Science.gov

Sample records for 5-year local control

  1. AB020. Thoracoscopy under local anesthesia, the 5-year experience of a single center

    PubMed Central

    Efthymiou, Christopher; Spiratos, Dionisios; Iakovidis, Dimitrios; Spyropoulos, George; Voudrislis, Grigoris; Kontakiotis, Theodoros

    2016-01-01

    Background This is a retrospective analysis of the histological reports and the diagnostic ability of thoracoscopy under local anesthesia (medical thoracoscopy) in a single center with 5-year experience (2011–2016). Methods We assessed the histological results of all thoracoscopies that were performed at the endoscopy suite of the respiratory system at General Hospital “G. Papanikolaou”, Thessaloniki, Greece. All patients suffered from undiagnosed exudative pleural effusion with at least two cytology tests negative for malignancy. The thoracoscopies were performed using the single-port method with a rigid thoracoscope 10 mm (HOPKINS Straight Forward Telescope 00, with angled eyepiece, diameter 10 mm, length 27 cm, with 6 mm working channel, KARL STORZ). Results A total of 133 thoracoscopies were performed during the study period (1/11/2011–5/10/2016). In seven cases no biopsy was taken (failure to enter the pleural cavity due to adhesions, refusal of the patient, respiratory arrest). The diagnoses that were set for the rest of cases (126 patients) were: lung adenocarcinoma (27 patients, 21%), mesothelioma (20 patients, 16%), other malignant pleurisy (18 patients, 14%) nonspecific chronic inflammatory pleurisy (54 patients, 43%), tuberculous pleurisy (4 patients, 3%) and para-malignant effusion (3 patients, 2%). The diagnosis of malignant pleurisy was made in a total of 63 patients (50%). In patients with other malignancies the distribution was: breast adenocarcinoma (3), adenocarcinoma of the gastrointestinal system (3), reproductive system adenocarcinoma (1), carcinoma of unknown primary site (4), other lung carcinomas (5, large cell: 2; neuroendocrine: 1; squamous: 1; small cell: 1), melanoma (1) and giant cell carcinoma (1). Three patients with nonspecific chronic inflammation were eventually diagnosed with a malignancy (in 2: lung adenocarcinoma on the basis of cytology test of fluid and in 1: mesothelioma on the basis of open biopsy). Conclusions

  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. HIFU therapy for local recurrence of prostate cancer after external beam radiotherapy and radical prostatectomy - 5,5 years experience

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

    Objectives. To evaluate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) for local recurrence of prostate cancer after external beam radiotherapy (EBRT) and radical prostatectomy (RPE). Materials and Methods: During 2007-2013 years 47 patients with local recurrence of prostate cancer after EBRT and RPE undertook HIFU therapy on the system "Ablaterm» (EDAP, France). Relapse arose after an average of 2 years after EBRT and RPE. Median follow-up after HIFU therapy was 38 (12-60) months. The mean age was 68.5 ± 5.8 years. The median PSA level before HIFU - 15.4 (7-48) ng / mL. Results: In 34 patients (72.3%) at six months after treatment the median PSA was 0.4 (0-3.2) ng / mL, in 48 months - 0.9 (0.4-7.5) ng / mL. In 13 patients (27.7%) at 6 months was observed progression of the disease. In general, after a 5-year follow-up 72.3% of the patients had no data for the progression and recurrence. Conclusion: HIFU therapy in patients with local recurrence of prostate cancer after EBRT and RPE is minimally invasive and effective technology.

  4. Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

    PubMed Central

    Fuller, Donald Blake; Naitoh, John; Mardirossian, George

    2014-01-01

    Purpose: Prostate stereotactic body radiotherapy (SBRT) may substantially recapitulate the dose distribution of high-dose-rate (HDR) brachytherapy, representing an externally delivered “Virtual HDR” treatment method. Herein, we present 5-year outcomes from a cohort of consecutively treated virtual HDR SBRT prostate cancer patients. Methods: Seventy-nine patients were treated from 2006 to 2009, 40 low-risk, and 39 intermediate-risk, under IRB-approved clinical trial, to 38 Gy in four fractions. The planning target volume (PTV) included prostate plus a 2-mm volume expansion in all directions, with selective use of a 5-mm prostate-to-PTV expansion and proximal seminal vesicle coverage in intermediate-risk patients, to better cover potential extraprostatic disease; rectal PTV margin reduced to zero in all cases. The prescription dose covered >95% of the PTV (V100 ≥95%), with a minimum 150% PTV dose escalation to create “HDR-like” PTV dose distribution. Results: Median pre-SBRT PSA level of 5.6 ng/mL decreased to 0.05 ng/mL 5 years out and 0.02 ng/mL 6 years out. At least one PSA bounce was seen in 55 patients (70%) but only 3 of them subsequently relapsed, biochemical-relapse-free survival was 100 and 92% for low-risk and intermediate-risk patients, respectively, by ASTRO definition (98 and 92% by Phoenix definition). Local relapse did not occur, distant metastasis-free survival was 100 and 95% by risk-group, and disease-specific survival was 100%. Acute and late grade 2 GU toxicity incidence was 10 and 9%, respectively; with 6% late grade 3 GU toxicity. Acute urinary retention did not occur. Acute and late grade 2 GI toxicity was 0 and 1%, respectively, with no grade 3 or higher toxicity. Of patient’s potent pre-SBRT, 65% remained so at 5 years. Conclusion: Virtual HDR prostate SBRT creates a very low PSA nadir, a high rate of 5-year disease-free survival and an acceptable toxicity incidence, with results closely resembling those reported

  5. A 5-year follow-up study on one-stage implants inserted concomitantly with localized alveolar ridge augmentation.

    PubMed

    Juodzbalys, G; Raustia, A M; Kubilius, R

    2007-10-01

    The aim of this study was to evaluate the success of one-stage implants placed at the time of alveolar bone augmentation using simultaneous guided bone regeneration technique with a collagen barrier membrane in patients suffering from insufficient bone width. Seventeen patients were treated with 20 one-stage OSTEOFIX (Oulu, Finland) implants using simultaneous guided bone regeneration technique. Dehiscence defects were filled by bovine bone mineral Bio-Oss and covered with collagen membrane. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1- and 5-year follow-ups. Diagnostic dehiscence defect measurements after implant placement showed that the mean vertical defect varied from 3.8 mm to 10.0 mm. At the moment of prosthesis placement and at 1- and 5-year follow-ups all implants were stable, painless and without biological complications. Clinical and radiographic parameters of the peri-implant conditions remained stable during follow-up. The cumulative implant survival rate was 100% after the 5-year observation period and the success rate for all pooled implants was 90%. The present study showed predictable treatment outcomes recorded after 5 years of function for one-stage OSTEOFIX (Oulu, Finland) oral implants placed simultaneously with guided bone regeneration using collagen membrane and deproteinized bovine bone mineral.

  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. [African schistosomiasis at the invasion stage. Criteria for diagnosis. Control after 5 years (author's transl)].

    PubMed

    Laverdant, C; Thabaut, A; Hardelin, J; Cristau, P; Molinie, C; Durosoir, J L; Essioux, H; Daly, J P; Larroque, P; Cathalan, G

    1980-01-01

    The authors expose their conclusions after controlling 181 young soldiers affected by schistosomiasis in an epidemic having occured in Tchad en 1973-74, none of them having been later on submitted to parasitic infection: --relative value of classical diagnosis criteria (50 p. 100); --reliability of immunologic symptoms; -- frequency, importance and precocity of specific granulomatous hepatic changes, detected by laparoscopie and biopsy (87,2 p. 100 of the cases). The value of niridazole is confirmed but continuance of granulomatosis after clinical recovery is not an exceptionnal possibility five years after the treatment, then raising diagnostic and immunologic problems.

  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. 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)

  11. 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.

  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. Developmental milestones record - 5 years

    MedlinePlus

    ... Childhood growth milestones - 5 years; Growth milestones for children - 5 years; Well child - 5 years ... skill milestones for a typical 5-year-old child include: Gains about 4 to 5 pounds (1. ...

  14. Alternative endpoints to the 5-year overall survival and locoregional control for nasopharyngeal carcinoma: A retrospective analysis of 2,450 patients.

    PubMed

    Chen, Chen; Yi, Wei; Gao, Jin; Li, Xiao-Hui; Shen, Lu-Jun; Li, Bo-Fei; Tu, Zi-Wei; Tao, Ya-Lan; Jiang, Chang-Bin; Xia, Yun-Fei

    2014-05-01

    The purpose of the present study was to investigate alternative endpoints to the 5-year overall survival (OS) and locoregional control (LRC) for nasopharyngeal carcinoma (NPC). A total of 2,450 NPC patients were enrolled in this study, including 1,842 patients treated with two-dimensional (2D) radiotherapy (RT), 451 treated with 3D conformal RT (CRT) and 157 treated with intensity-modulated RT (IMRT). We sequentially calculated the 1-, 2-, 3- and 4-year survival rates using a life table and compared these with the 5-year survival rate using the McNemar method, with the survival rate of the last indifferent comparison being considered as the alternative endpoint. For 2D RT, stage I patients exhibited similar survival rates at 1 and 5 years (98.9 vs. 94.4%, respectively; P=0.125 for both OS and LRC); stage N3 patients exhibited similar 4-year OS (55.2 vs. 53.5%; P=1.000) and 2-year LRC (78.3 vs. 71.2%; P=0.125) to the 5-year OS and LRC. For IMRT, the 1-, 2-, 3-, 4- and 5-year OS and LRC rates in stage I/II NPC patients were 100, 98, 96, 94 and 94% for OS and 100, 98, 96, 96 and 96% for LRC, respectively. No significant differences were observed for all the comparisons. For stage III/IV NPC patients treated with IMRT, the 1-, 2-, 3-, 4- and 5-year rates were 99.1, 96.3, 92.5, 88.8 and 85.0% for OS and 98.1, 97.2, 95.3, 90.7 and 89.7% for LRC, respectively. Only the 4-year OS and LRC rates were indifferent from those at 5 years (P=0.125 for OS and P=1.00 for LRC). In conclusion, the 1-year OS and LRC for stage I NPC patients treated with 2D RT or stage I/II NPC patients treated with IMRT, the 4-year OS and 2-year LRC for stage N3 NPC patients treated with 2D RT and the 4-year OS and LRC for stage III/IV NPC patients treated with IMRT were determined as the alternative endpoints to the 5-year OS and LRC for NPC patients.

  15. 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…

  16. A 5-year prospective case-control study of the influence of early otitis media with effusion on reading achievement.

    PubMed

    Lous, J; Fiellau-Nikolajsen, M

    1984-10-01

    In a still ongoing prospective longitudinal study, more than 500 children--a total birth-cohort in a Danish municipality--were followed from their 3rd to their 9th year of life by multiple impedance tests in order to investigate a number of factors concerning epidemiology and long-term impacts of otitis media with effusion. This is a report on the influence of otitis media with effusion early in life on reading achievement. The study revealed no difference in school-class level between the 9% of the children (n = 46) who constantly had abnormal tympanometry during a 6-month period at the age of 3, and the other pupils in the municipality. At the Silent Reading Test (OS-400), done on 40 of the 46 case-pupils the results did not differ from (1) the other pupils in the municipality, (2) from other pupils of the same sex in the same classroom, or (3) from individual control-pupils matched by sex, social group and classroom.

  17. 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

  18. Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: a randomized controlled trial.

    PubMed

    Parra, Olga; Sánchez-Armengol, Ángeles; Capote, Francisco; Bonnin, Marc; Arboix, Adrià; Campos-Rodríguez, Francisco; Pérez-Ronchel, José; Durán-Cantolla, Joaquín; Martínez-Null, Cristina; de la Peña, Mónica; Jiménez, Maria Carmen; Masa, Fernando; Casadon, Ignacio; Alonso, Maria Luz; Macarrón, José L

    2015-02-01

    The main purpose of the present analysis is to assess the influence of introducing early nasal continuous positive airway pressure (nCPAP) treatment on cardiovascular recurrences and mortality in patients with a first-ever ischaemic stroke and moderate-severe obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) ≥20 events h(-1) during a 5-year follow-up. Patients received conventional treatment for stroke and were assigned randomly to the nCPAP group (n = 71) or the control group (n = 69). Cardiovascular events and mortality were registered for all patients. Survival and cardiovascular event-free survival analysis were performed after 5-year follow-up using the Kaplan-Meier test. Patients in the nCPAP group had significantly higher cardiovascular survival than the control group (100 versus 89.9%, log-rank test 5.887; P = 0.015) However, and also despite a positive tendency, there were no significant differences in the cardiovascular event-free survival at 68 months between the nCPAP and control groups (89.5 versus 75.4%, log-rank test 3.565; P = 0.059). Early nCPAP therapy has a positive effect on long-term survival in ischaemic stroke patients and moderate-severe OSA.

  19. Local control stations

    SciTech Connect

    Brown, W.S.; Higgins, J.C.; Wachtel, J.A.

    1993-05-01

    This paper describes research concerning the effects of human engineering design at local control stations (i.e., operator interfaces located outside the control room) on human performance and plant safety. The research considered both multifunction panels (e.g. remote shutdown panels) as well as single-function interfaces (e.g., valves, breakers, gauges, etc.). Changes in performance shaping factors associated with variations in human engineering at LCSs were estimated based on expert opinion. By means of a scaling procedure, these estimates were used to modify the human error probabilities in a PRA model, which was then employed to generate estimates of plant risk and scoping-level value/impact ratios for various human engineering upgrades. Recent documentation of human engineering deficiencies at single-function LCSs was also reviewed, and an assessment of the current status of LCSs with respect to human engineering was conducted.

  20. Aging in Sweden: local variation, local control.

    PubMed

    Davey, Adam; Malmberg, Bo; Sundström, Gerdt

    2014-08-01

    Aging in Sweden has been uniquely shaped by its history-most notably the long tradition of locally controlled services for older adults. We considered how local variations and local control shape the experience of aging in Sweden and organized the paper into 3 sections. First, we examine aging in Sweden along demography, economy, and housing. Next, we trace the origins and development of the Swedish welfare state to consider formal supports (service provision) and informal supports (caregiving and receipt of care). Finally, we direct researchers to additional data resources for understanding aging in Sweden in greater depth. Sweden was one of the first countries to experience rapid population aging. Quality of life for a majority of older Swedes is high. Local control permits a flexible and adaptive set of services and programs, where emphasis is placed on improving the quality and targeting of services that have already reached a plateau as a function of population and expenditures.

  1. Global and local processing in adult humans (Homo sapiens), 5-year-old children (Homo sapiens), and adult cotton-top tamarins (Saguinus oedipus).

    PubMed

    Neiworth, Julie J; Gleichman, Amy J; Olinick, Anne S; Lamp, Kristen E

    2006-11-01

    This study compared adults (Homo sapiens), young children (Homo sapiens), and adult tamarins (Saguinus oedipus) while they discriminated global and local properties of stimuli. Subjects were trained to discriminate a circle made of circle elements from a square made of square elements and were tested with circles made of squares and squares made of circles. Adult humans showed a global bias in testing that was unaffected by the density of the elements in the stimuli. Children showed a global bias with dense displays but discriminated by both local and global properties with sparse displays. Adult tamarins' biases matched those of the children. The striking similarity between the perceptual processing of adult monkeys and humans diagnosed with autism and the difference between this and normatively developing human perception is discussed.

  2. 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

  3. 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

  4. Exaggerated morning blood pressure surge and cardiovascular events. A 5-year longitudinal study in normotensive and well-controlled hypertensive elderly.

    PubMed

    Amici, A; Cicconetti, P; Sagrafoli, C; Baratta, A; Passador, P; Pecci, T; Tassan, G; Verrusio, W; Marigliano, V; Cacciafesta, M

    2009-01-01

    Cardiovascular events (CE) occur most frequently in the morning hours in hypertensive subjects. We studied the association between the morning blood pressure (BP) surge and CE in prognosis of 10 normotensive and 32 well-controlled hypertensive elderly, in whom ambulatory BP monitoring was performed and who were followed prospectively for 5 years. The morning surge (MS) of BP was calculated as mean systolic BP during 2h after awakening--mean systolic BP during 1h that included the lowest sleep BP. During an average of 60 months, five CE occurred. When the patients were divided into two groups according to MS, those in the top terzile (MS group; MS> or =34 mmHg, n=14) had a higher prevalence of CE (5 versus 0, p=0.001) during the follow-up period, than the others (non-MS group; MS<34 mmHg, n=28). The logistic regression analysis showed the MS sleep-trough surge as predictive variable of CE (odds ratio, OR=0.794, p=0.022). In conclusion, in older normotensives and well-controlled hypertensives, a higher BP MS is associated with vascular risk independently of clinical and ambulatory BP. Reduction of the MS could thus be a therapeutic target for preventing vascular events also in non-hypertensive patients.

  5. 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.

  6. Community Control of Local Radio.

    ERIC Educational Resources Information Center

    Lewis, Peter M.

    This study was designed to determine to what extent local communities control the local radio which serves them, by what formal mechanisms their control is secured, and the underlying assumptions and goals which govern the practice of the professionals who have charge of the facilities. Two British radio stations, BBC Radio Bristol and the…

  7. 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

  8. 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

  9. 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.

  10. 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

  11. A randomized, double-blind, placebo-controlled noninferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age

    PubMed Central

    Le Saux, Nicole; Gaboury, Isabelle; Baird, Marian; Klassen, Terry P.; MacCormick, Johnna; Blanchard, Colline; Pitters, Carrol; Sampson, Margaret; Moher, David

    2005-01-01

    Objectives Debate continues with respect to a “watch and wait” approach versus immediate antibiotic treatment for the initial treatment of acute otitis media. In this double-blind noninferiority trial, we compared clinical improvement rates at 14 days for children (6 months to 5 years of age) with acute otitis media who were randomly assigned to receive amoxicillin or placebo. Methods We enrolled healthy children who presented to clinics or the emergency department with a new episode of acute otitis media during the fall and winter months in Ottawa (from December 1999 to the end of March 2002). The children were randomly assigned to receive amoxicillin (60 mg/kg daily) or placebo for 10 days. Telephone follow-up was performed on each of days 1, 2 and 3 and once between day 10 and day 14. The primary outcome was clinical resolution of symptoms, defined as absence of receipt of an antimicrobial (other than the amoxicillin in the treatment group) at any time during the 14-day period. Secondary outcomes were the presence of pain and fever and the activity level in the first 3 days, recurrence rates, and the presence of middle ear effusion at 1 and 3 months. Results According to clinical scoring, 415 of the 512 children who could be evaluated had moderate disease. At 14 days 84.2% of the children receiving placebo and 92.8% of those receiving amoxicillin had clinical resolution of symptoms (absolute difference –8.6%, 95% confidence interval –14.4% to –3.0%). Children who received placebo had more pain and fever in the first 2 days. There were no statistical differences in adverse events between the 2 groups, nor were there any significant differences in recurrence rates or middle ear effusion at 1 and 3 months. Interpretation Our results did not support the hypothesis that placebo was noninferior to amoxicillin (i.e., that the 14-day cure rates among children with clinically diagnosed acute otitis media would not be substantially worse in the placebo group

  12. 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…

  13. 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

  14. 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.

  15. 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

  16. [Fissure sealants--5 years of use].

    PubMed

    Azul, A M

    1990-01-01

    This study assesses the caries prevalence, retention and cost-effectiveness of a pit and fissure sealant in a children population with 622 cases, 5 years after a single application of an auto-polymerized sealant to permanent molars. The status of the sealant and the presence of caries or restaurations on the sealed teeth was assessed. In a self-controlled group of children, the prevalence of disease (caries and restaurations) was also assessed in non-sealed teeth, for comparison. The sealant application was compared with Class I-restauration with amalgam for cost-effectiveness analysis.

  17. 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

  18. Radiation, hormonotherapy, survival and local control in prostatic carcinoma.

    PubMed

    Cellini, N; Luzi, S; Morganti, A G; Smaniotto, D; Niespolo, R M; Valentini, V

    1998-01-01

    The combination of concomitant external beam radiotherapy (ERT) and neoadjuvant hormonotherapy was shown to be able to significantly improve local control and disease-free survival in locally advanced prostatic carcinoma. (RTOG study 8610). Aim of this analysis was to assess the clinical results observed in a population of patients undergoing this combined treatment and, more particularly, to examine the prognostic impact of local control. 84 patients (T2: 47%, T3: 49.4%, T4: 3.6%) underwent concomitant ERT (dose to pelvic volume: 45 Gy; mean dose to prostatic volume: 65 Gy) and neoadjuvant hormonotherapy (flutamide: 250 mg three times/daily for 30 days; LH-RH analogue: 1 oral dose every 28 days starting 2 months prior to radiotherapy and for its whole duration). With a median follow-up of 36 months, 3.6% of patients were deceased; hematogenous metastases and local disease progression were recorded in 16.7% and 4.8% of patients, respectively. Local disease progression was shown to be significantly correlated with the incidence of metastases. In fact, the actuarial incidence of metastases at 5 years was 100% and 27% in patients with and without local recurrence (p = 0.0043) respectively. Overall, metastases-free local and biochemical recurrence-free survival was 89.2%, 66.5%, 85.0% and 41.9% respectively. At univariate analysis (logrank) the clinical stage (T) was shown to be significantly correlated with the incidence of metastases (p = .0004) and local progression (p < .0001). In conclusion, this study has confirmed the low rate of local progression with the combination of hormonotherapy and radiotherapy and the significant correlation of local control with the incidence of hematogenous metastases.

  19. 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…

  20. Attitude Control by Localized Outgassing

    NASA Technical Reports Server (NTRS)

    Elleman, D. D.; Wang, T. G.; Croonquist, A.

    1983-01-01

    Attitude control of levitated object achieved by using laser to vaporize selectively sublimate coating. Laser heats material that will sublime or outgas. To obtain torque reaction force vector from subliming material must not pass through center-of-mass of object. Laser provides beam suitable for controlling objects in noncontact manufacturing processes in acoustic levitation chambers.

  1. Good maintenance of exercise-induced bone gain with decreased training of female tennis and squash players: a prospective 5-year follow-up study of young and old starters and controls.

    PubMed

    Kontulainen, S; Kannus, P; Haapasalo, H; Sievänen, H; Pasanen, M; Heinonen, A; Oja, P; Vuori, I

    2001-02-01

    This prospective 5-year follow-up study of 64 adult female racquet sports players and 27 controls assessed the changes in the playing-to-nonplaying arm bone mineral content (BMC) differences to answer three questions: (1) Are training-induced bone gains lost with decreased training? (2) Is the bone response to decreased training different if the playing career has been started before or at puberty rather than after it? (3) Are the possible bone changes related to the changes in training? The players were divided into two groups according to the starting age of their tennis or squash playing. The mean starting age was 10.5 years (SD, 2.2) among the players who had started training before or at menarche (young starters; n = 36) while 26.4 years (SD, 8.0) among those players who had begun training a minimum of 1 year after menarche (old starters; n = 28). At baseline of the 5-year follow-up, the mean age of the young starters was 21.6 years (SD, 7.6) and that of old starters was 39.4 years (SD, 10.5). During the follow-up, the young starters had reduced the average training frequency from 4.7 times a week (2.7) to 1.4 times a week (1.3) and the old starters from 4.0 times a week (1.4) to 2.0 times a week (1.4), respectively. The 5-year follow-up revealed that despite reduced training the exercise-induced bone gain was well maintained in both groups of players regardless of their clearly different starting age of activity and different amount of exercise-induced bone gain. The gain was still 1.3-2.2 times greater in favor of the young starters (at the follow-up, the dominant-to-nondominant arm BMC difference was 22% [8.4] in the humeral shaft of the young starters versus 10% [3.8] in the old starters, and 3.5% [2.4] in controls). In the players, changes in training were only weakly related to changes in the side-to-side BMC difference (r(s) = 0.05-0.34, all NS), and this was true even among the players who had stopped training completely a minimum 1 year before the

  2. Local control approach to ultrafast electron transfer

    NASA Astrophysics Data System (ADS)

    Vindel-Zandbergen, Patricia; Meier, Christoph; Sola, Ignacio R.

    2016-10-01

    We study ultrafast electron transfer between separated nuclei using local control theory. By imposing electron ionization and electron transport through the continuum, different local control formulations are used to increase the yield of retrapping the electron at the desired nuclei. The control mechanism is based on impulsive de-excitation. Both symmetric and asymmetric nuclear arrangements are analyzed, as well as the role of the nuclear motion.

  3. Control methods for localization of nonlinear waves.

    PubMed

    Porubov, Alexey; Andrievsky, Boris

    2017-03-06

    A general form of a distributed feedback control algorithm based on the speed-gradient method is developed. The goal of the control is to achieve nonlinear wave localization. It is shown by example of the sine-Gordon equation that the generation and further stable propagation of a localized wave solution of a single nonlinear partial differential equation may be obtained independently of the initial conditions. The developed algorithm is extended to coupled nonlinear partial differential equations to obtain consistent localized wave solutions at rather arbitrary initial conditions.This article is part of the themed issue 'Horizons of cybernetical physics'.

  4. Control methods for localization of nonlinear waves

    NASA Astrophysics Data System (ADS)

    Porubov, Alexey; Andrievsky, Boris

    2017-03-01

    A general form of a distributed feedback control algorithm based on the speed-gradient method is developed. The goal of the control is to achieve nonlinear wave localization. It is shown by example of the sine-Gordon equation that the generation and further stable propagation of a localized wave solution of a single nonlinear partial differential equation may be obtained independently of the initial conditions. The developed algorithm is extended to coupled nonlinear partial differential equations to obtain consistent localized wave solutions at rather arbitrary initial conditions. This article is part of the themed issue 'Horizons of cybernetical physics'.

  5. Control of coupled localized nonlinear wave solutions

    NASA Astrophysics Data System (ADS)

    Porubov, A. V.; Antonov, I. D.

    2017-01-01

    A method of forced localization of non-linear wave by a feedback control is developed for coupled equations accounting for non-linear dynamic processes in complex lattices. It is shown, that the control of the shape and velocity of the wave function of macro-strain allows to achieve localization of the shape of the function describing variations of defects in the lattice. Moreover, change of the sign of the amplitude of the last wave may be achieved by variation of the parameters of the control function but independent of the initial conditions.

  6. 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.

  7. 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.

  8. Soviet business chaos seen lasting 5 years

    SciTech Connect

    Not Available

    1991-12-16

    This paper reports that companies seeking work in the collapsing Soviet Union can expect political uncertainty for another 5 years. PW discussed changes in the Soviet Union and offered advice on dealing with officials of the central government and Soviet republics at a recent meeting in Houston with executives of oil field service companies. That meeting preceded reports of the Russian federation, Ukraine, and Byelorussia agreeing to form a Slavic commonwealth.

  9. Local control theory applied to molecular photoassociation.

    PubMed

    Marquetand, Philipp; Engel, Volker

    2007-08-28

    Local control theory (LCT) is employed to achieve molecular photoassociation with shaped laser pulses. Within LCT, the control fields are constructed from the response of the system to the perturbation which makes them accessible to a straightforward interpretation. This is shown regarding the ground-state collision of H+F and H+I atoms. Different objectives are defined, which aim at the formation of vibrational cold or hot associated molecules, respectively. Results are presented for s-wave scattering, where the rotational degree of freedom is ignored and also for full scale calculations including rotations, in order to describe more realistic conditions.

  10. General paediatric surgery for patients aged under 5 years: a 5-year experience at a district general hospital

    PubMed Central

    Gordon, AC

    2016-01-01

    Introduction The gradual shift of general paediatric surgery (GPS) provision from district general hospitals (DGH) to specialised units is well recognised in the UK. The consequences of centralisation include a reduction in exposure to GPS for current surgical trainees. The GPS practice of a DGH is examined here. Methods All operations performed on children aged under 5 years over a 5-year period were identified using the local electronic operation database. Electronic hospital records and clinic letters were accessed to collect data on demographics, operations performed and outcome measures. Results 472 GPS operations were performed on children between the age of 22 days and 5 years between 2009 and 2014, of which 43 were on an emergency basis and 105 were performed on patients aged less than 1 year. Three patients were admitted following day case surgery. Six patients were readmitted within 30 days. Complication rates for all procedures and the four most common procedures were similar to those found in published literature. Conclusions GPS for patients aged less than 5 years is comparatively safe in the DGH setting. The training opportunities available at DGHs are invaluable to surgical trainees and vital for sustaining the future provision of GPS by such hospitals. PMID:27269243

  11. 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

  12. 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.

  13. 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.

  14. 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)

  15. Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03

    PubMed Central

    Martinelli, Giovanni; Hitz, Felicitas; Mingrone, Walter; Pabst, Thomas; Cevreska, Lidija; del Giglio, Auro; Vanazzi, Anna; Laszlo, Daniele; Raats, Johann; Rauch, Daniel; Vorobiof, Daniel A.; Lohri, Andreas; Biaggi Rudolf, Christine; Rondeau, Stéphanie; Rusterholz, Corinne; Heijnen, Ingmar A.F.M.; Zucca, Emanuele; Ghielmini, Michele

    2016-01-01

    Purpose Rituximab maintenance therapy has been shown to improve progression-free survival in patients with follicular lymphoma; however, the optimal duration of maintenance treatment remains unknown. Patients and Methods Two hundred seventy patients with untreated, relapsed, stable, or chemotherapy-resistant follicular lymphoma were treated with four doses of rituximab monotherapy in weekly intervals (375 mg/m2). Patients achieving at least a partial response were randomly assigned to receive maintenance therapy with one infusion of rituximab every 2 months, either on a short-term schedule (four administrations) or a long-term schedule (maximum of 5 years or until disease progression or unacceptable toxicity). The primary end point was event-free survival (EFS). Progression-free survival, overall survival (OS), and toxicity were secondary end points. Comparisons between the two arms were performed using the log-rank test for survival end points. Results One hundred sixty-five patients were randomly assigned to the short-term (n = 82) or long-term (n = 83) maintenance arms. Because of the low event rate, the final analysis was performed after 95 events had occurred, which was before the targeted event number of 99 had been reached. At a median follow-up period of 6.4 years, the median EFS was 3.4 years (95% CI, 2.1 to 5.3) in the short-term arm and 5.3 years (95% CI, 3.5 to not available) in the long-term arm (P = .14). Patients in the long-term arm experienced more adverse effects than did those in the short-term arm, with 76% v 50% of patients with at least one adverse event (P < .001), five versus one patient with grade 3 and 4 infections, and three versus zero patients discontinuing treatment because of unacceptable toxicity, respectively. There was no difference in OS between the two groups. Conclusion Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity

  16. On controllability of thermocapillary instability by local temperature control

    NASA Astrophysics Data System (ADS)

    Shiomi, Junichiro

    Thermally nonequilibrium liquid processing and experiments in microgravity or microscale of-ten suffer from dominant thermocapillary convection and its instability. While the instability can be utilized to promote mixing, there are certainly situations where it is desirable to atten-uate the fluid motion. Here, we theoretically investigate the possibility to control the unstable thermocapillary convection by taking a simple model system, i.e. a liquid-filled open cavity. The system is closely related to the liquid bridge and annular systems, which have been investi-gated extensively over the last few decades, being motivated by the crystal growth application. Such system is suitable for flow control target since they usually have strong mode selectivity, and hence, the observability and controllability can be satisfied by small number of controllers. In addition, since the convection is driven by the temperature distribution at the free surface, the entire flow field can be influenced by perturbing the scalar quantity (temperature). Fur-thermore, the relatively slow timescales of the phenomena (e.g. compared with turbulent flow) allow us to apply advanced real-time control laws. The author and coworkers have demon-strated the possibility of stabilizing the convective instability by applying mode-selective linear and weakly nonlinear feedback control schemes with only a few pairs of local temperature sen-sors and actuators (heaters) [1]. In this work, with an aim to develop a practical control scheme that is applicable to various degrees of nonlinearity and number of modes, an optimal control problem has been formulated. Based on the reduced toy model of the open cavity system [2] with 6 oscillatory modes, the linear optimal control was applied with only 2 actuators. The performance of the control was quantified for different strengths of nonlinearity. Dependences of the control performance on the actuator position and size were also investigated. The result shows

  17. Olfactory Dysfunction Predicts 5-Year Mortality in Older Adults

    PubMed Central

    Pinto, Jayant M.; Wroblewski, Kristen E.; Kern, David W.; Schumm, L. Philip; McClintock, Martha K.

    2014-01-01

    Prediction of mortality has focused on disease and frailty, although antecedent biomarkers may herald broad physiological decline. Olfaction, an ancestral chemical system, is a strong candidate biomarker because it is linked to diverse physiological processes. We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57–85 were studied in 2005–6 (Wave 1) and their mortality determined in 2010–11 (Wave 2). Olfactory dysfunction, determined objectively at Wave 1, was used to estimate the odds of 5-year, all cause mortality via logistic regression, controlling for demographics and health factors. Mortality for anosmic older adults was four times that of normosmic individuals while hyposmic individuals had intermediate mortality (p<0.001), a “dose-dependent” effect present across the age range. In a comprehensive model that included potential confounding factors, anosmic older adults had over three times the odds of death compared to normosmic individuals (OR, 3.37 [95%CI 2.04, 5.57]), higher than and independent of known leading causes of death, and did not result from the following mechanisms: nutrition, cognitive function, mental health, smoking and alcohol abuse or frailty. Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process. PMID:25271633

  18. Olfactory dysfunction predicts 5-year mortality in older adults.

    PubMed

    Pinto, Jayant M; Wroblewski, Kristen E; Kern, David W; Schumm, L Philip; McClintock, Martha K

    2014-01-01

    Prediction of mortality has focused on disease and frailty, although antecedent biomarkers may herald broad physiological decline. Olfaction, an ancestral chemical system, is a strong candidate biomarker because it is linked to diverse physiological processes. We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57-85 were studied in 2005-6 (Wave 1) and their mortality determined in 2010-11 (Wave 2). Olfactory dysfunction, determined objectively at Wave 1, was used to estimate the odds of 5-year, all cause mortality via logistic regression, controlling for demographics and health factors. Mortality for anosmic older adults was four times that of normosmic individuals while hyposmic individuals had intermediate mortality (p<0.001), a "dose-dependent" effect present across the age range. In a comprehensive model that included potential confounding factors, anosmic older adults had over three times the odds of death compared to normosmic individuals (OR, 3.37 [95%CI 2.04, 5.57]), higher than and independent of known leading causes of death, and did not result from the following mechanisms: nutrition, cognitive function, mental health, smoking and alcohol abuse or frailty. Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process.

  19. Your Child's Development: 2.5 Years (30 Months)

    MedlinePlus

    ... Old Your Child’s Development: 2.5 Years (30 Months) KidsHealth > For Parents > Your Child’s Development: 2.5 Years (30 Months) A A A Are you amazed by the ... TOPIC Your Child's Checkup: 2.5 Years (30 Months) Home and Away: How to Keep Toddlers Active ...

  20. Carcinoma of the tonsil: the effect of dose-time-volume factors on local control

    SciTech Connect

    Garrett, P.G.; Beale, F.A.; Cummings, B.J.; Harwood, A.R.; Keane, T.J.; Payne, D.G.; Rider, W.D.

    1985-04-01

    Between 1970 and 1979, 372 patients with squamous cell carcinoma of the tonsil were treated with primary irradiation therapy, with salvage surgery for failures. The median age was 60 years and the male to female ratio was 2:1. All patients received external beam radiation which was supplemented in 68 patients with a radioactive implant for disease into adjacent tongue. The overall survival for all patients was 38% at 5 years and 54% when corrected for intercurrent disease. Local control was 87% for T1 lesions, 68% for T2 lesions and 50% for T3 lesions. Regional control was 96% for NO, 67% for N1 and 37% for N2-3. A detailed dose-time-volume analysis revealed that increasing volume improved local control in T1 and T2 lesions. Increasing the dose in the range of 5000 to 6500 rad had no significant effect on primary control in any stage of disease. The addition of a radioactive implant did not increase local control if disease extended into the tongue. This study demonstrates the significance of adequate treatment volume in local control for carcinoma of the tonsil. No significant dose response was found and subsequent surgery was not compromised when a moderate dose of radiation was used.

  1. 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

  2. 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.

  3. Local control network and internetwork ISO-OSI reference model

    SciTech Connect

    Damsker, D.

    1983-05-01

    The paper describes a new local control network architecture. The new control network is totally distributed and redundantly hardware and software structured, based on a bus configuration and on CSMA/CD media access control. The architecture of the control structure and of the data communications structure for both Local Network and Internetwork is discussed in comparison with ISO-OSI and Local Area Network IEEE Standard 802 (Draft) Reference Models. A previous paper dealt with the physical implementation of this concept. The present paper is more software structure oriented.

  4. 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.

  5. 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.

  6. Local Energy Monitoring and Control Analysis

    DTIC Science & Technology

    1980-08-28

    reducing total operating cost and enabling the system to run more efficiently and thus use less energy. (j) Enthalpy Control Through the use, when...efficient, of outside air instead of conditioned air a building may be cooled without the use of a mechanical cooling system. (see (a)) (k) Enthalpy ...outdoor and return air DB temperature or can be a more com- ... plex system based on the total heat or enthalpy of the supply air. Single zone single

  7. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up.

    PubMed

    Lewis, Joshua R; Calver, Janine; Zhu, Kun; Flicker, Leon; Prince, Richard L

    2011-01-01

    Concern has been expressed that calcium supplementation, a key intervention for preventing osteoporotic fracture in older women, may increase the risk of atherosclerotic vascular disease. To evaluate the risk further, an examination of complete verified atherosclerotic vascular hospitalization and mortality data from a 5-year randomized, controlled trial (RCT) of calcium carbonate and 4.5 years of posttrial follow-up was undertaken. This study used data from a published 5-year randomized, double-blinded, placebo-controlled trial [Calcium Intake Fracture Outcome Study (CAIFOS)]. The participants were 1460 women aged 75.1 ± 2.7 years at baseline (1998) recruited from the general population and randomized to receive 1200 mg of calcium carbonate daily or an identical placebo. All hospital admission and deaths during the 5-year study and the 4.5-year follow-up were derived from the Western Australian Data Linkage Service (WADLS). Hazard ratios (HRs) for the combined endpoint of atherosclerotic vascular mortality or first hospitalization were calculated using prespecified intention-to-treat and per-protocol models. The intervention group that received calcium supplementation did not have a higher risk of death or first-time hospitalization from atherosclerotic vascular disease in either the 5-year RCT [multivariate-adjusted HR = 0.938, 95% confidence interval (CI) 0.690-1.275] or during the 9.5 years of observational study (multivariate-adjusted HR = 0.919, 95% CI 0.737-1.146). Further analysis suggested that calcium supplementation may reduce the risk of hospitalization and mortality in patients with preexisting atherosclerotic cardiovascular disease. This trial provides compelling evidence that calcium supplementation of 1200 mg daily does not significantly increase the risk of atherosclerotic vascular disease in elderly women.

  8. Analytical study of spatiotemporal chaos control by applying local injections

    PubMed

    Gang; Jinghua; Jihua; Xiangming; Yugui; Hu

    2000-09-01

    Spatiotemporal chaos control by applying local feedback injections is investigated analytically. The influence of gradient force on the controllability is investigated. It is shown that as the gradient force of the system is larger than a critical value, local control can reach very high efficiency to drive the turbulent system of infinite size to a regular target state by using a single control signal. The complex Ginzburg-Landau equation is used as a model to confirm the above analysis, and a four-wave-mixing mode is revealed to determine the dynamical behavior of the controlled system at the onset of instability.

  9. Golden Years? Further Education Colleges under Local Authority Control

    ERIC Educational Resources Information Center

    Simmons, Robin

    2008-01-01

    Fifteen years ago further education (FE) colleges in England were removed from local education authority (LEA) control and re-formed as "FE corporations". Now, it is proposed that, from 2010, local authorities will become re-involved in the running of FE. Given such a prospect, this article takes the opportunity to look back at colleges…

  10. Latino Children's Body Mass Index at 2–3.5 Years Predicts Sympathetic Nervous System Activity at 5 Years

    PubMed Central

    Harley, Kim G.; Neilands, Torsten B.; Tambellini, Katelyn; Lustig, Robert H.; Boyce, W. Thomas; Eskenazi, Brenda

    2014-01-01

    Abstract Background: To understand whether the relationship between young children's autonomic nervous system (ANS) responses predicted their BMI, or vice versa, the association between standardized BMI (zBMI) at 2, 3.5, and 5 years of age and ANS reactivity at 3.5–5 years of age, and whether zBMI predicts later ANS reactivity or whether early ANS reactivity predicts later zBMI, was studied. Methods: Low-income, primarily Latino children (n=112) were part of a larger cohort study of mothers recruited during early pregnancy. Study measures included maternal prenatal weight, children's health behaviors (i.e., time watching television, fast food consumption, and time playing outdoors), children's height and weight at 2, 3.5, and 5 years, and children's ANS reactivity at 3.5 and 5 years. ANS measures of sympathetic nervous system (i.e., pre-ejection period) and parasympathetic nervous system (i.e., respiratory sinus arrhythmia) activity were monitored during rest and four challenges. Reactivity was calculated as the difference between mean challenge response and rest. Structural equation models analyzed the relationship between children's zBMI at 2, 3.5, and 5 years and ANS reactivity at 3.5 and 5 years, adjusting for mother's BMI, children's behaviors, and changes in height. Results: There was no association between zBMI and ANS cross-sectionally. Children with high zBMI at 2 or 3.5 years or large zBMI increases from 2 to 3.5 years of age had decreased sympathetic activity at 5 years. Neither sympathetic nor parasympathetic reactivity at 3.5 years predicted later zBMI. Conclusions: Increased zBMI early in childhood may dampen young children's SNS responses later in life. PMID:24745554

  11. Effect of local controlled heat on transdermal delivery of nicotine.

    PubMed

    Petersen, Kristian Kjær; Rousing, Mark Lillelund; Jensen, Carina; Arendt-Nielsen, Lars; Gazerani, Parisa

    2011-09-30

    Skin permeability and local blood perfusion are important factors for transdermal drug delivery. Application of heat is expected to enhance microcirculation and local perfusion and/or blood vessel permeability, thus facilitating drug transfer to the systemic circulation. In addition, heating prior to or during topical application of a drug may facilitate skin penetration, increase kinetic energy, and facilitate drug absorption. The aim of the present study was to investigate whether application of controlled local heat would enhance transdermal delivery from the nicotine patch mounted on the upper arm of ten healthy non-smoking male Caucasian subjects. Local skin perfusion was monitored using Laser Doppler Imaging (LDI) at baseline (32 °C) and following application of local controlled heat (43 °C) on the upper arm, where the patch was placed. The residue of the nicotine patches was then examined by High-Performance Liquid Chromatography (HPLC) to indicate the uptake of nicotine from the patch due to the local controlled heat. Controlled heat application (43°C) caused significant cutaneous hyperaemia (up to 9 folds increase in skin perfusion) with an increase in nicotine uptake (up to 13 folds). The method was well tolerated without causing any pain or discomfort. These data suggest that controlled heat application, which is a simple, non-invasive method, can significantly enhance local skin perfusion and drug uptake from patches.

  12. 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

  13. Calcium supplements and cardiovascular risk: 5 years on.

    PubMed

    Bolland, Mark J; Grey, Andrew; Reid, Ian R

    2013-10-01

    Calcium supplements have been widely used by older men and women. However, in little more than a decade, authoritative recommendations have changed from encouraging the widespread use of calcium supplements to stating that they should not be used for primary prevention of fractures. This substantial shift in recommendations has occurred as a result of accumulated evidence of marginal antifracture efficacy, and important adverse effects from large randomized controlled trials of calcium or coadministered calcium and vitamin D supplements. In this review, we discuss this evidence, with a particular focus on increased cardiovascular risk with calcium supplements, which we first described 5 years ago. Calcium supplements with or without vitamin D marginally reduce total fractures but do not prevent hip fractures in community-dwelling individuals. They also cause kidney stones, acute gastrointestinal events, and increase the risk of myocardial infarction and stroke. Any benefit of calcium supplements on preventing fracture is outweighed by increased cardiovascular events. While there is little evidence to suggest that dietary calcium intake is associated with cardiovascular risk, there is also little evidence that it is associated with fracture risk. Therefore, for the majority of people, dietary calcium intake does not require close scrutiny. Because of the unfavorable risk/benefit profile, widespread prescribing of calcium supplements to prevent fractures should be abandoned. Patients at high risk of fracture should be encouraged to take agents with proven efficacy in preventing vertebral and nonvertebral fractures.

  14. Your Child's Development: 1.5 Years (18 Months)

    MedlinePlus

    ... Your 1- to 2-Year-Old Your Child's Development: 1.5 Years (18 Months) KidsHealth > For Parents > ... parts ("Where is your nose?") Movement and Physical Development runs walks up stairs with hand held throws ...

  15. Fitness and Your 4-to 5-Year Old

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Fitness and Your 4- to 5-Year-Old KidsHealth > ... the risk of serious illnesses later in life. Fitness for Preschoolers Physical activity guidelines for preschoolers recommend ...

  16. General Principles for 5-year Regional Haze Progress Reports

    EPA Pesticide Factsheets

    This guidance document was developed by the U.S. EPA for EPA Regional Offices and states in preparing and reviewing the 5-year progress reports for the initial regional haze state implementation plans.

  17. Medical Care and Your 4- to 5-Year-Old

    MedlinePlus

    ... compared with other kids the same age and gender. The doctor will take a medical and family ... cooperatively with other kids understand the concept of gender identify colors Developmental milestones for 5-year-olds ...

  18. The Amphibian Research and Monitoring Initiative (ARMI): 5-year report

    USGS Publications Warehouse

    Muths, Erin; Gallant, Alisa L.; Campbell Grant, Evan H.; Battaglin, William A.; Green, David E.; Staiger, Jennifer S.; Walls, Susan C.; Gunzburger, Margaret S.; Kearney, Rick F.

    2006-01-01

    This report is a 5-year retrospective of the structure, methodology, progress, and contributions to the broader scientific community that have resulted from this national USGS program. We evaluate ARMI’s success to date, with regard to the challenges faced by the program and the strengths that have emerged. We chart objectives for the next 5 years that build on current accomplishments, highlight areas meriting further research, and direct efforts to overcome existing weaknesses.

  19. 5-Year Update Environmental Assessment for CV-22 Beddown

    DTIC Science & Technology

    2007-02-01

    Final 5-Year Update Environmental Assessment for CV-22 Beddown Hurlburt Field , Florida...SIGNIFICANT IMPACT 5-YEAR UPDATE CV-22 BEDDOWN HURLBURT FIELD , FL Agencies: The United States Air Force (USAF) and the United States Navy (Navy...the CV-22 Osprey at Hurlburt Field , Florida. The purpose of the Proposed Action is to: • Conduct IOT&E by testing the operation of the CV-22 in as

  20. Notions of local controllability and optimal feedforward control for quantum systems

    NASA Astrophysics Data System (ADS)

    Chakrabarti, Raj

    2011-05-01

    Local controllability is an essential concept for regulation and control of time-varying nonlinear dynamical systems; in the classical control logic it is at the foundation of neighboring optimal feedback and feedforward control. We introduce notions of local controllability suited to feedforward control of classical input disturbances in bilinear quantum systems evolving on projective spaces and Lie groups. Tests for local controllability based on a Gramian matrix analogous to the nonlinear local controllability Gramian, which allow assessment of which trajectories can be regulated by perturbative feedforward in the presence of classical input noise, are presented. These notions explicitly incorporate system bilinearity and the geometry of quantum states into the definition of local controllability of quantum systems. Associated feedforward strategies are described.

  1. 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).

  2. Controlled release for local delivery of drugs: barriers and models.

    PubMed

    Weiser, Jennifer R; Saltzman, W Mark

    2014-09-28

    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.

  3. Cancer control and complications of salvage local therapy after failure of radiotherapy for prostate cancer: a systematic review.

    PubMed

    Parekh, Arti; Graham, Powell L; Nguyen, Paul L

    2013-07-01

    The National Comprehensive Cancer Network guidelines currently endorse salvage local therapy as a reasonable alternative to observation or androgen-deprivation therapy for select men with a biopsy-proven local recurrence after definitive radiation for prostate cancer. Patients being considered for salvage therapy should have had localized disease at presentation, a prostate-specific antigen < 10 at recurrence, a life expectancy >10 years at recurrence, and a negative metastatic workup. In this systematic review, we synthesize the current literature describing the oncologic efficacy and toxicity profile of salvage brachytherapy, prostatectomy, cryotherapy, and high-intensity focused ultrasound. We found 5-year biochemical control rates to be similar across treatments, in the range of 52%-56%, although patient selection and definition of failure was variable. Toxicity profiles were also distinct between local salvage modalities.

  4. 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

  5. Stabilizing hierarchical compensation for locally controlled large flexible structures

    NASA Technical Reports Server (NTRS)

    Das, B.; Balas, M.

    1989-01-01

    A two-level hierarchical control strategy is proposed for large flexible space structures. The lower level consists of a set of local controllers. The higher level is a stabilizing compensator to account for any instabilities caused by controller-structure interaction with unmodeled dynamics. The advantage of this hierarchical strategy is that the lower level can be designed to meet the performance requirements, and the higher level can be designed independently to produce overall stability.

  6. Trabecular metal tibia still stable at 5 years

    PubMed Central

    Henricson, Anders; Rösmark, Dan; Nilsson, Kjell G

    2013-01-01

    Background and purpose Clinical results of total knee replacement (TKR) are inferior in younger patients, mainly due to aseptic loosening. Coating of components with trabecular metal (TM) is a new way of enhancing fixation to bone. We have previously reported stabilization of TM tibial components at 2 years. We now report the 5-year follow-up of these patients, including RSA of their TM tibial components. Patients and methods 22 patients (26 knees) received an uncemented TM cruciate-retaining tibial component and 19 patients (21 knees) a cemented NexGen Option cruciate-retaining tibial component. Follow-up with RSA, and clinical and radiographic examinations were done at 5 years. In bilaterally operated patients, the statistical analyses included only the first-operated knee. Results Both groups had most migration within the first 3 months, the TM implants to a greater extent than the cemented implants. After 3 months, both groups stabilized and remained stable up to the 5-year follow-up. Interpretation After a high initial degree of migration, the TM tibia stabilized. This stabilization lasted for at least 5 years, which suggests a good long-term performance regarding fixation. The cemented NexGen CR tibial components showed some migration in the first 3 months and then stabilized up to the 5-year follow-up. This has not been reported previously. PMID:23992142

  7. Temperature control of microheaters for localized carbon nanotube synthesis.

    PubMed

    Lu, Jingyu; Xu, Ting; Miao, Jianmin

    2011-12-01

    The temperatures of microheater devices for the localized growth of carbon nanotubes (CNTs) were brought under control to a great extent by providing the appropriate electric load (direct current or voltage) to the microheater circuit. The electrical-thermal coupled field simulations show that high temperatures only appear in very local areas under certain electric load. The infrared image of the produced microheater device agrees well with the simulation results. By applying the selected current to the fabricated microheater device and providing the mixed reaction gases, long, dense, and vertically well aligned CNT bundles were successfully grown very locally on the substrate. The control of temperatures paves the way to the localized growth of CNTs with good compatibility with CMOS process, and thus facilitating the direct integration of CNTs into future micro/nano electronics as interconnects. What's more, the method will also excite more in depth investigations on the applications of microheaters in many other fields.

  8. Towards AC-induced optimum control of dynamical localization

    NASA Astrophysics Data System (ADS)

    Revuelta, F.; Chacón, R.; Borondo, F.

    2015-05-01

    It is shown that dynamical localization (quantum suppression of classical diffusion) in the context of ultracold atoms in periodically shaken optical lattices subjected to time-periodic modulations having equidistant zeros depends on the impulse transmitted by the external modulation over half-period rather than on the modulation amplitude. This result provides a useful principle for optimally controlling dynamical localization in general periodic systems, which is capable of experimental realization.

  9. 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.

  10. 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.

  11. Approximations to and local properties of diffusions with discontinuous controls

    NASA Technical Reports Server (NTRS)

    Kushner, H. J.

    1974-01-01

    The paper discusses several properties of control systems defined by stochastic differential equations, which are defined by the method of Girsanov, using a transformation of measures, and where the controls are discontinuous. Uniqueness of the multivariate distributions of the process is proved, and it is shown that the process is a limit, in a natural sense, of a certain discrete time approximation. Other questions, concerning the effects on the distributions of the paths, and of the cost of approximating the control by a smooth control and concerning local properties of the solution, are discussed.

  12. Rhinoscleroma in a 5-year-old Portuguese Child.

    PubMed

    Simão, Inês; Gaspar, Iuri; Faustino, Rosário; Brito, Maria João Rocha

    2014-07-01

    Rhinoscleroma is a chronic granulomatous infectious disease that is rare in Western Europe. We report the case of a 5-year-old Portuguese boy diagnosed with rhinoscleroma in the context of recurrent epistaxis. He had a 6-month course of antibiotic (amoxicillin plus clavulanate) therapy with full recovery.

  13. 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…

  14. Supporting tobacco control: stimulating local newspaper coverage with a technical assistance website for local coalitions.

    PubMed

    Buller, David B; Bettinghaus, Erwin P; Helme, Donald; Young, Walter F; Borland, Ron; Maloy, Julie A; Cutter, Gary R; Andersen, Peter A; Walther, Joseph B

    2011-11-01

    A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions' efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.

  15. 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…

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. Onychomatricoma: A Case Report with 5-year Follow-up

    PubMed Central

    Ishida, Cleide Eiko; Gouveia, Bruna Melhoranse; Cuzzi, Tullia; Ramos-e-Silva, Marcia

    2016-01-01

    The authors present a case of onychomatricoma, a rare benign tumour of the nail matrix, first described by Baran and Kint in 1992. The lesion appeared on the proximal nail fold, covering half the nail of the second left finger. The nail was thickened and yellowish with longitudinal melanonychia. It was surgically removed with very satisfactory aesthetic results even after 5 years. A review on the subject is also presented. PMID:28163462

  1. 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 were…

  2. 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…

  3. Behavior Problems at 5 Years of Age and Maternal Mental Health in Autism and Intellectual Disability

    ERIC Educational Resources Information Center

    Totsika, Vasiliki; Hastings, Richard P.; Emerson, Eric; Berridge, Damon M.; Lancaster, Gillian A.

    2011-01-01

    We examined child behavior problems and maternal mental health in a British population-representative sample of 5 year-old children with an autism spectrum disorder (ASD), controlling for the presence of an intellectual disability (ID). Behavior problems were significantly higher in children with ASD with/out ID compared to typically developing…

  4. Active vibroacoustic control with multiple local feedback loops.

    PubMed

    Elliott, Stephen J; Gardonio, Paolo; Sors, Thomas C; Brennan, Michael J

    2002-02-01

    When multiple actuators and sensors are used to control the vibration of a panel, or its sound radiation, they are usually positioned so that they couple into specific modes and are all connected together with a centralized control system. This paper investigates the physical effects of having a regular array of actuator and sensor pairs that are connected only by local feedback loops. An array of 4 x 4 force actuators and velocity sensors is first simulated, for which such a decentralized controller can be shown to be unconditionally stable. Significant reductions in both the kinetic energy of the panel and in its radiated sound power can be obtained for an optimal value of feedback gain, although higher values of feedback gain can induce extra resonances in the system and degrade the performance. A more practical transducer pair, consisting of a piezoelectric actuator and velocity sensor, is also investigated and the simulations suggest that a decentralized controller with this arrangement is also stable over a wide range of feedback gains. The resulting reductions in kinetic energy and sound power are not as great as with the force actuators, due to the extra resonances being more prominent and at lower frequencies, but are still worthwhile. This suggests that an array of independent modular systems, each of which included an actuator, a sensor, and a local feedback control loop, could be a simple and robust method of controlling broadband sound transmission when integrated into a panel.

  5. 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.

  6. Controlling Androgen receptor nuclear localization by dendrimer conjugates

    NASA Astrophysics Data System (ADS)

    Wang, Haoyu

    Androgen Receptor (AR) antagonists, such as bicalutamide and flutamide have been used widely in the treatment of prostate cancer. Although initial treatment is effective, prostate cancer cells often acquire antiandrogen resistance with prolonged treatment. AR over-expression and AR mutations contribute to the development of antiandrogen resistant cancer. Second generation antiandrogens such as enzalutamide are more effective and show reduced AR nuclear localization. In this study, derivatives of PAN52, a small molecule antiandrogen previously developed in our lab, were conjugated to the surface of generation 4 and generation 6 PAMAM dendrimers to obtain antiandrogen PAMAM dendrimer conjugates (APDC). APDCs readily enter cells and associate with AR in the cytoplasm. Due to their large size and positive charge, they can not enter the nucleus, thus retaining AR in the cytoplasm. In addition, APDCs are effective in decreasing AR mediated transcription and cell proliferation. APDC is the first AR antagonists that inhibit DHT-induced nuclear localization of AR. By inhibiting AR nuclear localization, APDC represents a new class of antiandrogens that offer an alternative approach to addressing antiandrogen-resistant prostate cancer. Lysine post-translational modification of AR Nuclear Localization Sequence (NLS) has great impact on AR cellular localization. It is of interest to understand which modifications modulate AR translocation into the nucleus. In this study, we prepared dendrimer-based acetyltransferase mimetic (DATM), DATM is able to catalytically acetylate AR in CWR22Rv1 cells, which will be a useful tool for studying AR modification effect on AR cellular localization. Derivatives of DATM, which transfer other chemical groups to AR, can be prepared similarly, and with more dendrimer based AR modification tools prepared in future, we will be able to understand and control AR cellular localization through AR modification.

  7. Kinetochore localization of spindle checkpoint proteins: who controls whom?

    PubMed

    Vigneron, Suzanne; Prieto, Susana; Bernis, Cyril; Labbé, Jean-Claude; Castro, Anna; Lorca, Thierry

    2004-10-01

    The spindle checkpoint prevents anaphase onset until all the chromosomes have successfully attached to the spindle microtubules. The mechanisms by which unattached kinetochores trigger and transmit a primary signal are poorly understood, although it seems to be dependent at least in part, on the kinetochore localization of the different checkpoint components. By using protein immunodepletion and mRNA translation in Xenopus egg extracts, we have studied the hierarchic sequence and the interdependent network that governs protein recruitment at the kinetochore in the spindle checkpoint pathway. Our results show that the first regulatory step of this cascade is defined by Aurora B/INCENP complex. Aurora B/INCENP controls the activation of a second regulatory level by inducing at the kinetochore the localization of Mps1, Bub1, Bub3, and CENP-E. This localization, in turn, promotes the recruitment to the kinetochore of Mad1/Mad2, Cdc20, and the anaphase promoting complex (APC). Unlike Aurora B/INCENP, Mps1, Bub1, and CENP-E, the downstream checkpoint protein Mad1 does not regulate the kinetochore localization of either Cdc20 or APC. Similarly, Cdc20 and APC do not require each other to be localized at these chromosome structures. Thus, at the last step of the spindle checkpoint cascade, Mad1/Mad2, Cdc20, and APC are recruited at the kinetochores independently from each other.

  8. 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.

  9. Descending and Local Network Interactions Control Adaptive Locomotion

    DTIC Science & Technology

    2014-12-04

    sensilla act through local reflexes to increase motor activity, thereby providing the added force needed to push the insect up and over the object...developed, in our previous AFOSR grant, a hardware model based upon neural circuitry that had been documented in stick insects (Ekeberg et al., 2004; Rutter...control network for every joint of every leg of the model insect . This simulation based upon all known and implied thoracic connections was developed

  10. RHIC local orbit control and power supply resolution

    SciTech Connect

    Satogata, T.

    2009-12-01

    Slow global orbit correction at store, running every 30-60 minutes, has been in place since RHIC Run-8. This correction should include tight orbit drift tolerances at the interaction point and collimators, as these are locations where orbit drift of a few hundred microns is observable in backgrounds and luminosity. Future improvements in low beta optics will only lower these tolerances. runfy09 attempts to control the collimator orbit with local three-bumps after global orbit corrections appeared to be limited by corrector power supply resolution. This paper evaluates orbit control in the context of existing corrector power supply resolution, and makes recommendations for planned RHIC operations scenarios.

  11. 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.

  12. The acquired cardiac disease domain: the next 5 years.

    PubMed

    Pepper, John R

    2013-01-01

    At a recent in-house meeting at the European Association for Cardiothoracic Surgery (EACTS) headquarters in Windsor, the Chairs of the four domains were asked by the President to present their perception of the next 5 years in their respective domains. This review represents a distillation of our discussions on adult cardiac surgery. Advances in technology and imaging are having a radical effect on the working lives of surgeons. In clinical practice, the growth of heart teams and the breaking down of artificial barriers between specialities are altering the way we practice for the better. We see the development of hybrid approaches to many areas such as coronary artery surgery and operations on the thoracic aorta. These changes require careful analysis to ensure that they produce better outcomes that are also cost-effective. All health-care systems are at breaking point, and it is our responsibility to harness new technology to benefit our patients. This is all part of placing the patient at the centre of our activities. Hence, we see the involvement of patients in the design and analysis of clinical trials, which also require great mutual trust and cooperation between surgeons in different countries. Because of the dramatic changes in the pattern of working, we have had to alter our patterns of training and education, and we will continue to make significant innovations in the future. These are exciting challenges that will keep us all busy for the next 5 years at least.

  13. Local thermal control of the human cutaneous circulation.

    PubMed

    Johnson, John M; Kellogg, Dean L

    2010-10-01

    The level of skin blood flow is subject to both reflex thermoregulatory control and influences from the direct effects of warming and cooling the skin. The effects of local changes in temperature are capable of maximally vasoconstricting or vasodilating the skin. They are brought about by a combination of mechanisms involving endothelial, adrenergic, and sensory systems. Local warming initiates a transient vasodilation through an axon reflex, succeeded by a plateau phase due largely to nitric oxide. Both phases are supported by sympathetic transmitters. The plateau phase is followed by the die-away phenomenon, a slow reversal of the vasodilation that is dependent on intact sympathetic vasoconstrictor nerves. The vasoconstriction with local skin cooling is brought about, in part, by a postsynaptic upregulation of α(2c)-adrenoceptors and, in part, by inhibition of the nitric oxide system at at least two points. There is also an early vasodilator response to local cooling, dependent on the rate of cooling. The mechanism for that transient vasodilation is not known, but it is inhibited by intact sympathetic vasoconstrictor nerve function and by intact sensory nerve function.

  14. 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.

  15. Technologies for Controlled, Local Delivery of siRNA

    PubMed Central

    Sarett, Samantha M.; Nelson, Christopher E.; Duvall, Craig L.

    2015-01-01

    The discovery of RNAi in the late 1990s unlocked a new realm of therapeutic possibilities by enabling potent and specific silencing of theoretically any desired genetic target. Better elucidation of the mechanism of action, the impact of chemical modifications that stabilize and reduce nonspecific effects of siRNA molecules, and the key design considerations for effective delivery systems has spurred progress toward developing clinically-successful siRNA therapies. A logical aim for initial siRNA translation is local therapies, as delivering siRNA directly to its site of action helps to ensure that a sufficient dose reaches the target tissue, lessens the potential for off-target side effects, and circumvents the substantial systemic delivery barriers. While topical siRNA delivery has progressed into numerous clinical trials, an enormous opportunity also exists to develop sustained-release, local delivery systems that enable both spatial and temporal control of gene silencing. This review focuses on material platforms that establish both localized and controlled gene silencing, with emphasis on the systems that show most promise for clinical translation. PMID:26476177

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

    PubMed Central

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

    2012-01-01

    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

  17. 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.

  18. Highly tunable local gate controlled complementary graphene device performing as inverter and voltage controlled resistor.

    PubMed

    Kim, Wonjae; Riikonen, Juha; Li, Changfeng; Chen, Ya; Lipsanen, Harri

    2013-10-04

    Using single-layer CVD graphene, a complementary field effect transistor (FET) device is fabricated on the top of separated back-gates. The local back-gate control of the transistors, which operate with low bias at room temperature, enables highly tunable device characteristics due to separate control over electrostatic doping of the channels. Local back-gating allows control of the doping level independently of the supply voltage, which enables device operation with very low VDD. Controllable characteristics also allow the compensation of variation in the unintentional doping typically observed in CVD graphene. Moreover, both p-n and n-p configurations of FETs can be achieved by electrostatic doping using the local back-gate. Therefore, the device operation can also be switched from inverter to voltage controlled resistor, opening new possibilities in using graphene in logic circuitry.

  19. 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.

  20. Localization of the Brainstem GABAergic Neurons Controlling Paradoxical (REM) Sleep

    PubMed Central

    Bérod, Anne; Goutagny, Romain; Léger, Lucienne; Ravassard, Pascal; Clément, Olivier; Hanriot, Lucie; Fort, Patrice; Luppi, Pierre-Hervé

    2009-01-01

    Paradoxical sleep (PS) is a state characterized by cortical activation, rapid eye movements and muscle atonia. Fifty years after its discovery, the neuronal network responsible for the genesis of PS has been only partially identified. We recently proposed that GABAergic neurons would have a pivotal role in that network. To localize these GABAergic neurons, we combined immunohistochemical detection of Fos with non-radioactive in situ hybridization of GAD67 mRNA (GABA synthesis enzyme) in control rats, rats deprived of PS for 72 h and rats allowed to recover after such deprivation. Here we show that GABAergic neurons gating PS (PS-off neurons) are principally located in the ventrolateral periaqueductal gray (vlPAG) and the dorsal part of the deep mesencephalic reticular nucleus immediately ventral to it (dDpMe). Furthermore, iontophoretic application of muscimol for 20 min in this area in head-restrained rats induced a strong and significant increase in PS quantities compared to saline. In addition, we found a large number of GABAergic PS-on neurons in the vlPAG/dDPMe region and the medullary reticular nuclei known to generate muscle atonia during PS. Finally, we showed that PS-on neurons triggering PS localized in the SLD are not GABAergic. Altogether, our results indicate that multiple populations of PS-on GABAergic neurons are distributed in the brainstem while only one population of PS-off GABAergic neurons localized in the vlPAG/dDpMe region exist. From these results, we propose a revised model for PS control in which GABAergic PS-on and PS-off neurons localized in the vlPAG/dDPMe region play leading roles. PMID:19169414

  1. Examining spatial variations in the prevalence of mental health problems among 5-year-old children in Canada.

    PubMed

    Raos, Robert; Janus, Magdalena

    2011-02-01

    The purpose of this study is to examine spatial variations in the prevalence rates of the three most common behaviour problems among 5-year-old children in Canada, to establish the data's suitability for potential spatial analyses of factors contributing to the prevalence of such problems. Data on kindergarten children's outcomes are routinely collected for populations of children in Canada using the Early Development Instrument (EDI), a population-level, teacher completed questionnaire. These data have been previously used to estimate prevalence rates of aggression, anxiety, and hyperactivity. The current study geographically analyzed these estimates to examine their consistency in relation to gender differences at larger provincial geographies and smaller Census Subdivision (CSD) geographies. Multilevel analyses were completed to examine the variation in prevalence at both levels of geography. Data for over 150,000 5-year-olds in three Canadian provinces and 410 Census Subdivisions were available for analyses. Prevalence rates of behaviour problems estimated with the EDI showed consistent gender relationships at both levels of aggregation. Controlling for individuals' age and sex, there was significant variation at the CSD level in risk of behavioural problems, and for anxiety and aggression, this was not explained by the distribution of CSDs in different provinces. This suggests local variation in these aspects of children's behaviour, within provinces. These findings open up the opportunity to further explore the utility and variability of EDI-based spatial variation in children's mental health.

  2. Sudden and unexpected death between 1 and 5 years.

    PubMed Central

    Southall, D P; Stebbens, V; Shinebourne, E A

    1987-01-01

    Of a population of 9856 children followed up from birth, 9251 of whom underwent 24 hour tape recordings of electrocardiograms and abdominal wall breathing movements during early infancy, five died suddenly and unexpectedly at home at ages ranging from 16 months to 4 years. Postmortem examination, including full histological and microbiological investigations. failed to identify abnormalities ordinarily associated with death in all five cases. Two of the children were known to have had frequent cyanotic episodes and died during these events. In the three remaining cases there was no previous history of cyanotic or apnoeic episodes. The death of one of these three children was seen by his parents and the clinical features suggested that apnoea rather than a cardiac arrhythmia was the primary mechanism for his death. As in infancy, sudden and unexpected death for which no adequate cause is found at necropsy seems to constitute a major component of mortality between 1 and 5 years. PMID:3632016

  3. Statistical analyses for NANOGrav 5-year timing residuals

    NASA Astrophysics Data System (ADS)

    Wang, Yan; Cordes, James M.; Jenet, Fredrick A.; Chatterjee, Shami; Demorest, Paul B.; Dolch, Timothy; Ellis, Justin A.; Lam, Michael T.; Madison, Dustin R.; McLaughlin, Maura A.; Perrodin, Delphine; Rankin, Joanna; Siemens, Xavier; Vallisneri, Michele

    2017-02-01

    In pulsar timing, timing residuals are the differences between the observed times of arrival and predictions from the timing model. A comprehensive timing model will produce featureless residuals, which are presumably composed of dominating noise and weak physical effects excluded from the timing model (e.g. gravitational waves). In order to apply optimal statistical methods for detecting weak gravitational wave signals, we need to know the statistical properties of noise components in the residuals. In this paper we utilize a variety of non-parametric statistical tests to analyze the whiteness and Gaussianity of the North American Nanohertz Observatory for Gravitational Waves (NANOGrav) 5-year timing data, which are obtained from Arecibo Observatory and Green Bank Telescope from 2005 to 2010. We find that most of the data are consistent with white noise; many data deviate from Gaussianity at different levels, nevertheless, removing outliers in some pulsars will mitigate the deviations.

  4. Renal transplantation in children less than 5 years of age.

    PubMed Central

    Rizzoni, G; Malekzadeh, M H; Pennisi, A J; Ettenger, R B; Uittenbogaart, C H; Fine, R N

    1980-01-01

    19 young children (less than 5 years old) have received 31 renal transplants from 4 live relatives and 27 cadaver donors. The 2-year allograft survival rate for the patients receiving their 1st allograft from the 4 live donors was 75 +/- 22% while for the patients receiving their 1st allograft from 15 cadaver donors was 26 +/- 11%. 10 children are currently surviving with functioning allographs (7 cadavers and 3 live relatives); 4 have died and 5 are undergoing dialysis after the loss of at least one allograft. Despite the poor allograft survival rate the fact that 7 children are surviving with cadaver allografts indicates that the lack of a living related donor should not prevent transplants in young children. PMID:7002060

  5. Typing Local Control and State Using Flow Analysis

    NASA Astrophysics Data System (ADS)

    Guha, Arjun; Saftoiu, Claudiu; Krishnamurthi, Shriram

    Programs written in scripting languages employ idioms that confound conventional type systems. In this paper, we highlight one important set of related idioms: the use of local control and state to reason informally about types. To address these idioms, we formalize run-time tags and their relationship to types, and use these to present a novel strategy to integrate typing with flow analysis in a modular way. We demonstrate that in our separation of typing and flow analysis, each component remains conventional, their composition is simple, but the result can handle these idioms better than either one alone.

  6. Residual gentamicin-release from antibiotic-loaded polymethylmethacrylate beads after 5 years of implantation.

    PubMed

    Neut, Daniëlle; van de Belt, Hilbrand; van Horn, Jim R; van der Mei, Henny C; Busscher, Henk J

    2003-05-01

    In infected joint arthroplasty, high local levels of antibiotics are achieved through temporary implantation of non-biodegradable gentamicin-loaded polymethylmethacrylate beads. Despite their antibiotic release, these beads act as a biomaterial surface to which bacteria preferentially adhere, grow and potentially develop antibiotic resistance. In routine clinical practice, these beads are removed after 14 days, but for a variety of reasons, we were confronted with a patient in which these beads were left in situ for 5 years. Retrieval of gentamicin-loaded beads from this patient constituted an exceptional case to study the effects of long-term implantation on potentially colonizing microflora and gentamicin release. Gentamicin-release test revealed residual antibiotic release after being 5 years in situ and extensive microbiological sampling resulted in recovery of a gentamicin-resistant staphylococcal strain from the bead surface. This case emphasizes the importance of developing biodegradable antibiotic-loaded beads as an antibiotic delivery system.

  7. Spherical loudspeaker array for local active control of sound.

    PubMed

    Rafaely, Boaz

    2009-05-01

    Active control of sound has been employed to reduce noise levels around listeners' head using destructive interference from noise-canceling sound sources. Recently, spherical loudspeaker arrays have been studied as multiple-channel sound sources, capable of generating sound fields with high complexity. In this paper, the potential use of a spherical loudspeaker array for local active control of sound is investigated. A theoretical analysis of the primary and secondary sound fields around a spherical sound source reveals that the natural quiet zones for the spherical source have a shell-shape. Using numerical optimization, quiet zones with other shapes are designed, showing potential for quiet zones with extents that are significantly larger than the well-known limit of a tenth of a wavelength for monopole sources. The paper presents several simulation examples showing quiet zones in various configurations.

  8. Controlled generation of intrinsic localized modes in microelectromechanical cantilever arrays

    NASA Astrophysics Data System (ADS)

    Chen, Qingfei; Lai, Ying-Cheng; Dietz, David

    2010-12-01

    We propose a scheme to induce intrinsic localized modes (ILMs) at an arbitrary site in microelectromechanical cantilever arrays. The idea is to locate the particular cantilever beam in the array that one wishes to drive to an oscillating state with significantly higher amplitude than the average and then apply small adjustments to the electrical signal that drives the whole array system. Our scheme is thus a global closed-loop control strategy. We argue that the dynamical mechanism on which our global driving scheme relies is spatiotemporal chaos and we develop a detailed analysis based on the standard averaging method in nonlinear dynamics to understand the working of our control scheme. We also develop a Markov model to characterize the transient time required for inducing ILMs.

  9. 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.

  10. Controlling a microdisk laser by local refractive index perturbation

    SciTech Connect

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

    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.

  11. 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

  12. Immunologic memory 5 years after meningococcal A/C conjugate vaccination in infancy.

    PubMed

    MacLennan, J; Obaro, S; Deeks, J; Lake, D; Elie, C; Carlone, G; Moxon, E R; Greenwood, B

    2001-01-01

    Infant vaccination with meningococcal conjugates may provide long-term protection against disease. Antibody levels and immunologic memory were assessed in 5-year-old Gambian children who received meningococcal A/C conjugate vaccination (MenA/C) in infancy. At 2 years, they were randomized to receive a booster of MenA/C (conjugate group), meningococcal A/C polysaccharide (MPS group), or inactivated polio vaccine (IPV group). All groups were revaccinated with 10 microg MPS at 5 years of age, as were 39 previously unvaccinated age-matched control subjects. Before revaccination, titers were higher in the conjugate and MPS groups than in control subjects (P<.001); titers for the IPV group were similar to those for control subjects. Ten days after revaccination, the conjugate and IPV groups had similar serogroup C serum bactericidal antibody titers (3421 vs. 2790, respectively). These levels were significantly higher than those in the MPS (426) and control (485) groups (P<.001). Thus, immunologic memory was sustained for > or =5 years; however, MPS challenge at 2 years interfered with a subsequent memory response.

  13. 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

  14. Pain control via opioid analgesic-local anesthetic loaded IPNs.

    PubMed

    Keskin, Dilek Sendil; Wise, Donald L; Hasirci, Vasif

    2004-01-01

    Relief of chronic pain is an important clinical problem requiring special care and approaches. The present study was designed for the construction of a controlled release system for local application of analgesics (hydromorphone (HM), morphine (M), and codeine (C)) and a local anesthetic, bupivacaine (BP). An interpenetrating network (IPN) drug release system was prepared by using a biocompatible, biodegradable copolyester, poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and another biocompatible but synthetic, nondegradable polymer, poly (2- hydroxyethyl methacrylate), (PHEMA). In situ release kinetics of the IPN system was first order for BP but could not be fitted to any known equation for the other drugs. Complete release from the IPNs occurred within a considerably short time (24 h for 80 % of the drugs) most probably due to the significant hydrophilicity of PHEMA. In order to slow down the release rate these IPNs were coated with PHBV. Release from these coated IPNs (cIPN) resulted in rates that could be described by Higuchi's equations. In vivo measurement of antinociceptive efficacy was carried out in rats with tail flick and paw-withdrawal tests after inducing chronic pain created by sciatic nerve ligation at the right side. Control groups received placebo implants. In vivo studies showed potent, prolonged (2-3 days) antinociception at the site of injury (right paw) for strong opioids (HM and M) and about 2 days for the weak opioid (C) and local anesthetic (BP). In all cases the release rate was found to be as important as the antinociceptive potency. The weakest opioid analgesic of those evaluated (C) had a higher first day antinociception than its stronger counterpart M, probably due to its higher initial concentration that was expected from its faster release rate in the in situ experiments.

  15. 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

  16. 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.

  17. 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.

  18. Minimal access surgery in children – 5 years institutional experience

    PubMed Central

    Oak, S N; Parelkar, S V; Akhtar, T; Joshi, M; Pathak, R; Viswanath, N; V, K Satish Kumar; Ravikiran, K; Manjunath, L; Ahmed, A

    2005-01-01

    Context: Minimal access surgery (MAS) in children are common place and performed worldwide with gratifying results as the learning curve of the surgeon attains plateau. We share our experience of this technically evolving modality of surgery, performed at our setup over a period of 5 years. We also review and individually compare the data for commonly performed procedures with other available series. Author also briefly discuss potential advantages of MAS in certain debatable conditions performed quickly and with cosmesis as open procedure. Materials and methods: We performed 677 MAS in children aged between 7 days and 12 years. Five hundred and sixty-eight of these were Laparoscopic procedures and 109 were Video assisted thoracoscopic surgeries (VATS). In all laparoscopic procedures, the primary port placement was by the Hasson's open technique. We have used 5, 3 and 2 mm instruments. Our study include 259 inguinal hernia, 161 Appendectomies, 95 VATS for empyema, 51 orchiopexies, 49 diagnostic laparoscopy, 29 cholecystectomies, 22 adhesionlysis and other uncommonly performed procedures. Results: The ultimate outcome of all the performed procedures showed gratifying trend, the data of which are discussed in detail in the article. Conclusion: As we gained experience the operating time showed a decreasing trend, the complication rates and conversion rate also reduced. The advantages we came across were better postoperative appearances, less pain and early return to unrestricted activities. PMID:21188009

  19. 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

  20. 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

  1. Cell Cycle Programs of Gene Expression Control Morphogenetic Protein Localization

    PubMed Central

    Lord, Matthew; Yang, Melody C.; Mischke, Michelle; Chant, John

    2000-01-01

    Genomic studies in yeast have revealed that one eighth of genes are cell cycle regulated in their expression. Almost without exception, the significance of cell cycle periodic gene expression has not been tested. Given that many such genes are critical to cellular morphogenesis, we wanted to examine the importance of periodic gene expression to this process. The expression profiles of two genes required for the axial pattern of cell division, BUD3 and BUD10/AXL2/SRO4, are strongly cell cycle regulated. BUD3 is expressed close to the onset of mitosis. BUD10 is expressed in late G1. Through promotor-swap experiments, the expression profile of each gene was altered and the consequences examined. We found that an S/G2 pulse of BUD3 expression controls the timing of Bud3p localization, but that this timing is not critical to Bud3p function. In contrast, a G1 pulse of BUD10 expression plays a direct role in Bud10p localization and function. Bud10p, a membrane protein, relies on the polarized secretory machinery specific to G1 to be delivered to its proper location. Such a secretion-based targeting mechanism for membrane proteins provides cells with flexibility in remodeling their architecture or evolving new forms. PMID:11134078

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Prenatal Lead Exposure and Weight of 0- to 5-Year-Old Children in Mexico City

    PubMed Central

    Peterson, Karen E.; Sánchez, Brisa N.; Cantonwine, David; Lamadrid-Figueroa, Héctor; Schnaas, Lourdes; Ettinger, Adrienne S.; Hernández-Avila, Mauricio; Hu, Howard; Téllez-Rojo, Martha M.

    2011-01-01

    Background: Cumulative prenatal lead exposure, as measured by maternal bone lead burden, has been associated with smaller weight of offspring at birth and 1 month of age, but no study has examined whether this effect persists into early childhood. Objective: We investigated the association of perinatal maternal bone lead, a biomarker of cumulative prenatal lead exposure, with children’s attained weight over time from birth to 5 years of age. Methods: Children were weighed at birth and at several intervals up until 60 months. Maternal tibia and patella lead were measured at 1 month postpartum using in vivo K-shell X-ray fluorescence. We used varying coefficient models with random effects to assess the association of maternal bone lead with weight trajectories of 522 boys and 477 girls born between 1994 and 2005 in Mexico City. Results: After controlling for breast-feeding duration, maternal anthropometry, and sociodemographic characteristics, a 1-SD increase in maternal patella lead (micrograms per gram) was associated with a 130.9-g decrease in weight [95% confidence interval (CI), –227.4 to –34.4 g] among females and a 13.0-g nonsignificant increase in weight among males (95% CI, –73.7 to 99.9 g) at 5 years of age. These associations were similar after controlling for concurrent blood lead levels between birth and 5 years. Conclusions: Maternal bone lead was associated with lower weight over time among female but not male children up to 5 years of age. Given that the association was evident for patellar but not tibial lead levels, and was limited to females, results need to be confirmed in other studies. PMID:21715242

  7. Ribbon Ion Beam with Controlled Directionality and Local Reactive Chemistry

    NASA Astrophysics Data System (ADS)

    Biloiu, Costel; Gilchrist, Glen; Kontos, Alex; Basame, Solomon; Rockwell, Tyler; Campbell, Chris; Daniels, Kevin; Allen, Ernest; Wallace, Jay; Ballou, Jon; Hertel, Richard; Chen, Tsung-Liang; Liang, Shurong; Singh, Vikram

    2016-09-01

    A plasma processing technology designed for etch of 3D semiconductor structures is presented. The technology is characterized by controllable ion directionality and local reactive chemistry and it is based on proprietary Applied Materials - Varian Semiconductor Equipment ribbon ion beam architecture. It uses a combination of inert gas ion beam and injection of reactive chemical species at the Point-of-Use (PoU), i.e., at the wafer surface. The ion source uses an inductively coupled plasma source and a diode-type extraction optics. A beam shaping electrode allows extraction of two symmetrical ribbon-like beamlets. The ion beam has in situ controllable ion angular distribution in both mean angle and angular spread. The beam has a uniform distribution of beam current and angles over a waist exceeding 300 mm, allowing full wafer processing in one pass. Chemical compounds are delivered at PoU through linear shower heads. The reactive chemical compound delivered in this fashion maintains its molecular integrity. This result in protection of the trench side walls from deposition of etch residue and facilitates formation of volatile byproducts. The technology was used successfully for mitigation of Magnetic Tunel Junction etch residue. Other applications were this technology differentiate from present technologies are contact liner etch, Co recess, and 1D hole elongation.

  8. 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.

  9. 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

  10. 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

  11. Development of allocentric spatial memory abilities in children from 18 months to 5 years of age.

    PubMed

    Ribordy, Farfalla; Jabès, Adeline; Banta Lavenex, Pamela; Lavenex, Pierre

    2013-02-01

    Episodic memories for autobiographical events that happen in unique spatiotemporal contexts are central to defining who we are. Yet, before 2 years of age, children are unable to form or store episodic memories for recall later in life, a phenomenon known as infantile amnesia. Here, we studied the development of allocentric spatial memory, a fundamental component of episodic memory, in two versions of a real-world memory task requiring 18 month- to 5-year-old children to search for rewards hidden beneath cups distributed in an open-field arena. Whereas children 25-42-months-old were not capable of discriminating three reward locations among 18 possible locations in absence of local cues marking these locations, children older than 43 months found the reward locations reliably. These results support previous findings suggesting that allocentric spatial memory, if present, is only rudimentary in children under 3.5 years of age. However, when tested with only one reward location among four possible locations, children 25-39-months-old found the reward reliably in absence of local cues, whereas 18-23-month-olds did not. Our findings thus show that the ability to form a basic allocentric representation of the environment is present by 2 years of age, and its emergence coincides temporally with the offset of infantile amnesia. However, the ability of children to distinguish and remember closely related spatial locations improves from 2 to 3.5 years of age, a developmental period marked by persistent deficits in long-term episodic memory known as childhood amnesia. These findings support the hypothesis that the differential maturation of distinct hippocampal circuits contributes to the emergence of specific memory processes during early childhood.

  12. 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.

  13. Local control of squamous cell carcinoma of the mobile tongue: an experience of different modalities

    SciTech Connect

    Kondo, M.; Hashimoto, S.; Dokiya, T.; Inuyama, Y.; Murakami, Y.; Nagai, T.; Asanami, S.; Fukutake, K.

    1986-05-01

    From 1966 through 1983, 163 patients with squamous cell carcinoma of the mobile tongue were treated. Fifty-two patients were staged as T1N0, 77 as T2N0, 14 as T2N+, 8 as T3N0, 7 as T3N+, and 5 as T4. The follow-ups were complete. Treatment modalities varied considerably during that period, because of increasing difficulty to use radioactive sources by regulations. All T3N+ and T4 patients died shortly after treatment. Five year absolute survivals for the T1N0, T2N0, T2N+, and T3N0 patients were 87%, 60%, 27% and 63%, respectively. Local recurrence free survivals at 5 years for the T1N0, T2N0, T2N+, and T3N0 patients were 72, 48, 58, and 88%, respectively. Local recurrence free survivals seemed to be better with Ra-226 needling +/- external irradiation (EXT) than other modalities. Because many patients with local recurrence were salvaged, ultimate local-disease-free survivals should also be considered. They were 96 and 70% at 5 years for the T1N0 patients treated with Ra-226 +/- EXT, and with surgery +/- EXT, respectively; the corresponding figures for the T2N0 patients were 83 and 64%. For these reasons, Ra-226 needling may be preferable to other modalities as initial treatment. Although cervical failures did not develop after 2 years of treatment, late local recurrences were rather common, even after 5 years. Long-term follow-up is mandatory for the management of the patients, and analyzing and comparing the results.

  14. Gross Motor Development in Children Aged 3-5 Years, United States 2012.

    PubMed

    Kit, Brian K; Akinbami, Lara J; Isfahani, Neda Sarafrazi; Ulrich, Dale A

    2017-02-14

    Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p < 0.05). However, the mean locomotor standardized scores for both boys and girls fell into the range categorized as "average." There were no other differences by age, race/Hispanic origin, weight status, or income in either of the subtest standardized scores (p > 0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

  15. The 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture.

    PubMed

    Plath, J; Gurk, S; Strophal, G; Johnson, M; Jansson, V

    2001-09-01

    In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.

  16. Evaluation of acute pyelonephritis with DMSA scans in children presenting after the age of 5 years.

    PubMed

    Ataei, Neamatollah; Madani, Abbas; Habibi, Reza; Khorasani, Mosa

    2005-10-01

    It is generally believed that infants are more susceptible to development of renal scarring after pyelonephritis than children over 5 years old. This view has led to differences in investigations and treatment according to age. The aim of this prospective study was to assess the occurrence of renal parenchymal lesion in children over 5 years admitted with a first-time symptomatic urinary tract infection (UTI). Between October 2000 and April 2002, 52 children aged over 5 years who were admitted to our department with probable acute pyelonephritis (APN) and a positive urine culture were included in this study. All children received antibiotics for 14 days. During the acute phase of infection, scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA) and ultrasonography (US) were done. Voiding cystourethrography (VCUG) was performed in all children early in the course of the illness, generally within 5-7 days of hospitalization. When scintigraphy showed renal parenchymal changes, repeat scintigraphy was done after at least 3 months to assess the progression of renal abnormalities. Of the 52 children with a first-time documented pyelonephritis, cortical scintigraphy showed renal lesion in 41 children (78.8%). US was normal in all children with normal renal scintigraphy, while it detected renal abnormalities in 16 of the 41 (39 %) with abnormal scintigraphy (p <0.0001). Topographic analysis of the 165 focal lesions showed that 42.4% were localized to the upper poles, 17.5% to the middle third, and 40% to the lower poles of the kidneys. Repeat scintigraphy showed persistent lesions corresponding to those on the initial scan in nine (28.2%) of the 32 children. Renal lesions had partly regressed in 23 (71.8%) of the patients who underwent repeat scintigraphy. Vesicoureteral reflux was observed in 13.4% of kidneys and renal parenchymal abnormalities were identified in 71.4% and 72.2% of renal units, respectively, with and without reflux ( p >0.05). In

  17. The impact factors on 5-year survival rate in patients operated with oral cancer

    PubMed Central

    Geum, Dong-Ho; Roh, Young-Chea; Yoon, Sang-Yong; Kim, Hyo-Geon; Lee, Jung-Han; Song, Jae-Min; Lee, Jae-Yeol; Hwang, Dae-Seok; Kim, Yong-Deok; Shin, Sang-Hun; Chung, In-Kyo

    2013-01-01

    Objectives The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. Materials and Methods Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. Results By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. Conclusion The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors. PMID:24471047

  18. WMAP 5-year constraints on α and me

    NASA Astrophysics Data System (ADS)

    Scóccola, Claudia G.; Landau, Susana J.; Vucetich, Héctor

    2010-11-01

    We have studied the role of fundamental constants in an updated recombination scenario. We focus on the time variation of the fine structure constant α, and the electron mass me in the early Universe. In the last years, helium recombination has been studied in great detail revealing the importance of taking new physical processes into account in the calculation of the recombination history. The equations to solve the detailed recombination scenario can be found for example in Wong et al. 2008. In the equation for helium recombination, a term which accounts for the semi-forbidden transition 23p-11s is added. Furthermore, the continuum opacity of HI is taken into account by a modification in the escape probability of the photons that excite helium atoms, with the fitting formulae proposed Kholupenko et al 2007. We have analized the dependences of the quantities involved in the detailed recombination scenario on α and me. We have performed a statistical analysis with COSMOMC to constrain the variation of α and me at the time of neutral hydrogen formation. The observational set used for the analysis was data from the WMAP 5-year temperature and temperature-polarization power spectrum and other CMB experiments such as CBI, ACBAR and BOOMERANG and the power spectrum of the 2dFGRS. Considering the joint variation of α and me we obtain the following bounds: -0.011 < {Δα}/{α_0} < 0.019 and -0.068 < {Δ m_e}/{(m_e)_0 < 0.030 (68% c.l.). When considering only the variation of one fundamental constant we obtain: -0.010 < {Δ α}/{α_0} < 0.008 and -0.04 < {Δ m_e}/{(m_e)_0} < 0.02 (68% c.l.). We compare these results with the ones presented in Landau et al 2008, which were obtained in the standard recombination scenario and using WMAP 3 year release data. The constraints are tighter in the current analysis, which is an expectable fact since we are working with more accurate data from WMAP. The bounds obtained are consistent with null variation, for both α and me, but

  19. Increased caries prevalence in 2.5-year-old children with cleft lip and/or palate.

    PubMed

    Bokhout, B; Hofman, F X; van Limbeek, J; Kramer, G J; Prahl-Andersen, B

    1996-01-01

    The prevalence of dental caries was determined clinically in 2.5-year-old Dutch cleft lip and/or palate children (n = 76) and in children without congenital malformation (n = 75). The parents were given a structured questionnaire regarding the child's dietary habits, oral hygiene, fluoride exposure and social economic background. The prevalence of dental caries was higher in children with oral cleft than in children without oral cleft. Initial caries (white spots) was diagnosed in 17.1% of the subjects with oral cleft compared with 4.0% of the control subjects. Manifest caries (cavities) was found in 26.3% of the children with oral cleft compared with 5.3% of the controls. The dft score (manifest caries) was significantly higher for the oral cleft group (0.59 +/- 1.35) than for the control group (0.11 +/- 0.54). 52% of the total number of initial and manifest lesions were localized to the maxillary incisors. A multivariate analysis yielded initial caries, oral hygiene and treatment with preoperative infant orthopaedics as the variables significantly associated with manifest caries.

  20. 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.

  1. 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

  2. Local control and complications after radiation therapy for primary orbital lymphoma: A case for low-dose treatment

    SciTech Connect

    Minehan, K.J.; Martenson, J.A. Jr.; Garrity, J.A.; Kurtin, P.J.; Banks, P.M.; Chen, M.G.; Earle, J.D. )

    1991-04-01

    Orbital involvement at the time of initial presentation is unusual in non-Hodgkin's lymphoma. In an effort to identify potential ways of improving the radiotherapeutic management of this disease, the records of 22 patients were reviewed retrospectively. All had biopsy-proven orbital non-Hodgkin's lymphoma, and the minimal, median, and maximal durations of follow-up in surviving patients were 4.8 years, 7.0 years, and 17.4 years, respectively. Permanent local control was achieved in 21 of the 22 patients (96%). Complications were scored according to a grading scheme in which grade 1 was the least significant complication and grade 4 was blindness as a result of radiation therapy. Of the 12 patients who received a radiation dose less than 35 Gy, 6 developed a grade 1 or grade 2 complication. Of the 10 patients treated with greater than or equal to 35 Gy, 6 experienced a complication, 1 of whom had a grade 4 complication resulting in blindness and another who developed a severe keratitis, which was scored as a grade 3 complication resulting in decreased visual acuity. At last follow-up, 10 patients were alive at 4.8 to 17.4 years after completion of radiation therapy, 4 had died of intercurrent disease at 3 months to 10.6 years, and 8 had died of disease at 3 months to 15.8 years. Actuarial survival for the entire group was 75% at 5 years and 48% at 10 years. Survival in patients with Stage I AE disease (lymphoma confined to orbit) at presentation was 87% at 5 years and 50% at 10 years, and survival in patients with Stage II A through Stage IV disease was 36% at 5 years and at 10 years. Primary orbital lymphoma is an indolent disease characterized by prolonged survival after radiation therapy. Excellent local control can be achieved with radiation doses of 20 Gy to 35 Gy. Higher doses may result in an increased risk of complications.

  3. Association between depression in carers and malnutrition in children aged 6 months to 5 years

    PubMed Central

    Ganiyu, Adewale B.; Firth, Jacqueline A.

    2017-01-01

    Background Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. Aim The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. Setting The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. Methods This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. Results From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. Conclusion This study found a significant association between PCG depression and child malnutrition. PMID:28155288

  4. Local effects of structure formation and control in self-organizing systems. II

    SciTech Connect

    Chugaev, V.I.

    1995-09-01

    This theoretical problem focuses on stability, controllability, and adaptation methods in nonlinear distributed dissipative systems subject to external local changes of diffusion coefficients. The control directly affect the main equations describing the controlled system, and it is applied in the form of a local change in the field of diffusion coefficients of the reactive system at the control point.

  5. Gait in 5-year-old children with idiopathic clubfoot

    PubMed Central

    Lööf, Elin; Andriesse, Hanneke; André, Marie; Böhm, Stephanie; Broström, Eva W

    2016-01-01

    Background and purpose Idiopathic clubfoot can be bilateral or unilateral; however, most studies of gait have assessed clubfoot cases as one uniform group. The contralateral foot in children with unilateral clubfoot has shown deviations in pedobarographic measurements, but it is seldom included in studies of gait. We evaluated gait in children with idiopathic clubfoot, concentrating on foot involvement. Patients and methods Three-dimensional gait analyses of 59 children, mean age 5.4 years, with bilateral (n = 30) or unilateral (n = 29) idiopathic clubfoot were stratified into groups of bilateral, unilateral, or contralateral feet. Age-matched controls (n = 28) were evaluated for comparison. Gait assessment included: (1) discrete kinematic and kinetic parameters, and (2) gait deviation index for kinematics (GDI) and kinetics (GDI-k). Results No differences in gait were found between bilateral and unilateral idiopathic clubfoot, but both groups deviated when compared to controls. Compared to control feet, contralateral feet showed no deviations in discrete gait parameters, but discrepancies were evident in relation to unilateral clubfoot, causing gait asymmetries in children with unilateral involvement. However, all groups deviated significantly from control feet according to GDI and GDI-k. Interpretation Bilateral and unilateral idiopathic clubfoot cases show the same persistent deviations in gait, mainly regarding reduced plantarflexion. Nevertheless, knowledge of foot involvement is important as children with unilateral clubfoot show gait asymmetries, which might give an impression of poorer deviations. The results of GDI/GDI-k indicate global gait adaptations of the contralateral foot, so the foot should preferably not be used as a reference for gait. PMID:27331243

  6. Racial Isolation, Poverty, and the Limits of Local Control in Oakland

    ERIC Educational Resources Information Center

    Noguera, Pedro A.

    2004-01-01

    Historically, schools in the United States have been governed at the local level by elected school boards, and finances have been raised primarily through local property taxes. While local control theoretically allows for greater responsiveness to local concerns, it does not take into account the vast inequality among and between communities in…

  7. [Analysis on research projects for acupuncture and moxibustion supported by NSFC during the 11th 5-year-plan].

    PubMed

    Zhao, Chang-Long; Jing, Xiang-Hong; Li, Yu-Qing; Li, Liang; Rong, Pei-Jing; Wang, Chang-En

    2012-08-01

    In the present paper, the authors introduce the approved and finished research projects for acupuncture and moxibustion therapies supported by the National Natural Science Foundation of China (NSFC) during the 11th 5-year-plan. A total of 194 research projects were subsidized by NSFC from 2006 to 2010. These projects include 6 aspects: meridian-collaterals, acupoint theory, acupuncture analgesia, mechanisms underlying improvement of different clinical problems, clinical trials, and moxibustion therapy. The research on acupoints has been becoming a new hotspot in recent years. Majority of the research projects focus on the mechanism of acu-moxibustion underlying improvement of different clinical problems, while fewer projects on clinical trials. During the 11th 5-year-plan, 119 projects were completed; most of them involved meridian-collateral theory, acupoint theory, mechanism of acu-moxibustion underlying improvement of clinical problems and acupuncture manipulations. Following analysis of the finished research projects, we find that 1) many neurobiological methods and techniques are commonly used in the research on meridian-collateral theory; 2) the research on acupoint theory is changing from observing the local morphological structure to identifying characteristics of the regional activated receptors, particularly under the circumstances of visceral pathological conditions and efficacies of acupoints; 3) researches on the underlying mechanism of acu-moxibusiton for improving clinical disorders mainly focused on its cerebral protective effects against cerebral ischemia, in addition, researches about other diseases on clinical conditions have been also carried out, but the related mechanisms are far from understanding; 4) In many research projects, various new methods and techniques, such as fMRI, position emission tomography, genomics, proteomics, molecular biology, nerve stem cell, etc. were widely used; 5) Randomized controlled multi-center clinical trials are

  8. 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…

  9. Arterial identity of endothelial cells is controlled by local cues.

    PubMed

    Othman-Hassan, K; Patel, K; Papoutsi, M; Rodriguez-Niedenführ, M; Christ, B; Wilting, J

    2001-09-15

    The ephrins and their Eph receptors comprise the largest family of receptor tyrosine kinases. Studies on mice have revealed an important function of ephrin-B2 and Eph-B4 for the development of the arterial and venous vasculature, respectively, but the mechanisms regulating their expression have not been studied yet. We have cloned a chick ephrin-B2 cDNA probe. Expression was observed in endothelial cells of extra- and intraembryonic arteries and arterioles in all embryos studied from day 2 (stage 10 HH, before perfusion of the vessels) to day 16. Additionally, expression was found in the somites and neural tube in early stages, and later also in the smooth muscle cells of the aorta, parts of the Müllerian duct, dosal neural tube, and joints of the limbs. We isolated endothelial cells from the internal carotid artery and the vena cava of 14-day-old quail embryos and grafted them separately into day-3 chick embryos. Reincubation was performed until day 6 and the quail endothelial cells were identified with the QH1 antibody. The grafted arterial and venous endothelial cells expressed ephrin-B2 when they integrated into the lining of arteries. Cells that were not integrated into vessels, or into vessels other than arteries, were ephrin-B2-negative. The studies show that the expression of the arterial marker ephrin-B2 is controlled by local cues in arterial vessels of older embryos. Physical forces or the media smooth muscle cells may be involved in this process.

  10. 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.

  11. Controlling chaos with localized heterogeneous forces in oscillator chains.

    PubMed

    Chacón, Ricardo

    2006-10-01

    The effects of decreasing the impulse transmitted by localized periodic pulses on the chaotic behavior of homogeneous chains of coupled nonlinear oscillators are studied. It is assumed that when the oscillators are driven synchronously, i.e., all driving pulses transmit the same impulse, the chains display chaotic dynamics. It is shown that decreasing the impulse transmitted by the pulses of the two free end oscillators results in regularization with the whole array exhibiting frequency synchronization, irrespective of the chain size. A maximum level of amplitude desynchrony as the pulses of the two end oscillators narrow is typically found, which is explained as the result of two competing universal mechanisms: desynchronization induced by localized heterogeneous pulses and oscillation death of the complete chain induced by drastic decreasing of the impulse transmitted by such localized pulses. These findings demonstrate that decreasing the impulse transmitted by localized external forces can suppress chaos and lead to frequency-locked states in networks of dissipative systems.

  12. 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

  13. 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.

  14. A 10-year epidemiologic review of homicide cases in children younger than 5 years in Fulton County, GA: 1996-2005.

    PubMed

    Fajardo, Geroncio Cagigas; Hanzlick, Randy L

    2010-12-01

    The primary purpose of this study was to present the epidemiologic review of homicide deaths certified by the Fulton County Medical Examiner's Office from January 1, 1996 through December 31, 2005 in children younger than 5 years. The secondary purpose of this study was to determine if the observed cases of homicide deaths among children younger than 5 years in Fulton County are significantly greater than expected when compared with those in the State of Georgia. For purposes of this study, only homicide deaths of Fulton County residents were included. The authors reviewed all homicide cases in children younger than 5 years: infancy (<1 year) and early childhood (1-4 years). χ values were calculated using Epi Info (version 3.4.1; Centers for Disease Control and Prevention, Atlanta, Ga) to determine differences in homicide among age group, race, and sex variables. In addition, a χ test at the α level of 0.05 was done to determine if the observed cases of homicide deaths among children younger than 5 years in Fulton County were significantly greater than expected when compared with those in the State of Georgia. There were 49 homicide cases in children younger than 5 years identified over this 10-year period. The yearly distribution of these 49 homicide deaths ranged from 1 death in 2003 to 9 deaths in 2004. Most of the patients were male (n=29, 59.2%) and black (n=44, 89.8%). Between infancy and early childhood cases, homicide victims were nearly equally divided between the 2 groups. However, χ values showed that decedents younger than 5 years are more likely to have died of homicide compared with decedents 5 years or older (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.29-2.35). Black decedents younger than 5 years are more likely to have died of homicide compared with other races (OR, 3.21; 95% CI, 1.21-9.28). Male and female decedents are equally at risk to have died of homicide (OR, 1.14; 95% CI, 0.61-2.11). The authors also determined that the

  15. Characterization and evolution of exposure to volatile organic compounds in the Spanish shoemaking industry over a 5-year period.

    PubMed

    Estevan, Carmen; Ferri, Francisca; Sogorb, Miguel Angel; Vilanova, Eugenio

    2012-01-01

    This study measured inhalation exposure to 13 volatile organic compounds (VOCs) among workers in the leatherwear industry in Spain, examined the changes in those exposures over a 5-year period, and documented local exhaust ventilation practices that affected exposure. In collaboration with an occupational risk prevention company, air samples were collected from 849 workers' personal breathing zones using personal air pumps with activated charcoal tubes. VOCs were analyzed using a GC/MS-optimized method modified in our laboratory from that proposed by Spanish authorities (INSHT). Airborne concentrations were compared with occupational exposure limit (OEL) values from the European authorities. The most frequently detected VOCs were acetone (98.1%), toluene (94.8%), n-hexane (71.2%) and other C6-C7 branched alkyl hydrocarbons (97.5%). Other frequently detected VOCs were MEK (64.9%), ethylacetate (60.7%), and cyclohexane (29.3%). Benzene was detected in 24.6% of samples. Although all the samples were taken while workers performed tasks judged to have the highest VOC exposure potential, only 14% of samples showed excessive aggregate exposure, and chemical-specific OELs were exceeded in a relatively small number of cases: 7.2% for n-hexane, 2.8% for toluene, 0.6% for acetone, and 0.4% for hexane isomers. Over the study period, a diminished use of n-hexane in solvent formulations and an increased use of branched hexane and heptane isomers were observed. Six factors relating to work location conditions and types were evaluated. Most high-exposure cases were associated with three task types. The presence of local exhaust ventilation was an important exposure control, but significant exposures despite the use of local exhaust were observed. Although n-hexane exposures significantly decreased over the study period, the overall level of VOC exposure did not decrease. More effective exposure prevention measures need to be implemented.

  16. The impact of age on local control in women with pT1 breast cancer treated with conservative surgery and radiation therapy.

    PubMed

    Jobsen, J J; van der Palen, J; Meerwaldt, J H

    2001-10-01

    The aim of the study was to evaluate the importance of young age with regard to local control in a prospective cohort of 1085 women with pathological T1 tumours treated with breast conservative treatment (BCT). Patients were divided into two age groups: 40 years or younger, 7.8%, and older than 40 years, 92.2%. With a median follow-up of 71 months, the local recurrence rate was 10.6% in women < or =40 years, and 3.7% in older women. The local recurrence-free survival (LRFS) was significantly different for the two age groups, respectively 89%, < or =40 years, and 97.6%, >40 years (P=0.0046). A separate analysis showed a significantly decreased LRFS for young women with a positive family history, 75.4% versus 98.4% 5-year LRFS for older women. A worse LRFS for young women with a negative lymph node status was also observed, respectively 84% versus 98% 5-year LRFS (both P<0.001). In a multivariate analysis, taking into account the pre-treatment and treatment factors, age < or =40 years, was the only significant predictor of a decreased LRFS. Thus, young age is an important factor in relation to local control. In a subset analysis, this significant adverse effect of young age on outcome appears to be limited to the node-negative patients and those with a positive family history. To date, there is no evidence that young women with pT1 breast cancer, treated by mastectomy have an improved outcome when compared with those treated with conservative surgery and radiotherapy. Taking into account results from a subset analysis suggests that giving systemic therapy to a subgroup of women who are < or =40 years, node-negative and/or have a positive family history might give a better local control.

  17. Snoring, sleep disturbance, and behaviour in 4-5 year olds.

    PubMed Central

    Ali, N J; Pitson, D J; Stradling, J R

    1993-01-01

    Parents of 996 children aged 4-5 years identified consecutively from the Oxford health visitor register were asked to complete a questionnaire about breathing disorders during sleep. A total of 782 (78.5%) was returned. Ninety five (12.1%) children were reported to snore on most nights. Habitual snoring was significantly associated with daytime sleepiness, restless sleep, and hyperactivity. The questionnaire responses were used to select two subgroups, one at high risk of a sleep and breathing disorder and a control group. These children (132 in total) were monitored at home with overnight video recording and oximetry, and had formal behavioural assessment using the Conners scale. Seven (7/66) children from the high risk group and none from the control group had obvious sleep disturbance consequent on snoring and upper airway obstruction. Thus our estimate of the prevalence of sleep and breathing disorders in this age group is 7/996 or 0.7%. The high risk group had significantly higher nocturnal movement, oxygen saturation dip rates, and overnight pulse rates than the controls. Maternal but not paternal smoking was associated with the high risk group. Parents and teachers thought those in the high risk group were more hyperactive and inattentive than the controls, but only their parents thought them more aggressive. Significant sleep and breathing disorders occur in about 0.7% of 4-5 year olds. Children whose parents report snoring and sleep disturbance have objective evidence of sleep disruption and show more behaviour problems than controls. PMID:8280201

  18. Pranlukast reduces asthma exacerbations during autumn especially in 1- to 5-year-old boys

    PubMed Central

    Campos Alberto, Eduardo; Suzuki, Shuichi; Sato, Yoshinori; Hoshioka, Akira; Abe, Hiroki; Saito, Kimiyuki; Tsubaki, Toshikazu; Haraki, Mana; Sawa, Akiko; Nakayama, Yoshio; Kojima, Hiroyuki; Shigeta, Midori; Yamaide, Fumiya; Kohno, Yoichi; Shimojo, Naoki

    2017-01-01

    Background Leukotriene receptor antagonists have been used to prevent virus-induced asthma exacerbations in autumn. Its efficacy, however, might differ with age and sex. Objective This study aimed to investigate whether pranlukast added to usual asthma therapy in Japanese children during autumn, season associated with the peak of asthma, reduces asthma exacerbations. It was also evaluated the effect of age and sex on pranlukast's efficacy. Methods A total of 121 asthmatic children aged 1 to 14 years were randomly assigned to receive regular pranlukast or not according to sex, and were divided in 2 age groups, 1–5 years and 6–14 years. The primary outcome was total asthma score calculated during 8 weeks by using a sticker calendar related to the days in which a child experienced a worsening of asthma symptoms. This open study lasted 60 days from September 15 to November 14, 2007. Results Significant differences in pranlukast efficacy were observed between sex and age groups. Boys aged 1 to 5 years had the lower total asthma score at 8 weeks (p = 0.002), and experienced fewer cold episodes (p = 0.007). There were no significant differences between pranlukast and control group in total asthma score at 8 weeks (p = 0.35), and in the days in which a child experienced a worsening of asthma symptoms (p = 0.67). Conclusion There was a substantial benefit of adding pranlukast to usual therapy in asthmatic children, especially in boys aged 1 to 5 years, during autumn season. PMID:28154801

  19. Global strategy for the diagnosis and management of asthma in children 5 years and younger.

    PubMed

    Pedersen, Soren Erik; Hurd, Suzanne S; Lemanske, Robert F; Becker, Allan; Zar, Heather J; Sly, Peter D; Soto-Quiroz, Manuel; Wong, Gary; Bateman, Eric D

    2011-01-01

    Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalisation. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non-specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms-only descriptive approach that includes the definition of various wheezing phenotypes has been recommended. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information. In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in

  20. Controlling local order of athermal self-propelled particles

    NASA Astrophysics Data System (ADS)

    Dougan, Niamh; Crowther, Peter; Royall, C. Patrick; Turci, Francesco

    2016-12-01

    We consider a model of self-propelled dynamics for athermal active particles, where the non-equilibrium active forces are modelled by a Ornstein-Uhlenbeck process. In the limit of no-driving force, the model reduces to the passive, Brownian dynamics of an atomistic glass forming fluid, the Wahnström binary mixture. The Wahnström mixture is known to show strong correlations between the emergence of slow dynamics and the formation of locally favoured structures based on icosahedra. Here, we study how the non-equilibrium driving affects the local structure of the system, and find that it strongly promotes icosahedral order. The states rich in local icosahedral order correspond to configurations of very low potential energy, suggesting that the non-equilibrium dynamics in the self propelled model can be effectively exploited to explore the potential energy surface of the binary mixture and have access to states that are difficult to attain using passive dynamics.

  1. 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.

  2. 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

  3. 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''.

  4. 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.

  5. 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

  6. Fasting increases risk for onset of binge eating and bulimic pathology: a 5-year prospective study.

    PubMed

    Stice, Eric; Davis, Kendra; Miller, Nicole P; Marti, C Nathan

    2008-11-01

    Although adolescent girls with elevated dietary restraint scores are at increased risk for future binge eating and bulimic pathology, they do not eat less than those with lower restraint scores. The fact that only a small proportion of individuals with elevated dietary restraint scores develop bulimic pathology suggests that some extreme but rare form of dietary restriction may increase risk for this disturbance. The authors tested the hypothesis that fasting (going without eating for 24 hr for weight control) would be a more potent predictor of binge eating and bulimic pathology onset than dietary restraint scores using data from 496 adolescent girls followed over 5 years. Results confirmed that only 23% of participants with elevated dietary restraint scores reported fasting. Furthermore, fasting generally showed stronger and more consistent predictive relations to future onset of recurrent binge eating and threshold/subthreshold bulimia nervosa over 1- to 5-year follow-up relative to dietary restraint, though the former effects were only significantly stronger than the latter for some comparisons. Results provide preliminary support for the hypothesis that fasting is a stronger risk factor for bulimic pathology than is self-reported dieting.

  7. Aetiology and clinical features of dysentery in children aged <5 years in rural Bangladesh.

    PubMed

    Ferdous, F; Ahmed, S; DAS, S K; Farzana, F D; Latham, J R; Chisti, M J; Faruque, A S G

    2014-01-01

    The study identified the common aetiological agents and prominent clinical features of dysentery cases in children aged <5 years and compared this to non-dysentery diarrhoeal cases from the same population. From January 2010 to December 2011, 2324 children aged <5 years received treatment at Kumudini Hospital, of which 682 (29%) presented with dysentery. Of the dysenteric children, aetiology could not be determined for over half (61%). Shigella spp. accounted for 32% of dysentery cases. Significant associations were found between presence of blood in stool and: child age (24-59 months) [odds ratio (OR) 2.21, 95% confidence interval (CI) 1.49-3.27], no treatment of drinking water at home (OR 2.00, 95% CI 1.09-3.67), vomiting (OR 0.19, 95% CI 0.14-0.25), abdominal pain (OR 4.68, 95% CI 3.24-6.77), straining (OR 16.45, 95% CI 11.92-22.69), wasting (OR 1.66, 95% CI 1.15-2.41), and presence of Shigella in stool (OR 6.25, 95% CI 4.20-9.29) after controlling for confounders. This study makes it clear that appropriate public health strategies are needed to reduce the burden of dysentery in Bangladesh.

  8. 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%.

  9. Local Anesthesia Versus Local Anesthesia and Conscious Sedation for Inguinal Hernioplasty: Protocol of a Randomized Controlled Trial

    PubMed Central

    Toppin, Patrick J; Reid, Marvin; Plummer, Joseph M; Roberts, Patrick O; Harding-Goldson, Hyacinth; McFarlane, Michael E

    2017-01-01

    Background Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. Reports suggest that the addition of conscious sedation to local anesthesia for inguinal hernioplasty is safe and effective in improving patient satisfaction. No previous randomized controlled trial has assessed the benefit of conscious sedation in this regard. Objective To determine whether the addition of conscious sedation to local anesthesia improves patient satisfaction with inguinal hernioplasty. Methods This trial is designed as a single-center, randomized, placebo-controlled, blinded trial of 148 patients. Adult patients diagnosed with a reducible, unilateral inguinal hernia eligible for hernioplasty using local anesthesia will be recruited. The intervention will be the use of intravenous midazolam for conscious sedation. Normal saline will be used as placebo in the control group. The primary outcome will be patient satisfaction, measured using the validated Iowa Satisfaction with Anesthesia Scale. Secondary outcomes will include intra- and postoperative pain, operative time, volumes of sedative agent and local anesthetic used, time to discharge, early and late complications, and postoperative functional status. Results To date, 171 patients have been recruited. Surgery has been performed on 149 patients, meeting the sample size requirements. Follow-up assessments are still ongoing. Trial completion is expected in August 2017. Conclusions This randomized controlled trial is the first to assess the effectiveness of conscious sedation in improving patient satisfaction with inguinal hernioplasty using local anesthesia. If the results demonstrate improved patient satisfaction with conscious sedation, this would support routine incorporation of conscious sedation in local inguinal hernioplasty and potentially influence national and international hernia surgery guidelines. Trial registration Clinicaltrials.gov NCT02444260; https

  10. Local Government Planning Tool to Calculate Institutional and Engineering Control Costs for Brownfield Properties

    EPA Pesticide Factsheets

    This cost calculator is designed as a guide for municipal or local governments to assist in calculating their expected costs of implementing and conducting long-term stewardship of institutional controls and engineering controls at brownfield properties.

  11. Local geology controlled the feasibility of vitrifying Iron Age buildings

    PubMed Central

    Wadsworth, Fabian B.; Heap, Michael J.; Damby, David E.; Hess, Kai-Uwe; Najorka, Jens; Vasseur, Jérémie; Fahrner, Dominik; Dingwell, Donald B.

    2017-01-01

    During European prehistory, hilltop enclosures made from polydisperse particle-and-block stone walling were exposed to temperatures sufficient to partially melt the constituent stonework, leading to the preservation of glassy walls called ‘vitrified forts’. During vitrification, the granular wall rocks partially melt, sinter viscously and densify, reducing inter-particle porosity. This process is strongly dependent on the solidus temperature, the particle sizes, the temperature-dependence of the viscosity of the evolving liquid phase, as well as the distribution and longevity of heat. Examination of the sintering behaviour of 45 European examples reveals that it is the raw building material that governs the vitrification efficiency. As Iron Age forts were commonly constructed from local stone, we conclude that local geology directly influenced the degree to which buildings were vitrified in the Iron Age. Additionally, we find that vitrification is accompanied by a bulk material strengthening of the aggregates of small sizes, and a partial weakening of larger blocks. We discuss these findings in the context of the debate surrounding the motive of the wall-builders. We conclude that if wall stability by bulk strengthening was the desired effect, then vitrification represents an Iron Age technology that failed to be effective in regions of refractory local geology. PMID:28079121

  12. Local geology controlled the feasibility of vitrifying Iron Age buildings.

    PubMed

    Wadsworth, Fabian B; Heap, Michael J; Damby, David E; Hess, Kai-Uwe; Najorka, Jens; Vasseur, Jérémie; Fahrner, Dominik; Dingwell, Donald B

    2017-01-12

    During European prehistory, hilltop enclosures made from polydisperse particle-and-block stone walling were exposed to temperatures sufficient to partially melt the constituent stonework, leading to the preservation of glassy walls called 'vitrified forts'. During vitrification, the granular wall rocks partially melt, sinter viscously and densify, reducing inter-particle porosity. This process is strongly dependent on the solidus temperature, the particle sizes, the temperature-dependence of the viscosity of the evolving liquid phase, as well as the distribution and longevity of heat. Examination of the sintering behaviour of 45 European examples reveals that it is the raw building material that governs the vitrification efficiency. As Iron Age forts were commonly constructed from local stone, we conclude that local geology directly influenced the degree to which buildings were vitrified in the Iron Age. Additionally, we find that vitrification is accompanied by a bulk material strengthening of the aggregates of small sizes, and a partial weakening of larger blocks. We discuss these findings in the context of the debate surrounding the motive of the wall-builders. We conclude that if wall stability by bulk strengthening was the desired effect, then vitrification represents an Iron Age technology that failed to be effective in regions of refractory local geology.

  13. Local geology controlled the feasibility of vitrifying Iron Age buildings

    USGS Publications Warehouse

    Fabian B Wadsworth,; Michael J Heap,; Damby, David; Kai-Uwe Hess,; Jens Najorka,; Jérémie Vasseur,; Dominik Fahrner,; Donald B Dingwell,

    2017-01-01

    During European prehistory, hilltop enclosures made from polydisperse particle-and-block stone walling were exposed to temperatures sufficient to partially melt the constituent stonework, leading to the preservation of glassy walls called ‘vitrified forts’. During vitrification, the granular wall rocks partially melt, sinter viscously and densify, reducing inter-particle porosity. This process is strongly dependent on the solidus temperature, the particle sizes, the temperature-dependence of the viscosity of the evolving liquid phase, as well as the distribution and longevity of heat. Examination of the sintering behaviour of 45 European examples reveals that it is the raw building material that governs the vitrification efficiency. As Iron Age forts were commonly constructed from local stone, we conclude that local geology directly influenced the degree to which buildings were vitrified in the Iron Age. Additionally, we find that vitrification is accompanied by a bulk material strengthening of the aggregates of small sizes, and a partial weakening of larger blocks. We discuss these findings in the context of the debate surrounding the motive of the wall-builders. We conclude that if wall stability by bulk strengthening was the desired effect, then vitrification represents an Iron Age technology that failed to be effective in regions of refractory local geology.

  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. Control synthesis of continuous-time T-S fuzzy systems with local nonlinear models.

    PubMed

    Dong, Jiuxiang; Wang, Youyi; Yang, Guang-Hong

    2009-10-01

    This paper is concerned with the problem of designing fuzzy controllers for a class of nonlinear dynamic systems. The considered nonlinear systems are described by T-S fuzzy models with nonlinear local models, and the fuzzy models have fewer fuzzy rules than conventional T-S fuzzy models with local linear models. A new fuzzy control scheme with local nonlinear feedbacks is proposed, and the corresponding control synthesis conditions are given in terms of solutions to a set of linear matrix inequalities (LMIs). In contrast to the existing methods for fuzzy control synthesis, the new proposed control design method is based on fewer fuzzy rules and less computational burden. Moreover, the local nonlinear feedback laws in the new fuzzy controllers are also helpful in achieving good control effects. Numerical examples are given to illustrate the effectiveness of the proposed method.

  16. Wettability controls slow immiscible displacement through local interfacial instabilities

    NASA Astrophysics Data System (ADS)

    Jung, Michael; Brinkmann, Martin; Seemann, Ralf; Hiller, Thomas; Sanchez de La Lama, Marta; Herminghaus, Stephan

    2016-11-01

    Immiscible fluid displacement with average front velocities in the capillary-dominated regime is studied in a transparent Hele-Shaw cell with cylindrical posts. Employing various combinations of fluids and wall materials allows us to cover a range of advancing contact angles 46∘≤θa≤180∘ of the invading fluid in our experiments. In parallel, we study the displacement process in particle-based simulations that account for wall wettability. Considering the same arrangement of posts in experiments and simulation, we find a consistent crossover between stable interfacial displacement at θa≲80∘ and capillary fingering at high contact angles θa≳120∘ . The position of the crossover is quantified through the evolution of the interface length and the final saturation of the displaced fluid. A statistical analysis of the local displacement processes demonstrates that the shape evolution of the fluid front is governed by local instabilities as proposed by Cieplak and Robbins for a quasistatic interfacial displacement [Cieplak and Robbins, Phys. Rev. Lett. 60, 2042 (1988), 10.1103/PhysRevLett.60.2042]. The regime of stable front advances coincides with a corresponding region of contact angles where cooperative interfacial instabilities prevail. Capillary fingering, however, is observed only for large θa, where noncooperative instabilities dominate the invasion process.

  17. 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.

  18. Speaking a tone language enhances musical pitch perception in 3-5-year-olds.

    PubMed

    Creel, Sarah C; Weng, Mengxing; Fu, Genyue; Heyman, Gail D; Lee, Kang

    2017-01-16

    Young children learn multiple cognitive skills concurrently (e.g., language and music). Evidence is limited as to whether and how learning in one domain affects that in another during early development. Here we assessed whether exposure to a tone language benefits musical pitch processing among 3-5-year-old children. More specifically, we compared the pitch perception of Chinese children who spoke a tone language (i.e., Mandarin) with English-speaking American children. We found that Mandarin-speaking children were more advanced at pitch processing than English-speaking children but both groups performed similarly on a control music task (timbre discrimination). The findings support the Pitch Generalization Hypothesis that tone languages drive attention to pitch in nonlinguistic contexts, and suggest that language learning benefits aspects of music perception in early development. A video abstract of this article can be viewed at: https://youtu.be/UY0kpGpPNA0.

  19. 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.

  20. Mesenteric panniculitis: prevalence, clinicoradiological presentation and 5-year follow-up

    PubMed Central

    van Bommel, E F H; Elgersma, O E; Hendriksz, T R

    2014-01-01

    Objective: To determine prevalence, clinicoradiological characteristics and outcome of patients with mesenteric panniculitis (MP) in a large hospital-based population. Methods: Consecutive abdominal CT examinations of 3820 patients were evaluated for MP. Clinical characteristics, therapy and outcome of patients with MP were evaluated during a 5-year follow-up period. A matched pair analysis was performed to further investigate the relation between MP and malignancy. Results: 94 (2.5%) patients with MP were identified (mean age, 66.6 ± 11.2 years, 70.2% male). MP coexisted with malignancy (especially prostatic carcinoma) in 48.9% of patients, and this was slightly but significantly higher than in age- and sex-matched control patients (n = 188, 46.3%). In 48 patients, MP was presumed to be idiopathic. The most frequent presenting symptom was pain (54.3%). Laboratory findings revealed increased acute-phase reactants in half of the patients with MP. CT findings included increased density of mesenterial fat (mean, −56.8 ± 10.8 HU), fat ring sign, tumoural pseudocapsule and small soft-tissue nodules. Patients with MP (14.6%) developed significantly more malignancies during a 5-year follow-up than did the control group (6.9%). One patient was treated with prednisone without satisfactory response. Conclusion: The prevalence of MP in this study was 2.5%. In most patients, radiologic features included increased mesenteric fat density, fat ring sign and small soft-tissue nodules. MP was associated with a significant higher prevalence of coexisting malignancies and a higher prevalence of future cancer development. Advances in knowledge: A more accurate prevalence of MP on CT is demonstrated. An underlying malignancy may play a role. PMID:25271412

  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. Micro-environmental control for efficient local cooling

    DOE PAGES

    Kong, Meng; Dang, Thong Q.; Zhang, Jianshun; ...

    2017-06-01

    Micro-environment is hereby defined as the air space and environment around a person that directly impacts his/her thermal sensation. Most existing HVAC systems condition the air of the entire room including the unoccupied space, which leaves a big potential to save energy. This study aims at evaluating the performance of three existing air terminal devices (ATDs) to locally remove enough heat from the micro-environment to manage the thermal balance so as not to sacrifice thermal comfort when the ambient unoccupied space temperature is increased by 2.2 °C from 23.9 °C to 26.1 °C in the summer to reduce the externalmore » cooling load. A computational fluid dynamics (CFD) model was developed, validated by full-scale chamber tests and applied to evaluate different configurations of the ATDs for local cooling. Results show that the predicted performance agreed well with the measurements, and the selected ATD, with only 50 W cooling power, was always able to remove a sufficient amount of heat from the microenvironment in a room of raised temperature, when the manikin was moved inside a semicircle movement range. The cooling performance of the jet was increased more by increasing the supply air flow rate than reducing the supply temperature and was highly dependent on the shooting angle. Finally, the heat flux from the manikin surface is very sensitive to the surface temperature and furniture placement, and proper specification of the surface temperature is crucial for the CFD simulation to match the measured results.« less

  3. [Eutrophication control in local area by physic-ecological engineering].

    PubMed

    Li, Qiu-Hua; Xia, Pin-Hua; Wu, Hong; Lin, Tao; Zhang, You-Chun; Li, Cun-Xiong; Chen, Li-Li; Yang, Fan

    2012-07-01

    An integrated physical and ecological engineering experiment for ecological remediation was performed at the Maixi River bay in Baihua Reservoir Guizhou Province, China. The results show that eutrophic parameters, such as total nitrogen, total phosphorus, chlorophyll a and chemical oxygen demand from the experimental site (enclosed water) were significantly lower than those of the reference site. The largest differences between the sites were 0.61 mg x L(-1), 0.041 mg x L(-1), 23.06 microg x L(-1), 8.4 mg x L(-1) respectively; experimental site transparency was > 1.50 m which was significantly higher than that of the reference site. The eutrophic index of the experimental site was oligo-trophic and mid-trophic, while the control site was mid-trophic state and eutrophic state. Phytoplankton abundance was 2 125.5 x 10(4) cells x L(-1) in June, 2011 at the control site,but phytoplankton abundance was lower at the experimental site with 33 x 10(4) cells x L(-1). Cyanobacteria dominated phytoplankton biomass at both sites, however the experimental site consisted of a higher proportion of diatoms and dinoflagellates. After more than one year of operation, the ecological engineering technology effectively controlled the occurrence of algae blooms, changed phytoplankton community structure, and controlled the negative impacts of eutrophication. Integrating physical and ecological engineering technology could improve water quality for reservoirs on the Guizhou plateau.

  4. 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

  5. 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.

  6. Controllable injector for local flux entry into superconducting films

    SciTech Connect

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

    2016-07-21

    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.

  7. 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

  8. 5-year Angiographic and Clinical Follow-up of Coil-embolised Intradural Saccular Aneurysms

    PubMed Central

    Batista, LL.; Mahadevan, J.; Sachet, M.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.

    2002-01-01

    Summary The purpose of the paper is the follow-up of embolised intradural saccular Arterial Aneurysms (AA), excluding giant, dissecting, inflammatory, fusiform or AA associated to BVAM. Since its introduction in 1991, the Guglielmi Detachable Coil has offered protection against aneurysmal rebleeding in the critical few days and months after SAH regardless of the grade. A number of questions remain: is complete angiographic obliteration necessary at first embolisation? What duration of clinical / angiographic follow-up (FU) is required to ensure the risk of haemorrhage has been eliminated? What is the long-term protection against rebleeding? One hundred and two patients with 160 intradural saccular AA embolised before april 1997 were selected for this study. They had at least 5-yrs clinical FU, of which 22 patients had a midterm (3 years) and 45 patients had a 5year or more angiographic FU (mean 67,7 months per patient). Twenty-eight embolised AAs with 100% occlusion at 1 year, remained unchanged on the 5year angiograms. A further 14 patients with complete occlusion at 1 year showed persisting complete occlusion on angiogram at 3-years FU, which in our series means that complete occlusion after the first year post-embolisation implies that the aneurysm will remain completely occluded. All secondary spontaneous thromboses (27.6% of cases), occurred during the first year pos-embolisation. In six patients with subtotal or partial occlusion no change was seen for three consecutive years of FU; none showed later change at 5-year angiography. Below 80% occlusion our series does not provide enough information but we consider the situation instable. No mortality related to the procedure was observed in the unruptured AA group. No bleeding or re-bleeding has occurred since the beginning of our experience (1993) in saccular AA treated by GDC-Coil. Coil-embolisation of properly selected patients is effective in protecting against bleeding or re-bleeding at short and long

  9. Radiotherapy alone for local tumour control in esthesioneuroblastoma.

    PubMed

    Benfari, G; Fusconi, M; Ciofalo, A; Gallo, A; Altissimi, G; Celani, T; De Vincentiis, M

    2008-12-01

    Esthesioneuroblastoma is an uncommon tumour. Due to its low incidence, this neoplasm is difficult to evaluate and its treatment remains a matter of debate. Although the role of post-operative radiation is relatively well-defined, little is reported regarding the role of radiotherapy as the only treatment modality. A retrospective analysis of the literature has been conducted. With reference to the treatment of esthesioneuroblastoma, 55 patients submitted only to radiotherapy have been selected from publications of internationally indexed literature between 1979 and 2006. According to the Kadish classification, 6 patients were in stage A, 12 in stage B, and 37 in stage C. Response to therapy for each stage was assessed. There was no evidence of disease in: 6/6 stage A patients with a median follow-up period of 103.6 months, 7/12 stage B patients with a median followup period of 120 months, and 7/37 stage C patients with a median follow-up period of 77.3 months. A total of 27 patients died due to tumour-related causes and 5 due to intercurrent disease, while 3 patients were alive with disease (local recurrence and cervical lymph node metastasis). In conclusion, esthesioneuroblastoma is a malignant tumour which grows both locoregionally and distantly. For this reason, despite the satisfying results regarding response to radiotherapy alone in stage A patients, irradiation should be used only in early lesions arising below the cribriform plate, whereas all other cases require aggressive and multimodal therapy.

  10. Renal anemia control in Lithuania: influence of local conditions and local guidelines.

    PubMed

    Ziginskiene, Edita; Kuzminskis, Vytautas; Petruliene, Kristina; 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Molecular Designs for Controlling the Local Environments around Metal Ions

    PubMed Central

    Cook, Sarah A.; Borovik, A.S.

    2015-01-01

    CONSPECTUS 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. Non-covalent 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 FeIII–oxo species directly from the activation of O2 that was subsequently oxidized to form a monomeric FeIV–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 MnIII–oxo center that was prepared from water could be converted to a high spin MnV–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 MnIV–oxyl species rather than the isoelectronic MnV–oxo system as the key oxidant based on computational studies. However, there is no experimental information to support the existence

  16. 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

  17. Multi-platform RF emitter localization using extremum seeking control

    NASA Astrophysics Data System (ADS)

    Al Issa, Huthaifa; Ordóñez, Raúl

    2013-05-01

    In recent years there has been growing interest in Ad-hoc and Wireless Sensor Networks (WSNs) for a variety of indoor applications. Thus, recent developments in communications and RF technology have enabled system concept formulations and designs for low-cost radar systems using state-of-the-art software radio modules. Position-Adaptive radar concepts have been formulated and investigated at the Air Force Research Laboratory (AFRL) within the past few years. Adopting a position-adaptive approach to the design of distributed radar systems shows potential for the development of future radar systems that function under new and challenging environments that contain large clutter discretes and require co-functionality within multi-signal RF environments. 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 based on cross-path loss exponents estimates between sensors, thereby minimizing the unknown estimation error. As a result we achieved source seeking and collision avoidance of the entire group of the sensor positions.

  18. 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.

  19. Controlled Release System for Localized and Sustained Drug Delivery Applications

    NASA Astrophysics Data System (ADS)

    Rodriguez, Lidia Betsabe

    Current controlled release formulations has many drawbacks such as excess of initial burst release, low drug efficiency, non-degradability of the system and low reproducibility. The present project aims to offer an alternative by developing a technique to prepare uniform, biodegradable particles ( ˜19 mum ) that can sustainably release a drug for a specific period of time. Chitosan is a natural polysaccharide that has many characteristics to be used for biomedical applications. In the last two decades, there have been a considerable number of studies affirming that chitosan could be used for pharmaceutical applications. However, chitosan suffers from inherent weaknesses such as low mechanical stability and dissolution of the system in acidic media. In the present study, chitosan microparticles were prepared by emulsification process. The model drug chosen was acetylsalicylic acid as it is a small and challenging molecule. The maximum loading capacity obtained for the microparticles was approximately 96%. The parameters for the preparation of uniform particles with a narrow size distribution were identified in a triangular phase diagram. Moreover, chitosan particles were successfully coated with thin layers of poly lactic-coglycolic acid (PLGA) and poly lactic acid (PLA). The performance of different layerswas tested for in vitro drug release and degradation studies. Additionally, the degradability of the system was evaluated by measuring the weight loss of the system when exposed to enzyme and without enzyme. Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), atomic force microscopy (AFM) and inductively coupled plasma optical emission spectrometry (ICP-OES) were used to characterize the controlled release system. Additionally, the in vitro drug release was monitored by ultraviolet-visible spectrophotometry (UV-Vis) and liquid chromatography mass spectrometry (LC-MS). The results obtained from this project showed that it is

  20. [Auto-injection with epinephrine in the finger of a 5-year-old child].

    PubMed

    Janssen, R L H; Roeleveld-Versteegh, A B C; Wessels-Basten, S J W; Hendriks, T

    2008-04-26

    A 5-year-old boy with food allergies complicated by anaphylactic reactions with dyspnoea and angioedema had been prescribed an autoinjector with epinephrine (0.15 mg) so that his parents could treat him at home if necessary. The patient accidentally injected himself in a finger, which likely makes him the youngest patient to receive an epinephrine auto-injection reported to date. Treatment consisted of phentolamine (0.15 mg in 0.5 ml normal saline) injected subcutaneously at the site of accidental injection; the dose and volume were not adapted according to the age and body weight of the patient as only a local effect was intended. Finger circulation was restored within 20 minutes. Headache, nausea and vomiting were observed after 30 minutes and were most likely a systemic side effect of phentolamine. No other complications occurred. The patient recovered fully and was discharged the following morning. Intramuscular epinephrine autoinjection is standard therapy for severe anaphylactic reactions. The epinephrine autoinjector was introduced in 1980. As allergy and anaphylaxis become more common, increasing numbers of autoinjectors are prescribed, and it is likely that the number of accidental digital autoinjections will also increase. These digits are then at risk of ischaemic necrosis. There is no consensus on therapeutic strategies in such cases. Phentolamine administration appears to be an effective intervention. However, several recent studies have shown that epinephrine may be used safely in hand surgery, which suggests that accidental digital epinephrine autoinjection may not always require immediate treatment.

  1. The pragmatics of clinical hypermedia: experiences from 5 years of participatory design in the MEDEA project.

    PubMed

    Timpka, T; Sjöberg, C; Svensson, B

    1995-02-01

    To explore a medical hypermedia design process where requirements engineering and participatory design are used in a naturalistic setting, 5 years of participatory action research (PAR) have been performed in the development of a hypermedia system to be used in primary care practice. In PAR, the participating organizations cooperate with the researchers in deciding and later evaluating organizational actions, and the results are concluded cooperatively. A new type of system emerged from the study, in that the resulting design has its focus on the management of large volumes of hypermedia material, the traceability of authority in the documents, and teamwork support. Regarding the participatory design process, it was found to be essential to deal with social and organizational issues in the design group and its surroundings--and not to cover these over. For instance, an agreement was reached with the managers responsible for health care in the county where the design process took place, whereby the design activity was also given priority at the highest local administrative level. Since health care is a practice organization, there is a potential market for similar systems if only ways of organizing design and marketing the products of participatory design are further developed. Modified versions of structured product specification methods could be a valuable complement. The conclusion of the study is that the development and spread of hypermedia systems in health care may require considerable changes in current design routines and organizations.

  2. 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

    ...; 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 sturgeon... of requested information include: (1) Species biology including, but not limited to,...

  3. 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...

  4. 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,…

  5. 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…

  6. 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. PMID:28281704

  7. 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

  8. Temporally selective attention supports speech processing in 3- to 5-year-old children.

    PubMed

    Astheimer, Lori B; Sanders, Lisa D

    2012-01-01

    Recent event-related potential (ERP) evidence demonstrates that adults employ temporally selective attention to preferentially process the initial portions of words in continuous speech. Doing so is an effective listening strategy since word-initial segments are highly informative. Although the development of this process remains unexplored, directing attention to word onsets may be important for speech processing in young children who would otherwise be overwhelmed by the rapidly changing acoustic signals that constitute speech. We examined the use of temporally selective attention in 3- to 5-year-old children listening to stories by comparing ERPs elicited by attention probes presented at four acoustically matched times relative to word onsets: concurrently with a word onset, 100 ms before, 100 ms after, and at random control times. By 80 ms, probes presented at and after word onsets elicited a larger negativity than probes presented before word onsets or at control times. The latency and distribution of this effect is similar to temporally and spatially selective attention effects measured in adults and, despite differences in polarity, spatially selective attention effects measured in children. These results indicate that, like adults, preschool aged children modulate temporally selective attention to preferentially process the initial portions of words in continuous speech.

  9. [Dental decay in 5-year-old children: sociodemographic factors, monitoring points and parental attitudes].

    PubMed

    Nunes, Vinícius Humberto; Perosa, Gimol Benzaquen

    2017-01-01

    Dental decay affects many children, especially those from the lower socioeconomic classes. In this cross-sectional study designed to investigate the role played by sociodemographic factors, parental attitudes, and monitoring points, which are an indicator of personal perception of what controls individual health, on the prevalence of tooth decay among 5-year-old pre-school children living in a midsized city in São Paulo, Brazil. The ceo-d index of 426 children was assessed; the parents reported sociodemographic characteristics and completed two questionnaires concerning monitoring points and parental attitudes. The results show that 52.35% of the children had decay; higher levels of severe decay were observed among lower E-F socioeconomic classes. Higher socioeconomic status and low externality appear to be protective factors. Low parental internality emerged as a risk factor for decay in primary teeth, possibly because the mother expects or delegates the action to others, delaying care. Parental perceptions of control over a child's health seem to impact preventive care and, consequently, the level of tooth decay among children.

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

    PubMed

    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.

  11. 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.

  12. Control of quantum localization and classical diffusion in laser-kicked molecular rotors

    NASA Astrophysics Data System (ADS)

    Bitter, M.; Milner, V.

    2017-01-01

    We experimentally study a system of quantum kicked rotors—an ensemble of diatomic molecules exposed to a periodic sequence of ultrashort laser pulses. In the regime where the underlying classical dynamics is chaotic, we investigate the quantum phenomenon of dynamical localization by means of state-resolved coherent Raman spectroscopy. We examine the dependence of the exponentially localized angular momentum distribution and of the total rotational energy on the time period between the pulses and their amplitude. The former parameter is shown to provide control over the localization center, whereas the latter one controls the localization length. Similar control of the center and width of a nonlocalized rotational distribution is demonstrated in the limit of classical diffusion, established by adding noise to the periodic pulse sequence.

  13. 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

  14. 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.

  15. Organization of nosocomial infection control measures and local networks for infectious disease control in middle-scale hospitals in Japan.

    PubMed

    Mori-Yoshikawa, Namiko; Ohmagari, Norio; Kirikae, Teruo

    2014-01-01

    The aims of this study were to assess nosocomial infection control measures at middle-scale hospitals throughout Japan. Of the 823 hospitals participating in this questionnaire-based survey, more than half of the middle-scale hospitals have implemented nosocomial infection control measures, including infection surveillance or infection control rounds, while acknowledging a shortage of infection control staff. These hospitals most frequently consulted public health centers to obtain information and advice. Improved nosocomial infection control in middle-scale hospitals requires sufficient staffing and a local network, with active participation by public health centers.

  16. Can a One-Item Mood Scale Do the Trick? Predicting Relapse over 5.5-Years in Recurrent Depression

    PubMed Central

    van Rijsbergen, Gerard D.; Bockting, Claudi L. H.; Berking, Matthias; Koeter, Maarten W. J.; Schene, Aart H.

    2012-01-01

    Background To examine whether a simple Visual Analogue Mood Scale (VAMS) is able to predict time to relapse over 5.5-years. Methodology/Principal Findings 187 remitted recurrently depressed out-patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the 17-item Hamilton Depression rating scale (HAM-D) to verify remission status (HAM-D <10). All patients rated their current mood with the help of a Visual Analogue Mood Scale (VAMS) at baseline and at a follow-up assessment three months later. Relapse over 5.5-years was assessed by the SCID-I. Cox regression revealed that both the VAMS at baseline and three months later significantly predicted time to relapse over 5.5-years. Baseline VAMS even predicted time to relapse when the number of previous depressive episodes and HAM-D scores were controlled for. The baseline VAMS explained 6.3% of variance in time to relapse, comparable to the HAM-D interview. Conclusions/Significance Sad mood after remission appears to play a pivotal role in the course of depression. Since a simple VAMS predicted time to relapse, the VAMS might be an easy and time-effective way to monitor mood and risk of early relapse, and offers possibilities for daily monitoring using e-mail and SMS. Trial Registration International Standard Randomized Controlled Trial Register Identifier: ISRCTN68246470. PMID:23056456

  17. Conflict resolution in 5-year-old boys: does postconflict affiliative behaviour have a reconciliatory role?

    PubMed

    Ljungberg; Westlund; Lindqvist Forsberg AJ

    1999-11-01

    In nonhuman primates, affiliative behaviours, such as social grooming and various forms of body contact, become more frequent after an aggressive interaction. Since such behaviours lead to a decrease in postconflict aggressive behaviour and displacement activities and to increased social tolerance, they have been labelled reconciliatory. We videofilmed sessions of free play in daycare centres in Stockholm and investigated whether affiliative behaviours used by 5-year-old boys in the postconflict period had a similar reconciliatory function. For 219 conflicts in 21 h 40 min of observation we recorded postconflict affiliative/prosocial, aggressive and displacement behaviours. When affiliative behaviours were shown and accepted by the opponent, aggressive and displacement behaviours decreased and play was promoted. These behaviours thus serve a function similar to reconciliatory behaviour in nonhuman primates and we think it is applicable to call accepted affiliative behaviours in postconflict periods of preschool children reconciliatory. However, conflicts were often polyadic and nonconflict periods consisted of intense play with a rich exchange of affiliative behaviours. These factors were limitations to the postconflict/matched-control method traditionally used in primatological research to document reconciliatory behaviour. We suggest that for preschool children, video recordings and an analysis and description of postconflict affiliative, aggressive and displacement behaviours can be used instead. Copyright 1999 The Association for the Study of Animal Behaviour.

  18. 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.

  19. 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

  20. Interventions to Increase Physical Activity in Children Aged 2-5 Years: A Systematic Review.

    PubMed

    Ling, Jiying; Robbins, Lorraine B; Wen, Fujun; Peng, Wei

    2015-08-01

    Comprehensive evaluation of prior interventions designed to increase preschoolers' physical activity is lacking. This systematic review aimed to examine the effect of interventions on objectively measured physical activity in children aged 2-5 years. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In May 2014, we searched PubMed, CINAHL, PsycINFO, ERIC, SPORTDiscus, Cochrane, and Embase. Two reviewers independently identified and appraised the studies. Twenty-four articles describing 23 independent studies and 20 unique interventions met inclusion criteria. Of the 8 interventions resulting in a significant effect in objectively measured physical activity, all were center-based and included a structured physical activity component, 6 included multiple components, 5 integrated theories or models, and 4 actively involved parents. Seven of the 8 were randomized controlled trials. Due to the heterogeneity of the study designs, physical activity measures, and interventions, drawing definitive conclusions was difficult. Although the overall intervention effect was less than optimal, the review indicated that theory-driven, multicomponent interventions including a structured physical activity component and targeting both parents and their children may be a promising approach for increasing preschoolers' physical activity and warrant continued investigation using rigorous designs to identify those that are most effective.

  1. Haemophilus type B meningitis in Saudi children under 5 years old.

    PubMed

    Al-Mazrou, Yagob Y; Al-Jeffri, Mohamed H; Al-Haggar, Sami H; Musa, Elgeili K; Mohamed, Omer M; Abdalla, Mohamed N

    2004-06-01

    This study was designed to determine the magnitude of bacterial meningitis in general and Hib meningitis in particular among children below the age of 5 years. A population-based, prospective descriptive and analytical study was conducted in five regions, one each in northern, southern, eastern, western, and central parts of Saudi Arabia. Active surveillance for cases of bacterial meningitis among the study population, which comprised 171,818 children under 5 years of age, was implemented. A total of 208 cases of meningitis were identified, of which 141 (67.8 per cent) were identified with a definite causative organism. The remaining 67 cases (32 per cent) were labeled as aseptic meningitis. The overall incidence of meningitis was 60.53/10(5) in under-fives with a disease spectrum similar to that reported in studies conducted in other countries. The three leading causes of meningitis were Hib (Haemophilus influenzae type B), MCM (Neisseria menigitides) and SPN (Streptococcus pneumoniae). Hib meningitis constituted 28 per cent of cases with an incidence rate of 16.88/10(5) children. There was a marked regional variation in Hib incidence. MCM was the second leading cause (18 per cent) of meningitis with an incidence of 10.77/10(5) while SPN comprised 11 per cent of cases and its incidence was 9.69/10(5). Almost all MCM cases were related to meningitis outbreaks that occurred in Saudi Arabia during two successive Hajj seasons (2000-2001). Hib cases showed a bimodal seasonality, one peak during March-May, the other during September-November. The fact that this study is the first national base-line data on meningitis in general and Hib incidence in particular, has augmented further justification for introducing Hib vaccine within the national Expanded Program on Immunization (EPI). Based on the experience gained during this study regarding surveillance of meningitis disease, optimal methods to strengthen meningitis surveillance were identified. A model of Meningitis

  2. Puzzling Plans and Budgets: Making Sense of California's Second Year Local Control and Accountability Plans

    ERIC Educational Resources Information Center

    Chen, Theresa

    2016-01-01

    On July 1, 2013, Gov. Jerry Brown signed California's landmark Local Control Funding Formula (LCFF) into law. In addition to providing districts with greater control over how to spend funds, LCFF marked a tremendous opportunity for educational equity. The new funding law gave districts additional resources, called supplemental and concentration…

  3. 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...

  4. 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...

  5. 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...

  6. 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...

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

    PubMed

    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

  8. 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

  9. The Western Sydney Stroke Risk in the Elderly Study. A 5-year prospective study.

    PubMed

    Gliksman, M D; Lazarus, R; Wilson, A; Leeder, S R; Koutts, J

    1994-01-01

    Aging of the Australian population, as in other developed nations, will ensure that stroke remains one of the most important causes of death and disability. The Stroke Risk in the Elderly (SITE) study aims to measure prospectively the independent contribution of dietary, sociodemographic, blood lipid, blood pressure, and hemostatic factors to risk of stroke and other cardiovascular outcomes. The target population included all independently living men and women aged 65 years and over, residents in several retirement villages in western metropolitan Sydney, New South Wales, Australia. The study cohort consists of 225 men and 787 women, selected as a convenience sample from all eligible residents in the local government areas (LGAs) adjacent to Westmead Hospital. Participants attended a baseline session to complete dietary, life-style, medical, and sociodemographic questionnaires. Anthropomorphic variables and blood pressure were measured. Blood was taken for measurement of serum lipid, glucose, and hemostatic factors. Questionnaire results were compared with an age/sex-stratified, randomly selected sample drawn from the community (in the same LGAs), in order to quantify potential sampling and selection biases. The study cohort will be followed for a minimum of 5 years. The attendance rate of eligible residents for a baseline medical, dietary, life-style, and sociodemographic assessment was 72% for males and 69% for females. The study cohort was older, better educated, less ethnically diverse, and among women, less likely to have ever been married compared to people aged over 65 years in the comparison group. The baseline results suggest that hemostatic factors may be of importance in assessing risk of cardiovascular disease, (CVD), particularly in older men.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. 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

  11. 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.

  12. Barriers to adopting and implementing local-level tobacco control policies.

    PubMed

    Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

    2011-08-01

    Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

  13. 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.

  14. Local Knowledge, Science, and Institutional Change: The Case of Desertification Control in Northern China

    NASA Astrophysics Data System (ADS)

    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.

  15. 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.

  16. [Strategy to control methicillin-resistant Staphylococcus aureus: the 5 year experience of a hospital].

    PubMed

    Peres, David; Neves, Isabel; Vieira, Fernanda; Devesa, Ilda

    2014-01-01

    Introdução: O Staphylococcus aureus resistente à meticilina é um dos microrganismos multirresistentes mais frequentemente implicados em infeções associadas a cuidados de saúde. Definiu-se como objetivo implementar uma estratégia multimodal para controlar este microrganismo num hospital.Material e Métodos: Procedimento baseado em rastreio ativo e medidas de isolamento numa população selecionada (doentes provenientes de outras instituições de saúde e lares ou com historial de internamento/ staphylococcus aureus resistente à meticilina; doentes dos cuidados intensivos e intermédios e, nos restantes serviços, rastreio aos contactos diretos se detetado um novo caso de staphylococcus aureus resistente à meticilina e, desde 2012, hemodialisados). Outras ações paralelas: (1) revisão das normas Precauções Básicas e Isolamento; (2) reforço dos pontos de desinfeção alcoólica das mãos; (3) sessões de esclarecimento aos profissionais de saúde; (4) folha ‘Alerta de staphylococcus aureus resistente à meticilina’ no processo dos doentes; (5) panfleto de informação aos doentes/ visitas; (6) monitorização do procedimento através de auditoria e (7) descolonização de doentes nos cuidados intensivos e intermédios, com rastreios de follow-up.Resultados: Entre 2007 e 2012 registou-se um decréscimo da proporção de staphylococcus aureus resistente à meticilina de 66% para 57% e da densidade de incidência de 1,80 para 0,68 casos por mil dias de internamento (p < 0,001; RR 0,38; IC95%: 0,29-0,49).Discussão/Conclusão: De acordo com dados europeus publicados, referentes a isolados no sangue e líquor, Portugal foi o país com maior proporção de staphylococcus aureus resistente à meticilina em 2011. Utilizando este critério de inclusão, o nosso hospital revelou uma proporção de staphylococcus aureus resistente à meticilina inferior à média nacional (34% versus 55%). A estratégia multimodal demonstrou ser eficaz na diminuição dos casos de staphylococcus aureus resistente à meticilina. Salvaguarda-se a necessidade de realizar vigilância epidemiológica deste agente, bem como monitorização da aplicação do procedimento, com feedback aos profissionais de saúde.

  17. 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

  18. 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.

  19. Distributed model predictive control for constrained nonlinear systems with decoupled local dynamics.

    PubMed

    Zhao, Meng; Ding, Baocang

    2015-03-01

    This paper considers the distributed model predictive control (MPC) of nonlinear large-scale systems with dynamically decoupled subsystems. According to the coupled state in the overall cost function of centralized MPC, the neighbors are confirmed and fixed for each subsystem, and the overall objective function is disassembled into each local optimization. In order to guarantee the closed-loop stability of distributed MPC algorithm, the overall compatibility constraint for centralized MPC algorithm is decomposed into each local controller. The communication between each subsystem and its neighbors is relatively low, only the current states before optimization and the optimized input variables after optimization are being transferred. For each local controller, the quasi-infinite horizon MPC algorithm is adopted, and the global closed-loop system is proven to be exponentially stable.

  20. Output feedback fuzzy controller design with local nonlinear feedback laws for discrete-time nonlinear systems.

    PubMed

    Dong, Jiuxiang; Wang, Youyi; Yang, Guang-Hong

    2010-12-01

    This paper considers the output feedback control problem for nonlinear discrete-time systems, which are represented by a type of fuzzy systems with local nonlinear models. By using the estimations of the states and nonlinear functions in local models, sufficient conditions for designing observer-based controllers are given for discrete-time nonlinear systems. First, a separation property, i.e., the controller and the observer can be independently designed, is proved for the class of fuzzy systems. Second, a two-step procedure with cone complementarity linearization algorithms is also developed for solving the H( ∞) dynamic output feedback (DOF) control problem. Moreover, for the case where the nonlinear functions in local submodels are measurable, a convex condition for designing H(∞) controllers is given by a new DOF control scheme. In contrast to the existing methods, the new methods can design output feedback controllers with fewer fuzzy rules as well as less computational burden, which is helpful for controller designs and implementations. Lastly, numerical examples are given to illustrate the effectiveness of the proposed methods.

  1. 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

  2. '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'.

  3. Visual function and car driving: longitudinal results 5 years after cataract surgery in a population

    PubMed Central

    Mönestam, E; Lundquist, B; Wachtmeister, L

    2005-01-01

    Aims: To determine visual function in drivers who had cataract surgery 5 years previously, and to analyse longitudinal data, by comparing preoperative and postoperative changes in subjective driving ability and objective visual function. Methods: All patients (810) who underwent cataract surgery, during a 1 year period, were prospectively studied. Data regarding present driving status were collected from self administered questionnaires and visual acuity (VA) data were measured before and after surgery. All patients who were alive 5 years later were invited to participate with a new eye examination and questionnaire. Results: Before surgery 36 active drivers (16%) did not fulfil the visual requirements for driving; with improved glasses this number could be reduced to 24 (11%). 5 years after surgery, the corresponding figures were 5% and 3% (5/174), respectively. Before surgery 50% stated visual difficulties while driving in daylight and 79% in darkness. A few months and 5 years after surgery the corresponding figures were 6% and 5%, respectively, for daytime driving and 34% and 44%, respectively, for night-time driving. Conclusions: Long term results regarding cataract surgery in car drivers are beneficial. 5 years after surgery only a few patients drove not fulfilling the requirements, but there were a larger proportion of patients with problems driving in darkness compared with a few months after surgery. PMID:15774924

  4. Seizures and Methemoglobinemia After Topical Application of Eutectic Mixture of Lidocaine and Prilocaine on a 3.5-Year-Old Child with Molluscum Contagiosum and Atopic Dermatitis.

    PubMed

    Cho, Yong Se; Chung, Bo Young; Park, Chun Wook; Kim, Hye One

    2016-09-01

    A eutectic mixture of lidocaine and prilocaine (EMLA) is used topically to provide local anesthesia for a variety of painful superficial procedures. Although the side effects of EMLA are usually mild and transient local reactions, potentially life-threatening complications can occur. We report a case of generalized seizures and methemoglobinemia after topical application of EMLA for curettage of molluscum contagiosum lesions in a 3.5-year-old girl with atopic dermatitis.

  5. Ertapenem: the new carbapenem 5 years after first FDA licensing for clinical practice.

    PubMed

    Burkhardt, Olaf; Derendorf, Hartmut; Welte, Tobias

    2007-02-01

    Ertapenem, a parenteral broad-spectrum 1-beta-methyl-carbapenem, was licensed 5 years ago for clinical practice in the US and Europe. The substance has a good in vitro activity against many common aerobic and anaerobic Gram-positive and -negative bacteria. Its in vitro activity against Enterobacteriaceae carrying plasmid- or chromosomal-mediated beta-lactamases, including AmpC- and extended-spectrum beta-lactamases, is especially clinically significant. Advantages concerning in vitro activity and low potential for so-called 'collateral damage', and development of own resistance during therapy, as shown in several randomized, controlled clinical trials, make ertapenem an excellent treatment choice for complicated aerobic and anaerobic mix infections caused by ertapenem-sensitive bacteria. On the other hand, due to its limited activity against Acinetobacter spp., enterococci and Pseudomonas aeruginosa, it is less suitable for late-onset nosocomial infections. International guidelines recommend the initial empirical use of ertapenem for intra-abdominal infections, skin and skin-structure infections, acute pelvic infections, complicated urinary tract infections and pneumonia (both community-acquired and 'early-onset' nosocomial) in a dose of 1.0 g administered once daily. However, recent results from pharmacokinetic/pharmacodynamic modelling studies in critically ill patients with ventilator-associated pneumonia and adipose volunteers with a body mass index of > or = 20 kg/m(2) showed that the standard dose of 1.0 g/day may not provide adequate free, protein-unbound drug concentrations in plasma and organ tissues. Therefore, a shortening of the dosage interval or continuous infusion of ertapenem should be considered to ensure optimal free concentrations in these particular populations.

  6. 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.

  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. Quantification of local and global benefits from air pollution control in Mexico City.

    PubMed

    Mckinley, Galen; Zuk, Miriam; Höjer, Morten; Avalos, Montserrat; González, Isabel; Iniestra, Rodolfo; Laguna, Israel; Martínez, Miguel A; Osnaya, Patricia; Reynales, Luz M; Valdés, Raydel; Martínez, Julia

    2005-04-01

    Complex sociopolitical, economic, and geographical realities cause the 20 million residents of Mexico City to suffer from some of the worst air pollution conditions in the world. Greenhouse gas emissions from the city are also substantial, and opportunities for joint local-global air pollution control are being sought. Although a plethora of measures to improve local air quality and reduce greenhouse gas emissions have been proposed for Mexico City, resources are not available for implementation of all proposed controls and thus prioritization must occur. Yet policy makers often do not conduct comprehensive quantitative analyses to inform these decisions. We reanalyze a subset of currently proposed control measures, and derive cost and health benefit estimates that are directly comparable. This study illustrates that improved quantitative analysis can change implementation prioritization for air pollution and greenhouse gas control measures in Mexico City.

  9. Stability of localized solutions in a subcritically unstable pattern-forming system under a global delayed control.

    PubMed

    Rubinstein, B Y; Nepomnyashchy, A A; Golovin, A A

    2007-04-01

    The formation of spatially localized patterns in a system with subcritical instability under feedback control with delay is investigated within the framework of globally controlled Ginzburg-Landau equation. It is shown that feedback control can stabilize spatially localized solutions. With the increase of delay, these solutions undergo oscillatory instability that, for large enough control strength, results in the formation of localized oscillating pulses. With further increase of the delay the solution blows up.

  10. 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.

  11. 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…

  12. 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…

  13. A Closer Look at "Local Control": Communities, Commodities, and the Collapse of the Coast.

    ERIC Educational Resources Information Center

    Gramling, Robert; Freudenburg, William R.

    1990-01-01

    External boom-bust forces may be so great as to overwhelm even well-prepared communities. In two oil-dependent coastal Louisiana parishes, over 90 percent of variation in total employment, 1970-88, was explained by commodity-related variables completely outside local community control. Contains 53 references. (Author/SV)

  14. 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...

  15. 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...

  16. Local Control in the Era of Accountability: A Case Study of Wisconsin PreK

    ERIC Educational Resources Information Center

    Graue, M. Elizabeth; Wilinski, Bethany; Nocera, Amato

    2016-01-01

    The opposing principles of local control and increased standardization are a prominent tension in the United States' education system. Since at least the early 1990s, this tension has taken shape around the accountability movement, defined by educational reforms that hold schools, teachers, and students accountable for performance on new…

  17. New Accountability in California through Local Control Funding Reforms: The Promise and the Gaps

    ERIC Educational Resources Information Center

    Affeldt, John T.

    2015-01-01

    California is in the midst of the nation's most significant current overhaul of a state school funding and accountability system. This paper examines the state's recent reforms enacted through the Local Control Funding Formula (LCFF) against the new accountability framework articulated by Linda Darling-Hammond, Gene Wilhoit, and Linda Pittenger in…

  18. 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…

  19. Assessing local planning to control groundwater depletion: California as a microcosm of global issues

    NASA Astrophysics Data System (ADS)

    Nelson, Rebecca L.

    2012-01-01

    Groundwater pumping has caused excessive groundwater depletion around the world, yet regulating pumping remains a profound challenge. California uses more groundwater than any other U.S. state, and serves as a microcosm of the adverse effects of pumping felt worldwide—land subsidence, impaired water quality, and damaged ecosystems, all against the looming threat of climate change. The state largely entrusts the control of depletion to the local level. This study uses internationally accepted water resources planning theories systematically to investigate three key aspects of controlling groundwater depletion in California, with an emphasis on local-level action: (a) making decisions and engaging stakeholders; (b) monitoring groundwater; and (c) using mandatory, fee-based and voluntary approaches to control groundwater depletion (e.g., pumping restrictions, pumping fees, and education about water conservation, respectively). The methodology used is the social science-derived technique of content analysis, which involves using a coding scheme to record these three elements in local rules and plans, and State legislation, then analyzing patterns and trends. The study finds that Californian local groundwater managers rarely use, or plan to use, mandatory and fee-based measures to control groundwater depletion. Most use only voluntary approaches or infrastructure to attempt to reduce depletion, regardless of whether they have more severe groundwater problems, or problems which are more likely to have irreversible adverse effects. The study suggests legal reforms to the local groundwater planning system, drawing upon its empirical findings. Considering the content of these recommendations may also benefit other jurisdictions that use a local groundwater management planning paradigm.

  20. 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.

  1. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 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...

  2. 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…

  3. 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…

  4. 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…

  5. Trauma Revisited: A 5-Year-Old's Journey from Experiences, to Thoughts, to Words, towards Hope

    ERIC Educational Resources Information Center

    Jackson, Emil

    2004-01-01

    In this paper, I describe the first 2 years of intensive psychotherapy of a multiply traumatized 5-year-old girl. I explore some of the ways in which violent and traumatic experiences were re-lived in the therapy and how they impacted on both patient and therapist. Within the discussion and illustrated by clinical vignettes, I consider the…

  6. 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…

  7. 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…

  8. Developmental Norms of Children Aged 2 1/2-5 Years: A Pilot Study.

    ERIC Educational Resources Information Center

    Muralidharan, Rajalakshmi

    1969-01-01

    The purpose of this pilot study, aside from collection of developmental data on 38 nursery school children aged 2 1/2 to 5 years, was (1) to develop, modify and adapt the testing equipment used in Gesell's Developmental Schedule, in the field of motor, adaptive, language, and personal-social development; (2) to develop elaborate, exhaustive,…

  9. The Dynamics of an Online Knowledge Building Community: A 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Myllari, Jarkko; Ahlberg, Mauri; Dillon, Patrick

    2010-01-01

    This paper reports a 5-year design experiment on cumulative knowledge building as part of an international project. Through a longitudinal study and analysis of cumulative research data, we sought to answer the question, "what happened and why in knowledge building?" Research data constitute messages which participants have written into a shared…

  10. Parental Strategies and Trajectories of Peer Victimization in 4 to 5 Year Olds

    ERIC Educational Resources Information Center

    Bonnet, Marielle; Goossens, Frits A.; Schuengel, Carlo

    2011-01-01

    This study was designed to examine how parental strategies contribute to explaining trajectories of peer victimization in young children. A total of 73 4 and 5 year old children identified as victims of peer aggression in the fall semester and their parents were recruited from 46 classrooms in 18 schools in the Netherlands. All children were…

  11. 75 FR 57254 - American Community Survey 5-Year Data Product Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ...' specific feedback on the following four dimensions: 1. Block Group Level Geography--The Census Bureau... block group geography level, (2) the types of data products to be included in the 5-year data products... response is below. 1. Block Group Level Geography The Census Bureau received six comments in response...

  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. 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...

  14. 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…

  15. 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…

  16. 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…

  17. Low antibiotic resistance among anaerobic Gram-negative bacteria in periodontitis 5 years following metronidazole therapy.

    PubMed

    Dahlen, G; Preus, H R

    2017-02-01

    The objective of this study was to assess antibiotic susceptibility among predominant Gram-negative anaerobic bacteria isolated from periodontitis patients who 5 years prior had been subject to mechanical therapy with or without adjunctive metronidazole. One pooled sample was taken from the 5 deepest sites of each of 161 patients that completed the 5 year follow-up after therapy. The samples were analyzed by culture. A total number of 85 anaerobic strains were isolated from the predominant subgingival flora of 65/161 patient samples, identified, and tested for antibiotic susceptibility by MIC determination. E-tests against metronidazole, penicillin, amoxicillin, amoxicillin + clavulanic acid and clindamycin were employed. The 73/85 strains were Gram-negative rods (21 Porphyromonas spp., 22 Prevotella/Bacteroides spp., 23 Fusobacterium/Filifactor spp., 3 Campylobacter spp. and 4 Tannerella forsythia). These were all isolated from the treated patients irrespective of therapy procedures (+/-metronidazole) 5 years prior. Three strains (Bifidobacterium spp., Propionibacterium propionicum, Parvimonas micra) showed MIC values for metronidazole over the European Committee on Antimicrobial Susceptibility Testing break point of >4 μg/mL. All Porphyromonas and Tannerella strains were highly susceptible. Metronidazole resistant Gram-negative strains were not found, while a few showed resistance against beta-lactam antibiotics. In this population of 161 patients who had been subject to mechanical periodontal therapy with or without adjunct metronidazole 5 years prior, no cultivable antibiotic resistant anaerobes were found in the predominant subgingival microbiota.

  18. 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…

  19. 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…

  20. 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…

  1. Children Born to Women with Intellectual Disabilities--5-Year Incidence in a Swedish County

    ERIC Educational Resources Information Center

    Weiber, I.; Berglund, J.; Tengland, P.-A.; Eklund, M.

    2011-01-01

    Background: Families with parental intellectual disabilities (ID) are likely to need support in achieving a decent family life. In order to accurately plan for such support services, society needs data regarding the occurrence of those parents and their children. The aim of this study was to investigate the 5-year incidence of children born to…

  2. Plastic bronchitis developing 5 years after Fontan procedure in a girl with Kartagener's syndrome.

    PubMed

    Nawa, Tomohiro; Yokozawa, Masato; Takamuro, Motoki; Kasuga, Ai

    2012-06-01

    Although rare, plastic bronchitis (PB) is an important early complication after Fontan procedure. Kartagener's syndrome is characterized by mucociliary dysfunction of the respiratory tract and has a triad of features, including situs inversus totalis, chronic sinusitis, and bronchiectasia. We experienced PB in a patient with Kartagener's syndrome 5 years after Fontan procedure.

  3. 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…

  4. 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…

  5. 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,…

  6. 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…

  7. 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…

  8. 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

  9. Investigation of spherical loudspeaker arrays for local active control of sound.

    PubMed

    Peleg, Tomer; Rafaely, Boaz

    2011-10-01

    Active control of sound can be employed globally to reduce noise levels in an entire enclosure, or locally around a listener's head. Recently, spherical loudspeaker arrays have been studied as multiple-channel sources for local active control of sound, presenting the fundamental theory and several active control configurations. In this paper, important aspects of using a spherical loudspeaker array for local active control of sound are further investigated. First, the feasibility of creating sphere-shaped quiet zones away from the source is studied both theoretically and numerically, showing that these quiet zones are associated with sound amplification and poor system robustness. To mitigate the latter, the design of shell-shaped quiet zones around the source is investigated. A combination of two spherical sources is then studied with the aim of enlarging the quiet zone. The two sources are employed to generate quiet zones that surround a rigid sphere, investigating the application of active control around a listener's head. A significant improvement in performance is demonstrated in this case over a conventional headrest-type system that uses two monopole secondary sources. Finally, several simulations are presented to support the theoretical work and to demonstrate the performance and limitations of the system.

  10. Memo interacts with c-Src to control Estrogen Receptor alpha sub-cellular localization.

    PubMed

    Frei, Anna; MacDonald, Gwen; Lund, Ingrid; Gustafsson, Jan-Åke; Hynes, Nancy E; Nalvarte, Ivan

    2016-08-30

    Understanding the complex interaction between growth factor and steroid hormone signaling pathways in breast cancer is key to identifying suitable therapeutic strategies to avoid progression and therapy resistance. The interaction between these two pathways is of paramount importance for the development of endocrine resistance. Nevertheless, the molecular mechanisms behind their crosstalk are still largely obscure. We previously reported that Memo is a small redox-active protein that controls heregulin-mediated migration of breast cancer cells. Here we report that Memo sits at the intersection between heregulin and estrogen signaling, and that Memo controls Estrogen Receptor alpha (ERα) sub-cellular localization, phosphorylation, and function downstream of heregulin and estrogen in breast cancer cells. Memo facilitates ERα and c-Src interaction, ERα Y537 phosphorylation, and has the ability to control ERα extra-nuclear localization. Thus, we identify Memo as an important key mediator between the heregulin and estrogen signaling pathways, which affects both breast cancer cell migration and proliferation.

  11. 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

  12. Dopaminergic therapy and subthalamic stimulation in Parkinson's disease: a review of 5-year reports.

    PubMed

    Romito, Luigi M; Albanese, Alberto

    2010-11-01

    The long-term efficacy and safety of deep brain stimulation (DBS) implant for Parkinson's disease (PD) is described in several recent papers. This procedure has been reported to permit a stable reduction of dopaminergic therapy requirements for up to 5 years, although some expectation of deterioration in non-dopaminergic signs has been recently stated. Our aim is to perform a literature-based review of papers available describing long-term post-operative follow-up after a bilateral implant for subthalamic DBS (STN-DBS). Only peer-reviewed published papers with a post-operative follow-up of at least 5 years were considered. Clinical outcome, disease progression and side effects were assessed at baseline and 2 (or 3 years) and 5 years after surgery. Seven papers were included in the review. A total of 238 patients were analyzed. STN-DBS was confirmed to be an effective treatment for selected patients with PD. In all studies, off-related motor symptoms improved dramatically, compared with pre-implant, at 2 (or 3, according to the study) years and this result persisted at 5-year evaluations. Antiparkinsonian drug reductions, improvements in motor fluctuations and dyskinesias, functional measures and the progression of underlying PD were also reported in all series. Some axial scores, in particular postural stability and speech, improved transiently. Persisting adverse effects included eyelid opening apraxia, weight gain, psychiatric disorders, depression, dysarthria, dyskinesias, and apathy. The present review of the 5-year observations confirms that STN-DBS is a powerful method in the management of PD, but its long-term effects must be thoroughly assessed.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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).

  18. Stability and collapse of localized solutions of the controlled three-dimensional Gross-Pitaevskii equation

    NASA Astrophysics Data System (ADS)

    Fedele, R.; Jovanović, D.; Eliasson, B.; de Nicola, S.; Shukla, P. K.

    2010-03-01

    On the basis of recent investigations, a newly developed analytical procedure is used for constructing a wide class of localized solutions of the controlled three-dimensional (3D) Gross-Pitaevskii equation (GPE) that governs the dynamics of Bose-Einstein condensates (BECs) in the presence of a spatio-temporally varying external potential. The controlled 3D GPE is decomposed into a two-dimensional (2D) linear Schrödinger equation (called the `transverse equation’) and a one-dimensional (1D) nonlinear Schrödinger equation (called the `longitudinal equation’), constrained by a variational condition for the controlling potential. The latter corresponds to the requirement for the minimization of the control operation in the transverse plane. Then, the above class of localized solutions are constructed as the product of the solutions of the transverse and longitudinal equations. A consistency condition between the transverse and longitudinal solutions yields a relationship between the transverse and longitudinal restoring forces produced by the external trapping potential well through a `controlling parameter’ (i.e. the average, with respect to the transverse profile, of the nonlinear inter-atomic interaction term of the GPE). It is found that the longitudinal profile supports localized solutions in the form of bright, dark or grey solitons with time-dependent amplitudes, widths and centroids. The related longitudinal phase is varying in space and time with time-dependent curvature radius and wavenumber. In turn, all the above parameters (i.e. amplitudes, widths, centroids, curvature radius and wavenumbers) can be easily expressed in terms of the controlling parameter. It is also found that the transverse profile has the form of Hermite-Gauss functions (depending on the transverse coordinates), and the explicit spatio-temporal dependence of the controlling potential is self-consistently determined. On the basis of these exact 3D analytical solutions, a stability

  19. Control of epidemic spreading on complex networks by local traffic dynamics

    NASA Astrophysics Data System (ADS)

    Yang, Han-Xin; Wang, Wen-Xu; Lai, Ying-Cheng; Xie, Yan-Bo; Wang, Bing-Hong

    2011-10-01

    Despite extensive work on traffic dynamics and epidemic spreading on complex networks, the interplay between these two types of dynamical processes has not received adequate attention. We study the effect of local-routing-based traffic dynamics on epidemic spreading. For the case of unbounded node-delivery capacity, where the traffic is free of congestion, we obtain analytic and numerical results indicating that the epidemic threshold can be maximized by an optimal routing protocol. This means that epidemic spreading can be effectively controlled by local traffic dynamics. For the case of bounded delivery capacity, numerical results and qualitative arguments suggest that traffic congestion can suppress epidemic spreading. Our results provide quantitative insight into the nontrivial role of traffic dynamics associated with a local-routing scheme in the epidemic spreading.

  20. 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

  1. 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

    2016-03-10

    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.

  2. 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.

  3. Two-dimensional sub-half-wavelength atom localization via controlled spontaneous emission.

    PubMed

    Wan, Ren-Gang; Zhang, Tong-Yi

    2011-12-05

    We propose a scheme for two-dimensional (2D) atom localization based on the controlled spontaneous emission, in which the atom interacts with two orthogonal standing-wave fields. Due to the spatially dependent atom-field interaction, the position probability distribution of the atom can be directly determined by measuring the resulting spontaneously emission spectrum. The phase sensitive property of the atomic system leads to quenching of the spontaneous emission in some regions of the standing-waves, which significantly reduces the uncertainty in the position measurement of the atom. We find that the frequency measurement of the emitted light localizes the atom in half-wavelength domain. Especially the probability of finding the atom at a particular position can reach 100% when a photon with certain frequency is detected. By increasing the Rabi frequencies of the driving fields, such 2D sub-half-wavelength atom localization can acquire high spatial resolution.

  4. Control of epidemic spreading on complex networks by local traffic dynamics.

    PubMed

    Yang, Han-Xin; Wang, Wen-Xu; Lai, Ying-Cheng; Xie, Yan-Bo; Wang, Bing-Hong

    2011-10-01

    Despite extensive work on traffic dynamics and epidemic spreading on complex networks, the interplay between these two types of dynamical processes has not received adequate attention. We study the effect of local-routing-based traffic dynamics on epidemic spreading. For the case of unbounded node-delivery capacity, where the traffic is free of congestion, we obtain analytic and numerical results indicating that the epidemic threshold can be maximized by an optimal routing protocol. This means that epidemic spreading can be effectively controlled by local traffic dynamics. For the case of bounded delivery capacity, numerical results and qualitative arguments suggest that traffic congestion can suppress epidemic spreading. Our results provide quantitative insight into the nontrivial role of traffic dynamics associated with a local-routing scheme in the epidemic spreading.

  5. 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

  6. 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

  7. 75 FR 53272 - Endangered and Threatened Species; Initiation of 5-Year Review of the Eastern Distinct Population...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... of 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY: National..., 2010, announcing the initiation of a 5-year review of the eastern Distinct Population Segment (DPS) of..., announcing the initiation of a 5-year review of the eastern Distinct Population Segment (DPS) of the...

  8. Local Control Strategy: Simple Analyses of Air Pollution Data Can Reveal Heterogeneity in Longevity Outcomes.

    PubMed

    Obenchain, Robert L; Young, S Stanley

    2017-02-23

    Claims from observational studies that use traditional model specification searches often fail to replicate, partially because the available data tend to be biased. There is an urgent need for an alternative statistical analysis strategy, that is not only simple and easily understood but also is more likely to give reliable insights when the available data have not been designed and balanced. The alternative strategy known as local control first generates local, nonparametric effect-size estimates (fair treatment comparisons) and only then asks whether the observed variation in these local estimates can be predicted from potential confounding factors. Here, we illustrate application of local control to a historical air pollution data set describing a "natural experiment" initiated by the federal Clean Air Act Amendments of 1970. Our reanalysis reveals subgroup heterogeneity in the effects of air quality regulation on elderly longevity (one size does not fit all), and we show that this heterogeneity is largely explained by socioeconomic and environmental confounders other than air quality.

  9. Control of Local Intracellular Calcium Concentration with Dynamic-Clamp Controlled 2-Photon Uncaging

    PubMed Central

    Idoux, Erwin; Mertz, Jerome

    2011-01-01

    The variations of the intracellular concentration of calcium ion ([Ca2+]i) are at the heart of intracellular signaling, and their imaging is therefore of enormous interest. However, passive [Ca2+]i imaging provides no control over these variations, meaning that a full exploration of the functional consequences of [Ca2+]i changes is difficult to attain. The tools designed so far to modify [Ca2+]i, even qualitatively, suffer drawbacks that undermine their widespread use. Here, we describe an electro-optical technique to quantitatively set [Ca2+]i, in real time and with sub-cellular resolution, using two-photon Ca2+ uncaging and dynamic-clamp. We experimentally demonstrate, on neurons from acute olfactory bulb slices of Long Evans rats, various capabilities of this technique previously difficult to achieve, such as the independent control of the membrane potential and [Ca2+]i variations, the functional knocking-in of user-defined virtual voltage-dependent Ca2+ channels, and the standardization of [Ca2+]i patterns across different cells. Our goal is to lay the groundwork for this technique and establish it as a new and versatile tool for the study of cell signaling. PMID:22216105

  10. Resting Energy Expenditure and Systolic Blood Pressure Relationships in Women Across 4.5 Years

    PubMed Central

    Sriram, Neeraj; Hunter, Gary R.; Fisher, Gordon; Brock, David W.

    2014-01-01

    Recent studies have reported a strong association between blood pressure (BP) and resting energy expenditure (REE). However, it is not known if this relationship persists over time. Therefore, we examined the temporal relationship between REE and systolic BP. Additionally, we examined the impact of sympathetic tone and anthropometric variables on this relationship. All testing was performed on healthy, overweight African American and European American women aged 25 – 45 years over 4.5 years in the UAB General Clinical Research Center. Repeated measures mixed-models revealed REE as a significant determinant of systolic BP (β=0.0155, P<0.0001), independent of catecholamines, leg fat, visceral fat, fat free mass, fat mass, height, RSMI, and resting heart rate. Observations that REE is predictive of systolic BP across 4.5 years support previous findings that REE may potentially mediate resting BP, independent of anthropometric variables and a marker for sympathetic tone. PMID:24548382

  11. Screw fixation for atlantoaxial dislocation related to Down syndrome in children younger than 5 years.

    PubMed

    Ito, Kenyu; Imagama, Shiro; Ito, Zenya; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ishikawa, Yoshimoto; Ishiguro, Naoki

    2017-01-01

    The aim of this study was to present cases of upper cervical fixation in Down syndrome patients younger than 5 years. In two cases, C1 lateral mass screws were installed. However, owing to the irreducible atlantoaxial dislocation, the screw backed out and fractured. Therefore, O-C2 fusion was performed. Furthermore, C2 bilateral lamina screws were added to the C2 pedicle screw for reinforcement. C1-C2 fusion is an option for Down syndrome patients younger than 5 years with atlantoaxial dislocation, when the dislocation is reducible. If the dislocation is irreducible, or the implant cannot be firmly secured, the fixation range should be expanded to O-C2 or below.

  12. [Tibial valgization osteotomy in gonarthrosis with or without chondrocalcinosis. Results after 5 years].

    PubMed

    Job-Deslandre, C; Languepin, A; Benvenuto, M; Menkès, C J

    1991-01-01

    The authors compare the results of valgisation tibial osteotomies in osteoarthrosis of the knee (146 cases) and osteoarthrosis of the knee with chondrocalcinosis (94 cases). The two groups were identical in terms of age, but differed by sex ratio (female predominance in CCA) and the initial radiological stage (more advanced forms in the CCA group). Results differed after the second year and reached significantly different values at 5 years (73% in knee osteoarthrosis as against 34% good clinical results in chondrocalcinosis). Study of two groups of patients paired for age, sex, weight and radiological stage showed that results at 5 years were significantly less good in the CCA group. These results are discussed and compared with those in the 1990 literature.

  13. Dissociating local and global levels of perceptuo-motor control in masked priming.

    PubMed

    Schlaghecken, Friederike; Bowman, Howard; Eimer, Martin

    2006-06-01

    Masked prime stimuli presented near the threshold of conscious awareness affect responses to subsequent targets. The direction of these priming effects depends on the interval between masked prime and target. With short intervals, benefits for compatible trials (primes and targets mapped to the same response) and costs for incompatible trials are observed. This pattern reverses with longer intervals. We argue (a) that these effects reflect the initial activation and subsequent self-inhibition of the primed response, and the corresponding inhibition and subsequent disinhibition of the nonprimed response, and (b) that they are generated at dissociable local (within response channels) and global (between channels) levels of motor control. In two experiments, global-level priming effects were modulated by changing the number of response alternatives, whereas local-level effects remained unaffected. These experiments suggest that low-level motor control mechanisms can be successfully decomposed into separable subcomponents, operating at different levels within the motor system.

  14. Prototyping the E-ELT M1 local control system communication infrastructure

    NASA Astrophysics Data System (ADS)

    Argomedo, J.; Kornweibel, N.; Grudzien, T.; Dimmler, M.; Andolfato, L.; Barriga, P.

    2016-08-01

    The primary mirror of the E-ELT is composed of 798 hexagonal segments of about 1.45 meters across. Each segment can be moved in piston and tip-tilt using three position actuators. Inductive edge sensors are used to provide feedback for global reconstruction of the mirror shape. The E-ELT M1 Local Control System will provide a deterministic infrastructure for collecting edge sensor and actuators readings and distribute the new position actuators references while at the same time providing failure detection, isolation and notification, synchronization, monitoring and configuration management. The present paper describes the prototyping activities carried out to verify the feasibility of the E-ELT M1 local control system communication architecture design and assess its performance and potential limitations.

  15. Local Voltage Control in Distribution Networks: A Game-Theoretic Perspective

    SciTech Connect

    Zhou, Xinyang; Tian, Jie; Chen, Lijun; Dall'Anese, Emiliano

    2016-11-21

    Inverter-based voltage regulation is gaining importance to alleviate emerging reliability and power-quality concerns related to distribution systems with high penetration of photovoltaic (PV) systems. This paper seeks contribution in the domain of reactive power compensation by establishing stability of local Volt/VAr controllers. In lieu of the approximate linear surrogate used in the existing work, the paper establishes existence and uniqueness of an equilibrium point using nonlinear AC power flow model. Key to this end is to consider a nonlinear dynamical system with non-incremental local Volt/VAr control, cast the Volt/VAr dynamics as a game, and leverage the fixed-point theorem as well as pertinent contraction mapping argument. Numerical examples are provided to complement the analytical results.

  16. Local Voltage Control in Distribution Networks: A Game-Theoretic Perspective: Preprint

    SciTech Connect

    Zhou, Xinyang; Tian, Jie; Chen, Lijun; Dall'Anese, Emiliano

    2016-09-01

    Inverter-based voltage regulation is gaining importance to alleviate emerging reliability and power-quality concerns related to distribution systems with high penetration of photovoltaic (PV) systems. This paper seeks contribution in the domain of reactive power compensation by establishing stability of local Volt/VAr controllers. In lieu of the approximate linear surrogate used in the existing work, the paper establishes existence and uniqueness of an equilibrium point using nonlinear AC power flow model. Key to this end is to consider a nonlinear dynamical system with non-incremental local Volt/VAr control, cast the Volt/VAr dynamics as a game, and leverage the fixed-point theorem as well as pertinent contraction mapping argument. Numerical examples are provided to complement the analytical results.

  17. Kinetochore Localization of Spindle Checkpoint Proteins: Who Controls Whom?D⃞

    PubMed Central

    Vigneron, Suzanne; Prieto, Susana; Bernis, Cyril; Labbé, Jean-Claude; Castro, Anna; Lorca, Thierry

    2004-01-01

    The spindle checkpoint prevents anaphase onset until all the chromosomes have successfully attached to the spindle microtubules. The mechanisms by which unattached kinetochores trigger and transmit a primary signal are poorly understood, although it seems to be dependent at least in part, on the kinetochore localization of the different checkpoint components. By using protein immunodepletion and mRNA translation in Xenopus egg extracts, we have studied the hierarchic sequence and the interdependent network that governs protein recruitment at the kinetochore in the spindle checkpoint pathway. Our results show that the first regulatory step of this cascade is defined by Aurora B/INCENP complex. Aurora B/INCENP controls the activation of a second regulatory level by inducing at the kinetochore the localization of Mps1, Bub1, Bub3, and CENP-E. This localization, in turn, promotes the recruitment to the kinetochore of Mad1/Mad2, Cdc20, and the anaphase promoting complex (APC). Unlike Aurora B/INCENP, Mps1, Bub1, and CENP-E, the downstream checkpoint protein Mad1 does not regulate the kinetochore localization of either Cdc20 or APC. Similarly, Cdc20 and APC do not require each other to be localized at these chromosome structures. Thus, at the last step of the spindle checkpoint cascade, Mad1/Mad2, Cdc20, and APC are recruited at the kinetochores independently from each other. PMID:15269280

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

    PubMed

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

    2015-11-07

    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.

  19. 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

  20. 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.

  1. Increased risk of cancer after Bell's palsy: a 5-year follow-up study.

    PubMed

    Sheu, Jau-Jiuan; Keller, Joseph J; Lin, Herng-Ching

    2012-11-01

    Reactivation of latent herpes simplex virus (HSV) type I or varicella-zoster virus (VZV) has been recognized as the most common pathomechanism underlying Bell's palsy. There is also increased reactivation of HSV or VZV in patients with immunosuppressed states and in cancer patients. The purpose of this study was to investigate the risk for cancer during a 5-year follow-up period after diagnosis of Bell's palsy by using a population-based dataset in Taiwan. We used data from the "Longitudinal Health Insurance Database". We identified 2,618 patients with Bell's palsy as the study cohort and randomly selected 13,090 patients to be used as a comparison cohort. Cox proportional hazards regression was performed to compare the 5-year risk of subsequent cancer between the study and comparison cohorts. We found that the incidence of cancer was 1.55 (95 % CI 1.35-1.78) per 100 person-years for patients with Bell's palsy and 1.09 (95 % CI 1.02-1.18) per 100 person-years for comparison patients. After censoring cases that died from non-cancer causes during the follow-up period and adjusting for urbanization, monthly income, geographic region, and diabetes, the hazard ratio (HR) for cancer during the 5-year follow-up period for patients with Bell's palsy was 1.43 times that for comparison patients (95 % CI 1.22-1.73). There was a particularly increased risk of oral cancer (HR = 2.49; 95 % CI 1.54-4.03) for patients with Bell's palsy compared with the other patients. We conclude that patients with Bell's palsy were at significant risk of cancer during a 5-year follow-up period after diagnosis.

  2. Childhood leukaemia incidence below the age of 5 years near French nuclear power plants.

    PubMed

    Laurier, D; Hémon, D; Clavel, J

    2008-09-01

    A recent study indicated an excess risk of leukaemia among children under the age of 5 years living in the vicinity of nuclear power plants in Germany. We present results relating to the incidence of childhood leukaemia in the vicinity of nuclear power plants in France for the same age range. These results do not indicate an excess risk of leukaemia in young children living near French nuclear power plants.

  3. Relief of membranous obstruction of the inferior vena cava in a 5-year-old child.

    PubMed

    Amodeo, A; Di Donato, R; Dessanti, A; Caccia, G; Zaltron, D; Alberti, D; Callea, F; Marcelletti, C

    1986-12-01

    Membranous obstruction of the inferior vena cava is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of the hepatic drainage. We report membranous obstruction of the inferior vena cava in a 5-year-old boy. Surgical repair was prompted by signs and symptoms of hepatic venous obstruction. To our knowledge, this is the youngest patient successfully operated on for this anomaly.

  4. 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

  5. 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.

  6. Esthetic restorations: observations and insights gained over a 5-year period demonstrated with three case reports.

    PubMed

    Obama, Tadakazu

    2007-01-01

    This article presents two prosthodontically treated patient cases that were observed over a period of at least 5 years after treatment. The evaluation, diagnosis, treatment planning, and treatment stages were critically reviewed and reassessed from different perspectives. The conclusions drawn from this evaluation were subsequently implemented in a third clinical case. To ensure the long-term success of a restoration, certain biologic and mechanical principles must be observed, and the appropriate prosthodontic treatment must be chosen accordingly.

  7. Prevalence and Factors Associated with Anemia among Children under 5 Years of Age—Uganda, 2009

    PubMed Central

    Menon, Manoj P.; Yoon, Steven S.

    2015-01-01

    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

  8. Psychological distress and the development of hypertension over 5 years in black South Africans.

    PubMed

    Schutte, Aletta E; Ware, Lisa J; Huisman, Hugo W; Fourie, Carla M T; Greeff, Minrie; Khumalo, Tumi; Wissing, Marie P

    2015-02-01

    Alarming increases in the incidence of hypertension in many low- and middle-income countries are related to alcohol overuse. It is unclear whether alcohol overuse is a symptom of psychological distress. The authors assessed psychological distress in Africans and its relationship with a 5-year change in blood pressure (BP), independent of alcohol intake. The authors followed 107 Africans with optimal BP (≤120/80 mm Hg) (aged 35-75 years) over 5 years. Alcohol intake (self-report and serum γ-glutamyl transferase) and nonspecific psychological distress (Kessler Screening Scale for Psychological Distress [K6]) were assessed. The K6 predicted hypertension development (P=.019), and its individual component "nervous" increased a participant's risk two-fold to become hypertensive (hazard ratio, 2.00 [1.23-3.26]). By entering K6 and γ-glutamyl transferase into multivariable-adjusted regression models for change in systolic BP, both were independently associated with change in systolic BP. Psychological distress and scoring high on being nervous predicted the development of hypertension over 5 years, independent of alcohol intake.

  9. Hypoadiponectinemia As an Independent Predictor for the Progression of Carotid Atherosclerosis: A 5-Year Prospective Study

    PubMed Central

    Hui, Elaine; Xu, Aimin; Chow, Wing-Sun; Lee, Paul C.H.; Fong, Carol H.Y.; Cheung, Stephen C.W.; Tse, Hung Fat; Chau, Ming-Tak; Cheung, Bernard M.Y.

    2014-01-01

    Abstract Background: Hypoadiponectinemia predicts the development of diabetes and hypertension, both being potent atherosclerotic risk factors. Whether adiponectin predicts the progression of early atherosclerosis remains unclear. In this 5-year prospective study, we examined the relationship between serum adiponectin and carotid intima media thickness (CIMT), a marker of subclinical atherosclerosis. Methods: A total of 265 subjects from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study, with no known cardiovascular disease, underwent CIMT measurement at baseline and at 5 years. Results: In all, 129 men and 136 women, aged 54.6±12.3 years, were studied. Median CIMT at baseline was 0.63 mm (interquartile range 0.52–0.73 mm) and increased to 0.67 mm (0.56–0.78 mm) after 5 years (P<0.001). CIMT increment correlated with baseline adiponectin, age, and smoking (all P<0.05) and baseline CIMT (P<0.001), but not with sex, fasting glucose, lipid profiles, hypertension, or diabetes. In multiple linear regression analysis, baseline serum adiponectin level was an independent predictor of CIMT increment β (standardized beta)=−0.17, P=0.015], after adjusting for age, smoking, baseline CIMT, hypertension, body mass index, fasting glucose, low-density lipoprotein cholesterol, and triglycerides. Conclusion: Hypoadiponectinemia predicted CIMT progression, independent of known predictive factors such as age, smoking, hyperlipidemia, and hypertension. PMID:25211296

  10. 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

  11. Profiling the ethnic characteristics of domestic injuries in children younger than age 5 years.

    PubMed

    Oyetunji, Tolulope A; Stevenson, Adrienne A; Oyetunji, Aderonke O; Onguti, Sharon K; Ames, Sarah A; Haider, Adil H; Nwomeh, Benedict C

    2012-04-01

    The home remains a very common location for deadly injuries among children younger than 5 years. The aim of this study is to describe the demographic and injury characteristics of domestic injuries in children younger than 5 years. The National Trauma Data Bank's National Sample Program data set was queried for children younger than 5 years with the injury site classified as home. Bivariate analysis was performed to determine unadjusted differences by ethnicity. Appropriate weight was applied to the sample to determine accurate national estimates. A total of 7,364 children, representing 32,033 children, were analyzed. Overall mortality was 1.6 per cent. Among whites, blacks, Hispanics, Asians, and Native Americans, intentional injuries accounted for 6.5, 12.8, 10.2, 5.2, and 19.0 per cent of all injuries by intent, respectively (P < 0.003). Burn injury was disproportionately higher in blacks (24.1%) followed by Native Americans and Asians (15.3 and 11.5%, P = 0.008). On multivariate analysis, black ethnicity was associated with increased length of stay. Intentional injuries were significantly higher in blacks and Native Americans with black patients sustaining a disproportionately higher proportion of burn injury. Therefore, greater attention is needed to provide more effective home safety interventions to children among high-risk ethnic groups.

  12. The Local Control Funding Formula: An Opportunity for Early Childhood & Low-Income Students. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for low-income students. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and revised annually by each district. Early…

  13. The Local Control Funding Formula: An Opportunity for Early Childhood & Dual Language Learners. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for English language learners, also known as dual language learners. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and…

  14. The Local Control Funding Formula: An Opportunity for Early Childhood & Children in Foster Care. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in California are responsible for using LCFF funds to improve outcomes for children in the foster care system. Each district has created a Local Control Accountability Plan (LCAP), the expenditure plan for LCFF. The LCAP is reviewed and revised annually by each…

  15. Adrenoceptor and local modulator control of cutaneous blood flow in thermal stress.

    PubMed

    Roberts, Michael; Rivers, Tanya; Oliveria, Seth; Texeira, Paul; Raman, Erik

    2002-03-01

    Blood flow to the skin is controlled by body temperatures in two ways: core and mean skin temperature combine in the central nervous system to form a reflex mechanism that controls the frequency of activity in sympathetic nerves to the cutaneous blood vessels; and local mechanisms independent of reflex effects control contractile response to the sympathetic transmitter norepinephrine (NE) at different temperatures. Cutaneous vessels differ in responsiveness to NE across temperatures: in limbs and tails, the superficial vessels constrict more strongly to NE when cooled, while the deep vessels show weaker responses to NE when cooled. This allows the limb to dissipate heat when warm and to conserve heat when cool. The mechanism for this difference in thermal response of deep and superficial vessels is not completely known, but may relate to differences in the adrenoceptors on which NE acts, and/or to the actions of locally produced substances that modulate the responses to NE in different ways at different temperatures. This paper discusses the alpha1- and alpha2-adrenoceptors involved in contraction of deep and superficial cutaneous vessels and also describes the roles of the local modulator nitric oxide, which interacts with adrenoceptors to affect cutaneous blood flow.

  16. Electric-field control of magnetic domain wall motion and local magnetization reversal

    PubMed Central

    Lahtinen, Tuomas H. E.; Franke, Kévin J. A.; van Dijken, Sebastiaan

    2012-01-01

    Spintronic devices currently rely on magnetic switching or controlled motion of domain walls by an external magnetic field or spin-polarized current. Achieving the same degree of magnetic controllability using an electric field has potential advantages including enhanced functionality and low power consumption. Here we report on an approach to electrically control local magnetic properties, including the writing and erasure of regular ferromagnetic domain patterns and the motion of magnetic domain walls, in CoFe-BaTiO3 heterostructures. Our method is based on recurrent strain transfer from ferroelastic domains in ferroelectric media to continuous magnetostrictive films with negligible magnetocrystalline anisotropy. Optical polarization microscopy of both ferromagnetic and ferroelectric domain structures reveals that domain correlations and strong inter-ferroic domain wall pinning persist in an applied electric field. This leads to an unprecedented electric controllability over the ferromagnetic microstructure, an accomplishment that produces giant magnetoelectric coupling effects and opens the way to electric-field driven spintronics. PMID:22355770

  17. 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.

  18. 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.

  19. Development of the Intrinsic Language Network in Preschool Children from Ages 3 to 5 Years

    PubMed Central

    Xiao, Yaqiong; Brauer, Jens; Lauckner, Mark; Zhai, Hongchang; Jia, Fucang; Margulies, Daniel S.; Friederici, Angela D.

    2016-01-01

    Resting state studies of spontaneous fluctuations in the functional magnetic resonance imaging (fMRI) blood oxygen level dependent signal have shown great potential in mapping the intrinsic functional connectivity of the human brain underlying cognitive functions. The aim of the present study was to explore the developmental changes in functional networks of the developing human brain exemplified with the language network in typically developing preschool children. To this end, resting-sate fMRI data were obtained from native Chinese children at ages of 3 and 5 years, 15 in each age group. Resting-state functional connectivity (RSFC) was analyzed for four regions of interest; these are the left and right anterior superior temporal gyrus (aSTG), left posterior superior temporal gyrus (pSTG), and left inferior frontal gyrus (IFG). The comparison of these RSFC maps between 3- and 5-year-olds revealed that RSFC decreases in the right aSTG and increases in the left hemisphere between aSTG seed and IFG, between pSTG seed and IFG, as well as between IFG seed and posterior superior temporal sulcus. In a subsequent analysis, functional asymmetry of the language network seeding in aSTG, pSTG and IFG was further investigated. The results showed an increase of left lateralization in both RSFC of pSTG and of IFG from ages 3 to 5 years. The IFG showed a leftward lateralized trend in 3-year-olds, while pSTG demonstrated rightward asymmetry in 5-year-olds. These findings suggest clear developmental trajectories of the language network between 3- and 5-year-olds revealed as a function of age, characterized by increasing long-range connections and dynamic hemispheric lateralization with age. Our study provides new insights into the developmental changes of a well-established functional network in young children and also offers a basis for future cross-culture and cross-age studies of the resting-state language network. PMID:27812160

  20. Development of the Intrinsic Language Network in Preschool Children from Ages 3 to 5 Years.

    PubMed

    Xiao, Yaqiong; Brauer, Jens; Lauckner, Mark; Zhai, Hongchang; Jia, Fucang; Margulies, Daniel S; Friederici, Angela D

    2016-01-01

    Resting state studies of spontaneous fluctuations in the functional magnetic resonance imaging (fMRI) blood oxygen level dependent signal have shown great potential in mapping the intrinsic functional connectivity of the human brain underlying cognitive functions. The aim of the present study was to explore the developmental changes in functional networks of the developing human brain exemplified with the language network in typically developing preschool children. To this end, resting-sate fMRI data were obtained from native Chinese children at ages of 3 and 5 years, 15 in each age group. Resting-state functional connectivity (RSFC) was analyzed for four regions of interest; these are the left and right anterior superior temporal gyrus (aSTG), left posterior superior temporal gyrus (pSTG), and left inferior frontal gyrus (IFG). The comparison of these RSFC maps between 3- and 5-year-olds revealed that RSFC decreases in the right aSTG and increases in the left hemisphere between aSTG seed and IFG, between pSTG seed and IFG, as well as between IFG seed and posterior superior temporal sulcus. In a subsequent analysis, functional asymmetry of the language network seeding in aSTG, pSTG and IFG was further investigated. The results showed an increase of left lateralization in both RSFC of pSTG and of IFG from ages 3 to 5 years. The IFG showed a leftward lateralized trend in 3-year-olds, while pSTG demonstrated rightward asymmetry in 5-year-olds. These findings suggest clear developmental trajectories of the language network between 3- and 5-year-olds revealed as a function of age, characterized by increasing long-range connections and dynamic hemispheric lateralization with age. Our study provides new insights into the developmental changes of a well-established functional network in young children and also offers a basis for future cross-culture and cross-age studies of the resting-state language network.

  1. Medium-term outcomes and complications after total replacement of the temporomandibular joint. Prospective outcome analysis after 3 and 5 years.

    PubMed

    Gruber, E A; McCullough, J; Sidebottom, A J

    2015-05-01

    In this prospective analysis, we assess the medium-term benefits, efficacy, and safety of the TMJ Concepts joint replacement system in the United Kingdom. Outcome measures of pain, maximum mouth opening, and diet were recorded preoperatively and at intervals up to 3 and 5 years. All patients who had replacement temporomandibular joints (TMJ) within a 6-year period were included. A total of 58 patients (84 joints) were followed up for 3 years (mean age 47, range 19-72) and 26 (42 joints) for 5 years (mean age 46, range 27-70). The female to male ratio was 52:6 at 3 years and 23:3 at 5 years. The most common diagnosis was degenerative disease, and the mean number of previous TMJ procedures was 2.4 (range 0-14). There were significant improvements in pain scores (7.4 reduced to 0.6 at 3 years and 0.8 at 5 years), maximum mouth opening (21.0-35.5mm at 3 years and 23.8-33.7mm at 5 years), and dietary scores (4.1-9.7 at 3 years and 3.7-9.6 at 5 years). Revision operations were required in 2 patients (not included in the outcome data) for biofilm infection of the prosthesis secondary to local infection in the head and neck. One patient had weakness of the temporal branch of the facial nerve that needed correction. TMJ replacement is an effective form of management for an irreparably damaged joint, particularly in cases of ankylosis. It lessens pain and improves function with minimal long-term morbidity.

  2. Neurodevelopmental outcomes at 5 years in children exposed prenatally to maternal dental amalgam: the Seychelles Child Development Nutrition Study.

    PubMed

    Watson, Gene E; van Wijngaarden, Edwin; Love, Tanzy M T; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; Yeates, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Thurston, Sally W; Harrington, Donald; Zareba, Grazyna; Wallace, Julie M W; Myers, Gary J

    2013-01-01

    Limited human data are available to assess the association between prenatal mercury vapor (Hg⁰)) exposure from maternal dental amalgam restorations and neurodevelopment of children. We evaluated the association between maternal dental amalgam status during gestation and children's neurodevelopmental outcomes at 5 years in the Seychelles Child Development Nutrition Study (SCDNS). Maternal amalgam status was determined prospectively in a longitudinal cohort study examining the associations of prenatal exposure to nutrients and methylmercury (MeHg) with neurodevelopment. A total of 236 mother-child pairs initially enrolled in the SCDNS in 2001 were eligible to participate. Maternal amalgam status was measured as number of amalgam surfaces (the primary metric) and number of occlusal points. The neurodevelopmental assessment battery was comprised of age-appropriate tests of cognitive, language, and perceptual functions, and scholastic achievement. Linear regression analysis controlled for MeHg exposure, maternal fatty acid status, and other covariates relevant to child development. Maternal amalgam status evaluation yielded an average of 7.0 surfaces (range 0-28) and 11.0 occlusal points (range 0-40) during pregnancy. Neither the number of maternal amalgam surfaces nor occlusal points were associated with any outcome. Our findings do not provide evidence to support a relationship between prenatal exposure to Hg⁰ from maternal dental amalgam and neurodevelopmental outcomes in children at 5 years of age.

  3. 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

  4. 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.

  5. Deferiprone versus deferoxamine in thalassemia intermedia: Results from a 5-year long-term Italian multicenter randomized clinical trial.

    PubMed

    Calvaruso, Giuseppina; Vitrano, Angela; Di Maggio, Rosario; Lai, Eliana; Colletta, Grazia; Quota, Alessandra; Gerardi, Calogera; Rigoli, Luciana Concetta; Sacco, Massimiliano; Pitrolo, Lorella; Maggio, Aurelio

    2015-07-01

    In patients with thalassemia intermedia (TI), such as beta-TI, alpha-thalassemia (mainly HbH disease and mild/moderate forms of HbE/beta-thalassemia), iron overload is an important challenge in terms of diagnosis, monitoring, and treatment. Moreover, to date, the only possible chelators available are deferoxamine, deferasirox, and deferiprone. Here, we report the first 5-year long-term randomized clinical trial comparing the effectiveness of deferiprone versus deferoxamine in patients with TI. Body iron burden, which was determined by measuring serum ferritin levels in the same patient over 5 years and analyzed according to the generalized linear mixed model (GLMM), showed a linear decrease over time in the mean serum ferritin levels in both treatment groups (P-value = 0.035). The overall period of observation was 235.2 person-years for the deferiprone patients compared with 214.3 person-years for the deferoxamine patients. The results of the log-rank test suggested that the deferiprone treatment did not affect survival compared with the deferoxamine treatment (P-value = 0.360). The major adverse events observed included gastrointestinal symptoms and joint pain or arthralgia. Neutropenia and agranulocytosis were also detected, suggesting needing of strict hematological control. In conclusion, long-term iron chelation therapy with deferiprone is associated with an efficacy and safety similar to that of deferoxamine, suggesting that this drug is an alternative option in cases in which deferoxamine and deferasirox are contraindicated.

  6. Localizing Effects of Leptin on Upper Airway and Respiratory Control during Sleep

    PubMed Central

    Yao, Qiaoling; Pho, Huy; Kirkness, Jason; Ladenheim, Ellen E.; Bi, Sheng; Moran, Timothy H.; Fuller, David D.; Schwartz, Alan R.; Polotsky, Vsevolod Y.

    2016-01-01

    Study Objectives: Obesity hypoventilation and obstructive sleep apnea are common complications of obesity linked to defects in respiratory pump and upper airway neural control. Leptin-deficient ob/ob mice have impaired ventilatory control and inspiratory flow limitation during sleep, which are both reversed with leptin. We aimed to localize central nervous system (CNS) site(s) of leptin action on respiratory and upper airway neuroventilatory control. Methods: We localized the effect of leptin to medulla versus hypothalamus by administering intracerbroventricular leptin (10 μg/2 μL) versus vehicle to the lateral (n = 14) versus fourth ventricle (n = 11) of ob/ob mice followed by polysomnographic recording. Analyses were stratified for effects on respiratory (nonflow-limited breaths) and upper airway (inspiratory flow limitation) functions. CNS loci were identified by (1) leptin-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation and (2) projections of respiratory and upper airway motoneurons with a retrograde transsynaptic tracer (pseudorabies virus). Results: Both routes of leptin administration increased minute ventilation during nonflow-limited breathing in sleep. Phrenic motoneurons were synaptically coupled to the nucleus of the solitary tract, which also showed STAT3 phosphorylation, but not to the hypothalamus. Inspiratory flow limitation and obstructive hypopneas were attenuated by leptin administration to the lateral but not to the fourth cerebral ventricle. Upper airway motoneurons were synaptically coupled with the dorsomedial hypothalamus, which exhibited STAT3 phosphorylation. Conclusions: Leptin relieves upper airway obstruction in sleep apnea by activating the forebrain, possibly in the dorsomedial hypothalamus. In contrast, leptin upregulates ventilatory control through hindbrain sites of action, possibly in the nucleus of the solitary tract. Citation: Yao Q, Pho H, Kirkness J, Ladenheim EE, Bi S, Moran TH, Fuller DD

  7. 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.

  8. An evaluation of a local exhaust ventilation control system for a foundry casting-cleaning operation.

    PubMed

    Gressel, M G

    1997-05-01

    A study was conducted to evaluate the effectiveness of a local exhaust ventilation system for a foundry casting-cleaning operation in which a worker cleaned gray iron castings using a variety of handheld chipping and grinding tools. The operation originally had an exhaust system consisting only of an exhaust duct terminating approximately 1 m (3 ft) above the floor and 2 m (6 ft) from the casting-cleaning workstation. An earlier evaluation of this original control system found time-weighted average exposures to respirable silica ranging from 124 to 160 micrograms/m3. The local exhaust ventilation system evaluated in this present study consisted of a downdraft booth outfitted with a turntable for manipulating the castings. The modified local exhaust ventilation system was installed at this facility and connected to the existing plant exhaust ventilation system through the original ductwork. A direct-reading instrument was used to measure the operator's respirable aerosol exposure concentrations during a single day both before and after the installation of the new workstation. The same worker was sampled both times. The operator's activities were recorded on videotape so that the exposures associated with the various tools could be determined. While day-to-day variability could not be accounted for, depending on the type of tool used the local exhaust ventilation system reduced exposures by 59 to 79% during casting cleaning by the sampled worker when compared with the original configuration. These reductions were statistically significant.

  9. Localized slip controlled by dehydration embrittlement of partly serpentinized dunites, Leka Ophiolite Complex, Norway

    NASA Astrophysics Data System (ADS)

    Dunkel, Kristina G.; Austrheim, Håkon; Renard, François; Cordonnier, Benoit; Jamtveit, Bjørn

    2017-04-01

    Dehydration of partly or completely serpentinized ultramafic rocks can increase the pore fluid pressure and induce brittle failure, a process referred to as dehydration embrittlement. However the extents of strain localization and unstable frictional sliding during deserpentinization are still under debate. In the layered ultramafic sections of the Leka Ophiolite Complex in the Central Norwegian Caledonides, prograde metamorphism of serpentinite veins led to local fluid production and to the growth of Mg-rich and coarse-grained olivine with abundant magnetite inclusions and δ18O values 1.0- 1.5 ‰ below the host rock. Embrittlement associated with the dehydration caused faulting along highly localized (<10 μm-wide) slip planes near the centers of the original serpentinite veins and pulverization of wall rock olivine. These features along with an earthquake-like size distribution of fault offsets suggest unstable frictional sliding rather than slower creep. Structural heterogeneities in the form of serpentinite veins clearly have first-order controls on strain localization and frictional sliding during dehydration. As most of the oceanic lithosphere is incompletely serpentinized, heterogeneities represented by a non-uniform distribution of serpentinite are common and may increase the likelihood that dehydration embrittlement triggers earthquakes.

  10. 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

  11. Positive and negative regulation of a SNARE protein by control of intracellular localization.

    PubMed

    Nakanishi, Hideki; de los Santos, Pablo; Neiman, Aaron M

    2004-04-01

    In Saccharomyces cerevisiae, the developmentally regulated Soluble N-ethylmaleimide sensitive factor attachment protein receptor (SNARE) protein Spo20p mediates the fusion of vesicles with the prospore membrane, which is required for the formation of spores. Spo20p is subject to both positive and negative regulation by separate sequences in its aminoterminal domain. We report that the positive activity is conferred by a short, amphipathic helix that is sufficient to confer plasma membrane or prospore membrane localization to green fluorescent protein. In vitro, this helix binds to acidic phospholipids, and mutations that reduce or eliminate phospholipid binding in vitro inactivate Spo20p in vivo. Genetic manipulation of phospholipid pools indicates that the likely in vivo ligand of this domain is phosphatidic acid. The inhibitory activity is a nuclear targeting signal, which confers nuclear localization in vegetative cells and in cells entering meiosis. However, as cells initiate spore formation, fusions containing the inhibitory domain exit the nucleus and localize to the nascent prospore membrane. Thus, the SNARE Spo20p is both positively and negatively regulated by control of its intracellular localization.

  12. Blind RSSD-Based Indoor Localization with Confidence Calibration and Energy Control.

    PubMed

    Zou, Tengyue; Lin, Shouying; Li, Shuyuan

    2016-05-31

    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.

  13. Renin dynamics in adipose tissue: adipose tissue control of local renin concentrations.

    PubMed

    Fowler, Jason D; Krueth, Stacy B; Bernlohr, David A; Katz, Stephen A

    2009-02-01

    The renin-angiotensin system (RAS) has been implicated in a variety of adipose tissue functions, including tissue growth, differentiation, metabolism, and inflammation. Although expression of all components necessary for a locally derived adipose tissue RAS has been demonstrated within adipose tissue, independence of local adipose RAS component concentrations from corresponding plasma RAS fluctuations has not been addressed. To analyze this, we varied in vivo rat plasma concentrations of two RAS components, renin and angiotensinogen (AGT), to determine the influence of their plasma concentrations on adipose and cardiac tissue levels in both perfused (plasma removed) and nonperfused samples. Variation of plasma RAS components was accomplished by four treatment groups: normal, DOCA salt, bilateral nephrectomy, and losartan. Adipose and cardiac tissue AGT concentrations correlated positively with plasma values. Perfusion of adipose tissue decreased AGT concentrations by 11.1%, indicating that adipose tissue AGT was in equilibrium with plasma. Cardiac tissue renin levels positively correlated with plasma renin concentration for all treatments. In contrast, adipose tissue renin levels did not correlate with plasma renin, with the exception of extremely high plasma renin concentrations achieved in the losartan-treated group. These results suggest that adipose tissue may control its own local renin concentration independently of plasma renin as a potential mechanism for maintaining a functional local adipose RAS.

  14. 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.

  15. 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

  16. Plasmon-assisted local temperature control to pattern individual semiconductor nanowires and carbon nanotubes.

    PubMed

    Cao, Linyou; Barsic, David N; Guichard, Alex R; Brongersma, Mark L

    2007-11-01

    We demonstrate a new versatile strategy to rapidly heat and cool subdiffraction-limited volumes of material with a focused light beam. The local temperature rise is obtained by exploiting the unique optical properties of metallic nanostructures that facilitate efficient light-to-heat conversion through the excitation of surface plasmons (collective electron oscillations). By locally heating nanoscale metallic catalysts, growth of semiconductor nanowires and carbon nanotubes can be initiated and controlled at arbitrarily prespecified locations and down to the single nanostructure level in a room-temperature chamber. This local heating strategy can be orders of magnitude (>10(5)) more energy efficient than conventional chemical vapor deposition (CVD) tools in which an entire chamber/substrate is heated. For these reasons, it has great potential for use in process- and energy-efficient assembly of nanowires into complementary metal-oxide-semiconductor (CMOS) compatible device architectures. In general, the high degree of spatial and temporal control over nanoscale thermal environments afforded by this method inspires new pathways for manipulating a range of important thermally stimulated processes and the development of novel photothermal devices.

  17. Radio-chemotherapy for bladder cancer: Contribution of chemotherapy on local control

    PubMed Central

    Plataniotis, George A; Dale, Roger G

    2013-01-01

    The purpose of this study was to review the magnitude of contribution of chemotherapy (CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy (RCT) was used (how much higher local control rates are obtained with RCT compared to RT alone). Studies on radiotherapy (RT) and combined RCT, neo-adjuvant, concurrent, adjuvant or combinations, reported after 1990 were reviewed. The mean complete response (CR) rates were significantly higher for the RCT studies compared to RT-alone studies: 75.9% vs 64.4% (Wilcoxon rank-sum test, P = 0.001). Eleven of the included RCT studies involved 2-3 cycles of neo-adjuvant CT, in addition to concurrent RCT. The RCT studies included the one-phase type (where a full dose of RCT was given and then assessment of response and cystectomy for non-responders followed) and the two-phase types (where an assessment of response was undertaken after an initial RCT course, followed 6 wk later by a consolidation RCT for those patients with a CR). CR rates between the two subgroups of RCT studies were 79.6% (one phase) vs 71.6% (two-phase) (P = 0.015). The average achievable tumour control rates, with an acceptable rate of side effects have been around 70%, which may represent a plateau. Further increase in CR response rates demands for new chemotherapeutic agents, targeted therapies, or modified fractionation in various combinations. Quantification of RT and CT contribution to local control using radiobiological modelling in trial designs would enhance the potential for both improved outcomes and the estimation of the potential gain. PMID:24003352

  18. 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

  19. Intrauterine Adiposity and BMI in 4- to 5-Year-Old Offspring from Diabetic Pregnancies

    PubMed Central

    Hammoud, Nurah M.; de Valk, Harold W.; Biesma, Douwe H.; Visser, Gerhard H.A.

    2016-01-01

    Background Pregnancies complicated by maternal diabetes are associated with disproportionate intrauterine growth that subsequently may lead to pediatric adiposity. Objectives We investigated whether disproportionate intrauterine growth leads to differences in BMI in 4- to 5-year-old offspring from pregnancies complicated by type 1 (ODM1), type 2 (ODM2), or gestational diabetes (OGDM). Methods Ultrasound data of fetal head-to-abdominal circumference (HC/AC) ratio obtained between 32 and 36 weeks of gestational age were related to offspring anthropometrics that were retrieved from infant welfare centers. Results Data from 27 ODM1, 22 ODM2, and 24 OGDM were obtained. Ultrasound measurements for the HC/AC ratio were performed at a mean of 33-34 weeks, with a mean Z-score of the HC/AC ratio of -0.801, -0.879, and 0.017 in ODM1, ODM2, and OGDM. Mean BMI SDS was highest in ODM2 as compared to ODM1 and OGDM. In ODM1 there was a negative correlation between HC/AC ratio and BMI SDS at the ages of 4 and 5 years, but not in ODM2 or OGDM. The birth weight Z-score was positively correlated to BMI SDS in ODM2 and OGDM. Conclusion Disproportionate intrauterine growth, expressed as the HC/AC ratio, was inversely related with BMI SDS in ODM1 at the ages of 4-5 years, but not in ODM2 or OGDM. Weight and maybe obesity in ODM1 offspring are likely to be related to intrauterine adiposity, whereas overweight in ODM2 and OGDM offspring seems more related to other factors such as birth weight centile, maternal obesity, and altered lifestyle factors during childhood. PMID:27788515

  20. Renal amyloidosis followed more than 5 years: report of 12 cases.

    PubMed

    Kaaroud, H; Boubaker, K; Béji, S; Abderrahim, E; Moussa, F Ben; Turki, S; Goucha, R; Hedri, H; El Younsi, F; Kheder, A; Maiz, H Ben

    2004-01-01

    Renal involvement with amyloidosis is common but causes patient survival to be poor, rarely reaching 5 years. In this study, we retrospectively reviewed clinical and biological characteristics as well as treatments and outcomes of patients with renal amyloidosis followed for more than 5 years. Between 1975 and 2003, 485 patients were diagnosed with renal amyloidosis including only 12 patients who were followed more than 5 years. The six men and six women of mean age 42.4 years (range 18 to 66 years) displayed renal signs of lower limb edema in all cases; hypertension in four cases, proteinuria on urinalysis in all cases with microscopic hematuria in five cases. Biological tests showed nephrotic syndrome in 11 patients, normal renal function in nine patients, and renal failure in three patients whose mean creatinine was 481.6 micromol/L (range 294 to 726). The amyloidosis was AA type in 11 cases and non-AA in one case. An etiologic survey revealed spondylarthropathy in one patient, pulmonary tuberculosis in two patients, chronic bronchitis in three patients, hepatic hydatic cyst in one patient, Mediterranean familial fever in two patients, Crohn's disease in one patient, Hodgkin's lymphoma in one patient, and multiple myeloma in one patient. Specific treatment was initiated with colchicine in seven patients. At a 110-month mean follow-up (range 53 to 153 months), remission of nephrotic syndrome was observed in four cases, progression to chronic renal failure in two patients, and to end-stage renal failure in five cases (range 53 to 196 months), with stabilization of renal function in seven patients. In conclusion, primary amyloid disease should be optimally suppressed in patients with renal involvement. The role of this treatment in remission of renal amyloidosis is not well established. This efficacy of the treatment has been demonstrated in some patients with improved survival.

  1. Development of aerobic and anaerobic power in adolescent rowers: a 5-year follow-up study.

    PubMed

    Mikulic, P

    2011-12-01

    We aimed to determine whether the physical and physiological superiority of early-maturing rowing athletes, observed at ages 12-13 years, over that of their late-maturing counterparts observed at the same ages, still persists at 17-18 years of age, when all adolescent athletes are expected to have completed pubertal development. We hypothesized that this superiority of early maturers would not be observed at reassessment, as late maturers would have likely "caught up" with their early-maturing peers. Twenty-one male rowers were assessed at age 12.8 ± 0.5 years and again at 17.5 ± 0.5 years (mean ± SD). They were divided into groups of early-maturing and late-maturing rowing athletes based on Tanner's sexual maturity ratings. A two-way repeated-measures MANOVA followed by a series of ANOVAs with one within-subject factor (time) and one between-subject factor (group) indicated significant (P≤0.003) within-subject and between-subjects main effects for lean body mass (LBM), maximal oxygen uptake (VO2max), and mean power (MP). The group × time interaction effects were significant for LBM (P=0.003), VO2max (P=0.004), but not for MP (P=0.171). Over 5 years, early-maturers' advantage dwindled in terms of LBM (+38% to +9%), VO2max (+47% to +9%), and MP (+76% to +15%); however, these differences may still be considered practically relevant. The proposed hypothesis was not supported.

  2. Trends in 5-year survival rates among breast cancer patients by hormone receptor status and stage

    PubMed Central

    Chen, Lu; Linden, Hannah M.; Anderson, Benjamin O.; Li, Christopher I.

    2014-01-01

    Purpose Improvement in breast cancer survival has been observed in recent decades in the U.S., but it is unclear if similar survival gains are consistent across breast cancer subtypes, especially with regards to more advanced stages of the disease. Methods Data were from 13 population-based cancer registries participating in the Surveillance, Epidemiology and End Results (SEER) program, consisting of women between 20–79 years of age diagnosed with invasive breast cancer between 1992 and 2008. 2-year (1992–2008) and 5-year (1992–2006) breast cancer cause-specific survival rates were calculated and stratified by estrogen receptor (ER)/progesterone receptor (PR) status, stage and race. Annual percent changes in survival rates were assessed. Results From 1992 through 1998–1999, 5-year and 2-year cause specific survival rates significantly improved across ER+/PR+, ER−/PR− and ER+/PR− subtypes, with an annual increase ranging from 0.5%–1.0%. From 1998–1999 to 2006, different patterns were observed by ER/PR subtypes with survival rates slightly improving for ER+/PR+, continuing to improve at a rate of 0.5% per year for ER−/PR−, and dropping 0.3% annually for ER+/PR− No significant survival gains were experienced by patients with ER−/PR+ cancer during the study period. In terms of advanced diseases, greatest annual increases in survival rates were seen for patients with stage III–IV ER+/PR+ and ER−/PR− tumors but less progress was observed for advanced ER+/PR− breast cancers. Conclusion Steady improvements in survival rates for breast cancer have been achieved over the past several decades. However, 5-year survival rates for stage IV disease remained dismally below 20% for most ER/PR subtypes. PMID:25164974

  3. 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.

  4. Full term delivery following cryopreservation of human embryos for 7. 5 years.

    PubMed

    Ben-Ozer, S; Vermesh, M

    1999-06-01

    Successful pregnancy in a 44 year old woman is described following the transfer of embryos which were cryopreserved for 7.5 years. The embryos were obtained during a gamete intra-Fallopian transfer (GIFT) procedure in 1989. To our knowledge this is one of the longest published periods of cryopreservation of embryos which has resulted in a healthy baby. This report illustrates the previously presumed viability and normality of human embryos undergoing long-term cryopreservation. Additionally, it emphasizes the importance for advanced reproductive technique programmes and patients to review and update their embryo status.

  5. 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.

  6. Socioeconomic status and changes in body mass from 3 to 5 years

    PubMed Central

    De Spiegelaere, M; Dramaix, M; Hennart, P

    1998-01-01

    The influence of social status on the development of body mass was analysed in a retrospective cohort study of 675 Belgian children monitored between the ages of 3 and 5 years by the preventive medical services in Brussels. At age 3, no association between excess weight and social status was observed. Adiposity rebound before age 5 was inversely related to body mass at age 3 and was independent of social status. The social influences on obesity observed in adolescence cannot be explained by a higher frequency of early adiposity rebound in children of low socioeconomic status.

 PMID:9659099

  7. 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

  8. Giant pericardial cyst in a 5-year-old child: A rare anomaly

    PubMed Central

    Kumar, Sanjay; Jain, Promil; Sen, Rajeev; Rattan, KN; Agarwal, Ruchi; Garg, Shilpa

    2011-01-01

    Pericardial cysts are uncommon congenital abnormalities that occur in the middle mediastinum. Most of these are found incidentally on chest x-rays. The occurrence of pericardial cyst in children is quite rare. It needs to be differentiated from other cystic mediastinal masses. A rare case of pericardial cyst in a 5 year old male child is reported. The child presented with chest pain, cough and fever. The preoperative diagnosis of pericardial cyst was suggestive on echocardiography and CT scan. It was confirmed on histopathology after successful surgical excision. The rarity of this benign mediastinal lesion in children prompted us to report this case. PMID:21677811

  9. Complex venous anomalies: magnetic resonance imaging findings in a 5-year-old boy.

    PubMed

    Hazirolan, Tuncay; Ozkan, Efe; Haliloglu, Mithat; Celiker, Alpay; Balkanci, Ferhun

    2006-10-01

    We report magnetic resonance imaging (MRI) findings of a very unusual venous anomaly case. A 5-year-old boy who had surgical repair of coarctation of the thoracic aorta was referred to our department for evaluation of an enlarged venous structure anterior to the aorta, which had been noted during the surgery. Contrast enhanced dynamic MRI revealed partial anomalous pulmonary venous return to the left azygos vein, double inferior and superior vena cava with the left azygos continuation of the left superior vena cava. The recognition of venous anomalies allows correct planning of surgical and interventional procedures. MRI is a valuable imaging tool providing detailed anatomical information.

  10. Malnutrition among children younger than 5 years-old in conflict zones of Chiapas, Mexico.

    PubMed

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A; Brentlinger, Paula

    2007-02-01

    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.

  11. [Acute cerebellar ataxia in a 5-year-old boy. Clinical warnings].

    PubMed

    Mrozińska, M; Horwath, A; Ostoja-Chrzastowski, W

    1998-01-01

    A case of acute cerebellar ataxia caused by ECHO virus 30.5-year-old boy admitted to the Clinic of Gastroenterology and Nutrition in Warsaw, in September, 1996, complaining of headache, dizziness, weakness, somnolence, dysarthria and an unsteady walk. On neurological examination he had imparied coordination, rombergism, generalized hypotonia. There was no history of exposure to contagious diseases, ear discharge, convulsions, trauma. Parents suggested that the child could have swallowed an unidentified pill--toxicological tests ruled out poisoning. The diagnosis is based on the clinical examination and amplification ECHO virus from CSF.

  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. 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

  14. 5-Year Downstream Outcomes Following Prostate-Specific Antigen (PSA) Screening in Older Men

    PubMed Central

    Walter, Louise C.; Fung, Kathy Z.; Kirby, Katharine A.; Shi, Ying; Espaldon, Roxanne; O'Brien, Sarah; Freedland, Stephen J.; Powell, Adam A.; Hoffman, Richard M.

    2013-01-01

    Background Despite ongoing controversies surrounding PSA screening, large numbers of men age 65+ undergo screening. However, there are few data quantifying the chain of events following screening in clinical practice to better inform decisions. The objective of this study is to quantify 5-year downstream outcomes following a PSA screening result > 4 ng/ml in older men. Methods Longitudinal cohort study of 295,645 men age 65+ who underwent PSA screening in the VA healthcare system in 2003 and were followed for 5 years using national VA and Medicare data. Among men whose index screening PSA was > 4 ng/ml we determined the number who underwent biopsy, were diagnosed with prostate cancer, were treated and survived 5-years, according to baseline characteristics. Biopsy and treatment complications were also assessed. Results 25,208 (8.5%) men had an index PSA > 4 ng/ml. During 5-year follow-up, 8,313 (33%) men underwent at least one biopsy, 5,220 (63%) of men biopsied were diagnosed with prostate cancer of whom 4,284 (82%) were treated. Receipt of biopsy decreased with advancing age and worsening comorbidity (P<0.001), whereas the percentage treated for biopsy-detected cancer exceeded 75% even among men age 85+, those with Charlson score 3+, and those with low-risk cancer. Among men with biopsy-detected cancer, the risk of dying of non-prostate cancer causes increased with advancing age and comorbidity (P<0.001). 468 (6%) of men had 7-day biopsy complications. Treatment complications included 584 (14%) men with new incontinence and 588 (14%) men with new erectile dysfunction. Conclusions Receipt of biopsy is low in older men with abnormal screening PSA and decreases with advancing age and comorbidity. However, once biopsy detects cancer most men undergo immediate treatment regardless of advancing age, comorbidity, or low-risk cancer. Understanding downstream outcomes in clinical practice should better inform individualized decisions among older men considering PSA

  15. 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.

  16. 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

  17. High-precision atom localization via controllable spontaneous emission in a cycle-configuration atomic system.

    PubMed

    Ding, Chunling; Li, Jiahua; Yu, Rong; Hao, Xiangying; Wu, Ying

    2012-03-26

    A scheme for realizing two-dimensional (2D) atom localization is proposed based on controllable spontaneous emission in a coherently driven cycle-configuration atomic system. As the spatial-position-dependent atom-field interaction, the frequency of the spontaneously emitted photon carries the information about the position of the atom. Therefore, by detecting the emitted photon one could obtain the position information available, and then we demonstrate high-precision and high-resolution 2D atom localization induced by the quantum interference between the multiple spontaneous decay channels. Moreover, we can achieve 100% probability of finding the atom at an expected position by choosing appropriate system parameters under certain conditions.

  18. 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.

  19. Electrochemotherapy increases local control after incomplete excision of a recurring penile fibrosarcoma in a stallion

    PubMed Central

    Spugnini, E.P.; Bolaffio, C.; Scacco, L.; Baldi, A.

    2016-01-01

    An eleven-year-old stallion was referred for adjuvant treatment of an incompletely excised, recurring penile fibrosarcoma. The horse was bright, alert and responsive with a 15 x 12 cm ulcerated lesion on the ventral side of the penis. The lesion was the tumor bed of an incompletely excised fibrosarcoma. After complete staging procedures, the owner elected to treat the horse with electrochemotherapy (ECT) using cisplatin as chemotherapy agent. Two sessions of ECT were performed at two-week intervals using local cisplatin followed by trains of biphasic electric pulses applied using different electrodes until complete coverage of the area was achieved. The treatment was well tolerated, and the patient is still disease free after 12 months. ECT resulted in improved local control and should be considered among the available adjuvant treatments in equines carrying soft tissue tumors. PMID:27995080

  20. Local Control After Intensity-Modulated Radiotherapy for Head-and-Neck Rhabdomyosarcoma

    SciTech Connect

    Curtis, Amarinthia E.; Okcu, M. Fatih; Chintagumpala, Murali; Paulino, Arnold C.

    2009-01-01

    Purpose: To examine the patterns of failure in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma (RMS). Methods and Materials: Between 1998 and 2005, 19 patients with a diagnosis of head-and-neck RMS received IMRT at The Methodist Hospital. There were 11 male and 8 female patients, with a median age of 6 years at time of irradiation. Tumor location was parameningeal in 7, orbital in 6, and other head-and-neck RMS in 6. Chemotherapy was given to all patients, with vincristine, actinomycin D, and cyclophosphamide being the most common regimen (n = 18). The median prescribed dose was 5040 cGy. The clinical target volume included the gross tumor volume with a 1.5-cm margin. The median duration of follow-up for surviving patients was 56 months. Results: The 4-year overall survival and local control rates were 76% and 92.9%, respectively. One patient developed a local failure in the high-dose region of the radiation field; there were no marginal failures. Distant metastasis was seen in 4 patients. Overall survival was 42.9% for parameningeal sites and 100% for other sites (p < 0.01). Late toxicities were seen in 7 patients. Two secondary malignancies occurred in 1 child with embryonal RMS of the face and a p53 mutation. Conclusions: Local control was excellent in patients receiving IMRT for head-and-neck RMS. Patterns of local failure reveal no marginal failures in this group of patients.

  1. Wear in conventional and highly cross-linked polyethylene cups: a 5-year follow-up study.

    PubMed

    Olyslaegers, Christophe; Defoort, Koen; Simon, Jean-Pierre; Vandenberghe, Luc

    2008-06-01

    Highly cross-linked polyethylene (XLPE) has been introduced in total hip arthroplasty in an effort to reduce polyethylene wear and the associated periprosthetic osteolysis. Our aim was to demonstrate these reduced wear rates in a 2-dimensional head penetration model and to perform a clinical comparison of both groups using the Harris Hip Score (and SF-36 questionnaire). Sixty hips with a Trilogy XLPE liner (Zimmer) were matched and compared to a control group of 20 conventional Trilogy PE liners (Zimmer). No differences in clinical outcome were seen, but a statistically significant reduction in linear wear was observed in the XLPEgroup, after 5 years. It is clear that, because of the reduction and stabilization of free radicals in polyethylene, a reduction in annual wear can be achieved.

  2. Identifying and avoiding singularity-induced local traps over control landscapes of spin chain systems.

    PubMed

    Sun, Qiuyang; Pelczer, István; Riviello, Gregory; Wu, Re-Bing; Rabitz, Herschel

    2015-11-28

    The wide success of quantum optimal control in experiments and simulations is attributed to the properties of the control landscape, defined by the objective value as a functional of the controls. Prior analysis has shown that on satisfaction of some underlying assumptions, the landscapes are free of suboptimal traps that could halt the search for a global optimum with gradient-based algorithms. However, violation of one particular assumption can give rise to a so-called singular control, possibly bringing about local traps on the corresponding landscapes in some particular situations. This paper theoretically and experimentally demonstrates the existence of singular traps on the landscape in linear spin-1/2 chains with Ising couplings between nearest neighbors and with certain field components set to zero. The results in a two-spin example show how a trap influences the search trajectories passing by it, and how to avoid encountering such traps in practice by choosing sufficiently strong initial control fields. The findings are also discussed in the context of the generally observed success of quantum control.

  3. 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

  4. Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases.

    PubMed

    Bardosh, Kevin

    2014-01-01

    Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the "neglected" status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.

  5. 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

    2016-03-11

    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.

  6. Locally optimal control under unknown dynamics with learnt cost function: application to industrial robot positioning

    NASA Astrophysics Data System (ADS)

    Guérin, Joris; Gibaru, Olivier; Thiery, Stéphane; Nyiri, Eric

    2017-01-01

    Recent methods of Reinforcement Learning have enabled to solve difficult, high dimensional, robotic tasks under unknown dynamics using iterative Linear Quadratic Gaussian control theory. These algorithms are based on building a local time-varying linear model of the dynamics from data gathered through interaction with the environment. In such tasks, the cost function is often expressed directly in terms of the state and control variables so that it can be locally quadratized to run the algorithm. If the cost is expressed in terms of other variables, a model is required to compute the cost function from the variables manipulated. We propose a method to learn the cost function directly from the data, in the same way as for the dynamics. This way, the cost function can be defined in terms of any measurable quantity and thus can be chosen more appropriately for the task to be carried out. With our method, any sensor information can be used to design the cost function. We demonstrate the efficiency of this method through simulating, with the V-REP software, the learning of a Cartesian positioning task on several industrial robots with different characteristics. The robots are controlled in joint space and no model is provided a priori. Our results are compared with another model free technique, consisting in writing the cost function as a state variable.

  7. Focused ultrasound treatment of VX2 tumors controlled by local harmonic motion.

    PubMed

    Curiel, Laura; Huang, Yuexi; Vykhodtseva, Natalia; Hynynen, Kullervo

    2009-06-07

    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.

  8. Evaluation of Public Service Advertising Messages with Local and Non-Local Source Attribution: A Controlled Laboratory Experiment.

    ERIC Educational Resources Information Center

    Lynn, Jerry R.; Gagnard, Alice

    A study was conducted to examine message evaluations of selected public service advertisements (PSAs) by a young adult population and to test whether local and nonlocal source attribution would influence those evaluations. In addition, the study investigated the extent to which audience characteristics such as fatalism (the degree to which a…

  9. 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

  10. 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

  11. Tamoxifen beyond 5 years--patients' decisions regarding entry to the aTTom trial.

    PubMed

    Ferguson, M J; Dewar, J A

    2002-09-01

    The aim of this study was to assess among a population of women who had taken adjuvant tamoxifen for 5 years, how many were prepared to enter a randomised trial looking at the duration of tamoxifen treatment and what was the preference of those who declined trial entry. There is uncertainty as to the optimum duration of adjuvant tamoxifen and this is the subject of the aTTom (adjuvant Tamoxifen Treatment offer more?) trial in which patients are randomised to continue or stop tamoxifen after 5 years. Patients have been recruited to the aTTom trial in Dundee since 1996 and a record has been kept of all the patients with whom the trial was discussed. Patients who declined trial entry were allowed to choose whether to electively stop or continue tamoxifen. 306 patients were eligible for trial entry of whom 171 (56%) consented to randomisation (82 to continue and 89 to stop). Amongst the 135 (44%) who declined randomisation, 28 (21%) elected to stop tamoxifen treatment, 90 (67%) elected to continue and in 17 (13%) their decision was unclear. These results illustrate that patients eligible for the aTTom trial share our clinical equipoise. A majority (56%) of patients were agreeable to randomisation, but among those who declined, some (67%) preferred to continue, some (21%) to stop tamoxifen. This trial is unusual in that the patients have already experienced the treatment options, so the patients' preferences reflect a truly informed choice.

  12. Body composition during fetal development and infancy through the age of 5 years

    PubMed Central

    Toro-Ramos, T; Paley, C; Pi-Sunyer, FX; Gallagher, D

    2015-01-01

    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

  13. 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

  14. The Thermal State of KS 1731-260 after 14.5 years in Quiescence

    NASA Astrophysics Data System (ADS)

    Merritt, Rachael L.; Cackett, Edward M.; Brown, Edward F.; Page, Dany; Cumming, Andrew; Degenaar, Nathalie; Deibel, Alex; Homan, Jeroen; Miller, Jon M.; Wijnands, Rudy

    2016-12-01

    Crustal cooling of accretion-heated neutron stars provides insight into the stellar interior of neutron stars. The neutron star X-ray transient, KS 1731-260, was in outburst for 12.5 years before returning to quiescence in 2001. We have monitored the cooling of this source since then through Chandra and XMM-Newton observations. Here we present a 150 ks Chandra observation of KS 1731-260 taken in 2015 August, about 14.5 years into quiescence and 6 years after the previous observation. We find that the neutron star surface temperature is consistent with the previous observation, suggesting that crustal cooling has likely stopped and the crust has reached thermal equilibrium with the core. Using a theoretical crust thermal evolution code, we fit the observed cooling curves and constrain the core temperature (T c = 9.35 ± 0.25 × 107 K), composition (Q {}{imp}={4.4}-0.5+2.2), and level of extra shallow heating required (Q sh = 1.36 ± 0.18 MeV/nucleon). We find that the presence of a low thermal conductivity layer, as expected from nuclear pasta, is not required to fit the cooling curve well, but cannot be excluded either.

  15. Family meal frequency and weight status among adolescents: cross-sectional and 5-year longitudinal associations.

    PubMed

    Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Hannan, Peter J; Story, Mary

    2008-11-01

    This study examined cross-sectional and 5-year longitudinal associations between the frequency of family meals and overweight status (>85th percentile for age and gender) in a large, diverse population of adolescents (n = 2,516). The population included two cohorts (midadolescence to young adulthood, n = 1,710, and early adolescence to midadolescence, n = 806). Logistic regression models tested cross-sectional and longitudinal (1999-2004) associations between family meal frequency and overweight status. Two sets of models are presented: (i) models adjusted only for baseline demographic characteristics and (ii) models also adjusted for physical activity, sedentary behaviors, and energy intake. Longitudinal models adjusted for baseline overweight status. Although significant inverse associations between family meal frequency and overweight status were observed for early adolescent females in all cross-sectional models (P < 0.001), longitudinal associations were not significant. Neither cross-sectional nor longitudinal associations were significant for males of either cohort and older females in any models. Young adolescent females who do not eat meals with their families may be at risk for overweight; however, the increased risk may not persist over a 5-year period. Eating family meals during high school may not protect against overweight during young adulthood. Although previous longitudinal research has suggested significant dietary and psychosocial benefits related to family meal frequency, the weight-related benefits of family meals may be more complex and deserving of further study, including an examination of the quality and quantity of food consumed at family meals.

  16. 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.

  17. 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.

  18. 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.

  19. [Bocavirus in infants under 5 years with acute respiratory infection. Chaco Province, Argentina, 2014].

    PubMed

    Deluca, Gerardo D; Urquijo, María Cecilia; Passarella, Carolina; Picón, César; Picón, Dimas; Acosta, María; Rovira, Carina; Marín, Héctor M

    2016-01-01

    Acute respiratory infection (ARI) is the most frequent pathology along human life, being the most common cause of morbidity and mortality in children under 5 years. The aim of this study was to determine the frequency of bocavirus (BoV) in infants under 5 years with symptoms of ARI from north Argentina (Chaco province). The study was performed on nasopharyngeal aspirates from 488 patients, in the period of January-December 2014. The samples were tested by real time PCR and 36 positive BoV cases (7.4%) were detected. The period with the highest detection rate was June-September with 28 cases (77.8%), of which 26 (72.2%) were infants between 6-18 moths of life. In half of BoV positive cases this virus was detected as single infection of the upper respiratory tract, and in the remaining 50%, as concomitant infection with other microorganisms. To our knowledge, this would be the first study on molecular epidemiology of BoV in northern Argentina. We emphasize the importance of investigating these new viruses capable of generating acute respiratory disease and also to disseminate awareness on their circulation within the community.

  20. Gender Differences in Appraisal of Stress and Coping 5 Years after Heart Transplantation

    PubMed Central

    Grady, Kathleen L; Andrei, Adin-Cristian; Li, Zhi; Rybarczyk, Bruce; White-Williams, Connie; Gordon, Robert; McGee, Edwin C.

    2015-01-01

    OBJECTIVES We examined whether gender differences exist regarding stress, symptom distress, coping, adherence, and social support 5 years after heart transplantation. BACKGROUND Differences exist in health-related quality of life outcomes by gender after heart transplantation; women report poorer outcomes. METHODS Patients (n=210, female=42), were from a prospective, multi-site, study of health-related quality of life long-term after heart transplantation. Patients completed self-report instruments 5 years after heart transplantation (mean=4.98±0.17 years after transplant). Statistical analyses included two-sample t-tests, Chi-square or Fisher’s exact test, and multivariable modeling. RESULTS Women did not report more overall stress or symptom distress, but reported more difficulty adhering to the transplant regimen, yet more actual adherence than men. Women reported using more negative coping styles, but reported more satisfaction with social support. CONCLUSIONS Gender differences exist regarding appraisal of stress, coping styles, and coping resources long-term after heart transplantation. These differences may guide tailoring therapy regarding stress, poor coping, and lack of resources. PMID:26514074

  1. Discourse prominence effects on 2.5-year-old children’s interpretation of pronouns

    PubMed Central

    Song, Hyun-joo; Fisher, Cynthia

    2007-01-01

    Three experiments examined 2.5-year-olds’ sensitivity to discourse structure in pronoun interpretation. Children heard simple two-character stories illustrated by pictures on two video screens. In Experiments 1 and 2, one character in each story was established as more prominent than the other in several context sentences because it was mentioned first, appeared in subject position, was mentioned more often, and was pronominalized once. In Experiment 3, one character was singled out as more prominent only by being mentioned first and placed in subject position. In all three experiments, after hearing a pronoun subject in the final (test) sentence of each story, children looked longer at the character established as more prominent in the preceding sentences. These experiments show that 2.5-year-olds, like older children and adults, interpret pronouns relative to a discourse representation in which referents are ranked in prominence, and that the prominence of discourse referents is influenced by some of the same factors that guide pronoun interpretation in adulthood. PMID:18978930

  2. EXPOSE-E: an ESA astrobiology mission 1.5 years in space.

    PubMed

    Rabbow, Elke; Rettberg, Petra; Barczyk, Simon; Bohmeier, Maria; Parpart, André; Panitz, Corinna; Horneck, Gerda; von Heise-Rotenburg, Ralf; Hoppenbrouwers, Tom; Willnecker, Rainer; Baglioni, Pietro; Demets, René; Dettmann, Jan; Reitz, Guenther

    2012-05-01

    The multi-user facility EXPOSE-E was designed by the European Space Agency to enable astrobiology research in space (low-Earth orbit). On 7 February 2008, EXPOSE-E was carried to the International Space Station (ISS) on the European Technology Exposure Facility (EuTEF) platform in the cargo bay of Space Shuttle STS-122 Atlantis. The facility was installed at the starboard cone of the Columbus module by extravehicular activity, where it remained in space for 1.5 years. EXPOSE-E was returned to Earth with STS-128 Discovery on 12 September 2009 for subsequent sample analysis. EXPOSE-E provided accommodation in three exposure trays for a variety of astrobiological test samples that were exposed to selected space conditions: either to space vacuum, solar electromagnetic radiation at >110 nm and cosmic radiation (trays 1 and 3) or to simulated martian surface conditions (tray 2). Data on UV radiation, cosmic radiation, and temperature were measured every 10 s and downlinked by telemetry. A parallel mission ground reference (MGR) experiment was performed on ground with a parallel set of hardware and samples under simulated space conditions. EXPOSE-E performed a successful 1.5-year mission in space.

  3. [The Octabaix study. Baseline assessment and 5 years of follow-up].

    PubMed

    Ferrer, Assumpta; Formiga, Francesc; Padrós, Gloria; Badia, Teresa; Almeda, Jesús; Octabaix, Grupo Estudio

    This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group.

  4. Lateralization of tongue movements during eating in children 2 to 5 years old.

    PubMed

    Gisel, E G; Schwaab, L; Lange-Stemmler, L; Niman, C W; Schwartz, J L

    1986-04-01

    Normative data on skills of the tongue used in eating are presented. Normal children 2 to 5 years old were studied regarding their preference of placing food either on the right or left side when eating, and they were compared with age-matched Down's syndrome children. In addition, the ability to move food from the right to the left side of the mouth was studied. Normal children underwent a transition from predominantly placing food on the right side at 2 years of age to predominantly placing it on the left side at 4 years of age. Among Down's syndrome children females preferred the right side, and males preferred the left side. The ability to move food from right to left (lateralizing) undergoes a developmental progression from tilting the head to rolling, followed by slow and eventually by smooth movement from one side to the other. Only 15% of the 5-year-olds were able to move food smoothly from side to side. These data provide a baseline against which children with eating problems can be compared.

  5. Separable sustained and selective attention factors are apparent in 5-year-old children.

    PubMed

    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-Ch(J)) 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-Ch(J) 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-Ch(J) 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.

  6. Survival of rock-colonizing organisms after 1.5 years in outer space.

    PubMed

    Onofri, Silvano; de la Torre, Rosa; de Vera, Jean-Pierre; Ott, Sieglinde; Zucconi, Laura; Selbmann, Laura; Scalzi, Giuliano; Venkateswaran, Kasthuri J; Rabbow, Elke; Sánchez Iñigo, Francisco J; Horneck, Gerda

    2012-05-01

    Cryptoendolithic microbial communities and epilithic lichens have been considered as appropriate candidates for the scenario of lithopanspermia, which proposes a natural interplanetary exchange of organisms by means of rocks that have been impact ejected from their planet of origin. So far, the hardiness of these terrestrial organisms in the severe and hostile conditions of space has not been tested over extended periods of time. A first long-term (1.5 years) exposure experiment in space was performed with a variety of rock-colonizing eukaryotic organisms at the International Space Station on board the European EXPOSE-E facility. Organisms were selected that are especially adapted to cope with the environmental extremes of their natural habitats. It was found that some-but not all-of those most robust microbial communities from extremely hostile regions on Earth are also partially resistant to the even more hostile environment of outer space, including high vacuum, temperature fluctuation, the full spectrum of extraterrestrial solar electromagnetic radiation, and cosmic ionizing radiation. Although the reported experimental period of 1.5 years in space is not comparable with the time spans of thousands or millions of years believed to be required for lithopanspermia, our data provide first evidence of the differential hardiness of cryptoendolithic communities in space.

  7. A 5-year study of adenoviruses causing conjunctivitis in Izmir, Turkey.

    PubMed

    Erdin, Begüm Nalça; Pas, Suzan D; Durak, İsmet; Schutten, Martin; Sayıner, A Arzu

    2015-03-01

    Adenoviruses are a common cause of conjunctivitis. Genotypes are diverse and differ according to population and geographical distribution of the virus. There is limited data regarding ocular adenoviral infections and genotype distribution in Turkey. This study aimed to determine the adenovirus genotypes and their epidemiological features among patients with conjunctivitis between 2006 and 2010, in Izmir, Turkey. Adenoviral DNA was detected by PCR in 213 of 488 (44%) of the ocular samples collected from patients with viral conjunctivitis during the 5-year study period. Of these, 101 (47%) were randomly chosen and genotyped by sequence analysis. Seven genotypes were identified, including 3, 4, 8, 11, 19, 37, and 53. Genotype 8 and 4 were the dominant types detected in 67 (66.3%) and 25 (24.7%) of the samples, respectively. Other five genotypes (3, 11, 19, 37, 53) were detected in 9 (8.9%) samples. Genotype and seasonal differences observed throughout the study. Human adenoviruse (HAdV)-8 was the most frequent type, except 2008. The prevalence of genotype 4 increased starting from 2006, became dominant in 2008 and decreased in the following years. The peak season was mostly spring months, although it was possible to detect positive samples throughout the year. In conclusion, genotype 8 followed by genotype 4 was the most frequent adenoviral types causing conjunctivitis during the 5-year study period. Findings suggest that there is a slow shift between genotypes throughout the years.

  8. Molecular characterization of cryptosporidium in children aged 0- 5 years with diarrhea in Jos, Nigeria

    PubMed Central

    Anejo-Okopi, Joseph Aje; Okojokwu, Julius Ocheme; Ebonyi, Augustine Odo; Ejeliogu, Emeka Uba; Isa, Samson Ejiji; Audu, Onyemocho; Akpakpan, Edoama Edet; Nwachukwu, Esther Ebere; Ifokwe, Christabel Kelechi; Ali, Murna; Lar, Patricia; Oguche, Stephen

    2016-01-01

    Introduction Cryptosporidium is an important cause of diarrhea in children and immune-compromised individuals. Recent advances in molecular diagnostics have led to the discovery of subtype families that are thought to be more commonly associated with diarrhea. We aimed to isolate and characterize Cryptosporidium spp among children with diarrhea in Jos, Nigeria. Methods Stool samples were collected from165 children aged 0-5 years with diarrhea. Cryptosporidium oocysts were examined by wet mount preparation, using formalin ether and a modified acid fast staining method. DNA was extracted from positive samples using QIAamp DNA stool mini kit and PCR-RFLP assay was carried out after quantification. Genotyping and phylogenetic analysis were done to determine the subtype families and their relatedness. Results From the 165 children studied, 8 (4.8%) were infected with Cryptosporidium. PCR-RFLP assay and genotype characterization found the following Cryptosporidium species: C. hominis 6 (75%) and C. parvum 2 (25.0%), with family subtypes Id-5, Ie-1 and IIa-1, IId-1 respectively.The most common species was C. hominis and the frequent subtype was C. hominis-Id 5 (62.5%). Conclusion Cryptosporidium is not an uncommon cause of diarrhea in children, with C. hominis being the dominant species. Also C. hominis Id is the commonest sub-family subtype. Put together, zoonotic species may be an important cause of diarrhea in children aged 0-5 years in Jos, Nigeria. PMID:28293369

  9. 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

  10. Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China

    PubMed Central

    Zhou, Xinhua; Zhang, Ying; Wang, Yan; Zhang, Hao; Chen, Li; Liu, Yuehua

    2017-01-01

    The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3–5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7%) was the highest in children with malocclusion, followed by deep overjet (33.9%), midline deviation (26.6%), anterior crossbite (8.0%) and anterior crowding (6.5%). The results revealed a high prevalence of malocclusion in primary dentition in children aged 3–5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened. PMID:28327525

  11. 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.

  12. Control of rolled edge based on the discrete local error figuring technique

    NASA Astrophysics Data System (ADS)

    Du, Hang; Li, Shengyi; Song, Ci

    2016-10-01

    Computer Controlled Optical Surfacing (CCOS) is an important technology for manufacturing optical aspheric mirrors. Edge effect of small tool manufacturing restricts the machining precision and efficiency of CCOS technology. Edge effect is mainly caused by the polish tool cannot move to the very edge of workpiece and the change of pressure distribution when the tool move to the edge of workpiece. This article corrects the rolled edge effect of CCOS by different dimensions of polishing tool combination process and incorporated with the locality residual error trace contour path planning. Provide feasibility for the rolled edge by different dimensions of polishing tool combination process.

  13. What is the effect of local controls on the temporal stability of soil water contents?

    NASA Astrophysics Data System (ADS)

    Martinez, G.; Pachepsky, Y. A.; Vereecken, H.; Vanderlinden, K.; Hardelauf, H.; Herbst, M.

    2012-04-01

    Temporal stability of soil water content (TS SWC) reflects the spatio-temporal organization of SWC. Factors and their interactions that control this organization, are not completely understood and have not been quantified yet. It is understood that these factors should be classified into groups of local and non-local controls. This work is a first attempt to evaluate the effects of soil properties at a certain location as local controls Time series of SWC were generated by running water flow simulations with the HYDRUS6 code. Bare and grassed sandy loam, loam and clay soils were represented by sets of 100 independent soil columns. Within each set, values of saturated hydraulic conductivity (Ks) were generated randomly assuming for the standard deviation of the scaling factor of ln Ks a value ranging from 0.1 to 1.0. Weather conditions were the same for all of the soil columns. SWC at depths of 0.05 and 0.60 m, and the average water content of the top 1 m were analyzed. The temporal stability was characterized by calculating the mean relative differences (MRD) of soil water content. MRD distributions from simulations, developed from the log-normal distribution of Ks, agreed well with the experimental studies found in the literature. Generally, Ks was the leading variable to define the MRD rank for a specific location. Higher MRD corresponded to the lowest values of Ks when a single textural class was considered. Higher MRD were found in the finer texture when mixtures of textural classes were considered and similar values of Ks were compared. The relationships between the spread of the MRD distributions and the scaling factor of ln Ks were nonlinear. Variation in MRD was higher in coarser textures than in finer ones and more variability was seen in the topsoil than in the subsoil. Established vegetation decreased variability of MRD in the root zone and increased variability below. The dependence of MRD on Ks opens the possibility of using SWC sensor networks to

  14. 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.

  15. Similarity of the CDC and WHO weight-for-length growth charts in predicting risk of obesity at age 5 years.

    PubMed

    Rifas-Shiman, Sheryl L; Gillman, Matthew W; Oken, Emily; Kleinman, Ken; Taveras, Elsie M

    2012-06-01

    The World Health Organization (WHO) 2006 weight-for-length (WFL) or BMI growth charts are now recommended as the new standard for children under 24 months. The objective of this study was to examine associations of ever being overweight during 1-24 months, based on the older Centers for Disease Control and Prevention (CDC) and WHO cutpoints, with risk of obesity at age 5 years. From well-child visits to a Massachusetts multi-site group practice during 1980-2008, we studied 15,488 children with length/height and weight measurements at 1, 6, 12, 18, and 24 months, and at 5 years. The main exposures were ever being overweight during 1-24 months using each of three cutpoints: CDC WFL ≥ 95th percentile, WHO WFL or BMI ≥ 97.7th percentile. The main outcome was obesity at 5 years (CDC BMI ≥ 95th percentile). We calculated multivariable odds ratios (ORs), adjusted for age, sex, race/ethnicity, and year. At 5 years, 10.8% of participants were obese. During 1-24 months, 21.3, 18.3, and 20.2% were ever overweight using CDC WFL, WHO WFL, and WHO BMI cutpoints, respectively. ORs (95% confidence interval (CI)) for associations of ever being overweight during 1-24 months with obesity at 5 years were 6.0 (5.4, 6.6), 6.3 (5.7, 7.0), and 6.0 (5.4, 6.7), respectively. Ever being overweight in the first 2 years of life is a strong predictor of obesity at 5 years. CDC WFL, WHO WFL, and WHO BMI cutpoints for overweight in early childhood provided similar estimates of later obesity risk.

  16. Correlation of a hypoxia based tumor control model with observed local control rates in nasopharyngeal carcinoma treated with chemoradiotherapy

    SciTech Connect

    Avanzo, Michele; Stancanello, Joseph; Franchin, Giovanni; Sartor, Giovanna; Jena, Rajesh; Drigo, Annalisa; Dassie, Andrea; Gigante, Marco; Capra, Elvira

    2010-04-15

    Purpose: To extend the application of current radiation therapy (RT) based tumor control probability (TCP) models of nasopharyngeal carcinoma (NPC) to include the effects of hypoxia and chemoradiotherapy (CRT). Methods: A TCP model is described based on the linear-quadratic model modified to account for repopulation, chemotherapy, heterogeneity of dose to the tumor, and hypoxia. Sensitivity analysis was performed to determine which parameters exert the greatest influence on the uncertainty of modeled TCP. On the basis of the sensitivity analysis, the values of specific radiobiological parameters were set to nominal values reported in the literature for NPC or head and neck tumors. The remaining radiobiological parameters were determined by fitting TCP to clinical local control data from published randomized studies using both RT and CRT. Validation of the model was performed by comparison of estimated TCP and average overall local control rate (LCR) for 45 patients treated at the institution with conventional linear-accelerator-based or helical tomotherapy based intensity-modulated RT and neoadjuvant chemotherapy. Results: Sensitivity analysis demonstrates that the model is most sensitive to the radiosensitivity term {alpha} and the dose per fraction. The estimated values of {alpha} and OER from data fitting were 0.396 Gy{sup -1} and 1.417. The model estimate of TCP (average 90.9%, range 26.9%-99.2%) showed good correlation with the LCR (86.7%). Conclusions: The model implemented in this work provides clinicians with a useful tool to predict the success rate of treatment, optimize treatment plans, and compare the effects of multimodality therapy.

  17. 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.

  18. 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.

  19. 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

  20. Solid-state nanopore localization by controlled breakdown of selectively thinned membranes

    NASA Astrophysics Data System (ADS)

    Carlsen, Autumn T.; Briggs, Kyle; Hall, Adam R.; Tabard-Cossa, Vincent

    2017-02-01

    We demonstrate precise positioning of nanopores fabricated by controlled breakdown (CBD) on solid-state membranes by spatially varying the electric field strength with localized membrane thinning. We show 100 × 100 nm2 precision in standard SiN x membranes (30–100 nm thick) after selective thinning by as little as 25% with a helium ion beam. Control over nanopore position is achieved through the strong dependence of the electric field-driven CBD mechanism on membrane thickness. Confinement of pore formation to the thinned region of the membrane is confirmed by TEM imaging and by analysis of DNA translocations. These results enhance the functionality of CBD as a fabrication approach and enable the production of advanced nanopore devices for single-molecule sensing applications.

  1. Edge plasma control by a local island divertor in the Compact Helical System

    SciTech Connect

    Komori, A.; Ohyabu, N.; Masuzaki, S.

    1997-12-31

    A local island divertor (LID) experiment was performed on the Compact Helical System (CHS) to demonstrate the principle of the LID. It was clearly demonstrated that the particle flow is controlled by adding a resonant perturbation field to the CHS magnetic configuration, and is guided to the back of an m/n = 1/1 island which is created by the perturbation field. The particles recycled there were pumped out with a pumping rate in the range from a few percent to about 10%. As a result, the line averaged core density was reduced by a factor of about 2 in comparison with non-LID discharges at the same gas puffing rate. In addition to the demonstration of these fundamental divertor functions, a modest improvement of energy confinement was observed, which could be attributed to the edge plasma control by the LID.

  2. The distinct cognitive syndromes of Parkinson's disease: 5 year follow-up of the CamPaIGN cohort.

    PubMed

    Williams-Gray, Caroline H; Evans, Jonathan R; Goris, An; Foltynie, Thomas; Ban, Maria; Robbins, Trevor W; Brayne, Carol; Kolachana, Bhaskar S; Weinberger, Daniel R; Sawcer, Stephen J; Barker, Roger A

    2009-11-01

    Cognitive abnormalities are common in Parkinson's disease, with important social and economic implications. Factors influencing their evolution remain unclear but are crucial to the development of targeted therapeutic strategies. We have investigated the development of cognitive impairment and dementia in Parkinson's disease using a longitudinal approach in a population-representative incident cohort (CamPaIGN study, n = 126) and here present the 5-year follow-up data from this study. Our previous work has implicated two genetic factors in the development of cognitive dysfunction in Parkinson's disease, namely the genes for catechol-O-methyltransferase (COMT Val(158)Met) and microtubule-associated protein tau (MAPT) H1/H2. Here, we have explored the influence of these genes in our incident cohort and an additional cross-sectional prevalent cohort (n = 386), and investigated the effect of MAPT H1/H2 haplotypes on tau transcription in post-mortem brain samples from patients with Lewy body disease and controls. Seventeen percent of incident patients developed dementia over 5 years [incidence 38.7 (23.9-59.3) per 1000 person-years]. We have demonstrated that three baseline measures, namely, age >or=72 years, semantic fluency less than 20 words in 90 s and inability to copy an intersecting pentagons figure, are significant predictors of dementia risk, thus validating our previous findings. In combination, these factors had an odds ratio of 88 for dementia within the first 5 years from diagnosis and may reflect the syndrome of mild cognitive impairment of Parkinson's disease. Phonemic fluency and other frontally based tasks were not associated with dementia risk. MAPT H1/H1 genotype was an independent predictor of dementia risk (odds ratio = 12.1) and the H1 versus H2 haplotype was associated with a 20% increase in transcription of 4-repeat tau in Lewy body disease brains. In contrast, COMT genotype had no effect on dementia, but a significant impact on Tower of London

  3. [Edwards syndrome--most frequent indications for genetic amniocentesis. Analysis of the last 5 years].

    PubMed

    Chuchracki, Marek; Janiak, Justyna; Ziółkowska, Katarzyna; Sedziak, Anna; Opala, Tomasz

    2012-01-01

    Edwards syndrome (trisomy 18) occurs in 1: 8000 live births and is closely related to the mother's age. Most of the embryos and fetuses with trisomy of 18 chromosome pair undergo natural abortion. Change in number and structure of chromosomes usually takes place spontaneously. However, the incidence of chromosome mutations increases with the presence of mutagenic factors. One of the chemical mutagenic factors is benzopyrene - present in cigarette smoke. Prenatal cytogenetic diagnostic is used for detecting diseases and clinical syndromes conditioned by chromosome aberrations. To this date the "golden standard" of this diagnostic is the assessment of the fetus karyotype by means of analysis of chromosome banding pattern from amniotic fluid-derived cells. The aim of the study was the analysis of indications for genetic amniocenteses carried out in the last 5 years and in case of which trisomy of chromosome 18 (Edwards syndrome) was diagnosed. The analysis covered 1593 results of fetus karyotypes obtained from Cytogenetic Laboratory of the Central Gynecological-Obstetric Clinical Hospital in Poznań over the last 5 years. The study procedure consisted in producing cell culture from amniotic fluid, appliance of appropriate color techniques and thorough microscopic analysis of chromosome banding pattern. As a result of the analysis it was discovered that in 1538 cases the karyotype was normal, and in 55 cases trisomy 18 was diagnosed, which constituted 3% of all cytogenetic tests. The highest number of trisomy 18 cases was noted in 2009 - 19 cases, which constitutes 5% of all tests. In 2010 and 2011 the results included respectively 2% and 3% of diagnosed trisomy 18 (Edwards syndrome). In the last 5 years normal results for karyotypes constituted 87%, in 10% cases other aberrations were diagnosed through cystogenetic tests, whereas 3% of the results have shown trisomy 18 (Edwards syndrome The most frequent indications for performing genetic amniocentesis, as a result of

  4. Tectonic control of Triassic sedimentation in southern New Brunswick: Local and regional implications

    NASA Astrophysics Data System (ADS)

    Nadon, G. C.; Middleton, G. V.

    1984-10-01

    Both regional and local tectonics controlled the sediment distribution in the Fundy half-graben during the Triassic. Locally, alluvial fans built out into the basin from the western boundary fault along what is now the south shore of New Brunswick. The alluvial fan red beds of the Honeycomb Point Formation are covered by fluvial conglomerates of the Quaco Formation, which in turn are buried by a resurgence of alluvial fan deposition represented by the Echo Cove Formation. Pollen recovered from the upper part of the Echo Cove Formation indicates that, regionally, the system of Triassic-Jurassic grabens along the eastern seaboard is composed of two separate graben systems; one stretching from South Carolina to Connecticut, the other from the Gulf of Maine to the southern Grand Banks. Initial graben formation began at the southern end of each system, followed by successive grabens opening toward the north. The areal distribution of both graben systems appears to have been controlled by four large transform-fault systems from the Middle Triassic through the Jurassic. The age and overall distribution of sediments within the Fundy Basin confirm the existence of a hot spot along the Kelvin Seamount chain and refines determination of the position and timing of the initial rifting that led to the formation of the present Atlantic Ocean.

  5. An optimal local active noise control method based on stochastic finite element models

    NASA Astrophysics Data System (ADS)

    Airaksinen, T.; Toivanen, J.

    2013-12-01

    A new method is presented to obtain a local active noise control that is optimal in stochastic environment. The method uses numerical acoustical modeling that is performed in the frequency domain by using a sequence of finite element discretizations of the Helmholtz equation. The stochasticity of domain geometry and primary noise source is considered. Reference signals from an array of microphones are mapped to secondary loudspeakers, by an off-line optimized linear mapping. The frequency dependent linear mapping is optimized to minimize the expected value of error in a quiet zone, which is approximated by the numerical model and can be interpreted as a stochastic virtual microphone. A least squares formulation leads to a quadratic optimization problem. The presented active noise control method gives robust and efficient noise attenuation, which is demonstrated by a numerical study in a passenger car cabin. The numerical results demonstrate that a significant, stable local noise attenuation of 20-32 dB can be obtained at lower frequencies (<500 Hz) by two microphones, and 8-36 dB attenuation at frequencies up to 1000 Hz, when 8 microphones are used.

  6. 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.

  7. Improved local control for advanced oropharyngeal carcinoma following twice daily radiation therapy

    SciTech Connect

    Wang, C.C.

    1985-12-01

    This paper presents the results of treatment on 99 patients with squamous cell carcinoma of the oropharynx irradiated by the twice-a-day radiation therapy program at the Massachusetts General Hospital. The program consisted of 1.6 Gy per fraction, two fractions per day with 4 hours between fractions, for 12 days, 5 days a week. After 38.4 Gy, the patients were given a 2 week break and then resumed twice-a-day radiation therapy for a total of 64 Gy and occasionally 67.2 Gy. Fifty-two patients had carcinoma of the faucial tonsil and 47 patients had carcinoma of the base of the tongue. For the entire group of patients, the 36 month actuarial local control rate was 58%, and for the T1-2 and T3-4 lesions, the rates were 77% and 48% respectively. In comparison with patients treated by once-a-day radiation therapy for a few years immediately prior to the twice-a-day program, the local control rates were improved to a statistically significant level. Likewise, the results as compared to those published in the literature were no worse and perhaps superior to those of patients treated by the once-a-day schedule.

  8. 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.

  9. [A Case of Pure Type Mucinous Carcinoma Recurrence after Local Control].

    PubMed

    Enomoto, Katsuhisa; Sakurai, Kenichi; Amano, Sadao

    2015-11-01

    The patient was a 44-year-old woman. Mastectomy and sentinel lymph node biopsy had been performed for carcinoma of the left breast approximately 1 year previously. The diagnosis was mucinous carcinoma, T3N0M0, stage ⅡB, ER(+), PgR(+), HER2 score 0, Ki-67 20%. Hormone therapy was administered postoperatively. Four months after the surgery, left axilla lymphadenopathy was observed. Chemotherapy with EC and nab-PTX was started for the postoperative lymph node recurrence. To achieve local control, axillary lymphadenectomy was performed within 1 year postoperatively, and 1 metastatic lesion in the lymph nodes was observed. Hormone therapy was started sequentially, with no subsequent recurrence or metastasis. Mucinous carcinomas are classified as a breast cancer subtype. Mixed type, including breast ductal carcinoma, form a large proportion of mucinous carcinomas and the therapy for breast ductal carcinoma is usually administered in such cases. Conversely, pure type mucinous carcinomas rarely show metastasis and have a good prognosis. In this case, however, metastasis was noted and chemotherapy was not completely effective, and local control was achieved with surgical resection.

  10. Control of myofibroblast differentiation by microtubule dynamics through a regulated localization of mDia2.

    PubMed

    Sandbo, Nathan; Ngam, Caitlyn; Torr, Elizabeth; Kregel, Steve; Kach, Jacob; Dulin, Nickolai

    2013-05-31

    Myofibroblast differentiation plays a critical role in wound healing and in the pathogenesis of fibrosis. We have previously shown that myofibroblast differentiation is mediated by the activity of serum response factor (SRF), which is tightly controlled by the actin polymerization state. In this study, we investigated the role of the microtubule cytoskeleton in modulating myofibroblast phenotype. Treatment of human lung fibroblasts with the microtubule-destabilizing agent, colchicine, resulted in a formation of numerous stress fibers and expression of myofibroblast differentiation marker proteins. These effects of colchicine were independent of Smad signaling but were mediated by Rho signaling and SRF, as they were attenuated by the Rho kinase inhibitor, Y27632, or by the SRF inhibitor, CCG-1423. TGF-β-induced myofibroblast differentiation was not accompanied by gross changes in the microtubule polymerization state. However, microtubule stabilization by paclitaxel attenuated TGF-β-induced myofibroblast differentiation. Paclitaxel had no effect on TGF-β-induced Smad activation and Smad-dependent gene transcription but inhibited actin polymerization, nuclear accumulation of megakaryoblastic leukemia-1 protein, and SRF activation. The microtubule-associated formin, mDIA2, localized to actin stress fibers upon treatment with TGF-β, and paclitaxel prevented this localization. Treatment with the formin inhibitor, SMI formin homology 2 domain, inhibited stress fiber formation and myofibroblast differentiation induced by TGF-β, without affecting Smad-phosphorylation or microtubule polymerization. Together, these data suggest that (a) TGF-β promotes association of mDia2 with actin stress fibers, which further drives stress fiber formation and myofibroblast differentiation, and (b) microtubule polymerization state controls myofibroblast differentiation through the regulation of mDia2 localization.

  11. 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.

  12. Etiology and Incidence of Viral Acute Respiratory Infections among Refugees Aged 5 Years and Older in Hagadera Camp, Dadaab, Kenya

    PubMed Central

    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.

    2015-01-01

    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

  13. 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.

  14. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5-year-old children

    PubMed Central

    Eriksen, H-L Falgreen; Mortensen, EL; Kilburn, T; Underbjerg, M; Bertrand, J; Støvring, H; Wimberley, T; Grove, J; Kesmodel, US

    2015-01-01

    Objective To examine the effects of low to moderate maternal alcohol consumption during early pregnancy on children’s intelligence (IQ) at age 5 years. Design Prospective follow-up study. Setting Neuropsychological testing in four Danish cities 2003–2008. Population A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Methods Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, children were tested with the Wechsler Preschool and Primary Scale of Intelligence—Revised (WPPSI-R). Parental education, maternal IQ, maternal smoking in pregnancy, the child’s age at testing, gender, and tester were considered core confounding factors, whereas the full model also controlled for maternal binge drinking, age, BMI, parity, home environment, postnatal smoking in the home, health status, and indicators for hearing and vision impairments. Main outcome measures The WPPSI-R. Results No differences in test performance were observed between children whose mothers reported consuming between one and four or between five and eight drinks per week at some point during pregnancy, compared with children of mothers who abstained. For women who reported consuming nine or more drinks per week no differences were observed for mean differences; however, the risks of low full-scale IQ (OR 4.6; 95% CI 1.2–18.2) and low verbal IQ (OR 5.9; 95% CI 1.4–24.9) scores, but not low performance IQ score, were increased. Conclusions Maternal consumption of low to moderate quantities of alcohol during pregnancy was not associated with the mean IQ score of preschool children. Despite these findings, acceptable levels of alcohol use during pregnancy have not yet been established, and conservative advice for women continues to be to avoid alcohol use during pregnancy. PMID:22712749

  15. Mycobacterium tuberculosis complex transmission is not associated with recent immigration (≤5 years) in Florida.

    PubMed

    Séraphin, Marie Nancy; Lauzardo, Michael

    2015-12-01

    As tuberculosis (TB) incidence decreases in the US, foreign-born persons continue to account for a larger proportion of the burden. In these cross-sectional analyses of 1149 culture-confirmed TB cases genotyped using spoligotyping and 24-locus MIRU, we show that over a quarter of cases among the foreign-born population in Florida resulted from recent transmission of the Mycobacterium tuberculosis complex. In addition, over a third of these cases occurred among persons who had immigrated 5 years or less prior to their diagnosis. Although recent immigration was not a significant predictor of TB transmission, younger age, birthplace in the Americas, homelessness, drug use and TB lineage are risk factors for TB transmission among the foreign-born population in Florida. These data provide actionable insights into TB transmission among the foreign-born population in Florida.

  16. ECG-based PICC tip verification system: an evaluation 5 years on.

    PubMed

    Oliver, Gemma; Jones, Matt

    2016-10-27

    In 2011, the vascular access team at East Kent Hospitals University NHS Foundation Trust safely and successfully incorporated the use of electrocardiogram (ECG) guidance technology for verification of peripherally inserted central catheters (PICC) tip placement into their practice. This study, 5 years on, compared the strengths and limitations of using this ECG method with the previous gold-standard of post-procedural chest X-ray. The study was undertaken using an embedded case study approach, and the cost, accuracy and efficiency of both systems were evaluated and compared. Using ECG to confirm PICC tip position was found to be cheaper, quicker and more accurate than post-procedural chest X-ray.

  17. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-05-15

    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.

  18. 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

  19. 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.

  20. Prevalence and etiology of nosocomial diarrhoea in children < 5 years in Tikrit teaching hospital.

    PubMed

    Alrifai, S B; Alsaadi, A; Mahmood, Y A; Ali, A A; Al-Kaisi, L A

    2009-01-01

    A cross-sectional hospital-based study was carried out at Tikrit teaching hospital, Iraq, from October 2004 to September 2005, to identify the prevalence and etiology of nosocomial infectious diarrhoea among children under 5 years of age. Of 259 children admitted to the paediatric ward for reasons other than diarrhoea and hospitalized for more than 3 days, clinical and laboratory analysis of stool samples showed nosocomial diarrhoea in 84 children (32.4%). The most common causative agents were enteropathogenic Escherichia coli (25.9%), Clostridium difficile (21.0%) and rotavirus (18.5%). Single infectious agents caused 63.1% of the cases, while mixed infections were detected in 16.7%; in 20.2% of children the cause remained unknown.

  1. Salter-Harris type-IV displaced distal radius fracture in a 5-year-old.

    PubMed

    Huntley, Samuel R; Summers, Spencer H; Stricker, Stephen J

    2016-03-01

    Displaced Salter-Harris type-IV fractures are rare in young children and can result in articular incongruity or premature physeal arrest. We describe a 5-year-old boy who sustained a displaced left distal radial Salter-Harris type-IV fracture. The patient had normal wrist function and physeal growth at the 3-year postoperative follow-up. Our patient is by far the youngest reported child with a displaced Salter-Harris type-IV fracture of the distal radius. Prompt anatomic reduction and fixation of a displaced distal radial Salter-Harris type-IV fracture can result in excellent short-term wrist motion with maintenance of physeal function.

  2. Re-embodying eating: patients' experiences 5 years after bariatric surgery.

    PubMed

    Natvik, Eli; Gjengedal, Eva; Moltu, Christian; Råheim, Målfrid

    2014-12-01

    Health experts advise and expect patients to eat healthily after bariatric surgery. For patients, difficulties with eating might have been a long-standing, problematic part of life-a part that is not necessarily healed by surgery. Empirical research on patients' experiences of eating practices after bariatric surgery is lacking. Aiming to contribute to the development of clinical practice, we explored meanings attached to eating in the long term and sought descriptions of change and bodily sensations. We interviewed 14 patients at least 5 years after bariatric surgery. The surgical restriction forced changes in the way patients sensed their own body in eating, but the uncertainty related to maintaining weight loss in the long term remained. Meanings attached to eating transcended food as choices situated in a nourishment and health perspective, and were not necessarily changed. Eating was an existential and embodied practice, which remained an ambiguous and sensitive matter after surgery.

  3. Degradation assessment of LYRA after 5 years on orbit - Technology Demonstration -

    NASA Astrophysics Data System (ADS)

    BenMoussa, A.; Giordanengo, B.; Gissot, S.; Dammasch, I. E.; Dominique, M.; Hochedez, J.-F.; Soltani, A.; Bourzgui, N.; Saito, T.; Schühle, U.; Gottwald, A.; Kroth, U.; Jones, A. R.

    2015-03-01

    We present a long-term assessment of the radiometric calibration and degradation of the Large Yield Radiometer (LYRA), which has been on orbit since 2009. LYRA is an ultraviolet (UV) solar radiometer and is the first space experiment using aboard a pioneering diamond detector technology. We show that LYRA has degraded after the commissioning phase but is still exploitable scientifically after almost 5 years on orbit thanks to its redundancy design and calibration strategy correcting for instrument degradation. We focus on the inflight detector's calibration and show that diamond photodetectors have not degraded while silicon reference photodiodes that are even less exposed to the Sun show an increase of their dark current and a decrease of their photoresponse.

  4. Climatic factors associated with hospitalizations for rotavirus diarrhoea in children under 5 years of age

    PubMed Central

    D'SOUZA, R. M.; HALL, G.; BECKER, N. G.

    2008-01-01

    SUMMARY This study compares the seasonality of rotavirus diarrhoeal hospital admissions and its relationship to climatic factors across three Australian cities. Weekly admission of rotavirus diarrhoea (1993–2003) in children aged <5 years and weekly average temperature and relative humidity for each city were modelled using a log-linear model with a cubic trend and season. Interactions were included to test for differences in the effect of temperature and humidity between seasons and between cities. Admissions of rotavirus diarrhoea peaked in winter and spring and were lowest in summer. Higher temperature and humidity in the previous week were associated with a decrease in rotavirus diarrhoeal admissions in three cities. The effects of both temperature and humidity on rotavirus admissions in Brisbane differed across seasons. Strategies to combat outbreaks of rotavirus diarrhoea should take climatic factors and seasonal effects into consideration to plan for the excess seasonal hospital admissions. PMID:17352836

  5. 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

  6. Large laryngeal vascular malformation in a 5-year-old child

    PubMed Central

    Danstrup, Christian Sander; Madsen, Mette Hjørringgaard; Bille, Jesper

    2015-01-01

    A 5-year-old boy was admitted with stridor, which was initially interpreted as subglottic laryngitis. He had a history of prolonged hoarseness and his voice was deep for his age. The stridor persisted despite treatment with epinephrine inhalations and intravenous glucocorticoids. A direct laryngoscopy and blood work up did not support the suspected diagnosis. A MRI was then carried out, followed by angiography. The latter revealed an arteriovenous malformation (AVM) involving the lingual and superior thyroid arteries bilaterally. Owing to the rareness and extent of such an AVM, the patient was referred to Paris for further treatment. This case presents the difficulties in diagnostics and emphasises the importance of diagnostics and multidisciplinary approaches with regard to treatment of AVMs. PMID:25795744

  7. Renal stone associated with the ketogenic diet in a 5-year old girl with intractable epilepsy.

    PubMed

    Choi, Ji Na; Song, Ji Eun; Shin, Jae Il; Kim, Heung Dong; Kim, Myung Joon; Lee, Jae Seung

    2010-05-01

    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 patient'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.

  8. 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

  9. Assessing the Performance of a Medical Intensive Care Unit: A 5-year single-center Experience

    PubMed Central

    Anushiravani, Amir; Masoompour, Seyed Masoom

    2017-01-01

    Patient care in the Intensive Care Unit (ICU) is complex and expensive, serving to provide optimal outcome as well as the adequate use of resources. Our objective was to determine variables associated with admission practices, processes of care, and clinical outcomes for critically ill patients. Admission records of a 10-bed ICU were gathered during a 5-year period. Variables such as average length of stay, bed turnover, bed occupancy rate, and turnover interval were evaluated. Of the 1719 patients evaluated, 54% were men. Mortality was highest between 10 pm and 2 am. There was no significant difference in ICU mortality during different days of the week. We showed that nonoffice hour admissions were not associated with poorer clinical outcomes, and significant differences in ICU mortality and ICU length of stay were not seen. Moreover, hospital mortality rates were not significantly higher for patients admitted to our ICU on weekends, at nights, or any day of the week.

  10. Imerslund-Grasbeck syndrome in a 5-year-old Iranian boy

    PubMed Central

    Goudarzipour, K.; Zavvar, N.; Behnam, B.; Ahmadi, M. A.

    2016-01-01

    Imerslund-Grasbeck syndrome (IGS) is a rare syndrome characterized by clinical symptoms and signs of Vitamin B12 deficiency and proteinuria. Our patient was a 5-year-old boy with pallor, lack of appetite, and low weight gain. Laboratory studies showed severe macrocytic anemia, normal reticulocyte count, negative direct coombs test, normal osmotic fragility, and autohemolysis test. He has had intermittent proteinuria since 3 years ago despite normal creatinine level and absence of hematuria or hypertension. Finally, based on low level of serum B12 vitamin and normal folate level accompanied by asymptomatic proteinuria, the diagnosis of IGS was made. Furthermore, his sister has had laboratory abnormalities without any symptoms. IGS responded to B12 replacement therapy dramatically but intermittent proteinuria persisted even after appropriate therapy. PMID:27942180

  11. 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.

  12. 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

  13. Coral reefs in Saudi Arabia: 3.5 years after the Gulf War oil spill

    NASA Astrophysics Data System (ADS)

    Vogt, I. P.

    1995-11-01

    As a consequence of the 1991 Gulf War, 6-8 million barrels of oil were released into the marine environment and a total of 1.12 billion barrels were burned in the Kuwaiti oil fields. In order to detect delayed effects of the Gulf War pollution, six permanent transect lines were placed on Saudi Arabian offshore and inshore reefs. A comparison of three sets of video recordings taken between 1992 and 1994 indicated a significant increase in live coral cover. Therefore, it has been concluded that corals in Saudi Arabia survived the largest oil spill on record remarkably unscathed, with no visible signs of immediate or late effects up to 3.5 years after the Gulf War.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. Surgical Treatment for Adult Spinal Deformity: Projected Cost Effectiveness at 5-Year Follow-Up

    PubMed Central

    Terran, Jamie; McHugh, Brian J.; Fischer, Charla R.; Lonner, Baron; Warren, Daniel; Glassman, Steven; Bridwell, Keith; Schwab, Frank; Lafage, Virginie

    2014-01-01

    Background In the United States, expenditures related to spine care are estimated to account for $86 billion annually. Policy makers have set a cost-effectiveness benchmark of less than $100,000/quality adjusted life year (QALY), forcing surgeons to defend their choices economically. This study projects the cost/QALY for surgical treatment of adult spinal deformity at 5-year follow-up based on 2-year cost- and health-related quality-of-life (HRQOL) data. Methods In a review of 541 patients with adult spinal deformity, the patients who underwent revision or were likely to undergo revision were identified and cost of surgery was doubled to account for the second procedure; all other patients maintained the cost of the initial surgery. Oswestry Disability Index (ODI) was modeled by revision status based on literature findings. Total surgical cost was based on Medicare reimbursement. Chi square and student t tests were utilized to compare cost-effective and non–cost-effective patients. Results The average cost/QALY at 5-year follow-up was $120,311.73. A total of 40.7% of patients fell under the threshold of a cost/QALY <$100,000. Cost-effective patients had higher baseline ODI scores (45% vs 34% [P=0.001]), lower baseline total Scoliosis Research Society scores (2.89 vs 3.00 [P=0.04]), and shorter fusions (8.23 vs 9.87 [P=0.0001]). Conclusion We found 40.7% of patients to be below the threshold of cost effectiveness. Factors associated with reaching the threshold <$100,000/QALY were greater preoperative disability, diagnosis of idiopathic scoliosis, poor preoperative HRQOL scores, and fewer fusion levels. PMID:24688328

  1. 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.

  2. Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study

    PubMed Central

    Geng, Zhi-Yu; Wang, Dong-Xin

    2017-01-01

    Background: The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA). Methods: We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups. Results: During the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups. Conclusions: Our results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies. PMID:28218212

  3. POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

    PubMed

    Irwanto; 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.

  4. 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

  5. Diabetic foot reconstruction using free flaps increases 5-year-survival rate.

    PubMed

    Oh, Tae Suk; Lee, Ho Seung; Hong, Joon Pio

    2013-02-01

    The purpose of this study was to evaluate the outcome of the diabetic foot reconstructed with free flaps and analyse the preoperative risk factors. This study reviews 121 cases of reconstructed diabetic foot in 113 patients over 9 years (average follow-up of 53.2 months). Patients' age ranged from 26 to 78 years (average, 54.6 years). Free flaps used were anterolateral thigh (ALT, 90), superficial circumflex iliac artery perforator (SCIP, 20), anteromedial thigh (AMT, 5), upper medial thigh (UMT, 3), and other perforator free flaps (3). Correlation between the surgical outcome and preoperative risk factors were analysed using logistic regression model. Total loss was seen in 10 cases and 111 free-tissue transfers were successful (flap survival rate of 91.7%). During follow-up, limb was eventually lost in 17 patients and overall limb salvage rate was 84.9% and the 5-year survival was 86.8%. Correlation between flap loss and 14 preoperative risk factors (computed tomography (CT) angiogram showing intact numbers of major vessels, history of previous angioplasty, peripheral arterial disease (PAD), heart problem, chronic renal failure (CRF), American Society of Anaesthesiologists (ASA) physical status classification system, smoking, body mass index (BMI), HBA1c, lymphocyte count, ankle-brachial index (ABI), osteomyelitis, C-reactive protein (CRP) level and whether taking immunosuppressive agents) were analysed. Significant odds ratio were seen in patients who underwent lower extremity angioplasties (odds ratio: 17.590, p<0.001), with PAD (odds ratio: 10.212, p=0.032) and taking immunosuppressive agents after kidney transplantation (odds ratio: 4.857, p<0.041). Diabetic foot reconstruction using free flaps has a high chance for success and significantly increases the 5-year survival rate. Risk factors such as PAD, history of angioplasties in the extremity and using immunosuppressive agents after transplant may increase the chance for flap loss.

  6. 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

  7. Local-field effects and nanostructuring for controlling optical properties and enabling novel optical phenomena

    NASA Astrophysics Data System (ADS)

    Dolgaleva, Ksenia

    My Ph. D. thesis is devoted to the investigation of the methods of controlling and improving the linear and nonlinear optical properties of materials. Within my studies, two approaches are considered: nanostructuring and invoking local-field effects. These broad topics involve various projects that I have undertaken during my Ph. D. research. The first project is on composite laser gain media. It involves both nanostructuring and using local-field effects to control the basic laser parameters, such as the radiative lifetime, small-signal gain and absorption, and the saturation intensity. While being involved in this project, I have performed both theoretical and experimental studies of laser characteristics of composite materials. In particular, I have developed simple theoretical models for calculating the effective linear susceptibilities of layered and Maxwell Garnett composite materials with a gain resonance in one of their components. The analysis of the results given by the models suggests that local-field effects provide considerable freedom in controlling the optical properties of composite laser gain media. I have also experimentally measured the radiative lifetime of Nd:YAG nanopowder suspended in different liquids to extract information regarding local-field effects. The second project is devoted to the investigation of a not-well-known phenomenon that local-field effects can induce, which is microscopic cascading in nonlinear optics. This project involves the theoretical prediction of local-field-induced microscopic cascading effect in the fifth-order nonlinear response and its first experimental observation. This effect has been mostly overlooked or underestimated, but could prove useful in quantum optics. I have shown that, under certain conditions, the microscopic cascaded contribution can be a dominant effect in high-order nonlinearities. The third project is about characterization of laser performance of a new dye, oligofluorene, embedded into

  8. State preemption of local tobacco control policies restricting smoking, advertising, and youth access--United States, 2000-2010.

    PubMed

    2011-08-26

    Preemptive state tobacco control legislation prohibits localities from enacting tobacco control laws that are more stringent than state law. State preemption provisions can preclude any type of local tobacco control policy. The three broad types of state preemption tracked by CDC include preemption of local policies that restrict 1) smoking in workplaces and public places, 2) tobacco advertising, and 3) youth access to tobacco products. A Healthy People 2020 objective (TU-16) calls for eliminating state laws that preempt any type of local tobacco control law. A previous study reported that the number of states that preempt local smoking restrictions in one or more of three settings (government worksites, private-sector worksites, and restaurants) has decreased substantially in recent years. To measure progress toward achieving Healthy People 2020 objectives, this study expands on the previous analysis to track changes in state laws that preempt local advertising and youth access restrictions and to examine policy changes from December 31, 2000, to December 31, 2010. This new analysis found that, in contrast with the substantial progress achieved during the past decade in reducing the number of states that preempt local smoking restrictions, no progress has been made in reducing the number of states that preempt local advertising restrictions and youth access restrictions. Increased progress in removing state preemption provisions will be needed to achieve the relevant Healthy People 2020 objective.

  9. 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

  10. Selection with inbreeding control in simulated young bull schemes for local dairy cattle breeds.

    PubMed

    Gandini, G; Stella, A; Del Corvo, M; Jansen, G B

    2014-03-01

    Local breeds are rarely subject to modern selection techniques; however, selection programs will be required if local breeds are to remain a viable livelihood option for farmers. Selection in small populations needs to take into account accurate inbreeding control. Optimum contribution selection (OCS) is efficient in controlling inbreeding and maximizes genetic gain. The current paper investigates genetic progress in simulated dairy cattle populations from 500 to 6,000 cows undergoing young bull selection schemes with OCS compared with truncation selection (TS) at an annual inbreeding rate of 0.003. Selection is carried out for a dairy trait with a base heritability of 0.3. A young bull selection scheme was used because of its simplicity in implementation. With TS, annual genetic gain from 0.111 standard deviation units with 500 cows increases rapidly to 0.145 standard deviation units with 4,000 cows. Then, genetic gain increases more slowly up to 6,000 cows. At the same inbreeding rate, OCS produces higher genetic progress than TS. Differences in genetic gain between OCS and TS vary from to 2 to 6.3%. Genetic gain is also improved by increasing the number of years that males can be used as sires of sires. When comparing OCS versus TS at different heritabilities, we observe an advantage of OCS only at high heritability, up to 8% with heritability of 0.9. By increasing the constraint on inbreeding, the difference of genetic gain between the 2 selection methods increases in favor of OCS, and the advantage at the inbreeding rate of 0.001 per generation is 6 times more than at the inbreeding rate of 0.003. Opportunities exist for selection even in dairy cattle populations of a few hundred females. In any case, selection in local breeds will most often require specific investments in infrastructure and manpower, including systems for accurate data recording and selection skills and the presence of artificial insemination and breeders organizations. A cost

  11. 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.

  12. Dynamic growth and deposition of hygroscopic aerosols in the nasal airway of a 5-year-old child.

    PubMed

    Kim, Jong Won; Xi, Jinxiang; Si, Xiuhua A

    2013-01-01

    Hygroscopic growth within the human respiratory tract can be significant, which may notably alter the behavior and fate of the inhaled aerosols. The objective of this study is to evaluate the hygroscopic effects upon the transport and deposition of nasally inhaled fine-regime aerosols in children. A physiologically realistic nasal-laryngeal airway model was developed based on magnetic resonance imaging of a 5-year-old boy. Temperature and relative humidity field were simulated using the low Reynolds number k - ε turbulence model and chemical specie transport model under a spectrum of four thermo-humidity conditions. Particle growth and transport were simulated using a well validated Lagrangian tracking model coupled with a user-defined hygroscopic growth module. The subsequent aerosol depositions for the four inhalation scenarios were evaluated on a multiscale basis such as total, subregional, and cellular-level depositions. Results of this study show that a supersaturated humid environment is possible in the nasal turbinate region and can lead to significant condensation growth (d / d(0)  > 10) of nasally inhaled aerosols. Depositions in the nasal airway can also be greatly enhanced by condensation growth with appropriate inhalation temperature and humidity. For subsaturated and mild inh