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Sample records for 5-year local control

  1. Perceived Control and Intellectual Functioning in the Elderly: A 5-Year Longitudinal Study.

    ERIC Educational Resources Information Center

    Lachman, Margie E.; Leff, Rona

    1989-01-01

    Examined the relation of control beliefs to individual differences in 63 elderly adults in 1981 and 1986. Over the 5 years, generalized control and intellectual performance did not change, but intellectual control beliefs did. (RJC)

  2. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    SciTech Connect

    Netson, Kelli L.; Conklin, Heather M.; Wu Shengjie; Xiong Xiaoping; Merchant, Thomas E.

    2012-09-01

    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  3. SVI implantation for carcinoma of the prostate: 5-year survival free of disease and incidence of local failure

    SciTech Connect

    Schellhammer, P.F.; el-Mahdi, A.E.; Ladaga, L.E.; Schultheiss, T.

    1985-12-01

    Interstitial implantation with the iodine isotope, SVI has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with SVI is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.

  4. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

    PubMed

    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano

    2014-05-01

    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique. PMID:24469371

  5. Sealing caries in primary molars: randomized control trial, 5-year results.

    PubMed

    Innes, N P T; Evans, D J P; Stirrups, D R

    2011-12-01

    The Hall Technique (HT) is a method for managing carious primary molars. Decay is sealed under pre-formed metal crowns without any caries removal, tooth preparation, or local anesthesia. The aim of this study was to compare HT clinical/radiographic failure rates with General Dental Practitioners' (GDPs) standard (control) restorations. We conducted a split-mouth, randomized control trial (132 children, aged 3-10 yrs, GDPs n = 17) in Scotland. There were 264 study teeth with initial lesions, 42% of which were radiographically > half-way into dentin, and 67% of which had Class II restorations. Teeth were randomized to HT (intervention) or GDPs' usual treatment (control). Annual clinical/radiographic follow-up data were recorded. Ninety-one patients (69%) had 48 months' minimum follow-up. At 60 months, 'Major' failures (irreversible pulpitis, loss of vitality, abscess, or unrestorable tooth) were recorded: HT, 3 (3%); control restorations, 15 (16.5%) (p = 0.000488; NNT 8); and 'Minor' failures (reversible pulpitis, restoration loss/wear/fracture; or secondary caries): HT, 4 (5%); control restorations, 38 (42%) (p < 0.000001; NNT 3). Overall, there were follow-up data for 130 patients (2-60 mos): 'Major' failures: HT, 3 (2%); control restorations, 22 (17%) (p = 0.000004; NNT 7); and 'Minor' failures, HT, 7 (5%); control restorations, 60 (46%) (p < 0.000001; NNT 3). Sealing in caries by the Hall Technique statistically, and clinically, significantly outperformed GDPs' standard restorations in the long term (Trial registration no. ISRCTN 47267892). PMID:21921249

  6. Predictors of Paternal and Maternal Controlling Feeding Practices with 2- to 5-Year-Old Children

    ERIC Educational Resources Information Center

    Haycraft, Emma; Blissett, Jackie

    2012-01-01

    Objective: This study aimed to identify predictors of controlling feeding practices in both mothers and fathers of young children. Design: Cross-sectional, questionnaire design. Setting: Nursery schools within the United Kingdom recruited participants. Participants: Ninety-six mothers and fathers comprising 48 mother-father pairs of male and…

  7. Local Wellness Policy 5 Years Later: Is It Making a Difference for Students in Low-Income, Rural Colorado Elementary Schools?

    PubMed Central

    Cutforth, Nick; Gilbert, Lynn; Litt, Jill; Reed, Hannah; Scarbro, Sharon; Marshall, Julie A.

    2013-01-01

    Introduction The federally mandated Local Wellness Policy (LWP) was intended to promote student health in schools. This study assesses the 5-year effects of the LWP on the health practices of rural elementary schools in Colorado. Methods One year before and 5 years after the LWP mandate, a survey was administered to a random sample of principals, physical education (PE) teachers, and food-service managers in 45 rural, low-income elementary schools in Colorado. Response rates were 71% in 2005 and 89% in 2011. Results Minutes for PE and recess did not increase, nor did offerings of fresh fruits and vegetables. More schools adopted policies prohibiting teachers from taking recess away as punishment (9.7% in 2005 vs 38.5% in 2011, P = .02) or for making up missed instructional time, class work, or tests in other subjects (3.2% in 2005 vs 28.2% in 2011, P = .03). More schools scheduled recess before lunch (22.6% in 2005 vs 46.2% in 2011, P = .04) and developed policies for vending machines (42.9% in 2005 vs 85.7% in 2011, P = .01) and parties (21.4% in 2005 vs 57.9% in 2011, P = .004). Conclusion Changes in school practices are modest, and arguably the important school practices such as increased PE and recess time and increased offerings of fruits and vegetables in the lunch line have not changed in the 5 years since the mandate went into effect. Further investigation is needed to identify the knowledge, skills, and attitudes as well as financial and physical resources required for school administrators to make changes in school practices. PMID:24199737

  8. 70 Gy Versus 80 Gy in Localized Prostate Cancer: 5-Year Results of GETUG 06 Randomized Trial;Prostate cancer; Dose escalation; Conformal radiotherapy; Randomized trial

    SciTech Connect

    Beckendorf, Veronique; Guerif, Stephane; Le Prise, Elisabeth; Cosset, Jean-Marc; Bougnoux, Agnes; Chauvet, Bruno; Salem, Naji; Chapet, Olivier; Bourdain, Sylvain; Bachaud, Jean-Marc; Maingon, Philippe; Hannoun-Levi, Jean-Michel; Malissard, Luc; Simon, Jean-Marc; Pommier, Pascal; Hay, Men; Dubray, Bernard; Lagrange, Jean-Leon; Luporsi, Elisabeth; Bey, Pierre

    2011-07-15

    Purpose: To perform a randomized trial comparing 70 and 80 Gy radiotherapy for prostate cancer. Patients and Methods: A total of 306 patients with localized prostate cancer were randomized. No androgen deprivation was allowed. The primary endpoint was biochemical relapse according to the modified 1997-American Society for Therapeutic Radiology and Oncology and Phoenix definitions. Toxicity was graded using the Radiation Therapy Oncology Group 1991 criteria and the late effects on normal tissues-subjective, objective, management, analytic scales (LENT-SOMA) scales. The patients' quality of life was scored using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30-item cancer-specific and 25-item prostate-specific modules. Results: The median follow-up was 61 months. According to the 1997-American Society for Therapeutic Radiology and Oncology definition, the 5-year biochemical relapse rate was 39% and 28% in the 70- and 80-Gy arms, respectively (p = .036). Using the Phoenix definition, the 5-year biochemical relapse rate was 32% and 23.5%, respectively (p = .09). The subgroup analysis showed a better biochemical outcome for the higher dose group with an initial prostate-specific antigen level >15 ng/mL. At the last follow-up date, 26 patients had died, 10 of their disease and none of toxicity, with no differences between the two arms. According to the Radiation Therapy Oncology Group scale, the Grade 2 or greater rectal toxicity rate was 14% and 19.5% for the 70- and 80-Gy arms (p = .22), respectively. The Grade 2 or greater urinary toxicity was 10% at 70 Gy and 17.5% at 80 Gy (p = .046). Similar results were observed using the LENT-SOMA scale. Bladder toxicity was more frequent at 80 Gy than at 70 Gy (p = .039). The quality-of-life questionnaire results before and 5 years after treatment were available for 103 patients with no differences found between the 70- and 80-Gy arms. Conclusion: High-dose radiotherapy provided a

  9. High-Intensity Focused Ultrasound for the Treatment of Localized and Locally Advanced Hormone-Resistant Prostate Cancer: 2,5 Year Outcome

    NASA Astrophysics Data System (ADS)

    Solovov, V. A.; Dvoynikov, S. Y.; Vozdvizhenskiy, M. O.

    2011-09-01

    Introduction & Objectives: High-Intensity Focused Ultrasound (HIFU) has been shown to be a successful treatment for localised prostate cancer (PC). Here we have explored the effectiveness of the HIFU treatment for hormone-resistant prostate cancer (HRPC). Materials & Methods: 341 patients were treated in our center between September 2007 and December 2009; all of them showed treatment failure following hormone ablation. The median time before hormone-resistance was 20 (3-48) months. In the group with localised PC: number of patients 237, Gleason score ≤7, stage T1-2N0M0, age 69 (60-89) years, mean PSA before treatment 40,0 (5,8-92,9) ng/ml, mean prostate volume—39,3 (28-92) cc; in the group with locally advanced PC: number of patients 104, Gleason score ≤9, stage T2-3N0M0, age 72 (52-83) years, PSA before treatment 30,3 (20,1-60) ng/ml, mean prostate volume—41,2 (25-198) cc. HIFU was delivered under spinal anesthesia using the Ablatherm HIFU device (EDAP, France). Pre HIFU transurethral resection of the prostate (TURP) was performed for all patients. Mean follow-up time 18 months (3-30). Results: The median PSA level 12 months after HIFU treatment was 0,04 (0-2,24) ng/ml—localised PC, and for locally advanced disease—0,05 (0-48,4) ng/ml, at 18 months after HIFU treatment this was 0,2 (0,02-2,0) ng/ml for localised PC, and for locally advanced disease 0,18 (0,04-7,45) ng/ml. Patients with localised PC has 4,5% recurrence, those with locally advanced PC 20%. Kaplan-Meir analyses of the total group indicated that the risk of recurrence after 1 year follow-up was 10%, the risk of recurrence was 19% after 2 years of follow-up. Conclusions: Our initial experience shows that ultrasound ablation is safe, minimally invasive and effective as a treatment for localised and locally advanced hormone-resistant prostate cancer.

  10. Review of 5 years of a combined dietary and physical fitness intervention for control of serum cholesterol

    NASA Technical Reports Server (NTRS)

    Angotti, C. M.; Levine, M. S.

    1994-01-01

    A chart review covering the first 5 years of clinical experience with a combined dietary and exercise intervention program for the reduction of hypercholesterolemia at the National Aeronautics and Space Administration headquarters demonstrated the program's success in maintaining high-density lipoprotein cholesterol (HDL-C) levels while significantly lowering total serum cholesterol levels. This combined program also resulted in improved ratios of total serum cholesterol to HDL-C and lowered levels of low-density lipoprotein cholesterol, thus further reducing the risk for cardiovascular disease. The National Aeronautics and Space Administration Cardiovascular Risk Reduction Program was developed after it was determined that although dietary intervention alone improved total cholesterol levels, it often resulted in a more than proportionate decrease in HDL-C and a worsening of the ratio of cholesterol to HDL-C. An approach was needed that would positively affect all factors of the lipid profile. The findings from the program indicate that reduction of cardiovascular risk can be accomplished easily and effectively at the worksite through dietary intervention, personal monitoring, and a reasonable exercise program.

  11. 5-Year Budget Forecasting.

    ERIC Educational Resources Information Center

    Conyers, John G.; Lingel, George; Piekarski, Robert

    2000-01-01

    Financial planning is the key to providing a high-quality instructional plan. A 5-year financial plan is typically updated by looking at district financial history, future instructional plans, staffing requirements, and revenue projections. Planning assumptions must be clearly understood by the financial team and the community. (MLH)

  12. Cognitive and Emotional Control and Perspective Taking and Their Relations to Empathy in 5-Year-Old Children

    ERIC Educational Resources Information Center

    Hinnant, J. Benjamin; O'Brien, Marion

    2007-01-01

    The experience of empathy has been described as involving both emotional and cognitive components. The primary hypothesis tested in this study is that cognition and emotion are integrated within 2 distinct types of abilities--control and perspective taking--and that interactions between emotional and cognitive control and between affective and…

  13. Father-Child Interaction: Associations with Self-Control and Aggression among 4.5-Year-Olds

    ERIC Educational Resources Information Center

    Meece, Darrell; Robinson, Cheryl Malone

    2014-01-01

    Examined correlates of positive father caregiving and harsh control among 721 (350 girls) four-year-old children through analysis of NICHD Study of Early Child Care data and 7050 (3450 girls) four-year-old children through analysis of Early Childhood Longitudinal Study-Birth Cohort data. Findings from both samples suggest that, for both boys and…

  14. BST-CarGel® Treatment Maintains Cartilage Repair Superiority over Microfracture at 5 Years in a Multicenter Randomized Controlled Trial

    PubMed Central

    Stanish, William D.; McCormack, Robert; Forriol, Francisco; Mohtadi, Nicholas; Pelet, Stéphane; Desnoyers, Jacques; Méthot, Stéphane; Vehik, Kendra; Restrepo, Alberto

    2015-01-01

    Objective The efficacy and safety of BST-CarGel®, a chitosan scaffold for cartilage repair was compared with microfracture alone at 1 year during a multicenter randomized controlled trial in the knee. This report was undertaken to investigate 5-year structural and clinical outcomes. Design The international randomized controlled trial enrolled 80 patients, aged 18 to 55 years, with grade III or IV focal lesions on the femoral condyles. Patients were randomized to receive BST-CarGel® treatment or microfracture alone, and followed standardized 12-week rehabilitation. Co-primary endpoints of repair tissue quantity and quality were evaluated by 3-dimensional MRI quantification of the degree of lesion filling (%) and T2 relaxation times. Secondary endpoints were clinical benefit measured with WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) questionnaires and safety. General estimating equations were used for longitudinal statistical analysis of repeated measures. Results Blinded MRI analysis demonstrated that BST-CarGel®-treated patients showed a significantly greater treatment effect for lesion filling (P = 0.017) over 5 years compared with microfracture alone. A significantly greater treatment effect for BST-CarGel® was also found for repair tissue T2 relaxation times (P = 0.026), which were closer to native cartilage compared to the microfracture group. BST-CarGel® and microfracture groups showed highly significant improvement at 5 years from pretreatment baseline for each WOMAC subscale (P < 0.0001), and there were no differences between the treatment groups. Safety was comparable for both groups. Conclusions BST-CarGel® was shown to be an effective mid-term cartilage repair treatment. At 5 years, BST-CarGel® treatment resulted in sustained and significantly superior repair tissue quantity and quality over microfracture alone. Clinical benefit following BST-CarGel® and microfracture treatment were highly significant over baseline

  15. Palatal positioned implants in severely atrophic maxillae versus conventional implants to support fixed full-arch prostheses: Controlled retrospective study with 5 years of follow-up

    PubMed Central

    Candel-Marti, Eugenia; Peñarrocha-Oltra, David; Bagán, Leticia; Peñarrocha-Diago, Maria

    2015-01-01

    Background To evaluate soft tissue conditions and bone loss around palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic maxillae after a minimum follow-up of 5 years. Material and Methods A clinical retrospective study was performed of patients that were rehabilitated with full-arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) and with class III maxilla and treated with implants well-centered in the alveolar ridge and completely surrounded by bone (control). The following variables were assessed: age, sex, frequency of tooth brushing, smoking, type of prosthesis, type of implant, implant success, amount of buccal keratinized mucosa, buccal retraction, probing depth, plaque index, modified bleeding index, presence of mucositis or peri-implantitis and peri-implant bone loss. Statistical analysis was performed applying Chi2 Test and Student’s t-test using alpha set at 0.05. Results A total of 57 patients were included: 32 patients with 161 palatal positioned implants (test) and 25 patients with 132 well centered implants (control). No statistically significant differences were found regarding age, sex and smoking, but test group patients reported a significantly higher frequency of daily tooth brushing. Implant success rates were 96.9% for test group implants and 96.0% for control group implants. Peri-implant mucosa retraction was significantly higher in the control group than in the test group (p=0,017). No significant differences were observed either for all the other assessed clinical parameters or for peri-implant bone loss. Conclusions Despite its limitations the outcomes of the present study suggest

  16. SU-E-J-265: Feasibility Study of Texture Analysis for Prognosis of Local Tumor Recurrence Within 5-Years for Pharyngeal-Laryngeal Carcinoma Patients Received Radiotherapy Treatment

    SciTech Connect

    Huang, W; Tu, S

    2015-06-15

    Purpose: Pharyngeal and laryngeal carcinomas (PLC) are among the top leading cancers in Asian populations. Typically the tumor may recur and progress in a short period of time if radiotherapy fails to deliver a successful treatment. Here we used image texture features extracted from images of computed tomography (CT) planning and conducted a retrospective study to evaluate whether texture analysis is a feasible approach to predict local tumor recurrence for PLC patients received radiotherapy treatment. Methods: CT planning images of 100 patients with PLC treated by radiotherapy at our facility between 2001 and 2010 are collected. These patients were received two separate CT scans, before and mid-course of the treatment delivery. Before the radiotherapy, a CT scanning was used for the first treatment planning. A total of 30 fractions were used in the treatment and patients were scanned with a second CT around the end of the fifteenth delivery for an adaptive treatment planning. Only patients who were treated with intensity modulated radiation therapy and RapidArc were selected. Treatment planning software of Eclipse was used. The changes of texture parameters between two CT acquisitions were computed to determine whether they were correlated to the local tumor recurrence. The following texture parameters were used in the preliminary assessment: mean, variance, standard deviation, skewness, kurtosis, energy, entropy, inverse difference moment, cluster shade, inertia, cluster prominence, gray-level co-occurrence matrix, and gray-level run-length matrix. The study was reviewed and approved by the committee of our institutional review board. Results: Our calculations suggested the following texture parameters were correlated with the local tumor recurrence: skewness, kurtosis, entropy, and inertia (p<0.0.05). Conclusion: The preliminary results were positive. However some works remain crucial to be completed, including addition of texture parameters for different image

  17. A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-upT Lin et al

    PubMed Central

    Lin, T; Fan, X; Zhang, C; Xu, K; Liu, H; Zhang, J; Jiang, C; Huang, H; Han, J; Yao, Y; Xie, W; Dong, W; Bi, L; Huang, J

    2014-01-01

    Background: Laparoscopic radical cystectomy (LRC) is increasingly being used for muscle-invasive bladder cancer. However, high levels of clinical evidence comparing laparoscopic vs open radical cystectomy (ORC) are lacking. Methods: A prospective randomised controlled clinical trial comparing LRC vs ORC in patients undergoing radical cystectomy for bladder cancer. Thirty-five patients were eligible for final analysis in each group. Results: The median follow-up was 26 months (range, 4–59 months) for laparoscopic vs 32 months (range, 6–60 months) for ORC. Significant differences were noted in operative time, estimated blood loss (EBL), blood transfusion rate, analgesic requirement, and time to resumption of oral intake. No significant differences were noted in the length of hospital stay, complication rate, lymph node yield (14.1±6.3 for LRC and 15.2±5.9 for ORC), positive surgical margin rate, postoperative pathology, or recurrence rate (7 for LRC and 8 for ORC). The 5-year recurrence-free survival with laparoscopic vs ORC was 78.5% vs 70.9%, respectively (P=0.773). The overall survival with laparoscopic vs ORC was 73.8% vs 67.4%, respectively (P=0.511). Conclusion: Our study demonstrated that LRC is superior to ORC in perioperative outcomes, including EBL, blood transfusion rate, and analgesic requirement. We found no major difference in oncologic outcomes. The number of patients is too small to allow for a final conclusion. PMID:24407192

  18. Predictors of head start and child-care providers' healthful and controlling feeding practices with children aged 2 to 5 years.

    PubMed

    Dev, Dipti A; McBride, Brent A; Speirs, Katherine E; Donovan, Sharon M; Cho, Hyun Keun

    2014-09-01

    Few child-care providers meet the national recommendations for healthful feeding practices. Effective strategies are needed to address this disparity, but research examining influences on child-care providers' feeding practices is limited. The purpose of this study was to identify determinants of child-care providers' healthful and controlling feeding practices for children aged 2 to 5 years. In this cross-sectional study, child-care providers (n=118) from 24 center-based programs (six Head Start [HS], 11 Child and Adult Care Food Program [CACFP] funded, and seven non-CACFP) completed self-administered surveys during 2011-2012. Multilevel multivariate linear regression models were used to predict seven feeding practices. Working in an HS center predicted teaching children about nutrition and modeling healthy eating; that may be attributed to the HS performance standards that require HS providers to practice healthful feeding. Providers who reported being concerned about children's weight, being responsible for feeding children, and had an authoritarian feeding style were more likely to pressure children to eat, restrict intake, and control food intake to decrease or maintain children's weight. Providers with nonwhite race, who were trying to lose weight, who perceived nutrition as important in their own diet, and who had a greater number of nutrition training opportunities were more likely to use restrictive feeding practices. These findings suggest that individual- and child-care-level factors, particularly provider race, education, training, feeding attitudes and styles, and the child-care context may influence providers' feeding practices with young children. Considering these factors when developing interventions for providers to meet feeding practice recommendations may add to the efficacy of childhood obesity prevention programs. PMID:24618036

  19. Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study

    PubMed Central

    Messaoudi, Mélina; Sánchez Picot, Valentina; Telles, Jean-Noël; Diakite, Abdoul-Aziz; Komurian-Pradel, Florence; Endtz, Hubert; Diallo, Souleymane; Paranhos-Baccalà, Gláucia; Vanhems, Philippe

    2015-01-01

    Background There are very limited data on children with pneumonia in Mali. The objective was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children <5 years of age in Mali. Methods A prospective hospital-based case-control study was implemented in the Pediatric department of Gabriel Touré University Hospital at Bamako, Mali, between July 2011-December 2012. Cases were children with radiologically-confirmed pneumonia; Controls were hospitalized children without respiratory features, matched for age and period. Respiratory specimens, were collected to identify 19 viruses and 5 bacteria. Whole blood was collected from cases only. Factors associated with pneumonia were assessed by multivariate logistic regression. Results Overall, 118 cases and 98 controls were analyzed; 44.1% were female, median age was 11 months. Among pneumonia cases, 30.5% were hypoxemic at admission, mortality was 4.2%. Pneumonia cases differed from the controls regarding clinical signs and symptoms but not in terms of past medical history. Multivariate analysis of nasal swab findings disclosed that S. pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6–7.0), human metapneumovirus (aOR = 17.2, 95% CI: 2.0–151.4), respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3–23.3), and influenza A virus (aOR = 10.7, 95% CI: 1.0–112.2) were associated with pneumonia, independently of patient age, gender, period, and other pathogens. Distribution of S. pneumoniae and RSV differed by season with higher rates of S. pneumoniae in January-June and of RSV in July-September. Pneumococcal serotypes 1 and 5 were more frequent in pneumonia cases than in the controls (P = 0.009, and P = 0.04, respectively). Conclusions In this non-PCV population from Mali, pneumonia in children was mainly attributed to S. pneumoniae, RSV, human metapneumovirus, and influenza A virus. Increased pneumococcal conjugate vaccine coverage in

  20. Control of soil-transmitted helminthiasis in Yunnan province, People's Republic of China: experiences and lessons from a 5-year multi-intervention trial.

    PubMed

    Steinmann, Peter; Yap, Peiling; Utzinger, Jürg; Du, Zun-Wei; Jiang, Jin-Yong; Chen, Ran; Wu, Fang-Wei; Chen, Jia-Xu; Zhou, Hui; Zhou, Xiao-Nong

    2015-01-01

    The current global strategy for the control of soil-transmitted helminthiasis emphasises periodic administration of anthelminthic drugs to at-risk populations. However, this approach fails to address the root social and ecological causes of soil-transmitted helminthiasis. For sustainable control, it has been suggested that improvements in water, sanitation and hygiene behaviour are required. We designed a 5-year multi-intervention trial in Menghai county, Yunnan province, People's Republic of China. Three different interventions were implemented, each covering a village inhabited by 200-350 people. The interventions consisted of (i) initial health education at study inception and systematic treatment of all individuals aged ≥2 years once every year with a single dose of albendazole; (ii) initial health education and bi-annual albendazole administration; and (iii) bi-annual treatment coupled with latrine construction at family level and regular health education. Interventions were rigorously implemented for 3 years, whilst the follow-up, which included annual albendazole distribution, lasted for 2 more years. Before the third round of treatment, the prevalence of Ascaris lumbricoides was reduced by only 2.8% in the annual treatment arm, whilst bi-annual deworming combined with latrine construction and health education resulted in a prevalence reduction of 53.3% (p<0.001). All three control approaches significantly reduced the prevalence of Trichuris trichiura and hookworm, with the highest reductions achieved when chemotherapy was combined with sanitation and health education. The prevalence of T. trichiura remained at 30% and above regardless of the intervention. Only bi-annual treatment combined with latrine construction and health education significantly impacted on the prevalence of Taenia spp., but none of the interventions significantly reduced the prevalence of Strongyloides stercoralis. Our findings support the notion that in high-endemicity areas

  1. Zinc as an adjunct to antibiotics for the treatment of severe pneumonia in children <5 years: a meta-analysis of randomised-controlled trials.

    PubMed

    Tie, Hong-Tao; Tan, Qi; Luo, Ming-Zhu; Li, Qiang; Yu, Jia-Lin; Wu, Qing-Chen

    2016-03-14

    The effect of Zn, as an adjunct to antibiotics, on the treatment of severe pneumonia in young children is still under debate; therefore, we performed a meta-analysis to evaluate the therapeutic role of Zn for severe pneumonia in children younger than 5 years. PubMed, Cochrane library and Embase databases were systematically searched from inception until October 2015 for randomised-controlled trials (RCT) that assessed the effect of Zn as an adjunct to antibiotics for severe pneumonia. Random-effects model was used for calculating the pooled estimates, and intention-to-treat principle was also applied. Nine RCT involving 2926 children were included. Overall, the pooled results showed that adjunct treatment with Zn failed to reduce the time to recovery from severe pneumonia (hazard ratios (HR)=1·04; 95% CI 0·90, 1·19; I(2)=39%; P=0·58), hospital length of stay (HR=1·04; 95% CI 0·83, 1·33; I(2)=57%; P=0·74), treatment failure (relative risk (RR)=0·95; 95% CI 0·79, 1·14; I(2)=20%; P=0·58) or change of antibiotics (RR=1·07; 95% CI 0·79, 1·45; I(2)=44%; P=0·67). In addition, continuous outcomes were consistent while meta-analysed with standard mean difference, and all outcomes remained stable in intention-to-treat analysis. No significant differences were observed in the two groups between death rate, adverse events or recovery times of severe pneumonia indicators. Our results suggested that adjunct treatment with Zn failed to benefit young children in the treatment of severe pneumonia. Considering the clinical heterogeneity, baseline characteristics of children, definition of severe pneumonia and Zn supplement way should be taken into consideration in future research. This study was registered at PRESPERO as CRD42015019798. PMID:26811108

  2. Developmental milestones record - 5 years

    MedlinePlus

    ... milestones for children - 5 years References Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  3. Incoherent control of locally controllable quantum systems

    SciTech Connect

    Dong Daoyi; Zhang Chenbin; Rabitz, Herschel; Pechen, Alexander; Tarn, T.-J.

    2008-10-21

    An incoherent control scheme for state control of locally controllable quantum systems is proposed. This scheme includes three steps: (1) amplitude amplification of the initial state by a suitable unitary transformation, (2) projective measurement of the amplified state, and (3) final optimization by a unitary controlled transformation. The first step increases the amplitudes of some desired eigenstates and the corresponding probability of observing these eigenstates, the second step projects, with high probability, the amplified state into a desired eigenstate, and the last step steers this eigenstate into the target state. Within this scheme, two control algorithms are presented for two classes of quantum systems. As an example, the incoherent control scheme is applied to the control of a hydrogen atom by an external field. The results support the suggestion that projective measurements can serve as an effective control and local controllability information can be used to design control laws for quantum systems. Thus, this scheme establishes a subtle connection between control design and controllability analysis of quantum systems and provides an effective engineering approach in controlling quantum systems with partial controllability information.

  4. Progression of Dementia Assessed by Temporal Correlations of Physical Activity: Results From a 3.5-Year, Longitudinal Randomized Controlled Trial

    PubMed Central

    Hu, Kun; Riemersma - van der Lek, Rixt F.; Patxot, Melissa; Li, Peng; Shea, Steven A.; Scheer, Frank A. J. L.; Van Someren, Eus J. W.

    2016-01-01

    Cross-sectional studies show that activity fluctuations in healthy young adults possess robust temporal correlations that become altered with aging, and in dementia and depression. This study was designed to test whether or not within-subject changes of activity correlations (i) track the clinical progression of dementia, (ii) reflect the alterations of depression symptoms in patients with dementia, and (iii) can be manipulated by clinical interventions aimed at stabilizing circadian rhythmicity and improving sleep in dementia, namely timed bright light therapy and melatonin supplementation. We examined 144 patients with dementia (70–96 years old) who were assigned to daily treatment with bright light, bedtime melatonin, both or placebos only in a 3.5-year double-blinded randomized clinical trial. We found that activity correlations at temporal scales <~2 hours significantly decreased over time and that light treatment attenuated the decrease by ~73%. Moreover, the decrease of temporal activity correlations positively correlated with the degrees of cognitive decline and worsening of mood though the associations were relatively weak. These results suggest a mechanistic link between multiscale activity regulation and circadian/sleep function in dementia patients. Whether temporal activity patterns allow unobtrusive, long-term monitoring of dementia progression and mood changes is worth further investigation. PMID:27292543

  5. Self-Control, Gender, and Age: A Survival Analysis of Recidivism among Boot Camp Graduates in a 5-Year Follow-Up

    ERIC Educational Resources Information Center

    Benda, Brent B.; Toombs, Nancy J.; Corwyn, Robert Flynn

    2005-01-01

    This study of 572 male and 120 female graduates of a boot camp investigates the potency of self-control as a predictor of recidivism in comparison to gender, age, and elements of life-course theory. It also examines whether the effects of self-control on recidivism are commensurate within the categories of gender. Recidivism is defined as a felony…

  6. A Randomized Controlled Trial of Brief Motivational Interviewing in Impaired Driving Recidivists: A 5-Year Follow-Up of Traffic Offenses and Crashes

    PubMed Central

    Ouimet, Marie Claude; Dongier, Maurice; Di Leo, Ivana; Legault, Lucie; Tremblay, Jacques; Chanut, Florence; Brown, Thomas G

    2013-01-01

    Background In a previously published randomized controlled trial (Brown et al. Alcohol Clin Exp Res 2010; 34, 292–301), our research team showed that a 30-minute brief motivational interviewing (BMI) session was more effective in reducing percentages of risky drinking days in drunk driving recidivists than a control information–advice intervention at 12-month follow-up. In this sequel to the initial study, 2 main hypotheses were tested: (i) exposure to BMI increases the time to further arrests and crashes compared with exposure to the control intervention (CTL) and (ii) characteristics, such as age, moderate the benefit of BMI. Methods A sample of 180 community-recruited recidivists who had drinking problems participated in the study. Participants gave access to their provincial driving records at baseline and were followed up for a mean of 1,684.5 days (SD = 155.7) after randomization to a 30-minute BMI or CTL session. Measured outcomes were driving arrests followed by convictions including driving while impaired (DWI), speeding, or other moving violations as well as crashes. Age, readiness to change alcohol consumption, alcohol misuse severity, and number of previous DWI convictions were included as potential moderators of the effect of the interventions. Results For arrests, Cox proportional hazards modeling revealed no significant differences between the BMI and the CTL group. When analyses were adjusted to age tertile categories, a significant effect of BMI in the youngest age tertile (<43 years old) emerged. For crashes, no between-group differences were detected. Conclusions BMI was better at delaying DWI and other dangerous traffic violations in at-risk younger drivers compared with a CTL similar to that provided in many remedial programs. BMI may be useful as an opportunistic intervention for DWI recidivism prevention in settings such as DWI courts. Treatment effectiveness studies are needed to ascertain how the present findings generalize to the

  7. Project Energize: whole-region primary school nutrition and physical activity programme; evaluation of body size and fitness 5 years after the randomised controlled trial.

    PubMed

    Rush, Elaine; McLennan, Stephanie; Obolonkin, Victor; Vandal, Alain C; Hamlin, Michael; Simmons, David; Graham, David

    2014-01-28

    Project Energize, a region-wide whole-school nutrition and physical activity programme, commenced as a randomised controlled trial (RCT) in the period 2004-6 in 124 schools in Waikato, New Zealand. In 2007, sixty-two control schools were engaged in the programme, and by 2011, all but two of the 235 schools in the region were engaged. Energizers (trained nutrition and physical activity specialists) work with eight to twelve schools each to achieve the goals of the programme, which are based on healthier eating and enhanced physical activity. In 2011, indices of obesity and physical fitness of 2474 younger (7·58 (sd 0·57) years) and 2330 older (10·30 (sd 0·51) years) children attending 193 of the 235 primary schools were compared with historical measurements. After adjusting for age, sex, ethnicity, socio-economic status (SES) and school cluster effects, the combined prevalence of obesity and overweight among younger and older children in 2011 was lower by 31 and 15 %, respectively, than that among 'unEnergized' children in the 2004 to 2006 RCT. Similarly, BMI was lower by 3·0 % (95 % CI - 5·8, - 1·3) and 2·4 % (95 % CI - 4·3, - 0·5). Physical fitness (time taken to complete a 550 m run) was significantly higher in the Energized children (13·7 and 11·3 %, respectively) than in a group of similarly aged children from another region. These effects were observed for boys and girls, both indigenous Māori and non-Māori children, and across SES. The long-term regional commitment to the Energize programme in schools may potentially lead to a secular reduction in the prevalence of overweight and obesity and gains in physical fitness, which may reduce the risk of developing obesity and type 2 diabetes. PMID:23867069

  8. Cognitive Control Deficits in Shifting and Inhibition in Preschool Age Children are Associated with Increased Depression and Anxiety Over 7.5 Years of Development.

    PubMed

    Kertz, Sarah J; Belden, Andy C; Tillman, Rebecca; Luby, Joan

    2016-08-01

    Although depression and anxiety are common in youth (Costello et al. 2003), factors that put children at risk for such symptoms are not well understood. The current study examined associations between early childhood cognitive control deficits and depression and anxiety over the course of development through school age. Participants were 188 children (at baseline M = 5.42 years, SD = 0.79 years) and their primary caregiver. Caregivers completed ratings of children's executive functioning at preschool age and measures of depression and anxiety severity over seven assessment waves (a period of approximately 7.5 years). Longitudinal multilevel linear models were used to examine the effect of attention shifting and inhibition deficits on depression and anxiety. Inhibition deficits at preschool were associated with significantly greater depression severity scores at each subsequent assessment wave (up until 7.5 years later). Inhibition deficits were associated with greater anxiety severity from 3.5 to 7.5 years later. Greater shifting deficits at preschool age were associated with greater depression severity up to 5.5 years later. Shifting deficits were also associated with significantly greater anxiety severity up to 3.5 years later. Importantly, these effects were significant even after accounting for the influence of other key predictors including assessment wave/time, gender, parental education, IQ, and symptom severity at preschool age, suggesting that effects are robust. Overall, findings indicate that cognitive control deficits are an early vulnerability factor for developing affective symptoms. Timely assessment and intervention may be beneficial as an early prevention strategy. PMID:26607383

  9. Pelvic Organ Prolapse Repair with and without Concomitant Burch Colposuspension in Incontinent Women: A Randomised Controlled Trial with at Least 5-Year Followup

    PubMed Central

    Costantini, Elisabetta; Lazzeri, Massimo; Bini, Vittorio; Del Zingaro, Michele; Frumenzio, Emanuela; Porena, Massimo

    2012-01-01

    The aim of this study was to reevaluate and update the followup of a previously published randomized controlled trial (RCT) on the impact of Burch Colposuspension (BC), as an anti-incontinence procedure, in patients with UI and POP, who underwent POP repair. Forty-seven women were randomly assigned to abdominal POP repair and concomitant BC (24 patients; group A) or POP repair alone without any anti-incontinence procedure (23 patients; group B). Median followup was 82 months (range 60–107); from over 47 patients, 30 reached 6-year followup. Two patients were lost at followup. In group A, 2 patients showed a stage I rectocele. In group B, 2 patients had a stage I rectocele and 1 a stage II rectocele. In group A, 13/23 (56.5%) were still incontinent after surgery compared with 9/22 patients (40.9%) in group B (P = 0.298). No significant changes were observed between the first and the current followup. The update of long-term followup confirmed that BC did not improve outcome significantly in incontinent women when they undergo POP repair. PMID:22028719

  10. An analysis of infection control of varicella-zoster virus infections in Addenbrooke's Hospital Cambridge over a 5-year period, 1987-92.

    PubMed Central

    Wreghitt, T. G.; Whipp, J.; Redpath, C.; Hollingworth, W.

    1996-01-01

    This prospective study analyses infections with varicella-zoster virus (VZV) in Addenbrooke's Hospital, Cambridge during 1987-92 and examines the spread of infection. In total, 93 patients and staff experienced VZV infection. Twenty-one patients had varicella and 49 experienced zoster. None of 101 patients and 1 of 625 staff members in contact with varicella cases acquired infection. By contrast, 2 of 227 patients, and 5 of 1039 staff in contact with zoster cases acquired varicella. One out of 28 (3.6%) VZV antibody-negative patients and staff in contact with varicella acquired infection, compared with 5 out of 29 (17.2%) VZV antibody-negative patients and staff in contact with zoster. Thus, zoster was found to be a more frequent cause of nosocomial infection than varicella. Fourteen members of staff had VZV infection during the study period. One of 99 patients and none of 389 staff members in contact with these cases developed varicella. The cost of dealing with infection control for VZV infections in our hospital is estimated to be Pounds 714 per patient case and a total of Pounds 13,204 per year. PMID:8760965

  11. Building the evaluation capacity of California's local tobacco control programs.

    PubMed

    Treiber, Jeanette; Cassady, Diana; Kipke, Robin; Kwon, Nicole; Satterlund, Travis

    2011-11-01

    Successful evaluation capacity building requires a dynamic balance between responding to local agency needs and ensuring that local staff have appropriate skills to conduct rigorous evaluations. In 2004, the California Tobacco Control Program established the Tobacco Control Evaluation Center (TCEC), based at a public research university, to provide evaluation technical assistance to approximately 100 local agencies implementing tobacco control programs. TCEC has been responsive to local needs, for instance, by answering 512 technical assistance requests in the first 5 years of operation and by tailoring training according to needs assessment results. About 50% of the technical assistance requests were for new data collection instruments (n = 255). TCEC has sought proactively to improve local evaluation skills, most recently in a data analysis and report writing skill building campaign that included a webinar, newsletter, and seven regional training meetings. Preliminary analysis suggests a 20% improvement in scores for the local final evaluation reports as a result of this campaign. It is concluded that evaluation technical assistance can be provided effectively by a university as long as the local context is kept in mind, and a balance of responsive and proactive technical assistance is provided. PMID:22068574

  12. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    SciTech Connect

    Osa, Etin-Osa O.; DeWyngaert, Keith; Roses, Daniel; Speyer, James; Guth, Amber; Axelrod, Deborah; Fenton Kerimian, Maria; Goldberg, Judith D.; Formenti, Silvia C.

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  13. Microbiological monitoring of endoscopes: 5-year review.

    PubMed

    Gillespie, Elizabeth E; Kotsanas, Despina; Stuart, Rhonda L

    2008-07-01

    Periodic microbiological monitoring of endoscopes is a recommendation of the Gastroenterological Society of Australia (GENSA). The aim of monitoring has been to provide quality assurance of the cleaning and disinfection of endoscopes; however, there is controversy regarding its frequency. This lack of consensus stimulated a review of the experience within our health service. At Southern Health, routine microbiological sampling has involved 4-weekly monitoring of bronchoscopes, duodenoscopes and automated flexible endoscope reprocessors (AFER), and 3-monthly monitoring of all other gastrointestinal endoscopes. Records of testing were reviewed from 1 January 2002 until 31 December 2006. A literature review was conducted, cost analysis performed and positive cultures investigated. There were 2374 screening tests performed during the 5-year period, including 287 AFER, 631 bronchoscopes for mycobacteria and 1456 endoscope bacterial screens. There were no positive results of the AFER or bronchoscopes for mycobacteria. Of the 1456 endoscopic bacterial samples, six were positive; however, retesting resulted in no growth. The overall cost of tests performed and cost in time for nursing staff to collect the samples was estimated at $AUD 100,400. Periodic monitoring of endoscopes is both time-consuming and costly. Our review demonstrates that AFER (Soluscope) perform well in cleaning endoscopes. Based on our 5-year experience, assurance of quality for endoscopic use could be achieved through process control as opposed to product control. Maintenance of endoscopes and AFER should be in accordance with the manufacturer's instructions and microbiological testing performed on commissioning, annually and following repair. Initial prompt manual leak testing and manual cleaning followed by mechanical leak testing, cleaning and disinfection should be the minimum standard in reprocessing of endoscopes. PMID:18086113

  14. Local Control of Blood Flow

    ERIC Educational Resources Information Center

    Clifford, Philip S.

    2011-01-01

    Organ blood flow is determined by perfusion pressure and vasomotor tone in the resistance vessels of the organ. Local factors that regulate vasomotor tone include myogenic and metabolic autoregulation, flow-mediated and conducted responses, and vasoactive substances released from red blood cells. The relative importance of each of these factors…

  15. IOERT as anticipated tumor bed boost during breast-conserving surgery after neoadjuvant chemotherapy in locally advanced breast cancer--results of a case series after 5-year follow-up.

    PubMed

    Fastner, Gerd; Reitsamer, Roland; Ziegler, Ingrid; Zehentmayr, Franz; Fussl, Christoph; Kopp, Peter; Peintinger, Florentia; Greil, Richard; Fischer, Thorsten; Deutschmann, Heinrich; Sedlmayer, Felix

    2015-03-01

    To evaluate retrospectively rates of local (LCR) and locoregional tumor control (LRCR) in patients with locally advanced breast cancer (LABC) who were treated with preoperative chemotherapy (primary systemic treatment, PST) followed by breast-conserving surgery (BCS) and either intraoperative radiotherapy with electrons (IOERT) preceding whole-breast irradiation (WBI) (Group 1) or with WBI followed by an external tumor bed boost (electrons or photons) instead of IOERT (Group 2). From 2002 to 2007, 83 patients with clinical Stage II or III breast cancer were enrolled in Group 1 and 26 in Group 2. All patients received PST followed by BCS and axillary lymph node dissection. IOERT boosts were applied by single doses of 9 Gy (90% reference isodose) versus external boosts of 12 Gy (median dose range, 6-16) in 2 Gy/fraction (ICRU). WBI in both groups was performed up to total doses of 51-57 Gy (1.7-1.8 Gy/fraction). The respective median follow-up times for Groups 1 and 2 amount 59 months (range, 3-115) and 67.5 months (range, 13-120). Corresponding 6-year rates for LCR, LRCR, metastasis-free survival, disease-specific survival and overall survival were 98.5, 97.2, 84.7, 89.2 and 86.4% for Group 1 and 88.1, 88.1, 74, 92 and 92% for Group 2, respectively, without any statistical significances. IOERT as boost modality during BCS in LABC after PST shows a trend to be superior in terms of LCR and LRCR in comparison with conventional boosts. PMID:24995409

  16. Evaluation of Decompression and Interlaminar Stabilization Compared with Decompression and Fusion for the Treatment of Lumbar Spinal Stenosis: 5-year Follow-up of a Prospective, Randomized, Controlled Trial

    PubMed Central

    Lauryssen, Carl; Davis, Reginald J.; Bae, Hyun W.; Peloza, John H.; Guyer, Richard D.; Zigler, Jack E.; Ohnmeiss, Donna D.; Leary, Scott

    2016-01-01

    Introduction If nonoperative treatment for lumbar stenosis fails, surgery may be considered. This traditionally includes decompression often combined with fusion. Desire for less extensive surgery led to developing new techniques and implants, including an interlaminar device designed with the goal of providing segmental stability without fusion, following decompression. The purpose of this study was to investigate 5-year outcomes associated with an interlaminar device. Methods This prospective, randomized, controlled trial was conducted at 21 centers. Patients with moderate to severe lumbar stenosis at one or two contiguous levels and up to Grade I spondylolisthesis were randomized (2:1 ratio) to decompression and interlaminar stabilization (D+ILS; n=215) using the coflex® Interlaminar Stabilization® device (Paradigm Spine, LLC) or decompression and fusion with pedicle screws (D+PS; n=107). Clinical evaluations were made preoperatively and at 6 weeks and 3, 6, 12, 18, 24, 36, 48, and 60 months postoperatively. Overall Food and Drug Administration success criteria required that a patient meet 4 criteria: 1) >15 point improvement in Oswestry Disability Index (ODI) score; 2) no reoperation, revision, removal, or supplemental fixation; 3) no major device-related complication; and 4) no epidural steroid injection after surgery. Results At 5 years, 50.3% of D+ILS vs. 44% of D+PS patients (p>0.35) met the composite success criteria. Reoperation/revision rates were similar in the two groups (16.3% vs. 17.8%; p >0.90). Both groups had statistically significant improvement through 60 months in ODI scores with 80.6% of D+ILS patients and 73.2% of D+PS patients demonstrating >15 point improvement (p>0.30). VAS, SF-12, and ZCQ scores followed a similar pattern of maintained significant improvement throughout follow-up. On the SF-12 and ZCQ, D+ILS group scores were statistically significantly better during early follow-up compared to D+PS. In the D+ILS group, foraminal height

  17. Localized control of oxidized RNA.

    PubMed

    Zhan, Yu; Dhaliwal, James S; Adjibade, Pauline; Uniacke, James; Mazroui, Rachid; Zerges, William

    2015-11-15

    The oxidation of biological molecules by reactive oxygen species (ROS) can render them inactive or toxic. This includes the oxidation of RNA, which appears to underlie the detrimental effects of oxidative stress, aging and certain neurodegenerative diseases. Here, we investigate the management of oxidized RNA in the chloroplast of the green alga Chlamydomonas reinhardtii. Our immunofluorescence microscopy results reveal that oxidized RNA (with 8-hydroxyguanine) is localized in the pyrenoid, a chloroplast microcompartment where CO2 is assimilated by the Calvin cycle enzyme Rubisco. Results of genetic analyses support a requirement for the Rubisco large subunit (RBCL), but not Rubisco, in the management of oxidized RNA. An RBCL pool that can carry out such a 'moonlighting' function is revealed by results of biochemical fractionation experiments. We also show that human (HeLa) cells localize oxidized RNA to cytoplasmic foci that are distinct from stress granules, processing bodies and mitochondria. Our results suggest that the compartmentalization of oxidized RNA management is a general phenomenon and therefore has some fundamental significance. PMID:26449969

  18. Periampullary adenocarcinoma: analysis of 5-year survivors.

    PubMed Central

    Yeo, C J; Sohn, T A; Cameron, J L; Hruban, R H; Lillemoe, K D; Pitt, H A

    1998-01-01

    OBJECTIVE: This single-institution experience retrospectively reviews the outcomes in a group of patients treated 5 or more years ago by pancreaticoduodenectomy for periampullary adenocarcinoma. SUMMARY BACKGROUND DATA: Controversy exists regarding the benefit of resection for periampullary adenocarcinoma, particularly for pancreatic tumors. Many series report only Kaplan-Meier actuarial 5-year survival rates. There are believed to be discrepancies between the actuarial 5-year survival data and the actual 5-year survival rates. METHODS: From April 1970 through May 1992, 242 patients underwent pancreaticoduodenal resection for periampullary adenocarcinoma at The Johns Hopkins Hospital. Follow-up was complete through May 1997. All pathology specimens were reviewed and categorized. Actual 5-year survival rates were calculated. The demographic, intraoperative, pathologic, and postoperative features of patients surviving > or =5 years were compared with those of patients who survived <5 years. RESULTS: Of the 242 patients with resected periampullary adenocarcinoma, 149 (62%) were pancreatic primaries, 46 (19%) arose in the ampulla, 30 (12%) were distal bile duct cancers, and 17 (7%) were duodenal cancers. There was a 5.3% operative mortality rate during the 22 years of the review, with a 2% operative mortality rate in the last 100 patients. There were 58 5-year survivors, 28 7-year survivors, and 7 10-year survivors. The tumor-specific 5-year actual survival rates were pancreatic 15%, ampullary 39%, distal bile duct 27%, and duodenal 59%. When compared with patients who did not survive 5 years, the 5-year survivors had a significantly higher percentage of well-differentiated tumors (14% vs. 4%; p = 0.02) and higher incidences of negative resection margins (98% vs. 73%, p < 0.0001) and negative nodal status (62% vs. 31%, p < 0.0001). The tumor-specific 10-year actuarial survival rates were pancreatic 5%, ampullary 25%, distal bile duct 21%, and duodenal 59%. CONCLUSIONS

  19. Local position control: A new concept for control of manipulators

    NASA Technical Reports Server (NTRS)

    Kelly, Frederick A.

    1988-01-01

    Resolved motion rate control is currently one of the most frequently used methods of manipulator control. It is currently used in the Space Shuttle remote manipulator system (RMS) and in prosthetic devices. Position control is predominately used in locating the end-effector of an industrial manipulator along a path with prescribed timing. In industrial applications, resolved motion rate control is inappropriate since position error accumulates. This is due to velocity being the control variable. In some applications this property is an advantage rather than a disadvantage. It may be more important for motion to end as soon as the input command is removed rather than reduce the position error to zero. Local position control is a new concept for manipulator control which retains the important properties of resolved motion rate control, but reduces the drift. Local position control can be considered to be a generalization of resolved position and resolved rate control. It places both control schemes on a common mathematical basis.

  20. The first 5 years after the dissertation.

    PubMed

    Hodges, L C; Poteet, G W

    1992-01-01

    To succeed in academia, nursing faculty members must devote the first 5 years following the dissertation to achieving a standard to tenure characteristic of the profession. Most institutions in the country adhere to the American Association of University Professors' guidelines for tenure. These guidelines mandate excellence in teaching, scholarship, and service. A fourth characteristic, leadership, is increasingly considered in tenure decisions. The expectations of an academic career in nursing serve as the foundation for a framework to evaluate the likelihood of success in a particular setting. A detailed 5-year plan for achieving tenure is proposed. PMID:1634654

  1. Local feedback control of light honeycomb panels.

    PubMed

    Hong, Chinsuk; Elliott, Stephen J

    2007-01-01

    This paper summarizes theoretical and experimental work on the feedback control of sound radiation from honeycomb panels using piezoceramic actuators. It is motivated by the problem of sound transmission in aircraft, specifically the active control of trim panels. Trim panels are generally honeycomb structures designed to meet the design requirement of low weight and high stiffness. They are resiliently mounted to the fuselage for the passive reduction of noise transmission. Local coupling of the closely spaced sensor and actuator was observed experimentally and modeled using a single degree of freedom system. The effect of the local coupling was to roll off the response between the actuator and sensor at high frequencies, so that a feedback control system can have high gain margins. Unfortunately, only relatively poor global performance is then achieved because of localization of reduction around the actuator. This localization prompts the investigation of a multichannel active control system. Globalized reduction was predicted using a model of 12-channel direct velocity feedback control. The multichannel system, however, does not appear to yield a significant improvement in the performance because of decreased gain margin. PMID:17297778

  2. Models for local implementation of comprehensive cancer control: meeting local cancer control needs through community collaboration.

    PubMed

    Behringer, Bruce; Lofton, Staci; Knight, Margaret L

    2010-12-01

    The comprehensive cancer control approach is used by state, tribes, tribal organizations, territorial and Pacific Island Jurisdiction cancer coalitions to spur local implementation of cancer plans to reduce the burden of cancer in jurisdictions across the country. There is a rich diversity of models and approaches to the development of relationships and scope of planning for cancer control activities between coalitions and advocates in local communities. The national comprehensive cancer control philosophy provides an operational framework while support from the Centers for Disease Control and Prevention enables coalitions to act as catalysts to bring local partners together to combat cancer in communities. This manuscript describes multiple characteristics of cancer coalitions and how they are organized. Two models of how coalitions and local partners collaborate are described. A case study method was used to identify how five different state and tribal coalitions use the two models to organize their collaborations with local communities that result in local implementation of cancer plan priorities. Conclusions support the use of multiple organizing models to ensure involvement of diverse interests and sensitivity to local cancer issues that encourages implementation of cancer control activities. PMID:20938731

  3. 5-year Follow-up of a Randomized Controlled Trial of Immediate versus Delayed Zoledronic Acid for Prevention of Bone Loss in Postmenopausal Women with Breast Cancer Starting Letrozole after Tamoxifen: N03CC (Alliance)

    PubMed Central

    Wagner-Johnston, Nina D.; Sloan, Jeff A.; Liu, Heshan; Kearns, Ann E.; Hines, Stephanie L.; Puttabasavaiah, Suneetha; Dakhil, Shaker R.; Lafky, Jacqueline M.; Perez, Edith A.; Loprinzi, Charles L.

    2015-01-01

    Background Postmenopausal women with breast cancer (BC) receiving aromatase inhibitors are at increased risk for bone loss. The current study was undertaken to determine whether upfront versus delayed treatment with zoledronic acid (ZA) impacted bone loss. This report describes the 5-year follow-up results. Methods 551 postmenopausal women with BC completing tamoxifen and undergoing daily letrozole treatment were randomized to upfront (274) or delayed (277) ZA 4 mg IV every 6 months. In the delayed arm, ZA was initiated for post-baseline bone mineral density (BMD) T-score < -2.0 or fracture. Results The incidence of a 5% decrease in total lumbar spine BMD at 5 years was 10.2% in the upfront arm versus 41.2% in the delayed arm, p < 0.0001. 41 patients in the delayed arm were eventually started on ZA. With the exception of increased grade 1/2 elevated creatinine and fever in the upfront arm and cerebrovascular ischemia in the delayed arm, there were no significant differences between arms with respect to the most common adverse events of arthralgia and back pain. Osteoporosis occurred less frequently in the upfront arm (2 versus 8 cumulative cases) though this difference was not statistically significant. Bone fractures occurred in 24 patients in the upfront arm versus 25 patients in the delayed arm. Conclusions Immediate treatment with ZA prevented bone loss compared with delayed treatment in postmenopausal women on letrozole and these differences were maintained at 5 years. The incidence of osteoporosis or fractures was not different between arms. PMID:25930719

  4. Spontaneous Pneumothorax: A 5-Year Experience

    PubMed Central

    Sousa, Cristiana; Neves, Joao; Sa, Nuno; Goncalves, Fabienne; Oliveira, Julio; Reis, Ernestina

    2011-01-01

    Background Spontaneous pneumothorax (SP) is defined by the presence of air in the pleural space without history of trauma. It is classified as secondary if coexisting with underlying pulmonary disease. Its an entity with considerable incidence and treatment particularities which give reason for a reflection on the subject. We present a 5-year casuistry, characterizing the SP epidemiology, clinical presentation, investigation and therapeutic choices. Methods Sixty-six patients were included in the study, corresponding to 93 episodes of SP. Results We have found male predominance and the mean age was 34.5 years old. In 60.6% of cases there was history of tobacco use; 36.4% of cases were classified as secondary; 30.1% of patients with secondary SP and 21.7% with primary SP recurred; 89.2% had an acute presentation. The most frequent initial symptom was chest pain (90.3%) and 81.7% had diminished breath sounds. In 17.3% it was documented a physical strain associated. We did not identify statistically significant association between the SP occurrence and the variation of the atmospheric pressure, on the first day of symptoms. In 12.9% of episodes the initial treatment option was observation. In most of the episodes the lung totally expanded. However, in 29.1% of the episodes surgical treatment was needed. Conclusions Our results are similar to the literature. Some clinical records are incomplete, demanding the implementation of rules to improve knowledge about this matter. Keywords Spontaneous pneumothorax; Primary spontaneous pneumothorax; Secondary spontaneous pneumothorax; Epidemiology PMID:21811541

  5. Optically controlled local nanosoldering of metal nanowires

    NASA Astrophysics Data System (ADS)

    Li, Qiang; Liu, Guoping; Yang, Hangbo; Wang, Wei; Luo, Si; Dai, Shuowei; Qiu, Min

    2016-05-01

    Nanojoining (including nanowelding, nanosoldering, etc.) of metal nanomaterials offers the opportunity of constructing complex structures and advanced functional devices at the nanoscale. In comparison with nanowelding, nanosoldering does not involve the melting of base metal and shows considerable mechanical strength and good thermal and electrical conductivity. Here, an optically controlled local nanosoldering technique, which ensures the nanostructures to be bonded while their original structural integrity is retained, is proposed and demonstrated. Typical elemental devices (V-shaped, T-shaped, and X-shaped nanostructures) are formed with this nanosoldering technique. The conductivity of one V-shaped junction is enhanced by 500 times after nanosoldering. This facile nanosoldering technique provides an avenue to locally manipulate light, charge, heat, and mass transport at the nanoscale and is thereby expected to benefit the development of nanophotonics and nanoelectronics.

  6. The Local Control Index: A Proposed Model for Classifying Types of Local Control As a Function of Statutory Provisions.

    ERIC Educational Resources Information Center

    Luna, Lonnie Lynn

    The purpose of this study was to derive an operational definition of local control and to devise a model, the Local Control Index, for classifying degrees of local control by using the education codes of eight states--Arizona, California, Illinois, Mississippi, New Mexico, New York, Oklahoma, and Texas. The Local Control Index consists of four…

  7. Control of Cell Migration Through Mrna Localization and Local Translation

    PubMed Central

    Liao, Guoning; Mingle, Lisa; Van De Water, Livingston; Liu, Gang

    2014-01-01

    Cell migration plays an important role in many normal and pathological functions such as development, wound healing, immune defense and tumor metastasis. Polarized migrating cells exhibit asymmetric distribution of many cytoskeletal proteins which is believed to be critical for establishing and maintaining cell polarity and directional cell migration. To target these proteins to the site of function, cells use a variety of mechanisms such as protein transport and mRNA localization-mediated local protein synthesis. In contrast to the former which is intensively investigated and relatively well understood, the latter has been under-studied and relatively poorly understood. However, recent advances in the study of mRNA localization and local translation have demonstrated that mRNA localization and local translation are specific and effective ways for protein localization and are crucial for embryo development, neuronal function and many other cellular processes. There are excellent reviews on mRNA localization, transport and translation during development and other cellular processes. This review will focus on mRNA localization-mediated local protein biogenesis and its impact on somatic cell migration. PMID:25264217

  8. Local Geometrical Machinery for Complexity and Control

    NASA Astrophysics Data System (ADS)

    Ivancevic, Vladimir G.; Reid, Darryn J.

    2015-11-01

    In this Chapter, we present local geometrical machinery for studying complexity and control, consisting of dynamics on Kähler manifolds, which combine three geometrical structures-Riemannian, symplectic and complex (Hermitian)-in a mutually compatible way. In other words, every Kähler manifold is simultaneously Riemannian, symplectic and complex (Hermitian). It is well known that Riemannian manifolds represent the stage on which Lagrangian dynamics is set, symplectic manifolds represent the stage for Hamiltonian dynamics, and complex (Hermitian) varieties comprise the stage for quantum dynamics. Therefore, Kähler manifolds represent the richest dynamical stage available where Lagrangian, Hamiltonian, and quantum dynamics all dance together.

  9. Local flow control for active building facades

    NASA Astrophysics Data System (ADS)

    Kaligotla, Srikar; Chen, Wayne; Glauser, Mark

    2010-11-01

    Existing building facade designs are for a passive and an impermeable shell to prevent migration of outdoor air into the building and to control heat transfers between the exterior environment and the building interior. An active facade that can respond in real time to changing environmental conditions like wind speed and direction, pollutant load, temperature, humidity and light can lower energy use and maximize occupant comfort. With an increased awareness of cost and environmental effects of energy use, cross or natural ventilation has become an attractive method to lower energy use. Separated flow regions around such buildings are undesirable due to high concentration of pollutants, especially if the vents or dynamic windows for cross ventilation are situated in these regions. Outside pollutant load redistribution through vents can be regulated via flow separation control to minimize transport of pollutants into the building. Flow separation has been substantially reduced with the application of intelligent flow control tools developed at Syracuse University for flow around "silo" (turret) like structures. Similar flow control models can be introduced into buildings with cross ventilation for local external flow separation control. Initial experiments will be performed for turbulent flow over a rectangular block (scaled to be a mid-rise building) that has been configured with dynamic vents and unsteady suction actuators in a wind tunnel at various wind speeds.

  10. Pyomyositis in a 5-year-old child.

    PubMed

    Romeo, S; Sunshine, S

    2000-07-01

    We present a case of pyomyositis in an otherwise healthy 5-year-old child that underscores the potential for serious, life-threatening complications. Pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septic pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purulent infection of striated muscle thought to be caused by seeding from a transient bacteremia. The focal infection typically forms an abscess that generally responds to intravenous antibiotics and occasionally requires adjunctive computed tomography-guided aspiration and drainage. This localized infectious process rarely produces further sequelae unless treatment is delayed. Pyomyositis is rare in healthy individuals and requires a high clinical suspicion in patients who present with fever, leukocytosis, and localized pain. PMID:10910315

  11. State Aid, Voter Power and Local Control in Education.

    ERIC Educational Resources Information Center

    Zak, Itai; Glasman, Naftaly S.

    1979-01-01

    Not only did voter power contribute meaningfully to local control behavior regardless of the exact shape of the relations between state aid and local control, but the hypothesized inverse relationship between state aid and local control did not receive support. Journal availability: see EA 511 898. (Author/IRT)

  12. Towards structural controllability of local-world networks

    NASA Astrophysics Data System (ADS)

    Sun, Shiwen; Ma, Yilin; Wu, Yafang; Wang, Li; Xia, Chengyi

    2016-05-01

    Controlling complex networks is of vital importance in science and engineering. Meanwhile, local-world effect is an important ingredient which should be taken into consideration in the complete description of real-world complex systems. In this letter, structural controllability of a class of local-world networks is investigated. Through extensive numerical simulations, firstly, effects of local world size M and network size N on structural controllability are examined. For local-world networks with sparse topological configuration, compared to network size, local-world size can induce stronger influence on controllability, however, for dense networks, controllability is greatly affected by network size and local-world effect can be neglected. Secondly, relationships between controllability and topological properties are analyzed. Lastly, the robustness of local-world networks under targeted attacks regarding structural controllability is discussed. These results can help to deepen the understanding of structural complexity and connectivity patterns of complex systems.

  13. Local Control: Use It or Lose It.

    ERIC Educational Resources Information Center

    California School Boards Association, Sacramento.

    Two California laws have increased the autonomy of local school districts. As of January 1982, virtually all provisions of the California Education Code can be waived at the request of local school boards with the approval of the state board of education. Under Article 2 of Assembly Bill 777, Chapter 100, programs that may be waived include state…

  14. The Alcohol Warning and Adolescents: 5-Year Effects.

    ERIC Educational Resources Information Center

    MacKinnon, David P.; Nohre, Liva; Pentz, Mary Ann; Stacy, Alan W.

    2000-01-01

    Examined the effect of alcohol warning labels on adolescents during the first 5 years that the warning was required. Surveys of 10th and 12th grade students over 5 years indicated that the initial positive effects of the labels on adolescents leveled off after 3.5 years. The labels have not affected adolescents' beliefs about alcohol or…

  15. Modifiable diarrhoea risk factors in Egyptian children aged <5 years.

    PubMed

    Mansour, A M; Mohammady, H El; Shabrawi, M El; Shabaan, S Y; Zekri, M Abou; Nassar, M; Salem, M E; Mostafa, M; Riddle, M S; Klena, J D; Messih, I A Abdel; Levin, S; Young, S Y N

    2013-12-01

    By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged <5 years attending outpatient clinics for diarrhoea were matched by age and sex with controls. Data were collected on family demographics, socioeconomic indicators, and risk behaviour practices. Two rectal swabs and a stool specimen were collected from cases and controls. Samples were cultured for bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus and Cryptosporidium spp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4.9, 95% CI 2.8-8.4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1.7-5.4), and the child being cared for outside home (mOR 2.6, 95% CI 1.3-5.2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6.3, 95% CI 1.2-33.9) for children aged 7-12 months, and pacifier use (mOR 1.9, 95% CI 1.0-3.5) in children aged 0-6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years. PMID:23433452

  16. Remote Control of Gene Function by Local Translation

    PubMed Central

    Jung, Hosung; Gkogkas, Christos G.; Sonenberg, Nahum; Holt, Christine E.

    2014-01-01

    The subcellular position of a protein is a key determinant of its function. Mounting evidence indicates that RNA localization, where specific mRNAs are transported subcellularly and subsequently translated in response to localized signals, is an evolutionarily conserved mechanism to control protein localization. On-site synthesis confers novel signaling properties to a protein and helps to maintain local proteome homeostasis. Local translation plays particularly important roles in distal neuronal compartments, and dysregulated RNA localization and translation cause defects in neuronal wiring and survival. Here, we discuss key findings in this area and possible implications of this adaptable and swift mechanism for spatial control of gene function. PMID:24679524

  17. The role of the electric toothbrush in the control of plaque and gingivitis: a review of 5 years clinical experience with the Braun Oral-B Plaque Remover [D7].

    PubMed

    Warren, P R; Chater, B

    1996-07-01

    The Braun Oral-B Plaque Remover (D7) (previously known as D5) is a well established electric toothbrush available worldwide. It has a round brush head with a diameter of 13 mm, with bristle tufts arranged in three circular rings, and an oscillating/rotating action. Since its introduction in 1991, a significant number of well designed clinical investigations have been published comparing the D7 with manual toothbrushes, as well as with other electric devices. A review of the findings from these various studies indicates that while both the D7 and manual toothbrushes effectively remove plaque and improve gingival condition, the efficacy of the D7 is clearly greater than that of the manual toothbrush. It is suggested that this advantage is related in particular to greater efficiency in interproximal, vestibular and lingual sites. Compared to other electric toothbrushes, there is evidence that the D7 also offers greater efficacy, but this requires clarification in further clinical investigations. It is concluded that the greater efficacy of the D7 over that of a manual toothbrush, together with the motivational effect that has been shown to be associated with electric toothbrush use, should offer potential for improved oral hygiene control. PMID:9002781

  18. Local Control and Outcome in Children with Localized Vaginal Rhabdomyosarcoma: A Report from the Soft Tissue Sarcoma Committee of the Children’s Oncology Group

    PubMed Central

    Walterhouse, David O.; Meza, Jane L.; Breneman, John C.; Donaldson, Sarah S.; Hayes-Jordan, Andrea; Pappo, Alberto S.; Arndt, Carola; Raney, R. Beverly; Meyer, William H.; Hawkins, Douglas S.

    2012-01-01

    Background The local control approach for girls with non-resected vaginal rhabdomyosarcoma (RMS) enrolled onto Intergroup RMS Study Group (IRSG)/Children’s Oncology Group (COG) studies has differed from that used at other primary sites by delaying or eliminating radiotherapy (RT) based on response achieved with chemotherapy and delayed primary resection. Procedures We reviewed locoregional treatment and outcome for patients with localized RMS of the vagina on the two most recent COG low-risk RMS studies. Results Forty-one patients with localized vaginal RMS were enrolled: 25 onto D9602 and 16 onto Subset 2 of ARST0331. Only four of the 39 with non-resected tumors received RT. The 5-year cumulative incidence of local recurrence was 26% on D9602, and the 2-year cumulative incidence of local recurrence was 43% on ARST0331. Increased local failure rates appeared to correlate with chemotherapy regimens that incorporated lower cumulative doses of cyclophosphamide. Estimated 5-year and 2-year failure free survival rates were 70% (95% CI: 46%, 84%) on D9602 and 42% (95% CI: 11%, 70%) on ARST0331, respectively. Conclusions To prevent local recurrence, we recommend a local control approach for patients with non-resected RMS of the vagina that is similar to that used for other primary sites and includes RT. We recognize that potential long-term effects of RT are sometimes unacceptable, especially for children less than 24 months of age. However, when making the decision to eliminate RT, the risk of local recurrence must be considered especially when using a chemotherapy regimen with a total cumulative cyclophosphamide dose of ≤ 4.8 g/m2. PMID:21298768

  19. National and Local Control of Indian Education.

    ERIC Educational Resources Information Center

    Antell, Will

    The crucial elements of control which have developed in the educational systems of the U.S. are: (1) the collective social power of government to require participation in formal education and to stipulate the conditions of that participation (i.e., legal control); (2) the authority to make and the power to enforce decisions that appropriate…

  20. Gamma knife radiosurgery of radiation-induced intracranial tumors: Local control, outcomes, and complications

    SciTech Connect

    Jensen, Ashley W.; Brown, Paul D.; Pollock, Bruce E.; Stafford, Scott L.; Link, Michael J.; Garces, Yolanda I.; Foote, Robert L.; Gorman, Deborah A.; Schomberg, Paula J.

    2005-05-01

    Purpose: To determine local control (LC) and complication rates for patients who underwent radiosurgery for radiation-induced intracranial tumors. Methods and Materials: Review of a prospectively maintained database (2,714 patients) identified 16 patients (20 tumors) with radiation-induced tumors treated with radiosurgery between 1990 and 2004. Tumor types included typical meningioma (n = 17), atypical meningioma (n = 2), and schwannoma (n 1). Median patient age at radiosurgery was 47.5 years (range, 27-70 years). The median tumor margin dose was 16 Gy (range, 12-20 Gy). Median follow-up was 40.2 months (range, 10.8-146.2 months). Time-to-event outcomes were calculated with Kaplan-Meier estimates. Results: Three-year and 5-year LC rates were 100%. Three-year and 5-year overall survival rates were 92% and 80%, respectively. Cause-specific survival rates at 3 and 5 years were 100%. Three patients died: 1 had in-field progression 65.1 months after radiosurgery and later died of the tumor, 1 died of progression of a preexisting brain malignancy, and 1 died of an unrelated cause. One patient had increased seizure activity that correlated with development of edema seen on neuroimaging. Conclusions: LC, survival, and complication rates in our series are comparable to those in previous reports of radiosurgery for intracranial meningiomas. Also, LC rates with radiosurgery are at least comparable to those of surgical series for radiation-induced meningiomas. Radiosurgery is a safe and effective treatment option for radiation-induced intracranial tumors, most of which are typical meningiomas.

  1. Desmoid tumors: local control and patterns of relapse following radiation therapy

    SciTech Connect

    Leibel, S.A.; Wara, W.M.; Hill, D.R.; Bovill, E.G. Jr.; De Lorimier, A.A.; Beckstead, J.H.; Phillips, T.L.

    1983-08-01

    Desmoid tumors are benign neoplasms, arising from musculoaponeurotic tissues, which tend to be locally infiltrative, resulting in a high rate of local recurrence following surgical resection. Nineteen patients with desmoid tumors underwent radiation therapy at the University of California, San Francisco, between 1970 and 1980. Fifteen patients were referred with local recurrence following one or more surgical resections. Three patients were referred for initial radiation therapy with unresectable tumors, and one patient received planned postoperative irradiation following subtotal tumor resection. At the time of treatment, 8 patients had nonresectable disease measuring greater than 10 cm. The majority of patients were treated to a tumor dose of 50 to 55 Gy at 1.6 to 1.8 Gy per fraction. With a median follow-up of 8 years, 13 patients remained free of recurrent disease following radiation therapy. Local control was not related to the amount of disease present at the time of treatment. Of the 6 patients who developed recurrent disease, only 1 patient had a true in-field recurrence. Four patients recurred at the margin of the radiation field 1 to 5 years following therapy. Moderate dose radiation therapy to desmoid tumors can result in lasting local control when surgical resection is not possible. Post operative radiation can improve the rate of local control for patients with a high risk of recurrence. As desmoid tumors tend to be locally infiltrative, fields must be very generous to prevent marginal recurrence. Systemic chemotherapy offers an alternative to ablative surgery in the event of local failure following radiation therapy.

  2. Caveolin-1 as a Prognostic Marker for Local Control After Preoperative Chemoradiation Therapy in Rectal Cancer

    SciTech Connect

    Roedel, Franz Capalbo, Gianni; Roedel, Claus; Weiss, Christian

    2009-03-01

    Purpose: Caveolin-1 is a protein marker for caveolae organelles and has an essential impact on cellular signal transduction pathways (e.g., receptor tyrosine kinases, adhesion molecules, and G-protein-coupled receptors). In the present study, we investigated the expression of caveolin-1 in patients with rectal adenocarcinoma and correlated its expression pattern with the risk for disease recurrences after preoperative chemoradiation therapy (CRT) and surgical resection. Methods and Materials: Caveolin-1 mRNA and protein expression were evaluated by Affymetrix microarray analysis (n = 20) and immunohistochemistry (n = 44) on pretreatment biopsy samples of patients with locally advanced adenocarcinoma of the rectum, and were correlated with clinical and histopathologic characteristics as well as with 5-year rates of local failure and overall survival. Results: A significantly decreased median caveolin-1 intracellular mRNA level was observed in tumor biopsy samples as compared with noncancerous mucosa. Individual mRNA levels and immunohistologic staining, however, revealed an overexpression in 7 of 20 patients (35%) and 17 of 44 patients (38.6%), respectively. Based on immunohistochemical evaluation, local control rates at 5 years for patients with tumors showing low caveolin-1 expression were significantly better than for patients with high caveolin-1-expressing carcinoma cells (p = 0.05; 92%, 95% confidence interval [95% CI] = 82-102% vs. 72%, 95% CI = 49-84%). A low caveolin-1 protein expression was also significantly related to an increased overall survival rate (p = 0.05; 45%, 95% CI 16-60% vs. 82%, 95% CI = 67-97%). Conclusion: Caveolin-1 may provide a novel prognostic marker for local control and survival after preoperative CRT and surgical resection in rectal cancer.

  3. Segmented nanowires displaying locally controllable properties

    DOEpatents

    Sutter, Eli Anguelova; Sutter, Peter Werner

    2013-03-05

    Vapor-liquid-solid growth of nanowires is tailored to achieve complex one-dimensional material geometries using phase diagrams determined for nanoscale materials. Segmented one-dimensional nanowires having constant composition display locally variable electronic band structures that are determined by the diameter of the nanowires. The unique electrical and optical properties of the segmented nanowires are exploited to form electronic and optoelectronic devices. Using gold-germanium as a model system, in situ transmission electron microscopy establishes, for nanometer-sized Au--Ge alloy drops at the tips of Ge nanowires (NWs), the parts of the phase diagram that determine their temperature-dependent equilibrium composition. The nanoscale phase diagram is then used to determine the exchange of material between the NW and the drop. The phase diagram for the nanoscale drop deviates significantly from that of the bulk alloy.

  4. mRNA Localization and Translational Control in Drosophila Oogenesis

    PubMed Central

    Lasko, Paul

    2012-01-01

    Localization of an mRNA species to a particular subcellular region can complement translational control mechanisms to produce a restricted spatial distribution of the protein it encodes. mRNA localization has been studied most in asymmetric cells such as budding yeast, early embryos, and neurons, but the process is likely to be more widespread. This article reviews the current state of knowledge about the mechanisms of mRNA localization and its functions in early embryonic development, focusing on Drosophila where the relevant knowledge is most advanced. Links between mRNA localization and translational control mechanisms also are examined. PMID:22865893

  5. Localized flow control with energy deposition

    NASA Astrophysics Data System (ADS)

    Adelgren, Russell Gene

    A series of experiments with energy deposition via laser-induced optical breakdown of air, i.e., a laser spark, have been performed. These experiments have demonstrated the possibility of using a laser spark for supersonic flow control. In the first of these experiments, Rayleigh scattering flow visualization was taken for energy deposition into quiescent air. A time sequence of images showed the post breakdown fluid motion created by the laser spark for different laser energy levels. Blast wave radius and wave speed measurements were made and correlated to five different laser energy deposition levels. Laser energy was deposited upstream of a sphere in Mach 3.45 flow. The energy was deposited one sphere diameter and 0.6 diameters upstream of the front of the sphere. The frontal surface pressure on the sphere was recorded as the laser spark perturbed region interacted with the flow about the sphere. Tests for three different energy levels and two different incident laser beam diameters were completed. It has been demonstrated that the peak surface pressure associated with the Edney IV interaction can be momentarily reduced by 30% by the interaction with the thermal spot created by the laser spark. The effects of laser energy deposition on another shock interaction phenomena were studied. Laser energy deposition was used to modify the shock structure formed by symmetric wedges at Mach 3.45 within the dual solution domain. It was demonstrated experimentally that the Mach reflection could be reduced by 80% momentarily. The numerical simulations show a transition from the stable Mach reflection to a stable regular reflection. Two energy deposition methods (electric arcing and laser energy deposition) were used to force and control compressible mixing layers of axisymmetric jets. The energy deposition forcing methods have been experimentally investigated with the schlieren technique, particle image velocimetry, Mie scattering, and static pressure probe diagnostic

  6. Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes

    SciTech Connect

    Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto; Roach, Mack; Nash, Marc; Gottschalk, Alexander; Chang, Albert J.; Hsu, I-Chow

    2013-06-01

    Purpose: Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT). Methods and Materials: We retrospectively analyzed 52 consecutively accrued patients undergoing salvage HDRB between 1998 and 2009 for locally recurrent prostate cancer after previous definitive RT. After pathologic confirmation of locally recurrent disease, patients received 36 Gy in 6 fractions. Twenty-four patients received neoadjuvant hormonal therapy before salvage, and no patients received adjuvant hormonal therapy. Determination of biochemical failure after salvage HDRB was based on the Phoenix definition. Overall survival (OS) and bF distributions were calculated using the Kaplan-Meier method. Univariate analyses were performed to identify predictors of biochemical control. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities, based on Common Terminology Criteria for Adverse Events (version 4), were documented. Results: Median follow-up after salvage HDRB was 59.6 months. The 5-year OS estimate was 92% (95% confidence interval [CI]: 80%-97%) with median survival not yet reached. Five-year biochemical control after salvage was 51% (95% CI: 34%-66%). Median PSA nadir postsalvage was 0.1 (range: 0-7.2) reached at a median of 10.2 months after completing HDRB. As for complications, acute and late grade 3 GU toxicities were observed in only 2% and 2%, respectively. No grade 2 or higher acute GI events and 4% grade 2 GI late events were observed. On univariate analysis, disease-free interval after initial definitive RT (P=.07), percent of positive cores at the time of diagnosis (P=.08), interval from first recurrence to salvage HDRB (P=.09), and pre-HDRB prostate-specific antigen (P=.07) were each of borderline significance in predicting biochemical control after salvage HDRB. Conclusions: Prostate HDRB is an effective salvage modality with relatively few long-term toxicities. We

  7. Does early establishment of favorable oral health behavior influence caries experience at age 5 years?

    PubMed Central

    Wigen, Tove I.; Wang, Nina J.

    2015-01-01

    Objective The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 year of age and having caries experience at 5 years of age. Methods This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 year of age having the teeth brushed less than twice daily (OR 2.1, CI 1.3–3.6) and being offered sugary drinks at least once a week (OR 1.8, CI 1.1–2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Conclusions Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during preschool age independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children’s first years of life should receive special attention from health personnel. PMID:25385683

  8. Two consecutive randomized controlled pertussis booster trials in children initially vaccinated in infancy with an acellular vaccine: The first with a five-component Tdap vaccine to 5-year olds and the second with five- or monocomponent Tdap vaccines at age 14-15 years.

    PubMed

    Carlsson, R M; Gustafsson, L; Hallander, H O; Ljungman, M; Olin, P; Gothefors, L; Nilsson, L; Netterlid, E

    2015-07-17

    Prior study children from a DTaP efficacy trial were recruited at ages 5 and 15 years to randomized booster trials addressing immunogenicity and reactogenicity; 475 preschool children received mixed or separate injections of a reduced antigen vaccine (Tdap5, Sanofi Pasteur MSD) and an inactivated polio vaccine, and 230 adolescents received the same or another booster vaccine (Tdap1, SSI, Denmark). Pre-vaccination antibody concentrations against pertussis antigens were significantly higher at 15 than 5 years of age, probably due to natural boosting between the studies. Tdap5 induced comparable anti-PT concentrations at both ages, but antibody responses were significantly higher to filamentous haemagglutinin, pertactin and fimbriae 2/3 in adolescents. As expected, a higher amount of PT (Tdap1, 20μg) induced a stronger anti-PT response than a lower amount (Tdap5, 2.5μg). The frequency of adverse events was low and there were no serious adverse reactions. All local reactions had an early onset and a short duration. A large swelling or redness of more than half of the upper arm circumference was reported in 8/475 5-year-olds and in 6/230 15-year-olds. Children vaccinated with Tdap5 reported more moderate pain in adolescence than at preschool age, whereas itching was only reported in preschool children. Sweden introduced DTaP vaccines in 1996 after a 17-year hiatus with no general pertussis vaccination and pertussis was still endemic at the time of the studies. The frequency of adverse events was nevertheless low in both preschool children and adolescents and antibody responses were adequate. These studies document immunogenicity and reactogenicity in a trial cohort consecutively vaccinated with acellular pertussis vaccines from infancy to adolescence. The adolescent study was registered at ClinicalTrials.gov on 26 March 2009 (NCT00870350). PMID:26057135

  9. Controlled Release for Local Delivery of Drugs: Barriers and Models

    PubMed Central

    Weiser, Jennifer R.; Saltzman, W. Mark

    2014-01-01

    Controlled release systems are an effective means for local drug delivery. In local drug delivery, the major goal is to supply therapeutic levels of a drug agent at a physical site in the body for a prolonged period. A second goal is to reduce systemic toxicities, by avoiding the delivery of agents to non-target tissues remote from the site. Understanding the dynamics of drug transport in the vicinity of a local drug delivery device is helpful in achieving both of these goals. Here, we provide an overview of controlled release systems for local delivery and we review mathematical models of drug transport in tissue, which describe the local penetration of drugs into tissue and illustrate the factors—such as diffusion, convection, and elimination—that control drug dispersion and its ultimate fate. This review highlights the important role of controlled release science in development of reliable methods for local delivery, as well as the barriers to accomplishing effective delivery in the brain, blood vessels, mucosal epithelia, and the skin. PMID:24801251

  10. Limits of localized control in extended nonlinear systems

    NASA Astrophysics Data System (ADS)

    Handel, Andreas

    We investigate the limits of localized linear control in spatially extended, nonlinear systems. Spatially extended, nonlinear systems can be found in virtually every field of engineering and science. An important category of such systems are fluid flows. Fluid flows play an important role in many commercial applications, for instance in the chemical, pharmaceutical and food-processing industries. Other important fluid flows include air- or water flows around cars, planes or ships. In all these systems, it is highly desirable to control the flow of the respective fluid. For instance control of the air flow around an airplane or car leads to better fuel-economy and reduced noise production. Usually, it is impossible to apply control everywhere. Consider an airplane: It would not be feasibly to cover the whole body of the plane with control units. Instead, one can place the control units at localized regions, such as points along the edge of the wings, spaced as far apart from each other as possible. These considerations lead to an important question: For a given system, what is the minimum number of localized controllers that still ensures successful control? Too few controllers will not achieve control, while using too many leads to unnecessary expenses and wastes resources. To answer this question, we study localized control in a class of model equations. These model equations are good representations of many real fluid flows. Using these equations, we show how one can design localized control that renders the system stable. We study the properties of the control and derive several expressions that allow us to determine the limits of successful control. We show how the number of controllers that are needed for successful control depends on the size and type of the system, as well as the way control is implemented. We find that especially the nonlinearities and the amount of noise present in the system play a crucial role. This analysis allows us to determine under

  11. Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft-Tissue Sarcomas After Preoperative Concurrent Chemoradiotherapy

    SciTech Connect

    MacDermed, Dhara M.; Miller, Luke L.; Peabody, Terrance D.; Simon, Michael A.; Luu, Hue H.; Haydon, Rex C.; Montag, Anthony G.; Undevia, Samir D.

    2010-03-15

    Purpose: Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft-tissue sarcomas. This retrospective study describes a uniquely modified version of the Eilber regimen developed at the University of Chicago. Methods and Materials: We treated 34 patients (28 Stage III and 6 Stage IV) with locally advanced soft-tissue sarcomas of an extremity between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m2 per day for 5 days) with concurrent radiation (28 Gy in 3.5-Gy daily fractions), sandwiched between various chemotherapy regimens. Postoperatively, 47% received further adjuvant chemotherapy. Results: Most tumors (94%) were Grade 3, and all were T2b, with a median size of 10.3 cm. Wide excision was performed in 29 patients (85%), and 5 required amputation. Of the resected tumor specimens, 50% exhibited high (>=90%) treatment-induced necrosis and 11.8% had a complete pathologic response. Surgical margins were negative in all patients. The 5-year survival rate was 42.3% for all patients and 45.2% for Stage III patients. For limb-preservation patients, the 5-year local control rate was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom-from-distant metastasis rate was 53.4% (Stage IV patients excluded), and freedom from distant metastasis was superior if treatment-induced tumor necrosis was 90% or greater (84.6% vs. 19.9%, p = 0.02). Conclusions: This well-tolerated concurrent chemoradiotherapy approach yields excellent rates of limb preservation and local control. The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies.

  12. Knowledge-based control for robot self-localization

    NASA Technical Reports Server (NTRS)

    Bennett, Bonnie Kathleen Holte

    1993-01-01

    Autonomous robot systems are being proposed for a variety of missions including the Mars rover/sample return mission. Prior to any other mission objectives being met, an autonomous robot must be able to determine its own location. This will be especially challenging because location sensors like GPS, which are available on Earth, will not be useful, nor will INS sensors because their drift is too large. Another approach to self-localization is required. In this paper, we describe a novel approach to localization by applying a problem solving methodology. The term 'problem solving' implies a computational technique based on logical representational and control steps. In this research, these steps are derived from observing experts solving localization problems. The objective is not specifically to simulate human expertise but rather to apply its techniques where appropriate for computational systems. In doing this, we describe a model for solving the problem and a system built on that model, called localization control and logic expert (LOCALE), which is a demonstration of concept for the approach and the model. The results of this work represent the first successful solution to high-level control aspects of the localization problem.

  13. Controlled Delivery of Zoledronate Improved Bone Formation Locally In Vivo

    PubMed Central

    Peng, Jiang; Lu, Qiang; Wang, Yu; Wang, Aiyuan; Guo, Quanyi; Gao, Xupeng; Xu, Wenjing; Lu, Shibi

    2014-01-01

    Bisphosphonates (BPs) have been widely used in clinical treatment of bone diseases with increased bone resorption because of their strong affinity for bone and their inhibition of bone resorption. Recently, there has been growing interest in their improvement of bone formation. However, the effect of local controlled delivery of BPs is unclear. We used polylactide acid-glycolic acid copolymer (PLGA) as a drug carrier to deliver various doses of the bisphosphonate zoledronate (Zol) into the distal femur of 8-week-old Sprague-Dawley rats. After 6 weeks, samples were harvested and analyzed by micro-CT and histology. The average bone mineral density and mineralized bone volume fraction were higher with medium- and high-dose PLGA-Zol (30 and 300 µg Zol, respectively) than control and low-dose Zol (3 µg PLGA-Zol; p<0.05). Local controlled delivery of Zol decreased the numbers of osteoclast and increased the numbers of osteoblast. Moreover, local controlled delivery of medium- and high-dose Zol accelerated the expression of bone-formation markers. PLGA used as a drug carrier for controlled delivery of Zol may promote local bone formation. PMID:24618585

  14. 2001 IFT Education Standards: A 5-Year Perspective

    ERIC Educational Resources Information Center

    Hartel, Richard W.

    2006-01-01

    The current IFT Education Standards used to evaluate Food Science programs for IFT approval have been in place now for 5 years. Most Food Science programs in the United States (as well as some in Mexico and Canada) have been reviewed according to these standards. The transition to instruction based on assessment of student learning outcomes, in…

  15. True or False: Do 5-Year-Olds Understand Belief?

    ERIC Educational Resources Information Center

    Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

    2010-01-01

    In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds…

  16. Upper Body Muscular Endurance Among Children 2-5 Years.

    ERIC Educational Resources Information Center

    Gabbard, Carl P.; And Others

    The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

  17. Stimulant Treatment over 5 Years: Effects on Growth

    ERIC Educational Resources Information Center

    Charach, Alice; Figueroa, Max; Chen, Shirley; Ickowicz, Abel; Schachar, Russell

    2006-01-01

    Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and…

  18. Local Control of Schools: Is Local Governance a Viable Option? Policy Issues.

    ERIC Educational Resources Information Center

    Faber, Charles F.

    The historical and current balance among the federal, state, and local levels in the control of education is reviewed in this report, with a focus on effective schools research and the management of change. Five policy instruments are described, which include mandates, inducements, capacity-building, system-changing, and leadership. A conceptual…

  19. Dynamic subcellular localization of a respiratory complex controls bacterial respiration

    PubMed Central

    Alberge, François; Espinosa, Leon; Seduk, Farida; Sylvi, Léa; Toci, René; Walburger, Anne; Magalon, Axel

    2015-01-01

    Respiration, an essential process for most organisms, has to optimally respond to changes in the metabolic demand or the environmental conditions. The branched character of their respiratory chains allows bacteria to do so by providing a great metabolic and regulatory flexibility. Here, we show that the native localization of the nitrate reductase, a major respiratory complex under anaerobiosis in Escherichia coli, is submitted to tight spatiotemporal regulation in response to metabolic conditions via a mechanism using the transmembrane proton gradient as a cue for polar localization. These dynamics are critical for controlling the activity of nitrate reductase, as the formation of polar assemblies potentiates the electron flux through the complex. Thus, dynamic subcellular localization emerges as a critical factor in the control of respiration in bacteria. DOI: http://dx.doi.org/10.7554/eLife.05357.001 PMID:26077726

  20. A Preliminary Analysis of California's New Local Control Funding Formula

    ERIC Educational Resources Information Center

    Wolf, Rebecca; Sands, Janelle

    2016-01-01

    California recently overhauled its K-12 public education finance system. Enacted in 2013, the Local Control Funding Formula (LCFF) replaced California's 40-year-old funding formula. The LCFF increases district officials' fiscal flexibility; provides more resources to districts serving larger proportions of low-income, English learner (EL), and…

  1. Local Control and Self-Determination: The San Juan Case.

    ERIC Educational Resources Information Center

    Garman, Keats; Jack, Donald

    Rapidly increasing Navajo enrollment in San Juan County, Utah, public schools in the 1960's forced the rural school district to improve educational services to a sizable Navajo population while attempting to preserve local control in the face of changing Indian self-determination policy. The district implemented a Curriculum Development Center, a…

  2. Seizing the Moment for Transformation: California's Local Control Funding Formula

    ERIC Educational Resources Information Center

    Miles, Karen Hawley; Feinberg, Randi

    2014-01-01

    In 2013 California adopted a new funding formula that includes a significant reinvestment in public education after years of budget cuts. The new law allocates funds differently, directing more resources to students with higher needs and providing more local control and greater transparency. This revolutionary change presents California districts…

  3. THE INFLUENCES AND CONTROLS OVER LOCAL SCHOOL SYSTEMS.

    ERIC Educational Resources Information Center

    EYE, GLEN G.

    THE DEFINITION OF SCHOOL ADMINISTRATION AS THE SELECTION, ASSIGNMENT, STIMULATION, GUIDANCE, AND EVALUATION OF HUMAN EFFORT TOWARD THE DEVELOPMENT OF HUMAN QUALITIES IS USED AS A FUNCTIONAL DEFINITION FOR IDENTIFYING AND CLARIFYING THE INFLUENCES AND CONTROLS OVER LOCAL SCHOOL SYSTEMS. IF INFLUENCE REFERS TO THE POWER OF PRODUCING EFFECTS BY…

  4. Local Control of Ultrafast Dynamics of Magnetic Nanoparticles

    SciTech Connect

    Sukhov, A.; Berakdar, J.

    2009-02-06

    Using the local control theory we derive analytical expressions for magnetic field pulses that steer the magnetization of a monodomain magnetic nanoparticle to a predefined state. Finite-temperature full numerical simulations confirm the analytical results and show that a magnetization switching or freezing is achievable within few precessional periods and that the scheme is exploitable for fast thermal switching.

  5. Hearings Before the General Subcommittee on Education of the Committee on Education and Labor, House of Representatives, Ninety-Second Congress, First Session on H.R. 6247; a Bill to Extend the Provisions of the Juvenile Delinquency Prevention and Control Act of 1968 for 5 Years. Hearings Held Washington, D.C., March 26; April 28-29, 1971.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    The purpose of the Juvenile Delinquency Prevention and Control Act is to provide Federal funds to assist the States and localities in improving their services dealing with the juvenile delinquency problem. This would apply to the juvenile justice and juvenile aid systems including courts, correctional facilities, police agencies, and other…

  6. Excellent Local Control Rates and Distinctive Patterns of Failure in Myxoid Liposarcoma Treated With Conservation Surgery and Radiotherapy

    SciTech Connect

    Guadagnolo, B. Ashleigh Zagars, Gunar K.; Ballo, Matthew T.; Patel, Shreyaskumar R.; Lewis, Valerae O.; Benjamin, Robert S.; Pollock, Raphael E.

    2008-03-01

    Purpose: To evaluate the local control rates and patterns of metastatic relapse in patients with localized myxoid liposarcoma treated with conservation surgery and radiotherapy (RT). Patients and Methods: Between 1960 and 2003, 127 patients with non-metastatic myxoid liposarcoma were treated with conservation surgery and RT at our institution. The median patient age was 39 years (range, 14-79 years). Of the 127 patients, 46% underwent preoperative RT (median dose, 50 Gy) and 54% underwent postoperative RT (median dose, 60 Gy). Also, 28% received doxorubicin-based chemotherapy as a part of their treatment. Results: The median follow-up was 9.1 years. The overall survival rate at 5 and 10 years was 87% and 79%, respectively. The corresponding disease-free survival rates were 81% and 73%. The local control rate at {>=}5 years was 97%. The actuarial rate of distant metastases at 5 and 10 years was 15% and 24%, respectively. Of the 27 patients who developed distant metastases, 48% did so in the retroperitoneum, 22% in other extrapulmonary soft tissues, 22% in the lung, 15% in bone, and 4% in the liver. Conclusion: The results of our study have shown that RT and conservation surgery for localized myxoid liposarcoma provide excellent local control. Distant metastatic relapse tended to occur in the retroperitoneum and other nonpulmonary soft tissues. Therefore, staging and surveillance imaging should include the abdomen and pelvis, as well as the thorax, for patients with localized myxoid liposarcoma.

  7. Local Recurrence After Complete Clinical Response and Watch and Wait in Rectal Cancer After Neoadjuvant Chemoradiation: Impact of Salvage Therapy on Local Disease Control

    SciTech Connect

    Habr-Gama, Angelita; Gama-Rodrigues, Joaquim; São Julião, Guilherme P.; Proscurshim, Igor; Sabbagh, Charles; Lynn, Patricio B.; Perez, Rodrigo O.

    2014-03-15

    Purpose: To review the risk of local recurrence and impact of salvage therapy after Watch and Wait for rectal cancer with complete clinical response (cCR) after chemoradiation therapy (CRT). Methods and Materials: Patients with cT2-4N0-2M0 distal rectal cancer treated with CRT (50.4-54 Gy + 5-fluorouracil-based chemotherapy) and cCR at 8 weeks were included. Patients with cCR were enrolled in a strict follow-up program with no immediate surgery (Watch and Wait). Local recurrence-free survival was compared while taking into account Watch and Wait strategy alone and Watch and Wait plus salvage. Results: 90 of 183 patients experienced cCR at initial assessment after CRT (49%). When early tumor regrowths (up to and including the initial 12 months of follow-up) and late recurrences were considered together, 28 patients (31%) experienced local recurrence (median follow-up time, 60 months). Of those, 26 patients underwent salvage therapy, and 2 patients were not amenable to salvage. In 4 patients, local re-recurrence developed after Watch and Wait plus salvage. The overall salvage rate for local recurrence was 93%. Local recurrence-free survival at 5 years was 69% (all local recurrences) and 94% (after salvage procedures). Thirteen patients (14%) experienced systemic recurrence. The 5-year cancer-specific overall survival and disease-free survival for all patients (including all recurrences) were 91% and 68%, respectively. Conclusions: Local recurrence may develop in 31% of patients with initial cCR when early regrowths (≤12 months) and late recurrences are grouped together. More than half of these recurrences develop within 12 months of follow-up. Salvage therapy is possible in ≥90% of recurrences, leading to 94% local disease control, with 78% organ preservation.

  8. Excellent Local Control With Stereotactic Radiotherapy Boost After External Beam Radiotherapy in Patients With Nasopharyngeal Carcinoma

    SciTech Connect

    Hara, Wendy; Loo, Billy W.; Goffinet, Don R.; Chang, Steven D.; Adler, John R.; Pinto, Harlan A.; Fee, Willard E.; Kaplan, Michael J.; Fischbein, Nancy J.; Le, Quynh-Thu

    2008-06-01

    Purpose: To determine long-term outcomes in patients receiving stereotactic radiotherapy (SRT) as a boost after external beam radiotherapy (EBRT) for locally advanced nasopharyngeal carcinoma (NPC). Methods and Materials: Eight-two patients received an SRT boost after EBRT between September 1992 and July 2006. Nine patients had T1, 30 had T2, 12 had T3, and 31 had T4 tumors. Sixteen patients had Stage II, 19 had Stage III, and 47 had Stage IV disease. Patients received 66 Gy of EBRT followed by a single-fraction SRT boost of 7-15 Gy, delivered 2-6 weeks after EBRT. Seventy patients also received cisplatin-based chemotherapy delivered concurrently with and adjuvant to radiotherapy. Results: At a median follow-up of 40.7 months (range, 6.5-144.2 months) for living patients, there was only 1 local failure in a patient with a T4 tumor. At 5 years, the freedom from local relapse rate was 98%, freedom from nodal relapse 83%, freedom from distant metastasis 68%, freedom from any relapse 67%, and overall survival 69%. Late toxicity included radiation-related retinopathy in 3, carotid aneurysm in 1, and radiographic temporal lobe necrosis in 10 patients, of whom 2 patients were symptomatic with seizures. Of 10 patients with temporal lobe necrosis, 9 had T4 tumors. Conclusion: Stereotactic radiotherapy boost after EBRT provides excellent local control for patients with NPC. Improved target delineation and dose homogeneity of radiation delivery for both EBRT and SRT is important to avoid long-term complications. Better systemic therapies for distant control are needed.

  9. Local Control Mechanisms of Implicit and Explicit Conflicts.

    PubMed

    Zhao, Liang; Bai, Yang; Ma, Jie; Wang, Yonghui

    2015-01-01

    Congruency sequence effects are observed when the congruency effects following incongruent trials are smaller than those following congruent trials. It is typically assumed that such flexible adjustments are evidence of cognitively controlled dynamic modulations. The present study investigated whether cognitive control acts locally or globally when implicit and explicit conflicts exist simultaneously within a system. The implicit SNARC task and explicit Simon task were combined in a single task. The results showed that congruency effects of one type (e.g., SNARC effect) were only smaller following an incongruent trial of the same type (e.g., SNARC effect), but not when following an incongruent trial of the other type (e.g., Simon effect). These results indicate the operation of local control mechanisms triggered by implicit and explicit conflicts. PMID:25516007

  10. Local gate control in carbon nanotube quantum devices

    NASA Astrophysics Data System (ADS)

    Biercuk, Michael Jordan

    This thesis presents transport measurements of carbon nanotube electronic devices operated in the quantum regime. Nanotubes are contacted by source and drain electrodes, and multiple lithographically-patterned electrostatic gates are aligned to each device. Transport measurements of device conductance or current as a function of local gate voltages reveal that local gates couple primarily to the proximal section of the nanotube, hence providing spatially localized control over carrier density along the nanotube length. Further, using several different techniques we are able to produce local depletion regions along the length of a tube. This phenomenon is explored in detail for different contact metals to the nanotube. We utilize local gating techniques to study multiple quantum dots in carbon nanotubes produced both by naturally occurring defects, and by the controlled application of voltages to depletion gates. We study double quantum dots in detail, where transport measurements reveal honeycomb charge stability diagrams. We extract values of energy-level spacings, capacitances, and interaction energies for this system, and demonstrate independent control over all relevant tunneling rates. We report rf-reflectometry measurements of gate-defined carbon nanotube quantum dots with integrated charge sensors. Aluminum rf-SETs are electrostatically coupled to carbon nanotube devices and detect single electron charging phenomena in the Coulomb blockade regime. Simultaneous correlated measurements of single electron charging are made using reflected rf power from the nanotube itself and from the rf-SET on microsecond time scales. We map charge stability diagrams for the nanotube quantum dot via charge sensing, observing Coulomb charging diamonds beyond the first order. Conductance measurements of carbon nanotubes containing gated local depletion regions exhibit plateaus as a function of gate voltage, spaced by approximately 1e2/h, the quantum of conductance for a single

  11. Locally oriented potential field for controlling multi-robots

    NASA Astrophysics Data System (ADS)

    Romero, Roseli A. F.; Prestes, Edson; Idiart, Marco A. P.; Faria, Gedson

    2012-12-01

    In this paper, we present an extension of the boundary value problem path planner (BVP PP) to control multiple robots in a robot soccer scenario. This extension is called Locally Oriented Potential Field (LOPF) and computes a potential field from the numerical solution of a BVP using local relaxations in different patches of the solution space. This permits that a single solution of the BVP endows distinct robots with different behaviors in a team. We present the steps to implement LOPF as well as several results obtained in simulation.

  12. Failure to immunize children under 5 years: a literature review.

    PubMed

    Lochhead, Y J

    1991-02-01

    This paper aims to provide a critical review of the current literature related to immunization default in children under 5 years of age. The author has used a health belief model as the framework for analysis, examining each area in detail. The principle recommendations for practice are addressed and critically evaluated with a concluding summary of the main points raised and the author's recommendation for practice. PMID:2013653

  13. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    ERIC Educational Resources Information Center

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  14. Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

    2014-01-01

    This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants…

  15. Modified Mandibulotomy Technique to Reduce Postoperative Complications: 5-Year Results

    PubMed Central

    Na, Hye-Young; Choi, Eun-Joo; Kim, Hyung Jun; Cha, In-Ho

    2013-01-01

    Purpose To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. Results There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. Conclusion Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation, can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications. PMID:23918577

  16. The effects of oil pollution on Antarctic benthic diatom communities over 5 years.

    PubMed

    Polmear, R; Stark, J S; Roberts, D; McMinn, A

    2015-01-15

    Although considered pristine, Antarctica has not been impervious to hydrocarbon pollution. Antarctica's history is peppered with oil spills and numerous abandoned waste disposal sites. Both spill events and constant leakages contribute to previous and current sources of pollution into marine sediments. Here we compare the response of the benthic diatom communities over 5 years to exposure to a commonly used standard synthetic lubricant oil, an alternative lubricant marketed as more biodegradable, in comparison to a control treatment. Community composition varied significantly over time and between treatments with some high variability within contaminated treatments suggesting community stress. Both lubricants showed evidence of significant effects on community composition after 5 years even though total petroleum hydrocarbon reduction reached approximately 80% over this time period. It appears that even after 5 years toxicity remains high for both the standard and biodegradable lubricants revealing the temporal scale at which pollutants persist in Antarctica. PMID:25499184

  17. Controllable Atom Localization in Four-Level Atomic Systems

    SciTech Connect

    Jin Luling; Jin Shiqi; Gong Shangqing

    2007-12-26

    We propose controllable atom localization schemes for four-level atomic systems. In the alkaline earth atomic system we give the analytical expressions of the localization peak positions as well as the widths versus the parameters of the optical fields. We show that the probability of finding the atom at a particular position can be increased from 1/4 to 1/3 or 1/2 by adjusting the detuning of the probe field and the Rabi frequencies of the optical fields. Furthermore, the localization precision can be dramatically enhanced by increasing the intensity of the standing-wave field. In the ladder-type system, we use two standing-wave fields and find that the detecting probability can be increased to 1/2 by adjusting the Rabi frequencies of the standing-wave fields.

  18. Tuberculosis control: decentralization, local planning and management specificities.

    PubMed

    Trigueiro, Janaína Von Söhsten; Nogueira, Jordana de Almeida; de Sá, Lenilde Duarte; Palha, Pedro Fredemir; Villa, Tereza Cristina Scatena; Trigueiro, Débora Raquel Soares Guedes

    2011-01-01

    The goal was to analyze, according to the perception of health managers, the practices that guide tuberculosis control actions in cities in the metropolitan region of João Pessoa - PB, Brazil. This qualitative study involved eight professionals in management functions. Testimonies were collected through semi-structured interviews between May and June 2009 and organized through content analysis. Despite the acknowledged benefits of tuberculosis control action decentralization, local planning indicates the predominance of a bureaucratic model that is restricted to negotiation and supplies. Local programming is centered on the coordinator, which shows a command line and vertical management that lead to the fragmentation of the work process. Management action should follow an innovative and transformative route that surpasses bureaucratic barriers and faces the biggest challenge it is proposed: to balance professional interrelations with a view to improving health work performance. PMID:22249661

  19. Toward Reform in Land Reform: Coupling Local Control and Social Control.

    ERIC Educational Resources Information Center

    Geisler, Charles C.

    An alternative to the traditional land reform movement in the United States and the recent land use reform movement would result in a merging of social control with local control over land. Traditional land reformers perceive that land is a private commodity subject to fee-simple ownership and near absolute control over its use and disposition.…

  20. Clinically Apparent Internal Mammary Nodal Metastasis in Patients With Advanced Breast Cancer: Incidence and Local Control

    SciTech Connect

    Zhang Yujing; Oh, Julia L.; Whitman, Gary J.

    2010-07-15

    Purpose: To investigate the incidence and local control of internal mammary lymph node metastases (IMN+) in patients with clinical N2 or N3 locally advanced breast cancer. Methods and Materials: We retrospectively reviewed the records of 809 breast cancer patients diagnosed with advanced nodal disease (clinical N2-3) who received radiation treatment at our institution from January 2000 December 2006. Patients were considered IMN+ on the basis of imaging studies. Results: We identified 112 of 809 patients who presented with IMN+ disease (13.8%) detected on ultrasound, computed tomography (CT), positron emission tomography/CT (PET/CT), and/or magnetic resonance imaging (MRI) studies. All 112 patients with IMN+ disease received anthracycline and taxane-based chemotherapy. Neoadjuvant chemotherapy (NCT) resulted in a complete response (CR) on imaging studies of IMN disease in 72.1% of patients. Excluding 16 patients with progressive disease, 96 patients received adjuvant radiation to the breast or the chest wall and the regional lymphatics including the IMN chain with a median dose of 60 Gy if the internal mammary lymph nodes normalized after chemotherapy and 66 Gy if they did not. The median follow-up of surviving patients was 41 months (8-118 months). For the 96 patients able to complete curative therapy, the actuarial 5-year IMN control rate, locoregional control, overall survival, and disease-free survival were 89%, 80%, 76%, and 56%. Conclusion: Over ten percent of patients with advanced nodal disease will have IMN metastases on imaging studies. Multimodality therapy including IMN irradiation achieves excellent rates of control in the IMN region and a DFS of more than 50% after curative treatment.

  1. PRMT1-mediated arginine methylation controls ATXN2L localization

    SciTech Connect

    Kaehler, Christian; Guenther, Anika; Uhlich, Anja; Krobitsch, Sylvia

    2015-05-15

    Arginine methylation is a posttranslational modification that is of importance in diverse cellular processes. Recent proteomic mass spectrometry studies reported arginine methylation of ataxin-2-like (ATXN2L), the paralog of ataxin-2, a protein that is implicated in the neurodegenerative disorder spinocerebellar ataxia type 2. Here, we investigated the methylation state of ATXN2L and its significance for ATXN2L localization. We first confirmed that ATXN2L is asymmetrically dimethylated in vivo, and observed that the nuclear localization of ATXN2L is altered under methylation inhibition. We further discovered that ATXN2L associates with the protein arginine-N-methyltransferase 1 (PRMT1). Finally, we showed that neither mutation of the arginine–glycine-rich motifs of ATXN2L nor methylation inhibition alters ATXN2L localization to stress granules, suggesting that methylation of ATXN2L is probably not mandatory. - Highlights: • ATXN2L is asymmetrically dimethylated in vivo. • ATXN2L interacts with PRMT1 under normal and stress conditions. • PRMT1-mediated dimethylation of ATXN2L controls its nuclear localization. • ATXN2L localization to stress granules appears independent of its methylation state.

  2. Local control theory in trajectory-based nonadiabatic dynamics

    SciTech Connect

    Curchod, Basile F. E.; Penfold, Thomas J.; Rothlisberger, Ursula; Tavernelli, Ivano

    2011-10-15

    In this paper, we extend the implementation of nonadiabatic molecular dynamics within the framework of time-dependent density-functional theory in an external field described in Tavernelli et al.[Phys. Rev. A 81, 052508 (2010)] by calculating on-the-fly pulses to control the population transfer between electronic states using local control theory. Using Tully's fewest switches trajectory surface hopping method, we perform MD to control the photoexcitation of LiF and compare the results to quantum dynamics (QD) calculations performed within the Heidelberg multiconfiguration time-dependent Hartree package. We show that this approach is able to calculate a field that controls the population transfer between electronic states. The calculated field is in good agreement with that obtained from QD, and the differences that arise are discussed in detail.

  3. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  4. Circumcision: a refined technique and 5 year review.

    PubMed Central

    Tucker, S. C.; Cerqueiro, J.; Sterne, G. D.; Bracka, A.

    2001-01-01

    The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe with a haematoma rate of only 1.4%, and an overall complication rate of 3%. Images Figure 1 Figure 1 (G,H) Figure 2 PMID:11320921

  5. Migration of the Duraloc cup after 5 years.

    PubMed

    Stihsen, Christoph; Pabinger, Christof; Radl, Roman; Rehak, Peter; Windhager, Reinhard

    2008-12-01

    The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters > or = 54 mm migrated significantly more than cups < 54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%). PMID:17609953

  6. Predictive 5-Year Survivorship Model of Cystic Fibrosis

    PubMed Central

    Liou, Theodore G.; Adler, Frederick R.; FitzSimmons, Stacey C.; Cahill, Barbara C.; Hibbs, Jonathan R.; Marshall, Bruce C.

    2007-01-01

    The objective of this study was to create a 5-year survivorship model to identify key clinical features of cystic fibrosis. Such a model could help researchers and clinicians to evaluate therapies, improve the design of prospective studies, monitor practice patterns, counsel individual patients, and determine the best candidates for lung transplantation. The authors used information from the Cystic Fibrosis Foundation Patient Registry (CFFPR), which has collected longitudinal data on approximately 90% of cystic fibrosis patients diagnosed in the United States since 1986. They developed multivariate logistic regression models by using data on 5,820 patients randomly selected from 11,630 in the CFFPR in 1993. Models were tested for goodness of fit and were validated for the remaining 5,810 patients for 1993. The validated 5-year survivorship model included age, forced expiratory volume in 1 second as a percentage of predicted normal, gender, weight-for-age z score, pancreatic sufficiency, diabetes mellitus, Staphylococcus aureus infection, Burkerholderia cepacia infection, and annual number of acute pulmonary exacerbations. The model provides insights into the complex nature of cystic fibrosis and supplies a rigorous tool for clinical practice and research. PMID:11207152

  7. Local control of reactive power by distributed photovoltaic generators

    SciTech Connect

    Chertkov, Michael; Turitsyn, Konstantin; Sulc, Petr; Backhaus, Scott

    2010-01-01

    High penetration levels of distributed photovoltaic (PV) generation on an electrical distribution circuit may severely degrade power quality due to voltage sags and swells caused by rapidly varying PV generation during cloud transients coupled with the slow response of existing utility compensation and regulation equipment. Although not permitted under current standards for interconnection of distributed generation, fast-reacting, VAR-capable PV inverters may provide the necessary reactive power injection or consumption to maintain voltage regulation under difficult transient conditions. As side benefit, the control of reactive power injection at each PV inverter provides an opportunity and a new tool for distribution utilities to optimize the performance of distribution circuits, e.g. by minimizing thermal losses. We suggest a local control scheme that dispatches reactive power from each PV inverter based on local instantaneous measurements of the real and reactive components of the consumed power and the real power generated by the PVs. Using one adjustable parameter per circuit, we balance the requirements on power quality and desire to minimize thermal losses. Numerical analysis of two exemplary systems, with comparable total PV generation albeit a different spatial distribution, show how to adjust the optimization parameter depending on the goal. Overall, this local scheme shows excellent performance; it's capable of guaranteeing acceptable power quality and achieving significant saving in thermal losses in various situations even when the renewable generation in excess of the circuit own load, i.e. feeding power back to the higher-level system.

  8. Quality of local control for simple sewer networks

    NASA Astrophysics Data System (ADS)

    Kolechkina, Alla; van Nooijen, Ronald

    2016-04-01

    Combined sewer networks, where both foul water and storm water are transported through the same system, tend to develop into complex networks due to expansion of towns and villages. The transport capacity of these systems is always limited, so occasional controlled spills into surface water, combined sewer overflows (CSO), are part of the normal operating procedure. Occasionally the ideas and rules present in the original design are not respected when the system is extended to cover a larger area. One way to deal with this problem is to implement central control. Another is to add pipes and hardware to bring the extended system into line with the original rules and ideas. We show that for a design rule often followed in the Netherlands, local control does quite well as long as the rule is respected and there are no large variations in precipitation intensity over the area covered by the system.

  9. Torso RTK controls Capicua degradation by changing its subcellular localization.

    PubMed

    Grimm, Oliver; Sanchez Zini, Victoria; Kim, Yoosik; Casanova, Jordi; Shvartsman, Stanislav Y; Wieschaus, Eric

    2012-11-01

    The transcriptional repressor Capicua (Cic) controls multiple aspects of Drosophila embryogenesis and has been implicated in vertebrate development and human diseases. Receptor tyrosine kinases (RTKs) can antagonize Cic-dependent gene repression, but the mechanisms responsible for this effect are not fully understood. Based on genetic and imaging studies in the early Drosophila embryo, we found that Torso RTK signaling can increase the rate of Cic degradation by changing its subcellular localization. We propose that Cic is degraded predominantly in the cytoplasm and show that Torso reduces the stability of Cic by controlling the rates of its nucleocytoplasmic transport. This model accounts for the experimentally observed spatiotemporal dynamics of Cic in the early embryo and might explain RTK-dependent control of Cic in other developmental contexts. PMID:23048183

  10. Final Results of Local-Regional Control and Late Toxicity of RTOG 90-03; A Randomized Trial of Altered Fractionation Radiation for Locally Advanced Head And Neck Cancer

    PubMed Central

    Beitler, Jonathan J; Zhang, Qiang; Fu, Karen K; Trotti, Andy; Spencer, Sharon A; Jones, Christopher U; Garden, Adam S; Shenouda, George; Harris, Jonathan; Ang, Kian K

    2015-01-01

    Purpose To test whether altered radiation fractionation schemes improved local-regional control (LRC) rates for patients with squamous cell cancers (SCC) of the head and neck when compared to standard fractionation (SFX) of 70 Gy. Patients and Methods Patients with stage III or IV (or stage II base of tongue) SCC were randomized to 4 treatment arms: (1) SFX-70 Gy/35 daily fxns/7 week; (2) HFX-81.6 Gy/68 BID fxns/7 weeks; (3) AFX-S 67.2 Gy/42 fxns/6 weeks with a 2 week rest after 38.4 Gy; and (4) AFX-C 72 Gy/42 fxns/6 weeks. n=1,076. The 3 experimental arms were to be compared to SFX. Results With patients censored for LRC at 5 years, only the comparison of HFX with SFX was significantly different (HFX: Hazard Ratio-0.79(0.62–1.00), p=0.05; AFX-C 0.82 (0.65–1.05), p=0.11). Censored at 5 years, HFX improved Overall Survival (OS) (Hazard Ratio 0.81, p=0.05). Prevalence of any Grade 3, 4, or 5 toxicity at 5 years, any feeding tube use after 180 days, or feeding tube use at 1 year did not differ significantly when the experimental arms were compared to SFX. When 7 week treatments were compared to 6 week treatments, accelerated fractionation appeared to increase Grade 3, 4 or 5 toxicity at 5 years (p=0.06). Looking at the worst toxicity per patient by treatment only the AFX-C arm seemed to trend worse than the SFX arm when comparing Grade 0–2 vs. 3–5 toxicity(p=0.09). Conclusions At 5 years, only HFX improved LRC & OS for patients with locally advanced SCC without increasing late toxicity. PMID:24613816

  11. Immunogenicity of a low-dose diphtheria, tetanus and acellular pertussis combination vaccine with either inactivated or oral polio vaccine compared to standard-dose diphtheria, tetanus, acellular pertussis when used as a pre-school booster in UK children: A 5-year follow-up of a randomised controlled study.

    PubMed

    John, T; Voysey, M; Yu, L M; McCarthy, N; Baudin, M; Richard, P; Fiquet, A; Kitchin, N; Pollard, A J

    2015-08-26

    This serological follow up study assessed the kinetics of antibody response in children who previously participated in a single centre, open-label, randomised controlled trial of low-dose compared to standard-dose diphtheria booster preschool vaccinations in the United Kingdom (UK). Children had previously been randomised to receive one of three combination vaccines: either a combined adsorbed tetanus, low-dose diphtheria, 5-component acellular pertussis and inactivated polio vaccine (IPV) (Tdap-IPV, Repevax(®); Sanofi Pasteur MSD); a combined adsorbed tetanus, low-dose diphtheria and 5-component acellular pertussis vaccine (Tdap, Covaxis(®); Sanofi Pasteur MSD) given concomitantly with oral polio vaccine (OPV); or a combined adsorbed standard-dose diphtheria, tetanus, 2-component acellular pertussis and IPV (DTap-IPV, Tetravac(®); Sanofi Pasteur MSD). Blood samples for the follow-up study were taken at 1, 3 and 5 years after participation in the original trial (median, 5.07 years of age at year 1), and antibody persistence to each vaccine antigen measured against defined serological thresholds of protection. All participants had evidence of immunity to diphtheria with antitoxin concentrations greater than 0.01IU/mL five years after booster vaccination and 75%, 67% and 79% of children who received Tdap-IPV, Tdap+OPV and DTap-IPV, respectively, had protective antitoxin levels greater than 0.1IU/mL. Long lasting protective immune responses to tetanus and polio antigens were also observed in all groups, though polio responses were lower in the sera of those who received OPV. Low-dose diphtheria vaccines provided comparable protection to the standard-dose vaccine and are suitable for use for pre-school booster vaccination. PMID:26165918

  12. Curvature-Controlled Defect Localization in Elastic Surface Crystals

    NASA Astrophysics Data System (ADS)

    Jiménez, Francisco López; Stoop, Norbert; Lagrange, Romain; Dunkel, Jörn; Reis, Pedro M.

    2016-03-01

    We investigate the influence of curvature and topology on crystalline dimpled patterns on the surface of generic elastic bilayers. Our numerical analysis predicts that the total number of defects created by adiabatic compression exhibits universal quadratic scaling for spherical, ellipsoidal, and toroidal surfaces over a wide range of system sizes. However, both the localization of individual defects and the orientation of defect chains depend strongly on the local Gaussian curvature and its gradients across a surface. Our results imply that curvature and topology can be utilized to pattern defects in elastic materials, thus promising improved control over hierarchical bending, buckling, or folding processes. Generally, this study suggests that bilayer systems provide an inexpensive yet valuable experimental test bed for exploring the effects of geometrically induced forces on assemblies of topological charges.

  13. Local and Remote Controls on Forced Sahelian Rainfall

    NASA Astrophysics Data System (ADS)

    Hill, S. A.; Ming, Y.

    2014-12-01

    Some models dry the African Sahel in response to uniform SST warming; others wetten it. Myriad local and remote processes determine this behavior, their relative importance and interactions uncertain. We present a conceptual framework for Sahelian rainfall centered on the region's moist stability, in which local processes dictate near-surface moist static energy (MSE) and remote convection controls MSE aloft via the weak temperature gradient dynamical constraint. A remote region's influence depends on that region's (1) convection characteristics relative to Sahelian convection and (2) proximity to the Sahel. We present tests of this picture from a series of atmospheric general circulation model simulations, discuss its limitations, and speculate on its applicability to other regions.

  14. Local implementation of cancer control activities in rural Appalachia, 2006.

    PubMed

    Behringer, Bruce; Mabe, Karen Harrell; Dorgan, Kelly A; Hutson, Sadie P

    2009-01-01

    Underserved communities with high cancer rates often are not involved in implementing state cancer control activities locally. An East Tennessee State University research team formed 2 Appalachian Community Cancer Research Review Work Groups, 1 in northeast Tennessee and 1 in southwest Virginia. During 4 sessions, the research team presented regional cancer data to the work groups. Work group participants explored research from a lay perspective and identified possible reasons for cancer disparities in central Appalachia. The fifth session was a community dissemination activity in which work group participants engaged in cancer education and action by presenting the research to their local communities in unique ways. During a sixth session, both work groups discussed these interventions and further attempted to answer the question, "What makes the experience of cancer unique in Appalachia?" This article describes the key steps of this community-based participatory research process. PMID:19080040

  15. Understanding persistence in bulimia nervosa: a 5-year naturalistic study.

    PubMed

    Fairburn, Christopher G; Stice, Eric; Cooper, Zafra; Doll, Helen A; Norman, Patricia A; O'Connor, Marianne E

    2003-02-01

    Bulimia nervosa shows a marked tendency to persist, suggesting that powerful maintaining mechanisms operate. Using data from a prospective, 5-year, study of the natural course of 102 people with bulimia nervosa, the authors sought to identify predictors of persistence and to test specific hypotheses derived from the cognitive-behavioral theory of the persistence of bulimia nervosa. The results of both sets of analyses were consistent with the theory, with the degree of overevaluation of shape and weight and a history of childhood obesity predicting a persistent course. There was also support for the central prediction of the cognitive-behavioral theory. These findings suggest that the mechanisms specified by the theory influence its longer term natural course. PMID:12602430

  16. Control of tissue growth by locally produced activator: Liver regeneration

    NASA Astrophysics Data System (ADS)

    Zhdanov, Vladimir P.

    2015-03-01

    In general, the tissue development is controlled by growth factors and depends on the biomechanics of cells. The corresponding kinetic models are focused primarily on the early stages of the development. The attempts to construct such models for the later stages are still rare. One of the notable examples here is liver regeneration. Referring to this process, the author proposes and analyzes a generic kinetic model describing the regulation of tissue growth by locally produced activator. The model includes activator diffusion and control of the rate of cell proliferation which is described by using the Hill expression. Although this control may be moderately or strongly non-linear, the qualitative changes in the regeneration kinetics are predicted to be modest. For moderately non-linear control, the evolution of the tissue volume to the steady-state value exhibits an initial relatively short linear stage and then becomes slightly slower so that the whole kinetics is close to exponential. For strongly non-linear control, the linear stage dominates and/or the kinetics may exhibit a S-like shape feature which is, however, rather weak. The identification of such qualitative features in experimentally measured kinetics is shown to be difficult, because the error bars in the experiments are typically too large.

  17. Changes in Exercise Capacity of Cardiac Asymptomatic Hereditary Hemochromatosis Subjects over 5-Year Follow up

    PubMed Central

    Shizukuda, Yukitaka; Smith, Kevin P.; Tripodi, Dorothy J.; Arena, Ross; Yau, Yu-Ying; Bolan, Charles D.; Waclawiw, Myron A.; Leitman, Susan F.; Rosing, Douglas R.

    2012-01-01

    Objective A long-term effect of hereditary hemochromatosis (HH) on aerobic exercise capacity (AEC) has not been well described. Design Forty-three HH and 21 volunteer control (VC) subjects who were asymptomatic underwent cardiopulmonary exercise testing using the Bruce protocol. AEC was assessed with minute ventilation (VE), oxygen uptake (VO2), and carbon dioxide production (VCO2) at baseline (BL) at a 5-year follow up (5Y) assessment. A paired t-test was used for analyses of normality data; otherwise, a Wilcoxon singed rank sum test was used. Results Thirty-three HH subjects and 18 VC subjects returned for a repeat CPX at 5Y (80% overall return rate). At 5Y, AEC was not different between the two groups. As compared with BL measurements, exercise time, peak VO2, and the VE/VCO2 slope did not differ statistically at 5Y between both groups. Iron depletion by phlebotomy for 5 years did not significantly affect AEC in newly diagnosed HH subjects at baseline (n=14) and cardiac arrhythmias during exercise tended to decrease after 5 years of therapy in this group. Conclusions The AEC of asymptomatic HH subjects treated with conventional therapy is not statistically affected by the disease over a 5-year period. PMID:22311055

  18. Control of local immunity by airway epithelial cells.

    PubMed

    Weitnauer, M; Mijošek, V; Dalpke, A H

    2016-03-01

    The lung is ventilated by thousand liters of air per day. Inevitably, the respiratory system comes into contact with airborne microbial compounds, most of them harmless contaminants. Airway epithelial cells are known to have innate sensor functions, thus being able to detect microbial danger. To avoid chronic inflammation, the pulmonary system has developed specific means to control local immune responses. Even though airway epithelial cells can act as proinflammatory promoters, we propose that under homeostatic conditions airway epithelial cells are important modulators of immune responses in the lung. In this review, we discuss epithelial cell regulatory functions that control reactivity of professional immune cells within the microenvironment of the airways and how these mechanisms are altered in pulmonary diseases. Regulation by epithelial cells can be divided into two mechanisms: (1) mediators regulate epithelial cells' innate sensitivity in cis and (2) factors are produced that limit reactivity of immune cells in trans. PMID:26627458

  19. TDDFT-based local control theory for chemical reactions

    NASA Astrophysics Data System (ADS)

    Tavernelli, Ivano; Curchod, Basile F. E.; Penfold, Thomas J.

    In this talk I will describe the implementation of local control theory for laser pulse shaping within the framework of TDDFT-based nonadiabatic dynamics. The method is based on a set of modified Tully's surface hopping equations and provides an efficient way to control the population of a selected reactive state of interest through the coupling with an external time-dependent electric field generated on-the-fly during the dynamics. This approach is applied to the investigation of the photoinduced intramolecular proton transfer reaction in 4-hydroxyacridine in gas phase and in solution. The generated pulses reveal important information about the underlying excited-state nuclear dynamics highlighting the involvement of collective vibrational modes that would be neglected in studies performed on model systems. Finally, this approach can help to shed new light on the photophysics and photochemistry of complex molecular systems and guide the design of novel reaction paths.

  20. Controlling a microdisk laser by local refractive index perturbation

    NASA Astrophysics Data System (ADS)

    Liew, Seng Fatt; Ge, Li; Redding, Brandon; Solomon, Glenn S.; Cao, Hui

    2016-02-01

    We demonstrate a simple yet effective approach of controlling lasing in a semiconductor microdisk by photo-thermal effect. A continuous wave green laser beam, focused onto the microdisk perimeter, can enhance or suppress lasing in different cavity modes, depending on the position of the focused beam. Its main effect is a local modification of the refractive index of the disk, which results in an increase in the power slope of some lasing modes and a decrease of others. The boundary roughness breaks the rotational symmetry of a circular disk, allowing the lasing process to be tuned by varying the green beam position. Using the same approach, we can also fine tune the relative intensity of a quasi-degenerate pair of lasing modes. Such post-fabrication control, enabled by an additional laser beam, is flexible and reversible, thus enhancing the functionality of semiconductor microdisk lasers.

  1. Nitrogen fixation control under drought stress. Localized or systemic?

    PubMed

    Marino, Daniel; Frendo, Pierre; Ladrera, Ruben; Zabalza, Ana; Puppo, Alain; Arrese-Igor, Cesar; González, Esther M

    2007-04-01

    Legume-Rhizobium nitrogen fixation is dramatically affected under drought and other environmental constraints. However, it has yet to be established as to whether such regulation of nitrogen fixation is only exerted at the whole-plant level (e.g. by a systemic nitrogen feedback mechanism) or can also occur at a local nodule level. To address this question, nodulated pea (Pisum sativum) plants were grown in a split-root system, which allowed for half of the root system to be irrigated at field capacity, while the other half was water deprived, thus provoking changes in the nodule water potential. Nitrogen fixation only declined in the water-deprived, half-root system and this result was correlated with modifications in the activities of key nodule's enzymes such as sucrose synthase and isocitrate dehydrogenase and in nodular malate content. Furthermore, the decline in nodule water potential resulted in a cell redox imbalance. The results also indicate that systemic nitrogen feedback signaling was not operating in these water-stressed plants, since nitrogen fixation activity was maintained at control values in the watered half of the split-root plants. Thus, the use of a partially droughted split-root system provides evidence that nitrogen fixation activity under drought stress is mainly controlled at the local level rather than by a systemic nitrogen signal. PMID:17416644

  2. Local problems, local solutions: improving tuberculosis control at the district level in Malawi.

    PubMed Central

    Kelly, P. M.

    2001-01-01

    OBJECTIVE: To examine the causes of a low cure rate at the district level of a tuberculosis (TB) control programme and to formulate, implement, and evaluate an intervention to improve the situation. METHODS: The study setting was Mzuzu (population 60,000), where the annual smear-positive pulmonary TB incidence was 160 per 100,000 and the human immunodeficiency virus (HIV) seroprevalence was 67% among TB patients. There is one TB treatment unit, but several other organizations are involved with TB control. An examination of case-holding activities was carried out, potential areas for improvement were identified, and interventions performed. FINDINGS: In 1990-91, the cure rate was 24% among smear-positive cases (29% among survivors to end of treatment). Problems identified included a fragmented TB control programme; inadequate training and supervision; suboptimal recording of patients' addresses; and nonadherence to national TB control programme protocols. These problems were addressed, and in 1992-93 the cure rate rose to 68% (relative risk (RR) = 2.85 (95% confidence interval (CI) = 1.63, 4.96)) and to 92% among survivors to the end of treatment (RR = 3.12 (95% CI = 1.84, 5.29)). High cure rates are therefore achievable despite high HIV prevalence. CONCLUSIONS: Simple, inexpensive, local programmatic interventions can dramatically improve TB case holding. This study demonstrates the need for evaluation, training, and supervision at all levels of the programme. PMID:11242817

  3. Evaluating the effectiveness of localized control strategies to curtail chikungunya

    PubMed Central

    Ndeffo-Mbah, Martial L.; Durham, David P.; Skrip, Laura A.; Nsoesie, Elaine O.; Brownstein, John S.; Fish, Durland; Galvani, Alison P.

    2016-01-01

    Chikungunya, a re-emerging arbovirus transmitted to humans by Aedes aegypti and Ae. albopictus mosquitoes, causes debilitating disease characterized by an acute febrile phase and chronic joint pain. Chikungunya has recently spread to the island of St. Martin and subsequently throughout the Americas. The disease is now affecting 42 countries and territories throughout the Americas. While chikungunya is mainly a tropical disease, the recent introduction and subsequent spread of Ae. albopictus into temperate regions has increased the threat of chikungunya outbreaks beyond the tropics. Given that there are currently no vaccines or treatments for chikungunya, vector control remains the primary measure to curtail transmission. To investigate the effectiveness of a containment strategy that combines disease surveillance, localized vector control and transmission reduction measures, we developed a model of chikungunya transmission dynamics within a large residential neighborhood, explicitly accounting for human and mosquito movement. Our findings indicate that prompt targeted vector control efforts combined with measures to reduce transmission from symptomatic cases to mosquitoes may be highly effective approaches for controlling outbreaks of chikungunya, provided that sufficient detection of chikungunya cases can be achieved. PMID:27045523

  4. Flutter of wings involving a locally distributed flexible control surface

    NASA Astrophysics Data System (ADS)

    Mozaffari-Jovin, S.; Firouz-Abadi, R. D.; Roshanian, J.

    2015-11-01

    This paper undertakes to facilitate appraisal of aeroelastic interaction of a locally distributed, flap-type control surface with aircraft wings operating in a subsonic potential flow field. The extended Hamilton's principle serves as a framework to ascertain the Euler-Lagrange equations for coupled bending-torsional-flap vibration. An analytical solution to this boundary-value problem is then accomplished by assumed modes and the extended Galerkin's method. The developed aeroelastic model considers both the inherent flexibility of the control surface displaced on the wing and the inertial coupling between these two flexible bodies. The structural deformations also obey the Euler-Bernoulli beam theory, along with the Kelvin-Voigt viscoelastic constitutive law. Meanwhile, the unsteady thin-airfoil and strip theories are the tools of producing the three-dimensional airloads. The origin of aerodynamic instability undergoes analysis in light of the oscillatory loads as well as the loads owing to arbitrary motions. After successful verification of the model, a systematic flutter survey was conducted on the theoretical effects of various control surface parameters. The results obtained demonstrate that the flapping modes and parameters of the control surface can significantly impact the flutter characteristics of the wings, which leads to a series of pertinent conclusions.

  5. Outpatient and Home Chemotherapy with Novel Local Control Strategies in Desmoplastic Small Round Cell Tumor

    PubMed Central

    Aguilera, Dolly; Hayes-Jordan, Andrea; Anderson, Peter; Woo, Shiao; Pearson, Margaret; Green, Holly

    2008-01-01

    Desmoplastic Small Round Cell Tumor (DSRCT) has a very poor prognosis. This report illustrates novel chemotherapy and local control interventions in a 5-year old patient. The patient was treated in the outpatient setting, achieved remission, with excellent quality of life. The patient presented with massive ascites and >1000 abdominal tumors. Neoadjuvant chemotherapy included vincristine (1.5 mg/m2), ifosfamide (3 g/m2/day × 3), dexrazoxane/doxorubicin (750/75 mg/m2), and etoposide (150 mg/m2). Continuous hyperthermic peritoneal perfusion (CHPP) with cisplatin (100 mg/m2) was given after extensive cytoreductive surgery. This was followed by irinotecan (10 mg/m2/day × 5 × 2 weeks) + temozolomide monthly × 2, then abdominal radiation 30 Gy with simultaneous temozolomide (100 mg/m2/day × 5). A total of 12 cycles of irinotecan and temozolamide were given. Except for initial chemotherapy, subsequent courses were in the outpatient setting. Focal retroperitoneal relapse at 18 months was treated with IMRT with bevacizumab (5 mg/kg) and 2 perihepatic metastases with radio frequency ablation/cryoablation followed by chronic outpatient maintenance chemotherapy (valproic acid, cyclophosphamide, and rapamycin). Almost 2 years from diagnosis, the patient maintained an excellent quality of life. This is a novel approach to the treatment of children with massive abdomino-pelvic DSRCT. PMID:18566684

  6. Interaction Between Strategic and Local Traffic Flow Controls

    NASA Technical Reports Server (NTRS)

    Grabbe, Son; Sridhar, Banavar; Mukherjee, Avijit; Morando, Alexander

    2010-01-01

    The loosely coordinated sets of traffic flow management initiatives that are operationally implemented at the national- and local-levels have the potential to under, over, and inconsistently control flights. This study is designed to explore these interactions through fast-time simulations with an emphasis on identifying inequitable situations in which flights receive multiple uncoordinated delays. Two operationally derived scenarios were considered in which flights arriving into the Dallas/Fort Worth International Airport were first controlled at the national-level, either with a Ground Delay Program or a playbook reroute. These flights were subsequently controlled at the local level. The Traffic Management Advisor assigned them arrival scheduling delays. For the Ground Delay Program scenarios, between 51% and 53% of all arrivals experience both pre-departure delays from the Ground Delay Program and arrival scheduling delays from the Traffic Management Advisor. Of the subset of flights that received multiple delays, between 5.7% and 6.4% of the internal departures were first assigned a pre-departure delay by the Ground Delay Program, followed by a second pre-departure delay as a result of the arrival scheduling. For the playbook reroute scenario, Dallas/Fort Worth International Airport arrivals were first assigned pre-departure reroutes based on the MW_2_DALLAS playbook plan, and were subsequently assigned arrival scheduling delays by the Traffic Management Advisor. Since the airport was operating well below capacity when the playbook reroute was in effect, only 7% of the arrivals were observed to receive both rerouting and arrival scheduling delays. Findings from these initial experiments confirm field observations that Ground Delay Programs operated in conjunction with arrival scheduling can result in inequitable situations in which flights receive multiple uncoordinated delays.

  7. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    PubMed

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

  8. NASA Infrared Telescope Facility- The Next 5 Years

    NASA Astrophysics Data System (ADS)

    Tokunaga, A. T.; Bus, S. J.; Tollestrup, E. V.; Rayner, J. T.

    2005-08-01

    The NASA Infrared Telescope Facility (IRTF) is a 3-meter optical/IR telescope dedicated to NASA-related programs of mission support and basic solar system research. All of the funding for IRTF operations comes from the Planetary Astronomy Program. We are preparing the Cooperative Agreement with NASA for the next 5 years (Feb. 2006 -- Jan. 2011). We will strive to refurbish the telescope in order to provide mission support and to allow the IRTF to provide fundamental data for future missions to Mars, comets, satellites, Near-Earth Objects, and asteroids. A major component of our activities will be to improve the image quality of the telescope and to provide high dynamic imaging on the IRTF. Details of our plans can be obtained at: http://irtfweb.ifa.hawaii.edu/Documents/pdf/1_plan_mar04C.pdf We acknowledge the support of NASA Cooperative Agreement no. NCC 5-538 with the National Aeronautics and Space Administration, Planetary Astronomy Program.

  9. Prediction of 5-Year Survival with Data Mining Algorithms.

    PubMed

    Sailer, Fabian; Pobiruchin, Monika; Bochum, Sylvia; Martens, Uwe M; Schramm, Wendelin

    2015-01-01

    Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. However, predicting the outcome of cancer on the basis of clinical information is a challenging task. We now examined the ability of ten different data mining algorithms (Perceptron, Rule Induction, Support Vector Machine, Linear Regression, Naïve Bayes, Decision Tree, k-nearest Neighbor, Logistic Regression, Neural Network, Random Forest) to predict the dichotomous attribute "5-year-survival" based on seven attributes (sex, UICC-stage, etc.) which are available at the time of diagnosis. For this study we made use of the nationwide German research data set on colon cancer provided by the Robert Koch Institute. To assess the results a comparison between data mining algorithms and physicians' opinions was performed. Therefore, physicians guessed the survival time by leveraging the same seven attributes. The average accuracy of the physicians' opinion was 59%, the average accuracy of the machine learning algorithms was 67.7%. PMID:26152957

  10. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India

    PubMed Central

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1st5-year plan. A progressive path of development could be observed since the first to the 12th5-year plan. It was up to the 7thplan the growth was little sluggish and from 8thplan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11th5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of “Mainstreaming of AYUSH and revitalization of local health traditions” to strengthen public health services. This scheme is currently in operation in its second phase, since 1stApril 2012, with the 12th5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this study, the

  11. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India.

    PubMed

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1(st)5-year plan. A progressive path of development could be observed since the first to the 12(th)5-year plan. It was up to the 7(th)plan the growth was little sluggish and from 8(th)plan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11(th)5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of "Mainstreaming of AYUSH and revitalization of local health traditions" to strengthen public health services. This scheme is currently in operation in its second phase, since 1(st)April 2012, with the 12(th)5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this

  12. Impulse-induced localized control of chaos in starlike networks

    NASA Astrophysics Data System (ADS)

    Chacón, Ricardo; Palmero, Faustino; Cuevas-Maraver, Jesús

    2016-06-01

    Locally decreasing the impulse transmitted by periodic pulses is shown to be a reliable method of taming chaos in starlike networks of dissipative nonlinear oscillators, leading to both synchronous periodic states and equilibria (oscillation death). Specifically, the paradigmatic model of damped kicked rotators is studied in which it is assumed that when the rotators are driven synchronously, i.e., all driving pulses transmit the same impulse, the networks display chaotic dynamics. It is found that the taming effect of decreasing the impulse transmitted by the pulses acting on particular nodes strongly depends on their number and degree of connectivity. A theoretical analysis is given explaining the basic physical mechanism as well as the main features of the chaos-control scenario.

  13. Impulse-induced localized control of chaos in starlike networks.

    PubMed

    Chacón, Ricardo; Palmero, Faustino; Cuevas-Maraver, Jesús

    2016-06-01

    Locally decreasing the impulse transmitted by periodic pulses is shown to be a reliable method of taming chaos in starlike networks of dissipative nonlinear oscillators, leading to both synchronous periodic states and equilibria (oscillation death). Specifically, the paradigmatic model of damped kicked rotators is studied in which it is assumed that when the rotators are driven synchronously, i.e., all driving pulses transmit the same impulse, the networks display chaotic dynamics. It is found that the taming effect of decreasing the impulse transmitted by the pulses acting on particular nodes strongly depends on their number and degree of connectivity. A theoretical analysis is given explaining the basic physical mechanism as well as the main features of the chaos-control scenario. PMID:27415258

  14. A fuzzy controller with nonlinear control rules is the sum of a global nonlinear controller and a local nonlinear PI-like controller

    NASA Technical Reports Server (NTRS)

    Ying, Hao

    1993-01-01

    The fuzzy controllers studied in this paper are the ones that employ N trapezoidal-shaped members for input fuzzy sets, Zadeh fuzzy logic and a centroid defuzzification algorithm for output fuzzy set. The author analytically proves that the structure of the fuzzy controllers is the sum of a global nonlinear controller and a local nonlinear proportional-integral-like controller. If N approaches infinity, the global controller becomes a nonlinear controller while the local controller disappears. If linear control rules are used, the global controller becomes a global two-dimensional multilevel relay which approaches a global linear proportional-integral (PI) controller as N approaches infinity.

  15. Parameters influencing local control of meningiomas treated with radiosurgery.

    PubMed

    Kaprealian, Tania; Raleigh, David R; Sneed, Penny K; Nabavizadeh, Nima; Nakamura, Jean L; McDermott, Michael W

    2016-06-01

    To identify parameters that influence local control after stereotactic radiosurgery (SRS) for meningiomas we retrospectively analyzed all meningiomas treated with Gamma Knife SRS at our institution from 1991 to 2007. Endpoints were measured from the date of SRS and estimated using the Kaplan-Meier method; subgroups were compared with log-rank tests. Sex, performance status, age, SRS setting, radiation dose, grade, volume and location were evaluated with univariate and multivariate Cox proportional hazards analyses. Of 280 patients with 438 tumors, 264 patients with clinical follow-up and 406 tumors with imaging follow-up were analyzed (median follow-up: 75.9 months). Thirty-seven percent of the tumors had no tissue diagnosis, 32 % were benign (grade I), 12 % atypical (grade II), and 19 % malignant (grade III). Five-year freedom from progression (FFP) was 97 % for presumed meningiomas, 87 % for grade I tumors, 56 % for grade II tumors, and 47 % for grade III tumors (p < 0.0001). Five-year FFP probabilities for upfront SRS versus SRS at recurrence after surgery versus SRS at recurrence after RT were 97, 86, and 38 %, respectively (p < 0.0001). Univariate analysis revealed that higher grade, larger target volume (median diameter: 2.4 cm) and SRS setting were associated with poorer FFP. Only target volume and SRS setting remained significant on multivariate analysis. Local control of presumed and grade I meningiomas is excellent with Gamma Knife SRS, but is suboptimal with high-grade tumors as well as for those treated at recurrence after RT or of large volume. PMID:27131883

  16. Endocrine and Local Control of the Primate Corpus Luteum

    PubMed Central

    Stouffer, Richard L.; Bishop, Cecily V.; Bogan, Randy L.; Xu, Fuhua; Hennebold, Jon D.

    2014-01-01

    The primate corpus luteum is a transient endocrine gland that differentiates from the ovulatory follicle midway through the ovarian (menstrual) cycle. Its formation and limited lifespan is critical for fertility, as luteal-derived progesterone is the essential steroid hormone required for embryo implantation and maintenance of intra-uterine pregnancy until the placenta develops. It is well-established that LH and the LH-like hormone, CG, are the vital luteotropic hormones during the menstrual cycle and early pregnancy, respectively. Recent advances, particularly through genome analyses and cellular studies, increased our understanding of various local factors and cellular processes associated with the development, maintenance and repression of the corpus luteum. These include paracrine or autocrine factors associated with angiogenesis (e.g., VEGF), and that mediate LH/CG actions (e.g., progesterone), or counteract luteotropic effects (i.e., local luteolysis; e.g., PGF2α). However, areas of mystery and controversy remain, particularly regarding the signals and events that initiate luteal regression in the non-fecund cycle. Novel approaches capable of gene “knockdown” or amplification”, in vivo as well as in vitro, should identify novel or underappreciated gene products that are regulated by or modulate LH/CG actions to control the functional lifespan of the primate corpus luteum. Further advances in our understanding of luteal physiology will help to improve or control fertility for purposes ranging from preservation of endangered primate species to designing novel ovary-based contraceptives and treating ovarian disorders in women. R01 HD020869, R01 HD042000, U54 HD018185, U54 HD055744, P51 OD011092, T32 HD007133, Bayer Schering Pharma AG. PMID:24287034

  17. Blunt traumatic cardiac rupture. A 5-year experience.

    PubMed

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  18. Working with Workflows: Highlights from 5 years Building Scientific Workflows

    SciTech Connect

    Critchlow, Terence J.; Altintas, Ilkay; Chin, George; Crawl, Daniel; Iyer, H.; Khan, Ayla; Klasky, S.; Koehler, Sven; Ludaescher, Bertram T.; Mouallem, Pierre; Nagappan, Mie; Podhorszki, Norbert; Shoshani, Arie; Silva, C.; Tchoua, Roselynne; Vouk, M.

    2011-07-30

    In 2006, the SciDAC Scientific Data Management (SDM) Center proposed to continue its work deploying leading edge data management and analysis capabilities to scientific applications. One of three thrust areas within the proposed center was focused on Scientific Process Automation (SPA) using workflow technology. As a founding member of the Kepler consortium [LAB+09], the SDM Center team was well positioned to begin deploying workflows immediately. We were also keenly aware of some of the deficiencies in Kepler when applied to high performance computing workflows, which allowed us to focus our research and development efforts on critical new capabilities which were ultimately integrated into the Kepler open source distribution, benefiting the entire community. Significant work was required to ensure Kepler was capable of supporting large-scale production runs for SciDAC applications. Our work on generic actors and templates have improved the portability of workflows across machines and provided a higher level of abstraction for workflow developers. Fault tolerance and provenance tracking were obvious areas for improvement within Kepler given the longevity and complexity of our target workflows. To monitor workflow execution, we developed and deployed a web-based dashboard. We then generalized this interface and released it so it could be deployed at other locations. Outreach has always been a primary focus of our work and we had many successful deployments across a number of scientific domains while continually publishing and presenting our work. This short paper describes our most significant accomplishments over the past 5 years. Additional information about the SDM Center can be found in the companion paper: The Scientific Data Management Center: Available Technologies and Highlights.

  19. Controlling the localization and migration of optical excitation

    NASA Astrophysics Data System (ADS)

    Andrews, David L.; Bradshaw, David S.

    2012-09-01

    In the nanoscale structure of a wide variety of material systems, a close juxtaposition of optically responsive components can lead to the absorption of light by one species producing fluorescence that is clearly attributable to another. The effect is generally evident in systems comprising two or more light-absorbing components (molecules, chromophores or quantum dots) with well-characterised fluorescence bands at similar, differentiable wavelengths. This enables the fluorescence associated with transferred energy to be discriminated against fluorescence from an initially excited component. The fundamental mechanism at the heart of the phenomenon, molecular (resonance) energy transfer, also operates in systems where the product of optical absorption is optical frequency up-conversion. In contrast to random media, structurally organised materials offer the possibility of pre-configured control over the delocalization of energy, through molecular energy transfer following optical excitation. The Förster mechanism that conveys energy between molecular-scale components is strongly sensitive to specific forms of correlation between the involved components, in terms of position, spectroscopic character, and orientation; one key factor is a spectroscopic gradient. Suitably designed materials offer a broad scope for the widespread exploitation of such features, in applications ranging from chemical and biological sensing to the detection of nanoscale motion or molecular conformations. Recently, attention has turned to the prospect of actively controlling the process of energy migration, for example by changing the relative efficiencies of fluorescence and molecular energy transfer. On application of static electric fields or off-resonant laser light - just two of the possibilities - each represents a means for achieving active control with ultrafast response, in suitably configured systems. As the principles are established and the theory is developed, a range of new

  20. Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity

    PubMed Central

    2014-01-01

    Purpose To evaluate efficacy and toxicity after salvage brachytherapy (BT) in prostate local recurrence after radiation therapy. Methods and materials Between 1993 and 2007, we retrospectively analyzed 56 consecutively patients (pts) undergoing salvage brachytherapy. After local biopsy-proven recurrence, pts received 145 Gy LDR-BT (37 pts, 66%) or HDR-BT (19 pts, 34%) in different dose levels according to biological equivalent doses (BED2 Gy). By the time of salvage BT, only 15 pts (27%) received ADT. Univariate and multivariate analyses were performed to identify predictors of biochemical control and toxicities. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were graded using Common Terminology Criteria for Adverse Events (CTCv3.0). Results Median follow-up after salvage BT was 48 months. The 5-year FFbF was 77%. HDR and LDR late grade 3 GU toxicities were observed in 21% and 24%. Late grade 3 GI toxicities were observed in 2% (HDR) and 2.7% (LDR). On univariate analysis, pre-salvage prostate-specific antigen (PSA) > 10 ng/ml (p = 0.004), interval to relapse after initial treatment < 24 months (p = 0.004) and salvage HDR-BT doses BED2 Gy level < 227 Gy (p = 0.012) were significant in predicting biochemical failure. On Cox multivariate analysis, pre-salvage PSA, and time to relapse were significant in predicting biochemical failure. HDR-BT BED2 Gy (α/β 1.5 Gy) levels ≥ 227 (p = 0.013), and ADT (p = 0.049) were significant in predicting grade ≥ 2 urinary toxicity. Conclusions Prostate BT is an effective salvage modality in some selected prostate local recurrence patients after radiation therapy. Even, we provide some potential predictors of biochemical control and toxicity for prostate salvage BT, further investigation is recommended. PMID:24885287

  1. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    PubMed Central

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  2. A 5-year experience with an elective scholarly concentrations program

    PubMed Central

    George, Paul; Green, Emily P.; Park, Yoon S.; Gruppuso, Philip A.

    2015-01-01

    Problem Programs that encourage scholarly activities beyond the core curriculum and traditional biomedical research are now commonplace among US medical schools. Few studies have generated outcome data for these programs. The goal of the present study was to address this gap. Intervention The Scholarly Concentration (SC) Program, established in 2006 at the Warren Alpert Medical School of Brown University, is a 4-year elective program that not only encourages students to pursue scholarly work that may include traditional biomedical research but also seeks to broaden students’ focus to include less traditional areas. We compared characteristics and academic performance of SC students and non-SC students for the graduating classes of 2010–2014. Context Approximately one-third of our students opt to complete an SC during their 4-year undergraduate medical education. Because this program is additional to the regular MD curriculum, we sought to investigate whether SC students sustained the academic achievement of non-SC students while at the same time producing scholarly work as part of the program. Outcome Over 5 years, 35% of students elected to enter the program and approximately 81% of these students completed the program. The parameters that were similar for both SC and non-SC students were age at matriculation, admission route, proportion of undergraduate science majors, and number of undergraduate science courses. Most academic indicators, including United States Medical Licensing Examinations scores, were similar for the two groups; however, SC students achieved more honors in the six core clerkships and were more likely to be inducted into the medical school's two honor societies. Residency specialties selected by graduates in the two groups were similar. SC students published an average of 1.3 peer-reviewed manuscripts per student, higher than the 0.8 manuscripts per non-SC student (p=0.013). Conclusions An elective, interdisciplinary scholarly program with

  3. Copolymeric nanofilm platform for controlled and localized therapeutic delivery.

    PubMed

    Chow, Edward Kai-Hua; Pierstorff, Erik; Cheng, Genhong; Ho, Dean

    2008-01-01

    Nanomaterials such as block copolymeric membranes provide a platform for both cellular interrogation and biological mimicry. Their biomimetic properties are based upon the innate possession of hydrophilic and hydrophobic units that enable their integration with a broad range of therapeutic materials. As such, they can be engineered for specific applications in nanomedicine, including controlled/localized drug delivery. Here we describe a method for the functionalization of the polymethyloxazoline-polydimethylsiloxane-polymethyloxazoline (PMOXA-PDMS-PMOXA) block copolymer with anti-inflammatory molecules to develop copolymer-therapeutic hybrids, effectively conferring biological functionality to a versatile synthetic nanomembrane matrix and creating a platform for an anti-inflammatory drug delivery system. Utilizing self-assembly and Langmuir-Blodgett deposition methods, we mixed copolymers with dexamethasone (Dex), an anti-inflammatory glucocorticoid receptor agonist. The successful mixing of the copolymer with the drug was confirmed by surface pressure isotherms and fluorescence microscopy. Furthermore, at 4 nm thick per layer, orders of magnitude thinner than conventional drug delivery coatings, these dexamethasone-copolymer mixtures (PolyDex) suppressed in vitro expression of the inflammatory cytokines/signaling elements interleukin 6 (IL-6), interleukin 12 (IL-12), tumor necrosis factor alpha (TNFalpha), inducible nitric oxide synthase (iNOS), and interferon gamma inducible protein (IP-10). Finally, PolyDex maintained its anti-inflammatory properties in vivo confirmed through punch biopsies with tissue imagery via hematoxylin/eosin and macrophage specific staining using CD11b. Thus, we demonstrated that PolyDex may be utilized as a localized, highly efficient drug-copolymer composite for active therapeutic delivery to confer anti-inflammatory protection or as a platform material for broad drug elution capabilities. PMID:19206545

  4. Controlled localized buckling responses of orthodontic arch wires.

    PubMed

    Nikolai, R J; Chung, A Y

    1999-09-01

    The orthodontic arch wire is often activated locally, in transverse bending and/or longitudinal torsion, to engage an individual malaligned tooth. Arch wires with substantial flexibilities and elastic ranges in bending are available. Several clinical reports of distal displacements of molars with appliances activated by locally buckling the arch wire have appeared in the recent published literature. This article contains an explanation of buckling or "column" action and the postbuckling response of a wire, and a report of the results of a controlled, in-vitro study of a sample of 256 wire segments subjected to activation-deactivation, buckling-postbuckling-unbuckling cycles. Continuous force-displacement diagrams were obtained from mechanical tests run at oral temperature. Four orthodontics-relevant, mechanical characteristics were quantified from each diagram, and each specimen was subjected to posttest evaluation for inelastic behavior. Although the deformation of the buckled wire is, in fact, bending, the force-displacement diagrams obtained differed substantially from their familiar counterparts generated in transverse bending. Judging from the force magnitudes induced as the deactivation half-cycles commenced as well as the deactivation rates, not all of the 8 wires seem to be clinically suitable for activation initiated by buckling. Magnitudes of springback were substantial from activations as large as 6 mm, and only 2 of the 8 wires exhibited full deactivations less than 80% of their activating displacements. This relatively new mode of arch wire activation that enables delivery to the dentition of mesiodistal pushing forces has substantial potential for clinical application from several biomechanical standpoints. PMID:10474103

  5. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  6. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  7. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  8. Intraindividual variation in plasma 25-hydroxyvitamin D measures 5 years apart among postmenopausal women

    PubMed Central

    Meng, Jennifer E.; Hovey, Kathleen M.; Wactawski-Wende, Jean; Andrews, Christopher A; LaMonte, Michael J.; Horst, Ronald L.; Genco, Robert J.; Millen, Amy E.

    2012-01-01

    Background Current literature examining associations between vitamin D and chronic disease generally use a single assessment of 25-hydroxyvitamin D (25(OH)D), assuming an individual’s 25(OH)D concentration is consistent over time. Methods We investigated the intraindividual variability between two measures of plasma 25(OH)D concentrations collected ~5 years apart (1997-2000 to 2002-2005) in 672 postmenopausal women participating in the Women’s Health Initiative. Plasma 25(OH)D was assessed using the DiaSorin LIAISON® chemiluminescence immunoassay. The within-pair coefficient of variation (CV) was 4.9% using blinded quality control samples. Mean and standard deviations (SD) of 25(OH)D at the two time points were compared using a paired t-test. An intraindividual CV and intra-class correlation coefficient (ICC) were used to assess intraindividual variability. A Spearman correlation coefficient (r) assessed the strength of the association between the two measures and concordance in vitamin D status at two time points Results Mean 25(OH)D concentrations (nmol/L) significantly increased over time from 60.0 (SD=22.2) to 67.8 (SD=22.2) (p<0.05). The CV was 24.6%, the ICC (95% Confidence Interval (CI)) was 0.59 (0.54-0.64), and the Spearman r was 0.61 (95% CI=0.56-0.66). Greater concordance over 5 years was observed in participants with sufficient compared to deficient or inadequate baseline 25(OH)D concentrations (weighted kappa=0.39). Reliability measures were moderately influenced by season of blood draw and vitamin D supplement use. Conclusion There is moderate intraindividual variation in 25(OH)D concentrations over approximately 5 years. Impact These data support the use of a one-time measure of blood 25(OH)D in prospective studies with ≤ 5 years of follow-up. PMID:22523182

  9. Understanding Local Control in the Wake of State Education Reform.

    ERIC Educational Resources Information Center

    Fuhrman, Susan H.; Elmore, Richard F.

    1990-01-01

    It is argued that traditional notions of state-local relations as a zero-sum game need recasting. It appears that local effects of state policy are greater than those predicted on the basis of state capacity and that localities often gain, rather than lose, influence as a result of state policymaking. (TJH)

  10. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period—The Da Qing Children Cohort Study

    PubMed Central

    Chen, Yan Yan; Wang, Jin Ping; Jiang, Ya Yun; Li, Hui; Hu, Ying Hua; Lee, Kok Onn; Li, Guang Wei

    2015-01-01

    Background The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance. Objective To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood. Methods 424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later. Results Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight). Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001) in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001) in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index) at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglycerides at 10 years of age. Conclusions Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin. PMID:26047327

  11. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years.

    PubMed

    Firatli, E

    1997-02-01

    The clinical periodontal status of 44 insulin-dependent diabetic children and adolescents and 20 healthy control subjects was compared for a period of approximately 5 years. Fasting blood glucose, fructosamine, and glycosylated hemoglobin (HbA1) values were determined at baseline and 5 years later. The differences in the clinical and laboratory parameters were compared during the study period. The differences between the two groups were also evaluated. The only statistically significant difference observed in the diabetic group was clinical attachment loss (CAL). The CAL was statistically significantly higher in the diabetic group compared to the controls, and a statistically significantly higher in the diabetic group compared to the controls, and a statistically significant positive correlation was observed between the duration of diabetes and CAL. Fructosamine was also correlated with the gingival index in the diabetic group while there was no correlation in the controls. It may be concluded that diabetes modifies the clinical status of the periodontal tissues and increases clinical attachment loss. PMID:9058330

  12. Meningitis in infancy in England and Wales: follow up at age 5 years

    PubMed Central

    Bedford, Helen; de Louvois, John; Halket, Susan; Peckham, Catherine; Hurley, Rosalinde; Harvey, David

    2001-01-01

    Objective To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987. Design Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded. Setting England and Wales. Participants General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls. Main outcome measures The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls. Results Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms. Conclusion The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent. What is already known on this topicMeningitis in infancy is associated with important long term consequencesThere is considerable variation in outcome depending on which organism caused the infectionWhat this study addsThis follow up study of 1717 children who had meningitis in infancy

  13. Local modulation of steroid action: rapid control of enzymatic activity

    PubMed Central

    Charlier, Thierry D.; Cornil, Charlotte A.; Patte-Mensah, Christine; Meyer, Laurence; Mensah-Nyagan, A. Guy; Balthazart, Jacques

    2015-01-01

    Estrogens can induce rapid, short-lived physiological and behavioral responses, in addition to their slow, but long-term, effects at the transcriptional level. To be functionally relevant, these effects should be associated with rapid modulations of estrogens concentrations. 17β-estradiol is synthesized by the enzyme aromatase, using testosterone as a substrate, but can also be degraded into catechol-estrogens via hydroxylation by the same enzyme, leading to an increase or decrease in estrogens concentration, respectively. The first evidence that aromatase activity (AA) can be rapidly modulated came from experiments performed in Japanese quail hypothalamus homogenates. This rapid modulation is triggered by calcium-dependent phosphorylations and was confirmed in other tissues and species. The mechanisms controlling the phosphorylation status, the targeted amino acid residues and the reversibility seem to vary depending of the tissues and is discussed in this review. We currently do not know whether the phosphorylation of the same amino acid affects both aromatase and/or hydroxylase activities or whether these residues are different. These processes provide a new general mechanism by which local estrogen concentration can be rapidly altered in the brain and other tissues. PMID:25852459

  14. Local control stations: Human engineering issues and insights

    SciTech Connect

    Brown, W.S.; Higgins, J.C.; O`Hara, J.M.

    1994-09-01

    The objective of this research project was to evaluate current human engineering at local control stations (LCSs) in nuclear power plants, and to identify good human engineering practices relevant to the design of these operator interfaces. General literature and reports of operating experience were reviewed to determine the extent and type of human engineering deficiencies at LCSs in nuclear power plants. In-plant assessments were made of human engineering at single-function as well as multifunction LCSs. Besides confirming the existence of human engineering deficiencies at LCSs, the in-plant assessments provided information about the human engineering upgrades that have been made at nuclear power plants. Upgrades were typically the result of any of three influences regulatory activity, broad industry initiatives such as INPO, and specific in-plant programs (e.g. activities related to training). It is concluded that the quality of LCSs is quite variable and might be improved if there were greater awareness of good practices and existing human engineering guidance relevant to these operator interfaces, which is available from a variety of sources. To make such human engineering guidance more readily accessible, guidelines were compiled from such sources and included in the report as an appendix.

  15. Remote and Local Display Applications for the Launch Control System and the Kennedy Ground Control System

    NASA Technical Reports Server (NTRS)

    Gordillo, Orlando Enrique

    2016-01-01

    This spring 2016 semester, I interned through the OSSI Intern program, sponsored by USRA, at NASA's Kennedy Space Center. I worked under the Engineering Directorate (NE-ES), under the software branch. We are creating the future Launch Control System (LCS). The system monitors, manages and sends commands to ground or flight subsystems. I worked on both the remote applications, which reside in the firing room, and local applications that are in Panel Views. The two kinds of applications have completely different development environments but work in parallel. For each project I was assigned to work with a specific subsystems team. I worked with the Launch Release Subsystem (LRS) on the remote side and with the Environmental Control Subsystem (ECS) on the Local side.

  16. Locally Controlled Deeply Saturated Fiber Optic Parametric Amplifiers

    NASA Astrophysics Data System (ADS)

    Nissim, Ron Reuven

    A new class of highly efficient Optical Parametric Amplifiers (OPA) is explored in this dissertation, which have the potential to reduce the power requirement on the pump and enable new functionalities. This originates from the simple notion that figure of merit (FoM) of an OPA is proportional to the product of the pump power and amplifier's length and nonlinearity. Silica fibers have been developed for over five decades and offer unparalleled transparency. By merely extending the fiber, i.e. the amplifier's length, a high FoM amplifier can be formed while keeping the pump at a moderate, sub-Watt power level. Unfortunately, optical fibers are inherently non-uniform. Their core size fluctuates along the fiber on a nanometer scale which is on the order of the fiber's molecular constituents. It is currently established that the performance of a fiber-based OPA (FOPA) is dictated by its stochastic nature. In fact, given a moderate pump power level, the highly efficient OPA will be required to maintain a strict phase matching condition across hundreds of meters. Facing this challenge, this dissertation focuses on a locally-controlled, high FoM FOPA. A high FoM FOPA operates in the deeply saturated regime in which a weak signal saturates the amplifier and depletes the pump power, effectively generating an inverse response of the pump output power to the signal input power. Given FOPAs' inhomogeneous nature, the performance limit of deeply saturated FOPAs is studied. So far, FOPAs have been commonly treated as a uniform entity; however, this study discovers unique features of the system which originate from and are strongly influenced by the fiber's inhomogeneous nature. One major example is the non-reciprocal response of deeply saturated FOPAs. It was found that deeply saturated FOPAs perform very highly, as the pump can respond to a rapidly varying (sub-THz) weak (sub-muW) signal. This is a novel method which obtained orders of magnitude improvement over current

  17. California's First Year with Local Control Finance and Accountability

    ERIC Educational Resources Information Center

    Menefee-Libey, David J.; Kerchner, Charles Taylor

    2015-01-01

    In 2013, Governor Jerry Brown and the California legislature radically restructured the state's school funding system and accountability systems with a weighted student formula and a mandated local planning process in each district. The new law substitutes local politics and grassroots agency for state-driven mandates and compliance reviews. While…

  18. Interface Shape Control Using Localized Heating during Bridgman Growth

    NASA Technical Reports Server (NTRS)

    Volz, M. P.; Mazuruk, K.; Aggarwal, M. D.; Croll, A.

    2008-01-01

    Numerical calculations were performed to assess the effect of localized radial heating on the melt-crystal interface shape during vertical Bridgman growth. System parameters examined include the ampoule, melt and crystal thermal conductivities, the magnitude and width of localized heating, and the latent heat of crystallization. Concave interface shapes, typical of semiconductor systems, could be flattened or made convex with localized heating. Although localized heating caused shallower thermal gradients ahead of the interface, the magnitude of the localized heating required for convexity was less than that which resulted in a thermal inversion ahead of the interface. A convex interface shape was most readily achieved with ampoules of lower thermal conductivity. Increasing melt convection tended to flatten the interface, but the amount of radial heating required to achieve a convex interface was essentially independent of the convection intensity.

  19. Supervisor Localization: A Top-Down Approach to Distributed Control of Discrete-Event Systems

    NASA Astrophysics Data System (ADS)

    Cai, K.; Wonham, W. M.

    2009-03-01

    A purely distributed control paradigm is proposed for discrete-event systems (DES). In contrast to control by one or more external supervisors, distributed control aims to design built-in strategies for individual agents. First a distributed optimal nonblocking control problem is formulated. To solve it, a top-down localization procedure is developed which systematically decomposes an external supervisor into local controllers while preserving optimality and nonblockingness. An efficient localization algorithm is provided to carry out the computation, and an automated guided vehicles (AGV) example presented for illustration. Finally, the 'easiest' and 'hardest' boundary cases of localization are discussed.

  20. 5-year review of Metal Hydride Center of Excellence.

    SciTech Connect

    Keller, Jay O.; Klebanoff, Leonard E.

    2010-05-01

    The purpose of the DOE Metal Hydride Center of Excellence (MHCoE) is to develop hydrogen storage materials with engineering properties that allow the use of these materials in a way that satisfies the DOE/FreedomCAR Program system requirements for automotive hydrogen storage. The Center is a multidisciplinary and collaborative effort with technical interactions divided into two broad areas: (1) mechanisms and modeling (which provide a theoretically driven basis for pursuing new materials) and (2) materials development (in which new materials are synthesized and characterized). Driving all of this work are the hydrogen storage system specifications outlined by the FreedomCAR Program for 2010 and 2015. The organization of the MHCoE during the past year is show in Figure 1. During the past year, the technical work was divided into four project areas. The purpose of the project areas is to organize the MHCoE technical work along appropriate and flexible technical lines. The four areas summarized are: (1) Project A - Destabilized Hydrides, The objective of this project is to controllably modify the thermodynamics of hydrogen sorption reactions in light metal hydrides using hydride destabilization strategies; (2) Project B - Complex Anionic Materials, The objective is to predict and synthesize highly promising new anionic hydride materials; (3) Project C - Amides/Imides Storage Materials, The objective of Project C is to assess the viability of amides and imides (inorganic materials containing NH{sub 2} and NH moieties, respectively) for onboard hydrogen storage; and (4) Project D - Alane, AlH{sub 3}, The objective of Project D is to understand the sorption and regeneration properties of AlH{sub 3} for hydrogen storage.

  1. A Study on Mental Disorders: 5-year Retrospective Study

    PubMed Central

    Celine, Thalappillil Mathew; Antony, Jimmy

    2014-01-01

    Background: “Mental disorder” is the most common used term in the modern life and the main reason behind this may be the mechanical way of life or stress and strain among youth. Aim: To find the pattern of mental disorders of hospitalized patients in a medical college hospital from 1st April 2005 to 31st March 2010. Settings and Design: A retrospective study conducted among the patients admitted with mental disorders in a medical college hospital from 1st April 2005 to 31st March 2010. Materials and Methods: Data collected from the registers maintained in the medical records department. Statistical Analysis: Z test is used for the comparison of proportions. Results: A total of 7908 mental disorder cases reported in the medical college hospital, 5564 (70.36%) were males and 2344 (29.64%) were females. Most cases occurred in the age group of 30-44 years. Mental disorder was more among females than males in 0-29 years and ≥ 60 years, but in 30-59 years males were more. In each year, mental disorders were reported more in males than females. Of the cases, most of them were mood disorders. Mental and behavioral disorders due to psychoactive substance use were more among males but schizophrenia, delusional disorders, mood disorders, stress-related disorders, mental retardation, and so on were more among females. Conclusion: Mood disorder was the most occurred mental disorder and the next leading mental disorder was mental and behavioral disorders due to psychoactive substance use. Counseling can be helpful for preventing most of the mental disorders. Improve the mental health care facilities will be the solution for controlling the mental disorders. PMID:24791229

  2. 24 CFR 257.303 - Prohibition on subordinate liens during first 5 years.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CFR 226.2). ... during first 5 years. 257.303 Section 257.303 Housing and Urban Development Regulations Relating to... Prohibition on subordinate liens during first 5 years. (a) Prohibition on subordinate liens during first...

  3. Specialist Pediatric Palliative Care Referral Practices in Pediatric Oncology: A Large 5-year Retrospective Audit

    PubMed Central

    Ghoshal, Arunangshu; Salins, Naveen; Damani, Anuja; Deodhar, Jayita; Muckaden, MaryAnn

    2016-01-01

    Purpose: To audit referral practices of pediatric oncologists referred to specialist pediatric palliative care services. Patients and Methods: Retrospective review of medical case records of pediatric palliative care patients over a period of 5 years from January 1, 2010 to December 31, 2014. Descriptive summaries of demographic, clinical variables, and patient circumstances at the time of referral and during end-of-life care were examined. Results: A total of 1135 patients were referred from pediatric oncology with a gradual increasing trend over 5 years. About 84.6% consultations took place in the outpatient setting. In 97.9% of the cases, parents were the primary caregivers. Availability of specialist pediatric health-care services at local places was available in 21.2% cases and 48% families earned <5000 INR (approximately 73 USD) in a month. Around 28.3% of the referrals were from leukemia clinic and maximum references were late with 72.4% patients having advanced disease at presentation. 30.3% of the referrals were made for counseling and communication and 54.2% had high symptom burden during referral. After referral, 21.2% patients continued with oral metronomic chemotherapy and 10.5% were referred back to oncology services for palliative radiotherapy. Only 4.9% patients had more than 2 follow-ups. 90.8% of the patients were cared for at home in the last days of illness by local general practitioners. 70.6% of the deaths were anticipated. Conclusions: Oncologists referred patients late in the course of disease trajectory. Most of the referrals were made for counseling and communication, but many patients had high symptom burden during referral. PMID:27559254

  4. How does mass loading impact local versus global control on dayside reconnection?

    NASA Astrophysics Data System (ADS)

    Zhang, B.; Brambles, O. J.; Wiltberger, M.; Lotko, W.; Ouellette, J. E.; Lyon, J. G.

    2016-03-01

    This paper investigates the effects of magnetospheric mass loading on the control of dayside magnetic reconnection using global magnetospheric simulations. The study iys motivated by a recent debate on whether the integrated dayside magnetic reconnection rate is solely controlled by local processes (local-control theory) or global merging processes (global-control theory). The local-control theory suggests that the integrated dayside reconnection rate is controlled by the local plasma parameters. The global-control theory argues that the integrated rate is determined by the net force acting on the flow in the magnetosheath rather than the local microphysics. Controlled numerical simulations using idealized ionospheric outflow specifications suggest a possible mixed-control theory, that is, (1) a small amount of mass loading at the dayside magnetopause only redistributes local reconnection rate without a significant change in the integrated reconnection rate and (2) a large amount of mass loading reduces both local reconnection rates and the integrated reconnection rate on the dayside. The transition between global-control- and local-control-dominated regimes depends on (but not limited to) the source region, the amount, the location, and the spatial extension of the mass loading at the dayside magnetopause.

  5. Local Measurement of Fuel Energy Deposition and Heat Transfer Environment During Fuel Lifetime Using Controlled Calorimetry

    SciTech Connect

    Don W. Miller; Andrew Kauffmann; Eric Kreidler; Dongxu Li; Hanying Liu; Daniel Mills; Thomas D. Radcliff; Joseph Talnagi

    2001-12-31

    A comprehensive description of the accomplishments of the DOE grant titled, ''Local Measurement of Fuel Energy Deposition and Heat Transfer Environment During Fuel Lifetime using Controlled Calorimetry''.

  6. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    SciTech Connect

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  7. Thailand Momentum on Policy and Practice in Local Legislation on Dengue Vector Control

    PubMed Central

    Bhumiratana, Adisak; Intarapuk, Apiradee; Chujun, Suriyo; Kaewwaen, Wuthichai; Sorosjinda-Nunthawarasilp, Prapa; Koyadun, Surachart

    2014-01-01

    Over a past decade, an administrative decentralization model, adopted for local administration development in Thailand, is replacing the prior centralized (top-down) command system. The change offers challenges to local governmental agencies and other public health agencies at all the ministerial, regional, and provincial levels. A public health regulatory and legislative framework for dengue vector control by local governmental agencies is a national topic of interest because dengue control program has been integrated into healthcare services at the provincial level and also has been given priority in health plans of local governmental agencies. The enabling environments of local administrations are unique, so this critical review focuses on the authority of local governmental agencies responsible for disease prevention and control and on the functioning of local legislation with respect to dengue vector control and practices. PMID:24799896

  8. Adjuvant Radiation Therapy Improves Local Control After Surgical Resection in Patients With Localized Adrenocortical Carcinoma

    SciTech Connect

    Sabolch, Aaron; Else, Tobias; Griffith, Kent A.; Ben-Josef, Edgar; Williams, Andrew; Miller, Barbra S.; Worden, Francis; Jolly, Shruti

    2015-06-01

    Purpose: Adrenocortical carcinoma (ACC) is a rare malignancy known for high rates of local recurrence, though the benefit of postoperative radiation therapy (RT) has not been established. In this study of grossly resected ACC, we compare local control of patients treated with surgery followed by adjuvant RT to a matched cohort treated with surgery alone. Methods and Materials: We retrospectively identified patients with localized disease who underwent R0 or R1 resection followed by adjuvant RT. Only patients treated with RT at our institution were included. Matching to surgical controls was on the basis of stage, surgical margin status, tumor grade, and adjuvant mitotane. Results: From 1991 to 2011, 360 ACC patients were evaluated for ACC at the University of Michigan (Ann Arbor, MI). Twenty patients with localized disease received postoperative adjuvant RT. These were matched to 20 controls. There were no statistically significant differences between the groups with regard to stage, margins, grade, or mitotane. Median RT dose was 55 Gy (range, 45-60 Gy). Median follow-up was 34 months. Local recurrence occurred in 1 patient treated with RT, compared with 12 patients not treated with RT (P=.0005; hazard ratio [HR] 12.59; 95% confidence interval [CI] 1.62-97.88). However, recurrence-free survival was no different between the groups (P=.17; HR 1.52; 95% CI 0.67-3.45). Overall survival was also not significantly different (P=.13; HR 1.97; 95% CI 0.57-6.77), with 4 deaths in the RT group compared with 9 in the control group. Conclusions: Postoperative RT significantly improved local control compared with the use of surgery alone in this case-matched cohort analysis of grossly resected ACC patients. Although this retrospective series represents the largest study to date on adjuvant RT for ACC, its findings need to be prospectively confirmed.

  9. Radiometric calibration stability of the EO-1 advanced land imager: 5 years on-orbit

    USGS Publications Warehouse

    Markham, B.L.; Ong, L.; Barsi, J.A.; Mendenhall, J.A.; Lencioni, D.E.; Helder, D.L.; Hollaren, D.M.; Morfitt, R.

    2006-01-01

    The Advanced Land Imager (ALI) was developed as a prototype sensor for follow on missions to Landsat-7. It was launched in November 2000 on the Earth Observing One (EO-1) satellite as a nominal one-year technology demonstration mission. As of this writing, the sensor has continued to operate in excess of 5 years. Six of the ALl's nine multi-spectral (MS) bands and the panchromatic band have similar spectral coverage as those on the Landsat-7 ETM+. In addition to on-board lamps, which have been significantly more stable than the lamps on ETM+, the ALI has a solar diffuser and has imaged the moon monthly since launch. This combined calibration dataset allows understanding of the radiometric stability of the ALI system, its calibrators and some differentiation of the sources of the changes with time. The solar dataset is limited as the mechanism controlling the aperture to the solar diffuser failed approximately 18 months after launch. Results over 5 years indicate that: the shortest wavelength band (443 nm) has degraded in response about 2%; the 482 nm and 565 nm bands decreased in response about 1%; the 660 nm, 790 nm and 868 nm bands each degraded about 5%; the 1250 nm and 1650 nm bands did not change significantly and the 2215 nm band increased in response about 2%.

  10. Promoting Equalization and Local Control in Financing Colorado's Schools.

    ERIC Educational Resources Information Center

    Mathers, Judith K.; King, Richard A.

    1997-01-01

    Per-pupil property valuation extremes among Colorado school districts are as varied as the landscape. A foundation plan levels funding disparities for school operations, but financing of major capital outlay projects still depends on local property taxation. Funds are needed to finance classroom technologies and Internet connections. (MLH)

  11. Scalable quantum computation via local control of only two qubits

    SciTech Connect

    Burgarth, Daniel; Maruyama, Koji; Murphy, Michael; Montangero, Simone; Calarco, Tommaso; Nori, Franco; Plenio, Martin B.

    2010-04-15

    We apply quantum control techniques to a long spin chain by acting only on two qubits at one of its ends, thereby implementing universal quantum computation by a combination of quantum gates on these qubits and indirect swap operations across the chain. It is shown that the control sequences can be computed and implemented efficiently. We discuss the application of these ideas to physical systems such as superconducting qubits in which full control of long chains is challenging.

  12. Local Control, Democracy, and the Separation in the Public Opinion of School Finance Reform

    ERIC Educational Resources Information Center

    Shelly, Bryan

    2007-01-01

    What role does a person's support for local educational control play in determining her attitude towards equity-minded school finance reform? This article reports estimations of binary and ordered probit models of two state public opinion polls and discusses newspaper coverage from the same two states to determine if and how local control has such…

  13. [Research review on apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years].

    PubMed

    Song, Feng-Jun; Zhang, Hong; Zheng, Shi-Li; Fang, Jun-Hui; Liu, Hai-Fei

    2011-10-01

    The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index. PMID:22043698

  14. Local control of osteogenic sarcoma by radiation and chemotherapy

    SciTech Connect

    Caceres, E.; Zaharia, M.; Valdivia, S.; Misad, O.; de la Flor, J.; Tejada, F.; Zubrod, G.

    1984-01-01

    Sixteen patients with osteogenic sarcoma of limbs were treated with high dose methotrexate followed by leucovorin rescue, adriamycin and radiotherapy to the primary tumor. A post-treatment surgical biopsy was performed in 15 of the 16 patients. In 12 of 15 patients (80%), the follow-up biopsy was negative for active tumor. Complications of treatment were myelosuppression (16 cases), moist desquamation (13 cases), soft tissue necrosis (2 cases) local infection (2 cases), fibrosis (9 cases) and bone fracture (4 cases). The mean survival time in this group of patients was 712 days.

  15. What controls the local time extent of flux transfer events?

    NASA Astrophysics Data System (ADS)

    Milan, S. E.; Imber, S. M.; Carter, J. A.; Walach, M.-T.; Hubert, B.

    2016-02-01

    Flux transfer events (FTEs) are the manifestation of bursty and/or patchy magnetic reconnection at the magnetopause. We compare two sequences of the ionospheric signatures of flux transfer events observed in global auroral imagery and coherent ionospheric radar measurements. Both sequences were observed during very similar seasonal and interplanetary magnetic field (IMF) conditions, though with differing solar wind speed. A key observation is that the signatures differed considerably in their local time extent. The two periods are 26 August 1998, when the IMF had components BZ≈-10 nT and BY≈9 nT and the solar wind speed was VX≈650 km s-1, and 31 August 2005, IMF BZ≈-7 nT, BY≈17 nT, and VX≈380 km s-1. In the first case, the reconnection rate was estimated to be near 160 kV, and the FTE signatures extended across at least 7 h of magnetic local time (MLT) of the dayside polar cap boundary. In the second, a reconnection rate close to 80 kV was estimated, and the FTEs had a MLT extent of roughly 2 h. We discuss the ramifications of these differences for solar wind-magnetosphere coupling.

  16. A procedure concept for local reflex control of grasping

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Chang, Jeffrey

    1989-01-01

    An architecture is proposed for the control of robotic devices, and in particular of anthropomorphic hands, characterized by a hierarchical structure in which every level of the architecture contains data and control function with varying degree of abstraction. Bottom levels of the hierarchy interface directly with sensors and actuators, and process raw data and motor commands. Higher levels perform more symbolic types of tasks, such as application of boolean rules and general planning operations. Layers implementation has to be consistent with the type of operation and its requirements for real time control. It is proposed to implement the rule level with a Boolean Artificial Neural Network characterized by a response time sufficient for producing reflex corrective action at the actuator level.

  17. Corticothalamic Projections Control Synchronization in Locally Coupled Bistable Thalamic Oscillators

    NASA Astrophysics Data System (ADS)

    Mayer, Jörg; Schuster, Heinz Georg; Claussen, Jens Christian; Mölle, Matthias

    2007-08-01

    Thalamic circuits are able to generate state-dependent oscillations of different frequencies and degrees of synchronization. However, little is known about how synchronous oscillations, such as spindle oscillations in the thalamus, are organized in the intact brain. Experimental findings suggest that the simultaneous occurrence of spindle oscillations over widespread territories of the thalamus is due to the corticothalamic projections, as the synchrony is lost in the decorticated thalamus. In this Letter we study the influence of corticothalamic projections on the synchrony in a thalamic network, and uncover the underlying control mechanism, leading to a control method which is applicable for several types of oscillations in the central nervous system.

  18. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children.

    PubMed

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  19. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children

    PubMed Central

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  20. Percutaneous dermal drug delivery for local pain control

    PubMed Central

    Tadicherla, Sujatha; Berman, Brian

    2006-01-01

    Topical anesthetics have evolved from a simple solution of cocaine to creams, ointments, gels, liposomal preparations, and to the latest sophisticated patches and peels. Topical anesthetics are essential for performing diagnostic, therapeutic, and cosmetic dermatology procedures. These anesthetics noninvasively deliver anesthesia in locally required areas. In this review, we present an overview on the mechanism of precutaneous absorption of skin and address the composition, duration of onset of anesthetic effect, uses, and side effects that are applicable for the products. Also discussed are the novel advances of using heat to enhance penetration of the anesthetic as seen in Synera™ patch and delivery of anesthesia using a peel method as seen in the yet to be US Food and Drug Administration-approved S-Caine peel. PMID:18360585

  1. Stable and metastable nanowires displaying locally controllable properties

    DOEpatents

    Sutter, Eli Anguelova; Sutter, Peter Werner

    2014-11-18

    Vapor-liquid-solid growth of nanowires is tailored to achieve complex one-dimensional material geometries using phase diagrams determined for nanoscale materials. Segmented one-dimensional nanowires having constant composition display locally variable electronic band structures that are determined by the diameter of the nanowires. The unique electrical and optical properties of the segmented nanowires are exploited to form electronic and optoelectronic devices. Using gold-germanium as a model system, in situ transmission electron microscopy establishes, for nanometer-sized Au--Ge alloy drops at the tips of Ge nanowires (NWs), the parts of the phase diagram that determine their temperature-dependent equilibrium composition. The nanoscale phase diagram is then used to determine the exchange of material between the NW and the drop. The phase diagram for the nanoscale drop deviates significantly from that of the bulk alloy.

  2. Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

    PubMed Central

    Choi, Yunseon; Lee, Yun-Han; Park, Sung Kwang; Cho, Heunglae; Ahn, Ki Jung

    2016-01-01

    Purpose: The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2–3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m2) in local control was evaluated. Results: The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m2 as a cutoff value. Conclusion: Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted. PMID:27306771

  3. Controllable injector for local flux entry into superconducting films

    NASA Astrophysics Data System (ADS)

    Carmo, D.; Colauto, F.; de Andrade, A. M. H.; Oliveira, A. A. M.; Ortiz, W. A.; Johansen, T. H.

    2016-09-01

    A superconducting flux injector (SFI) has been designed to allow for controlled injections of magnetic flux into a superconducting film from a predefined location along the edge. The SFI is activated by an external current pulse, here chosen to be 200 ms long, and it is demonstrated on films of Nb that the amount of injected flux is controlled by the pulse height. Examples of injections at two different temperatures where the flux enters by stimulated flux-flow and by triggered thermomagnetic avalanches are presented. The boundary between the two types of injection is determined and discussed. The SFI opens up for active use of phenomena which up to now have been considered hazardous for a safe operation of superconducting devices.

  4. Reversible control of current across lipid membranes by local heating

    NASA Astrophysics Data System (ADS)

    Urban, Patrick; Kirchner, Silke R.; Mühlbauer, Christian; Lohmüller, Theobald; Feldmann, Jochen

    2016-03-01

    Lipid membranes are almost impermeable for charged molecules and ions that can pass the membrane barrier only with the help of specialized transport proteins. Here, we report how temperature manipulation at the nanoscale can be employed to reversibly control the electrical resistance and the amount of current that flows through a bilayer membrane with pA resolution. For this experiment, heating is achieved by irradiating gold nanoparticles that are attached to the bilayer membrane with laser light at their plasmon resonance frequency. We found that controlling the temperature on the nanoscale renders it possible to reproducibly regulate the current across a phospholipid membrane and the membrane of living cells in absence of any ion channels.

  5. Reversible control of current across lipid membranes by local heating

    PubMed Central

    Urban, Patrick; Kirchner, Silke R.; Mühlbauer, Christian; Lohmüller, Theobald; Feldmann, Jochen

    2016-01-01

    Lipid membranes are almost impermeable for charged molecules and ions that can pass the membrane barrier only with the help of specialized transport proteins. Here, we report how temperature manipulation at the nanoscale can be employed to reversibly control the electrical resistance and the amount of current that flows through a bilayer membrane with pA resolution. For this experiment, heating is achieved by irradiating gold nanoparticles that are attached to the bilayer membrane with laser light at their plasmon resonance frequency. We found that controlling the temperature on the nanoscale renders it possible to reproducibly regulate the current across a phospholipid membrane and the membrane of living cells in absence of any ion channels. PMID:26940847

  6. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

    SciTech Connect

    Freedman, Gary M.; Anderson, Penny R.; Bleicher, Richard J.; Litwin, Samuel; Li Tianyu; Swaby, Ramona F.; Ma, Chang-Ming Charlie; Li Jinsheng; Sigurdson, Elin R.; Watkins-Bruner, Deborah; Morrow, Monica; Goldstein, Lori J.

    2012-11-15

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

  7. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    SciTech Connect

    Khan, Atif J.; Vicini, Frank A.; Beitsch, Peter; Goyal, Sharad; Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard; Lyden, Maureen; Haffty, Bruce G.

    2012-10-01

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  8. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    SciTech Connect

    Strnad, Vratislav; Hildebrandt, Guido; Poetter, Richard; Hammer, Josef; Hindemith, Marion; Resch, Alexandra; Spiegl, Kurt; Lotter, Michael; Uter, Wolfgang; Bani, Mayada; Kortmann, Rolf-Dieter; Beckmann, Matthias W.; Fietkau, Rainer; Ott, Oliver J.

    2011-05-01

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was < 3 cm, resection margins were clear by at least 2 mm, no lymph node metastases existed, age was >35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (D{sub ref} = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (D{sub ref} = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects {>=}Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  9. Participatory health impact assessment for the development of local government regulation on hazard control

    SciTech Connect

    Inmuong, Uraiwan; Rithmak, Panee; Srisookwatana, Soomol; Traithin, Nathathai; Maisuporn, Pornpun

    2011-07-15

    The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action research attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.

  10. Prenatal Drug Exposure: Effects on Cognitive Functioning at 5 Years of Age

    PubMed Central

    Pulsifer, Margaret B.; Butz, Arlene M.; Foran, Megan O’Reilly; Belcher, Harolyn M. E.

    2008-01-01

    The goal of this cross-sectional study was to compare cognitive functioning at age 5 years in prenatal drug-exposed children with nondrug-exposed children from a comparable inner-city environment. Children with prenatal drug exposure scored significantly lower on measures of language, school readiness skills, impulse control, and visual attention span/sequencing than controls matched for age and socioeconomic status. Intelligence, visual-motor, manual dexterity, and sustained attention scores were not significantly different between groups. The total sample scored significantly below the normative mean on standardized measures of intelligence, language, school readiness, visual-motor skills, impulse control, and sustained attention, with 40% scoring at least 1 standard deviation below the mean (IQ <85) on a measure of intelligence. Findings suggest that children with prenatal drug exposure are at increased risk for learning and attention problems and are in need of close developmental surveillance and possible intervention to support school success and improve behavioral outcome. PMID:17766581

  11. A 5 Year Study of Carbon Fluxes from a Restored English Blanket Bog

    NASA Astrophysics Data System (ADS)

    Worrall, F.; Dixon, S.; Evans, M.

    2014-12-01

    This study aimed to measure the effects of ecological restoration on blanket peat water table depths, DOC concentrations and CO2 fluxes. In April 2003 the Bleaklow Plateau, an extensive area of deep blanket peat in the Peak District National Park, northern England, was devegetated by a wildfire. As a result the area was selected for large scale restoration. In this study we considered a 5-year study of four restored sites in comparison to both an unrestored, bare peat control and to vegetated control that did not require restoration. Results suggested that sites with revegetation alongside slope stabilisation had the highest rates of photosynthesis and were the largest net (daylight hours) sinks of CO2. Bare sites were the largest net sources of CO2 and had the deepest water table depths. Sites with gully wall stabilisation were between 5-8 times more likely to be net CO2 sinks than the bare sites. Revegetation without gully flow blocking using plastic dams did not have a large effect on water table depths in and around the gullies investigated whereas a blocked gully had water table depths comparable to a naturally revegetating gully. A ten centimetre lowering in water table depth decreased the probability of observing a net CO2 sink, on a given site, by up to 30%. With respect to DOC the study showed that the average soil porewater DOC concentration on the restored sites rose significantly over the 5 year study representing a 34% increase relative to the vegetated control and an 11% increase relative to the unrestored, bare control. Soil pore water concentrations were not significantly different from surface runoff DOC concentrations and therefore restoration as conducted by this study would have contributed to water quality deterioration in the catchment. The most important conclusion of this research was that restoration interventions were apparently effective at increasing the likelihood of net CO2 sink behaviour and raising water tables on degraded

  12. Renal Anemia Control in Lithuania: Influence of Local Conditions and Local Guidelines

    PubMed Central

    Kuzminskis, Vytautas; Vaiciuniene, Ruta; Stankuviene, Asta; Bumblyte, Inga Arune

    2013-01-01

    Erythropoietin stimulating agents had a long haul in Lithuania—we had no epoetin till 1994 and there was no intravenous iron in 2001–2004. The aim of this study was to assess the changes of renal anemia control in hemodialysis patients from early independence of Lithuania till nowadays and to evaluate the link of anemia with hospitalization rates and survival and hemoglobin variability in association with mortality. In December of each year since 1996 all hemodialysis centers have been visited and data has been collected using special questionnaires. The history of renal anemia control in Lithuania was complicated; however, a significant improvement was achieved: 54.7% of hemodialysis patients reached the target hemoglobin; all patients have a possibility of treatment with epoetin and intravenous iron. The involuntary experiment with an intravenous iron occurred in Lithuania because of economic reasons and confirmed the significant role of intravenous iron in the management of renal anemia. Hemoglobin below 100 g/L was associated with a 2.5-fold increase in relative risk of death and 1.7-fold increase in relative risk of hospitalization in Lithuanian hemodialysis patients. Although hemoglobin variability was common in Lithuanian hemodialysis patients, we did not find the association between hemoglobin variability and all-cause mortality in our study. PMID:24367239

  13. PADF electromagnetic source localization using extremum seeking control

    NASA Astrophysics Data System (ADS)

    Al Issa, Huthaifa A.; Ordóñez, Raúl

    2014-10-01

    Wireless Sensor Networks (WSNs) are a significant technology attracting considerable research interest. Recent advances in wireless communications and electronics have enabled the development of low-cost, low-power and multi-functional sensors that are small in size and communicate over short distances. Most WSN applications require knowing or measuring locations of thousands of sensors accurately. For example, sensing data without knowing the sensor location is often meaningless. Locations of sensor nodes are fundamental to providing location stamps, locating and tracking objects, forming clusters, and facilitating routing. This research focused on the modeling and implementation of distributed, mobile radar sensor networks. In particular, we worked on the problem of Position-Adaptive Direction Finding (PADF), to determine the location of a non- collaborative transmitter, possibly hidden within a structure, by using a team of cooperative intelligent sensor networks. Position-Adaptive radar concepts have been formulated and investigated at the Air Force Research Laboratory (AFRL) within the past few years. In this paper, we present the simulation performance analysis on the application aspect. We apply Extremum Seeking Control (ESC) schemes by using the swarm seeking problem, where the goal is to design a control law for each individual sensor that can minimize the error metric by adapting the sensor positions in real-time, thereby minimizing the unknown estimation error. As a result we achieved source seeking and collision avoidance of the entire group of the sensor positions.

  14. Molecular designs for controlling the local environments around metal ions.

    PubMed

    Cook, Sarah A; Borovik, A S

    2015-08-18

    The functions of metal complexes are directly linked to the local environment in which they are housed; modifications to the local environment (or secondary coordination sphere) are known to produce changes in key properties of the metal centers that can affect reactivity. Noncovalent interactions are the most common and influential forces that regulate the properties of secondary coordination spheres, which leads to complexities in structure that are often difficult to achieve in synthetic systems. Using key architectural features from the active sites of metalloproteins as inspiration, we have developed molecular systems that enforce intramolecular hydrogen bonds (H-bonds) around a metal center via incorporation of H-bond donors and acceptors into rigid ligand scaffolds. We have utilized these molecular species to probe mechanistic aspects of biological dioxygen activation and water oxidation. This Account describes the stabilization and characterization of unusual M-oxo and heterobimetallic complexes. These types of species have been implicated in a range of oxidative processes in biology but are often difficult to study because of their inherent reactivity. Our H-bonding ligand systems allowed us to prepare an Fe(III)-oxo species directly from the activation of O2 that was subsequently oxidized to form a monomeric Fe(IV)-oxo species with an S = 2 spin state, similar to those species proposed as key intermediates in non-heme monooxygenases. We also demonstrated that a single Mn(III)-oxo center that was prepared from water could be converted to a high-spin Mn(V)-oxo species via stepwise oxidation, a process that mimics the oxidative charging of the oxygen-evolving complex (OEC) of photosystem II. Current mechanisms for photosynthetic O-O bond formation invoke a Mn(IV)-oxyl species rather than the isoelectronic Mn(V)-oxo system as the key oxidant based on computational studies. However, there is no experimental information to support the existence of a Mn

  15. Transonic flow control by means of local energy deposition

    NASA Astrophysics Data System (ADS)

    Aul'Chenko, S. M.; Zamuraev, V. P.; Kalinina, A. P.

    2011-11-01

    Experimental data for the feasibility of transonic flow control by means of energy deposition are generalized. Energy supplied to the immediate vicinity of a body in stream before a compression shock is found to result in the nonlinear interaction of introduced disturbances with the shock and the surface in zones extended along the surface. A new, explosive gasdynamic mechanism behind the shift of the compression shock is discovered. It is shown that the nonlinear character of the interaction may considerably decrease the wave resistance of, e.g., transonic airfoils. It is found that energy supply from without stabilizes a transonic flow about an airfoil—the effect similar to the Khristianovich stabilization effect. The dependence of the energy deposition optimal frequency on the energy source parameters and Mach number of the incoming flow at which the resistance drops to the greatest extent is obtained. The influence of the real thermodynamic properties and viscosity of air is studied.

  16. Edge localized mode control with an edge resonant magnetic perturbation

    SciTech Connect

    Moyer, R.A.; Boedo, J.A.; Rudakov, D.L.; Evans, T.E.; Osborne, T.H.; Gohil, P.; Groebner, R.J.; Jackson, G.L.; La Haye, R.J.; Leonard, A.W.; Schaffer, M.J.; Snyder, P.B.; West, W.P.; Thomas, P.R.; Becoulet, M.; Harris, J.; Finken, K.-H.; Doyle, E.J.; Rhodes, T.L.; Wang, G.

    2005-05-15

    A low amplitude ({delta}b{sub r}/B{sub T}=1 part in 5000) edge resonant magnetic field perturbation with toroidal mode number n=3 and poloidal mode numbers between 8 and 15 has been used to suppress most large type I edge localized modes (ELMs) without degrading core plasma confinement. ELMs have been suppressed for periods of up to 8.6 energy confinement times when the edge safety factor q{sub 95} is between 3.5 and 4. The large ELMs are replaced by packets of events (possibly type II ELMs) with small amplitude, narrow radial extent, and a higher level of magnetic field and density fluctuations, creating a duty cycle with long 'active' intervals of high transport and short 'quiet' intervals of low transport. The increased transport associated with these events is less impulsive and slows the recovery of the pedestal profiles to the values reached just before the large ELMs without the n=3 perturbation. Changing the toroidal phase of the perturbation by 60 deg. with respect to the best ELM suppression case reduces the ELM amplitude and frequency by factors of 2-3 in the divertor, produces a more stochastic response in the H-mode pedestal profiles, and displays similar increases in small scale events, although significant numbers of large ELMs survive. In contrast to the best ELM suppression case where the type I ELMs are also suppressed on the outboard midplane, the midplane recycling increases until individual ELMs are no longer discernable. The ELM response depends on the toroidal phase of the applied perturbation because intrinsic error fields make the target plasma nonaxisymmetric, and suggests that at least some of the variation in ELM behavior in a single device or among different devices is due to differences in the intrinsic error fields in these devices. These results indicate that ELMs can be suppressed by small edge resonant magnetic field perturbations. Extrapolation to next-step burning plasma devices will require extending the regime of operation to

  17. Measurement of primordial non-Gaussianity using the WMAP 5-year temperature skewness power spectrum

    SciTech Connect

    Smidt, Joseph; Amblard, Alexandre; Serra, Paolo; Cooray, Asantha

    2009-12-15

    We constrain the primordial non-Gaussianity parameter of the local model f{sub NL} using the skewness power spectrum associated with the two-to-one cumulant correlator of cosmic microwave background temperature anisotropies. This bispectrum-related power spectrum was constructed after weighting the temperature map with the appropriate window functions to form an estimator that probes the multipolar dependence of the underlying bispectrum associated with the primordial non-Gaussianity. We also estimate a separate skewness power spectrum sensitive more strongly to unresolved point sources. When compared to previous attempts at measuring the primordial non-Gaussianity with WMAP data, our estimators have the main advantage that we do not collapse information to a single number. When model fitting the two-to-one skewness power spectrum, we make use of bispectra generated by the primordial non-Gaussianity, radio point sources, and lensing-secondary correlation. We analyze Q, V, and W-band WMAP 5-year data using the KQ75 mask out to l{sub max}=600. Using V and W-band data and marginalizing over model parameters related to point sources and lensing-secondary bispectrum, our overall and preferred constraint on f{sub NL} is 11.0{+-}23.7 at the 68% confidence level (-36.4

  18. 77 FR 64959 - Endangered and Threatened Species; Initiation of 5-Year Review for the Southern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... update, if necessary, the Northern DPS' status in five years time (70 FR 17386; April 6, 2005). Therefore...; Initiation of 5-Year Review for the Southern Distinct Population Segment of North American Green Sturgeon... 5-year review of the Southern Distinct Population Segment (DPS) of North American green...

  19. 77 FR 5491 - Endangered and Threatened Species; Initiation of 5-Year Review for Sei Whales

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ...; Initiation of 5-Year Review for Sei Whales AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...; request for information. SUMMARY: NMFS announces a 5-year review of sei whales (Balaenoptera borealis... of any such information on sei whales that has become available since that has become available...

  20. Electroosmotic micro-pump array for local control of droplets.

    NASA Astrophysics Data System (ADS)

    Gupta, Amit; Hirsa, Amir; Borca-Tasciuc, Diana-Andra

    2006-11-01

    Droplet-based microfluidic devices have a wide range of applications in various fields such as diagnostics and clinical testing, drug delivery and opto-electronics. This paper presents a novel microfluidic device for actuation and control of individual droplets employing electroosmotic pumping across a nanoporous membrane. To fabricate the device, arrays of gold electrodes pairs are first patterned on both sides of an anodic alumina membrane (Whatman, ˜50 μm in thickness, with parallel cylindrical pores of 150 nm in diameter). One side of the membrane is then attached to a liquid reservoir while the other side is covered partially with Teflon to prevent droplet spreading. When voltage is applied between the two aligned top and bottom gold electrodes electroosmotic flow occurs from the liquid reservoir through the membrane and a droplet forms onto the Teflon-coated surface of the membrane. Actuation time and droplet shape are investigated by video microscopy in order to assess the effect of electrode configuration and electrolyte ionic strength Possible applications for the device include addressable liquid microlens arrays, fast-response droplet switches and fast, sample collection devices for brain microdialysis.

  1. Local strategic control of information in visual word recognition.

    PubMed

    Kang, H; Simpson, G B

    2001-06-01

    In the present studies, we examined strategic flexibility in the use of lexical and sublexical information in Korean word recognition. Korean readers show a large frequency effect for words printed in the alphabetic Hangul script only if these words are embedded in a list consisting largely of logographic (Hanza) words. In the first experiment, high- and low- frequency Hangul words were preceded by Hangul or Hanza words. Frequency effects were eliminated when a Hangul target word was preceded by two Hangul words, even when the overall proportion of Hanza words in the list was large. In the second experiment, one group saw each stimulus preceded by a cue indicating which script would be seen on that trial. Frequency effects for Hangul targets were absent under this condition, but were present when subjects were not so cued. These results indicate that Korean readers are able to control their use of lexical and sublexical information over a small number of stimuli or even trial by trial. PMID:11504013

  2. Local, integrated control of blood flow: Professor Tudor Griffith Memorial.

    PubMed

    Edwards, David H

    2013-11-01

    Professor Tudor Griffith was one of the founding members of the European Study Group on Cardiovascular Oscillations, and hosted the 1st ESGCO Conference in Cardiff, Wales in 2000. Tudor was a passionate scientist, who managed to combine his enthusiasm for vascular biology with his background in physics, to make key and insightful advances to our knowledge and understanding of the integrated vascular control mechanisms that co-ordinate blood flow in tissue perfusion. He had a particular interest in the endothelium, the monolayer of cells that lines the entire cardiovascular system and which is in prime position to sense a wide variety of modulatory stimuli, both chemical and mechanical. Over the last 20 years Tudor produced a series of research papers in which he used chaos theory to analyse the behaviour of arteries that underpins vasomotion. The research led to the development of mathematical models that were able to predict calcium oscillations in vascular smooth muscle with a view to predicting events in a complete virtual artery. This article will review the field in which he worked, with an obvious emphasis on his contribution. PMID:23522722

  3. Two Years of California's Local Control Funding Formula: Time to Reaffirm the Grand Vision

    ERIC Educational Resources Information Center

    Koppich, Julia E.; Humphrey, Daniel C.; Marsh, Julie A.

    2015-01-01

    California ended 40 years of reliance on categorical funding for schools when Governor Jerry Brown signed the Local Control Funding Formula (LCFF) into law on July 1, 2013. LCFF intends to enhance services for high-needs students through new flexibility, targeted student funding, and local accountability. Two years into LCFF implementation,…

  4. The Long Goodbye: How Local Authorities Lost Control of Further Education

    ERIC Educational Resources Information Center

    Simmons, Robin

    2009-01-01

    Following the 1992 Further and Higher Education Act, local education authorities (LEAs) lost control of further education in England. Now, after spending almost two decades out in the cold, from 2010, local authorities are set to become re-involved in the further education system. Given this, this paper takes the opportunity to look back on the…

  5. Infectious disease and health systems modelling for local decision making to control neglected tropical diseases

    PubMed Central

    2015-01-01

    Most neglected tropical diseases (NTDs) have complex life cycles and are challenging to control. The “2020 goals” of control and elimination as a public health programme for a number of NTDs are the subject of significant international efforts and investments. Beyond 2020 there will be a drive to maintain these gains and to push for true local elimination of transmission. However, these diseases are affected by variations in vectors, human demography, access to water and sanitation, access to interventions and local health systems. We therefore argue that there will be a need to develop local quantitative expertise to support elimination efforts. If available now, quantitative analyses would provide updated estimates of the burden of disease, assist in the design of locally appropriate control programmes, estimate the effectiveness of current interventions and support ‘real-time’ updates to local operations. Such quantitative tools are increasingly available at an international scale for NTDs, but are rarely tailored to local scenarios. Localised expertise not only provides an opportunity for more relevant analyses, but also has a greater chance of developing positive feedback between data collection and analysis by demonstrating the value of data. This is essential as rational program design relies on good quality data collection. It is also likely that if such infrastructure is provided for NTDs there will be an additional impact on the health system more broadly. Locally tailored quantitative analyses can help achieve sustainable and effective control of NTDs, but also underpin the development of local health care systems.

  6. Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children

    PubMed Central

    Bernard, Stéphane; Proust, Joëlle; Clément, Fabrice

    2015-01-01

    Some studies, so far limited in number, suggest the existence of procedural metacognition in young children, that is, the practical capacity to monitor and control one’s own cognitive activity in a given task. The link between procedural metacognition and false belief understanding is currently under theoretical discussion. If data with primates seem to indicate that procedural metacognition and false belief understanding are not related, no study in developmental psychology has investigated this relation in young children. The present paper aims, first, to supplement the findings concerning young children’s abilities to monitor and control their uncertainty (procedural metacognition) and, second, to explore the relation between procedural metacognition and false belief understanding. To examine this, 82 3- to 5-year-old children were presented with an opt-out task and with 3 false belief tasks. Results show that children can rely on procedural metacognition to evaluate their perceptual access to information, and that success in false belief tasks does not seem related to success in the task we used to evaluate procedural metacognition. These results are coherent with a procedural view of metacognition, and are discussed in the light of recent data from primatology and developmental psychology. PMID:26517260

  7. Local Control Over the Schools in Two American Indian Communities: A Preliminary Examination of Structural Constraints and "Internal Control" Attitudes.

    ERIC Educational Resources Information Center

    Weinman, Janice Jennie

    Underlying present Governmental and private objectives to institute local control over the schools on Indian reservations is the hope that such a policy will improve American Indians' sense of relevance of their own behavior to the outcome of their destiny. Although the connection between community control and sense of personal efficacy has never…

  8. Tuning the local temperature during feedback controlled electromigration in gold nanowires

    SciTech Connect

    Xiang, An; Hou, Shimin Liao, Jianhui

    2014-06-02

    Feedback controlled electromigration (FCE) in metallic nanowires has been widely used for various purposes. However, the control of the local temperature during FCE remains a challenge. Here, we report that the environment temperature can be used as a knob to tune the local temperature during FCE in gold nanowires. FCE was performed in gold nanowires at various environment temperatures ranging from 4.2 K to 300 K. We find that the dissipated power normalized by the cross section area of the nano constriction is linearly proportional to the environment temperature. Interestingly, the estimated local maximum temperature parabolically depends on the environment temperature. A minimum in the local temperature can be reached if an appropriate environment temperature is chosen. Our findings are well supported by the finite element simulation. Moreover, the data indicates the coupling between FCE triggering current density and local temperature.

  9. Alveolar Ridge Contouring with Free Connective Tissue Graft at Implant Placement: A 5-Year Consecutive Clinical Study.

    PubMed

    Hanser, Thomas; Khoury, Fouad

    2016-01-01

    This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implant placement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissue volume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P < .05) in all six reference points representing the outer alveolar soft tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P < .05) decrease in volume. Clinically, 5 years after prosthetic incorporation the originally concave buccal alveolar contour was still convex in all implants, leading to a continuous favorable anatomical shape and improved esthetic situation. Intraoral radiographs confirmed osseointegration and stable peri-implant parameters with a survival rate of 100% after a follow-up of approximately 5 years. Implant placement with concomitant free connective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal

  10. SU-E-J-52: Decreasing Frequency of Performing TG-142 Imaging QA – 5 Year Experience

    SciTech Connect

    Lin, T; Ma, C

    2015-06-15

    Purpose This study is an update to check if the frequency of imaging QA suggested by AAPM Task Group Report 142 (TG142) is necessary with our 5 year experience. TG142 presents recommendations for QA criteria of IGRT treatment. ACR has adopted it to be the requirements for any radiatiotherapy practices; however, we propose to reduce the frequency on image quality QA according to this 5 year study.Method and Materials: This study uses VarianIX2100 and Siemens Artiste Linacs to perform QAs on KV, MV, CBCT modalities. The QA was designed following under the recommendations of TG142. This study reports the daily imaging positioning/repositioning and imaging and treatment coordinate coincidence. QA results on kV, MV and CBCT from 4/7/2010∼3/11/15 are analyzed. KV, MV, CBCT images are taken with the Varian isocube localized at the isocenter. Digital graticule is used in the software to verify the isocenter position. CBCT images are taken with the cube placed at 1cm superior, lateral and anterior of the isocenter. In-line fusion software is used to verify the contrived shift. Digital ruler provided at the on-board-imaging software or adaptive-targeting software was used to measure the position differences. The position differences were recorded at AP,LR,SI directions. Results 5 year records on kV, MV, CBCT show the shifts in all three directions are within the tolerance of 1mm suggested in TG142 for stereotactic radiation treatment(SRS/SRT). There is no occasion where shifts are outside 1mm tolerance. Conclusions The daily imaging QA suggested in TG142 is useful in ensuring the accuracy needed for SRS/SRT in IGRT. 5 year measurements presented suggest that decreasing the frequency of imaging QA may be acceptable, in particular for institutions reporting no violation of tolerance over periods of few years.

  11. Continuous improvement of arterial compliance beyond blood pressure decrease after 5 years of antihypertensive treatment.

    PubMed

    Bellido, Claudio A; Iavicoli, Oscar R; Rusak, Eduardo J; Vazquez, Sonia T; Piñeiro, Daniel J; Lerman, Jorge

    2006-08-01

    Pulse wave velocity is a reliable marker of arterial compliance. Stiffness of large and elastic arteries leads to a faster propagation of pulse wave. The aim of this study was to evaluate changes in arterial distensibility using antihypertensive drugs. This treatment focused on the inhibition of the renin-angiotensin-aldosterone system and the changes produced in blood pressure. Measurements were taken at baseline and throughout 60 months in 66 previously untreated hypertensive patients (22 men and 44 women, aged 54 +/- 9.5 years, range 38-73 years at baseline). All patients received either angiotensin-converting enzyme inhibitors or, in case of adverse effects, angiotensin receptor blockers. To control blood pressure, diuretics, calcium channel blocking agents, or beta blockers were added when appropriate. Statistical analysis was performed by means of ANOVA with alpha = 0.05. Systolic and diastolic blood pressure decreased during the first year without significant changes thereafter. There were no significant changes in pulse pressure. Pulse wave velocity showed a continuous and significant decrease throughout the follow-up period, but its reduction since the third year was more evident than the decrease in systolic and diastolic blood pressure (p < 0.0001 for both). This observation could be related to changes in arterial remodeling probably due to angiotensin-converting enzyme inhibition or renin angiotensin system blockade. Further investigations are needed to establish this relationship. PMID:16896271

  12. Dimensionality and Reliability of Letter Writing in 3- to 5-Year-Old Preschool Children

    PubMed Central

    Puranik, Cynthia S.; Petscher, Yaacov; Lonigan, Christopher J.

    2015-01-01

    The primary purpose of this study was to examine the dimensionality and reliability of letter writing skills in preschool children with the aim of determining whether a sequence existed in how children learn to write the letters of the alphabet. Additionally, we examined gender differences in the development of letter writing skills. 471 children aged 3 to 5 years old completed a letter writing task. Results from factor analyses indicated that letter writing represented a unidimensional skill. Similar to research findings that the development of letter-names and letter-sound knowledge varies in acquisition, our findings indicate that the ability to write some letters is acquired earlier than the ability to write other letters. Although there appears to be an approximate sequence for the easiest and most difficult letters, there appears to be a less clear sequence for letters in the middle stages of development. Overall, girls had higher letter writing scores compared to boys. Gender differences regarding difficulty writing specific letters was less conclusive; however, results indicated that when controlling for ability level, girls had a higher probability of writing a letter correctly than boys. Implications of these findings for the assessment and instruction of letter writing are discussed. PMID:26346443

  13. Residual strength of repaired graphite/epoxy laminates after 5 years of outdoor exposure

    NASA Technical Reports Server (NTRS)

    Deaton, Jerry W.

    1990-01-01

    The NASA Langley Research Center has sponsored research to develop generic repair techniques and processes for advanced graphite/epoxy (Gr/Ep) composites applicable to secondary structures for commercial transport aircraft. The long-term durability of such repairs is being addressed in a 10-year outdoor exposure program at the Langley Research Center. Details of the program and results of residual strength tests after 5 years of outdoor exposure are presented. Four repair methods are being evaluated. These include: (1) externally bolted aluminum-plus adhesive; (2) precured, bonded external Gr/Ep; (3) cure-in-place external Gr/Ep; and (4) cure-in-place flush Gr/Ep. Repaired specimens as well as undamaged and damaged unrepaired controls are being exposed outdoors for 1, 3, 5, 7, and 10 years. The residual tensile strength of stressed, unstressed, and fatigue specimens from each group is reported and compared with the tensile strength of baseline specimens which received no outdoor exposure. Identification of the commercial products and companies is used to describe adequately the test materials. The identification of these commercial products does not constitute endorsement, expressed or implied, of such products by the National Aeronautics and Space Administration.

  14. Friability and aggregate stability of loamy soil after 5 years of biochar application

    NASA Astrophysics Data System (ADS)

    Utomo, Wani; Ganika, Shaory; Wisnubroto, Erwin; Islami, Titiek

    2016-04-01

    The effect of biochar application on soil friability and aggregate stability of loamy soil was studied at Brawijaya University field experimental station, Jatikerto, Malang, Indonesia. The soil has been planted with cassava for 4 years continuously and 1 year planted with maiz. The biochar applied was made from cassava stem and farm yard manure. It was found that biochar application, either made from cassava stem or farm yard manure improved soil qualities. Soil applied with biochar was more friable compared to that of the no biochar soil, although biochar application did not influence Atterberg limits. It seems that the higher friability of biochar applied soil was associated with the higher soil organic matter. It was found that until 5 years application, the biochar treated soil had a higher soil organic matter content. Soil applied with biochar possessed a better soil aggregate stability, both dry and wet stability. This was shown by the higher aggregate mean weight diameter (MWD) of biochar applied soil. The cassava biochar applied soil had MWD of 2.22 mm (dry stability) and 1.56 mm (wet stability), whereas the control soil had MWD of 1.45 mm (dry stability) and 1.25 (wet stability). There was a significant positive correlation between soil friability and dry aggregate stability. The biochar applied soils also had higher soil permeability. Key words: soil qualities, soil physical properties, Atterberg limits, hydraulic conductivity

  15. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    PubMed Central

    Demiralp, Kemal Özgür; Akbulut, Nihat; Kursun, Sebnem; Argun, Didem; Bagis, Nilsun; Orhan, Kaan

    2015-01-01

    Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm) according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P < 0.05). Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P < 0.05). Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials. PMID:25961004

  16. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of...

  17. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of...

  18. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of...

  19. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of...

  20. Marginal bone preservation in single-tooth replacement: a 5-year prospective clinical multicenter study.

    PubMed

    2016-06-10

    Although this study heralded that over half the implants gained bone, this was between 1 and 5 years after placement, the amounts were trivial, and this has to be balanced with loss of bone during the first year. PMID:27283560

  1. Explaining variation in gun control policy advocacy tactics among local organizations.

    PubMed

    Zakocs, Ronda C; Earp, Jo Anne L

    2003-06-01

    The goal of this study was to determine how well four organizational characteristics (structure, resources, motivation, or political capacity) explained local organizations' use of a variety of advocacy tactics aimed at promoting state gun control laws. In 1998, 679 local organizations were identified as potentially active on state gun control issues; a questionnaire was mailed to each group's leader. Seventy-nine percent (n = 538) responded to the survey, with 81% (n = 207) of eligible organizations completing questionnaires. The four organizational characteristics explained approximately half the variation in local groups' use of a wide range of advocacy tactics. Organizations with stronger motivation to address the gun control issue and greater political capacity engaged in more diverse gun control advocacy tactics; the authors found organizational structure and resources unlikely to be related. Leaders of advocacy organizations should consider ways to encourage members' motivations on the issue while fostering greater capacity for political action. PMID:19731501

  2. Local knowledge, science, and institutional change: the case of desertification control in Northern China.

    PubMed

    Yang, Lihua

    2015-03-01

    This article studies the influence of local knowledge on the impact of science on institutional change in ecological and environmental management. Based on an empirical study on desertification control in 12 counties in north China, the study found the following major results: (1) although there was a cubic relationship between the extent and effect of local knowledge, local knowledge significantly influenced the impact of science on institutional change; (2) local knowledge took effect mainly through affecting formal laws and regulations, major actors, and methods of desertification control in institutional change but had no significant impact on the types of property rights; and (3) local knowledge enhanced the impact of science on the results of desertification control through affecting the impact of science on institutional change. These findings provide a reference for researchers, policy makers, and practitioners, both in China and in other regions of the world, to further explore the influence of local knowledge on the impact of science on institutional change and the roles of local knowledge or knowledge in institutional change and governance. PMID:25479704

  3. Excellent Local Control From Radiation Therapy for High-Risk Neuroblastoma

    SciTech Connect

    Gatcombe, Heather G.; Marcus, R.B.; Katzenstein, Howard M.; Tighiouart, Mourad; Esiashvili, Natia

    2009-08-01

    Purpose: Local recurrence has been demonstrated in previous studies to be one of the obstacles to cure in neuroblastoma. Radiation therapy indications, optimal dose, and technique are still evolving. Here we report our experience of high-risk neuroblastoma patients who received local radiation therapy as part of their cancer management. Methods and Materials: We conducted a retrospective study of 34 high-risk neuroblastoma patients who received radiation therapy to local sites of disease from March 2001 until February 2007 at our institution as part of their multimodality therapy. Results: At a median follow-up of 33.6 months, 6 patients died of disease, 7 patients were alive with disease, and 21 patients were in clinical remission. Eleven patients relapsed, all distantly. Two patients failed locally in addition to distant sites. Both of these patients had persistent gross disease after induction chemotherapy and surgery. Our 3-year local control, event-free survival, overall survival were 94%, 66%, and 86%, respectively. Conclusion: Patients with high-risk neuroblastoma in our series achieved excellent local control. Doses of 21-24 Gy to the primary tumor site appear to be adequate for local control for patients in the setting of minimal residual disease after induction chemotherapy and surgery. Patients with significant residual disease may benefit from radiation dose escalation, and this should be evaluated in a prospective clinical trial.

  4. Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

    PubMed Central

    Lunze, Fatima I.; Lunze, Karsten; Tsorieva, Zemfira M.; Esenov, Constantin T.; Reutov, Alexandr; Eichhorn, Thomas; Offergeld, Christian

    2015-01-01

    Background Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results Patients were treated for trauma related to terrorism (53%) and for indications not related to violence (47%). None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism) who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include specialized

  5. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    PubMed Central

    2012-01-01

    Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131) were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE) were employed to assess predictors of outcome. Results We could follow up 95 (72.5%) patients. Sixty-five of these patients (68.4%) achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context, acceptable cultural explanations

  6. Supporting countries in establishing and strengthening NITAGs: lessons learned from 5 years of the SIVAC initiative.

    PubMed

    Adjagba, Alex; Senouci, Kamel; Biellik, Robin; Batmunkh, Nyambat; Faye, Pape Coumba; Durupt, Antoine; Gessner, Bradford D; da Silva, Alfred

    2015-01-29

    To empower governments to formulate rational policies without pressure from any group, and to increase the use of evidence-based decision-making to adapt global recommendations on immunization to their local context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine Action Plan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across all populations. In 2012, according to the WHO-UNICEF Joint Reporting Form, among 57 countries eligible for immunization program financial support from the GAVI Alliance, only 9 reported having a functional NITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and other partners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, the initiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based processes for decision-making aligned with international standards. After 5 years of implementation and based on lessons learned, we recommend that future efforts should target both expanding new NITAGs and strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity within NITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collaborations. These should be done through the development

  7. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

    PubMed Central

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

    2015-01-01

    Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.

  8. Liberty and the New Localism: Toward an Evaluation of the Trade-Off between Educational Equity and Local Control of Schools.

    ERIC Educational Resources Information Center

    Bull, Barry L.

    1984-01-01

    The value of local control of school systems is discussed. Local control is defined, and its connection with justice explored. Implications for school finance based on personal and participatory liberty rules for distributing costs are given. Robert K. Winpelberg offers comments on this article. (DF)

  9. The influence of diabetic peripheral neuropathy on local postural muscle and central sensory feedback balance control.

    PubMed

    Toosizadeh, Nima; Mohler, Jane; Armstrong, David G; Talal, Talal K; Najafi, Bijan

    2015-01-01

    Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15-second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P<0.01), which suggests a compromised local-control balance behavior in DPN patients. Unlike local-control, the rate of sway within central-control was 60% smaller in the DPN group (healthy central-controlslope-Log = 0.39±0.23, P<0.02), which suggests an adaptation mechanism to reduce the overall body sway in DPN patients. Interestingly, significant negative correlations were observed between central-control rate of sway with neuropathy severity (rPearson = 0.65-085, P<0.05) and the history of diabetes (rPearson = 0.58-071, P<0.05). Results suggest that in the lack of sensory feedback cueing, DPN participants were highly unstable compared to controls. However, as soon as they perceived the magnitude of sway using sensory feedback, they chose a high rigid postural control strategy, probably due to high concerns for fall, which may increase the energy cost during extended period of standing; the adaptation mechanism

  10. The Influence of Diabetic Peripheral Neuropathy on Local Postural Muscle and Central Sensory Feedback Balance Control

    PubMed Central

    2015-01-01

    Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15-second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P<0.01), which suggests a compromised local-control balance behavior in DPN patients. Unlike local-control, the rate of sway within central-control was 60% smaller in the DPN group (healthy central-controlslope-Log = 0.39±0.23, P<0.02), which suggests an adaptation mechanism to reduce the overall body sway in DPN patients. Interestingly, significant negative correlations were observed between central-control rate of sway with neuropathy severity (rPearson = 0.65-085, P<0.05) and the history of diabetes (rPearson = 0.58-071, P<0.05). Results suggest that in the lack of sensory feedback cueing, DPN participants were highly unstable compared to controls. However, as soon as they perceived the magnitude of sway using sensory feedback, they chose a high rigid postural control strategy, probably due to high concerns for fall, which may increase the energy cost during extended period of standing; the adaptation mechanism

  11. Specialist Pediatric Palliative Care Prescribing Practices: A Large 5-year Retrospective Audit

    PubMed Central

    Damani, Anuja; Salins, Naveen; Ghoshal, Arunangshu; Muckaden, MaryAnn

    2016-01-01

    Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010–2014) to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%), and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription noncompliance by

  12. Control of Grain Structure in Pure Copper by a Local Heating

    NASA Astrophysics Data System (ADS)

    Shibayanagi, Toshiya; Tsukamoto, Masahiro; Abe, Nobuyuki

    The present work deals with a preferential grain growth process in a localized region utilizing local heating method in order to fabricate some unique microstructures different from those fabricated in the homogeneous way of microstructure evolution. A Monte Carlo simulation of grain growth under a heterogeneous temperature gradient, i.e. spot heating, was performed. Steep temperature gradient brought about a preferential grain growth in the higher temperature region, showing that the local heating was effective for the control of grain structure of polycrystalline materials. Such type of preferential grain growth became less significant under the mild temperature gradient. Local heating of pure copper foil with 0.2mm in thickness utilizing laser beam was performed by changing the irradiation conditions. In the case of 200W for laser power and 18mm/s for sweep velocity, some grains were observed to have larger grain sizes than their surrounding grains, suggesting a possibility of preferential grain growth in the localized region.

  13. Results of treatment in patients with IIa - IIIast. breast cancer treated by combination of low-level laser therapy (LLLT) and surgery (5-year experience)

    NASA Astrophysics Data System (ADS)

    Mikhailov, V. A.; Skobelkin, Oleg K.; Denisov, I. N.; Frank, George A.; Voltchenko, N. N.

    1996-01-01

    Laser therapy with semiconductor laser (wavelength 890 nm) was performed in 41 patients with IIa - IIIast. breast cancer. LLLT was used before surgery and in postoperative period during 2 years. LLLT decreased postoperative complications by 15.3% and decreased duration of lymphorrhea. 5 years survival in patients with IIast. breast cancer treated by LLLT was 100%, in control group--85.71%. In patients with IIIast. breast cancer treated by LLLT survival was 94.44%, in control group--78.94%. 91.3% of patients with IIast. treated by LLLT had not recurrences in 5 year period, in the controls they were in about 77.7%. 82.35% of patients with IIIast. treated by laser therapy had no recurrences in 5 year period, in control group--60%.

  14. The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions

    PubMed Central

    Lal, Aparna; Fearnley, Emily; Kirk, Martyn

    2015-01-01

    The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2–1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2–2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3–6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9–9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years. PMID:26393636

  15. Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease.

    PubMed

    Olivieri, I; Foto, M; Ruju, G P; Gemignani, G; Giustarini, S; Pasero, G

    1992-03-01

    In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences. PMID:1578464

  16. An integrative model of the cardiac ventricular myocyte incorporating local control of Ca2+ release.

    PubMed Central

    Greenstein, Joseph L; Winslow, Raimond L

    2002-01-01

    The local control theory of excitation-contraction (EC) coupling in cardiac muscle asserts that L-type Ca(2+) current tightly controls Ca(2+) release from the sarcoplasmic reticulum (SR) via local interaction of closely apposed L-type Ca(2+) channels (LCCs) and ryanodine receptors (RyRs). These local interactions give rise to smoothly graded Ca(2+)-induced Ca(2+) release (CICR), which exhibits high gain. In this study we present a biophysically detailed model of the normal canine ventricular myocyte that conforms to local control theory. The model formulation incorporates details of microscopic EC coupling properties in the form of Ca(2+) release units (CaRUs) in which individual sarcolemmal LCCs interact in a stochastic manner with nearby RyRs in localized regions where junctional SR membrane and transverse-tubular membrane are in close proximity. The CaRUs are embedded within and interact with the global systems of the myocyte describing ionic and membrane pump/exchanger currents, SR Ca(2+) uptake, and time-varying cytosolic ion concentrations to form a model of the cardiac action potential (AP). The model can reproduce both the detailed properties of EC coupling, such as variable gain and graded SR Ca(2+) release, and whole-cell phenomena, such as modulation of AP duration by SR Ca(2+) release. Simulations indicate that the local control paradigm predicts stable APs when the L-type Ca(2+) current is adjusted in accord with the balance between voltage- and Ca(2+)-dependent inactivation processes as measured experimentally, a scenario where common pool models become unstable. The local control myocyte model provides a means for studying the interrelationship between microscopic and macroscopic behaviors in a manner that would not be possible in experiments. PMID:12496068

  17. Direct subwavelength imaging and control of near-field localization in individual silver nanocubes

    SciTech Connect

    Mårsell, Erik; Svärd, Robin; Miranda, Miguel; Guo, Chen; Harth, Anne; Lorek, Eleonora; Mauritsson, Johan; Arnold, Cord L.; L'Huillier, Anne; Mikkelsen, Anders; Losquin, Arthur; Xu, Hongxing

    2015-11-16

    We demonstrate the control of near-field localization within individual silver nanocubes through photoemission electron microscopy combined with broadband, few-cycle laser pulses. We find that the near-field is concentrated at the corners of the cubes, and that it can be efficiently localized to different individual corners depending on the polarization of the incoming light. The experimental results are confirmed by finite-difference time-domain simulations, which also provide an intuitive picture of polarization dependent near-field localization in nanocubes.

  18. Real-time neural network based camera localization and its extension to mobile robot control.

    PubMed

    Choi, D H; Oh, S Y

    1997-06-01

    The feasibility of using neural networks for camera localization and mobile robot control is investigated here. This approach has the advantages of eliminating the laborious and error-prone process of imaging system modeling and calibration procedures. Basically, two different approaches of using neural networks are introduced of which one is a hybrid approach combining neural networks and the pinhole-based analytic solution while the other is purely neural network based. These techniques have been tested and compared through both simulation and real-time experiments and are shown to yield more precise localization than analytic approaches. Furthermore, this neural localization method is also shown to be directly applicable to the navigation control of an experimental mobile robot along the hallway purely guided by a dark wall strip. It also facilitates multi-sensor fusion through the use of multiple sensors of different types for control due to the network's capability of learning without models. PMID:9427102

  19. Three-Centimeter Bullet in the Orbita of a 2.5-Year-Old Syrian Boy.

    PubMed

    Solmaz, İskender A; Tekerekoğlu, Bülent

    2015-06-01

    Aim of this report is to present a patient who has had a retrobulbar bullet in his left orbit after gunshot injury and had full recovery after surgery. A Syrian boy aged 2.5 years was referred to our emergency after a gunshot injury from left temple. First examination showed stable vital functions; the boy was conscious but had marked proptosis and edema on the left eye. Left intraorbital bullet was observed in X-ray and computed tomography. The exact localization of the bullet and the integrity of the left eye cannot be determined because of shining in computed tomography. Under general anesthesia, lateral and inferior orbitotomy was performed and 3-cm long bullet was excised, which was obliquely localized in the retrobulbar, intraconal area. Ten days later, the patient was sent to his homeland with almost full recovery and minimum sequela. PMID:26080186

  20. Aggressive Angiomyxoma of the Vulva with No Recurrence on a 5-year Follow up: A Case Report.

    PubMed

    Narayama, Chisa; Ikeda, Masae; Yasaka, Miwa; Sagara, Yusuke; Kan-No, Yasuhira; Hayashi, Io; Narita, Atuya; Asai, Satoshi; Tajima, Toshiki; Shida, Masako; Hirasawa, Takeshi; Mikami, Mikio

    2016-01-01

    We report a case of vulvar aggressive angiomyxoma (AA) which is a rare, slow growing and benign tumor of mesenchymal origin, but has a high risk of local recurrence. A 49-year-old Japanese female was referred to us with a large mass of the left vulva, measuring 15×9.5×9 centimeters. She underwent surgical excision of the tumor with no evidence of recurrence on a 5-year follow up. In this case, histopathological examination and immunohistochemical staining after excision revealed a diagnosis of vulvar AA with estrogen and progesterone receptors positive. Aggressive angiomyxoma of the vulva needs to be distinguished from benign myxoid tumor with a low risk of local recurrence as well as from malignant neoplasma. The first line treatment of AA is complete surgical excision with tumor free margins, it will reduce the recurrence. PMID:27050895

  1. Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances.

    PubMed

    Yin, You; Liu, Yan; Zhuang, Jianhua; Pan, Xiao; Li, Peng; Yang, Yuechang; Li, Yan-Peng; Zhao, Zheng-Qing; Huang, Liu-Qing; Zhao, Zhong-Xin

    2015-01-01

    Sleep disturbances (SD) accelerate the progression of Alzheimer's disease (AD) and increase the stress of caregivers. However, the long-term outcome of disturbed nocturnal sleep/wake patterns in AD and on increased stress of spousal caregivers is unclear. This study assessed the 5-year effect of nocturnal SD on the long-term outcome in AD patients. A total of 156 donepezil-treated mild-moderate AD patients (93 AD + SD and 63 AD - SD as a control group) were recruited. The AD + SD patients were formed into 4 subgroups according to the preferences of spousal caregivers for treatment with atypical antipsychotics (0.5-1 mg risperidone, n = 22), non-benzodiazepine hypnotic (5-10 mg zolpidem tartrate, n = 33), melatonin (2.55 mg, n = 9), or no-drug treatment (n = 29). SD were evaluated by polysomnography, sleep scale, and cognitive scale examinations. Moreover, all spousal caregivers of AD patients were assessed using a series of scales, including sleep, anxiety, mood, and treatment attitude scales. Our data showed that nocturnal sleep/wake disturbances were significantly associated with lower 5-year outcomes for AD patients, earlier nursing home placement, and more negative emotions of spousal caregivers. Treatment with low-dose atypical antipsychotic risperidone improved the 5-year outcome in AD + SD patients. In conclusion, low-dose atypical antipsychotic risperidone improves the 5-year outcome in AD patients with SD. Moreover, improvement of nocturnal sleep problems in AD patients will also bring better emotional stability for AD caregivers. PMID:26279176

  2. Local Tumor Control, Visual Acuity, and Survival After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

    SciTech Connect

    Dunavoelgyi, Roman; Dieckmann, Karin; Gleiss, Andreas; Sacu, Stefan; Kircher, Karl; Georgopoulos, Michael; Georg, Dietmar; Zehetmayer, Martin; Poetter, Richard

    2011-09-01

    Purpose: To evaluate long-term local tumor control, visual acuity, and survival after hypofractionated linear accelerator-based stereotactic photon radiotherapy in patients with choroidal melanoma. Methods and Materials: Between 1997 and 2007, 212 patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at a linear accelerator with 6-MV photon beams at the Medical University of Vienna in five fractions over 7 days. Twenty-four patients received a total dose of 70 Gy (five fractions of 14 Gy), 158 a total dose of 60 Gy (five fractions of 12 Gy) and 30 patients a total dose of 50 Gy (five fractions of 10 Gy) applied on the 80% isodose. Ophthalmologic examinations were performed at baseline and every 3 months in the first 2 years, every 6 months until 5 years, and once a year thereafter until 10 years after radiotherapy. Assessment of visual acuity, routine ophthalmologic examinations, and measurement of tumor base dimension and height using standardized A-scan and B-scan echography were done at each visit. Funduscopy and fluorescein angiography were done when necessary to document tumor response. Results: Median tumor height and volume decreased from 4.8 mm and 270.7 mm{sup 3} at baseline to 2.6 mm and 86.6 mm{sup 3} at the last individual follow-up, respectively (p < 0.001, p < 0.001). Median visual acuity decreased from 0.55 at baseline to hand motion at the last individual follow-up (p < 0.001). Local tumor control was 95.9% after 5 years and 92.6% after 10 years. Thirty-two patients developed metastatic disease, and 22 of these patients died during the follow-up period. Conclusion: Hypofractionated stereotactic photon radiotherapy with 70 to 50 Gy delivered in five fractions in 7 days is sufficient to achieve excellent local tumor control in patients with malignant melanoma of the choroid. Disease outcome and vision are comparable to those achieved with proton beam radiotherapy. Decreasing the

  3. Local fluctuation control of papain by changing a highly fluctuating residue

    NASA Astrophysics Data System (ADS)

    Nishiyama, Katsuhiko

    2013-01-01

    To control the local fluctuation of the amino acid residues of papain, ARG59, a highly fluctuating residue in papain, has been changed to GLY. We investigated the binding properties of 2-10GLY (peptides with between 2 and 10 glycine residues) to the modified papain structure via molecular dynamics and docking simulations. The change of the ARG59 residue to GLY alters the binding sites for some peptides, and changed its substrate specificity. Furthermore, the modification alters the binding stability of some peptides. Thus, control of the local fluctuations of residues in proteins has the potential to alter the protein's function.

  4. Active local control of propeller-aircraft run-up noise.

    PubMed

    Hodgson, Murray; Guo, Jingnan; Germain, Pierre

    2003-12-01

    Engine run-ups are part of the regular maintenance schedule at Vancouver International Airport. The noise generated by the run-ups propagates into neighboring communities, disturbing the residents. Active noise control is a potentially cost-effective alternative to passive methods, such as enclosures. Propeller aircraft generate low-frequency tonal noise that is highly compatible with active control. This paper presents a preliminary investigation of the feasibility and effectiveness of controlling run-up noise from propeller aircraft using local active control. Computer simulations for different configurations of multi-channel active-noise-control systems, aimed at reducing run-up noise in adjacent residential areas using a local-control strategy, were performed. These were based on an optimal configuration of a single-channel control system studied previously. The variations of the attenuation and amplification zones with the number of control channels, and with source/control-system geometry, were studied. Here, the aircraft was modeled using one or two sources, with monopole or multipole radiation patterns. Both free-field and half-space conditions were considered: for the configurations studied, results were similar in the two cases. In both cases, large triangular quiet zones, with local attenuations of 10 dB or more, were obtained when nine or more control channels were used. Increases of noise were predicted outside of these areas, but these were minimized as more control channels were employed. By combining predicted attenuations with measured noise spectra, noise levels after implementation of an active control system were estimated. PMID:14714802

  5. Telerobot local-remote control architecture for space flight program applications

    NASA Technical Reports Server (NTRS)

    Zimmerman, Wayne; Backes, Paul; Steele, Robert; Long, Mark; Bon, Bruce; Beahan, John

    1993-01-01

    The JPL Supervisory Telerobotics (STELER) Laboratory has developed and demonstrated a unique local-remote robot control architecture which enables management of intermittent communication bus latencies and delays such as those expected for ground-remote operation of Space Station robotic systems via the Tracking and Data Relay Satellite System (TDRSS) communication platform. The current work at JPL in this area has focused on enhancing the technologies and transferring the control architecture to hardware and software environments which are more compatible with projected ground and space operational environments. At the local site, the operator updates the remote worksite model using stereo video and a model overlay/fitting algorithm which outputs the location and orientation of the object in free space. That information is relayed to the robot User Macro Interface (UMI) to enable programming of the robot control macros. This capability runs on a single Silicon Graphics Inc. machine. The operator can employ either manual teleoperation, shared control, or supervised autonomous control to manipulate the intended object. The remote site controller, called the Modular Telerobot Task Execution System (MOTES), runs in a multi-processor VME environment and performs the task sequencing, task execution, trajectory generation, closed loop force/torque control, task parameter monitoring, and reflex action. This paper describes the new STELER architecture implementation, and also documents the results of the recent autonomous docking task execution using the local site and MOTES.

  6. Ultrafast active control of localized surface plasmon resonances in silicon bowtie antennas.

    PubMed

    Berrier, Audrey; Ulbricht, Ronald; Bonn, Mischa; Rivas, Jaime Gómez

    2010-10-25

    Localized surface plasmon polaritons (LSPPs) provide an efficient means of achieving extreme light concentration. In recent years, their active control has become a major aspiration of plasmonic research. Here, we demonstrate direct control of semiconductor bowtie antennas, enabling active excitation of LSPPs, at terahertz (THz) frequencies. We modify the LSPPs by ultrafast optical modulation of the free carrier density in the plasmonic structure itself, allowing for active control of the semiconductor antennas on picosecond timescales. Moreover, this control enables the manipulation of the field intensity enhancements in ranges of four orders of magnitude. PMID:21164664

  7. Stereotactic Body Radiotherapy for Pulmonary Metastases From Soft-Tissue Sarcomas: Excellent Local Lesion Control and Improved Patient Survival

    SciTech Connect

    Dhakal, Sughosh; Corbin, Kimberly S.; Milano, Michael T.; Philip, Abraham; Sahasrabudhe, Deepak; Jones, Carolyn

    2012-02-01

    Purpose: Patients with pulmonary metastases (PM) from soft-tissue sarcomas (STS) have historically been treated with surgery and/or chemotherapy. Since 2001, we have treated PM with stereotactic body radiation therapy (SBRT). We postulated that SBRT for PM from STS would yield excellent local control (LC) and overall survival (OS). Methods and Materials: Fifty-two patients with PM from STS, diagnosed between 1990 and 2006 at University of Rochester, were retrospectively reviewed. Most patients received multimodality treatment comprising of surgery, chemotherapy, and/or radiation. SBRT used the Novalis ExacTrac patient positioning platform, vacuum bag immobilization, and relaxed end-expiratory breath hold techniques. Results: Leiomyosarcoma (23%), malignant fibrous histiocytoma (19%), and synovial sarcoma (15%) were the most common histologies. Forty-eight percent initially presented with PM, whereas 52% developed PM at a median of 0.7 (0.3-7.3) years after initial diagnosis. Median follow-up from diagnosis of PM was 0.9 (0.3-7.3) years. Fifteen patients underwent SBRT to 74 lesions. Median number of lesions treated was 4 (1-16) per patient and 3.5 (1-6) per session. Preferred dose and fractionation was 50 Gy in 5 Gy fractions. Three-year LC was 82%. No patients experienced Grade {>=}3 toxicity. Median OS was 2.1 (0.8-11.5) years for patients treated with SBRT, and 0.6 (0.1-7.8) years for those who never received SBRT (p = 0.002). Conclusions: SBRT provides excellent LC of PM and may extend OS. SBRT should be considered for all patients with PM from STS, particularly those who are not surgical candidates. Further investigation is warranted to establish criteria for the use of SBRT for STS patients with PM.

  8. Toward Online Control of Local Bifurcation in Power Systems via Network Topology Optimization

    NASA Astrophysics Data System (ADS)

    Wang, Lei; Chiang, Hsiao-Dong

    This paper presents online methods for controlling local bifurcations of power grids with the goal of increasing bifurcation values (i.e. increasing load margins) via network topology optimization, a low-cost control. In other words, this paper presents online methods for increasing power transfer capability subject to static stability limit via switching transmission line out/in (i.e. disconnecting a transmission line or connecting a transmission line). To illustrate the impact of network topology on local bifurcations, two common local bifurcations, i.e. saddle-node bifurcation and structure-induced bifurcation on small power grids with different network topologies are shown. A three-stage online control methodology of local bifurcations via network topology optimization is presented to delay local bifurcations of power grids. Online methods must meet the challenging requirements of online applications such as the speed requirement (in the order of minutes), accuracy requirement and robustness requirement. The effectiveness of the three-stage methodology for online applications is demonstrated on the IEEE 118-bus and a 1648-bus practical power systems.

  9. Control of localized surface plasmon resonance energy in monolayer structures of gold and silver nanoparticles.

    PubMed

    Yokota, Hiroki; Taniguchi, Taichi; Watanabe, Taichi; Kim, DaeGwi

    2015-10-28

    Monolayer structures of Au and Ag nanoparticles (NPs) were fabricated by a dipping method to realize the control of localized surface plasmon resonance (LSPR) energy. The mean inter-particle distance in the monolayer was controlled by changing the concentration of NPs in the colloidal solution used for the monolayer assembly. The extinction-peak energy of the monolayer structure was red-shifted with decreasing inter-particle distance, reflecting plasmon coupling between NPs. PMID:26411840

  10. Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

    PubMed Central

    Cvetkova, Nadezhda P; Hölldobler, Kristina; Prahs, Philipp; Radeck, Viola; Helbig, Horst; Märker, David

    2016-01-01

    Purpose Our aim was to evaluate an optical coherence tomography (OCT) and visual acuity (VA)-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD) from 2007 to 2012. Design This was a retrospective clinical study of 5 years follow-up in a tertiary eye center. Patients and methods In this study, 66 patients with neovascular AMD (mean age of 74 years, SD 8.7 years) were included. We investigated the development of best-corrected visual acuity (BCVA), the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis) over 5 years of intravitreal treatment. Results The mean number of intravitreal ranibizumab injections over 5 years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR). After 5 years of therapy, the mean BCVA was 0.6 logMAR. In all, 16% of treated patients had stable VA over 5 years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295 µm; after 5 years of treatment, the mean central retinal thickness was 315 µm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8 injections over 5 years. In OCT, an increase in central retinal thickness over 5 years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of the disease completely. Patients with late stages of neovascular AMD can maintain VA even if they are relatively undertreated. PMID:27354758

  11. Supervisory autonomous local-remote control system design: Near-term and far-term applications

    NASA Technical Reports Server (NTRS)

    Zimmerman, Wayne; Backes, Paul

    1993-01-01

    The JPL Supervisory Telerobotics Laboratory (STELER) has developed a unique local-remote robot control architecture which enables management of intermittent bus latencies and communication delays such as those expected for ground-remote operation of Space Station robotic systems via the TDRSS communication platform. At the local site, the operator updates the work site world model using stereo video feedback and a model overlay/fitting algorithm which outputs the location and orientation of the object in free space. That information is relayed to the robot User Macro Interface (UMI) to enable programming of the robot control macros. The operator can then employ either manual teleoperation, shared control, or supervised autonomous control to manipulate the object under any degree of time-delay. The remote site performs the closed loop force/torque control, task monitoring, and reflex action. This paper describes the STELER local-remote robot control system, and further describes the near-term planned Space Station applications, along with potential far-term applications such as telescience, autonomous docking, and Lunar/Mars rovers.

  12. Local and Distant Input Controlling Excitation in Layer II of the Medial Entorhinal Cortex

    PubMed Central

    Fuchs, Elke C.; Neitz, Angela; Pinna, Roberta; Melzer, Sarah; Caputi, Antonio; Monyer, Hannah

    2016-01-01

    Summary Layer II (LII) of the medial entorhinal cortex (MEC) comprises grid cells that support spatial navigation. The firing pattern of grid cells might be explained by attractor dynamics in a network, which requires either direct excitatory connectivity between phase-specific grid cells or indirect coupling via interneurons. However, knowledge regarding local networks that support in vivo activity is incomplete. Here we identified essential components of LII networks in the MEC. We distinguished four types of excitatory neurons that exhibit cell-type-specific local excitatory and inhibitory connectivity. Furthermore, we found that LII neurons contribute to the excitation of contralateral neurons in the corresponding layer. Finally, we demonstrated that the medial septum controls excitation in the MEC via two subpopulations of long-range GABAergic neurons that target distinct interneurons in LII, thereby disinhibiting local circuits. We thus identified local connections that could support attractor dynamics and external inputs that likely govern excitation in LII. PMID:26711115

  13. Factors that determine local control with gamma knife radiosurgery: The role of primary histology†

    PubMed Central

    Black, Paul J.; Page, Brandi R.; Lucas, John T.; Hughes, Ryan T.; Laxton, Adrian W.; Tatter, Stephen B.; Munley, Michael T.; Chan, Michael D.

    2015-01-01

    Background Stereotactic radiosurgery for the treatment of brain metastases is commonly delivered without regard to primary cancer histology. This study sought to determine if the primary site of origin for brain metastases affected the propensity for local failure. Methods A total of 83 patients with 200 brain metastases were examined retrospectively for predictors of infield failure. Tumor, patient, and treatment characteristics were analyzed including primary tumor histology, radiosurgical dose and age. Cox proportional hazards models, univariate and multivariate analyses were used to identify predictors of local failure. Results Freedom from local failure for the entire population was 83% and 65% at 6 and 12 months, respectively. Multivariate analysis revealed that breast cancer brain metastases have a significantly lower risk of local failure than melanoma (HR = 0.31, p< 0.001). Additionally, multivariate analysis revealed that increasing dose lowered risk for local failure (HR = 0.87, p<0.001). Conclusions Melanoma histology leads to a higher rate of local failure. Higher prescription dose results in higher incidence of local control. PMID:26478823

  14. Effects of a Randomized Reading Intervention Study Aimed at 9-Year-Olds: A 5-Year Follow-up.

    PubMed

    Wolff, Ulrika

    2016-05-01

    The present paper reports on a 5-year follow-up of a randomized reading intervention in grade 3 in Sweden. An intervention group (n = 57) received daily training for 12 weeks in phoneme/grapheme mapping, reading comprehension and reading speed, whereas a control group (n = 55) participated in ordinary classroom activities. The main aim was to investigate if there were remaining effects of the intervention on reading-related skills. Previous analyses showed that the intervention group performed significantly better than the control group on spelling, reading speed, reading comprehension and phoneme awareness at the immediate post-test with sustained effects 1 year later. Results from the 5-year follow-up show that the only significant difference between the intervention (n = 47) and the control group (n = 37) was on word decoding. There was also a significant interaction effect of group assignment and initial word decoding, in the way that the lowest-performing students benefitted the most from the intervention. Another aim was to examine if the children identified in a screening (n = 2212) as poor readers in grade 2 still performed worse than typical readers. The analyses showed that the typically developing students (n = 66) outperformed the students identified as poor readers in grade 2 on working memory, spelling, reading comprehension and word decoding. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27146373

  15. Community-Based School Finance and Accountability: A New Era for Local Control in Education Policy?

    ERIC Educational Resources Information Center

    Vasquez Heilig, Julian; Ward, Derrick R.; Weisman, Eric; Cole, Heather

    2014-01-01

    Top-down accountability policies have arguably had very limited impact over the past 20 years. Education stakeholders are now contemplating new forms of bottom-up accountability. In 2013, policymakers in California enacted a community-based approach that creates the Local Control Funding Formula (LCFF) process for school finance to increase…

  16. Local Control Funding Formula in California: How to Monitor Progress and Learn from a Grand Experiment

    ERIC Educational Resources Information Center

    Fuller, Bruce; Tobben, Laura

    2014-01-01

    The Local Control Funding Formula (LCFF) was enacted by the California legislature in June 2013 and fundamentally changes the distribution of education dollars to districts. The legislation simplifies the formula for sending money to districts and now takes into account the higher costs of educating certain groups of students, specifically those…

  17. Application of a locally optimized control theory to pump dump laser-driven chemical reactions

    NASA Astrophysics Data System (ADS)

    Ohtsuki, Y.; Yahata, Y.; Kono, H.; Fujimura, Y.

    1998-05-01

    A locally optimized control theory is developed. This theory is applied to pump-dump laser-driven chemical reactions via an electronically excited state. The results show that the theory can design the pulse shapes for chemical reactions with high quantum yields in strong laser intensity regimes in which perturbative treatments break down.

  18. LandScape Command Set: Local Area Network Distributed Supervisory Control and Programming Environment

    SciTech Connect

    Burchard, R.L.; Small, D.E.

    1999-01-01

    This paper presents the Local Area Network Distributed Supervisory Control and Programming Environment (LandScape) commands set that provides a Generic Device Subsystem Application Programmers Interface (API). These commands are implemented using the Common Object Request Broker Architecture (CORBA) specification with Orbix from Iona Technologies.

  19. Industry/Government Teleconference on Pollution Control. Proceedings National Telecast and Local Panel Sessions.

    ERIC Educational Resources Information Center

    National Association of Manufacturers, New York, NY.

    Proceedings of the closed-circuit Teleconference on Pollution Control conducted by the National Association of Manufacturers on May 26, 1971 are supplied in this compendium. Edited transcripts are provided for the national programs and local panel sessions. Seeking to bring business and government together for cooperative problem solving, the…

  20. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Measures in the event of inadequate local control. 70.2 Section 70.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.2 Measures in the event of inadequate...

  1. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Measures in the event of inadequate local control. 70.2 Section 70.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.2 Measures in the event of inadequate...

  2. Radiation therapy for T2N0 laryngeal cancer: A retrospective analysis for the impact of concurrent chemotherapy on local control

    SciTech Connect

    Akimoto, Tetsuo . E-mail: takimoto@showa.gunma-u.ac.jp; Nonaka, Tetsuo; Kitamoto, Yoshizumi; Ishikawa, Hitoshi; Ninomiya, Hiroshi; Chikamatsu, Kazuaki; Furuya, Nobuhiko; Hayakawa, Kazushige; Mitsuhashi, Norio; Nakano, Takashi

    2006-03-15

    Purpose: The impact of concurrent chemotherapy on the local control in patients with T2N0 laryngeal cancer who receive radiation therapy (RT) was evaluated. Methods and Materials: Sixty-three patients with T2N0 laryngeal cancer who were treated by definitive RT were analyzed. The primary site of the cancer was the glottis in 50 patients, the supraglottis in 9 patients, and the subglottis in 4 patients. Thirty-six patients were treated by RT alone and the remaining 27 patients received concurrent chemoradiotherapy (CRT). Results: Complete response (CR) was obtained in 92% of the patients who received RT alone and 100% of the patients who received CRT. Voice preservation in the group who received CRT (89%) was significantly higher than that in the group treated by RT alone (61%). The 5-year disease-free survival rates in those who received concurrent CRT was significantly superior to that in the patients who received RT alone, although no significant difference was seen in the cause-specific survival rate between the 2 groups. The multivariate analysis revealed that the treatment method (RT alone vs. CRT) was the most significant risk factor that predicted recurrence after RT. Conclusion: Concurrent CRT had a positive impact on the local control of T2N0 laryngeal cancer.

  3. Implementation of local feedback controllers for vibration supression of a truss using active struts

    NASA Astrophysics Data System (ADS)

    McClelland, Robert; Lim, Tae W.; Bosse, Albert; Fisher, Shalom

    1996-05-01

    This paper describes the design and implementation of local feedback controllers for active vibration suppression of a laboratory truss referred to as the Naval Research Laboratory (NRL) space truss. The NRL space truss is a 3.7 meter, 12-bay aluminum laboratory truss used as a testbed to explore smart structures technologies for future Navy spacecraft missions. To conduct real-time control and data acquisition for the implementation of controllers, a digital signal processor based system is used. Two piezoceramic active struts are employed in this experimental study. Each strut is instrumented with a force transducer and a displacement sensor. Modal strain energy computed using a refined finite element model was used to select the optimum locations of the two actuators to ensure controllability of the first two structural modes. Two local feedback controllers were designed and implemented, an integral force feedback and an integral plus double-integral force feedback. The controllers were designed independently for each active strut using classical control design techniques applied to an identified model of the system dynamics. System identification results and controller design procedure are described along with closed loop test results. The test results show up to a factor of 1/110 attenuation of the truss tip motion due to sinusoidal resonant input disturbances and up to 100 times increase in damping of the lower frequency modes of the truss.

  4. Episodic Memory and Episodic Foresight in 3- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    Hayne, Harlene; Gross, Julien; McNamee, Stephanie; Fitzgibbon, Olivia; Tustin, Karen

    2011-01-01

    In the present study, we examined the development of episodic memory and episodic foresight. Three- and 5-year-olds were interviewed individually using a personalised timeline that included photographs of them at different points in their life. After constructing the timeline with the experimenter, each child was asked to discuss a number of…

  5. How Do 5-Year-Olds Understand Questions? Differences in Languages across Europe

    ERIC Educational Resources Information Center

    Sauerland, Uli; Grohmann, Kleanthes K.; Guasti, Maria Teresa; Andelkovic, Darinka; Argus, Reili; Armon-Lotem, Sharon; Arosio, Fabrizio; Avram, Larisa; Costa, João; Dabašinskiene, Ineta; de López, Kristine; Gatt, Daniela; Grech, Helen; Haman, Ewa; van Hout, Angeliek; Hrzica, Gordana; Kainhofer, Judith; Kamandulyte-Merfeldiene, Laura; Kunnari, Sari; Kovacevic, Melita; Kuvac Kraljevic, Jelena; Lipowska, Katarzyna; Mejias, Sandrine; Popovic, Maša; Ruzaite, Jurate; Savic, Maja; Sevcenco, Anca; Varlokosta, Spyridoula; Varnava, Marina; Yatsushiro, Kazuko

    2016-01-01

    The comprehension of constituent questions is an important topic for language acquisition research and for applications in the diagnosis of language impairment. This article presents the results of a study investigating the comprehension of different types of questions by 5-year-old, typically developing children across 19 European countries, 18…

  6. Ready, Set, Grow! Health Education for 3-5 Year Olds.

    ERIC Educational Resources Information Center

    Peterson, Paula J.

    Intended for use in family day care, preschool centers, professional preparation institutions, and in homes, this comprehensive health education curriculum for 3- through 5-year-old children contains units designed to sequentially teach concepts about physical health, mental health, family living, and safety. Contents include the following…

  7. Secondary Science Teachers' Use of Technology in the Classroom during Their First 5 Years

    ERIC Educational Resources Information Center

    Bang, EunJin; Luft, Julie A.

    2013-01-01

    This study examined the technology use of beginning secondary science teachers and explored factors facilitating or inhibiting their use of technology. The researchers collected and analyzed interviews and observational data from 95 teachers over a 5-year period. The results show that teachers used PowerPoint the most and other software the least…

  8. A Multidimensional Scaling Study of Visual Memory of 5-Year Olds and Adults

    ERIC Educational Resources Information Center

    Arabie, Phipps; And Others

    1975-01-01

    An investigation of memory development using nonmetric multidimensional scaling. Judgments of similarities between complex objects were obtained from 5-year-olds and adults under two conditions: (1) when objects were simultaneously present at the time of comparison, and (2) when the objects were not simultaneously present and had to be compared on…

  9. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    ERIC Educational Resources Information Center

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  10. The Use of Psychological State Words by Late Talkers at Ages 3, 4, and 5 Years

    ERIC Educational Resources Information Center

    Lee, Eliza Carlson; Rescorla, Leslie

    2008-01-01

    The use of four types of psychological state words (physiological, emotional, desire, and cognitive) during mother-child play sessions at ages 3, 4, and 5 years was examined in 30 children diagnosed with delayed expressive language at 24-31 months and 15 age-matched comparison children with typical development. The children's mean length of…

  11. Cognitive and Temperament Clusters in 3- to 5-Year-Old Children with Aggressive Behavior

    ERIC Educational Resources Information Center

    Sakimura, Jean N.; Dang, Michelle T.; Ballard, Kelley B.; Hansen, Robin L.

    2008-01-01

    Background: This study assessed the co-occurrence of cognitive problems and difficult temperament characteristics in children aged 3 to 5 years exhibiting aggressive behavior. Methods: Thirty-one children with high ratings on the Aggressive Behavior subscale of the Achenbach Child Behavior Checklist or Teacher Report Form were recruited from a…

  12. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN...

  13. Early Book Stages, 0-5 Years [and] Creciendo con Libros (Growing [up] with Books). [Videotape.

    ERIC Educational Resources Information Center

    Holguin, Roxanna

    Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…

  14. Renal adenoma in a 5-year-old Labrador retriever: Big is not always bad

    PubMed Central

    Lillakas, Kristina

    2013-01-01

    A 5-year-old Labrador retriever was presented with anorexia, hematuria, and a 3-week history of mild lethargy, periodic inappetance, and weight loss. A firm mass in the cranial abdomen was discovered on physical examination. Following clinical work-up the owners elected euthanasia. On postmortem examination, histopathology determined that the mass was a benign renal adenoma. PMID:23904644

  15. Therapeutic Community in a California Prison: Treatment Outcomes after 5 Years

    ERIC Educational Resources Information Center

    Zhang, Sheldon X.; Roberts, Robert E. L.; McCollister, Kathryn E.

    2011-01-01

    Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial…

  16. Ensemble Perception of Size in 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Sweeny, Timothy D.; Wurnitsch, Nicole; Gopnik, Alison; Whitney, David

    2015-01-01

    Groups of objects are nearly everywhere we look. Adults can perceive and understand the "gist" of multiple objects at once, engaging ensemble-coding mechanisms that summarize a group's overall appearance. Are these group-perception mechanisms in place early in childhood? Here, we provide the first evidence that 4-5-year-old children use…

  17. Structural Priming as Learning: Evidence from Mandarin-Learning 5-Year-Olds

    ERIC Educational Resources Information Center

    Hsu, Dong-Bo

    2014-01-01

    Three experiments on structural priming in Mandarin-speaking 5-year-olds were conducted to test the priming as implicit learning hypothesis. It describes a learning mechanism that acts on a shared abstract syntactic representation in response to linguistic input using an equi-biased Mandarin SVO-"ba" alternation. The first two…

  18. Introducing Engineering in Elementary Education: A 5-Year Study of Teachers and Students

    ERIC Educational Resources Information Center

    Diefes-Dux, Heidi A.

    2015-01-01

    Engineering, when integrated into K-12 education, may offer a number of potential student learning and future success benefits. In a 5-year study, four cohorts of elementary teachers of grades 2 to 4 in a single US school district were provided with teacher professional development with engineering education. Teachers were prepared to teach…

  19. 5-year mortality in hemodialysis patients: a single center study in Tripoli.

    PubMed

    Buargub, Mahdia A

    2008-03-01

    To investigate the 5-year mortality of patients undergoing maintenance hemo-dialysis (HD) at Al-Shat center Tripoli, we reviewed during June 2007 the records of all the HD patients initiated on HD from Jun 2000 and Jan 2002. There were 124 patients in the study, 77 males (63.6%) and 47 (36.4%) females, with a mean age of 49 +/- 14 years. Diabetic nephropathy (DN) was the underlying kidney disease in 34 (27.4%) patients. After 5 years; 3 patients were transferred to other centers, 18 (14.9%) patients underwent kidney transplan-tation. Out of the 103 patients who continued on hemodialysis, 53 (51.4%) expired during the 5-year follow-up. Mortality was associated with older age (p 50 years) and DN (p< 0.002 and OR of 3.9). Mortality rate in diabetics was 74.1% and significantly associated with male sex (p< 0.0067 and OR of 2.4), older age (p< 0.004), presence of hypertension (p< 0.003 and OR of 3.9), type 1 diabetes (OR 1.6), and elevated mean body weight (p< 0.046). Mortality was also relatively higher in black patients (OR of 2.0) and smokers (OR of 1.39). In conclusion, the overall 5- year mortality for dialysis patients was elevated and higher in the diabetics. PMID:18310882

  20. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

  1. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  2. Hands as Companions of the Mind: Essential Practical Life for the 5-Year-Old

    ERIC Educational Resources Information Center

    Gilder, Sharon Allen

    2012-01-01

    Numerous observations in Montessori classrooms led veteran Montessorians Pamela W. Trumble and Eleni Bokas to the conclusion that a universal need exists to bring integrity back to Practical Life, especially for 5-year-olds. Maria Montessori's observations over a century ago revealed the importance of Practical Life and its relationship to the…

  3. 76 FR 70156 - Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... Bureau of Ocean Energy Management Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2012-2017 AGENCY: Bureau of Ocean... FURTHER INFORMATION CONTACT: Bureau of Ocean Energy Management, Headquarters, 381 Elden Street,...

  4. Treatment of Sleep Problems in a 5-Year-Old Boy with Autism Using Behavioural Principles.

    ERIC Educational Resources Information Center

    Weiskop, Sophie; Matthews, Jan; Richdale, Amanda

    2001-01-01

    This article describes the successful treatment of sleep problems in a 5-year-old boy with autism. The intervention was based on behavioral principles and involved the parents attending an individually run parent training program. The parents learned how to use a bedtime routine, reinforcement, effective instructions, partner support strategies,…

  5. Wakefulness (Not Sleep) Promotes Generalization of Word Learning in 2.5-Year-Old Children

    ERIC Educational Resources Information Center

    Werchan, Denise M.; Gómez, Rebecca L.

    2014-01-01

    Sleep enhances generalization in adults, but this has not been examined in toddlers. This study examined the impact of napping versus wakefulness on the generalization of word learning in toddlers when the contextual background changes during learning. Thirty 2.5-year-old children (M = 32.94, SE = 0.46) learned labels for novel categories of…

  6. Guidelines for Health Assessment and Intervention Techniques for 3, 4, and 5 Year Old Children.

    ERIC Educational Resources Information Center

    Bentley, Judy K.

    These guidelines were developed to help registered nurses identify preschoolers with potential handicaps in the course of health assessments. Contents include guidelines on 3-, 4-, and 5-year-olds. Contents are organized within age levels in terms of functioning levels and anticipatory guidance. Functional areas covered include physical,…

  7. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2009-01-01

    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  8. Effects of A 2.5-Year Campus-Wide Intervention to Reduce College Drinking

    ERIC Educational Resources Information Center

    Seo, Dong-Chul; Owens, Dee; Gassman, Ruth; Kingori, Caroline

    2013-01-01

    Objective: The present study reports on the results of a 2.5-year college-wide, coordinated intervention that was implemented from June 2007 to December 2009 to reduce the amount and frequency of students' alcohol consumption. Design: Quasi-experimental study using a one-group (freshmen living on campus) pretest/posttest design ("N"…

  9. Influence of Emotional Facial Expressions on 3-5-Year-Olds' Face Recognition

    ERIC Educational Resources Information Center

    Freitag, Claudia; Schwarzer, Gudrun

    2011-01-01

    Three experiments examined 3- and 5-year-olds' recognition of faces in constant and varied emotional expressions. Children were asked to identify repeatedly presented target faces, distinguishing them from distractor faces, during an immediate recognition test and during delayed assessments after 10 min and one week. Emotional facial expression…

  10. 76 FR 50447 - Endangered and Threatened Species; 5-Year Reviews for 5 Evolutionarily Significant Units of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ..., Oregon, Washington, and Idaho (75 FR 13082). Both ESUs and DPSs are treated as ``species'' under the ESA... FR 37204). The 5-year review reports prepared by the Southwest Region, the Southwest Science Center's... since they were previously reviewed in 2005 (70 FR 37160) and 2006 (71 FR 834), respectively....

  11. 76 FR 50448 - Endangered and Threatened Species; 5-Year Reviews for 17 Evolutionarily Significant Units and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Regional Offices announced initiation of 5-year reviews of Pacific salmon ESUs and steelhead DPSs (75 FR... Salmon and Steelhead in Listing Determinations under the ESA (70 FR 37204) to complete this evaluation...-promulgating the threatened listing for Oregon Coast coho salmon (76 FR 35755). This notice also addresses...

  12. Controlling the Localization of Liquid Droplets in Polymer Matrices by Evaporative Lithography.

    PubMed

    Zhao, Huaixia; Xu, Jiajia; Jing, Guangyin; Prieto-López, Lizbeth Ofelia; Deng, Xu; Cui, Jiaxi

    2016-08-26

    Localized inclusions of liquids provide solid materials with many functions, such as self-healing, secretion, and tunable mechanical properties, in a spatially controlled mode. However, a strategy to control the distribution of liquid droplets in solid matrices directly obtained from a homogeneous solution has not been reported thus far. Herein, we describe an approach to selectively localize liquid droplets in a supramolecular gel directly obtained from its solution by using evaporative lithography. In this process, the formation of droplet-embedded domains occurs in regions of free evaporation where the non-volatile liquid is concentrated and undergoes a phase separation to create liquid droplets prior to gelation, while a homogeneous gel matrix is formed in the regions of hindered evaporation. The different regions of a coating with droplet embedment patterns display different secretion abilities, enabling the control of the directional movement of water droplets. PMID:27460600

  13. The Effect of Local Violence on Children’s Attention and Impulse Control

    PubMed Central

    Tirado-Strayer, Nicole; Papachristos, Andrew V.; Raver, C. Cybele

    2012-01-01

    Objectives. We examined whether the burden of violence in a child’s community environment alters the child’s behavior and functioning in the classroom setting. Methods. To identify the effects of local violence, we exploited variation in the timing of local homicides, based on data from the Chicago Police Department, relative to the timing of interview assessments conducted as part of a randomized controlled trial conducted with preschoolers in Head Start programs from 2004–2006, the Chicago School Readiness Project. We compared children’s scores when exposed to recent local violence with scores when no recent violence had occurred to identify causal effects. Results. When children were assessed within a week of a homicide that occurred near their home, they exhibited lower levels of attention and impulse control and lower preacademic skills. The analysis showed strong positive effects of local violence on parental distress, providing suggestive evidence that parental responses may be a likely pathway by which local violence affects young children. Conclusions. Exposure to homicide generates acute psychological distress among caregivers and impairs children’s self-regulatory behavior and cognitive functioning. PMID:23078491

  14. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014

    PubMed Central

    Homaira, Nusrat; Luby, Stephen P.; Hossain, Kamal; Islam, Kariul; Ahmed, Makhdum; Rahman, Mustafizur; Rahman, Ziaur; Paul, Repon C.; Bhuiyan, Mejbah Uddin; Brooks, W. Abdullah; Sohel, Badrul Munir; Banik, Kajal Chandra; Widdowson, Marc-Alain; Willby, Melisa; Rahman, Mahmudur; Bresee, Joseph; Ramirez, Katharine-Sturm; Azziz-Baumgartner, Eduardo

    2016-01-01

    Background We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. Methods Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. Results We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10–12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2–3), 0.5(0.4–0.8), 0.4 (0.3–0.6), 0.4 (0.3–0.6), and 0.4 (0.3–0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3–7), 2 (1–3), 1 (0.6–2), and 3 (2–4) in 2010, 2011, 2012 and 2013, respectively. Conclusion Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh. PMID:26840782

  15. Extended Long-Term (5 Years) Outcomes of Triangle Tilt Surgery in Obstetric Brachial Plexus Injury

    PubMed Central

    Nath, Rahul K; Somasundaram, Chandra

    2013-01-01

    Objective: We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. Methods: Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. Results: Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, p<0.0001), hand-to-spine (2.6±0.6 to 3.4±1.1, p<0.005), hand-to-neck (2.7±0.7 to 4.3±0.7, p<0.0001), hand-to-mouth (2.3±0.9 (92º±33) to 4.2±0.5 (21º±16), p<0.0001), and supination (2.6±1.1 (-8.2º ±51) to 4.1±0.7 (61±32)) were significantly improved (p<0.0001), and maintained over the extended long-term (5 years). Total modified Mallet functional score was also shown to improve from 14.1±2.7 to 20.3±2.5. Conclusions: The triangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients. PMID:23730369

  16. Pest control experiments show benefits of complexity at landscape and local scales.

    PubMed

    Chaplin-Kramer, Rebecca; Kremen, Claire

    2012-10-01

    Farms benefit from pest control services provided by nature, but management of these services requires an understanding of how habitat complexity within and around the farm impacts the relationship between agricultural pests and their enemies. Using cage experiments, this study measures the effect of habitat complexity across scales on pest suppression of the cabbage aphid Brevicoryne brassicae in broccoli. Our results reveal that proportional reduction of pest density increases with complexity both at the landscape scale (measured by natural habitat cover in the 1 km around the farm) and at the local scale (plant diversity). While high local complexity can compensate for low complexity at landscape scales and vice versa, a delay in natural enemy arrival to locally complex sites in simple landscapes may compromise the enemies' ability to provide adequate control. Local complexity in simplified landscapes may only provide adequate top-down pest control in cooler microclimates with relatively low aphid colonization rates. Even so, strong natural enemy function can be overwhelmed by high rates of pest reproduction or colonization from nearby source habitat. PMID:23210310

  17. Open Air Silicon Deposition by Atmospheric Pressure Plasma under Local Ambient Gas Control

    NASA Astrophysics Data System (ADS)

    Naito, Teruki; Konno, Nobuaki; Yoshida, Yukihisa

    2015-09-01

    In this paper, we report open air silicon (Si) deposition by combining a silane free Si deposition technology and a newly developed local ambient gas control technology. Recently, material processing in open air has been investigated intensively. While a variety of materials have been deposited, there were only few reports on Si deposition due to the susceptibility to contamination and the hazardous nature of source materials. Since Si deposition is one of the most important processes in device fabrication, we have developed open air silicon deposition technologies in BEANS project. For a clean and safe process, a local ambient gas control head was designed. Process gas leakage was prevented by local evacuation, and air contamination was shut out by inert curtain gas. By numerical and experimental investigations, a safe and clean process condition with air contamination less than 10 ppm was achieved. Si film was deposited in open air by atmospheric pressure plasma enhanced chemical transport under the local ambient gas control. The film was microcrystalline Si with the crystallite size of 17 nm, and the Hall mobility was 2.3 cm2/V .s. These properties were comparable to those of Si films deposited in a vacuum chamber. This research has been conducted as one of the research items of New Energy and Industrial Technology Development Organization ``BEANS'' project.

  18. Overlapping signal sequences control nuclear localization and endoplasmic reticulum retention of GRP58

    SciTech Connect

    Adikesavan, Anbu Karani; Unni, Emmanual; Jaiswal, Anil K.

    2008-12-12

    Glucose-regulated GRP58 has shown clinical applications to endoplasmic reticulum (ER) stress and cancer. GRP58 is localized in the cytosol, endoplasmic reticulum (ER) and nucleus. Twenty-four amino acids at the N-terminal hydrophobic region are known to target GRP58 to ER for synthesis at the ER membrane and translocation into the ER lumen. In addition, GRP58 contains putative nuclear localization (494KPKKKKK500) and ER retention (502QEDL505) signals. However, the role of these signals in nuclear import and ER retention of GRP58 remains unknown. Present studies investigated the signals that control nuclear localization and ER retention of GRP58. Deletion/mutation of nuclear localization signal (NLS) abrogated nuclear import of GRP58. NLS attached to EGFP localized EGFP in the nucleus. However, deletion/mutation of putative ER retention signal alone did not alter ER retention of GRP58. Interestingly, a combined deletion/mutation of NLS and ER retention signals blocked the GRP58 retention in the ER. These results concluded that overlapping NLS and ER retention signal sequences regulate nuclear localization and ER retention of GRP58.

  19. Durable control of locally recurrent renal cell carcinoma using stereotactic body radiotherapy

    PubMed Central

    Maclean, Jillian; Breau, Rodney H; Scheida, Nicola; Malone, Shawn

    2014-01-01

    Renal cell carcinoma (RCC) is generally poorly responsive to conventional radiation doses, and patients with inoperable local recurrence have limited therapeutic options. Stereotactic body radiotherapy (SBRT) is an increasingly available technology that allows delivery of a radiation schedule providing doses far more biologically effective against cancer cells than conventional radiotherapy. We present a case where durable disease control was achieved using SBRT in a patient with inoperable locally recurrent RCC who presented 18 years from original nephrectomy. The patient remains asymptomatic with no evidence of active disease 30 months following SBRT. This case highlights the need to reconsider the role of therapies with continuing advances in technology. PMID:25199199

  20. Immediate postoperative radiotherapy in residual nonfunctioning pituitary adenoma: Beneficial effect on local control without additional negative impact on pituitary function and life expectancy

    SciTech Connect

    Bergh, Alfons C.M. van den . E-mail: a.c.m.van.den.bergh@rt.umcg.nl; Berg, Gerrit van den; Schoorl, Michiel A.; Sluiter, Wim J.; Vliet, Anton M. van der; Hoving, Eelco W.; Szabo, Ben G.; Langendijk, Johannes A.; Wolffenbuttel, Bruce H.R.; Dullaart, Robin P.F.

    2007-03-01

    Purpose: To demonstrate the benefit of immediate postoperative radiotherapy in residual nonfunctioning pituitary adenoma (NFA) in perspective to the need for hormonal substitution and life expectancy. Methods and Materials: Retrospective cohort analysis of 122 patients, operated for NFA between 1979 and 1998. Recurrence was defined as regrowth on computed tomography or magnetic resonance imaging. The occurrence of hormonal deficiencies was defined as the starting date of hormonal substitution therapy. Results: Seventy-six patients had residual NFA after surgery and received immediate postoperative radiotherapy (Group 1); three patients developed a recurrence, resulting in a 95% local control rate at 10 years. Twenty-eight patients had residual NFA after surgery, but were followed by a wait-and-see policy (Group 2). Sixteen developed a recurrence, resulting in a local control rate of 49% at 5 years and 22% at 10 years (p < 0.001 compared with Group 1). There were no differences between Group 1 and 2 regarding the need for substitution with thyroid hormone, glucocorticoids, and sex hormones before first surgery, directly after surgery and at end of follow-up. There were no differences in hormone substitution free survival between Group 1 and Group 2 during the study period after first surgery. Life expectancy was similar in Group 1 and 2, and their median life expectancy did not differ from median life expectancy in the general population. Conclusions: Immediate postoperative radiotherapy provides a marked improvement of local control among patients with residual NFA compared with surgery alone, without an additional deleterious effect on pituitary function and life expectancy.

  1. Local Support for Alcohol Control Policies and Perceptions of Neighborhood Issues in Two College Communities

    PubMed Central

    Fairlie, Anne M.; DeJong, William; Wood, Mark D.

    2014-01-01

    Background Although valuable, national opinion surveys on alcohol policy may be less informative for policy development at the local level. Using samples of adult residents in two college communities, the present study: 1) measured public support for local alcohol control policies to stem underage drinking and alcohol over-service in on-premise outlets; 2) assessed residents' opinions regarding neighborhood problems; and 3) identified factors associated with strong policy support. Methods We administered random-sample telephone surveys to residents ages 21 years and older in college communities located in Community 1 (N = 501; mean age = 57.4 years, SD = 14.7) and Community 2 (N = 505; mean age = 56.0 years, SD = 15.2). The response rates were typical of telephone surveys (Community 1: 33.5%; Community 2: 29.9%). We assessed support for 16 alcohol control policies and the occurrence of specific types of neighborhood incidents (e.g., witnessing intoxicated people). We used multiple regression analyses to determine factors associated with policy support. Results Residents in Community 1 reported significantly higher weekly alcohol use, a greater number of witnessed neighborhood incidents, and a higher level of perceived neighborhood problems than did residents in Community 2. Residents in Community 1 perceived local alcohol control policies and their enforcement to be significantly stricter. Overall, policy support was high and did not differ between the communities. In both communities, higher policy support was significantly associated with being female, being older, less weekly alcohol use, and lower perceived strictness of alcohol control policies and enforcement. Conclusions It is important for campus officials and community leaders to be aware of and publicize favorable public opinion when advocating for policy change, especially at the local level. Information on residents' perceptions of the neighborhood issues they face can also inform local policy and

  2. Participation in an Intensive Longitudinal Study with Weekly Web Surveys Over 2.5 Years

    PubMed Central

    Barber, Jennifer; Kusunoki, Yasamin; Schulz, Paul

    2016-01-01

    Background Technological advances have made it easier for researchers to collect more frequent longitudinal data from survey respondents via personal computers, smartphones, and other mobile devices. Although technology has led to an increase in data-intensive longitudinal studies, little is known about attrition from such studies or the differences between respondents who complete frequently administered surveys in a timely manner, and respondents who do not. Objective We examined respondent characteristics and behaviors associated with continued and on-time participation in a population-based intensive longitudinal study, using weekly web-based survey interviews over an extended period. Methods We analyzed data from the Relationship Dynamics and Social Life study, an intensive longitudinal study that collected weekly web-based survey interviews for 2.5 years from 1003 18- and 19-year-olds to investigate factors shaping the dynamics of their sexual behavior, contraceptive use, and pregnancies. Results Ordinary least squares and logistic regression analyses showed background respondent characteristics measured at baseline were associated with the number of days respondents remained enrolled in the study, the number of interviews they completed, and the odds that they were late completing interviews. In addition, we found that changes in pregnancy-related behaviors reported in the weekly interviews were associated with late completion of interviews. Specifically, after controlling for sociodemographic, personality, contact information, and prior experience variables, we found that weekly reports such as starting to have sex (odds ratio [OR] 1.17, 95% CI 1.03-1.32, P=.01), getting a new partner (OR 1.76, 95% CI 1.53-2.03, P<.001), stopping the use of contraception (OR 1.28, 95% CI 1.10-1.49, P=.001), and having a new pregnancy (OR 5.57, 95% CI 4.26-7.29, P<.001) were significantly associated with late survey completion. However, young women who reported changes in

  3. Characterization of RanBPM Molecular Determinants that Control Its Subcellular Localization

    PubMed Central

    Salemi, Louisa M.; Loureiro, Sandra O.; Schild-Poulter, Caroline

    2015-01-01

    RanBPM/RanBP9 is a ubiquitous, nucleocytoplasmic protein that is part of an evolutionary conserved E3 ubiquitin ligase complex whose function and targets in mammals are still unknown. RanBPM itself has been implicated in various cellular processes that involve both nuclear and cytoplasmic functions. However, to date, little is known about how RanBPM subcellular localization is regulated. We have conducted a systematic analysis of RanBPM regions that control its subcellular localization using RanBPM shRNA cells to examine ectopic RanBPM mutant subcellular localization without interference from the endogenously expressed protein. We show that several domains and motifs regulate RanBPM nuclear and cytoplasmic localization. In particular, RanBPM comprises two motifs that can confer nuclear localization, one proline/glutamine-rich motif in the extreme N-terminus which has a dominant effect on RanBPM localization, and a second motif in the C-terminus which minimally contributes to RanBPM nuclear targeting. We also identified a nuclear export signal (NES) which mutation prevented RanBPM accumulation in the cytoplasm. Likewise, deletion of the central RanBPM conserved domains (SPRY and LisH/CTLH) resulted in the relocalization of RanBPM to the nucleus, suggesting that RanBPM cytoplasmic localization is also conferred by protein-protein interactions that promote its cytoplasmic retention. Indeed we found that in the cytoplasm, RanBPM partially colocalizes with microtubules and associates with α-tubulin. Finally, in the nucleus, a significant fraction of RanBPM is associated with chromatin. Altogether, these analyses reveal that RanBPM subcellular localization results from the combined effects of several elements that either confer direct transport through the nucleocytoplasmic transport machinery or regulate it indirectly, likely through interactions with other proteins and by intramolecular folding. PMID:25659156

  4. Sustained Transmission of Pertussis in Vaccinated, 1–5-Year-Old Children in a Preschool, Florida, USA

    PubMed Central

    Pritchard, P. Scott; Martin, Stacey W.; Dusek, Cristina; Cathey, Erika; D’Alessio, Rebecca; Kirsch, Marjorie

    2016-01-01

    In September 2013, local county health officials in Tallahassee, Florida, USA, were notified of a laboratory-confirmed pertussis case in a 1-year-old preschool attendee. During a 5-month period, 26 (22%) students 1–5 years of age, 2 staff from the same preschool, and 11 family members met the national case definition for pertussis. Four persons during this outbreak were hospitalized for clinical management of pertussis symptoms. Only 5 students, including 2 students with pertussis, had not received the complete series of vaccinations for pertussis. Attack rates in 1 classroom for all students who received the complete series of vaccinations for pertussis approached 50%. This outbreak raises concerns about vaccine effectiveness in this preschool age group and reinforces the idea that recent pertussis vaccination should not dissuade physicians from diagnosing, testing, or treating persons with compatible illness for pertussis. PMID:26814429

  5. Investigating local controls on soil moisture temporal stability using an inverse modeling approach

    NASA Astrophysics Data System (ADS)

    Bogena, Heye; Qu, Wei; Huisman, Sander; Vereecken, Harry

    2013-04-01

    A better understanding of the temporal stability of soil moisture and its relation to local and nonlocal controls is a major challenge in modern hydrology. Both local controls, such as soil and vegetation properties, and non-local controls, such as topography and climate variability, affect soil moisture dynamics. Wireless sensor networks are becoming more readily available, which opens up opportunities to investigate spatial and temporal variability of soil moisture with unprecedented resolution. In this study, we employed the wireless sensor network SoilNet developed by the Forschungszentrum Jülich to investigate soil moisture variability of a grassland headwater catchment in Western Germany within the framework of the TERENO initiative. In particular, we investigated the effect of soil hydraulic parameters on the temporal stability of soil moisture. For this, the HYDRUS-1D code coupled with a global optimizer (DREAM) was used to inversely estimate Mualem-van Genuchten parameters from soil moisture observations at three depths under natural (transient) boundary conditions for 83 locations in the headwater catchment. On the basis of the optimized parameter sets, we then evaluated to which extent the variability in soil hydraulic conductivity, pore size distribution, air entry suction and soil depth between these 83 locations controlled the temporal stability of soil moisture, which was independently determined from the observed soil moisture data. It was found that the saturated hydraulic conductivity (Ks) was the most significant attribute to explain temporal stability of soil moisture as expressed by the mean relative difference (MRD).

  6. Epileptogenic zone localization and seizure control in coupled neural mass models.

    PubMed

    Ma, Zhen; Zhou, Weidong; Zhang, Yanli; Geng, Shujuan

    2015-12-01

    Exact localization of the epileptogenic zone (EZ) is the first priority for ensuring epilepsy treatments and reducing side effects. The results of traditional visual methods for localizing the origin of seizures are far from satisfactory in some cases. Signal processing methods could extract substantial information that may complement visual inspection of EEG signals. In this study, EZ localization is changed into a driver identification problem, and a nonlinear interdependence measure, the weighted rank interdependence, is proposed and used as a driver indicator because it can detect coupling information, especially directionality, from EEG signals. A proportional integral derivative (PID) controller is then explored, using simulations, to establish its suitability for seizure control. The seizure control we propose rests on identifying the EZ using nonlinear interdependence measures of directed functional connectivity. Two directionally coupled neural mass models are employed for simulation investigation. Two parameters can adjust the sensitivity and completeness of the weighted rank interdependence for different applications, and their effect is discussed in the context of neural mass models. Simulation results demonstrate that use of the weighted rank interdependence for EZ identification can be applied to different EZ types, and the approach achieves an overall identification rate of 98.84 % for several EZ types. Simulations also indicate that PID control can effectively regulate synchronization between neural masses. PMID:26585963

  7. Fracture Prediction After Discontinuation of 4 to 5 Years of Alendronate Therapy

    PubMed Central

    Bauer, Douglas C.; Schwartz, Ann; Palermo, Lisa; Cauley, Jane; Hochberg, Marc; Santora, Art; Cummings, Steven R.; Black, Dennis M.

    2015-01-01

    IMPORTANCE Discontinuation of bisphosphonate therapy after 3 to 5 years is increasingly considered, but methods to monitor fracture risk after discontinuation have not been established. OBJECTIVE To test methods of predicting fracture risk among women who have discontinued alendronate therapy after 4 to 5 years. DESIGN, SETTING, AND PARTICIPANTS The prospective Fracture Intervention Trial Long-term Extension (FLEX) study randomized postmenopausal women aged 61 to 86 years previously treated with 4 to 5 years of alendronate therapy to 5 more years of alendronate or placebo from 1998 through 2003; the present analysis includes only the placebo group. Hip and spine dual-energy x-ray absorptiometry (DXA) were measured when placebo was begun (FLEX baseline) and after 1 to 3 years of follow-up. Two biochemical markers of bone turnover, urinary type 1 collagen cross-linked N-telopeptide (NTX) and serum bone-specific alkaline phosphatase (BAP), were measured at FLEX baseline and after 1 and 3 years. MAIN OUTCOMES AND MEASURES Symptomatic spine and nonspine fractures occurring after the follow-up measurement of DXA or bone turnover. RESULTS During 5 years of placebo, 94 of 437 women (22%) experienced 1 or more symptomatic fractures; 82 had fractures after 1 year. One-year changes in hip DXA, NTX, and BAP were not related to subsequent fracture risk, but older age and lower hip DXA at time of discontinuation were significantly related to increased fracture risk (lowest tertile of baseline femoral neck DXA vs other 2 tertiles relative hazard ratio, 2.17 [95%CI, 1.38–3.41]; total hip DXA relative hazard ratio, 1.87 [95%CI, 1.20–2.92]). CONCLUSIONS AND RELEVANCE Among postmenopausal women who discontinue alendronate therapy after 4 to 5 years, age and hip BMD at discontinuation predict clinical fractures during the subsequent 5 years. Follow-up measurements of DXA 1 year after discontinuation and of BAP or NTX 1 to 2 years after discontinuation are not associated with

  8. Spatial control of chemical processes on nanostructures through nano-localized water heating

    PubMed Central

    Jack, Calum; Karimullah, Affar S.; Tullius, Ryan; Khorashad, Larousse Khosravi; Rodier, Marion; Fitzpatrick, Brian; Barron, Laurence D.; Gadegaard, Nikolaj; Lapthorn, Adrian J.; Rotello, Vincent M.; Cooke, Graeme; Govorov, Alexander O.; Kadodwala, Malcolm

    2016-01-01

    Optimal performance of nanophotonic devices, including sensors and solar cells, requires maximizing the interaction between light and matter. This efficiency is optimized when active moieties are localized in areas where electromagnetic (EM) fields are confined. Confinement of matter in these ‘hotspots' has previously been accomplished through inefficient ‘top-down' methods. Here we report a rapid ‘bottom-up' approach to functionalize selective regions of plasmonic nanostructures that uses nano-localized heating of the surrounding water induced by pulsed laser irradiation. This localized heating is exploited in a chemical protection/deprotection strategy to allow selective regions of a nanostructure to be chemically modified. As an exemplar, we use the strategy to enhance the biosensing capabilities of a chiral plasmonic substrate. This novel spatially selective functionalization strategy provides new opportunities for efficient high-throughput control of chemistry on the nanoscale over macroscopic areas for device fabrication. PMID:26961708

  9. Spatial control of chemical processes on nanostructures through nano-localized water heating.

    PubMed

    Jack, Calum; Karimullah, Affar S; Tullius, Ryan; Khorashad, Larousse Khosravi; Rodier, Marion; Fitzpatrick, Brian; Barron, Laurence D; Gadegaard, Nikolaj; Lapthorn, Adrian J; Rotello, Vincent M; Cooke, Graeme; Govorov, Alexander O; Kadodwala, Malcolm

    2016-01-01

    Optimal performance of nanophotonic devices, including sensors and solar cells, requires maximizing the interaction between light and matter. This efficiency is optimized when active moieties are localized in areas where electromagnetic (EM) fields are confined. Confinement of matter in these 'hotspots' has previously been accomplished through inefficient 'top-down' methods. Here we report a rapid 'bottom-up' approach to functionalize selective regions of plasmonic nanostructures that uses nano-localized heating of the surrounding water induced by pulsed laser irradiation. This localized heating is exploited in a chemical protection/deprotection strategy to allow selective regions of a nanostructure to be chemically modified. As an exemplar, we use the strategy to enhance the biosensing capabilities of a chiral plasmonic substrate. This novel spatially selective functionalization strategy provides new opportunities for efficient high-throughput control of chemistry on the nanoscale over macroscopic areas for device fabrication. PMID:26961708

  10. Spatial control of chemical processes on nanostructures through nano-localized water heating

    NASA Astrophysics Data System (ADS)

    Jack, Calum; Karimullah, Affar S.; Tullius, Ryan; Khorashad, Larousse Khosravi; Rodier, Marion; Fitzpatrick, Brian; Barron, Laurence D.; Gadegaard, Nikolaj; Lapthorn, Adrian J.; Rotello, Vincent M.; Cooke, Graeme; Govorov, Alexander O.; Kadodwala, Malcolm

    2016-03-01

    Optimal performance of nanophotonic devices, including sensors and solar cells, requires maximizing the interaction between light and matter. This efficiency is optimized when active moieties are localized in areas where electromagnetic (EM) fields are confined. Confinement of matter in these `hotspots' has previously been accomplished through inefficient `top-down' methods. Here we report a rapid `bottom-up' approach to functionalize selective regions of plasmonic nanostructures that uses nano-localized heating of the surrounding water induced by pulsed laser irradiation. This localized heating is exploited in a chemical protection/deprotection strategy to allow selective regions of a nanostructure to be chemically modified. As an exemplar, we use the strategy to enhance the biosensing capabilities of a chiral plasmonic substrate. This novel spatially selective functionalization strategy provides new opportunities for efficient high-throughput control of chemistry on the nanoscale over macroscopic areas for device fabrication.

  11. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  12. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development Regulations... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  13. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  14. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  15. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  16. Estimating the Impacts of Local Policy Innovation: The Synthetic Control Method Applied to Tropical Deforestation

    PubMed Central

    Sills, Erin O.; Herrera, Diego; Kirkpatrick, A. Justin; Brandão, Amintas; Dickson, Rebecca; Hall, Simon; Pattanayak, Subhrendu; Shoch, David; Vedoveto, Mariana; Young, Luisa; Pfaff, Alexander

    2015-01-01

    Quasi-experimental methods increasingly are used to evaluate the impacts of conservation interventions by generating credible estimates of counterfactual baselines. These methods generally require large samples for statistical comparisons, presenting a challenge for evaluating innovative policies implemented within a few pioneering jurisdictions. Single jurisdictions often are studied using comparative methods, which rely on analysts’ selection of best case comparisons. The synthetic control method (SCM) offers one systematic and transparent way to select cases for comparison, from a sizeable pool, by focusing upon similarity in outcomes before the intervention. We explain SCM, then apply it to one local initiative to limit deforestation in the Brazilian Amazon. The municipality of Paragominas launched a multi-pronged local initiative in 2008 to maintain low deforestation while restoring economic production. This was a response to having been placed, due to high deforestation, on a federal “blacklist” that increased enforcement of forest regulations and restricted access to credit and output markets. The local initiative included mapping and monitoring of rural land plus promotion of economic alternatives compatible with low deforestation. The key motivation for the program may have been to reduce the costs of blacklisting. However its stated purpose was to limit deforestation, and thus we apply SCM to estimate what deforestation would have been in a (counterfactual) scenario of no local initiative. We obtain a plausible estimate, in that deforestation patterns before the intervention were similar in Paragominas and the synthetic control, which suggests that after several years, the initiative did lower deforestation (significantly below the synthetic control in 2012). This demonstrates that SCM can yield helpful land-use counterfactuals for single units, with opportunities to integrate local and expert knowledge and to test innovations and permutations on

  17. Estimating the Impacts of Local Policy Innovation: The Synthetic Control Method Applied to Tropical Deforestation.

    PubMed

    Sills, Erin O; Herrera, Diego; Kirkpatrick, A Justin; Brandão, Amintas; Dickson, Rebecca; Hall, Simon; Pattanayak, Subhrendu; Shoch, David; Vedoveto, Mariana; Young, Luisa; Pfaff, Alexander

    2015-01-01

    Quasi-experimental methods increasingly are used to evaluate the impacts of conservation interventions by generating credible estimates of counterfactual baselines. These methods generally require large samples for statistical comparisons, presenting a challenge for evaluating innovative policies implemented within a few pioneering jurisdictions. Single jurisdictions often are studied using comparative methods, which rely on analysts' selection of best case comparisons. The synthetic control method (SCM) offers one systematic and transparent way to select cases for comparison, from a sizeable pool, by focusing upon similarity in outcomes before the intervention. We explain SCM, then apply it to one local initiative to limit deforestation in the Brazilian Amazon. The municipality of Paragominas launched a multi-pronged local initiative in 2008 to maintain low deforestation while restoring economic production. This was a response to having been placed, due to high deforestation, on a federal "blacklist" that increased enforcement of forest regulations and restricted access to credit and output markets. The local initiative included mapping and monitoring of rural land plus promotion of economic alternatives compatible with low deforestation. The key motivation for the program may have been to reduce the costs of blacklisting. However its stated purpose was to limit deforestation, and thus we apply SCM to estimate what deforestation would have been in a (counterfactual) scenario of no local initiative. We obtain a plausible estimate, in that deforestation patterns before the intervention were similar in Paragominas and the synthetic control, which suggests that after several years, the initiative did lower deforestation (significantly below the synthetic control in 2012). This demonstrates that SCM can yield helpful land-use counterfactuals for single units, with opportunities to integrate local and expert knowledge and to test innovations and permutations on policies

  18. The Diagnosis of the Os Trigonum Syndrome with a Fluoroscopically Controlled Injection of Local Anesthetic

    PubMed Central

    Jones, Darron M; Saltzman, Charles L; El-Khoury, George

    1999-01-01

    Purpose To report the results of excision of the os trigonum using a fluoroscopically controlled injection of local anesthetic to diagnose the os trigonum syndrome. Design and patients Os trigonum syndrome is a recognized cause of pain in the posterior aspect of the foot and ankle. The symptoms and physical findings, however, are often nonspecific and difficult to differentiate from other causes of posterior ankle pain. We report four patients with persistent posterolateral ankle pain despite prolonged nonoperative treatment. An os trigonal syndrome was diagnosed by a positive response to a fluoroscopically guided local anesthetic injection in the region of synchondrosis between the os trigonum and the posterior talus. Results All four patients underwent excision of the os trigonum with complete resolution of symptoms and return to full activity. Conclusions Fluoroscopically controlled injection can help confirm the suspected diagnosis of an os trigonum syndrome and may have positive predictive value regarding the outcome of excisional surgery. PMID:10847526

  19. Preparation of subradiant states using local qubit control in circuit QED

    SciTech Connect

    Filipp, S.; Loo, A. F. van; Baur, M.; Steffen, L.; Wallraff, A.

    2011-12-15

    Transitions between quantum states by photon absorption or emission are intimately related to the symmetries of the system which lead to selection rules and the formation of dark states. In a circuit quantum electrodynamics setup, in which two resonant superconducting qubits are coupled through an on-chip cavity and driven via the common cavity field, one single-excitation state remains dark. Here, we demonstrate that this dark state can be excited using local phase control of individual qubit drives to change the symmetry of the excitation field. We observe that the dark state decay via spontaneous emission into the cavity is suppressed, a characteristic signature of subradiance. This local control technique could be used to prepare and study highly correlated quantum states of cavity-coupled qubits.

  20. 'A potential fifth column': conflicts and struggles for control in the context of local NHS privatization.

    PubMed

    Aldred, Rachel

    2009-09-01

    This article uses case study data to discuss how a new procurement policy (Local Improvement Finance Trust, or LIFT) in English primary care may affect general practitioners' control over their work. LIFT, a series of 51 public-private partnerships, will enable over the medium term a shift towards the corporate ownership of surgeries and the creation of polyclinics or 'onestop-shops'. In this article, I explore the struggles over work autonomy and control within these new LIFT structures, as expressed by clinicians and managers in meetings and in research interviews. More generally, I consider how the findings inform debates over the changing position of professionals within increasingly financialized 'local health economies'. PMID:19696135

  1. Developmental potential in the first 5 years for children in developing countries.

    PubMed

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data--the prevalence of early childhood stunting and the number of people living in absolute poverty--to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  2. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    PubMed

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life. PMID:25909527

  3. GEOPHYSICS, ASTRONOMY, AND ASTROPHYSICS: Reconstructing Quintom from WMAP 5-year Observations: Generalized Ghost Condensate

    NASA Astrophysics Data System (ADS)

    Zhang, Jing-Fei; Gui, Yuan-Xing

    2010-08-01

    In the 5-year WMAP data analysis, a new parametrization form for dark energy equation-of-state was used, and it has been shown that the equation-of-state, w(z), crosses the cosmological-constant boundary w = -1. Based on this observation, in this paper, we investigate the reconstruction of quintom dark energy model. As a single-real-scalarfield model of dark energy, the generalized ghost condensate model provides us with a successful mechanism for realizing the quintom-like behavior. Therefore, we reconstruct this scalar-field quintom dark energy model from the WMAP 5-year observational results. As a comparison, we also discuss the quintom reconstruction based on other specific dark energy ansatzs, such as the CPL parametrization and the holographic dark energy scenarios.

  4. Synovial Sarcoma in the Foot of a 5-Year-Old ChildA Case Report.

    PubMed

    Lepow, Gary M; Grimmer, Daniel L; Lemar, Onya V; Bridges, Evan A

    2016-07-01

    The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised. PMID:27489968

  5. Surveillance of lymphatic filariasis 5 years after stopping mass drug administration in Menoufiya Governorate, Egypt.

    PubMed

    Moustafa, M A; Thabet, H S; Saad, G A; El-Setouhy, M; Mehrez, M; Hamdy, D M

    2014-05-01

    The World Health Organization recommends that before lymphatic filariasis elimination in an area can be confirmed, an additional survey should be performed at least 5 years after stopping mass drug administration. The current study aimed to determine the status of lymphatic filariasis 5 years after cessation ofthe mass drug administration in 3 sentinel Egyptian villages in Menoufiya Governorate. The rapid immunochromatographic card test (ICT) and a new commercial antibody detection kit (CELISA®) were used. All 1321 primary-school children aged 6-7 years old were ICT negative but 27 children were antibody positive. All households surveyed in one village with the highest antibody prevalence were ICT negative, indicating an absence of lymphatic filariasis. The CELISA antibody kit needs more standardization and development to be useful under field conditions. We conclude that lymphatic filariasis is no longer a public health problem in these villages and other villages with similar epidemiological conditions. PMID:24952286

  6. Regulation of emotion and behavior among 3- and 5-year-olds.

    PubMed

    Kalpidou, Maria D; Power, Thomas G; Cherry, Katie E; Gottfried, Nathan W

    2004-04-01

    In this cross-sectional study, the authors examined the relationship between emotion and behavior regulation in 3- and 5-year olds. Eighty-seven children performed a compliance sorting task. The authors manipulated the demand for emotion regulation by presenting and then hiding toys (low) or making toys visible (high). Mothers and teachers rated children's coping responses. Five-year-olds sorted less in the high condition than in the low condition, and 3-year-olds spent equal time sorting in both conditions. Compliance was positively correlated with problem-focused coping and negatively correlated with emotion-focused coping. Correlations between emotion and behavior regulation were stronger for the 5-year-olds. Age groups were differently affected by the higher demands of emotion regulation, indicating that the child's resources for regulation interact with the task demands to determine behavioral outcome. PMID:15088868

  7. folded gastrulation, cell shape change and the control of myosin localization.

    PubMed

    Dawes-Hoang, Rachel E; Parmar, Kush M; Christiansen, Audrey E; Phelps, Chris B; Brand, Andrea H; Wieschaus, Eric F

    2005-09-01

    The global cell movements that shape an embryo are driven by intricate changes to the cytoarchitecture of individual cells. In a developing embryo, these changes are controlled by patterning genes that confer cell identity. However, little is known about how patterning genes influence cytoarchitecture to drive changes in cell shape. In this paper, we analyze the function of the folded gastrulation gene (fog), a known target of the patterning gene twist. Our analysis of fog function therefore illuminates a molecular pathway spanning all the way from patterning gene to physical change in cell shape. We show that secretion of Fog protein is apically polarized, making this the earliest polarized component of a pathway that ultimately drives myosin to the apical side of the cell. We demonstrate that fog is both necessary and sufficient to drive apical myosin localization through a mechanism involving activation of myosin contractility with actin. We determine that this contractility driven form of localization involves RhoGEF2 and the downstream effector Rho kinase. This distinguishes apical myosin localization from basal myosin localization, which we find not to require actinomyosin contractility or FOG/RhoGEF2/Rho-kinase signaling. Furthermore, we demonstrate that once localized apically, myosin continues to contract. The force generated by continued myosin contraction is translated into a flattening and constriction of the cell surface through a tethering of the actinomyosin cytoskeleton to the apical adherens junctions. Our analysis of fog function therefore provides a direct link from patterning to cell shape change. PMID:16123312

  8. Attenuating microwave radiation by absorption through controlled nanoparticle localization in PC/PVDF blends.

    PubMed

    Biswas, Sourav; Kar, Goutam Prasanna; Bose, Suryasarathi

    2015-11-01

    Nanoscale ordering in a polymer blend structure is indispensable to obtain materials with tailored properties. It was established here that controlling the arrangement of nanoparticles, with different characteristics, in co-continuous PC/PVDF (polycarbonate/poly(vinylidene fluoride)) blends can result in outstanding microwave absorption (ca. 90%). An excellent reflection loss (RL) of ca. -71 dB was obtained for a model blend structure wherein the conducting (multiwall carbon nanotubes, MWNTs) and the magnetic inclusions (Fe3O4) are localized in PVDF and the dielectric inclusion (barium titanate, BT) is in PC. The MWNTs were modified using polyaniline, which facilitates better charge transport in the blends. Furthermore, by introducing surface active groups on BT nanoparticles and changing the macroscopic processing conditions, the localization of BT nanoparticles can be tailored, otherwise BT nanoparticles would localize in the preferred phase (PVDF). In this study, we have shown that by ordered arrangement of nanoparticles, the incoming EM radiation can be attenuated. For instance, when PANI-MWNTs were localized in PVDF, the shielding was mainly through reflection. Now by localizing the conducting inclusion and the magnetic lossy materials in PVDF and the dielectric materials in PC, an outstanding shielding effectiveness of ca. -37 dB was achieved where shielding was mainly through absorption (ca. 90%). Thus, this study clearly demonstrates that lightweight microwave absorbers can be designed using polymer blends as a tool. PMID:26431367

  9. OLFACTION AND THE 5-YEAR INCIDENCE OF COGNITIVE IMPAIRMENT IN AN EPIDEMIOLOGIC STUDY OF OLDER ADULTS

    PubMed Central

    Schubert, Carla R.; Carmichael, Lakeesha L.; Murphy, Claire; Klein, Barbara E.K.; Klein, Ronald; Cruickshanks, Karen J.

    2008-01-01

    Objectives To determine if odor identification ability is associated with the 5-year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and if olfactory impairment contributes to the prediction of cognitive decline in a population. Design Population-based longitudinal study. Setting Beaver Dam, WI. Participants 1920 participants in the Epidemiology of Hearing Loss Study (mean age = 66.9 years). Measurements Olfaction was measured by the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini-Mental State Exam Score (MMSE) < 24 or reported diagnosis of dementia or Alzheimer’s disease (AD) at the follow-up among people with MMSE ≥ 24 and no diagnosis of dementia or AD at baseline. Results There was a significant association between olfactory impairment at baseline and the 5-year incidence of cognitive impairment (Odds Ratio (O.R.) = 6.62, 95% Confidence Interval (C.I.) = 4.36, 10.05). The association remained significant after adjusting for possible confounders (O.R. = 3.72, 95% C.I. = 2.31, 5.99). The Positive Predictive Value of the SDOIT was 15.9%, the Negative Predictive Value was 97.2% and the sensitivity and specificity were 55.1% and 84.4%, respectively, for the 5-year incidence of cognitive impairment. Conclusion Olfactory impairment at baseline was strongly associated with the 5-year incidence of cognitive impairment as measured by the MMSE. Odor identification testing may be useful in high risk settings, but not in the general population, to identify patients at risk for cognitive decline. PMID:18662205

  10. Mercury toxicity presenting as acrodynia and a papulovesicular eruption in a 5-year-old girl.

    PubMed

    Lai, Olivia; Parsi, Kory K; Wu, Davina; Konia, Thomas H; Younts, Alexandra; Sinha, Natasha; McNelis, Amy; Sharon, Victoria R

    2016-01-01

    Acrodynia is a reaction that occurs in children who have been exposed to mercury. Mercury toxicity has systemic manifestations as well as cutaneous manifestations, which can appear similar to those found in a number of other diseases. We present a case of acrodynia caused by mercury exposure in a previously healthy 5-year-old girl who developed hypertension, palmoplantar pruritus, and a papulovesicular eruption. PMID:27136627

  11. Equatorial Annual Oscillation with QBO-driven 5-year Modulation in NCEP Data

    NASA Technical Reports Server (NTRS)

    Mayr, H. G.; Mengel, J. G.; Huang, F. T.; Nash, E. R.

    2007-01-01

    An analysis is presented of the zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP), which have been assimilated in the Reanalysis and the Climate Prediction Center (CCP) data sets. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the annual 12-month oscillation and Quasi-biennial Oscillation (QBO). For data samples that cover as much as 40 years, the results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also inferred for the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different data samples indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this periodicity of the QBO is involved in generating the oscillation. The spectral analysis shows that there is a weak anti-symmetric 5-year oscillation in the zonal winds, which could interact with the large antisymmetric A0 to produce the modulation of the symmetric AO as was shown in earlier modeling studies. According to these studies, the 30-month QBO tends to be synchronized by the equatorial Semi-annual Oscillation (SAO), and this would explain why the inferred 5-year modulation is observed to persist and is phase locked over several cycles.

  12. A 5-year Journey with Cutis Laxa in an Indian Child: The De Barsy Syndrome Revisited

    PubMed Central

    Dutta, Abhijit; Ghosh, Sudip Kumar; Ghosh, Arghyaprasun; Roy, Sutirtha

    2016-01-01

    De Barsy syndrome (DBS), synonymously known as autosomal recessive cutis laxa type III, is an extremely rare condition clinically characterized by cutis laxa, a progeroid appearance, and ophthalmologic abnormalities. We present here an account of 5-year follow-up since the birth of an Indian boy with DBS, who had a few rare and unusual manifestations. In addition, our case probably represents the first reported case of DBS from India. PMID:26955101

  13. The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

    PubMed Central

    Gopinath, Vellore Kannan

    2016-01-01

    Objective: The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. Materials and Methods: A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. Results: In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05). Conclusions: The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion. PMID:27095899

  14. Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report.

    PubMed

    Snoek, K G; Jacobsohn, M; van As, A B

    2012-01-01

    We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar) spinal cord injury without radiographic abnormalities (SCIWORAs). The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2. PMID:22649746

  15. Development and verification of child observation sheet for 5-year-old children.

    PubMed

    Fujimoto, Keiko; Nagai, Toshisaburo; Okazaki, Shin; Kawajiri, Mie; Tomiwa, Kiyotaka

    2014-02-01

    The aim of the study was to develop a newly devised child observation sheet (COS-5) as a scoring sheet, based on the Childhood Autism Rating Scale (CARS), for use in the developmental evaluation of 5-year-old children, especially focusing on children with autistic features, and to verify its validity. Seventy-six children were studied. The children were recruited among participants of the Japan Children's Cohort Study, a research program implemented by the Research Institute of Science and Technology for Society (RISTEX) from 2004 to 2009. The developmental evaluation procedure was performed by doctors, clinical psychologists, and public health nurses. The COS-5 was also partly based on the Kyoto Scale of Psychological Development 2001 (Kyoto Scale 2001). Further, the Developmental Disorders Screening Questionnaire for 5-Years-Olds, PDD-Autism Society Japan Rating Scale (PARS), doctor interview questions and neurological examination for 5-year-old children, and the Draw-a-Man Test (DAM) were used as evaluation scales. Eighteen (25.4%) children were rated as Suspected, including Suspected PDD, Suspected ADHD and Suspected MR. The COS-5 was suggested to be valid with favorable reliability (α=0.89) and correlation with other evaluation scales. The COS-5 may be useful, with the following advantages: it can be performed within a shorter time frame; it facilitates the maintenance of observation quality; it facilitates sharing information with other professions; and it is reliable to identify the autistic features of 5-year-old children. In order to verify its wider applications including the screening of infants (18months to 3years old) by adjusting the items of younger age, additional study is needed. PMID:23415454

  16. Prognostic factors affecting local control of hepatic tumors treated by stereotactic body radiation therapy

    PubMed Central

    2012-01-01

    Purpose Robotic Stereotactic Body Radiation Therapy with real-time tumor tracking has shown encouraging results for hepatic tumors with good efficacy and low toxicity. We studied the factors associated with local control of primary or secondary hepatic lesions post-SBRT. Methods and materials Since 2007, 153 stereotactic liver treatments were administered to 120 patients using the CyberKnife® System. Ninety-nine liver metastases (72 patients), 48 hepatocellular carcinomas (42 patients), and six cholangiocarcinomas were treated. On average, three to four sessions were delivered over 12 days. Twenty-seven to 45 Gy was prescribed to the 80% isodose line. Margins consisted of 5 to 10 mm for clinical target volume (CTV) and 3 mm for planning target volume (PTV). Results Median size was 33 mm (range, 5–112 mm). Median gross tumor volume (GTV) was 32.38 cm3 (range, 0.2–499.5 cm3). Median total dose was 45 Gy in three fractions. Median minimum dose was 27 Gy in three fractions. With a median follow-up of 15.0 months, local control rates at one and two years were 84% and 74.6%, respectively. The factors associated with better local control were lesion size < 50 mm (p = 0.019), GTV volume (p < 0.05), PTV volume (p < 0.01) and two treatment factors: a total dose of 45 Gy and a dose–per-fraction of 15 Gy (p = 0.019). Conclusions Dose, tumor diameter and volume are prognostic factors for local control when a stereotactic radiation therapy for hepatic lesions is considered. These results should be considered in order to obtain a maximum therapeutic efficacy. PMID:23050794

  17. Controllable local modification of fractured Nb-doped SrTiO{sub 3} surfaces.

    SciTech Connect

    Chien, T. Y.; Santos, T. S.; Bode, M.; Guisinger, N. P.; Freeland, J. W.

    2009-01-01

    Nanoscale surface modification of a fractured Nb-doped SrTiO{sub 3} surface is demonstrated in a controlled way by scanning tunneling microscopy. By applying positive voltage pulses, holes can be created and the width and depth of the hole can be controlled by selecting the appropriate bias and pulse duration. The process shows a threshold condition for creation of the holes and change in the local electronic density of state consistent with exposure of the underlying TiO{sub 2} layer by removal of SrO. By applying negative bias, the hole can be partially refilled from the transfer of adsorbates on the tip.

  18. Study on Rotavirus Infection and Its Genotyping in Children Below 5 Years in South West Iran

    PubMed Central

    Azaran, Azarakhsh; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Neisi, Niloofar; Hoseinzadeh, Mohsen; Rasti, Mojtaba; Teymurirad, Majid; Teimoori, Ali; Varnaseri, Mehran; Makvandi, Kamyar

    2016-01-01

    Background Human rotaviruses are the most important agents for severe dehydrating diarrhea in children below 5 years old. Rotaviruses (RV) is a serious public health problem in developing and developed countries. Objectives The aim of this study was to determine the prevalence of rotavirus infection and their genotypes in children younger than 5 years of age with acute diarrhea in Ahvaz, Iran. Materials and Methods For this study, 200 stool samples from children below 5 years of age with acute diarrhea were collected between October 2011 and March 2012. Initially all stool samples were tested for rotavirus antigen by ELISA, and positive samples were confirmed by RT-PCR targeting the VP6 rotavirus gene. Determination of rotavirus genotypes was carried out by performing RT-PCR for G and P types. Altogether, 15 samples were sequenced. Results Out of 200 stool samples, 100 (50%) had rotavirus antigen detected by ELISA and 73 (36.5%) were found positive by RT-PCR. Of the rotavirus strains identified, only 63 (86.3%) were positive for both VP7 and VP4 while 10 (13.7%) strains were found nontypeable. Rotavirus infection accounts for 36.5% of gastroenteritis cases in samples from symptomatic children. The most prevalent rotavirus genotypes were G1P [8] (80%) followed by G2P [4] (20%). Conclusions Our results suggest that group A rotavirus is a major pathogene of acute diarrhea in Ahvaz city. The genotypes circulating are similar with those of other countries. PMID:27307959

  19. Cryobanking of human ovarian tissue: Do women still want their tissue stored beyond 5 years?

    PubMed

    Macklon, Kirsten Tryde; Ernst, Erik; Andersen, Anders Nyboe; Andersen, Claus Yding

    2014-10-01

    Cryopreservation of ovarian tissue is one way of preserving fertility in young women with a malignant disease or other disorders that require gonadotoxic treatment. The purpose of the study was to explore how many women remained interested in continued cryostorage of their ovarian tissue beyond an initial 5-year period. Between 1999 and 2006, a total of 201 girls and young women had one ovary cryopreserved for fertility preservation in Denmark. One hundred of these met our inclusion criteria, which included a follow-up period of at least 5 years, and were mailed a questionnaire. The response rate was 95%. Sixteen of the patients (17%) stated that they wanted disposal of their tissue; the main reason was completion of family (63%). The mean age of those requesting disposal was 36.6 years, whereas those still wanting their tissue stored were significantly younger, with a mean age of 33.0 years (P < 0.008). In conclusion, most women with ovarian tissue cryobanked requested continued cryostorage after an initial period of at least 5 years. The main reason for requesting disposal was successful completion of a family. PMID:25129692

  20. The Treatment of Parasomnias with Hypnosis: a 5-Year Follow-Up Study

    PubMed Central

    Hauri, Peter J.; Silber, Michael H.; Boeve, Bradley F.

    2007-01-01

    Study Objectives: This study involves a replication and extension of a previous one reported by Hurwitz et al (1991) on the treatment of certain parasomnias with hypnosis. Methods: Thirty-six patients (17 females), mean age 32.7 years (range 6–71). Four were children aged 6 to 16. All had chronic, “functionally autonomous” (self-sustaining) parasomnias. All underwent 1 or 2 hypnotherapy sessions and were then followed by questionnaire for 5 years. Results: Of the 36 patients, 45.4% were symptom-free or at least much improved at the 1-month follow-up, 42.2% at the 18-month follow-up, and 40.5% at the 5-year follow-up. Conclusions: One or 2 sessions of hypnotherapy might be an efficient first-line therapy for patients with certain types of parasomnias. Citation: Hauri PJ; Silber MH; Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med 2007;3(4):369-373. PMID:17694725

  1. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study

    PubMed Central

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  2. Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age--Uganda, 2009.

    PubMed

    Menon, Manoj P; Yoon, Steven S

    2015-09-01

    Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

  3. Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia

    PubMed Central

    Mahévas, Matthieu; Lee, Soo Y.; Stasi, Roberto; Cunningham-Rundles, Susanna; Godeau, Bertrand; Kanter, Julie; Neufeld, Ellis; Taube, Tillmann; Ramenghi, Ugo; Shenoy, Shalini; Ward, Mary J.; Mihatov, Nino; Patel, Vinay L.; Bierling, Philippe; Lesser, Martin; Cooper, Nichola; Bussel, James B.

    2012-01-01

    Treatments for immune thrombocytopenic purpura (ITP) providing durable platelet responses without continued dosing are limited. Whereas complete responses (CRs) to B-cell depletion in ITP usually last for 1 year in adults, partial responses (PRs) are less durable. Comparable data do not exist for children and 5-year outcomes are unavailable. Patients with ITP treated with rituximab who achieved CRs and PRs (platelets > 150 × 109/L or 50-150 × 109/L, respectively) were selected to be assessed for duration of their response; 72 adults whose response lasted at least 1 year and 66 children with response of any duration were included. Patients had baseline platelet counts < 30 × 109/L; 95% had ITP of > 6 months in duration. Adults and children each had initial overall response rates of 57% and similar 5-year estimates of persisting response (21% and 26%, respectively). Children did not relapse after 2 years from initial treatment whereas adults did. Initial CR and prolonged B-cell depletion predicted sustained responses whereas prior splenectomy, age, sex, and duration of ITP did not. No novel or substantial long-term clinical toxicity was observed. In summary, 21% to 26% of adults and children with chronic ITP treated with standard-dose rituximab maintained a treatment-free response for at least 5 years without major toxicity. These results can inform clinical decision-making. PMID:22566601

  4. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study.

    PubMed

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  5. Prediction of glucuronidated drug clearance in pediatrics (≤5 years): An allometric approach.

    PubMed

    Mahmood, Iftekhar

    2015-03-01

    Children are not small adults. The differences between children of different age groups and adults are not merely due to body weight, but also due to physiological and biochemical differences resulting in different rates of drug metabolism or renal clearance. Glucuronidation is an important pathway of drug metabolism. Therefore, the objective of this study is to evaluate the predictive performance of several allometric exponents in children of ≤5 years for the total clearance of drugs which are mainly metabolized by glucuronidation. Four exponents (0.75, 1.0, 1.2, or 1.4) on the body weights and an allometric model developed from adults were evaluated. The four exponents and the allometric model were examined to determine the suitability of the method(s) to predict the clearances of drugs which are glucuronidated in children ≤5 years of age. Based on the analysis of ten drugs, it was noted that the combination of two allometric exponents 1.2 (for children ≤3 months) and 1.0 (for children ≥3 months ≤5 years) can be used to predict mean clearances of drugs which are mainly metabolized by glucuronidation. The suggested approach may be used to estimate a first-in-pediatric dose to initiate a pediatric clinical trial. PMID:24519316

  6. Total wrist arthroplasty: a systematic review of the evidence from the last 5 years.

    PubMed

    Yeoh, D; Tourret, L

    2015-06-01

    We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential. PMID:24963082

  7. The control of sets of motoneurones by local interneurones in the locust.

    PubMed Central

    Burrows, M

    1980-01-01

    1. A motoneurone innervating a muscle in a hind leg of a locust is controlled in a graded manner by many non-spiking, local interneurones. There is overlap and fractionation of control between these interneurones. Some interneurones depolarize the motoneurone over part of its range, others hyperpolarize it, whilst some do both. 2. The interneurones organize the small number of motoneurones that innervate one muscle into overlapping sets of various sizes. A motoneurone can therefore be activated individually or in particular combinations with its fellow motoneurones. 3. The motoneurones innervating two muscles of a joint are also organized into overlapping sets by many local interneurones. This permits the motoneurones to the two muscles to be activated reciprocally, together, or independently. 4. One interneurone can elicit a co-ordinated movement of one, two or even three joints in a hind leg that are components of the normal behaviour of the locust. 5. A single interneurone acting alone does not usually elicit the maximum output from one motoneurone, nor a complete piece of behaviour. A stronger contraction of a muscle and a more complete movement results from the action of groups of interneurones. 6. It is suggested that local interneurones, exerting graded control over motoneurones are a major element in the organization of motor patterns in the locust. PMID:7359394

  8. Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation

    PubMed Central

    Smith, David W.; Gardiner, Bruce S.; Dunstan, Colin

    2012-01-01

    Maintaining bone volume during bone turnover by a BMU is known as bone balance. Balance is required to maintain structural integrity of the bone and is often dysregulated in disease. Consequently, understanding how a BMU controls bone balance is of considerable interest. This paper develops a methodology for identifying potential balance controls within a single cortical BMU. The theoretical framework developed offers the possibility of a directed search for biological processes compatible with the constraints of balance control. We first derive general control constraint equations and then introduce constitutive equations to identify potential control processes that link key variables that describe the state of the BMU. The paper describes specific local bone volume balance controls that may be associated with bone resorption and bone formation. Because bone resorption and formation both involve averaging over time, short-term fluctuations in the environment are removed, leaving the control systems to manage deviations in longer-term trends back towards their desired values. The length of time for averaging is much greater for bone formation than for bone resorption, which enables more filtering of variability in the bone formation environment. Remarkably, the duration for averaging of bone formation may also grow to control deviations in long-term trends of bone formation. Providing there is sufficient bone formation capacity by osteoblasts, this leads to an extraordinarily robust control mechanism that is independent of either osteoblast number or the cellular osteoid formation rate. A complex picture begins to emerge for the control of bone volume. Different control relationships may achieve the same objective, and the ‘integration of information’ occurring within a BMU may be interpreted as different sets of BMU control systems coming to the fore as different information is supplied to the BMU, which in turn leads to different observable BMU behaviors

  9. Retrospective Analysis of Local Control and Cosmetic Outcome of 147 Periorificial Carcinomas of the Face Treated With Low-Dose Rate Interstitial Brachytherapy

    SciTech Connect

    Ducassou, Anne; David, Isabelle; Filleron, Thomas; Rives, Michel; Bonnet, Jacques; Delannes, Martine

    2011-11-01

    Purpose: Skin cancer is the most common malignancy in white populations. We evaluated the local cure rate and cosmetic outcome of patients with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) of the face treated with low-dose rate brachytherapy. Methods and Materials: Between February 1990 and May 2000, 147 facial carcinomas in 132 patients were treated by {sup 192}Ir wire implantation. Side effects of brachytherapy were noted. Follow-up was 2 years or more. Locoregional recurrence-free survival (LRFS) and overall survival were recorded. Group A included patients treated by primary brachytherapy, and Group B included those treated after recurrence. Results: A total of 121 carcinomas were BCCs (82.3%) and 26 were SCCs (17.7%); the median tumor size was 10 mm. Of the tumors, 86 (58.5%) were in men and 61 (41.5%) were in women; the median age was 71 years. Group A comprised 116 lesions (78.9%), and Group B, 31 (21.1%). There were 17 relapses (11.6%) after a median follow-up of 72 months: 12 local, 4 nodal, and 1 local and nodal. Locoregional-free survival was 96.6% at 2 years and 87.3% at 5 years. Five-year LRFS was 82.6% in men and 93.3% in women (p = 0.027). After adjustment for gender, LRFS was better after primary treatment than after recurrence (hasard ratio HR, 2.91; 95% confidence interval, 1.06-8.03; p = 0.039). Five-year LRFS was 90.4% for BCC and 70.8% for SCC (p = 0.03). There were no Grade 3 complications. Conclusions: Low-dose rate brachytherapy offers good local control and cosmetic outcome in patients with periorificial skin carcinomas, with no Grade 3 complications. Brchytherapy is more efficient when used as primary treatment.

  10. An Effective Preoperative Three-Dimensional Radiotherapy Target Volume for Extremity Soft Tissue Sarcoma and the Effect of Margin Width on Local Control

    SciTech Connect

    Kim, Bo Kyong; Chen, Yen-Lin E.; Kirsch, David G.; Goldberg, Saveli I.; Kobayashi, Wendy; Kung, Jong Hyun; Wolfgang, John A.; Doppke, Karen

    2010-07-01

    Purpose: There is little information on the appropriate three-dimensional (3D) preoperative radiotherapy (XRT) volume for extremity soft-tissue sarcomas (STS). We retrospectively analyzed the pattern of local failure (LF) to help elucidate optimal field design. Methods and Materials: We analyzed the 56 patients who underwent computed tomography-planned XRT for Stage I to III extremity STS between June 2000 and December 2006. Clinical target volume (CTV) included the T1 post-gadolinium-defined gross tumor volume with 1- to 1.5-cm radial and 3.5-cm longitudinal margins. Planning target volume expansion was 5 to 7 mm, and {>=}95% of dose was delivered to the planning target volume. Preoperative XRT was 44 to 50.4 Gy (median, 50). Postoperative boost of 10 to 20 Gy was given to 12 patients (6 with positive and 6 with close margins). Results: Follow-up ranged from 15 to 76 months (median, 41 months). The 5-year local control, freedom from distant metastasis, disease-free survival, and overall survival were 88.5%, 80.0%, 77.5% and 82.8%, respectively. Three patients (all with positive margin) experienced local failure (LF) as first relapse (2 isolated, 1 with distant failure), and 2 additional patients (all with margin<1 mm) had late LF after distant metastasis. The LFs were within the CTV in 3 patients and within and also extending beyond the CTV in 2 patients. Conclusions: These target volume definitions appear to be appropriate for most patients. No local recurrences were observed with surgical margins {>=}1 mm, and it appears that these may be adequate for patients with extremity STS treated with preoperative radiotherapy.

  11. A Longitudinal Assessment of the Relation between Executive Function and Theory of Mind at 3, 4, and 5 Years

    PubMed Central

    Marcovitch, Stuart; O’Brien, Marion; Calkins, Susan D.; Leerkes, Esther M.; Weaver, Jennifer M.; Levine, Douglas W.

    2014-01-01

    This longitudinal study contributes to the growing literature on the predictive nature of the relation between executive function (EF) and theory of mind (ToM). A latent variable model was fit to the data acquired from 226 socioeconomically and racially diverse children (52% female) at 3, 4, and 5 years of age on a number of age-appropriate tasks designed to assess EF and ToM. After controlling for sex, income-to-needs, and receptive language ability, there was substantial stability within each construct as children aged. In addition, EF at 3 years predicted ToM at 4 years but ToM did not predict EF, replicating earlier results. This pattern also appeared from 4 to 5 years of age, suggesting that the developmental precedence of EF persists later in development. Implications of these findings are discussed in terms of contemporary cognitive development theories, as well as the relation between EF and social reasoning in general. PMID:25642021

  12. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    PubMed

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed. PMID:16464703

  13. Public information officers' perceived control in building local public health agendas and the impact of community size.

    PubMed

    Avery, Elizabeth Johnson; Lariscy, Ruthann Weaver

    2011-12-01

    Using data collected from 280 local public health information officers (PIOs) serving community sizes from rural to urban across the United States, this study examines issues of local autonomy or lack thereof in establishing local health agendas. It specifically addresses how size of community as well as state and federal agencies' agendas affect public health promotion at the local level. Findings reveal low levels of perceived local departmental control in building public health agendas among rural PIOs. Alternatively, urban PIOs report low levels of both perceived state and federal departmental control yet higher levels of local departmental control compared to counterparts in other sized locales. Implications and importance of findings are discussed. PMID:21660791

  14. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    PubMed Central

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  15. External Beam Radiation Therapy Enhances Local Control in Pigmented Villonodular Synovitis

    SciTech Connect

    Horoschak, Melissa; Tran, Phuoc T. Bachireddy, Pavan; West, Robert B.; Mohler, David; Beaulieu, Christopher F.; Kapp, Daniel S.; Donaldson, Sarah S.

    2009-09-01

    Purpose: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovium with locally aggressive behavior. We reviewed our experience using radiation therapy in the treatment of PVNS. Materials and Methods: Seventeen patients with 18 sites of PVNS were treated with radiation between 1993 and 2007. Cases were retrospectively reviewed for patient information, treatment parameters, complications, and outcome. Seven sites were primary presentations and 11 were recurrent with an average of 2.5 prior surgical interventions. The most common location was the knee joint (67%). Cytoreductive surgery was performed before radiation therapy in 16/18 sites with all having proven or suspected residual disease. Radiation was delivered using 4-15 MV photons with an average total dose 34 Gy (range, 20-36 Gy). Seventeen of 18 sites (94%) had postradiotherapy imaging. Results: With average follow-up of 46 months (range, 8-181 months), initial local control was achieved in 75% (12/16) of the sites with prior cytoreductive surgery (mean time to recurrence, 38 months). Ultimate local control was 100% after repeat resection (mean follow-up, 61 months). Two additional sites without prior cytoreductive surgery showed growth after radiotherapy (mean time to documented growth, 10.5 months). Seventeen of the 18 involved joints (94%) were scored as excellent or good PVNS-related function, one site (5%) as fair function, and no site with poor function. No patient required amputation; and there were no Grade 3/4 treatment-related complications. Conclusion: Postoperative external beam radiation is effective in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in PVNS.

  16. Changing the patterns of failure for high-risk prostate cancer patients by optimizing local control

    SciTech Connect

    Stock, Richard G. . E-mail: richard.stock@msnyuhealth.org; Ho, Alice; Cesaretti, Jamie A.; Stone, Nelson N.

    2006-10-01

    Purpose: Standard therapies for high-risk prostate cancer have resulted in suboptimal outcomes with both local and distant failures. Prostate-specific antigen (PSA) and distant metastases rates as well as biopsy outcomes are reported after a regimen of trimodality therapy with hormonal, radioactive seed, and external beam radiation therapy to demonstrate how patterns of failure are changed when local control is optimized. Methods and Materials: From 1994 to 2003, a total of 360 patients with high-risk prostate cancer were treated with trimodality therapy. Patients were defined as being at high risk if they possessed at least one of the following high-risk features: Gleason score 8 to 10, PSA >20, clinical stage t2c to t3, or two or more intermediate risk features: Gleason score 7, PSA >10 to 20, or stage t2b. Patients were followed for a median of 4.25 years (range, 2 to 10 years). Results: The actuarial 7-year freedom from PSA failure and freedom from distant metastases (FFDM) rates were 83% and 89% respectively. Patients (n = 51) developing PSA failure exhibited aggressive disease behavior with short PSA doubling times (median, 5 months) and a 7-year freedom from distant metastases rate of 48%. Local control was high. The last posttreatment biopsy results were negative in 97% of cases (68 of 70 patients). In multivariate analysis, only PSA >20 predicted biochemical failure (p = 0.04), and only seminal vesicle status predicted developing distant failure (p = 0.01). Conclusions: Trimodality therapy results in excellent local control that alters patterns of failure, resulting in similar actuarial biochemical and distant failure rates. Most failures appear to be distant and exhibit biologically aggressive behavior.

  17. Magnetic Sphincter Augmentation for Gastroesophageal Reflux at 5 Years: Final Results of a Pilot Study Show Long-Term Acid Reduction and Symptom Improvement

    PubMed Central

    Saino, Greta; Bonavina, Luigi; Lipham, John C.; Dunn, Daniel

    2015-01-01

    Abstract Background: As previously reported, the magnetic sphincter augmentation device (MSAD) preserves gastric anatomy and results in less severe side effects than traditional antireflux surgery. The final 5-year results of a pilot study are reported here. Patients and Methods: A prospective, multicenter study evaluated safety and efficacy of the MSAD for 5 years. Prior to MSAD placement, patients had abnormal esophageal acid and symptoms poorly controlled by proton pump inhibitors (PPIs). Patients served as their own control, which allowed comparison between baseline and postoperative measurements to determine individual treatment effect. At 5 years, gastroesophageal reflux disease (GERD)-Health Related Quality of Life (HRQL) questionnaire score, esophageal pH, PPI use, and complications were evaluated. Results: Between February 2007 and October 2008, 44 patients (26 males) had an MSAD implanted by laparoscopy, and 33 patients were followed up at 5 years. Mean total percentage of time with pH <4 was 11.9% at baseline and 4.6% at 5 years (P < .001), with 85% of patients achieving pH normalization or at least a 50% reduction. Mean total GERD-HRQL score improved significantly from 25.7 to 2.9 (P < .001) when comparing baseline and 5 years, and 93.9% of patients had at least a 50% reduction in total score compared with baseline. Complete discontinuation of PPIs was achieved by 87.8% of patients. No complications occurred in the long term, including no device erosions or migrations at any point. Conclusions: Based on long-term reduction in esophageal acid, symptom improvement, and no late complications, this study shows the relative safety and efficacy of magnetic sphincter augmentation for GERD. PMID:26437027

  18. Fast local temperature tracking in electrophysiological preparations by means of controlled laser irradiation

    NASA Astrophysics Data System (ADS)

    Lin, Shien-Fong; Rymer, William Z.

    1992-06-01

    The design and application of a temperature-tracking apparatus using a laser as heating source for electrophysiological preparation are presented. The apparatus provides the ability to follow a given temperature pattern at a local site. The studies were conducted to understand the mechanisms underlying thermal damage to ion channels in the frog nerve node of Ranvier. Main objectives of the temperature controller design are short temperature rise time and precise static temperature control. The temperature controller allows a minimum rise time of 150 ms with an accuracy of +/- 0.2 degree(s)C in the nerve membrane of nodes of Ranvier. The application of the device to nerve membrane thermal damage study showed that after a 5-second exposure to laser-induced hyperthermia at temperature of 48 - 54 degree(s)C, there was a differential suppression of Na and K currents in the nodal membrane currents. Potential applications of the temperature controller design can be found in other research areas in medicine and biophysics that require a stable high temperature heat source for local heating.

  19. A tether tension control law for tethered subsatellites deployed along local vertical. [space shuttle orbiters - satellite control/towed bodies

    NASA Technical Reports Server (NTRS)

    Rupp, C. C.

    1975-01-01

    A tethered subsatellite deployed along the local vertical is in stable equilibrium. This applies equally to subsatellites deployed in the direction towards the earth from the main spacecraft or away from the earth. Momentary perturbations from this stable equilibrium will result in a swinging motion, which decays very slowly if passive means are relied upon to provide damping. A control law is described which actively damps the swinging motion by employing a reel, or other mechanism, to apply appropriate tension as a function of tetherline length, rate of change of length, and desired length. The same control law is shown to be useful for deployment and retrieval of tethered subsatellites in addition to damping to steady state.

  20. Blind RSSD-Based Indoor Localization with Confidence Calibration and Energy Control

    PubMed Central

    Zou, Tengyue; Lin, Shouying; Li, Shuyuan

    2016-01-01

    Indoor localization based on wireless sensor networks (WSNs) is an important field of research with numerous applications, such as elderly care, miner security, and smart buildings. In this paper, we present a localization method based on the received signal strength difference (RSSD) to determine a target on a map with unknown transmission information. To increase the accuracy of localization, we propose a confidence value for each anchor node to indicate its credibility for participating in the estimation. An automatic calibration device is designed to help acquire the values. The acceleration sensor and unscented Kalman filter (UKF) are also introduced to reduce the influence of measuring noise in the application. Energy control is another key point in WSN systems and may prolong the lifetime of the system. Thus, a quadtree structure is constructed to describe the region correlation between neighboring areas, and the unnecessary anchor nodes can be detected and set to sleep to save energy. The localization system is implemented on real-time Texas Instruments CC2430 and CC2431 embedded platforms, and the experimental results indicate that these mechanisms achieve a high accuracy and low energy cost. PMID:27258272

  1. Blind RSSD-Based Indoor Localization with Confidence Calibration and Energy Control.

    PubMed

    Zou, Tengyue; Lin, Shouying; Li, Shuyuan

    2016-01-01

    Indoor localization based on wireless sensor networks (WSNs) is an important field of research with numerous applications, such as elderly care, miner security, and smart buildings. In this paper, we present a localization method based on the received signal strength difference (RSSD) to determine a target on a map with unknown transmission information. To increase the accuracy of localization, we propose a confidence value for each anchor node to indicate its credibility for participating in the estimation. An automatic calibration device is designed to help acquire the values. The acceleration sensor and unscented Kalman filter (UKF) are also introduced to reduce the influence of measuring noise in the application. Energy control is another key point in WSN systems and may prolong the lifetime of the system. Thus, a quadtree structure is constructed to describe the region correlation between neighboring areas, and the unnecessary anchor nodes can be detected and set to sleep to save energy. The localization system is implemented on real-time Texas Instruments CC2430 and CC2431 embedded platforms, and the experimental results indicate that these mechanisms achieve a high accuracy and low energy cost. PMID:27258272

  2. Activity-dependent control of neuronal output by local and global dendritic spike attenuation.

    PubMed

    Remy, Stefan; Csicsvari, Jozsef; Beck, Heinz

    2009-03-26

    Neurons possess elaborate dendritic arbors which receive and integrate excitatory synaptic signals. Individual dendritic subbranches exhibit local membrane potential supralinearities, termed dendritic spikes, which control transfer of local synaptic input to the soma. Here, we show that dendritic spikes in CA1 pyramidal cells are strongly regulated by specific types of prior input. While input in the linear range is without effect, supralinear input inhibits subsequent spikes, causing them to attenuate and ultimately fail due to dendritic Na(+) channel inactivation. This mechanism acts locally within the boundaries of the input branch. If an input is sufficiently strong to trigger axonal action potentials, their back-propagation into the dendritic tree causes a widespread global reduction in dendritic excitability which is prominent after firing patterns occurring in vivo. Together, these mechanisms control the capability of individual dendritic branches to trigger somatic action potential output. They are invoked at frequencies encountered during learning, and impose limits on the storage and retrieval rates of information encoded as branch excitability. PMID:19323999

  3. Auxin controls local cytokinin biosynthesis in the nodal stem in apical dominance.

    PubMed

    Tanaka, Mina; Takei, Kentaro; Kojima, Mikiko; Sakakibara, Hitoshi; Mori, Hitoshi

    2006-03-01

    In intact plants, the shoot apex grows predominantly and inhibits outgrowth of axillary buds. After decapitation of the shoot apex, outgrowth of axillary buds begins. This phenomenon is called an apical dominance. Although the involvement of auxin, which represses outgrowth of axillary buds, and cytokinin (CK), which promotes outgrowth of axillary buds, has been proposed, little is known about the underlying molecular mechanisms. In the present study, we demonstrated that auxin negatively regulates local CK biosynthesis in the nodal stem by controlling the expression level of the pea (Pisum sativum L.) gene adenosine phosphate-isopentenyltransferase (PsIPT), which encodes a key enzyme in CK biosynthesis. Before decapitation, PsIPT1 and PsIPT2 transcripts were undetectable; after decapitation, they were markedly induced in the nodal stem along with accumulation of CK. Expression of PsIPT was repressed by the application of indole-3-acetic acid (IAA). In excised nodal stem, PsIPT expression and CK levels also increased under IAA-free conditions. Furthermore, beta-glucuronidase expression, under the control of the PsIPT2 promoter region in transgenic Arabidopsis, was repressed by an IAA. Our results indicate that in apical dominance one role of auxin is to repress local biosynthesis of CK in the nodal stem and that, after decapitation, CKs, which are thought to be derived from the roots, are locally biosynthesized in the nodal stem rather than in the roots. PMID:16507092

  4. Springtime cloud properties in the Taiwan Strait: synoptic controls and local processes

    NASA Astrophysics Data System (ADS)

    Kueh, Mien-Tze; Lin, Pay-Liam

    2014-05-01

    This paper examines the springtime cloud properties in the Taiwan Strait (TS), with emphases on their dependence on synoptic controls and local processes, using a suite of in situ and remote sensing observations. Cloud properties in the TS are inferred from a combination of MODIS and in situ observations and further classified into two synoptic conditions: continental cold air surge and frontal system. The study reveals a predominance of synoptic-scale controls in regulating the cloud properties in the TS. The sensitivity of clouds to the local thermodynamic mechanisms as well as the underlying surface conditions is fundamentally dependent on synoptic-scale flow patterns. The springtime clouds over the TS are commonly a mixture of stratocumulus and alto clouds. More precisely, there is a preponderance of stratocumulus over the strait. A preferential occupancy of stratiform alto clouds is recognized during cold air surge, whereas vertical development of cloud layers (mostly the stratocumulus) is commonly observed with frontal passage. The most distinct difference between the local clouds formation associated with the two synoptic conditions is the suppression of very low cloud and fog along with cold air surge. Stratus clouds and fog are present within the northward prefrontal airflow from warmer to colder water sites, along with an increase in stability relating to lower altitudes of boundary layer clouds. Although the rainfall occurrences are about the same for both synoptic conditions, the frontal rain amounts are larger on average.

  5. Control of Nitrous Oxide Exposure in Dental Operatories Using Local Exhaust Ventilation

    PubMed Central

    Jacobs, David E.; Middendorf, Paul J.

    1986-01-01

    An experimental portable local exhaust ventilation system was installed in three dental operatories where nitrous oxide was used routinely. Standard methods of exhaust ventilation design used in industry to control exposures to toxic airborne substances were applied to the dental operatory setting. The concentration of nitrous oxide in the dentists' breathing zones was measured before and after installation to determine the efficiency of the system in reducing occupational exposures. Results indicate that placement of the exhaust opening and exhaust air flow rate are important in determining the degree of control achieved. After the system had been installed in one operatory, peak exposures declined from over 600 parts per million (ppm) to less than 70 ppm: the time-weighted average exposure was below the NIOSH recommended level of 25 ppm. A permanently installed local exhaust ventilation system modeled after the portable one used in this pilot study may be feasible for most operatories and should not interfere with dental procedures. The results suggest that nitrous oxide exposures can be greatly reduced if dental operatories are equipped with local exhaust ventilation. ImagesFig. 4Fig. 7 PMID:3465259

  6. Real-time feedback control for high-intensity focused ultrasound system using localized motion imaging

    NASA Astrophysics Data System (ADS)

    Sugiyama, Ryusuke; Kanazawa, Kengo; Seki, Mika; Azuma, Takashi; Sasaki, Akira; Takeuchi, Hideki; Fujiwara, Keisuke; Itani, Kazunori; Tamano, Satoshi; Yoshinaka, Kiyoshi; Takagi, Shu; Matsumoto, Yoichiro

    2015-07-01

    High-intensity focused ultrasound (HIFU) is one of the noninvasive treatment for tumors. Visualizing the treated area inside the human body is necessary to control the HIFU exposure. Localized motion imaging (LMI) using ultrasound to induce and detect tissue deformation is one technique to detect a change in tissue stiffness caused by thermal coagulation. In experiments with porcine liver, LMI has shown to detect deformation with less than 20% accuracy. We have developed a prototype feedback control system using real-time LMI. In this system, coagulation size was measured every 1 s and controlled to correspond to a targeted size. The typical size error was reduced to 14% from 35%. LMI displacements in normal and coagulated tissues were sufficiently different to discriminate between coagulated areas and noncoagulated ones after HIFU sonication and to visualize treated areas after HIFU treatment.

  7. Local phase control for a planar array of fiber laser amplifiers

    NASA Astrophysics Data System (ADS)

    Steffanic, Patrick; Johannes, Benjamin T.; Sison, Claudia A.; Hughes, Gary B.; Lubin, Philip; Meinhold, Peter; Suen, Jonathan; O'Neill, Hugh; Kangas, Miikka; Brashears, Travis; Zhang, Qicheng; Griswold, Janelle; Riley, Jordan; Motta, Caio

    2015-09-01

    Arrays of phase-locked lasers have been developed for numerous directed-energy applications. Phased-array designs are capable of producing higher beam intensity than similar sized multi-beam emitters, and also allow beam steering and beam profile manipulation. In phased-array designs, individual emitter phases must be controllable, based on suitable feedback. Most current control schemes sample individual emitter phases, such as with an array-wide beam splitter, and compare to a master phase reference. Reliance on a global beam splitter limits scalability to larger array sizes due to lack of design modularity. This paper describes a conceptual design and control scheme that relies only on feedback from the array structure itself. A modular and scalable geometry is based on individual hexagonal frames for each emitter; each frame cell consists of a conventional lens mounted in front of the fiber tip. A rigid phase tap structure physically connects two adjacent emitter frame cells. A target sensor is mounted on top of the phase tap, representing the local alignment datum. Optical sensors measure the relative position of the phase tap and target sensor. The tap senses the exit phase of both emitters relative to the target normal plane, providing information to the phase controller for each emitter. As elements are added to the array, relative local position data between adjacent phase taps allows accurate prediction of the relative global position of emitters across the array, providing additional constraints to the phase controllers. The approach is scalable for target distance and number of emitters without loss of control.

  8. 5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings

    PubMed Central

    Kenton, Kimberly; Stoddard, Anne M.; Zyczynski, Halina; Albo, Michael; Rickey, Leslie; Norton, Peggy; Wai, Clifford; Kraus, Stephen R.; Sirls, Larry T.; Kusek, John W.; Litman, Heather J.; Chang, Robert P.; Richter, Holly E.

    2014-01-01

    Background Few studies have characterized longer-term outcomes after retropubic and transobturator midurethral slings. Methods Women completing 2-year participation in a randomized equivalence trial who had not received surgical retreatment for stress urinary incontinence were invited to participate in a 5-year observational cohort. The primary outcome, treatment success, was defined as no retreatment or self-reported stress incontinence symptoms. Secondary outcomes included urinary symptoms and quality of life, satisfaction, sexual function and adverse events. Results 404 of 597 (68%) women from the original trial enrolled. Five-years after surgical treatment, success was 7.9% greater in women assigned to retropubic-sling compared to transobturator-sling (51.3% vs 43.4%, 95% CI −1.4%, 17.2%) not meeting pre-specified criteria for equivalence. Satisfaction decreased over 5-years, but remained high and similar between arms (79%, retropubic-sling vs 85%, transobturator-sling groups, p=0.15). Urinary symptoms and quality of life worsened over time (p<0.001), and women with retropubic-sling reported greater urinary urgency (P=0.001), more negative quality of life impact (p=0.02), and worse sexual function (P=0.001). There was no difference in proportion of women experiencing at least 1 adverse event (p=0.17). Seven new mesh erosions were noted (retropubic-sling-3, transobturator-sling-4). Conclusion Treatment success declined over 5-years for retropubic and transobturator-slings and did not meet pre-specified criteria for equivalence with retropubic demonstrating a slight benefit. However, satisfaction remained high in both arms. Women undergoing transobturator-sling reported more sustained improvement in urinary symptoms and sexual function. New mesh erosions occurred in both arms over time, although at a similarly low rate. PMID:25158274

  9. Calcineurin activity in tacrolimus-treated renal transplant patients early after and 5 years after transplantation.

    PubMed

    Mortensen, D M; Koefoed-Nielsen, P B; Jørgensen, K A

    2006-10-01

    The pharmacodynamic (PD) action of tacrolimus (FK) within the T-cell is inhibition of calcineurin phosphatase (CaN). Determination of CaN activity provides us with an important PD marker. Eleven renal transplant patients treated with FK were investigated on day 14 following transplantation and 5 years later. Blood samples drawn before as well as 1, 2, 3, and 4 hours after oral intake of FK were analyzed for CaN activity and blood FK concentrations. Twenty healthy subjects had one blood sample drawn for CaN activity, which was measured as the release of (32)P from a phosphorylated peptide. Radioactivity of (32)P was quantitated by liquid scintillation counting with the results converted to units of CaN utilizing a calibration curve. On day 14, we observed significant inhibition of CaN activity at T:1, 2, and 3 compared with the predose level (P = .002; P = .015; P = .015). Furthermore, all measured CaN activities were significantly different from those observed in healthy nonmedicated subjects. In contrast, at 5 years posttransplant only the CaN activity at T:2 was significantly inhibited compared with the predose level (P = .02). Additionally, all CaN activities at this time were not significantly different from CaN activities in the healthy subjects. We were not able to demonstrate individual CaN activity profiles in the patients. The lack of CaN inhibition at 5 years after transplantation despite relevant drug concentrations, probably reflected the lower drug dose used long after transplantation. This result raises the question of whether CaN inhibition is necessary to hold graft function and whether FK possess CaN-independent mechanisms of action. PMID:17098028

  10. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    PubMed

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up. PMID:24598507

  11. Small bowel obstruction 5 years following the ingestion of serrated scissors

    PubMed Central

    Limb, Richard; Karam, Edward; Lingam, Krishna M.

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  12. Drifter-based estimate of the 5 year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I. I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K.

    2014-11-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Good agreement between the drifter-based predictions and the observations is found.

  13. Maintenance pharmacotherapy for recurrent major depressive disorder: 5-year follow-up study.

    PubMed

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Isometsä, Erkki T

    2008-08-01

    Practice guidelines endorse maintenance antidepressant treatment for recurrent major depressive disorder. In the Vantaa Depression Study, we followed 218 psychiatric patients with major depressive disorder for up to 5 years with a life-chart. Of these patients, 86 (39.4%) had more than three lifetime episodes and an indication for maintenance pharmacotherapy. However, of these, only 57% received treatment and only for 16% of the time indicated. Good adherence to pharmacotherapy in the acute phase independently predicted maintenance treatment. The tertiary preventive impact of maintenance treatment may remain limited, as many patients with major depressive disorder either do not receive it, or receive it for too short a period. PMID:18670005

  14. Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico

    PubMed Central

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula

    2007-01-01

    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

  15. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child

    PubMed Central

    Geramizadeh, Bita; Khademi, Bijan; Karimi, Mehran; Shekarkhar, Golsa

    2015-01-01

    Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin. PMID:26604519

  16. Symptoms of Central Anticholinergic Syndrome After Glycopyrrolate Administration in a 5-Year-Old Child.

    PubMed

    Toksvang, Linea Natalie; Plovsing, Ronni R

    2016-01-15

    Anesthesia-related central anticholinergic syndrome (CAS) is most commonly associated with administration of atropine or scopolamine, whereas glycopyrrolate is an extremely rare cause of CAS. Here, we report a case of CAS in a 5-year-old boy admitted to the intensive care unit. Immediately after the administration of glycopyrrolate, he became agitated and developed apnea, hypertension, tachycardia, and anuria. Although the present case describes a rare cause of CAS, it is an important reminder of an iatrogenic condition that is presumably underdiagnosed in the operating theater as well as the intensive care unit. PMID:26513676

  17. Bilateral renal leiomyoma with 5 year follow-up: Case report.

    PubMed

    Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Goren, Vinil; Bal, Nebil

    2015-01-01

    Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas. PMID:26664510

  18. Meckel's diverticulum with intussusception in a 5-year-old patient with Down's syndrome.

    PubMed

    Anwar, Mohammed Omer; Ahmed, Hamza Ibn; Al Hindi, Saeed; Al Omran, Yasser

    2014-01-01

    Meckel's diverticulum is understood to be the commonest congenital malformation within the gastrointestinal tract with a prevalence of 2%, as found on autopsy studies. Although many cases are asymptomatic, complications can occur including haemorrhage, diverticulitis, chronic ulceration and intestinal obstruction. Intussusception is also a complication, but extremely rare. We present a rare case of Meckel's diverticulum causing intussusception, which was surgically resolved, in a 5-year-old girl. Our aim through this case report is to generate greater awareness of this complication and to provide some potential guidance towards its treatment. PMID:25540213

  19. Stage I carcinoma of the endometrium: a 5-year experience utilizing preoperative cesium

    SciTech Connect

    Belinson, J.L.; Spirou, B.; McClure, M.; Badger, G.; Pretorius, R.G.; Roland, T.A.

    1985-03-01

    A treatment protocol for the management of stage I endometrial carcinoma utilizing preoperative cesium is evaluated. One hundred and twelve consecutive patients were treated according to this protocol over a 5-year period. Based on this experience and a literature review a new protocol is recommended. The significant changes include primary surgery without preoperative cesium, primary treatment based on grade without regard to uterine size, modified radical hysterectomy for G3 tumors, pelvic radiotherapy for clear cell carcinoma confined to the pelvis regardless of depth of invasion, cytoxan, adriamycin, and cis-platinum for papillary serous tumors, and postoperative vaginal cuff cesium for G2 and G3 tumors not requiring pelvic radiotherapy.

  20. Small bowel obstruction 5 years following the ingestion of serrated scissors.

    PubMed

    Limb, Richard; Karam, Edward; Lingam, Krishna M

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  1. Early Onset Bipolar Disorder in a 5.5 Years- Old Child

    PubMed Central

    Zarei, Mina; Bidaki, Reza; Hakim-Shooshtari, Mitra

    2011-01-01

    Bipolar disorder is a mental disease that can be presented as irritable mood with affective storms, mixed symptoms of depression and mania, rapid cycles, emotional labiality and irritability during all episodes. A confirmed positive familial history of the disease is the single most robust risk factor for developing the illness. This report presents 5.5 years-old girl with the symptoms of bipolar disorder and with the purpose to draw attention to the diversity of possible symptoms of mood disorders in childhood. PMID:24644461

  2. Drifter-based estimate of the 5-year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K. O.

    2014-12-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time-scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Excellent agreement between the drifter-based predictions and the observations is found.

  3. Angiomyolipoma of donor kidney: Successful transplantation and 5-year follow-up

    PubMed Central

    Gopalakrishnan, N.; Dhanapriya, J.; Sakthirajan, R.; Dineshkumar, T.; Balasubramaniyan, T.; Haris, Md.

    2016-01-01

    Angiomyolipomas (AML) of the kidney are non-encapsulated benign neoplasms with the incidence of 45-80% in patients with tuberous sclerosis and 1-3% in sporadic cases. There are very few case reports in the literature in which kidneys with AML have been used for transplantation. We report here a 27-year-old female patient who received a live related renal transplant from her mother with isolated angiomyolipoma in donor kidney and on follow-up after 5 years, has stable graft function and tumor size. PMID:27051138

  4. A Performance Management Initiative for Local Health Department Vector Control Programs

    PubMed Central

    Gerding, Justin; Kirshy, Micaela; Moran, John W.; Bialek, Ron; Lamers, Vanessa; Sarisky, John

    2016-01-01

    Local health department (LHD) vector control programs have experienced reductions in funding and capacity. Acknowledging this situation and its potential effect on the ability to respond to vector-borne diseases, the U.S. Centers for Disease Control and Prevention and the Public Health Foundation partnered on a performance management initiative for LHD vector control programs. The initiative involved 14 programs that conducted a performance assessment using the Environmental Public Health Performance Standards. The programs, assisted by quality improvement (QI) experts, used the assessment results to prioritize improvement areas that were addressed with QI projects intended to increase effectiveness and efficiency in the delivery of services such as responding to mosquito complaints and educating the public about vector-borne disease prevention. This article describes the initiative as a process LHD vector control programs may adapt to meet their performance management needs. This study also reviews aggregate performance assessment results and QI projects, which may reveal common aspects of LHD vector control program performance and priority improvement areas. LHD vector control programs interested in performance assessment and improvement may benefit from engaging in an approach similar to this performance management initiative. PMID:27429555

  5. Compact vibration isolation and suspension for Australian International Gravitational Observatory: local control system.

    PubMed

    Dumas, Jean-Charles; Barriga, Pablo; Zhao, Chunnong; Ju, Li; Blair, David G

    2009-11-01

    High performance vibration isolators are required for ground based gravitational wave detectors. To attain very high performance at low frequencies we have developed multistage isolators for the proposed Australian International Gravitational Observatory detector in Australia. New concepts in vibration isolation including self-damping, Euler springs, LaCoste springs, Roberts linkages, and double preisolation require novel sensors and actuators. Double preisolation enables internal feedback to be used to suppress low frequency seismic noise. Multidegree of freedom control systems are required to attain high performance. Here we describe the control components and control systems used to control all degrees of freedom. Feedback forces are injected at the preisolation stages and at the penultimate suspension stage. There is no direct actuation on test masses. A digital local control system hosted on a digital signal processor maintains alignment and position, corrects drifts, and damps the low frequency linear and torsional modes without exciting the very high Q-factor test mass suspension. The control system maintains an optical cavity locked to a laser with a high duty cycle even in the absence of an autoalignment system. An accompanying paper presents the mechanics of the system, and the optical cavity used to determine isolation performance. A feedback method is presented, which is expected to improve the residual motion at 1 Hz by more than one order of magnitude. PMID:19947744

  6. Local Stable and Unstable Manifolds and Their Control in Nonautonomous Finite-Time Flows

    NASA Astrophysics Data System (ADS)

    Balasuriya, Sanjeeva

    2016-03-01

    It is well known that stable and unstable manifolds strongly influence fluid motion in unsteady flows. These emanate from hyperbolic trajectories, with the structures moving nonautonomously in time. The local directions of emanation at each instance in time is the focus of this article. Within a nearly autonomous setting, it is shown that these time-varying directions can be characterised through the accumulated effect of velocity shear. Connections to Oseledets spaces and projection operators in exponential dichotomies are established. Availability of data for both infinite- and finite-time intervals is considered. With microfluidic flow control in mind, a methodology for manipulating these directions in any prescribed time-varying fashion by applying a local velocity shear is developed. The results are verified for both smoothly and discontinuously time-varying directions using finite-time Lyapunov exponent fields, and excellent agreement is obtained.

  7. SIMULATING LOCAL DENSE AREAS USING PMMA TO ASSESS AUTOMATIC EXPOSURE CONTROL IN DIGITAL MAMMOGRAPHY.

    PubMed

    Bouwman, R W; Binst, J; Dance, D R; Young, K C; Broeders, M J M; den Heeten, G J; Veldkamp, W J H; Bosmans, H; van Engen, R E

    2016-06-01

    Current digital mammography (DM) X-ray systems are equipped with advanced automatic exposure control (AEC) systems, which determine the exposure factors depending on breast composition. In the supplement of the European guidelines for quality assurance in breast cancer screening and diagnosis, a phantom-based test is included to evaluate the AEC response to local dense areas in terms of signal-to-noise ratio (SNR). This study evaluates the proposed test in terms of SNR and dose for four DM systems. The glandular fraction represented by the local dense area was assessed by analytic calculations. It was found that the proposed test simulates adipose to fully glandular breast compositions in attenuation. The doses associated with the phantoms were found to match well with the patient dose distribution. In conclusion, after some small adaptations, the test is valuable for the assessment of the AEC performance in terms of both SNR and dose. PMID:26977073

  8. Comment on controlling dental post-operative pain and the intraoral local delivery of drugs.

    PubMed

    Hersh, Elliot V; Moore, Paul A

    2015-12-01

    The results of numerous double-blind, placebo-controlled clinical trials consistently demonstrate that nonsteroidal antiinflammatory drugs should be the first line agents in treating postsurgical dental pain. Additive and potential opioid-sparing effects have also been reported in oral surgery pain by combining an optimal dose of an NSAID with acetaminophen 500 mg. While opioid combination drugs are indicated in some dental postsurgical patients, clinicians can no longer ignore the scourge of prescription opioid abuse in the United States. Other potential opioid sparing strategies include the use of locally delivered antimicrobial/antiinflammatory agents such as Bexident Post or extended duration local anesthetic agents such as liposomal bupivacaine placed directly in or in the vicinity of the extraction socket. PMID:26471741

  9. Tissue-Specific Signals Control Reversible Program of Localization and Functional Polarization of Macrophages

    PubMed Central

    Okabe, Yasutaka; Medzhitov, Ruslan

    2014-01-01

    SUMMARY Tissue-resident macrophages are highly heterogeneous in terms of their functions and phenotypes as a consequence of adaptation to different tissue environments. Local tissue-derived signals are thought to control functional polarization of resident macrophages; however, the identity of these signals remains largely unknown. It is also unknown whether functional heterogeneity is a result of irreversible lineage-specific differentiation or a consequence of continuous but reversible induction of diverse functional programs. Here, we identified retinoic acid as a signal that induces tissue-specific localization and functional polarization of peritoneal macrophages through the reversible induction of transcription factor GATA6. We further found that GATA6 in macrophages regulates gut IgA production through peritoneal B-1 cells. These results provide insight into the regulation of tissue-resident macrophage functional specialization by tissue-derived signals. PMID:24792964

  10. Bovine serum albumin nanoparticles as controlled release carrier for local drug delivery to the inner ear

    PubMed Central

    2014-01-01

    Nanoparticles have attracted increasing attention for local drug delivery to the inner ear recently. Bovine serum albumin (BSA) nanoparticles were prepared by desolvation method followed by glutaraldehyde fixation or heat denaturation. The nanoparticles were spherical in shape with an average diameter of 492 nm. The heat-denatured nanoparticles had good cytocompatibility. The nanoparticles could adhere on and penetrate through the round window membrane of guinea pigs. The nanoparticles were analyzed as drug carriers to investigate the loading capacity and release behaviors. Rhodamine B was used as a model drug in this paper. Rhodamine B-loaded nanoparticles showed a controlled release profile and could be deposited on the osseous spiral lamina. We considered that the bovine serum albumin nanoparticles may have potential applications in the field of local drug delivery in the treatment of inner ear disorders. PMID:25114637

  11. Local Stable and Unstable Manifolds and Their Control in Nonautonomous Finite-Time Flows

    NASA Astrophysics Data System (ADS)

    Balasuriya, Sanjeeva

    2016-08-01

    It is well known that stable and unstable manifolds strongly influence fluid motion in unsteady flows. These emanate from hyperbolic trajectories, with the structures moving nonautonomously in time. The local directions of emanation at each instance in time is the focus of this article. Within a nearly autonomous setting, it is shown that these time-varying directions can be characterised through the accumulated effect of velocity shear. Connections to Oseledets spaces and projection operators in exponential dichotomies are established. Availability of data for both infinite- and finite-time intervals is considered. With microfluidic flow control in mind, a methodology for manipulating these directions in any prescribed time-varying fashion by applying a local velocity shear is developed. The results are verified for both smoothly and discontinuously time-varying directions using finite-time Lyapunov exponent fields, and excellent agreement is obtained.

  12. Control of defect localization in crystalline wrinkling by curvature and topology

    NASA Astrophysics Data System (ADS)

    Lopez Jimenez, Francisco

    We investigate the influence of curvature and topology on crystalline wrinkling patterns in generic elastic bilayers. Our numerical analysis predicts that the total number of defects created by adiabatic compression exhibits universal quadratic scaling for spherical, ellipsoidal and toroidal surfaces over a wide range of system sizes. However, both the localization of individual defects and the orientation of defect chains depend strongly on the local Gaussian curvature and its gradients across a surface. Our results imply that curvature and topology can be utilized to pattern defects in elastic materials, thus promising improved control over hierarchical bending, buckling or folding processes. Generally, this study suggests that bilayer systems provide an inexpensive yet valuable experimental test-bed for exploring the effects of geometrically induced forces on assemblies of topological charges. Joint work with Norbert Stoop, Romain Lagrange, Jorn Dunkel and Pedro M. Reis.

  13. Synaptic Integration of Adult-Born Hippocampal Neurons Is Locally Controlled by Astrocytes.

    PubMed

    Sultan, Sébastien; Li, Liyi; Moss, Jonathan; Petrelli, Francesco; Cassé, Frédéric; Gebara, Elias; Lopatar, Jan; Pfrieger, Frank W; Bezzi, Paola; Bischofberger, Josef; Toni, Nicolas

    2015-12-01

    Adult neurogenesis is regulated by the neurogenic niche, through mechanisms that remain poorly defined. Here, we investigated whether niche-constituting astrocytes influence the maturation of adult-born hippocampal neurons using two independent transgenic approaches to block vesicular release from astrocytes. In these models, adult-born neurons but not mature neurons showed reduced glutamatergic synaptic input and dendritic spine density that was accompanied with lower functional integration and cell survival. By taking advantage of the mosaic expression of transgenes in astrocytes, we found that spine density was reduced exclusively in segments intersecting blocked astrocytes, revealing an extrinsic, local control of spine formation. Defects in NMDA receptor (NMDAR)-mediated synaptic transmission and dendrite maturation were partially restored by exogenous D-serine, whose extracellular level was decreased in transgenic models. Together, these results reveal a critical role for adult astrocytes in local dendritic spine maturation, which is necessary for the NMDAR-dependent functional integration of newborn neurons. PMID:26606999

  14. Bovine serum albumin nanoparticles as controlled release carrier for local drug delivery to the inner ear

    NASA Astrophysics Data System (ADS)

    Yu, Zhan; Yu, Min; Zhang, Zhibao; Hong, Ge; Xiong, Qingqing

    2014-07-01

    Nanoparticles have attracted increasing attention for local drug delivery to the inner ear recently. Bovine serum albumin (BSA) nanoparticles were prepared by desolvation method followed by glutaraldehyde fixation or heat denaturation. The nanoparticles were spherical in shape with an average diameter of 492 nm. The heat-denatured nanoparticles had good cytocompatibility. The nanoparticles could adhere on and penetrate through the round window membrane of guinea pigs. The nanoparticles were analyzed as drug carriers to investigate the loading capacity and release behaviors. Rhodamine B was used as a model drug in this paper. Rhodamine B-loaded nanoparticles showed a controlled release profile and could be deposited on the osseous spiral lamina. We considered that the bovine serum albumin nanoparticles may have potential applications in the field of local drug delivery in the treatment of inner ear disorders.

  15. Pain Levels after Local Anaesthetic with or without Hyaluronidase in Carpal Tunnel Release: A Randomised Controlled Trial

    PubMed Central

    Yeo, G.; Gupta, A.; Ding, G.; Skerman, H.; Khatun, M.; Melsom, D.

    2015-01-01

    Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release. Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase group receiving both hyaluronidase and local anaesthetic. Pain scores were rated using the visual analogue scale (VAS) by patients immediately after local anaesthetic injection and again immediately after the carpal tunnel release. Results. Preoperative VAS scores, taken after local anaesthetic injection, were greater than postoperative VAS scores. Postoperative VAS scores were significantly lower in the hyaluronidase group and tourniquet times were significantly shorter in the hyaluronidase group. Conclusion. Hyaluronidase addition to local anaesthetic in carpal tunnel release resulted in significant reductions in operative time and pain immediately after operation. PMID:26587288

  16. Focused ultrasound treatment of VX2 tumors controlled by local harmonic motion

    NASA Astrophysics Data System (ADS)

    Curiel, Laura; Huang, Yuexi; Vykhodtseva, Natalia; Hynynen, Kullervo

    2009-06-01

    The purpose of this study was to evaluate the feasibility of using localized harmonic motion (LHM) to monitor and control focused ultrasound surgery (FUS) in VX2 tumors in vivo. FUS exposures were performed on 13 VX2 tumors implanted in nine rabbits. The same transducer induced coagulation and generated a localized oscillatory motion by periodically varying the radiation force. A separate diagnostic ultrasound transducer tracked motion by cross-correlating echo signals at different instances. A threshold in motion amplitude was instituted to cease exposure. Coagulation was confirmed by T2-weighted MR images, thermal dose obtained through MR thermometry and histological examinations. For tumor locations achieving coagulation, the LHM amplitude was 9% (p = 0.04) to 57% (p < 0.0001) lower than that before exposure. Control was successful for 74 (69%) out of 108 cases, with 52 (48%) reaching the threshold and achieving coagulation and 22 (21%) never reaching threshold nor coagulating. For the 34 (31%) unsuccessful exposures, 16 (15%) never reached the threshold but coagulation occurred, and 18 (16%) reached threshold without coagulation confirmed. Noise or radio-frequency signal changes explained motion over- or underestimation in 24 (22%) cases; the remaining 10 (9%) had other causes of error. The control was generally successful, but sudden change or noise in the acquired echo signal caused failure. Coagulation after exposure could be validated by comparing amplitudes before and after exposure.

  17. Vision-Based Steering Control, Speed Assistance and Localization for Inner-City Vehicles

    PubMed Central

    Olivares-Mendez, Miguel Angel; Sanchez-Lopez, Jose Luis; Jimenez, Felipe; Campoy, Pascual; Sajadi-Alamdari, Seyed Amin; Voos, Holger

    2016-01-01

    Autonomous route following with road vehicles has gained popularity in the last few decades. In order to provide highly automated driver assistance systems, different types and combinations of sensors have been presented in the literature. However, most of these approaches apply quite sophisticated and expensive sensors, and hence, the development of a cost-efficient solution still remains a challenging problem. This work proposes the use of a single monocular camera sensor for an automatic steering control, speed assistance for the driver and localization of the vehicle on a road. Herein, we assume that the vehicle is mainly traveling along a predefined path, such as in public transport. A computer vision approach is presented to detect a line painted on the road, which defines the path to follow. Visual markers with a special design painted on the road provide information to localize the vehicle and to assist in its speed control. Furthermore, a vision-based control system, which keeps the vehicle on the predefined path under inner-city speed constraints, is also presented. Real driving tests with a commercial car on a closed circuit finally prove the applicability of the derived approach. In these tests, the car reached a maximum speed of 48 km/h and successfully traveled a distance of 7 km without the intervention of a human driver and any interruption. PMID:26978365

  18. Cancer mortality among local authority pest control officers in England and Wales.

    PubMed Central

    Thomas, H F; Winter, P D; Donaldson, L J

    1996-01-01

    OBJECTIVE: To examine cancer mortality by tumour site among local authority pest control officers. METHODS: Prospective mortality study, and follow up to the end of 1994, of 1485 male pest control officers aged between 17 and 69 and employed in 296 local authorities in England and Wales for at least six months between January 1980 and April 1984. Observed numbers of deaths were compared with those expected on the basis of the rates for relevant calendar year, cause, sex, and age specific groups for England and Wales. RESULTS: 200 deaths occurred during the follow up period of which 65 were certified as due to malignant neoplasms. No tumour type showed significantly more deaths than expected. Total all cause, lung cancer, and respiratory disease mortality were significantly lower than expected. CONCLUSIONS: 15 year follow up of a group of men handling a wide range of pesticides did not show any significant risk of cancer. This may be partially explained by the healthy worker effect and also the limited power of the study to detect significant increases in the less common tumours. Further long term follow up of this cohort will continue. Chemical control of pests that can cause human disease and can contaminate food and water has been, and will continue to be, a major public health measure. It is important to ensure that the health of those applying pesticides is not at excess risk. Negative results are important. PMID:9038805

  19. Case studies from community coalitions: advancing local tobacco control policy in a preemptive state.

    PubMed

    Douglas, Malinda R; Manion, Candida A; Hall-Harper, Vanessa D; Terronez, Kristina M; Love, Corey A; Chan, Andie

    2015-01-01

    Policies that shield people from the harm of tobacco exposure are essential to protect the health of the population. Coalitions have often led the way in safeguarding community health by promoting social norm change though policy adoption. In some states, tobacco control laws are weak, in part because of a tobacco industry tactic of prohibiting or pre-empting communities from enacting ordinances that are more protective. In spite of strong state-level preemptions, local coalitions in Oklahoma have implemented hundreds of voluntary policies in tobacco control that have improved the protection and health of their communities while not violating preemption. Three case studies of policy change are presented that exemplify the key approach of local coalitions working with strong allies and informed decision makers to establish tobacco-free businesses, schools, and outdoor recreational areas. In each of the cases, the policy changes surpassed the protection provided by the state laws and inspired additional policy changes. The key strategies and lessons learned may help tobacco control coalitions in other states limited by preemption to garner more support and momentum for important policy changes within their communities and states. PMID:25528703

  20. Global, local and focused geographic clustering for case-control data with residential histories

    PubMed Central

    Jacquez, Geoffrey M; Kaufmann, Andy; Meliker, Jaymie; Goovaerts, Pierre; AvRuskin, Gillian; Nriagu, Jerome

    2005-01-01

    Background This paper introduces a new approach for evaluating clustering in case-control data that accounts for residential histories. Although many statistics have been proposed for assessing local, focused and global clustering in health outcomes, few, if any, exist for evaluating clusters when individuals are mobile. Methods Local, global and focused tests for residential histories are developed based on sets of matrices of nearest neighbor relationships that reflect the changing topology of cases and controls. Exposure traces are defined that account for the latency between exposure and disease manifestation, and that use exposure windows whose duration may vary. Several of the methods so derived are applied to evaluate clustering of residential histories in a case-control study of bladder cancer in south eastern Michigan. These data are still being collected and the analysis is conducted for demonstration purposes only. Results Statistically significant clustering of residential histories of cases was found but is likely due to delayed reporting of cases by one of the hospitals participating in the study. Conclusion Data with residential histories are preferable when causative exposures and disease latencies occur on a long enough time span that human mobility matters. To analyze such data, methods are needed that take residential histories into account. PMID:15784151

  1. Vision-Based Steering Control, Speed Assistance and Localization for Inner-City Vehicles.

    PubMed

    Olivares-Mendez, Miguel Angel; Sanchez-Lopez, Jose Luis; Jimenez, Felipe; Campoy, Pascual; Sajadi-Alamdari, Seyed Amin; Voos, Holger

    2016-01-01

    Autonomous route following with road vehicles has gained popularity in the last few decades. In order to provide highly automated driver assistance systems, different types and combinations of sensors have been presented in the literature. However, most of these approaches apply quite sophisticated and expensive sensors, and hence, the development of a cost-efficient solution still remains a challenging problem. This work proposes the use of a single monocular camera sensor for an automatic steering control, speed assistance for the driver and localization of the vehicle on a road. Herein, we assume that the vehicle is mainly traveling along a predefined path, such as in public transport. A computer vision approach is presented to detect a line painted on the road, which defines the path to follow. Visual markers with a special design painted on the road provide information to localize the vehicle and to assist in its speed control. Furthermore, a vision-based control system, which keeps the vehicle on the predefined path under inner-city speed constraints, is also presented. Real driving tests with a commercial car on a closed circuit finally prove the applicability of the derived approach. In these tests, the car reached a maximum speed of 48 km/h and successfully traveled a distance of 7 km without the intervention of a human driver and any interruption. PMID:26978365

  2. Long-term Efficacy of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A 5-year Follow-up Study in China

    PubMed Central

    Jiang, Lu-Lu; Liu, Jin-Long; Fu, Xiao-Li; Xian, Wen-Biao; Gu, Jing; Liu, Yan-Mei; Ye, Jing; Chen, Jie; Qian, Hao; Xu, Shao-Hua; Pei, Zhong; Chen, Ling

    2015-01-01

    Background: Subthalamic nucleus deep brain stimulation (STN DBS) is effective against advanced Parkinson's disease (PD), allowing dramatic improvement of Parkinsonism, in addition to a significant reduction in medication. Here we aimed to investigate the long-term effect of STN DBS in Chinese PD patients, which has not been thoroughly studied in China. Methods: Ten PD patients were assessed before DBS and followed up 1, 3, and 5 years later using Unified Parkinson's Disease Rating Scale Part III (UPDRS III), Parkinson's Disease Questionnatire-39, Parkinson's Disease Sleep Scale-Chinese Version, Mini-mental State Examination, Montreal Cognitive Assessment, Hamilton Anxiety Scale and Hamilton Depression Scale. Stimulation parameters and drug dosages were recorded at each follow-up. Data were analyzed using the ANOVA for repeated measures. Results: In the “off” state (off medication), DBS improved UPDRS III scores by 35.87% in 5 years, compared with preoperative baseline (P < 0.001). In the “on” state (on medication), motor scores at 5 years were similar to the results of preoperative levodopa challenge test. The quality of life is improved by 58.18% (P < 0.001) from baseline to 3 years and gradually declined afterward. Sleep, cognition, and emotion were mostly unchanged. Levodopa equivalent daily dose was reduced from 660.4 ± 210.1 mg at baseline to 310.6 ± 158.4 mg at 5 years (by 52.96%, P < 0.001). The average pulse width, frequency and amplitude at 5 years were 75.0 ± 18.21 μs, 138.5 ± 19.34 Hz, and 2.68 ± 0.43 V, respectively. Conclusions: STN DBS is an effective intervention for PD, although associated with a slightly diminished efficacy after 5 years. Compared with other studies, patients in our study required lower voltage and medication for satisfactory symptom control. PMID:26365958

  3. Local and synoptic controls on rapid supraglacial lake drainage in West Greenland

    NASA Astrophysics Data System (ADS)

    Williamson, Andrew; Banwell, Alison; Arnold, Neil; Willis, Ian

    2016-04-01

    Many supraglacial lakes within the ablation zone of the Greenland Ice Sheet (GrIS) are known to drain rapidly (in <1 day) in the mid- to late melt season, delivering large meltwater pulses to the subglacial drainage system, thus affecting basal water pressures and ice-sheet dynamics. Although it is now generally recognised that rapid lake drainage is caused by hydrofracture, the precise controls on hydrofracture initiation remain poorly understood: they may be linked to a local critical water-volume threshold, or they may be associated with synoptic-scale factors, such as ice thickness, driving stresses, ice velocities and strain rates. A combination of the local water-volume threshold and one or more synoptic-scale factors may explain the overall patterns of rapid lake drainage, but this requires verification using targeted field- and remotely-based studies that cover large areas of the GrIS and span long timescales. Here, we investigate a range of potential controls on rapid supraglacial lake drainage in the land-terminating Paakitsoq region of the ice sheet, northeast of Jakobshavn Isbræ, for the 2014 melt season. We have analysed daily 250-m Moderate Resolution Imaging Spectroradiometer (MODIS) imagery in order to calculate lake areas, depths and volumes, and have developed an automatic lake-tracking algorithm to determine the dates on which all rapid lake drainage events occur. For each rapidly draining lake, the water volumes immediately prior to drainage are compared with other local factors, notably lake-filling rate and ice thickness, and with a variety of synoptic-scale features, such as slope angles, driving stresses, surface velocities, surface strain rates and the incidence of nearby lake-drainage events. We present the outcomes of our statistical analysis to elicit the statistically significant controls on hydrofracture beneath supraglacial lakes.

  4. Local control of embryonal rhabdomyosarcoma in children by radiation therapy when combined with chemotherapy

    SciTech Connect

    Jereb, B.; Ghavimi, F.; Exelby, P.; Zang, E.

    1980-07-01

    Between August 1970 and March 1978, 58 patients with embryonal rhabdomyosarcoma (ERMS) were treated at the Radiation Therapy and Pediatric Departments of MSKCC. Chemotherapy was given according to T2 protocol (sequential administration of dactinomycin, vincristine, adriamycin and cyclophosphamide) or the T6 protocol (simultaneous administration of the previous drugs plus bleomycin, methotrexate and BCNU), which was introduced in 1975. The primary tumor or regional metastases were completely or partially removed in 43 patients, while biopsy was the only surgical procedure in 15. There were 41 boys and 17 girls, between 4 months and 19 years old. Eight had stage I-B disease (microscopic residual), 16 stage II (gross residual), 24 stage III (node metastases), and 10 patients stage IV (disseminated tumors). Thirty-five patients were treated with T2 protocol, twenty-three with T6 protocol. Sixteen patients received more than 5000 rad, 21 had between 4000 and 5000 rad and 21 had less than 4000 rad. Forty-four patients are alive, 38 of them disease free. Local tumor control was not achieved in 14 patients, 10 of them were treated with T2 and 4 with T6. There were no local failures in patients treated for microscopic disease with doses between 3000 and 4000 rad. In patients treated for bulky tumors with 4000 to 5000 rad there were 3 failures out of 11 tumors and 3 out of 17 in those treated with higher doses. Radiation doses 3000 to 4000 rad were sufficient for local control of microscopic disease and 4000 to 5000 rad were as effective for control of bulky tumors as higher doses.

  5. Simultaneous control of emission localization and two-photon absorption efficiency in dissymmetrical chromophores

    SciTech Connect

    Tretiak, Sergei

    2009-01-01

    The aim of the present work is to demonstrate that combined spectral tuning of fluorescence and two-photon absorption (TPA) properties of multipolar chromophores can be achieved by introduction of slight electronic chemical dissymmetry. In that perspective, two novel series of structurally related chromophores have been designed and studied: a first series based on rod-like quadrupolar chromophores bearing different electron-donating (D) end groups and a second series based on three-branched octupolar chromophores built from a trigonal donating moiety and bearing various acceptor (A) peripheral groups. The influence of the electronic dissymmetry is investigated by combined experimental and theoretical studies of the linear and nonlinear optical properties of dissymmetric chromophores compared to their symmetrical counterparts. In both types of systems (i.e. quadrupoles and octupoles) experiments and theory reveal that excitation is essentially delocalized and that excitation involves synchronized charge redistribution between the different D and A moieties within the multipolar structure (i.e. concerted intramolecular charge transfer). In contrast, the emission stems only from a particular dipolar subunit bearing the strongest D or A moieties due to fast excitation localization after excitation prior to emission. Hence control of emission characteristics (polarization and emission spectrum) in addition to localization can be achieved by controlled introduction of electronic dissymmetry (i.e. replacement of one of the D or A end-groups by a slightly stronger D{prime} or A{prime} units). Interestingly dissymmetrical functionalization of both quadrupolar and octupolar compounds does not lead to significant loss in TPA responses and can even be beneficial due to the spectral broadening and peak position tuning that it allows. This study thus reveals an original molecular engineering route strategy allowing major TPA enhancement in multipolar structures due to concerted

  6. "A Fiberoptic Local-Area-Network Solution For Tactical Command And Control Systems"

    NASA Astrophysics Data System (ADS)

    Vlasak, Weldon; Pfister, Gerhard

    1983-11-01

    This paper examines key network requirements for the elements of distributed tactical command and control system. System concepts are evolved that support implementation solutions with emphasis on advanced technologies. Mobile command and control elements of ground and air forces are becoming more vulnerable in an ever increasing threat environment. This vulnerability is caused by the employment of these elements in a manner characterized by functional and physical centralization. A command and control unit typically consists of a centralized operations center surrounded by closely clustered communications and surveillance equipments. Because these elements have different deployment and employment requirements, the command and control unit is not optimized in terms of survivability, mobility, effectiveness, and operational flexibility. In recent years, convincing arguments have been put forth to the effect that distributed operations centers, redundantly structured communication functions, and netted surveillance systems can provide the necessary attributes to be effective in the advanced threat environment. Current technology does not meet the requirements of such a system. A local area network provides a power interconnection mechanism for the distributed elements of the command and control system. The requirements are for a rapid, efficient, and reliable means of transferring voice and data communications between elements. The topology of such a network must primarily consider survivability and reliability of communications interchanges with special emphasis on continued operations under degraded conditions. When such conditions occur, e.g., the result of combat attrition, a complete command and control capability should remain even though it may be at somewhat of a reduced capacity. The interconnection medium for the local area network should be immune to external disruptions, e.g., EMI, EMP, or C3CM, and should have a wide transmission bandwidth with a minimum

  7. Epidemiology of invasive pneumococcal disease in Saudi Arabian children younger than 5years of age.

    PubMed

    Almazrou, Yagob; Shibl, Atef M; Alkhlaif, Riyadh; Pirçon, Jean-Yves; Anis, Sameh; Kandeil, Walid; Hausdorff, William P

    2016-06-01

    This study evaluated the incidence, serotype distribution, and antimicrobial susceptibility of invasive pneumococcal disease (IPD) in Saudi Arabian children. This multicenter, prospective, clinical surveillance study included children under 5years of age, residents of one of the seven study health areas, who were brought to a study hospital with suspicion of IPD. Bacterial isolates from sterile site samples, collected less than 24h after hospital visit/admission, were identified, serotyped, and tested for antibiotic susceptibility. Between June 2007 and January 2009, 631 episodes of suspected IPD were recorded, and 623 were included in the analysis. One child (0.2%) had previously received one dose of a pneumococcal vaccine. Forty-seven episodes were positive for Streptococcus pneumoniae and three for Haemophilus influenzae. The incidence of confirmed IPD cases was estimated to be 2.5-21.6 per 100,000 children (<5years). Among the 46 S. pneumoniae isolates serotyped and tested for antibiotic susceptibility, the most common serotypes were 5 and 23F (20% each), 6B (17%), and 1 and 14 (11% each). Sixty-three percent of isolates were multidrug-resistant. Vaccination of Saudi Arabian children with expanded-coverage conjugate pneumococcal vaccines containing serotypes 1 and 5 could have a substantial impact to prevent IPD in this population. PMID:26368823

  8. The 5-Year Onset and Regression of Diabetic Retinopathy in Chinese Type 2 Diabetes Patients

    PubMed Central

    Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

    2014-01-01

    Purpose To determine the rate and risk factors of diabetic retinopathy (DR) onset and regression in Chinese type 2 diabetes mellitus patients. Methods This is a 5-year community-based prospective study. The demographic information, systemic examination results and ophthalmological test results of each participant were collected. The study outcomes were DR incidence, defined as the onset of DR in at least one eye, and DR regression, defined as full regression from existing DR to no retinopathy without invasive treatments. The associations between each potential risk factor and the outcomes were studied. Results In total, 778 participants were enrolled. There were 322 patients without DR at baseline, of which 151 participants developed DR during follow-up (DR incidence rate = 46.89%). Baseline hyperglycemia and high blood pressure were two independent risk factors associated with DR incidence. Among the 456 participants with existing DR at entry, 110 fully recovered after 5 years (DR regression rate = 24.12%). Low baseline glucose and low serum triglyceride were two independent factors associated with DR regression. Conclusions DR incidence occurred more frequently in patients with hyperglycemia and high blood pressure. DR regression occurred mostly in patients with lower glucose and lower serum triglyceride levels among Chinese type 2 diabetes patients. PMID:25402474

  9. Body composition during fetal development and infancy through the age of 5 years.

    PubMed

    Toro-Ramos, T; Paley, C; Pi-Sunyer, F X; Gallagher, D

    2015-12-01

    Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life. PMID:26242725

  10. A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

    PubMed Central

    Spivey, Christina; Martin, Jennifer R.; Wyles, Christina; Ehrman, Clara; Schlesselman, Lauren S.

    2012-01-01

    Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates. Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH). Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006). Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications. PMID:23049099

  11. Factors associated with vaccination coverage in children < 5 years in Angola

    PubMed Central

    de Oliveira, Manuel Falcão Saturnino; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-01-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  12. Stability of Pediatric Migraine Subtype After a 5-year Follow-Up.

    PubMed

    Cuvellier, Jean-Christophe; Tourte, Mathilde; Lucas, Christian; Vallée, Louis

    2016-08-01

    The study assessed the 5-year follow-up outcome and possible prognostic factors of migraine subtypes with onset in childhood or adolescence. A total of 343 patients meeting the International Classification of Headache Disorders (ICHD)-II criteria for migraine without aura (MO), migraine with aura (MA), or both MO+MA (ie, 1.1, 1.2) were contacted by phone and underwent structured follow-up headache interviews. Of the original sample patients, 22.7% were headache-free at follow-up, 14.1% had a transformed headache diagnosis (tension-type headache: 8.2%, chronic daily headache: 5.8%), and 63.3% still had migraine fulfilling the criteria for ICHD-II 1.1. or 1.2, but those who were still migraineurs at follow-up were older at baseline (respectively 12.93, 9.99, and 11.02 years for MO, MA and MO+MA, P = .0005). The probability of having the same migraine subtype diagnosis at baseline and at 5-year follow-up was 55.2%, 95.1%, and 31.1% for ICHD-II 1.1, 1.2, and both 1.1 and 1.2, respectively. PMID:27071466

  13. Factors associated with vaccination coverage in children < 5 years in Angola.

    PubMed

    Oliveira, Manuel Falcão Saturnino de; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-12-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children's individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother's level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  14. Developmental potential in the first 5 years for children in developing countries

    PubMed Central

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  15. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. PMID:24908442

  16. The understanding and experience of mixed emotions in 3-5-year-old children.

    PubMed

    Smith, Joshua P; Glass, Daniel J; Fireman, Gary

    2015-01-01

    The term mixed emotions refers to the presence of two opposite-valence emotions toward a single target. Identifying when children begin to report experiencing and understanding mixed emotions is critical in identifying how skills such as adaptive functioning, coping strategies, environmental understanding, and socioemotional competence emerge. Prior research has shown that children as young as 5 years old can understand and experience mixed emotion, but perhaps appropriately sensitive methodologies can reveal these abilities in younger children. The present study evaluated 57 children between 3 and 5 years old for mixed emotion experience and understanding using an animated video clip in which a character experiences a mixed emotional episode. Ordinal logistic regression was utilized to examine the relation of gender, attention, and understanding of content to experience and understanding of mixed emotion. While only 12% of children reported experiencing mixed emotion while watching the clip, 49% of children-some as young as 3 years old-were able to recognize the mixed emotional experience of the character. Thus, mixed emotion understanding emerges earlier than previously identified and the expression of understanding may develop independently of the ability to report mixed emotion experience. These findings are discussed in relation to cognitive and developmental considerations. PMID:25695201

  17. Longitudinal study of dental caries increment in Malaysian school children: a 5-year cohort study.

    PubMed

    Masood, Mohd; Yusof, Norashikin; Hassan, Mohamed I A; Jaafar, Nasaruddin

    2014-05-01

    The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study. PMID:22218936

  18. Fatal head injuries in children under the age of 5 years in Pretoria.

    PubMed

    du Toit-Prinsloo, Lorraine; Saayman, Gert

    2014-09-01

    The incidence of fatal injuries in children has been reported to be highest among children aged 1 to 4 years. Major causes of head injury include road traffic accidents, falls, and intentional or inflicted injury (such as nonaccidental injury syndrome). This study reviewed the profile of children (under 5 years of age) who had been admitted to a large urban medicolegal mortuary (in Pretoria, the capital city of South Africa), after having suffered fatal head injuries. This study was conducted over a 5-year period (from January 2004 through December 2008), and a total of 107 cases were identified for inclusion. These cases constituted nearly a fifth of admissions in this age group. The male-to-female ratio was 56%:44%, and the peak age of injury was less than 1 year. Most head injuries were sustained in road traffic accidents (70%) followed by falls (10%) and other types of blunt force injuries (9%). Only 1 case of nonaccidental injury syndrome (child abuse) was found. The great majority of deaths were deemed to have been accidental in nature (91%) with 6 (6%) homicides. Urgent review pertaining to the use of child restraint devices and the safety of pedestrians is required, and the institution of childhood injury registers could aid in reducing childhood fatalities in South Africa. PMID:25072811

  19. Separable Sustained and Selective Attention Factors Are Apparent in 5-Year-Old Children

    PubMed Central

    Underbjerg, Mette; George, Melanie S.; Thorsen, Poul; Kesmodel, Ulrik S.; Mortensen, Erik L.; Manly, Tom

    2013-01-01

    In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy population. A new test battery (TEA-ChJ) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual and auditory stimuli were good. In a factor analysis, the two TEA-ChJ selective attention tasks (one visual, one auditory) loaded onto a common factor and diverged from the two sustained attention tasks (one auditory, one motor), which shared a common loading on the second factor. This pattern, which suggests that the tests are indeed sensitive to underlying attentional capacities, was supported by the relationships between the TEA-ChJ factors and Test of Everyday Attention for Children subtests in the older children in the sample. It is possible to gain convincing performance-based estimates of attention at the age of 5 with the results reflecting a similar factor structure to that obtained in older children and adults. The results are discussed in light of contemporary models of attention function. Given the potential advantages of early intervention for attention difficulties, the findings are of clinical as well as theoretical interest. PMID:24376591

  20. An implantable neuroprosthesis for standing and walking in paraplegia: 5-year patient follow-up

    NASA Astrophysics Data System (ADS)

    Guiraud, David; Stieglitz, Thomas; Koch, Klaus Peter; Divoux, Jean-Louis; Rabischong, Pierre

    2006-12-01

    We present the results of a 5-year patient follow-up after implantation of an original neuroprosthesis. The system is able to stimulate both epimysial and neural electrodes in such a way that the complete flexor-extensor chain of the lower limb can be activated without using the withdrawal reflex. We demonstrate that standing and assisted walking are possible, and the results have remained stable for 5 years. Nevertheless, some problems were noted, particularly regarding the muscle response on the epimysial channels. Analysis of the electrical behaviour and thresholds indicated that the surgical phase is crucial because of the sensitivity of the functional responses to electrode placement. Neural stimulation proved to be more efficient and more stable over time. This mode requires less energy and provides more selective stimulation. This FES system can be improved to enable balanced standing and less fatiguing gait, but this will require feedback on event detection to trigger transitions between stimulation sequences, as well as feedback to the patient about the state of his lower limbs.

  1. Local control rates with five-fraction stereotactic body radiotherapy for oligometastatic cancer to the lung

    PubMed Central

    Chen, Yuhchyau; Hare, Mary Z.; Usuki, Kenneth Y.; Zhang, Hong; Lundquist, Thomas; Joyce, Neil; Schell, Michael C.; Milano, Michael T.

    2014-01-01

    Objective To report our institutional experience with five fractions of daily 8-12 Gy stereotactic body radiotherapy (SBRT) for the treatment of oligometastatic cancer to the lung. Methods Thirty-four consecutive patients with oligometastatic cancers to the lung were treated with image-guided SBRT between 2008 and 2011. Patient age ranged from 38 to 81 years. There were 17 males and 17 females. Lung metastases were from the following primary cancer types: colon cancer (n=13 patients), head and neck cancer (n=6), breast cancer (n=4), melanoma (n=4), sarcoma (n=4) and renal cell carcinoma (n=3). The median prescription dose was 50 Gy in five fractions (range, 40-60 Gy) to the isocenter, with the 80% isodose line encompassing the planning target volume (PTV) [defined as gross tumor volume (GTV) + 7-11 mm volumetric expansion]. The follow-up interval ranged from 2.4-54 months, with a median of 16.7 months. Results The 1-, 2-, and 3-year patient local control (LC) rates for all patients were 93%, 88%, and 80% respectively. The 1-, 2-, and 3-year overall survival (OS) rates were 62%, 44%, and 23% respectively. The 1- and 2-year patient LC rates were 95% and 88% for tumor size 1-2 cm (n=25), and 86% for tumor size 2-3 cm (n=7). The majority (n=4) of local failures occurred within 12 months. No patient experienced local failure after 12 months except for one patient with colon cancer whose tumors progressed locally at 26 months. All five patients with local recurrences had colorectal cancer. Statistical analyses showed that age, gender, previous chemotherapy, previous surgery or radiation had no significant effect on LC rates. No patient was reported to have any symptomatic pneumonitis at any time point. Conclusions SBRT for oligometastatic disease to the lung using 8-12 Gy daily fractions over five treatments resulted in excellent 1- and 2-year LC rates. Most local failures occurred within the first 12 months, with five local failures associated with colorectal cancer

  2. An electrochemical platform for localized pH control on demand.

    PubMed

    Fomina, N; Johnson, C A; Maruniak, A; Bahrampour, S; Lang, C; Davis, R W; Kavusi, S; Ahmad, H

    2016-06-21

    Solution pH is a powerful tool for regulating many kinds of chemical activity, but is generally treated as a static property defined by a pre-selected buffer. Introducing dynamic control of pH in space, time, and magnitude can enable richer and more efficient chemistries, but is not feasible with traditional methods of titration or buffer exchange. Recent reports have featured electrochemical strategies for modifying bulk pH in constrained volumes, but only demonstrate switching between two preset values and omit spatial control entirely. Here, we use a combination of solution-borne quinones and galvanostatic excitation to enable quantitative control of pH environments that are highly localized to an electrode surface. We demonstrate highly reproducible acidification and alkalinization with up to 0.1 pH s(-1) (±0.002 pH s(-1)) rate of change across the dynamic range of our pH sensor (pH 4.5 to 7.5) in buffered solutions. Using dynamic current control, we generate and sustain 3 distinct pH microenvironments simultaneously to within ±0.04 pH for 13 minutes in a single solution, and we leverage these microenvironments to demonstrate spatially-resolved, pH-driven control of enzymatic activity. In addition to straightforward applications of spatio-temporal pH control (e.g. efficiently studying pH-dependencies of chemical interactions), the technique opens completely new avenues for implementing complex systems through dynamic control of enzyme activation, protein binding affinity, chemical reactivity, chemical release, molecular self-assembly, and many more pH-controlled processes. PMID:27199277

  3. Externally controlled local magnetic field in a conducting mesoscopic ring coupled to a quantum wire

    SciTech Connect

    Maiti, Santanu K.

    2015-01-14

    In the present work, the possibility of regulating local magnetic field in a quantum ring is investigated theoretically. The ring is coupled to a quantum wire and subjected to an in-plane electric field. Under a finite bias voltage across the wire a net circulating current is established in the ring which produces a strong magnetic field at its centre. This magnetic field can be tuned externally in a wide range by regulating the in-plane electric field, and thus, our present system can be utilized to control magnetic field at a specific region. The feasibility of this quantum system in designing spin-based quantum devices is also analyzed.

  4. Large-scale atmospheric controls on local precipitation in tropical Mexico

    NASA Technical Reports Server (NTRS)

    Hewitson, Bruce C.; Crane, Robert G.

    1992-01-01

    Sixty-five percent of the short term variability in southern Mexican precipitation is accounted for by the large-scale circulation. Empirical relationships between sea level and 500 mb circulation fields, and the local precipitation in Chiapas, Mexico, are derived using a neural net. Although much of the rainfall is a result of convective processes, the neural net captures the onset of the precipitation season, and the phase of individual precipitation events. The analysis indicates that both of these aspects of the precipitation regime are controlled to a large extent by the atmospheric circulation.

  5. Micro bubble condensation in micro channel controlled by local electrical field method

    NASA Astrophysics Data System (ADS)

    Ohata, Shunsuke; Kawai, Akira

    2009-12-01

    Micro bubbles in several tens micrometer diameter can act as effective structural elements of micro devices. In this study, the micro device employing the bubble motion is characterized. It has been experimentally revealed that bubble motion in micro channel is trapped at the channel branches. The local electrodes are set at a part of micro channel in order to control the bubble motion. Negatively charged bubble surface is received a certain force due to Coulomb's effect. This study will provide effective information to bioscience, medical science and agriculture engineering.

  6. Focused Ultrasound Surgery Control Using Local Harmonic Motion: VX2 Tumor Study

    NASA Astrophysics Data System (ADS)

    Curiel, Laura; Chopra, Rajiv; Goertz, David; Hynynen, Kullervo

    2009-04-01

    The objective of this study was to develop a real-time method for controlling focused ultrasound surgery using ultrasound imaging. The approach uses measurements of localized harmonic motion (LHM) in order to perform controlled FUS exposures by detecting changes in the elastic properties of tissues during coagulation. Methods: Nine New Zealand rabbits with VX2 tumors implanted in the thigh were used for this study. LHM was generated within the tumors by periodic induction of radiation force using a FUS transducer (80-mm focal length, 100-mm diameter, 20-mm central hole, 1.485-MHz). Tissue motion was tracked by collecting and cross-correlating RF signals during the motion using a separate diagnostic transducer (3-kHz PRF, 5-MHz). After locating the tumor in MR images, a series of sonications were performed to treat the tumors using a reduction in LHM amplitude to control the exposure. Results: LHM was successfully used to control the sonications. A LHM amplitude threshold value was determined at which changes were considered significant and then the exposure was started and stopped when the LHM amplitude dropped below the threshold. The appearance of a lesion was then verified by MRI. The feasibility of LHM measurements to control FUS exposure was validated.

  7. Focused Ultrasound Surgery Control Using Local Harmonic Motion: VX2 Tumor Study

    SciTech Connect

    Curiel, Laura; Chopra, Rajiv; Goertz, David; Hynynen, Kullervo

    2009-04-14

    The objective of this study was to develop a real-time method for controlling focused ultrasound surgery using ultrasound imaging. The approach uses measurements of localized harmonic motion (LHM) in order to perform controlled FUS exposures by detecting changes in the elastic properties of tissues during coagulation. Methods: Nine New Zealand rabbits with VX2 tumors implanted in the thigh were used for this study. LHM was generated within the tumors by periodic induction of radiation force using a FUS transducer (80-mm focal length, 100-mm diameter, 20-mm central hole, 1.485-MHz). Tissue motion was tracked by collecting and cross-correlating RF signals during the motion using a separate diagnostic transducer (3-kHz PRF, 5-MHz). After locating the tumor in MR images, a series of sonications were performed to treat the tumors using a reduction in LHM amplitude to control the exposure. Results: LHM was successfully used to control the sonications. A LHM amplitude threshold value was determined at which changes were considered significant and then the exposure was started and stopped when the LHM amplitude dropped below the threshold. The appearance of a lesion was then verified by MRI. The feasibility of LHM measurements to control FUS exposure was validated.

  8. Bending Two-Dimensional Materials To Control Charge Localization and Fermi-Level Shift.

    PubMed

    Yu, Liping; Ruzsinszky, Adrienn; Perdew, John P

    2016-04-13

    High-performance electronics requires the fine control of semiconductor conductivity. In atomically thin two-dimensional (2D) materials, traditional doping technique for controlling carrier concentration and carrier type may cause crystal damage and significant mobility reduction. Contact engineering for tuning carrier injection and extraction and carrier type may suffer from strong Fermi-level pinning. Here, using first-principles calculations, we predict that mechanical bending, as a unique attribute of thin 2D materials, can be used to control conductivity and Fermi-level shift. We find that bending can control the charge localization of top valence bands in both MoS2 and phosphorene nanoribbons. The donor-like in-gap edge-states of armchair MoS2 ribbon and their associated Fermi-level pinning can be removed by bending. A bending-controllable new in-gap state and accompanying direct-indirect gap transition are predicted in armchair phosphorene nanoribbon. We demonstrate that such emergent bending effects are realizable. The bending stiffness as well as the effective thickness of 2D materials are also derived from first principles. Our results are of fundamental and technological relevance and open new routes for designing functional 2D materials for applications in which flexuosity is essential. PMID:26938458

  9. Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

    PubMed Central

    Du, Lei; Zhang, Xin-Xin; Ma, Lin; Feng, Lin-Chun; Li, Fang; Zhou, Gui-Xia; Qu, Bao-Lin; Xu, Shou-Ping; Xie, Chuan-Bin; Yang, Jack

    2014-01-01

    Background. To evaluate the outcomes of nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT). Methods. Between September 2007 and August 2012, 190 newly diagnosed NPC patients were treated with HT. Thirty-one patients were treated with radiation therapy as single modality, 129 with additional cisplatin-based chemotherapy with or without anti-EGFR monoclonal antibody therapy, and 30 with concurrent anti-EGFR monoclonal antibody therapy. Results. Acute radiation related side effects were mainly grade 1 or 2. Grade 3 and greater toxicities were rarely noted. The median followup was 32 (3–38) months. The local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 96.1%, 98.2%, 92.0%, and 86.3%, respectively, at 3 years. Cox multivariate regression analysis showed that age and T stage were independent predictors for 3-year OS. Conclusions. Helical tomotherapy for NPC patients achieved excellent 3-year locoregional control, distant metastasis-free survival, and overall survival, with relatively minor acute and late toxicities. Age and T stage were the main prognosis factors. PMID:25114932

  10. Controlling spin-dependent localization and directed transport in a bipartite lattice

    NASA Astrophysics Data System (ADS)

    Luo, Yunrong; Lu, Gengbiao; Kong, Chao; Hai, Wenhua

    2016-04-01

    We study coherent control of spin-dependent dynamical localization (DL) and directed transport (DT) of a spin-orbit-coupled single atom held in a driven optical bipartite lattice. Under the high-frequency limit and nearest-neighbor tight-binding approximation, we find a new decoupling mechanism between states with the same (different) spins, which leads to two sets of analytical solutions describing DL and DT with (without) spin flipping. The analytical results are numerically confirmed, and perfect agreements are found. Extending the research to a system of spin-orbit-coupled single atoms, the spin current and quantum information transport with controllable propagation speed and distance are investigated. The results can be experimentally tested in the current setups and may be useful in quantum information processing.

  11. Mitochondrial Localization of Telomeric Protein TIN2 Links Telomere Regulation to Metabolic Control

    PubMed Central

    Chen, Liuh-Yow; Zhang, Yi; Zhang, Qinfen; Li, Hongzhi; Luo, Zhenhua; Fang, Hezhi; Kim, Sok Ho; Qin, Li; Yotnda, Patricia; Xu, Jianmin; Tu, Benjamin P.; Bai, Yidong; Songyang, Zhou

    2012-01-01

    Summary Both mitochondria, which are metabolic powerhouses, and telomeres, which help maintain genomic stability, have been implicated in cancer and aging. However, the signaling events that connect these two cellular structures remain poorly understood. Here we report that the canonical telomeric protein TIN2 is also a regulator of metabolism. TIN2 is recruited to telomeres and associates with multiple telomere regulators including TPP1. TPP1 interacts with TIN2 N-terminus, which contains overlapping mitochondrial and telomeric targeting sequences, and controls TIN2 localization. We have found that TIN2 is post-translationally processed in mitochondria, and regulates mitochondria oxidative phosphorylation. Reducing TIN2 expression by RNAi knockdown inhibited glycolysis and reactive oxygen species (ROS) and production, and enhanced ATP levels and oxygen consumption in cancer cells. These results suggest a link between telomeric proteins and metabolic control, providing an additional mechanism by which telomeric proteins regulate cancer and aging. PMID:22885005

  12. Wettability control by laser texturing process generating localized gold nanoparticles on polymeric thin films.

    PubMed

    Spano, F; Castellano, A; Massaro, A; Fragouli, D; Cingolani, R; Athanassiou, A

    2012-06-01

    In this work a new approach is introduced for surface properties control by laser texturing process. By UV laser irradiation, we are able to control the surface wettability of a chitosan polymeric film in which is introduced a chloroauric acid salt by immersion. Specifically the UV irradiation is responsible for the creation of gold nanoparticles at the irradiated surface of the polymeric film. This photolytic process allows us to localize and design accurately surface patterns and moreover to tune metallic particle size in the range of nanoscale. After the characterization of our gold textured surfaces by atomic force and scanning electron microscopies, we demonstrate the link between wettability surface properties and gold nanoparticles size. The experimental results indicate the influence of the laser intensity, the irradiation time and the polymer film thickness (by increasing the gold concentration) on the gold nanoparticle density and size. PMID:22905535

  13. Control of vertebrate core planar cell polarity protein localization and dynamics by Prickle 2

    PubMed Central

    Butler, Mitchell T.; Wallingford, John B.

    2015-01-01

    Planar cell polarity (PCP) is a ubiquitous property of animal tissues and is essential for morphogenesis and homeostasis. In most cases, this fundamental property is governed by a deeply conserved set of ‘core PCP’ proteins, which includes the transmembrane proteins Van Gogh-like (Vangl) and Frizzled (Fzd), as well as the cytoplasmic effectors Prickle (Pk) and Dishevelled (Dvl). Asymmetric localization of these proteins is thought to be central to their function, and understanding the dynamics of these proteins is an important challenge in developmental biology. Among the processes that are organized by the core PCP proteins is the directional beating of cilia, such as those in the vertebrate node, airway and brain. Here, we exploit the live imaging capabilities of Xenopus to chart the progressive asymmetric localization of fluorescent reporters of Dvl1, Pk2 and Vangl1 in a planar polarized ciliated epithelium. Using this system, we also characterize the influence of Pk2 on the asymmetric dynamics of Vangl1 at the cell cortex, and we define regions of Pk2 that control its own localization and those impacting Vangl1. Finally, our data reveal a striking uncoupling of Vangl1 and Dvl1 asymmetry. This study advances our understanding of conserved PCP protein functions and also establishes a rapid, tractable platform to facilitate future in vivo studies of vertebrate PCP protein dynamics. PMID:26293301

  14. Local tumor control after {sup 106}Ru brachytherapy of choroidal melanoma

    SciTech Connect

    Damato, Bertil . E-mail: Bertil@damato.co.uk; Patel, Imran; Campbell, Ian R.; Mayles, Helen M.; Errington, R. Douglas

    2005-10-01

    Purpose To report on local tumor control after {sup 106}Ru brachytherapy for choroidal melanoma. Methods and Materials A total of 458 patients with choroidal melanoma were treated at a single institution between January 1993 and December 2001. The tumors had a median longest basal dimension of 10.6 mm and a median height of 3.2 mm. The brachytherapy was administered using a 15- or 20-mm plaque. For posterior tumors, the plaque was positioned eccentrically with its posterior edge aligned with the posterior tumor margin to reduce the radiation dose to the optic disk and fovea. A minimal scleral dose sufficient to cause visible choroidal atrophy provided a permanent ophthalmoscopic record of the distribution of choroidal irradiation. If radiotherapy to the posterior tumor was uncertain, adjunctive transpupillary thermotherapy was administered 6 months postoperatively. Results The actuarial rates of tumor recurrence were 1%, 2%, and 3% at 2, 5, and 7 years, respectively. Local tumor recurrence correlated with the longest basal tumor dimension (Cox univariate analysis, p = 0.02, risk ratio 1.41, 95% confidence interval 1.06-1.88). Seven of the nine eyes with recurrent tumor were salvaged with additional conservative therapy. Conclusion The low rate of local tumor recurrence suggests that ruthenium plaque radiotherapy is effective with good case selection and if special measures are taken to ensure that the plaque is positioned correctly.

  15. X11/Mint Genes Control Polarized Localization of Axonal Membrane Proteins in Vivo

    PubMed Central

    Gross, Garrett G.; Lone, G. Mohiddin; Leung, Lok Kwan; Hartenstein, Volker

    2013-01-01

    Mislocalization of axonal proteins can result in misassembly and/or miswiring of neural circuits, causing disease. To date, only a handful of genes that control polarized localization of axonal membrane proteins have been identified. Here we report that Drosophila X11/Mint proteins are required for targeting several proteins, including human amyloid precursor protein (APP) and Drosophila APP-like protein (APPL), to axonal membranes and for their exclusion from dendrites of the mushroom body in Drosophila, a brain structure involved in learning and memory. Axonal localization of APP is mediated by an endocytic motif, and loss of X11/Mint results in a dramatic increase in cell-surface levels of APPL, especially on dendrites. Mutations in genes required for endocytosis show similar mislocalization of these proteins to dendrites, and strongly enhance defects seen in X11/Mint mutants. These results suggest that X11/Mint-dependent endocytosis in dendrites may serve to promote the axonal localization of membrane proteins. Since X11/Mint binds to APP, and abnormal trafficking of APP contributes to Alzheimer's disease, deregulation of X11/Mint may be important for Alzheimer's disease pathogenesis. PMID:23658195

  16. X11/Mint genes control polarized localization of axonal membrane proteins in vivo.

    PubMed

    Gross, Garrett G; Lone, G Mohiddin; Leung, Lok Kwan; Hartenstein, Volker; Guo, Ming

    2013-05-01

    Mislocalization of axonal proteins can result in misassembly and/or miswiring of neural circuits, causing disease. To date, only a handful of genes that control polarized localization of axonal membrane proteins have been identified. Here we report that Drosophila X11/Mint proteins are required for targeting several proteins, including human amyloid precursor protein (APP) and Drosophila APP-like protein (APPL), to axonal membranes and for their exclusion from dendrites of the mushroom body in Drosophila, a brain structure involved in learning and memory. Axonal localization of APP is mediated by an endocytic motif, and loss of X11/Mint results in a dramatic increase in cell-surface levels of APPL, especially on dendrites. Mutations in genes required for endocytosis show similar mislocalization of these proteins to dendrites, and strongly enhance defects seen in X11/Mint mutants. These results suggest that X11/Mint-dependent endocytosis in dendrites may serve to promote the axonal localization of membrane proteins. Since X11/Mint binds to APP, and abnormal trafficking of APP contributes to Alzheimer's disease, deregulation of X11/Mint may be important for Alzheimer's disease pathogenesis. PMID:23658195

  17. Local inversion-symmetry breaking controls the boson peak in glasses and crystals

    NASA Astrophysics Data System (ADS)

    Milkus, R.; Zaccone, A.

    2016-03-01

    It is well known that amorphous solids display a phonon spectrum where the Debye ˜ω2 law at low frequency melds into an anomalous excess-mode peak (the boson peak) before entering a quasilocalized regime at higher frequencies dominated by scattering. The microscopic origin of the boson peak has remained elusive despite various attempts to put it in a clear connection with structural disorder at the atomic/molecular level. Using numerical calculations on model systems, we show that the microscopic origin of the boson peak is directly controlled by the local breaking of center-inversion symmetry. In particular, we find that both the boson peak and the nonaffine softening of the material display a strong correlation with a new order parameter describing the local inversion symmetry of the lattice. The standard bond-orientational order parameter, instead, is shown to be inadequate and cannot explain the boson peak in randomly-cut crystals with perfect bond-orientational order. Our results bring a unifying understanding of the boson peak anomaly for model glasses and defective crystals in terms of a universal local symmetry-breaking principle of the lattice.

  18. Control Strategies for Electric Vehicle (EV) Charging Using Renewables and Local Storage

    SciTech Connect

    Castello, Charles C; LaClair, Tim J; Maxey, L Curt

    2014-01-01

    The increase of electric vehicle (EV) and plug-in hybrid-electric vehicle (PHEV) adoption creates a need for more EV supply equipment (EVSE) infrastructure (i.e., EV chargers). The impact of EVSE installations could be significant due to limitations in the electric grid and potential demand charges for residential and commercial customers. The use of renewables (e.g., solar) and local storage (e.g., battery bank) can mitigate loads caused by EVSE on the electric grid. This would eliminate costly upgrades needed by utilities and decrease demand charges for consumers. This paper aims to explore control systems that mitigate the impact of EVSE on the electric grid using solar energy and battery banks. Three control systems are investigated and compared in this study. The first control system discharges the battery bank at a constant rate during specific times of the day based on historical data. The second discharges the battery bank based on the number of EVs charging (linear) and the amount of solar energy being generated. The third discharges the battery bank based on a sigmoid function (non-linear) in response to the number of EVs charging, and also takes into consideration the amount of renewables being generated. The first and second control systems recharge the battery bank at night when demand charges are lowest. The third recharges the battery bank at night and during times of the day when there is an excess of solar. Experiments are conducted using data from a private site that has 25 solar-assisted charging stations at Oak Ridge National Laboratory (ORNL) in Oak Ridge, TN and 4 at a public site in Nashville, TN. Results indicate the third control system having better performance, negating up to 71% of EVSE load, compared with the second control system (up to 61%) and the first control system (up to 58%).

  19. Evaluation of 5-Year Trends in Knee Society Scores Stratified by Comorbidities: A Prospective, Longitudinal Study.

    PubMed

    Jauregui, Julio J; Issa, Kimona; Cherian, Jeffrey J; Harwin, Steven F; Given, Kristin; Mont, Michael A

    2016-01-01

    Total knee arthroplasties (TKAs) are reliable procedures for treating end-stage knee osteoarthritis with excellent long-term outcomes. The purpose of this study was to longitudinally evaluate temporal trends of Knee Society Scores (KSS) after TKA and to identify potential demographic and comorbid factors that affect these outcomes. This prospective study evaluated 281 patients (108 men and 173 women) with a mean age of 66 years (range, 39-80 years) who underwent primary TKA (minimum follow-up 5 years). During each follow-up visit, KS objective, function, and total scores were evaluated. The effects of different demographics and comorbidities on outcomes were further analyzed using multivariate regression analysis. Following TKA, peak mean KSS were observed at 1-year follow-up (mean, 92 points), after which there was no significant difference in scores at 5 years compared with 1-year follow-up (mean, 92 points). KS function scores were observed to be unchanged from preoperative levels (mean, 53 points) and at 6 weeks (mean, 56 points). These were significantly higher at 3 months (mean, 78 points) and reached a maximum mean peak at 1 year (mean, 85 points). KS objective scores increased earlier than function scores. The demographic variables and comorbidities that demonstrated a significantly negative impact in KS function scores were increased age, female gender, higher body mass index, and several medical comorbidities including immunological and neurological disease, and neoplasm. Race was the only variable that significantly decreased the KS objective scores. KSS after TKA follow temporal trends with scores initially unchanged from preoperative levels for the objective component, but the scores increased for the functional component. All components demonstrated higher levels compared with preoperative scores by 3 months and peaked at 1-year follow-up. At 5-year follow-up, all mean KSS were unchanged relative to peak scores seen at 1 year. Various patient

  20. SN-38-loaded nanofiber matrices for local control of pediatric solid tumors after subtotal resection surgery.

    PubMed

    Monterrubio, Carles; Pascual-Pasto, Guillem; Cano, Francisco; Vila-Ubach, Monica; Manzanares, Alejandro; Schaiquevich, Paula; Tornero, Jose A; Sosnik, Alejandro; Mora, Jaume; Carcaboso, Angel M

    2016-02-01

    In addition to surgery, local tumor control in pediatric oncology requires new treatments as an alternative to radiotherapy. SN-38 is an anticancer drug with proved activity against several pediatric solid tumors including neuroblastoma, rhabdomyosarcoma and Ewing sarcoma. Taking advantage of the extremely low aqueous solubility of SN-38, we have developed a novel drug delivery system (DDS) consisting of matrices made of poly(lactic acid) electrospun polymer nanofibers loaded with SN-38 microcrystals for local release in difficult-to-treat pediatric solid tumors. To model the clinical scenario, we conducted extensive preclinical experiments to characterize the biodistribution of the released SN-38 using microdialysis sampling in vivo. We observed that the drug achieves high concentrations in the virtual space of the surgical bed and penetrates a maximum distance of 2 mm within the tumor bulk. Subsequently, we developed a model of subtotal tumor resection in clinically relevant pediatric patient-derived xenografts and used such models to provide evidence of the activity of the SN-38 DDS to inhibit tumor regrowth. We propose that this novel DDS could represent a potential future strategy to avoid harmful radiation therapy as a primary tumor control together with surgery. PMID:26695118

  1. Nitrogen Fixation Control under Drought Stress. Localized or Systemic?1[OA

    PubMed Central

    Marino, Daniel; Frendo, Pierre; Ladrera, Ruben; Zabalza, Ana; Puppo, Alain; Arrese-Igor, Cesar; González, Esther M.

    2007-01-01

    Legume-Rhizobium nitrogen fixation is dramatically affected under drought and other environmental constraints. However, it has yet to be established as to whether such regulation of nitrogen fixation is only exerted at the whole-plant level (e.g. by a systemic nitrogen feedback mechanism) or can also occur at a local nodule level. To address this question, nodulated pea (Pisum sativum) plants were grown in a split-root system, which allowed for half of the root system to be irrigated at field capacity, while the other half was water deprived, thus provoking changes in the nodule water potential. Nitrogen fixation only declined in the water-deprived, half-root system and this result was correlated with modifications in the activities of key nodule's enzymes such as sucrose synthase and isocitrate dehydrogenase and in nodular malate content. Furthermore, the decline in nodule water potential resulted in a cell redox imbalance. The results also indicate that systemic nitrogen feedback signaling was not operating in these water-stressed plants, since nitrogen fixation activity was maintained at control values in the watered half of the split-root plants. Thus, the use of a partially droughted split-root system provides evidence that nitrogen fixation activity under drought stress is mainly controlled at the local level rather than by a systemic nitrogen signal. PMID:17416644

  2. Control of in vivo microvessel ingrowth by modulation of biomaterial local architecture and chemistry

    SciTech Connect

    Sanders, Joan E.; Baker, Aaron B.; Golledge, Stephen

    2002-04-01

    We developed a method for controlling local architecture and chemistry simultaneously in biomaterial implants to control microvessel ingrowth in vivo. Porous polypropylene disks (5 mm in diameter and 40 um thick) were plasma-coated with a fluoropolymer and then laser-drilled with 50-*m-diameter holes through their thickness. We then oxidized the disks to create hydroxyl functionality on the exposed polypropylene (inside the holes). Acrylamide was grafted to the hydroxyl groups through polymerization in the presence of activating ceric ions. Staining with toluidine blue O demonstrated that grafting occurred only inside the holes. We used the Hoffman degradation reaction to convert the amide groups of acrylamide to amine groups, and then we used ethylene glycol diglycidyl ether to attach biomolecules of interest inside the holes: secreted protein acidic and rich in cysteine (SPARC) peptide Lys-Gly-His-Lys (KGHK; angiogenic), thrombospondin-2 (TSP; antiangiogenic), or albumin (rat; neutral). In vivo testing in a rat subcutaneous dorsum model for a 3-week interval demonstrated a greater vessel surface area (p = 0.032) and a greater number of vessels (p = 0.043) in tissue local to the holes with KGHKimmobilized disks than with TSP-immobilized disks. However, differences between KGHK-immobilized and albuminimmobilized disks were less significant (p = 0.120 and p = 0.289 for the vessel surface area and number of vessels, respectively). The developed methods have potential applications in biomaterial design applications for which selective neovascularization is desired.

  3. Subcellular optogenetic activation of Cdc42 controls local and distal signaling to drive immune cell migration

    PubMed Central

    O’Neill, Patrick R.; Kalyanaraman, Vani; Gautam, N.

    2016-01-01

    Migratory immune cells use intracellular signaling networks to generate and orient spatially polarized responses to extracellular cues. The monomeric G protein Cdc42 is believed to play an important role in controlling the polarized responses, but it has been difficult to determine directly the consequences of localized Cdc42 activation within an immune cell. Here we used subcellular optogenetics to determine how Cdc42 activation at one side of a cell affects both cell behavior and dynamic molecular responses throughout the cell. We found that localized Cdc42 activation is sufficient to generate polarized signaling and directional cell migration. The optically activated region becomes the leading edge of the cell, with Cdc42 activating Rac and generating membrane protrusions driven by the actin cytoskeleton. Cdc42 also exerts long-range effects that cause myosin accumulation at the opposite side of the cell and actomyosin-mediated retraction of the cell rear. This process requires the RhoA-activated kinase ROCK, suggesting that Cdc42 activation at one side of a cell triggers increased RhoA signaling at the opposite side. Our results demonstrate how dynamic, subcellular perturbation of an individual signaling protein can help to determine its role in controlling polarized cellular responses. PMID:26941336

  4. Subcellular optogenetic activation of Cdc42 controls local and distal signaling to drive immune cell migration.

    PubMed

    O'Neill, Patrick R; Kalyanaraman, Vani; Gautam, N

    2016-05-01

    Migratory immune cells use intracellular signaling networks to generate and orient spatially polarized responses to extracellular cues. The monomeric G protein Cdc42 is believed to play an important role in controlling the polarized responses, but it has been difficult to determine directly the consequences of localized Cdc42 activation within an immune cell. Here we used subcellular optogenetics to determine how Cdc42 activation at one side of a cell affects both cell behavior and dynamic molecular responses throughout the cell. We found that localized Cdc42 activation is sufficient to generate polarized signaling and directional cell migration. The optically activated region becomes the leading edge of the cell, with Cdc42 activating Rac and generating membrane protrusions driven by the actin cytoskeleton. Cdc42 also exerts long-range effects that cause myosin accumulation at the opposite side of the cell and actomyosin-mediated retraction of the cell rear. This process requires the RhoA-activated kinase ROCK, suggesting that Cdc42 activation at one side of a cell triggers increased RhoA signaling at the opposite side. Our results demonstrate how dynamic, subcellular perturbation of an individual signaling protein can help to determine its role in controlling polarized cellular responses. PMID:26941336

  5. DISCHARGE IMPROVEMENT THROUGH CONTROL OF NEOCLASSICAL TEARING MODES BY LOCALIZED ECCD IN DIII-D

    SciTech Connect

    PRATER,R; LAHAYE,RJ; LOHR,J; LUCE,TC; PETTY,CC; FERRON,JR; HUMPHREYS,DA; STRAIT,EJ; PERKINS,FW; HARVEY,RW

    2002-10-01

    A271 DISCHARGE IMPROVEMENT THROUGH CONTROL OF NEOCLASSICAL TEARING MODES BY LOCALIZED ECCD IN DIII-D. Neoclassical tearing modes (NTMs) are MHD modes which can limit the performance of high beta discharges in tokamaks, in some cases leading to a major disruption. The destabilizing effect which results in NTM growth is a helical decrease in the bootstrap current caused by a local reduction of the plasma pressure gradient by seed magnetic islands. The NTM is particularly well suited to control since the mode is linearly stable although nonlinearly unstable, so if the island amplitude can be decreased below a threshold size the mode will decay and vanish. One means of shrinking the island is the replacement of the missing bootstrap current by a localized current generated by electron cyclotron current drive (ECCD). This method has been applied to the m=3/n=2 neoclassical tearing mode in DIII-D, in H-mode plasmas with ongoing ELMs and sawteeth, both of which generate seed islands periodically. In the case of the 3/2 mode, full suppression was obtained robustly by applying about 1.5 MW of ECCD very near the rational surface of the mode. When the mode first appears in the plasma the stored energy decreases by 20%, but after the mode is stabilized by the ECCD the beta may be raised above the initial threshold pressure by 20% by additional neutral beam heating, thereby generating an improvement in the limiting beta of nearly a factor 2. An innovative automated search algorithm was implemented to find and retain the optimum location for the ECCD in the presence of the mode.

  6. Etiology and Incidence of Viral Acute Respiratory Infections Among Refugees Aged 5 Years and Older in Hagadera Camp, Dadaab, Kenya.

    PubMed

    Mohamed, Gedi A; Ahmed, Jamal A; Marano, Nina; Mohamed, Abdinoor; Moturi, Edna; Burton, Wagacha; Otieno, Samora; Fields, Barry; Montgomery, Joel; Kabugi, Willy; Musa, Hashim; Cookson, Susan T

    2015-12-01

    We used the Centers for Disease Control and Prevention-Kenya Medical Research Institute Acute Respiratory Infection (ARI) Surveillance System data to estimate severe acute respiratory infection (SARI) hospitalization rates, viral etiology, and associated complaints of influenza-like illnesses (ILI) and SARI conditions among those aged 5 years and older in Hagadera, Dadaab refugee camp, Kenya, for 2010-2012. A total of 471 patients aged ≥ 5 years met the case definition for ILI or SARI. SARI hospitalization rates per 10,000 person-years were 14.7 (95% confidence interval [CI] = 9.1, 22.2) for those aged 5-14 years; 3.4 (95% CI = 1.6, 7.2) for those aged 15-24 year; and 3.8 (95% CI = 1.6, 7.2) for those aged ≥ 25 years. Persons between the ages of 5 and 14 years had 3.5 greater odds to have been hospitalized as a result of SARI than those aged ≥ 25 years (odds ratio [OR] = 3.5, P < 0.001). Among the 419 samples tested, 169 (40.3%) were positive for one or more virus. Of those samples having viruses, 36.9% had influenza A; 29.9% had adenovirus; 20.2% had influenza B; and 14.4% had parainfluenza 1, 2, or 3. Muscle/joint pain was associated with influenza A (P = 0.002), whereas headache was associated with influenza B (P = 0.019). ARIs were responsible for a substantial disease burden in Hagadera camp. PMID:26458776

  7. Localized controlled release of stratifin reduces implantation-induced dermal fibrosis.

    PubMed

    Rahmani-Neishaboor, Elham; Hartwell, Ryan; Jalili, Reza; Jackson, John; Brown, Erin; Ghahary, Aziz

    2012-10-01

    Localized controlled release of anti-fibrogenic factors can potentially prevent tissue fibrosis surrounding biomedical prostheses, such as vascular stents and breast implants. We have previously demonstrated that therapeutic intervention with topically applied stratifin in a rabbit ear fibrotic model not only prevents dermal fibrosis but also promotes more normal tissue repair by regulating extracellular matrix deposition. In this work, the anti-fibrogenic effect of a controlled release form of stratifin was investigated in the prevention of fibrosis induced by dermal poly(lactic-co-glycolic acid) (PLGA) microsphere/poly(vinyl alcohol) (PVA) hydrogel implants. Pharmacodynamic effects were evaluated by histopathological examination of subcutaneous tissue surrounding implanted composites. Controlled release of stratifin from PLGA microsphere/PVA hydrogel implants significantly moderated dermal fibrosis and inflammation by reducing collagen deposition (30%), total tissue cellularity (48%) and infiltrated CD3(+) immune cells (81%) in the surrounding tissue compared with the stratifin-free implants. The controlled release of stratifin from implants markedly increased the level of matrix metalloproteinase-1 expression in the surrounding tissue, which resulted in less collagen deposition. These stratifin-eluting PLGA/PVA composites show promise as coatings to decrease the typical fibrosis exhibited around implanted biomedical prostheses, such as breast implants and vascular stents. PMID:22743110

  8. Morphogenetic fields in embryogenesis, regeneration, and cancer: Non-local control of complex patterning

    PubMed Central

    Levin, Michael

    2012-01-01

    Establishment of shape during embryonic development, and the maintenance of shape against injury or tumorigenesis, requires constant coordination of cell behaviors toward the patterning needs of the host organism. Molecular cell biology and genetics have made great strides in understanding the mechanisms that regulate cell function. However, generalized rational control of shape is still largely beyond our current capabilities. Significant instructive signals function at long range to provide positional information and other cues to regulate organism-wide systems properties like anatomical polarity and size control. Is complex morphogenesis best understood as the emergent property of local cell interactions, or as the outcome of a computational process that is guided by a physically-encoded map or template of the final goal state? Here I review recent data and molecular mechanisms relevant to morphogenetic fields: large-scale systems of physical properties that have been proposed to store patterning information during embryogenesis, regenerative repair, and cancer suppression that ultimately controls anatomy. Placing special emphasis on the role of endogenous bioelectric signals as an important component of the morphogenetic field, I speculate on novel approaches for the computational modeling and control of these fields with applications to synthetic biology, regenerative medicine, and evolutionary developmental biology. PMID:22542702

  9. Renal Stone Associated with the Ketogenic Diet in a 5-Year Old Girl with Intractable Epilepsy

    PubMed Central

    Choi, Ji Na; Song, Ji Eun; Shin, Jae Il; Kim, Heung Dong; Kim, Myung Joon

    2010-01-01

    In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered. PMID:20376903

  10. Constraints on the Time Variation of the Fine Structure Constant by the 5-Year WMAP Data

    NASA Astrophysics Data System (ADS)

    Nakashima, M.; Nagata, R.; Yokoyama, J.

    2008-12-01

    The constraints on the time variation of the fine structure constant at recombination epoch relative to its present value, Δα/α ≡ (α_{rec} - α_{now})/α_{now}, are obtained from the analysis of the 5-year WMAP cosmic microwave background data. As a result of Markov-Chain Monte-Carlo analysis, it is found that, contrary to the analysis based on the previous WMAP data, the mean value of Δα/α = -0.0009 does not change significantly whether we use the Hubble Space Telescope (HST) measurement of the Hubble parameter as a prior or not. The resultant 95% confidence ranges of Δα/α are -0.028 < Δα/α < 0.026 with HST prior and -0.050 < Δα/α < 0.042 without HST prior.

  11. The thermoregulatory theory of yawning: what we know from over 5 years of research

    PubMed Central

    Gallup, Andrew C.; Eldakar, Omar T.

    2012-01-01

    Over the past 5 years numerous reports have confirmed and replicated the specific brain cooling and thermal window predictions derived from the thermoregulatory theory of yawning, and no study has found evidence contrary to these findings. Here we review the comparative research supporting this model of yawning among homeotherms, while highlighting a recent report showing how the expression of contagious yawning in humans is altered by seasonal climate variation. The fact that yawning is constrained to a thermal window of ambient temperature provides unique and compelling support in favor of this theory. Heretofore, no existing alternative hypothesis of yawning can explain these results, which have important implications for understanding the potential functional role of this behavior, both physiologically and socially, in humans and other animals. In discussion we stress the broader applications of this work in clinical settings, and counter the various criticisms of this theory. PMID:23293583

  12. Performance of the MIR Cooperative Solar Array After 2.5 Years in Orbit

    NASA Technical Reports Server (NTRS)

    Kerslake, Thomas W.; Hoffman, David J.

    1999-01-01

    The Mir Cooperative Solar Array (MCSA) was developed jointly by the United States and Russia to produce 6 kW of power for the Russian space station Mir. Four, multi-orbit test sequences were executed between June 1996 and December 1998 to measure MCSA electrical performance. A dedicated Fortran computer code was developed to analyze the detailed thermal-electrical performance of the MCSA. The computational performance results compared very favorably with the measured flight data in most cases. Minor performance degradation was detected in one current generating section of the MCSA. Yet overall, the flight data indicated the MCSA was meeting and exceeding performance expectations. There was no precipitous performance loss due to contamination or other causes after 2.5 years of operation. In this paper, we review the MCSA flight electrical performance tests, data and computational modeling and discuss findings from data comparisons with the computational results.

  13. 5 years of experience with a large-scale mentoring program for medical students

    PubMed Central

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R.; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  14. Neurological Recovery of Upper Extremity in Stroke Woman after 5 Years: A Case Report.

    PubMed

    Vejabhuti, Chayanin

    2016-02-01

    Strokes are common neurological disorders in Thailand. Rehabilitation programs significantly improve arm function outcomes if performed during the sub-acute period of stroke rehabilitation, within 6 months of the attack. This report describes the case of a stroke patient who gained upper extremity motor recovery after 5 years, which is beyond the normal recovery period. Although the patient does not have functionality, she has partial motor recovery, and she is enthusiastic about learning to gain better use of her hand. However there is still limited evidence to use in designing effective intervention and proper timing of rehabilitation administered by personnel in training chronic stroke patients. Therefore, evidence based on neuroplasticity and neurological recovery in chronic stroke patients, including rehabilitation intervention, is presented in this report. PMID:27266238

  15. A 5-year-old male child with late infantile metachromatic leukodystrophy: a case report.

    PubMed

    Mahmood, Afreen; Chacham, Swathi; Reddy, Uppin Narayan; Rao, Jillalla Narsing; Rao, S Pratap

    2015-03-01

    Metachromatic leukodystrophy is a rare disorder of myelin metabolism. This degenerative disorder results from the accumulation of cerebroside sulfatide within the myelin sheath of central and peripheral nervous system, due to deficiency of aryl sulfatase A enzyme. We report a 5-year-old male child, who presented with regression of milestones, recurrent seizures and spasticity from second year of life. Initially neurodegenerative disorder was considered and the case was investigated with neuroimaging and enzyme levels. Computed tomography (CT) of the brain showed hypodensities in the corpus callosum and bilateral periventricular and deep cerebral white matter suggestive of neurodegenerative disorder. Subsequently, magnetic resonance imaging (MRI) of the brain was done, which showed symmetrical hyperintensities in the periventricular white matter with classical sparing of subcortical "U" fibers. The β-galactosidase enzyme activity was normal; however, the activity of aryl sulfatase A enzyme was undetectable, confirming the diagnosis of late infantile variant of metachromatic leukodystrophy. PMID:25117420

  16. A student-centred, problem-based curriculum: 5 years' experience.

    PubMed Central

    Des Marchais, J E

    1993-01-01

    In 1987, the University of Sherbrooke's school of medicine implemented a student-centred, problem-based learning (PBL) curriculum. The experience of the first 5 years is reviewed; program goals, the schedule of learning activities, the instructional format and assessment of student learning are described. The new program is more demanding of teachers and requires better faculty training in pedagogy. No new financial resources have been available. The preclinical reform has led to revision of the clerkship, where sessions on clinical reasoning are now based on the PBL philosophy. Student reactions to the program are reported. The Sherbrooke experience has demonstrated that it is both possible and feasible to shift from a traditional to a problem-based curriculum. PMID:8477383

  17. The 5-Year Scientific Achievement of NASA's Chandra X-Ray Observatory

    NASA Technical Reports Server (NTRS)

    2004-01-01

    NASA's Chandra X-Ray Observatory (CXO) was launched July 22, 1999 aboard the Space Shuttle Columbia, STS-93 mission. This image was produced by combining a dozen CXO observations made of a 130 light-year region in the center of the Milky Way over the last 5 years. The colors represent low (red), medium (green) and high (blue) energy x-rays. Thanks to Chandra's unique resolving power, astronomers have now been able to identify thousands of point-like x-ray sources due to neutron stars, black holes, white dwarfs, foreground stars, and background galaxies. What remains is a diffuse x-ray glow extending from the upper left to the lower right, along the direction of the disk of the galaxy. NASA's Marshall Space Flight Center in Huntsville, Alabama manages the Chandra program. (NASA/CXC/UCLA/M. Muno et al.)

  18. [The geriatric psychiatric day hospital: an analysis of 5 years of activities].

    PubMed

    Trifonov, E G; Ognev, A E

    1997-01-01

    233 patients (53 men and 180 women) at the age of 60 years and older were treated in day gerontopsychiatric out-patient clinic for 5 years. 60-69 year old patients prevailed (146 individuals). Nearly all mental diseases characteristic for the old age were found in such patients; majority of patients suffered from schizophrenia (31.3%) and affective pathology (25.8%). Vascular form of dementia prevailed among the patients with dementia while atrophic degenerative dementia was rarely observed (2 patients). Syndromological distribution revealed that the main groups were formed by patients with depressions (41.6%) as well as individuals with neurosis- and psychopathic-like conditions (37.3%). Mental disorders with paranoid syndromes were observed in 8.6% of the patients. It is shown that day gerontopsychiatric out-patient clinic had some preferences in comparison with usual mental hospitals and psychoneurological out-patient clinic. PMID:9157762

  19. Full-mouth rehabilitation of Class II deep-bite patient: A 5-year clinical report

    PubMed Central

    Ergun, Gulfem; Bozkaya, Erdal

    2016-01-01

    This case report demonstrates the full-mouth rehabilitation of a 45-year-old male patient with severe deep-bite by increasing vertical dimension. The technique of anterior maxillary osteotomy performed in the present situation has been found to be effective, requiring anterior and inferior repositioning of the anterior maxilla to provide an esthetic and functional implant supported fixed prosthesis. Four months after surgery, the fixation system was removed, and 6 dental implants were placed. The anterior and inferior movements of the segment allowed for natural tooth anatomy and size in the definitive implant supported partial fixed prosthesis. A satisfactory functional and esthetic result was obtained after 5 years of follow-up. PMID:27403066

  20. Central venous catheters for chemotherapy of solid tumors--our results in the last 5 years.

    PubMed

    Zganjer, Mirko; Cizmić, Ante; Butković, Diana; Matolić, Martina; Karaman-Ilić, Maja; Stepan, Jasminka

    2008-09-01

    Central venous catheters provide an easy access for intravenous medications. Having a central line in place will relieve a child from the discomfort and danger of multiple regular intravenous lines for chemotherapy. The use of indwelling central venous catheters has become commonplace in the management of children undergoing oncological treatment. There are two types of central lines commonly used. There are Broviac catheters and Port-A-Cath (PAC) catheters. In the last 5 years we inserted 194 catheters in 175 children. We inserted 121 Broviac catheters and 73 PAC catheters. During the follow up of 39382 catheter days 44 complications were observed. In Broviac group the median follow up was 155 days and in PAC group was 230 days. We observed differences in the incidence between two devices. In Broviac group infections were more frequent and in PAC group other complications were more frequent than infections. PMID:18982750

  1. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-01-01

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications. PMID:24832710

  2. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study.

    PubMed

    Rösler, H; Triller, J; Baer, H U; Geiger, L; Beer, H F; Becker, C; Blumgart, L H

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. PMID:7997379

  3. A 5-year experience of the changing management of ectopic pregnancy.

    PubMed

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée

    2016-07-01

    This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability. PMID:27012598

  4. The impact patient-specific instrumentation has had on my practice in the last 5 years.

    PubMed

    Collins, Michael J

    2014-03-01

    I have performed total knee arthroplasty (TKA) using patient- specific instrumentation (PSI) (TRUMATCH® Personalized Solutions, DePuy Synthes Joint Reconstruction, Warsaw, Indiana) since July 2009. Since that time, I have performed over 600 of these procedures, all at the same hospital and all using the same personnel I worked with before I began using PSI. I do not have a physician assistant, but I do have a surgical assistant who scrubs with and assists me on all TKAs. There are a number of reasons why a surgeon may decide to use PSI. This paper discusses the effect PSI has had on my practice in the last 5 years, including my experiences and conclusions. PMID:24911641

  5. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor.

    PubMed

    Carmichael, Samuel P; Pulliam, Joseph F; D'Orazio, John A

    2013-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her initial chemotherapeutic course was complicated by tumor lysis syndrome manifested by elevated serum uric acid and was treated effectively with hyperhydration and alkalization of intravenous fluids. The patient's disease responded well to chemotherapy, and she underwent successful tumor excision after 12 weeks of chemotherapy. The resected tumor was identified as anaplastic Wilms tumor, illustrating that pathologic identification of Wilms tumor is possible even after multiple cycles of neoadjuvant chemotherapy and marked tumor shrinkage. PMID:24964423

  6. 5 years of experience with a large-scale mentoring program for medical students.

    PubMed

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  7. The magnetosphere, ionosphere, and atmosphere as a system - Dynamics Explorer 5 years later

    NASA Technical Reports Server (NTRS)

    Hoffman, R. A.

    1988-01-01

    The Dynamics Explorer (DE) program summarizes its accomplishments during the first 5 years since the launch of the two DE satellites. This introduction to six review articles provides background information and a brief history of the program, especially citing the contributions of many people to its development. The principal investigators who had primary responsibility to implement the program are listed, together with the instruments they provided. Orbital information and approaches and constraints to data acquisition are explained. The brief description of the ground data processing and analysis system provides information on access to data catalogs and data sets. Each review article is then placed in the context of the categories of scientific objectives of the program.

  8. Department of Energy Resource Assessment Program 5-year plan, FY 1991--FY 1995

    SciTech Connect

    Not Available

    1990-10-01

    The US Department of Energy's (DOE) Resource Assessment Program produces scientific descriptions and assessments of the nation's renewable energy resources, such as solar energy. Information about the resources --- for example, how solar energy varies with location and climate --- is required to develop energy conversion technologies, design and site systems, and forecast the systems' performance. With information about resource availability and renewable energy system performance, DOE can assess the potential for renewable energy to contribute to the nation's energy supply as part of the long-term national energy strategy. This 5-year plan for fiscal years (FY) 1991 through 1995 gives the strategy to produce solar radiation resource characterizations and assessments under the DOE project at SERI. It is consistent with the mini-multiyear plan for resource assessment prepared by DOE in 1989 and incorporates the comments received at a project overview held in April 1990 at DOE Headquarters. 7 figs.

  9. Predictors and consequences of childhood depressive symptoms: a 5-year longitudinal study.

    PubMed

    Nolen-Hoeksema, S; Girgus, J S; Seligman, M E

    1992-08-01

    A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings. PMID:1500598

  10. A 5-year activity report from the Oral Cancer Center, Tokyo Dental College.

    PubMed

    Yamamoto, Nobuharu; Sato, Kazumichi; Yamauchi, Tomohiro; Suzuki, Taiki; Osaka, Ryuta; Kin, Mira; Yoshida, Yoshifumi; Noguchi, Sunaki; Ishizaki, Ken; Takano, Masayuki; Katakura, Akira; Tanaka, Yoichi; Shibahara, Takahiko; Takano, Nobuo

    2013-01-01

    The Tokyo Dental College Oral Cancer Center was established on April 1st, 2006 at our Ichikawa General Hospital for the purpose of providing multimodal treatment for oral cancer. This report summarizes the Center's activities over the last 5 years. The total number of oral cancer patients treated was 360 (April 2006 to March 2011), with 205 primary cases. We investigated the following treatment-related items: 1) site, 2) age, 3) sex, 4) pathological examination, 5) staging, 6) systemic disorder, 7) double cancer, 8) treatment, and 9) prognosis. Out of 205 patients, 60% were men and 40% were women. Men in their 60s and women in their 80s were seen the most. The most common site was the tongue, at 42%, followed by the mandibular gingiva, maxillary gingiva, oral floor, and buccal mucosa. Squamous cell carcinomas were seen most frequently, at 94% (15% were stage I, 33% stage II, 15% stage III, and 34% stage IV). The most common treatment method was surgical treatment, at 83%. The 5-year survival rate at all stages was 85.4%. At the Oral Cancer Center, oral surgeons take the initiative in establishing treatment in cooperation with other departments and branches. Since the establishment of the Ambulatory Center for Maxillary Prosthetics in October 2011, 26 patients have undergone treatment. Related departments and branches work in teams, enabling comprehensive treatment, from the preoperative state to postoperative functional recovery. We wish to use these strengths to improve oral cancer treatment in Japan and will continue to work toward providing the best possible care for our patients. PMID:24521553

  11. 5 Years review of periocular basal cell carcinoma and proposed follow-up protocol

    PubMed Central

    Ho, S F; Brown, L; Bamford, M; Sampath, R; Burns, J

    2013-01-01

    Aim (1) To investigate the recurrence of periocular basal cell carcinoma (BCC) reported as completely excised on histology. (2) To identify risks associated with recurrence. (3) To recommend a rational follow-up protocol. Methods This is a cohort study by case note review of consecutive patients undergoing excision of periocular BCC between 2000 and 2006 at University Hospitals of Leicester. All lesions were excised with 3 mm clinical margin and the defect reconstructed only after the excision margin was declared clear. Results A total of 413 episodes of surgical excision were recorded for 270 patients over the 7-year period of 2000–2006. All of them have 5 years follow-up. Mean age 73.7 (±12.5). In all, 67% were nodular BCC and 45.4% located in the lower eyelid. The main outcome measure was the recurrence rate. None of the patients with primary nodular BCC suffered recurrence. The recurrence rate for primary morphoeaform BCC following complete excision is 3.8%. In total, 8.1% of patients had several lesions simultaneously whereas 7.8% patients had BCC in multiple locations subsequently (metachronous). Three patients who had previously recurrent BCC (rBCC) treated elsewhere or not using this method had orbital/lacrimal drainage system involvement requiring exenteration. Conclusion We recommend that patients with a single, completely excised primary solid or nodular BCC can be discharged after one 6-monthly review, although they should be instructed to monitor for the development of further lesions. The incidence of recurrence for primary morphoeaform BCC is 3.8% and for rBCC is 3.6% over 5 years and these patients should stay under review for this period. PMID:23154501

  12. POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

    PubMed

    Irwantol; Faisal; Zulfa, Hendra

    2015-09-01

    Children are at risk for developing posttraumatic stress disorder (PTSD) due to experiencing or living in a disaster area. The factors that increase the likelihood of a child developing PTSD need further clarification. We studied the factors associated with PTSD among children who experienced the tsunami in Sumatra, Indonesia. We conducted a cross sectional study in 2 subdistricts of Sumatra 5 years after experiencing a tsunami. Children aged 7-13 years were enrolled using stratified cluster sampling. A tsunami-modified version of The PsySTART Rapid Triage System was used to question children about their tsunami-specific traumatic experiences. Trauma symptoms were evaluated using the Trauma Symptom Checklist For Children (TSCC). The diagnosis of PTSD was made using the Child PTSD Symptom Scale (CPSS) and DSM-IV criteria. The data were analyzed with chi-square tests and multivariate logistic regression analysis with 95% confidence intervals (CI). A total of 262 children were enrolled in this study. The prevalence of PTSD in these children was 20.6%. On multivariate analysis, having experienced a delay in evacuation (PR = 4.5; 95% CI: 2.794-13.80; p < 0.001) and being unable to escape (PR = 13.07; 95% CI: 5.884-64; p < 0.001) were significantly associated with PTSD 5 years after the tsunami. Children who experienced a traumatic event in which they were unable to escape or when there is a delay in evacuation are at risk of developing PTSD and need appropriate treatment. PMID:26863863

  13. Smoking in pregnancy and children's mental and motor development at age 1 and 5 years.

    PubMed

    Trasti, N; Vik, T; Jacobsen, G; Bakketeig, L S

    1999-06-01

    We used data from a Scandinavian prospective multicenter study to investigate if smoking in pregnancy may have an adverse effect on the child's mental and motor abilities. Eligible for enrolment were para I and 2 women with a singleton pregnancy, who resided in one of the study areas and could be registered before the 20th gestational week. Women were classified as 'smokers' or 'non-smokers' at study start. At 13 months, 376 children (124 children of smokers) were evaluated with the Bayley Scales of Infant Development. At this age, children of smokers and non-smokers performed equally well. At 5 years, 369 children (132 children of smokers) were tested with the Wechsler Preschool and Primary Scales of Intelligence Revised (WPPSI-R), and 362 children with the Peabody Developmental Motor Scales (PDMS). Children of smokers had an increased risk of getting a WPPSI-R score below the median value of the population (OR = 2.1, 95% CI: 1.2-3.3), but the risk was reduced when we adjusted for maternal education (OR = 1.6, 95% CI: 0.9-3.7). Children of smokers had an increased risk of getting a test score below the median population value on the subscale 'balance' from PDMS (OR = 1.8, 95% CI: 1.2-2.8). Thus, we found that smoking in pregnancy was associated with a small, but demonstrable adverse effect on the child's balance at 5 years, whereas the negative effect on cognitive function did not reach statistical significance, when we adjusted for the mother's level of education. PMID:10390089

  14. Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience

    PubMed Central

    Emara, Mohamed H; Darwiesh, Ehab M; Refaey, Mohamed M; Galal, Sherif M

    2014-01-01

    Background Foreign bodies (FBs) in the upper gastrointestinal tract are produced chiefly by accidental swallowing but rarely produce symptoms. Removal of FBs is not an infrequent challenge for upper gastrointestinal endoscopy. The aim of this study is to elicit our experience in a 5-year period in dealing with FBs in the upper gastrointestinal tract using upper endoscopy. Methods This retrospective study was conducted at Zagazig University Hospitals, Egypt, over a 5-year period. We reviewed all patients’ files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. Results A total of 45 patients were identified. Their ages ranged from 6 months to 102 years. Slight male predominance was noticed (53.3%). The most frequent presentation was a history of FB ingestion without any associated manifestations (44.4%). Coins were the most commonly encountered FBs (14/45). Esophagus was the most common site of trapping (27/45). The overall success rate was 95.6% (43/45). Upper endoscopy successfully resolved the problem by either FB removal (41/43) or dislodgment of the impacted fleshy meat to the stomach (2/43). Two cases were referred for surgical removal. The rate of complications was 6.7%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. Conclusion Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units, and under conscious sedation in most cases, with high success rates and minor complications. PMID:25053889

  15. Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event

    PubMed Central

    Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H.; Vidal-Jordana, Angela; Montalban, Xavier; Rovira, Alex; Tintoré, Mar; Amato, Maria Pia; Brochet, Bruno; de Seze, Jérôme; Brassat, David; Vermersch, Patrick; De Stefano, Nicola

    2014-01-01

    Objective To report the 5-year risk and to identify risk factors for the development of a seminal acute or progressive clinical event in a multi-national cohort of asymptomatic subjects meeting 2009 RIS Criteria. Methods Retrospectively identified RIS subjects from 22 databases within 5 countries were evaluated. Time to the first clinical event related to demyelination (acute or 12-month progression of neurological deficits) was compared across different groups by univariate and multivariate analyses utilizing a Cox regression model. Results Data were available in 451 RIS subjects (F: 354 (78.5%)). The mean age at from the time of the first brain MRI revealing anomalies suggestive of MS was 37.2 years (y) (median: 37.1 y, range: 11–74 y) with mean clinical follow-up time of 4.4 y (median: 2.8 y, range: 0.01–21.1 y). Clinical events were identified in 34% (standard error = 3%) of individuals within a 5-year period from the first brain MRI study. Of those who developed symptoms, 9.6% fulfilled criteria for primary progressive MS. In the multivariate model, age [hazard ratio (HR): 0.98 (95% CI: 0.96–0.99); p = 0.03], sex (male) [HR: 1.93 (1.24–2.99); p = 0.004], and lesions within the cervical or thoracic spinal cord [HR: 3.08 (2.06–4.62); p = <0.001] were identified as significant predictors for the development of a first clinical event. Interpretation These data provide supportive evidence that a meaningful number of RIS subjects evolve to a first clinical symptom. An age <37 y, male sex, and spinal cord involvement appear to be the most important independent predictors of symptom onset. PMID:24598783

  16. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    PubMed Central

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  17. Food assistance programmes are indirectly associated with anaemia status in children <5 years old in Mexico.

    PubMed

    Shamah-Levy, Teresa; Méndez-Gómez-Humarán, Ignacio; Gaona-Pineda, Elsa B; Cuevas-Nasu, Lucia; Villalpando, Salvador

    2016-09-01

    Anaemia in children is a public health concern in Mexico; Federal food assistance programmes are being implemented to prevent it. We undertook this research to investigate the indirect association between food assistance programmes (FAP) and anaemia through dietary and socio-economic conditions of beneficiary children. A structural equation model (SEM) was constructed to assess associations among FAP, dietary and socio-economic conditions, as well as anaemia. A cross-sectional comparative study was conducted based on a sample of 1214 households with children <5 years old, beneficiaries of two FAP: Prospera and rescue from malnutrition with amaranth (RMA) and a comparison group in San Luis Potosí, Mexico. The SEM and a decomposition effect analysis revealed the existence of a significant indirect association of FAP on the prevalence of anaemia via dietary and socio-economic conditions in children under 5 years old. The Prospera assistance programme showed a significant indirect positive association with the prevalence of anaemia (standard coefficient=0·027, P<0·031), and the RMA programme showed a significant indirect negative association with the prevalence of anaemia (standard coefficient=-0·029, P=0·047). There was a direct association between FAP and dietary and socio-economic conditions. FAP could indirectly modify the prevalence of anaemia in young children with a direct improvement on dietary and socio-economic conditions. The unexpected finding of the association between RMA, dietary and socio-economic conditions and the prevalence of anaemia reflects differences in the focus of the programmes. PMID:27545977

  18. Status of medical education reform at Saga Medical School 5 years after introducing PBL.

    PubMed

    Oda, Yasutomo; Koizumi, Shunzo

    2008-03-01

    In Japan, problem-based learning (PBL) is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums) to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors). Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum) is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including "silent tutors" and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan. PMID:18364287

  19. Stereopsis Results at 4.5 Years of Age in the Infant Aphakia Treatment Study

    PubMed Central

    Hartmann, E. Eugenie; Stout, Ann U.; Lynn, Michael J.; Yen, Kimberly G.; Kruger, Stacey J.; Lambert, Scott R.

    2014-01-01

    Purpose To determine whether stereopsis of infants treated for monocular cataracts varies with the type of optical correction used. Design Randomized prospective clinical trial Methods The Infant Aphakia Treatment Study randomized 114 patients with unilateral cataracts at age 1 to 7 months to either primary intraocular lens (IOL) or contact lens correction. At 4.5 years of age a masked examiner assessed stereopsis on these patients using three different tests: 1) Frisby; 2) Randot Preschool; and 3) Titmus fly. Results Twenty-eight patients (25%) had a positive response to at least one of the stereopsis tests. There was no statistically significant difference in stereopsis between the two treatment groups. Frisby (contact lens, 6 (11%); IOL, 7 (13%); p=0.99), Randot (contact lens, 3 (6%); IOL, 1 (2%); p=0.62) or Titmus: (contact lens, 8 (15%); IOL, 13 (23%); p=0.34). The median age at surgery for patients with stereopsis was younger than for those without stereopsis (1.2 versus 2.4 months; p=0.002). The median visual acuity for patients with stereopsis was better than for those without stereopsis (20/40 vs. 20/252; p=0.0003). Conclusion The type of optical correction did not influence stereopsis outcomes. However, two other factors did: age at surgery and visual acuity in the treated eye at age 4.5 years. Early surgery for unilateral congenital cataract and the presence of visual acuity better than or equal to 20/40 appear to be more important than the type of initial optical correction used for the development of stereopsis. PMID:25261241

  20. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    PubMed Central

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  1. Midterm survivorship and clinical outcome of INDUS knee prosthesis: 5 year followup study

    PubMed Central

    Sancheti, Kantilal H; Sancheti, Parag K; Joshi, Rajeev S; Patil, Kailash R; Shyam, Ashok K; Bhaskar, Raja R

    2016-01-01

    Background: INDUS knee implant has been designed as per the anatomical morphology of the Indian population and has shown good clinical outcome in short term studies. The purpose of the present study was to report the midterm survivorship and clinical outcome of this implant. Materials and Methods: Two hundred and twenty three primary total knee arthroplasties in 209 consecutive patients using the INDUS knee prosthesis were prospectively enrolled. There were 145 females (155 knees) and 64 males (68 knees) with a mean age of 69.95 years (range 42–86 years). Annual followup with clinical and radiological examination was conducted, and a survivorship analysis was done using the Kaplan–Meier analysis. Results: Mean followup was 5.8 years (range 5–6.5 years). Eleven patients died while eight were lost to followup and a total of 204 knees were available for followup. The mean knee flexion improved from preoperative 110.4° ± 11.24° (range 60°–130°) to 128.17° ± 8.32° (range 100°–140°) at the final followup. The mean knee score improved from 40.1 ± 10.7 to 90.3 ± 5.34 while the function score improved from 44.35 ± 12.9 to 89.58 ± 7.43. Two patient developed infection and required revision. The Kaplan–Meier analysis reported a survivorship of 98.6% (confidence interval 95.7–99.6%) at the end for 5 years for INDUS knee prosthesis. Conclusion: INDUS knee prosthesis has excellent survivorship with a good clinical outcome and low failure rate. PMID:27053801

  2. Multimodality Local Therapy for Retroperitoneal Sarcoma

    SciTech Connect

    Paryani, Nitesh N.; Zlotecki, Robert A.; Swanson, Erika L.; Morris, Christopher G.; Grobmyer, Stephen R.; Hochwald, Steven N.; Marcus, Robert B.; Indelicato, Daniel J.

    2012-03-01

    Purpose: Soft-tissue sarcomas of the retroperitoneum are rare tumors comprising less than 1% of all malignancies. Although surgery continues as the mainstay of treatment, the large size of these tumors coupled with their proximity to critical structures make resection with wide margins difficult to achieve. The role and timing of radiotherapy are controversial. This study updates our institutional experience using multimodality local therapy for resectable retroperitoneal sarcoma and identifies prognostic factors impacting disease control and survival. Methods and Materials: Between 1974 and 2007, 58 patients with nonmetastatic retroperitoneal sarcoma were treated with surgery and radiation at University of Florida. The median age at radiotherapy was 57 years old (range, 18-80 years). Forty-two patients received preoperative radiotherapy and 16 received postoperative radiotherapy. Nineteen patients received 1.8 Gy once daily and 39 patients received 1.2 Gy twice daily. Variables analyzed for prognostic value included age, grade, kidney involvement, histology, de novo versus recurrent presentation, tumor diameter, margin status, radiotherapy sequencing (preoperative vs. postoperative), total radiation dose, fractionation scheme, and treatment era. Results: The 5-year overall survival, cause-specific survival, and local control rates were 49%, 58%, and 62%, respectively. Nearly two-thirds of disease failures involved a component of local progression. On multivariate analysis, only margin status was significantly associated with improved 5-year local control (85%, negative margins; 63%, microscopic positive margins; 0%, gross positive margins; p < 0.0001) and 5-year overall survival (64%, negative margins; 56%, microscopic positive margins; 13%, gross positive margins; p = 0.0012). Thirty-one Grade 3 or greater toxicities were observed in 22 patients, including two treatment-related deaths (3%). Conclusion: For retroperitoneal sarcoma, local control remains a

  3. Tracking Control of Mobile Robots Localized via Chained Fusion of Discrete and Continuous Epipolar Geometry, IMU and Odometry.

    PubMed

    Tick, David; Satici, Aykut C; Shen, Jinglin; Gans, Nicholas

    2013-08-01

    This paper presents a novel navigation and control system for autonomous mobile robots that includes path planning, localization, and control. A unique vision-based pose and velocity estimation scheme utilizing both the continuous and discrete forms of the Euclidean homography matrix is fused with inertial and optical encoder measurements to estimate the pose, orientation, and velocity of the robot and ensure accurate localization and control signals. A depth estimation system is integrated in order to overcome the loss of scale inherent in vision-based estimation. A path following control system is introduced that is capable of guiding the robot along a designated curve. Stability analysis is provided for the control system and experimental results are presented that prove the combined localization and control system performs with high accuracy. PMID:26502433

  4. Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays: The First 5 Years of Experience With a Novel Approach

    SciTech Connect

    Wenz, Frederik; Welzel, Grit; Blank, Elena; Hermann, Brigitte; Steil, Volker; Suetterlin, Marc; Kraus-Tiefenbacher, Uta

    2010-08-01

    Purpose: Intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS) has been recently introduced using different devices. We report the first 5 years of a single-center experience after introduction of a novel approach to deliver IORT as a tumor bed boost during BCS for breast cancer. Methods and Materials: A total of 155 breast cancers in 154 women (median age, 63 years; range, 30-83 years; T1/T2 = 100/55; N0/N+ = 108/47) were treated between February 2002 and December 2007 at the University Medical Center Mannheim, in whom IORT as tumor bed boost was applied using 50-kV X-rays (20 Gy) followed by 46-50 Gy whole-breast external-beam radiotherapy (EBRT). Chemotherapy, if indicated, was given before EBRT. The median interval between BCS plus IORT and EBRT was 40 days. Median follow-up was 34 months (maximum 80 months, 1 patient lost to follow-up). Overall survival and local relapse-free survival were calculated at 5 years using the Kaplan-Meier method. Seventy-nine patients were evaluated at 3-year follow-up for late toxicity according to the Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic system. Results: Ten patients died, 2 had in-breast relapse, and 8 developed distant metastases (5-year overall survival = 87.0%; 5-year local relapse-free survival = 98.5%). Grade 3 fibroses of the tumor bed were detected in 5% of the patients after 3 years. Skin toxicity was mild (telangiectases and hyperpigmentations in approximately 6% each). Conclusions: Intraoperative radiotherapy as a tumor bed boost during BCS for breast cancer using low-kilovoltage X-rays followed by EBRT yields low recurrence and toxicity rates.

  5. Balancing Local Control and State Responsibility for K-12 Education. Yearbook of the American Education Finance Association, 2000.

    ERIC Educational Resources Information Center

    Theobald, Neil D., Ed.; Malen, Betty, Ed.

    This yearbook's focus is the connection between state responsibility and local control. Its purpose is to analyze the evolving balance between state responsibility for funding K-12 education and local autonomy in operating these schools. The goals of this analysis are twofold; the book seeks to characterize how this relationship has changed, both…

  6. Controlling the Properties of 2D Chiral Fermions and Local Moments in Graphene

    NASA Astrophysics Data System (ADS)

    Killi, Matthew P.

    The primary subject of this thesis is graphene and how the rudimentary attributes of its charge carriers, and local moments on its surface, can be directly manipulated and controlled with electrostatic potentials. We first consider bilayer graphene subject to a spatially varying electrostatic potential that forms two neighbouring regions with opposite interlayer bias. Along the boundary, 1D chiral 'kink' states emerge. We find that these 1D modes behave as a strongly interacting Tomonaga-Luttinger liquid whose properties can be tuned via an external gate. Next, we consider superlattices in bilayer graphene. Superlattices are seen to have a more dramatic effect on bilayer graphene than monolayer graphene because the quasi-particles are changed in a fundamental way; the dispersion goes from a quadratic band touching point to linearly dispersing Dirac cones. We illustrate that a 1D superlattice of either the chemical potential or an interlayer bias generates multiple anisotropic Dirac cones. General arguments delineate how certain symmetries protect the Dirac points. We then map the Hamiltonian of an interlayer bias superlattice onto a coupled chain model comprised of 'topological' edge modes. We then discuss the relevance of spatially varying potentials to recent transport measurements. This is followed by another study that considers the effect of a magnetic field on graphene superlattices. We show that magnetotransport measurements in a weak perpendicular (orbital) magnetic field probe the number of emergent Dirac points and reveal further details about the dispersion. In the case of bilayer graphene, we also discuss the properties of kink states in an applied magnetic field. We then consider the implications of these results with regards to scanning tunnelling spectroscopy, valley filtering, and impurity induced breakdown of the quantum Hall effect. Finally, we investigate local moment formation of adatoms on bilayer graphene using an Anderson impurity model. We

  7. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    PubMed Central

    Peters-Veluthamaningal, Cyriac; Winters, Jan C; Groenier, Klaas H; Meyboom-deJong, Betty

    2009-01-01

    Background De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local corticosteroid injections for de Quervain's tenosynovitis provided by general practitioners was assessed. Methods Participants with de Quervain's tenosynovitis were recruited by general practitioners. Short-term outcomes (one week after injections) were assessed in a randomised, placebo-controlled trial. Long-term effectiveness was evaluated in an open prospective cohort-study of steroid responders during a follow-up period of 12 months. Participants were randomised to one or two local injections of 1 ml of triamcinolonacetonide (TCA) or 1 ml of NaCl 0.9% (placebo). Non-responders to NaCl were treated with additional TCA injections. Main outcomes were immediate treatment response, severity of pain, improvement as perceived by participant and functional disability using sub items hand and finger function of the Dutch Arthritis Impact Measurement Scale (Dutch AIMS-2-HFF). Results 11 general practitioners included 21 wrists in 21 patients. The TCA-group had better results for short-term outcomes treatment response (78% vs. 25%; p = 0.015), perceived improvement (78% vs. 33%; p = 0.047) and severity of pain (4.27 vs. 1.33; p = 0.031) but not for the Dutch-AIMS-HFF (2.71 vs. 1.92; p = 0.112). Absolute risk reduction for the main outcome short-term treatment response was 0.55 (95% CI: 0.34, 0.76) with a number needed to treat of 2 (95% CI: 1, 3). In the cohort of steroid responders (n = 12) the beneficial effects of steroid injections were sustained during the follow-up of 12 months regarding severity of pain (p = 0.67) and scores of Dutch AIMS-2-HFF (p = 0.36), but not for patient perceived improvement (p = 0.02). No adverse events were observed during the 12 months of follow

  8. Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up

    PubMed Central

    Jahanimoghadam, Fatemeh; Pishbin, Lida; Rad, Maryam

    2016-01-01

    Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her familial history was negative for any genetic anomaly, regional odontodysplasia or other dental anomalies. The patient’s general health was good and no congenital or acquired disease was reported. She was kept under follow-up care until she reached the age of 10 years. Panoramic radiograph showed the involvement of permanent teeth on the right maxillary quadrant. The affected edentulous quadrant was rehabilitated with temporary acrylic maxillary partial denture. The presentation of this case would hopefully have valuable information for pediatric dentists to review the clinical and radiographic features of regional odontodysplasia, yet expediting the diagnosis and treatment of patients with this condition. PMID:27284563

  9. Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up.

    PubMed

    Jahanimoghadam, Fatemeh; Pishbin, Lida; Rad, Maryam

    2016-06-01

    Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her familial history was negative for any genetic anomaly, regional odontodysplasia or other dental anomalies. The patient's general health was good and no congenital or acquired disease was reported. She was kept under follow-up care until she reached the age of 10 years. Panoramic radiograph showed the involvement of permanent teeth on the right maxillary quadrant. The affected edentulous quadrant was rehabilitated with temporary acrylic maxillary partial denture. The presentation of this case would hopefully have valuable information for pediatric dentists to review the clinical and radiographic features of regional odontodysplasia, yet expediting the diagnosis and treatment of patients with this condition. PMID:27284563

  10. Observation by SEM/EDXS of leached layers on SRL-165 glass from 5-year MIIT test

    SciTech Connect

    Macedo, P.B.; Buechele, A.C.

    1993-12-31

    Long-term tests on the durability of nuclear waste glasses, both under laboratory conditions and in actual burial environments, have shown that after periods of several months or years the rates of glass corrosion can show unexpected increases. In burial tests in brine environments the growth of the thickness of the surface layer during years 3 to 5 as revealed by SIMS and SEM measurements was found to be faster than expected on the basis of findings during the first 2 years. In this paper we report on our SEM-EDXS observations of a 5 year burial sample of SRL-165 glass from the MIIT test, and compare our findings to those of other studies, especially SIMS measurements. Our average thickness measurement for the leached layer at the glass-metal interface is 3.70 {mu}m, but wide variation is observed, as well as evidence of partial loss of the leached layer in some areas. A thicker, better retained layer is observed on the glass-brine interface near the core heater averaging 8 to 12 {mu}m in thickness with occasional local attack producing leached layers of greater depth, in one case nearly 40 {mu}m. These findings show that it is important to extend durability tests to long periods in order to establish a reliable basis for predictive modeling of long-term glass durability.

  11. 75 FR 57492 - Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year Annual PHA Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year... public comments on the subject proposal. PHAs are required to submit annual and 5-Year Plans to HUD as required by section 5A of the United States Housing Act of 1937 (42 U.S.C. 1437c-1) The purpose of the...

  12. 75 FR 38979 - Endangered and Threatened Species; Initiation of a 5-Year Review of the Eastern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-07

    ... for the eastern Distinct Population Segment of the Steller sea lion (75 FR 37385). NMFS inadvertently... of a 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY... of a 5-year review of the eastern Distinct Population Segment (DPS) of the Steller Sea...

  13. Industry Speed Bumps on Local Tobacco Control in Japan? The Case of Hyogo

    PubMed Central

    Yamada, Keiko; Mori, Nagisa; Kashiwabara, Mina; Yasuda, Sakiko; Horie, Rumi; Yamato, Hiroshi; Garçon, Loic; Armada, Francisco

    2015-01-01

    Background Despite being a signatory since 2004, Japan has not yet fully implemented Article 8 of the World Health Organization’s Framework Convention on Tobacco Control regarding 100% protection against exposure to second-hand smoke (SHS). The Japanese government still recognizes designated smoking rooms (DSRs) in public space as a valid control measure. Furthermore, subnational initiatives for tobacco control in Japan are of limited effectiveness. Through an analysis of the Hyogo initiative in 2012, we identified key barriers to the achievement of a smoke-free environment. Methods Using a descriptive case-study approach, we analyzed the smoke-free policy development process. The information was obtained from meeting minutes and other gray literature, such as public records, well as key informant interviews. Results Hyogo Prefecture established a committee to propose measures against SHS, and most committee members agreed with establishing completely smoke-free environments. However, the hospitality sector representatives opposed regulation, and tobacco companies were allowed to make a presentation to the committee. Further, political power shifted against completely smoke-free environments in the context of upcoming local elections, which was an obvious barrier to effective regulation. Throughout the approving process, advocacy by civil society for stronger regulation was weak. Eventually, the ordinance approved by the Prefectural Assembly was even weaker than the committee proposal and included wide exemptions. Conclusions The analysis of Hyogo’s SHS control initiative shed light on three factors that present challenges to implementing tobacco control regulations in Japan, from which other countries can also draw lessons: incomplete national legislation, the weakness of advocacy by the civil society, and the interference of the tobacco industry. PMID:26155758

  14. LOCAL CASE-CONTROL SAMPLING: EFFICIENT SUBSAMPLING IN IMBALANCED DATA SETS

    PubMed Central

    Fithian, William; Hastie, Trevor

    2014-01-01

    For classification problems with significant class imbalance, subsampling can reduce computational costs at the price of inflated variance in estimating model parameters. We propose a method for subsampling efficiently for logistic regression by adjusting the class balance locally in feature space via an accept–reject scheme. Our method generalizes standard case-control sampling, using a pilot estimate to preferentially select examples whose responses are conditionally rare given their features. The biased subsampling is corrected by a post-hoc analytic adjustment to the parameters. The method is simple and requires one parallelizable scan over the full data set. Standard case-control sampling is inconsistent under model misspecification for the population risk-minimizing coefficients θ*. By contrast, our estimator is consistent for θ* provided that the pilot estimate is. Moreover, under correct specification and with a consistent, independent pilot estimate, our estimator has exactly twice the asymptotic variance of the full-sample MLE—even if the selected subsample comprises a miniscule fraction of the full data set, as happens when the original data are severely imbalanced. The factor of two improves to 1+1c if we multiply the baseline acceptance probabilities by c > 1 (and weight points with acceptance probability greater than 1), taking roughly 1+c2 times as many data points into the subsample. Experiments on simulated and real data show that our method can substantially outperform standard case-control subsampling. PMID:25492979

  15. Predictors of Individual Tumor Local Control After Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Brain Metastases

    SciTech Connect

    Garsa, Adam A.; Badiyan, Shahed N.; DeWees, Todd; Simpson, Joseph R.; Huang, Jiayi; Drzymala, Robert E.; Barani, Igor J.; Dowling, Joshua L.; Rich, Keith M.; Chicoine, Michael R.; Kim, Albert H.; Leuthardt, Eric C.; Robinson, Clifford G.

    2014-10-01

    Purpose: To evaluate local control rates and predictors of individual tumor local control for brain metastases from non-small cell lung cancer (NSCLC) treated with stereotactic radiosurgery (SRS). Methods and Materials: Between June 1998 and May 2011, 401 brain metastases in 228 patients were treated with Gamma Knife single-fraction SRS. Local failure was defined as an increase in lesion size after SRS. Local control was estimated using the Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis. Receiver operating characteristic analysis was used to identify an optimal cutpoint for conformality index relative to local control. A P value <.05 was considered statistically significant. Results: Median age was 60 years (range, 27-84 years). There were 66 cerebellar metastases (16%) and 335 supratentorial metastases (84%). The median prescription dose was 20 Gy (range, 14-24 Gy). Median overall survival from time of SRS was 12.1 months. The estimated local control at 12 months was 74%. On multivariate analysis, cerebellar location (hazard ratio [HR] 1.94, P=.009), larger tumor volume (HR 1.09, P<.001), and lower conformality (HR 0.700, P=.044) were significant independent predictors of local failure. Conformality index cutpoints of 1.4-1.9 were predictive of local control, whereas a cutpoint of 1.75 was the most predictive (P=.001). The adjusted Kaplan-Meier 1-year local control for conformality index ≥1.75 was 84% versus 69% for conformality index <1.75, controlling for tumor volume and location. The 1-year adjusted local control for cerebellar lesions was 60%, compared with 77% for supratentorial lesions, controlling for tumor volume and conformality index. Conclusions: Cerebellar tumor location, lower conformality index, and larger tumor volume were significant independent predictors of local failure after SRS for brain metastases from NSCLC. These results warrant further investigation in a prospective

  16. [Enteropathogens associated with diarrheal disease in infants (< 5 years old) in a population sample in Greater Metropolitan Criciúma, Santa Catarina State, Brazil].

    PubMed

    Schnack, Felice Jaqueline; Fontana Ld, Lidiani de Medeiros; Barbosa, Paulo Roberto; Silva, Loraine Storch Meyer da; Baillargeon, Clair Maria Martinello; Barichello, Tatiana; Póvoa, Marinete Marins; Cavasini, Carlos Eug nio; Machado, Ricardo Luiz Dantas

    2003-01-01

    Enteropathogens were investigated in 94 children with diarrhea and 45 age-matched controls, 0 to 5 years old, attending an outpatient unit in Criciúma, Santa Catarina State, Brazil. Cryptosporidium (85.1%) topped the list of parasite isolates, followed by Entamoeba histolytica (56.4%) and Giardia lamblia (4.3%). Four samples contained enteropathogenic Escherichia coli (4.3%). Samonella and Shiguella were not detected. Only one sample contained rotavirus (1.1%). PMID:12973585

  17. Excellent local control with IOERT and postoperative EBRT in high grade extremity sarcoma: results from a subgroup analysis of a prospective trial

    PubMed Central

    2014-01-01

    Background To report the results of a subgroup analysis of a prospective phase II trial focussing on radiation therapy and outcome in patients with extremity soft tissue sarcomas (STS). Methods Between 2005 and 2010, 50 patients (pts) with high risk STS (size ≥ 5 cm, deep/extracompartimental location, grade II-III (FNCLCC)) were enrolled. The protocol comprised 4 cycles of neoadjuvant chemotherapy with EIA (etoposide, ifosfamide and doxorubicin), definitive surgery with IOERT, postoperative EBRT and 4 adjuvant cycles of EIA. 34 pts, who suffered from extremity tumors and received radiation therapy after limb-sparing surgery, formed the basis of this subgroup analysis. Results Median follow-up from inclusion was 48 months in survivors. Margin status was R0 in 30 pts (88%) and R1 in 4 pts (12%). IOERT was performed as planned in 31 pts (91%) with a median dose of 15 Gy, a median electron energy of 6 MeV and a median cone size of 9 cm. All patients received postoperative EBRT with a median dose of 46 Gy after IOERT or 60 Gy without IOERT. Median time from surgery to EBRT and median EBRT duration was 36 days, respectively. One patient developed a local recurrence while 11 patients showed nodal or distant failures. The estimated 5-year rates of local control, distant control and overall survival were 97%, 66% and 79%, respectively. Postoperative wound complications were found in 7 pts (20%), resulting in delayed EBRT (>60 day interval) in 3 pts. Acute radiation toxicity mainly consisted of radiation dermatitis (grade II: 24%, no grade III reactions). 4 pts developed grade I/II radiation recall dermatitis during adjuvant chemotherapy, which resolved during the following cycles. Severe late toxicity was observed in 6 pts (18%). Long-term limb preservation was achieved in 32 pts (94%) with good functional outcome in 81%. Conclusion Multimodal therapy including IOERT and postoperative EBRT resulted in excellent local control and good overall survival in

  18. Positron Emission Tomography (PET) Evaluation After Initial Chemotherapy and Radiation Therapy Predicts Local Control in Rhabdomyosarcoma

    SciTech Connect

    Dharmarajan, Kavita V.; Wexler, Leonard H.; Gavane, Somali; Fox, Josef J.; Schoder, Heiko; Tom, Ashlyn K.; Price, Alison N.; Meyers, Paul A.; Wolden, Suzanne L.

    2012-11-15

    Purpose: 18-fluorodeoxyglucose positron emission tomography (PET) is already an integral part of staging in rhabdomyosarcoma. We investigated whether primary-site treatment response characterized by serial PET imaging at specific time points can be correlated with local control. Patients and Methods: We retrospectively examined 94 patients with rhabdomyosarcoma who received initial chemotherapy 15 weeks (median) before radiotherapy and underwent baseline, preradiation, and postradiation PET. Baseline PET standardized uptake values (SUVmax) and the presence or absence of abnormal uptake (termed PET-positive or PET-negative) both before and after radiation were examined for the primary site. Local relapse-free survival (LRFS) was calculated according to baseline SUVmax, PET-positive status, and PET-negative status by the Kaplan-Meier method, and comparisons were tested with the log-rank test. Results: The median patient age was 11 years. With 3-year median follow-up, LRFS was improved among postradiation PET-negative vs PET-positive patients: 94% vs 75%, P=.02. By contrast, on baseline PET, LRFS was not significantly different for primary-site SUVmax {<=}7 vs >7 (median), although the findings suggested a trend toward improved LRFS: 96% for SUVmax {<=}7 vs 79% for SUVmax >7, P=.08. Preradiation PET also suggested a statistically insignificant trend toward improved LRFS for PET-negative (97%) vs PET-positive (81%) patients (P=.06). Conclusion: Negative postradiation PET predicted improved LRFS. Notably, 77% of patients with persistent postradiation uptake did not experience local failure, suggesting that these patients could be closely followed up rather than immediately referred for intervention. Negative baseline and preradiation PET findings suggested statistically insignificant trends toward improved LRFS. Additional study may further understanding of relationships between PET findings at these time points and outcome in rhabdomyosarcoma.

  19. Tele-Autonomous control involving contact. Final Report Thesis; [object localization

    NASA Technical Reports Server (NTRS)

    Shao, Lejun; Volz, Richard A.; Conway, Lynn; Walker, Michael W.

    1990-01-01

    Object localization and its application in tele-autonomous systems are studied. Two object localization algorithms are presented together with the methods of extracting several important types of object features. The first algorithm is based on line-segment to line-segment matching. Line range sensors are used to extract line-segment features from an object. The extracted features are matched to corresponding model features to compute the location of the object. The inputs of the second algorithm are not limited only to the line features. Featured points (point to point matching) and featured unit direction vectors (vector to vector matching) can also be used as the inputs of the algorithm, and there is no upper limit on the number of the features inputed. The algorithm will allow the use of redundant features to find a better solution. The algorithm uses dual number quaternions to represent the position and orientation of an object and uses the least squares optimization method to find an optimal solution for the object's location. The advantage of using this representation is that the method solves for the location estimation by minimizing a single cost function associated with the sum of the orientation and position errors and thus has a better performance on the estimation, both in accuracy and speed, than that of other similar algorithms. The difficulties when the operator is controlling a remote robot to perform manipulation tasks are also discussed. The main problems facing the operator are time delays on the signal transmission and the uncertainties of the remote environment. How object localization techniques can be used together with other techniques such as predictor display and time desynchronization to help to overcome these difficulties are then discussed.

  20. The Redox State of SECIS Binding Protein 2 Controls Its Localization and Selenocysteine Incorporation Function

    PubMed Central

    Papp, Laura V.; Lu, Jun; Striebel, Frank; Kennedy, Derek; Holmgren, Arne; Khanna, Kum Kum

    2006-01-01

    Selenoproteins are central controllers of cellular redox homeostasis. Incorporation of selenocysteine (Sec) into selenoproteins employs a unique mechanism to decode the UGA stop codon. The process requires the Sec insertion sequence (SECIS) element, tRNASec, and protein factors including the SECIS binding protein 2 (SBP2). Here, we report the characterization of motifs within SBP2 that regulate its subcellular localization and function. We show that SBP2 shuttles between the nucleus and the cytoplasm via intrinsic, functional nuclear localization signal and nuclear export signal motifs and that its nuclear export is dependent on the CRM1 pathway. Oxidative stress induces nuclear accumulation of SBP2 via oxidation of cysteine residues within a redox-sensitive cysteine-rich domain. These modifications are efficiently reversed in vitro by human thioredoxin and glutaredoxin, suggesting that these antioxidant systems might regulate redox status of SBP2 in vivo. Depletion of SBP2 in cell lines using small interfering RNA results in a decrease in Sec incorporation, providing direct evidence for its requirement for selenoprotein synthesis. Furthermore, Sec incorporation is reduced substantially after treatment of cells with agents that cause oxidative stress, suggesting that nuclear sequestration of SBP2 under such conditions may represent a mechanism to regulate the expression of selenoproteins. PMID:16782878