet, and the power grid. We then show how a toolkit of design approaches that

Rick Kazman; Philippe Kruchten



Group 4 Metalloporphyrin diolato Complexes and Catalytic Application of Metalloporphyrins and Related Transition Metal Complexes  

SciTech Connect

In this work, the first examples of group 4 metalloporphyrin 1,2-diolato complexes were synthesized through a number of strategies. In general, treatment of imido metalloporphyrin complexes, (TTP)M=NR, (M = Ti, Zr, Hf), with vicinal diols led to the formation of a series of diolato complexes. Alternatively, the chelating pinacolate complexes could be prepared by metathesis of (TTP)MCl{sub 2} (M = Ti, Hf) with disodium pinacolate. These complexes were found to undergo C-C cleavage reactions to produce organic carbonyl compounds. For titanium porphyrins, treatment of a titanium(II) alkyne adduct, (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh), with aromatic aldehydes or aryl ketones resulted in reductive coupling of the carbonyl groups to produce the corresponding diolato complexes. Aliphatic aldehydes or ketones were not reactive towards (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh). However, these carbonyl compounds could be incorporated into a diolato complex on reaction with a reactive precursor, (TTP)Ti[O(Ph){sub 2}C(Ph){sub 2}O] to provide unsymmetrical diolato complexes via cross coupling reactions. In addition, an enediolato complex (TTP)Ti(OCPhCPhO) was obtained from the reaction of (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh) with benzoin. Titanium porphyrin diolato complexes were found to be intermediates in the (TTP)Ti=O-catalyzed cleavage reactions of vicinal diols, in which atmospheric oxygen was the oxidant. Furthermore, (TTP)Ti=O was capable of catalyzing the oxidation of benzyl alcohol and {alpha}-hydroxy ketones to benzaldehyde and {alpha}-diketones, respectively. Other high valent metalloporphyrin complexes also can catalyze the oxidative diol cleavage and the benzyl alcohol oxidation reactions with dioxygen. A comparison of Ti(IV) and Sn(IV) porphyrin chemistry was undertaken. While chelated diolato complexes were invariably obtained for titanium porphyrins on treatment with 1,2-diols, the reaction of vicinal diols with tin porphyrins gave a number of products, including mono-, bis-alkoxo, and chelating diolato complexes, depending on the identity of diols and the stoichiometry employed. It was also found that tin porphyrin complexes promoted the oxidative cleavage of vicinal diols and the oxidation of {alpha}-ketols to {alpha}-diketones with dioxygen. In extending the chemistry of metalloporphyrins and analogous complexes, a series of chiral tetraaza macrocyclic ligands and metal complexes were designed and synthesized. Examination of iron(II) complexes showed that they were efficient catalysts for the cyclopropanation of styrene by diazo reagents. Good yields and high diastereoselectivity were obtained with modest enantioselectivity. A rationalization of the stereoselectivity was presented on the basis of structural factors in a carbene intermediate.

Guodong Du



Treatment of a Gastric Lactobezoar with N-Acetylcysteine  

PubMed Central

Lactobezoars are a rare finding with potentially serious sequelae in pediatric patients with feeding intolerance. Aggressive treatment may be preferred to traditional treatments to avoid complications in medically complex patients. In our patient, N-acetylcysteine lavage was a safe and effective alternative that resulted in rapid resolution of his feeding intolerance. PMID:25505999



Assisted reproduction in the treatment of polycystic ovarian syndrome  

Microsoft Academic Search

Treatment of patients with polycystic ovary syndrome (PCOS) with assisted reproductive techniques is a great challenge for the infertility specialist. Patients with PCOS demonstrate many problems, such as excessive body weight and hyperinsulinaemia, that render management more complex. Prior to treatment with IVF, the PCOS patient should be thoroughly evaluated for disclosure of endometrial neoplasia, hyperinsulinaemia, and other general health

Bulent Urman; Bulent Tiras; Kayhan Yakin



Treatment of patients with systemic sclerosis with extracorporeal photochemotherapy (photopheresis)  

Microsoft Academic Search

Background: Effective treatment modalities for systemic sclerosis, a life-threatening and disabling disease, are still lacking. Possible efficacy of photopheresis has been reported in several studies. Because of the complexity of the treatment, placebo-controlled trials are difficult to perform. Objective: We investigated the effect of photopheresis on clinical parameters (skin score and internal organ functions), immunologic parameters, and quality of life.

Dory N. H. Enomoto; Jan R. Mekkes; Patrick M. M. Bossuyt; Si-La Yong; Theo A. Out; Rick Hoekzema; Menno A. de Rie; Peter T. A. Schellekens; Ineke J. M. ten Berge; Jan D. Bos



Cell complexes through time  

NASA Astrophysics Data System (ADS)

The history of cell complexes is closely related to the birth and development of topology in general. Johann Benedict Listing (1802 - 1882) introduced the term 'topology' into mathematics in a paper published in 1847, and he also defined cell complexes for the first time in a paper published in 1862. Carl Friedrich Gauss (1777 - 1855) is often cited as the one who initiated these ideas, but he did not publish either on topology or on cell complexes. The pioneering work of Leonhard Euler (1707 - 1783) on graphs is also often cited as the birth of topology, and Euler's work was cited by Listing in 1862 as a stimulus for his research on cell complexes. There are different branches in topology which have little in common: point set topology, algebraic topology, differential topology etc. Confusion may arise if just 'topology' is specified, without clarifying the used concept. Topological subjects in mathematics are often related to continuous models, and therefore quite irrelevant to computer based solutions in image analysis. Compared to this, only a minority of topology publications in mathematics addresses discrete spaces which are appropriate for computer-based image analysis. In these cases, often the notion of a cell complex plays a crucial role. This paper briefly reports on a few of these publications. This paper is not intended to cover the very lively progress in cell complex studies within the context of image analysis during the last two decades. Basically it stops its historic review at the time when this subject in image analysis research gained speed in 1980 - 1990. As a general point of view, the paper indicates that image analysis contributes to a fusion of topological concepts, the geometric and the abstract cell structure approach and point set topology, which may lead towards new problems for the study of topologies defined on geometric or abstract cell complexes.

Klette, Reinhard



Treatment Binds of Drug Treatment Personnel.  

ERIC Educational Resources Information Center

The person directly involved in providing drug treatment services is often caught in a bind of dual or multiple loyalties to his patient and his employer, as well as to various laws and regulations. The article explores the influence of these binds upon patients, counselors, and treatment outcomes. (LPG)

Saxon, Steve; Blaine, Jack D.



Magnetic resonance imaging of triangular fibrocartilage.  


Due to their small size and complex structure, diagnosing injury of the proximal wrist ligamentous structures can be challenging. The triangular fibrocartilage complex (TFCC) is an example of one such structure, for which lesions may be missed unless high-resolution magnetic resonance imaging (MRI) obtained via a standard matrix with a small field of view or high-resolution imaging matrix (small spatial scale matrix elements/large matrix size) is utilized. While there have been recent advances in increasing MRI spatial resolution, attempts at improved visualization by isolated increase in the spatial resolution will be ineffective if the signal-to-noise ratio (SNR) of the images obtained is low. Additionally, high contrast resolution is important to facilitate a more precise visualization of these structures and their pathology. Thus, a balance of the three important imaging factor qualifications of high spatial resolution, high SNR, and high contrast resolution must be struck for optimized TFCC and wrist imaging. The goal of this article, then, is to elucidate the theory and techniques of effective high-resolution imaging of the proximal ligamentous structures of the wrist, balancing SNR and high contrast resolution constraints, and focusing on imaging of the TFCC as a prototypical example. PMID:22434698

Yoshioka, Hiroshi; Burns, Joseph E



Manganese 2 -Complexes as Auxiliaries  

E-print Network

Manganese 2 -Complexes as Auxiliaries for Stereoselective Aldol Synthesis of Allenyl Carbinols manganese auxiliary was linked via an 2 -bond to alkynyl esters and ketones using a mild complexation reaction with methylcyclopentadienyl manganese tricarbonyl. This complex readily underwent aldol reactions

Lepore, Salvatore D.


Section 5.6 Complex Numbers1 Section 5.Section 5.Section 5.Section 5.6666 Complex NumbersComplex NumbersComplex NumbersComplex Numbers  

E-print Network

Section 5.6 Complex Numbers1 Section 5.Section 5.Section 5.Section 5.6666 Complex NumbersComplex NumbersComplex NumbersComplex Numbers Purpose of SectionPurpose of SectionPurpose of SectionPurpose of Section To introduce the field ( ), ,+ ×» of complex numbers and their Cartesian

Farlow, Jerry


Treatment goals of pulmonary hypertension.  


With significant therapeutic advances in the field of pulmonary arterial hypertension, the need to identify clinically relevant treatment goals that correlate with long-term outcome has emerged as 1 of the most critical tasks. Current goals include achieving modified New York Heart Association functional class I or II, 6-min walk distance >380 m, normalization of right ventricular size and function on echocardiograph, a decreasing or normalization of B-type natriuretic peptide (BNP), and hemodynamics with right atrial pressure <8 mm Hg and cardiac index >2.5 mg/kg/min(2). However, to more effectively prognosticate in the current era of complex treatments, it is becoming clear that the "bar" needs to be set higher, with more robust and clearer delineations aimed at parameters that correlate with long-term outcome; namely, exercise capacity and right heart function. Specifically, tests that accurately and noninvasively determine right ventricular function, such as cardiac magnetic resonance imaging and BNP/N-terminal pro-B-type natriuretic peptide, are emerging as promising indicators to serve as baseline predictors and treatment targets. Furthermore, studies focusing on outcomes have shown that no single test can reliably serve as a long-term prognostic marker and that composite treatment goals are more predictive of long-term outcome. It has been proposed that treatment goals be revised to include the following: modified New York Heart Association functional class I or II, 6-min walk distance ? 380 to 440 m, cardiopulmonary exercise test-measured peak oxygen consumption >15 ml/min/kg and ventilatory equivalent for carbon dioxide <45 l/min/l/min, BNP level toward "normal," echocardiograph and/or cardiac magnetic resonance imaging demonstrating normal/near-normal right ventricular size and function, and hemodynamics showing normalization of right ventricular function with right atrial pressure <8 mm Hg and cardiac index >2.5 to 3.0 l/min/m(2). PMID:24355644

McLaughlin, Vallerie V; Gaine, Sean Patrick; Howard, Luke S; Leuchte, Hanno H; Mathier, Michael A; Mehta, Sanjay; Palazzini, Massimillano; Park, Myung H; Tapson, Victor F; Sitbon, Olivier



Cellulite and its treatment.  


The presence of cellulite is an aesthetically unacceptable cosmetic problem for most post-adolescent women. It is largely observed in the gluteal-fermoral regions with its 'orange-peel' or 'cottage cheese' appearance. It is not specific to overweight women although increased adipogenicity will exacerbate the condition. It is a complex problem involving the microcirculatory system and lymphatics, the extracellular matrix and the presence of excess subcutaneous fat that bulges into the dermis. It has been described as a normal condition that maximizes subcutaneous fat retention to ensure adequate caloric availability for pregnancy and lactation. Differences in the fibrous septae architecture that compartmentalize the adipose tissue have recently been reported in women with cellulite compared with men. Weight loss has been reported to improve the cellulite severity by surface topography measures although in obese subject's skin dimpling does not seem to change appreciably. However, histological analysis suggests that fat globules retract out of the dermis with weight loss. Cellulite has been treated with massage which decreases tissue oedema but it is also likely to have its effects at the cellular level by stimulating fibroblast (and keratinocyte) activity while decreasing adipocyte activity. In addition to massage, effective topical creams with a variety of agents were used to ameliorate the condition. Nevertheless, only a few studies are reported in the scientific literature. Xanthines, botanicals, fragrances and ligands for the retinoid and peroxisomal proliferator-activated receptors appear to be giving some benefit. Reducing adipogenesis and increasing thermogenesis appear to be primary routes and also improving the microcirculation and collagen synthesis. Many agents are being investigated for weight management in the supplement industry [hydroxycitrate, epigallocatechin gallate, conjugated linoleic acid (CLA), etc.] and some of these agents seem to be beneficial for the treatment of cellulite. In fact, CLA was proven to ameliorate the signs of cellulite. One product, Cellasene, containing a variety of botanicals and polyunsaturated fatty acids also appears to provide some relief from these symptoms. Although more work is needed, clearly these treatments do improve the appearance of skin in subjects with cellulite. It is quite possible, however, that synergies between both oral and topical routes may be the best intervention to ameliorate the signs and symptoms of cellulite. PMID:18489274

Rawlings, A V



ICDF Complex Remedial Action Work Plan  

SciTech Connect

This Remedial Action Work Plan provides the framework for operation of the Idaho Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Disposal Facility Complex (ICDF). This facility includes (a) an engineered landfill that meets the substantial requirements of DOE Order 435.1, Resource Conservation and Recovery Act Subtitle C, Idaho Hazardous Waste Management Act, and Toxic Substances Control Act polychlorinated biphenyl landfill requirements; (b) centralized receiving, inspections, administration, storage/staging, and treatment facilities necessary for CERCLA investigation-derived, remedial, and removal waste at the Idaho National Laboratory (INL) prior to final disposition in the disposal facility or shipment off-Site; and (c) an evaporation pond that has been designated as a corrective action management unit. The ICDF Complex, including a buffer zone, will cover approximately 40 acres, with a landfill disposal capacity of approximately 510,000 yd3. The ICDF Complex is designed and authorized to accept INL CERCLA-generated wastes, and includes the necessary subsystems and support facilities to provide a complete waste management system. This Remedial Action Work Plan presents the operational approach and requirements for the various components that are part of the ICDF Complex. Summaries of the remedial action work elements are presented herein, with supporting information and documents provided as appendixes to this work plan that contain specific detail about the operation of the ICDF Complex. This document presents the planned operational process based upon an evaluation of the remedial action requirements set forth in the Operable Unit 3-13 Final Record of Decision.

W. M. Heileson



Selective inhibition of deactivated mitochondrial complex I by biguanides.  


Biguanides are widely used antihyperglycemic agents for diabetes mellitus and prediabetes treatment. Complex I is the rate-limiting step of the mitochondrial electron transport chain (ETC), a major source of mitochondrial free radical production, and a known target of biguanides. Complex I has two reversible conformational states, active and de-active. The deactivated state is promoted in the absence of substrates but is rapidly and fully reversed to the active state in the presence of NADH. The objective of this study was to determine the relative sensitivity of active/de-active complex I to biguanide-mediated inhibition and resulting superoxide radical (O2(•-)) production. Using isolated rat heart mitochondria, we show that deactivation of complex I sensitizes it to metformin and phenformin (4- and 3-fold, respectively), but not to other known complex I inhibitors, such as rotenone. Mitochondrial O2(•-) production by deactivated complex I was measured fluorescently by NADH-dependent 2-hydroxyethidium formation at alkaline pH to impede reactivation. Superoxide production was 260.4% higher than in active complex I at pH 9.4. However, phenformin treatment of de-active complex I decreased O2(•-) production by 14.9%, while rotenone increased production by 42.9%. Mitochondria isolated from rat hearts subjected to cardiac ischemia, a condition known to induce complex I deactivation, were sensitized to phenformin-mediated complex I inhibition. This supports the idea that the effects of biguanides are likely to be influenced by the complex I state in vivo. These results demonstrate that the complex I active and de-active states are a determinant in biguanide-mediated inhibition. PMID:25719498

Matsuzaki, Satoshi; Humphries, Kenneth M



Ecology, Complexity, and Metaphor  

NSDL National Science Digital Library

This peer-reviewed article from Bioscience is about Ecology, Complexity and Metaphor.Complexity has recently risen to prominence in ecology as part of a broader interest that suggests its status is something more than just a scientific theory or property of reality. It may be helpful to consider complexity, and related terms such as "self-organization," as recent metaphors deployed to advance knowledge on fundamental questions in ecology, including the relationship between parts and wholes, and between order and disorder. Though not commonly viewed as such, metaphors are an indispensable component of science, and should not be appraised as true or false, but rather in terms of how they help or hinder knowledge. By understanding metaphor as a necessary ally and not a threat to ecological knowledge, we may enrich our contextual understanding of complexity while continuing to invoke it in useful ways. The special section introduced by this article features essays by two prominent experts in ecology, complexity, and metaphor: science studies scholar Evelyn Fox Keller and theoretical ecologist Simon Levin




Hydridomethyl iridium complex  


A process for functionalizing methane comprising: (a) reacting methane with a hydridoalkyl metal complex of the formula: CpIr[P(R.sub.1).sub.3 ]H(R.sub.2) wherein Cp represents a cyclopentadienyl or alkylcyclopentadienyl radical having from 1 to 5 carbon atoms; Ir represents an iridium atom; P represents a phosphorus atom; R.sub.1 represents an alkyl group; R.sub.2 represents an alkyl group having at least two carbon atoms; and H represents a hydrogen atom, in the presence of a liquid alkane R.sub.3 H having at least three carbon atoms to form a hydridomethyl complex of the formula: CpIr[P(R.sub.1).sub.3 ]HMe where Me represents a methyl radical. (b) reacting said hydridomethyl complex with an organic halogenating agent such as a tetrahalomethane or a haloform of the formulas: CX'X"X'"X"" or CHX'X"X'"; wherein X', X", X"', and X"" represent halogens selected from bromine, iodine and chlorine, to halomethyl complex of step (a) having the formula: CpIr[P(R.sub.1).sub.3 ]MeX: (c) reacting said halomethyl complex with a mercuric halide of the formula HgX.sub.2 to form a methyl mercuric halide of the formula HgMeX; and (d) reacting said methyl mercuric halide with a molecular halogen of the formula X.sub.2 to form methyl halide.

Bergman, Robert G. (P.O. Box 7141, San Francisco, CA 94120-7141); Buchanan, J. Michael (P.O. Box 7141, San Francisco, CA 94120-7141); Stryker, Jeffrey M. (P.O. Box 7141, San Francisco, CA 94120-7141); Wax, Michael J. (P.O. Box 7141, San Francisco, CA 94120-7141)



Complexes and imagination.  


Fantasies as imaginative activities are seen by Jung as expressions of psychic energy. In the various descriptions of active imagination the observation of the inner image and the dialogue with inner figures, if possible, are important. The model of symbol formation, as Jung describes it, can be experienced in doing active imagination. There is a correspondence between Jung's understanding of complexes and our imaginations: complexes develop a fantasy life. Complex episodes are narratives of difficult dysfunctional relationship episodes that have occurred repeatedly and are internalized with episodic memory. This means that the whole complex episode (the image for the child and the image for the aggressor, connected with emotions) is internalized and can get constellated in everyday relationship. Therefore inner dialogues do not necessarily qualify as active imaginations, often they are the expression of complex-episodes, very similar to fruitless soliloquies. If imaginations of this kind are repeated, new symbols and new possibilities of behaviour are not found. On the contrary, old patterns of behaviour and fantasies are perpetuated and become cemented. Imaginations of this kind need an intervention by the analyst. In clinical examples different kinds of imaginations are discussed. PMID:25331506

Kast, Verena



Quantum Complexity in Graphene  

NASA Astrophysics Data System (ADS)

Carbon has a unique position among elements in the periodic table. It produces an allotrope, graphene, a mechanically robust two dimensional semimetal. The multifarious properties that graphene exhibits has few parallels among elemental metals. From simplicity, namely carbon atoms connected by pure sp2 bonds, a wealth of novel quantum properties emerge. In classical complex systems such as a spin glass or a finance market, several competing agents or elements are responsible for unanticipated and difficult to predict emergent properties. The complex (sic) structure of quantum mechanics is responsbile for an unanticipated set of emergent properties in graphene. We call this quantum complexity. In fact, most quantum systems, phenomena and modern quantum field theory could be viewed as examples of quantum complexity. After giving a brief introduction to the quantum complexity we focus on our own work, which indicates the breadth in the type of quantum phenomena that graphene could support. We review our theoretical suggestions of, (i) spin-1 collective mode in netural graphene, (ii) relativistic type of phenomena in crossed electric and magnetic fields, (iii) room temperature superconductivity in doped graphene and (iv) composite Fermi sea in neutral graphene in uniform magnetic field and (v) two-channel Kondo effect. Except for the relativistic type of phenomena, the rest depend in a fundamental way on a weak electron correlation that exists in the broad two-dimensional band of graphene.

Baskaran, G.


7 CFR 305.10 - Treatment schedules for combination treatments.  

Code of Federal Regulations, 2010 CFR

...must be used for the methyl bromide portion of the treatment...treatment, and MB represents methyl bromide fumigation: Treatment schedule Type...treatment, and MB represents methyl bromide fumigation: Treatment schedule...



Pharmacologic treatment of paraphilias.  


The treatment of paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of paraphilia and in cases of sexual compulsions and juvenile paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed. PMID:24877704

Assumpção, Alessandra Almeida; Garcia, Frederico Duarte; Garcia, Heloise Delavenne; Bradford, John M W; Thibaut, Florence



Knitted Complex Networks  

E-print Network

To a considerable extent, the continuing importance and popularity of complex networks as models of real-world structures has been motivated by scale free degree distributions as well as the respectively implied hubs. Being related to sequential connections of edges in networks, paths represent another important, dual pattern of connectivity (or motif) in complex networks (e.g., paths are related to important concepts such as betweeness centrality). The present work proposes a new supercategory of complex networks which are organized and/or constructed in terms of paths. Two specific network classes are proposed and characterized: (i) PA networks, obtained by star-path transforming Barabasi-Albert networks; and (ii) PN networks, built by performing progressive paths involving all nodes without repetition. Such new networks are important not only from their potential to provide theoretical insights, but also as putative models of real-world structures. The connectivity structure of these two models is investig...

Costa, Luciano da Fontoura



Programming Complex Systems  

E-print Network

Classical programming languages cannot model essential elements of complex systems such as true random number generation. This paper develops a formal programming language called the lambda-q calculus that addresses the fundamental properties of complex systems. This formal language allows the expression of quantumized algorithms, which are extensions of randomized algorithms in that probabilities can be negative, and events can cancel out. An illustration of the power of quantumized algorithms is the ability to efficiently solve the satisfiability problem, something that many believe is beyond the capability of classical computers. This paper proves that the lambda-q calculus is not only capable of solving satisfiability but can also simulate such complex systems as quantum computers. Since satisfiability is believed to be beyond the capabilities of quantum computers, the lambda-q calculus may be strictly stronger.

Philip Maymin



Beyond Complex Numbers  

E-print Network

There has been always an ambiguity in division when zero is present in the denominator. So far this ambiguity has been neglected by assuming that division by zero as a non-allowed operation. In this paper, I have derived the new set of numbers by considering that a number divided by zero gives rise to "a beyond complex number". This is very similar to the way imaginary numbers are defined. It was only after considering i = sqrt(-1), we have been able to deduce all the laws for imaginary numbers. Similarly here, I have considered "a number when divided by zero gives rise to a beyond complex number". This is the introduction paper to this "beyond complex numbers" containing the algebra of it.

Mohd Abubakr



Synchronization in complex networks  

SciTech Connect

Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.

Arenas, A.; Diaz-Guilera, A.; Moreno, Y.; Zhou, C.; Kurths, J.



Plasmid-protein relaxation complexes in Staphylococcus aureus.  


Protein-deoxyribonucleic acid relaxation complexes have been demonstrated for six Staphylococcus aureus plasmids out of sixteen examined. Four of these encode stretomycin resistence, have molecular weights of about 2.7 x 10(6), and are isolated as supercoiled molecules that are virtally 100% relaxable by treatment with sodium dodecyl sulfate. It is probable that these four isolates represent a single widely disseminated plasmid species. The other two plasmids showing relaxation complexes have molecular weights of about 3 x 10(6) and encode chloramphenicol resistance. The complexes in these cases are unstable, and it has not been possible to induce more than 50% relaxation by any of the standard treatments. Ten other plasmids do not show detectable complexes. These include three penicillinase plasmids, four tetracycline-resistance plasmids, one plasmid carrying kanamycin-neomycin resistance, and finally, two chloramphenicol-resistance plasmids. PMID:956124

Novick, R



Design and initial operation of Dofasco's CPCM waste water treatment plant  

Microsoft Academic Search

A new Coupled Pickling\\/Cold Mill (CPCM) complex was recently commissioned at Dofasco. The complex produces oily, particulate bearing and acidic wastewaters which must be managed in an environmentally sound manner. Segregation of these streams within the mill and a new wastewater treatment plant satisfy this requirement. The design of the wastewater treatment plant was based on meeting current and anticipated

E. L. Ray; P. Harschnitz; W. Kowalchuk; K. A. Rynn



In pursuit of homoleptic actinide alkyl complexes.  


This Forum Article describes the pursuit of isolable homoleptic actinide alkyl complexes, starting with the pioneering work of Gilman during the Manhattan project. The initial reports in this area suggested that homoleptic uranium alkyls were too unstable to be isolated, but Wilkinson demonstrated that tractable uranium alkyls could be generated by purposeful "ate" complex formation, which serves to saturate the uranium coordination sphere and provide the complexes with greater kinetic stability. More recently, we reported the solid-state molecular structures of several homoleptic uranium alkyl complexes, including [Li(THF)4][U(CH2(t)Bu)5], [Li(TMEDA)]2[UMe6], [K(THF)]3[K(THF)2][U(CH2Ph)6]2, and [Li(THF)4][U(CH2SiMe3)6], by employing Wilkinson's strategy. Herein, we describe our attempts to extend this chemistry to thorium. The treatment of ThCl4(DME)2 with 5 equiv of LiCH2(t)Bu or LiCH2SiMe3 at -25 °C in THF affords [Th(CH2(t)Bu)5] (1) and [Li(DME)2][Th(CH2SiMe3)5 (2), respectively, in moderate yields. Similarly, the treatment of ThCl4(DME)2 with 6 equiv of K(CH2Ph) produces [K(THF)]2[Th(CH2Ph)6] (3), in good yield. Complexes 1-3 have been fully characterized, while the structures of 1 and 3 were confirmed by X-ray crystallography. Additionally, the electronic properties of 1 and 3 were explored by density functional theory. PMID:22716022

Seaman, Lani A; Walensky, Justin R; Wu, Guang; Hayton, Trevor W



The ESCRT Complexes  

PubMed Central

The ESCRT machinery consists of the peripheral membrane protein complexes, ESCRT-0, -I, -II, -III, and Vps4-Vta1, and the ALIX homodimer. The ESCRT system is required for degradation of unneeded or dangerous plasma membrane proteins; biogenesis of the lysosome and the yeast vacuole; the budding of most membrane enveloped viruses; the membrane abscission step in cytokinesis; macroautophagy; and several other processes. From their initial discovery in 2001-2002, the literature on ESCRTs has grown exponentially. This review will describe the structure and function of the six complexes noted above and summarizes current knowledge of their mechanistic roles in cellular pathways and in disease. PMID:20653365

Hurley, James H.



Complex matrix model duality  

SciTech Connect

The same complex matrix model calculates both tachyon scattering for the c=1 noncritical string at the self-dual radius and certain correlation functions of operators which preserve half the supersymmetry in N=4 super-Yang-Mills theory. It is dual to another complex matrix model where the couplings of the first model are encoded in the Kontsevich-like variables of the second. The duality between the theories is mirrored by the duality of their Feynman diagrams. Analogously to the Hermitian Kontsevich-Penner model, the correlation functions of the second model can be written as sums over discrete points in subspaces of the moduli space of punctured Riemann surfaces.

Brown, T. W. [DESY, Hamburg, Theory Group, Notkestrasse, 85, D-22603 Hamburg (Germany)



Luminescent macrocyclic lanthanide complexes  


The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

Raymond, Kenneth N; Corneillie, Todd M; Xu, Jide



Luminescent macrocyclic lanthanide complexes  


The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

Raymond, Kenneth N. (Berkeley, CA); Corneillie, Todd M. (Campbell, CA); Xu, Jide (Berkeley, CA)



Planning Complex Projects Automatically  

NASA Technical Reports Server (NTRS)

Automated Manifest Planner (AMP) computer program applies combination of artificial-intelligence techniques to assist both expert and novice planners, reducing planning time by orders of magnitude. Gives planners flexibility to modify plans and constraints easily, without need for programming expertise. Developed specifically for planning space shuttle missions 5 to 10 years ahead, with modifications, applicable in general to planning other complex projects requiring scheduling of activities depending on other activities and/or timely allocation of resources. Adaptable to variety of complex scheduling problems in manufacturing, transportation, business, architecture, and construction.

Henke, Andrea L.; Stottler, Richard H.; Maher, Timothy P.



Honors question 3: Complex numbers (revisited). Arithmetic of complex numbers  

E-print Network

Honors question 3: Complex numbers (revisited). Arithmetic of complex numbers Recall that the complex numbers are formally defined as C = {a + bi} where a and b can be any real numbers and i is treated as a variable (so we can identify the complex numbers with the set of linear polynomials with real

Leininger, Christopher J.


Abstract. Geometry and Complex Numbers GEOMETRY AND COMPLEX NUMBERS  

E-print Network

Abstract. Geometry and Complex Numbers GEOMETRY AND COMPLEX NUMBERS JERZY DYDAK Contents 1. Introduction 2 2. Solving equations 10 3. Geometric proofs 20 Key words and phrases. Complex numbers. 1 #12-Euclidean, Projective, and Discrete' by Michael Henle (2nd edition, Prentice Hall). (2) `Complex numbers and geometry

Lee, Carl


Hyperprolactinemia Diagnosis and Treatment  


... few months, symptomatic patients often receive treatment with cabergoline or bromocriptine. What is the treatment of prolactinoma ... pregnant, it is usually best to stop taking cabergoline or bromocriptine. Do not stop taking the medicine ...


Treatments for Alzheimer's Disease  


... 3900 Find your chapter: search by state Home > Alzheimer's Disease > Treatments Overview What Is Dementia? What Is Alzheimer's? ... and move closer to a cure. Treatments for Alzheimer's disease Get weekly e-news Take the Brain Tour ...


Paying for Chemo Treatment  


... aware of new treatments. They may limit the selection of drugs that doctors can use for chemo. ... for certain treatments. Contact the office that handles social services in your city or county to find ...


Thyroid Hormone Treatment  


Thyroid Hormone Treatment Thyroid hormone is used in two situations: to replace the function of the thyroid gland, which ... working as they should. Definition, Therapy & Treatment Thyroid hormone replacement therapy Many people have a thyroid gland ...


Varicose vein - noninvasive treatment  


... The vein will harden and then disappear. Laser treatment can be used on the surface of the skin. Small bursts of light make small varicose veins disappear. Phlebectomy treats surface ... guide treatment. This may be done along with other procedures, ...


[Preprosthetic orthodontic treatments].  


The objective of a preprosthetic orthodontic treatment is to position the teeth in such a way that a treatment with (fixed) dental prostheses is made possible or simplified or to affect the result of this treatment positively. Conceivable preprosthetic orthodontic treatments are: correcting primary orthodontic anomalies, closing or reducing interdental spaces and correcting the migration of teeth. In the case of unfavourable maxillomandibular relations, a preprosthetic surgical treatment is usually needed together with a preprosthetic orthodontic treatment. For children with agenesis and/or early loss of teeth and/or aberrant morphology of teeth, a treatment with fixed dental prostheses, either implant-supported or not, may be indicated after the tooth development or in some cases earlier. Until that time, preprosthetic orthodontic treatments may be indicated to offer an aesthetically sound provisional solution and to achieve optimal teeth positions for the final fixed dental prostheses. PMID:24684136

Prahl-Andersen, B; Prahl, C; de Baat, C; Creugers, N H J



Treatment Option Overview (Melanoma)  


... a high risk that the cancer will come back. A clinical trial of new types of treatment to be used ... a high risk that the cancer will come back. A clinical trial of new kinds of treatments to be used ...


Assertive Community Treatment (ACT)  


... Treatment FACT SHEET NAMI • The National Alliance on Mental Illness • 1 (800) 950-NAMI • 3803 ... be very effective in the treatment of severe mental illness. ACT is aimed at providing comprehensive multidisciplinary care ...


Pelvic Inflammatory Disease: Treatment  


... treatment, 20 to 40 percent of women with chlamydia and 10 to 40 percent of women with ... a wide range of bacteria, including those causing chlamydia and gonorrhea. You should begin treatment as soon ...


Treatments for Sleep Changes  


... Contributing medical factors Non-drug strategies Medications Common sleep changes Many people with Alzheimer’s experience changes in ... at night. Subscribe now Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep ...


Incontinence Treatment: Biofeedback  


... Personal Stories Who We Are Contact Us Donate Incontinence Treatment: Biofeedback Jump to Topic Lifestyle changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures ...


Incontinence Treatment: Medication  


... Personal Stories Who We Are Contact Us Donate Incontinence Treatment: Medication Jump to Topic Lifestyle changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures ...


Prostate cancer - treatment  


National Cancer Institute: PDQ Prostate Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified 11/19/2013. Available at ...


Antimicrobial Treatments and Efficacy  

EPA Science Inventory

To limit exposure to indoor biological contamination a risk-management approach which employs various antimicrobial treatments can effectively control contaminants and reduce exposure. Antimicrobial treatment of biological contaminants, especially mold in buildings, it is often n...


Advances in Alcoholism Treatment  

PubMed Central

Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and cost-effectiveness of treatment for alcohol use disorders (AUDs). This overview article summarizes the approaches reviewed in this issue, including potential future developments for alcoholism treatment, such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with AUDs and co-occurring disorders, the role of 12-step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment. This research will not only reveal new medications and behavioral therapies but also will contribute to new ways of approaching current treatment problems. PMID:23580014

Huebner, Robert B.; Kantor, Lori Wolfgang



Water Treatment Process  

NSDL National Science Digital Library

This interactive diagram allows the user to follow a drop of water from the source through the treatment process. Water may be treated differently in different communities depending on the quality of the water which enters the plant. Groundwater is water located under ground and typically requires less treatment than water from lakes, rivers, and streams. Users are invited to click on each treatment point on the image to see a little information about that treatment point.


Onsite Wastewater Treatment Systems: Aerobic Treatment Unit  

E-print Network

Aerobic units treat wastewater using the same process, only scaled down, as municipal wastewater treatment systems. This publication explains how aerobic units work, what their design requirements are, and how to maintain them....

Lesikar, Bruce J.