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Sample records for aat augmentation therapy

  1. Adenosine augmentation therapies (AATs) for epilepsy: prospect of cell and gene therapies

    PubMed Central

    Boison, Detlev

    2009-01-01

    Deficiencies in the brain’s own adenosine-based seizure control system contribute to seizure generation. Consequently, reconstitution of adenosinergic neuromodulation constitutes a rational approach for seizure control. This review will critically discuss focal adenosine augmentation strategies and their potential for antiepileptic and disease modifying therapy. Due to systemic side effects of adenosine focal adenosine augmentation – ideally targeted to an epileptic focus – becomes a therapeutic necessity. This has experimentally been achieved in kindled seizure models as well as in post status epilepticus models of spontaneous recurrent seizures using three different therapeutic strategies that will be discussed here: (i) Polymer-based brain implants that were loaded with adenosine; (ii) Brain implants comprised of cells engineered to release adenosine and embedded in a cell-encapsulation device; (iii) Direct transplantation of stem cells engineered to release adenosine. To meet the therapeutic goal of focal adenosine augmentation, genetic disruption of the adenosine metabolizing enzyme adenosine kinase (ADK) in rodent and human cells was used as a molecular strategy to induce adenosine release from cellular brain implants, which demonstrated antiepileptic and neuroprotective properties. New developments and therapeutic challenges in using AATs for epilepsy therapy will critically be evaluated. PMID:19428218

  2. Long-term augmentation therapy with alpha-1 antitrypsin in an MZ-AAT severe persistent asthma.

    PubMed

    Blanco, I; Canto, H; Flóres, J; Camblor, C; Cárcaba, V; de Serres, F J; Janciauskiene, S; Bustillo, E F

    2008-12-01

    A young Caucasian female with severe bronchial asthma and Alpha1-antitrypsin (AAT) deficiency, MZ phenotype, experienced a quick and severe limitation of her physical capacity, which negatively affected her psychological state and social life, though she was under a strong antiasthmatic treatment. Given her declining health status and the significant chronic corticoid administration-related side-effects (including high reduction of muscle mass and bone density), a clinical trial with commercial intravenous AAT was proposed by the patient's doctors, and accepted by the Spanish Ministry of Health, although it this therapy was not approved for MZ phenotypes yet. This new therapy quickly stopped lung function decline rate, dramatically reduced the number of hospital admissions of the patient, suppressed the oral administration of prednisone, reversed the corticosteroid-related health adverse effects, significantly improving her quality of life. Thus, although AAT replacement therapy is not approved nor indicated for the treatment of bronchial asthma in MZ patients, its favourable effects observed in this isolated case support the hypothesis that bronchial asthma could be due to pathogenic mechanisms related to a protease-antiprotease imbalance, what which could open new perspectives for future research on the field.

  3. Sustained miRNA-mediated knockdown of mutant AAT with simultaneous augmentation of wild-type AAT has minimal effect on global liver miRNA profiles.

    PubMed

    Mueller, Christian; Tang, Qiushi; Gruntman, Alisha; Blomenkamp, Keith; Teckman, Jeffery; Song, Lina; Zamore, Phillip D; Flotte, Terence R

    2012-03-01

    α-1 antitrypsin (AAT) deficiency can exhibit two pathologic states: a lung disease that is primarily due to the loss of AAT's antiprotease function, and a liver disease resulting from a toxic gain-of-function of the PiZ-AAT (Z-AAT) mutant protein. We have developed several recombinant adeno-associated virus (rAAV) vectors that incorporate microRNA (miRNA) sequences targeting the AAT gene while also driving the expression of miRNA-resistant wild-type AAT-PiM (M-AAT) gene, thus achieving concomitant Z-AAT knockdown in the liver and increased expression of M-AAT. Transgenic mice expressing the human PiZ allele treated with dual-function rAAV9 vectors showed that serum PiZ was stably and persistently reduced by an average of 80%. Treated animals showed knockdown of Z-AAT in liver and serum with concomitant increased serum M-AAT as determined by allele-specific enzyme-linked immunosorbent assays (ELISAs). In addition, decreased globular accumulation of misfolded Z-AAT in hepatocytes and a reduction in inflammatory infiltrates in the liver was observed. Results from microarray studies demonstrate that endogenous miRNAs were minimally affected by this treatment. These data suggests that miRNA mediated knockdown does not saturate the miRNA pathway as has been seen with viral vector expression of short hairpin RNAs (shRNAs). This safe dual-therapy approach can be applied to other disorders such as amyotrophic lateral sclerosis, Huntington disease, cerebral ataxia, and optic atrophies.

  4. Augmentation therapy with alpha1-antitrypsin: novel perspectives.

    PubMed

    Sabina, Janciauskiene; Tobias, Welte

    2013-08-01

    SERPINA1, α-antitrypsin (AAT) is an acute phase protein, a member of the serpin (serine protease inhibitor) super family and one of the most abundant protease inhibitors in the circulation. The clinical importance of AAT is emphasized in persons with inherited AAT deficiency who exhibit high risk of developing early onset pulmonary emphysema, neonatal hepatitis, liver cirrhosis, which may appear at any age, and in rare cases panniculitis and vasculitis. The most common and severe AAT deficiency is associated with the Z (Glu342 to Lys) mutation. It is also well established that Z AAT deficiency results from the polymerization and accumulation of the misfolded AAT protein. Consequently, low levels of circulating Z AAT are assumed to be inadequate to neutralize elastolytic activity and to prevent lung tissue damage. Novel studies, however, are expanding the link between AAT and human diseases. Associations are shown between reduced AAT levels and HIV type 1 infection, hepatitis C infection, diabetes mellitus, vasculitis, panniculitis and other diseases. Given the importance of the protease/antiprotease imbalance in causing emphysema, augmentation of circulating AAT is used as a specific therapy for patients with AAT deficiency-related emphysema but not for those with liver diseases. According to the novel findings, therapy with AAT possesses antiinflammatory and immuno-modulatory effects across a broad spectrum of experimental models of systemic and local inflammation. Hence, in this article we will discuss putative new directions for the clinical use of therapy with AAT.

  5. Sustained transgene expression despite T lymphocyte responses in a clinical trial of rAAV1-AAT gene therapy.

    PubMed

    Brantly, Mark L; Chulay, Jeffrey D; Wang, Lili; Mueller, Christian; Humphries, Margaret; Spencer, L Terry; Rouhani, Farshid; Conlon, Thomas J; Calcedo, Roberto; Betts, Michael R; Spencer, Carolyn; Byrne, Barry J; Wilson, James M; Flotte, Terence R

    2009-09-22

    Alpha-1 antitrypsin (AAT) deficiency is well-suited as a target for human gene transfer. We performed a phase 1, open-label, dose-escalation clinical trial of a recombinant adeno-associated virus (rAAV) vector expressing normal (M) AAT packaged into serotype 1 AAV capsids delivered by i.m. injection. Nine AAT-deficient subjects were enrolled sequentially in cohorts of 3 each at doses of 6.9 x 10(12), 2.2 x 10(13), and 6.0 x 10(13) vector genome particles per patient. Four subjects receiving AAT protein augmentation discontinued therapy 28 or 56 days before vector administration. Vector administration was well tolerated, with only mild local reactions and 1 unrelated serious adverse event (bacterial epididymitis). There were no changes in hematology or clinical chemistry parameters. M-specific AAT was expressed above background in all subjects in cohorts 2 and 3 and was sustained at levels 0.1% of normal for at least 1 year in the highest dosage level cohort, despite development of neutralizing antibody and IFN-gamma enzyme-linked immunospot responses to AAV1 capsid at day 14 in all subjects. These findings suggest that immune responses to AAV capsid that develop after i.m. injection of a serotype 1 rAAV vector expressing AAT do not completely eliminate transduced cells in this context.

  6. Sustained transgene expression despite T lymphocyte responses in a clinical trial of rAAV1-AAT gene therapy

    PubMed Central

    Brantly, Mark L.; Chulay, Jeffrey D.; Wang, Lili; Mueller, Christian; Humphries, Margaret; Spencer, L. Terry; Rouhani, Farshid; Conlon, Thomas J.; Calcedo, Roberto; Betts, Michael R.; Spencer, Carolyn; Byrne, Barry J.; Wilson, James M.; Flotte, Terence R.

    2009-01-01

    Alpha-1 antitrypsin (AAT) deficiency is well-suited as a target for human gene transfer. We performed a phase 1, open-label, dose-escalation clinical trial of a recombinant adeno-associated virus (rAAV) vector expressing normal (M) AAT packaged into serotype 1 AAV capsids delivered by i.m. injection. Nine AAT-deficient subjects were enrolled sequentially in cohorts of 3 each at doses of 6.9 × 1012, 2.2 × 1013, and 6.0 × 1013 vector genome particles per patient. Four subjects receiving AAT protein augmentation discontinued therapy 28 or 56 days before vector administration. Vector administration was well tolerated, with only mild local reactions and 1 unrelated serious adverse event (bacterial epididymitis). There were no changes in hematology or clinical chemistry parameters. M-specific AAT was expressed above background in all subjects in cohorts 2 and 3 and was sustained at levels 0.1% of normal for at least 1 year in the highest dosage level cohort, despite development of neutralizing antibody and IFN-γ enzyme-linked immunospot responses to AAV1 capsid at day 14 in all subjects. These findings suggest that immune responses to AAV capsid that develop after i.m. injection of a serotype 1 rAAV vector expressing AAT do not completely eliminate transduced cells in this context. PMID:19706466

  7. Questionnaire on animal-assisted therapy (AAT): The expectation for AAT as a day-care program for Japanese schizophrenic patients.

    PubMed

    Iwahashi, Kazuhiko; Waga, Chikako; Ohta, Mitsuaki

    2007-01-01

    Animal-assisted therapy (AAT) was developed to promote human social and emotional functioning as a day-care program for psychiatric patients. In this study, we determined which animals 481 schizophrenic patients liked and what they thought about AAT, using an original questionnaire. It was found that more than 80% of the present patients liked animals and that they thought contact with animals was useful as a novel therapy. They had much interest in, and many hopes, for AAT.

  8. Efficacy of alpha1-antitrypsin augmentation therapy in conditions other than pulmonary emphysema.

    PubMed

    Blanco, Ignacio; Lara, Beatriz; de Serres, Frederick

    2011-04-12

    Up to now alpha 1-antitrypsin (AAT) augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null alleles expressing AAT serum concentrations <11 μmol/L). However, the compassionate use of augmentation therapy in recent years has proven outstanding efficacy in small cohorts of patients suffering from uncommon AAT deficiency-related diseases other than pulmonary emphysema, such as fibromyalgia, systemic vasculitis, relapsing panniculitis and bronchial asthma. Moreover, a series of preclinical studies provide evidence of the efficacy of AAT augmentation therapy in several infectious diseases, diabetes mellitus and organ transplant rejection. These facts have generated an expanding number of medical applications and patents with claims for other indications of AAT besides pulmonary emphysema. The aim of the present study is to compile and analyze both clinical and histological features of the aforementioned published case studies and reports where AAT augmentation therapy was used for conditions other than pulmonary emphysema. Particularly, our research refers to ten case reports and two clinical trials on AAT augmentation therapy in patients with both AAT deficiency and, at least, one of the following diseases: fibromyalgia, vasculitis, panniculitis and bronchial asthma. In all the cases, AAT was successfully applied whereas previous maximal conventional therapies had failed. In conclusion, laboratory studies in animals and humans as well as larger clinical trials should be, thus, performed in order to determine both the strong clinical efficacy and security of AAT in the treatment of conditions other than pulmonary emphysema.

  9. Efficacy of alpha1-antitrypsin augmentation therapy in conditions other than pulmonary emphysema

    PubMed Central

    2011-01-01

    Up to now alpha 1-antitrypsin (AAT) augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null alleles expressing AAT serum concentrations <11 μmol/L). However, the compassionate use of augmentation therapy in recent years has proven outstanding efficacy in small cohorts of patients suffering from uncommon AAT deficiency-related diseases other than pulmonary emphysema, such as fibromyalgia, systemic vasculitis, relapsing panniculitis and bronchial asthma. Moreover, a series of preclinical studies provide evidence of the efficacy of AAT augmentation therapy in several infectious diseases, diabetes mellitus and organ transplant rejection. These facts have generated an expanding number of medical applications and patents with claims for other indications of AAT besides pulmonary emphysema. The aim of the present study is to compile and analyze both clinical and histological features of the aforementioned published case studies and reports where AAT augmentation therapy was used for conditions other than pulmonary emphysema. Particularly, our research refers to ten case reports and two clinical trials on AAT augmentation therapy in patients with both AAT deficiency and, at least, one of the following diseases: fibromyalgia, vasculitis, panniculitis and bronchial asthma. In all the cases, AAT was successfully applied whereas previous maximal conventional therapies had failed. In conclusion, laboratory studies in animals and humans as well as larger clinical trials should be, thus, performed in order to determine both the strong clinical efficacy and security of AAT in the treatment of conditions other than pulmonary emphysema. PMID:21486454

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

    PubMed Central

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

    2012-01-01

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

  11. A day care program and evaluation of animal-assisted therapy (AAT) for the elderly with senile dementia.

    PubMed

    Kanamori, M; Suzuki, M; Yamamoto, K; Kanda, M; Matsui, Y; Kojima, E; Fukawa, H; Sugita, T; Oshiro, H

    2001-01-01

    We conducted a survey to clarify the evaluation methods of animal-assisted therapy (AAT) for the elderly with senile dementia in an adult day care center. AAT was implemented for a total of six biweekly sessions. The AAT group consisted of seven subjects and the control group numbered 20 subjects. In a comparison between Mini-Mental State Exam (MMSE) scores at baseline and those measured three months later, the average MMSE score before AAT (baseline) was 11.43 (+/- 9.00), and three months later it was 12.29(+/- 9.69). In the AAT group, the average score on Nishimura's Activities of Daily Living (N-ADL) at baseline was 28.43(+/- 14.00), and after ATT it was 29.57(+/- 14.47). In the AAT group, the average baseline score on behavioral pathology of Alzheimer's disease (Behave-AD) was 11.14(+/- 4.85), and three months after AAT it was 7.29(+/- 7.11) (p < 0.05). In the control group, the average baseline score was 5.45(+/- 3.27) and three months later it was 5.63(+/- 3.59). The evaluation of salivary CgA, as a mental stress index, showed a decreasing tendency in the AAT group. Our findings demonstrate the usefulness of using several methods for evaluation of the changes in patients given AAT.

  12. Quantification of Z-AAT by a Z-Specific "Sandwich" ELISA.

    PubMed

    Borel, Florie; Tang, Qiushi; Mueller, Christian

    2017-01-01

    This protocol describes an enzyme-linked immunosorbent assay (ELISA) to specifically detect Z-alpha-1 antitrypsin (AAT), the most common protein variant associated with alpha-1 antitrypsin deficiency. This "sandwich" ELISA relies on an anti-Z-AAT specific capture antibody and a HRP-conjugated anti-AAT detection antibody. This method would be of interest to identify and quantify Z-AAT in a variety of samples such as cell culture medium, cell or tissue lysate, animal or patient serum. Because this method is specific and sensitive, it would be particularly valuable for detection of Z-AAT in the presence of background M-AAT, for instance when quantifying silencing of Z-AAT in patients undergoing M-AAT augmentation therapy.

  13. Alpha-1 antitrypsin (AAT) deficiency - what are the treatment options?

    PubMed

    Modrykamien, Ariel; Stoller, James K

    2009-11-01

    Alpha-1 antitrypsin (AAT) deficiency is an under-recognized genetic condition that predisposes to liver disease and early-onset emphysema. Although AAT is mainly produced in the liver, its main function is to protect the lung against proteolytic damage from neutrophil elastase. The most common mutation responsible for severe AAT deficiency, the so-called Z variant, reduces serum levels by promoting polymerization of the molecule within the hepatocyte, thereby reducing secretion. Serum levels below the putative protective threshold level of 11 micromolar (mumol/L) increase the risk of emphysema. In addition to the usual treatments for emphysema, infusion of purified AAT from pooled human plasma represents a specific therapy for AAT deficiency and raises serum and epithelial lining fluid levels above the protective threshold. Substantial evidence supports the biochemical efficacy of this approach, particularly for the weekly infusion regimen. Definitive evidence of clinical efficacy is still needed, as the two available randomized controlled trials showed non-significant trends towards slowing rates of loss of lung density on lung computerized axial tomography. However, concordant results of prospective cohort studies suggest that augmentation therapy has efficacy in slowing the rate of decline of lung function in patients with moderate airflow obstruction and severe deficiency of AAT. Overall, augmentation therapy is well-tolerated and, despite its failure to satisfy criteria for cost-effectiveness, is recommended because it is the only currently available specific therapy for AAT deficiency.

  14. Evaluation of cerebral activity in the prefrontal cortex in mood [affective] disorders during animal-assisted therapy (AAT) by near-infrared spectroscopy (NIRS): a pilot study.

    PubMed

    Aoki, Jun; Iwahashi, Kazuhiko; Ishigooka, Jun; Fukamauchi, Fumihiko; Numajiri, Maki; Ohtani, Nobuyo; Ohta, Mitsuaki

    2012-09-01

    Previous studies have shown the possibility that animal-assisted therapy (AAT) is useful for promoting the recovery of a patient's psychological, social, and physiological aspect. As a pilot study, we measured the effect that AAT had on cerebral activity using near-infrared spectroscopy (NIRS), and examined whether or not NIRS be used to evaluate the effect of AAT biologically and objectively. Two patients with mood [affective] disorders and a healthy subject participated in this study. We performed two AAT and the verbal fluency task (VFT). The NIRS signal during AAT showed great [oxy-Hb] increases in most of the prefrontal cortex (PFC) in the two patients. When the NIRS pattern during AAT was compared with that during VFT, greater or lesser differences were observed between them in all subjects. The present study suggested that AAT possibly causes biological and physiological changes in the PFC, and that AAT is useful for inducing the activity of the PFC in patients with depression who have generally been said to exhibit low cerebral activity in the PFC. In addition, the possibility was also suggested that the effect of AAT can be evaluated using NIRS physiologically and objectively.

  15. Severe postoperative wound healing disturbance in a patient with alpha-1-antitrypsin deficiency: the impact of augmentation therapy.

    PubMed

    Cathomas, Marionna; Schüller, Alexandra; Candinas, Daniel; Inglin, Roman

    2015-10-01

    Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50-year-old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha-1-antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work-up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease-related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.

  16. [Prospective evaluation of clinical parameters of AAT patients with i. v. prolastin therapy in a homecare setting].

    PubMed

    Wilke, A; Grohé, C

    2013-10-01

    Prognostic parameters and indicators of deterioration of prolastin substituted alpha 1 antitrypsin deficient COPD (AAT) are poorly defined. In particular, there is a lack of information how patients with AAT report exacerbations or how intravenous therapy with prolastin is tolerated and leads to a stabilization of the clinical course of the disease. In a prospective study seven patients were followed over 36 months who received i. v. prolastin at home. Both clinical parameters such as exacerbations and spirometric lung function tests were used to monitor the clinical course of the disease. During the time period given 2.1 exacerbations/year were documented, the average lung function loss over the period of 36 month was mean FEV1 1.02 ± 0.61 l/s to 0.94 ± 0.63 l/s and mean vital capacity 2.95 ± 0.82 l to 2.87 ± 0.81 l. Complications related to home based infusion therapy did not occur. No non elective hospitalisations were reported. Taken together, this prospective feasibility trial could show that home based i. v. therapy in patients with AAT is safe and leads to less exacerbations and loss of lung function as compared to the historical cohort.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  19. Gene Therapy for Alpha-1 Antitrypsin Deficiency Lung Disease.

    PubMed

    Chiuchiolo, Maria J; Crystal, Ronald G

    2016-08-01

    Alpha-1 antitrypsin (AAT) deficiency, characterized by low plasma levels of the serine protease inhibitor AAT, is associated with emphysema secondary to insufficient protection of the lung from neutrophil proteases. Although AAT augmentation therapy with purified AAT protein is efficacious, it requires weekly to monthly intravenous infusion of AAT purified from pooled human plasma, has the risk of viral contamination and allergic reactions, and is costly. As an alternative, gene therapy offers the advantage of single administration, eliminating the burden of protein infusion, and reduced risks and costs. The focus of this review is to describe the various strategies for AAT gene therapy for the pulmonary manifestations of AAT deficiency and the state of the art in bringing AAT gene therapy to the bedside.

  20. Therapeutics: Alpha-1 Antitrypsin Augmentation Therapy.

    PubMed

    Campos, Michael; Lascano, Jorge

    2017-01-01

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

  1. AAT as a diagnostic tool.

    PubMed

    Lisowska-Myjak, Barbara

    2005-02-01

    Serum alpha-1-antitrypsin (AAT) concentration can be affected by both inflammatory and non-inflammatory conditions. This paper characterizes the nature of AAT in physiology and pathologic deficiency and increasing states. The relationships between the AAT concentration in different clinical materials (serum, urine, faeces) and various diseases connected with different organs were analyzed.

  2. Structure and characterization of AAT-1 isoforms.

    PubMed

    Matsuda, Eiko; Ishizaki, Ray; Taira, Takahiro; Iguchi-Ariga, Sanae M M; Ariga, Hiroyoshi

    2005-05-01

    A novel protein, AAT-1, was identified as a AMY-1-binding protein and three splicing variants of AAT-1, AAT-1alpha, -beta and -gamma were identified. The function of AAT-1 is thought to be related to spermatogenesis. In this study, we further identified other splicing isoforms of AAT-1, AAT-1L, AAT-1M and AAT-1S, consisting of 767, 603 and 252 amino acids, respectively. These isoforms were found to use a promoter different from that used by AAT-1alpha, -beta and -gamma in the aat-1 gene, which contains 20 exons. Only 60 amino acids in the C-terminal portion of AAT-1 derived from exons 15-17 are common among AAT-1L, AAT-1M, AAT-1S and AAT-1alpha. While AAT-1alpha is specifically expressed in the testis, AAT-1L, AAT-1M, AAT-1S were found to be differentially expressed in human tissues. All of the isoforms of AAT-1 were found to bind to and colocalized with AMY-1 in human cells. While AAT-1L and AAT-1M were found to be localized diffusely in the cytoplasm, AAT-1S, like AAT-1alpha, was found to be localized in the mitochondria-like structure, suggesting different roles of AAT-1 isoforms in cells.

  3. Augmentation of cognitive behavioral therapy with pharmacotherapy.

    PubMed

    Ganasen, K A; Ipser, J C; Stein, D J

    2010-09-01

    There has long been interest in combining pharmacotherapy with psychotherapy, including cognitive behavioral therapy (CBT). More recently, basic research on fear extinction has led to interest in augmentation of CBT with the N-methyl Daspartate (NMDA) glutamate receptor partial agonist D-cycloserine (DCS) for anxiety disorders. In this article, the literature on clinical trials that have combined pharmacotherapy and CBT is briefly reviewed, focusing particularly on the anxiety disorders. The literature on CBT and DCS is then systematically reviewed. A series of randomized placebo-controlled trials on panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia suggest that low dose DCS before therapy sessions may be more effective compared with CBT alone in certain anxiety disorders. The strong translational foundation of this work is compelling, and the positive preliminary data gathered so far encourage further work. Issues for future research include delineating optimal dosing, and demonstrating effectiveness in real-world settings.

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

    PubMed Central

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

    2017-01-01

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

  5. Therapeutic epilepsy research: from pharmacological rationale to focal adenosine augmentation

    PubMed Central

    Boison, Detlev; Stewart, Kerry-Ann

    2009-01-01

    Epilepsy is a common seizure disorder affecting approximately 70 million people worldwide. Current pharmacotherapy is neuron-centered, frequently accompanied by intolerable side-effects, and fails to be effective in about one third of patients. Therefore, new therapeutic concepts are needed. Recent research suggests an astrocytic basis of epilepsy, presenting the possibility of novel therapeutic targets. In particular, dysfunction of the astrocyte-controlled, endogenous, adenosine-based seizure control system of the brain is implicated in seizure generation. Thus, astrogliosis – a pathological hallmark of the epileptic brain – is associated with upregulation of the adenosine-removing enzyme adenosine kinase (ADK), resulting in focal adenosine deficiency. Both astrogliotic upregulation of ADK in epilepsy and transgenic overexpression of ADK are associated with seizures, and inhibition of ADK prevents seizures in a mouse model of pharmacoresistant epilepsy. These findings link adenosine deficiency with seizures and predict that adenosine augmentation therapies (AATs) will likely be effective in preventing seizures. Given the widespread systemic and central side effects of systemically administered AATs, focal AATs (i.e., limited to the astrogliotic lesion) are a necessity. This Commentary will discuss the pharmacological rationale for the development of focal AATs. Additionally, several AAT strategies will be discussed: (1) adenosine released from silk-based brain implants; (2) adenosine released from locally implanted encapsulated cells; (3) adenosine released from stem cell-derived brain implants; and (4) adenosine augmenting gene therapies. Finally, new developments and therapeutic challenges in using focal AATs for epilepsy therapy will critically be evaluated. PMID:19682439

  6. Striae distensae of augmented breasts after oral contraceptive therapy.

    PubMed

    Har-Shai, Y; Barak, A; Taran, A; Weissman, A

    1999-02-01

    A case of striae distensae (SD) of bilateral augmented breasts following oral contraceptive therapy is presented. Striae maturation and the prevention of additional skin marks was achieved with immediate cessation of oral contraceptive pill therapy and long-term daily topical application of tretinoin cream. It is suggested that patients who are candidates for breast augmentation surgery should be informed of the possible risk of developing SD if they are taking or planning to take the contraceptive pill.

  7. Intradermal alpha1-antitrypsin therapy avoids fatal anaphylaxis, prevents type 1 diabetes and reverses hyperglycaemia in the NOD mouse model of the disease.

    PubMed

    Ma, H; Lu, Y; Li, H; Campbell-Thompson, M; Parker, M; Wasserfall, C; Haller, M; Brantly, M; Schatz, D; Atkinson, M; Song, S

    2010-10-01

    Human alpha1-antitrypsin (hAAT) gene therapy prevents type 1 diabetes in a NOD mouse model of diabetes. However, repeated i.p. injections of hAAT into NOD mice leads to fatal anaphylaxis. The aim of the study was to determine if an alternative route of administration avoids anaphylaxis and allows evaluation of hAAT's potential for diabetes prevention and reversal. We also sought to determine if the addition of granulocyte colony-stimulating factor (G-CSF), augments hAAT's capacity to prevent or reverse disease in the NOD mice. To evaluate hAAT pharmacokinetics, serum hAAT levels were monitored in NOD mice receiving a single dose (2 mg) of hAAT by i.p., s.c. or i.d. injection. For studies of type 1 diabetes prevention and reversal, mice received i.d. hAAT (2 mg/mouse/3 days) for 8 or 10 weeks or hAAT and G-CSF (i.p., 6 microg/day) for 6 weeks. Blood glucose determinations, glucose tolerance testing and insulin tolerance tests were performed. Both i.p. and s.c. injections resulted in fatal anaphylaxis. The i.d. injection avoided anaphylaxis and i.d. injection of hAAT into 11-week-old NOD mice prevented disease (p = 0.005, AAT vs PBS at 40 weeks of age). Treatment of diabetic NOD mice with hAAT or hAAT plus G-CSF provided long-term (at least 100 days) reversal of diabetes in 50% of treated animals. G-CSF did not enhance the reversal rates of hAAT. Glucose tolerance and insulin levels were normalised in mice with hAAT prevention and reversal. Intradermal hAAT prevents and reverses disease in a NOD mouse model of type 1 diabetes without inducing anaphylaxis.

  8. Challenges and Prospects for Alpha-1 Antitrypsin Deficiency Gene Therapy

    PubMed Central

    Wozniak, Joanna; Wandtke, Tomasz; Kopinski, Piotr; Chorostowska-Wynimko, Joanna

    2015-01-01

    Alpha-1 antitrypsin (AAT) is a protease inhibitor belonging to the serpin family. A number of identified mutations in the SERPINA1 gene encoding this protein result in alpha-1 antitrypsin deficiency (AATD). A decrease in AAT serum concentration or reduced biological activity causes considerable risk of chronic respiratory and liver disorders. As a monogenic disease, AATD appears to be an attractive target for gene therapy, particularly for patients with pulmonary dysfunction, where augmentation of functional AAT levels in plasma might slow down respiratory disease development. The short AAT coding sequence and its activity in the extracellular matrix would enable an increase in systemic serum AAT production by cellular secretion. In vitro and in vivo experimental AAT gene transfer with gamma-retroviral, lentiviral, adenoviral, and adeno-associated viral (AAV) vectors has resulted in enhanced AAT serum levels and a promising safety profile. Human clinical trials using intramuscular viral transfer with AAV1 and AAV2 vectors of the AAT gene demonstrated its safety, but did not achieve a protective level of AAT >11 μM in serum. This review provides an in-depth critical analysis of current progress in AATD gene therapy based on viral gene transfer. The factors affecting transgene expression levels, such as site of administration, dose and type of vector, and activity of the immune system, are discussed further as crucial variables for optimizing the clinical effectiveness of gene therapy in AATD subjects. PMID:26413996

  9. Challenges and Prospects for Alpha-1 Antitrypsin Deficiency Gene Therapy.

    PubMed

    Wozniak, Joanna; Wandtke, Tomasz; Kopinski, Piotr; Chorostowska-Wynimko, Joanna

    2015-11-01

    Alpha-1 antitrypsin (AAT) is a protease inhibitor belonging to the serpin family. A number of identified mutations in the SERPINA1 gene encoding this protein result in alpha-1 antitrypsin deficiency (AATD). A decrease in AAT serum concentration or reduced biological activity causes considerable risk of chronic respiratory and liver disorders. As a monogenic disease, AATD appears to be an attractive target for gene therapy, particularly for patients with pulmonary dysfunction, where augmentation of functional AAT levels in plasma might slow down respiratory disease development. The short AAT coding sequence and its activity in the extracellular matrix would enable an increase in systemic serum AAT production by cellular secretion. In vitro and in vivo experimental AAT gene transfer with gamma-retroviral, lentiviral, adenoviral, and adeno-associated viral (AAV) vectors has resulted in enhanced AAT serum levels and a promising safety profile. Human clinical trials using intramuscular viral transfer with AAV1 and AAV2 vectors of the AAT gene demonstrated its safety, but did not achieve a protective level of AAT >11 μM in serum. This review provides an in-depth critical analysis of current progress in AATD gene therapy based on viral gene transfer. The factors affecting transgene expression levels, such as site of administration, dose and type of vector, and activity of the immune system, are discussed further as crucial variables for optimizing the clinical effectiveness of gene therapy in AATD subjects.

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

    PubMed Central

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

    2016-01-01

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

  11. Augmentation of seizure induction in electroconvulsive therapy: a clinical reappraisal.

    PubMed

    Datto, Catherine; Rai, Anil K; Ilivicky, Howard J; Caroff, Stanley N

    2002-09-01

    Missed or abortive seizures during electroconvulsive therapy (ECT) may preclude completion of an effective course of treatment in some cases. Seizure augmentation, using proconvulsant agents, has been used to overcome resistance to the induction and continuation of seizure activity. In this review, we analyze published clinical data on the effects and safety of seizure augmentation techniques. Clinical studies and case reports were obtained through a MEDLINE literature search from 1966 to 2001, cross-referencing ECT and proconvulsant agents. Article references were also scanned for relevant studies. Data from clinical trials indicate that augmentation facilitates seizure induction when maximal electrical stimuli fail. Anesthetic modifications, including hyperventilation and substitution with etomidate, ketamine, or other agents, often are successful in overcoming seizure resistance and compare favorably with the use of caffeine. In a few studies, augmentation enabled the use of lower stimulus intensities and fewer treatments without loss of efficacy, even in patients not resistant to seizure induction. However, effects of proconvulsants must be reconciled with increasing evidence of the importance of stimulus dosing relative to seizure threshold and other parameters, now considered key to the efficacy of ECT. Further investigations of pharmacologic augmentation could facilitate the administration of ECT and could provide further insights concerning parameters of seizure efficacy and the mechanism of action underlying convulsive therapies.

  12. Customized biomaterials to augment chondrocyte gene therapy.

    PubMed

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

    2017-02-07

    A persistent challenge in enhancing gene therapy is the transient availability of the target gene product. This is particularly true in tissue engineering applications. The transient exposure of cells to the product could be insufficient to promote tissue regeneration. Here we report the development of a new material engineered to have a high affinity for a therapeutic gene product. We focus on insulin-like growth factor-I (IGF-I) for its highly anabolic effects on many tissues such as spinal cord, heart, brain and cartilage. One of the ways that tissues store IGF-I is through a group of insulin like growth factor binding proteins (IGFBPs), such as IGFBP-5. We grafted the IGF-I binding peptide sequence from IGFBP-5 onto alginate in order to retain the endogenous IGF-I produced by transfected chondrocytes. This novel material bound IGF-I and released the growth factor for at least 30days in culture. We found that this binding enhanced the biosynthesis of transfected cells up to 19-fold. These data demonstrate the coordinated engineering of cell behavior and material chemistry to greatly enhance extracellular matrix synthesis and tissue assembly, and can serve as a template for the enhanced performance of other therapeutic proteins.

  13. Atypical antipsychotics as augmentation therapy in anorexia nervosa.

    PubMed

    Marzola, Enrica; Desedime, Nadia; Giovannone, Cristina; Amianto, Federico; Fassino, Secondo; Abbate-Daga, Giovanni

    2015-01-01

    Anorexia nervosa (AN) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

  14. Effectiveness of Electroconvulsive Therapy Augmentation on Clozapine-Resistant Schizophrenia

    PubMed Central

    Kim, Hye Sung; Kim, Se Hyun; Lee, Nam Young; Youn, Tak; Lee, Jeoung Hyuk; Chung, Seunghyun; Kim, Yong Sik

    2017-01-01

    Objective This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. Methods Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. Results The average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. Conclusion This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy. PMID:28096876

  15. Atypical Antipsychotics as Augmentation Therapy in Anorexia Nervosa

    PubMed Central

    Marzola, Enrica; Desedime, Nadia; Giovannone, Cristina; Amianto, Federico; Fassino, Secondo; Abbate-Daga, Giovanni

    2015-01-01

    Anorexia nervosa (AN) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings. PMID:25922939

  16. Augmentation therapy of alpha-1 antitrypsin deficiency associated emphysema.

    PubMed

    Traclet, J; Delaval, P; Terrioux, P; Mornex, J-F

    2015-04-01

    Alpha-1 antitrypsin, secreted by the liver, inhibits neutrophil elastase. Its deficiency favours the development of emphysema. Restoring a "protective" serum level in deficient patients should make it possible to inhibit the development of emphysema. Human plasma-derived alpha-1 antitrypsin is a blood-derived drug sold in France under the name Alfalastin(®). The recommended posology is an I.V. administration of 60 mg/kg once a week. Human plasma-derived alpha-1 antitrypsin restores anti-elastase protection in the lower lung and prevents experimental emphysema induced by the elastasis of human neutrophils in hamster. The low number of patients with alpha-1 antitrypsin deficiency is one of the difficulties to perform sufficiently powerful randomised studies. However, randomised studies have reported the efficacy of human plasma-derived alpha-1 antitrypsin perfusions on mortality, FEV1 decline and the frequency of exacerbations. Randomised control trials have demonstrated the efficacy of human plasma-derived alpha-1 antitrypsin perfusions on the loss of lung density assessed by CT scan. Augmentation therapy is simple in its conception and implementation, but it is expensive. However, there are currently no other solutions. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  17. Phase I trial of intramuscular injection of a recombinant adeno-associated virus serotype 2 alphal-antitrypsin (AAT) vector in AAT-deficient adults.

    PubMed

    Brantly, Mark L; Spencer, L Terry; Humphries, Margaret; Conlon, Thomas J; Spencer, Carolyn T; Poirier, Amy; Garlington, Wendy; Baker, Dawn; Song, Sihong; Berns, Kenneth I; Muzyczka, Nicholas; Snyder, Richard O; Byrne, Barry J; Flotte, Terence R

    2006-12-01

    A phase I trial of intramuscular injection of a recombinant adeno-associated virus serotype 2 (rAAV2) alpha1-antitrypsin (AAT) vector was performed in 12 AAT-deficient adults, 10 of whom were male. All subjects were either homozygous for the most common AAT mutation (a missense mutation designated PI*Z) or compound heterozygous for PI*Z and another mutation known to cause disease. There were four dose cohorts, ranging from 2.1 x 10(12) vector genomes (VG) to 6.9 x 10(13) VG, with three subjects per cohort. Subjects were injected sequentially in a dose-escalating fashion with a minimum of 14 days between patients. Subjects who had been receiving AAT protein replacement discontinued that therapy 28 days before vector administration. There were no vector-related serious adverse events in any of the 12 participants. Vector DNA sequences were detected in the blood between 1 and 3 days after injection in nearly all patients receiving doses of 6.9 x 10(12) VG or higher. Anti-AAV2 capsid antibodies were present and rose after vector injection, but no other immune responses were detected. One subject who had not been receiving protein replacement exhibited low-level expression of wild-type M-AAT in the serum (82 nM), which was detectable 30 days after receiving an injection of 2.1 x 10(13) VG. Unfortunately, residual but declining M-AAT levels from the washout of the protein replacement elevated background levels sufficiently to obscure any possible vector expression in that range in most of the other individuals in the higher dose cohorts.

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

    PubMed

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

    2016-07-30

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

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

    PubMed

    Andrade-Domínguez, Andrés; Kolter, Roberto

    2016-08-25

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

  20. Anterior cruciate ligament augmentation for rotational instability following primary reconstruction with an accelerated physical therapy protocol.

    PubMed

    Carey, Timothy; Oliver, David; Pniewski, Josh; Mueller, Terry; Bojescul, John

    2013-01-01

    The purpose of the present study is to present the results of anterior cruciate ligament (ACL) augmentation for patients having rotational instability despite an intact vertical graft in lieu of conventional revision ACL reconstruction. ACL augmentation surgery with a horizontal graft was performed to augment a healed vertical graft on five patients and an accelerated rehabilitation protocol was instituted. Functional outcomes were assessed by the Lower Extremity Functional Scale (LEFS) and the Modified Cincinnati Rating System (MCRS). All patients completed physical therapy within 5 months and were able to return to full military duty without limitation. LEFS and MCRS were significantly improved. ACL augmentation with a horizontal graft provides an excellent alternative to ACL revision reconstruction for patients with an intact vertical graft, allowing an earlier return to duty for military service members.

  1. Capsular contracture after lumpectomy and radiation therapy in patients who have undergone uncomplicated bilateral augmentation mammoplasty.

    PubMed

    Mark, R J; Zimmerman, R P; Greif, J M

    1996-09-01

    To assess complications and cosmesis in patients with breast cancer who underwent lumpectomy and radiation therapy and who previously underwent uncomplicated bilateral augmentation mammoplasty. Twenty-one patients (aged 36-70 years; median age, 50 years) with breast cancer who had previously undergone bilateral breast augmentation without complications underwent ipsilateral lumpectomy and radiation therapy. Radiation therapy was delivered to the augmented breast in opposed tangential fields with a 4- or 6-MV linear accelerator. The tangential fields received an average radiation dose of 5,021 cGy (range, 4,500-5,600 cGy), with an average fraction of 187 cGy (range, 180- 200 cGy). Sixteen patients received an additional 1,000-2,000-cGy boost to the surgical bed with a 9-18-MeV electron beam. Follow-up was 4-48 months (median, 22 months). At the last follow-up examination, 18 (86%) of the 21 patients were free of disease. Twelve patients had capsular contracture (57%). Seven patients underwent attempted surgical repair of capsular contracture. Twelve patients (57%) reported fair to poor cosmesis. The radiation dose, the location of the implant, the type of implant, and systemic therapy were not correlated with poor cosmesis. Lumpectomy and radiation therapy in patients with breast cancer who have previously undergone augmentation mammoplasty result in a high prevalence of capsular contracture and suboptimal cosmesis.

  2. Micro/Nanoparticle-Augmented Sonodynamic Therapy (SDT): Breaking the Depth Shallow of Photoactivation.

    PubMed

    Qian, Xiaoqin; Zheng, Yuanyi; Chen, Yu

    2016-10-01

    The fast development of photoactivation for cancer treatment provides an efficient photo-therapeutic strategy for cancer treatment, but traditional photodynamic or photothermal therapy suffers from the critical issue of low in vivo penetration depth of tissues. As a non-invasive therapeutic modality, sonodynamic therapy (SDT) can break the depth barrier of photoactivation because ultrasound has an intrinsically high tissue-penetration performance. Micro/nanoparticles can efficiently augment the SDT efficiency based on nanobiotechnology. The state-of-art of the representative achievements on micro/nanoparticle-enhanced SDT is summarized, and specific functions of micro/nanoparticles for SDT are discussed, from the different viewpoints of ultrasound medicine, material science and nanobiotechnology. Emphasis is put on the relationship of structure/composition-SDT performance of micro/nanoparticle-based sonosensitizers. Three types of micro/nanoparticle-augmented SDT are discussed, including organic and inorganic sonosensitizers and micro/nanoparticle-based but sonosensitizer-free strategies to enhance the SDT outcome. SDT-based synergistic cancer therapy augmented by micro/nanoparticles and their biosafety are also included. Some urgent critical issues and potential developments of micro/nanoparticle-augmented SDT for efficient cancer treatment are addressed. It is highly expected that micro/nanoparticle-augmented SDT will be quickly developed as a new and efficient therapeutic modality which will find practical applications in cancer treatment. At the same time, fundamental disciplines regarding materials science, chemistry, medicine and nanotechnology will be advanced.

  3. Significant Effect of Valproate Augmentation Therapy in Patients With Schizophrenia: A Meta-analysis Study.

    PubMed

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

    2016-01-01

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

  4. An Investigation of Vascular Strategies to Augment Radiation Therapy

    NASA Astrophysics Data System (ADS)

    El Kaffas, Ahmed Nagy

    Radiation therapy is administered to more than 50% of patients diagnosed with cancer. Mechanisms of interaction between radiation and tumour cells are relatively well understood on a molecular level, but much remains uncertain regarding how radiation interacts with the tumour as a whole. Recent studies have suggested that tumour response to radiation may in fact be regulated by endothelial cell response, consequently stressing the role of tumour blood vessels in radiation treatment response. As a result, various treatment regimens have been proposed to strategically combine radiation with vascular targeting agents. A great deal of effort has been aimed towards developing efficient vascular targeting agents. Nonetheless, no optimal method has yet been devised to strategically deliver such agents. Recent evidence suggesting that these drugs may "normalize" tumour blood vessels and enhance radiosensitivity, is supporting experiments where anti-angiogenic drugs are combined with cytotoxic therapies such as radiotherapy. In contrast, ultrasound-stimulated microbubbles have recently been demonstrated to enhance radiation therapy by biophysically interacting with endothelial cells. When combined with single radiation doses, these microbubbles are believed to cause localized vascular destruction followed by tumour cell death. Finally, a new form of 'pro-angiogenics' has also been demonstrated to induce a therapeutic tumour response. The overall aim of this thesis is to study the role of tumour blood vessels in treatment responses to single-dose radiation therapy and to investigate radiation-based vascular targeting strategies. Using pharmacological and biophysical agents, blood vessels were altered to determine how they influence tumour cell death, clonogenicity, and tumour growth, and to study how these may be optimally combined with radiation. Three-dimensional high-frequency power Doppler ultrasound was used throughout these studies to investigate vascular response to

  5. Augmentation of cognitive and behavioural therapies (CBT) with d-cycloserine for anxiety and related disorders.

    PubMed

    Ori, Rasmita; Amos, Taryn; Bergman, Hanna; Soares-Weiser, Karla; Ipser, Jonathan C; Stein, Dan J

    2015-05-10

    A significant number of patients who suffer with anxiety and related disorders (that is post-traumatic stress disorder (PTSD), social anxiety disorder (SAnD), panic disorder with or without agoraphobia (PD), specific phobia (SPh) and obsessive compulsive disorder (OCD)) fail to respond optimally to first-line treatment with medication or cognitive and behavioural therapies. The addition of d-cycloserine (DCS) to cognitive and behavioural therapies may improve treatment response by impacting the glutamatergic system. This systematic review aimed to investigate the effects of adding DCS to cognitive and behavioural therapies by synthesising data from relevant randomised controlled trials and following the guidelines recommended by Cochrane. To assess the effect of DCS augmentation of cognitive and behavioural therapies compared to placebo augmentation of cognitive and behavioural therapies in the treatment of anxiety and related disorders. Additionally, to assess the efficacy and tolerability of DCS across different anxiety and related disorders. This review fully incorporates studies identified from a search of the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) to 12 March 2015. This register includes relevant randomised controlled trials (RCTs) from: the Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date), the World Health Organization's trials portal (ICTRP) and ClinicalTrials.gov . Reference lists from previous meta-analyses and reports of RCTs were also checked. No restrictions were placed on language, setting, date or publication status. All RCTs of DCS augmentation of cognitive and behavioural therapies versus placebo augmentation of cognitive and behavioural therapies for anxiety and related disorders were included. Two authors (RO and TA) independently assessed RCTs for eligibility and inclusion, extracted outcomes and risk of bias data and entered these into a customised

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

    PubMed

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

    2017-07-01

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

  7. Nonadherence as a predictor of antidiabetic drug therapy intensification (augmentation).

    PubMed

    Kogut, Stephen J; Andrade, Susan E; Willey, Cynthia; Larrat, E Paul

    2004-09-01

    To determine if nonadherence with antidiabetic drug therapy is predictive of subsequent antidiabetic drug therapy intensification. We conducted a retrospective cohort study examining retail pharmacy dispensings of sulfonylureas or metformin to 1067 patients having diabetes. Patients that did not receive a sufficient quantity of medication to cover at least 80% of days during the evaluation period were classified as nonadherent. Outcomes identified were increase in the dose of antidiabetic medication utilized, the addition of a second antidiabetic agent to the regimen or either. Among users of sulfonylurea monotherapy, those classified as nonadherent were 45% more likely to intensify therapy in subsequent months as compared with those classified as adherent (age-adjusted odds ratio (OR) 1.45; 95% confidence interval (CI) 1.06-2.00). This finding was largely driven by observed increases in dosage, which were more likely among patients classified as nonadherent (age-adjusted OR 1.48, 95%CI 1.07-2.05). Nonadherence was not found to be predictive of the subsequent addition of a second antidiabetic agent (OR 1.02; 95%CI 0.64-1.63). Overall findings were similar for the smaller sample of patients receiving metformin monotherapy, though observed differences did not achieve statistical significance. Patients who were poorly adherent to oral antidiabetic drug therapy more frequently experienced an increase in the dose of medication prescribed, as compared to patients that were classified as adherent. This finding underscores the need for prescribers to consider nonadherence as a root cause when patients fail to achieve therapeutic goals.

  8. D-cycloserine as an augmentation strategy for cognitive behavioral therapy for anxiety disorders: an update.

    PubMed

    Hofmann, Stefan G; Sawyer, Alice T; Asnaani, Anu

    2012-01-01

    Cognitive behavioral therapy (CBT) has been shown to be an effective intervention for anxiety disorders. However, despite its proven efficacy, some patients fail to respond to an adequate course of treatment. In attempts to improve the efficacy of CBT, researchers have augmented the core learning processes of the intervention with d-cycloserine (DCS), an N-Methyl-D-Aspartate partial agonist. This article reviews the current literature on DCS as an augmentation strategy for CBT for anxiety disorders. We will describe the memory enhancing properties of DCS, review findings from randomized controlled studies of DCS in anxious populations and discuss mechanism, dosing and timing issues.

  9. Radiation therapy after breast augmentation or reconstruction in early or recurrent breast cancer.

    PubMed

    Ryu, J; Yahalom, J; Shank, B; Chaglassian, T A; McCormick, B

    1990-09-01

    Fourteen patients whose augmented or reconstructed breasts were treated with radiation therapy were analyzed. Silicone gel implants were used in 13 patients and free-injected silicone in one patient. The total radiation dose ranged from 4400 to 6200 cGy using tangential photon fields or an en face electron field by megavoltage equipment. In several cases, electron boost radiation was added to the tumor bed. The majority of the patients tolerated therapy well with minimal transient skin reactions; only three patients required a treatment break secondary to moist desquamation. Three patients developed documented implant encapsulation, although the majority retained good to excellent cosmesis. In summary, when breast carcinoma arises in the augmented or reconstructed breast, conservative management (i.e., limited surgery and definitive irradiation) is feasible without compromising the therapy or the cosmetic result. Thus, conservative management should be offered as an option to patients who are interested in breast prosthesis conservation.

  10. Radiation therapy after breast augmentation or reconstruction in early or recurrent breast cancer

    SciTech Connect

    Ryu, J.; Yahalom, J.; Shank, B.; Chaglassian, T.A.; McCormick, B. )

    1990-09-01

    Fourteen patients whose augmented or reconstructed breasts were treated with radiation therapy were analyzed. Silicone gel implants were used in 13 patients and free-injected silicone in one patient. The total radiation dose ranged from 4400 to 6200 cGy using tangential photon fields or an en face electron field by megavoltage equipment. In several cases, electron boost radiation was added to the tumor bed. The majority of the patients tolerated therapy well with minimal transient skin reactions; only three patients required a treatment break secondary to moist desquamation. Three patients developed documented implant encapsulation, although the majority retained good to excellent cosmesis. In summary, when breast carcinoma arises in the augmented or reconstructed breast, conservative management (i.e., limited surgery and definitive irradiation) is feasible without compromising the therapy or the cosmetic result. Thus, conservative management should be offered as an option to patients who are interested in breast prosthesis conservation.

  11. D-cycloserine augmentation in behavioral therapy for obsessive-compulsive disorder: a meta-analysis

    PubMed Central

    Xia, Jing; Du, Yanqiu; Han, Jiyang; Liu, Guo; Wang, Xumei

    2015-01-01

    Objective To evaluate the overall effect of D-cycloserine (DCS) augmentation on exposure and response prevention (ERP) therapy for obsessive-compulsive disorder (OCD). Methods Clinical studies on the effect of DCS augmentation on ERP therapy for OCD compared to placebo were included for meta analysis. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Meta-analyses were performed with a random-effect model or a fixed-effect model using the Cochrane Review Manager (RevMan, version 5.2) to calculate the odds ratio and the mean difference, with their corresponding 95% confidence intervals. Results A total of six studies was included in the current meta-analyses, and their data were extracted. Among them, four were for analyses of DCS and Y-BOCS at midtreatment, six for analysis at posttreatment, and four at 3-month follow-up. Besides, three of the six eligible studies were included in the meta-analysis of the DCS and Clinical Global Impression–Severity Scale at posttreatment, and three in the meta-analysis of DCS and proportions of treatment responders and of subjects attaining clinical remission status criteria at posttreatment. Our meta-analyses do not reveal a significant effect of DCS augmentation in ERP therapy for OCD patients, except when measured at midtreatment. Compared to the placebo group, DCS augmentation did show a trend toward significantly lower/decreased Y-BOCS; when measured at posttreatment and in the subpopulation of DCS taken before some of the ERP sessions, DCS augmentation showed a trend toward significantly lower/decreased Y-BOCS. Conclusion Our result suggested that with the careful optimization of DCS-augmented ERP therapy by fine-tuning timing and dosing of DCS administration and number and frequency of ERP sessions, DCS may enhance the efficacy of ERP therapy in reducing the symptomatic severity of OCD patients, especially at early stage of the treatment; therefore, DCS augmentation could possibly reduce treatment

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

    PubMed Central

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

    2015-01-01

    The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug–polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and particle size analysis, and evaluated for morphology, drug loading, in vitro drug release and ex vivo diffusion as well. There were no chemical interactions between drug and polymers used as revealed by compatibility studies outcomes. The drug polymer ratio reflected notable effect on drug content, encapsulation efficiency and particle size. SEM results revealed spherical microsponges with porous surface, and had 7.21 μm mean particle size. The microsponges were then incorporated in gel; which exhibited viscous modulus along with pseudoplastic behavior. In vitro drug release results depicted that microsponges with 1:2 drug–polymer ratio were more efficient to give extended drug release of 75.88% at the end of 8 h; while conventional formulation get exhausted incredibly earlier by releasing 81.11% drug at the end of 4 h only. Thus the formulated microsponge-based gel of diclofenac diethylamine would be a promising alternative to conventional therapy for safer and efficient treatment of arthritis and musculoskeletal disorders. PMID:26594124

  13. Integrating the HERMES spectrograph for the AAT

    NASA Astrophysics Data System (ADS)

    Heijmans, Jeroen; Asplund, Martin; Barden, Sam; Birchall, Michael; Carollo, Daniela; Bland-Hawthorn, Joss; Brzeski, Jurek; Case, Scott; Churilov, Vladimir; Colless, Matthew; Dean, Robert; De Silva, Gayandhi; Farrell, Tony; Fiegert, Kristin; Freeman, Kenneth; Gers, Luke; Goodwin, Michael; Gray, Doug; Heald, Ron; Heng, Anthony; Jones, Damien; Kobayashi, Chiaki; Klauser, Urs; Kondrat, Yuriy; Lawrence, Jon; Lee, Steve; Mathews, Darren; Mayfield, Don; Miziarski, Stan; Monnet, Guy J.; Muller, Rolf; Pai, Naveen; Patterson, Robert; Penny, Ed; Orr, David; Sheinis, Andrew; Shortridge, Keith; Smedley, Scott; Smith, Greg; Stafford, Darren; Staszak, Nicholas; Vuong, Minh; Waller, Lewis; Whittard, Denis; Wylie de Boer, Elisabeth; Xavier, Pascal; Zheng, Jessica; Zhelem, Ross; Zucker, Daniel

    2012-09-01

    The High Efficiency and Resolution Multi Element Spectrograph, HERMES is an optical spectrograph designed primarily for the GALAH, Galactic Archeology Survey, the first major attempt to create a detailed understanding of galaxy formation and evolution by studying the history of our own galaxy, the Milky Way1. The goal of the GALAH survey is to reconstruct the mass assembly history of the of the Milky way, through a detailed spatially tagged abundance study of one million stars in the Milky Way. The spectrograph will be based at the Anglo Australian Telescope (AAT) and be fed with the existing 2dF robotic fibre positioning system. The spectrograph uses VPH-gratings to achieve a spectral resolving power of 28,000 in standard mode and also provides a high resolution mode ranging between 40,000 to 50,000 using a slit mask. The GALAH survey requires a SNR greater than 100 aiming for a star brightness of V=14. The total spectral coverage of the four channels is about 100nm between 370 and 1000nm for up to 392 simultaneous targets within the 2 degree field of view. Current efforts are focused on manufacturing and integration. The delivery date of spectrograph at the telescope is scheduled for 2013. A performance prediction is presented and a complete overview of the status of the HERMES spectrograph is given. This paper details the following specific topics: The approach to AIT, the manufacturing and integration of the large mechanical frame, the opto-mechanical slit assembly, collimator optics and cameras, VPH gratings, cryostats, fibre cable assembly, instrument control hardware and software, data reduction.

  14. Low-dose transdermal testosterone augmentation therapy improves depression severity in women.

    PubMed

    Miller, Karen K; Perlis, Roy H; Papakostas, George I; Mischoulon, David; Losifescu, Dan V; Brick, Danielle J; Fava, Maurizio

    2009-12-01

    Inadequate response to antidepressant monotherapy in women with major depressive disorder is common. Testosterone administration has been shown to be an effective augmentation therapy in depressed hypogonadal men with selective serotonin reuptake inhibitor-resistant depression. However, the effects of low-dose testosterone as augmentation therapy in women with treatment-resistant depression have not been studied. Low-dose transdermal testosterone (300 mcg/day, Intrinsa, Procter and Gamble Pharmaceuticals) was administered to nine women with treatment-resistant depression in an 8 week open-label pilot protocol. There was a statistically significant improvement in mean Montgomery-Asberg Depression Rating Scale (MADRS) scores at 2 weeks, sustained through the 8 week period. Two-thirds of subjects achieved a response to the treatment (decrease in MADRS score of 250%) and 33% achieved remission (final MADRS score <10) after 8 weeks of therapy. Mean levels of fatigue, as measured by the MADRS lassitude item, significantly decreased at all time points with a mean 38% decrease from baseline to 8 weeks. These preliminary pilot data suggest that low-dose transdermal testosterone may be an effective augmentation therapy in women with treatment-resistant depression. Further studies are warranted. CNS Spectr. 2009;14(12):688-694

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2008-01-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2016-10-14

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

  19. Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) Study

    PubMed Central

    Bergenstal, Richard M.; Tamborlane, William V.; Ahmann, Andrew; Buse, John B.; Dailey, George; Davis, Stephen N.; Joyce, Carol; Perkins, Bruce A.; Welsh, John B.; Willi, Steven M.; Wood, Michael A.

    2011-01-01

    OBJECTIVE To examine the effects of crossing over from optimized multiple daily injection (MDI) therapy to sensor-augmented pump (SAP) therapy for 6 months, and the effects of 18 months’ sustained use of SAP. RESEARCH DESIGN AND METHODS The 6-month, single-crossover continuation phase of Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) provided SAP therapy to 420 subjects who completed the 1-year randomized study. The primary outcome was change in A1C in the crossover group. RESULTS A1C values were initially lower in the continuing-SAP group than in the crossover group (7.4 vs. 8.0%, P < 0.001). A1C values remained reduced in the SAP group. After 3 months on the SAP system, A1C decreased to 7.6% in the crossover group (P < 0.001); this was a significant and sustained decrease among both adults and children (P < 0.05). CONCLUSIONS Switching from optimized MDI to SAP therapy allowed for rapid and safe A1C reductions. Glycemic benefits of SAP therapy persist for at least 18 months. PMID:21933908

  20. Alpha-1-antitrypsin augmentation therapy in deficient individuals enrolled in the Alpha-1 Foundation DNA and Tissue Bank.

    PubMed

    Tonelli, Adriano R; Rouhani, Farshid; Li, Ning; Schreck, Pam; Brantly, Mark L

    2009-01-01

    Intravenous augmentation therapy with purified intravenous alpha-1 antitrypsin replaces the deficient protein and is the only currently approved treatment for alpha-1 antitrypsin deficiency (AATD) related lung disease. While augmentation therapy has been available for more than 20 years, there are a limited number of studies evaluating the effect of augmentation on lung function. We examined the decline in forced expiratory volume in one second (FEV(1)) in patients enrolled in the Alpha-1 Foundation DNA and Tissue Bank in relation to the use or not of alpha-1 antitrypsin augmentation therapy. For the purpose of our analysis we included 164 patients with AATD and PI ZZ genotype. Mean age of the patients was 60 years, 52% were females, 94% were white and 78% ex-smokers. The mean FEV(1) at baseline was 1.7 L and the mean FEV(1) % of predicted was 51.3%. The mean follow-up time was 41.7 months. A total of 124 (76%) patients received augmentation therapy (augmented group) while 40 patients (24%) did not received it (non-augmented group). When adjusted by age at baseline, sex, smoking status, baseline FEV(1) % of predicted, the mean overall change in FEV(1) was 47.6 mL/year, favoring the augmented group (DeltaFEV(1) 10.6 +/- 21.4 mL/year) in comparison with the non-augmented group (DeltaFEV(1) -36.96 +/- 12.1 mL/year) (P = 0.05). Beneficial DeltaFEV(1) were observed in ex-smokers and the group with initial FEV(1) % of predicted of <50%. No differences were observed in mortality. In conclusion, augmentation therapy improves lung function in subjects with AATD when adjusted by age, gender, smoking status and baseline FEV(1) % of predicted. The beneficial effects were noted in ex-smoker subjects with FEV(1) below 50% of predicted.

  1. The Thai version of Aachen aphasia test (THAI-AAT).

    PubMed

    Pracharitpukdee, N; Phanthumchinda, K; Huber, W; Willmes, K

    2000-06-01

    The lack of a standardized Thai Language aphasia test raises difficulties not only with the assessment and treatment planning for the clinical but also with the accurate diagnosis and the reliable incidence for research on aphasiology in Thailand. This study aimed to use the Thai version of German Aachen aphasia (THAI-AAT), which is systematically adapted according to well-defined linguistic criteria and psychometric requirement, to assess the language deficit of Thai aphasic patients. The subjects participating in this study were 125 aphasia patients, 60 non-aphasic brain damaged patients and 120 normal subjects. The result revealed that the THAI-AAT is linguistically parallel in test design and fulfills the same psychometric properties as the original. The THAI-AAT obtains the goals: to differential diagnosis of aphasia distinguishing it from non-aphasic disturbance and to identify the type of aphasic syndrome.

  2. Lessons for new large telescopes from the AAT

    NASA Astrophysics Data System (ADS)

    Gillingham, P. R.

    1989-10-01

    When it began operating in 1975, the Anglo-Australian Telescope set new standards for pointing, tracking, and efficient observing. Since then, several large telescopes with more advanced control systems and on better sites have come into competition but the AAT retains the reputation of having the best overall observing efficiency. A number of organizational factors in the design and construction phase and in the Anglo-Australian Observatory's operational years have contributed to the AAT's success. Careful consideration of these factors should help groups planning the construction and operation of new telescopes.

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

    PubMed Central

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

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

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

    PubMed

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

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

  5. Antidepressant Medication Augmented With Cognitive-Behavioral Therapy for Generalized Anxiety Disorder in Older Adults

    PubMed Central

    Wetherell, Julie Loebach; Petkus, Andrew J.; White, Kamila S.; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J.

    2014-01-01

    Objective Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. Method Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions:16 weeks of escitalopram (10–20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. Results Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. Conclusions This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy. PMID:23680817

  6. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.

    PubMed

    Wetherell, Julie Loebach; Petkus, Andrew J; White, Kamila S; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J

    2013-07-01

    OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy.

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

    PubMed

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

    2017-09-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. A feasibility study using interactive graphic art feedback to augment acute neurorehabilitation therapy.

    PubMed

    Worthen-Chaudhari, Lise; Whalen, Cara N; Swendal, Catherine; Bockbrader, Marcia; Haserodt, Sarah; Smith, Rashana; Bruce, Michael Kelly; Mysiw, W Jerry

    2013-01-01

    Interactive arts technologies, designed to augment the acute neurorehabilitation provided by expert therapists, may overcome existing barriers of access for patients with low motor and cognitive function. Develop an application prototype to present movement feedback interactively and creatively. Evaluate feasibility of use within acute neurorehabilitation. Record demographics and Functional Independent Measure™ scores among inpatients who used the technology during physical, occupational or recreational therapy. Record exercises performed with the technology, longest exercise duration performed (calculated from sensor data), user feedback, and therapist responses to a validated technology assessment questionnaire. Inpatients (n = 21) between the ages of 19 and 86 (mean 57 ± 18; 12 male/9 female) receiving treatment for motor deficits associated with neuropathology used the application in conjunction with occupational, recreational, or physical therapy during 1 to 7 sessions. Patients classified on the Functional Independence Measure™ as requiring 75%+ assistance for cognitive and motor function were able to use the interactive application. Customized interactive arts applications are appropriate for further study as a therapeutic modality. In addition to providing interactivity to individuals with low motor function, interactive arts applications might serve to augment activity-based medicine among inpatients with low problem-solving and memory function.

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

    PubMed

    Gadberry, Anita L; Sweeney, Alison

    2017-07-01

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

  12. Chemotherapy Delivered After Viral Immunogene Therapy Augments Antitumor Efficacy Via Multiple Immune-mediated Mechanisms

    PubMed Central

    Fridlender, Zvi G; Sun, Jing; Singhal, Sunil; Kapoor, Veena; Cheng, Guanjun; Suzuki, Eiji; Albelda, Steven M

    2010-01-01

    The most widely used approach to cancer immunotherapy is vaccines. Unfortunately, the need for multiple administrations of antigens often limits the use of one of the most effective vaccine approaches, immunogene therapy using viral vectors, because neutralizing antibodies are rapidly produced. We hypothesized that after viral immunogene therapy “primed” an initial strong antitumor immune response, subsequent “boosts” could be provided by sequential courses of chemotherapy. Three adenoviral (Ad)-based immunogene therapy regimens were administered to animals with large malignant mesothelioma and lung cancer tumors followed by three weekly administrations of a drug regimen commonly used to treat these tumors (Cisplatin/Gemcitabine). Immunogene therapy followed by chemotherapy resulted in markedly increased antitumor efficacy associated with increased numbers of antigen-specific, activated CD8+ T-cells systemically and within the tumors. Possible mechanisms included: (i) decreases in immunosuppressive cells such as myeloid-derived suppressor cells (MDSC), T-regulatory cells (T-regs), and B-cells, (ii) stimulation of memory cells by intratumoral antigen release leading to efficient cross-priming, (iii) alteration of the tumor microenvironment with production of “danger signals” and immunostimulatory cytokines, and (iv) augmented trafficking of T-cells into the tumors. This approach is currently being tested in a clinical trial and could be applied to other trials of viral immunogene therapy. PMID:20683443

  13. Chemotherapy delivered after viral immunogene therapy augments antitumor efficacy via multiple immune-mediated mechanisms.

    PubMed

    Fridlender, Zvi G; Sun, Jing; Singhal, Sunil; Kapoor, Veena; Cheng, Guanjun; Suzuki, Eiji; Albelda, Steven M

    2010-11-01

    The most widely used approach to cancer immunotherapy is vaccines. Unfortunately, the need for multiple administrations of antigens often limits the use of one of the most effective vaccine approaches, immunogene therapy using viral vectors, because neutralizing antibodies are rapidly produced. We hypothesized that after viral immunogene therapy "primed" an initial strong antitumor immune response, subsequent "boosts" could be provided by sequential courses of chemotherapy. Three adenoviral (Ad)-based immunogene therapy regimens were administered to animals with large malignant mesothelioma and lung cancer tumors followed by three weekly administrations of a drug regimen commonly used to treat these tumors (Cisplatin/Gemcitabine). Immunogene therapy followed by chemotherapy resulted in markedly increased antitumor efficacy associated with increased numbers of antigen-specific, activated CD8(+) T-cells systemically and within the tumors. Possible mechanisms included: (i) decreases in immunosuppressive cells such as myeloid-derived suppressor cells (MDSC), T-regulatory cells (T-regs), and B-cells, (ii) stimulation of memory cells by intratumoral antigen release leading to efficient cross-priming, (iii) alteration of the tumor microenvironment with production of "danger signals" and immunostimulatory cytokines, and (iv) augmented trafficking of T-cells into the tumors. This approach is currently being tested in a clinical trial and could be applied to other trials of viral immunogene therapy.

  14. Automated Apprenticeship Training (AAT). A Systematized Audio-Visual Approach to Self-Paced Job Training.

    ERIC Educational Resources Information Center

    Pieper, William J.; And Others

    Two Automated Apprenticeship Training (AAT) courses were developed for Air Force Security Police Law Enforcement and Security specialists. The AAT was a systematized audio-visual approach to self-paced job training employing an easily operated teaching device. AAT courses were job specific and based on a behavioral task analysis of the two…

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-04-01

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

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

    PubMed

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

    2017-01-01

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

  20. Involvement of AAT transporters in methylmercury toxicity in Caenorhabditis elegans.

    PubMed

    Caito, Samuel W; Zhang, Yaofang; Aschner, Michael

    2013-06-14

    Methylmercury (MeHg) is a potent neurotoxin that enters mammalian cells as a conjugate with L-cysteine through L-type large neutral amino acid transporter, LAT1, by a molecular mimicry mechanism by structurally resembling L-methionine. Caenorhabditis elegans (C. elegans) has been increasingly used to study the neurotoxic effects of MeHg, but little is known about uptake and transport of MeHg in the worm. This study examined whether MeHg uptake through LAT1 is evolutionarily conserved in nematodes. MeHg toxicity in C. elegans was blocked by pre-treatment of worms with l-methionine, suggesting a role for amino acid transporters in MeHg transport. Knockdown of aat-1, aat-2, and aat-3, worm homologues to LAT1, increased the survival of C. elegans following MeHg treatment and significantly attenuated MeHg content following exposure. These results indicate that MeHg is transported in the worm by a conserved mechanism dependent on functioning amino acid transporters.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  3. Prophylactic Leukotriene Inhibitor Therapy for the Reduction of Capsular Contracture in Primary Silicone Breast Augmentation: Experience with over 1100 Cases

    PubMed Central

    2017-01-01

    Background: The role of leukotriene inhibitors used immediately postoperatively to potentially influence the development of capsular contracture is unknown. The purpose of this study was to evaluate the incidence of capsular contracture among women undergoing primary smooth silicone gel breast augmentation, with or without postoperative leukotriene inhibitor therapy. Methods: Between 2007 and 2013, 1122 consecutive women undergoing primary silicone gel breast augmentation were evaluated retrospectively. All underwent augmentation with smooth, Mentor Memory Gel implants, using a dual-plane technique, with periareolar or inframammary approaches. Patients were treated voluntarily with either no leukotriene inhibitor, montelukast (Singulair), or zafirlukast (Accolate) for 3 months. All patients received informed consent for the off-label use of leukotriene inhibitors. Liver function studies were obtained for all patients undergoing Accolate therapy after 1 month of therapy. The presence of capsular contracture was measured by the Baker scale at 1 year postoperatively. Results: Patients receiving Accolate therapy (n = 520) demonstrated an encapsulation rate of 2.19 percent. Women receiving Singulair therapy (n = 247) had an encapsulation rate of 3.27 percent. Patients not receiving leukotriene inhibitor therapy had an encapsulation rate of 5.02 percent. There were no long-term complications among patients evaluated. Conclusions: Accolate therapy used for 3 months postoperatively was associated with significantly lower capsular contracture rates compared with untreated patients at 1-year follow-up (p < 0.05). Patients treated with Singulair demonstrated lower contracture rates compared with controls, but the differences were not statistically significant. The findings suggest that Accolate therapy, with monitoring and consent, reduces the incidence of capsular contracture following primary smooth silicone gel breast augmentation. CLINICAL QUESTION/LEVEL OF EVIDENCE

  4. Alpha-1-antitrypsin (AAT) anomalies are associated with lung disease due to rapidly growing mycobacteria and AAT inhibits Mycobacterium abscessus infection of macrophages.

    PubMed

    Chan, Edward D; Kaminska, Aleksandra M; Gill, Wendy; Chmura, Kathryn; Feldman, Nicole E; Bai, Xiyuan; Floyd, Corinne M; Fulton, Kayte E; Huitt, Gwen A; Strand, Matthew J; Iseman, Michael D; Shapiro, Leland

    2007-01-01

    Rapidly growing mycobacteria (RGM) are ubiquitous in the environment but cause lung disease in only a fraction of exposed individuals. This variable susceptibility to disease implies vulnerability to RGM infection due to weakness in host defense. Since most persons who contract RGM lung disease have no known host defense defect, it is likely that uncharacterized host deficiencies exist that predispose to RGM infection. Alpha-1-antitrypsin (AAT) is a host factor that may protect individuals from respiratory infections. Therefore, we assessed AAT protein anomalies as a risk factor for RGM lung disease. In a cohort of 100 patients with RGM lung disease, Mycobacterium (M.) abscessus was the most prevalent organism, isolated in 64 (64%) subjects. Anomalous AAT proteins were present in 27% of the cohort, which is 1.6 times the estimated prevalence of anomalous AAT proteins in the United States population (p=0.008). In in vitro studies, both AAT and a synthetic inhibitor of serine proteases suppressed M. abscessus infection of monocyte-derived macrophages by up to 65% (p<0.01). AAT may be an anti-RGM host-defense factor, and anomalous AAT phenotypes or AAT deficiency may constitute risk factors for pulmonary disease due to RGM.

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

    PubMed

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

    2015-11-01

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

  6. "The lion, the witch and the wardrobe": impact on sibs of individuals with AAT deficiency.

    PubMed

    Fanos, Joanna H; Strange, Charlie

    2004-10-15

    Alpha(1)-antitrypsin (AAT) deficiency is a genetic disorder that may cause serious pulmonary or liver impairment in children or adults. Although genetic sequencing of the AAT gene has only been available for 20 years, analysis of the amount and electrophoretic mobility of the AAT protein has allowed clinical phenotyping for more than 40 years. There have been no studies assessing the psychological impact of having a sib affected by AAT deficiency. Twenty-five participants drawn from the Alpha-1 Research Registry completed a questionnaire and semi-structured interview. Respondents were supportive of testing prior to adulthood for AAT status; 18 thought it was a good idea to test a child, three did not know, and four said children should not be tested, primarily citing insurance concerns. Of those 18 who stated it was a good idea, 14 would test at birth. Knowledge of genetics of AAT deficiency was limited; only 44% of respondents understood the inheritance pattern. We recommend: (1) parents and sibs need help in mourning the loss of children with AAT deficiency; young sibs are at risk for trauma and long-term developmental problems. (2) Teams evaluating donors for liver transplantation should be aggressive in ruling out AAT deficiency prior to invasive testing. (3) Testing should be offered to individuals with a family history of AAT deficiency to obtain the health benefits of lifestyle modification and limit the burden of disease discovery in symptomatic relatives. (4) Awareness of liver disease from AAT deficiency should be increased.

  7. Aromatic amino acid transporter AAT-9 of Caenorhabditis elegans localizes to neurons and muscle cells.

    PubMed

    Veljkovic, Emilija; Bacconi, Andrea; Stetak, Attila; Hajnal, Alex; Stasiuk, Susan; Skelly, Patrick J; Forster, Ian; Shoemaker, Charles B; Verrey, Francois

    2004-11-19

    The Caenorhabditis elegans genome encodes nine homologues of mammalian glycoprotein-associated amino acid transporters. Two of these C. elegans proteins (AAT-1 and AAT-3) have been shown to function as catalytic subunits (light chains) of heteromeric amino acid transporters. These proteins need to associate with a glycoprotein heavy chain subunit (ATG-2) to reach the cell surface in a manner similar to that of their mammalian homologues. AAT-1 and AAT-3 contain a cysteine residue in the second putative extracellular loop through which a disulfide bridge can form with a heavy chain. In contrast, six C. elegans members of this family (AAT-4 to AAT-9) lack such a cysteine residue. We show here that one of these transporter proteins, AAT-9, reaches the cell surface in Xenopus oocytes without an exogenous heavy chain and that it functions as an exchanger of aromatic amino acids. Two-electrode voltage clamp experiments demonstrate that AAT-9 displays a substrate-activated conductance. Immunofluorescence shows that it is expressed close to the pharyngeal bulbs within C. elegans neurons. The selective expression of an aat-9 promoter-green fluorescent protein construct in several neurons of this region and in wall muscle cells around the mouth supports and extends these localization data. Taken together, the results show that AAT-9 is expressed in excitable cells of the nematode head and pharynx in which it may provide a pathway for aromatic amino acid transport.

  8. APOBEC3G-Augmented Stem Cell Therapy to Modulate HIV Replication: A Computational Study

    PubMed Central

    Hosseini, Iraj; Mac Gabhann, Feilim

    2013-01-01

    The interplay between the innate immune system restriction factor APOBEC3G and the HIV protein Vif is a key host-retrovirus interaction. APOBEC3G can counteract HIV infection in at least two ways: by inducing lethal mutations on the viral cDNA; and by blocking steps in reverse transcription and viral integration into the host genome. HIV-Vif blocks these antiviral functions of APOBEC3G by impeding its encapsulation. Nonetheless, it has been shown that overexpression of APOBEC3G, or interfering with APOBEC3G-Vif binding, can efficiently block in vitro HIV replication. Some clinical studies have also suggested that high levels of APOBEC3G expression in HIV patients are correlated with increased CD4+ T cell count and low levels of viral load; however, other studies have reported contradictory results and challenged this observation. Stem cell therapy to replace a patient’s immune cells with cells that are more HIV-resistant is a promising approach. Pre-implantation gene transfection of these stem cells can augment the HIV-resistance of progeny CD4+ T cells. As a protein, APOBEC3G has the advantage that it can be genetically encoded, while small molecules cannot. We have developed a mathematical model to quantitatively study the effects on in vivo HIV replication of therapeutic delivery of CD34+ stem cells transfected to overexpress APOBEC3G. Our model suggests that stem cell therapy resulting in a high fraction of APOBEC3G-overexpressing CD4+ T cells can effectively inhibit in vivo HIV replication. We extended our model to simulate the combination of APOBEC3G therapy with other biological activities, to estimate the likelihood of improved outcomes. PMID:23724012

  9. APOBEC3G-Augmented Stem Cell Therapy to Modulate HIV Replication: A Computational Study.

    PubMed

    Hosseini, Iraj; Mac Gabhann, Feilim

    2013-01-01

    The interplay between the innate immune system restriction factor APOBEC3G and the HIV protein Vif is a key host-retrovirus interaction. APOBEC3G can counteract HIV infection in at least two ways: by inducing lethal mutations on the viral cDNA; and by blocking steps in reverse transcription and viral integration into the host genome. HIV-Vif blocks these antiviral functions of APOBEC3G by impeding its encapsulation. Nonetheless, it has been shown that overexpression of APOBEC3G, or interfering with APOBEC3G-Vif binding, can efficiently block in vitro HIV replication. Some clinical studies have also suggested that high levels of APOBEC3G expression in HIV patients are correlated with increased CD4+ T cell count and low levels of viral load; however, other studies have reported contradictory results and challenged this observation. Stem cell therapy to replace a patient's immune cells with cells that are more HIV-resistant is a promising approach. Pre-implantation gene transfection of these stem cells can augment the HIV-resistance of progeny CD4+ T cells. As a protein, APOBEC3G has the advantage that it can be genetically encoded, while small molecules cannot. We have developed a mathematical model to quantitatively study the effects on in vivo HIV replication of therapeutic delivery of CD34+ stem cells transfected to overexpress APOBEC3G. Our model suggests that stem cell therapy resulting in a high fraction of APOBEC3G-overexpressing CD4+ T cells can effectively inhibit in vivo HIV replication. We extended our model to simulate the combination of APOBEC3G therapy with other biological activities, to estimate the likelihood of improved outcomes.

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

    PubMed Central

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

    2017-01-01

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

  11. Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data

    PubMed Central

    Powers, Mark B.; Medina, Johnna L.; Burns, Stephanie; Kauffman, Brooke Y.; Monfils, Marie; Asmundson, Gordon J.G.; Diamond, Allison; McIntyre, Christa; Smits, Jasper A.J.

    2015-01-01

    Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, MAge = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure + exercise (PE + E). Participants randomized to the PE + E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HRmax) prior to each PE session. Consistent with prediction, the PE + E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy. PMID:25706090

  12. Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data.

    PubMed

    Powers, Mark B; Medina, Johnna L; Burns, Stephanie; Kauffman, Brooke Y; Monfils, Marie; Asmundson, Gordon J G; Diamond, Allison; McIntyre, Christa; Smits, Jasper A J

    2015-01-01

    Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M(Age) = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR(max)) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.

  13. Successful Treatment of Pyoderma Gangrenosum after Augmentation Mastopexy Using Vacuum Therapy

    PubMed Central

    Soncini, Julio Alberto; Frizzo Neto, Juvenal Antonio; Gemperli, Rolf

    2016-01-01

    Background: Pyoderma gangrenosum (PG) is a rare, severe, destructive neutrophilic dermatosis characterized by a progressive, necrotizing process after skin injury. Its cause is still unknown, and diagnosis represents a challenge when ulcers are seen after surgery. Bacterial infection is not found in the wounds. Patients exhibit “pathergy” with the appearance of new lesions after local trauma such as surgical procedures, debridements, and wound care, suggesting altered inflammatory response. The objective of this study was to review the literature and report a case of PG that was satisfactorily treated with vacuum therapy (vacuum-assisted closure [VAC]). Case Report: A 19-year-old healthy patient presented with skin ulceration 4 days after augmentation mastopexy, progressing to extensive necrosis. On the eighth day, she underwent debridement and implant removal. Two days later, the necrotic process was again evident and progressed, resulting in a significant increase in wound size, with each wound reaching 20 × 25 cm. Intense and diffuse neutrophilic exudate and areas of necrosis were present. Systemic corticosteroids and VAC under general anesthesia were initiated 5 days after the second surgery. From the fourth VAC session, some adherence between the mammary gland and pectoral muscles was visible, so deep sutures avoiding the dermis were placed to direct wound closure. Conclusions: PG is a life-threatening complication with devastating outcomes. Early diagnosis is critical. Although some reported cases needed up to 2 years for wound closure, in this case, VAC therapy allowed the patient to be discharged after only 42 days and permitted wound closure without the need for skin grafts. PMID:27975008

  14. Inhibition of Hsp90 Augments Docetaxel Therapy in Castrate Resistant Prostate Cancer

    PubMed Central

    Ku, ShengYu; Lasorsa, Elena; Adelaiye, Remi; Ramakrishnan, Swathi; Ellis, Leigh; Pili, Roberto

    2014-01-01

    First line treatment of patients with castrate resistant prostate cancer (CRPC) primarily involves administration of docetaxel chemotherapy. Unfortunately, resistance to docetaxel therapy is an ultimate occurrence. Alterations in androgen receptor (AR) expression and signaling are associated mechanisms underlying resistance to docetaxel treatment in CRPC. Heat shock protein 90 (Hsp90) is a molecular chaperone, which regulates the activation, maturation and stability of critical signaling proteins involved in prostate cancer, including the AR. This knowledge and recent advances in compound design and development have highlighted Hsp90 as an attractive therapeutic target for the treatment of CRPC. We recently reported the development of a MYC-CaP castrate resistant (MYC-CaP/CR) transplant tumor model, which expresses amplified wild type AR. Within, we report that a second generation Hsp90 inhibitor, NVP-AUY922, inhibits cell growth and significantly induces cell death in MYC-CaP/CR and Pten-CaP/cE2 cell lines. NVP-AUY922 induced proteasome degradation of AR, though interestingly does not require loss of AR protein to inhibit AR transcriptional activity. Further, NVP-AUY922 increased docetaxel toxicity in MYC-CaP/CR and Pten-CaP/cE2 cell lines in vitro. Finally, NVP-AUY922/docetaxel combination therapy in mice bearing MYC-CaP/CR tumors resulted in greater anti-tumor activity compared to single treatment. This study demonstrates that NVP-AUY922 elicits potent activity towards AR signaling and augments chemotherapy response in a mouse model of CRPC, providing rationale for the continued clinical development of Hsp90 inhibitors in clinical trials for treatment of CRPC patients. PMID:25072314

  15. Use of animal-assisted therapy with psychiatric patients.

    PubMed

    Rossetti, Jeanette; King, Camille

    2010-11-01

    The use of animal-assisted therapy (AAT) as an adjunct treatment approach in psychiatric settings has received much attention in the literature. This article explores the use of AAT with psychiatric patients. The authors performed a literature review and found that AAT can have a significant effect on the improvement of psychiatric patients' socialization and provides a variety of psychological benefits. Nurses can benefit from learning about the potential benefits of AAT for psychiatric patients.

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

    NASA Astrophysics Data System (ADS)

    Sheinis, Andrew I.

    2016-08-01

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

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

    PubMed Central

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

    2014-01-01

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

  18. Patterns of therapy switching, augmentation, and discontinuation after initiation of treatment with select medications in patients with osteoarthritis.

    PubMed

    Gore, Mugdha; Sadosky, Alesia; Leslie, Douglas; Tai, Kei-Sing; Seleznick, Mitchel

    2011-12-01

    Osteoarthritis (OA) is a debilitating condition characterized by chronic pain. Several pain medications are recommended, and patients frequently alternate among these medications. The purpose of this study was to examine the use of pain medications in clinical practice with respect to recommended guidelines. This objective was accomplished by evaluating patterns of switching, augmentation, and discontinuation after treatment initiation with select medications in patients with OA. The LifeLink Health Plan Claims Database was used to select patients with OA (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 715.XX) who were newly prescribed (index event) nonsteroidal antiinflammatory drugs (NSAIDs), cyclooxygenase (COX)-2 inhibitors, acetaminophen, tramadol, weak opioids, and strong opioids. Descriptive statistics, Kaplan-Meier analyses, and the COX proportional hazards model were used to assess therapy switching, augmentation, and discontinuation during the 12-month postindex period. Patterns of intraarticular injections and joint replacement surgeries among the cohorts were also evaluated. Substantial proportions of OA patients switched, augmented, or discontinued therapy during the postindex period. Rates of therapy switching, augmentation, and discontinuation, respectively, were significantly different (all P < 0.0001 for overall effects using log-rank tests) across the evaluated medication cohorts: NSAIDs, 22.3%, 6.7%, 93.2%; COX-2 inhibitors, 27.5%, 10%, 87.4%; acetaminophen, 46.0%, 6.5%, 98.7%; tramadol, 44.5%, 8.4%, 95.6%; weak opioids, 27.2%, 4.1%, 98.3%; and strong opioids, 41.1%, 3.3%, 97%. Therapy switching, augmentation, and discontinuation occurred within 2 months after treatment initiation in two thirds of patients and within 6 months in >90% of patients. The patterns of intraarticular injections were significantly different across treatment cohorts, as were the patterns of joint replacement surgeries (both

  19. Rapid resolution of delusional parasitosis in pellagra with niacin augmentation therapy.

    PubMed

    Prakash, Ravi; Gandotra, Sachin; Singh, Lokesh Kumar; Das, Basudeb; Lakra, Anuja

    2008-01-01

    Pellagra is associated with low levels of vitamin B3 (niacin) and/or tryptophan and often involves other other B vitamins. Since the time Gasper Casal first described the disease in 1972, it was observed that the patients with pellagra were all poor, subsisted mainly on maize, and rarely ate fresh meat. Subsequent occurrences have been in the form of epidemic outbreaks, consequent to either introduction to maize as a major food or increased consumption of other niacin-deficient diets like Jowar (Sorgum vulgare). The virtual disappearance of pellagra as an endemic health problem in recent years can be attributed to a rise in the standard of living of farmers and diversification of the diet globally. The clinical picture is a combination of multisystem alterations typically involving gastrointestinal, skin and central nervous system abnormalities. The cardinal manifestations have been popularly known as the three D's, which are dementia, dermatitis and diarrhea. Psychiatric manifestations are fairly common but are easily overlooked due to their non specific nature. These are commonly seen as irritability, poor concentration, anxiety, fatigue, restlessness, apathy and depression. The occurence of psychosis in pellagra is an uncommon finding, which is usually seen in advanced stages of pellagroid encephalopathy, commonly found in chronic alcoholics. Delusional parasitosis has been also reported in this condition, although the association is still controversial. We report a case of pellagra manifesting with delusional parasitosis in a man whose delusion resolved rapidly after he started niacin-augmentation therapy. This case may provide clues to the biological underpinnings of delusional parasitosis as well as niacin treatment as treatment option in similar cases.

  20. NRFL-1, the C. elegans NHERF orthologue, interacts with amino acid transporter 6 (AAT-6) for age-dependent maintenance of AAT-6 on the membrane.

    PubMed

    Hagiwara, Kohei; Nagamori, Shushi; Umemura, Yasuhiro M; Ohgaki, Ryuichi; Tanaka, Hidekazu; Murata, Daisuke; Nakagomi, Saya; Nomura, Kazuko H; Kage-Nakadai, Eriko; Mitani, Shohei; Nomura, Kazuya; Kanai, Yoshikatsu

    2012-01-01

    The NHERF (Na(+)/H(+) exchanger regulatory factor) family has been proposed to play a key role in regulating transmembrane protein localization and retention at the plasma membrane. Due to the high homology between the family members, potential functional compensations have been a concern in sorting out the function of individual NHERF numbers. Here, we studied C. elegans NRFL-1 (C01F6.6) (nherf-like protein 1), the sole C. elegans orthologue of the NHERF family, which makes worm a model with low genetic redundancy of NHERF homologues. Integrating bioinformatic knowledge of C. elegans proteins into yeast two-hybrid scheme, we identified NRFL-1 as an interactor of AAT-6, a member of the C. elegans AAT (amino acid transporter) family. A combination of GST pull-down assay, localization study, and co-immunoprecipitation confirmed the binding and characterized the PDZ interaction. AAT-6 localizes to the luminal membrane even in the absence of NRFL-1 when the worm is up to four-day old. A fluorescence recovery after photobleaching (FRAP) analysis suggested that NRFL-1 immobilizes AAT-6 at the luminal membrane. When the nrfl-1 deficient worm is six-day or older, in contrast, the membranous localization of AAT-6 is not observed, whereas AAT-6 tightly localizes to the membrane in worms with NRFL-1. Sorting out the in vivo functions of the C. elegans NHERF protein, we found that NRFL-1, a PDZ-interactor of AAT-6, is responsible for the immobilization and the age-dependent maintenance of AAT-6 on the intestinal luminal membrane.

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

    NASA Astrophysics Data System (ADS)

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

    2007-02-01

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

  2. Long-term cognitive and behavioral therapies, combined with augmentative communication, are related to uncinate fasciculus integrity in autism.

    PubMed

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

    2012-04-01

    Recent evidence points to white-matter abnormalities as a key factor in autism physiopathology. Using Diffusion Tensor Imaging, we studied white-matter structural properties in a convenience sample of twenty-two subjects with low-functioning autism exposed to long-term augmentative and alternative communication, combined with sessions of cognitive and behavioral therapy. Uncinate fasciculus structural properties correlated significantly with therapy length and early onset, as well as to clinical outcome, independently from IQ, age or symptoms severity at therapy onset. Moreover, adherence to therapy was linked with better clinical outcome and uncinate fasciculus structural integrity. The results point to the capability of a long-term rehabilitation of subjects with low-functioning autism to produce white-matter structural modifications, which could thus play a role in the rehabilitative outcome.

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

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

  4. KAO and AAT observations of the Galactic Center filaments

    NASA Technical Reports Server (NTRS)

    Erickson, Edwin F.; Colgan, Sean W. J.; Simpson, Janet P.; Rubin, Robert H.; Haas, Michael R.; Morris, M.; Cotera, A. S.; Allen, David A.; Burton, Michael G.

    1995-01-01

    We have used the Kuiper Airborne Observatory (KAO) and the Anglo-Australian Telescope (AAT) to investigate the nature of the filamentary radio emission from the Galactic center region. KAO observations of the FIR line and continuum emission from the radio peak G0.095+0.012 and the E2 thermal radio filament northeast of the Galactic center can be produced by numerous nearby stars with T(sub eff) approx. 35,000 K; these can account for both the FIR luminosity and the excitation of the gas. Much of the FIR continuum and most of the strong (Si II) (34.8 micron) line emission are probably produced in the ionized gas of the filament. The FIR (O III) 52 and 88 micron lines imply an electron density of a few hundred; when compared with the radio emission measure, this implies the filament is roughly tubular or somewhat flattened in the plane of the sky. The (O III) and (S III) lines show higher excitation associated with the filament, and suggest that exciting stars may be located within the filaments and/or southeast of the E2 filament. AAT observations in the near infrared (NIR) in fact reveal a nearby cluster of hot stars southeast of the E2 filament. Additional hot stars, not identifiable from their NIR spectra, are likely to be present. These stars and those in the cluster can plausibly produce the observed radio and FIR emission in the region. The morphology of the filament is not explained by existing information however.

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

    PubMed

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

    2014-07-01

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

  6. Cognitive-Behavioral Therapy vs Risperidone for Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder

    PubMed Central

    Simpson, Helen Blair; Foa, Edna B.; Liebowitz, Michael R.; Huppert, Jonathan D.; Cahill, Shawn; Maher, Michael J.; McLean, Carmen P.; Bender, James; Marcus, Sue M.; Williams, Monnica T.; Weaver, Jamie; Vermes, Donna; Van Meter, Page E.; Rodriguez, Carolyn I.; Powers, Mark; Pinto, Anthony; Imms, Patricia; Hahn, Chang-Gyu; Campeas, Raphael

    2014-01-01

    IMPORTANCE Obsessive-compulsive disorder (OCD) is one of the world’s most disabling illnesses according to the World Health Organization. Serotonin reuptake inhibitors (SRIs) are the only medications approved by the Food and Drug Administration to treat OCD, but few patients achieve minimal symptoms from an SRI alone. In such cases, practice guidelines recommend adding antipsychotics or cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP). OBJECTIVE To compare the effects of these 2 SRI augmentation strategies vs pill placebo for the first time, to our knowledge, in adults with OCD. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial (conducted January 2007–August 2012) at 2 academic outpatient research clinics that specialize in OCD and anxiety disorders. Patients (aged 18–70 years) were eligible if they had OCD of at least moderate severity despite a therapeutic SRI dose for at least 12 weeks prior to entry. Of 163 who were eligible, 100 were randomized (risperidone, n = 40; EX/RP, n = 40; and placebo, n = 20), and 86 completed the trial. INTERVENTIONS While continuing their SRI at the same dose, patients were randomized to the addition of 8 weeks of risperidone (up to 4 mg/d), EX/RP (17 sessions delivered twice weekly), or pill placebo. Independent assessments were conducted every 4 weeks. MAIN OUTCOME AND MEASURE The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to measure OCD severity. RESULTS Patients randomized to EX/RP had significantly greater reduction in week 8 Y-BOCS scores based on mixed-effects models (vs risperidone: mean [SE], −9.72 [1.38]; P<.001 vs placebo: mean [SE], −10.10 [1.68]; P < .001). Patients receiving risperidone did not significantly differ from those receiving placebo (mean [SE], −0.38 [1.72]; P=.83). More patients receiving EX/RP responded (Y-BOCS score decrease ≥25%: 80% for EX/RP, 23% for risperidone, and 15% for placebo; P < .001). More patients receiving EX/RP achieved minimal

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

    PubMed

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

    2017-06-09

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

  8. Characterization and functional analysis of AatB, a novel autotransporter adhesin and virulence factor of avian pathogenic Escherichia coli.

    PubMed

    Zhuge, Xiangkai; Wang, Shaohui; Fan, Hongjie; Pan, Zihao; Ren, Jianluan; Yi, Li; Meng, Qingmei; Yang, Xuqiu; Lu, Chengping; Dai, Jianjun

    2013-07-01

    Autotransporter (AT) proteins constitute a large family of extracellular proteins that contribute to bacterial virulence. A novel AT adhesin gene, aatB, was identified in avian pathogenic Escherichia coli (APEC) DE205B via genomic analyses. The open reading frame of aatB was 1,017 bp, encoding a putative 36.3-kDa protein which contained structural motifs characteristic for AT proteins: a signal peptide, a passenger domain, and a translocator domain. The predicted three-dimensional structure of AatB consisted of two distinct domains, the C-terminal β-barrel translocator domain and an N-terminal passenger domain. The prevalence analyses of aatB in APEC indicated that aatB was detected in 26.4% (72/273) of APEC strains and was strongly associated with phylogenetic groups D and B2. Quantitative real-time reverse transcription-PCR analyses revealed that AatB expression was increased during infection in vitro and in vivo. Moreover, AatB could elicit antibodies in infected ducks, suggesting that AatB is involved in APEC pathogenicity. Thus, APEC DE205B strains with a mutated aatB gene and mutated strains complemented with the aatB gene were constructed. Inactivation of aatB resulted in a reduced capacity to adhere to DF-1 cells, defective virulence capacity in vivo, and decreased colonization capacity in lung during systemic infection compared with the capacities of the wild-type strain. Furthermore, these capacities were restored in the complementation strains. These results indicated that AatB makes a significant contribution to APEC virulence through bacterial adherence to host tissues in vivo and in vitro. In addition, biofilm formation assays with strain AAEC189 expressing AatB indicated that AatB mediates biofilm formation.

  9. Characterization and Functional Analysis of AatB, a Novel Autotransporter Adhesin and Virulence Factor of Avian Pathogenic Escherichia coli

    PubMed Central

    ZhuGe, Xiangkai; Wang, Shaohui; Fan, Hongjie; Pan, Zihao; Ren, Jianluan; Yi, Li; Meng, Qingmei; Yang, Xuqiu; Lu, Chengping

    2013-01-01

    Autotransporter (AT) proteins constitute a large family of extracellular proteins that contribute to bacterial virulence. A novel AT adhesin gene, aatB, was identified in avian pathogenic Escherichia coli (APEC) DE205B via genomic analyses. The open reading frame of aatB was 1,017 bp, encoding a putative 36.3-kDa protein which contained structural motifs characteristic for AT proteins: a signal peptide, a passenger domain, and a translocator domain. The predicted three-dimensional structure of AatB consisted of two distinct domains, the C-terminal β-barrel translocator domain and an N-terminal passenger domain. The prevalence analyses of aatB in APEC indicated that aatB was detected in 26.4% (72/273) of APEC strains and was strongly associated with phylogenetic groups D and B2. Quantitative real-time reverse transcription-PCR analyses revealed that AatB expression was increased during infection in vitro and in vivo. Moreover, AatB could elicit antibodies in infected ducks, suggesting that AatB is involved in APEC pathogenicity. Thus, APEC DE205B strains with a mutated aatB gene and mutated strains complemented with the aatB gene were constructed. Inactivation of aatB resulted in a reduced capacity to adhere to DF-1 cells, defective virulence capacity in vivo, and decreased colonization capacity in lung during systemic infection compared with the capacities of the wild-type strain. Furthermore, these capacities were restored in the complementation strains. These results indicated that AatB makes a significant contribution to APEC virulence through bacterial adherence to host tissues in vivo and in vitro. In addition, biofilm formation assays with strain AAEC189 expressing AatB indicated that AatB mediates biofilm formation. PMID:23630958

  10. Experimental Transport Benchmarks for Physical Dosimetry to Support Development of Fast-Neutron Therapy with Neutron Capture Augmentation

    SciTech Connect

    D. W. Nigg; J. K. Hartwell; J. R. Venhuizen; C. A. Wemple; R. Risler; G. E. Laramore; W. Sauerwein; G. Hudepohl; A. Lennox

    2006-06-01

    The Idaho National Laboratory (INL), the University of Washington (UW) Neutron Therapy Center, the University of Essen (Germany) Neutron Therapy Clinic, and the Northern Illinois University(NIU) Institute for Neutron Therapy at Fermilab have been collaborating in the development of fast-neutron therapy (FNT) with concurrent neutron capture (NCT) augmentation [1,2]. As part of this effort, we have conducted measurements to produce suitable benchmark data as an aid in validation of advanced three-dimensional treatment planning methodologies required for successful administration of FNT/NCT. Free-beam spectral measurements as well as phantom measurements with Lucite{trademark} cylinders using thermal, resonance, and threshold activation foil techniques have now been completed at all three clinical accelerator facilities. The same protocol was used for all measurements to facilitate intercomparison of data. The results will be useful for further detailed characterization of the neutron beams of interest as well as for validation of various charged particle and neutron transport codes and methodologies for FNT/NCT computational dosimetry, such as MCNP [3], LAHET [4], and MINERVA [5].

  11. Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study.

    PubMed

    Petrides, Georgios; Malur, Chitra; Braga, Raphael J; Bailine, Samuel H; Schooler, Nina R; Malhotra, Anil K; Kane, John M; Sanghani, Sohag; Goldberg, Terry E; John, Majnu; Mendelowitz, Alan

    2015-01-01

    Up to 70% of patients with treatment-resistant schizophrenia do not respond to clozapine. Pharmacological augmentation to clozapine has been studied with unimpressive results. The authors examined the use of ECT as an augmentation to clozapine for treatment-refractory schizophrenia. In a randomized single-blind 8-week study, patients with clozapine-resistant schizophrenia were assigned to treatment as usual (clozapine group) or a course of bilateral ECT plus clozapine (ECT plus clozapine group). Nonresponders from the clozapine group received an 8-week open trial of ECT (crossover phase). ECT was performed three times per week for the first 4 weeks and twice weekly for the last 4 weeks. Clozapine dosages remained constant. Response was defined as ≥40% reduction in symptoms based on the psychotic symptom subscale of the Brief Psychiatric Rating Scale, a Clinical Global Impressions (CGI)-severity rating <3, and a CGI-improvement rating ≤2. The intent-to-treat sample included 39 participants (ECT plus clozapine group, N=20; clozapine group, N=19). All 19 patients from the clozapine group received ECT in the crossover phase. Fifty percent of the ECT plus clozapine patients met the response criterion. None of the patients in the clozapine group met the criterion. In the crossover phase, response was 47%. There were no discernible differences between groups on global cognition. Two patients required the postponement of an ECT session because of mild confusion. The augmentation of clozapine with ECT is a safe and effective treatment option. Further research is required to determine the persistence of the improvement and the potential need for maintenance treatments.

  12. Attention bias modification treatment augmenting effects on cognitive behavioral therapy in children with anxiety: randomized controlled trial.

    PubMed

    Shechner, Tomer; Rimon-Chakir, Adi; Britton, Jennifer C; Lotan, Danny; Apter, Alan; Bliese, Paul D; Pine, Daniel S; Bar-Haim, Yair

    2014-01-01

    Attention bias modification treatment (ABMT) is a promising novel treatment for anxiety disorders, but clinical trials have focused largely on stand-alone formats among adults. This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy (CBT) in clinically anxious youth. Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to 1 of the following 3 treatment groups: ABMT + CBT; ABMT placebo + CBT; and CBT-alone. Participants in the 2 ABMT conditions received repeated training on dot-probe tasks either designed to shift attention away from threats (active) or designed to induce no changes in attention patterns (placebo). Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview. Self- and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment. Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group. Furthermore, only the active ABMT group showed significant reduction in self- or parent-rated anxiety symptoms. Finally, all groups showed a shift in attention patterns across the study, starting with a bias toward threat at baseline and shifting attention away from threat after treatment. Active and placebo ABMT might augment the clinical response to CBT for anxiety. This effect could arise from benefits associated with performing computer-based paradigms such as the dot-probe task. Given the absence of group differences in attention-bias changes during treatment, possible mechanisms and methodological issues underlying the observed findings are discussed. Clinical trial registration information-Augmenting Effects of ABMT on CBT in Anxious Children: A Randomized Clinical Trial; http://clinicaltrials.gov/; NCT01730625. Copyright © 2014 American Academy of Child and Adolescent

  13. Attention Bias Modification Treatment Augmenting Effects on Cognitive Behavioral Therapy in Children With Anxiety: Randomized Controlled Trial

    PubMed Central

    Shechner, Tomer; Rimon-Chakir, Adi; Britton, Jennifer C.; Lotan, Danny; Apter, Alan; Bliese, Paul D.; Pine, Daniel S.; Bar-Haim, Yair

    2015-01-01

    Objective Attention bias modification treatment (ABMT) is a promising novel treatment for anxiety disorders, but clinical trials have focused largely on stand-alone formats among adults. This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy (CBT) in clinically anxious youth. Method Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to 1 of the following 3 treatment groups: ABMT + CBT; ABMT placebo + CBT; and CBT-alone. Participants in the 2 ABMT conditions received repeated training on dot–probe tasks either designed to shift attention away from threats (active) or designed to induce no changes in attention patterns (placebo). Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview. Self- and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment. Results Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group. Furthermore, only the active ABMT group showed significant reduction in self- or parentrated anxiety symptoms. Finally, all groups showed a shift in attention patterns across the study, starting with a bias toward threat at baseline and shifting attention away from threat after treatment. Conclusions Active and placebo ABMT might augment the clinical response to CBT for anxiety. This effect could arise from benefits associated with performing computer-based paradigms such as the dot–probe task. Given the absence of group differences in attention-bias changes during treatment, possible mechanisms and methodological issues underlying the observed findings are discussed. Clinical trial registration information—Augmenting Effects of ABMT on CBT in Anxious Children: A Randomized Clinical Trial; http://clinicaltrials.gov/; NCT01730625. PMID:24342386

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  18. Combined surgical resective and regenerative therapy for advanced peri-implantitis with concomitant soft tissue volume augmentation: a case report.

    PubMed

    Schwarz, Frank; John, Gordon; Sahm, Narja; Becker, Jürgen

    2014-01-01

    This case report presents a 3-year follow-up of the clinical outcomes of a combined surgical therapy for advanced peri-implantitis with concomitant soft tissue volume augmentation using a collagen matrix. One patient suffering from advanced peri-implantitis and a thin mucosal biotype underwent access flap surgery, implantoplasty at buccally and supracrestally exposed implant parts, and augmentation of the intrabony components using a natural bone mineral and a native collagen membrane after surface decontamination. A collagen matrix was applied to the wound area to increase soft tissue volume and support transmucosal healing. The following clinical parameters were recorded over a period of 3 years: bleeding on probing (BOP), probing depth (PD), mucosal recession (MR), clinical attachment level (CAL), and width of keratinized mucosa (KM). At 36 months, the combined surgical procedure was associated with a clinically important reduction in mean BOP (100%), PD (4.3 ± 0.5 mm), and CAL (4.4 ± 0.4 mm). Site-level analysis of the buccal aspects pointed to an increase in MR (-1.0 ± 0.4 mm) and a decrease in KM (-1.3 ± 0.5 mm) values at 12 months. However, a regain in mucosal height and KM was noted at 24 months, even reaching respective baseline values after 36 months of healing. The presented combined surgical procedure was effective in controlling an advanced peri-implantitis lesion without compromising the overall esthetic outcome in the long term.

  19. Molecular cloning and expression of a gene encoding alcohol acyltransferase (MdAAT2) from apple (cv. Golden Delicious).

    PubMed

    Li, Dapeng; Xu, Yunfeng; Xu, Gangming; Gu, Lingkun; Li, Dequan; Shu, Huairui

    2006-04-01

    Volatile esters are major aroma components of apple, and an alcohol acyltransferase (AAT) catalyzes the final step in ester biosynthesis. The gene MdAAT2, which encodes a predicted 51.2 kDa protein containing features of other acyl transferases, was isolated from Malus domestica Borkh. (cv. Golden Delicious). In contrast to other apple varieties, the MdAAT2 gene of Golden Delicious is exclusively expressed in the fruit. The MdAAT2 protein is about 47.9 kDa and mainly localized in the fruit peel, as indicated by immunoblot and immunolocalization analysis. Northern blot and immunoblot analysis showed that the transcription and translation of MdAAT2 have a positive correlation with apple AAT enzyme activity and ester production, except in the later ripening stage, suggesting that MdAAT2 is involved in the regulation of ester biosysthesis and that a post-translation modification may be involved in regulation of AAT enzyme activity. Tissue disk assays of fruit peel revealed that using extraneous alcohols can recover the corresponding ester formation. Transcription and translation of MdAAT2 were both depressed by 1-methylcyclopropene (1-MCP) treatment and subsequent ester production was also prevented. These results suggest that: (1) ester production is mainly regulated by MdAAT2; (2) ethylene is also involved in this regulatory progress and (3) ester compounds rely principally on the availability of substrates.

  20. Experiences in Sensor-Augmented Pump Therapy in Families with two Children with Type 1 diabetes: A Qualitative Study.

    PubMed

    Bomba, Franziska; Müller-Godeffroy, Esther; von Sengbusch, Simone

    2017-07-27

    Background Caring for a child with type 1 diabetes is a tremendous challenge for a family. The aim of the study was to explore the experiences of transition to sensor-augmented pump therapy (SAP) in families with 2 affected children and the internal and external conditions which potentially impede or facilitate the adjustment process. Methods 5 families (9 parents, 8 children and adolescents) who used the SAP technology for 6 months were interviewed to describe their experiences. The interviews were analysed using thematic content analysis. Results Qualitative analysis of the transcribed interviews revealed that the adaptation process to SAP consisted of several phases and differed among families. There were benefits as well as hassles of using SAP with regard to managing the diabetes, and psychosocial issues: school and peer relations, as well as family relations. While parents clearly regarded the improved metabolic control and hypoglycaemic safety as the most important benefits of SAP, the hassles reported as most important covered a wide range, from technical problems of the system to family conflicts. On the whole, families rated the experience of using SAP as a positive one, with most recommending SAP to other families as long as they were willing to come to terms with the technology and commit to the work and time involved. Conclusion Sensor-augmented pump therapy can be extremely beneficial and a resource for families who care for more than one child with diabetes. During the adaptation process there is a great need of education and frequent follow-up e. g., by telemedical support. © Georg Thieme Verlag KG Stuttgart · New York.

  1. D-cycloserine augmentation of behavior therapy for anxiety and obsessive-compulsive disorders: A meta-analysis

    PubMed Central

    Bittner, Nadine; Holling, Heinz; Buhlmann, Ulrike

    2017-01-01

    Objective The present meta-analysis investigates whether the antibiotic D-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, can augment the effect of behavior therapy in humans with anxiety and obsessive-compulsive disorders. Method A keyword-based computer search was conducted using common electronic databases. Only studies investigating the effect of DCS in humans with anxiety and obsessive-compulsive disorders were included, resulting in 23 studies with a combined sample size of 1314 patients. Effect sizes were coded as Hedges’ g and SMCC, the latter also incorporating differences in pre-treatment values. Bayesian multilevel meta-analysis was applied to take dependencies of effect sizes obtained from the same study into account. Results While previous meta-analyses found small to moderate improvements, the current results including the most recent research indicate that the overall effect of DCS is very small and almost indistinguishable from zero (g = -0.12, CI = [-0.27, 0.02]; SMCC = -0.10, CI = [-0.29, 0.07]). Slightly larger effects were found for social anxious patients. Further, study quality and year of publication were relevant moderators, with higher quality / more recent studies reported smaller effects of DCS. Conclusions These findings raise the question of the usefulness of DCS as an augmentation of exposure therapy for anxiety and obsessive-compulsive disorders. At least, it seems to be less promising than initially thought. The fact that study quality was inversely related to the reported effect sizes underlines the importance of high quality primary research in order to avoid over-estimation of treatment effects in clinical psychology. PMID:28282427

  2. Breast conservation therapy without capsular contracture in young augmented women using interstitial brachytherapy

    PubMed Central

    2014-01-01

    Purpose To describe a breast-conserving technique using interstitial brachytherapy after lumpectomy and axillary nodal sampling in selected women who are diagnosed with breast cancer in the presence of augmentation mammoplasty. Material and methods Over the past 20 years, we have developed and improved a technique of “pinch view” image-guided catheter insertion that avoids implant puncture. Selection criteria include: 1) women of any age with either subpectoral or retroglandular, augmentation implants (silicone or saline) who were diagnosed with stages Tis, T1, T2, N0, or N1 breast cancer; 2) any pathologic subtype of malignant breast cancer was accepted; 3) microscopic tumor extent ≤ 3 cm; 4) axillary node negative or metastasis to 1 to 3 nodes without extracapsular extension; and 5) surgical margins clear by the NSABP “no ink on tumor” definition. More than 250 women have been successfully treated. Patients were treated with high dose rate Iridium-192 brachytherapy to 34 Gy in 10 or 32 Gy in 8 twice daily fractions. The target volume was the surgical cavity edge with 1.5 to 2 cm margin using 3-D treatment planning systems. Results The implant technique as currently employed is described. There have been no implant ruptures, and the Planning Treatment Volume (PTV-eval) exhibited at least 90% coverage by the 90% isodose line in the vast majority of cases. Dose Homogeneity Index exceeded 70% in most cases. The maximum skin dose was below the prescription dose in every case. Other than some patients with pre-existing capsular contracture, less than 5% experience new capsular contracture after interstitial brachytherapy. Conclusions A technique of reliable and reproducible accelerated partial breast irradiation is described that minimizes the risk of capsular contracture by avoiding circumferential dose to the foreign body in the breast. PMID:25097566

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

    PubMed

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

    2015-07-01

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

  4. Cell Therapy Augments Functional Recovery Subsequent to Spinal Cord Injury under Experimental Conditions

    PubMed Central

    Sabapathy, Vikram; Tharion, George; Kumar, Sanjay

    2015-01-01

    The spinal cord injury leads to enervation of normal tissue homeostasis ultimately leading to paralysis. Until now there is no proper cure for the treatment of spinal cord injury. Recently, cell therapy in animal spinal cord injury models has shown some progress of recovery. At present, clinical trials are under progress to evaluate the efficacy of cell transplantation for the treatment of spinal cord injury. Different types of cells such as pluripotent stem cells derived neural cells, mesenchymal stromal cells, neural stem cells, glial cells are being tested in various spinal cord injury models. In this review we highlight both the advances and lacuna in the field of spinal cord injury by discussing epidemiology, pathophysiology, molecular mechanism, and various cell therapy strategies employed in preclinical and clinical injury models and finally we discuss the limitations and ethical issues involved in cell therapy approach for treating spinal cord injury. PMID:26240569

  5. Cell Therapy Augments Functional Recovery Subsequent to Spinal Cord Injury under Experimental Conditions.

    PubMed

    Sabapathy, Vikram; Tharion, George; Kumar, Sanjay

    2015-01-01

    The spinal cord injury leads to enervation of normal tissue homeostasis ultimately leading to paralysis. Until now there is no proper cure for the treatment of spinal cord injury. Recently, cell therapy in animal spinal cord injury models has shown some progress of recovery. At present, clinical trials are under progress to evaluate the efficacy of cell transplantation for the treatment of spinal cord injury. Different types of cells such as pluripotent stem cells derived neural cells, mesenchymal stromal cells, neural stem cells, glial cells are being tested in various spinal cord injury models. In this review we highlight both the advances and lacuna in the field of spinal cord injury by discussing epidemiology, pathophysiology, molecular mechanism, and various cell therapy strategies employed in preclinical and clinical injury models and finally we discuss the limitations and ethical issues involved in cell therapy approach for treating spinal cord injury.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Abushakra, Ahmad; Faezipour, Miad

    2014-05-01

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

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

    PubMed

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

    2016-01-01

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

  9. Social Skills Training Augments the Effectiveness of Cognitive Behavioral Group Therapy for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Herbert, James D.; Gaudiano, Brandon A.; Rheingold, Alyssa A.; Myers, Valerie H.; Dalrymple, Kristy; Nolan, Elizabeth M.

    2005-01-01

    Cognitive Behavioral Group Therapy (CBGT) is the most widely researched intervention program for social anxiety disorder (SAD, also known as social phobia), with a number of studies demonstrating its effectiveness. Another common treatment, social skills training (SST), has also been shown to be efficacious for SAD. The present study compared the…

  10. Mirtazapine, yohimbine or olanzapine augmentation therapy for serotonin reuptake-associated female sexual dysfunction: a randomized, placebo controlled trial.

    PubMed

    Michelson, David; Kociban, Kristen; Tamura, Roy; Morrison, Mary F

    2002-01-01

    Many agents have been proposed as potential treatments for SSRI-associated sexual dysfunction, but few placebo-controlled trials have been reported. After a 1-month baseline evaluation, pre-menopausal women with moderate to severe sexual dysfunction associated with the institution of fluoxetine therapy were randomized to augmentation therapy with placebo (N=39), mirtazapine (N=36), yohimbine (N=35) or olanzapine (N=38) for a 6-week period. Outcomes were measured using a daily diary, a biweekly self-report assessment, and a computer assisted structured interview. At baseline, orgasm was most severely impaired. After 6 weeks, there was statistically significant improvement on most measures for the overall group of patients, however there were few differences between treatment groups. Isolated treatment differences were observed for the patient self-report of overall sexual function (olanzapine superior to placebo) and the structured interview sexual satisfaction item (mirtazapine inferior to placebo). No drug assessed was consistently associated with differences from placebo. The results of the study do not support uncontrolled reports of efficacy for these agents in premenopausal women.

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2015-02-01

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

  13. The MITK image guided therapy toolkit and its application for augmented reality in laparoscopic prostate surgery

    NASA Astrophysics Data System (ADS)

    Baumhauer, Matthias; Neuhaus, Jochen; Fritzsche, Klaus; Meinzer, Hans-Peter

    2010-02-01

    Image Guided Therapy (IGT) faces researchers with high demands and efforts in system design, prototype implementation, and evaluation. The lack of standardized software tools, like algorithm implementations, tracking device and tool setups, and data processing methods escalate the labor for system development and sustainable system evaluation. In this paper, a new toolkit component of the Medical Imaging and Interaction Toolkit (MITK), the MITK-IGT, and its exemplary application for computer-assisted prostate surgery are presented. MITK-IGT aims at integrating software tools, algorithms and tracking device interfaces into the MITK toolkit to provide a comprehensive software framework for computer aided diagnosis support, therapy planning, treatment support, and radiological follow-up. An exemplary application of the MITK-IGT framework is introduced with a surgical navigation system for laparos-copic prostate surgery. It illustrates the broad range of application possibilities provided by the framework, as well as its simple extensibility with custom algorithms and other software modules.

  14. Local tumor irradiation augments the response to IL-2 therapy in a murine renal adenocarcinoma.

    PubMed

    Younes, E; Haas, G P; Dezso, B; Ali, E; Maughan, R L; Kukuruga, M A; Montecillo, E; Pontes, J E; Hillman, G G

    1995-10-15

    We have previously demonstrated that local tumor irradiation effectively enhanced the therapeutic effect of IL-2 therapy on pulmonary metastases from a murine renal adenocarcinoma, Renca. Irradiation with 300 rad to the left lung only, followed by systemic IL-2 therapy, results in increased tumor reduction in both lungs, suggesting that radiation enhances the systemic effect of immunotherapy. In this study, we show that irradiation of the tumor-bearing organ is essential for the combined effect of both modalities. This effect is radiation dose-dependent as increases in the radiation dosage result in greater tumor reduction in the irradiated field as well as systemically in nonirradiated fields when combined with immunotherapy. We find that irradiation has a direct inhibitory effect on Renca cell growth in vitro. Irradiation of Renca cells also causes an upregulation in H-2Kd class I MHC antigen detectable at 300 rad and more pronounced with 800 rad. By in vivo selective depletion of lymphocyte subsets, we demonstrate the involvement of Lyt-2+ and L3T4+ T cell subsets and AsGM1+ cells, including NK cells, in the antitumor effect mediated by tumor irradiation and IL-2 therapy. Immunohistochemistry studies, performed on lung sections, showed a significant infiltration of CD3+ T cells and macrophages in the tumor nodules following treatment with tumor irradiation and IL-2 therapy. Our studies indicate that the mechanism of interaction between tumor irradiation and immunotherapy may include radiation-induced alterations in the tumor growth and antigenicity which may enhance or trigger an anti-tumor response elicited by IL-2 and mediated by T cells, AsGM1+ cells, and macrophages.

  15. Substrate Reduction Augments the Efficacy of Enzyme Therapy in a Mouse Model of Fabry Disease

    PubMed Central

    Marshall, John; Ashe, Karen M.; Bangari, Dinesh; McEachern, KerryAnne; Chuang, Wei-Lien; Pacheco, Joshua; Copeland, Diane P.; Desnick, Robert J.; Shayman, James A.; Scheule, Ronald K.; Cheng, Seng H.

    2010-01-01

    Fabry disease is an X-linked glycosphingolipid storage disorder caused by a deficiency in the activity of the lysosomal hydrolase α-galactosidase A (α-gal). This deficiency results in accumulation of the glycosphingolipid globotriaosylceramide (GL-3) in lysosomes. Endothelial cell storage of GL-3 frequently leads to kidney dysfunction, cardiac and cerebrovascular disease. The current treatment for Fabry disease is through infusions of recombinant α-gal (enzyme-replacement therapy; ERT). Although ERT can markedly reduce the lysosomal burden of GL-3 in endothelial cells, variability is seen in the clearance from several other cell types. This suggests that alternative and adjuvant therapies may be desirable. Use of glucosylceramide synthase inhibitors to abate the biosynthesis of glycosphingolipids (substrate reduction therapy, SRT) has been shown to be effective at reducing substrate levels in the related glycosphingolipidosis, Gaucher disease. Here, we show that such an inhibitor (eliglustat tartrate, Genz-112638) was effective at lowering GL-3 accumulation in a mouse model of Fabry disease. Relative efficacy of SRT and ERT at reducing GL-3 levels in Fabry mouse tissues differed with SRT being more effective in the kidney, and ERT more efficacious in the heart and liver. Combination therapy with ERT and SRT provided the most complete clearance of GL-3 from all the tissues. Furthermore, treatment normalized urine volume and uromodulin levels and significantly delayed the loss of a nociceptive response. The differential efficacies of SRT and ERT in the different tissues indicate that the combination approach is both additive and complementary suggesting the possibility of an improved therapeutic paradigm in the management of Fabry disease. PMID:21124789

  16. Approaches to augment CAR T-cell therapy by targeting the apoptotic machinery.

    PubMed

    Karlsson, Hannah

    2016-04-15

    Chimaeric antigen receptor (CAR) T-cells have shown impressive results in patients with B-cell leukaemia. Yet, in patients with lymphoma durable responses are still rare and heavy preconditioning required. Apoptosis resistance is considered a hallmark of cancer, often conveyed by a halted apoptosis signalling. Tumours regularly skew the balance of the components of the apoptotic machinery either through up-regulating anti-apoptotic proteins or silencing pro-apoptotic ones. Malignant B-cells frequently up-regulate anti-apoptotic B-cell lymphoma 2 (Bcl-2) family proteins leading to therapy resistance. CAR T-cells kill tumour cells via apoptosis induction and their efficacy may be affected by the level of Bcl-2 family proteins. Hence, there is an interesting possibility to increase the effect of CAR T-cell therapy by combining it with apoptosis inhibitor blockade agents. Compounds that inhibit Bcl-2, B-cell lymphoma extra large (Bcl-xL) and Bcl-2-like protein 2 (Bcl-w), can restore execution of apoptosis in tumour cells or sensitize them to other apoptosis-dependent treatments. Hence, there is a great interest to combine such agents with CAR T-cell therapy to potentiate the effect of CAR T-cell killing. This review will focus on the potential of targeting the apoptotic machinery to sensitize tumour cells to CAR T-cell killing. © 2016 Authors; published by Portland Press Limited.

  17. Enzyme augmentation therapy enhances the therapeutic efficacy of bone marrow transplantation in mucopolysaccharidosis type II mice.

    PubMed

    Akiyama, Kazumasa; Shimada, Yohta; Higuchi, Takashi; Ohtsu, Makoto; Nakauchi, Hiromitsu; Kobayashi, Hiroshi; Fukuda, Takahiro; Ida, Hiroyuki; Eto, Yoshikatsu; Crawford, Brett E; Brown, Jillian R; Ohashi, Toya

    2014-02-01

    Before the availability of an enzyme replacement therapy (ERT) for mucopolysaccharidosis type II (MPS II), patients were treated by bone marrow transplantation (BMT). However, the effectiveness of BMT for MPS II was equivocal, particularly at addressing the CNS manifestations. To study this further, we subjected a murine model of MPS II to BMT and evaluated the effect at correcting the biochemical and pathological aberrations in the viscera and CNS. Our results indicated that BMT reduced the accumulation of glycosaminoglycans (GAGs) in a variety of visceral organs, but not in the CNS. With the availability of an approved ERT for MPS II, we investigated and compared the relative merits of the two strategies either as a mono or combination therapy. We showed that the combination of BMT and ERT was additive at reducing tissue levels of GAGs in the heart, kidney and lung. Moreover, ERT conferred greater efficacy if the immunological response against the infused recombinant enzyme was low. Finally, we showed that pathologic GAGs might potentially represent a sensitive biomarker to monitor the therapeutic efficacy of therapies for MPS II. © 2013.

  18. Renal replacement therapy in congestive heart failure requiring left ventricular assist device augmentation.

    PubMed

    Thomas, Bernadette A; Logar, Christine M; Anderson, Arthur E

    2012-01-01

    "Cardiorenal syndrome" is a term used to describe a dys-regulation of the heart affecting the kidneys, or vice versa, in an acute or chronic manner (1,2). Renal impairment can range from reversible ischemic damage to renal failure requiring short- or long-term renal replacement therapy (2). Patients who require mechanical circulatory support, such as a left ventricular assist device (LVAD), as definitive treatment for congestive heart failure or as a bridge to cardiac transplantation pose a unique challenge with respect to receiving dialysis, because they experience higher rates of morbidity and mortality from infection in the post-LVAD period (3-7). Acute dialysis access can pose an increased infection risk. In this article, we present a patient who required renal replacement therapy and a LVAD for management of acute-on-chronic cardiorenal syndrome while awaiting heart transplantation. A literature review to determine whether peritoneal dialysis or hemodialysis is superior for patients with profound hemodynamic dysfunction and the need to minimize risk of infection did not offer clear guidance about which modality is superior in patients with advanced congestive heart failure. However, there is clear evidence of the superiority of peritoneal dialysis in reducing the risk of systemic infection secondary to acute dialysis access. Given the high risk of LVAD infection, we therefore conclude that, to decrease mortality secondary to systemic infection, peritoneal dialysis should strongly be considered in patients who require renal replacement therapy before or after LVAD placement.

  19. The moral basis of animal-assisted therapy.

    PubMed

    Zamir, Tzachi

    2006-01-01

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

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

    PubMed

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

    2017-08-23

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

  1. Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression.

    PubMed

    Abdollahi, Abbas; LeBouthillier, Daniel M; Najafi, Mahmoud; Asmundson, Gordon J G; Hosseinian, Simin; Shahidi, Shahriar; Carlbring, Per; Kalhori, Atefeh; Sadeghi, Hassan; Jalili, Marzieh

    2017-09-01

    Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Geographic variability in expression of the sex-linked AAT-1 gene of the bell-ring frog, Buergeria buergeri.

    PubMed

    Sumida, Masayuki; Ohta, Shigeru; Atsumi, Shigeru; Fujii, Tamotsu

    2004-03-15

    Cytological observation and artificial crossing experiments were used to examine the geographic differences in the sex-determining mechanism and mode of inheritance of the sex-linked AAT-1 gene in the bell-ring frog, Buergeria buergeri. The AAT-1 phenotypes were also examined by allozyme analysis using field-caught females and males collected from 19 populations from the Honshu, Shikoku, and Kyushu islands of Japan, in order to comprehensively elucidate the geographic variability in the expression of the sex-linked AAT-1 gene of B. buergeri. The results showed that the Aomori population of B. buergeri from the northern end of Honshu was female heterogametic in sex determination, that chromosome No. VII was a sex chromosome of the ZZ/ZW type, and that the sex-linked AAT-1 gene was expressed on both the Z and W chromosomes. This mode of AAT-1 expression in the Aomori population was different from that in the Hiroshima population from western Honshu, in which the AAT-1 gene was expressed on the Z chromosome but not on the W chromosome. The results also showed that there was no differentiation among populations in the expression of the AAT-1 genes on the Z chromosome, whereas two populations, the Hiroshima and Aomori frogs, exhibited distinct modes of expression of the AAT-1 gene on the W chromosome. These two modes of expression may be widely distributed in western and eastern Japan, and coexist in the central part of Honshu.

  3. Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia.

    PubMed

    Banin, Eyal; Gootwine, Elisha; Obolensky, Alexey; Ezra-Elia, Raaya; Ejzenberg, Ayala; Zelinger, Lina; Honig, Hen; Rosov, Alexander; Yamin, Esther; Sharon, Dror; Averbukh, Edward; Hauswirth, William W; Ofri, Ron

    2015-09-01

    Achromatopsia is a hereditary form of day blindness caused by cone photoreceptor dysfunction. Affected patients suffer from congenital color blindness, photosensitivity, and low visual acuity. Mutations in the CNGA3 gene are a major cause of achromatopsia, and a sheep model of this disease was recently characterized by our group. Here, we report that unilateral subretinal delivery of an adeno-associated virus serotype 5 (AAV5) vector carrying either the mouse or the human intact CNGA3 gene under the control of the red/green opsin promoter results in long-term recovery of visual function in CNGA3-mutant sheep. Treated animals demonstrated shorter maze passage times and a reduced number of collisions with obstacles compared with their pretreatment status, with values close to those of unaffected sheep. This effect was abolished when the treated eye was patched. Electroretinography (ERG) showed marked improvement in cone function. Retinal expression of the transfected human and mouse CNGA3 genes at the mRNA level was shown by polymerase chain reaction (PCR), and cone-specific expression of CNGA3 protein was demonstrated by immunohistochemisrty. The rescue effect has so far been maintained for over 3 years in the first-treated animals, with no obvious ocular or systemic side effects. The results support future application of subretinal AAV5-mediated gene-augmentation therapy in CNGA3 achromatopsia patients.

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

    PubMed

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

    2015-12-01

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

  5. Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia

    PubMed Central

    Banin, Eyal; Gootwine, Elisha; Obolensky, Alexey; Ezra-Elia, Raaya; Ejzenberg, Ayala; Zelinger, Lina; Honig, Hen; Rosov, Alexander; Yamin, Esther; Sharon, Dror; Averbukh, Edward; Hauswirth, William W; Ofri, Ron

    2015-01-01

    Achromatopsia is a hereditary form of day blindness caused by cone photoreceptor dysfunction. Affected patients suffer from congenital color blindness, photosensitivity, and low visual acuity. Mutations in the CNGA3 gene are a major cause of achromatopsia, and a sheep model of this disease was recently characterized by our group. Here, we report that unilateral subretinal delivery of an adeno-associated virus serotype 5 (AAV5) vector carrying either the mouse or the human intact CNGA3 gene under the control of the red/green opsin promoter results in long-term recovery of visual function in CNGA3-mutant sheep. Treated animals demonstrated shorter maze passage times and a reduced number of collisions with obstacles compared with their pretreatment status, with values close to those of unaffected sheep. This effect was abolished when the treated eye was patched. Electroretinography (ERG) showed marked improvement in cone function. Retinal expression of the transfected human and mouse CNGA3 genes at the mRNA level was shown by polymerase chain reaction (PCR), and cone-specific expression of CNGA3 protein was demonstrated by immunohistochemisrty. The rescue effect has so far been maintained for over 3 years in the first-treated animals, with no obvious ocular or systemic side effects. The results support future application of subretinal AAV5-mediated gene-augmentation therapy in CNGA3 achromatopsia patients. PMID:26087757

  6. Screening and study enrolment in the Randomized Evaluation of Normal vs. Augmented Level (RENAL) Replacement Therapy Trial.

    PubMed

    Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Goldsmith, Donna; Myburgh, John; Norton, Robyn; Scheinkestel, Carlos

    2009-01-01

    Aspects of trial design, screening and study efficiency can affect recruitment and the findings of the trial itself. A clear understanding of the screening and study inclusion process will assist clinicians in interpreting trial results. Prospective observational data collection on all patients screened for possible inclusion in a randomized controlled trial of normal vs. augmented renal replacement therapy in critically ill patients (the RENAL Trial). 35 hospitals in Australia and New Zealand. All patients screened for the RENAL Trial. We screened 4,551 patients. Of these patients, 767 were ineligible because of lack of inclusion criteria and 2,085 because of exclusion criteria. Of the remaining 1,699, 1,508 (88.7%) were enrolled. The three most common exclusion criteria which prevented recruitment of potentially eligible patients were that the patient had end-stage kidney failure and was already on chronic dialysis (484; 23.2%), the patient's body weight was either <60 or >120 kg (456; 21.8%), and the fact that the patient had already received renal replacement therapy during the index admission. Important modifiable impediments to recruitment were inability to obtain consent in 191 cases, unavailability of research staff in 124 cases, physician objection in 89 cases, and inability to deliver the trial protocol in 78 cases. The RENAL Trial's enrolment efficiency was high and compared favourably with previous large intensive care units trials and with that of trials in patients with acute renal failure. The high rate of enrolment suggests that the results can be applied with confidence to most patients with de novo acute renal failure. The loss of close to 1.5% of patients due to consent issues highlights a common problem in critical care trials. The low rate of physician objection suggests clinical equipoise.

  7. FLOYDS Classification of KAIT-17A/AT 2017be as an LBV Outburst

    NASA Astrophysics Data System (ADS)

    Hosseinzadeh, G.; McCully, C.; Arcavi, I.; Howell, D. A.; Valenti, S.

    2017-01-01

    We obtained a spectrum of KAIT-17A/AT 2017be, discovered by the Lick Observatory Supernova Search, on 2017 January 10.4 UT with the robotic FLOYDS instrument mounted on the Las Cumbres Observatory 2-meter telescope on Haleakala, Hawai'i.

  8. Augmented Feedback System to Support Physical Therapy of Non-specific Low Back Pain

    NASA Astrophysics Data System (ADS)

    Brodbeck, Dominique; Degen, Markus; Stanimirov, Michael; Kool, Jan; Scheermesser, Mandy; Oesch, Peter; Neuhaus, Cornelia

    Low back pain is an important problem in industrialized countries. Two key factors limit the effectiveness of physiotherapy: low compliance of patients with repetitive movement exercises, and inadequate awareness of patients of their own posture. The Backtrainer system addresses these problems by real-time monitoring of the spine position, by providing a framework for most common physiotherapy exercises for the low back, and by providing feedback to patients in a motivating way. A minimal sensor configuration was identified as two inertial sensors that measure the orientation of the lower back at two points with three degrees of freedom. The software was designed as a flexible platform to experiment with different hardware, and with various feedback modalities. Basic exercises for two types of movements are provided: mobilizing and stabilizing. We developed visual feedback - abstract as well as in the form of a virtual reality game - and complemented the on-screen graphics with an ambient feedback device. The system was evaluated during five weeks in a rehabilitation clinic with 26 patients and 15 physiotherapists. Subjective satisfaction of subjects was good, and we interpret the results as encouraging indication for the adoption of such a therapy support system by both patients and therapists.

  9. Diltiazem as augmentation therapy in patients with treatment-resistant bipolar disorder: a retrospective study.

    PubMed Central

    Silverstone, P H; Birkett, L

    2000-01-01

    OBJECTIVE: To examine the efficacy of a slow-release formulation of diltiazem as adjunctive therapy in patients with treatment-resistant bipolar disorder. DESIGN: Retrospective study. PATIENTS: Eight female patients with treatment-resistant bipolar disorder. INTERVENTIONS: Patients were administered diltiazem and monitored for a 6-month period before starting diltiazem and a 6-month period after starting the drug. OUTCOME MEASURES: All patients were seen at least monthly and usually every 2 weeks. The frequency and severity of both depressive and manic episodes were examined during the 6-month period after starting diltiazem, and compared with those during the 6-month period before diltiazem treatment. RESULTS: There was a statistically significant decrease in the frequency and severity of both manic and depressive episodes in these patients after they started treatment with diltiazem, compared with the period before they started treatment with diltiazem (p < 0.001). There was no evidence of side effects requiring patient withdrawal or of drug interactions. CONCLUSIONS: The results support previous suggestions that calcium-channel antagonists may be an effective adjunctive treatment in the management of bipolar disorder. Further controlled clinical studies are needed to confirm this small, open-label, retrospective study. PMID:10863888

  10. Combinatorial treatment with oncolytic adenovirus and helper-dependent adenovirus augments adenoviral cancer gene therapy

    PubMed Central

    Farzad, Lisa; Cerullo, Vincenzo; Yagyu, Shigeki; Bertin, Terry; Hemminki, Akseli; Rooney, Cliona; Lee, Brendan; Suzuki, Masataka

    2014-01-01

    Oncolytic adenoviruses (Onc.Ads) produce significant antitumor effects but as single agents they rarely eliminate tumors. Investigators have therefore incorporated sequences into these vectors that encode immunomodulatory molecules to enhance antitumor immunity. Successful implementation of this strategy requires multiple tumor immune inhibitory mechanisms to be overcome, and insertion of the corresponding multiple functional genes reduces the titer and replication of Onc.Ads, compromising their direct ant-tumor effects. By contrast, helper-dependent (HD) Ads are devoid of viral coding sequences, allowing inclusion of multiple transgenes. HDAds, however, lack replicative capacity. Since HDAds encode the adenoviral packaging signal, we hypothesized that the coadministration of Onc.Ad with HDAd would allow to be amplified and packaged during replication of Onc.Ad in transduced cancer cells. This combination could provide immunostimulation without losing oncolytic activity. We now show that coinfection of Onc.Ad with HDAd subsequently replicates HDAd vector DNA in trans in human cancer cell lines in vitro and in vivo, amplifying the transgenes the HDAd encode. This combinatorial treatment significantly suppresses the tumor growth compared to treatment with a single agent in an immunocompetent mouse model. Hence, combinatorial treatment of Onc.Ad with HDAd should overcome the inherent limitations of each agent and provide a highly immunogenic oncolytic therapy. PMID:27119096

  11. Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis: A Randomized Controlled Trial.

    PubMed

    Arya, Kamal Narayan; Pandian, Shanta; Kumar, Dharmendra; Puri, Vinod

    2015-08-01

    To establish the effect of the task-based mirror therapy (TBMT) on the upper limb recovery in stroke. A pilot, randomized, controlled, assessor-blinded trial was conducted in a rehabilitation institute. A convenience sample of 33 poststroke (mean duration, 12.5 months) hemiparetic subjects was randomized into 2 groups (experimental, 17; control, 16). The subjects were allocated to receive either TBMT or standard motor rehabilitation-40 sessions (5/week) for a period of 8 weeks. The TBMT group received movements using various goal-directed tasks and a mirror box. The movements were performed by the less-affected side superimposed on the affected side. The main outcome measures were Brunnstrom recovery stage (BRS) and Fugl-Meyer assessment (FMA)-FMA of upper extremity (FMA-UE), including upper arm (FMA-UA) and wrist-hand (FMA-WH). The TBMT group exhibited highly significant improvement on mean scores of FMA-WH (P < .001) and FMA-UE (P < .001) at postassessment in comparison to the control group. Furthermore, there was a 12% increase in the number of subjects at BRS stage 5 (out of synergy movement) in the experimental group as compared to a 0% rise at the same stage in the control group. This pilot trial confirmed the role of TBMT in improving the wrist-hand motor recovery in poststroke hemiparesis. MT using tasks may be used as an adjunct in stroke rehabilitation. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Stapleton, Mary

    2016-06-18

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

  13. Nicotinamide augments the survival and incidence of apoptosis in glioma cells following photodynamic therapy in vitro

    NASA Astrophysics Data System (ADS)

    Bisland, Stuart K.; Modi, Nayan; Wilson, Brian C.

    2004-10-01

    The ability to customize photodynamic therapy (PDT) parameters with regards to timing and dosing of administered drug and light can be beneficial in determining target specificity and mode of cell death. Sustained, low level PDT or metronomic PDT (mPDT) may afford enhanced apoptotic cell death. This is of particular importance when considering PDT for the treatment of brain tumors as unlike apoptosis, necrotic cell death often leads to inflammation with increased intracranial pressure. The ability, therefore, to 'fine tune' PDT in favour of apoptosis is paramount. We have studied both acute (one time treatment) PDT (aPDT) and mPDT delivery strategies in combination with nicotinamide (NA) in an attempt to maximize the number of tumor cells dieing by apoptosis. Using several different glioma cell lines (9L, U87-MG and CNS-1) we now confirm that NA provides a dose-dependent (0.1-0.5 mM) increase in apoptotic cells following d-aminolevulinic acid-mediated aPDT or mPDT. Furthermore, using the 9L cell line stably transfected with the luciferase gene, NA was shown to delay the depletion of bioluminscence signal in aPDT and mPDT treated cells, inferring that adenosine triphosphate levels are maintained for longer following NA treatment. NA has previously been reported as promoting neuronal and vascular cell survival in normal brain following a number of neurological insults in which reactive oxygen species are implicated including, stroke, Alzheimer's disease and toxin-induced lesions. It is likely that the effects of NA reflect its capacity as an antioxidant as well as its ability to inhibit poly (adenosine diphosphate-ribose) polymerase-mediated depletion of ATP. Our results indicate that NA may prove therapeutically advantageous when used in combination with PDT treatment of brain tumors.

  14. Mitochondrial gene therapy augments mitochondrial physiology in a Parkinson's disease cell model.

    PubMed

    Keeney, Paula M; Quigley, Caitlin K; Dunham, Lisa D; Papageorge, Christina M; Iyer, Shilpa; Thomas, Ravindar R; Schwarz, Kathleen M; Trimmer, Patricia A; Khan, Shaharyar M; Portell, Francisco R; Bergquist, Kristen E; Bennett, James P

    2009-08-01

    Neurodegeneration in Parkinson's disease (PD) affects mainly dopaminergic neurons in the substantia nigra, where age-related, increasing percentages of cells lose detectable respiratory activity associated with depletion of intact mitochondrial DNA (mtDNA). Replenishment of mtDNA might improve neuronal bioenergetic function and prevent further cell death. We developed a technology ("ProtoFection") that uses recombinant human mitochondrial transcription factor A (TFAM) engineered with an N-terminal protein transduction domain (PTD) followed by the SOD2 mitochondrial localization signal (MLS) to deliver mtDNA cargo to the mitochondria of living cells. MTD-TFAM (MTD = PTD + MLS = "mitochondrial transduction domain") binds mtDNA and rapidly transports it across plasma membranes to mitochondria. For therapeutic proof-of-principle we tested ProtoFection technology in Parkinson's disease cybrid cells, using mtDNA generated from commercially available human genomic DNA (gDNA; Roche). Nine to 11 weeks after single exposures to MTD-TFAM + mtDNA complex, PD cybrid cells with impaired respiration and reduced mtDNA genes increased their mtDNA gene copy numbers up to 24-fold, mtDNA-derived RNAs up to 35-fold, TFAM and ETC proteins, cell respiration, and mitochondrial movement velocities. Cybrid cells with no or minimal basal mitochondrial impairments showed reduced or no responses to treatment, suggesting the possibility of therapeutic selectivity. Exposure of PD but not control cybrid cells to MTD-TFAM protein alone or MTD-TFAM + mtDNA complex increased expression of PGC-1alpha, suggesting activation of mitochondrial biogenesis. ProtoFection technology for mitochondrial gene therapy holds promise for improving bioenergetic function in impaired PD neurons and needs additional development to define its pharmacodynamics and delineate its molecular mechanisms. It also is unclear whether single-donor gDNA for generating mtDNA would be a preferred therapeutic compared with the pooled

  15. Amantadine augmentation therapy for obsessive compulsive patients resistant to SSRIs-an open-label study.

    PubMed

    Stryjer, Rafael; Budnik, Dana; Ebert, Tania; Green, Tamar; Polak, Lea; Weizman, Shira; Spivak, Baruch

    2014-01-01

    It has been hypothesized that glutamatergic dysfunction may play a role in the development of obsessive compulsive disorder (OCD) and that glutamatergic modulation may ameliorate some of the OC symptoms. We evaluated the effectiveness of amantadine (AMN)- a weak, noncompetitive, antagonist of the N-methyl-D-aspartic acid (NMDA) receptor-as an adjunctive therapy to selective serotonin reuptake inhibitors (SSRIs), and its role in improving OC symptoms in cases refractory to SSRI pharmacotherapy alone. Eight patients (5 males and 3 females, aged 42.6 ± 13.1 years) that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for OCD, scored above 20 points on Yale Brown Obsessive Compulsive Scale (Y-BOCS) and were unresponsive to at least one SSRI, completed an open label study of 6 weeks duration. AMN was added to the current stable SSRI regimen and baseline and endpoint changes in Y-BOCS, depression and anxiety levels were analyzed. Significant reductions in total Y-BOCS (28 ± 4.5 vs. 18.8 ± 8.8; P < 0.01; df = 7; t = 2.36), Y-BOCS compulsion sub-scale (15.3 ± 3.2 vs. 10.6 ± 4.7; P < 0.02; df = 7; t = 2.36), and Y-BOCS obsession sub-scale (12.7 ± 3.3 vs. 8.1 ± 5; P < 0.05; df = 7; t = 2.36) scores were obtained at endpoint. The anxiety and depression levels remained unaltered. AMN adjunction to SSRI treatment may lead to a significant reduction in OC symptoms, supporting the hypothesis that transduction of the glutamate signal via NMDA receptor may play a role in OCD. A large scale, double-blind, placebo-controlled study is warranted to confirm our results.

  16. Mitochondrial Gene Therapy Augments Mitochondrial Physiology in a Parkinson's Disease Cell Model

    PubMed Central

    Keeney, Paula M.; Quigley, Caitlin K.; Dunham, Lisa D.; Papageorge, Christina M.; Iyer, Shilpa; Thomas, Ravindar R.; Schwarz, Kathleen M.; Trimmer, Patricia A.; Khan, Shaharyar M.; Portell, Francisco R.; Bergquist, Kristen E.

    2009-01-01

    Abstract Neurodegeneration in Parkinson's disease (PD) affects mainly dopaminergic neurons in the substantia nigra, where age-related, increasing percentages of cells lose detectable respiratory activity associated with depletion of intact mitochondrial DNA (mtDNA). Replenishment of mtDNA might improve neuronal bioenergetic function and prevent further cell death. We developed a technology (“ProtoFection”) that uses recombinant human mitochondrial transcription factor A (TFAM) engineered with an N-terminal protein transduction domain (PTD) followed by the SOD2 mitochondrial localization signal (MLS) to deliver mtDNA cargo to the mitochondria of living cells. MTD–TFAM (MTD = PTD + MLS = “mitochondrial transduction domain”) binds mtDNA and rapidly transports it across plasma membranes to mitochondria. For therapeutic proof-of-principle we tested ProtoFection technology in Parkinson's disease cybrid cells, using mtDNA generated from commercially available human genomic DNA (gDNA; Roche). Nine to 11 weeks after single exposures to MTD–TFAM + mtDNA complex, PD cybrid cells with impaired respiration and reduced mtDNA genes increased their mtDNA gene copy numbers up to 24-fold, mtDNA-derived RNAs up to 35-fold, TFAM and ETC proteins, cell respiration, and mitochondrial movement velocities. Cybrid cells with no or minimal basal mitochondrial impairments showed reduced or no responses to treatment, suggesting the possibility of therapeutic selectivity. Exposure of PD but not control cybrid cells to MTD–TFAM protein alone or MTD–TFAM + mtDNA complex increased expression of PGC-1α, suggesting activation of mitochondrial biogenesis. ProtoFection technology for mitochondrial gene therapy holds promise for improving bioenergetic function in impaired PD neurons and needs additional development to define its pharmacodynamics and delineate its molecular mechanisms. It also is unclear whether single-donor gDNA for generating mtDNA would be a

  17. Using Animal-assisted Therapy to Enrich Psychotherapy.

    PubMed

    Amerine, Jeanne Louise; Hubbard, Grace B

    2016-01-01

    Animal-assisted therapy (AAT) has been shown to be effective in the treatment of many psychological disorders, including autism spectrum disorders, depression, anxiety, and posttraumatic stress disorder (PTSD). AAT can be used as an adjunct to other forms of psychotherapy. With AAT, the animal becomes a part of the treatment plan. Outcomes for clients that are associated with the use of AAT include (1) increased sense of comfort and safety, (2) increased motivation, (3) enhanced self-esteem, (4) increased prosocial behaviors, and (5) decreased behavioral problems. AAT provides a bridge for the therapist to develop a therapeutic relationship with a client, and the animal can provide supportive reassurance for the therapist. The amount of data that supports the benefits of AAT for the treatment of those with mental illnesses is growing, but evidence-based research that supports its use is lacking. Further research is needed.

  18. Outcome of implant therapy involving localised lateral alveolar ridge and/or sinus floor augmentation: a clinical and radiographic retrospective 1-year study.

    PubMed

    Hansen, Esben Juhl; Schou, Soren; Harder, Flemming; Hjorting-Hansen, Erik

    2011-01-01

    To retrospectively evaluate the 1-year outcome of implant therapy involving various types of localised lateral alveolar ridge and/or sinus floor augmentation procedures performed before implant placement. Forty-seven patients were consecutively treated with oral implants on average 6.5 months after bone grafting. A total of 82 regions were augmented and 151 implants were inserted. All regions were augmented with autogenous bone harvested intraorally. Block grafts (13 regions, 16%), particulate grafts (25 regions, 30%), and a combination of block and particulate grafts (44 regions, 54%) were used. The particulate grafts were sometimes mixed with less than 25% anorganic porous bovine-derived bone mineral (28 regions, 34%). Finally, the grafted areas were in most cases covered by either an expanded polytetrafluoroethylene (e-PTFE) membrane (58 regions, 71%) or a resorbable collagen membrane (11 regions, 13%). The selection of the performed procedure was based upon the experience of the surgeon and thorough evaluation of each case. All surgical procedures were performed by two oral and maxillofacial surgeons with extensive clinical experience with regenerative procedures. The outcome measures were complications related to the augmentation procedure, prosthesis survival, implant survival and peri-implant marginal bone loss. No dropouts occurred. Complications occurred in eight patients (17%) after bone harvesting: temporary paraesthesia (two patients, 4%), membrane exposure (five patients, 11%) and acute sinusitis (one patient, 2%). Membrane exposure was exclusively observed when an e-PTFE membrane was used. However, the subsequent implant placement was not compromised. Regarding the patient with acute sinusitis, the graft was removed and implant/prosthesis placement was not possible. No further prosthesis failures occurred during the 1-year follow-up period. Thus, the prosthesis survival was 99%. The implant survival involving sinus lift, lateral augmentation, and

  19. Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study): study protocol for a randomised clinical trial

    PubMed Central

    Nakagawa, Atsuo; Sado, Mitsuhiro; Mitsuda, Dai; Fujisawa, Daisuke; Kikuchi, Toshiaki; Abe, Takayuki; Sato, Yuji; Iwashita, Satoru; Mimura, Masaru; Ono, Yutaka

    2014-01-01

    Introduction Major depression is a serious mental disorder that causes substantial distress and impairment in individuals and places an enormous burden on society. Although antidepressant treatment is the most common therapy provided in routine practice, there is little evidence to guide second-line therapy for patients who have failed to respond to antidepressants. The aim of this paper is to describe the study protocol for a randomised controlled trial that measures the clinical effectiveness of cognitive behavioural therapy (CBT) as an augmentation strategy to treat patients with non-psychotic major depression identified as suboptimal responders to usual depression care. Methods and analysis The current study is a 16-week assessor-blinded randomised, parallel-groups superiority trial with 12-month follow-up at an outpatient clinic as part of usual depression care. Patients aged 20–65 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Major Depressive Disorder who have experienced at least one failed trial of antidepressants as part of usual depression care, will be randomly assigned to receive CBT plus treatment as usual, or treatment as usual alone. The primary outcome is the change in clinician-rated 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD) score at 16 weeks, and secondary outcomes include severity and change in scores of subjective depression symptoms, proportion of responders and remitters, safety and quality of life. The primary population will be the intention-to-treat patients. Ethics and dissemination All protocols and the informed consent form comply with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethics review committees at the Keio University School of Medicine and the Sakuragaoka Memorial Hospital approved the study protocol. The results of the study will be disseminated at several research conferences and as published articles in peer

  20. Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials

    PubMed Central

    Okuyama, Yuji; Oya, Kazuto; Matsunaga, Shinji; Kishi, Taro; Iwata, Nakao

    2016-01-01

    This study aimed to perform a comprehensive meta-analysis of topiramate-augmentation therapy in patients with schizophrenia receiving antipsychotic agents. Data published up to June 20, 2016 were obtained from the PubMed, PsycINFO, and Cochrane Library databases. Twelve randomized controlled trials comparing topiramate to placebo or antipsychotic only were included (n=676 patients). The primary outcome was change in overall symptoms. Relative risk (RR) and standardized mean difference (SMD), along with 95% confidence intervals, were calculated using random effects model for each outcome. Topiramate-augmentation therapy was superior to the control for decreasing overall symptoms (SMD −0.55, 95% confidence interval −0.86 to −0.24; P=0.001; I2=55%, eight comparisons, n=380), positive symptoms (SMD −0.4), negative symptoms (SMD −0.47), and Positive and Negative Syndrome Scale general subscale scores (SMD −0.67). Furthermore, topiramate-augmentation therapy decreased weight (SMD −0.69) and body mass index (SMD −0.95) compared with the control. Topiramate was similar to the control with respect to discontinuation due to all causes (RR 1.19), inefficacy (RR 1.71), and adverse events (RR 1.09). Topiramate was associated with higher incidence of paresthesia (RR 2.67) and attention difficulty (RR 8.97) compared with the control. Our results seemed to suggest that topiramate-augmentation therapy improves the psychopathology of schizophrenia with good tolerability and has the additional advantage of weight maintenance. However, because there were some limitations (numbers of studies and patients included in the meta-analysis were small, some studies used completer analysis, Chinese studies were included in the meta-analysis, and studies that had a risk of bias were included in the meta-analysis) in this study, we cannot apply the results of this study in daily clinical practice. PMID:28008259

  1. Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial.

    PubMed

    Rosnick, Christopher B; Wetherell, Julie L; White, Kamila S; Andreescu, Carmen; Dixon, David; Lenze, Eric J

    2016-04-01

    Elevated cortisol in stress and aging, such as has been seen in late-life anxiety disorders, is postulated to accelerate cognitive and physiological decline in this large and increasing population. Selective serotonin-reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are both effective treatments for generalized anxiety disorder (GAD) in older adults. On the other hand, there is very little research examining the effect of combining these therapies on peak cortisol levels. For the current analyses, we examined the effectiveness of CBT augmentation on peak cortisol levels in older adults diagnosed with GAD. The sample consisted of 42 individuals with late-life GAD who received an acute course of the SSRI escitalopram and then entered a 16-week randomized phase. Twenty-one participants were randomized to receive 16 sessions of CBT in addition to continuing escitalopram and the remaining 21 participants continued on escitalopram without CBT. Generalized estimating equations were performed to assess the effectiveness of CBT augmentation on peak cortisol levels (30 min after waking). Older adults with GAD who received both escitalopram and CBT demonstrated a significant reduction in peak cortisol levels at posttreatment compared to the group who received escitalopram without CBT augmentation. CBT augmentation of SSRI treatment reduced peak cortisol levels for older adults with GAD. Since persistently high cortisol levels in aging are thought to increase age-related cognitive and medical problems, our findings suggest that there may be a benefit to health and cognition of CBT augmentation for late-life anxiety disorders. (c) 2016 APA, all rights reserved).

  2. Human alpha 1-antitrypsin therapy induces fatal anaphylaxis in non-obese diabetic mice

    PubMed Central

    Lu, Y; Parker, M; Pileggi, A; Zhang, B; Choi, Y-K; Molano, R D; Wasserfall, C; Ricordi, C; Inverardi, L; Brantly, M; Schatz, D; Atkinson, M; Song, S

    2008-01-01

    Previous studies have shown that human alpha-1 antitrypsin (hAAT) gene delivery prevents type 1 diabetes (T1D) in non-obese diabetic (NOD) mice. Furthermore, hAAT protein administration prolongs acceptance of islet allografts. Therefore, we evaluated the use of purified hAAT protein therapy to prevent T1D in NOD mice. Female NOD, non-obese resistant (NOR), Balb/c and C57BL/6 mice were injected intraperitoneally with vehicle alone or vehicle containing hAAT, human albumin or mouse albumin (or mg/injection/mouse; 2×/week). Preparations of clinical-grade hAAT included API®, Aralast®, Prolastin® and Zemaira®. Surprisingly, hAAT administration was associated with a high rate of fatal anaphylaxis. In studies seeking T1D prevention at 4 weeks of age, 100% mice died after six injections of hAAT. When administrated at 8–10 weeks of age, most (80–100%) NOD mice died following the fourth injection of hAAT, while 0% of Balb/c and C57BL/6 mice and 10% of NOR mice died. Interestingly, repeated injections of human albumin, but not mouse albumin, also induced sudden death in NOD mice. Antibodies to hAAT were induced 2–3 weeks after hAAT administration and death was prevented by treatment with anti-platelet-activating factor along with anti-histamine. In studies of disease reversal in NOD mice, using the four pharmaceutical grade formulations of hAAT, anaphylactic deaths were observed with all hAAT preparations. The propensity for fatal anaphylaxis following antigenic administration appears to be NOD- but not hAAT-specific. The susceptibility of NOD mice to hypersensitivity provides a significant limitation for testing of hAAT. Development of strategies to avoid this unwanted response is required to use this promising therapeutic agent for T1D. PMID:18759852

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

    PubMed

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

    2014-08-01

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

  4. Augmented Berlin-Frankfurt-Münster Therapy in Adolescents and Young Adults (AYA) with Acute Lymphoblastic Leukemia (ALL)

    PubMed Central

    Rytting, Michael E; Thomas, Deborah A; O'Brien, Susan M; Ravandi-Kashani, Farhad; Jabbour, Elias J; Franklin, Anna R; Kadia, Tapan M; Pemmaraju, Naveen; Daver, Naval G.; Ferrajoli, Alessandra; Garcia-Manero, Guillermo; Konopleva, Marina Y; Cortes, Jorge E; Borthakur, Gautham; Garris, Rebecca; Cardenas-Turanzas, Maria; Schroeder, Kurt; Jorgensen, Jeffrey L; Kornblau, Steven M; Kantarjian, Hagop M.

    2014-01-01

    Background Various trials report improved outcomes for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric- based regimens. This prompted the investigation of the pediatric Augmented Berlin-Frankfurt-Münster (ABFM) regimen in AYA patients. Results were compared with the hyper–fractionated cyclophosphamide, vincristine, Adriamycin and dexamethasone (hyper-CVAD) regimen in a similar population. Methods Eighty-five patients age 12 to 40 years with Philadelphia chromosome- (Ph) negative ALL were treated with ABFM from 10/2006 through 4/2012. Their outcome was compared to 71 historical AYA patients treated with hyper-CVAD from our institution. Patient and disease characteristics, as well as status of minimal residual disease (MRD), were analyzed for their impact on outcomes. Results The complete remission (CR) rate with ABFM was 94%. The 3-year complete remission duration (CRD) and overall survival (OS) rates were 70% and 74%, respectively. The 3-year CRD and OS were 72% and 85%, respectively, with age ≤ 21 years, and 69% and 60%, respectively, with age 21-40 years. Initial white blood cell count was an independent predictive factor of OS and CRD. The MRD status on Day 29 and Day 84 of therapy were also predictive of long-term outcomes. Severe regimen toxicities included transient hepatotoxicity in 35-39%, pancreatitis in 11%, osteonecrosis in 11%, and thrombosis in 22%. The 3-year OS rate was 74% with ABFM versus 71% with hyper-CVAD; the 3-year CRD rate was 70% with ABFM versus 66% with hyper-CVAD. Conclusion ABFM was tolerable in AYA patients with ALL but was not associated with significant improvements in CRD and OS compared with hyper-CVAD. PMID:25042398

  5. Expanding the Clinical Indications for α1-Antitrypsin Therapy

    PubMed Central

    Lewis, Eli C

    2012-01-01

    α1-Antitrypsin (AAT) is a 52-kDa circulating serine protease inhibitor. Production of AAT by the liver maintains 0.9–1.75 mg/mL circulating levels. During acute-phase responses, circulating AAT levels increase more than fourfold. In individuals with one of several inherited mutations in AAT, low circulating levels increase the risk for lung, liver and pancreatic destructive diseases, particularly emphysema. These individuals are treated with lifelong weekly infusions of human plasma–derived AAT. An increasing amount of evidence appears to suggest that AAT possesses not only the ability to inhibit serine proteases, such as elastase and proteinase-3 (PR-3), but also to exert antiinflammatory and tissue-protective effects independent of protease inhibition. AAT modifies dendritic cell maturation and promotes T regulatory cell differentiation, induces interleukin (IL)-1 receptor antagonist and IL-10 release, protects various cell types from cell death, inhibits caspases-1 and -3 activity and inhibits IL-1 production and activity. Importantly, unlike classic immunosuppressants, AAT allows undeterred isolated T-lymphocyte responses. On the basis of preclinical and clinical studies, AAT therapy for nondeficient individuals may interfere with disease progression in type 1 and type 2 diabetes, acute myocardial infarction, rheumatoid arthritis, inflammatory bowel disease, cystic fibrosis, transplant rejection, graft versus host disease and multiple sclerosis. AAT also appears to be antibacterial and an inhibitor of viral infections, such as influenza and human immunodeficiency virus (HIV), and is currently evaluated in clinical trials for type 1 diabetes, cystic fibrosis and graft versus host disease. Thus, AAT therapy appears to have advanced from replacement therapy, to a safe and potential treatment for a broad spectrum of inflammatory and immune-mediated diseases. PMID:22634722

  6. Effect of recombinant α1-antitrypsin Fc-fused (AAT-Fc)protein on the inhibition of inflammatory cytokine production and streptozotocin-induced diabetes.

    PubMed

    Lee, Siyoung; Lee, Youngmin; Hong, Kwangwon; Hong, Jaewoo; Bae, Suyoung; Choi, Jida; Jhun, Hyunjhung; Kwak, Areum; Kim, Eunsom; Jo, Seunghyun; Dinarello, Charles A; Kim, Soohyun

    2013-05-20

    α1-Antitrypsin (AAT) is a member of the serine proteinase inhibitor family that impedes the enzymatic activity of serine proteinases, including human neutrophil elastase, cathepsin G and neutrophil proteinase 3. Here, we expressed recombinant AAT by fusing the intact AAT gene to the constant region of IgG1 to generate soluble recombinant AAT-Fc protein. The recombinant AAT-Fc protein was produced in Chinese hamster ovary (CHO) cells and purified using mini-protein A affinity chromatography. Recombinant AAT-Fc protein was tested for antiinflammatory function and AAT-Fc sufficiently suppressed tumor necrosis factor (TNF)-α-induced interleukin (IL)-6 in human peripheral blood mononuclear cells (PBMCs) and inhibited cytokine-induced TNFα by different cytokines in mouse macrophage Raw 264.7 cells. However, AAT-Fc failed to suppress lipopolysaccharide-induced cytokine production in both PBMCs and macrophages. In addition, our data showed that AAT-Fc blocks the development of hyperglycemia in a streptozotocin-induced mouse model of diabetes. Interestingly, we also found that plasma-derived AAT specifically inhibited the enzymatic activity of elastase but that AAT-Fc had no inhibitory effect on elastase activity.

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

    ERIC Educational Resources Information Center

    Jenkins, Christie D.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Jenkins, Christie D.

    2009-01-01

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

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

    PubMed

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

    2015-12-01

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

  10. Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial.

    PubMed

    Simpson, Helen Blair; Foa, Edna B; Liebowitz, Michael R; Huppert, Jonathan D; Cahill, Shawn; Maher, Michael J; McLean, Carmen P; Bender, James; Marcus, Sue M; Williams, Monnica T; Weaver, Jamie; Vermes, Donna; Van Meter, Page E; Rodriguez, Carolyn I; Powers, Mark; Pinto, Anthony; Imms, Patricia; Hahn, Chang-Gyu; Campeas, Raphael

    2013-11-01

    Obsessive-compulsive disorder (OCD) is one of the world's most disabling illnesses according to the World Health Organization. Serotonin reuptake inhibitors (SRIs) are the only medications approved by the Food and Drug Administration to treat OCD, but few patients achieve minimal symptoms from an SRI alone. In such cases, practice guidelines recommend adding antipsychotics or cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP). To compare the effects of these 2 SRI augmentation strategies vs pill placebo for the first time, to our knowledge, in adults with OCD. A randomized clinical trial (conducted January 2007-August 2012) at 2 academic outpatient research clinics that specialize in OCD and anxiety disorders. Patients (aged 18-70 years) were eligible if they had OCD of at least moderate severity despite a therapeutic SRI dose for at least 12 weeks prior to entry. Of 163 who were eligible, 100 were randomized (risperidone, n = 40; EX/RP, n = 40; and placebo, n = 20), and 86 completed the trial. While continuing their SRI at the same dose, patients were randomized to the addition of 8 weeks of risperidone (up to 4 mg/d), EX/RP (17 sessions delivered twice weekly), or pill placebo. Independent assessments were conducted every 4 weeks. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to measure OCD severity. Patients randomized to EX/RP had significantly greater reduction in week 8 Y-BOCS scores based on mixed-effects models (vs risperidone: mean [SE], -9.72 [1.38]; P < .001 vs placebo: mean [SE], -10.10 [1.68]; P < .001). Patients receiving risperidone did not significantly differ from those receiving placebo (mean [SE], -0.38 [1.72]; P = .83). More patients receiving EX/RP responded (Y-BOCS score decrease ≥25%: 80% for EX/RP, 23% for risperidone, and 15% for placebo; P < .001). More patients receiving EX/RP achieved minimal symptoms (Y-BOCS score ≤12: 43% for EX/RP, 13% for risperidone, and 5% for

  11. Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges.

    PubMed

    Tsapkini, Kyrana; Frangakis, Constantine; Gomez, Yessenia; Davis, Cameron; Hillis, Argye E

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and family life call for the investigation of treatment alternatives. In this article, we present new data indicating that neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows some promise for maintaining or even improving language, at least temporarily, in PPA. The main aim of the present article is to determine whether tDCS plus spelling intervention is more effective than spelling intervention alone in treating written language in PPA. We also asked whether the effects of tDCS are sustained longer than the effects of spelling intervention alone. We present data from six PPA participants who underwent anodal tDCS or sham plus spelling intervention in a within-subject crossover design. Each stimulation condition lasted 3 weeks or a total of 15 sessions with a 2-month interval in between. Participants were evaluated on treatment tasks as well as on other language and cognitive tasks at 2-week and 2-month follow-up intervals after each stimulation condition. All participants showed improvement in spelling (with sham or tDCS). There was no difference in the treated items between the two conditions. There was, however, consistent and significant improvement for untrained items only in the tDCS plus spelling intervention condition. Furthermore, the improvement lasted longer in the tDCS plus spelling intervention condition compared to sham plus spelling intervention condition. Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function at least temporarily in PPA. The consistent finding of generalisation of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. However

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

    PubMed

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

    2011-08-23

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

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

    PubMed

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

    2017-03-01

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

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed Central

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  18. Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial: high-dose versus standard-dose hemofiltration in acute renal failure.

    PubMed

    Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Goldsmith, Donna; Myburgh, John; Norton, Robyn; Scheinkestel, Carlos

    2008-01-01

    The optimal dose of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. The Randomized Evaluation of Normal versus Augmented Level Replacement Therapy Trial tests the hypothesis that higher dose continuous veno-venous hemodiafiltration (CVVHDF) at an effluent rate of 40 ml/kg/h will increase survival compared to CVVHDF at 25 ml/kg/h of effluent dose. This trial is currently randomizing critically ill patients in 35 intensive care units in Australia and New Zealand with a planned sample size of 1,500 patients. This trial will be the largest trial ever conducted on acute blood purification in critically ill patients. A trial of this magnitude and with demanding technical requirements poses design difficulties and challenges in the logistics, conduct, data collection, data analysis and monitoring. Our report will assist in the development of future trials of blood purification in intensive care.

  19. Discovery of AAT-008, a novel, potent, and selective prostaglandin EP4 receptor antagonist.

    PubMed

    Okumura, Yoshiyuki; Yamagishi, Tatsuya; Nukui, Seiji; Nakao, Kazunari

    2017-03-01

    Starting from acylsufonamide HTS hit 2, a novel series of para-N-acylaminomethylbenzoic acids was identified and developed as selective prostaglandin EP4 receptor antagonists. Structural modifications on lead compound 4a were explored with the aim of improving potency, physicochemical properties, and animal PK predictive of QD (once a day) dosing regimen in human. These efforts led to the discovery of the clinical candidate AAT-008 (4j), which exhibited significantly improved pharmacological profiles over grapiprant (1). Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Alpha1-antitrypsin gene therapy modulates cellular immunity and efficiently prevents type 1 diabetes in nonobese diabetic mice.

    PubMed

    Lu, Yuanqing; Tang, Mei; Wasserfall, Clive; Kou, Zhongchen; Campbell-Thompson, Martha; Gardemann, Thomas; Crawford, James; Atkinson, Mark; Song, Sihong

    2006-06-01

    An imbalance of the immune-regulatory pathways plays an important role in the development of type 1 diabetes. Therefore, immunoregulatory and antiinflammatory strategies hold great potential for the prevention of this autoimmune disease. Studies have demonstrated that two serine proteinase inhibitors, alpha1-antitrypsin (AAT) and elafin, act as potent antiinflammatory agents. In the present study, we sought to develop an efficient gene therapy approach to prevent type 1 diabetes. Cohorts of 4-week-old female nonobese diabetic (NOD) mice were injected intramuscularly with rAAV1-CB-hAAT, rAAV1-CB-hElafin, or saline. AAV1 vector mediated sustained high levels of transgene expression, sufficient to overcome a humoral immune response against hAAT. AAT gene therapy, contrary to elafin and saline, was remarkably effective in preventing type 1 diabetes. T cell receptor spectratyping indicated that AAT gene therapy altered T cell repertoire diversity in splenocytes from NOD mice. Adoptive transfer experiments demonstrated that AAT gene therapy attenuated cellular immunity associated with beta cell destruction. This study demonstrates that AAT gene therapy attenuates cell-mediated autoimmunity, alters the T cell receptor repertoire, and efficiently prevents type 1 diabetes in the NOD mouse model. These results strongly suggest that rAAV1-mediated AAT gene therapy may be useful as a novel approach to prevent type 1 diabetes.

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

    ERIC Educational Resources Information Center

    Smith, Kelly A.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Smith, Kelly A.

    2010-01-01

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

  3. Cross linguistic aphasia testing: the Portuguese version of the Aachen Aphasia Test (AAT).

    PubMed

    Lauterbach, Martin; Martins, Isabel Pavão; Garcia, Paula; Cabeça, Joana; Ferreira, Ana Cristina; Willmes, Klaus

    2008-11-01

    We report the adaptation of the Aachen Aphasia Test (AAT) to the Portuguese language (PAAT) and the results of its standardization in 125 persons with aphasia and 153 healthy controls. Patients with aphasia had a previous syndromic diagnosis, obtained through a Portuguese aphasia battery, which served as a reference. The control group was stratified by age and educational level. Hierarchical cluster analyses showed good construct validity. The increasing degree of difficulty and complexity throughout the item sets comprising subtests was confirmed. The discriminatory power of the PAAT for the selection of aphasic from non-aphasic persons proved to be as high as for the AAT versions in other languages. Classification of standard aphasic syndromes by means of discriminant analyses was good. Internal consistency, measured by means of Cronbach's alpha coefficient, was high to very high for the different PAAT subtests. Performance differences caused by age or educational level among the healthy control persons emphasized the need for correction factors. In conclusion, the PAAT showed robust psychometric properties, comparable to the original German and to adaptations to other languages. It constitutes a useful tool for cross-linguistic and multicenter studies.

  4. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement, Part III: Pulmonic valve.

    PubMed

    Hijazi, Ziyad M; Ruiz, Carlos E; Zahn, Evan; Ringel, Richard; Aldea, Gabriel S; Bacha, Emile A; Bavaria, Joseph; Bolman, R Morton; Cameron, Duke E; Dean, Larry S; Feldman, Ted; Fullerton, David; Horlick, Eric; Mack, Michael J; Miller, D Craig; Moon, Marc R; Mukherjee, Debabrata; Trento, Alfredo; Tommaso, Carl L

    2015-07-01

    With the evolution of transcatheter valve replacement, an important opportunity has arisen for cardiologists and surgeons to collaborate in identifying the criteria for performing these procedures. Therefore, The Society for Cardiovascular Angiography and Interventions (SCAI), American Association for Thoracic Surgery (AATS), American College of Cardiology (ACC), and The Society of Thoracic Surgeons (STS) have partnered to provide recommendations for institutions to assess their potential for instituting and/or maintaining a transcatheter valve program. This article concerns transcatheter pulmonic valve replacement (tPVR). tPVR procedures are in their infancy with few reports available on which to base an expert consensus statement. Therefore, many of these recommendations are based on expert consensus and the few reports available. As the procedures evolve, technology advances, experience grows, and more data accumulate, there will certainly be a need to update this consensus statement. The writing committee and participating societies believe that the recommendations in this report serve as appropriate requisites. In some ways, these recommendations apply to institutions more than to individuals. There is a strong consensus that these new valve therapies are best performed using a Heart Team approach; thus, these credentialing criteria should be applied at the institutional level. Partnering societies used the ACC's policy on relationships with industry (RWI) and other entities to author this document (http://www.acc.org/guidelines/about-guidelines-and-clinical-documents). To avoid actual, potential, or perceived conflicts of interest due to industry relationships or personal interests, all members of the writing committee, as well as peer reviewers of the document, were asked to disclose all current healthcare-related relationships including those existing 12 months before the initiation of the writing effort. A committee of interventional cardiologists and

  5. Augmentation of clozapine with electroconvulsive therapy in treatment resistant schizophrenia: A systematic review and meta-analysis.

    PubMed

    Lally, John; Tully, John; Robertson, Dene; Stubbs, Brendon; Gaughran, Fiona; MacCabe, James H

    2016-03-01

    The primary aim of this systematic review and meta-analysis was to assess the proportion of patients with Treatment Resistant Schizophrenia (TRS) that respond to ECT augmentation of clozapine (C+ECT). We searched major electronic databases from 1980 to July 2015. We conducted a random effects meta-analysis reporting the proportion of responders to C+ECT in RCTs and open-label trials. Five clinical trials met our eligibility criteria, allowing us to pool data from 71 people with TRS who underwent C+ ECT across 4 open label trials (n=32) and 1 RCT (n=39). The overall pooled proportion of response to C+ECT was 54%, (95% CI: 21.8-83.6%) with some heterogeneity evident (I(2)=69%). With data from retrospective chart reviews, case series and case reports, 192 people treated with C+ECT were included. All studies together demonstrated an overall response to C+ECT of 66% (95% CI: 57.5-74.3%) (83 out of 126 patients responded to C+ECT). The mean number of ECT treatments used to augment clozapine was 11.3. 32% of cases (20 out of 62 patients) with follow up data (range of follow up: 3-468weeks) relapsed following cessation of ECT. Adverse events were reported in 14% of identified cases (24 out of 166 patients). There is a paucity of controlled studies in the literature, with only one single blinded randomised controlled study located, and the predominance of open label trials used in the meta-analysis is a limitation. The data suggests that ECT may be an effective and safe clozapine augmentation strategy in TRS. A higher number of ECT treatments may be required than is standard for other clinical indications. Further research is needed before ECT can be included in standard TRS treatment algorithms.

  6. Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report

    PubMed Central

    McKey, Katelyn P; Alappattu, Meryl J

    2016-01-01

    Background and purpose Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one’s own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient’s main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. Case Description A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. Outcomes At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. Discussion The patient’s smallest upper

  7. Augmentation of a Novel Enzyme/Pro-Drug Gene Therapy "Distant Bystander Effect" to Target Prostate Cancer Metastasis

    DTIC Science & Technology

    2005-09-01

    enzyme/prodrug therapy(GDEPT)_ mIL-12; mIL-18; cytosine deaminase and uracil phopho-ribosyl transferase (CDUPRT) 16. SECURITY CLASSIFICATION OF: 17...therapy, a gene (a fusion of cytosine deaminase and uracil phosphoribosyltransferase (CD/UPRT)) is delivered to a cancer cell so that harmless bacterial...reduction both at the treatment site and at remote locations. In this therapy, a gene (a fusion of cytosine deaminase and uracil phosphoribosyltransferase

  8. Human Augmentics: augmenting human evolution.

    PubMed

    Kenyon, Robert V; Leigh, Jason

    2011-01-01

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

  9. The Thai version of the German Aachen Aphasia Test (AAT): description of the test and performance in normal subjects.

    PubMed

    Pracharitpukdee, N; Phanthumchinda, K; Huber, W; Willmes, K

    1998-06-01

    The Aachen Aphasia Test (AAT), originally developed as a test for aphasia language disorders in Germany, consists of six spontaneous speech rating scales and five subtests: Token Test, Repetition, Written Language, Confronting Naming and Comprehension. The study aimed to describe the linguistic properties of the AAT Thai version and to investigate the test performances of the normal subjects. In this study some problems of linguistic changes in the construction of the Thai version were discussed. The results revealed that the normal subjects' performances on the test were independent of age, sex and education level. Therefore, the Thai version of AAT is applicable to the differential diagnosis of the communicative abilities of Thai aphasic patients.

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

    PubMed

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

    2014-10-30

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

  11. Cognitive-behavioural therapy with post-session D-cycloserine augmentation for paediatric obsessive-compulsive disorder: pilot randomised controlled trial.

    PubMed

    Mataix-Cols, David; Turner, Cynthia; Monzani, Benedetta; Isomura, Kayoko; Murphy, Caroline; Krebs, Georgina; Heyman, Isobel

    2014-01-01

    A partial N-methyl-D-aspartate agonist, D-cycloserine, enhances fear extinction when given before or shortly after exposure to feared stimuli in animals. In this pilot double-blind placebo-controlled trial (trial number: ISRCTN70977225), 27 youth with obsessive-compulsive disorder were randomised to either 50 mg D-cycloserine or placebo administered immediately after each of ten cognitive-behavioural therapy (CBT) sessions, primarily consisting of exposure and ritual prevention. Both groups improved significantly and maintained their gains at 1-year follow-up, with no significant advantage of D-cycloserine over placebo at any time point. The effects of CBT may not be augmented or accelerated when D-cycloserine is administered after sessions.

  12. SPARTA clinical trial design: exploring the efficacy and safety of two dose regimens of alpha1-proteinase inhibitor augmentation therapy in alpha1-antitrypsin deficiency.

    PubMed

    Sorrells, Susan; Camprubi, Sandra; Griffin, Rhonda; Chen, Junliang; Ayguasanosa, Jaume

    2015-04-01

    Alpha1-antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder that results in early-onset emphysema due to low serum levels of alpha1-proteinase inhibitor (alpha1-PI), leading to increased activity of tissue-damaging neutrophil elastase. Clinical outcomes of AATD may be improved by administering alpha1-PI augmentation therapy. Here, we describe the design of the ongoing Study of ProlAstin-c Randomized Therapy with Alpha-1 augmentation (SPARTA), a phase 3 trial designed to evaluate progression of lung tissue loss in patients with severe AATD receiving human alpha1-PI (Prolastin(®)-C) versus placebo, using whole-lung computed tomography (CT) densitometry. SPARTA is a randomized, placebo-controlled trial assessing the efficacy and safety of two separate doses of Prolastin-C (60 and 120 mg/kg) administered weekly over 3 years in patients aged 18-70 years with a diagnosis of AATD and clinical evidence of pulmonary emphysema. The primary measure of efficacy (change from baseline whole-lung 15th percentile lung density [PD15]) will be determined by CT lung densitometry measured at total lung capacity. Secondary efficacy variables will be the evaluation of severe chronic obstructive pulmonary disease exacerbations, as defined by American Thoracic Society/European Respiratory Society criteria, and PD15 of the basal lung region using CT densitometry. Adverse events will be collected and documented. The SPARTA trial is designed to evaluate the long-term (3-year) efficacy of 2 separate doses of Prolastin-C for the treatment of emphysema in patients with AATD. Protocol number: GTi1201. NCT01983241. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression: a randomized, double-blind controlled study.

    PubMed

    Straasø, Birgit; Lauritzen, Lise; Lunde, Marianne; Vinberg, Maj; Lindberg, Lone; Larsen, Erik Roj; Dissing, Steen; Bech, Per

    2014-10-01

    To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields (T-PEMF) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after 8 weeks of augmentation therapy. A self-treatment set-up of the T-PEMF device was used allowing self-administration by patients in own homes. All patients were treated for 30 min per T-PEMF session. The antidepressant medication the patients were receiving at baseline remained unchanged during the trial. The patients were randomised to either one T-PEMF dose (active dose in the morning and sham in the afternoon) or two T-PEMF doses (active dose both morning and afternoon) in a double-blind procedure. A score of 7 or less on the Hamilton Depression Scale (HAM-D17) was the criterion of remission. In total 34 patients received active T-PEMF once a day and 31 patients twice daily. After 5 weeks of therapy remission was obtained in 26.5% and 32.3% on one dose and two doses of T-PEMF, respectively. After 8 weeks the rate of remission was 73.5% and 67.7%, respectively. The side effects as measured by the Udvalget for Kliniske Undersøgelser scale showed a better toleration of the antidepresssive medication in both treatment groups, which was reflected by the WHO-5 well-being scale with increased scores in both groups of patients. The high remission rate obtained by the T-PEMF augmentation was not a dose effect (one versus two daily T-PEMF sessions) but was explained by the extension of the treatment period from 5 to 8 weeks.

  14. Effectiveness of methylphenidate as augmentation therapy after failure of adjunctive neuromodulation for patients with treatment-refractory bipolar depression: a case report.

    PubMed

    Adida, Marc; Azorin, Jean-Michel

    2014-01-01

    Adjunctive use of methylphenidate, a central stimulant, has been considered as a potential therapeutic choice for patients with refractory unipolar, geriatric, or bipolar depression, and depression secondary to medical illness. We present a case of bipolar depression in which the patient responded significantly to augmentation with methylphenidate, without any side effects, after failure of adjunctive repetitive transcranial magnetic stimulation and electroconvulsive therapy. Mr U, a 56-year-old man with bipolar I disorder, had melancholic symptoms during his sixth episode of bipolar depression. After failure of repetitive transcranial magnetic stimulation and electroconvulsive therapy, he was treated with fluoxetine 80 mg/day, duloxetine 360 mg/day, mirtazapine 60 mg/day, and sodium valproate 1,000 mg/day, with no improvement. We added methylphenidate at a dose of 10 mg/day for one week, which resulted in mild clinical improvement, and then methylphenidate extended-release 20 mg/day for one week, with significant clinical improvement. He tolerated his medications well. His clinical recovery was stable over one year. The patient's antidepressants and methylphenidate were gradually tapered and finally discontinued after one year with no withdrawal syndrome. To date, he remains well on sodium valproate as monotherapy and is being followed up at our bipolar department. This case suggests that methylphenidate augmentation might be a therapeutic option when treating highly treatment-resistant patients with bipolar depression, even if they had not responded to adjunctive neuromodulation. In these clinical situations, physicians might be interested in prescribing methylphenidate because of its efficacy and safety.

  15. Effectiveness of methylphenidate as augmentation therapy after failure of adjunctive neuromodulation for patients with treatment-refractory bipolar depression: a case report

    PubMed Central

    Adida, Marc; Azorin, Jean-Michel

    2014-01-01

    Adjunctive use of methylphenidate, a central stimulant, has been considered as a potential therapeutic choice for patients with refractory unipolar, geriatric, or bipolar depression, and depression secondary to medical illness. We present a case of bipolar depression in which the patient responded significantly to augmentation with methylphenidate, without any side effects, after failure of adjunctive repetitive transcranial magnetic stimulation and electroconvulsive therapy. Mr U, a 56-year-old man with bipolar I disorder, had melancholic symptoms during his sixth episode of bipolar depression. After failure of repetitive transcranial magnetic stimulation and electroconvulsive therapy, he was treated with fluoxetine 80 mg/day, duloxetine 360 mg/day, mirtazapine 60 mg/day, and sodium valproate 1,000 mg/day, with no improvement. We added methylphenidate at a dose of 10 mg/day for one week, which resulted in mild clinical improvement, and then methylphenidate extended-release 20 mg/day for one week, with significant clinical improvement. He tolerated his medications well. His clinical recovery was stable over one year. The patient’s antidepressants and methylphenidate were gradually tapered and finally discontinued after one year with no withdrawal syndrome. To date, he remains well on sodium valproate as monotherapy and is being followed up at our bipolar department. This case suggests that methylphenidate augmentation might be a therapeutic option when treating highly treatment-resistant patients with bipolar depression, even if they had not responded to adjunctive neuromodulation. In these clinical situations, physicians might be interested in prescribing methylphenidate because of its efficacy and safety. PMID:24729710

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

    ERIC Educational Resources Information Center

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

    2017-01-01

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

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

    ERIC Educational Resources Information Center

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

    2017-01-01

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

  18. Inhibition of Src and forkhead box O1 signaling by induced pluripotent stem-cell therapy attenuates hyperoxia-augmented ventilator-induced diaphragm dysfunction.

    PubMed

    Li, Li-Fu; Chang, Yuh-Lih; Chen, Ning-Hung; Wang, Chien-Ying; Chang, Gwo-Jyh; Lin, Meng-Chih; Chang, Chih-Hao; Huang, Chung-Chi; Chuang, Jen-Hua; Yang, Yi-Pin; Chiou, Shih-Hwa; Liu, Yung-Yang

    2016-07-01

    Mechanical ventilation (MV) with hyperoxia is required for providing life support to patients with acute lung injury (ALI). However, MV may cause diaphragm weakness through muscle injury and atrophy, an effect termed ventilator-induced diaphragm dysfunction (VIDD). Src protein tyrosine kinase and class O of forkhead box 1 (FoxO1) mediate acute inflammatory responses and muscle protein degradation induced by oxidative stress. Induced pluripotent stem cells (iPSCs) have been reported to improve hyperoxia-augmented ALI; however, the mechanisms regulating the interactions among VIDD, hyperoxia, and iPSCs are unclear. In this study, we hypothesized that iPSC therapy can ameliorate hyperoxia-augmented VIDD by suppressing the Src-FoxO1 pathway. Male C57BL/6 mice, either wild-type or Src-deficient, aged between 6 and 8 weeks were exposed to MV (6 or 10 mL/kg) with or without hyperoxia for 2-8 h after the administration of 5 × 10(7) cells/kg Oct4/Sox2/Parp1 mouse iPSCs or iPSC-derived conditioned medium (iPSC-CM). Nonventilated mice were used as controls. MV during hyperoxia aggravated VIDD, as demonstrated by the increases in Src activation, FoxO1 dephosphorylation, malondialdehyde, caspase-3, atrogin-1 and muscle ring finger-1 production, microtubule-associated protein light chain 3-II, disorganized myofibrils, disrupted mitochondria, autophagy, and myonuclear apoptosis; however, MV with hyperoxia reduced mitochondrial cytochrome C, diaphragm muscle fiber size, and contractility (P < 0.05). Hyperoxia-exacerbated VIDD was attenuated in Src-deficient mice and by iPSCs and iPSC-CM (P < 0.05). Our data indicate that iPSC therapy attenuates MV-induced diaphragmatic injury that occurs during hyperoxia-augmented VIDD by inhibiting the Src-FoxO1 signaling pathway. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. How Can Alpha-1 Antitrypsin Deficiency Be Prevented?

    MedlinePlus

    ... in which you receive infusions of AAT protein. Augmentation therapy raises the level of AAT protein in your blood and lungs. (For more information, go to ... National Institutes of Health Department of Health and Human Services USA.gov

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

    PubMed

    Yap, Esther; Scheinberg, Adam; Williams, Katrina

    2017-02-01

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

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

    PubMed

    Schaffer, Caroline Brunsman

    2008-01-01

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

  2. Oncostatin M induced alpha1-antitrypsin (AAT) gene expression in Hep G2 cells is mediated by a 3' enhancer.

    PubMed

    Morgan, Kevin; Marsters, Peter; Morley, Stephen; van Gent, Diana; Hejazi, Ala; Backx, Matt; Thorpe, Emma R K; Kalsheker, Noor

    2002-07-15

    alpha(1)-Antitrypsin (AAT) is the major serine proteinase inhibitor (SERPIN A1) in human plasma. Its target proteinase is neutrophil elastase and its main physiological function is protection of the lower respiratory tract from the destructive effects of neutrophil elastase during an inflammatory response. Circulating levels of AAT rise 2-3-fold during inflammation and the liver produces most of this increase. The cytokines oncostatin M (OSM) and interleukin-6 have been shown to be mainly responsible for this effect, which is mediated via the interaction of cytokine-inducible transcription factors with regulatory elements within the gene. In the present study, we report for the first time that OSM stimulation of hepatocyte AAT occurs via an interaction between the hepatocyte promoter and an OSM-responsive element at the 3'-end of the AAT gene. This effect is mediated by the transcription factor signal transducer and activator of transcription 3 ('STAT 3') binding to an OSM-responsive element (sequence TTCTCTTAA), and this site is distinct from, but close to, a previously reported interleukin-6-responsive element.

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

    PubMed

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

    2013-08-01

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

  4. Gene therapy augments the efficacy of hematopoietic cell transplantation and fully corrects mucopolysaccharidosis type I phenotype in the mouse model

    PubMed Central

    Visigalli, Ilaria; Delai, Stefania; Politi, Letterio S.; Di Domenico, Carmela; Cerri, Federica; Mrak, Emanuela; D'Isa, Raffaele; Ungaro, Daniela; Stok, Merel; Sanvito, Francesca; Mariani, Elisabetta; Staszewsky, Lidia; Godi, Claudia; Russo, Ilaria; Cecere, Francesca; del Carro, Ubaldo; Rubinacci, Alessandro; Brambilla, Riccardo; Quattrini, Angelo; Di Natale, Paola; Ponder, Katherine; Naldini, Luigi

    2010-01-01

    Type I mucopolysaccharidosis (MPS I) is a lysosomal storage disorder caused by the deficiency of α-L-iduronidase, which results in glycosaminoglycan accumulation in tissues. Clinical manifestations include skeletal dysplasia, joint stiffness, visual and auditory defects, cardiac insufficiency, hepatosplenomegaly, and mental retardation (the last being present exclusively in the severe Hurler variant). The available treatments, enzyme-replacement therapy and hematopoietic stem cell (HSC) transplantation, can ameliorate most disease manifestations, but their outcome on skeletal and brain disease could be further improved. We demonstrate here that HSC gene therapy, based on lentiviral vectors, completely corrects disease manifestations in the mouse model. Of note, the therapeutic benefit provided by gene therapy on critical MPS I manifestations, such as neurologic and skeletal disease, greatly exceeds that exerted by HSC transplantation, the standard of care treatment for Hurler patients. Interestingly, therapeutic efficacy of HSC gene therapy is strictly dependent on the achievement of supranormal enzyme activity in the hematopoietic system of transplanted mice, which allows enzyme delivery to the brain and skeleton for disease correction. Overall, our data provide evidence of an efficacious treatment for MPS I Hurler patients, warranting future development toward clinical testing. PMID:20847202

  5. [Can the efficacy of behavioral and cognitive therapy for obsessive compulsive disorder be augmented by innovative computerized adjuvant?

    PubMed

    Morgiève, M; N'Diaye, K; Clair, A-H; Pelissolo, A; Mallet, L

    2016-10-01

    Cognitive behavioral therapy (CBT) is recognized as an effective treatment for obsessive-compulsive disorder (OCD). To maximize its effectiveness, we designed an "experimental" CBT defined by the addition of a computerized psychoeducative tool. In a participative process involving patients through meetings of the French OCD association (AFTOC) and therapists through methodological workshops, we built a therapeutic tool from an experimental checking task. This task, which had been published in an earlier work, was adapted for its psychoeducative dimension. We here report on a randomized double-blind trial which included 35 patients with a moderate to severe OCD (Yale-Brown obsessive-compulsive scale, YBOCS between 16 and 25) predominant checking symptoms, no comorbidities, and 2-month stabilized or no treatment. Patients were randomly assigned to either "standard" versus "experimental" CBT. Both therapies were conducted by four CBT-experienced therapists specialized in OCD through weekly individualized sessions over 3 months. Therapy sessions of the experimental CBT were conducted as the standard CBT except for a short exercise with the computerized psychoeducative tool performed by the patient and debriefed with the therapist at the end of the sessions. Patients were assessed before, during, after therapy and again 6 months later using standard clinical tools and a neurobehavioral assessment based on an original symptom-provocation task with anxiety ratings including three types of photographs: neutral, generic inducing obsessions (e.g., doorknobs, electric wires…) and personalized (taken by the patients in their own environment). Clinically, "standard" and "experimental" CBT resulted in a significant but equivalent improvement (48% vs 45% reduction of the Y-BOCS score; P=0.36; d=0.12). Therapists were satisfied with the psychoeducative dimension of the computerized psychoeducative tool but reported variable acceptance across patients. Patients appreciated its

  6. The transcriptional response of apple alcohol acyltransferase (MdAAT2) to salicylic acid and ethylene is mediated through two apple MYB TFs in transgenic tobacco.

    PubMed

    Li, Peng-Cheng; Yu, Shao-Wei; Shen, Jin; Li, Qing-Qing; Li, Da-Peng; Li, De-Quan; Zheng, Cheng-Chao; Shu, Huai-Rui

    2014-08-01

    Volatile esters are major factors affecting the aroma of apple fruits, and alcohol acyltransferases (AATs) are key enzymes involved in the last steps of ester biosynthesis. The expression of apple AAT (MdAAT2) is known to be induced by salicylic acid (SA) or ethylene in apple fruits, although the mechanism of its transcriptional regulation remains elusive. In this study, we reveal that two apple transcription factors (TFs), MdMYB1 and MdMYB6, are involved in MdAAT2 promoter response to SA and ethylene in transgenic tobacco. According to electrophoretic mobility shift assays, MdMYB1 or MdMYB6 can directly bind in vitro to MYB binding sites in the MdAAT2 promoter. In vivo, overexpression of the two MYB TFs can greatly enhance MdAAT2 promoter activity, as demonstrated by dual luciferase reporter assays in transgenic tobacco. In contrast to the promoter of MdMYB1 or MdMYB6, the MdAAT2 promoter cannot be induced by SA or ethephon (ETH) in transgenic tobacco, even in stigmas in which the MdAAT2 promoter can be highly induced under normal conditions. However, the induced MYB TFs can dramatically enhance MdAAT2 promoter activity under SA or ETH treatment. We conclude that MdMYB1 and MdMYB6 function in MdAAT2 responses to SA and ethylene in transgenic tobacco, suggesting that a similar regulation mechanism may exist in apple.

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. A Multifunctional Role for Adjuvant Anti-4-1BB Therapy in Augmenting Antitumor Response by Chimeric Antigen Receptor T Cells.

    PubMed

    Mardiana, Sherly; John, Liza B; Henderson, Melissa A; Slaney, Clare Y; von Scheidt, Bianca; Giuffrida, Lauren; Davenport, Alexander J; Trapani, Joseph A; Neeson, Paul J; Loi, Sherene; Haynes, Nicole M; Kershaw, Michael H; Beavis, Paul A; Darcy, Phillip K

    2017-03-15

    Adoptive immunotherapy utilizing chimeric antigen receptor (CAR) T cells has demonstrated high success rates in hematologic cancers, but results against solid malignancies have been limited to date, due in part to the immunosuppressive tumor microenvironment. Activation of the 4-1BB (CD137) pathway using an agonistic α-4-1BB antibody is known to provide strong costimulatory signals for augmenting and diversifying T-cell responses. We therefore hypothesized that a combination of α-4-1BB and CAR T-cell therapy would result in improved antitumor responses. Using a human-Her2 self-antigen mouse model, we report here that α-4-1BB significantly enhanced CAR T-cell efficacy directed against the Her2 antigen in two different established solid tumor settings. Treatment also increased the expression of IFNγ and the proliferation marker Ki67 in tumor-infiltrating CAR T cells when combined with α-4-1BB. Strikingly, α-4-1BB significantly reduced host immunosuppressive cells at the tumor site, including regulatory T cells and myeloid-derived suppressor cells, correlating with an increased therapeutic response. We conclude that α-4-1BB has a multifunctional role for enhancing CAR T-cell responses and that this combination therapy has high translational potential, given current phase I/II clinical trials with α-4-1BB against various types of cancer. Cancer Res; 77(6); 1296-309. ©2017 AACR.

  10. Structural characterization and substrate specificity of VpAAT1 protein related to ester biosynthesis in mountain papaya fruit.

    PubMed

    Morales-Quintana, Luis; Fuentes, Lida; Gaete-Eastman, Carlos; Herrera, Raúl; Moya-León, María Alejandra

    2011-02-01

    The aroma in fruits is an important attribute of quality that influences consumer's acceptance. This attribute is a complex character determined by a set of low molecular weight volatile compounds. In mountain papaya fruit (Vasconcellea pubescens) the aroma is determined mainly by esters, which are produced through an esterification reaction catalyzed by the enzyme alcohol acyltransferase (AAT) that utilizes alcohols and acyl-CoAs as substrates. In order to understand the molecular mechanism involved in the production of esters in this fruit, an AAT gene which has been previously cloned and characterized from mountain papaya (VpAAT1) was expressed in yeasts, and the highest enzyme activity of the recombinant protein was obtained when the enzyme was tested for its ability to produce benzyl acetate. On the other hand, to gain insight the mechanism of action at the molecular level, a structural model for VpAAT1 protein was built by comparative modelling methodology, which was validated and refined by molecular dynamics simulation. The VpAAT1 structure consists of two domains connected by a large crossover loop, with a solvent channel in the center of the structure formed between the two domains. Residues H166 and D170, important for catalytic action, displayed their side chains towards the central cavity of the channel allowing their interaction with the substrates. The conformational interaction between the protein and several ligands was explored by molecular docking simulations, and the predictions obtained were tested through kinetic analysis. Kinetic results showed that the lowest K(M) values were obtained for acetyl-CoA and benzyl alcohol. In addition, the most favorable predicted substrate orientation was observed for benzyl alcohol and acetyl CoA, showing a perfect coincidence between kinetic studies and molecular docking analysis.

  11. Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial.

    PubMed

    Franklin, Martin E; Sapyta, Jeffrey; Freeman, Jennifer B; Khanna, Muniya; Compton, Scott; Almirall, Daniel; Moore, Phoebe; Choate-Summers, Molly; Garcia, Abbe; Edson, Aubrey L; Foa, Edna B; March, John S

    2011-09-21

    The extant literature on the treatment of pediatric obsessive-compulsive disorder (OCD) indicates that partial response to serotonin reuptake inhibitors (SRIs) is the norm and that augmentation with short-term OCD-specific cognitive behavior therapy (CBT) may provide additional benefit. To examine the effects of augmenting SRIs with CBT or a brief form of CBT, instructions in CBT delivered in the context of medication management. A 12-week randomized controlled trial conducted at 3 academic medical centers between 2004 and 2009, involving 124 pediatric outpatients between the ages of 7 and 17 years with OCD as a primary diagnosis and a Children's Yale-Brown Obsessive Compulsive Scale score of 16 or higher despite an adequate SRI trial. Participants were randomly assigned to 1 of 3 treatment strategies that included 7 sessions over 12 weeks: 42 in the medication management only, 42 in the medication management plus instructions in CBT, and 42 in the medication management plus CBT; the last included 14 concurrent CBT sessions. Whether patients responded positively to treatment by improving their baseline obsessive-compulsive scale score by 30% or more and demonstrating a change in their continuous scores over 12 weeks. The medication management plus CBT strategy was superior to the other 2 strategies on all outcome measures. In the primary intention-to-treat analysis, 68.6% (95% CI, 53.9%-83.3%) in the plus CBT group were considered responders, which was significantly better than the 34.0% (95% CI, 18.0%-50.0%) in the plus instructions in CBT group, and 30.0% (95% CI, 14.9%-45.1%) in the medication management only group. The results were similar in pairwise comparisons with the plus CBT strategy being superior to the other 2 strategies (P < .01 for both). The plus instructions in CBT strategy was not statistically superior to medication management only (P = .72). The number needed-to-treat analysis with the plus CBT vs medication management only in order to see 1

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

    PubMed

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

    2013-09-25

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

  13. Palliative care and use of animal-assisted therapy.

    PubMed

    Engelman, Suzanne R

    2013-01-01

    A growing body of research and clinical reports support the benefits of utilizing animal-assisted therapy (AAT) as a complementary, transdisciplinary treatment intervention in medical settings. However, fewer articles are found demonstrating AAT's use in palliative care settings. This article is a study of the effects of AAT in palliative care situations, presenting one anecdotal clinical vignette. In this way, the efficacy of this technique in decreasing patient pain, thereby increasing patient quality of life, and lowering staff stress levels may be illustrated.

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

    PubMed

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

    2006-01-01

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

  15. Sorafenib-irinotecan sequential therapy augmented the anti-tumor efficacy of monotherapy in hepatocellular carcinoma cells HepG2.

    PubMed

    Wang, Z; Zhao, Z; Wu, T; Song, L; Zhang, Y

    2015-01-01

    The current study aimed to evaluate the efficacy of sorafenib-based combined therapy against hepatocellular carcinoma (HCC). HepG2 cells were exposed to sorafenib, irinotecan, and oxaliplatin and then subjected to MTT assay to determine chemosensitivity. Flow cytometry was used to examine cell cycle distribution and cell apoptosis. Levels of cleaved caspase-8, -3, and PARP were determined by Western blot. Real-time PCR and Western blot were used to determine p53 expression, respectively. The efficacy of combined therapy were verified in nude mice bearing HepG2 xenografts. HepG2 cells used in the current study were sensitive to sorafenib, irinotecan, and oxaliplatin. Sorafenib arrested cell cycle in S phase and the peak effect appeared at 30 h post treatment. Sorafenib exposure for 30 h followed by irinotecan exposure for 48 h synergistically induced cell apoptosis in HepG2 cells. On the other hand, sorafenib-oxaliplatin sequential exposure for the same time only acted an additive effect in soliciting cell apoptosis. Sorafenib and irinotecan sequential treatment significantly increased the levels of cleaved caspase-8, -3, and PARP in HepG2 cells. Sorafenib suppressed p53 expression at both mRNA and protein levels, which might contribute to cell cycle arrest and sensitize tumor cells to irinotecan. Sorafenib and irinotecan sequential therapy was obviously superior to monotherapy in suppressing the growth of HepG2 xenografts. Sorafenib-irinotecan sequential treatment augmented the efficacy of either drug used alone in soliciting HepG2 cells apoptosis in vitro and in suppressing the growth of HepG2 xenografts in vivo. hepatocellular carcinoma, irinotecan, sorafenib, synergistic effect.

  16. Effects of animal-assisted therapy on patients' anxiety, fear, and depression before ECT.

    PubMed

    Barker, Sandra B; Pandurangi, Anand K; Best, Al M

    2003-03-01

    To determine whether animal-assisted therapy (AAT) is associated with reductions in fear, anxiety, and depression in psychiatric patients before electroconvulsive therapy (ECT). Before their scheduled ECT treatment, 35 patients were assigned on alternate days to the treatment condition, consisting of a 15-minute AAT session, and the standard (comparison) condition, consisting of 15 minutes with magazines. Visual analogue scales were used to measure anxiety, fear, and depression before and after treatment and standard conditions. The effect of AAT on fear was significant in both the mixed-model, repeated-measures analysis of covariance (ANCOVA) (p = 0.0006) and the secondary analysis (p = 0.0050), which covaried out all of the demographic conditions (gender, race, marital status, pet ownership, age), condition order, and the pretest rating. The effect of AAT on anxiety approached significance in the ANCOVA (p = 0.0982), but in the secondary analysis, the effect was not significant (p = 0.6498). The AAT effect on depression was not significant in ANCOVA (p = 0.7665) or in the secondary analysis (p = 0.9394). A least squares mean analysis showed that AAT reduced fear by 37% and anxiety by 18%. There was no demonstrated effect of AAT on depression. Animal-assisted therapy may have a useful role in psychiatric and medical therapies in which the therapeutic procedure is inherently fear-inducing or has a negative societal perception.

  17. Using a magnetic field to redirect an oncolytic adenovirus complexed with iron oxide augments gene therapy efficacy.

    PubMed

    Choi, Joung-Woo; Park, Ji Won; Na, Youjin; Jung, Soo-Jung; Hwang, June Kyu; Choi, Dongho; Lee, Kyeong Geun; Yun, Chae-Ok

    2015-10-01

    Adenovirus (Ad) is a widely used vector for cancer gene therapy but its therapeutic efficacy is limited by low coxsackievirus and adenovirus receptor (CAR) expression in tumors and non-specifically targeted infection. Ad infectivity and specificity can be markedly improved by creating Ad-magnetic nanoparticles cluster complexes and directing their migration with an external magnetic field (MGF). We electrostatically complexed GFP-expressing, replication-incompetent Ad (dAd) with PEGylated and cross-linked iron oxide nanoparticles (PCION), generating dAd-PCION complexes. The dAd-PCION showed increased transduction efficiency, independent of CAR expression, in the absence or presence of an MGF. Cancer cell killing and intracellular oncolytic Ad (HmT)-PCION replication significantly increased with MGF exposure. Site-directed, magnetically-targeted delivery of the HmT-PCION elicited significantly greater therapeutic efficacy versus treatment with naked HmT or HmT-PCION without MGF in CAR-negative MCF7 tumors. Immunohistochemical tumor analysis showed increased oncolytic Ad replication in tumors following infection by HmT-PCION using an MGF. Whole-body bioluminescence imaging of tumor-bearing mice showed a 450-fold increased tumor-to-liver ratio for HmT-PCION with, versus without, MGF. These results demonstrate the feasibility and potential of external MGF-responsive PCION-coated oncolytic Ads as smart hybrid vectors for cancer gene therapy.

  18. VpAAT1, a gene encoding an alcohol acyltransferase, is involved in ester biosynthesis during ripening of mountain papaya fruit.

    PubMed

    Balbontín, Cristian; Gaete-Eastman, Carlos; Fuentes, Lida; Figueroa, Carlos R; Herrera, Raúl; Manriquez, Daniel; Latché, Alain; Pech, Jean-Claude; Moya-León, María Alejandra

    2010-04-28

    Mountain papaya ( Vasconcellea pubescens ) is a climacteric fruit that develops a strong and characteristic aroma during ripening. Esters are the main volatile compounds produced by the fruit, and most of them are dependent on ethylene. As esters are synthesized through alcohol acyltransferases (AAT), a full-length cDNA (VpAAT1) was isolated that displayed the characteristic motifs of most plant acyltransferases. The full-length cDNA sequence was cloned and expressed in yeasts, obtaining a functional enzyme with high AAT activity toward the formation of benzyl acetate. The transcript accumulation pattern provided by qPCR analysis showed that the VpAAT1 gene is expressed exclusively in fruit tissues and that a high level of transcripts is accumulated during ripening. The increase in VpAAT1 transcripts in fruit is coincident with the increase in AAT activity; transcript accumulation is induced by ethylene, and it is avoided by 1-methylcyclopropene (1-MCP) treatment. The data indicate that VpAAT1 is involved in aroma formation and that ethylene plays a major role in regulating its expression.

  19. D-Cycloserine Augmentation of Exposure Therapy for Post-Traumatic Stress Disorder: A Pilot Randomized Clinical Trial

    PubMed Central

    Difede, JoAnn; Cukor, Judith; Wyka, Katarzyna; Olden, Megan; Hoffman, Hunter; Lee, Francis S; Altemus, Margaret

    2014-01-01

    Viewing post-traumatic stress disorder (PTSD) as a disorder of emotional learning, this study used a cognitive enhancer synergistically with virtual reality exposure (VRE) therapy for the treatment of PTSD. The main objective was to determine if a novel pharmacotherapy, D-cycloserine (DCS), enhanced the efficacy of the psychotherapy. Pre-clinical studies suggest that when fear extinction occurs during DCS administration, neuroplasticity may be enhanced. VRE therapy is a particularly promising format to test the hypothesis that DCS enhances extinction learning, as sensory fear cues are standardized across patients. In a pilot randomized, double-blind, placebo-controlled trial, 100 mg of DCS or placebo was administered 90 min before each weekly VRE session, to ensure peak plasma concentrations during the sessions in 25 patients with chronic PTSD. The primary outcome measure was the Clinician Administered PTSD Scale (CAPS). Secondary outcome measures included the Beck Depression Inventory-II and the State-Trait Anger Expression Inventory-2. Assessments occurred at pre-treatment, following sessions 3, 6, 10, post-treatment, and at 6 months. The difference in CAPS between the VRE-DCS (n=13) and VRE-placebo (n=12) groups increased over time beginning at 6 weeks, with medium to large between-group effect sizes immediately post-treatment and 6 months later (d=0.68 and d=1.13, respectively). A similar pattern was observed for depression, anger expression, and sleep. PTSD remission rates were significantly greater for the VRE-DCS group (46% vs 8% at post-treatment; 69% vs 17% at 6 months). Patients in the VRE-DCS group showed earlier and greater improvement in PTSD symptoms compared with the VRE-placebo group. These results suggest a promising new treatment for PTSD. PMID:24217129

  20. Ramadan fasting in diabetes patients on insulin pump therapy augmented by continuous glucose monitoring: an observational real-life study.

    PubMed

    Khalil, Ali Bernard; Beshyah, Salem A; Abu Awad, Samar M; Benbarka, Mahmoud M; Haddad, Marcil; Al-Hassan, Dana; Kahwatih, Marwa; Nagelkerke, Nico

    2012-09-01

    Hypoglycemia during the daytime of Ramadan fasting is the most feared complication of diabetes. Insulin pump therapy has been proposed as the ideal "theoretical" method for insulin delivery. We report a prospective observational, single-center study of insulin-treated patients using insulin pump therapy during Ramadan 2011. Twenty-one patients (10 males and 11 females) were selected; median age was 26 years. They adjusted their insulin as per their usual practices. Outcome measures obtained before and during Ramadan included body weight, glycosylated hemoglobin, blood glucose, total insulin dose differences, overriding tendency, suspension time during fasting, and number of hypoglycemic episodes. The patients fasted for a median of 29 days. The observed changes during Ramadan were overall not significant quantitatively, but some trends were noted. The total insulin administered during Ramadan was not different from that in the pre-Ramadan period, but there was a redistribution of insulin over a 24-h period in relation to the changes in the daily lifestyle and eating patterns. Basal insulin was decreased during the daytime by 5-20% from before Ramadan and increased during the nighttime. The mean change in the overall amount of basal insulin was not significant. A larger than usual amount of insulin bolus was given at the meals Iftar, Fowala, and Suhur; the change in the total amount of bolus insulin as a percentage change from total insulin was also not significant. No major hypoglycemic episodes were reported. Minor hypoglcemic episodes were equally distributed between daytime and nighttime and were managed by either basal insulin adjustment or suspension from the pump. This study confirms the advantages provided by insulin pump use in patients with diabetes were enhanced by the use of continuous glucose monitoring. We provided more evidence-based advice on how best to adjust the insulin pump during fasting.

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

    PubMed

    Abuahmad, H

    2015-06-01

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

  2. A survey of the use of aided augmentative and alternative communication during music therapy sessions with persons with autism spectrum disorders.

    PubMed

    Gadberry, Anita L

    2011-01-01

    Research indicates that as many as 50% of children with autism spectrum disorders (ASD) will not develop adequate speech to meet their communication needs (Noens & van Berckelaer-Onnes, 2004). Thus, alternate means of communication such as Augmentative and Alternative Communication (AAC) are necessary. Though many music therapists work with clients with ASD, there is a lack of research regarding music therapists' use of aided AAC. This study sought to obtain information from music therapists who work with persons with ASD via a survey to answer the following questions: (a) how many music therapists are using aided AAC in their sessions, (b) how they are using aided AAC, and (c) what type of training they have had regarding AAC systems. To assess the research questions, the author created an electronic survey. Upon distribution, the survey response rate was 49.6%. Results indicated that only 14.6% of respondents utilize aided AAC with all of their clients who use aided AAC outside of music therapy. The most common form of aided input used by music therapists in their sessions with clients with ASD is a picture schedule. Only 40% of respondents have additional training in aided AAC. Chi square tests revealed significant relationships among many of the variables: use of aided AAC and additional training, use and treatment setting, literacy promotion and additional training, modeling and additional training, referral for AAC systems and length of work with clients with ASD, referral and additional training. Results are discussed in relation to current communication literature.

  3. [Augmentation therapy with cilostazol for the intractable geriatric major depressive disorder patients with deep white matter hyperintensities on T2-weighted brain MRI].

    PubMed

    Takahashi, Keisuke; Mikuni, Masahiko

    2012-01-01

    Several studies report that vascular lesions contribute to depression in late life, but whether vascular lesions contribute to depression or indeed result from depression is debatable. To address this question, we segregated mood disorder patients into late- and early-onset mood disorder groups (LOM and EOM, respectively) and compared the areas of high intensity on the subcortical MRI scans of the 2 groups. We found that the LOM group exhibited higher ratings than the EOM group; significant between-group differences were detected in the bilateral frontal areas and in the left parieto-occipital area. Our results suggest that vascular lesions in these areas are crucial for the development of late-onset mood disorders. Furthermore, treatment is often difficult in depressed patients with cerebrovascular lesions. Therefore, a new therapeutic approach that takes into account cerebrovascular factors is necessary. We concomitantly administered cilostazol with conventional antidepressants to patients with intractable geriatric major depressive disorder; of these patients, 2 showed improvements of their depressive symptoms. These findings suggest a potential efficacy of cilostazol as a novel drug for use in augmentation therapy for depressed patients with silent cerebrovascular disorder. Evidence that vascular disease is the underlying link between depression and dementia is strong. Therefore, further studies that include follow-up of such cases are necessary.

  4. Calorie intake and patient outcomes in severe acute kidney injury: findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial.

    PubMed

    Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Lee, Joanne; Lo, Serigne; McArthur, Colin; McGuinness, Shay; Myburgh, John; Norton, Robyn; Scheinkestel, Carlos; Su, Steve

    2014-03-14

    Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes. We performed a secondary analysis in 1456 patients from the RENAL trial. We measured the dose and evolution of DCI during treatment and analyzed its association with major clinical outcomes using multivariable logistic regression, Cox proportional hazards models, and time adjusted models. Overall, mean DCI during treatment in ICU was low at only 10.9 ± 9 Kcal/kg/day for non-survivors and 11 ± 9 Kcal/kg/day for survivors. Among patients with a lower DCI (below the median) 334 of 729 (45.8%) had died at 90-days after randomization compared with 316 of 727 (43.3%) patients with a higher DCI (above the median) (P = 0.34). On multivariable logistic regression analysis, mean DCI carried an odds ratio of 0.95 (95% confidence interval (CI): 0.91-1.00; P = 0.06) per 100 Kcal increase for 90-day mortality. DCI was not associated with significant differences in renal replacement (RRT) free days, mechanical ventilation free days, ICU free days and hospital free days. These findings remained essentially unaltered after time adjusted analysis and Cox proportional hazards modeling. In the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes. ClinicalTrials.gov number, NCT00221013.

  5. An observational study fluid balance and patient outcomes in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy trial.

    PubMed

    Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Lee, Joanne; Lo, Serigne; McArthur, Colin; McGuiness, Shay; Norton, Robyn; Myburgh, John; Scheinkestel, Carlos; Su, Steve

    2012-06-01

    To examine associations between mean daily fluid balance during intensive care unit study enrollment and clinical outcomes in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level (RENAL) replacement therapy study. Statistical analysis of data from multicenter, randomized, controlled trials. Thirty-five intensive care units in Australia and New Zealand. Cohort of 1453 patients enrolled in the RENAL study. We analyzed the association between daily fluid balance on clinical outcomes using multivariable logistic regression, Cox proportional hazards, time-dependent analysis, and repeated measure analysis models. During intensive care unit stay, mean daily fluid balance among survivors was -234 mL/day compared with +560 mL/day among nonsurvivors (p < .0001). Mean cumulative fluid balance over the same period was -1941 vs. +1755 mL (p = .0003). A negative mean daily fluid balance during study treatment was independently associated with a decreased risk of death at 90 days (odds ratio 0.318; 95% confidence interval 0.24-0.43; p < .000.1) and with increased survival time (p < .0001). In addition, a negative mean daily fluid balance was associated with significantly increased renal replacement-free days (p = .0017), intensive care unit-free days (p < .0001), and hospital-free days (p = .01). These findings were unaltered after the application of different statistical models. In the RENAL study, a negative mean daily fluid balance was consistently associated with improved clinical outcomes. Fluid balance may be a target for specific manipulation in future interventional trials of critically ill patients receiving renal replacement therapy.

  6. Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies

    PubMed Central

    Al-Janabi, Shahd; Nickels, Lyndsey A.; Sowman, Paul F.; Burianová, Hana; Merrett, Dawn L.; Thompson, William F.

    2014-01-01

    The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia. PMID:24550864

  7. Inhibition of intracellular antiviral defense mechanisms augments lentiviral transduction of human natural killer cells: implications for gene therapy.

    PubMed

    Sutlu, Tolga; Nyström, Sanna; Gilljam, Mari; Stellan, Birgitta; Applequist, Steven E; Alici, Evren

    2012-10-01

    Adoptive immunotherapy with genetically modified natural killer (NK) cells is a promising approach for cancer treatment. Yet, optimization of highly efficient and clinically applicable gene transfer protocols for NK cells still presents a challenge. In this study, we aimed at identifying conditions under which optimum lentiviral gene transfer to NK cells can be achieved. Our results demonstrate that stimulation of NK cells with interleukin (IL)-2 and IL-21 supports efficient transduction using a VSV-G pseudotyped lentiviral vector. Moreover, we have identified that inhibition of innate immune receptor signaling greatly enhances transduction efficiency. We were able to boost the efficiency of lentiviral genetic modification on average 3.8-fold using BX795, an inhibitor of the TBK1/IKKɛ complex acting downstream of RIG-I, MDA-5, and TLR3. We have also observed that the use of BX795 enhances lentiviral transduction efficiency in a number of human and mouse cell lines, indicating a broadly applicable, practical, and safe approach that has the potential of being applicable to various gene therapy protocols.

  8. Augmentation strategies: focus on anxiolytics.

    PubMed

    Joffe, R T; Levitt, A J; Sokolov, S T

    1996-01-01

    Approximately 20% to 40% of patients will fail to respond to the first antidepressant used for their current major depressive episode. Furthermore, it has been suggested that a further 20% to 30% of patients will have only a partial response. There are four main options to consider in the treatment of these patients: optimization, substitution, augmentation, and combination therapy. Several combination antidepressant treatments have been used in treatment-refractory depression. Moreover, various augmentation strategies have also proved to be successful. Although the empirical data to support these treatment options are limited, augmentation treatment has several potential advantages over the other clinical options available, particularly substitution. These data are reviewed and clinical applications discussed. Particular attention is paid to the role of anxiolytics as augmentation agents in the treatment of major depression.

  9. Discovery and Classification of DES15E1kwg and DES15X3kqv by SALT and AAT

    NASA Astrophysics Data System (ADS)

    Bassett, B.; Kasai, E.; Crawford, S.; Depagne, E.; Kotze, J. P.; Koen, T.; Smith, M.; Lewis, G.; Mould, J.; Lidman, C.; Tucker, B. E.; Sharp, R.; Yuan, F.; Martini, P.; Schubnell, M.; Kessler, R.; Scolnic, D.; Covarrubias, R. A.; Brout, D. J.; Fischer, J. A.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; D'Andrea, C.; Sullivan, M.; Childress, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.

    2015-10-01

    We report optical spectroscopy of 2 supernovae discovered by the Dark Energy Survey (ATel #4668). We obtained spectra (400-850nm) using the Robert Stobie Spectrograph (RSS) on the Southern African Large Telescope (SALT) and the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389; wavelength range 370-885nm) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  10. Tumor-Unrelated CD4 T Cell Help Augments CD134 plus CD137 Dual Costimulation Tumor Therapy

    PubMed Central

    Mittal, Payal; St Rose, Marie-Clare; Wang, Xi; Ryan, Joseph M.; Wasser, Jeffrey S.; Vella, Anthony T.; Adler, Adam J.

    2015-01-01

    The ability of immune-based cancer therapies to elicit beneficial CD8+ CTL is limited by tolerance pathways that inactivate tumor-specific CD4 helper T cells. A strategy to bypass this problem is to engage tumor-unrelated CD4 helper T cells. Thus, CD4 T cells, regardless of their specificity per se, can boost CD8+ CTL priming so long as the cognate epitopes are linked via presentation on the same dendritic cell. Here, we assessed the therapeutic impact of engaging tumor-unrelated CD4 T cells during dual costimulation with CD134 plus CD137 that not only provide help via the above-mentioned classical linked pathway, but also provide non-linked help that facilitates CTL function in T cells not directly responding to cognate antigen. We found that engagement of tumor-unrelated CD4 helper T cells dramatically boosted the ability of dual costimulation to control the growth of established B16 melanomas. Surprisingly, this effect depended upon a CD134-dependent component that was extrinsic to the tumor-unrelated CD4 T cells, suggesting that the dual-costimulated helper cells are themselves helped by a CD134+ cell(s). Nevertheless, the delivery of therapeutic help tracked with an increased frequency of tumor-infiltrating granzyme B+ effector CD8 T cells and a reciprocal decrease in Foxp3+CD4+ cell frequency. Notably, the tumor-unrelated CD4 helper T cells also infiltrated the tumors, and their deletion several days following initial T cell priming negated their therapeutic impact. Taken together, dual costimulation programs tumor-unrelated CD4 T cells to deliver therapeutic help during both the priming and effector stages of the anti-tumor response. PMID:26561553

  11. Interaction of DAPI with individual strands of trinucleotide repeats. Effects of replication in vitro of the AAT x ATT triplet.

    PubMed

    Trotta, Edoardo; Del Grosso, Nicoletta; Erba, Maura; Melino, Sonia; Cicero, Daniel; Paci, Maurizio

    2003-12-01

    The structural changes produced by the minor-groove binding ligand DAPI (4',6-diamidine-2-phenylindole) on individual strands of trinucleotide repeat sequences were detected by electrophoretic band-shift analysis and related to their effects on DNA replication in vitro. Among the 20 possible single-stranded trinucleotide repeats, only the T-rich strand of the AAT.ATT triplet exhibits an observable fluorescence band and a change in electrophoretic mobility due to the drug binding. This is attributable to the property of DAPI that favours folding of the random coil ATT strand into a fast-migrating hairpin structure by a minor-groove binding mechanism. Electrophoretic characteristics of AAT, ACT, AGT, ATG and ATC are unchanged by DAPI, suggesting the crucial role of T.T with respect to A.A, C.C and G.G mismatch, in favouring the binding properties and the structural features of the ATT-DAPI complexes. Primer extension experiments, using the Klenow fragment of DNA polymerase I, demonstrate that such a selective structural change at ATT targets presents a marked property to stall DNA replication in vitro in comparison with the complementary AAT and a random GC-rich sequence. The results suggest a novel molecular mechanism of action of the DNA minor-groove binding ligand DAPI.

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

    PubMed

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

    2015-09-01

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

  13. Efficacy of Augmentation of Cognitive Behavior Therapy With Weight-Adjusted d-Cycloserine vs Placebo in Pediatric Obsessive-Compulsive Disorder: A Randomized Clinical Trial.

    PubMed

    Storch, Eric A; Wilhelm, Sabine; Sprich, Susan; Henin, Aude; Micco, Jamie; Small, Brent J; McGuire, Joseph; Mutch, P Jane; Lewin, Adam B; Murphy, Tanya K; Geller, Daniel A

    2016-08-01

    Cognitive behavior therapy (CBT) among youth with obsessive-compulsive disorder (OCD) is effective, but many patients remain symptomatic after intervention. d-cycloserine, a partial agonist at the N-methyl-d-aspartate receptor in the amygdala, has been associated with enhanced CBT outcome for OCD among adults but requires evaluation among youth. To examine the relative efficacy of weight-adjusted d-cycloserine (25 or 50 mg) vs placebo augmentation of CBT for youth with OCD and to assess if concomitant antidepressant medication moderated effects. In a placebo-controlled randomized clinical trial, 142 youths (age range, 7-17 years) enrolled between June 1, 2011, and January 30, 2015, at 2 academic health science centers (University of South Florida and Massachusetts General Hospital) with a primary diagnosis of OCD were randomized in a double-blind fashion to d-cycloserine plus CBT or placebo plus CBT. Intent-to-treat analysis was performed. Patients were randomly assigned in a 1:1 ratio to either 10 sessions of d-cycloserine plus CBT or placebo plus CBT. d-cycloserine (25 or 50 mg) or placebo was taken 1 hour before sessions 4 through 10. Children's Yale-Brown Obsessive Compulsive Scale at randomization, biweekly, midtreatment, and posttreatment. Secondary outcomes included the Clinical Global Impressions-Severity or Clinical Global Impressions-Improvement, remission status, Children's Depression Rating Scale, Multidimensional Anxiety Scale for Children, and Children's Obsessive-Compulsive Impact Scale-Parent Version. The study cohort comprised 142 participants. Their mean (SD) age was 12.7 (2.9) years, and 53.5% (76 of 142) were female. A mixed-effects model using all available data indicated significant declines in the Children's Yale-Brown Obsessive Compulsive Scale total score and Clinical Global Impressions-Severity. No significant interaction between treatment group and changes in the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global

  14. [Augmented reality for image guided therapy (ARIGT) of kidney tumor during nephron sparing surgery (NSS): animal model and clinical approach].

    PubMed

    Drewniak, Tomasz; Rzepecki, Maciej; Juszczak, Kajetan; Kwiatek, Wojciech; Bielecki, Jakub; Zieliński, Krzysztof; Ruta, Andrzej; Czekierda, Łukasz; Moczulskis, Zbigniew

    2011-01-01

    The main problem in nephron sparing surgery (NSS) is to preserve renal tumors oncological purity during the removal of the tumor with a margin of macroscopically unchanged kidney tissue while keeping the largest possible amount of normal parenchyma of the operated kidney. The development of imaging techniques, in particular IGT (Image Guided Therapy) allows precise imaging of the surgical field and, therefore, is essential in improving the effectiveness of NSS (increase of nephron sparing with the optimal radicality). The aim of this study was to develop a method of the three-dimensional (3D) imaging of the kidney tumor and its lodge in the operated kidney using 3D laser scanner during NSS procedure. Additionally, the animal model of visualization was developed. The porcine kidney model was used to test the set built up with HD cameras and linear laser scanner connected to a laptop with graphic software (David Laser Scanner, Germany) showing the surface of the kidney and the lodge after removal the chunk of renal parenchyma. Additionally, the visualization and reconstruction was performed on animal porcine model. Moreover, 5 patients (3 women, 2 men) aged from 37 to 68 years (mean 56), diagnosed with kidney tumors in CT scans with a diameter of 3.7-6.9 cm (mean 4.9) were operated in our Department this year, scanning the surface during the treatment with the kidney tumor and kidney tumor after it is removed with a margin of renal tissue. In one case, the lodge of removed tumor was scanned. Dimensions in 3D reconstruction images of laser scans in the study of animal model and the images obtained intraoperatively were compared with the dimensions evaluated during preoperative CT scans, intraoperative measurements. Three-dimensional imaging laser scanner operating field loge resected tumor and the tumor on the kidney of animal models and during NSS treatments for patients with kidney tumors is possible in real time with an accuracy of -2 mm do +9 mm (+/- 3 mm). The

  15. Mainstreaming animal-assisted therapy.

    PubMed

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

    2010-01-01

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

  16. 3D augmented reality mirror visual feedback therapy applied to the treatment of persistent, unilateral upper extremity neuropathic pain: a preliminary study.

    PubMed

    Mouraux, Dominique; Brassinne, Eric; Sobczak, Stéphane; Nonclercq, Antoine; Warzée, Nadine; Sizer, Phillip S; Tuna, Turgay; Penelle, Benoît

    2017-07-01

    Objective: We assessed whether or not pain relief could be achieved with a new system that combines 3D augmented reality system (3DARS) and the principles of mirror visual feedback. Methods: Twenty-two patients between 18 and 75 years of age who suffered of chronic neuropathic pain. Each patient performed five 3DARS sessions treatment of 20 mins spread over a period of one week. The following pain parameters were assessed: (1) visual analogic scale after each treatment session (2) McGill pain scale and DN4 questionnaire were completed before the first session and 24 h after the last session. Results: The mean improvement of VAS per session was 29% (p < 0.001). There was an immediate session effect demonstrating a systematic improvement in pain between the beginning and the end of each session. We noted that this pain reduction was partially preserved until the next session. If we compare the pain level at baseline and 24 h after the last session, there was a significant decrease (p < 0.001) of pain of 37%. There was a significant decrease (p < 0.001) on the McGill Pain Questionnaire and DN4 questionnaire (p < 0.01). Conclusion: Our results indicate that 3DARS induced a significant pain decrease for patients who presented chronic neuropathic pain in a unilateral upper extremity. While further research is necessary before definitive conclusions can be drawn, clinicians could implement the approach as a preparatory adjunct for providing temporary pain relief aimed at enhancing chronic pain patients' tolerance of manual therapy and exercise intervention. Level of Evidence: 4.

  17. Evaluation of the Adherence to Continuous Glucose Monitoring in the Management of Type 1 Diabetes Patients on Sensor-Augmented Pump Therapy: The SENLOCOR Study.

    PubMed

    Picard, Sylvie; Hanaire, Hélène; Baillot-Rudoni, Sabine; Gilbert-Bonnemaison, Elisabeth; Not, Didier; Reznik, Yves; Guerci, Bruno

    2016-03-01

    Continuous glucose monitoring (CGM) and sensor-augmented pump (SAP) therapy improve glucose control provided good adherence. In France, not only diabetologists, nurses, and dieticians but also nurses employed by homecare providers (HCPNs) are together involved in the initiation and/or follow-up of continuous subcutaneous insulin injection (CSII) and SAP training. The SENLOCOR Study is an observational study designed to assess SAP adherence over 6 months (primary objective). Secondary objectives included the impact of SAP on metabolic control and patients' satisfaction. CGM initiation (M0) was performed within 3 months after CSII. CGM adherence, defined by sensor wear >70% of the time, glycated hemoglobin (HbA1c) levels, and satisfaction questionnaires were collected at inclusion and at 3 (M3) and 6 (M6) months. The analysis population was 234 patients, including 27 children. Of the physicians, 88.0% were involved in SAP education for the whole cohort (median time, 45 min), whereas HCPNs were involved in CGM training for 190 patients (81.2%) (median time: at M0, 156 min; at M3, 20 min). Good adherence was obtained in 86.1% (M0-M3) and 68.9% (M3-M6) of the patients. The HbA1c level decreased from 8.16 ± 1.35% (M0) to 7.67 ± 1.01% (M6) in 189 patients (change, -0.48%; 95% confidence interval, -0.64, -0.33). The percentage of patients who experienced severe hypoglycemia decreased from 20.7% (M0) to 13.6% (M3) and 13.3% (M6). Satisfaction scores were high. In patients with type 1 diabetes, a 6-month training on SAP involving a multidisciplinary team, and especially HCPNs, improved metabolic control with a high level of adherence and satisfaction.

  18. Long-term health economic benefits of sensor-augmented pump therapy vs continuous subcutaneous insulin infusion alone in type 1 diabetes: a U.K. perspective.

    PubMed

    Roze, Stéphane; Smith-Palmer, Jayne; Valentine, William J; Cook, Mark; Jethwa, Manisha; de Portu, Simona; Pickup, John C

    2016-01-01

    Continuous subcutaneous insulin infusion (CSII) is an important treatment option for type 1 diabetes patients unable to achieve adequate glycemic control with multiple daily injections (MDI). Combining CSII with continuous glucose monitoring (CGM) in sensor-augmented pump therapy (SAP) with a low glucose-suspend (LGS) feature may further improve glycemic control and reduce the frequency of hypoglycemia. A cost-effectiveness analysis of SAP + LGS vs. CSII plus self-monitoring of blood glucose (SMBG) was performed to determine the health economic benefits of SAP + LGS in type 1 diabetes patients using CSII in the U.K. Cost-effectiveness analysis was performed using the CORE diabetes model. Treatment effects were sourced from the literature, where SAP + LGS was associated with a projected HbA1c reduction of -1.49% vs. -0.62% for CSII, and a reduced frequency of severe hypoglycemia. The time horizon was that of patient lifetimes; future costs and clinical outcomes were discounted at 3.5% and 1.5% per annum, respectively. Projected outcomes showed that SAP + LGS was associated with higher mean quality-adjusted life expectancy (17.9 vs. 14.9 quality-adjusted life years [QALYs], SAP + LGS vs. CSII), and higher life expectancy (23.8 vs. 21.9 years), but higher mean lifetime direct costs (GBP 125,559 vs. GBP 88,991), leading to an incremental cost-effectiveness ratio (ICER) of GBP 12,233 per QALY gained for SAP + LGS vs. CSII. Findings of the base-case analysis remained robust in sensitivity analyses. For UK-based type 1 diabetes patients with poor glycemic control, the use of SAP + LGS is likely to be cost-effective compared with CSII plus SMBG.

  19. The effects of lowering nighttime and breakfast glucose levels with sensor-augmented pump therapy on hemoglobin A1c levels in type 1 diabetes.

    PubMed

    Maahs, David M; Chase, H Peter; Westfall, Emily; Slover, Robert; Huang, Suiying; Shin, John J; Kaufman, Francine R; Pyle, Laura; Snell-Bergeon, Janet K

    2014-05-01

    This study determined the association of continuous glucose monitoring glucose (CGM-glucose) levels at different times of the day with improvement in glycated hemoglobin (HbA1c) levels. The potential application of these data is to focus effort to improve glucose control in patients with type 1 diabetes. Data were analyzed from 196 patients with type 1 diabetes who were randomized to receive sensor-augmented pump therapy in the 1-year STAR 3 trial. CGM-glucose values and HbA1c levels from baseline and after 1 year were evaluated to determine associations of improvement in CGM-glucose at different times of the day with longitudinal improvement in HbA1c. Improvement in HbA1c levels after 1 year was related to improvement in mean CGM-glucose levels in daytime (6 a.m.-midnight), overnight (midnight-6 a.m.), and each mealtime period (P<0.0001 for each). In multivariable analysis, only improvement in breakfast meal period was associated with improvement in HbA1c after 1 year, explaining 59% of the HbA1c improvement using the partial R(2) test. Moreover, among those patients who only improved CGM-glucose in the overnight period there was an associated improvement in breakfast meal period CGM-glucose of 26 ± 22 mg/dL (P<0.01). Breakfast period glucose improvement had the greatest effect on lowering HbA1c levels in patients with type 1 diabetes. Improving glucose control overnight resulted in subsequent improvement in the breakfast period. Although glucose control should be improved at all times, methods to improve overnight and post-breakfast glucose levels may be of primary importance in improving glucose control in patients with type 1 diabetes.

  20. Do patient-reported androgen-deprivation therapy side effects predict anxiety and depression among prostate cancer patients undergoing radiotherapy? Implications for psychosocial therapy interventions.

    PubMed

    Sharpley, Christopher F; Bitsika, Vicki; Christie, David R H

    2012-01-01

    Antiandrogen therapy (AAT) is a common adjunct treatment for prostate cancer (PCa) patients and has shown significant benefits to long-term outcomes from radiation or surgery. Although AAT has some adverse side effects and data from breast cancer patients indicate that such side effects from hormonal therapies may contribute to anxiety and depression and may also hinder AAT treatment compliance, this issue has not been investigated within a sample of PCa patients. This study explores the incidence of AAT side effects in a sample of PCa patients, the links between those side effects and anxiety and depression, the possible ways in which these factors may contribute to AAT treatment noncompliance in PCa patients, and how psychosocial treatments might be developed to attend to this issue. 147 PCa patients completed questionnaires on demographic factors, treatment compliance, AAT side effects, anxiety and depression. About 18% of the sample reported AAT side effects, and there was a significant association between the presence of side effects and elevated anxiety and depression scores. Increased frequency of side effects was significantly associated with elevated anxiety, but not depression. The most powerful relationship between AAT side effects and anxiety-depression was for the subfactors of (1) Fatigue, Pain and Discomfort, and (2) Psychological Agitation and Pessimism. Although fatigue, pain, and discomfort may be outcomes of the hormonal treatment itself, psychological agitation and pessimism represent a discrete psychological pathway between AAT side effects and anxiety and depression and (potentially) treatment noncompliance. Methods of addressing patients' loss of optimism in their treatment outcomes are discussed.

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

    PubMed

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

    2012-01-01

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

  2. "Let the Algorithm Do the Work": Reduction of Hypoglycemia Using Sensor-Augmented Pump Therapy with Predictive Insulin Suspension (SmartGuard) in Pediatric Type 1 Diabetes Patients.

    PubMed

    Biester, Torben; Kordonouri, Olga; Holder, Martin; Remus, Kerstin; Kieninger-Baum, Dorothee; Wadien, Tanja; Danne, Thomas

    2017-03-01

    A sensor-augmented insulin pump (SAP) using the MiniMed(®) 640G system with SmartGuard™ technology allows an automatic stop of insulin delivery based on prediction of low glucose levels. Since pediatric patients are particularly prone to hypoglycemia, this device may offer additional protection beyond conventional sensor-augmented therapy. This prospective, pediatric multicenter user evaluation assessed 6 weeks of SAP with SmartGuard (threshold setting for hypoglycemia: 70 mg/dL) compared to a preceding period of 2 weeks with SAP only. The primary outcome was the potential reduction in the frequency of hypoglycemic episodes and hypoglycemic intensity (area under the curve [AUC] and time <70 mg/dL). The study included 24 patients with at least 3 months of insulin pump use (average age: 11.6 ± 5.1 years, 15 female, average type 1 diabetes duration: 7.5 ± 4.2 years, mean ± SD) who had on average 3.2 ± 1.0 predictive suspensions/patient/day. The mean sensor glucose minimum during suspension was 78 ± 6 mg/dL and the average suspension time was 155 ± 47 min/day. Use of SmartGuard in patients treated as per the protocol (n = 18) reduced the number of instances in which the glucose level was <70 mg/dL (1.02 ± 0.52 to 0.72 ± 0.36; P = 0.027), as well as AUC <70 mg/dL (0.76 ± 0.73 to 0.38 ± 0.24; P = 0.027) and the time/day the level fell below 70 mg/dL (73 ± 56 to 31 ± 22 min). The reduction of hypoglycemia was not associated with a significant change in mean glucose concentration (171 ± 26 to 180 ± 19 mg/dL, P = 0.111) and HbA1c (7.5% ± 0.5% to 7.6% ± 0.7%, (P = 0.329). Manual resumption of insulin delivery followed by carbohydrate intake resulted in significantly higher glucose levels 1 h after suspension compared to SmartGuard suspensions with automatic resume (190.8 ± 26.5 vs. 138.7 ± 10.3 mg/dL; P < 0.001). SmartGuard technology

  3. Comparison between sensor-augmented insulin therapy with continuous subcutaneous insulin infusion or multiple daily injections in everyday life: 3-day analysis of glucose patterns and sensor accuracy in children.

    PubMed

    Zucchini, Stefano; Scipione, Mirella; Balsamo, Claudia; Maltoni, Giulio; Rollo, Alessandra; Molinari, Emanuela; Mangoni, Lorenza; Cicognani, Alessandro

    2011-12-01

    Sensor-augmented continuous subcutaneous insulin infusion (CSII) therapy is superior to CSII therapy alone, but little is known on the effectiveness of sensor-augmented multiple daily injections (MDI) therapy. We compared during everyday life mean glucose control and several variability indexes recorded for 3 days by a real-time glucose sensor (Medtronic, Northridge, CA) in two groups of children treated with either CSII or MDI. Fifty-five consecutive subjects were examined: 17 receiving CSII and 38 receiving MDI basal-bolus therapy (age range, 7-22 years). All subjects wore the sensor for 4 days, and 3 days were used for statistical analysis. Mean glucose and SD, coefficient of variation (CV), mean amplitude of glucose excursion (MAGE), mean of daily differences (MODD), continuous overall net glycemic action (CONGA) at 2 and 4 h, blood glucose (BG) rate, area under the curve (AUC) above 180 mg/dL and below 70 mg/dL, Low BG Index (LBGI), and High BG Index (HBGI) were calculated. Patients receiving CSII administered more daily boluses than patients receiving MDI (5.2±1.5 vs. 3.2±0.3, respectively; P=0.001). Mean glucose was lower in the CSII group. AUC above 180 mg/dL and HBGI were higher in the MDI group. CV, CONGA at 2 h, CONGA at 2 h during the day, and HBGI were worse in the MDI group, whereas MODD, LBGI, BG rate, and MAGE were similar. A positive correlation (r=0.95; P<0.05) was found between the paired sensor-meter values. For the glucose values <70 mg/dL, sensitivity was 40%, and specificity was 99%. In our pediatric patients during everyday life sensor-augmented CSII therapy seemed more effective than sensor-augmented MDI therapy, in terms both of glucose mean values and of intraday variability. Mild hypoglycemic episodes and indexes of low BG values were similar in the two groups, although the latter results may be inaccurate because of low sensor sensitivity at low glucose value.

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

    PubMed

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

    2010-06-07

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

  5. A prospective comparison of alginate-hydrogel with standard medical therapy to determine impact on functional capacity and clinical outcomes in patients with advanced heart failure (AUGMENT-HF trial)

    PubMed Central

    Anker, Stefan D.; Coats, Andrew J.S.; Cristian, Gabriel; Dragomir, Dinu; Pusineri, Enrico; Piredda, Massimo; Bettari, Luca; Dowling, Robert; Volterrani, Maurizio; Kirwan, Bridget-Anne; Filippatos, Gerasimos; Mas, Jean-Louis; Danchin, Nicolas; Solomon, Scott D.; Lee, Randall J.; Ahmann, Frank; Hinson, Andy; Sabbah, Hani N.; Mann, Douglas L.

    2015-01-01

    Aims AUGMENT-HF was an international, multi-centre, prospective, randomized, controlled trial to evaluate the benefits and safety of a novel method of left ventricular (LV) modification with alginate-hydrogel. Methods Alginate-hydrogel is an inert permanent implant that is directly injected into LV heart muscle and serves as a prosthetic scaffold to modify the shape and size of the dilated LV. Patients with advanced chronic heart failure (HF) were randomized (1 : 1) to alginate-hydrogel (n = 40) in combination with standard medical therapy or standard medical therapy alone (Control, n = 38). The primary endpoint of AUGMENT-HF was the change in peak VO2 from baseline to 6 months. Secondary endpoints included changes in 6-min walk test (6MWT) distance and New York Heart Association (NYHA) functional class, as well as assessments of procedural safety. Results Enrolled patients were 63 ± 10 years old, 74% in NYHA functional class III, had a LV ejection fraction of 26 ± 5% and a mean peak VO2 of 12.2 ± 1.8 mL/kg/min. Thirty-five patients were successfully treated with alginate-hydrogel injections through a limited left thoracotomy approach without device-related complications; the 30-day surgical mortality was 8.6% (3 deaths). Alginate-hydrogel treatment was associated with improved peak VO2 at 6 months—treatment effect vs. Control: +1.24 mL/kg/min (95% confidence interval 0.26–2.23, P = 0.014). Also 6MWT distance and NYHA functional class improved in alginate-hydrogel-treated patients vs. Control (both P < 0.001). Conclusion Alginate-hydrogel in addition to standard medical therapy for patients with advanced chronic HF was more effective than standard medical therapy alone for improving exercise capacity and symptoms. The results of AUGMENT-HF provide proof of concept for a pivotal trial. Trial Registration Number NCT01311791. PMID:26082085

  6. Discovery and Classification of DES15S2nr as a SLSN-I by VLT and AAT

    NASA Astrophysics Data System (ADS)

    D'Andrea, C.; Smith, M.; Sullivan, M.; Childress, M.; Tucker, B.; Sharp, R.; Yuan, F.; Zhang, B.; Davis, T. M.; Mould, J.; Lidman, C.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Scolnic, D.; Covarrubias, R. A.; Brout, D. J.; Fischer, J. A.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Castander, F. J.

    2015-09-01

    We report optical spectroscopy of DES15S2nr as a type I super-luminous supernova (SLSN-I), discovered by the Dark Energy Survey. We obtained spectra using the X-SHOOTER instrument (wavelength range 380-950nm) on the Very Large Telescope (VLT) of the European Southern Observatory (ESO) and the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389; wavelength range 370-885nm) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

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

    PubMed Central

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

    2017-01-01

    Objectives: Diabetes management imposes considerable demands on patients. Treatment method used has an impact on treatment satisfaction. We aim to examine the relationship between treatment satisfaction and health perception with the method used for treatment of type 1 diabetes mellitus in children and adolescents. Subjects and method: We have interviewed patients with type 1 diabetes mellitus using questionnaires to assess treatment satisfaction and health perception. Patients were divided into three groups based on treatment used: multiple daily injection, insulin pump and sensor-augmented pump therapy. Comparison of scores was done between the groups. Results: A total of 72 patients were enrolled (36 males). Mean age (standard deviation) was 11.4 (4.4) years and duration of diabetes of 4.9 (3.5) years. Mean (standard deviation) HbA1c was 8.1 (1.2). Median (range) duration of sensor use was 17.7 (3–30) days/month. Mean scale for treatment satisfaction and health perception questions was 25.3, 29.7 and 31.7 and 60, 79.7 and 81 for the multiple daily injection, pump and sensor-augmented pump, respectively (p = 0.00). Significant difference was seen between the multiple daily injection and both other groups. Sensor-augmented pump group scored higher than the pump group. However, the difference was not statistically significant. Duration of sensor use showed no correlation with treatment satisfaction. Conclusion: The method used for diabetes treatment has an impact on patients’ satisfaction and health perception in children and adolescents with type 1 diabetes mellitus. Insulin pump users have a higher treatment satisfaction and better health perception than those on multiple daily injection. Augmenting pump therapy with sensor use adds value to treatment satisfaction without correlation with the duration of the sensors use. PMID:28321303

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

    PubMed

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

    2017-01-01

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

  9. Serum levels of brain-derived neurotrophic factor and cortisol to sulfate of dehydroepiandrosterone molar ratio associated with clinical response to L-theanine as augmentation of antipsychotic therapy in schizophrenia and schizoaffective disorder patients.

    PubMed

    Miodownik, Chanoch; Maayan, Rachel; Ratner, Yael; Lerner, Vladimir; Pintov, Leonid; Mar, Maria; Weizman, Abraham; Ritsner, Michael S

    2011-01-01

    L-Theanine (γ-glutamylethylamide) augmentation to antipsychotic therapy ameliorates positive, activation, and anxiety symptoms in schizophrenia and schizoaffective disorder patients. This study examines the association between circulating levels of neurochemical indicators and the beneficial clinical effects of L-theanine augmentation. Serum levels of neurochemical indicators such as brain-derived neurotrophic factor (BDNF), dehydroepiandrosterone (DHEA), its sulfate (DHEAS), cortisol, cholesterol, and insulin were monitored in 40 schizophrenia and schizoaffective disorder patients during an 8-week, double-blind, randomized, placebo-controlled trial with L-theanine (400 mg/d). Multiple regression analysis was applied for searching association between improvement in symptom scores and changes in circulating levels of neurochemical indicators for an 8-week trial. Regression models among L-theanine-treated patients indicate that circulating levels of BDNF and cortisol-to-DHEAS*100 molar ratio were significantly associated with the beneficial clinical effects of L-theanine augmentation. Variability of serum BDNF levels accounted for 26.2% of the total variance in reduction of dysphoric mood and 38.2% in anxiety scores. In addition, the changes in cortisol-to-DHEAS*100 molar ratio accounted for 30% to 34% of the variance in activation factor and dysphoric mood scores and for 15.9% in anxiety scores. Regression models among placebo-treated patients did not reach significant level. These preliminary results indicate that circulating BDNF and cortisol-to-DHEAS*100 molar ratio may be involved in the beneficial clinical effects of L-theanine as augmentation of antipsychotic therapy in schizophrenia and schizoaffective disorder patients.

  10. Efficacy and safety of oxytocin augmentation therapy for schizophrenia: an updated systematic review and meta-analysis of randomized, placebo-controlled trials.

    PubMed

    Oya, Kazuto; Matsuda, Yuki; Matsunaga, Shinji; Kishi, Taro; Iwata, Nakao

    2016-08-01

    The aim of this study was to perform a systematic review and an updated and comprehensive meta-analysis of oxytocin augmentation therapy in patients with schizophrenia who received antipsychotic agents. Data published up to 07/11/2015 were obtained from PubMed, PsycINFO, and Cochrane Library databases. We conducted a systematic review and meta-analysis of patients' data from randomized controlled trials (RCTs) comparing oxytocin with placebo. Relative risk (RR), standardized mean difference (SMD), and 95 % confidence intervals (95 % CI) based on the random-effects model were calculated. We included seven RCTs; the total sample size was 206 patients. Oxytocin was superior to placebo for decreasing the Positive and Negative Syndrome Scale (PANSS) general subscale scores (SMD = -0.44, 95 % CI -0.82 to -0.06, p = 0.02, I (2) = 0 %, N = 4, n = 112); however, it was not different from placebo for total symptoms (SMD = -0.46, 95 % CI -1.20 to 0.28, p = 0.22, I (2) = 80 %, N = 6, n = 162), positive symptoms (SMD = -0.18, 95 % CI -0.87 to 0.51, p = 0.60, I (2) = 81 %, N = 6, n = 192), and negative symptoms (SMD = -0.34, 95 % CI -0.76 to 0.08, p = 0.12, I (2) = 55 %, N = 7, n = 214). However, a sensitivity analysis including only oxytocin administration on consecutive days studies was superior to placebo in negative symptoms (SMD = -0.44, 95 % CI -0.87 to -0.01, p = 0.04, I (2) = 51 %, N = 6 n = 192). There were no significant differences for all-cause discontinuation (RR = 1.02) and individual side effects such as headache and dizziness between oxytocin and placebo. Oxytocin may improve PANSS general subscale scores in schizophrenia and seems to be well tolerated. However, because the number of studies in the current analysis was small, further study will be required using larger sample sizes.

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

    PubMed

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

    2017-05-01

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

  12. How Is Alpha-1 Antitrypsin Deficiency Treated?

    MedlinePlus

    ... surgery, you may be a candidate for it. Augmentation (og-men-TA-shun) therapy is a treatment ... bloodstream. They're also studying a type of augmentation therapy in which the AAT protein is inhaled ...

  13. Attitudes to animal-assisted therapy with farm animals among health staff and farmers.

    PubMed

    Berget, B; Ekeberg, Ø; Braastad, B O

    2008-09-01

    Green care is a concept that involves the use of farm animals, plants, gardens or the landscape in cooperation with health institutions for different target groups of clients. The present study aimed at examining psychiatric therapists' (n = 60) and farmers' (n = 15) knowledge, experience and attitudes to Green care and animal-assisted therapy (AAT) with farm animals for people with psychiatric disorders. Most respondents had some or large knowledge about Green care, but experience with Green care was generally low in both groups. Both farmers and therapists believed that AAT with farm animals could contribute positively to therapy to a large or very large extent, with farmers being significantly more positive. Most of the therapists thought that AAT with farm animals contributes to increased skills in interactions with other humans, with female therapists being more positive than males. Two-thirds of the therapists believed that AAT with farm animals to a large extent could contribute better to mental health than other types of occupational therapy. There were no differences in attitudes to AAT between psychiatrists/psychologists and psychiatric nurses. This study confirms the marked potential of offering AAT services with farm animals for psychiatric patients by documenting positive attitudes to it among psychiatric therapists.

  14. The DARS (Dopamine Augmented Rehabilitation in Stroke) trial: protocol for a randomised controlled trial of Co-careldopa treatment in addition to routine NHS occupational and physical therapy after stroke.

    PubMed

    Bhakta, Bipin B; Hartley, Suzanne; Holloway, Ivana; Couzens, J Alastair; Ford, Gary A; Meads, David; Sackley, Catherine M; Walker, Marion F; Ruddock, Sharon P; Farrin, Amanda J

    2014-08-08

    Stroke has a huge impact, leaving more than a third of affected people with lasting disability and rehabilitation remains a cornerstone treatment in the National Health Service (NHS). Recovery of mobility and arm function post-stroke occurs through re-learning to use the affected body parts and/or learning to compensate with the lesser affected side. Promising evidence suggests that the addition of Co-careldopa to physical therapy and occupational therapy may improve the recovery of arm and leg movement and lead to improved function. Dopamine Augmented Rehabilitation in Stroke (DARS) is a multi-centre double-blind, randomised, placebo, controlled clinical trial of Co-careldopa in addition to routine NHS occupational therapy and physical therapy as part of early stroke rehabilitation. Participants will be randomised on a 1:1 basis to either Co-careldopa or placebo. The primary objective of the trial is to determine whether the addition of six weeks of Co-careldopa treatment to rehabilitation therapy can improve the proportion of patients who can walk independently eight weeks post-randomisation. The DARS trial will provide evidence as to whether Co-careldopa, in addition to routine NHS occupational and physical therapy, leads to a greater recovery of motor function, a reduction in carer dependency and advance rehabilitation treatments for people with stroke. ISRCTN99643613 assigned on 4 December 2009.

  15. (AAT)n repeat in the cannabinoid receptor gene (CNR1): association with cocaine addiction in an African-Caribbean population.

    PubMed

    Ballon, N; Leroy, S; Roy, C; Bourdel, M C; Charles-Nicolas, A; Krebs, M O; Poirier, M F

    2006-01-01

    Owing to their agonist action on dopaminergic systems, cannabinoids may play a major role in substance dependency and schizophrenia. We examined the (AAT)n triplet repeat polymorphism nearby the CNR1 gene, which encodes human cannabinoid (CB1) receptor, in a male Afro-Caribbean population. The allelic and genotypic distributions were significantly different in non-schizophrenic cocaine dependents (n = 97), schizophrenic cocaine dependents (n = 45) and matched controls (n = 88) (P < 10(-4)). The frequency of the (AAT)12 repeat allele was increased in non-schizophrenic cocaine dependents and schizophrenic cocaine dependents vs controls (25.3 and 26.7 vs 5.7%) (P < 10(-4)). Our results support that the (AAT)n polymorphism nearby the CNR1 gene could be associated with predisposition to cocaine dependency.

  16. Psychotherapy Augmentation through Preconscious Priming

    PubMed Central

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

    2013-01-01

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

  17. Genotoxicity of o-aminoazotoluene (AAT) determined by the Ames test, the in vitro chromosomal aberration test, and the transgenic mouse gene mutation assay.

    PubMed

    Ohsawa, K; Hirano, N; Sugiura, M; Nakagawa, S; Kimura, M

    2000-11-20

    o-Aminoazotoluene (AAT) has been evaluated as a possible human carcinogen (Class 2B) by the International Agency for Research on Cancer (IARC). The Ames test found it to be mutagenic in the presence of a metabolic activation system, whereas it has little clastogenicity either in vitro or in vivo in the chromosomal aberration assay. AAT is also carcinogenic in the lung or liver of mice and rats given long-term administrations. Therefore, metabolites generated in the liver etc. may have gene mutation activity, and carcinogenesis would occur. We examined the mutagenicity of AAT in a gene mutation assay, using lacZ transgenic mice (MutaMice) and a positive selection method. AAT showed positive results for organs with metabolic functions, such as liver and colon and other organs. Positive results were also seen in an Ames test in the presence of metabolic activation and negative results seen in a chromosomal aberration test. Therefore, AAT had the potential to cause gene mutation in the presence of metabolic activation systems in vitro and the same reaction was confirmed in vivo with organs with metabolic function, such as liver and colon, but little clastogenicity in vitro or in vivo. Thus, metabolites with gene mutation activity may be responsible for the carcinogenicity of AAT. The transgenic mouse mutation assay proved to be useful for concurrent assessment of in vivo mutagenicity in multiple organs and to supplement the standard in vivo genotoxicity tests, such as the micronucleus assay which is limited to bone marrow as the only target organ.

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

    PubMed Central

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

    2014-01-01

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

  19. Insertion of N-linked glycosylation sites in the variable regions of the human immunodeficiency virus type 1 surface glycoprotein through AAT triplet reiteration.

    PubMed Central

    Bosch, M L; Andeweg, A C; Schipper, R; Kenter, M

    1994-01-01

    Variable regions with sequence length variation in the human immunodeficiency virus type 1 envelope exhibit an unusual pattern of codon usage with AAT, ACT, and AGT together composing > 70% of all codons used. We postulate that this distribution is caused by insertion of AAT triplets followed by point mutations and selection. Accumulation of the encoded amino acids (asparagine, serine, and threonine) leads to the creation of new N-linked glycosylation sites, which helps the virus to escape from the immune pressure exerted by virus-neutralizing antibodies. PMID:7933144

  20. The effects of animal-assisted therapy on wounded warriors in an Occupational Therapy Life Skills program.

    PubMed

    Beck, Christine E; Gonzales, Florie; Sells, Carol Haertlein; Jones, Cynthia; Reer, Theresa; Zhu, Yao Yao

    2012-01-01

    Animal-assisted therapy (AAT) has gained much attention in civilian and military health care. Evidence supports its benefits with varied populations with diseases and disabilities, but no research has been done with injured or ill service members. This pretest, posttest nonrandomized control group study evaluated the effects of AAT on Warriors in transition (N=24) attending an Occupational Therapy Life Skills program with the long-term goal of improving their successful reintegration. Although significant differences were not found between the groups on most measures, anecdotal reports by participants and observers indicate that participants eagerly anticipated being with the therapy dogs, expressed pleasure and satisfaction with the experience, and regretted seeing it end. There were significant correlations between mood, stress, resilience, fatigue, and function at various measurement points. This is the first study to formally assess the benefits of AAT with wounded service members in garrison. Suggestions for future research are provided.

  1. Recombinant adeno-associated virus-mediated alpha-1 antitrypsin gene therapy prevents type I diabetes in NOD mice.

    PubMed

    Song, S; Goudy, K; Campbell-Thompson, M; Wasserfall, C; Scott-Jorgensen, M; Wang, J; Tang, Q; Crawford, J M; Ellis, T M; Atkinson, M A; Flotte, T R

    2004-01-01

    Type I diabetes results from an autoimmune destruction of the insulin-producing pancreatic beta cells. Although the exact immunologic processes underlying this disease are unclear, increasing evidence suggests that immunosuppressive, immunoregulatory and anti-inflammatory agents can interrupt the progression of the disease. Alpha 1 antitrypsin (AAT) is a multifunctional serine proteinase inhibitor (serpin) that also displays a wide range of anti-inflammatory properties. To test the ability of AAT to modulate the development of type I diabetes, we performed a series of investigations involving recombinant adeno-associated virus vector (rAAV)-mediated gene delivery of human alpha-1 antitrypsin (hAAT) to nonobese diabetic (NOD) mice. Recombinant AAV-expressing hAAT (rAAV2-CB-AT) was administered intramuscularly to 4-week-old female NOD mice (1 x 10(10) i.u./mouse). A single injection of this vector reduced the intensity of insulitis, the levels of insulin autoantibodies, and the frequency of overt type I diabetes (30% (3/10) at 32 weeks of age versus 70% (7/10) in controls). Transgene expression at the injection sites was confirmed by immunostaining. Interestingly, antibodies against hAAT were present in a majority of the vector-injected mice and circulating hAAT was undetectable when assessed 10 weeks postinjection. This study suggests a potential therapeutic role for AAT in preventing type I diabetes as well as the ability of AAV gene therapy-based approaches to ameliorate disease effectively.

  2. Helping Children with Disabilities through Animal-Assisted Therapy

    ERIC Educational Resources Information Center

    Watts, Katie; Everly, Janet Stout

    2009-01-01

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

  3. Helping Children with Disabilities through Animal-Assisted Therapy

    ERIC Educational Resources Information Center

    Watts, Katie; Everly, Janet Stout

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Pitts, John L.

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Pitts, John L.

    2005-01-01

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

  6. A novel AAT-deletion mutation in the coding sequence of the BCO2 gene in yellow-fat rabbits.

    PubMed

    Strychalski, Janusz; Brym, Paweł; Czarnik, Urszula; Gugołek, Andrzej

    2015-11-01

    The carcasses of yellow-fat rabbits may be attractive to modern consumers, because they have a relatively high content of biologically active compounds. One of the main candidate genes associated with the yellow-fat trait is β-carotene 9',10'-oxygenase (BCO2). This study is the first report of the novel AAT-deletion mutation at codon 248 of the BCO2 gene, which has been found in homozygous yellow-fat rabbits. The deletion mutation, located at the beginning of exon 6, results in the absence of asparagine in protein. We also developed a PCR-RFLP test that supports intravital genotyping of indel polymorphism based on genomic DNA.

  7. A prospective comparison of alginate-hydrogel with standard medical therapy to determine impact on functional capacity and clinical outcomes in patients with advanced heart failure (AUGMENT-HF trial).

    PubMed

    Anker, Stefan D; Coats, Andrew J S; Cristian, Gabriel; Dragomir, Dinu; Pusineri, Enrico; Piredda, Massimo; Bettari, Luca; Dowling, Robert; Volterrani, Maurizio; Kirwan, Bridget-Anne; Filippatos, Gerasimos; Mas, Jean-Louis; Danchin, Nicolas; Solomon, Scott D; Lee, Randall J; Ahmann, Frank; Hinson, Andy; Sabbah, Hani N; Mann, Douglas L

    2015-09-07

    AUGMENT-HF was an international, multi-centre, prospective, randomized, controlled trial to evaluate the benefits and safety of a novel method of left ventricular (LV) modification with alginate-hydrogel. Alginate-hydrogel is an inert permanent implant that is directly injected into LV heart muscle and serves as a prosthetic scaffold to modify the shape and size of the dilated LV. Patients with advanced chronic heart failure (HF) were randomized (1 : 1) to alginate-hydrogel (n = 40) in combination with standard medical therapy or standard medical therapy alone (Control, n = 38). The primary endpoint of AUGMENT-HF was the change in peak VO2 from baseline to 6 months. Secondary endpoints included changes in 6-min walk test (6MWT) distance and New York Heart Association (NYHA) functional class, as well as assessments of procedural safety. Enrolled patients were 63 ± 10 years old, 74% in NYHA functional class III, had a LV ejection fraction of 26 ± 5% and a mean peak VO2 of 12.2 ± 1.8 mL/kg/min. Thirty-five patients were successfully treated with alginate-hydrogel injections through a limited left thoracotomy approach without device-related complications; the 30-day surgical mortality was 8.6% (3 deaths). Alginate-hydrogel treatment was associated with improved peak VO2 at 6 months-treatment effect vs. +1.24 mL/kg/min (95% confidence interval 0.26-2.23, P = 0.014). Also 6MWT distance and NYHA functional class improved in alginate-hydrogel-treated patients vs. Control (both P < 0.001). Alginate-hydrogel in addition to standard medical therapy for patients with advanced chronic HF was more effective than standard medical therapy alone for improving exercise capacity and symptoms. The results of AUGMENT-HF provide proof of concept for a pivotal trial. NCT01311791. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  8. Augmentation in restless legs syndrome patients in Korea.

    PubMed

    Jeon, Ji-Ye; Moon, Hye-Jin; Song, Mei Ling; Lee, Hochang B; Cho, Yong Won

    2015-05-01

    Augmentation has been known as the major complication of long-term dopaminergic treatment of restless legs syndrome (RLS). However, there have been no reports on the prevalence of augmentation in Korea. Thus, we aimed to assess the rate of augmentation and evaluate related factors in Korean RLS patients. Ninety-four idiopathic RLS patients who have been treated over a period of at least 6 months were enrolled. Thirty subjects were treated with a dopamine agonist only, and 64 were treated with a dopamine agonist and alpha two delta ligands. We assessed the clinical characteristics of those RLS subjects and evaluated the rate of augmentation. Augmentation was assessed using the NIH criteria for augmentation by two RLS experts independently. Eleven subjects (11.7%) were classified as having definitive or highly suggestive clinical indication of augmentation. In comparing the augmentation group with the non-augmentation group, there were no significant differences of baseline clinical characteristics. Four (13.3%) of the dopamine agonists monotherapy group and seven (10.9%) of the combination therapy group were categorized as augmentation. There was no significant difference in the augmentation rate between these two groups. We found an 11.7% augmentation rate in Korean RLS subjects. There was no difference in the rate of RLS augmentation between the dopaminergic monotherapy group and the combined treatment group. It may be related with using a similar dosage of dopaminergic drugs.

  9. [Evaluation of animal-assisted therapy for the elderly with senile dementia in a day care program].

    PubMed

    Kanamori, M; Suzuki, M; Yamamoto, K; Kanda, M; Matsui, Y; Kozima, E; Takeuchi, S; Oshiro, H

    2001-09-01

    We conducted animal-assisted therapy (AAT) for the elderly with senile dementia in a day care center. AAT was performed between July 27 and October 12, 1999 for a total of six biweekly sessions. The AAT group consisted of 7 subjects; 5 with senile dementia of Alzheimer's type (SDAT) and 2 with vascular dementia (VD). The control group was 20 elderly subjects (7 SDAT, 13 VD). The results were as follows: Comparing between MMS scores at the baseline and those three months later, the average score on MMS before AAT (baseline) was 11.43 (+/- 9.00), and that three months later was 12.29 (+/- 9.69). In the AAT group, the average baseline N-ADL score was 28.43 (+/- 14.00) and that after ATT was 29.57 (+/- 14.47). In the AAT group, the average baseline score on Behave-AD was 11.14 (+/- 4.85), and that three months after AAT was 7.29 (+/- 7.11) (p < 0.05). In the control group, the average baseline score was 5.45 (+/- 3.27) and that three month later was 5.63 (+/- 3.59). However, the results of eight subscales of communication behavior three months later were significantly low comparing to those at the baseline in the control group. The evaluation of CgA, which was a mental stress index, showed a decreasing tendency in the AAT group. Our findings suggested we should use several evaluation methods for evaluation of the changes of patients receiving AAT.

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

    ERIC Educational Resources Information Center

    Frank, Jennifer Vest

    2012-01-01

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

  11. Augmented Reality in astrophysics

    NASA Astrophysics Data System (ADS)

    Vogt, Frédéric P. A.; Shingles, Luke J.

    2013-09-01

    Augmented Reality consists of merging live images with virtual layers of information. The rapid growth in the popularity of smartphones and tablets over recent years has provided a large base of potential users of Augmented Reality technology, and virtual layers of information can now be attached to a wide variety of physical objects. In this article, we explore the potential of Augmented Reality for astrophysical research with two distinct experiments: (1) Augmented Posters and (2) Augmented Articles. We demonstrate that the emerging technology of Augmented Reality can already be used and implemented without expert knowledge using currently available apps. Our experiments highlight the potential of Augmented Reality to improve the communication of scientific results in the field of astrophysics. We also present feedback gathered from the Australian astrophysics community that reveals evidence of some interest in this technology by astronomers who experimented with Augmented Posters. In addition, we discuss possible future trends for Augmented Reality applications in astrophysics, and explore the current limitations associated with the technology. This Augmented Article, the first of its kind, is designed to allow the reader to directly experiment with this technology.

  12. Horizontal ridge augmentation using a combination approach

    PubMed Central

    Rachana, C.; Sridhar, N.; Rangan, Anand V.; Rajani, V.

    2012-01-01

    Resorption of alveolar bone - a common sequel of tooth loss jeopardizes the functional and esthetic outcome of treatment, especially in the maxillary anterior areas. Therefore, augmentation of deficient alveolar ridges is an important aspect of dental implant therapy. A case of severe maxillary ridge deficiency successfully treated with horizontal ridge augmentation to facilitate implant placement is described. Ridge augmentation was achieved using a combination of autogenous block graft, particulate grafting, and guided bone regeneration (GBR). Follow-up was done next day, after ten days, three months, and six months. Various approaches can be followed in order to achieve an increase in the ridge width. In our case, we used a combination of different techniques for ridge augmentation. A significant improvement in ridge width was noticed at six months thus facilitating the placement of implants. PMID:23162345

  13. Animal-Assisted Therapies and Dementia: A Systematic Mapping Review Using the Lived Environment Life Quality (LELQ) Model.

    PubMed

    Wood, Wendy; Fields, Beth; Rose, Michelle; McLure, Merinda

    The authors mapped the literature on animal-assisted therapies (AATs) and institutionalized adults with dementia onto the Lived Environment Life Quality (LELQ) Model as a guide for future services and research. Refereed literature addressing AATs and institutionalized people with dementia was comprehensively gathered, described, categorized, and synthesized in this systematic mapping review. From 1,342 screened records, the authors included 10 research articles that incorporated dogs in therapy for institutionalized adults with dementia. These canine-assisted therapies offered occupational opportunities and environmental supports conducive to experiences of relative well-being, occupational engagement, and optimal functioning. The findings offer proof of the concept that canine-assisted therapies are feasible and can elicit positive quality-of-life experiences in institutionalized people with dementia. Researchers and practitioners need to elucidate the theoretical foundations of AATs. The LELQ Model may serve as a guide for client-centered, occupation-focused, and ecologically valid approaches to animal-assisted occupational therapy.

  14. Animal-assisted therapy as a pain relief intervention for children.

    PubMed

    Braun, Carie; Stangler, Teresa; Narveson, Jennifer; Pettingell, Sandra

    2009-05-01

    Animal-assisted therapy (AAT) is a healing modality involving a patient, an animal therapist, and handler with a goal of achieving a specified therapeutic outcome. Despite the myriad of studies documenting the benefits of AAT, no studies have yet determined the impact of animals on alleviation of pain in children. Therefore, a quasi-experimental intervention design was used to capture the change in pain and vital signs with (n=18) or without (n=39) AAT in children ages 3-17 in one acute care pediatric setting. The AAT intervention group experienced a significant reduction in pain level compared to the control group, t(55)=-2.86, p=.006. Although blood pressure and pulse were not impacted, respiratory rates became significantly higher in the AAT group (by an average of 2.22 breaths/min) as compared to the control group, t(55)=-2.63, p=.011. This study provides further support to the numerous health benefits of AAT, particularly for children in pain.

  15. STAR 3 Randomized Controlled Trial to Compare Sensor-Augmented Insulin Pump Therapy with Multiple Daily Injections in the Treatment of Type 1 Diabetes: Research Design, Methods, and Baseline Characteristics of Enrolled Subjects

    PubMed Central

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

    2010-01-01

    Abstract Background Sensor-augmented pump therapy (SAPT) integrates real-time continuous glucose monitoring (RT-CGM) with continuous subcutaneous insulin infusion (CSII) and offers an alternative to multiple daily injections (MDI). Previous studies provide evidence that SAPT may improve clinical outcomes among people with type 1 diabetes. Sensor-Augmented Pump Therapy for A1c Reduction (STAR) 3 is a multicenter randomized controlled trial comparing the efficacy of SAPT to that of MDI in subjects with type 1 diabetes. Methods Subjects were randomized to either continue with MDI or transition to SAPT for 1 year. Subjects in the MDI cohort were allowed to transition to SAPT for 6 months after completion of the study. SAPT subjects who completed the study were also allowed to continue for 6 months. The primary end point was the difference between treatment groups in change in hemoglobin A1c (HbA1c) percentage from baseline to 1 year of treatment. Secondary end points included percentage of subjects with HbA1c ≤7% and without severe hypoglycemia, as well as area under the curve of time spent in normal glycemic ranges. Tertiary end points include percentage of subjects with HbA1c ≤7%, key safety end points, user satisfaction, and responses on standardized assessments. Results A total of 495 subjects were enrolled, and the baseline characteristics similar between the SAPT and MDI groups. Study completion is anticipated in June 2010. Conclusions Results of this randomized controlled trial should help establish whether an integrated RT-CGM and CSII system benefits patients with type 1 diabetes more than MDI. PMID:20210562

  16. Rapamycin/IL-2 Combination Therapy in Patients With Type 1 Diabetes Augments Tregs yet Transiently Impairs β-Cell Function

    PubMed Central

    Long, S. Alice; Rieck, Mary; Sanda, Srinath; Bollyky, Jennifer B.; Samuels, Peter L.; Goland, Robin; Ahmann, Andrew; Rabinovitch, Alex; Aggarwal, Sudeepta; Phippard, Deborah; Turka, Laurence A.; Ehlers, Mario R.; Bianchine, Peter J.; Boyle, Karen D.; Adah, Steven A.; Bluestone, Jeffrey A.; Buckner, Jane H.; Greenbaum, Carla J.

    2012-01-01

    Rapamycin/interleukin-2 (IL-2) combination treatment of NOD mice effectively treats autoimmune diabetes. We performed a phase 1 clinical trial to test the safety and immunologic effects of rapamycin/IL-2 combination therapy in type 1 diabetic (T1D) patients. Nine T1D subjects were treated with 2–4 mg/day rapamycin orally for 3 months and 4.5 × 106 IU IL-2 s.c. three times per week for 1 month. β-Cell function was monitored by measuring C-peptide. Immunologic changes were monitored using flow cytometry and serum analyses. Regulatory T cells (Tregs) increased within the first month of therapy, yet clinical and metabolic data demonstrated a transient worsening in all subjects. The increase in Tregs was transient, paralleling IL-2 treatment, whereas the response of Tregs to IL-2, as measured by STAT5 phosphorylation, increased and persisted after treatment. No differences were observed in effector T-cell subset frequencies, but an increase in natural killer cells and eosinophils occurred with IL-2 therapy. Rapamycin/IL-2 therapy, as given in this phase 1 study, resulted in transient β-cell dysfunction despite an increase in Tregs. Such results highlight the difficulties in translating therapies to the clinic and emphasize the importance of broadly interrogating the immune system to evaluate the effects of therapy. PMID:22721971

  17. Confronting an Augmented Reality

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  18. Subfascial gluteal augmentation.

    PubMed

    de la Peña, J Abel; Rubio, Omar V; Cano, Jacobo P; Cedillo, Mariana C; Garcés, Miriam T

    2006-07-01

    Developing the concept of gluteal augmentation through the past 17 years has been an academic adventure. During these years my coworkers and I have progressively improved surgical technique and devised an anatomical system for gluteal augmentation that includes an ideal implant design and templates to assist in evaluating patients in the preoperative period and to identify the most appropriate implant size.

  19. Equating of Augmented Subscores

    ERIC Educational Resources Information Center

    Sinharay, Sandip; Haberman, Shelby J.

    2011-01-01

    Recently, there has been an increasing level of interest in subscores for their potential diagnostic value. Haberman (2008b) suggested reporting an augmented subscore that is a linear combination of a subscore and the total score. Sinharay and Haberman (2008) and Sinharay (2010) showed that augmented subscores often lead to more accurate…

  20. Confronting an Augmented Reality

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  1. The Augmentation System Framework.

    ERIC Educational Resources Information Center

    Engelbart, Doug; Hooper, Kristina

    1986-01-01

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

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

    PubMed

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

    2017-01-01

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

  3. Characterization of a Pseudomonas putida ABC transporter (AatJMQP) required for acidic amino acid uptake: biochemical properties and regulation by the Aau two-component system.

    PubMed

    Singh, Birendra; Röhm, Klaus-Heinrich

    2008-03-01

    We describe an ATP-binding cassette (ABC) transporter in Pseudomonas putida KT2440 that mediates the uptake of glutamate and aspartate. The system (AatJMQP, for acidic amino acid transport) is encoded by an operon involving genes PP1071-PP1068. A deletion mutant with inactivated solute-binding protein (KTaatJ) failed to grow on Glu and Gln as sole sources of carbon and nitrogen, while a mutant lacking a functional nucleotide-binding domain (KTaatP) was able to adapt to growth on Glu after an extended lag phase. Uptake of Glu and Asp by either mutant was greatly impaired at both low and high amino acid concentrations. The purified solute-binding protein AatJ exhibited high affinity towards Glu and Asp (K(d)=0.4 and 1.3 muM, respectively), while Gln and Asn as well as dicarboxylates (succinate and fumarate) were bound with much lower affinity. We further show that the expression of AatJMQP is controlled by the sigma(54)-dependent two-component system AauRS. Binding of the response regulator AauR to the aat promoter was examined by gel mobility shift assays and DNase I footprinting. By in silico screening, the AauR-binding motif (the inverted repeat TTCGGNNNNCCGAA) was detected in further P. putida KT2440 genes with established or putative functions in acidic amino acid utilization, and also occurred in other pseudomonads. The products of these AauR-responsive genes include the H(+)/Glu symporter GltP, a periplasmic glutaminase/asparaginase, AnsB, and phosphoenolpyruvate synthase (PpsA), a key enzyme of gluconeogenesis in Gram-negative bacteria. Based on these findings, we propose that AauR is a central regulator of acidic amino acid uptake and metabolism in pseudomonads.

  4. Truncation of Ube3a-ATS unsilences paternal Ube3a and ameliorates behavioral defects in the Angelman syndrome mouse model.

    PubMed

    Meng, Linyan; Person, Richard Erwin; Huang, Wei; Zhu, Ping Jun; Costa-Mattioli, Mauro; Beaudet, Arthur L

    2013-01-01

    Angelman syndrome (AS) is a severe neurodevelopmental disorder caused by maternal deficiency of the imprinted gene UBE3A. Individuals with AS suffer from intellectual disability, speech impairment, and motor dysfunction. Currently there is no cure for the disease. Here, we evaluated the phenotypic effect of activating the silenced paternal allele of Ube3a by depleting its antisense RNA Ube3a-ATS in mice. Premature termination of Ube3a-ATS by poly(A) cassette insertion activates expression of Ube3a from the paternal chromosome, and ameliorates many disease-related symptoms in the AS mouse model, including motor coordination defects, cognitive deficit, and impaired long-term potentiation. Studies on the imprinting mechanism of Ube3a revealed a pattern of biallelic transcription initiation with suppressed elongation of paternal Ube3a, implicating transcriptional collision between sense and antisense polymerases. These studies demonstrate the feasibility and utility of unsilencing the paternal copy of Ube3a via targeting Ube3a-ATS as a treatment for Angelman syndrome.

  5. Truncation of Ube3a-ATS Unsilences Paternal Ube3a and Ameliorates Behavioral Defects in the Angelman Syndrome Mouse Model

    PubMed Central

    Meng, Linyan; Person, Richard Erwin; Huang, Wei; Zhu, Ping Jun; Costa-Mattioli, Mauro; Beaudet, Arthur L.

    2013-01-01

    Angelman syndrome (AS) is a severe neurodevelopmental disorder caused by maternal deficiency of the imprinted gene UBE3A. Individuals with AS suffer from intellectual disability, speech impairment, and motor dysfunction. Currently there is no cure for the disease. Here, we evaluated the phenotypic effect of activating the silenced paternal allele of Ube3a by depleting its antisense RNA Ube3a-ATS in mice. Premature termination of Ube3a-ATS by poly(A) cassette insertion activates expression of Ube3a from the paternal chromosome, and ameliorates many disease-related symptoms in the AS mouse model, including motor coordination defects, cognitive deficit, and impaired long-term potentiation. Studies on the imprinting mechanism of Ube3a revealed a pattern of biallelic transcription initiation with suppressed elongation of paternal Ube3a, implicating transcriptional collision between sense and antisense polymerases. These studies demonstrate the feasibility and utility of unsilencing the paternal copy of Ube3a via targeting Ube3a-ATS as a treatment for Angelman syndrome. PMID:24385930

  6. Augmented reality: a review.

    PubMed

    Berryman, Donna R

    2012-01-01

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

  7. [A daycare program of animal assisted therapy for affective disorder patients during psychotropic drug therapy: evaluation of the relaxation effect by fNIRS (functional near-infrared spectroscopy)].

    PubMed

    Iwahashi, Kazuhiko; Fukamauchi, Fumihiko; Aoki, Jun; Kurihara, Kouhei; Yoshihara, Eiji; Inoue, Masao; Shibanai, Hiroko; Ishigooka, Jun

    2010-06-01

    During daycare programs of animal assisted therapy (AAT), we collected data on the brain function of two affective disorder patients who received psychotropic drug therapy with fNIRS, after written informed consent was obtained. A male patient at first showed a bloodstream drop, seen in the lower inside part of frontal lobe. In both patients, at least a slight activation of the function of the frontal lobe was seen during the therapy. Therefore, an activation effect of AAT was seen at least objectively by fNIRS.

  8. Relationship between plasma concentrations of lamotrigine and its early therapeutic effect of lamotrigine augmentation therapy in treatment-resistant depressive disorder.

    PubMed

    Kagawa, Shoko; Mihara, Kazuo; Nakamura, Akifumi; Nemoto, Kenji; Suzuki, Takeshi; Nagai, Goyo; Kondo, Tsuyoshi

    2014-12-01

    The relationship between plasma concentrations of lamotrigine and its therapeutic effects was prospectively studied on 34 (9 men and 25 women) inpatients with treatment-resistant depressive disorder during an 8-week treatment of lamotrigine augmentation using an open-study design. The subjects were depressed patients who had already shown insufficient response to at least 3 psychotropics, including antidepressants, mood stabilizers, and atypical antipsychotics. The diagnoses were major depressive disorder (n = 12), bipolar I disorder (n = 7), and bipolar II disorder (n = 15). The final doses of lamotrigine were 100 mg/d for 18 subjects who were not taking valproate and 75 mg/d for 16 subjects taking valproate. Depressive symptoms were evaluated by the Montgomery Åsberg Depression Rating Scale (MADRS) before and after the 8-week treatment. Blood sampling was performed at week 8. Plasma concentrations of lamotrigine were measured by high-performance liquid chromatography. There was a significant linear relationship between the plasma concentrations of lamotrigine and percentage improvements at week 8 (r = 0.418, P < 0.05). A stepwise multiple regression analysis showed that plasma lamotrigine concentrations alone had a significant effect on the percentage improvements at week 8 (standardized partial correlation coefficients = 0.454, P < 0.001). The receiver operating characteristics analysis indicated that a plasma lamotrigine concentration of 12.7 μmol/L or greater was significantly (P < 0.001) predictive of response (50% or more reduction in the MADRS score). The proportion of the responders was significantly higher in the groups with a lamotrigine concentration >12.7 μmol/L (11/15 versus 4/19, P < 0.01). The present study suggests that an early therapeutic response to lamotrigine is dependent on its plasma concentration and that a plasma lamotrigine concentration of 12.7 μmol/L may be a threshold for a good therapeutic response in treatment

  9. CK2 inhibitor CX-4945 suppresses DNA repair response triggered by DNA-targeted anticancer drugs and augments efficacy: mechanistic rationale for drug combination therapy.

    PubMed

    Siddiqui-Jain, Adam; Bliesath, Joshua; Macalino, Diwata; Omori, Mayuko; Huser, Nanni; Streiner, Nicole; Ho, Caroline B; Anderes, Kenna; Proffitt, Chris; O'Brien, Sean E; Lim, John K C; Von Hoff, Daniel D; Ryckman, David M; Rice, William G; Drygin, Denis

    2012-04-01

    Drug combination therapies are commonly used for the treatment of cancers to increase therapeutic efficacy, reduce toxicity, and decrease the incidence of drug resistance. Although drug combination therapies were originally devised primarily by empirical methods, the increased understanding of drug mechanisms and the pathways they modulate provides a unique opportunity to design combinations that are based on mechanistic rationale. We have identified protein kinase CK2 as a promising therapeutic target for combination therapy, because CK2 regulates not just one but many oncogenic pathways and processes that play important roles in drug resistance, including DNA repair, epidermal growth factor receptor signaling, PI3K/AKT/mTOR signaling, Hsp90 machinery activity, hypoxia, and interleukin-6 expression. In this article, we show that CX-4945, a clinical stage selective small molecule inhibitor of CK2, blocks the DNA repair response induced by gemcitabine and cisplatin and synergizes with these agents in models of ovarian cancer. Mechanistic studies show that the enhanced activity is a result of inactivation of XRCC1 and MDC1, two mediator/adaptor proteins that are essential for DNA repair and that require phosphorylation by CK2 for their function. These data position CK2 as a valid pharmacologic target for intelligent drug combinations and support the evaluation of CX-4945 in combination with gemcitabine and platinum-based chemotherapeutics in the clinical setting. ©2012 AACR.

  10. Chin augmentation - slideshow

    MedlinePlus

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

  11. Breast augmentation - slideshow

    MedlinePlus

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

  12. The influence of cell growth and enzyme activity changes on intracellular metabolite dynamics in AGE1.HN.AAT cells.

    PubMed

    Rath, Alexander G; Rehberg, Markus; Janke, Robert; Genzel, Yvonne; Scholz, Sebastian; Noll, Thomas; Rose, Thomas; Sandig, Volker; Reichl, Udo

    2014-05-20

    Optimization of bioprocesses with mammalian cells mainly concentrates on cell engineering, cell screening and medium optimization to achieve enhanced cell growth and productivity. For improving cell lines by cell engineering techniques, in-depth understandings of the regulation of metabolism and product formation as well as the resulting demand for the different medium components are needed. In this work, the relationship of cell specific growth and uptake rates and of changes in maximum in vitro enzyme activities with intracellular metabolite pools of glycolysis, pentose phosphate pathway, citric acid cycle and energy metabolism were determined for batch cultivations with AGE1.HN.AAT cells. Results obtained by modeling cell growth and consumption of main substrates showed that the dynamics of intracellular metabolite pools is primarily linked to the dynamics of specific glucose and glutamine uptake rates. By analyzing maximum in vitro enzyme activities we found low activities of pyruvate dehydrogenase and pyruvate carboxylase which suggest a reduced metabolite transfer into the citric acid cycle resulting in lactate release (Warburg effect). Moreover, an increase in the volumetric lactate production rate during the transition from exponential to stationary growth together with a transient accumulation of fructose 1,6-bisphosphate, fructose 1-phosphate and ribose 5-phosphate point toward an upregulation of PK via FBP. Glutaminase activity was about 44-fold lower than activity of glutamine synthetase. This seemed to be sufficient for the supply of intermediates for biosynthesis but might lead to unnecessary dissipation of ATP. Taken together, our results elucidate regulation of metabolic networks of immortalized mammalian cells by changes of metabolite pools over the time course of batch cultivations. Eventually, it enables the use of cell engineering strategies to improve the availability of building blocks for biomass synthesis by increasing glucose as well as

  13. Inhibition of the CaM-kinases augments cell death in response to oxygen radicals and oxygen radical inducing cancer therapies in MCF-7 human breast cancer cells.

    PubMed

    Rodriguez-Mora, Oswaldo G; Lahair, Michelle M; Evans, Mark J; Kovacs, Charles J; Allison, Ron R; Sibata, Claudio H; White, Kawana S; McCubrey, James A; Franklin, Richard A

    2006-08-01

    Many cancer treatments induce cell death through lethal oxidative stress. Oxidative stress also induces the activation of the calcium/calmodulin-dependent kinases (CaM-Ks), CaM-KII and CaM-KIV. In turn, the CaM-Ks are known to induce the activation of antiapoptotic signaling pathways, such as Akt, ERK, and NF-kappaB in many different cell types. The aim of this study was to determine the role of CaM-Kinases in resistance to hydrogen peroxide and three oxidative stress-inducing cancer therapies in MCF-7 breast cancer cells. We found that oxidative stress induced CaM-Kinase activity in MCF-7 breast cancer cells and that CaM-K inhibition increased hydrogen peroxide-induced cell death in MCF-7 human breast cancer cells. When MCF-7 cells were treated with doxorubicin, ionizing radiation, or photodynamic therapy in the presence of a CaM-K inhibitor a greater level of cell killing was observed than when cells were treated with doxorubicin, ionizing radiation, or photodynamic therapy alone. In support of this finding, CaM-K inhibition increased hydrogen peroxide-induced apoptosis in MCF-7 cells, as determined by increased number of apoptotic cells, DNA fragmentation, and PARP cleavage. Pharmacological and molecular inhibition indicated that CaM-KII was participating in hydrogen peroxide-induced ERK phosphorylation in breast cancer cells indicating a potential mechanism by which this sensitization occurs. This is the first time that CaM-K inhibition is reported to sensitize cancer cells to reactive oxygen intermediate inducing cancer treatments.

  14. Stereotactic Radiation Therapy Augments Antigen-Specific PD-1-Mediated Anti-Tumor Immune Responses via Cross-Presentation of Tumor Antigen

    PubMed Central

    Sharabi, Andrew B.; Nirschl, Christopher J.; Kochel, Christina M.; Nirschl, Thomas R.; Francisca, Brian J.; Velarde, Esteban; Deweese, Theodore L.; Drake, Charles G.

    2014-01-01

    The immune-modulating effects of radiation therapy have gained considerable interest recently and there have been multiple reports of synergy between radiation and immunotherapy. However, additional pre-clinical studies are needed to demonstrate the antigen-specific nature of radiation-induced immune responses and elucidate potential mechanisms of synergy with immunotherapy. Here we demonstrate the ability of stereotactic radiotherapy to induce endogenous antigen-specific immune responses when combined with anti-PD-1 checkpoint blockade immunotherapy. Using the small animal radiation research platform (SARRP), image-guided stereotactic radiotherapy delivered to B16-OVA melanoma or 4T1-HA breast carcinoma tumors resulted in the development of antigen-specific T and B cell-mediated immune responses. These immune-stimulating effects of radiotherapy were significantly increased when combined with either anti-PD-1 therapy or regulatory T cell (Treg) depletion, resulting in improved local tumor control. Phenotypic analyses of antigen-specific CD8 T cells revealed that radiotherapy increased the percentage of antigen-experienced T cells and effector memory T cells. Mechanistically we found that radiotherapy up-regulates tumor-associated antigen-MHC complexes, enhances antigen cross-presentation in the draining lymph node, and increased T-cell infiltration into tumors. These findings demonstrate the ability of radiotherapy to prime an endogenous antigen-specific immune response and provide additional mechanistic rationale for combining radiation with PD-1 blockade in the clinic. PMID:25527358

  15. Novel insulin delivery profiles for mixed meals for sensor-augmented pump and closed-loop artificial pancreas therapy for type 1 diabetes mellitus.

    PubMed

    Srinivasan, Asavari; Lee, Joon Bok; Dassau, Eyal; Doyle, Francis J

    2014-09-01

    Maintaining euglycemia for people with type 1 diabetes is highly challenging, and variations in glucose absorption rates with meal composition require meal type specific insulin delivery profiles for optimal blood glucose control. Traditional basal/bolus therapy is not fully optimized for meals of varied fat contents. Thus, regimens for low- and high-fat meals were developed to improve current insulin pump therapy. Simulations of meals with varied fat content demonstrably replicated published data. Subsequently, an insulin profile library with optimized delivery regimens under open and closed loop for various meal compositions was constructed using particle swarm optimization. Calculations showed that the optimal basal bolus insulin profiles for low-fat meals comprise a normal bolus or a short wave. The preferred delivery for high-fat meals is typically biphasic, but can extend to multiple phases depending on meal characteristics. Results also revealed that patients that are highly sensitive to insulin could benefit from biphasic deliveries. Preliminary investigations of the optimal closed-loop regimens also display bi- or multiphasic patterns for high-fat meals. The novel insulin delivery profiles present new waveforms that provide better control of postprandial glucose excursions than existing schemes. Furthermore, the proposed novel regimens are also more or similarly robust to uncertainties in meal parameter estimates, with the closed-loop schemes demonstrating superior performance and robustness. © 2014 Diabetes Technology Society.

  16. Impact of long-term use of eHealth systems in adolescents with type 1 diabetes treated with sensor-augmented pump therapy.

    PubMed

    Schiaffini, R; Tagliente, I; Carducci, C; Ullmann, N; Ciampalini, P; Lorubbio, A; Cappa, M

    2016-07-01

    Telemedicine in diabetes includes telemonitoring and transmission of important data (self monitoring of blood glucose data, insulin therapy, pump setting, etc.) from the patient s home to the diabetic unit, with a real-time health feedback. Moreover, an eHealth approach is thought to facilitate diabetes management and to improve compliance to CSII/SAP treatment in adolescents, but to date, limited literature related to this topic is available and long-term studies are still lacking. The main aim of this study was to compare the long-term effect on glycometabolic control of eHealth intervention and traditional care in T1DM SAP-treated adolescents. In our study we demonstrated a favorable impact of monthly teleassistance on treatment compliance. Adolescents receiving frequent feedback provided by the medicalmultidisciplinary team, due to the telemonitoring, resulted more compliant in self-management of diabetes. In particular, the medical team feedback resulted in interventions on behavioral errors and insulin therapy adjustments, leading to an improved glycometabolic control. © The Author(s) 2015.

  17. Augmenting computer networks

    NASA Technical Reports Server (NTRS)

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

    1984-01-01

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

  18. Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial.

    PubMed

    Udy, Andrew A; Dulhunty, Joel M; Roberts, Jason A; Davis, Joshua S; Webb, Steven A R; Bellomo, Rinaldo; Gomersall, Charles; Shirwadkar, Charudatt; Eastwood, Glenn M; Myburgh, John; Paterson, David L; Starr, Therese; Paul, Sanjoy K; Lipman, Jeffrey

    2017-03-09

    Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessation. A total of 254 patients were included, among which 45 (17.7%) manifested ARC [median (IQR) CLCr 165 (144-198) mL/min]. ARC patients were younger (P <0.001), more commonly male (P = 0.04) and had less organ dysfunction (P <0.001). There was no difference in ICU-free days at Day 28 [ARC, 21 (12-24) days; no ARC, 21 (11-25) days; P = 0.89], although clinical cure was significantly greater in the unadjusted analysis in those manifesting ARC [33/45 (73.3%) vs. 115/209 (55.0%) P = 0.02]. This was attenuated in the multivariable analysis. No difference was noted in 90-day mortality. There were no statistically significant differences in clinical outcomes in ARC patients according to the dosing strategy employed. In this substudy of a large clinical trial of β-lactam antibiotics in severe sepsis, ARC was not associated with any differences in outcomes, regardless of dosing strategy.

  19. Local mild hypothermia therapy as an augmentation strategy for minimally invasive surgery of hypertensive intracerebral hemorrhage: a meta-analysis of randomized clinical trials

    PubMed Central

    Han, Yu; Sheng, Ke; Su, Meilan; Yang, Nan; Wan, Dong

    2017-01-01

    Background Previous studies reported that the mild hypothermia therapy (MHT) could significantly improve the clinical outcomes for patients with hypertensive intracerebral hemorrhage (HICH). Therefore, this meta-analysis was conducted to systematically assess whether the addition of local MHT (LMHT) could significantly improve the efficacy of minimally invasive surgery (MIS) in treating HICH. Methods Randomized clinical trials on the combined application of MIS and LMHT (MIS+LMHT) vs MIS alone for treating HICH were searched up to September 2016 in databases. Response rate and mortality rate were the primary outcomes, and the neurologic function and Barthel index were the secondary outcomes. Side effects were also analyzed. Results Totally, 28 studies composed of 2,325 patients were included to compare the efficacy of MIS+LMHT to MIS alone. The therapeutic effects of MIS+LMHT were significantly better than MIS alone. The pooled odds ratio of response rate and mortality rate was 2.68 (95% confidence interval [CI]=2.22–3.24) and 0.43 (95% CI=0.32–0.57), respectively. In addition, the MIS+LMHT led to a significantly better improvement in the neurologic function and activities of daily living. The incidence of pneumonia was similar between the two treatment methods. Conclusion These results indicated that compared to MIS alone, the MIS+LMHT could be more effective for the acute treatment of patients with HICH. This treatment modality should be further explored and optimized. PMID:28096671

  20. A Pilot Trial of Cognitive-Behavioral Therapy Augmentation of Antibiotic Treatment in Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome-Related Obsessive-Compulsive Disorder

    PubMed Central

    Jordan, Cary; Selles, Robert R.; Wu, Monica S.; King, Morgan A.; Patel, Priyal D.; Hanks, Camille E.; Arnold, Elysse B.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2015-01-01

    Abstract Background: This study reports an open trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD) exhibiting an onset pattern consistent with pediatric acute-onset neuropsychiatric syndrome (PANS). Methods: Eleven primarily Caucasian youth with PANS-related OCD (range=4–14 years; 6 boys) who were incomplete responders to antibiotic treatment, received family-based CBT delivered either face-to-face or via web camera. Results: All participants completing treatment (8 of 8) were considered improved at posttreatment, and average obsessive-compulsive symptom severity was reduced by 49%. Significant reductions in obsessive-compulsive symptom severity and in clinician- and parent-rated OCD-related impairment were noted. Reductions in parent- and child-rated anxiety, child-rated OCD-related impairment, and comorbid neuropsychiatric symptoms were not statistically significant. Conclusions: Gains were maintained at follow-up, with 100% (6 of 6) of those assessed remaining improved. Implications for treatment and further research are discussed. PMID:25978743

  1. The Efficacy of Augment of D-Cycloserine and Cognitive-behavioral Therapy on Adolescent with one Type of Anxiety Disorders: A Double-blind Randomized Controlled Trial

    PubMed Central

    Arman, Soroor; Soheilimehr, Ali; Maracy, Mohammad Reza

    2017-01-01

    Background: This study was designed to investigating the effect of combining D-cycloserine (DCS) and cognitive-behavioral therapy (CBT) on adolescent with at least one type of anxiety disorders. Materials and Methods: The present study was conducted as a double-blind randomized controlled trial on 36 adolescent with anxiety disorders. Patients were assessed in two groups. In addition to 4 sessions of weekly CBT in both groups; case group, received a 50-mg DCS capsules, control group, received Placebo daily for a month. Patients received DCS capsules or placebo 1 h before sessions of CBT. Age, sex, kind of anxiety disorders “screen for child anxiety related disorders (SCARED)” and “cognitive abilities test (CATS)” scores were evaluated and compared between groups. Results: The mean age of the studied patients (29 females (80.6%) and 7 males (19.4%)) was 14.1 ± 1.8 years. The most frequent anxiety disorder among the study population was generalized social disorder (GAD) (77.7%). Age, sex and the frequency of anxiety disorders were not statistically significant between the study groups (P > 0.05). The mean score of “SCARED” and “CATS” at before starting the treatment, after treatment and three month after the treatment were not statistically significant between groups (P > 0.05). Also, decrease in values of “SCARED” and “CATS” during the evaluation time periods was not statistically significant between groups (P > 0.05). Conclusions: Findings of this study showed that there has been no difference in symptoms improvement in adolescent with anxiety disorder who received treatment protocol including 4 sessions of CBT, weekly, together with 50 mgs of DCS compared to the patients of the control group. PMID:28299303

  2. The Impact of Topical Corticosteroids Used in Conjunction with Antiamoebic Therapy on the Outcome of Acanthamoeba Keratitis.

    PubMed

    Carnt, Nicole; Robaei, Dana; Watson, Stephanie L; Minassian, Darwin C; Dart, John K G

    2016-05-01

    To examine the impact of topical corticosteroid use after the start of antiamoebic therapy (AAT) on the outcomes of Acanthamoeba keratitis (AK) therapy. Cohort study. A total of 196 patients diagnosed with AK at Moorfields Eye Hospital, London, between January 1991 and April 2012. In 13 patients with bilateral AK, 1 eye was randomly excluded from analysis. Patient demographics and clinical examination findings were collected both at the start of AAT and subsequently at the time that topical corticosteroid therapy was initiated. Preliminary a priori investigations were used to identify effect modifiers/confounders and extreme associations requiring consideration in multivariate regression modeling. A multivariable logistic model, optimized for assessment of corticosteroid use after the start of AAT, was used to estimate the odds ratios (ORs) of a suboptimal outcome. Suboptimal outcome was defined as final visual acuity ≤20/80, corneal perforation, or the need for keratoplasty. In multivariable analysis, restricted to 129 eyes (1 eye per patient) free of scleritis and hypopyon at the start of AAT, topical corticosteroids were not associated with worse outcomes (OR, 1.08; 95% confidence interval [CI], 0.39-3.03), even when corticosteroids had been used before the start of AAT. Risk factors significantly associated with worse outcomes were topical corticosteroid use before the start of AAT (OR, 3.85; 95% CI, 1.35-11.03), a corneal ring infiltrate (together with at least 1 other feature of AK) present at the start of AAT (OR, 5.89; 95% CI, 1.17-29.67), and age ≥33 years at the start of AAT (OR, 4.02; 95% CI, 1.46-11.06). Many corneal specialists currently are uncertain about the risk benefit associated with the use of topical corticosteroids for the management of inflammatory complications of AK. The evidence from this study gives clinicians and patients reassurance that the potential benefits of topical corticosteroid therapy, for treating pain and discomfort, are

  3. Augmented reality in surgical procedures

    NASA Astrophysics Data System (ADS)

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

    2008-02-01

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

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

    PubMed

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

    2017-06-01

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

  5. Outpatient 60-hour day-and-night glucose control with dual-hormone artificial pancreas, single-hormone artificial pancreas, or sensor-augmented pump therapy in adults with type 1 diabetes: An open-label, randomised, crossover, controlled trial.

    PubMed

    Haidar, Ahmad; Messier, Virginie; Legault, Laurent; Ladouceur, Martin; Rabasa-Lhoret, Rémi

    2017-05-01

    To assess whether the dual-hormone (insulin and glucagon) artificial pancreas reduces hypoglycaemia compared to the single-hormone (insulin alone) artificial pancreas in outpatient settings during the day and night. In a randomized, three-way, crossover trial we compared the dual-hormone artificial pancreas, the single-hormone artificial pancreas and sensor-augmented pump therapy (control) in 23 adults with type 1 diabetes. Each intervention was applied from 8 AM Day 1 to 8 PM Day 3 (60 hours) in outpatient free-living conditions. The primary outcome was time spent with sensor glucose levels below 4.0 mmol/L. A P value of less than .017 was regarded as significant. The median difference between the dual-hormone system and the single-hormone system was -2.3% (P = .072) for time spent below 4.0 mmol/L, -1.3% (P = .017) for time below 3.5 mmol/L, and -0.7% (P = .031) for time below 3.3 mmol/L. Both systems reduced (P < .017) hypoglycaemia below 4.0, 3.5 and 3.3 mmol/L compared to control therapy, but reductions were larger with the dual-hormone system than with the single-hormone system (medians -4.0% vs -3.4% for 4.0 mmol/L; -2.7% vs -2.2% for 3.5 mmol/L; and -2.2% vs -1.2% for 3.3 mmol/L). There were 34 hypoglycaemic events (<3.0 mmol/L for 20 minutes) with control therapy, 14 with the single-hormone system and 6 with the dual-hormone system. These differences in hypoglycaemia were observed while mean glucose level was low and comparable in all interventions (P = NS). The dual-hormone artificial pancreas had the lowest risk of hypoglycaemia, but the differences were not statistically significant. Larger studies are needed. © 2017 John Wiley & Sons Ltd.

  6. Augmentative & Alternative Communication

    ERIC Educational Resources Information Center

    Murphy, Patti

    2007-01-01

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

  7. Augmented Reality Binoculars.

    PubMed

    Oskiper, Taragay; Sizintsev, Mikhail; Branzoi, Vlad; Samarasekera, Supun; Kumar, Rakesh

    2015-05-01

    In this paper we present an augmented reality binocular system to allow long range high precision augmentation of live telescopic imagery with aerial and terrain based synthetic objects, vehicles, people and effects. The inserted objects must appear stable in the display and must not jitter and drift as the user pans around and examines the scene with the binoculars. The design of the system is based on using two different cameras with wide field of view and narrow field of view lenses enclosed in a binocular shaped shell. Using the wide field of view gives us context and enables us to recover the 3D location and orientation of the binoculars much more robustly, whereas the narrow field of view is used for the actual augmentation as well as to increase precision in tracking. We present our navigation algorithm that uses the two cameras in combination with an inertial measurement unit and global positioning system in an extended Kalman filter and provides jitter free, robust and real-time pose estimation for precise augmentation. We have demonstrated successful use of our system as part of information sharing example as well as a live simulated training system for observer training, in which fixed and rotary wing aircrafts, ground vehicles, and weapon effects are combined with real world scenes.

  8. Augmented thermal bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1993-01-01

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

  9. Augmented Thermal Bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1996-01-01

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

  10. Computer Augmented Video Education.

    ERIC Educational Resources Information Center

    Sousa, M. B.

    1979-01-01

    Describes project CAVE (Computer Augmented Video Education), an ongoing effort at the U.S. Naval Academy to present lecture material on videocassette tape, reinforced by drill and practice through an interactive computer system supported by a 12 channel closed circuit television distribution and production facility. (RAO)

  11. Computer Augmented Video Education.

    ERIC Educational Resources Information Center

    Sousa, M. B.

    1979-01-01

    Describes project CAVE (Computer Augmented Video Education), an ongoing effort at the U.S. Naval Academy to present lecture material on videocassette tape, reinforced by drill and practice through an interactive computer system supported by a 12 channel closed circuit television distribution and production facility. (RAO)

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

    PubMed

    Fike, Lorie; Najera, Cecilia; Dougherty, David

    2012-01-01

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

  13. Hematological and Molecular Characterization of Hb J-Buda [α61(E10)Lys → Asn, AAG > AAT].

    PubMed

    Panyasai, Sitthichai; Permsripong, Nopphadol; Jaiping, Kanokwan; Khantarag, Pisuttinee; Pornprasert, Sakorn

    2016-06-01

    Hemoglobin (Hb) J-Buda [α61(E10)Lys → Asn, AAG > AAT] is a very rare α-chain variant found in South-East Asia. We analyzed hematological parameters and provided a rapid molecular analysis method for detection of this hemoglobinopathy in two Thai women who had severe microcytic anemia with Hb and MCV <70 g/L and 80 fL, respectively. The HPLC revealed an abnormal Hb peak eluted ahead of HbA at retention time of 1.91-1.98 min. On CE, the abnormal Hb peak was observed at the electrophoretic zone 12 which corresponded to Hb Bart's. The DNA sequencing revealed the AAG → AAT mutation at codon 61 for Hb J-Buda on one allele of the α1-globin gene. The developed Allele-specific PCR (ASPCR) showed the 455 bp amplified fragment from Hb J-Buda allele. Thus, understanding of hematological characterizations and the developed ASPCR for diagnosis of Hb J-Buda are essential for genetic counseling of this hemoglobinopathy.

  14. [Intra- and interspecific polymorphism of (AAT)n in microsatellite locus du47D in parthenogenetic species of the genus Darevskia].

    PubMed

    Korchagin, V I; Vergun, A A; Godakova, S A; Tokarskaia, O N

    2013-03-01

    The molecular structure of the allelic variants of (AAT)n of the Du47D microsatellite locus was determined in parthenogenetic lizards Darevskia dahli, D. armeniaca, and D. rostombekovi. Comparative analysis of these alleles showed that they were characterized by perfect structure of microsatellite cluster, and were different in the number of (AAT) monomeric units, as well as in the combinations of species-specific substitutions and deletions in the microsatellite flanking regions. Molecular structure of microsatellite cluster, species-specific single nucleotide polymorphism (SNP), and different representation of alleles Du47 in the samples of parthenogenetic species examined point to the origin of the alleles from different bisexual species, which is consistent with the hybrid nature of unisexual species of the genus Darevskia. In addition, these data reflect different combination patterns of interspecific hybridization events with the participation of the same bisexual species upon the formation of hybrid genomes of parthenogenetic species. Possible application of the allelic variants of microsatellite loci of parthenogenetic lizards as the genetic markers for the analysis of the genomes of parthenogenetic species in the light of evolution, ecology, and parthenogenetic type of reproduction in vertebrates is discussed.

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

    PubMed

    Berget, Bente; Braastad, Bjarne O

    2011-01-01

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

  16. Comparison of alpha-1-antitrypsin levels and antineutrophil elastase capacity of blood and lung in a patient with the alpha-1-antitrypsin phenotype null-null before and during alpha-1-antitrypsin augmentation therapy.

    PubMed

    Wewers, M D; Casolaro, M A; Crystal, R G

    1987-03-01

    The null-null phenotype of alpha 1-antitrypsin (alpha 1AT), a phenotype characterized by no detectable alpha 1AT in serum, presents a rare opportunity to examine the contribution of alpha 1AT to the antineutrophil elastase protection of the lower respiratory tract. The subject, a 35-yr-old lifetime non-smoker with moderate emphysema, has been characterized as having alpha 1AT serum levels of zero resulting from the homozygous inheritance of alpha 1AT genes that do not express detectable alpha 1AT mRNA transcripts. Evaluation of the antineutrophil elastase capacity of the null-null serum showed it was less than 5% of normal, whereas that of the epithelial lining fluid (ELF) of the lower respiratory tract was 13% of normal. However, after 60 mg/kg of intravenously administered alpha 1AT augmentation therapy once weekly for 4 wk, the serum alpha 1AT levels peaked at greater than 300 mg/dl, trough levels just prior to the next infusion were 81 +/- 2 mg/dl, and the average serum level integrated for the month of infusions was 138 mg/dl. Consistent with this serum rise in alpha 1AT, the serum antineutrophil elastase capacity increased in parallel(r = 0.98). Importantly, evaluation of the ELF 2 and 6 days after infusion demonstrated increases of alpha 1AT levels (range, 1.4 to 2.1 microM) and antineutrophil elastase capacity (range, 1.6 to 2.5 microM), values within the lower range of normal. Furthermore, the lung ELF alpha 1AT levels rose in direct proportion to the serum alpha 1AT levels, and the ELF antineutrophil elastase capacity rose in direct proportion to the ELF alpha 1AT levels.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Intelligent Filtering for Augmented Reality

    DTIC Science & Technology

    2000-03-01

    1 Intelligent Filtering for Augmented Reality Sabrina Sestito*, Simon Julier, Marco Lanzagorta and Larry Rosenblum Advanced Information Technology...Technology Organisation, Melbourne, Australia) KEYWORDS: Augmented Reality , Intelligent Systems, Databases ABSTRACT: Recent developments in computing...hardware have begun to make mobile and wearable Augmented Reality (AR) systems a reality . With this new freedom, AR systems can now be used in a very wide

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

    ERIC Educational Resources Information Center

    Grado, Elisabeth M.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Grado, Elisabeth M.

    2011-01-01

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

  20. Effects of continuous aortic flow augmentation in patients with exacerbation of heart failure inadequately responsive to medical therapy: results of the Multicenter Trial of the Orqis Medical Cancion System for the Enhanced Treatment of Heart Failure Unresponsive to Medical Therapy (MOMENTUM).

    PubMed

    Greenberg, Barry; Czerska, Barbara; Delgado, Reynolds M; Bourge, Robert; Zile, Michael R; Silver, Marc; Klapholz, Marc; Haeusslein, Ernest; Mehra, Mandeep R; Mather, Paul; Abraham, William T; Neaton, James D; Brown, B Scott; Parker, Irene C; Konstam, Marvin A

    2008-09-16

    Prior investigations suggest that superimposing continuous flow on aortic flow (continuous aortic flow augmentation) produces vasodilation, cardiac unloading, and improved cardiac performance. We compared percutaneous continuous aortic flow augmentation (flow therapy versus medical therapy alone by randomizing 168 patients (device, n=109; control, n=59) hospitalized with heart failure, reduced left ventricular ejection fraction and cardiac index, elevated pulmonary capillary wedge pressure, and renal impairment or substantial diuretic requirement despite intravenous inotropes/vasodilators. The primary composite efficacy end point included pulmonary capillary wedge pressure (72 to 96 hours) and days alive out of hospital off mechanical support over 35 days. The population's illness severity posed unique challenges. Enrollment ended early because of an inability to demonstrate significant benefit on the primary composite end point (device, 17.4%; control, 13.6%; P=0.45) in the face of excess device group bleeding. Pulmonary capillary wedge pressure decreased from 28.8+/-6.3 mm Hg (mean+/-SD) to 24.9+/-7.2 mm Hg (average, 72 to 96 hours) and 28.9+/-7.1 to 26.5+/-6.2 mm Hg in the device and control groups, respectively (between-group P=0.074). Cardiac index progressively increased in the device (2.05+/-0.53 to 2.44+/-0.52 L min(-1) m(-2)) but not the control (between-group P<0.0001) group. Thirty-five-day Kansas City Cardiomyopathy Questionnaire Overall Summary scores increased by 38.4+/-22.7 and 31.2+/-26.0 points in the device and control groups (between-group P=0.10). Through 65 days, device-to-control hazard ratios were as follows: all-cause mortality, 1.05 (95% confidence interval, 0.60 to 1.82); death or heart failure hospitalization, 0.87 (95% confidence interval, 0.57 to 1.33); and heart failure hospitalization, 0.66 (95% confidence interval, 0.38 to 1.13). Major bleeds occurred in 16.5% in the device (7

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

    PubMed

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

    2013-11-01

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

  2. Biomechanics in augmentation rhinoplasty.

    PubMed

    Yang, J; Wang, X; Zeng, Y; Wu, W

    2005-01-01

    During the past 6 years, we have treated 406 patients with classical silicone augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation were examined. We have proposed that most complications are related to the depth of the implant and the character of the tissues. In order to improve our operation and prove our hypothesis, we performed subperiosteal augmentation rhinoplasty in 22 cases with satisfactory results. In order to determine scientifically which layer the silicone implant should be inserted into, we investigated the biomechanics of human nasal periosteum and fascia, including tensile strength, stress-strain relationship and stress relaxation characters under uniaxial tension. Although having less failure strain, the periosteum has more tensile strength than the fascia. So, in the view of biomechanics, the periosteum is thicker, tougher and stiffer than the fascia, thus is more suitable for covering silicone implants.

  3. Batten augmented triangular beam

    NASA Technical Reports Server (NTRS)

    Adams, Louis R.; Hedgepeth, John M.

    1986-01-01

    The BAT (Batten-Augmented Triangular) BEAM is characterized by battens which are buckled in the deployed state, thus preloading the truss. The preload distribution is determined, and the effects of various external loading conditions are investigated. The conceptual design of a deployer is described and loads are predicted. The influence of joint imperfections on effective member stiffness is investigated. The beam is assessed structurally.

  4. Augmented reality in surgery.

    PubMed

    Shuhaiber, Jeffrey H

    2004-02-01

    To evaluate the history and current knowledge of computer-augmented reality in the field of surgery and its potential goals in education, surgeon training, and patient treatment. National Library of Medicine's database and additional library searches. Only articles suited to surgical sciences with a well-defined aim of study, methodology, and precise description of outcome were included. Augmented reality is an effective tool in executing surgical procedures requiring low-performance surgical dexterity; it remains a science determined mainly by stereotactic registration and ergonomics. Strong evidence was found that it is an effective teaching tool for training residents. Weaker evidence was found to suggest a significant influence on surgical outcome, both morbidity and mortality. No evidence of cost-effectiveness was found. Augmented reality is a new approach in executing detailed surgical operations. Although its application is in a preliminary stage, further research is needed to evaluate its long-term clinical impact on patients, surgeons, and hospital administrators. Its widespread use and the universal transfer of such technology remains limited until there is a better understanding of registration and ergonomics.

  5. Simple Implant Augmentation Rhinoplasty

    PubMed Central

    Nguyen, Anh H.; Bartlett, Erica L.; Kania, Katarzyna; Bae, Sang Mo

    2015-01-01

    Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placement. An implant prosthesis should be used on a case-by-case basis. Augmentation rhinoplasty requires the consideration of specific anatomical preoperative factors, including the external nose, nasal length, nasofrontal angle, humps, and facial proportions. It is equally important to consider several operative guidelines to appropriately shape implants to minimize the occurrence of adverse effects and postoperative complications. The most common postoperative complications include infection, nasal height change, movement of implant prosthesis, and silicone implant protrusion. In addition, the surgeon should consider the current standards of Asian beauty aesthetics to better understand the patient's desired outcome. PMID:26648804

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

    PubMed

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

    2015-01-01

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

  7. Impact of cost-sharing on treatment augmentation in patients with depression.

    PubMed

    Gibson, Teresa B; Jing, Yonghua; Bagalman, Jill E; Cao, Zhun; Bates, John A; Hebden, Tony; Forbes, Robert A; Doshi, Jalpa A

    2012-01-01

    Many patients with depression do not respond to first-line antidepressant therapy and may require augmentation with another concurrent treatment such as a second antidepressant, a stimulant, a mood stabilizer, or a second-generation antipsychotic (SGA). The objective of this study was to examine the relationship between patient cost-sharing and the use of augmentation among a sample of commercially insured patients. Retrospective observational study of adult patients diagnosed with depression and receiving antidepressant therapy (n = 48,807). Logistic regression models estimated the likelihood of augmentation as a function of patient cost-sharing amounts. An alternative-specific conditional logit model of the likelihood of each augmentation class, varying the cost-sharing prices faced for each class, was also estimated. All models controlled for sociodemographic characteristics, physical and mental comorbidities, health plan type, and year of index antidepressant therapy initiation. The range of mean copayments paid by patients for augmentation therapy was from $27.05 (antidepressant) to $38.81 (SGA). A $10- higher cost-sharing index for all augmentation classes was associated with lower odds of augmentation (adjusted odds ratio = 0.85; 95% confidence interval 0.79-0.91). Doubling the costsharing amount for each augmentation class was associated with a smaller percentage of patients utilizing each class of augmentation therapy. Employers and payers should consider the relationship between cost-sharing and medication utilization patterns of patients with depression.

  8. Pancreatic islet xenograft survival in mice is extended by a combination of alpha-1-antitrypsin and single-dose anti-CD4/CD8 therapy.

    PubMed

    Ashkenazi, Efrat; Baranovski, Boris M; Shahaf, Galit; Lewis, Eli C

    2013-01-01

    Clinical pancreatic islet transplantation is under evaluation for the treatment of autoimmune diabetes, yet several limitations preclude widespread use. For example, there is a critical shortage of human pancreas donors. Xenotransplantation may solve this problem, yet it evokes a rigorous immune response which can lead to graft rejection. Alpha-1-antitrypsin (AAT), a clinically available and safe circulating anti-inflammatory and tissue protective glycoprotein, facilitates islet alloimmune-tolerance and protects from inflammation in several models. Here, we examine whether human AAT (hAAT), alone or in combination with clinically relevant approaches, achieves long-term islet xenograft survival. Rat-to-mouse islet transplantation was examined in the following groups: untreated (n = 6), hAAT (n = 6, 60-240 mg/kg every 3 days from day -10), low-dose co-stimulation blockade (anti-CD154/LFA-1) and single-dose anti-CD4/CD8 (n = 5-7), either as mono- or combination therapies. Islet grafting was accompanied by blood glucose follow-up. In addition, skin xenografting was performed in order to depict responses that occur in draining lymph nodes. According to our results hAAT monotherapy and hAAT/anti-CD154/LFA-1 combined therapy, did not delay rejection day (11-24 days untreated vs. 10-22 day treated). However, host and donor intragraft inflammatory gene expression was diminished by hAAT therapy in both setups. Single dose T-cell depletion using anti-CD4/CD8 depleting antibodies, which provided 14-15 days of reduced circulating T-cells, significantly delayed rejection day (28-52 days) but did not achieve graft acceptance. In contrast, in combination with hAAT, the group displayed significantly extended rejection days and a high rate of graft acceptance (59, 61, >90, >90, >90). In examination of graft explants, marginal mononuclear-cell infiltration containing regulatory T-cells predominated surviving xenografts. We suggest that temporal T-cell depletion, as in the

  9. De novo synthesis of a 2-acetamido-4-amino-2,4,6-trideoxy-D-galactose (AAT) building block for the preparation of a Bacteroides fragilis A1 polysaccharide fragment.

    PubMed

    Pragani, Rajan; Stallforth, Pierre; Seeberger, Peter H

    2010-04-02

    Zwitterionic polysaccharides (ZPSs) are potent T-cell activators that naturally occur on the cell surface of bacteria and show potential as immunostimulatory agents. An unusual, yet important component of many ZPSs is 2-acetamido-4-amino-2,4,6-trideoxy-D-galactose (AAT). AAT building block 2 was prepared via a de novo synthesis from N-Cbz-L-threonine 5. Furthermore, building block 2 was used to synthesize disaccharide 15 that constitutes a fragment of zwitterionic polysaccharide A1 (PS A1) found in Bacteroides fragilis.

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  11. AAT-1, a novel testis-specific AMY-1-binding protein, forms a quaternary complex with AMY-1, A-kinase anchor protein 84, and a regulatory subunit of cAMP-dependent protein kinase and is phosphorylated by its kinase.

    PubMed

    Yukitake, Hiroshi; Furusawa, Makoto; Taira, Takahiro; Iguchi-Ariga, Sanae M M; Ariga, Hiroyoshi

    2002-11-22

    AMY-1 has been identified by us as a c-Myc-binding protein and was found to stimulate c-Myc transcription activity. AMY-1 was also found to be associated with protein kinase A anchor protein 84/149 (S-AKAP84/AKAP149) in the mitochondria in somatic cells and sperm, suggesting that it plays a role in spermatogenesis. To determine the molecular function of AMY-1, a two-hybrid screening of cDNAs encoding AMY-1-binding proteins was carried out with AMY-1 as a bait using a human testis cDNA library, and a clone encoding a novel protein, AAT-1, was obtained. Three isoforms of AAT-1, AAT-1alpha, -beta, and -gamma, were found to be derived from an alternative splicing of the transcripts of the aat-1 gene, which was mapped at human chromosome 3q13-3q21. AAT-1 was found to be specifically expressed in the testis during the course of spermatogenesis and also to be present in the spermatid and mature sperm, as was AMY-1. AAT-1alpha was found to bind to and be colocalized in mitochondria with AMY-1 in human HeLa and mouse GC-1 cells. Furthermore, AAT-1alpha was found to bind to the N-terminal half of S-AKAP84/AKAP149 in a quaternary complex with AMY-1 and a regulatory subunit (RII) of cAMP-dependent kinase (PKA), in which AAT-1alpha was associated with RII via S-AKAP84/AKAP149, in rat testis and HeLa cells. It was then found that AAT-1alpha weakly stimulated a phosphorylation activity of PKA and also that AAT-1 itself was phosphorylated by PKA in vivo and in vitro. These results suggest that both AAT-1 and AMY-1 play roles in spermatogenesis.

  12. Mutually Augmented Cognition

    NASA Astrophysics Data System (ADS)

    Friesdorf, Florian; Pangercic, Dejan; Bubb, Heiner; Beetz, Michael

    In mac, an ergonomic dialog-system and algorithms will be developed that enable human experts and companions to be integrated into knowledge gathering and decision making processes of highly complex cognitive systems (e.g. Assistive Household as manifested further in the paper). In this event we propose to join algorithms and methodologies coming from Ergonomics and Artificial Intelligence that: a) make cognitive systems more congenial for non-expert humans, b) facilitate their comprehension by utilizing a high-level expandable control code for human experts and c) augment representation of such cognitive system into “deep representation” obtained through an interaction with human companions.

  13. History of gluteal augmentation.

    PubMed

    de la Peña, J Abel; Rubio, Omar V; Cano, Jacobo P; Cedillo, Mariana C; Garcés, Miriam T

    2006-07-01

    The concept of female beauty has changed throughout time, but the form and size of the breasts and gluteal region have remained constant as symbols of maximum femininity. Sculptures and prints show us feminine figures that are voluminous and reflect human history's interest in fertility. The early years of gluteal augmentation saw few published reports that described the procedure technique, follow-up, or possible complications. But developments continued as surgeons began experimenting with different anatomical planes for implant placement. The most important goal in plastic surgery is meeting a patient's expectations. It is important for the surgeon to thoroughly explain to patients what can realistically be achieved with a procedure.

  14. Radiative Augmented Combustion

    DTIC Science & Technology

    1988-03-01

    PbLFICE SY 7a NAME OF MONITORING ORGANIZATION M.L. ENERGIA , Inc. AFOSR/NA 6r. ADDRESS (City. State. anW ZIP Code) 7b. ADDRESS (City State, and ZIPCode...27 -00 N ’fPECTED 0 6I FOREWORD This is the Final Report on research on Radiative Augmented Combustion conducted at M. L. ENERGIA , Inc. It was a...the first two annual reports prior to this one. The entire research program was performed at ENERGIA , Inc., Princeton, New Jersey, with Dr. Moshe Lavid

  15. Radiative Augmented Combustion.

    DTIC Science & Technology

    1985-08-12

    86-0085 In 00I to RADIATIVE AUGMENTED COMBUSTION MOSHE LAVID M.L. ENERGIA , INC. P.O. BOX 1468 1 PRINCETON, NEW JERSEY 08542 AUGUST 1985 *.. plo...Combustion conducted at M.L. ENERGIA . It is funded by the Air Force Office of Scientific Research under Contract No. F49620-83-C-0133, with Dr. J.M...reported. It covers the second year of the contract, from July 15, 1984 through July 14, 1985. The work was performed at ENERGIA , Princeton, New Jersey

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

    PubMed

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

    2015-02-01

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

  17. [History of augmentation mammaplasty].

    PubMed

    Glicenstein, J

    2005-10-01

    The history of breast augmentation started effectively after World War II. Until then, this surgery was almost irrelevant because the indications were considered very rare and technical possibilities limited. During about two decades after 1945, two types of procedures were proposed. The first ones used autologous tissue especially fat in the form of dermofatty grafts taken from the buttocks. The results were very bad and sometimes disastrous for both techniques. At the beginning of the sixties, under the impulse of the Dow Corning Company, two surgeons: Frank Gerow and Thomas Cronin from Houston (Texas, USA) proposed an implant with a sheath filled with silicone gel. This new prosthesis had an immediate success and the number of breast augmentations growed very quickly. After an optimistic period, it had to be admitted that the results were sometimes deceiving or frankly bad. The breasts were often too firm, sometimes hard and even deformed. Capsular contracture occurred around the implants. During the 70's and 80's both consistency and envelops of the implants were regularly modified. The incision and the positioning were changed. At the end of the 80's, the problem of capsular contracture seemed to be resolved with the implants used, meanwhile a controversy took place about silicone in USA. Some cases of autoimmune diseases were attributed to silicone. In spite of scientific studies that proved the contrary, silicone implants were prohibited in the United States, Canada and temporarily in France.

  18. Hearing Loss: Hearing Augmentation.

    PubMed

    Atcherson, Samuel R; Moreland, Christopher; Zazove, Philip; McKee, Michael M

    2015-07-01

    Etiologies of hearing loss vary. When hearing loss is diagnosed, referral to an otology subspecialist, audiology subspecialist, or hearing aid dispenser to discuss treatment options is appropriate. Conventional hearing aids provide increased sound pressure in the ear canal for detection of sounds that might otherwise be soft or inaudible. Hearing aids can be used for sensorineural, conductive, or mixed hearing loss by patients with a wide range of hearing loss severity. The most common type of hearing loss is high-frequency, which affects audibility and perception of speech consonants, but not vowels. As the severity of hearing loss increases, the benefit of hearing aids for speech perception decreases. Implantable devices such as cochlear implants, middle ear implants, and bone-anchored implants can benefit specific patient groups. Hearing assistive technology devices provide auditory, visual, or tactile information to augment hearing and increase environmental awareness of sounds. Hearing assistive devices include wireless assistive listening device systems, closed captioning, hearing aid-compatible telephones, and other devices. For some patients, financial barriers and health insurance issues limit acquisition of hearing aids, implantable devices, and hearing assistive devices. Physicians should be aware that for some patients and families, hearing augmentation may not be desired for cultural reasons.

  19. Advanced intellect-augmentation techniques

    NASA Technical Reports Server (NTRS)

    Engelbart, D. C.

    1972-01-01

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

  20. Pilot-optimal augmentation synthesis

    NASA Technical Reports Server (NTRS)

    Schmidt, D. K.

    1978-01-01

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

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

    PubMed

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

    2016-11-01

    Adeno-associated virus (AAV) gene transfer is a promising treatment for genetic abnormalities. Optimal AAV vectors are showing success in clinical trials. Gene transfer to skeletal muscle and liver is being explored as a potential therapy for some conditions, that is, α1-antitrypsin (AAT) disorder and hemophilia B. Exploring approaches that enhance transduction of liver and skeletal muscle, using these vectors, is beneficial for gene therapy. Regulating hormones as an approach to improve AAV transduction is largely unexplored. In this study we tested whether insulin therapy improves liver and skeletal muscle gene transfer. In vitro studies demonstrated that the temporary coadministration (2, 8, and 24 hr) of insulin significantly improves AAV2-CMV-LacZ transduction of cultured liver cells and differentiated myofibers, but not of lung cells. In addition, there was a dose response related to this improved transduction. Interestingly, when insulin was not coadministered with the virus but given 24 hr afterward, there was no increase in the transgene product. Insulin receptor gene (INSR) expression levels were increased 5- to 13-fold in cultured liver cells and differentiated myofibers when compared with lung cells. Similar INSR gene expression profiles occurred in mouse tissues. Insulin therapy was performed in mice, using a subcutaneously implanted insulin pellet or a high-carbohydrate diet. Insulin treatment began just before intramuscular delivery of AAV1-CMV-schFIX or liver-directed delivery of AAV8-CMV-schFIX and continued for 28 days. Both insulin augmentation therapies improved skeletal muscle- and liver-directed gene transduction in mice as seen by a 3.0- to 4.5-fold increase in human factor IX (hFIX) levels. The improvement was observed even after the insulin therapy ended. Monitoring insulin showed that insulin levels increased during the brief period of rAAV delivery and during the entire insulin augmentation period (28 days). This study demonstrates

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

    PubMed

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

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

  3. NASA Communications Augmentation network

    NASA Technical Reports Server (NTRS)

    Omidyar, Guy C.; Butler, Thomas E.; Laios, Straton C.

    1990-01-01

    The NASA Communications (Nascom) Division of the Mission Operations and Data Systems Directorate (MO&DSD) is to undertake a major initiative to develop the Nascom Augmentation (NAUG) network to achieve its long-range service objectives for operational data transport to support the Space Station Freedom Program, the Earth Observing System (EOS), and other projects. The NAUG is the Nascom ground communications network being developed to accommodate the operational traffic of the mid-1990s and beyond. The NAUG network development will be based on the Open Systems Interconnection Reference Model (OSI-RM). This paper describes the NAUG network architecture, subsystems, topology, and services; addresses issues of internetworking the Nascom network with other elements of the Space Station Information System (SSIS); discusses the operations environment. This paper also notes the areas of related research and presents the current conception of how the network will provide broadband services in 1998.

  4. Augmented Virtual Reality Laboratory

    NASA Technical Reports Server (NTRS)

    Tully-Hanson, Benjamin

    2015-01-01

    Real time motion tracking hardware has for the most part been cost prohibitive for research to regularly take place until recently. With the release of the Microsoft Kinect in November 2010, researchers now have access to a device that for a few hundred dollars is capable of providing redgreenblue (RGB), depth, and skeleton data. It is also capable of tracking multiple people in real time. For its original intended purposes, i.e. gaming, being used with the Xbox 360 and eventually Xbox One, it performs quite well. However, researchers soon found that although the sensor is versatile, it has limitations in real world applications. I was brought aboard this summer by William Little in the Augmented Virtual Reality (AVR) Lab at Kennedy Space Center to find solutions to these limitations.

  5. NAESA Augmentation Pilot Project

    NASA Technical Reports Server (NTRS)

    Hoover, John J.

    1998-01-01

    This project was one project within the Native American Earth and Space Academy (NAESA). NAESA is a national initiative comprised of several organizations that support programs which focus on 1) enhancing the technological, scientific and pedagogical skills of K-14 teachers who instruct Native Americans, 2) enhancing the understanding and applications of science, technology, and engineering of college-bound Native Americans and teaching them general college "survival skills" (e.g., test taking, time management, study habits), 3) enhancing the scientific and pedagogical skills of the faculty of tribally-controllcd colleges and community colleges with large Native American enrollments, and 4) strengthening the critical relationships between students, their parents, tribal elders, and their communities. This Augmentation Pilot Project focused on the areas of community-school alliances and intemet technology use in teaching and learning and daily living addressing five major objectives.

  6. Magnetohydrodynamic Augmented Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Litchford, Ron J.

    2008-01-01

    Over the past several years, efforts have been under way to design and develop an operationally flexible research facility for investigating the use of cross-field MHD accelerators as a potential thrust augmentation device for thermal propulsion systems. The baseline configuration for this high-power experimental facility utilizes a 1.5-MWe multi-gas arc-heater as a thermal driver for a 2-MWe MHD accelerator, which resides in a large-bore 2-tesla electromagnet. A preliminary design study using NaK seeded nitrogen as the working fluid led to an externally diagonalized segmented MHD channel configuration based on an expendable heat-sink design concept. The current status report includes a review of engineering/design work and performance optimization analyses and summarizes component hardware fabrication and development efforts, preliminary testing results, and recent progress toward full-up assembly and testing

  7. Augmented reality system

    NASA Astrophysics Data System (ADS)

    Lin, Chien-Liang; Su, Yu-Zheng; Hung, Min-Wei; Huang, Kuo-Cheng

    2010-08-01

    In recent years, Augmented Reality (AR)[1][2][3] is very popular in universities and research organizations. The AR technology has been widely used in Virtual Reality (VR) fields, such as sophisticated weapons, flight vehicle development, data model visualization, virtual training, entertainment and arts. AR has characteristics to enhance the display output as a real environment with specific user interactive functions or specific object recognitions. It can be use in medical treatment, anatomy training, precision instrument casting, warplane guidance, engineering and distance robot control. AR has a lot of vantages than VR. This system developed combines sensors, software and imaging algorithms to make users feel real, actual and existing. Imaging algorithms include gray level method, image binarization method, and white balance method in order to make accurate image recognition and overcome the effects of light.

  8. Pure laparoscopic augmentation ileocystoplasty.

    PubMed

    Rebouças, Rafael B; Monteiro, Rodrigo C; Souza, Thiago N S de; Aragão, Augusto J de; Burity, Camila R T; Nóbrega, Júlio C de A; Oliveira, Natália S C de; Abrantes, Ramon B; Dantas Júnior, Luiz B; Cartaxo Filho, Ricardo; Negromonte, Gustavo R P; Sampaio, Rafael da C R; Britto, Cesar A

    2014-01-01

    Guillain-Barre syndrome is an acute neuropathy that rarely compromises bladder function. Conservative management including clean intermittent catheterization and pharmacotherapy is the primary approach for hypocompliant contracted bladder. Surgical treatment may be used in refractory cases to improve bladder compliance and capacity in order to protect the upper urinary tract. We describe a case of pure laparoscopic augmentation ileocystoplasty in a patient affected by Guillain-Barre syndrome. A 15-year-old female, complaining of voiding dysfunction, recurrent urinary tract infection and worsening renal function for three months. A previous history of Guillain-Barre syndrome on childhood was related. A voiding cystourethrography showed a pine-cone bladder with moderate post-void residual urine. The urodynamic demonstrated a hypocompliant bladder and small bladder capacity (190 mL) with high detrusor pressure (54 cmH2O). Nonsurgical treatments were attempted, however unsuccessfully.

  9. Augmented nonlinear differentiator design

    NASA Astrophysics Data System (ADS)

    Shao, Xingling; Liu, Jun; Yang, Wei; Tang, Jun; Li, Jie

    2017-06-01

    This paper presents a sigmoid function based augmented nonlinear differentiator (AND) for calculating the noise-less time derivative from a noisy measurement. The prominent advantages of the present differentiation technique are: (i) compared to the existing tracking differentiators, better noise suppression ability can be achieved without appreciable delay; (ii) the enhanced noise-filtering mechanism not only can be applied to the designed differentiator, but also can be extended for improving noise-tolerance capability of the available differentiators. In addition, the convergence property and robustness performance against noises are investigated via singular perturbation theory and describing function method, respectively. Also, comparison with several classical differentiators is given to illustrate the superiority of AND in noise suppression. Finally, applications on autopilot design and displacement following for nonlinear mass spring mechanical system are given to demonstrate the effectiveness and applicability of the proposed AND technique.

  10. NAESA Augmentation Pilot Project

    NASA Technical Reports Server (NTRS)

    Hoover, John J.

    1998-01-01

    This project was one project within the Native American Earth and Space Academy (NAESA). NAESA is a national initiative comprised of several organizations that support programs which focus on 1) enhancing the technological, scientific and pedagogical skills of K-14 teachers who instruct Native Americans, 2) enhancing the understanding and applications of science, technology, and engineering of college-bound Native Americans and teaching them general college "survival skills" (e.g., test taking, time management, study habits), 3) enhancing the scientific and pedagogical skills of the faculty of tribally-controllcd colleges and community colleges with large Native American enrollments, and 4) strengthening the critical relationships between students, their parents, tribal elders, and their communities. This Augmentation Pilot Project focused on the areas of community-school alliances and intemet technology use in teaching and learning and daily living addressing five major objectives.

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

    PubMed

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

    2016-07-01

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

  12. Stem Cells for Augmenting Tendon Repair

    PubMed Central

    Gulotta, Lawrence V.; Chaudhury, Salma; Wiznia, Daniel

    2012-01-01

    Tendon healing is fraught with complications such as reruptures and adhesion formation due to the formation of scar tissue at the injury site as opposed to the regeneration of native tissue. Stem cells are an attractive option in developing cell-based therapies to improve tendon healing. However, several questions remain to be answered before stem cells can be used clinically. Specifically, the type of stem cell, the amount of cells, and the proper combination of growth factors or mechanical stimuli to induce differentiation all remain to be seen. This paper outlines the current literature on the use of stem cells for tendon augmentation. PMID:22190960

  13. Flow Augmentation in Acute Ischemic Stroke.

    PubMed

    Yadollahikhales, Golnaz; Borhani-Haghighi, Afshin; Torabi-Nami, Mohammad; Edgell, Randall; Cruz-Flores, Salvador

    2016-01-01

    There is an urgent need for additional therapeutic options for acute ischemic stroke considering the major pitfalls of the options available. Herein, we briefly review the role of cerebral blood flow, collaterals, vasoreactivity, and reperfusion injury in acute ischemic stroke. Then, we reviewed pharmacological and interventional measures such as volume expansion and induced hypertension, intra-aortic balloon counterpulsation, partial aortic occlusion, extracranial-intracranial carotid bypass surgery, sphenopalatine ganglion stimulation, and transcranial laser therapy with regard to their effects on flow augmentation and neuroprotection. © The Author(s) 2014.

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

    PubMed

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

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

  15. Augmented Reality Comes to Physics

    ERIC Educational Resources Information Center

    Buesing, Mark; Cook, Michael

    2013-01-01

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

  16. Augmented Reality Comes to Physics

    ERIC Educational Resources Information Center

    Buesing, Mark; Cook, Michael

    2013-01-01

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

  17. BARS: Battlefield Augmented Reality System

    DTIC Science & Technology

    2001-04-01

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP010892 TITLE: BARS: Battlefield Augmented Reality System DISTRIBUTION...component part numbers comprise the compilation report: ADP010865 thru. ADP010894 UNCLASSIFIED 27-1 BARS: Battlefield Augmented Reality System Simon Julier... future military operations are expected to occur overload, we have developed an intelligent filter which in urban environments. These complex, 3D

  18. Advanced Intellect-Augmentation Techniques.

    ERIC Educational Resources Information Center

    Engelbart, D. C.

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

  19. Understanding Lung Deposition of Alpha-1 Antitrypsin in Acute Experimental Mouse Lung Injury Model Using Fluorescence Microscopy

    PubMed Central

    Zhan, Yutian; Chen, Jianqing; Rong, Haojing; O'Neil, Shawn P.; Ghosh, Brahma; Nguyen, Vuong; Li, Xianfeng

    2016-01-01

    Human plasma-derived α1-antitrypsin (AAT) delivered by intravenous infusion is used as augmentation therapy in patients with emphysema who have a genetic mutation resulting in deficiency of AAT. Inhalation is an alternative route of administration that can potentially increase the efficacy and convenience of treatment. This study was conducted to determine whether delivery to the lungs, initially via the intratracheal (IT) route of administration, would deliver efficacious levels of a recombinant AAT (rAAT) to the site of action in the lungs in mice. 125I-radiolabeled rAAT, fluorophore-conjugated rAAT (rAAT-Alexa488), and NE680 (neutrophil elastase 680, a silent fluorescent substrate of neutrophil elastase which fluoresces in the near-infrared range upon activation by neutrophil elastase) were used to characterize the pharmacokinetics and tissue distribution profile, distribution of rAAT within the lung, and efficacy of rAAT to inhibit neutrophil elastase at the site of action, respectively. The study has demonstrated that rAAT was able to gain access to locations where neutrophil elastase was localized. The histochemical quantification of rAAT activity relative to dose at the site of action provided here will improve confidence in predicting the human dose via the inhalation route. PMID:28050284

  20. Magnetohydrodynamic Augmented Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Litchford, Ron J.; Cole, John; Lineberry, John; Chapman, Jim; Schmidt, Harold; Cook, Stephen (Technical Monitor)

    2002-01-01

    A fundamental obstacle to routine space access is the specific energy limitations associated with chemical fuels. In the case of vertical take-off, the high thrust needed for vertical liftoff and acceleration to orbit translates into power levels in the 10 GW range. Furthermore, useful payload mass fractions are possible only if the exhaust particle energy (i.e., exhaust velocity) is much greater than that available with traditional chemical propulsion. The electronic binding energy released by the best chemical reactions (e.g., LOX/LH2 for example, is less than 2 eV per product molecule (approx. 1.8 eV per H2O molecule), which translates into particle velocities less than 5 km/s. Useful payload fractions, however, will require exhaust velocities exceeding 15 km/s (i.e., particle energies greater than 20 eV). As an added challenge, the envisioned hypothetical RLV (reusable launch vehicle) should accomplish these amazing performance feats while providing relatively low acceleration levels to orbit (2-3g maximum). From such fundamental considerations, it is painfully obvious that planned and current RLV solutions based on chemical fuels alone represent only a temporary solution and can only result in minor gains, at best. What is truly needed is a revolutionary approach that will dramatically reduce the amount of fuel and size of the launch vehicle. This implies the need for new compact high-power energy sources as well as advanced accelerator technologies for increasing engine exhaust velocity. Electromagnetic acceleration techniques are of immense interest since they can be used to circumvent the thermal limits associated with conventional propulsion systems. This paper describes the Magnetohydrodynamic Augmented Propulsion Experiment (MAPX) being undertaken at NASA Marshall Space Flight Center (MSFC). In this experiment, a 1-MW arc heater is being used as a feeder for a 1-MW magnetohydrodynamic (MHD) accelerator. The purpose of the experiment is to demonstrate

  1. Magnetohydrodynamic Augmented Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Litchford, Ron J.; Cole, John; Lineberry, John; Chapman, Jim; Schmidt, Harold; Cook, Stephen (Technical Monitor)

    2002-01-01

    A fundamental obstacle to routine space access is the specific energy limitations associated with chemical fuels. In the case of vertical take-off, the high thrust needed for vertical liftoff and acceleration to orbit translates into power levels in the 10 GW range. Furthermore, useful payload mass fractions are possible only if the exhaust particle energy (i.e., exhaust velocity) is much greater than that available with traditional chemical propulsion. The electronic binding energy released by the best chemical reactions (e.g., LOX/LH2 for example, is less than 2 eV per product molecule (approx. 1.8 eV per H2O molecule), which translates into particle velocities less than 5 km/s. Useful payload fractions, however, will require exhaust velocities exceeding 15 km/s (i.e., particle energies greater than 20 eV). As an added challenge, the envisioned hypothetical RLV (reusable launch vehicle) should accomplish these amazing performance feats while providing relatively low acceleration levels to orbit (2-3g maximum). From such fundamental considerations, it is painfully obvious that planned and current RLV solutions based on chemical fuels alone represent only a temporary solution and can only result in minor gains, at best. What is truly needed is a revolutionary approach that will dramatically reduce the amount of fuel and size of the launch vehicle. This implies the need for new compact high-power energy sources as well as advanced accelerator technologies for increasing engine exhaust velocity. Electromagnetic acceleration techniques are of immense interest since they can be used to circumvent the thermal limits associated with conventional propulsion systems. This paper describes the Magnetohydrodynamic Augmented Propulsion Experiment (MAPX) being undertaken at NASA Marshall Space Flight Center (MSFC). In this experiment, a 1-MW arc heater is being used as a feeder for a 1-MW magnetohydrodynamic (MHD) accelerator. The purpose of the experiment is to demonstrate

  2. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W.

    1988-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two-dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  3. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W. . Applied Mechanics Div. III)

    1989-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  4. Augmented Likelihood Image Reconstruction.

    PubMed

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M

    2016-01-01

    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction.

  5. Abstraction Augmented Markov Models.

    PubMed

    Caragea, Cornelia; Silvescu, Adrian; Caragea, Doina; Honavar, Vasant

    2010-12-13

    High accuracy sequence classification often requires the use of higher order Markov models (MMs). However, the number of MM parameters increases exponentially with the range of direct dependencies between sequence elements, thereby increasing the risk of overfitting when the data set is limited in size. We present abstraction augmented Markov models (AAMMs) that effectively reduce the number of numeric parameters of k(th) order MMs by successively grouping strings of length k (i.e., k-grams) into abstraction hierarchies. We evaluate AAMMs on three protein subcellular localization prediction tasks. The results of our experiments show that abstraction makes it possible to construct predictive models that use significantly smaller number of features (by one to three orders of magnitude) as compared to MMs. AAMMs are competitive with and, in some cases, significantly outperform MMs. Moreover, the results show that AAMMs often perform significantly better than variable order Markov models, such as decomposed context tree weighting, prediction by partial match, and probabilistic suffix trees.

  6. Phenobarbital Augments Hypothermic Neuroprotection

    PubMed Central

    Barks, John D.; Liu, Yi-Qing; Shangguan, Yu; Silverstein, Faye S.

    2010-01-01

    Seizures are associated with adverse outcome in infants with hypoxic-ischemic encephalopathy. We hypothesized that early administration of the anticonvulsant phenobarbital after cerebral hypoxia-ischemia could enhance the neuroprotective efficacy of delayed-onset hypothermia. We tested this hypothesis in a neonatal rodent model. Seven-day-old rats (n=104) underwent right carotid ligation, followed by 90 min 8%O2 exposure; 15 min later, they received injections of phenobarbital (40 mg/kg) or saline. One or 3h later, all were treated with hypothermia (30°C, 3h). Function and neuropathology were evaluated after 7 days (“early outcomes”) or 1 month (“late outcomes”). Early outcome assessment demonstrated better sensorimotor performance and less cortical damage in phenobarbital-treated groups; there were no differences between groups in which the hypothermia delay was shortened from 3h to 1h. Late outcome assessment confirmed sustained benefits of phenobarbital+hypothermia treatment; sensorimotor performance was better (persistent attenuation of contralateral forepaw placing deficits and absence of contralateral forepaw neglect); neuropathology scores were lower (medians, phenobarbital 2, saline 8.5, p<0.05), and less ipsilateral cerebral hemisphere %Damage (mean±SD, 11±17 vs. 28±22, p<0.05). These results suggest that early post-hypoxia-ischemia administration of phenobarbital may augment the neuroprotective efficacy of therapeutic hypothermia. PMID:20098339

  7. Control Augmented Structural Synthesis

    NASA Technical Reports Server (NTRS)

    Lust, Robert V.; Schmit, Lucien A.

    1988-01-01

    A methodology for control augmented structural synthesis is proposed for a class of structures which can be modeled as an assemblage of frame and/or truss elements. It is assumed that both the plant (structure) and the active control system dynamics can be adequately represented with a linear model. The structural sizing variables, active control system feedback gains and nonstructural lumped masses are treated simultaneously as independent design variables. Design constraints are imposed on static and dynamic displacements, static stresses, actuator forces and natural frequencies to ensure acceptable system behavior. Multiple static and dynamic loading conditions are considered. Side constraints imposed on the design variables protect against the generation of unrealizable designs. While the proposed approach is fundamentally more general, here the methodology is developed and demonstrated for the case where: (1) the dynamic loading is harmonic and thus the steady state response is of primary interest; (2) direct output feedback is used for the control system model; and (3) the actuators and sensors are collocated.

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

    PubMed

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

    2016-12-01

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

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

    PubMed

    Parish-Plass, Nancy

    2008-01-01

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

  10. Augmented Reality Comes to Physics

    NASA Astrophysics Data System (ADS)

    Buesing, Mark; Cook, Michael

    2013-04-01

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

  11. Surgical treatment of breast cancer in previously augmented patients.

    PubMed

    Karanas, Yvonne L; Leong, Darren S; Da Lio, Andrew; Waldron, Kathleen; Watson, James P; Chang, Helena; Shaw, William W

    2003-03-01

    The incidence of breast cancer is increasing each year. Concomitantly, cosmetic breast augmentation has become the second most often performed cosmetic surgical procedure. As the augmented patient population ages, an increasing number of breast cancer cases among previously augmented women can be anticipated. The surgical treatment of these patients is controversial, with several questions remaining unanswered. Is breast conservation therapy feasible in this patient population and can these patients retain their implants? A retrospective review of all breast cancer patients with a history of previous augmentation mammaplasty who were treated at the Revlon/UCLA Breast Center between 1991 and 2001 was performed. During the study period, 58 patients were treated. Thirty patients (52 percent) were treated with a modified radical mastectomy with implant removal. Twenty-eight patients (48 percent) underwent breast conservation therapy, which consisted of lumpectomy, axillary lymph node dissection, and radiotherapy. Twenty-two of the patients who underwent breast conservation therapy initially retained their implants. Eleven of those 22 patients (50 percent) ultimately required completion mastectomies with implant removal because of implant complications (two patients), local recurrences (five patients), or the inability to obtain negative margins (four patients). Nine additional patients experienced complications resulting from their implants, including contracture, erosion, pain, and rupture. The data illustrate that breast conservation therapy with maintenance of the implant is not ideal for the majority of augmented patients. Breast conservation therapy with explantation and mastopexy might be appropriate for rare patients with large volumes of native breast tissue. Mastectomy with immediate reconstruction might be a more suitable choice for these patients.

  12. Augmenter of liver regeneration.

    PubMed

    Gandhi, Chandrashekhar R

    2012-07-09

    'Augmenter of liver regeneration' (ALR) (also known as hepatic stimulatory substance or hepatopoietin) was originally found to promote growth of hepatocytes in the regenerating or injured liver. ALR is expressed ubiquitously in all organs, and exclusively in hepatocytes in the liver. ALR, a survival factor for hepatocytes, exhibits significant homology with ERV1 (essential for respiration and viability) protein that is essential for the survival of the yeast, Saccharomyces cerevisiae. ALR comprises 198 to 205 amino acids (approximately 22 kDa), but is post-translationally modified to three high molecular weight species (approximately 38 to 42 kDa) found in hepatocytes. ALR is present in mitochondria, cytosol, endoplasmic reticulum, and nucleus. Mitochondrial ALR may be involved in oxidative phosphorylation, but also functions as sulfhydryl oxidase and cytochrome c reductase, and causes Fe/S maturation of proteins. ALR, secreted by hepatocytes, stimulates synthesis of TNF-α, IL-6, and nitric oxide in Kupffer cells via a G-protein coupled receptor. While the 22 kDa rat recombinant ALR does not stimulate DNA synthesis in hepatocytes, the short form (15 kDa) of human recombinant ALR was reported to be equipotent as or even stronger than TGF-α or HGF as a mitogen for hepatocytes. Altered serum ALR levels in certain pathological conditions suggest that it may be a diagnostic marker for liver injury/disease. Although ALR appears to have multiple functions, the knowledge of its role in various organs, including the liver, is extremely inadequate, and it is not known whether different ALR species have distinct functions. Future research should provide better understanding of the expression and functions of this enigmatic molecule.

  13. Mersiline mesh in premaxillary augmentation.

    PubMed

    Foda, Hossam M T

    2005-01-01

    Premaxillary retrusion may distort the aesthetic appearance of the columella, lip, and nasal tip. This defect is characteristically seen in, but not limited to, patients with cleft lip nasal deformity. This study investigated 60 patients presenting with premaxillary deficiencies in which Mersiline mesh was used to augment the premaxilla. All the cases had surgery using the external rhinoplasty technique. Two methods of augmentation with Mersiline mesh were used: the Mersiline roll technique, for the cases with central symmetric deficiencies, and the Mersiline packing technique, for the cases with asymmetric deficiencies. Premaxillary augmentation with Mersiline mesh proved to be simple technically, easy to perform, and not associated with any complications. Periodic follow-up evaluation for a mean period of 32 months (range, 12-98 months) showed that an adequate degree of premaxillary augmentation was maintained with no clinically detectable resorption of the mesh implant.

  14. Validating MODIS Above-Cloud Aerosol Optical Depth Retrieved from Color Ratio Algorithm Using Direct Measurements Made by NASA's Airborne AATS and 4STAR Sensors

    NASA Technical Reports Server (NTRS)

    Jethva, Hiren; Torres, Omar; Remer, Lorraine; Redemann, Jens; Livingston, John; Dunagan, Stephen; Shinozuka, Yohei; Kacenelenbogen, Meloe; Segal Rozenhaimer, Michal; Spurr, Rob

    2016-01-01

    We present the validation analysis of above-cloud aerosol optical depth (ACAOD) retrieved from the color ratio method applied to MODIS cloudy-sky reflectance measurements using the limited direct measurements made by NASAs airborne Ames Airborne Tracking Sunphotometer (AATS) and Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR) sensors. A thorough search of the airborne database collection revealed a total of five significant events in which an airborne sun photometer, coincident with the MODIS overpass, observed partially absorbing aerosols emitted from agricultural biomass burning, dust, and wildfires over a low-level cloud deck during SAFARI-2000, ACE-ASIA 2001, and SEAC4RS 2013 campaigns, respectively. The co-located satellite-airborne match ups revealed a good agreement (root-mean-square difference less than 0.1), with most match ups falling within the estimated uncertainties associated with the MODIS retrievals (about -10 to +50 ). The co-retrieved cloud optical depth was comparable to that of the MODIS operational cloud product for ACE-ASIA and SEAC4RS, however, higher by 30-50% for the SAFARI-2000 case study. The reason for this discrepancy could be attributed to the distinct aerosol optical properties encountered during respective campaigns. A brief discussion on the sources of uncertainty in the satellite-based ACAOD retrieval and co-location procedure is presented. Field experiments dedicated to making direct measurements of aerosols above cloud are needed for the extensive validation of satellite based retrievals.

  15. Validating MODIS above-cloud aerosol optical depth retrieved from "color ratio" algorithm using direct measurements made by NASA's airborne AATS and 4STAR sensors

    NASA Astrophysics Data System (ADS)

    Jethva, Hiren; Torres, Omar; Remer, Lorraine; Redemann, Jens; Livingston, John; Dunagan, Stephen; Shinozuka, Yohei; Kacenelenbogen, Meloe; Segal Rosenheimer, Michal; Spurr, Rob

    2016-10-01

    We present the validation analysis of above-cloud aerosol optical depth (ACAOD) retrieved from the "color ratio" method applied to MODIS cloudy-sky reflectance measurements using the limited direct measurements made by NASA's airborne Ames Airborne Tracking Sunphotometer (AATS) and Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR) sensors. A thorough search of the airborne database collection revealed a total of five significant events in which an airborne sun photometer, coincident with the MODIS overpass, observed partially absorbing aerosols emitted from agricultural biomass burning, dust, and wildfires over a low-level cloud deck during SAFARI-2000, ACE-ASIA 2001, and SEAC4RS 2013 campaigns, respectively. The co-located satellite-airborne matchups revealed a good agreement (root-mean-square difference < 0.1), with most matchups falling within the estimated uncertainties associated the MODIS retrievals (about -10 to +50 %). The co-retrieved cloud optical depth was comparable to that of the MODIS operational cloud product for ACE-ASIA and SEAC4RS, however, higher by 30-50 % for the SAFARI-2000 case study. The reason for this discrepancy could be attributed to the distinct aerosol optical properties encountered during respective campaigns. A brief discussion on the sources of uncertainty in the satellite-based ACAOD retrieval and co-location procedure is presented. Field experiments dedicated to making direct measurements of aerosols above cloud are needed for the extensive validation of satellite-based retrievals.

  16. The Augmented REality Sandtable (ARES)

    DTIC Science & Technology

    2015-10-01

    Introduction The US Army Research Laboratory (ARL) Human Sciences Campaign calls out the topic of Virtual /Mixed and Augmented Reality as one of the...type of virtual environment. In virtual reality (VR), the totality of the environment is computer generated. In AR, the real world is augmented by...effectively. 20 17. References Alexander T. Visualisation of geographic data in virtual environments - what is essential for virtual reality systems

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

    PubMed

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

    2008-03-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2016-07-05

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

  20. An Absence of Cutaneous Neurofibromas Associated with a 3-bp Inframe Deletion in Exon 17 of the NF1 Gene (c.2970-2972 delAAT): Evidence of a Clinically Significant NF1 Genotype-Phenotype Correlation

    PubMed Central

    Upadhyaya, M.; Huson, S. M.; Davies, M.; Thomas, N.; Chuzhanova, N.; Giovannini, S.; Evans, D. G.; Howard, E.; Kerr, B.; Griffiths, S.; Consoli, C.; Side, L.; Adams, D.; Pierpont, M.; Hachen, R.; Barnicoat, A.; Li, H.; Wallace, P.; Van Biervliet, J. P.; Stevenson, D.; Viskochil, D.; Baralle, D.; Haan, E.; Riccardi, V.; Turnpenny, P.; Lazaro, C.; Messiaen, L.

    2007-01-01

    Neurofibromatosis type 1 (NF1) is characterized by café-au-lait spots, skinfold freckling, and cutaneous neurofibromas. No obvious relationships between small mutations (<20 bp) of the NF1 gene and a specific phenotype have previously been demonstrated, which suggests that interaction with either unlinked modifying genes and/or the normal NF1 allele may be involved in the development of the particular clinical features associated with NF1. We identified 21 unrelated probands with NF1 (14 familial and 7 sporadic cases) who were all found to have the same c.2970-2972 delAAT (p.990delM) mutation but no cutaneous neurofibromas or clinically obvious plexiform neurofibromas. Molecular analysis identified the same 3-bp inframe deletion (c.2970-2972 delAAT) in exon 17 of the NF1 gene in all affected subjects. The ΔAAT mutation is predicted to result in the loss of one of two adjacent methionines (codon 991 or 992) (ΔMet991), in conjunction with silent ACA→ACG change of codon 990. These two methionine residues are located in a highly conserved region of neurofibromin and are expected, therefore, to have a functional role in the protein. Our data represent results from the first study to correlate a specific small mutation of the NF1 gene to the expression of a particular clinical phenotype. The biological mechanism that relates this specific mutation to the suppression of cutaneous neurofibroma development is unknown. PMID:17160901

  1. Research directions in augmentative and alternative communication for preschool children.

    PubMed

    Sevcik, R A; Romski, M A; Adamson, L B

    To review issues related to the use of augmentative systems with young children and present a case study of one child and family's experience with the System for Augmenting Language (SAL). The case involved a preschool child with severe developmental delays who had little functional speech. Acquisition and use of graphic symbols on a speech-output communication device was studied in home and clinical settings. Language and communication behaviours of the child and his communication partners were observed and language assessment measures were collected. Child engagement state varied across the two settings with a stable profile seen in the therapy setting and a clear increase at home. Child communicative attempts increased following the introduction of the augmented system. Parents reported successful use of the SAL. SAL is a viable communication intervention approach for young children.

  2. Bayesian Alternation during Tactile Augmentation

    PubMed Central

    Goeke, Caspar M.; Planera, Serena; Finger, Holger; König, Peter

    2016-01-01

    A large number of studies suggest that the integration of multisensory signals by humans is well-described by Bayesian principles. However, there are very few reports about cue combination between a native and an augmented sense. In particular, we asked the question whether adult participants are able to integrate an augmented sensory cue with existing native sensory information. Hence for the purpose of this study, we build a tactile augmentation device. Consequently, we compared different hypotheses of how untrained adult participants combine information from a native and an augmented sense. In a two-interval forced choice (2 IFC) task, while subjects were blindfolded and seated on a rotating platform, our sensory augmentation device translated information on whole body yaw rotation to tactile stimulation. Three conditions were realized: tactile stimulation only (augmented condition), rotation only (native condition), and both augmented and native information (bimodal condition). Participants had to choose one out of two consecutive rotations with higher angular rotation. For the analysis, we fitted the participants' responses with a probit model and calculated the just notable difference (JND). Then, we compared several models for predicting bimodal from unimodal responses. An objective Bayesian alternation model yielded a better prediction (χred2 = 1.67) than the Bayesian integration model (χred2 = 4.34). Slightly higher accuracy showed a non-Bayesian winner takes all (WTA) model (χred2 = 1.64), which either used only native or only augmented values per subject for prediction. However, the performance of the Bayesian alternation model could be substantially improved (χred2 = 1.09) utilizing subjective weights obtained by a questionnaire. As a result, the subjective Bayesian alternation model predicted bimodal performance most accurately among all tested models. These results suggest that information from augmented and existing sensory modalities in

  3. Bayesian Alternation during Tactile Augmentation.

    PubMed

    Goeke, Caspar M; Planera, Serena; Finger, Holger; König, Peter

    2016-01-01

    A large number of studies suggest that the integration of multisensory signals by humans is well-described by Bayesian principles. However, there are very few reports about cue combination between a native and an augmented sense. In particular, we asked the question whether adult participants are able to integrate an augmented sensory cue with existing native sensory information. Hence for the purpose of this study, we build a tactile augmentation device. Consequently, we compared different hypotheses of how untrained adult participants combine information from a native and an augmented sense. In a two-interval forced choice (2 IFC) task, while subjects were blindfolded and seated on a rotating platform, our sensory augmentation device translated information on whole body yaw rotation to tactile stimulation. Three conditions were realized: tactile stimulation only (augmented condition), rotation only (native condition), and both augmented and native information (bimodal condition). Participants had to choose one out of two consecutive rotations with higher angular rotation. For the analysis, we fitted the participants' responses with a probit model and calculated the just notable difference (JND). Then, we compared several models for predicting bimodal from unimodal responses. An objective Bayesian alternation model yielded a better prediction (χred(2) = 1.67) than the Bayesian integration model (χred(2) = 4.34). Slightly higher accuracy showed a non-Bayesian winner takes all (WTA) model (χred(2) = 1.64), which either used only native or only augmented values per subject for prediction. However, the performance of the Bayesian alternation model could be substantially improved (χred(2) = 1.09) utilizing subjective weights obtained by a questionnaire. As a result, the subjective Bayesian alternation model predicted bimodal performance most accurately among all tested models. These results suggest that information from augmented and existing sensory modalities in

  4. Augmentation strategies for treatment-resistant depression: a literature review.

    PubMed

    Carvalho, A F; Cavalcante, J L; Castelo, M S; Lima, M C O

    2007-10-01

    The large majority of depressed patients fail to remit on the first antidepressant prescribed. These patients with residual symptoms have higher relapse rates and poorer outcomes than those who remit. Treatment-resistant depression (TRD) is a therapeutic challenge for the clinician. Augmentation pharmacotherapy refers to the addition of drugs that are not standard antidepressants in order to enhance the effect of a classical antidepressant drug. The aim of this paper was to review the available evidence on the various augmenting agents that have been tested for efficacy in TRD. Electronic databases and relevant textbooks were searched and the information retrieved was integrated in this review. Although augmentation strategies have been tested with various pharmacological agents, there are few controlled studies published. Lithium, triiodothyronine (T3), buspirone and pindolol have been most widely studied. Other agents include dopaminergic agents, atypical antipsychotics, psychostimulants, benzodiazepines/hypnotics, hormones and anticonvulsants. The augmentation therapy with the best evidence was the lithium-antidepressant combination, especially in patients not responding to tricyclic agents. However, good results have also been reported with augmentation strategies involving T3 and buspirone.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-03-30

    Several double blind, prospective trials have demonstrated an antidepressant augmentation efficacy of aripiprazole in depressed patients unresponsive to standard antidepressant therapy. Although aripiprazole is now widely used for this indication, and much is known about its receptor-binding properties, the mechanism of its antidepressant augmentation remains ill-defined. In vivo animal studies and in vitro human studies using cloned dopamine dopamine D2 receptors suggest aripiprazole is a partial dopamine agonist; in this preliminary neuroimaging trial, we hypothesized that aripiprazole's antidepressant augmentation efficacy arises from dopamine partial agonist activity. To test this, we assessed the effects of aripiprazole augmentation on the cerebral utilization of 6-[(18)F]-fluoro-3,4-dihydroxy-l-phenylalanine (FDOPA) using positron emission tomography (PET). Fourteen depressed patients, who had failed 8 weeks of antidepressant therapy with selective serotonin reuptake inhibitors, underwent FDOPA PET scans before and after aripiprazole augmentation; 11 responded to augmentation. Whole brain, voxel-wise comparisons of pre- and post-aripiprazole scans revealed increased FDOPA trapping in the right medial caudate of augmentation responders. An exploratory analysis of depressive symptoms revealed that responders experienced large improvements only in putatively dopaminergic symptoms of lassitude and inability to feel. These preliminary findings suggest that augmentation of antidepressant response by aripiprazole may be associated with potentiation of dopaminergic activity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Augmented Reality Tower Technology Assessment

    NASA Technical Reports Server (NTRS)

    Reisman, Ronald J.; Brown, David M.

    2009-01-01

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

  8. Augmentation cystoplasty in neurogenic bladder

    PubMed Central

    Kocjancic, Ervin; Demirdağ, Çetin

    2016-01-01

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

  9. Therapeutic options for lip augmentation.

    PubMed

    Segall, Lorne; Ellis, David A F

    2007-11-01

    Aesthetic ideals vary with emerging fashion trends and within different cultures. However, over the past few decades, fuller lips have been considered a desirable trait. Many younger patients are presenting for lip augmentation to achieve the sought-after look commonly seen in many fashion magazines. In addition, as individuals age, they lose lip volume, with a thinning of the red lip, some effacement of the vermillion border, and elongation and flattening of the white portion of the lip. Rejuvenation of the lips plays a key role in restoring a more youthful appearance. As a result, lip augmentation appeals to a wide spectrum of patients who present with various different aesthetic goals and expectations. Numerous therapeutic options exist for aesthetic lip augmentation, ranging from temporary and permanent injectable fillers to implants and other surgical techniques.

  10. Augmentation-related brain plasticity

    PubMed Central

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

    2014-01-01

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

  11. Augmented reality for anatomical education.

    PubMed

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

    2010-03-01

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

  12. Combustion-augmented laser ramjets

    NASA Astrophysics Data System (ADS)

    Horisawa, Hideyuki; Tamada, Kazunobu; Kimura, Itsuro

    2006-05-01

    A preliminary study of combustion-augmented laser-ramjets was conducted, in which chemical propellant such as a gaseous hydrogen/air mixture was utilized and detonated with a focused laser beam in order to obtain a higher impulse compared to the case only using lasers. CFD analysis of internal conical-nozzle flows and experimental measurements including impulse measurement were conducted to evaluate effects of chemical reaction on thrust performance improvement. From the results, a significant improvement in the thrust performances was confirmed with addition of a small amount of hydrogen to propellant air, or in combustion-augmented operation.

  13. Appropriate initial antibiotic therapy in hospitalized patients with gram-negative infections: systematic review and meta-analysis.

    PubMed

    Raman, Gowri; Avendano, Esther; Berger, Samantha; Menon, Vandana

    2015-09-30

    The rapid global spread of multi-resistant bacteria and loss of antibiotic effectiveness increases the risk of initial inappropriate antibiotic therapy (IAT) and poses a serious threat to patient safety. We conducted a systematic review and meta-analysis of published studies to summarize the effect of appropriate antibiotic therapy (AAT) or IAT against gram-negative bacterial infections in the hospital setting. MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched until May 2014 to identify English-language studies examining use of AAT or IAT in hospitalized patients with Gram-negative pathogens. Outcomes of interest included mortality, clinical cure, cost, and length of stay. Citations and eligible full-text articles were screened in duplicate. Random effect models meta-analysis was used. Fifty-seven studies in 60 publications were eligible. AAT was associated with lower risk of mortality (unadjusted summary odds ratio [OR] 0.38, 95 % confidence interval [CI] 0.30-0.47, 39 studies, 5809 patients) and treatment failure (OR 0.22, 95 % CI 0.14-0.35; 3 studies, 283 patients). Conversely, IAT increased risk of mortality (unadjusted summary OR 2.66, 95 % CI 2.12-3.35; 39 studies, 5809 patients). In meta-analyses of adjusted data, AAT was associated with lower risk of mortality (adjusted summary OR 0.43, 95 % CI 0.23-0.83; 6 studies, 1409 patients). Conversely, IAT increased risk of mortality (adjusted summary OR 3.30, 95 % CI 2.42-4.49; 16 studies, 2493 patients). A limited number of studies suggested higher cost and longer hospital stay with IAT. There was considerable heterogeneity in the definition of AAT or IAT, pathogens studied, and outcomes assessed. Using a large set of studies we found that IAT is associated with a number of serious consequences,including an increased risk of hospital mortality. Infections caused by drug-resistant, Gram-negative organisms represent a considerable financial burden to healthcare systems due to the increased costs

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

    PubMed Central

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

    2008-01-01

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

  15. Exploration of α1-antitrypsin treatment protocol for islet transplantation: dosing plan and route of administration.

    PubMed

    Baranovski, Boris M; Ozeri, Eyal; Shahaf, Galit; Ochayon, David E; Schuster, Ronen; Bahar, Nofar; Kalay, Noa; Cal, Pablo; Mizrahi, Mark I; Nisim, Omer; Strauss, Pnina; Schenker, Eran; Lewis, Eli C

    2016-11-07

    Life-long weekly infusions of human α1-antitrypsin (hAAT) are currently administered as augmentation therapy for patients with genetic AAT deficiency (AATD). Several recent clinical trials attempt to extend hAAT therapy to conditions outside AATD, including type 1 diabetes. Since the endpoint for AATD is primarily the reduction of risk for pulmonary emphysema, the present study explores hAAT dose protocols and routes of administration in attempt to optimize hAAT therapy for islet-related injury. Islet-grafted mice were treated with hAAT (Glassia™; i.p. or s.c.) under an array of clinically relevant dosing plans. Serum hAAT and immunocyte cell membrane association were examined, as well as parameters of islet survival. Results indicate that dividing the commonly prescribed 60 mg/kg i.p. dose to three 20 mg/kg injections is superior in affording islet graft survival; in addition, a short dynamic descending dose protocol (240→120→60→60 mg/kg i.p.) is comparable in outcomes to indefinite 60 mg/kg injections. While hAAT pharmacokinetics after i.p. administration in mice resembles exogenous hAAT treatment in humans, s.c. administration better imitated the physiological progressive rise of hAAT during acute phase responses; nonetheless, only the 60 mg/kg dose depicted an advantage using the s.c. route. Taken together, this study provides a platform for extrapolating an islet-relevant clinical protocol from animal models that use hAAT to protect islets. In addition, the study places emphasis on outcome-oriented analyses of drug efficacy, particularly important when considering that hAAT is presently at an era of drug-repurposing towards an extended list of clinical indications outside genetic AATD.

  16. Augmented assessment as a means to augmented reality.

    PubMed

    Bergeron, Bryan

    2006-01-01

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

  17. [Augmentation technique on the proximal humerus].

    PubMed

    Scola, A; Gebhard, F; Röderer, G

    2015-09-01

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

  18. Assessing the effectiveness of a 3-month day-and-night home closed-loop control combined with pump suspend feature compared with sensor-augmented pump therapy in youths and adults with suboptimally controlled type 1 diabetes: a randomised parallel study protocol.

    PubMed

    Bally, Lia; Thabit, Hood; Tauschmann, Martin; Allen, Janet M; Hartnell, Sara; Wilinska, Malgorzata E; Exall, Jane; Huegel, Viki; Sibayan, Judy; Borgman, Sarah; Cheng, Peiyao; Blackburn, Maxine; Lawton, Julia; Elleri, Daniela; Leelarathna, Lalantha; Acerini, Carlo L; Campbell, Fiona; Shah, Viral N; Criego, Amy; Evans, Mark L; Dunger, David B; Kollman, Craig; Bergenstal, Richard M; Hovorka, Roman

    2017-07-13

    Despite therapeutic advances, many individuals with type 1 diabetes are unable to achieve tight glycaemic target without increasing the risk of hypoglycaemia. The objective of this study is to determine the effectiveness of a 3-month day-and-night home closed-loop glucose control combined with a pump suspend feature, compared with sensor-augmented insulin pump therapy in youths and adults with suboptimally controlled type 1 diabetes. The study adopts an open-label, multi-centre, multi-national (UK and USA), randomised, single-period, parallel design and aims for 84 randomised patients. Participants are youths (6-21 years) or adults (>21 years) with type 1 diabetes treated with insulin pump therapy and suboptimal glycaemic control (glycated haemoglobin (HbA1c) ≥7.5% (58 mmol/mol) and ≤10% (86 mmol/mol)). Following a 4-week run-in period, eligible participants will be randomised to a 3-month use of automated closed-loop insulin delivery combined with pump suspend feature or to sensor-augmented insulin pump therapy. Analyses will be conducted on an intention-to-treat basis. The primary outcome is the time spent in the target glucose range from 3.9 to 10.0 mmol/L based on continuous glucose monitoring levels during the 3-month free-living phase. Secondary outcomes include HbA1c at 3 months, mean glucose, time spent below and above target; time with glucose levels <3.5 and <2.8 mmol/L; area under the curve when sensor glucose is <3.5 mmol/L, time with glucose levels >16.7 mmol/L, glucose variability; total, basal and bolus insulin dose and change in body weight. Participants' and their families' perception in terms of lifestyle change, daily diabetes management and fear of hypoglycaemia will be evaluated. Ethics/institutional review board approval has been obtained. Before screening, all participants/guardians will be provided with oral and written information about the trial. The study will be disseminated by peer-reviewed publications and conference

  19. Mechanical ventilation in mass casualty scenarios. Augmenting staff: project XTREME.

    PubMed

    Hanley, Michael E; Bogdan, Gregory M

    2008-02-01

    Disaster preparedness typically includes plans that address the need for surge capacity to manage mass-casualty events. A major concern of disaster preparedness in respiratory therapy focuses on responding to a sudden increase in the volume of patients who require mechanical ventilation. Plans for such disasters must include contingencies to address surge capacity in ventilator inventories and the respiratory therapy staff who will manage the ventilators. Tactics to address these situations include efforts to lower demand by transferring patients to other institutions as well as efforts to augment staffing levels. Staff can be augmented by mobilization of deployable teams of volunteers from outside the region and through exploitation of local resources. The latter includes strategies to recruit local respiratory therapists who are currently in either non-clinical or non-hospital-based positions and policies that optimize existing respiratory therapy resources within an institution by canceling elective surgeries, altering shift structure, and postponing vacations. An alternative approach would employ non-respiratory-therapy staff to assist in the management of patients with respiratory failure. Project XTREME (Cross-Training Respiratory Extenders for Medical Emergencies) is a cross-training program developed to facilitate training of non-respiratory-therapy health professionals to assist in the management of patients who require mechanical ventilation. It includes an interactive digital video disc as well as a competency validation laboratory and is designed to be performed at the time of an emergency. Pilot testing of the program suggests it is effective.

  20. Augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise.

    PubMed

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

    2009-03-01

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

  1. The Expanded Use of Auto-augmentation Techniques in Oncoplastic Breast Surgery.

    PubMed

    Losken, Albert; Hart, Alexandra M; Dutton, James Walter; Broecker, Justine S; Styblo, Toncred M; Carlson, Grant W

    2017-09-13

    Auto-augmentation techniques have been applied to oncoplastic reductions to assist with filling larger, more remote defects and women with smaller breasts. The purpose of this report is to describe the use of auto-augmentation techniques in OR and compare the results with traditional OR. We queried a prospectively maintained database of all women who underwent partial mastectomy and OR between 1994 and October 2015. The auto-augmentation techniques were defined as 1) extended primary nipple auto-augmentation pedicle, and 2) primary nipple pedicle and secondary auto-augmentation pedicle. Comparisons were made to a control oncoplastic group. There were a total of 333 patients, 222 patients (67.7%) without auto-augmentation and 111 patients (33%) with auto-augmentation. Fifty-one patients had extended auto-augmentation pedicle, and 60 patients with a secondary auto-augmentation pedicle. Biopsy weight was smallest in the extended pedicle group (136 grams) and largest in the regular oncoplastic group (235 grams, p=0.017). Superomedial was the most common extended pedicle and lateral being the most common location. Inferorolateral was the most common secondary pedicle for lateral and upper outer defects. There were no significant differences in the overall complication rate: 15.5% in the regular oncoplastic group, 19.6% in the extended pedicle group, and 20% in the secondary pedicle group. Auto-augmentation techniques have evolved to manage complex defects not amenable to standard oncoplastic reduction methods. They are often required for lateral defects especially in smaller breasts. Auto-augmentation can be done safely without increase risk of complications, broadening the indications for breast conservation therapy.

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

    PubMed

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

    2017-06-01

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

  3. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    PubMed Central

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R.; Lucchese, Guglielmo; Pulvermüller, Friedemann

    2017-01-01

    A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy). Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT). This diagnostic instrument requires patients to produce target words in two conditions: (i) utterance-centered object naming, and (ii) communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT). Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10–20 min) than for the AAT (60–90 min). Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy. PMID:28579951

  4. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy.

    PubMed

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R; Lucchese, Guglielmo; Pulvermüller, Friedemann

    2017-01-01

    A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy). Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT). This diagnostic instrument requires patients to produce target words in two conditions: (i) utterance-centered object naming, and (ii) communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT). Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10-20 min) than for the AAT (60-90 min). Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy.

  5. Measuring patient outcomes in breast augmentation: introducing the BREAST-Q Augmentation module.

    PubMed

    Pusic, Andrea L; Reavey, Patrick L; Klassen, Anne F; Scott, Amie; McCarthy, Colleen; Cano, Stefan J

    2009-01-01

    The Breast-Q Augmentation module is a new and unique questionnaire for measuring patient-reported outcomes following breast augmentation. It has undergone a rigorous development and validation process and is currently the only questionnaire for breast augmentation that meets international and federal standards for questionnaire development. The Breast-Q Augmentation module covers a comprehensive set of concerns of breast augmentation patients, including satisfaction with breasts and impact on quality of life. With its excellent psychometric properties, the Breast-Q Augmentation module can provide clinicians and researchers with a wealth of essential data to improve the field of breast augmentation from the perspectives of both surgeons and patients.

  6. Effective Augmentation of Complex Networks

    PubMed Central

    Wang, Jinjian; Yu, Xinghuo; Stone, Lewi

    2016-01-01

    Networks science plays an enormous role in many aspects of modern society from distributing electrical power across nations to spreading information and social networking amongst global populations. While modern networks constantly change in size, few studies have sought methods for the difficult task of optimising this growth. Here we study theoretical requirements for augmenting networks by adding source or sink nodes, without requiring additional driver-nodes to accommodate the change i.e., conserving structural controllability. Our “effective augmentation” algorithm takes advantage of clusters intrinsic to the network topology, and permits rapidly and efficient augmentation of a large number of nodes in one time-step. “Effective augmentation” is shown to work successfully on a wide range of model and real networks. The method has numerous applications (e.g. study of biological, social, power and technological networks) and potentially of significant practical and economic value. PMID:27165120

  7. Silicone implants in augmentation rhinoplasty.

    PubMed

    Zeng, Yanjun; Wu, Weihua; Yu, Hongmei; Yang, Jian; Chen, Guangshen

    2002-01-01

    During the past six years, we have treated 406 patients with classical silicon augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation were examined and discussed. We proposed that most complications are related to the depth of the implant and the character of the tissues. In order to improve our operation and prove our hypothesis, we performed subperiosteal augmentation rhinoplasty in 22 cases with satisfactory results. At the same time, we investigated the biomechanical properties of human nasal periosteum and fascia, including tensile strength, stress-strain relationship and stress relaxation characters under uniaxial tension. Although less elastic, the periosteum has more tensile strength than fascia. So, in the view of biomechanics, the periosteum is thicker, tougher, and stiffer than fascia, thus more suitable for covering silicon implants.

  8. Silicone implant in augmentation rhinoplasty.

    PubMed

    Zeng, Yanjun; Wu, Weihua; Yu, Hongmei; Yang, Jian; Chen, Guangshen

    2002-11-01

    During the past 6 years the authors have treated 406 patients with classic silicone augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation are examined and discussed. They propose that most complications are related to the depth of the implant and the character of the tissues. To improve their operation and to prove their hypothesis, they performed subperiosteal augmentation rhinoplasty in 22 patients with satisfactory results. At the same time, they investigated the biomechanical properties of human nasal periosteum and fascia, including tensile strength, the stress-strain relationship, and stress relaxation characteristics under uniaxial tension. Although it has less failure strain, the periosteum has more tensile strength than fascia. So, in the view of biomechanics, the periosteum is thicker, tougher, and stiffer than fascia, and thus more suitable for covering silicone implants.

  9. Augmented reality building operations tool

    DOEpatents

    Brackney, Larry J.

    2014-09-09

    A method (700) for providing an augmented reality operations tool to a mobile client (642) positioned in a building (604). The method (700) includes, with a server (660), receiving (720) from the client (642) an augmented reality request for building system equipment (612) managed by an energy management system (EMS) (620). The method (700) includes transmitting (740) a data request for the equipment (612) to the EMS (620) and receiving (750) building management data (634) for the equipment (612). The method (700) includes generating (760) an overlay (656) with an object created based on the building management data (634), which may be sensor data, diagnostic procedures, or the like. The overlay (656) is configured for concurrent display on a display screen (652) of the client (642) with a real-time image of the building equipment (612). The method (700) includes transmitting (770) the overlay (656) to the client (642).

  10. Effective Augmentation of Complex Networks

    NASA Astrophysics Data System (ADS)

    Wang, Jinjian; Yu, Xinghuo; Stone, Lewi

    2016-05-01

    Networks science plays an enormous role in many aspects of modern society from distributing electrical power across nations to spreading information and social networking amongst global populations. While modern networks constantly change in size, few studies have sought methods for the difficult task of optimising this growth. Here we study theoretical requirements for augmenting networks by adding source or sink nodes, without requiring additional driver-nodes to accommodate the change i.e., conserving structural controllability. Our “effective augmentation” algorithm takes advantage of clusters intrinsic to the network topology, and permits rapidly and efficient augmentation of a large number of nodes in one time-step. “Effective augmentation” is shown to work successfully on a wide range of model and real networks. The method has numerous applications (e.g. study of biological, social, power and technological networks) and potentially of significant practical and economic value.

  11. Media-Augmented Exercise Machines

    NASA Astrophysics Data System (ADS)

    Krueger, T.

    2002-01-01

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

  12. TDRSS Augmentation System for Satellites

    NASA Technical Reports Server (NTRS)

    Heckler, Gregory W.; Gramling, Cheryl; Valdez, Jennifer; Baldwin, Philip

    2016-01-01

    In 2015, NASA Goddard Space Flight Center (GSFC) reinvigorated the development of the TDRSS Augmentation Service for Satellites (TASS). TASS is a global, space-based, communications and navigation service for users of Global Navigation Satellite Systems(GNSS) and the Tracking and Data Relay Satellite System (TDRSS). TASS leverages the existing TDRSS to provide an S-band beacon radio navigation and messaging source to users at orbital altitudes 1400 km and below.

  13. Military Applications of Augmented Reality

    DTIC Science & Technology

    2011-01-01

    NOTES book chapter in Handbook of Augmented Reality, 2011. 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...real ob- jects by simply not rendering graphics where they are computed to be hidden from view; this is a standard property of the depth buffer in...Adam Lederer, Jason Jerald, Erik Tomlin, Eric Burns, Donald Char- ity, Joshua Eliason, Jesus Arango, and Scott Frees. In addition, the authors would like

  14. Photon management for augmented photosynthesis

    NASA Astrophysics Data System (ADS)

    Ooms, Matthew D.; Dinh, Cao Thang; Sargent, Edward H.; Sinton, David

    2016-09-01

    Microalgae and cyanobacteria are some of nature's finest examples of solar energy conversion systems, effortlessly transforming inorganic carbon into complex molecules through photosynthesis. The efficiency of energy-dense hydrocarbon production by photosynthetic organisms is determined in part by the light collected by the microorganisms. Therefore, optical engineering has the potential to increase the productivity of algae cultivation systems used for industrial-scale biofuel synthesis. Herein, we explore and report emerging and promising material science and engineering innovations for augmenting microalgal photosynthesis.

  15. Augment railgun and sequential discharge

    NASA Astrophysics Data System (ADS)

    Kobayashi, K.

    1993-01-01

    Proprietary R&D efforts toward the creation of tactical weapon systems-applicable railguns are presented. Attention is given to measures taken for projectile velocity maximization and sequential-discharge operation, and to an augmenting railgun which has demonstrated a 66-percent efficiency improvement over the two-rail baseline railgun system. This device is characterized by strong interaction between capacitor bank submodules during sequential discharge.

  16. Vortex Lift Augmentation by Suction

    NASA Technical Reports Server (NTRS)

    Taylor, A. H.; Jackson, L. R.; Huffman, J. K.

    1983-01-01

    Lift performance is improved on a 60 degrees swept Gothic wing. Vortex lift at moderate to high angles of attack on highly swept wings used to improve takeoff performance and maneuverability. New design proposed in which suction of propulsion system augments vortex. Turbofan placed at down stream end of leading-edge vortex system induces vortex to flow into inlet which delays onset of vortex breakdown.

  17. Vortex Lift Augmentation by Suction

    NASA Technical Reports Server (NTRS)

    Taylor, A. H.; Jackson, L. R.; Huffman, J. K.

    1983-01-01

    Lift performance is improved on a 60 degrees swept Gothic wing. Vortex lift at moderate to high angles of attack on highly swept wings used to improve takeoff performance and maneuverability. New design proposed in which suction of propulsion system augments vortex. Turbofan placed at down stream end of leading-edge vortex system induces vortex to flow into inlet which delays onset of vortex breakdown.

  18. Lamotrigine augmentation in unipolar depression.

    PubMed

    Rocha, Fabio Lopes; Hara, Claudia

    2003-03-01

    A significant number of patients with unipolar depression fail to achieve remission after one or a series of antidepressants. We present the results of a retrospective chart review of the efficacy and tolerability of lamotrigine as an augmentation drug in treatment-resistant unipolar depression. A previous absence of a response was defined as the clinically significant presence of depressive symptomatology after 6 weeks of treatment with an antidepressant, with at least 3 weeks at the maximum dose tolerated by the patient. The patients were rated retrospectively using the Clinical Global Impression rating scale. Seventy-six percent of the patients improved. Gender, age, basal severity of the episode and degree of previous non response were not statistically significantly associated with response to lamotrigine augmentation. Comorbidity showed a tendency to be negatively related with response to lamotrigine. Three patients abandoned the treatment with lamotrigine due to side-effects. Complaints were excessive somnolence, headache, dizziness, nausea and malaise. Data suggest that lamotrigine is a promising drug for treatment-refractory unipolar depression. Double-blind studies are necessary to confirm its use as an augmentation agent.

  19. Pharmacotherapy augmentation strategies in treatment-resistant anxiety disorders.

    PubMed

    Ipser, J C; Carey, P; Dhansay, Y; Fakier, N; Seedat, S; Stein, D J

    2006-10-18

    A large proportion of patients with anxiety disorders fail to respond to first-line medication interventions, despite evidence of the effectiveness of these agents. To assess the effects of medication versus placebo augmentation in the treatment of patients with anxiety disorders who have failed to respond adequately to first-line drug therapies. The Cochrane Depression, Anxiety & Neurosis Group (CCDAN) specialised registers (CCDANCTR-Studies and CCDANCTR-References) were searched on 3/8/2005, MEDLINE (January 1966 to July 2005) and PsycINFO (1966 to 2005, Part A). Unpublished trials were identified through the Controlled Trials database and the National Institute of Health's Computer Retrieval of Information on Scientific Projects (CRISP) service (1972 to 2005). Additional studies in any language were sought in reference lists of retrieved articles. All randomised controlled trials (RCTs) of the medication augmentation of pharmacotherapy for treatment resistant anxiety disorders. Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by class of augmentation agent and anxiety disorder. Overall effect estimates were calculated using a random-effects model, heterogeneity was assessed and subgroup/sensitivity analyses were undertaken. Twenty eight short-term (average of seven weeks) randomised controlled trials (740 participants) were included in the review, 20 of which investigated augmentation of medication for treatment-resistant obsessive compulsive disorder (OCD). Summary statistics for responder status from nine trials demonstrate overall superiority of a variety of medication agents to placebo (relative risk of non-response (RR) 3.16, 95% CI 1.08 to 9.23). Similarly, symptom severity was significantly reduced in the medication groups, relative to placebo (number of trials (N) = 14, standardised mean difference

  20. Striae distensae after breast augmentation.

    PubMed

    Basile, Filipe Volpe; Basile, Arthur Volpe; Basile, Antonio Roberto

    2012-08-01

    One known but not fully understood complication after breast augmentation is the new onset of stretch marks (striae distensae) on the surgically treated breast. To date, all publications on this subject have been case reports. No report has fully described the actual incidence, risk factors, or management of striae distensae after breast surgery. This study prospectively followed patients who underwent primary breast augmentation using silicone implants in a single group practice from 2007 to 2011. New-onset striae distensae were actively investigated. Time from surgery to the moment of striae onset, patient age, nulliparity, use of oral contraceptives, overweight, personal history of stretch marks, and other variables were evaluated. A total of 409 patients were included in the study. In 19 cases (4.6%), new-onset striae distensae after breast augmentation were observed. The population with striae distensae was significantly younger than the total population (29.56 vs 20.91 years; p=0.012). Striae distensae also were more common in nulliparous than in multiparous women (8.29 vs 0.52%; p=0.006), overweight women (17.77 vs 3.02%; p=0.016), women using oral contraceptives (7.89 vs 0.55%; p=0.008), and women with a personal history of stretch marks (8.97 vs 3.36%; p=0.031). No relation was shown regarding implant pocket type, size, or profile. Striae distensae may be a common but underreported complication after breast augmentation. In this series, striae distensae developed in 4.6% of the patients within 1 year after breast augmentation. Severity may vary from inconspicuous small marks (classifications 1 and 2) to wide red and active striae rubra (classifications 3 and 4). Nulliparity, use of oral contraceptives, overweight, personal history of stretch marks, and younger age were related to a higher incidence of striae distensae. The increased rates in these groups may be associated with their exposure to higher estrogen levels and the important role of this hormone

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

    PubMed

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

    2013-09-01

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

  2. An adaptive brain actuated system for augmenting rehabilitation

    PubMed Central

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

    2014-01-01

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

  3. Clinical Applications of Mesenchymal Stem Cells in Soft Tissue Augmentation

    PubMed Central

    Hanson, Summer E.; Gutowski, Karol A.; Hematti, Peiman

    2014-01-01

    Based on a variety of preclinical studies showing that mesenchymal stem cells (MSC) play a significant role in tissue repair and homeostasis, MSC have rapidly moved into a phase of clinical trials investigating their efficacy as a cell-based therapeutic modality for a diverse group of applications. An emerging body of evidence shows that in addition to being a progenitor cell population with self-renewing and multipotent differentiation capabilities, MSC have unique immunomodulatory properties, making them even more attractive for regenerative medicine. Emerging discoveries in stem cell biology have revealed a multitude of mechanisms through which MSC could potentially augment the current techniques in aesthetic surgery. In this article, the authors review the clinical advances in cell-based therapies relevant to aesthetic surgery, including tissue augmentation, rejuvenation, and regeneration. PMID:21131458

  4. Considerations of previous augmentation in subsequent breast reconstruction.

    PubMed

    Spear, Scott L; Clemens, Mark W; Dayan, Joseph H

    2008-01-01

    The number of patients receiving augmentation mammaplasty is rapidly growing. Breast cancer will develop in a significant number of these women. The authors report on a series (expanding the size of a previous study by the senior author, S.L.S.), encompassing one surgeon's experience performing breast reconstruction in women who had undergone previous augmentation. They compare the stage and detection method in this series with other published studies and also review their experience with regard to the benefit of subpectoral versus subglandular implant placement. A retrospective review of the senior author's reconstructive practice was performed, including the period from July 1983 to July 2007. Thirty-two consecutive women were identified who had previously received augmentation mammaplasty, were subsequently diagnosed with cancer, and then underwent breast reconstruction. Types of reconstructive procedures and outcomes were evaluated. A statistical analysis of the results was performed with a standard 2-tailed t test and chi(2) analysis. The occurrence of breast cancer diagnosis after augmentation ranged from 1 to 25 years (mean, 15 years). No implants were ruptured at the time of mastectomy. Of the 16 patients with previous subpectoral augmentation, cancer was detected mammographically in 12 (75%). Of the 16 patients with previous subglandular augmentation, cancer was detected mammographically in 7 (44%). This difference was not statistically significant, but that may be related to the insufficient population size (P = .15). Twenty-two (69%) of the patients underwent a purely prosthetic reconstruction. Flaps were used in the other 10 (31%), including 5 (16%) latissimus dorsi flaps and 5 (16%) transverse rectus abdominis flaps. Nine (90%) of those 10 flaps were used in patients undergoing radiation therapy. There were 9 stage 0 (28.1%), 9 stage I (28.1%), 12 stage II (37.5%), and 2 stage III (6.3%) patients. Among the subglandular group, there were 5 stage 0 (31

  5. [Special considerations in breast cancer treatment of an augmented breast].

    PubMed

    Mátrai, Zoltán; Gulyás, Gusztáv; Tóth, László; Sávolt, Akos; Kunos, Csaba; Pesthy, Pál; Bartal, Alexandra; Szabó, Eva; Kásler, Miklós

    2011-10-16

    Breast augmentation surgery involving the use of implants has been one of the most popular plastic surgical procedures for decades. As the multi-million female population who received breast implants ages, the risk of cancer is increasing rapidly, therefore the incidence of malignant disease in association with breast implants will increase as well. Although there is no relationship between tumor development and implants, these cases require special considerations in diagnostics, therapy and follow-up methods. Appropriate multidisciplinary treatment of tumors in augmented breasts corresponding with modern oncoplastic principles can only be accomplished based on adequate oncological, breast and plastic surgical knowledge. Supposing a possible increase of this condition in Hungary, too, authors provide a wide review of the literature on the special oncological and esthetic considerations, for the first time in Hungarian language.

  6. Webizing mobile augmented reality content

    NASA Astrophysics Data System (ADS)

    Ahn, Sangchul; Ko, Heedong; Yoo, Byounghyun

    2014-01-01

    This paper presents a content structure for building mobile augmented reality (AR) applications in HTML5 to achieve a clean separation of the mobile AR content and the application logic for scaling as on the Web. We propose that the content structure contains the physical world as well as virtual assets for mobile AR applications as document object model (DOM) elements and that their behaviour and user interactions are controlled through DOM events by representing objects and places with a uniform resource identifier. Our content structure enables mobile AR applications to be seamlessly developed as normal HTML documents under the current Web eco-system.

  7. Augmented reality in intraventricular neuroendoscopy.

    PubMed

    Finger, T; Schaumann, A; Schulz, M; Thomale, Ulrich-W

    2017-06-01

    Individual planning of the entry point and the use of navigation has become more relevant in intraventricular neuroendoscopy. Navigated neuroendoscopic solutions are continuously improving. We describe experimentally measured accuracy and our first experience with augmented reality-enhanced navigated neuroendoscopy for intraventricular pathologies. Augmented reality-enhanced navigated endoscopy was tested for accuracy in an experimental setting. Therefore, a 3D-printed head model with a right parietal lesion was scanned with a thin-sliced computer tomography. Segmentation of the tumor lesion was performed using Scopis NovaPlan navigation software. An optical reference matrix is used to register the neuroendoscope's geometry and its field of view. The pre-planned ROI and trajectory are superimposed in the endoscopic image. The accuracy of the superimposed contour fitting on endoscopically visualized lesion was acquired by measuring the deviation of both midpoints to one another. The technique was subsequently used in 29 cases with CSF circulation pathologies. Navigation planning included defining the entry points, regions of interests and trajectories, superimposed as augmented reality on the endoscopic video screen during intervention. Patients were evaluated for postoperative imaging, reoperations, and possible complications. The experimental setup revealed a deviation of the ROI's midpoint from the real target by 1.2 ± 0.4 mm. The clinical study included 18 cyst fenestrations, ten biopsies, seven endoscopic third ventriculostomies, six stent placements, and two shunt implantations, being eventually combined in some patients. In cases of cyst fenestrations postoperatively, the cyst volume was significantly reduced in all patients by mean of 47%. In biopsies, the diagnostic yield was 100%. Reoperations during a follow-up period of 11.4 ± 10.2 months were necessary in two cases. Complications included one postoperative hygroma and one insufficient

  8. Augmented-plane-wave forces

    NASA Astrophysics Data System (ADS)

    Soler, José M.; Williams, Arthur R.

    1990-11-01

    Results are presented that demonstrate the effectiveness of a calculational method of electronic-structure theory. The method combines the power (tractable basis-set size) and flexibility (transition and first-row elements) of the augmented-plane-wave method with the computational efficiency of the Car-Parrinello method of molecular dynamics and total-energy minimization. Equilibrium geometry and vibrational frequencies in agreement with experiment are presented for Si, to demonstrate agreement with existing methods and for Cu, N2, and H2O to demonstrate the broader applicability of the approach.

  9. Exploration of α1-Antitrypsin Treatment Protocol for Islet Transplantation: Dosing Plan and Route of Administration

    PubMed Central

    Baranovski, Boris M.; Ozeri, Eyal; Shahaf, Galit; Ochayon, David E.; Schuster, Ronen; Bahar, Nofar; Kalay, Noa; Cal, Pablo; Mizrahi, Mark I.; Nisim, Omer; Strauss, Pnina; Schenker, Eran

    2016-01-01

    Lifelong weekly infusions of human α1-antitrypsin (hAAT) are currently administered as augmentation therapy for patients with genetic AAT deficiency (AATD). Several recent clinical trials attempt to extend hAAT therapy to conditions outside AATD, including type 1 diabetes. Because the endpoint for AATD is primarily the reduction of risk for pulmonary emphysema, the present study explores hAAT dose protocols and routes of administration in attempt to optimize hAAT therapy for islet-related injury. Islet-grafted mice were treated with hAAT (Glassia; intraperitoneally or subcutaneously) under an array of clinically relevant dosing plans. Serum hAAT and immunocyte cell membrane association were examined, as well as parameters of islet survival. Results indicate that dividing the commonly prescribed 60 mg/kg i.p. dose to three 20 mg/kg injections is superior in affording islet graft survival; in addition, a short dynamic descending dose protocol (240→120→60→60 mg/kg i.p.) is comparable in outcomes to indefinite 60 mg/kg injections. Although pharmacokinetics after intraperitoneal administration in mice resembles exogenous hAAT treatment in humans, subcutaneous administration better imitated the physiologic progressive rise of hAAT during acute phase responses; nonetheless, only the 60 mg/kg dose depicted an advantage using the subcutaneous route. Taken together, this study provides a platform for extrapolating an islet-relevant clinical protocol from animal models that use hAAT to protect islets. In addition, the study places emphasis on outcome-oriented analyses of drug efficacy, particularly important when considering that hAAT is presently at an era of drug-repurposing toward an extended list of clinical indications outside genetic AATD. PMID:27821710

  10. α-1-antitrypsin inhibits acute liver failure in mice.

    PubMed

    Jedicke, Nils; Struever, Nina; Aggrawal, Nupur; Welte, Tobias; Manns, Michael P; Malek, Nisar P; Zender, Lars; Janciauskiene, Sabina; Wuestefeld, Torsten

    2014-06-01

    Acute liver failure remains a critical clinical condition, with high mortality rates, and increased apoptosis of hepatocytes represents a key event in the cause of liver failure. Alpha-1-antitrypsin (AAT) is synthesized and secreted mainly by hepatocytes, and plasma purified AAT is used for augmentation therapy in patients with AAT deficiency. Because AAT therapy exerts antiinflammatory and immune modulatory activities in various experimental models, and it was recently suggested that AAT exerts antiapoptotic activities, we aimed to explore whether administration of AAT may represent a therapeutic strategy to treat acute liver failure in mice. Well-established preclinical models of acute liver failure such as the Jo2 FAS/CD95 activating model and models of acetaminophen and α-amanitin poisoning were used. Therapeutic effects of AAT were evaluated by monitoring animal survival, histopathological changes, measurement of caspase activity, and serum cytokine levels. Systemic treatment with AAT significantly decreased Jo2-induced liver cell apoptosis and prolonged survival of mice. Native and oxidized (lacking elastase inhibitory activity) forms of AAT were equally effective in preventing acute liver injury and showed direct inhibition of active caspase-3 and -8 in liver homogenates and in a cell-free system in vitro. Concomitantly, mice treated with AAT showed significantly lower serum levels of tumor necrosis factor alpha (TNF-α), which also paralleled the reduced activity of ADAM17 (TACE). Noticeably, the increased survival and a reduction of apoptotic hepatocytes were also observed in the α-amanitin and acetaminophen-induced liver injury mouse models. Our data suggest that systemic administration of AAT can be a promising therapy to treat acute liver failure and clinical studies to explore this treatment in humans should be initiated. © 2014 by the American Association for the Study of Liver Diseases.

  11. PRP Augmentation for ACL Reconstruction

    PubMed Central

    Di Matteo, Berardo; Kon, Elizaveta; Marcacci, Maurilio

    2015-01-01

    Current research is investigating new methods to enhance tissue healing to speed up recovery time and decrease the risk of failure in Anterior Cruciate Ligament (ACL) reconstructive surgery. Biological augmentation is one of the most exploited strategies, in particular the application of Platelet Rich Plasma (PRP). Aim of the present paper is to systematically review all the preclinical and clinical papers dealing with the application of PRP as a biological enhancer during ACL reconstructive surgery. Thirty-two studies were included in the present review. The analysis of the preclinical evidence revealed that PRP was able to improve the healing potential of the tendinous graft both in terms of histological and biomechanical performance. Looking at the available clinical evidence, results were not univocal. PRP administration proved to be a safe procedure and there were some evidences that it could favor the donor site healing in case of ACL reconstruction with patellar tendon graft and positively contribute to graft maturation over time, whereas the majority of the papers did not show beneficial effects in terms of bony tunnels/graft area integration. Furthermore, PRP augmentation did not provide superior functional results at short term evaluation. PMID:26064903

  12. Augmented reality in medical education?

    PubMed

    Kamphuis, Carolien; Barsom, Esther; Schijven, Marlies; Christoph, Noor

    2014-09-01

    Learning in the medical domain is to a large extent workplace learning and involves mastery of complex skills that require performance up to professional standards in the work environment. Since training in this real-life context is not always possible for reasons of safety, costs, or didactics, alternative ways are needed to achieve clinical excellence. Educational technology and more specifically augmented reality (AR) has the potential to offer a highly realistic situated learning experience supportive of complex medical learning and transfer. AR is a technology that adds virtual content to the physical real world, thereby augmenting the perception of reality. Three examples of dedicated AR learning environments for the medical domain are described. Five types of research questions are identified that may guide empirical research into the effects of these learning environments. Up to now, empirical research mainly appears to focus on the development, usability and initial implementation of AR for learning. Limited review results reflect the motivational value of AR, its potential for training psychomotor skills and the capacity to visualize the invisible, possibly leading to enhanced conceptual understanding of complex causality.

  13. Augmentation of restless leg syndrome (Willis-Ekbom disease) during long-term dopaminergic treatment.

    PubMed

    Garcia-Borreguero, Diego; Benitez, Arturo; Kohnen, Ralf; Allen, Richard

    2015-01-01

    Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common sensorimotor disorder that can generally be effectively managed in the primary care clinic. However, some treatment complications may arise. According to the recommendations of the International Restless Legs Syndrome Study Group, non-ergot dopamine-receptor agonists have over the past years been one of the first-line treatments for patients with RLS/WED requiring pharmacological therapy. Augmentation is the main complication of long-term dopaminergic treatment of RLS/WED and is defined as an overall worsening of symptoms beyond pretreatment levels in patients who experienced an initial positive therapeutic response. Once identified on the basis of its characteristic clinical features, augmentation requires careful management. In order to provide clinicians with a comprehensive understanding of this common treatment complication, this review discusses the clinical features of augmentation, and its differentiation from morning rebound, symptom fluctuations and natural disease progression. Reported incidences of augmentation in clinical trials of dopaminergic RLS/WED therapies are summarized. Finally, the hypothetical pathophysiology of augmentation and the current recommendations for management of patients with augmented RLS/WED symptoms are discussed.

  14. Urban Terrain Modeling for Augmented Reality Applications

    DTIC Science & Technology

    2001-01-01

    Recent developments in wearable computers have begun to make mobile augmented reality systems a reality (Feiner, 1997; Piekarski, 1999, Julier, 2000...Augmented Reality Applications 3 Figure 1. A wearable augmented reality system. The large size of the system is the result of the fact that it is...for the light to travel out to the target and back to the LIDAR is used to determine the range of the target. LIDAR operates in the ultraviolet , visible

  15. Striae distensae after subfascial breast augmentation.

    PubMed

    Keramidas, Evangelos; Rodopoulou, Stavroula

    2008-03-01

    Striae distensae or stretch marks after breast augmentation are a rare complication. To date, 10 cases have been published. In seven of these cases, the implant was placed in a subglandular position and in the other three cases, placement was submuscular. Two cases of stretch marks in two young nulliparous women who underwent subfacial breast augmentation are presented. To the best of the authors' knowledge, this is the first report of striae distensae after subfascial breast augmentation.

  16. A Tracker Alignment Framework for Augmented Reality

    DTIC Science & Technology

    2003-01-01

    A Tracker Alignment Framework for Augmented Reality Yohan Baillot and Simon J. Julier ITT Advanced Engineering & Sciences 2560 Huntington Ave...with as few as three measurements. 1. Introduction Almost all Augmented Reality (AR) systems use a track- ing system to capture motion of objects in...DATES COVERED 00-00-2003 to 00-00-2003 4. TITLE AND SUBTITLE A Tracker Alignment Framework for Augmented Reality 5a. CONTRACT NUMBER 5b. GRANT

  17. Augmented Reality for Maintenance and Repair (ARMAR)

    DTIC Science & Technology

    2007-08-01

    The purpose of this research, Augmented Reality for Maintenance and Repair (ARMAR), was to research the design and development of experimental... augmented reality systems for maintenance job aiding. The goal was to explore and evaluate the feasibility of developing prototype adaptive augmented ... reality systems that can be used to investigate how real time computer graphics, overlaid on and registered with the actual equipment being maintained, can

  18. Developing a New Medical Augmented Reality System.

    DTIC Science & Technology

    1996-05-01

    Augmented reality is a technique for combining supplementary imagery such that it appears as part of the scene and can be used for guidance, training...and locational aids. In the medical domain, augmented reality can be used to combine medical imagery to the physician’s view of a patient to help...the physician establish a direct relation between the imagery and the patient. This project report will examine medical augmented reality systems for

  19. Eyekon: Distributed Augmented Reality for Soldier Teams

    DTIC Science & Technology

    2003-06-01

    Eyekon: Distributed Augmented Reality for Soldier Teams TOPIC: Information Superiority/Information Operations and Information Age... Augmented Reality for Soldier Teams 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER...by ANSI Std Z39-18 Eyekon: Distributed Augmented Reality for Soldier Teams Abstract The battlefield is a place of violence ruled by

  20. Nanotechnology to augment immunotherapy for the treatment of glioblastoma multiforme.

    PubMed

    Ung, Nolan; Yang, Isaac

    2015-07-01

    Glioblastoma multiforme (GBM) is characterized as one of the most common and most deadly malignant primary brain tumors. Current treatment modalities include the use of surgical resection and adjuvant chemotherapy and radiation therapy, though survival is still limited. Because of this, new treatment strategies are needed to improve overall survival. Immunotherapy has emerged as a potential treatment, but still possesses certain limitations to have a substantial clinical effect. In addition, nanotechnology has emerged as potent treatment effectors that have been shown to augment the effects of therapies including chemotherapy, gene therapy, and more. Nanoparticles possess a novel approach due to the myriad of functional groups that can create targeted treatments, though further optimization is still required. In this review, the authors will present the current uses and abilities of nanotechnology and its implication for use with immunotherapy in the treatment of GBM.

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

    PubMed

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

    2015-09-01

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

  2. Strategies and Challenges in Simultaneous Augmentation Mastopexy.

    PubMed

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

    2015-10-01

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

  3. Challenges associated with reentry maxillary sinus augmentation.

    PubMed

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

    2010-09-01

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

  4. [Alpha-1-antitrypsin deficiency - an update].

    PubMed

    Bernhard, Nikolas; Bals, Robert; Fähndrich, Sebastian

    2016-09-01

    Alpha-1-antitrypsin deficiency is a genetic risk factor for the development of chronic obstructive airway disease (COPD) and liver cirrhosis. The disease is widely underdiagnosed. The hallmarks of therapy are smoking cessation, prevention from environmental dust exposure and augmentation therapy. Findings from the recently published prospective, placebo-controlled and randomized RAPID trial proved effectiveness of AAT augmentation therapy for slowing progression of emphysema, measured by CT lung density. CT lung density may be more sensitive than forced exspiratory volume in one second (FEV1) or monoxid diffusion capacity (DLCO). The data suggest that higher therapeutic serum AAT levels lead to lower decline in lung density.

  5. LOFT Augmented Operator Capability Program

    SciTech Connect

    Hollenbeck, D.A.; Krantz, E.A.; Hunt, G.L.; Meyer, O.R.

    1980-01-01

    The outline of the LOFT Augmented Operator Capability Program is presented. This program utilizes the LOFT (Loss-of-Fluid Test) reactor facility which is located at the Idaho National Engineering Laboratory and the LOFT operational transient experiment series as a test bed for methods of enhancing the reactor operator's capability for safer operation. The design of an Operational Diagnotics and Display System is presented which was backfit to the existing data acquisition computers. Basic color-graphic displays of the process schematic and trend type are presented. In addition, displays were developed and are presented which represent safety state vector information. A task analysis method was applied to LOFT reactor operating procedures to test its usefulness in defining the operator's information needs and workload.

  6. Unilateral galactocele following augmentation mammoplasty.

    PubMed

    Deloach, E D; Lord, S A; Ruf, L E

    1994-07-01

    Development of unilateral galactoceles following breast augmentation is reported in 2 young females. Both galactoceles were drained and cultured. In 1 patient the implant was removed and a delayed reinsertion was undertaken. In the second patient the implant was replaced at the time of the drainage procedure. Culture and sensitivity in 1 patient showed no growth and in the second patient revealed Staphylococcus aureus. Although the cause is unknown, galactocele formation may be due to manipulation of breast tissue during surgery. The use of oral contraceptives may also play a role in this process. Hormonal suppression of lactation and removal of the implants may be indicated in these patients. Consideration should be also given to the use of systemic antibiotics directed toward skin pathogens.

  7. Sensory Augmentation for the Blind

    PubMed Central

    Kärcher, Silke M.; Fenzlaff, Sandra; Hartmann, Daniela; Nagel, Saskia K.; König, Peter

    2012-01-01

    Common navigational aids used by blind travelers during large-scale navigation divert attention away from important cues of the immediate environment (i.e., approaching vehicles). Sensory augmentation devices, relying on principles similar to those at work in sensory substitution, can potentially bypass the bottleneck of attention through sub-cognitive implementation of a set of rules coupling motor actions with sensory stimulation. We provide a late blind subject with a vibrotactile belt that continually signals the direction of magnetic north. The subject completed a set of behavioral tests before and after an extended training period. The tests were complemented by questionnaires and interviews. This newly supplied information improved performance on different time scales. In a pointing task we demonstrate an instant improvement of performance based on the signal provided by the device. Furthermore, the signal was helpful in relevant daily tasks, often complicated for the blind, such as keeping a direction over longer distances or taking shortcuts in familiar environments. A homing task with an additional attentional load demonstrated a significant improvement after training. The subject found the directional information highly expedient for the adjustment of his inner maps of familiar environments and describes an increase in his feeling of security when exploring unfamiliar environments with the belt. The results give evidence for a firm integration of the newly supplied signals into the behavior of this late blind subject with better navigational performance and more courageous behavior in unfamiliar environments. Most importantly, the complementary information provided by the belt lead to a positive emotional impact with enhanced feeling of security. The present experimental approach demonstrates the positive potential of sensory augmentation devices for the help of handicapped people. PMID:22403535

  8. Genomic Classifier Augments the Role of Pathological Features in Identifying Optimal Candidates for Adjuvant Radiation Therapy in Patients With Prostate Cancer: Development and Internal Validation of a Multivariable Prognostic Model.

    PubMed

    Dalela, Deepansh; Santiago-Jiménez, María; Yousefi, Kasra; Karnes, R Jeffrey; Ross, Ashley E; Den, Robert B; Freedland, Stephen J; Schaeffer, Edward M; Dicker, Adam P; Menon, Mani; Briganti, Alberto; Davicioni, Elai; Abdollah, Firas

    2017-06-20

    therapy.

  9. Novel Augmentation Strategies in Major Depression.

    PubMed

    Martiny, Klaus

    2017-04-01

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

  10. From Augmentation Media to Meme Media.

    ERIC Educational Resources Information Center

    Tanaka, Yuzuru

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

  11. Vertebral Augmentation for Osteoporotic Compression Fractures.

    PubMed

    Richmond, Bradford J

    2016-01-01

    Vertebral augmentation procedures such as vertebroplasty and kyphoplasty were developed to reduce pain and improve quality of life for patients with osteoporotic vertebral compression fractures. However, the use of vertebral augmentation has been debated and questioned since its inception. This article addresses some of these issues.

  12. Embedding Augmentative Communication within Early Childhood Classrooms.

    ERIC Educational Resources Information Center

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

    2000-01-01

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

  13. Enhancing Education through Mobile Augmented Reality

    ERIC Educational Resources Information Center

    Joan, D. R. Robert

    2015-01-01

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

  14. Nonsteady-Flow Thrust Augmenting Ejectors

    NASA Technical Reports Server (NTRS)

    Foa, J. V.

    1979-01-01

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

  15. Information Filtering for Mobile Augmented Reality

    DTIC Science & Technology

    2000-10-01

    Augmented reality is a potentially powerful paradigm for annotating the environment with computer-generated material. These benefits will be even...greater when augmented reality systems become mobile and wearable. However, to minimize the problem of clutter and maximize the effectiveness of the

  16. Information Filtering for Mobile Augmented Reality

    DTIC Science & Technology

    2002-07-02

    Augmented Reality (AR) has the potential to revolutionise the way in which information is delivered to a user. By tracking the user s position and...on the problem of developing mobile augmented reality systems which can be worn by an individual user operating in a large, complicated environment

  17. Outcomes of labours augmented with oxytocin.

    PubMed

    Bugg, George J; Stanley, Eleanor; Baker, Philip N; Taggart, Michael J; Johnston, Tracey A

    2006-01-01

    To highlight the differences in mode of delivery between women augmented with intravenous oxytocin because of failure to progress in labour with those who labour without the need for augmentation. An incidence study over a 5-year-period in a tertiary referral hospital comparing 1097 nulliparous women who were augmented in labour with 2745 nulliparous women who did not need augmentation. Only labours of spontaneous onset in the pregnancies of women at term were studied. The incidence of pregnancy outcomes were assessed by presenting estimates of relative risk (RR) and their 95% confidence intervals (CI). Only 51.1% of women who received augmentation achieved a normal vaginal delivery compared with 76.5% of women who did not need augmentation (RR 0.67; CI 0.63-0.71). Contributory factors to this disparity included a greater number of Caesarean sections (14.4% versus 6.6%; RR 2.18 CI 1.74-2.67), forcep deliveries (12.8% versus 5.3%; RR 2.41 CI 1.93-3.01) and ventouse deliveries (21.7% versus 11.5%; RR 1.89 CI 1.62-2.21) being performed among augmented labours as compared to normal progressive labours. Significant improvements in the management of labours which fail to progress are needed if normal vaginal delivery rates are to approach those seen in labours which progress without the need for augmentation.

  18. Hyperprolactinemia and galactocele formation after augmentation mammoplasty.

    PubMed

    Chun, Yoon S; Taghinia, Amir

    2009-02-01

    Galactorrhea and galactocele formation are rare complications of augmentation mammoplasty. A number of case reports have been published in the literature; however, the etiology remains unclear. A case is presented of a unilateral galactocele associated with transient hyperprolactinemia after augmentation mammoplasty.

  19. Augmented Reality for Close Quarters Combat

    ScienceCinema

    None

    2016-07-12

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

  20. Augmented Reality for Close Quarters Combat

    SciTech Connect

    2013-09-20

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

  1. In vitro cardiac catheter navigation via augmented reality surgical guidance

    NASA Astrophysics Data System (ADS)

    Linte, Cristian A.; Moore, John; Wiles, Andrew; Lo, Jennifer; Wedlake, Chris; Peters, Terry M.

    2009-02-01

    Catheter-driven cardiac interventions have emerged in response to the need of reducing invasiveness associated with the traditional cut-and-sew techniques. Catheter manipulation is traditionally performed under real-time fluoroscopy imaging, resulting in an overall trade-off of procedure invasiveness for radiation exposure of both the patient and clinical staff. Our approach to reducing and potentially eliminating the use of flouroscopy in the operating room entails the use of multi-modality imaging and magnetic tracking technologies, wrapped together into an augmented reality environment for enhanced intra-procedure visualization and guidance. Here we performed an in vitro study in which a catheter was guided to specific targets located on the endocardial atrial surface of a beating heart phantom. "Therapy delivery" was modeled in the context of a blinded procedure, mimicking a beating heart, intracardiac intervention. The users navigated the tip of a magnetically tracked Freezor 5 CRYOCATH catheter to the specified targets. Procedure accuracy was determined as the distance between the tracked catheter tip and the tracked surgical target at the time of contact, and it was assessed under three different guidance modalities: endoscopic, augmented reality, and ultrasound image guidance. The overall RMS targeting accuracy achieved under augmented reality guidance averaged to 1.1 mm. This guidance modality shows significant improvements in both procedure accuracy and duration over ultrasound image guidance alone, while maintianing an overall targeting accuracy comparable to that achieved under endoscopic guidance.

  2. Performance of a self-augmented railgun

    SciTech Connect

    Burton, R.L.; Witherspoon, F.D.; Goldstein, S.A. )

    1991-10-01

    The accelerating force of a railgun 1/2{ital L}{prime}{ital I}{sup 2}{sub {ital a}} can be increased by augmenting the self-induced magnetic field created by the armature current. Augmentation fields can be produced by external current coils or, as is done here, by shorting the railgun muzzle, and using the gun rails as the augmentation coil. Experimental results are presented for a 3.6-m railgun operated in this self-augmented mode, and effective inductance gradients are achieved which are as much as 9.3 times that of the unaugmented gun. A circuit model is presented which explains features of the measured shunt current and voltage. It is concluded that self-augmentation is an effective way to reduce ohmic heating in the armature of a railgun.

  3. Performance of a self-augmented railgun

    NASA Astrophysics Data System (ADS)

    Burton, Rodney L.; Witherspoon, F. D.; Goldstein, Shyke A.

    1991-10-01

    The accelerating force of a railgun can be increased by augmenting the self-induced magnetic field created by the armature current. Augmentation fields can be produced by external current coils or, as is done here, by shorting the railgun muzzle, and using the gun rails as the augmentation coil. Experimental results are presented for a 3.6-m railgun operated in this self-augmented mode, and effective inductance gradients are achieved which are as much as 9.3 times that of the unaugmented gun. A circuit model is presented which explains features of the measured shunt current and voltage. It is concluded that self-augmentation is an effective way to reduce ohmic heating in the armature of a railgun.

  4. Irradiated homologous costal cartilage for augmentation rhinoplasty

    SciTech Connect

    Lefkovits, G. )

    1990-10-01

    Although the ideal reconstructive material for augmentation rhinoplasty continues to challenge plastic surgeons, there exists no report in the literature that confines the use of irradiated homologous costal cartilage, first reported by Dingman and Grabb in 1961, to dorsal nasal augmentation. The purpose of this paper is to present a retrospective analysis of the author's experience using irradiated homologous costal cartilage in augmentation rhinoplasty. Twenty-seven dorsal nasal augmentations were performed in 24 patients between 16 and 49 years of age with a follow-up ranging from 1 to 27 months. Good-to-excellent results were achieved in 83.3% (20 of 24). Poor results requiring revision were found in 16.7% (4 of 24). Complication rates included 7.4% infection (2 of 27) and 14.8% warping (4 of 27). The resorption rate was zero. These results compare favorably with other forms of nasal augmentation. Advantages and disadvantages of irradiated homologous costal cartilage are discussed.

  5. A Systematic Review of Animal-Assisted Therapy on Psychosocial Outcomes in People with Intellectual Disability.

    PubMed

    Maber-Aleksandrowicz, Sarah; Avent, Cerian; Hassiotis, Angela

    2016-01-01

    The aim of the study was to review the literature on animal assisted therapy (AAT) in people with intellectual disabilities (ID) measuring psychosocial outcomes (behavioural, social, cognitive and emotional). Quantitative studies were found through a systematic search that identified studies using AAT in people with ID and measuring psychosocial outcomes (behavioural, cognitive, emotional and social). The quality of studies was assessed using a standardised tool and rated as strong, moderate or weak. Only published articles from peer-reviewed journals were included. No language or age restrictions were applied. Over half of the included studies were identified outside standard database searches (e.g. hand searching reference lists from included articles, references from AAT websites and using Google Scholar and a Grey Literature Database). Ten studies were included in the final review; two were rated as moderate quality and eight were rated as weak quality. Overall there was a positive improvement reported from studies for all psychosocial outcomes (with some cognitive, behavioural, social, emotional components reaching statistical significance p ≤ 0.01). Despite having no age restrictions, the included studies had participants that were mainly children and adolescents, in particular favouring male participants, which may limit generalisation. More rigorous methodology is required to improve the quality of future studies including in the main multicentre randomised designs and improved reporting according to CONSORT criteria. Further research should expand to include adults with ID and specific disorders such as challenging behaviour or mental illness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Zoonotic disease concerns in animal-assisted therapy and animal visitation programs

    PubMed Central

    Waltner-Toews, David

    1993-01-01

    A survey was done of 150 systematically selected United States animal care agencies and 74 Canadian humane societies to determine the prevalence of animal assisted therapy (AAT) programs; concerns about, and experience with, zoonotic diseases; and precautions taken to prevent zoonotic disease transmission. Of the 69 US agencies and 49 Canadian societies that reported having AAT programs, 94% used dogs and/or cats in their programs, 28% used rabbits, 15% used “pocket pets” (hamsters, gerbils, mice, guinea pigs), and 10% used birds (excluding poultry). About two-thirds of the programs were involved with the elderly in nursing homes, about a quarter of them worked with schools, and a quarter worked with hospitals. Half of the respondents had concerns about zoonotic disease control. Rabies, ringworm, and external parasitism were the most commonly cited zoonotic diseases of concern. Few concerns were based on actual experience. Fewer than half of the programs consulted a health professional about prevention of zoonotic diseases. Only 10% of the respondents reported having printed guidelines about the prevention of zoonotic disease transmission. Practising veterinarians are encouraged to make their expertise available to local AAT programs. PMID:17424285

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

    PubMed Central

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

    2010-01-01

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

  8. [Modular reconstruction in acetabular revision with antiprotrusio cages and metal augments : the cage-and-augment system].

    PubMed

    Günther, K-P; Wegner, T; Kirschner, S; Hartmann, A

    2014-04-01

    Restore primary center of rotation and reconstruct extensive bone defects in hip revision surgery with a modular off-label implant combined with antiprotrusion cage and metal augment, thus, achieving improved hip function. Large segmental acetabular defects with nonsupportive columns (Paprosky type 3a and 3b) in cup loosening or Girdlestone situation. In case of pelvic discontinuity posterior column-plating is possible. Persisting hip infection and severe systemic disorders impairing achievement of secondary stability through bony integration of metal augment. Posterolateral (if dorsal column plating) or other approach. Remove loose implant and granulation tissue with sufficient exposure of bleeding bone. Size acetabular defect with trial components of augment and appropriate antiprotrusio cage. Fixation of selected metal augment with screws. Fill additional acetabular defects with morsellized bone graft. Open a slot into the ischium to fix the distal flange of the cage. If necessary, bend both flanges according to patient's anatomy. Enter the ischium with distal flange and gradual impaction of the antiprotrusio ring. Final stabilization of the ring with several screws aiming at the posterior column or the acetabular dome. Inject cement between ring and augment to stabilize the construction and avoid metal wear. Final cement fixation of a polyethylene liner or a dual-mobility cup into the antiprotrusio ring. In pelvic discontinuity with major instability osteosynthesis of the dorsal column can be performed prior to cementation. Prophylaxis of periprosthetic infection, DVT and heterotopic ossification. Physical therapy with partial weight bearing (20 kp) for 6 weeks; in discontinuity initial wheel chair mobilization. Since 2008, 72 off-label implantations of a combined antiprotrusio cage and a Trabecular Metal™ Augment were performed. A total of 44 patients (46 operations) were investigated at 38.8 (36-51) months postoperatively. In all, 36 patients had a

  9. Augmented reality: past, present, future

    NASA Astrophysics Data System (ADS)

    Inzerillo, Laura

    2013-03-01

    A great opportunity has permitted to carry out a cultural, historical, architectural and social research with great impact factor on the international cultural interest. We are talking about the realization of a museum whose the main theme is the visit and the discovery of a monument of great prestige: the monumental building the "Steri" in Palermo. The museum is divided into sub themes including the one above all, that has aroused the international interest so much that it has been presented the instance to include the museum in the cultural heritage of UNESCO. It is the realization of a museum path that regards the cells of the Inquisition, which are located just inside of some buildings of the monumental building. The project, as a whole, is faced, in a total view, between the various competences implicated: historic, chemic, architectonic, topographic, drawing, representation, virtual communication, informatics. The birth of the museum will be a sum of the results of all these disciplines involved. Methodology, implementation, fruition, virtual museum, goals, 2D graphic restitution, effects on the cultural heritage and landscape environmental, augmented reality, Surveying 2D and 3D, hi-touch screen, Photogrammetric survey, Photographic survey, representation, drawing 3D and more than this has been dealt with this research.

  10. Experience with transumbilical breast augmentation.

    PubMed

    Sudarsky, L

    2001-05-01

    Transumbilical breast augmentation (TUBA), an endoscopicassisted procedure in which saline breast prostheses are inserted through the umbilicus, is a patient-driven, frequently performed procedure that remains controversial. The author describes the operative technique and results in 90 patients who underwent TUBA between October 1996 and July 2000 by the same surgeon in a community practice. A total of 85 patients underwent submammary TUBA and 5 patients underwent submuscular TUBA. Seventy patients were available for follow-up. Postoperative results of the 70 patients were graded as very good in 56 (80%), good in 12 (17%), and fair in 2 (2.9%). Complications were conversion to an open approach in 1 patient and an accidental submuscular entry into the pocket in 1 patient. There were four capsular contractures (5.7%), 5 patients (7.1%) were reoperated: 2 for capsulectomies, 1 for implant buckling, 1 for scar revision, and 1 for removal of the implants. There were no implant ruptures, hematomas, or infections. Advantages of TUBA include minimal scarring, remote incision, short operating time, low capsular contracture rate, and rapid recovery. These results of this evolving procedure suggest that in select patients TUBA provides a high level of patient satisfaction and low complication rates. As TUBA techniques for submuscular placement continue to develop, more patients may become TUBA candidates.

  11. Postauricular fascia in augmentation rhinoplasty.

    PubMed

    Guerra, Aldo Benjamin

    2014-06-01

    Ten rhinoplasty operations performed using postauricular fascia for the purpose of augmenting the radix and dorsum of the nose were analyzed retrospectively. All the operations were performed over a 1-year period, between 2005 and 2006. The fascia of the postauricular area has been used as a source of pliable soft-tissue grafts in primary and revision rhinoplasty. It may be easily accessed using a single sulcus incision that also enables harvesting of ear cartilage grafts. Deficiency in the radix is an overlooked abnormality seen in many patients undergoing primary as well as revision rhinoplasty after aggressive hump removal. Recent trends in rhinoplasty have been to avoid the overly reduced nasal skeleton and to create a more balanced nasal surgery result. This article presents the use of the postauricular fascia as a radix graft that has been found to be simple to carry out, reliable, and long lasting. In addition, the fascia graft is useful in the camouflage of various nasal deformities in the dorsum and sidewalls. The average patient follow-up for the study was 24 months.

  12. Wireless Augmented Reality Prototype (WARP)

    NASA Technical Reports Server (NTRS)

    Devereaux, A. S.

    1999-01-01

    Initiated in January, 1997, under NASA's Office of Life and Microgravity Sciences and Applications, the Wireless Augmented Reality Prototype (WARP) is a means to leverage recent advances in communications, displays, imaging sensors, biosensors, voice recognition and microelectronics to develop a hands-free, tetherless system capable of real-time personal display and control of computer system resources. Using WARP, an astronaut may efficiently operate and monitor any computer-controllable activity inside or outside the vehicle or station. The WARP concept is a lightweight, unobtrusive heads-up display with a wireless wearable control unit. Connectivity to the external system is achieved through a high-rate radio link from the WARP personal unit to a base station unit installed into any system PC. The radio link has been specially engineered to operate within the high- interference, high-multipath environment of a space shuttle or space station module. Through this virtual terminal, the astronaut will be able to view and manipulate imagery, text or video, using voice commands to control the terminal operations. WARP's hands-free access to computer-based instruction texts, diagrams and checklists replaces juggling manuals and clipboards, and tetherless computer system access allows free motion throughout a cabin while monitoring and operating equipment.

  13. Wireless Augmented Reality Prototype (WARP)

    NASA Technical Reports Server (NTRS)

    Devereaux, A. S.

    1999-01-01

    Initiated in January, 1997, under NASA's Office of Life and Microgravity Sciences and Applications, the Wireless Augmented Reality Prototype (WARP) is a means to leverage recent advances in communications, displays, imaging sensors, biosensors, voice recognition and microelectronics to develop a hands-free, tetherless system capable of real-time personal display and control of computer system resources. Using WARP, an astronaut may efficiently operate and monitor any computer-controllable activity inside or outside the vehicle or station. The WARP concept is a lightweight, unobtrusive heads-up display with a wireless wearable control unit. Connectivity to the external system is achieved through a high-rate radio link from the WARP personal unit to a base station unit installed into any system PC. The radio link has been specially engineered to operate within the high- interference, high-multipath environment of a space shuttle or space station module. Through this virtual terminal, the astronaut will be able to view and manipulate imagery, text or video, using voice commands to control the terminal operations. WARP's hands-free access to computer-based instruction texts, diagrams and checklists replaces juggling manuals and clipboards, and tetherless computer system access allows free motion throughout a cabin while monitoring and operating equipment.

  14. Malignancy after gastrointestinal augmentation in childhood.

    PubMed

    Husmann, Douglas A

    2009-04-01

    To review the incidence and risks of bladder cancer following gastrointestinal augmentations done for congenial anomalies in childhood. A literature search using PubMed and Ovid Med