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Sample records for acceptable daily dose

  1. The estrogenicity of methylparaben and ethylparaben at doses close to the acceptable daily intake in immature Sprague-Dawley rats.

    PubMed

    Sun, Libei; Yu, Tong; Guo, Jilong; Zhang, Zhaobin; Hu, Ying; Xiao, Xuan; Sun, Yingli; Xiao, Han; Li, Junyu; Zhu, Desheng; Sai, Linlin; Li, Jun

    2016-01-01

    The estrogenicity of parabens at human exposure levels has become a focus of concern due to the debate over whether the estrogenicity of parabens is strong enough to play a role in the increased incidence of breast cancer. In this study, the uterotrophic activities of methylparaben (MP) and ethylparaben (EP) at doses close to the acceptable daily intake as allocated by JECFA were demonstrated in immature Sprague-Dawley rats by intragastric administration, and up-regulations of estrogen-responsive biomarker genes were found in uteri of the rats by quantitative real-time RT-PCR (Q-RT-PCR). At the same time, the urinary concentrations of MP and EP, as measured by gas chromatography-mass spectrometry (GC-MS) in rats that received the same doses of MP and EP, were found to be near the high urinary levels reported in human populations in recent years. These results show the in vivo estrogenicity of MP and EP at human exposure levels, and indicate that populations exposed to large amounts of MP and EP may have a high burden of estrogenicity-related diseases. In addition, a molecular docking simulation showed interaction between the parabens and the agonist-binding pocket of human estrogen receptor α (hERα). PMID:27121550

  2. The estrogenicity of methylparaben and ethylparaben at doses close to the acceptable daily intake in immature Sprague-Dawley rats

    PubMed Central

    Sun, Libei; Yu, Tong; Guo, Jilong; Zhang, Zhaobin; Hu, Ying; Xiao, Xuan; Sun, Yingli; Xiao, Han; Li, Junyu; Zhu, Desheng; Sai, Linlin; Li, Jun

    2016-01-01

    The estrogenicity of parabens at human exposure levels has become a focus of concern due to the debate over whether the estrogenicity of parabens is strong enough to play a role in the increased incidence of breast cancer. In this study, the uterotrophic activities of methylparaben (MP) and ethylparaben (EP) at doses close to the acceptable daily intake as allocated by JECFA were demonstrated in immature Sprague-Dawley rats by intragastric administration, and up-regulations of estrogen-responsive biomarker genes were found in uteri of the rats by quantitative real-time RT–PCR (Q-RT-PCR). At the same time, the urinary concentrations of MP and EP, as measured by gas chromatography–mass spectrometry (GC-MS) in rats that received the same doses of MP and EP, were found to be near the high urinary levels reported in human populations in recent years. These results show the in vivo estrogenicity of MP and EP at human exposure levels, and indicate that populations exposed to large amounts of MP and EP may have a high burden of estrogenicity-related diseases. In addition, a molecular docking simulation showed interaction between the parabens and the agonist-binding pocket of human estrogen receptor α (hERα). PMID:27121550

  3. Acceptance of telepathology in daily practice.

    PubMed

    Mairinger, T

    2000-01-01

    The availability of pathology services differs greatly in our environment. Although pathology would be especially suitable for being practised at a distance by transporting digital image information, the spread of telepathology into everyday work still is relatively slow. The article describes the situation of diffusion of this innovative technology by reviewing the literature and discussing this in context to data based on questionnaires dealing with the acceptance of telepathology. The current situation of telepathology can be discussed by five items for innovation spead: (1) communication and influence; (2) economic costs and benefits; (3) knowledge barriers and learning; (4) feasibility of techniques offered for the demands of the users; (5) clarification of the legal status and other factors concerning international collaboration. All these head lines do not represent realistic obstacles for the more widespread use of telepathology. The real drawbacks may therefore be found behind certain professional habits of pathologists. The most important causes may be that (a) telediagnosis is not as easy as it may seem at the first glance; (b) telepathology is seen as a potential highway to a world-wide competition of pathology service providers. As soon as these mostly unjustified prejudices are corrected and telepathology is percepted as additional technique in pathology, it will become a diagnostic tool as common and as useful as the telephone.

  4. Zeaxanthin: Review of Toxicological Data and Acceptable Daily Intake.

    PubMed

    Edwards, James A

    2016-01-01

    Zeaxanthin is a nutritional carotenoid with a considerable amount of safety data based on regulatory studies, which form the basis of its safety evaluation. Subchronic OECD guideline studies with mice and rats receiving beadlet formulations of high purity synthetic zeaxanthin in the diet at dosages up to 1000 mg/kg body weight (bw)/day, and in dogs at over 400 mg/kg bw/day, produced no adverse effects or histopathological changes. In developmental toxicity studies, there was no evidence of fetal toxicity or teratogenicity in rats or rabbits at dosages up to 1000 or 400 mg/kg bw/day, respectively. Formulated zeaxanthin was not mutagenic or clastogenic in a series of in vitro and in vivo tests for genotoxicity. A 52-week chronic oral study in Cynomolgus monkeys at doses of 0.2 and 20 mg/kg bw/day, mainly designed to assess accumulation and effects in primate eyes, showed no adverse effects. In a rat two-generation study, the NOAEL was 150 mg/kg bw/day. In 2012, this dosage was used by EFSA (NDA Panel), in association with a 200-fold safety factor, to propose an Acceptable Daily Intake equivalent to 53 mg/day for a 70 kg adult. The requested use level of 2 mg/day was ratified by the EU Commission. PMID:26885380

  5. Using default methodologies to derive an acceptable daily exposure (ADE).

    PubMed

    Faria, Ellen C; Bercu, Joel P; Dolan, David G; Morinello, Eric J; Pecquet, Alison M; Seaman, Christopher; Sehner, Claudia; Weideman, Patricia A

    2016-08-01

    This manuscript discusses the different historical and more recent default approaches that have been used to derive an acceptable daily exposure (ADE). While it is preferable to derive a health-based ADE based on a complete nonclinical and clinical data package, this is not always possible. For instance, for drug candidates in early development there may be no or limited nonclinical or clinical trial data. Alternative approaches that can support decision making with less complete data packages represent a variety of methods that rely on default assumptions or data inputs where chemical-specific data on health effects are lacking. A variety of default approaches are used including those based on certain toxicity estimates, a fraction of the therapeutic dose, cleaning-based limits, the threshold of toxicological concern (TTC), and application of hazard banding tools such as occupational exposure banding (OEB). Each of these default approaches is discussed in this manuscript, including their derivation, application, strengths, and limitations. In order to ensure patient safety when faced with toxicological and clinical data-gaps, default ADE methods should be purposefully as or more protective than ADEs derived from full data packages. Reliance on the subset of default approaches (e.g., TTC or OEB) that are based on toxicological data is preferred over other methods for establishing ADEs in early development while toxicology and clinical data are still being collected. PMID:27233926

  6. Zeaxanthin: Review of Toxicological Data and Acceptable Daily Intake

    PubMed Central

    Edwards, James A.

    2016-01-01

    Zeaxanthin is a nutritional carotenoid with a considerable amount of safety data based on regulatory studies, which form the basis of its safety evaluation. Subchronic OECD guideline studies with mice and rats receiving beadlet formulations of high purity synthetic zeaxanthin in the diet at dosages up to 1000 mg/kg body weight (bw)/day, and in dogs at over 400 mg/kg bw/day, produced no adverse effects or histopathological changes. In developmental toxicity studies, there was no evidence of fetal toxicity or teratogenicity in rats or rabbits at dosages up to 1000 or 400 mg/kg bw/day, respectively. Formulated zeaxanthin was not mutagenic or clastogenic in a series of in vitro and in vivo tests for genotoxicity. A 52-week chronic oral study in Cynomolgus monkeys at doses of 0.2 and 20 mg/kg bw/day, mainly designed to assess accumulation and effects in primate eyes, showed no adverse effects. In a rat two-generation study, the NOAEL was 150 mg/kg bw/day. In 2012, this dosage was used by EFSA (NDA Panel), in association with a 200-fold safety factor, to propose an Acceptable Daily Intake equivalent to 53 mg/day for a 70 kg adult. The requested use level of 2 mg/day was ratified by the EU Commission. PMID:26885380

  7. Acceptable daily intake and the regulation of intense sweeteners.

    PubMed

    Renwick, A G

    1990-01-01

    At the present time there are four intense sweeteners that are available in a number of countries: acesulfame-K, aspartame, cyclamate and saccharin. Extensive toxicity databases are available on each sweetener and these have been assessed by both national and international regulatory authorities. This review considers briefly the critical toxicity of each sweetener that is the basis for establishing the no adverse effect level in animal studies. The calculation of an acceptable daily intake (ADI) for human intake employs a large safety factor applied to the no-effect level. The magnitude of the safety factor for each sweetener is discussed in relation to the ADI values recommended by the Scientific Committee for Food in 1985.

  8. Acceptable daily intake vs actual intake: the aspartame example.

    PubMed

    Butchko, H H; Kotsonis, F N

    1991-06-01

    This article discusses the acceptable daily intake (ADI) and the postmarketing surveillance of consumption levels for a food additive, using the widely used food additive aspartame (APM, L-aspartyl-L-phenylalanine methyl ester) as an example. The safety implications of the ADI and consumption levels are also discussed. Aspartame has been assigned an ADI of 40 mg/kg/day by the World Health Organization and regulatory authorities in Europe and Canada, and of 50 mg/kg/day by the US Food and Drug Administration. A number of different methods have been used to measure consumption levels of food additives. Consumption estimations for aspartame from one such method, the food intake survey, have been done in the United States, Canada, Germany, and Finland. APM consumption in all age groups and selected subpopulations, even at the 90th percentile, is approximately 2-10 mg/kg/day and is thus well below the ADI.

  9. A harmonization effort for acceptable daily exposure application to pharmaceutical manufacturing - Operational considerations.

    PubMed

    Hayes, Eileen P; Jolly, Robert A; Faria, Ellen C; Barle, Ester Lovsin; Bercu, Joel P; Molnar, Lance R; Naumann, Bruce D; Olson, Michael J; Pecquet, Alison M; Sandhu, Reena; Shipp, Bryan K; Sussman, Robert G; Weideman, Patricia A

    2016-08-01

    A European Union (EU) regulatory guideline came into effect for all new pharmaceutical products on June 1st, 2015, and for all existing pharmaceutical products on December 1st, 2015. This guideline centers around the use of the Acceptable Daily Exposure (ADE) [synonymous with the Permitted Daily Exposure (PDE)] and operational considerations associated with implementation are outlined here. The EU guidance states that all active pharmaceutical ingredients (API) require an ADE; however, other substances such as starting materials, process intermediates, and cleaning agents may benefit from an ADE. Problems in setting ADEs for these additional substances typically relate to toxicological data limitations precluding the ability to establish a formal ADE. Established methodologies such as occupational exposure limits or bands (OELs or OEBs) and the threshold of toxicological concern (TTC) can be used or adjusted for use as interim ADEs when only limited data are available and until a more formal ADE can be established. Once formal ADEs are derived, it is important that the documents are routinely updated and that these updates are communicated to appropriate stakeholders. Another key operational consideration related to data-poor substances includes the use of maximum daily dose (MDD) in setting cross-contamination limits. The MDD is an important part of the maximum allowable/safe concentration (MAC/MSC) calculation and there are important considerations for its use and definition. Finally, other considerations discussed include operational aspects of setting ADEs for pediatrics, considerations for large molecules, and risk management in shared facilities.

  10. Dose Estimation from Daily and Weekly Dosimetry Data

    SciTech Connect

    Ostrouchov, G.

    2001-11-16

    Statistical analyses of data from epidemiologic studies of workers exposed to radiation have been based on recorded annual radiation doses (yearly dose of record). It is usually assumed that the dose values are known exactly, although it is generally recognized that the data contain uncertainty due to measurement error and bias. In our previous work with weekly data, a probability distribution was used to describe an individual's dose during a specific period of time and statistical methods were developed for estimating it from weekly film dosimetry data. This study showed that the yearly dose of record systematically underestimates doses for Oak Ridge National Laboratory (ORNL) workers. This could result in biased estimates of dose-response coefficients and their standard errors. The results of this evaluation raise serious questions about the suitability of the yearly dose of record for direct use in low-dose studies of nuclear industry workers. Here, we extend our previous work to use full information in Pocket meter data and develop the Data Synthesis for Individual Dose Estimation (DSIDE) methodology. Although the DSIDE methodology in this study is developed in the context of daily and weekly data to produce a cumulative yearly dose estimate, in principle it is completely general and can be extended to other time period and measurement combinations. The new methodology takes into account the ''measurement error'' that is produced by the film and pocket-meter dosimetry systems, the biases introduced by policies that lead to recording left-censored doses as zeros, and other measurement and recording practices. The DSIDE method is applied to a sample of dose histories obtained from hard copy dosimetry records at ORNL for the years 1945 to 1955. First, the rigorous addition of daily pocket-meter information shows that the negative bias is generally more severe than was reported in our work based on weekly film data only, however, the amount of bias also varies

  11. Marijuana's dose-dependent effects in daily marijuana smokers.

    PubMed

    Ramesh, Divya; Haney, Margaret; Cooper, Ziva D

    2013-08-01

    Active marijuana produces significant subjective, psychomotor, and physiological effects relative to inactive marijuana, yet demonstrating that these effects are dose-dependent has proven difficult. This within-subject, double-blind study was designed to develop a smoking procedure to obtain a marijuana dose-response function. In four outpatient laboratory sessions, daily marijuana smokers (N = 17 males, 1 female) smoked six 5-s puffs from 3 marijuana cigarettes (2 puffs/cigarette). The number of puffs from active (≥5.5% Δ⁹-tetrahydrocannabinol/THC) and inactive (0.0% THC) marijuana varied according to condition (0, 2, 4, or 6 active puffs); active puffs were always smoked before inactive puffs. Subjective, physiological, and performance effects were assessed prior to and at set time points after marijuana administration. Active marijuana dose-dependently increased heart rate and decreased marijuana craving, despite evidence (carbon monoxide expiration, weight of marijuana cigarettes post-smoking) that participants inhaled less of each active marijuana cigarette than inactive cigarettes. Subjective ratings of marijuana "strength," "high," "liking," "good effect," and "take again" were increased by active marijuana compared with inactive marijuana, but these effects were not dose-dependent. Active marijuana also produced modest, non-dose-dependent deficits in attention, psychomotor function, and recall relative to the inactive condition. In summary, although changes in inhalation patterns as a function of marijuana strength likely minimized the difference between dose conditions, dose-dependent differences in marijuana's cardiovascular effects and ratings of craving were observed, whereas subjective ratings of marijuana effects did not significantly vary as a function of dose.

  12. Marijuana's dose-dependent effects in daily marijuana smokers.

    PubMed

    Ramesh, Divya; Haney, Margaret; Cooper, Ziva D

    2013-08-01

    Active marijuana produces significant subjective, psychomotor, and physiological effects relative to inactive marijuana, yet demonstrating that these effects are dose-dependent has proven difficult. This within-subject, double-blind study was designed to develop a smoking procedure to obtain a marijuana dose-response function. In four outpatient laboratory sessions, daily marijuana smokers (N = 17 males, 1 female) smoked six 5-s puffs from 3 marijuana cigarettes (2 puffs/cigarette). The number of puffs from active (≥5.5% Δ⁹-tetrahydrocannabinol/THC) and inactive (0.0% THC) marijuana varied according to condition (0, 2, 4, or 6 active puffs); active puffs were always smoked before inactive puffs. Subjective, physiological, and performance effects were assessed prior to and at set time points after marijuana administration. Active marijuana dose-dependently increased heart rate and decreased marijuana craving, despite evidence (carbon monoxide expiration, weight of marijuana cigarettes post-smoking) that participants inhaled less of each active marijuana cigarette than inactive cigarettes. Subjective ratings of marijuana "strength," "high," "liking," "good effect," and "take again" were increased by active marijuana compared with inactive marijuana, but these effects were not dose-dependent. Active marijuana also produced modest, non-dose-dependent deficits in attention, psychomotor function, and recall relative to the inactive condition. In summary, although changes in inhalation patterns as a function of marijuana strength likely minimized the difference between dose conditions, dose-dependent differences in marijuana's cardiovascular effects and ratings of craving were observed, whereas subjective ratings of marijuana effects did not significantly vary as a function of dose. PMID:23937597

  13. Hematopoietic tissue repair under chronic low daily dose irradiation

    NASA Astrophysics Data System (ADS)

    Seed, T. M.

    The capacity of the hematopoietic system to repair constantly accruing cellular damage under chronic, low daily dose gamma irradiation is essential for the maintenance of a functional hematopoietic system, and, in turn, long term survival. In certain individuals, however, such continuous cycles of damage and repair provide an essential inductive environment for selected types of hematopathologies, e.g., myeloid leukemia (ML). In our laboratory we have been studying temporal and causal relationships between hematopoietic capacity, associated repair functions, and propensities for hematologic disease in canines under variable levels of chronic radiation stress (0.3-26.3 cGy d^-1). Results indicate that the maximum exposure rate tolerated by the hematopoietic system is highly individual-specific (three major responding subgroups identified) and is based largely on the degree to which repair capacity, and, in turn, hematopoietic restoration, is augmented under chronic exposure. In low-tolerance individuals (prone to aplastic anemia, subgroup 1), the failure to augment basic repair functions seemingly results in a progressive accumulation of genetic and cellular damage within vital progenitorial marrow compartments (particularly marked within erythroid compartments) that results in loss of reproductive capacity and ultimately in collapse of the hematopoietic system. The high-tolerance individuals (radioaccommodated and either prone- or not prone to ML, subgroup 2 & 3) appear to minimize the accumulating damage effect of daily exposures by extending repair functions, which preserves reproductive integrity and fosters regenerative hematopoietic responses. As the strength of the regenerative response manifests the extent of repair augmentation, the relatively strong response of high-tolerance individuals progressing to patent ML suggests an insufficiency of repair quality rather than repair quantity. The kinetics of these repair-mediated, regenerative hematopoietic

  14. Alternate-day dosing of linagliptin in type 2 diabetes patients controlled on once daily dose: A case series

    PubMed Central

    Baruah, Manash P.; Bhuyan, Sonali B.; Deka, Jumi; Bora, Jatin; Bora, Smritisikha; Barkakati, Murchana

    2016-01-01

    Linagliptin, a dipeptidyl peptidase 4 (DPP 4) inhibitor with a long terminal half life, significantly inhibits the DPP 4 enzyme at a steady state up to 48 h after the last dose. The present case series examined the hypothesis that linagliptin retains its efficacy during alternate day dosing in type 2 diabetes patients when switched over from once daily (OD) dosing. Eight type 2 diabetes patients maintaining stable glycosylated hemoglobin (HbA1c) with acceptable fasting plasma glucose and postprandial glucose levels and receiving linagliptin 5 mg OD for at least 6 weeks, with a stable dose of concomitant antidiabetic medications were given linagliptin 5 mg every alternate day. The median HbA1c while on the OD regimen was 6.1% (43 mmol/mol) (range: 5.8–6.9% [40–52 mmol/mol]) and median duration of diabetes was 7 years (range: 0.75–16 years). After a median follow-up period of 21weeks,the glycemic control was maintained in all patients similar to their baseline values (median HbA1c: 6.0% [42 mmol/mol], range: 5.1–7.1% [32–54 mmol/mol]). The body weight, fasting, and random glucose levels at baseline were also well maintained at the end of treatment. Optimal glycemic status maintained in our study population favors our hypothesis that linagliptin used alternate daily after switching from initial OD dose of the drug in patients on a stable background antidiabetic medications retains its efficacy. Paradoxically, alternate day dosing may affect compliance if the patient forgets when they took the last dose. Further studies including larger cohorts are needed to validate this finding and identify patients who can benefit from the alternate day regimen. PMID:27366728

  15. Acceptance of Dog Guides and Daily Stress Levels of Dog Guide Users and Nonusers

    ERIC Educational Resources Information Center

    Matsunaka, Kumiko; Koda, Naoko

    2008-01-01

    The degree of acceptance of dog guides at public facilities, which is required by law in Japan, was investigated, and evidence of rejection was found. Japanese people with visual impairments who used dog guides reported higher daily stress levels than did those who did not use dog guides. (Contains 3 tables and 1 figure.)

  16. Hematopoietic tissue repair under chronic low daily dose irradiation

    SciTech Connect

    Seed, T.M.

    1994-12-01

    The capacity of the hematopoietic system to repair constantly accruing cellular damage under chronic, low daily dose gamma irradiation is essential for the maintenance of a functional hematopoietic system, and, in turn, long term survival. In certain individuals, however, such continuous cycles of damage and repair provide an essential inductive environment for selected types of hematopathologies, e.g., myeloid leukemia (ML). We have been studying temporal and causal relationships between hematopoietic capacity, associated repair functions, and propensities for hematologic disease in canines under variable levels of chronic radiation stress (0.3{minus}26.3 cGy d{sup {minus}1}). Results indicate that the maximum exposure rate tolerated by the hematopoietic system is highly individual-specific and is based largely on the degree to which repair capacity, and, in turn, hematopoietic restoration, is augmented under chronic exposure. In low-tolerance individuals (prone to aplastic anemia, subgroup (1), the failure to augment basic m-pair functions seemingly results in a progressive accumulation of genetic and cellular damage within vital progenitorial marrow compartments particularly marked within erythroid compartments. that results in loss of reproductive capacity and ultimately in collapse of the hematopoietic system. The high-tolerance individuals (radioaccomodated and either prone- or not prone to ML, subgroup 2 & 3 appear to minimize the accumulating damage effect of daily exposures by extending repair functions, which preserves reproductive integrity and fosters regenerative hematopoietic responses. As the strength of the regenerative response manifests the extent of repair augmentation, the relatively strong response of high- tolerance individuals progressing to patent ML suggests an insufficiency of repair quality rather than repair quantity.

  17. Daily dosing prophylaxis for haemophilia: a randomized crossover pilot study evaluating feasibility and efficacy.

    PubMed

    Lindvall, K; Astermark, J; Björkman, S; Ljung, R; Carlsson, K S; Persson, S; Berntorp, E

    2012-11-01

    Regular replacement therapy (prophylaxis) for haemophilia has been shown to prevent development of disabling arthropathy and to provide a better quality of life compared to treatment on demand; however, at a substantially higher cost. Calculations based on pharmacokinetic principles have shown that shortening dose intervals may reduce cost. The aim of this prospective, randomized, crossover pilot study was to address whether daily dosing is feasible, if it reduces concentrate consumption and is as effective in preventing bleeding as the standard prophylactic dosing regimen. In a 12+12 month crossover study, 13 patients were randomized to start either their own previously prescribed standard dose, or daily dosing adjusted to maintain at least the same trough levels as obtained with the standard dose. Ten patients completed the study. A 30% reduction in cost of factor concentrates was achieved with daily prophylaxis. However, the number of bleeding events increased in some patients in the daily dosing arm and patients reported decreased quality of life during daily prophylaxis. Daily treatment had a greater impact on daily life, and the patients found it more stressful.Prophylaxis with daily dosing may be feasible and efficacious in some patients. A substantial reduction of factor consumption and costs can be realized, but larger studies are needed before the introduction of daily prophylaxis into clinical routine can be recommended.

  18. Evaluating the coherence between environmental quality objectives and the acceptable or tolerable daily intake.

    PubMed

    Ragas, A M; Huijbregts, M A

    1998-06-01

    Environmental quality objectives (EQOs) for surface water, soil, air, drinking water, and food products are often derived independently. This may result in incoherent EQOs. A set of EQOs is called incoherent if simultaneous exposure to all media which are polluted up to their EQO results in the acceptable or tolerable daily intake (ADI or TDI) being exceeded. This paper outlines an integrated human exposure and uptake model (NORMTOX) which was developed to test the coherence of EQOs. NORMTOX predicts lifetime-averaged daily uptake levels of contaminants and compares these with acceptable or tolerable daily uptake levels. The model deals with variability and uncertainty in put data by using the Monte Carlo simulation technique. The model was applied to test the coherence of Dutch EQOs for benzene, lead, and lindane. The EQOs of these substances turned out to be coherent with probabilities of 100, 23, and 0%, respectively. The variance in the coherence indicators results from interpersonal variability in exposure, consumption, and uptake patterns and from uncertainty in input data due to a lack of knowledge. To prevent incoherent EQOs in the future, induction of a procedure for coherence testing and EQO adjustment is suggested. PMID:9693076

  19. Point of departure (PoD) selection for the derivation of acceptable daily exposures (ADEs) for active pharmaceutical ingredients (APIs).

    PubMed

    Bercu, Joel P; Morinello, Eric J; Sehner, Claudia; Shipp, Bryan K; Weideman, Patricia A

    2016-08-01

    The Acceptable Daily Exposure (ADE) derived for pharmaceutical manufacturing is a health-based limit used to ensure that medicines produced in multi-product facilities are safe and are used to validate quality processes. Core to ADE derivation is selecting appropriate point(s) of departure (PoD), i.e., the starting dose of a given dataset that is used in the calculation of the ADE. Selecting the PoD involves (1) data collection and hazard characterization, (2) identification of "critical effects", and (3) a dose-response assessment including the determination of the no-observed-adverse-effect-level (NOAEL) or lowest-observed-adverse-effect-level (LOAEL), or calculating a benchmark dose (BMD) level. Compared to other classes of chemicals, active pharmaceutical ingredients (APIs) are well-characterized and have unique, rich datasets that must be considered when selecting the PoD. Dataset considerations for an API include therapeutic/pharmacological effects, particularities of APIs for different indications and routes of administration, data gaps during drug development, and sensitive subpopulations. Thus, the PoD analysis must be performed by a qualified toxicologist or other expert who also understands the complexities of pharmaceutical datasets. In addition, as the pharmaceutical industry continues to evolve new therapeutic principles, the science behind PoD selection must also evolve to ensure state-of-the-science practices and resulting ADEs.

  20. [Estimate of the dose of chlorinated pesticides consumed daily by the Italian population (1978-1984)].

    PubMed

    Leoni, V; Camoni, I; Puccetti, G; Di Muccio, A; Fabiani, L

    1989-01-01

    This work reports an estimate of the doses of chlorinated pesticides taken with a total diet by the Italian population in the period 1978-84. Previous researches, carried out in 1971-72, had regarded both uncooked and cooked diets, ready for the consumption. It was found that the amount of the considered pesticides taken in total (HCB, gamma-BHC and total-BHC, Aldrin/Dieldrin, Heptachlor/Heptachlor-epoxide and DDT total-equivalent) calculated as a sum of the percentage of each acceptable daily intake (A.D.I.), at that time recommended was near the limit of acceptability (98.5% for cooked diets and 107.0% for uncooked diets). In addition it was found that nearly the 40% of the dose assumed in all came from milk and its derivates (butter, cheese). Then considering the contribution of milk and derivates to the amount of pollutants assumed with a total diet, a new evaluation has been done, with regard to the period 1978-84, i.e. after the prohibition of the use of these pesticides in Italy and in other industrialized countries. Then the data have been processed, with regard to 211 samples of foods (90 of milk, 45 of cheese, 76 butter) coming from determinations carried out by the Multizonal Laboratory of Hygiene and Prevention of Ferrara, Milano, Udine, Bolzano, Trento, Pescara and from the Institute of Hygiene of Rome University "La Sapienza" in the period mentioned. Furthermore, alimentary consumptions of milk, butter and cheese in 1978-84 have been evaluated, and amounts of chlorinated pesticides taken with these foods have been calculated. Finally the dose taken with these foods has been extrapolated to a total diet. It has come out that the doses (estimated) taken with the total diet have notably decreased between 1971-72 and 1978-84. An anomaly is yet represented by HCB: while the quantity taken with food has decreased from 1971-72 to 1978-84 (from 3.7 to 1.3 micrograms/man/day), the concentrations in human adipose tissues have increased (from 1.02 to 1.99 mg

  1. The pharmacokinetics of once-daily dosing with gentamicin in women with postpartum endometritis.

    PubMed Central

    Sunyecz, J A; Wiesenfeld, H C; Heine, R P

    1998-01-01

    OBJECTIVE: To evaluate the pharmacokinetics and cost of once-daily dosing with gentamicin in women with postpartum endometritis. METHODS: Gentamicin in a single daily dose of 4.5 mg/kg was administered intravenously to 10 women with postpartum endometritis. Peak and trough gentamicin levels were measured, and nephrotoxicity and clinical ototoxicity were monitored. Pharmacokinetic data were analyzed, and a cost analysis of once-daily gentamicin administration was performed. RESULTS: The mean elimination constant was 0.105 +/- 0.008 L/h, and the mean volume of distribution was 0.34 +/- 0.07 L/kg. Mean peak gentamicin levels exceeded 11 mg/L, and all trough levels were < 0.3 mg/L. Cost savings of 44% were achieved with once-daily dosing of gentamicin, compared with traditional thrice-daily dosing. CONCLUSIONS: Once-daily dosing with gentamicin in women with postpartum endometritis achieves therapeutic peak levels without drug accumulation. Substantial cost savings are realized with this dosing regimen. PMID:9812247

  2. Daily variations in delivered doses in patients treated with radiotherapy for localized prostate cancer

    SciTech Connect

    Kupelian, Patrick A. . E-mail: patrick.kupelian@orhs.org; Langen, Katja M.; Zeidan, Omar A.; Meeks, Sanford L.; Willoughby, Twyla R.; Wagner, Thomas H.; Jeswani, Sam; Ruchala, Kenneth J.; Haimerl, Jason; Olivera, Gustavo H.

    2006-11-01

    Purpose: The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy. Methods and Materials: Ten patients with localized prostate cancer were treated with helical tomotherapy to 78 Gy at 2 Gy per fraction in 39 fractions. Daily target localization was performed using intraprostatic fiducials and daily megavoltage pelvic computed tomography (CT) scans, resulting in a total of 390 CT scans. The prostate, rectum, and bladder were manually contoured on each CT by a single physician. Daily dosimetric analysis was performed with dose recalculation. The study endpoints were D95 (dose to 95% of the prostate), rV2 (absolute rectal volume receiving 2 Gy), and bV2 (absolute bladder volume receiving 2 Gy). Results: For the entire cohort, the average D95 ({+-}SD) was 2.02 {+-} 0.04 Gy (range, 1.79-2.20 Gy). The average rV2 ({+-}SD) was 7.0 {+-} 8.1 cc (range, 0.1-67.3 cc). The average bV2 ({+-}SD) was 8.7 {+-} 6.8 cc (range, 0.3-36.8 cc). Unlike doses for the prostate, there was significant daily variation in rectal and bladder doses, mostly because of variations in volume and shape of these organs. Conclusion: Large variations in delivered doses to the rectum and bladder can be documented with daily megavoltage CT scans. Image guidance for the targeting of the prostate, even with intraprostatic fiducials, does not take into account the variation in actual rectal and bladder doses. The clinical impact of techniques that take into account such dosimetric parameters in daily patient set-ups should be investigated.

  3. Issues and approaches for ensuring effective communication on acceptable daily exposure (ADE) values applied to pharmaceutical cleaning.

    PubMed

    Olson, Michael J; Faria, Ellen C; Hayes, Eileen P; Jolly, Robert A; Barle, Ester Lovsin; Molnar, Lance R; Naumann, Bruce D; Pecquet, Alison M; Shipp, Bryan K; Sussman, Robert G; Weideman, Patricia A

    2016-08-01

    This manuscript centers on communication with key stakeholders of the concepts and program goals involved in the application of health-based pharmaceutical cleaning limits. Implementation of health-based cleaning limits, as distinct from other standards such as 1/1000th of the lowest clinical dose, is a concept recently introduced into regulatory domains. While there is a great deal of technical detail in the written framework underpinning the use of Acceptable Daily Exposures (ADEs) in cleaning (for example ISPE, 2010; Sargent et al., 2013), little is available to explain how to practically create a program which meets regulatory needs while also fulfilling good manufacturing practice (GMP) and other expectations. The lack of a harmonized approach for program implementation and communication across stakeholders can ultimately foster inappropriate application of these concepts. Thus, this period in time (2014-2017) could be considered transitional with respect to influencing best practice related to establishing health-based cleaning limits. Suggestions offered in this manuscript are intended to encourage full and accurate communication regarding both scientific and administrative elements of health-based ADE values used in pharmaceutical cleaning practice. This is a large and complex effort that requires: 1) clearly explaining key terms and definitions, 2) identification of stakeholders, 3) assessment of stakeholders' subject matter knowledge, 4) formulation of key messages fit to stakeholder needs, 5) identification of effective and timely means for communication, and 6) allocation of time, energy, and motivation for initiating and carrying through with communications. PMID:27233923

  4. Development of a twice daily dosing regimen of amoxicillin/clavulanate.

    PubMed

    Bax, Richard

    2007-12-01

    Amoxicillin/clavulanate was first launched as a three times daily dosage for the treatment of a range of community-acquired infections. A decade later, it became necessary to introduce a twice daily dosage for reasons of convenience, compliance and to remain competitive with other recently launched antibacterials. Twice daily formulations of amoxicillin/clavulanate were developed in which the amount of amoxicillin was increased relative to clavulanate to provide equivalent bacteriological and clinical efficacy with no change in the safety profile. Equivalence of the two dosing regimens was confirmed by randomised clinical trials in adults (in skin and soft tissue, urinary tract and lower respiratory tract infections, sinusitis and recurrent tonsillitis) and paediatrics (in lower respiratory tract infections, otitis media and recurrent tonsillitis). An improvement in the safety profile, specifically gastrointestinal effects, due to the reduced daily dose of clavulanate, was noted for all patients, but particularly in children.

  5. The Efficacy and Safety of Insulin Degludec Given in Variable Once-Daily Dosing Intervals Compared With Insulin Glargine and Insulin Degludec Dosed at the Same Time Daily

    PubMed Central

    Meneghini, Luigi; Atkin, Stephen L.; Gough, Stephen C.L.; Raz, Itamar; Blonde, Lawrence; Shestakova, Marina; Bain, Stephen; Johansen, Thue; Begtrup, Kamilla; Birkeland, Kåre I.

    2013-01-01

    OBJECTIVE The requirement to inject current basal insulin analogs at a fixed time each day may complicate adherence and compromise glycemic control. This trial evaluated the efficacy and safety of varying the daily injection time of insulin degludec (IDeg), an ultra-long-acting basal insulin. RESEARCH DESIGN AND METHODS This 26-week, open-label, treat-to-target trial enrolled adults (≥18 years) with type 2 diabetes who were either insulin naïve and receiving oral antidiabetic drugs (OADs) (HbA1c = 7–11%) or previously on basal insulin ± OAD(s) (HbA1c = 7–10%). Participants were randomized to 1) once-daily (OD) IDeg in a prespecified dosing schedule, creating 8–40-h intervals between injections (IDeg OD Flex; n = 229); 2) once-daily IDeg at the main evening meal (IDeg OD; n = 228); or 3) once-daily insulin glargine at the same time each day (IGlar OD; n = 230). The primary outcome was noninferiority of IDeg OD Flex to IGlar OD in HbA1c reduction after 26 weeks. RESULTS After 26 weeks, IDeg OD Flex, IDeg OD, and IGlar OD improved HbA1c by 1.28, 1.07, and 1.26% points, respectively (estimated treatment difference [IDeg OD Flex − IGlar OD]: 0.04% points [–0.12 to 0.20], confirming noninferiority). No statistically significant differences in overall or nocturnal hypoglycemia were found between IDeg OD Flex and IGlar OD. Comparable glycemic control and rates of hypoglycemia were seen with IDeg OD Flex and IDeg OD. Adverse event profiles were similar across groups. CONCLUSIONS The use of extreme dosing intervals of 8–40 h demonstrates that the daily injection time of IDeg can be varied without compromising glycemic control or safety. PMID:23340894

  6. Single daily dosing of gentamicin: pharmacokinetic comparison of two dosing methodologies for postpartum endometritis.

    PubMed Central

    Liu, C; Abate, B; Reyes, M; Gonik, B

    1999-01-01

    OBJECTIVE: We compared the pharmacokinetics of two methods for dosing gentamicin for the treatment of postpartum endometritis with the goal of achieving adequate peak serum concentrations (>12 mg/L) and prolonged trough levels below 2 mg/L. METHODS: Group-I subjects (n = 5) received intravenous gentamicin, 5 mg/kg per total body weight over 60 min., with a maximum dose of 500 mg. Group-II subjects (n = 17) were dosed intravenously according to the following formula: Dose = desired peak concentration (fixed at 14 mg/L) * (volume of distribution, i.e., 0.35 L/kg) * adjusted body weight (in kilograms). Serum gentamicin levels were obtained 1 hr. and 8-12 hr. after infusion of the second dose. Pharmacokinetic parameters for the subjects in each group were calculated according to standard formulas. RESULTS: Subjects in Group I had significantly higher doses and peak drug concentrations (P < 0.01), while in Group II, 76% of patients had peak levels less than desired (<12 mg/L). Both groups maintained trough levels of <2 mg/L in excess of 12 hr. CONCLUSIONS: Changing to the adjusted body weight formula for Group I, while maintaining a dose between 4 and 5 mg/kg, would reduce excessive peak concentrations. Using a calculated volume of distribution of 0.4 L/kg in Group II would improve peak serum concentrations to the desired levels. Both dosing regimens ensure adequate aminoglycoside pharmacokinetic parameters and avoid the need for monitoring serial serum drug concentrations, provided the expected clinical response is also achieved. While the first dosing formula is simpler to calculate, the second dosing formula allows for more individualized dosing considerations. PMID:10371471

  7. Maximizing the biological effect of proton dose delivered with scanned beams via inhomogeneous daily dose distributions

    SciTech Connect

    Zeng Chuan; Giantsoudi, Drosoula; Grassberger, Clemens; Goldberg, Saveli; Niemierko, Andrzej; Paganetti, Harald; Efstathiou, Jason A.; Trofimov, Alexei

    2013-05-15

    Purpose: Biological effect of radiation can be enhanced with hypofractionation, localized dose escalation, and, in particle therapy, with optimized distribution of linear energy transfer (LET). The authors describe a method to construct inhomogeneous fractional dose (IFD) distributions, and evaluate the potential gain in the therapeutic effect from their delivery in proton therapy delivered by pencil beam scanning. Methods: For 13 cases of prostate cancer, the authors considered hypofractionated courses of 60 Gy delivered in 20 fractions. (All doses denoted in Gy include the proton's mean relative biological effectiveness (RBE) of 1.1.) Two types of plans were optimized using two opposed lateral beams to deliver a uniform dose of 3 Gy per fraction to the target by scanning: (1) in conventional full-target plans (FTP), each beam irradiated the entire gland, (2) in split-target plans (STP), beams irradiated only the respective proximal hemispheres (prostate split sagittally). Inverse planning yielded intensity maps, in which discrete position control points of the scanned beam (spots) were assigned optimized intensity values. FTP plans preferentially required a higher intensity of spots in the distal part of the target, while STP, by design, employed proximal spots. To evaluate the utility of IFD delivery, IFD plans were generated by rearranging the spot intensities from FTP or STP intensity maps, separately as well as combined using a variety of mixing weights. IFD courses were designed so that, in alternating fractions, one of the hemispheres of the prostate would receive a dose boost and the other receive a lower dose, while the total physical dose from the IFD course was roughly uniform across the prostate. IFD plans were normalized so that the equivalent uniform dose (EUD) of rectum and bladder did not increase, compared to the baseline FTP plan, which irradiated the prostate uniformly in every fraction. An EUD-based model was then applied to estimate tumor

  8. A method to estimate the effect of deformable image registration uncertainties on daily dose mapping

    SciTech Connect

    Murphy, Martin J.; Salguero, Francisco J.; Siebers, Jeffrey V.; Staub, David; Vaman, Constantin

    2012-02-15

    Purpose: To develop a statistical sampling procedure for spatially-correlated uncertainties in deformable image registration and then use it to demonstrate their effect on daily dose mapping. Methods: Sequential daily CT studies are acquired to map anatomical variations prior to fractionated external beam radiotherapy. The CTs are deformably registered to the planning CT to obtain displacement vector fields (DVFs). The DVFs are used to accumulate the dose delivered each day onto the planning CT. Each DVF has spatially-correlated uncertainties associated with it. Principal components analysis (PCA) is applied to measured DVF error maps to produce decorrelated principal component modes of the errors. The modes are sampled independently and reconstructed to produce synthetic registration error maps. The synthetic error maps are convolved with dose mapped via deformable registration to model the resulting uncertainty in the dose mapping. The results are compared to the dose mapping uncertainty that would result from uncorrelated DVF errors that vary randomly from voxel to voxel. Results: The error sampling method is shown to produce synthetic DVF error maps that are statistically indistinguishable from the observed error maps. Spatially-correlated DVF uncertainties modeled by our procedure produce patterns of dose mapping error that are different from that due to randomly distributed uncertainties. Conclusions: Deformable image registration uncertainties have complex spatial distributions. The authors have developed and tested a method to decorrelate the spatial uncertainties and make statistical samples of highly correlated error maps. The sample error maps can be used to investigate the effect of DVF uncertainties on daily dose mapping via deformable image registration. An initial demonstration of this methodology shows that dose mapping uncertainties can be sensitive to spatial patterns in the DVF uncertainties.

  9. Effect of computer-generated prompts on physician prescribing of multiple daily doses.

    PubMed

    Atkinson, V; Andrews, J D

    1987-06-01

    Cost containment of health care costs and computerization of pharmacy services are two trends that have become evident in recent years. The work described here was an attempt to reduce the prescribing of multiple daily doses of medications that could be prescribed once or twice daily by utilizing a pharmacy computer system. Ten drugs were identified as being prescribed more than 30% of the time in more frequent dosing schedules than recommended in the literature. Five of the drugs were randomly assigned to an experimental group and five to a control group. The computer system included a reminder with all experimental drug group orders for drugs effective given once or twice daily for maintenance therapy. This reminder was printed on both the physician's active medication profile and the nurse's medication administration record. The control period was designated as being the four month period prior to the initiation of the study. The experimental period was identified as the following four months where reminders were included with the drugs. No information concerning the study was circulated to the physicians or nursing staff. The results revealed no trend of fewer orders for multiple doses in the experimental group. In fact, all drugs in both the experimental and control groups showed random fluctuations in the number of orders for multiple doses. Possible reasons for the failure of this project include the impact of the reminders on the physicians, the timing of the study, and the medical condition of the patients. PMID:10282583

  10. Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention

    PubMed Central

    Bakker, Jindra; Vaessen, Thomas; Kasanova, Zuzana; Collip, Dina; van Os, Jim; Wichers, Marieke; Germeys, Inez; Peeters, Frenk

    2016-01-01

    Background With the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist’s office and the “real world.” The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. Objectives To assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL. Methods An observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life). Results More than three-quarters of the participants (76%) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT

  11. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women.

    PubMed

    Moretti, Diego; Goede, Jeroen S; Zeder, Christophe; Jiskra, Markus; Chatzinakou, Vaiya; Tjalsma, Harold; Melse-Boonstra, Alida; Brittenham, Gary; Swinkels, Dorine W; Zimmermann, Michael B

    2015-10-22

    Iron supplements acutely increase hepcidin, but the duration and magnitude of the increase, its dose dependence, and its effects on subsequent iron absorption have not been characterized in humans. Better understanding of these phenomena might improve oral iron dosing schedules. We investigated whether the acute iron-induced increase in hepcidin influences iron absorption of successive daily iron doses and twice-daily iron doses. We recruited 54 nonanemic young women with plasma ferritin ≤20 µg/L and conducted: (1) a dose-finding investigation with 40-, 60-, 80-, 160-, and 240-mg labeled Fe as [(57)Fe]-, [(58)Fe]-, or [(54)Fe]-FeSO4 given at 8:00 am fasting on 1 or on 2 consecutive days (study 1, n = 25; study 2, n = 16); and (2) a study giving three 60-mg Fe doses (twice-daily dosing) within 24 hours (study 3, n = 13). In studies 1 and 2, 24 hours after doses ≥60 mg, serum hepcidin was increased (P < .01) and fractional iron absorption was decreased by 35% to 45% (P < .01). With increasing dose, fractional absorption decreased (P < .001), whereas absolute absorption increased (P < .001). A sixfold increase in iron dose (40-240 mg) resulted in only a threefold increase in iron absorbed (6.7-18.1 mg). In study 3, total iron absorbed from 3 doses (2 mornings and an afternoon) was not significantly greater than that from 2 morning doses. Providing lower dosages (40-80 mg Fe) and avoiding twice-daily dosing maximize fractional absorption. The duration of the hepcidin response supports alternate day supplementation, but longer-term effects of these schedules require further investigation. These clinical trials were registered at www.ClinicalTrials.gov as #NCT01785407 and #NCT02050932.

  12. Hematopoietic responses under protracted exposures to low daily dose gamma irradiation

    NASA Astrophysics Data System (ADS)

    Seed, T. M.; Fritz, T. E.; Tolle, D. V.; Jackson, W. E.

    In attempting to evaluate the possible health consequences of chronic ionizing radiation exposure during extended space travel (e.g., Mars Mission), ground-based experimental studies of the clinical and pathological responses of canines under low daily doses of 60Co gamma irradiation (0.3-26.3 cGy d -1) have been examined. Specific reference was given to responses of the blood forming system. Results suggest that the daily dose rate of 7.5 cGy d -1 represents a threshold below which the hematopoietic system can retain either partial or full trilineal cell-producing capacity (erythropoiesis, myelopoiesis, and megakaryopoiesis) for extended periods of exposure (> 1yr). Trilineal capacity was fully retained for several years of exposure at the lowest dose-rate tested (0.3 cGy d -1) but was completely lost within several hundred days at the highest dose-rate (26.3 cGy d -1). Retention of hematopoietic capacity under chronic exposure has been demonstrated to be mediated by hematopoietic progenitors with acquired radioresistance and repair functions, altered cytogenetics, and cell-cycle characteristics. Radiological, biological, and temporal parameters responsible for these vital acquisitions by hematopoietic progenitors have been partially characterized. These parameters, along with threshold responses, are described and discussed in relation to potential health risks of the space traveler under chronic stress of low-dose irradiation.

  13. Hematopoietic responses under protracted exposures to low daily dose gamma irradiation.

    PubMed

    Seed, T M; Fritz, T E; Tolle, D V; Jackson, W E

    2002-01-01

    In attempting to evaluate the possible health consequences of chronic ionizing radiation exposure during extended space travel (e.g., Mars Mission), ground-based experimental studies of the clinical and pathological responses of canines under low daily doses of 60Co gamma irradiation (0.3-26.3 cGy d-1) have been examined. Specific reference was given to responses of the blood forming system. Results suggest that the daily dose rate of 7.5 cGy d-1 represents a threshold below which the hematopoietic system can retain either partial or full trilineal cell-producing capacity (erythropoiesis, myelopoiesis, and megakaryopoiesis) for extended periods of exposure (>1 yr). Trilineal capacity was fully retained for several years of exposure at the lowest dose-rate tested (0.3 cGy d-1) but was completely lost within several hundred days at the highest dose-rate (26.3 cGy d-1). Retention of hematopoietic capacity under chronic exposure has been demonstrated to be mediated by hematopoietic progenitors with acquired radioresistance and repair functions, altered cytogenetics, and cell-cycle characteristics. Radiological, biological, and temporal parameters responsible for these vital acquisitions by hematopoietic progenitors have been partially characterized. These parameters, along with threshold responses, are described and discussed in relation to potential health risks of the space traveler under chronic stress of low-dose irradiation.

  14. A Fourier analysis on the maximum acceptable grid size for discrete proton beam dose calculation

    SciTech Connect

    Li, Haisen S.; Romeijn, H. Edwin; Dempsey, James F.

    2006-09-15

    We developed an analytical method for determining the maximum acceptable grid size for discrete dose calculation in proton therapy treatment plan optimization, so that the accuracy of the optimized dose distribution is guaranteed in the phase of dose sampling and the superfluous computational work is avoided. The accuracy of dose sampling was judged by the criterion that the continuous dose distribution could be reconstructed from the discrete dose within a 2% error limit. To keep the error caused by the discrete dose sampling under a 2% limit, the dose grid size cannot exceed a maximum acceptable value. The method was based on Fourier analysis and the Shannon-Nyquist sampling theorem as an extension of our previous analysis for photon beam intensity modulated radiation therapy [J. F. Dempsey, H. E. Romeijn, J. G. Li, D. A. Low, and J. R. Palta, Med. Phys. 32, 380-388 (2005)]. The proton beam model used for the analysis was a near mono-energetic (of width about 1% the incident energy) and monodirectional infinitesimal (nonintegrated) pencil beam in water medium. By monodirection, we mean that the proton particles are in the same direction before entering the water medium and the various scattering prior to entrance to water is not taken into account. In intensity modulated proton therapy, the elementary intensity modulation entity for proton therapy is either an infinitesimal or finite sized beamlet. Since a finite sized beamlet is the superposition of infinitesimal pencil beams, the result of the maximum acceptable grid size obtained with infinitesimal pencil beam also applies to finite sized beamlet. The analytic Bragg curve function proposed by Bortfeld [T. Bortfeld, Med. Phys. 24, 2024-2033 (1997)] was employed. The lateral profile was approximated by a depth dependent Gaussian distribution. The model included the spreads of the Bragg peak and the lateral profiles due to multiple Coulomb scattering. The dependence of the maximum acceptable dose grid size on the

  15. Pain acceptance-based coping in complex regional pain syndrome Type I: daily relations with pain intensity, activity, and mood.

    PubMed

    Cho, Sungkun; McCracken, Lance M; Heiby, Elaine M; Moon, Dong-Eon; Lee, Jang-Han

    2013-10-01

    This study aimed to examine the temporal patterning of pain acceptance-based coping, activity, and mood in patients with complex regional pain syndrome Type I (CRPS-I), by using a daily diary method. A total of 30 patients with CRPS-I seeking treatment in a tertiary pain management center located in Seoul, Korea participated in the study. Multilevel random effects analyses indicated that (a) engagement in pain acceptance-based coping was significantly associated with lower same-day pain and negative mood and greater same-day activity and positive mood; (b) pain acceptance-based coping predicted increases in activity on the following day; (c) greater pain intensity was significantly associated with lower same-day pain acceptance-based coping and activity and greater same-day negative mood; and (d) pain intensity did not predict pain acceptance-based coping, activity, or mood on the following day. These findings suggest that patients with CRPS-I may benefit from responding to pain with acceptance. Further study and eventual application of this process in CRPS-I may improve upon the success of current approaches to this problem. PMID:22854886

  16. Pharmacodynamics and Pharmacokinetics Following Once-Daily and Twice-Daily Dosing of Tiotropium Respimat® in Asthma Using Standardized Sample-Contamination Avoidance

    PubMed Central

    Kirsten, Anne-Marie; Dusser, Daniel; Sharma, Ashish; Cornelissen, Piet; Sigmund, Ralf; Moroni-Zentgraf, Petra; Dahl, Ronald

    2016-01-01

    Abstract Background: This study was conducted to confirm the 24-hour bronchodilator efficacy and pharmacokinetic profile of once-daily tiotropium Respimat® 5 μg add-on to inhaled corticosteroids (ICS) in adults with symptomatic asthma. It used a trial protocol designed to minimize the risk of pharmacokinetic sample contamination resulting from improper sampling procedure, sample handling, or device handling during priming and subsequent inhalation procedure. Methods: A Phase II, randomized, double-blind, two-way crossover study (NCT01696071) comparing two daily dosing regimens of tiotropium for 4 weeks, once-daily 5 μg (evening dosing) or twice-daily 2.5 μg (morning and evening dosing), as add-on to maintenance therapy with ICS (400–800 μg budesonide or equivalent) as controller medication. There was no washout between treatment periods. Results: An increase in the area under the curve of the 24-hour forced expiratory volume in 1 second profile from study baseline was observed following once-daily tiotropium 5 μg (217 mL) and twice-daily 2.5 μg (219 mL), with no difference between the two regimens (−2 mL [95% confidence interval: −38, 34]). In a subset of the study population, total tiotropium exposure, expressed as area under the plasma concentration versus time curve over 24 hours, was comparable between dosing regimens. Unexpected tiotropium plasma levels were observed in two patients, possibly because of contamination. Conclusions: The observed bronchodilator efficacy over 24 hours was similar with once-daily tiotropium 5 μg and twice-daily 2.5 μg as add-on to ICS therapy, supporting the suitability of once-daily dosing to provide sustained improvements in lung function in adults with symptomatic asthma. PMID:26859538

  17. Safety and pharmacokinetics of multiple doses of aclidinium bromide administered twice daily in healthy volunteers.

    PubMed

    Lasseter, K; Dilzer, S; Jansat, J M; Garcia Gil, E; Caracta, C F; Ortiz, S

    2012-04-01

    Chronic obstructive pulmonary disease (COPD) is characterized by progressive airway obstruction and increased cholinergic tone. The global initiative for chronic obstructive lung disease (GOLD) guidelines recommend long-acting anticholinergics for COPD maintenance treatment. Aclidinium bromide is a novel, long-acting muscarinic antagonist developed for the treatment of COPD. A phase I, randomized, single-blind, multiple-dose clinical trial was conducted to assess the safety and pharmacokinetics (PK) of multiple doses of twice-daily (BID) aclidinium in healthy subjects. Thirty healthy male and female subjects received aclidinium 200 μg, 400 μg, 800 μg, or placebo twice daily for 7 days. Subjects were randomized to 1 of 3 cohorts and 10 subjects in each cohort were randomized (8:2) to either aclidinium or placebo groups. Safety was assessed via adverse events (AEs), laboratory evaluations, vital signs, and ECGs. Plasma samples were obtained at multiple time points throughout the study and analyzed for aclidinium and its inactive acid and alcohol metabolites using a fully validated method of liquid chromatography coupled with tandem mass spectrometry. A total of 9 treatment-emergent AEs were reported (1, placebo; 3, aclidinium 400 μg; 5, aclidinium 800 μg), all of which were mild in severity. No serious AEs were reported. There were no clinically meaningful changes in laboratory parameters or vital signs. PK parameters on Day 7 following BID dosing of aclidinium showed that steady state was achieved for aclidinium and its metabolites. On Days 1 and 7, maximum plasma concentrations (Cmax) of aclidinium were generally observed at the first PK time point (5 min postdose) and rapidly declined, with plasma concentrations generally less than 10% of Cmax by 6 h postdose in all aclidinium groups. Mean effective t(½) after the evening dose on Day 7 ranged from 4.6 to 7.0 h for aclidinium 400 μg and 800 μg, similar to the terminal t(½) observed on Day 1 (4.5-5.9 h

  18. Daily variation of radiation dose rate after the Fukushima Nuclear Accident

    NASA Astrophysics Data System (ADS)

    Yamauchi, Masatoshi

    2015-04-01

    After the radioactive contamination of the lands from the Fukushima Nuclear Power Plant accident, the radiation dose rates observed by the dosimeters often shows daily variations, at different local times at different places or time. These variations are caused by different reasons: the temperature-dependent characteristics of the dosimeter (instrumental effect), the daily convective wind that lifts up the radioactive small particle on the ground (local effect), and the daily sea-land wind that transports the radioactive small particle from highly contaminated area (regional effect). The last type is most important in understanding the internal dose by air taking. However, while very regular patterns can easily be judged as instrumental effect, variations that strongly depend on the weather conditions are not easily judged. Combining the atmospheric electric field measurement near the ground (potential gradient, PG) with the wind and weather data, some of these unclear cases can be classified into above three reasoning, which will be shown in the presentation. Thus, the PG measurement is important right after any nuclear accidents in the future.

  19. Dynamic interactions between hydrogeological and exposure parameters in daily dose prediction under uncertainty and temporal variability.

    PubMed

    Kumar, Vikas; de Barros, Felipe P J; Schuhmacher, Marta; Fernàndez-Garcia, Daniel; Sanchez-Vila, Xavier

    2013-12-15

    We study the time dependent interaction between hydrogeological and exposure parameters in daily dose predictions due to exposure of humans to groundwater contamination. Dose predictions are treated stochastically to account for an incomplete hydrogeological and geochemical field characterization, and an incomplete knowledge of the physiological response. We used a nested Monte Carlo framework to account for uncertainty and variability arising from both hydrogeological and exposure variables. Our interest is in the temporal dynamics of the total dose and their effects on parametric uncertainty reduction. We illustrate the approach to a HCH (lindane) pollution problem at the Ebro River, Spain. The temporal distribution of lindane in the river water can have a strong impact in the evaluation of risk. The total dose displays a non-linear effect on different population cohorts, indicating the need to account for population variability. We then expand the concept of Comparative Information Yield Curves developed earlier (see de Barros et al. [29]) to evaluate parametric uncertainty reduction under temporally variable exposure dose. Results show that the importance of parametric uncertainty reduction varies according to the temporal dynamics of the lindane plume. The approach could be used for any chemical to aid decision makers to better allocate resources towards reducing uncertainty.

  20. Preferred delivery method and acceptability of Wheat-Soy Blend (WSB++) as a daily complementary food supplement in northwest Bangladesh.

    PubMed

    Shamim, Abu Ahmed; Hanif, Abu A M; Merrill, Rebecca D; Campbell, Rebecca K; Kumkum, Mehnaz Alam; Shaikh, Saijuddin; de Pee, Saskia; Ahmed, Tahmeed; Parveen, Monira; Mehra, Sucheta; Klemm, Rolf D W; Labrique, Alain B; West, Keith P; Christian, Parul

    2015-01-01

    Fortified blended foods (FBFs) are widely used to prevent undernutrition in early childhood in food-insecure settings. We field tested enhanced Wheat Soy Blend (WSB++)-a FBF fortified with micronutrients, milk powder, sugar, and oil-in preparation for a complementary food supplement (CFS) trial in rural northwestern Bangladesh. Formative work was conducted to determine the optimal delivery method (cooked vs. not) for this CFS, to examine mothers' child feeding practices with and acceptance of the WSB++, and to identify potential barriers to adherence. Our results suggest WSB++ is an acceptable CFS in rural Bangladesh and the requirement for mothers to cook WSB++ at home is unlikely to be a barrier to its daily use as a CFS in this population. PMID:25427283

  1. Marijuana’s Dose-Dependent Effects in Daily Marijuana Smokers

    PubMed Central

    Ramesh, Divya; Haney, Margaret; Cooper, Ziva D.

    2015-01-01

    Active marijuana produces significant subjective, psychomotor, and physiological effects relative to inactive marijuana, yet demonstrating that these effects are dose-dependent has proven difficult. This within-subject, double-blind study was designed to develop a smoking procedure to obtain a marijuana dose–response function. In four outpatient laboratory sessions, daily marijuana smokers (N = 17 males, 1 female) smoked six 5-s puffs from 3 marijuana cigarettes (2 puffs/cigarette). The number of puffs from active (≥5.5% Δ9-tetrahydrocannabinol/THC) and inactive (0.0% THC) marijuana varied according to condition (0, 2, 4, or 6 active puffs); active puffs were always smoked before inactive puffs. Subjective, physiological, and performance effects were assessed prior to and at set time points after marijuana administration. Active marijuana dose-dependently increased heart rate and decreased marijuana craving, despite evidence (carbon monoxide expiration, weight of marijuana cigarettes post-smoking) that participants inhaled less of each active marijuana cigarette than inactive cigarettes. Subjective ratings of marijuana “strength,” “high,” “liking,” “good effect,” and “take again” were increased by active marijuana compared with inactive marijuana, but these effects were not dose-dependent. Active marijuana also produced modest, non-dose-dependent deficits in attention, psychomotor function, and recall relative to the inactive condition. In summary, although changes in inhalation patterns as a function of marijuana strength likely minimized the difference between dose conditions, dose-dependent differences in marijuana’s cardiovascular effects and ratings of craving were observed, whereas subjective ratings of marijuana effects did not significantly vary as a function of dose. PMID:23937597

  2. Estimation of Rectal Dose Using Daily Megavoltage Cone-Beam Computed Tomography and Deformable Image Registration

    SciTech Connect

    Akino, Yuichi; Yoshioka, Yasuo; Fukuda, Shoichi; Maruoka, Shintaroh; Takahashi, Yutaka; Yagi, Masashi; Mizuno, Hirokazu; Isohashi, Fumiaki; Ogawa, Kazuhiko

    2013-11-01

    Purpose: The actual dose delivered to critical organs will differ from the simulated dose because of interfractional organ motion and deformation. Here, we developed a method to estimate the rectal dose in prostate intensity modulated radiation therapy with consideration to interfractional organ motion using daily megavoltage cone-beam computed tomography (MVCBCT). Methods and Materials: Under exemption status from our institutional review board, we retrospectively reviewed 231 series of MVCBCT of 8 patients with prostate cancer. On both planning CT (pCT) and MVCBCT images, the rectal contours were delineated and the CT value within the contours was replaced by the mean CT value within the pelvis, with the addition of 100 Hounsfield units. MVCBCT images were rigidly registered to pCT and then nonrigidly registered using B-Spline deformable image registration (DIR) with Velocity AI software. The concordance between the rectal contours on MVCBCT and pCT was evaluated using the Dice similarity coefficient (DSC). The dose distributions normalized for 1 fraction were also deformed and summed to estimate the actual total dose. Results: The DSC of all treatment fractions of 8 patients was improved from 0.75±0.04 (mean ±SD) to 0.90 ±0.02 by DIR. Six patients showed a decrease of the generalized equivalent uniform dose (gEUD) from total dose compared with treatment plans. Although the rectal volume of each treatment fraction did not show any correlation with the change in gEUD (R{sup 2}=0.18±0.13), the displacement of the center of gravity of rectal contours in the anterior-posterior (AP) direction showed an intermediate relationship (R{sup 2}=0.61±0.16). Conclusion: We developed a method for evaluation of rectal dose using DIR and MVCBCT images and showed the necessity of DIR for the evaluation of total dose. Displacement of the rectum in the AP direction showed a greater effect on the change in rectal dose compared with the rectal volume.

  3. SU-E-T-94: Daily Fraction Dose Recalculation Based On Rigid Registration Using Cone Beam CT

    SciTech Connect

    Bosse, C; Tuohy, R; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

    2014-06-01

    Purpose: To calculate the daily fraction dose for a CBCT recalculation based on rigid registration and compare it to the planned CT dose. Methods: For this study, 30 patients that were previously treated (10 SBRT lung, 10 prostate and 10 abdomen) were considered. The daily CBCT images were imported into the Pinnacle treatment planning system from Mosaic. The prescribing physician contoured the regions of interest (ROI) on each CBCT and then dose was computed on each CBCT. Each CBCT dose distribution was then compared against the plan. The evaluation was based on isodose line comparison and Dose Volume Histogram comparison. Results: In the case of lung patients the dose differences between daily dose and plan dose were considered small. The PTV coverage was not compromised and the dose to the organs at risk had negligible differences. Larger differences were observed for prostate and abdomen patients. In these cases, although the PTV doses did not change on a daily basis, the doses to the organs at risk had significant differences. For a prostate patient, the bladder dose at 35% volume was 2714.444 cGy for the CT plan and 2844.747, 2801.556, 3552.37, and 2970.968 cGy for subsequent CBCTs. For the PTV on a SBRT patient, however, the CT plan had a dose at 35% volume of 6917.71 cGy and 6815.385, 6892.5, 6896.25, and 6922.9 cGy for the CBCTs. Conclusion: Daily dose validation is feasible using CBCT and treatment planning system. It provides means to evaluate the course of treatment for the patient undergoing radiation therapy and can assist in the decision of the need of adaptation of the treatment plan.

  4. [Benzalkonium chloride daily dose--an important criterion in glaucoma treatment].

    PubMed

    Výborný, P; Sicáková, S

    2011-04-01

    Preservatives in eye drops, especially benzalkonium chloride (BAC), may act as cytotoxic; furthermore, it may cause the instability of the tear film, conjunctivitis, subconjunctival fibrosis, epithelium apoptosis and worsening the prognosis of possible surgical treatment. The patient's subjective symptoms may decrease his compliance. For better orientation in this issue, the authors calculated the daily BAC doses in eye drops used in the glaucoma treatment. Significant differences are caused by different size of the drop in specific medicament, different BAC concentrations in the volume unit of the package, and frequency of application. The daily BAC doses are in micrograms as follows: Beta-blockers: Timo-COMOD 0.0, Arutimol 2.6, Vistagan 2.8, Timolol POS 3.0, Arteoptic 3.7, Carteol 4.0, Betoptic S 4.8, Timoptol MSD 6.3, Betoptic 10.0. Alpha-mimetics: Alphagan and Luxfen 3.5, Aruclonine 7.1. Prostaglandin derivates, prostamides and docosanoides: Taflotan 0.0, Lumigan 1.4, Unilat 3.0, Travatan 3.9, Rescula 5.8, Xalatan 6.0, Latanoprost-ratiopharm, Xaloptic, Latanoprost Actavis, Latanoprost Arrow, Solusan, Glaucotens 6.0. Carbonic anhydrase inhibitors: Azopt 4.8, Trusopt 5.4. Fixed combinations: Ganfort 1.4, Combigan 3.2, Duotrav 4.3, Cosopt 5.6, Xalacom 6.0. PMID:21751744

  5. Venous thromboembolism prophylaxis with unfractionated heparin in the hospitalized medical patient: the case for thrice daily over twice daily dosing.

    PubMed

    Mahan, Charles E; Pini, Mario; Spyropoulos, Alex C

    2010-08-01

    For venous thromboembolism (VTE) prevention in the hospitalized medical patient, no head-to-head trials have been performed of unfractionated heparin (UFH) 5,000 U subcutaneously thrice (i.e. q8 h or TID) daily versus twice daily (q12 h or BID). Several meta-analyses have been undertaken in attempts to determine whether one regimen may be more beneficial for safety and efficacy. Currently, not all international guidelines include a recommended frequency for UFH. Delineation of this frequency may be helpful to the practicing clinician. Primary studies (with a modified Jadad score of >or=6 to demonstrate a stronger study design) that compared low molecular weight heparin (LMWH) and UFH, and UFH and placebo were evaluated. Meta-analyses evaluating safety and efficacy of LMWH versus UFH, or TID UFH versus BID UFH were also evaluated. Although BID UFH shows some efficacy in one primary study, it is no more beneficial than no prophylaxis in another study. LMWH appears to be more efficacious than BID UFH, but comparable in safety and efficacy to TID UFH. Meta-analytic data demonstrates that BID UFH may have some reduction in deep vein thrombosis. Meta-analytic data also suggests that TID UFH is more efficacious than BID UFH at the cost of more major bleeding. The medical patient with risk factors for the development of VTE appears to be at moderate to high risk. International guidelines for VTE prevention should incorporate a frequency for UFH to guide use. TID UFH is superior in efficacy to BID UFH even when taking into consideration the increased rate of major bleeds. Newly published risk-assessment models may be beneficial in determining which patients would best benefit from BID UFH or TID UFH.

  6. Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch

    PubMed Central

    Claeys, Stéphanie; Rustichelli, Frederico; Noël, Stéphanie; Hamaide, Annick

    2011-01-01

    The objective of this retrospective study was to determine the efficacy of a single daily oral dose of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in bitches. Nine bitches diagnosed with USMI were treated with a single daily dose [1.5 mg/kg body weight (BW)] of PPA for at least 1 month. Urethral pressure profiles (UPP) were performed in 7 dogs before treatment and repeated in 4 of them after treatment. Treatment with PPA resulted in long-term continence in 8/9 bitches. One dog did not respond to PPA and was treated surgically later. Recheck UPPs showed a significant increase in maximal urethral closure pressure in the 4 bitches after treatment with PPA compared to before treatment. In conclusion, long-term continence can be achieved in bitches affected with USMI after administration of a single daily dose of PPA (1.5 mg/kg BW). PMID:22043069

  7. Comparison of the Efficacy and Safety of Oritavancin Front-Loaded Dosing Regimens to Daily Dosing: an Analysis of the SIMPLIFI Trial ▿

    PubMed Central

    Dunbar, Lala M.; Milata, Joe; McClure, Ty; Wasilewski, Margaret M.

    2011-01-01

    Oritavancin is a novel lipoglycopeptide with demonstrated effectiveness against complicated skin and skin structure infections (cSSSI) caused by Gram-positive pathogens, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). The pharmacokinetic and pharmacodynamic profile of oritavancin is favorable for single or infrequent dosing. A phase 2, multicenter, randomized, double-blind, parallel, active-comparator study (ClinicalTrials.gov identifier, NCT00514527) of single and infrequent dosing of intravenous (i.v.) oritavancin for the treatment of cSSSI caused by Gram-positive pathogens (wound infections, major abscess, and cellulitis) was undertaken to evaluate the noninferiority of front-loaded dosing regimens compared to a daily-dosing regimen. A total of 302 patients ≥18 years of age were randomized equally to one of three oritavancin treatment groups, receiving either a daily dose (200 mg) administered for 3 to 7 days, a single dose (1,200 mg), or an infrequent dose (800-mg dose, with the option for an additional 400 mg on day 5). The primary efficacy was defined as a clinical response in clinically evaluable (CE) patients assessed at days 21 to 29 (test of cure [TOC]). The cure rates in the CE population were 72.4% (55/76) in the daily-dose group, 81.5% (66/81) in the 1,200-mg-single-dose group, and 77.5% (55/71) in the infrequent-dose group. In patients with MRSA at baseline, the cure rates were 78.3% (18/23), 73.0% (27/37), and 87.0% (20/23) in the daily-, 1,200-mg-single-, and infrequent-dose groups, respectively; however, the study was not powered to assess outcomes in the MRSA subpopulation, and given the heterogeneity of the types of infection and the small sample size, these do not suggest any true differences in efficacy rates for these pathogens. The frequencies of adverse events were similar among treatment groups. The results of this study show that single- and infrequent-dosing schedules of oritavancin were as efficacious as

  8. High Acceptability of HIV Pre-exposure Prophylaxis but Challenges in Adherence and Use: Qualitative Insights from a Phase I Trial of Intermittent and Daily PrEP in At-Risk Populations in Kenya

    PubMed Central

    Van der Elst, Elisabeth Maria; Mbogua, Judie; Operario, Don; Mutua, Gaudensia; Kuo, Caroline; Mugo, Peter; Kanungi, Jennifer; Singh, Sagri; Haberer, Jessica; Priddy, Frances; Sanders, Eduard Joachim

    2013-01-01

    This paper used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya, who used oral preexposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence. Fifty-one of 72 volunteers who took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP underwent qualitative assessments after completing the trial. Analyses identified three themes: (i) acceptability of PrEP was high, i.e. side effects were experienced early in the study but diminished over time, however characteristics of pills could improve comfort and use; (ii) social impacts such as stigma, rumors, and relationship difficulties due to being perceived as HIV positive were prevalent; (iii) adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work. These themes resonated across dosing regimens and gender, and while most participants favored the intermittent dosing schedule, those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness. PMID:23080358

  9. Feasibility, performance, and acceptability of the Wisebag™ for potential monitoring of daily gel applicator use in Durban, South Africa

    PubMed Central

    van der Straten, Ariane; Montgomery, Elizabeth; Pillay, Diantha; Cheng, Helen; Naidoo, Anushka; Cele, Zakhele; Naidoo, Kalendri; Hartmann, Miriam; Piper, Jeanna; Nair, Gonasagrie

    2012-01-01

    The Wisebag™, a lunchbag-style container with an electronic events-monitoring system, was designed as a real-time indirect objective measure of microbicide gel use. Due to cost, alternative functionalities (i.e. use of offline and dummy versions) were explored. We conducted a three-arm, double-blinded pilot study among fifty HIV-negative women in Durban, South Africa to assess participant adherence and Wisebag acceptability and performance. Participants were randomized 2:2:1 to Wisebag with online (events transmitted via cellular signal in real-time), offline (events stored in device memory) or inactive “dummy” devices. Participants were instructed to open the Wisebag daily for two weeks, retrieve a study sticker and affix it on a diary card. All participants completed the study. At exit, 94% did not know which device they had received, nor could they differentiate the Wisebag types when presented with the three options. Five offline devices failed (no data recorded). Per Wisebag events, 26% of women were perfectly adherent compared to 48% by self-report and 46% per diary card. Of reported non-adherence, 92% did not open the Wisebag (travelling or forgot) and 22% opened Wisebag >1x/day (curiosity). Participants liked and were comfortable carrying Wisebag. Successful blinding will allow inclusion of offline and/or dummy Wisebags in future study designs. Perfect adherence by opening events was significantly lower than by self-report, highlighting the importance of objective measures of adherence in clinical trials. Additional studies to validate Wisebag data with actual products, with and without SMS and online functionality, in different populations and settings, and in comparison to biomarkers are warranted. PMID:23054042

  10. Early antiretroviral therapy: rationale, protease inhibitor-sparing regimens and once daily dosing.

    PubMed

    Gatell, J M

    1998-01-01

    In 1998 it seems reasonable and widely accepted that all human immunodeficiency virus type 1 (HIV-1)-infected patients willing to be treated may benefit from receiving antiretroviral therapy. Only those with undetectable plasma HIV-1 RNA, normal CD4 lymphocyte counts and lack of markers of immunological system activation may be possible exceptions. The rationale supporting the early initiation of antiretroviral therapy are (i) data on viral dynamics; (ii) preliminary data pointing toward a better and a quicker restoration of immune function when treatment is initiated in very early stages (during or within a few weeks or months of acute symptomatic or asymptomatic HIV-1 infection); (iii) the lack of a stable viral load set-point even in patients in the early stages (CD4 > 500 cells/mm3) who have a very low viral load (< 5000 copies/ml); (iv) the relatively high likelihood of clinical progression at mid-term of the approximately 50-75% of patients in very early disease stages (CD4 > 500 cells/mm3) who have a plasma viral load above 5000 to 10,000 HIV-1 RNA copies/ml; (v) data from the Spanish Earth-1 study, which used a composite endpoint (virological, immunological or clinical progression), demonstrating that even in these very early stages of HIV-1 disease any antiretroviral therapy (double or triple combination) was better than no treatment. Even in early disease stages, a triple combination is needed to achieve a durable and profound virological and immunological response. In addition, the combination of stavudine plus didanosine has several advantages and can be considered one of the best double nucleoside combinations to combine with a protease inhibitor or with a non-nucleoside reverse transcriptase inhibitor. The INCAS study and the preliminary results of the ongoing Spanish SCAN study have demonstrated the possibility of protease inhibitor-sparing combinations for initial antiretroviral treatment, at least in selected patient subsets, such as those with a

  11. Daily dose monitoring with atlas-based auto-segmentation on diagnostic quality CT for prostate cancer

    SciTech Connect

    Li, Wen; Vassil, Andrew; Xia, Ping; Zhong, Yahua

    2013-11-15

    Purpose: To evaluate the feasibility of daily dose monitoring using a patient specific atlas-based autosegmentation method on diagnostic quality verification images.Methods: Seven patients, who were treated for prostate cancer with intensity modulated radiotherapy under daily imaging guidance of a CT-on-rails system, were selected for this study. The prostate, rectum, and bladder were manually contoured on the first six and last seven sets of daily verification images. For each patient, three patient specific atlases were constructed using manual contours from planning CT alone (1-image atlas), planning CT plus first three verification CTs (4-image atlas), and planning CT plus first six verification CTs (7-image atlas). These atlases were subsequently applied to the last seven verification image sets of the same patient to generate the auto-contours. Daily dose was calculated by applying the original treatment plans to the daily beam isocenters. The autocontours and manual contours were compared geometrically using the dice similarity coefficient (DSC), and dosimetrically using the dose to 99% of the prostate CTV (D99) and the D5 of rectum and bladder.Results: The DSC of the autocontours obtained with the 4-image atlases were 87.0%± 3.3%, 84.7%± 8.6%, and 93.6%± 4.3% for the prostate, rectum, and bladder, respectively. These indices were higher than those from the 1-image atlases (p < 0.01) and comparable to those from the 7-image atlases (p > 0.05). Daily prostate D99 of the autocontours was comparable to those of the manual contours (p= 0.55). For the bladder and rectum, the daily D5 were 95.5%± 5.9% and 99.1%± 2.6% of the planned D5 for the autocontours compared to 95.3%± 6.7% (p= 0.58) and 99.8%± 2.3% (p < 0.01) for the manual contours.Conclusions: With patient specific 4-image atlases, atlas-based autosegmentation can adequately facilitate daily dose monitoring for prostate cancer.

  12. Treatment of advanced head and neck cancer: multiple daily dose fractionated radiation therapy and sequential multimodal treatment approach.

    PubMed

    Nissenbaum, M; Browde, S; Bezwoda, W R; de Moor, N G; Derman, D P

    1984-01-01

    Fifty-eight patients with advanced head and neck cancer were entered into a randomised trial comparing chemotherapy (DDP + bleomycin) alone, multiple daily fractionated radiation therapy, and multimodality therapy consisting of chemotherapy plus multiple fractionated radiation therapy. Multimodal therapy gave a significantly higher response rate (69%) than either single-treatment modality. The use of a multiple daily dose fractionation allowed radiation therapy to be completed over 10 treatment days, and the addition of chemotherapy to the radiation treatment did not significantly increase toxicity. Patients receiving multimodal therapy also survived significantly longer (median 50 weeks) than those receiving single-modality therapy (median 24 weeks).

  13. Phase I Randomized Safety Study of Twice Daily Dosing of Acidform Vaginal Gel: Candidate Antimicrobial Contraceptive

    PubMed Central

    Keller, Marla J.; Carpenter, Colleen A.; Lo, Yungtai; Einstein, Mark H.; Liu, Congzhou; Fredricks, David N.; Herold, Betsy C.

    2012-01-01

    Background Acidform gel, an acid-buffering product that inactivates spermatozoa, may be an effective topical non-hormonal contraceptive. This study was designed to evaluate the safety of vaginal dosing and effects of Acidform on mucosal immune mediators, antimicrobial properties of genital secretions, and vaginal microbiota. Methods Thirty-six sexually abstinent U.S. women were randomized to apply Acidform or hydroxyethylcellulose (HEC) placebo gel twice daily for 14 consecutive days. Safety was assessed by symptoms and pelvic examination. The impact of gel on mucosal immunity was assessed by quantifying cytokines, chemokines, antimicrobial proteins and antimicrobial activity of genital secretions collected by cervicovaginal lavage (CVL) at screening, 2 hours after gel application, and on days 7, 14 and 21. Vaginal microbiota was characterized at enrollment and day 14 using species-specific quantitative PCR assays. Results The median vaginal and cervical pH was significantly lower 2 hours after application of Acidform and was associated with an increase in the bactericidal activity of CVL against E. coli. However, 65% of women who received Acidform had at least one local adverse event compared with 11% who received placebo (p = 0.002). While there was no increase in inflammatory cytokines or chemokines, CVL concentrations of lactoferrin and interleukin-1 receptor antagonist (IL-1ra), an anti-inflammatory protein, were significantly lower following Acidform compared to HEC placebo gel application. There were no significant changes in Lactobacillus crispatus or Lactobacillus jensenii in either group but there was a decrease in Gardnerella vaginalis in the Acidform group (p = 0.08). Conclusions Acidform gel may augment mucosal defense as evidenced by an increase in bactericidal activity of genital secretions against E. coli and a decrease in Gardnerella vaginalis colonization. However, Acidform was associated with more irritation than placebo and lower levels

  14. The effects of hedonically acceptable red pepper doses on thermogenesis and appetite

    PubMed Central

    Ludy, Mary-Jon; Mattes, Richard D.

    2010-01-01

    Previous studies suggest consumption of red pepper (RP) promotes negative energy balance. However, the RP dose provided in these studies (up to 10 g/meal) usually exceeded the amount preferred by the general population in the United States (mean = ~ 1 g/meal). The objective of this study was to evaluate the effects of hedonically acceptable RP doses served at a single meal in healthy, lean individuals on thermogenesis and appetite. Twenty-five men and women (aged 23.0 ± 0.5 y, BMI 22.6 ± 0.3 kg/m2, 13 spicy food users and 12 non-users) participated in a randomized crossover trial during which they consumed a standardized quantity (1 g); their preferred quantity (regular spicy foods users 1.8 ± 0.3 g/meal, non-users 0.3 ± 0.1 g/meal); or no RP. Energy expenditure, core body and skin temperature, and appetite were measured. Postprandial energy expenditure and core body temperature were greater, and skin temperature was lower, after test loads with 1 g RP than no RP. Respiratory quotient was lower after the preferred RP dose was ingested orally, compared to in capsule form. These findings suggest that RP’s effects on energy balance stem from a combination of metabolic and sensory inputs, and that oral exposure is necessary to achieve RP’s maximum benefits. Energy intake was lower after test loads with 1 g RP than no RP in non-users, but not in users. Preoccupation with food, and the desire to consume fatty, salty, and sweet foods were decreased more (or tended to be decreased more) in non-users than users after a 1 g RP test load, but did not vary after a test load with no RP. This suggests that individuals may become desensitized to the effects of RP with long-term spicy food intake. PMID:21093467

  15. Adaptive Liver Stereotactic Body Radiation Therapy: Automated Daily Plan Reoptimization Prevents Dose Delivery Degradation Caused by Anatomy Deformations

    SciTech Connect

    Leinders, Suzanne M.; Breedveld, Sebastiaan; Méndez Romero, Alejandra; Schaart, Dennis; Seppenwoolde, Yvette; Heijmen, Ben J.M.

    2013-12-01

    Purpose: To investigate how dose distributions for liver stereotactic body radiation therapy (SBRT) can be improved by using automated, daily plan reoptimization to account for anatomy deformations, compared with setup corrections only. Methods and Materials: For 12 tumors, 3 strategies for dose delivery were simulated. In the first strategy, computed tomography scans made before each treatment fraction were used only for patient repositioning before dose delivery for correction of detected tumor setup errors. In adaptive second and third strategies, in addition to the isocenter shift, intensity modulated radiation therapy beam profiles were reoptimized or both intensity profiles and beam orientations were reoptimized, respectively. All optimizations were performed with a recently published algorithm for automated, multicriteria optimization of both beam profiles and beam angles. Results: In 6 of 12 cases, violations of organs at risk (ie, heart, stomach, kidney) constraints of 1 to 6 Gy in single fractions occurred in cases of tumor repositioning only. By using the adaptive strategies, these could be avoided (<1 Gy). For 1 case, this needed adaptation by slightly underdosing the planning target volume. For 2 cases with restricted tumor dose in the planning phase to avoid organ-at-risk constraint violations, fraction doses could be increased by 1 and 2 Gy because of more favorable anatomy. Daily reoptimization of both beam profiles and beam angles (third strategy) performed slightly better than reoptimization of profiles only, but the latter required only a few minutes of computation time, whereas full reoptimization took several hours. Conclusions: This simulation study demonstrated that replanning based on daily acquired computed tomography scans can improve liver stereotactic body radiation therapy dose delivery.

  16. IMRT planning and delivery incorporating daily dose from mega-voltage cone-beam computed tomography imaging.

    PubMed

    Miften, Moyed; Gayou, Olivier; Reitz, Bodo; Fuhrer, Russell; Leicher, Brian; Parda, David S

    2007-10-01

    The technology of online mega-voltage cone-beam (CB) computed tomography (MV-CBCT) imaging is currently used in many institutions to generate a 3D anatomical dataset of a patient in treatment position. It utilizes an accelerator therapy beam, delivered with 200 degrees gantry rotation, and captured by an electronic portal imager to account for organ motion and setup variations. Although the patient dose exposure from a single volumetric MV-CBCT imaging procedure is comparable to that from standard double-exposure orthogonal portal images, daily image localization procedures can result in a significant dose increase to healthy tissue. A technique to incorporate the daily dose, from a MV-CBCT imaging procedure, in the IMRT treatment planning optimization process was developed. A composite IMRT plan incorporating the total dose from the CB was optimized with the objective of ensuring uniform target coverage while sparing the surrounding normal tissue. One head and neck cancer patient and four prostate cancer patients were planned and treated using this technique. Dosimetric results from the prostate IMRT plans optimized with or without CB showed similar target coverage and comparable sparing of bladder and rectum volumes. Average mean doses were higher by 1.6 +/- 1.0 Gy for the bladder and comparable for the rectum (-0.3 +/- 1.4 Gy). In addition, an average mean dose increase of 1.9 +/- 0.8 Gy in the femoral heads and 1.7 +/- 0.6 Gy in irradiated tissue was observed. However, the V65 and V70 values for bladder and rectum were lower by 2.3 +/- 1.5% and 2.4 +/- 2.1% indicating better volume sparing at high doses with the optimized plans incorporating CB. For the head and neck case, identical target coverage was achieved, while a comparable sparing of the brain stem, optic chiasm, and optic nerves was observed. The technique of optimized planning incorporating doses from daily online MV-CBCT procedures provides an alternative method for imaging IMRT patients. It allows

  17. IMRT planning and delivery incorporating daily dose from mega-voltage cone-beam computed tomography imaging

    SciTech Connect

    Miften, Moyed; Gayou, Olivier; Reitz, Bodo; Fuhrer, Russell; Leicher, Brian; Parda, David S.

    2007-10-15

    The technology of online mega-voltage cone-beam (CB) computed tomography (MV-CBCT) imaging is currently used in many institutions to generate a 3D anatomical dataset of a patient in treatment position. It utilizes an accelerator therapy beam, delivered with 200 deg. gantry rotation, and captured by an electronic portal imager to account for organ motion and setup variations. Although the patient dose exposure from a single volumetric MV-CBCT imaging procedure is comparable to that from standard double-exposure orthogonal portal images, daily image localization procedures can result in a significant dose increase to healthy tissue. A technique to incorporate the daily dose, from a MV-CBCT imaging procedure, in the IMRT treatment planning optimization process was developed. A composite IMRT plan incorporating the total dose from the CB was optimized with the objective of ensuring uniform target coverage while sparing the surrounding normal tissue. One head and neck cancer patient and four prostate cancer patients were planned and treated using this technique. Dosimetric results from the prostate IMRT plans optimized with or without CB showed similar target coverage and comparable sparing of bladder and rectum volumes. Average mean doses were higher by 1.6{+-}1.0 Gy for the bladder and comparable for the rectum (-0.3{+-}1.4 Gy). In addition, an average mean dose increase of 1.9{+-}0.8 Gy in the femoral heads and 1.7{+-}0.6 Gy in irradiated tissue was observed. However, the V{sub 65} and V{sub 70} values for bladder and rectum were lower by 2.3{+-}1.5% and 2.4{+-}2.1% indicating better volume sparing at high doses with the optimized plans incorporating CB. For the head and neck case, identical target coverage was achieved, while a comparable sparing of the brain stem, optic chiasm, and optic nerves was observed. The technique of optimized planning incorporating doses from daily online MV-CBCT procedures provides an alternative method for imaging IMRT patients. It

  18. Daily radionuclide ingestion and internal radiation doses in Aomori prefecture, Japan.

    PubMed

    Ohtsuka, Yoshihito; Kakiuchi, Hideki; Akata, Naofumi; Takaku, Yuichi; Hisamatsu, Shun'ichi

    2013-10-01

    To assess internal annual dose in the general public in Aomori Prefecture, Japan, 80 duplicate cooked diet samples, equivalent to the food consumed over a 400-d period by one person, were collected from 100 volunteers in Aomori City and the village of Rokkasho during 2006–2010 and were analyzed for 11 radionuclides. To obtain average rates of ingestion of radionuclides, the volunteers were selected from among office, fisheries, agricultural, and livestock farm workers. Committed effective doses from ingestion of the diet over a 1-y period were calculated from the analytical results and from International Commission on Radiological Protection dose coefficients; for 40K, an internal effective dose rate from the literature was used. Fisheries workers had significantly higher combined internal annual dose than the other workers, possibly because of high rates of ingestion of marine products known to have high 210Po concentrations. The average internal dose rate, weighted by the numbers of households in each worker group in Aomori Prefecture, was estimated at 0.47 mSv y-1. Polonium-210 contributed 49% of this value. The sum of committed effective dose rates for 210Po, 210Pb, 228Ra, and 14C and the effective dose rate of 40K accounted for approximately 99% of the average internal dose rate. PMID:23982610

  19. FV-162 is a novel, orally bioavailable, irreversible proteasome inhibitor with improved pharmacokinetics displaying preclinical efficacy with continuous daily dosing.

    PubMed

    Wang, Z; Dove, P; Wang, X; Shamas-Din, A; Li, Z; Nachman, A; Oh, Y J; Hurren, R; Ruschak, A; Climie, S; Press, B; Griffin, C; Undzys, E; Aman, A; Al-awar, R; Kay, L E; O'Neill, D; Trudel, S; Slassi, M; Schimmer, A D

    2015-01-01

    Approved proteasome inhibitors have advanced the treatment of multiple myeloma but are associated with serious toxicities, poor pharmacokinetics, and most with the inconvenience of intravenous administration. We therefore sought to identify novel orally bioavailable proteasome inhibitors with a continuous daily dosing schedule and improved therapeutic window using a unique drug discovery platform. We employed a fluorine-based medicinal chemistry technology to synthesize 14 novel analogs of epoxyketone-based proteasome inhibitors and screened them for their stability, ability to inhibit the chymotrypsin-like proteasome, and antimyeloma activity in vitro. The tolerability, pharmacokinetics, pharmacodynamic activity, and antimyeloma efficacy of our lead candidate were examined in NOD/SCID mice. We identified a tripeptide epoxyketone, FV-162, as a metabolically stable, potent proteasome inhibitor cytotoxic to human myeloma cell lines and primary myeloma cells. FV-162 had limited toxicity and was well tolerated on a continuous daily dosing schedule. Compared with the benchmark oral irreversible proteasome inhibitor, ONX-0192, FV-162 had a lower peak plasma concentration and longer half-life, resulting in a larger area under the curve (AUC). Oral FV-162 treatment induced rapid, irreversible inhibition of chymotrypsin-like proteasome activity in murine red blood cells and inhibited tumor growth in a myeloma xenograft model. Our data suggest that oral FV-162 with continuous daily dosing schedule displays a favorable safety, efficacy, and pharmacokinetic profile in vivo, identifying it as a promising lead for clinical evaluation in myeloma therapy.

  20. Effects of daily pain intensity, positive affect, and individual differences in pain acceptance on work goal interference and progress.

    PubMed

    Mun, Chung Jung; Karoly, Paul; Okun, Morris A

    2015-11-01

    Multilevel modeling was used to examine the effects of morning pain intensity and morning positive and negative affect on pain's interference with afternoon work goal pursuit and with evening work goal progress in a community sample of 132 adults who completed a 21-day diary. The moderating effects of pain acceptance and pain catastrophizing on the associations between morning pain intensity and afternoon work goal interference were also tested. Results revealed that the positive relationship between morning pain intensity and pain's interference with work goal pursuit was significantly moderated by pain acceptance, but not by pain catastrophizing. Both morning pain intensity and positive affect exerted significant indirect effects on evening work goal progress through the perception of pain's interference with work goal pursuit in the afternoon. Furthermore, the mediated effect of morning pain on evening work goal progress was significant when pain acceptance was at the grand mean and 1 SD below the grand mean, but not when pain acceptance was 1 SD above the grand mean. Thus, it appears that high pain acceptance significantly attenuates pain's capacity to disrupt work goal pursuit. Moreover, morning positive affect appears to operate as a protective factor. Additional interpretations and potential explanations for some inconsistent outcomes are discussed along with limitations, clinical implications, and suggestions for future studies.

  1. Efficacy of a High-Dose in Addition to Daily Low-Dose Vitamin A in Children Suffering from Severe Acute Malnutrition with Other Illnesses

    PubMed Central

    Sattar, Samima; Ahmed, Tahmeed; Rasul, Choudhury Habibur; Saha, Debasish; Salam, Mohammed Abdus; Hossain, Md Iqbal

    2012-01-01

    Background Efficacy of high-dose vitamin A (VA) in children suffering from severe acute malnutrition (SAM) has recently been questioned. This study compared the efficacy of a single high-dose (200,000 IU) in addition to daily low-dose (5000 IU) VA in the management of children suffering from SAM with diarrhea and/or acute lower respiratory tract infection (ALRI). Methods In a randomized, double-blind, controlled clinical trial in icddr,b, Bangladesh during 2005–07, children aged 6–59 months with weight-for-height <−3 Z-score and/or bipedal edema (SAM) received either a high-dose VA or placebo on admission day. Both the groups received 5,000 IU/day VA in a multivitamins drop for 15 days and other standard treatment which is similar to WHO guidelines. Results A total 260 children (130 in each group) were enrolled. All had diarrhea, 54% had concomitant ALRI, 50% had edema, 48.5% were girl with a mean±SD age of 16±10 months. None had clinical signs of VA deficiency. Mean±SD baseline serum retinol was 13.15±9.28 µg/dl, retinol binding protein was 1.27±0.95 mg/dl, and pre-albumin was 7.97±3.96 mg/dl. Median (inter quartile range) of C-reactive protein was 7.8 (2.1, 22.2) mg/L. Children of the two groups did not differ in any baseline characteristic. Over the 15 days treatment period resolution of diarrhea, ALRI, edema, anthropometric changes, and biochemical indicators of VA were similar between the groups. The high-dose VA supplementation in children with SAM did not show any adverse event. Conclusions Efficacy of daily low-dose VA compared to an additional single high-dose was not observed to be better in the management of children suffering from SAM with other acute illnesses. A single high-dose VA may be given especially where the children with SAM may leave the hospital/treatment center early. Trial Registration ClinicalTrials.gov NCT00388921 PMID:22479361

  2. [Preservative substances - the daily dose of benzalkonium chloride in glaucoma treatment from the patients point of view].

    PubMed

    Výborný, P; Sičáková, S; Veselá Flórová, Z

    2014-06-01

    The author calculated the daily dose of Benzalkonium Chloride (BAC) in eye drops used in glaucoma treatment from the patients point of view, which means the real amount of BAC applied in the conjunctival sac. The information about BAC concentration in 1 milliliter (mL) do not offer sufficient picture about real circumstances, because the size of the drop, especially after the introducing of the use of generic products in clinical practice in specific anti-glaucomatic drugs, differs significantly. The daily dose of BAC may have substantial significance in the patients treatment tolerance. The overview of BAC daily dose in single therapeutic groups and drugs follows: betablockers: Timo-COMOD 0, Arutimol 2.6, Vistagan 2.8, Timolol-POS 3.0, Arteoptic 3.7, Betoptic S 4.8, Timoptol MSD 6.3, Betoptic 10.0; alpha-mimetics: Alphagan 3.5, Luxfen 3.5, Aruclonin 7.1; derivates of prostaglandine, prostamides: Taflotan 0, Monopost 0, Lumigan 1.4, Unilat 3.1, Travatan 3.9, Latanoprost Apotex 4.3, Rescula 5.8, Latanoprost POS 5.9, Xalatan 6.0, Latanoprost Ratiopharm 6.0, Latanoprost Actavis 6.0, Latanoprost Arrow 6.0, Arulatan 5.4, Latalux 6.0, Glaucotens 6.0, Xaloptic 6.0, Solusin 6.1; carboanhydrase inhibitors: Batidor 3.8, Azopt 4.8, Trusopt 5.4, Oftidor 8.1; fixed combinations: Ganfort 1.4, Dorzolamid/timolol TEVA 2.8, Combigan 3.2, Duotrav 4.3, Cosopt 5.6, Xalacom 6.0, Glaucotima 6.0, Latanoprost/timolol Apotex 6.3, Azarga 6.4, Dorzogen Combi 6.5, and Dozotima 8.8 µl. PMID:25032794

  3. Feasibility and Acceptability of a Smartphone App for Daily Reports of Substance Use and Antiretroviral Therapy Adherence among HIV-Infected Adults.

    PubMed

    Przybyla, Sarahmona M; Eliseo-Arras, Rebecca K; Krawiec, Gabriela; Gower, Emily; Dermen, Kurt

    2016-01-01

    While substance use is one of the most consistent predictors of poor adherence to antiretroviral therapy (ART), few studies among people living with HIV (PLH) have utilized mobile phone-based assessment of these health behaviors. PLH were recruited from primary care clinics to report ART and substance use using a smartphone application (app) for 14 consecutive days. The app's feasibility as a data collection tool was evaluated quantitatively via surveys and qualitatively via in-depth interviews to assess daily report completion, compliance, and study satisfaction. Overall, 26 participants (M = 49.5 years, 76% male) completed 95.3% of time-based daily reports. Participants reported high satisfaction with the app and expressed future interest in using smartphones to report daily behaviors. High completion rates and participant acceptability suggest that smartphones are a feasible, acceptable method for collecting substance use and ART data among PLH. Potential areas of concern such as sufficient training and assistance for those with limited smartphone experience should be considered for future app-based research studies among PLH. PMID:27610243

  4. Feasibility and Acceptability of a Smartphone App for Daily Reports of Substance Use and Antiretroviral Therapy Adherence among HIV-Infected Adults

    PubMed Central

    2016-01-01

    While substance use is one of the most consistent predictors of poor adherence to antiretroviral therapy (ART), few studies among people living with HIV (PLH) have utilized mobile phone-based assessment of these health behaviors. PLH were recruited from primary care clinics to report ART and substance use using a smartphone application (app) for 14 consecutive days. The app's feasibility as a data collection tool was evaluated quantitatively via surveys and qualitatively via in-depth interviews to assess daily report completion, compliance, and study satisfaction. Overall, 26 participants (M = 49.5 years, 76% male) completed 95.3% of time-based daily reports. Participants reported high satisfaction with the app and expressed future interest in using smartphones to report daily behaviors. High completion rates and participant acceptability suggest that smartphones are a feasible, acceptable method for collecting substance use and ART data among PLH. Potential areas of concern such as sufficient training and assistance for those with limited smartphone experience should be considered for future app-based research studies among PLH.

  5. Feasibility and Acceptability of a Smartphone App for Daily Reports of Substance Use and Antiretroviral Therapy Adherence among HIV-Infected Adults

    PubMed Central

    2016-01-01

    While substance use is one of the most consistent predictors of poor adherence to antiretroviral therapy (ART), few studies among people living with HIV (PLH) have utilized mobile phone-based assessment of these health behaviors. PLH were recruited from primary care clinics to report ART and substance use using a smartphone application (app) for 14 consecutive days. The app's feasibility as a data collection tool was evaluated quantitatively via surveys and qualitatively via in-depth interviews to assess daily report completion, compliance, and study satisfaction. Overall, 26 participants (M = 49.5 years, 76% male) completed 95.3% of time-based daily reports. Participants reported high satisfaction with the app and expressed future interest in using smartphones to report daily behaviors. High completion rates and participant acceptability suggest that smartphones are a feasible, acceptable method for collecting substance use and ART data among PLH. Potential areas of concern such as sufficient training and assistance for those with limited smartphone experience should be considered for future app-based research studies among PLH. PMID:27610243

  6. The efficacy and safety of high-dose arbekacin sulfate therapy (once-daily treatment) in patients with MRSA infection.

    PubMed

    Yamamoto, Yoshihiro; Izumikawa, Koichi; Hashiguchi, Koji; Fukuda, Yuichi; Kobayashi, Tsutomu; Kondo, Akira; Inoue, Yuichi; Morinaga, Yoshitomo; Nakamura, Shigeki; Imamura, Yoshifumi; Miyazaki, Taiga; Kakeya, Hiroshi; Yanagihara, Katsunori; Kohno, Shigeru

    2012-04-01

    The efficacy and safety of once-daily high-dose arbekacin sulfate therapy for methicillin-resistant Staphylococcus aureus (MRSA) infection were evaluated, with analysis of their relationship to blood drug levels. The study was conducted in patients with pneumonia or sepsis, the cause of which was suspected to be MRSA, who were admitted to the Nagasaki University Hospital or its affiliated hospitals between January 2009 and December 2010. The initial drug dose was set at a level expected to yield the goal peak of 20 μg/ml and a trough level of less than 2 μg/ml, using the Habekacin Therapeutic Drug Monitoring analysis software. Thirteen patients were enrolled: 10 patients had pneumonia and 3 patients had sepsis. Patient mean age was 72.0 years; mean initial drug dose was 269.2 mg. Clinical efficacy at completion of treatment and bacterial eradication-reduction were achieved in 66.7% (6/9) and 62.5% (5/8) of patients, respectively. Incidence of adverse reactions was 38.5% (5/13). In analysis of efficacy in relationship to serum drug levels, the peak drug level was 22.7 ± 5.50 μg/ml, on average, and 15 μg/ml or higher in all 6 responders. Also, in patients with renal dysfunction, it seemed to be essential to ensure a certain peak drug level and to control the trough level appropriately. Although the number of patients was limited, once-daily high-dose arbekacin sulfate therapy may be highly effective, without posing any major safety problems. Further larger-scale studies are needed.

  7. Assessment of Parotid Gland Dose Changes During Head and Neck Cancer Radiotherapy Using Daily Megavoltage Computed Tomography and Deformable Image Registration

    SciTech Connect

    Lee, Choonik Langen, Katja M.; Lu Weiguo; Haimerl, Jason; Schnarr, Eric; Ruchala, Kenneth J.; Olivera, Gustavo H.; Meeks, Sanford L.; Kupelian, Patrick A.; Shellenberger, Thomas D.; Manon, Rafael R.

    2008-08-01

    Purpose: To analyze changes in parotid gland dose resulting from anatomic changes throughout a course of radiotherapy in a cohort of head-and-neck cancer patients. Methods and Materials: The study population consisted of 10 head-and-neck cancer patients treated definitively with intensity-modulated radiotherapy on a helical tomotherapy unit. A total of 330 daily megavoltage computed tomography images were retrospectively processed through a deformable image registration algorithm to be registered to the planning kilovoltage computed tomography images. The process resulted in deformed parotid contours and voxel mappings for both daily and accumulated dose-volume histogram calculations. The daily and cumulative dose deviations from the original treatment plan were analyzed. Correlations between dosimetric variations and anatomic changes were investigated. Results: The daily parotid mean dose of the 10 patients differed from the plan dose by an average of 15%. At the end of the treatment, 3 of the 10 patients were estimated to have received a greater than 10% higher mean parotid dose than in the original plan (range, 13-42%), whereas the remaining 7 patients received doses that differed by less than 10% (range, -6-8%). The dose difference was correlated with a migration of the parotids toward the high-dose region. Conclusions: The use of deformable image registration techniques and daily megavoltage computed tomography imaging makes it possible to calculate daily and accumulated dose-volume histograms. Significant dose variations were observed as result of interfractional anatomic changes. These techniques enable the implementation of dose-adaptive radiotherapy.

  8. Tolerance to effects of high-dose oral δ9-tetrahydrocannabinol and plasma cannabinoid concentrations in male daily cannabis smokers.

    PubMed

    Gorelick, David A; Goodwin, Robert S; Schwilke, Eugene; Schwope, David M; Darwin, William D; Kelly, Deanna L; McMahon, Robert P; Liu, Fang; Ortemann-Renon, Catherine; Bonnet, Denis; Huestis, Marilyn A

    2013-01-01

    Oral cannabinoids are taken for medicinal or recreational purposes, yet little is known about tolerance to their effects after high-dose extended exposure. The development of tolerance to effects of around-the-clock oral synthetic Δ9-tetrahydrocannabinol (THC) (20 mg every 3.5-6 h) was evaluated in 13 healthy male daily cannabis smokers residing on a secure research unit: 40 mg on Day 1; 100 mg on Days 2-4; 120 mg on Days 5-6. Systolic and diastolic blood pressure (BP), heart rate, and symptoms of subjective intoxication (100 mm visual-analogue scales, VAS) were assessed the morning of Day 1 (before any oral THC), and on Days 2, 4 and 6, every 30 min for 3 h after the first morning THC dose. Morning subjective intoxication ratings increased from Days 1 to 2, and then declined on Days 4 and 6. The morning THC dose increased intoxication ratings on Day 2, but had less effect on Days 4 and 6, a pattern consistent with tolerance. THC lowered BP and increased heart rate over the six days. Plasma THC and 11-OH-THC concentrations increased significantly over the first five days of dosing. Six days of around-the-clock, oral THC produced tolerance to subjective intoxication, but not to cardiovascular effects. PMID:23074216

  9. Once Daily Dosing of Ceftriaxone and Metronidazole in Children With Perforated Appendicitis

    PubMed Central

    Ally, Saudia; Kelly, Brian; Kays, David; Thames, Lisa

    2016-01-01

    OBJECTIVES: The aim of this study was to compare hospital length of stay and rate of infectious complications in children with perforated appendicitis based on the postoperative antibiotic administered. METHODS: This study was a retrospective analysis of children with perforated appendicitis who underwent an appendectomy at a large academic medical center from 2008 to 2013. The primary outcome was hospital length of stay. The secondary outcomes were rates of abscess formation, wound infection, and 30-day readmissions. RESULTS: One hundred and twenty-three patients were included. Sixty-six patients (53%) were administered ceftriaxone and metronidazole once daily; 57 (47%) were administered other antibiotic regimens, which consisted of single, double, or triple antibiotic therapy with a beta-lactam backbone. There was no difference between the groups in terms of postoperative length of stay (5.7 versus 5.8 days, p = 0.83), postoperative abscess rate (8% versus 4%, p = 0.57), postoperative wound infection rate (5% versus 2%, p = 0.73), and 30-day readmissions (3% versus 11%, p = 0.19). CONCLUSIONS: While there was no statistically significant difierence in the outcomes evaluated, the rate of infectious complications was twofold higher in those given ceftriaxone and metronidazole than in others. A larger prospective randomized controlled trial is warranted to better understand the risks of using these agents. PMID:27199621

  10. Dietary intake of pesticide chemicals. Calculated daily consumption of pesticides with foods are discussed and compared with currently accepted values.

    PubMed

    Duggan, R E; Weatherwax, J R

    1967-09-01

    Residues of chlorinated organic pesticide chemicals were commonly found in all diet samples and all food classes within samples except beverages at a daily intake of 0.0014 mg per kilogram of body weight. Meat, fish, and poultry were the major source of pesticide residues and, when combined with dairy products, account for more than half of the intake of chlorinated organic pesticide chemicals. Fruits, garden fruits, and grain foods each accounted for about 10 percent of the intake of chlorinated pesticides. The DDT, its two analogs, dieldrin, lindane, and heptachlor epoxide account for 85 percent of the total intake of chlorinated pesticides. A single pesticide, DDT, accounts for one-third of the total. There was no statistically significant change in frequency or quantities of these compounds during this study. Frequency and quantities of the 14 additional chlorinated pesticides were too low to be meaningful.

  11. SU-E-T-86: Comparison of Two Commercially Available Programs for the Evaluation of Delivered Daily Dose Using Cone Beam CT (CBCT)

    SciTech Connect

    Tuohy, R; Bosse, C; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

    2014-06-01

    Purpose: In this study, two commercially available programs were compared for the evaluation of delivered daily dose using cone beam CT (CBCT). Methods: Thirty (n=30) patients previously treated in our clinic (10 prostate, 10 SBRT lung and 10 abdomen) were used in this study. The patients' plans were optimized and calculated using the Pinnacle treatment planning system. The daily CBCT scans were imported into Velocity and RayStation along with the corresponding planning CTs, structure sets and 3D dose distributions for each patient. The organs at risk (OAR) were contoured on each CBCT by the prescribing physician and were included in the evaluation of the daily delivered dose. Each CBCT was registered to the planning CT, once with rigid registration and then again, separately, with deformable registration. After registering each CBCT, the dose distribution from the planning CT was overlaid and the dose volume histograms (DVH) for the OAR and the planning target volumes (PTV) were calculated. Results: For prostate patients, we observed daily volume changes for the OARs. The DVH analysis for those patients showed variation in the sparing of the OARs while PTV coverage remained virtually unchanged using both Velocity and RayStation systems. Similar results were observed for abdominal patients. In contrast, for SBRT lung patients, the DVH for the OARs and target were comparable to those from the initial treatment plan. Differences in organ volume and organ doses were also observed when comparing the daily fractions using deformable and rigid registrations. Conclusion: By using daily CBCT dose reconstruction, we proved PTV coverage for prostate and abdominal targets is adequate. However, there is significant dosimetric change for the OARs. For lung SBRT patients, the delivered daily dose for both PTV and OAR is comparable to the planned dose with no significant differences.

  12. Successful introduction of a daily checklist to enhance compliance with accepted standards of care in the medical intensive care unit.

    PubMed

    Nama, A; Sviri, S; Abutbul, A; Stav, I; van Heerden, P V

    2016-07-01

    We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient. It was also noted each day which of the elements of the checklist had been forgotten and was therefore prompted to be completed by use of the checklist. Of the 75 patients surveyed there were 99 occasions, in 48 patients, when the checklist detected a forgotten element of the bundle of care (i.e. in 64% of patients). There was a decrease in the incidence of missed elements of the bundle of care the longer the patient stayed in the ICU. Types of missed elements varied with the duration of the ICU stay. We found that the introduction of a simple checklist, developed in collaboration with the junior medical staff who would be using the checklist every day in the ICU, resulted in the detection and correction of missed elements of a bundle of care we had previously introduced in the ICU.

  13. Successful introduction of a daily checklist to enhance compliance with accepted standards of care in the medical intensive care unit.

    PubMed

    Nama, A; Sviri, S; Abutbul, A; Stav, I; van Heerden, P V

    2016-07-01

    We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient. It was also noted each day which of the elements of the checklist had been forgotten and was therefore prompted to be completed by use of the checklist. Of the 75 patients surveyed there were 99 occasions, in 48 patients, when the checklist detected a forgotten element of the bundle of care (i.e. in 64% of patients). There was a decrease in the incidence of missed elements of the bundle of care the longer the patient stayed in the ICU. Types of missed elements varied with the duration of the ICU stay. We found that the introduction of a simple checklist, developed in collaboration with the junior medical staff who would be using the checklist every day in the ICU, resulted in the detection and correction of missed elements of a bundle of care we had previously introduced in the ICU. PMID:27456181

  14. SU-E-J-181: Effect of Prostate Motion On Combined Brachytherapy and External Beam Dose Based On Daily Motion of the Prostate

    SciTech Connect

    Narayana, V; McLaughlin, P; Ealbaj, J

    2015-06-15

    Purpose: In this study, the adequacy of target expansions on the combined external beam and implant dose was examined based on the measured daily motion of the prostate. Methods: Thirty patients received an I–125 prostate implant prescribed to dose of 90Gy. This was followed by external beam to deliver a dose of 90Gyeq (external beam equivalent) to the prostate over 25 to 30 fractions. An ideal IMRT plan was developed by optimizing the external beam dose based on the delivered implant dose. The implant dose was converted to an equivalent external beam dose using the linear quadratic model. Patients were set up on the treatment table by daily orthogonal imaging and aligning the marker seeds in the prostate. Orthogonal images were obtained at the end of treatment to assess prostate intrafraction motion. Based on the observed motion of the markers between the initial and final images, 5 individual plans showing the actual dose delivered to the patient were calculated. A final true dose distribution was established based on summing the implant dose and the 5 external beam plans. Dose to the prostate, seminal vesicles, lymphnodes and normal tissues, rectal wall, urethra and lower sphincter were calculated and compared to ideal. On 18 patients who were sexually active, dose to the corpus cavernosum and internal pudendal artery was also calculated. Results: The average prostate motion in 3 orthogonal directions was less than 1 mm with a standard deviation of less than +2 mm. Dose and volume parameters showed that there was no decrease in dose to the targets and a marginal decrease in dose to in normal tissues. Conclusion: Dose delivered by seed implant moves with the prostate, decreasing the impact of intrafractions dose movement on actual dose delivered. Combined brachytherapy and external beam dose delivered to the prostate was not sensitive to prostate motion.

  15. Analysis of clinical efficacy, side effects, and laboratory changes among patients with acne vulgaris receiving single versus twice daily dose of oral isotretinoin.

    PubMed

    Ahmad, Hesham M

    2015-01-01

    Acne vulgaris is a debilitating disorder and requires proper treatment. This work evaluates the clinical efficacy, side effects, and laboratory changes of serum lipids and liver function during oral isotretinoin therapy for acne vulgaris, comparing single versus twice daily dose. Fifty-eight patients with acne vulgaris were included and randomized into group I (26 patients), who received once daily dose, and group II (32 patients), who received twice daily dose of oral isotretinoin. Global acne scoring system was used to evaluate acne severity and post-treatment improvement. Both regimens resulted in highly significant clinical improvement of acne with no significant difference. However, side effects were significantly more common among patients of group I. Both regimens caused mild rise of serum cholesterol, alanine transaminase (ALT), and aspartate aminotransferase (AST) with more prominent rise of triglycerides especially with twice daily dose. Oral isotretinoin is a very effective treatment for acne vulgaris with no statistically significant difference in clinical efficacy between once and twice daily doses. However, dividing dose to twice per day might cause fewer incidence of side effects without reducing clinical efficacy. The drug causes mild clinically insignificant rise of serum cholesterol, triglycerides, AST, and ALT.

  16. Using Acceptance and Commitment Therapy during Methadone Dose Reduction: Rationale, Treatment Description, and a Case Report

    ERIC Educational Resources Information Center

    Stotts, Angela L.; Masuda, Akihiko; Wilson, Kelly

    2009-01-01

    Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from an MM client who voluntarily participated in an Acceptance and…

  17. A multiple dose powder inhaler (Turbuhaler) compared with a conventional aerosol. An acceptance study in asthmatics.

    PubMed

    Osterman, K; Norborg, A M; Stähl, E

    1989-05-01

    Nineteen patients with asthma completed an open, randomized, crossover study in which 0.5 mg terbutaline sulphate was administered either via Turbuhaler or via the metered dose inhaler (MDI) for 2-week periods. The clinical effect of the two treatment forms was comparable; both provided adequate bronchodilator therapy. Patients also considered Turbuhaler and MDI equally effective, with a small preference for the MDI. Turbuhaler seems to be a valuable alternative to bronchodilator MDI therapy. PMID:2735519

  18. Pharmacological Doses of Daily Ascorbate Protect Tumors from Radiation Damage after a Single Dose of Radiation in an Intracranial Mouse Glioma Model

    PubMed Central

    Grasso, Carole; Fabre, Marie-Sophie; Collis, Sarah V.; Castro, M. Leticia; Field, Cameron S.; Schleich, Nanette; McConnell, Melanie J.; Herst, Patries M.

    2014-01-01

    Pharmacological ascorbate is currently used as an anti-cancer treatment, potentially in combination with radiation therapy, by integrative medicine practitioners. In the acidic, metal-rich tumor environment, ascorbate acts as a pro-oxidant, with a mode of action similar to that of ionizing radiation; both treatments kill cells predominantly by free radical-mediated DNA damage. The brain tumor, glioblastoma multiforme (GBM), is very resistant to radiation; radiosensitizing GBM cells will improve survival of GBM patients. Here, we demonstrate that a single fraction (6 Gy) of radiation combined with a 1 h exposure to ascorbate (5 mM) sensitized murine glioma GL261 cells to radiation in survival and colony-forming assays in vitro. In addition, we report the effect of a single fraction (4.5 Gy) of whole brain radiation combined with daily intraperitoneal injections of ascorbate (1 mg/kg) in an intracranial GL261 glioma mouse model. Tumor-bearing C57BL/6 mice were divided into four groups: one group received a single dose of 4.5 Gy to the brain 8 days after tumor implantation, a second group received daily intraperitoneal injections of ascorbate (day 8–45) after implantation, a third group received both treatments and a fourth control group received no treatment. While radiation delayed tumor progression, intraperitoneal ascorbate alone had no effect on tumor progression. Tumor progression was faster in tumor-bearing mice treated with radiation and daily ascorbate than in those treated with radiation alone. Histological analysis showed less necrosis in tumors treated with both radiation and ascorbate, consistent with a radio-protective effect of ascorbate in vivo. Discrepancies between our in vitro and in vivo results may be explained by differences in the tumor microenvironment, which determines whether ascorbate remains outside the cell, acting as a pro-oxidant, or whether it enters the cells and acts as an anti-oxidant. PMID:25566497

  19. Investigating CT to CBCT image registration for head and neck proton therapy as a tool for daily dose recalculation

    SciTech Connect

    Landry, Guillaume; Nijhuis, Reinoud; Thieke, Christian; Reiner, Michael; Ganswindt, Ute; Belka, Claus; Dedes, George; Handrack, Josefine; Parodi, Katia; Janssens, Guillaume; Orban de Xivry, Jonathan; Kamp, Florian; Wilkens, Jan J.; Paganelli, Chiara; Riboldi, Marco; Baroni, Guido

    2015-03-15

    Purpose: Intensity modulated proton therapy (IMPT) of head and neck (H and N) cancer patients may be improved by plan adaptation. The decision to adapt the treatment plan based on a dose recalculation on the current anatomy requires a diagnostic quality computed tomography (CT) scan of the patient. As gantry-mounted cone beam CT (CBCT) scanners are currently being offered by vendors, they may offer daily or weekly updates of patient anatomy. CBCT image quality may not be sufficient for accurate proton dose calculation and it is likely necessary to perform CBCT CT number correction. In this work, the authors investigated deformable image registration (DIR) of the planning CT (pCT) to the CBCT to generate a virtual CT (vCT) to be used for proton dose recalculation. Methods: Datasets of six H and N cancer patients undergoing photon intensity modulated radiation therapy were used in this study to validate the vCT approach. Each dataset contained a CBCT acquired within 3 days of a replanning CT (rpCT), in addition to a pCT. The pCT and rpCT were delineated by a physician. A Morphons algorithm was employed in this work to perform DIR of the pCT to CBCT following a rigid registration of the two images. The contours from the pCT were deformed using the vector field resulting from DIR to yield a contoured vCT. The DIR accuracy was evaluated with a scale invariant feature transform (SIFT) algorithm comparing automatically identified matching features between vCT and CBCT. The rpCT was used as reference for evaluation of the vCT. The vCT and rpCT CT numbers were converted to stopping power ratio and the water equivalent thickness (WET) was calculated. IMPT dose distributions from treatment plans optimized on the pCT were recalculated with a Monte Carlo algorithm on the rpCT and vCT for comparison in terms of gamma index, dose volume histogram (DVH) statistics as well as proton range. The DIR generated contours on the vCT were compared to physician-drawn contours on the rp

  20. Examining Margin Reduction and Its Impact on Dose Distribution for Prostate Cancer Patients Undergoing Daily Cone-Beam Computed Tomography

    SciTech Connect

    Hammoud, Rabih Patel, Samir H.; Pradhan, Deepak; Kim, Jinkoo; Guan, Harrison; Li Shidong; Movsas, Benjamin

    2008-05-01

    Purpose: To examine the dosimetric impact of margin reduction and quantify residual error after three-dimensional (3D) image registration using daily cone-beam computed tomography (CBCT) for prostate cancer patients. Methods and Materials: One hundred forty CBCTs from 5 prostate cancer patients were examined. Two intensity-modulated radiotherapy plans were generated on CT simulation on the basis of two planning target volume (PTV) margins: 10 mm all around the prostate and seminal vesicles except 6 mm posteriorly (10/6) and 5 mm all around except 3 mm posteriorly (5/3). Daily CBCT using the Varian On-Board Imaging System was acquired. The 10/6 and 5/3 simulation plans were overlaid onto each CBCT, and each CBCT plan was calculated. To examine residual error, PlanCT/CBCT intensity-based 3D image registration was performed for prostate localization using center of mass and maximal border displacement. Results: Prostate coverage was within 2% between the 10/6 and 5/3 plans. Seminal vesicle coverage was reduced with the 5/3 plan compared with the 10/6 plan, with coverage difference within 7%. The 5/3 plan allowed 30-50% sparing of bladder and rectal high-dose regions. For residual error quantification, center of mass data show that 99%, 93%, and 96% of observations fall within 3 mm in the left-right, anterior-posterior, and superior-inferior directions, respectively. Maximal border displacement observations range from 79% to 99%, within 5 mm for all directions. Conclusion: Cone-beam CT dosimetrically validated a 10/6 margin when soft-tissue localization is not used. Intensity-based 3D image registration has the potential to improve target localization and to provide guidelines for margin definition.

  1. Pharmacokinetics and tolerability of daptomycin at doses up to 12 milligrams per kilogram of body weight once daily in healthy volunteers.

    PubMed

    Benvenuto, Mark; Benziger, David P; Yankelev, Sara; Vigliani, Gloria

    2006-10-01

    Daptomycin, a novel lipopeptide, is bactericidal against a broad range of gram-positive strains, including methicillin- (MRSA) and vancomycin-resistant Staphylococcus aureus. Daptomycin is approved at 4 mg/kg of body weight given intravenously once daily for the treatment of complicated skin and skin structure infections and at 6 mg/kg for the treatment of S. aureus bloodstream infections (bacteremia), including right-sided endocarditis caused by methicillin-susceptible S. aureus and MRSA. The present study was designed to evaluate the multiple-dose pharmacokinetics and safety of daptomycin at doses of 6 to 12 mg/kg in healthy volunteers. Three cohorts of 12 subjects each were given daptomycin (10 mg/kg) or placebo once daily for 14 days, daptomycin (12 mg/kg) or placebo once daily for 14 days, or daptomycin (6 or 8 mg/kg) once daily for 4 days. Daptomycin produced dose-proportional increases in the area under the plasma concentration-time curve and in trough daptomycin levels and nearly dose-proportional increases in peak daptomycin concentrations. Other pharmacokinetic parameters measured on day 1 and at steady state were independent of the dose, including the half-life (approximately 8 h), weight-normalized plasma clearance (9 to 10 ml/h/kg), and volume of distribution (approximately 100 ml/kg). Plasma protein binding was 90% to 93% and was independent of the daptomycin concentration. Daptomycin did not produce electrocardiographic abnormalities or electrophysiological evidence of muscle or nerve toxicity. Daptomycin was well tolerated in subjects dosed with up to 12 mg/kg intravenously for 14 days. Doses of daptomycin higher than 6 mg/kg once daily may be considered in further studies to evaluate the safety and efficacy of daptomycin in difficult-to-treat infections.

  2. Twice- or Once-Daily Dosing of Novel Oral Anticoagulants for Stroke Prevention: A Fixed-Effects Meta-Analysis with Predefined Heterogeneity Quality Criteria

    PubMed Central

    Clemens, Andreas; Noack, Herbert; Brueckmann, Martina; Lip, Gregory Y. H.

    2014-01-01

    Background A number of novel oral anticoagulants (direct thrombin inhibitors or factor Xa inhibitors) are in clinical use for various indications. The dosing regimens differ between twice-daily and once-daily dosing for the prevention of stroke in patients with atrial fibrillation. With the availability of the results from four phase 3 studies (>70,000 patients), we explored whether twice-daily or once-daily dosing provides better risk-benefit balance among novel oral anticoagulants. Methods We conducted a strict, stepwise, fixed-effects meta-analysis with predefined heterogeneity quality criteria to generate the most appropriate common estimates for twice-daily (BID) or once-daily (QD) dosing regimens. An indirect comparison of these dosing regimens with fixed-effects meta-analysis common estimates (where available), or individual compound results, was done respectively. Results Comparing indirectly BID vs QD dosing regimens resulted in hazard ratios (HR [95% confidence interval]) for stroke and systemic embolism of 0.75 (0.58–0.96) for dabigatran 150 mg BID, and 0.91 (0.73–1.13) for apixaban BID vs the QD dosing regimen. For ischemic stroke, the HR of BID vs QD was 0.85 (0.69–1.05). For intracranial hemorrhage, BID vs rivaroxaban QD was 0.57 (0.37–0.88) and, vs edoxaban QD, 0.81 (0.54–1.22). Due to heterogeneity, common estimates for major bleeding QD or BID were not justified, therefore indirect comparison of regimens were not possible. All non-vitamin K antagonist oral anticoagulants reduced all-cause mortality vs warfarin with a HR of 0.90 (0.86–0.96) without differences between regimen. Conclusions Based on the available phase 3 study evidence, the twice-daily dosing regimen of non-vitamin K antagonist oral anticoagulants appears to offer a more balanced risk-benefit profile with respect to stroke prevention and intracranial hemorrhage. PMID:24911432

  3. Reasons for raising the maximum acceptable daily intake of EDTA and the benefits for iron fortification of foods for children 6-24 months of age.

    PubMed

    Wreesmann, Carel Theo Jozef

    2014-10-01

    The current maximum acceptable daily intake (ADI) of ethylenediaminetetraacetic acid (EDTA) of 1.9 mg day(-1) per kilogram bodyweight (mg day(-1)  kgbw(-1) ) limits the daily intake of iron as iron EDTA [ferric sodium EDTA; sodium iron(III) EDTA] to approximately 2-2.5 mg day(-1) for children 6-24 months of age. This limit was defined by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1973 based on data from an animal-feed study published in 1963. Other animal studies indicate that this limit can be raised to 4.4 or possibly up to 21.7 mg day(-1)  kgbw(-1) , which is 2.3-11.4 times higher than the current value. For nearly 50 years, iron EDTA has been used in France in medicinal syrup for infants 1-6 months of age. The maximum recommended dosage of this drug is 37 times higher than the maximum ADI of EDTA. No adverse health effects have been reported as a result of this medicinal consumption of iron EDTA. Raising the maximum ADI of EDTA to only 4.4 mg day(-1)  kgbw(-1) would enable iron EDTA, an iron fortificant with proven bioavailability in phytate-rich meals, to be added in adequate amounts to cereal-based meals for children 6-24 months of age, who are at risk of iron deficiency.

  4. Do We Need Daily Image-Guided Radiotherapy by Megavoltage Computed Tomography in Head and Neck Helical Tomotherapy? The Actual Delivered Dose to the Spinal Cord

    SciTech Connect

    Duma, Marciana Nona; Kampfer, Severin; Schuster, Tibor; Aswathanarayana, Nandana; Fromm, Laura-Sophie; Molls, Michael; Andratschke, Nicolaus; Geinitz, Hans

    2012-09-01

    Purpose: To quantify the actual delivered dose to the cervical spinal cord with different image-guided radiotherapy (IGRT) approaches during head and neck (HN) cancer helical tomotherapy. Methods and Materials: Twenty HN patients (HNpts) treated with bilateral nodal irradiation were analyzed. Daily megavoltage computed tomography MVCT) scans were performed for setup purposes. The maximum dose on the planning CT scan (plan-Dmax) and the magnitude and localization of the actual delivered Dmax (a-Dmax) were analyzed for four scenarios: daily image-guided radiotherapy (dIGRT), twice weekly IGRT (2 Multiplication-Sign WkIGRT), once weekly IGRT (1 Multiplication-Sign WkIGRT), and no IGRT at all (non-IGRT). The spinal cord was recontoured on 236 MVCTs for each scenario (total, 944 fractions), and the delivered dose was recalculated for each fraction (fx) separately. Results: Fifty-one percent of the analyzed fx for dIGRT, 56% of the analyzed fx for the 2 Multiplication-Sign WkIGRT, 62% of the analyzed fx for the 1 Multiplication-Sign WkIGRT, and 63% of the analyzed fx for the non-IGRT scenarios received a higher a-Dmax than the plan-Dmax. The median increase of dose in these fx was 3.3% more for dIGRT, 5.8% more for 2 Multiplication-Sign WkIGRT, 10.0% more for 1 Multiplication-Sign WkIGRT, and 9.5% more for non-IGRT than the plan-Dmax. The median spinal cord volumes receiving a higher dose than the plan-Dmax were 0.02 cm{sup 3} for dIGRT, 0.11 cm{sup 3} for 2 Multiplication-Sign WkIGRT, 0.31 cm{sup 3} for 1 Multiplication-Sign WkIGRT, and 0.22 cm{sup 3} for non-IGRT. Differences between the dIGRT and all other scenarios were statistically significant (p < 0.05). Conclusions: Compared to the Dmax of the initial plan, daily IGRT had the smallest increase in dose. Furthermore, daily IGRT had the lowest proportion of fractions and the smallest volumes affected by a dose that was higher than the planned dose. For patients treated with doses close to the tolerance dose of the

  5. Short-term low-dose secondary prophylaxis for severe/moderate haemophilia A children is beneficial to reduce bleed and improve daily activity, but there are obstacle in its execution: a multi-centre pilot study in China.

    PubMed

    Tang, L; Wu, R; Sun, J; Zhang, X; Feng, X; Zhang, X; Luke, K-H; Poon, M-C

    2013-01-01

    We recently showed in a single centre trial that low-dose secondary prophylaxis in severe/moderate haemophilia patients with arthropathy is feasible and beneficial. However, this regimen has not been validated in a multicentre setting and what obstacles are there to prophylaxis remain unclear. (i) Benefit study: to confirm the benefits of similar prophylaxis protocol in severe/moderate haemophilia A (HA) in a multicentre setting in China. (ii) Follow-up obstacle study: to investigate obstacles in compliance to prophylaxis treatment. (i) Benefit study: severe/moderate HA children with arthropathy from 15 centres were enrolled to undergo an 8-week on-demand treatment, followed by 6 to 12-week low-dose secondary prophylaxis. Outcomes compared in the two periods include joint and severe bleeding, daily activities and factor consumption. (ii) Obstacle study: questionnaires to investigators to collect data on patient and centre factors contributing to inability to comply with prophylaxis. We enrolled 191 patients from 15 centres. Sixty-six (34.6%) from three centres completed the prophylaxis protocol, and they had significantly decreased bleeding (78.8% haemarthrosis and 68.9% severe bleedings) and improved daily activities with no increase in factor consumption over that in the on-demand therapy period. The remaining 125 patients from 12 centres were not compliant to the prophylaxis protocol; questionnaire data indicated that the major obstacles were inability of patients/parents to accept (41.7%) or to adhere (33.3%) to the prophylaxis protocol, mostly because of failure to understand the benefits and to accept the frequent injections. Non-availability of a centre comprehensive care team was another important determinant. Short-term low-dose secondary prophylactic therapy is beneficial without increasing factors consumption for severe/moderate HA with arthropathy in a multi-centre setting in China. Obstacles to overcome must include improvement in comprehensive care

  6. The Influences of Withdrawal and Daily Dose Reduction of Pioglitazone on Metabolic Parameters in Patients With Type 2 Diabetes: A Retrospective Longitudinal Observational Study

    PubMed Central

    Katsuyama, Hisayuki; Fukunaga, Takayuki; Hamasaki, Hidetaka; Adachi, Hiroki; Moriyama, Sumie; Kawaguchi, Akiko; Mishima, Shuichi; Sako, Akahito; Yanai, Hidekatsu

    2016-01-01

    Background The aim of the study was to understand the influences of withdrawal or dose reduction of pioglitazone in patients with type 2 diabetes. Methods We retrospectively picked up patients who had undergone withdrawal or daily dose reduction of pioglitazone after a continuous prescription for 3 months or longer between January 2010 and March 2014. We compared the data before the withdrawal or dose reduction of pioglitazone with the data at 3 or 6 months after those by a chart-based analysis. Results Among 713 patients taking pioglitazone at least once during the studied period, 20 patients had undergone withdrawal of pioglitazone (group A) and 51 patients had undergone daily dose reduction (group B). The mean pioglitazone dose at baseline was 23 mg in subjects of group A, and 30 mg in group B. The number of subjects who had taken high-dose metformin (≥ 1,000 mg) and dipeptidyl peptidase-4 (DPP-4) inhibitors increased after the withdrawal or dose reduction of pioglitazone in both groups. Although no significant change was observed in plasma glucose and HbA1c levels, body weight significantly decreased at 3 and 6 months after the dose reduction in group B. The same tendency was observed in group A. Serum high-density lipoprotein-cholesterol (HDL-C) levels significantly decreased at 3 and 6 months after the withdrawal in group A. The serum alanine aminotransferase levels significantly increased 3 months after the withdrawal in group A. Conclusions Present study demonstrated that the withdrawal of pioglitazone exacerbated serum HDL-C and liver function in patients with type 2 diabetes, although glycemic control could be maintained by using high-dose metformin or DPP-4 inhibitors. PMID:27429679

  7. Three in one: safety, efficacy, and patient acceptability of triple fixed-dose combination medicine in the management of hypertension

    PubMed Central

    Taylor, Addison A; Ragbir, Shawn

    2012-01-01

    Hypertensive patients whose blood pressures are more than 20 mmHg above their goal will often require three or more medications. Careful selection of medications whose actions are complementary or have an improved adverse effect profile when combined can affect not only the blood pressure but also patient acceptance, thus improving persistence in taking the medications as prescribed. This review will highlight the three single-pill three-drug combinations currently available in the US and will address their efficacy, safety, and tolerability. All three include the dihydropyridine calcium-channel blocker, amlodipine, and the thiazide diuretic, hydrochlorothiazide. They each contain a different renin–angiotensin system blocker. One includes the angiotensin-receptor blocker, olmesartan, while another contains valsartan. The third combination includes the direct renin inhibitor, aliskiren. All three fixed-dose combinations (FDC) at maximum doses of each component lowers the blood pressure of patients with stage II hypertension by 37 to 40 mmHg systolic and 21 to 25 mmHg diastolic, which is superior to any two of the components that comprise the three-drug FDC. These drugs are effective in males and females, the elderly, diabetics, minority populations, and patients with metabolic syndrome. Triple-drug FDCs are well tolerated with a low incidence of adverse effects, the most common being peripheral edema related to amlodipine. Extrapolation of data from two-drug FDC suggests that medication compliance (adherence and persistence) should be better with these FDCs than with the individual components taken as separate medications, although additional studies are necessary to confirm this. PMID:22927748

  8. Association between Total Daily Doses with duration of hospitalization among readmitted patients in a multi-ethnic Asian population

    PubMed Central

    Teo, Vivien; Toh, Ming Ren; Kwan, Yu Heng; Raaj, Sreemanee; Tan, Su-Yin Doreen; Tan, Joyce Zhen Yin

    2015-01-01

    Increased length of stay (LOS) in the hospital incurs substantial financial costs on the healthcare system. Multiple factors are associated with LOS. However, few studies have been done to associate the impact of Total Daily Doses (TDD) and LOS. Hence, the aim of this study is to examine the association between patients’ LOS upon readmission and their TDD before readmission. A retrospective cross-sectional study of readmission cases occurring from 1st January to 31st March 2013 was conducted at a regional hospital. Demographics and clinical variables were collected using electronic medical databases. Univariable and multiple linear regressions were used. Confounders such as comorbidities and drug related problems (DRP) were controlled for in this study. There were 432 patients and 649 readmissions examined. The average TDD and LOS were 18.04 ± 8.16 and 7.63 days ± 7.08 respectively. In the univariable analysis, variables that were significantly associated with the LOS included age above 75 year-old, race, comorbidity, number of comorbidities, number of medications, TDD and thrombocytopenia as DRPs. In the multiple linear regression, there was a statistically significant association between TDD (β = 0.0733, p = 0.030) and LOS. Variables that were found significant were age above 75 year-old (β = 1.5477, p = 0.008), Malay (β = −1.5123, p = 0.033), other races (β = −2.6174, p = 0.007), depression (β = 2.1551, p = 0.031) and thrombocytopenia as a type of DRP (β = 7.5548, p = 0.027). When TDD was replaced with number of medications, number of medications (β = 0.1487, p = 0.021), age of 75 year-old (β = 1.5303, p = 0.009), Malay (β = −1.4687, p = 0.038), race of others (β = −2.6499, p = 0.007), depression (β = 2.1951, p = 0.028) and thrombocytopenia as a type of DRP (β = 7.5260, p = 0.028) were significant. In conclusion, a significant relationship between TDD and number of medications before

  9. Stereotactic Body Radiation Therapy for Liver Tumors: Impact of Daily Setup Corrections and Day-to-Day Anatomic Variations on Dose in Target and Organs at Risk

    SciTech Connect

    Mendez Romero, Alejandra; Zinkstok, Roel Th.; Wunderink, Wouter; Os, Rob M. van; Joosten, Hans; Seppenwoolde, Yvette; Nowak, Peter; Brandwijk, Rene P.; Verhoef, Cornelis; Ijzermans, Jan N.M.; Levendag, Peter C.; Heijmen, Ben J.M.

    2009-11-15

    Purpose: To assess day-to-day differences between planned and delivered target volume (TV) and organ-at-risk (OAR) dose distributions in liver stereotactic body radiation therapy (SBRT), and to investigate the dosimetric impact of setup corrections. Methods and Materials: For 14 patients previously treated with SBRT, the planning CT scan and three treatment scans (one for each fraction) were included in this study. For each treatment scan, two dose distributions were calculated: one using the planned setup for the body frame (no correction), and one using the clinically applied (corrected) setup derived from measured tumor displacements. Per scan, the two dose distributions were mutually compared, and the clinically delivered distribution was compared with planning. Doses were recalculated in equivalent 2-Gy fraction doses. Statistical analysis was performed with the linear mixed model. Results: With setup corrections, the mean loss in TV coverage relative to planning was 1.7%, compared with 6.8% without corrections. For calculated equivalent uniform doses, these figures were 2.3% and 15.5%, respectively. As for the TV, mean deviations of delivered OAR doses from planning were small (between -0.4 and +0.3 Gy), but the spread was much larger for the OARs. In contrast to the TV, the mean impact of setup corrections on realized OAR doses was close to zero, with large positive and negative exceptions. Conclusions: Daily correction of the treatment setup is required to obtain adequate TV coverage. Because of day-to-day patient anatomy changes, large deviations in OAR doses from planning did occur. On average, setup corrections had no impact on these doses. Development of new procedures for image guidance and adaptive protocols is warranted.

  10. Recombinant LH supplementation during IVF cycles with a GnRH-antagonist in estimated poor responders: A cross-matched pilot investigation of the optimal daily dose and timing

    PubMed Central

    GIZZO, SALVATORE; ANDRISANI, ALESSANDRA; NOVENTA, MARCO; MANFÈ, SERENA; OLIVA, ALESSANDRA; GANGEMI, MICHELE; NARDELLI, GIOVANNI BATTISTA; AMBROSINI, GUIDO

    2015-01-01

    Although it is widely accepted that patients, who are considered poor responders to in vitro fertilization (IVF) benefit from recombinant luteinizing hormone (rLH) supplementation during an in vitro fertilization cycle, particularly when gonadotropin-releasing hormone (GnRH) antagonist (ant) treatment is used the optimal administration timing and daily dose of rLH remains to be elucidated. The aim of the present study was to investigate the optimal timing of rLH-supplementation to improve ovarian response, embryo quality, endometrial thickness and pregnancy rate in infertile, estimated poor responders to IVF, undergoing GnRH-ant treatment. In addition, the present study aimed to evaluate the optimal daily dose to achieve the same outcomes. A prospective-randomized-cross-matched investigation was performed on 40 patients undergoing a GnRH-ant-treatment-cycle The patients were randomly assigned to either group A (rLH-75 IU/day) or group B (rLH-150 IU/day) and further randomized into subgroup A1/B1, in which rLH was administered at recombinant follicle stimulating hormone (rFSH) administration, and subgroup A2/B2, in which rLH was administered at GnRH-ant administration. Patients who did not become pregnant during the first cycle (35 patients), were treated a second time, cross-matched for groups and subgroups. Improved ovarian response, embryo quality and pregnancy rate were achieved by administering rLH at 150 IU/day, starting from GnRH-ant administration, independently from the total rLH dose administered. Improved endometrial thickness at oocyte retrieval day was achieved by administering rLH at 150 IU from the start of rFSH administration. These data led to the hypothesis that ovarian responses are affected by the timing of administration more than the total-dose of rLH. The optimal window to administer rLH appears to be the mid-to-late follicular phase, despite the fact that rLH-supplementation in the early follicular phase appeared to increase endometrial

  11. Comparison of the efficacy and safety of once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction.

    PubMed

    Park, Soon Hyun; Park, Sung Woo; Cha, Bong Yun; Park, Ie Byung; Min, Kyung Wan; Sung, Yeon Ah; Kim, Tae Hwa; Lee, Jae Min; Park, Kang Seo

    2015-01-01

    We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction (ED). A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile (SEP) diary Question 2 and 3 (Q2 and Q3) were randomized into 200 mg on-demand (n = 80) or 50 mg once-daily (n = 81) dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function (IIEF) erectile function domain (EFD) score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate (EFD ≥ 26). Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment (P < 0.0001). There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients.

  12. Single- and multiple-dose pharmacokinetics of ethambutol and rifampicin in a tuberculosis patient with acute respiratory distress syndrome undergoing extended daily dialysis and ECMO treatment.

    PubMed

    Strunk, Ann-Kathrin; Ciesek, Sandra; Schmidt, Julius J; Kühn, Christian; Hoeper, Marius M; Welte, Tobias; Kielstein, Jan T

    2016-01-01

    The dosing of drugs in critically ill patients undergoing renal replacement therapy is based on limited data. We report for the first time single- and multiple-dose pharmacokinetics of ethambutol (EMB), which is cleared renally to 80%, and rifampicin (RIF), which is cleared renally to <30%, in a patient requiring both extracorporeal membrane oxygenation (ECMO) and renal replacement therapy. Extended dialysis removed a considerable amount of both EMB and RIF, with a dialyser plasma clearance ranging between 37 and 95 ml/min for EMB and between 39 and 53 ml/min for RIF. The EMB peak level (3h after a 2-h infusion) using a dose of 1000 mg/day on the first day of treatment was 2.3mg/l, which is in the low therapeutic range (2-5mg/l). Doubling the dose to 2000 mg/day resulted in peak levels slightly to markedly above the recommended range. There was no detectable effect of the ECMO membrane on the removal of both drugs. After an initial dose as for patients without renal impairment (15 mg/kg/day), therapeutic drug monitoring should be used to guide EMB dosing in patients undergoing extended daily dialysis. PMID:26518065

  13. Twice daily dosing of aspirin improves platelet inhibition in whole blood in patients with type 2 diabetes mellitus and micro- or macrovascular complications.

    PubMed

    Spectre, Galia; Arnetz, Lisa; Östenson, Claes-Göran; Brismar, Kerstin; Li, Nailin; Hjemdahl, Paul

    2011-09-01

    The efficacy of low-dose aspirin in type 2 diabetes mellitus (T2DM) has been questioned. We tested if twice daily dosing of aspirin would be more effective in T2DM, possibly due to increased platelet turnover. A randomised cross-over study compared 75 mg aspirin OD, 75 mg BID and 320 mg OD (≥ 2 week treatment periods) in 25 patients with T2DM and micro- or macrovascular complications. Platelet responses were examined by impedance aggregometry (WBA) and the IMPACT-R aspirin test in whole blood, light transmittance aggregometry in platelet-rich plasma (LTA), and urinary 11-dehydro-thromboxane B2 (TxM). Aspirin 75 mg BID decreased arachidonic acid (AA)-induced WBA compared to 75 mg OD (9.7 ± 4.5 vs. 12.6 ± 3.5 ohm; p = 0.003) or to 320 mg OD (11.5 ± 4.2 Ohms; p = 0.049). WBA responses to collagen were similarly attenuated by BID or high dosing (by 12-14%; p = 0.02 for both). The IMPACT-R showed a better response to 75 mg BID compared to 75 mg OD (p = 0.049), but not to 320 mg OD. AA-induced aggregation by LTA was <6.5% on all occasions, with no differences between aspirin dosages. TxM was reduced after 320 mg OD (p = 0.002), but not 75 mg BID (p = 0.07). Reticulated platelets were highly correlated with mean platelet volume (MPV; r2 = 0.74, p<0.0001). Both markers for platelet turnover were correlated with AA-induced WBA, but neither identified patients who benefited from BID dosing dependably. In conclusion, twice daily dosing improved laboratory responses to aspirin in high risk T2DM patients. Studies of whether BID dosing of aspirin can improve clinical outcomes in such patients are of interest. PMID:21800009

  14. Pharmacokinetics of zidovudine dosed twice daily according to World Health Organization weight bands in Ugandan HIV-infected children.

    PubMed

    Fillekes, Quirine; Kendall, Lindsay; Kitaka, Sabrina; Mugyenyi, Peter; Musoke, Philippa; Ndigendawani, Milly; Bwakura-Dangarembizi, Mutsa; Gibb, Diana M; Burger, David; Walker, Ann Sarah

    2014-05-01

    Data on zidovudine pharmacokinetics in children dosed using World Health Organization weight bands are limited. About 45 HIV-infected, Ugandan children, 3.4 (2.6-6.2) years, had intensive pharmacokinetic sampling. Geometric mean zidovudine AUC0-12h was 3.0 h.mg/L, which is higher than previously observed in adults, and was independently higher in those receiving higher doses, younger and underweight children. Higher exposure was also marginally associated with lower hemoglobin.

  15. Alendronate and Risedronate for the Treatment of Postmenopausal Osteoporosis: Clinical Profiles of the Once-Weekly and Once-Daily Dosing Formulations

    PubMed Central

    Emkey, Ronald

    2004-01-01

    Objective The objective of this review is to present the clinical profiles of the once-weekly and once-daily dosing formulations of alendronate and risedronate, the 2 bisphosphonates currently available in the United States for the prevention and treatment of postmenopausal osteoporosis. Data Source/Study Selection Data were obtained from a MEDLINE literature search of all English language articles published between January 1996 and April 2004 using generic names of the bisphosphonates alendronate and risedronate. Results were refined by incorporating terms such as "osteoporosis," "bone mineral density," "fracture risk," and "adverse events." Randomized, controlled trials of once-daily and once-weekly bisphosphonate therapies were selected. Also selected for review were post hoc analyses and extension studies of the original controlled trials, including more recent data from published abstracts from scientific meetings. Data Extraction Relevant portions of articles obtained from the literature search were used to summarize the efficacy and tolerability of the 2 therapies. Conclusions In prospective trials, both bisphosphonates were effective in reducing vertebral and hip fractures in women with postmenopausal osteoporosis. In the only prospective trial evaluating hip fracture risk reduction as the primary end point, risedronate was effective at reducing hip fracture vs placebo. Both alendronate and risedronate are available in once-weekly formulations that have efficacy and tolerability profiles similar to the once-daily doses. Clinicians should review all available data for both agents as well as the medical history of the patient to make the most appropriate treatment choice. PMID:15520628

  16. Relationship between high daily erythemal UV doses, total ozone, surface albedo and cloudiness: An analysis of 30 years of data from Switzerland and Austria

    NASA Astrophysics Data System (ADS)

    Rieder, H. E.; Staehelin, J.; Weihs, P.; Vuilleumier, L.; Maeder, J. A.; Holawe, F.; Blumthaler, M.; Lindfors, A.; Peter, T.; Simic, S.; Spichtinger, P.; Wagner, J. E.; Walker, D.; Ribatet, M.

    2010-10-01

    This work investigates the occurrence frequency of days with high erythemal UV doses at three stations in Switzerland and Austria (Davos, Hoher Sonnblick and Vienna) for the time period 1974-2003. While several earlier studies have reported on increases in erythemal UV dose up to 10% during the last decades, this study focuses on days with high erythemal UV dose, which is defined as a daily dose at least 15% higher than for 1950s clear-sky conditions (which represent preindustrial conditions with respect to anthropogenic chlorine). Furthermore, the influence of low column ozone, clear-sky/partly cloudy conditions and surface albedo on UV irradiance has been analyzed on annual and seasonal basis. The results of this study show that in the Central Alpine Region the number of days with high UV dose increased strongly in the early 1990s. A large fraction of all days with high UV dose occurring in the period 1974-2003 was found especially during the years 1994-2003, namely 40% at Davos, 54% at Hoher Sonnblick and 65% at Vienna. The importance of total ozone, clear-sky/partly cloudy conditions and surface albedo (e.g. in dependence of snow cover) varies strongly among the seasons. However, overall the interplay of low total ozone and clear-sky/partly cloudy conditions led to the largest fraction of days showing high erythemal UV dose. Furthermore, an analysis of the synoptic weather situation showed that days with high erythemal UV dose, low total ozone and high relative sunshine duration occur at all three stations more frequently during situations with low pressure gradients or southerly advection.

  17. Estimation of intracellular concentration of stavudine triphosphate in HIV-infected children given a reduced dose of 0.5 milligrams per kilogram twice daily.

    PubMed

    Sy, Sherwin K B; Innes, Steve; Derendorf, Hartmut; Cotton, Mark F; Rosenkranz, Bernd

    2014-01-01

    The antiviral efficacy of stavudine depends on the trough concentration of its intracellular metabolite, stavudine-triphosphate (d4T-TP), while the degree of stavudine's mitochondrial toxicity depends on its peak concentration. Rates of mitochondrial toxicity are high when stavudine is used at the current standard pediatric dose (1 mg/kg twice daily [BID]). Evidence from adult work suggests that half of the original standard adult dose (i.e., 20 mg BID) may be equally effective, with markedly less mitochondrial toxicity. We present a population pharmacokinetic model to predict intracellular d4T-TP concentrations in pediatric HIV-infected patients administered a dose of 0.5 mg/kg BID. Our model predicted that the reduced pediatric dose would result in a trough intracellular d4T-TP concentration above that of the reduced 20-mg adult dose and a peak concentration below that of the 20-mg adult dose. The simulated pediatric intracellular d4T-TP at 0.5 mg/kg BID resulted in median peak and trough values of approximately 23.9 fmol/10(6) cells (95% prediction interval [PI], 14.2 to 41 fmol/10(6) cells) and 14.8 fmol/10(6) cells (95% PI, 7.2 to 31 fmol/10(6) cells), respectively. The peak and trough concentrations resulting from a 20-mg BID adult dose were 28.4 fmol/10(6) cells (95% PI, 17.3 to 45.5 fmol/10(6) cells) and 13 fmol/10(6) cells (95% PI, 6.8 to 28.6 fmol/10(6) cells), respectively. Halving the current standard pediatric dose should therefore not compromise antiviral efficacy, while markedly reducing mitochondrial toxicity.

  18. Pharmacokinetics of Zidovudine Dosed Twice Daily According to World Health Organization Weight Bands in Ugandan HIV-infected Children

    PubMed Central

    2014-01-01

    Data on zidovudine pharmacokinetics in children dosed using World Health Organization weight bands are limited. About 45 HIV-infected, Ugandan children, 3.4 (2.6–6.2) years, had intensive pharmacokinetic sampling. Geometric mean zidovudine AUC0–12h was 3.0 h.mg/L, which is higher than previously observed in adults, and was independently higher in those receiving higher doses, younger and underweight children. Higher exposure was also marginally associated with lower hemoglobin. PMID:24736440

  19. Altered prostate growth and daily sperm production in male mice exposed prenatally to subclinical doses of 17alpha-ethinyl oestradiol.

    PubMed

    Thayer, K A; Ruhlen, R L; Howdeshell, K L; Buchanan, D L; Cooke, P S; Preziosi, D; Welshons, W V; Haseman, J; vom Saal, F S

    2001-05-01

    Approximately 2 million women in the USA and Europe continue taking oral contraceptives each year during undetected pregnancy due primarily to non-compliance and also to individual variation in sensitivity to hormones in the contraceptives. Prenatal exposure to oral contraceptives containing 17alpha-ethinyl oestradiol (EE) has generally not been associated with an increased incidence of externally observable malformations at birth. The purpose of this study was to assess effects on reproductive organs in adult male mice that had been exposed during gestation day 0 through 17 (equivalent to gestation week 16 in humans) to clinically relevant (approximately 0.5 microg/kg/day) and lower doses of EE. Doses used in this study ranged from 0.002 to 2 microg/kg/day. By 5 months of age, prostate weight was significantly (P < 0.05) higher than controls in most treatment groups of EE (0.02-2 microg/kg). Prostatic androgen receptor populations were significantly elevated only in the 0.02 microg/kg group, suggesting different mechanisms for the increase in prostate weight at different doses. Daily sperm production (DSP) and DSP per gramme of testis were reduced in all treatment groups during adolescence, but not later in adulthood. These findings are consistent with prior studies showing that prenatal exposure of mice to very low doses of a number of oestrogenic chemicals can alter the adult male reproductive system without causing gross external malformations.

  20. Ineffectiveness of daily standard and high-dose antiviral therapy in preventing short episodes of genital HSV-2 reactivation: three randomized, open-label cross-over trials

    PubMed Central

    Johnston, Christine; Saracino, Misty; Kuntz, Steve; Magaret, Amalia; Selke, Stacy; Huang, Meei-li; Schiffer, Joshua T.; Koelle, David M.; Corey, Lawrence; Wald, Anna

    2012-01-01

    Background Recent studies indicate that short subclinical episodes of herpes simplex virus type 2 (HSV-2) are the predominant form of skin and mucosal viral shedding. We evaluated whether standard or high-dose antiviral therapy reduced the frequency of such shedding. Methods To determine whether short episodes of genital HSV shedding are suppressed on standard dose (SD) and high-dose (HD) antiviral therapy, HSV-2 seropositive, HIV seronegative persons in Seattle, WA were enrolled into three separate but complementary randomized, open-label, cross-over studies comparing 1) no medication to aciclovir 400 mg twice daily (SD-ACV), 2) valaciclovir 500 mg daily (SD-VAL) to aciclovir 800 mg three times daily (TID) (HD-ACV), and 3) SD-VAL to HD-VAL (1 gm TID). Study arms lasted 4–7 weeks, separated by one week wash-out. Participants obtained genital swabs four times daily for quantitative HSV DNA PCR. The primary endpoint was within-person comparison of shedding rate on each study arm. Results Of 113 participants randomized, 90 were eligible for analysis of the primary endpoint. Participants collected 23,605 swabs; of these 1272 (5·4%) had HSV detected. HSV shedding was significantly higher during the no medication arm (18·1% of swabs) compared with SD-ACV (1.2% of swabs, IRR=0·05, 95% CI=0·03–0·08). Breakthrough reactivations occurred on all doses (SD-ACV 1·2%, SD-VAL 5·2%, HD-ACV 4·2%, and HD-VAL 3·3% of swabs). HD-VAL was associated with less shedding compared with SD-VAL (IRR=0·54, 95% CI=0·44–0·66), likely due to more rapid clearance of mucosal HSV (4·7 logs/6 hours on HD-VAL vs. 4·4 logs/6 hours on SD-VAL, (p=0·02)). However, the annualized breakthrough episodes was similar on SD-VAL (22·6) and HD-ACV (20·2, p=0·54) and SD-VAL (14.9) and HD-VAL (16·5, p=0·34). Regardless of dose, breakthrough episodes were short (median 7–10 hours) and 80% were subclinical. Studies were not designed to make inter-trial comparisons between antiviral doses

  1. SAFETY AND EFFICACY OF HIGH DOSE DAILY VITAMIN D3 SUPPLEMENTATION IN CHILDREN AND YOUNG ADULTS WITH SICKLE CELL DISEASE

    PubMed Central

    Dougherty, Kelly A.; Bertolaso, Chiara; Schall, Joan I.; Smith-Whitley, Kim; Stallings, Virginia A.

    2015-01-01

    Suboptimal vitamin D (vitD) status (<32 ng/ml) is ubiquitous among African American children with type SS sickle cell disease (SCD-SS). The vitD supplemental dose to normalize vitD status is unknown. Five to 20-year-old African-American children with (n=21) and without (n=23) SCD-SS were randomized to vitD3 supplementation (4,000 or 7,000 IU/day) and evaluated at 6- and 12-weeks for changes in vitD and SCD status. A dose was considered unsafe if serum calcium was elevated associated with elevated serum 25 hydroxyvitamin D (25(OH)D)). At baseline 95% of subjects with SCD-SS and 87% of healthy controls had suboptimal vitD status (mean ± SD, 19.2 ± 7.2 and 22.3 ± 9.3 ng/ml, respectively). After 12-weeks supplementation, both D3 doses were safe and well tolerated. Neither group achieved the a priori efficacy criterion of 25(OH)D ≥ 32 ng/ml in >80% of subjects (45% in SCD-SS and 63% in controls). However for both subjects with SCD-SS and healthy subjects by 12-weeks, deficient (< 20 ng/ml) vitD status was eliminated only in those receiving 7,000 IU/d. For subjects with SCD-SS, by 12-weeks there was a significant (all P<0.05) increase in fetal hemoglobin, decrease in HS-CRP, and reduction in the percentage of subjects with a high platelet count. PMID:25985241

  2. Estimation by a 24-hour study of the daily dose of intra-oral mercury vapor inhaled after release from dental amalgam

    SciTech Connect

    Berglund, A. )

    1990-10-01

    The difficulties associated with estimations of daily doses of inhaled mercury vapor released from dental amalgam are considerable. Existing data are often unreliable, especially if they are based on a single or a small series of samples of intra-oral concentrations of mercury vapor before, during, and after chewing stimulation. In the present paper, the aim was to obtain a more representative estimation of the daily dose of mercury vapor inhaled from amalgam fillings by measurement of amounts of mercury vapor released in the oral cavity during 24 h, under conditions that were as normal as possible. A series of measurements was carried out on each of 15 subjects, with at least nine occlusal surfaces restored with dental amalgam, and on five subjects without any amalgam restorations. The subjects had to follow a standardized schedule for 24 h, whereby they ate, drank, and brushed their teeth at pre-determined time periods. The amount of mercury vapor released per time unit was measured at intervals of 30-45 min by means of a measuring system based on atomic absorption spectrophotometry. None of the subjects was professionally exposed to mercury, and all of their amalgam fillings were more than one year old. Study casts were made for each subject, and the area of the amalgam surfaces was measured. Samples of urine and saliva were analyzed so that values for the mercury concentrations and the rate of release of mercury into saliva could be obtained. The average frequency of fish meals per month was noted.

  3. Prospective Trial of High-Dose Reirradiation Using Daily Image Guidance With Intensity-Modulated Radiotherapy for Recurrent and Second Primary Head-and-Neck Cancer

    SciTech Connect

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Cheng, Suzan; Donald, Paul J.; Purdy, James A.

    2011-07-01

    Purpose: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck. Methods and Materials: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment. Results: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 {+-} 1.25 mm, 1.79 {+-} 1.45 mm, and 1.98 {+-} 1.75 mm for the medial-lateral, superior-inferior, and anterior-posterior directions, respectively. Pretreatment shifts of >3 mm occurred in 19% of setups in the medial-lateral, 27% in the superior-inferior, and 33% in the anterior-posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy. Conclusions: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck.

  4. The Feasibility and Acceptability of Using Technology-Based Daily Diaries with HIV-Infected Young Men Who have Sex with Men: A Comparison of Internet and Voice Modalities.

    PubMed

    Cherenack, Emily M; Wilson, Patrick A; Kreuzman, Andrew M; Price, Georgine N

    2016-08-01

    This study delivered a daily diary to 67 HIV-infected men who have sex with men (MSM) between 16 and 24 years old for 66 days to measure HIV-risk behaviors and other psychosocial variables via two diary modalities: internet (accessible via any web-enabled device) and voice (accessible via telephone). Participants were randomized to complete one diary modality for 33 days before switching to the second modality for 33 days. The study was implemented in three urban HIV health care centers in the United States where participants were receiving services. Through diary data and qualitative interview data, we examined the feasibility and acceptability of the dairies and identified barriers and facilitators of dairy compliance. Results show high participant retention in the daily diary (93.4 %) and high compliance for the number of dairies completed (72.4 %). Internet diaries were preferred by 92 % of participants and completed at a significantly higher rate (77.5 %) than voice diaries (67.7 %). Facilitators included opportunities for self-reflection and cathartic sharing, monetary compensation, relationships with study staff, and daily reminders. Barriers included being busy or not having privacy at the time of reminders, forgetting, and falling asleep. Participants also described barriers and facilitators unique to each modality. Overall, both modalities were feasible and acceptable for use with our sample of HIV-infected MSM. PMID:26837629

  5. [Effects of once-daily low-dose administration of sustained-release theophylline on airway inflammation and airway hyperresponsiveness in patients with asthma].

    PubMed

    Terao, Ichiro

    2002-04-01

    Bronchial asthma is eosinophilic airway inflammation with enhanced airway responsiveness induced by eosinophilic granule proteins such as eosinophilic cationic protein (ECP) that are released from eosinophils. In the present study using 30 outpatients with mild to moderate asthma who had no history of treatment with steroid inhalation, we examined the effects of 4-week low-dose (200 mg/day) treatment with Uniphyl Tablets, a sustained-release theophylline formulated for once-daily dosing, on airway inflammation and airway hyperresponsiveness, as well as on respiratory function. Uniphyl Tablets significantly (p < 0.01) decreased peripheral blood eosinophil count from 647.00 to 444.17/mm3 and ECP level (geometric mean) from 1318 to 741 ng/ml and improved airway hyperresponsiveness as indicated by a decrease in airway hyperresponsiveness (Dmin, geometric mean) from 1.15 to 6.70 units. FEV1.0 and PEF showed statistically significant (p < 0.01) improvement from 2.39 to 2.69 L and from 6.21 to 7.14 L/sec, respectively. V25 and V50 also showed statistically significant (p < 0.05) improvement. Mean blood theophylline concentration at the time the improvements were seen was 3.95 mg/mL. These results suggest that low-dose administration of Uniphyl Tablets has anti-airway inflammatory and anti-airway hyperresponsiveness effects in mild to moderate asthmatic patients.

  6. [Long-term evacuation after the nuclear accident in Fukushima ~Different daily living under low-dose radioactive suffering~].

    PubMed

    Ishikawa, Kazunobu

    2013-01-01

    One year has passed since the Great East Japan Earthquake and the Fukushima No. 1 nuclear power plant accident. Even currently, more than 150,000 evacuees in Fukushima Prefecture are forced to leave their home and to move throughout Japan. Because of the limited space of temporary housing and the weakening of personal ties in local communities, many families need to move and have separate lives. As a consequence, Fukushima has a serious shortage of caregivers for the elderly. There have been more than 1,300 disaster-related deaths due to shock and stress after long-distance drifts from town to town. Most of the victims were the elderly, who collapsed, caught pneumonia, suffered stroke and heart attack. Concerns about the safety of low-dose radiation exposure deprived the elderly of important contact with playing outside with their grandchildren in Fukushima. Fear of invisible radioactive contamination inactivated outdoor activities such as farming, dairy, fishing, gardening, hiking and wild-vegetable/mushroom hunting, although most of these activities have been traditionally supported by the wisdom of the elderly. Several recent questionnaire investigations revealed that older evacuees wish to go home even if the environment has significant contamination. In contrast, more than half of younger generation with small children have a different attitude. Nuclear accident brought serious social pains although it did not acutely hurt our bodies.

  7. [Long-term evacuation after the nuclear accident in Fukushima ~Different daily living under low-dose radioactive suffering~].

    PubMed

    Ishikawa, Kazunobu

    2013-01-01

    One year has passed since the Great East Japan Earthquake and the Fukushima No. 1 nuclear power plant accident. Even currently, more than 150,000 evacuees in Fukushima Prefecture are forced to leave their home and to move throughout Japan. Because of the limited space of temporary housing and the weakening of personal ties in local communities, many families need to move and have separate lives. As a consequence, Fukushima has a serious shortage of caregivers for the elderly. There have been more than 1,300 disaster-related deaths due to shock and stress after long-distance drifts from town to town. Most of the victims were the elderly, who collapsed, caught pneumonia, suffered stroke and heart attack. Concerns about the safety of low-dose radiation exposure deprived the elderly of important contact with playing outside with their grandchildren in Fukushima. Fear of invisible radioactive contamination inactivated outdoor activities such as farming, dairy, fishing, gardening, hiking and wild-vegetable/mushroom hunting, although most of these activities have been traditionally supported by the wisdom of the elderly. Several recent questionnaire investigations revealed that older evacuees wish to go home even if the environment has significant contamination. In contrast, more than half of younger generation with small children have a different attitude. Nuclear accident brought serious social pains although it did not acutely hurt our bodies. PMID:23925101

  8. Comparative toxicokinetics of low-viscosity mineral oil in Fischer 344 rats, Sprague-Dawley rats, and humans--implications for an Acceptable Daily Intake (ADI).

    PubMed

    Boogaard, Peter J; Goyak, Katy O; Biles, Robert W; van Stee, Leo L P; Miller, Matthew S; Miller, Mary Jo

    2012-06-01

    Oral repeated-dose studies with low-viscosity mineral oils showed distinct species and strain differences, which are hypothesized to be due to differences in bioavailability, with Fischer 344 rats being more susceptible than Sprague-Dawley rats or dogs. Sensitive analytical methodology was developed for accurate measurement of low levels of mineral hydrocarbons and applied in single-dose toxicokinetics studies in rats and humans. Fischer 344 rats showed a 4-fold higher AUC(0-∞) and consistently higher blood and liver concentrations were found than Sprague-Dawley rats. Hepatic mineral hydrocarbon concentration tracked the blood concentration in both strains, indicating that blood concentrations can serve as functional surrogate measure for hepatic concentrations. In human volunteers receiving 1mg/kg body weight of low-viscosity white oil, all blood concentrations of mineral hydrocarbons were below the detection limit. Comparison with threshold blood concentrations associated with NOAELs in both rat strains, indicate that the margin-of-exposure is at least 37-fold. Using an internal dose metric rather than applied dose reduces the uncertainty around the temporary ADI considerably since it intrinsically accounts for intra- and inter-species differences. The current data support replacement of the temporary ADI of 0.01 mg/kg/day by a (permanent) ADI of at least 1.0mg/kg/day for low- and medium-viscosity mineral oils.

  9. Pharmacokinetics and buccal mucosal concentrations of a 15 milligram per kilogram of body weight total dose of liposomal amphotericin B administered as a single dose (15 mg/kg), weekly dose (7.5 mg/kg), or daily dose (1 mg/kg) in peripheral stem cell transplant patients.

    PubMed

    Gubbins, Paul O; Amsden, Jarrett R; McConnell, Scott A; Anaissie, Elias J

    2009-09-01

    The pharmacokinetics and safety of extended-interval dosing of prophylactic liposomal amphotericin B (L-AMB) in peripheral stem cell transplant recipients were evaluated. The patients received L-AMB daily at 1 mg/kg of body weight or weekly at 7.5 mg/kg or received L-AMB as a single dose (15 mg/kg). The buccal mucosal tissue concentrations of L-AMB were measured. Of the 24 patients enrolled, 5 withdrew after the initial dose due to an infusion-related reaction (n = 2) or significant increases in the serum creatinine (Scr) levels (n = 3). Weekly L-AMB dosing (7.5 mg/kg) produced mean plasma concentrations of >0.300 microg/ml for the first 7 days and >0.220 microg/ml for 7 days after the second dose. A single L-AMB dose (15 mg/kg) produced mean plasma concentrations of >0.491 microg/ml for at least 7 seven days. These concentrations are within the range of the MICs reported in the literature for susceptible strains of Candida and are at the lower limits of the MICs for Aspergillus spp. Extended-interval dosing produced buccal mucosal tissue concentrations well in excess of the MICs reported in the literature for susceptible strains of Candida and Aspergillus spp. Infusion-related reactions occurred in 24% of the patients. Baseline and end-of-study Scr, electrolyte (K+, Mg2+, PO4), and serum transaminase levels were similar across the dosage groups. Five (31%) patients met the nephrotoxicity definition prior to completion of the study. Patients in the weekly or single-dose groups experienced nephrotoxicity significantly faster than the patients in the daily dosing cohort. A weekly L-AMB dose (7.5 mg/kg) or a single L-AMB dose (15 mg/kg) produced sufficient concentrations in plasma and highly vascular tissue to warrant further studies of the safety, efficacy, and practicality of the weekly prophylactic administration of L-AMB. PMID:19546359

  10. Pharmacokinetics and Buccal Mucosal Concentrations of a 15 Milligram per Kilogram of Body Weight Total Dose of Liposomal Amphotericin B Administered as a Single Dose (15 mg/kg), Weekly Dose (7.5 mg/kg), or Daily Dose (1 mg/kg) in Peripheral Stem Cell Transplant Patients▿

    PubMed Central

    Gubbins, Paul O.; Amsden, Jarrett R.; McConnell, Scott A.; Anaissie, Elias J.

    2009-01-01

    The pharmacokinetics and safety of extended-interval dosing of prophylactic liposomal amphotericin B (L-AMB) in peripheral stem cell transplant recipients were evaluated. The patients received L-AMB daily at 1 mg/kg of body weight or weekly at 7.5 mg/kg or received L-AMB as a single dose (15 mg/kg). The buccal mucosal tissue concentrations of L-AMB were measured. Of the 24 patients enrolled, 5 withdrew after the initial dose due to an infusion-related reaction (n = 2) or significant increases in the serum creatinine (Scr) levels (n = 3). Weekly L-AMB dosing (7.5 mg/kg) produced mean plasma concentrations of >0.300 μg/ml for the first 7 days and >0.220 μg/ml for 7 days after the second dose. A single L-AMB dose (15 mg/kg) produced mean plasma concentrations of >0.491 μg/ml for at least 7 seven days. These concentrations are within the range of the MICs reported in the literature for susceptible strains of Candida and are at the lower limits of the MICs for Aspergillus spp. Extended-interval dosing produced buccal mucosal tissue concentrations well in excess of the MICs reported in the literature for susceptible strains of Candida and Aspergillus spp. Infusion-related reactions occurred in 24% of the patients. Baseline and end-of-study Scr, electrolyte (K+, Mg2+, PO4), and serum transaminase levels were similar across the dosage groups. Five (31%) patients met the nephrotoxicity definition prior to completion of the study. Patients in the weekly or single-dose groups experienced nephrotoxicity significantly faster than the patients in the daily dosing cohort. A weekly L-AMB dose (7.5 mg/kg) or a single L-AMB dose (15 mg/kg) produced sufficient concentrations in plasma and highly vascular tissue to warrant further studies of the safety, efficacy, and practicality of the weekly prophylactic administration of L-AMB. PMID:19546359

  11. Pharmacokinetics and buccal mucosal concentrations of a 15 milligram per kilogram of body weight total dose of liposomal amphotericin B administered as a single dose (15 mg/kg), weekly dose (7.5 mg/kg), or daily dose (1 mg/kg) in peripheral stem cell transplant patients.

    PubMed

    Gubbins, Paul O; Amsden, Jarrett R; McConnell, Scott A; Anaissie, Elias J

    2009-09-01

    The pharmacokinetics and safety of extended-interval dosing of prophylactic liposomal amphotericin B (L-AMB) in peripheral stem cell transplant recipients were evaluated. The patients received L-AMB daily at 1 mg/kg of body weight or weekly at 7.5 mg/kg or received L-AMB as a single dose (15 mg/kg). The buccal mucosal tissue concentrations of L-AMB were measured. Of the 24 patients enrolled, 5 withdrew after the initial dose due to an infusion-related reaction (n = 2) or significant increases in the serum creatinine (Scr) levels (n = 3). Weekly L-AMB dosing (7.5 mg/kg) produced mean plasma concentrations of >0.300 microg/ml for the first 7 days and >0.220 microg/ml for 7 days after the second dose. A single L-AMB dose (15 mg/kg) produced mean plasma concentrations of >0.491 microg/ml for at least 7 seven days. These concentrations are within the range of the MICs reported in the literature for susceptible strains of Candida and are at the lower limits of the MICs for Aspergillus spp. Extended-interval dosing produced buccal mucosal tissue concentrations well in excess of the MICs reported in the literature for susceptible strains of Candida and Aspergillus spp. Infusion-related reactions occurred in 24% of the patients. Baseline and end-of-study Scr, electrolyte (K+, Mg2+, PO4), and serum transaminase levels were similar across the dosage groups. Five (31%) patients met the nephrotoxicity definition prior to completion of the study. Patients in the weekly or single-dose groups experienced nephrotoxicity significantly faster than the patients in the daily dosing cohort. A weekly L-AMB dose (7.5 mg/kg) or a single L-AMB dose (15 mg/kg) produced sufficient concentrations in plasma and highly vascular tissue to warrant further studies of the safety, efficacy, and practicality of the weekly prophylactic administration of L-AMB.

  12. Risk evaluation of the Arctic environmental POP exposure based on critical body residue and critical daily dose using captive Greenland sledge dogs (Canis familiaris) as surrogate species.

    PubMed

    Sonne, Christian; Gustavson, Kim; Eulaers, Igor; Desforges, Jean-Pierre; Letcher, Robert J; Rigét, Frank F; Styrishave, Bjarne; Dietz, Rune

    2016-03-01

    The risk from POP (persistent organic pollutant) exposure and subsequent reproductive, immunotoxic and liver histopathological effects was evaluated in a classical parallel trial on Greenland sledge dogs (Canis familiaris) fed contaminated minke whale (Balaenoptera acutorostrata) blubber. First the critical body residues (CBRs) were estimated using the physiologically-based pharmacokinetic (PBPK) model for seven POP compounds based on rat critical daily doses (CDDs). These were then compared with the actual daily oral POP doses (DD) and body residues (BR) in the sledge dogs by calculating risk quotients (RQDD: DD/CDD; RQBR: BR/CBR; ≥1 indicates risk). The results showed that risk quotients for reproductive, immunotoxic and liver histopathological effects were significantly lowest in the control group (p<0.01) while risk quotients based on daily doses (RQDD) were significantly lower than RQs based on body residues (RQBR) (all p<0.01). RQBR in the exposed group ranged from 1.0-12 for reproductive and immunotoxic effects while those for liver histopathological effects ranged from 0.7-3.0. PCBs (polychlorinated biphenyls) and chlordanes were the dominant driver behind high immune and reproductive RQs while dieldrin was the most important factor behind RQs for liver histopathology. Principal component analyses and Spearman rank correlation analyses showed that complement and cellular immune parameters were significantly negative correlated with RQBR (all p<0.05) while logistic regression showed that RQDD had a significant effect on the number of born cups (p=0.03). No significantly relations were found between RQs and hormone concentrations, number of gestations, antibody titres or liver histopathology. These results confirm previous studies showing that POP exposure negatively impacts steroid hormones, various immune parameters, as well as liver histopathology in sledge dogs. It is also clear that RQBR is the best reflector of health effects from POP exposure and

  13. Daily Care

    MedlinePlus

    ... to Know Online Tools Enhancing Daily Life Daily Plan Activities Communication Food & Eating Music & Art Personal Care Incontinence Bathing ... Tweet Email | Print Create a Daily Routine Daily Plan Activities Communication Food/Eating Get Tips on Personal Care Bathing ...

  14. An approach to 'dynamic--DDD (defined daily dose) monitoring' to reduce adverse clinical outcomes and increase patient safety: information repositories and event triggers in clinical practice.

    PubMed

    Eryilmaz, Esat N

    2011-01-01

    The goal of every effort and actions/interventions in almost all healthcare settings throughout the world's health systems -primary care, inpatient, outpatient encounters, diagnostic and therapeutic interventions, peri-operative settings- is and has been to achieve a well defined outcome (a kind of improvement in health status of the patient under consideration, an observable and significant change(s) in selected set(s) of clinical parameters confirmed by laboratory results and pathology findings, improvements in clinical outcomes). Clinical inefficiencies, in this context, should be addressed very systematically and scientifically. This is achieved through a continuously monitoring approach to adverse drug events based on information repositories and evidence-based rule sets. For monitoring drug-related outcomes and clinical outcomes in general, the concept of DDD (Defined Daily Dose) compliance is explained in this article to eliminate and avoid adverse clinical outcomes.

  15. Letter report: Title listing of daily operating data on Hanford single-pass reactors, 1944--1971. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Gydesen, S.P.

    1992-02-01

    The primary objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation dose that populations and individuals could have received as a result of emissions from Hanford Site operations since 1944, with descriptions of the uncertainties inherent in such estimates. A secondary objective is to make project documentation and Hanford-originated references used in the reports available to the public. Hanford-originated documents of potential interest and/or use to the HEDR Project are made publicly available through the US Government`s National Technical Information Service and placed in the US Department of Energy Richland Field Office (RL) Public Reading Room in Richland, Washington. Project work is conducted under several technical tasks, among which is the Source Terms Task. Under this task, estimates of radioactive emissions from Hanford facilities since 1944 are developed. These estimates are based on historical measurements and production information. The Information Resources Task identifies and retrieves historical production operating information for developing source terms. The purpose of this letter report is to identify documents that record daily reactor operating information at the Hanford Site for the years 1944--1971. Complete bibliographic citations and sample pages from each different format for Hanford reactor operations data are included.

  16. Prospective study of daily low-dose nedaplatin and continuous 5-fluorouracil infusion combined with radiation for the treatment of esophageal squamous cell carcinoma

    PubMed Central

    2009-01-01

    Background Protracted low-dose concurrent chemotherapy combined with radiation has been proposed for enhanced treatment results for esophageal cancer. We evaluated the efficacy and the toxicity of a novel regimen of daily low-dose nedaplatin (cis-diammine-glycolatoplatinum) and continuous infusion of 5-fluorouracil (5-FU) with radiation in patients with esophageal squamous cell carcinoma. Methods Between January 2003 and June 2008, 33 patients with clinical stage I to IVB esophageal squamous cell carcinoma were enrolled. Nedaplatin (10 mg/body/day) was administered daily and 5-FU (500 mg/body/day) was administered continuously for 20 days. Fractionated radiotherapy for a total dose of 50.4-66 Gy was administered together with chemotherapy. Additional chemotherapy with nedaplatin and 5-FU was optionally performed for a maximum of 5 courses after chemoradiotherapy. The primary end-point of this study was to evaluate the tumor response, and the secondary end-points were to evaluate the toxicity and the overall survival. Results Twenty-two patients (72.7%) completed the regimen of chemoradiotherapy. Twenty patients (60.6%) achieved a complete response, 10 patients (30.3%) a partial response. One patient (3.0%) had a stable disease, and 2 (6.1%) a progressive disease. The overall response rate was 90.9% (95% confidence interval: 75.7%-98.1%). For grade 3-4 toxicity, leukopenia was observed in 75.8% of the cases, thrombocytopenia in 24.2%, anemia in 9.1%, and esophagitis in 36.4%, while late grade 3-4 cardiac toxicity occurred in 6.1%. Additional chemotherapy was performed for 26 patients (78.8%) and the median number of courses was 3 (range, 1-5). The 1-, 2- and 3-year survival rates were 83.9%, 76.0% and 58.8%, respectively. The 1- and 2-year survival rates were 94.7% and 88.4% in patients with T1-3 M0 disease, and 66.2% and 55.2% in patients with T4/M1 disease. Conclusion The treatment used in our study may yield a high complete response rate and better survival for

  17. Assessment of wear and periacetabular osteolysis using dual energy computed tomography on a pig cadaver to identify the lowest acceptable radiation dose

    PubMed Central

    Skorpil, M.; Nowik, P.; Olivecrona, H.; Crafoord, J.; Weidenhielm, L.; Persson, A.

    2016-01-01

    Objectives Computed tomography (CT) plays an important role in evaluating wear and periacetabular osteolysis (PAO) in total hip replacements. One concern with CT is the high radiation exposure since standard pelvic CT provides approximately 3.5 millisieverts (mSv) of radiation exposure, whereas a planar radiographic examination with three projections totals approximately 0.5 mSv. The objective of this study was to evaluate the lowest acceptable radiation dose for dual-energy CT (DECT) images when measuring wear and periacetabular osteolysis in uncemented metal components. Materials and Methods A porcine pelvis with bilateral uncemented hip prostheses and with known linear wear and acetabular bone defects was examined in a third-generation multidetector DECT scanner. The examinations were performed with four different radiation levels both with and without iterative reconstruction techniques. From the high and low peak kilo voltage acquisitions, polychrmoatic images were created together with virtual monochromatic images of energies 100 kiloelectron volts (keV) and 150 keV. Results We could assess wear and PAO while substantially lowering the effective radiation dose to 0.7 mSv for a total pelvic view with an accuracy of around 0.5 mm for linear wear and 2 mm to 3 mm for PAO. Conclusion CT for detection of prosthetic wear and PAO could be used with clinically acceptable accuracy at a radiation exposure level equal to plain radiographic exposures. Cite this article: B. Sandgren, M. Skorpil, P. Nowik, H. Olivecrona, J. Crafoord, L. Weidenhielm, A. Persson. Assessment of wear and periacetabular osteolysis using dual energy computed tomography on a pig cadaver to identify the lowest acceptable radiation dose. Bone Joint Res 2016;5:307–313. DOI: 10.1302/2046-3758.57.2000566. PMID:27445358

  18. Induction chemotherapy with carboplatin-paclitaxel followed by standard radiotherapy with concurrent daily low-dose cisplatin plus weekly paclitaxel for inoperable non-small-cell lung cancer.

    PubMed

    Ardizzoni, Andrea; Scolaro, Tindaro; Mereu, Carlo; Cafferata, Mara Argenide; Tixi, Lucia; Bacigalupo, Almalina; Tiseo, Marcello; Monetti, Francesco; Rosso, Riccardo

    2005-02-01

    Both induction chemotherapy and concurrent platinating agents have been shown to improve results of thoracic irradiation in the treatment of locally advanced non-small-cell lung cancer (NSCLC). This phase II study investigated activity and feasibility of a novel chemoradiation regimen, including platinum and paclitaxel, both as induction chemotherapy and concurrently with thoracic radiotherapy. Previously untreated patients with histologically/cytologically proven unresectable stage I-III NSCLC were eligible. Induction chemotherapy consisted of 2 courses of 200 mg/m2 paclitaxel and carboplatin at AUC of 6 mg/mL/min every 3 weeks. From day 43, continuous thoracic irradiation (60 Gy in 30 fractions radiotherapy for 6 weeks) was given concurrently with daily cisplatin at a dose of 5 mg/m2 intravenously and weekly paclitaxel at a dose of 45 mg/m2 for 6 weeks. Fifteen patients were accrued in the first stage of the trial. According to the previous statistical considerations, accrual at the second stage of the study was halted as a result of the achievement an insufficient number of successes. Major toxicity of combined chemoradiation was grade III-IV esophagitis requiring hospitalization for artificial nutrition, which occurred in 58% of patients. Other toxicities included grade II-IV fatigue in 75% of patients and grade I-IV neuromuscular toxicity in 67%. Only 7 patients completed the treatment program as scheduled. Eight patients (53.3%; 95% confidence interval, 26.5-78.7%) had a major response (5 partial response, 3 complete response), 2 patients had disease progression, and 1 was stable at the end of treatment. Four patients died early. With a median follow up of 38 months, the median survival was 12 months. A combined chemoradiation program, including platinum and paclitaxel, appears difficult to deliver at full dose as a result of toxicity, mainly esophagitis. More active and less toxic combined modality treatments need to be developed for inoperable NSCLC.

  19. Pharmacokinetics of a Once-Daily Dose of Tacrolimus Early After Liver Transplantation: With Special Reference to CYP3A5 and ABCB1 Single Nucleotide Polymorphisms.

    PubMed

    Miyata, Yoichi; Akamatsu, Nobuhisa; Sugawara, Yasuhiko; Kaneko, Junichi; Yamamoto, Takehito; Suzuki, Hiroshi; Arita, Junichi; Sakamoto, Yoshihiro; Hasegawa, Kiyoshi; Tamura, Sumihito; Kokudo, Norihiro

    2016-01-01

    BACKGROUND The aim of the present study was to investigate the pharmacokinetics of the once-daily tacrolimus formulation (QD form) in relation to polymorphisms of the donor cytochrome P450 family 3 sub-family A polypeptide 5 (CYP3A5) gene and recipient adenosine triphosphate-binding cassette sub-family B member 1 (ABCB1) gene. MATERIAL AND METHODS A total of 80 consecutive living-donor liver transplant (LDLT) recipients were started on the QD form of tacrolimus (day 1), and 60 patients were completely followed for 7 days early after liver transplantation in order to evaluate the pharmacokinetics. RESULTS The concentration/dose (C/D) ratio in recipients with the donor CYP3A5 *1 allele was significantly lower throughout the observation period compared with those with the CYP3A5 genotype *3/*3 (p<0.001), while no effect of single-nucleotide polymorphisms (SNPs) of ABCB1 was observed. The administered doses required to achieve the target trough level were significantly higher on day 7 than on day 1 among all groups, regardless of the differences in the SNPs, especially among those with donor CYP3A5 *1 allele. The tacrolimus concentration was kept within the targeted level all through the study regardless of SNPs. CONCLUSIONS The donor CYP3A5 *1 allele correlated with the lower C/D ratio after administration of the QD form, and higher doses of QD-form tacrolimus and careful monitoring for the trough level should be considered, especially in recipients with the donor CYP3A5 *1 allele. PMID:27503662

  20. Real-time monitoring of non-viable airborne particles correlates with airborne colonies and represents an acceptable surrogate for daily assessment of cell-processing cleanroom performance

    PubMed Central

    RAVAL, JAY S.; KOCH, EILEEN; DONNENBERG, ALBERT D.

    2014-01-01

    Background aims Airborne particulate monitoring is mandated as a component of good manufacturing practice. We present a procedure developed to monitor and interpret airborne particulates in an International Organization for Standardization (ISO) class 7 cleanroom used for the cell processing of Section 351 and Section 361 products. Methods We collected paired viable and non-viable airborne particle data over a period of 1 year in locations chosen to provide a range of air quality. We used receiver operator characteristic (ROC) analysis to determine empirically the relationship between non-viable and viable airborne particle counts. Results Viable and non-viable particles were well-correlated (r 2 = 0.78), with outlier observations at the low end of the scale (non-viable particles without detectable airborne colonies). ROC analysis predicted viable counts ≥0.5/feet 3 (a limit set by the United States Pharmacopeia) at an action limit of ≥32 000 particles (≥0.5 μ)/feet 3 , with 95.6% sensitivity and 50% specificity. This limit was exceeded 2.6 times during 18 months of retrospective daily cleanroom data (an expected false alarm rate of 1.3 times/year). After implementing this action limit, we were alerted in real time to an air-handling failure undetected by our hospital facilities management. Conclusions A rational action limit for non-viable particles was determined based on the correlation with airborne colonies. Reaching or exceeding the action limit of 32 000 non-viable particles/feet 3 triggers suspension of cleanroom cell-processing activities, deep cleaning, investigation of air handling, and a deviation management process. Our full procedure for particle monitoring is available as an online supplement. PMID:22746538

  1. Legal, ethical, and economic implications of breaking down once-daily fixed-dose antiretroviral combinations into their single components for cost reduction.

    PubMed

    Ramiro, Miguel A; Llibre, Josep M

    2014-11-01

    The availability of generic lamivudine in the context of the current economic crisis has raised a new issue in some European countries: breaking up the once-daily fixed-dose antiretroviral combinations (FDAC) of efavirenz/tenofovir/emtricitabine, tenofovir/emtricitabine, or abacavir/lamivudine, in order to administer their components separately, thereby allowing the use of generic lamivudine instead of branded emtricitabine or lamivudine. The legal, ethical, and economic implications of this potential strategy are reviewed, particularly in those patients receiving a once-daily single-tablet regimen. An unfamiliar change in antiretroviral treatment from a successful patient-friendly FDAC into a more complex regimen including separately the components to allow the substitution of one (or some) of them for generic surrogates (in the absence of a generic bioequivalent FDAC) could be discriminatory because it does not guarantee access to equal excellence in healthcare to all citizens. Furthermore, it could violate the principle of non-maleficence by potentially causing harm both at the individual level (hindering adherence and favouring treatment failure and resistance), and at the community level (hampering control of disease transmission and transmission of HIV-1 resistance). Replacing a FDAC with the individual components of that combination should only be permitted when the substituting medication has the same qualitative and quantitative composition of active ingredients, pharmaceutical form, method of administration, dosage and presentation as the medication being replaced, and a randomized study has demonstrated its non-inferiority. Finally, a strict pharma-economic study supporting this change, comparing the effectiveness and the cost of a specific intervention with the best available alternative, should be undertaken before its potential implementation. PMID:24139337

  2. Legal, ethical, and economic implications of breaking down once-daily fixed-dose antiretroviral combinations into their single components for cost reduction.

    PubMed

    Ramiro, Miguel A; Llibre, Josep M

    2014-11-01

    The availability of generic lamivudine in the context of the current economic crisis has raised a new issue in some European countries: breaking up the once-daily fixed-dose antiretroviral combinations (FDAC) of efavirenz/tenofovir/emtricitabine, tenofovir/emtricitabine, or abacavir/lamivudine, in order to administer their components separately, thereby allowing the use of generic lamivudine instead of branded emtricitabine or lamivudine. The legal, ethical, and economic implications of this potential strategy are reviewed, particularly in those patients receiving a once-daily single-tablet regimen. An unfamiliar change in antiretroviral treatment from a successful patient-friendly FDAC into a more complex regimen including separately the components to allow the substitution of one (or some) of them for generic surrogates (in the absence of a generic bioequivalent FDAC) could be discriminatory because it does not guarantee access to equal excellence in healthcare to all citizens. Furthermore, it could violate the principle of non-maleficence by potentially causing harm both at the individual level (hindering adherence and favouring treatment failure and resistance), and at the community level (hampering control of disease transmission and transmission of HIV-1 resistance). Replacing a FDAC with the individual components of that combination should only be permitted when the substituting medication has the same qualitative and quantitative composition of active ingredients, pharmaceutical form, method of administration, dosage and presentation as the medication being replaced, and a randomized study has demonstrated its non-inferiority. Finally, a strict pharma-economic study supporting this change, comparing the effectiveness and the cost of a specific intervention with the best available alternative, should be undertaken before its potential implementation.

  3. Hydrofluoroalkane-134a beclomethasone dipropionate extrafine aerosol provides equivalent asthma control to chlorofluorocarbon beclomethasone dipropionate at approximately half the total daily dose.

    PubMed

    Davies, R J; Stampone, P; O'Connor, B J

    1998-06-01

    The mandatory requirement to eliminate chlorofluorocarbons (CFCs) as propellants in pharmaceutical aerosols has provided the opportunity to enhance significantly the delivery of aerosol drugs to the respiratory tract. This randomized, parallel-group, double-blind, double-dummy, multicentre study was undertaken to assess whether beclomethasone dipropionate (BDP) in hydrofluoroalkane-134a (HFA) provided equivalent control of moderately severe asthma to BDP in CFC but at approximately half the total daily dose, as might be expected from the improved lung deposition of the HFA-BDP extrafine aerosol. The novel study design included a 10-12 day run-in period to confirm that patients met established criteria of moderately severe asthma and were symptomatic on current therapy (inhaled beta-agonist plus CFC-BDP 400-800 micrograms day-1). This run-in period was followed by a short course of oral steroid therapy (prednisolone 30 mg day-1 for 7-13 days) to demonstrate steroid responsiveness [> or = 15% improvement in morning peak expiratory flow (PEF)] and to provide a within-study baseline of improved asthma control. A total of 233 patients were randomized to treatment for 12 weeks with HFA-BDP 800 micrograms day-1 (116 patients) or CFC-BDP 1500 micrograms day-1 (117 patients). The mean change from oral steroid treatment in morning PEF with HFA-BDP was equivalent to that seen with CFC-BDP at all time intervals. Changes in other measures of pulmonary function, asthma symptom scores and beta-agonist use were equivalent in the two treatment groups throughout the 12 week treatment period. The safety profile of HFA-BDP compared favourably with that of CFC-BDP with no unexpected adverse events reported. Fewer patients on HFA-BDP than on CFC-BDP had plasma cortisol levels below the normal reference range after 12 weeks of therapy (5.1% vs. 17.3%, respectively). In conclusion, HFA-BDP extrafine aerosol was found to provide equivalent control of moderately severe asthma to CFC-BDP at

  4. Comparison of once and twice daily oral dosing schedules of bevantolol, a new beta-adrenoceptor antagonist with alpha-adrenoceptor partial antagonist activity in patients with angina of effort.

    PubMed

    Molajo, A O; Bray, C L; Hillier, V

    1989-11-01

    In a placebo controlled double-blind cross-over study following a dose titration phase, we compared the efficacy of benantolol, a new beta 1 adrenoceptor antagonist with alpha-adrenoceptor partial antagonist activity at 12 and 24 hours after dosing in patients with angina of effort. Twenty patients aged 43-65 years were studied. Each study phase lasted four weeks. Efficacy was determined by treadmill exercise testing using the standard Bruce protocol at the end of each phase. Fifteen patients satisfactorily completed the study. Data from five protocol violators were not analysed. In the four patients who received bevantolol 200 mg daily, exercise time increased from 395 +/- 192 (mean +/- 1 SD) sec on placebo to 468 +/- 171 sec at 10-12 hours and to 442 +/- 230 sec at 22-24 hours after dosing with bevantolol. In the eleven patients who received bevantolol 400 mg daily, exercise tolerance of 290 +/- 103 sec on placebo increased to 408 +/- 112 sec at 10-12 hours (P = 0.001) and to 400 +/- 98 sec at 22-24 hours (P = 0.001) after dosing with bevantolol. Maximum exercise capacity at 10-12 and 22-24 hours after dosing with bevantolol were comparable. Maximum exercise heart rate and systolic blood pressure on placebo and on bevantolol at 10-12 and at 22-24 hours after dosing were comparable. Thus, bevantolol has salutary effects on exertional angina up to 24 hours after dosing.

  5. SU-E-J-66: Significant Anatomical and Dosimetric Changes Observed with the Pharyngeal Constrictor During Head and Neck Radiotherapy Elicited From Daily Deformable Image Registration and Dose Accumulation

    SciTech Connect

    Kumarasiri, A; Siddiqui, F; Liu, C; Kamal, M; Fraser, C; Chetty, I; Kim, J

    2015-06-15

    Purpose: To evaluate the anatomical changes and associated dosimetric consequences to the pharyngeal constrictor (PC) that occurs during head and neck radiotherapy (H&N RT). Methods: A cohort of 13 oro-pharyngeal cancer patients, who had daily CBCT’s for localization, was retrospectively studied. On every 5th CBCT, PC was manually delineated by a radiation oncologist. The anterior-posterior PC thickness was measured at the C3 level. Delivered dose to PC was estimated by calculating daily doses on CBCT’s, and accumulating to corresponding planning CT images. For accumulation, a parameter-optimized B- spline-based deformable image registration algorithm (Elastix) was used, in conjunction with an energy-mass mapping dose transfer algorithm. Mean and maximum dose (Dmean, Dmax) to PC was determined and compared with corresponding planned quantities. Results: The mean (±standard deviation) volume increase (ΔV) and thickness increase (Δt) over the course of 35 total fractions were 54±33% (11.9±7.6 cc), and 63±39% (2.9±1.9 mm), respectively. The resultant cumulative mean dose increase from planned dose to PC (ΔDmean) was 1.4±1.3% (0.9±0.8 Gy), while the maximum dose increase (ΔDmax) was 0.0±1.6% (0.0±1.1 Gy). Patients with adaptive replanning (n=6) showed a smaller mean dose increase than those without (n=7); 0.5±0.2% (0.3±0.1 Gy) vs. 2.2±1.4% (1.4±0.9 Gy). There was a statistically significant (p<0.0001) strong correlation between ΔDmean and Δt (Pearson coefficient r=0.78), and a moderate-to-strong correlation (r=0.52) between ΔDmean and ΔV. Correlation between ΔDmean and weight loss ΔW (r=0.1), as well as ΔV and ΔW (r=0.2) were negligible. Conclusion: Patients were found to undergo considerable anatomical changes to pharyngeal constrictor during H&N RT, resulting in non-negligible dose deviations from intended dose. Results are indicative that pharyngeal constrictor thickness, measured at C3 level, is a good predictor for the dose change to

  6. Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App: Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial

    PubMed Central

    Lappalainen, Raimo; Välkkynen, Pasi; Sairanen, Essi; Lappalainen, Päivi; Karhunen, Leila; Peuhkuri, Katri; Korpela, Riitta; Kolehmainen, Marjukka; Ermes, Miikka

    2016-01-01

    Background Mobile phone apps offer a promising medium to deliver psychological interventions. A mobile app based on Acceptance and Commitment Therapy (ACT) was developed and studied in a randomized controlled trial (RCT). Objective To study usage metrics of a mobile ACT intervention and dose-response relationship between usage and improvement in psychological flexibility. Methods An RCT was conducted to investigate the effectiveness of different lifestyle interventions for overweight people with psychological stress. This paper presents a secondary analysis of the group that received an 8-week mobile ACT intervention. Most of the analyzed 74 participants were female (n=64, 86%). Their median age was 49.6 (interquartile range, IQR 45.4-55.3) years and their mean level of psychological flexibility, measured with the Acceptance and Action Questionnaire II, was 20.4 (95% confidence interval 18.3-22.5). Several usage metrics describing the intensity of use, usage of content, and ways of use were calculated. Linear regression analyses were performed to study the dose-response relationship between usage and the change in psychological flexibility and to identify the usage metrics with strongest association with improvement. Binary logistic regression analyses were further used to assess the role of usage metrics between those who showed improvement in psychological flexibility and those who did not. In addition, associations between usage and baseline participant characteristics were studied. Results The median number of usage sessions was 21 (IQR 11.8-35), the number of usage days was 15 (IQR 9.0-24), and the number of usage weeks was 7.0 (IQR 4.0-8.0). The participants used the mobile app for a median duration of 4.7 (IQR 3.2-7.2) hours and performed a median of 63 (IQR 46-98) exercises. There was a dose-response relationship between usage and the change in psychological flexibility. The strongest associations with psychological flexibility (results adjusted with gender

  7. The dose of hazelnuts influences acceptance and diet quality but not inflammatory markers and body composition in overweight and obese individuals.

    PubMed

    Tey, Siew Ling; Gray, Andrew R; Chisholm, Alexandra W; Delahunty, Conor M; Brown, Rachel C

    2013-08-01

    Regular nut consumption may improve markers of inflammation and endothelial dysfunction. The quantity of nuts required to achieve these health benefits without compromising body weight and acceptance is unknown. This study compared the effects of incorporating hazelnuts at 2 different doses with a diet without nuts on inflammatory markers, cell adhesion molecules, and body composition in 107 overweight and obese individuals. This was a randomized, controlled, parallel 12-wk intervention including 3 treatment arms: no nuts (control group), 30 g/d of hazelnuts, or 60 g/d of hazelnuts. Blood pressure, body composition, plasma high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), lipid, and apolipoprotein (apo) profiles were assessed at baseline and at 6 and 12 wk. "Desire" and "liking" for nuts were assessed during the intervention. Results showed no significant differences in follow-up clinical outcomes between groups after adjusting for baseline values, age, sex, and BMI (all P ≥ 0.10), except for a tendency toward improvement in VCAM-1 concentration in the 60-g/d nut group (P = 0.07). Hazelnut consumption significantly improved diet quality in a dose-response manner. Desire and liking for nuts remained stable in the 30-g/d group, whereas these ratings decreased significantly over time in the 60-g/d group (both P < 0.001). In conclusion, 12 wk of hazelnut consumption appears to have minimal effect on inflammatory markers and cell adhesion molecules in this group of healthy, normocholesterolemic overweight and obese individuals. Nut consumption improves diet quality without adversely affecting body composition. Consuming 30 g/d of nuts regularly is achievable, whereas 60 g/d appears to compromise desire and liking.

  8. A Dose-Escalation Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of 2 and 4 Weeks of Twice-Daily Ocular Trabodenoson in Adults with Ocular Hypertension or Primary Open-Angle Glaucoma

    PubMed Central

    Sall, Kenneth N.; DuBiner, Harvey; Slomowitz, Natanya; McVicar, William; Rich, Cadmus C.; Baumgartner, Rudolf A.

    2016-01-01

    Abstract Purpose: To evaluate the safety and ocular hypotensive efficacy of 4 trabodenoson doses administered twice daily over 14 or 28 days in subjects with ocular hypertension or primary open-angle glaucoma (POAG). Methods: In this multicenter, randomized, double-masked, placebo-controlled, dose-escalation Phase 2 study, patients received unilateral topical twice-daily trabodenoson (50, 100, or 200 mcg) or placebo for 14 days, or 500 mcg trabodenoson or placebo for 28 days. Ocular and systemic safety and tolerability were assessed by examinations, clinical and laboratory studies. Intraocular pressure (IOP) was assessed using Goldmann tonometry. Results: Trabodenoson was well tolerated; no clinically meaningful ocular or systemic side effects were identified. Trabodenoson produced a dose-dependent IOP reduction. IOP reductions in the 500 mcg group were significantly greater than placebo at all time points at Day 28. Mean IOP reductions from diurnal baseline ranged from −3.5 to −5.0 mmHg with a mean change of −4.1 mmHg in the 500 mcg group compared −1.0 to −2.5 mmHg with a mean change of −1.6 mmHg for the placebo group, and the Day 28 drop was significantly greater than at Day 14 (P = 0.0163) indicating improvement in IOP lowering with longer treatment time. IOP remained significantly reduced 24 h after the final 500 mcg dose (P = 0.048). Conclusion: Twice-daily ocular doses of trabodenoson, from 50 to 500 mcg, were well tolerated and showed a dose-related decrease in IOP that was statistically significant and clinically relevant at 500 mcg in patients with ocular hypertension or POAG. PMID:27002298

  9. Long term results of comparison of concurrent low-dose daily cisplatin versus the standard weekly cisplatin with six fractions per week radiotherapy in locally advanced head neck cancer

    PubMed Central

    Gupta, Pramod Kumar; Lal, Punita; Bajpai, Ranjeet; Goel, Anshu; Yadav, Rajan; Verma, Mranalini; Kumar, Shaleen

    2016-01-01

    Aim and Objective: Weekly administration of cisplatin (cis-diamminedichloroplatinum [CDDP]) appears more feasible and substantially more popular than the 3 weekly schedules due to better compliance. Different concurrent cisplatin schedules have been attempted including a daily schedule. We did a comparison of two consecutive single arm studies, i.e., use of weekly cisplatin versus daily cisplatin when used with concurrently with a moderately accelerated radiotherapy (RT) schedule. Patients and Methods: Two prospective feasibility, safety and efficacy studies were carried out consecutively within the department. The weekly CDDP study was done from August 2003 to August 2005 and daily CDDP study was conducted from November 2005 to June 2007. Both studies included locally advanced stage III and IV squamous cell carcinoma of the head and neck region with RT dose of 70 Gy. Concurrent single-agent cisplatin was administered weekly (35 mg/m2) in the first and daily (6 mg/m2) in the second study. Results: Weekly cisplatin study had 68 and daily CDDP study had 52 patients. The median follow-up in the two studies was 93 and 63 months, respectively. Compliance in the two studies was comparable. Acute Grade III/IV mucositis and dysphagia were significantly higher in weekly cisplatin study. Late Grade II/III toxicities such as xerostomia, dysphagia, ototoxicity and nephrotoxicity were similar. The 5 years locoregional control was 18% and 25% and 5 years overall survival rate was 32% and 31% in weekly and daily cisplatin studies, respectively. Conclusions: Modest acceleration along with either weekly or daily cisplatin, whichever is possible in one's setup, is do-able, provided due attention is paid to patient selection and supportive care. PMID:27275456

  10. New option for management of HIV-1 infection in treatment-naive patients: once-daily, fixed-dose combination of rilpivirine-emtricitabine-tenofovir

    PubMed Central

    Patel, Nimish; Miller, Christopher D

    2012-01-01

    Fixed-dose combination tablets have become an important therapy option for patients infected with the human immunodeficiency virus. Fixed-dose combination rilpivirine-tenofovir-emtricitabine is a recently approved therapy option that has been extensively studied within the treatment-naïve population. When compared with efavirenz-based therapy, improved tolerability with rilpivirine-based therapy was balanced by higher rates of virologic failure to provide similar overall efficacy rates within the intention-to-treat analysis. As a result, providers will need to balance the potential for improved tolerability with fixed-dose combination rilpivirine-tenofovir-emtricitabine against a higher potential for virologic failure, particularly among patients with baseline viral loads above 100,000 copies/mL. Current treatment guidelines have recommended that fixed-dose combination rilpivirine-tenofovir-emtricitabine be an alternative therapy option for treatment-naïve patients and advise caution in those patients with high viral loads at baseline. Similar to other non-nucleoside reverse transcriptase inhibitor-based regimens, there are a number of drug interaction concerns with fixed-dose combination rilpivirine-tenofovir-emtricitabine that will necessitate monitoring and, in some cases, appropriate management. Additionally, the emergence of drug resistance to fixed-dose combination rilpivirine-tenofovir-emtricitabine has been well documented in clinical studies and close attention will be necessary in order to protect current and future therapy options. Overall, fixed-dose combination rilpivirine-tenofovir-emtricitabine is poised to provide an important therapy option for patients when appropriately applied. PMID:22570576

  11. Daily affect and daily beliefs.

    PubMed

    Harris, Claire; Daniels, Kevin

    2005-10-01

    Human resource directorate employees of a large United Kingdom public hospital (N=36) completed an initial questionnaire and then participated in a daily diary study. The questionnaire included measures of affect and beliefs about high work demands' influence on affect and work performance. The diary included measures of affect, extent of high work demands, and daily beliefs, corresponding to those measured in the questionnaire. Participants were required to complete the diary twice daily, before and after work over a 2-week period. Measures of affect after work were associated with beliefs concerning work demands' influence on work performance and on affect measured after work. Beliefs about work demands measured in the questionnaire were associated with subsequent daily assessments of beliefs.

  12. Studies of the toxicological potential of capsinoids: II. A 26-week daily gavage dosing toxicity study of CH-19 Sweet extract in rats.

    PubMed

    Kodama, Terutaka; Watanabe, Eri; Masuyama, Takeshi; Tsubuku, Shoji; Otabe, Akira; Mochizuki, Masahiro; Bernard, Bruce K

    2008-01-01

    A 26-week oral toxicity study of capsinoids-containing CH-19 Sweet extract was conducted in Sprague-Dawley rats (20 males and 20 females per group) at 6 weeks of age. The test substance was administered by gavage for 26 weeks at dose levels of 0 (vehicle), 1.25, 2.5, and 5.0 ml/kg/day. The concentration of capsinoids in the CH-19 Sweet extract employed was 71.25 to 73.15 mg/ml, resulting in dose levels of capsinoids of 89.06 to 91.44, 178.13 to 182.88, and 356.25 to 365.75 mg/kg, respectively. Adverse test article-related changes were only observed in males, not in females, and within the males, only at the high dose (5.0 ml/kg). Within that group (high-dose males), increases were observed in the numbers of segmented neutrophils, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) activities, liver weights, and in the incidence and severity of hepatocellular focal necrosis. No test substance-related changes were detected in clinical signs, body weight, food consumption, water intake, ophthalmology, or urinalysis. No adverse test article-related changes were observed in low- or mid-dose males or in females at any dose. Based on the results of this chronic gavage study, the target organ was the liver and the no observed adverse effect level (NOAEL) for CH-19 Sweet extract in the rat was 2.5 ml/kg/day in males and 5.0 ml/kg/day in females (178.13 to 182.88 mg/kg and 356.25 to 365.75 mg/kg as capsinoids, respectively). PMID:19037796

  13. Hemodynamic interaction between a daily dosed phosphodiesterase 5 inhibitor, tadalafil, and the alpha-adrenergic blockers, doxazosin and tamsulosin, in middle-aged healthy male subjects.

    PubMed

    Guillaume, Michel; Lonsdale, Finnuala; Darstein, Christelle; Jimenez, Maria C; Mitchell, Malcolm I

    2007-10-01

    The hemodynamic interaction between tadalafil (5 mg/d) and doxazosin or tamsulosin was investigated in 2 randomized, double-blind, crossover phase 1 studies. Healthy men (n = 45) received tadalafil or placebo for 28 days and increasing doses of doxazosin (1, 2, and 4 mg/d) for the last 21 days of treatment. In the second study, participants (n = 39) received tadalafil or placebo for 14 days and tamsulosin (0.4 mg/d) for the last 7 days of treatment. Similar mean maximum postbaseline changes in standing systolic blood pressure were observed in subjects given tadalafil or placebo with 4 mg of doxazosin (-0.5 mm Hg; 95% confidence interval, -4 to 3.1 mm Hg) or with tamsulosin (0.9 mm Hg; 95% confidence interval, -1.4 to 3.2 mm Hg). Standing systolic blood pressure less than 85 mm Hg (blood pressure outlier) occurred in 1 subject treated with 4 mg of doxazosin plus tadalafil but was not reported in subjects treated with tamsulosin and tadalafil. Three subjects experienced moderate hypotensive events lasting less than 2 hours, 2 with syncope (after tadalafil alone or with 4 mg of doxazosin) and 1 without (after 4 mg of doxazosin with placebo). The incidence of hypotension was low in healthy men given increasing doses of doxazosin with chronically dosed tadalafil or placebo. Administration of tadalafil with tamsulosin was well tolerated in healthy men.

  14. Effect of CYP2C9, CYP4F2 and VKORC1 genetic polymorphisms on pharmacokinetics and pharmacodynamics of mean daily maintenance dose of warfarin in Chinese patients.

    PubMed

    Zhuang, Wenfang; Wen, Wei; Xuan, Binbin; Chen, Yanhong; Cao, Yanan; Sun, Zhixin; Ma, Jun

    2015-03-01

    In this study, we studied the effects of different genetic variants of CYP2C9, VKORC1 and CYP4F2, and clinical factors on the concentration levels of S-warfarin (WF), R-WF and S, R-7-OH-WF, as well as the mean daily maintenance dose of warfarin in 211 patients on warfarin therapy for at least 3 months. The genotypes of single nucleotide polymorphism (SNP), CYP2C9, VKORC1 1173C>T and CYP4F2 were identified by PCR. Plasma concentrations of S-WF and R-WF and S-7-OH-WF, R-7-OH-WF were determined by high-performance liquid chromatography tandem mass spectrometry on chiral columns. The warfarin dosage requirement correlated negatively with age and was in direct proportion to body weight. VKORC1 1173CC carrier had significantly lower dosage requirements than that with the heterozygous VKORC1 1173CT genotype. The concentration of both 7-OH-S-WF and 7-OH-R-WF, and the warfarin dose showed a significant difference. There were significant differences in the concentrations of S-WF and 7-OH-S-WF among the CYP2C9 variants. The concentration of warfarin, 7-OH-WF and warfarin maintenance dose were not affected by the CYP4F2 V433M variant. In conclusion, VKORC1 1173C>T genotype correlates strongly with a lower daily warfarin dose and the concentration of S-7-OH, R-7-OH warfarin in Han Shanghainese patients. In addition, the results not only demonstrated the effect on pharmacodynamics of warfarin, but also enhanced the enzymatic activity of CYP450 to influence the pharmacokinetic of warfarin. PMID:25304014

  15. Geographical diffusion of prazosin across Veterans Health Administration: Examination of regional variation in daily dosing and quality indicators among veterans with posttraumatic stress disorder.

    PubMed

    Abrams, Thad E; Lund, Brian C; Alexander, Bruce; Bernardy, Nancy C; Friedman, Matthew J

    2015-01-01

    Posttraumatic stress disorder (PTSD) is a high-priority treatment area for the Veterans Health Administration (VHA), and dissemination patterns of innovative, efficacious therapies can inform areas for potential improvement of diffusion efforts and quality prescribing. In this study, we replicated a prior examination of the period prevalence of prazosin use as a function of distance from Puget Sound, Washington, where prazosin was first tested as an effective treatment for PTSD and where prazosin use was previously shown to be much greater than in other parts of the United States. We tested the following three hypotheses related to prazosin geographic diffusion: (1) a positive geographical correlation exists between the distance from Puget Sound and the proportion of users treated according to a guideline recommended minimum therapeutic target dose (>/=6 mg/d), (2) an inverse geographic correlation exists between prazosin and benzodiazepine use, and (3) no geographical correlation exists between prazosin use and serotonin reuptake inhibitor/serotonin norepinephrine reuptake inhibitor (SSRI/SNRI) use. Among a national sample of veterans with PTSD, overall prazosin utilization increased from 5.5 to 14.8% from 2006 to 2012. During this time period, rates at the Puget Sound VHA location declined from 34.4 to 29.9%, whereas utilization rates at locations a minimum of 2,500 miles away increased from 3.0 to 12.8%. Rates of minimum target dosing fell from 42.6 to 34.6% at the Puget Sound location. In contrast, at distances of at least 2,500 miles from Puget Sound, minimum threshold dosing rates remained stable (range, 18.6 to 17.7%). No discernible association was demonstrated between SSRI/SNRI or benzodiazepine utilization and the geographic distance from Puget Sound. Minimal threshold dosing of prazosin correlated positively with increased diffusion of prazosin use, but there was still a distance diffusion gradient. Although prazosin adoption has improved, geographic

  16. The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction

    PubMed Central

    Gacci, Mauro; Salvi, Matteo; Sebastianelli, Arcangelo; Vignozzi, Linda; Corona, Giovanni; McVary, Kevin T; Kaplan, Steven A; Maggi, Mario; Carini, Marco; Oelke, Matthias

    2013-01-01

    A strong and independent association between lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and erectile dysfunction (ED) has been widely evidenced in several clinical epidemiologic studies. Preclinical animal models have provided a great deal of information on potential common pathogenic mechanisms underlying these two clinical identities. Although the efficacy of the most commonly used treatments for LUTS/BPH is well defined, the negative impact of these treatments on sexual function – in particular, on ED – has triggered the search for new treatment options. In this regard, a new role for phosphodiesterase type 5 inhibitors in the treatment of LUTS/BPH and ED has been claimed. Tadalafil is one of the most extensively investigated phosphodiesterase type 5 inhibitors for this new indication. All evidence reported to date suggests that tadalafil 5 mg once daily is a safe and effective treatment option for both LUTS/BPH and ED. PMID:24400241

  17. Low-dose tertiary prophylactic therapy reduces total number of bleeds and improves the ability to perform activities of daily living in adults with severe haemophilia A: a single-centre experience from Beijing.

    PubMed

    Hua, Baolai; Lian, Xiaoyun; Li, Kuixing; Lee, Adrienne; Poon, Man-Chiu; Zhao, Yongqiang

    2016-03-01

    Full-dose prophylaxis treatment for persons with haemophilia is not affordable in China due to its economic constraints, particularly in adults requiring higher clotting factor (CFC) doses. Low-dose tertiary prophylaxis for adults with severe haemophilia A (SHA) in Beijing became feasible and implemented when government insurance covering 85% CFC cost in Beijing began in December 2009. The aim of this study was to evaluate the benefits of low-dose tertiary prophylaxis in SHA adults. Analysis of data on 33 patients on low-dose tertiary prophylaxis (5-10 IU/kg, two to three times per week) at the Haemophilia Treatment Center, Peking Union Medical College Hospital between December 2009 and December 2013. The 33 patients (age 18-60 years, mean 33.4) were on prophylaxis for 20.8 ± 9.9 months (compared with prior on-demand therapy for 20.0 ± 11.7 months). Prophylaxis resulted in significant decrease in annual bleeding rate (ABR, 11.8 ± 7.6 vs. 41.5 ± 20.7, 71.1% reduction, P < 0.0001), and significant improvement in Functional Independence Score in Haemophilia (FISH) measurement reflecting improvement in self-care and mobility. Radiologic (Pettersson) joint score was neither improved nor deteriorated. Ten of the 33 patients originally wheel chair and bed-bound began to walk and function independently in their daily lives. Low-dose tertiary prophylaxis for adults with SHA in China is feasible and beneficial. Although the average ABR remained high, a significant improvement in self-care and mobility measured by FISH was observed. These promising clinical experiences form the basis for further formal studies with more defined therapeutic protocol and outcome measures for affordable prophylaxis regimens in haemophilia adults in China.

  18. Metronomic chemotherapy with daily low-dose temozolomide and celecoxib in elderly patients with newly diagnosed glioblastoma multiforme: a retrospective analysis.

    PubMed

    Welzel, Grit; Gehweiler, Julian; Brehmer, Stefanie; Appelt, Jens-Uwe; von Deimling, Andreas; Seiz-Rosenhagen, Marcel; Schmiedek, Peter; Wenz, Frederik; Giordano, Frank A

    2015-09-01

    Chemotherapy is often omitted in elderly patients with glioblastoma multiforme due to a fear of side effects. We applied metronomic chemotherapy with low-dose temozolomide and celecoxib (LD-TEM/CEL) during and after external beam radiotherapy (EBRT) and here report on how this regimen compares to standard temozolomide radiochemotherapy (SD-TEM) in elderly patients. We retrospectively analyzed records of 146 patients aged 65 years and older that underwent EBRT. Factors of interest were age, performance status, comorbidities, MGMT status, therapy (resection/biopsy, radiotherapy/dose, chemotherapy/regimen/dose), progression-free (PFS) and overall survival (OS) status. Irrespective of the regimen, addition of chemotherapy more than doubled median survival rates (EBRT only: 4.2 months; EBRT + LD-TEM/CEL: 8.5 months; EBRT + SD-TEM: 10.8 months; p ≤ 0.008). Although patients receiving metronomic LD-TEM/CEL were significantly older (62 % were ≥75 years vs. 22 %; p < 0.001), had significantly lower performance scores (50 % had a KPS <70 vs. 28 %; p = 0.049) and were significantly more comorbid (73 % had ≥4 comorbidities vs. 37 %; p = 0.002) than patients of the SD-TEM group, there were no significant differences in PFS and OS. Independent of other factors, omission of chemotherapy significantly impairs progression-free and overall survival. With all the limitations of a retrospective analysis, our data suggest that metronomic chemotherapy with LD-TEM/CEL may be equieffective and eventually better tolerated than SD-TEM. It may be offered to elderly patients that are not eligible for standard chemotherapy.

  19. Safety and Efficacy of High-dose Daily Vitamin D3 Supplementation in Children and Young Adults With Sickle Cell Disease.

    PubMed

    Dougherty, Kelly A; Bertolaso, Chiara; Schall, Joan I; Smith-Whitley, Kim; Stallings, Virginia A

    2015-07-01

    Suboptimal vitamin D (vit D) status (<32 ng/mL) is ubiquitous among African American children with type SS sickle cell disease (SCD-SS). The vit D supplemental dose to normalize vit D status is unknown. Five to 20-year-old African American children with (n=21) and without (n=23) SCD-SS were randomized to vit D3 supplementation (4000 or 7000 IU/d) and evaluated at 6 and 12 weeks for changes in vit D and SCD status. A dose was considered unsafe if serum calcium was elevated associated with elevated serum 25 hydroxyvitamin D (25(OH)D). At baseline 95% of subjects with SCD-SS and 87% of healthy controls had suboptimal vit D status (mean±SD, 19.2±7.2 and 22.3±9.3 ng/mL, respectively). After 12 weeks supplementation, both D3 doses were safe and well tolerated. Neither group achieved the a priori efficacy criterion of 25(OH)D≥32 ng/mL in >80% of subjects (45% in SCD-SS and 63% in controls). However, for both subjects with SCD-SS and healthy subjects by 12 weeks, deficient (<20 ng/mL) vit D status was eliminated only in those receiving 7000 IU/d. For subjects with SCD-SS, by 12 weeks there was a significant (all P<0.05) increase in fetal hemoglobin, decrease in high-sensitivity C-reactive protein, and reduction in the percentage of subjects with a high platelet count.

  20. Safety and Efficacy of High-Dose Daily Vitamin D3 Supplementation in Children and Young Adults Infected With Human Immunodeficiency Virus

    PubMed Central

    Dougherty, Kelly A.; Schall, Joan I.; Zemel, Babette S.; Tuluc, Florin; Hou, Xiaoling; Rutstein, Richard M.; Stallings, Virginia A.

    2014-01-01

    Background Suboptimal vitamin D (vitD) status is common in children and young adults infected with human immunodeficiency virus (HIV). The vitD supplemental dose needed to normalize vitD status in this population is unknown. Methods In this double-blind trial, subjects infected with HIV ages 8.3 to 24.9 years were randomized to vitD3 supplementation of 4000 IU/day or 7000 IU/day and evaluated at 6 and 12 week for changes in vitD status and HIV indicators. A dose was considered unsafe if serum calcium was elevated (above age and sex-specific range) associated with elevated serum 25 hydroxyvitamin D (25(OH)D); >160 ng/mL). Results At baseline, 95% of subjects (n = 44; 43% with perinatally acquired HIV, 57% with behaviorally acquired HIV) had a suboptimal serum 25(OH)D concentration of <32 ng/mL (mean ± standard deviation, 19.3 ± 7.4; range, 4.4–33.6 ng/mL). After 12 weeks (main outcome) of D3 supplementation, both D3 doses were safe and well tolerated, with no evidence of elevation of serum calcium concentrations or deterioration in HIV immunologic or virologic status. Sufficient vitD status, defined as serum 25(OH)D ≥32 ng/mL, was achieved in 81% of all subjects, and only the 7000 IU/day group (86%) achieved this a priori efficacy criterion in >80% of subjects. Change in serum 25(OH)D did not differ between HIV acquisition groups. Conclusions A 7000 IU/day D3 supplementation was safe and effective in children and young adults infected with HIV. PMID:26625449

  1. [Locally advanced carcinoma of the cervix uteri (stage IIB-IIIB TNM-UICC): radiotherapy combined with simultaneous daily low-dose platinum. Phase II study].

    PubMed

    Micheletti, E; La Face, B; Bianchi, E; Cagna, E; Sartori, E

    1996-05-01

    A prospective, single arm, phase-II trial was performed to assess the efficacy and local toxicity of the combination of low doses of platin and pelvic radiotherapy in patients with locally advanced carcinoma of the cervix. January, 1993, through August, 1994, twenty-three previously untreated patients with squamous carcinoma (stages IIB-IIIB UICC) entered the study. All patients were examined by a gynecologist and by a radiation oncologist and then submitted to conventional pretreatment staging procedures. Nine patients were classified as stage IIB and 14 patients as stage IIIB. Radiotherapy consisted of 60 Gy external beam irradiation (46 Gy to pelvis + 14 Gy boost to cervix uteri and parametria) plus one low dose rate intracavitary treatment to a dose of 8 Gy to point A. Cisplatin (3 mg/m2/day) or carboplatin (12 mg/m2/day) was also given for 6 weeks starting on radiotherapy day 1. The treatment was well tolerated and no patient required radiotherapy discontinuation. With a median follow-up time of 20 months, complete response was seen in 74% (17/23) of the patients. One of the 17 patients who achieved a complete remission, during follow-up, relapsed in the pelvis and one developed lung metastases. Total failure rate in the pelvis was 30.5% (7/23). Distant metastases were observed in 17.5% (4/23) of the patients. Actuarial overall and disease-free survival rates at 33 months were 69.1% and 65.2%, respectively. Late gastrointestinal toxicity (grade 3) occurred in 8.6% (2/23) of patients, with one patient developing a rectal ulcer-which was submitted to colostomy- and one patient a vaginal necrosis. The combination of platin and radiotherapy appears to be an effective regimen for the patients with locally advanced carcinoma of the cervix and caused a relatively low rate of late gastrointestinal complications.

  2. Nonresponders to Daily Paroxetine and Another SSRI in Men With Lifelong Premature Ejaculation: A Pharmacokinetic Dose-Escalation Study for a Rare Phenomenon

    PubMed Central

    Janssen, Paddy KC; Touw, Daan; Schweitzer, Dave H.

    2014-01-01

    Purpose Nonresponse to any selective serotonin reuptake inhibitor (SSRI) treatment is rare. In this study, we aimed to investigate ejaculation delay nonresponse to paroxetine treatment in men with lifelong premature ejaculation (PE) who were also known to be nonresponders to other SSRIs. Materials and Methods Five males with lifelong PE who were known nonresponders to paroxetine and other serotonergic antidepressants and eight males with lifelong PE who were specifically recruited were included. Blood sampling occurred 1 month and 1 day before the start of treatment and at the end of three consecutive series of 4 weeks of daily treatment with 10-, 20-, and 30-mg paroxetine, respectively. Blood samples for measurement of leptin and paroxetine were taken at 8:30 AM, 9:30 AM, 10:30 AM, and 11:30 AM, respectively. At 9:00 AM, one tablet of 10-, 20-, or 30-mg paroxetine was taken during the first, second, and third month, respectively. Intravaginal ejaculatory latency time (IELT) was measured with a stopwatch. The main outcome measures were the fold increase in the geometric mean IELT, serum leptin and paroxetine concentrations, body mass index (BMI), 5-HT1A receptor C-1019G polymorphism, and CYP2D6 mutations. Results Between the 7 paroxetine responders and 6 nonresponders, the fold increase in the geometric mean IELT was significantly different after daily 10-mg (p=0.003), 20-mg (p=0.002), and 30-mg paroxetine (p=0.026) and ranged from 2.0 to 8.8 and from 1.1 to 1.7, respectively. BMI at baseline and at the end of the study was not significantly different between responders and nonresponders. Serum leptin levels at baseline were similar in responders and nonresponders and did not change during treatment. The serum paroxetine concentration increased with increasing dosage and was not significantly different between responders and nonresponders. There was no association between the fold increase in the geometric mean IELT and serum paroxetine levels during the three

  3. Treatment of chemotherapy-induced neutropenia in a rat model by using multiple daily doses of oral administration of G-CSF-containing nanoparticles.

    PubMed

    Su, Fang-Yi; Chuang, Er-Yuan; Lin, Po-Yen; Chou, Yi-Chun; Chen, Chiung-Tong; Mi, Fwu-Long; Wey, Shiaw-Pyng; Yen, Tzu-Chen; Lin, Kun-Ju; Sung, Hsing-Wen

    2014-04-01

    Chemotherapy-induced neutropenia often increases the likelihood of life-threatening infections. In this study, a nanoparticle (NP) system composed of chitosan and poly(γ-glutamic acid) conjugated with diethylene triamine pentaacetic acid (γPGA-DTPA) was prepared for oral delivery of granulocyte colony-stimulating factor (G-CSF), a hematopoietic growth factor. The therapeutic potential of this NP system for daily administration of G-CSF to treat neutropenia associated with chemotherapy was evaluated in a rat model. In vitro results indicate that the procedures of NP loading and release preserved the structural integrity and bioactivity of the G-CSF molecules adequately. Those results further demonstrated the enzymatic inhibition activity of γPGA-DTPA towards G-CSF against intestinal proteases. Additionally, the in vivo biodistribution study clearly identified accumulations of G-CSF in the heart, liver, bone marrow, and urinary bladder, an indication of systemic absorption of G-CSF; its relative bioavailability was approximately 13.6%. Moreover, significant glucose uptake was observed in bone marrow during G-CSF treatment, suggesting increased bone marrow metabolism and neutrophil production. Consequently, neutrophil count in the blood increased in a sustained manner; this fact may help a patient's immune system recover from the side effects of chemotherapy.

  4. Daily Nutritional Dose Supplementation with Antioxidant Nutrients and Phytochemicals Improves DNA and LDL Stability: A Double-Blind, Randomized, and Placebo-Controlled Trial

    PubMed Central

    Kim, You Jin; Ahn, Yoon Hee; Lim, Yeni; Kim, Ji Yeon; Kim, Joohee; Kwon, Oran

    2013-01-01

    Reactive oxygen species are important risk factors for age-related diseases, but they also act as signaling factors for endogenous antioxidative defense. The hypothesis that a multi-micronutrient supplement with nutritional doses of antioxidant nutrients and phytochemicals (MP) may provide protection against oxidative damage and maintain the endogenous antioxidant defense capacity was assessed in subjects with a habitually low intake of fruits and vegetables. In a randomized, placebo-controlled, and parallel designed trial, 89 eligible subjects were assigned to either placebo or MP for eight weeks. Eighty subjects have completed the protocol and included for the analysis. MP treatment was superior at increasing serum folate (p < 0.0001) and resistance to DNA damage (p = 0.006, tail intensity; p = 0.030, tail moment by comet assay), and LDL oxidation (p = 0.009) compared with the placebo. Moreover, the endogenous oxidative defense capacity was not weakened after MP supplementation, as determined by the levels of glutathione peroxidase (p = 0.442), catalase (p = 0.686), and superoxide dismutase (p = 0.804). The serum folate level was negatively correlated with DNA damage (r = −0.376, p = 0.001 for tail density; r = −0.329, p = 0.003 for tail moment), but no correlation was found with LDL oxidation (r = −0.123, p = 0.275). These results suggest that MP use in healthy subjects with habitually low dietary fruit and vegetable intake may be beneficial in providing resistance to oxidative damage to DNA and LDL without suppressing the endogenous defense mechanisms. PMID:24352096

  5. Nonresected Non-Small-Cell Lung Cancer in Stages I Through IIIB: Accelerated, Twice-Daily, High-Dose Radiotherapy-A Prospective Phase I/II Trial With Long-Term Follow-Up

    SciTech Connect

    Wurstbauer, Karl; Deutschmann, Heinz; Kopp, Peter; Kranzinger, Manfred; Merz, Florian; Nairz, Olaf; Studnicka, Michael; Sedlmayer, Felix

    2010-08-01

    Purpose: Our purpose was to investigate the tolerability of accelerated, twice-daily, high-dose radiotherapy. The secondary endpoints were survival and locoregional tumor control. Methods and Materials: Thirty consecutive patients with histologically/cytologically proven non-small-cell lung cancer were enrolled. Tumor Stage I, II, IIIA, and IIIB was found in 7, 3, 12, and 8 patients, respectively. We applied a median of 84.6 Gy (range, 75.6-90.0 Gy) to the primary tumors, 63.0 Gy (range, 59.4-72.0 Gy) to lymph nodes, and 45 Gy to nodes electively (within a region of about 6 cm cranial to macroscopically involved sites). Fractional doses of 1.8 Gy twice daily, with an interval of 11 hours, were given, resulting in a median treatment time of 35 days. In the majority of patients the conformal target-splitting technique was used. In 19 patients (63%) two cycles of induction chemotherapy were given. The median follow-up time of survivors is 72 months (range, 62-74 months). Results: We found Grade 1, 2 and 3 acute esophageal toxicity in 11 patients (37%), 2 patients (7%), and 2 patients (7%), respectively. Grade 2 acute pneumonitis was seen in 2 patients (7%). No late toxicity greater than Grade 1 was observed. The actual overall survival rates at 2 and 5 years are 63% and 23%, respectively; the median overall survival, 27.7 months. In 9 patients a local failure occurred, 7 of them presenting initially with an atelectasis without availability of 18-fluorodeoxyglucose-positron emission tomography staging at that time. In 4 patients recurrence occurred regionally. Conclusions: This Phase I/II trial with long-term follow-up shows low toxicity with promising results for survival and locoregional tumor control.

  6. Phase IIa, randomized placebo-controlled trial of single high dose cholecalciferol (vitamin D3) and daily Genistein (G-2535) versus double placebo in men with early stage prostate cancer undergoing prostatectomy

    PubMed Central

    Jarrard, David; Konety, Badrinath; Huang, Wei; Downs, Tracy; Kolesar, Jill; Kim, Kyung Mann; Havighurst, Tom; Slaton, Joel; House, Margaret G; Parnes, Howard L; Bailey, Howard H

    2016-01-01

    Introduction and objectives: Prostate cancer (PCa) represents an important target for chemoprevention given its prolonged natural history and high prevalence. Epidemiologic and laboratory data suggest that vitamin D and genistein (soy isoflavone) may decrease PCa progression. The effect of vitamin D on prostate epithelial cell proliferation and differentiation is well documented and genistein may augment this affect through inhibition of the CYP24 enzyme, which is responsible for intracellular vitamin D metabolism. In addition, both genistein and vitamin D inhibit the intraprostatic synthesis of prostaglandin E2, an important mediator of inflammation. The objectives of this prospective multicenter trial were to compare prostate tissue calcitriol levels and down-stream related biomarkers in men with localized prostate cancer randomized to receive cholecalciferol and genistein versus placebo cholecalciferol and placebo genistein during the pre-prostatectomy period. Methods: Men undergoing radical prostatectomy were randomly assigned to one of two treatment groups: (1) cholecalciferol (vitamin D3) 200,000 IU as one dose at study entry plus genistein (G-2535), 600 mg daily or (2) placebo cholecalciferol day 1 and placebo genistein PO daily for 21-28 days prior to radical prostatectomy. Serum and tissue analyses were performed and side-effects recorded. Results: A total of 15 patients were enrolled, 8 in the placebo arm and 7 in the vitamin D3 + genistein (VD + G) arm. All patients were compliant and completed the study. No significant differences in side effect profiles were noted. Utilization of the VD + G trended toward increased calcitriol serum concentrations when compared to placebo (0.104 ± 0.2 vs. 0.0013 ± 0.08; p=0.08); however, prostate tissue levels did not increase. Calcidiol levels did not change (p=0.5). Immunohistochemistry for marker analyses using VECTRA automated quantitation revealed a increase in AR expression (p=0.04) and a trend toward increased

  7. Safety, efficacy, and patient acceptability of single-dose fosaprepitant regimen for the prevention of chemotherapy-induced nausea and vomiting

    PubMed Central

    Celio, Luigi; Ricchini, Francesca; De Braud, Filippo

    2013-01-01

    Control of chemotherapy-induced nausea and vomiting (CINV) is a crucial factor in ensuring that patients undergoing cancer chemotherapy can get the full benefit of therapy. Current antiemetic guidelines recommend that the neurokinin-1 receptor (NK-1R) antagonist aprepitant should be used as part of a combination regimen with dexamethasone and a serotonin receptor antagonist for the prevention of CINV in patients receiving highly emetogenic chemotherapy (HEC). Fosaprepitant is a water-soluble N-phosphoryl derivative of aprepitant that, when infused, is rapidly metabolized back to an active aprepitant. The existing literature in PubMed about fosaprepitant was screened and selected in order to address the emerging data from two randomized clinical trials evaluating the efficacy and safety of a single-dose fosaprepitant regimen. These phase III trials demonstrated that fosaprepitant given as a single intravenous dose of 150 mg was either noninferior to the conventional 3-day aprepitant or significantly superior to placebo for the prevention of acute and delayed CINV in patients receiving high-dose cisplatin. In both trials, fosaprepitant was well tolerated although more frequent infusion-site adverse events were observed with fosaprepitant. The new dosage regimen of fosaprepitant, therefore, would be an option for CINV control in patients receiving cisplatin-based chemotherapy. The clinical efficacy is consistent with the findings from a time-on-target, positron-emission tomography study evaluating the NK-1R occupancy in the central nervous system (CNS) over 5 days after a single-dose infusion of 150 mg fosaprepitant in healthy participants. The single-dose regimen is capable of blocking more than 90% of the NK-1Rs in the CNS for at least 48 hours after infusion, which is sufficient to control delayed CINV for 2 to 5 days after HEC. The new dosage regimen of fosaprepitant can provide a simplified treatment option that maintains high protection while ensuring adherence

  8. Clinical and Pharmacokinetic Data Support Once-Daily Low-Dose Boosted Saquinavir (1,200 Milligrams Saquinavir with 100 Milligrams Ritonavir) in Treatment-Naive or Limited Protease Inhibitor-Experienced Human Immunodeficiency Virus-Infected Patients▿

    PubMed Central

    Marin-Niebla, Ana; Lopez-Cortes, Luis Fernando; Ruiz-Valderas, Rosa; Viciana, Pompeyo; Mata, Rosario; Gutierrez, Alicia; Pascual, Rosario; Rodriguez, Magdalena

    2007-01-01

    We evaluated the plasma and intracellular pharmacokinetics, clinical efficacy, and safety of once-daily low-dose boosted saquinavir (SQVr; 1,200 of saquinavir [SQV] with 100 mg of ritonavir) plus two nucleotide reverse transcriptase inhibitors in treatment-naive or limited protease inhibitor (PI)-experienced human immunodeficiency virus (HIV)-infected patients. A prospective study without entry restrictions on the plasma HIV-RNA (VL) or CD4 cell count was carried out. Plasma and intracellular SQV levels were measured by high-performance liquid chromatography. Efficacy was evaluated by an intention-to-treat analysis; treatment failure was defined as virological failure (a VL of >50 copies/ml after 24 weeks or a confirmed rebound to >50 copies/ml) or interruption for any reason. A total of 151 patients were included in the study (106 of them either had never received PI or had no previous virological failure on PIs) and could be characterized as follows: previous C3 stage, 28.9%; injection-drug users, 69.1%; subjects with chronic viral hepatitis, 53%; and subjects with cirrhosis, 10%. The median baseline CD4 level was 184/μl, and the median VL was 4.8 log10 copies/ml. Median Cmax, area under the concentration-time curve from 0 to 24 h, and Cmin plasma and intracellular SQV levels were 3,672 and 10,105 ng/ml, 34,283 and 99,535 ng·h/ml, and 359 and 1,062 ng/ml, respectively. The efficacy as determined by intention to treat at 52 weeks was 69.7% (96% in the on-treatment analysis), with similar results regardless of the baseline VL and CD4 counts. Only five patients had virological failure despite adequate Cmin levels, but with a poor adherence (the only variable related to virological failure). Adverse events caused the withdrawal of the treatment in four patients (2.6%). In conclusion, given the pharmacokinetic profile, efficacy, and tolerability of this regimen, once-daily low-dose SQVr may be considered a treatment option in treatment-naive or limited PI

  9. Urinary hormone excretion patterns during low-dose progestogen administration.

    PubMed

    Varga, L; Tamme, E

    1975-01-01

    An investigation was made to determine the exact mode of action of continuous low-dosage progestogens used as oral contraceptives. 9 women were studied: 4 received daily doses of 5 mg of lynestrenol, 4 received .35 mg daily doses of norethisterone, and 1 subject received both dosages daily. Basal body temperature and urinary measurements of LH, pregnanediol, and total estrogens were taken. When treatment first started, ovulation was usually inhibited, with anovulatory bleeding occu rring. After a few months of therapy, ovulation and corpus luteum function generally resumed. Luteal insufficiency remained. Functional reserves of the hypothalamic-pituitary axis determined response to the progestogen administration. The ability to reverse the initial anovulation by a function increase was responsible for individual acceptability of the method.

  10. Efficacy and acceptability of perindopril in essential hypertension.

    PubMed

    Sukonthasarn, A; Ratanaprakarn, R; Koanantakul, B; Ngam-Ukos, P

    1994-06-01

    The clinical efficacy and acceptability of once-daily perindopril (4 to 8 mg) monotherapy and in combination with hydrochlorothiazide (50 mg/day) was studied in mild to moderate stable essential hypertensive patients in 4 centres in Thailand. After 2-4 weeks of placebo run-in period, patients received active treatment for 3 months starting with 4 mg perindopril once daily. Dose titration was at second and third month of active treatment if the supine DBP was > 90 mmHg. The dose was doubled and if necessary, 50 mg/day hydrochlorothiazide was added in the last month. The results in 95 patients showed that the mean reduction in supine SBP/DBP at 1, 2 and 3 months of treatment was 10.3/8.0, 13.2/8.7 and 19.1/13.7 mmHg respectively. At the end of the study, 80 per cent of the patients showed normalisation of the supine diastolic blood pressure (supine DBP < or = 90 mmHg) with 30 per cent receiving combined therapy of perindopril and hydrochlorothiazide. There was no significant change in routine haematology or serum biochemistry except for slight increase of potassium levels in patients receiving 8 mg perindopril monotherapy. The incidence of side effects and withdrawal from treatment were quite low. Cough was the major side effect reported comprising 13.6 per cent with only 1 case withdrawn. The study confirms the previous studies that perindopril had satisfactory antihypertensive efficacy and acceptability profiles. PMID:7869013

  11. 26 CFR 44.4403-1 - Daily record.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... operations: (a) The gross amount of all wagers accepted; (b) The gross amount of each class or type of wager accepted on each separate event, contest, or other wagering medium. For example, in the case of wagers accepted on a horse race, the daily record shall show separately the gross amount of each class or type...

  12. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

    Viewgraphs on daily exercise routines are presented. Topics covered include: daily exercise and periodic stress testings; exercise equipment; physiological monitors; exercise protocols; physiological levels; equipment control; control systems; and fuzzy logic control.

  13. Touch screen man machine interfere for emergency dose calculations

    SciTech Connect

    Woodard, K.; Abrams, M.

    1987-01-01

    Emergency dose calculation systems generally use a keyboard to provide the interface between the user and the computer. This interface is preferred by users who work daily with computers; however, for many plant personnel who are not continuously involved with computer operations, the use of a keyboard can be cumbersome and time consuming. This is particularly true when the user is under pressure during a drill or an actual emergency. Experience in many applications of Pickard, Lowe and Garrick's PLG's Meteorological Information and Dose Assessment System (MIDAS) has shown that user friendliness is a key ingredient toward achieving acceptance of computerized systems. Hardware to support to touch screen interface is now available and has been implemented in MIDAS. Recent experience has demonstrated that selection times for dose calculations are reduced, data entry errors have been minimized, and confusion over appropriate entries has been avoided due to the built-in logic. A 10-yr search for an acceptable keyboard replacement has ended.

  14. Phase I North Central Cancer Treatment Group Trial-N9923 of escalating doses of twice-daily thoracic radiation therapy with amifostine and with alternating chemotherapy in limited stage small-cell lung cancer

    SciTech Connect

    Garces, Yolanda I. . E-mail: garces.yolanda@Mayo.edu; Okuno, Scott H.; Schild, Steven E.; Mandrekar, Sumithra J.; Bot, Brian M.; Martens, John M.; Wender, Donald B.; Soori, Gamini S.; Moore, Dennis F.; Kozelsky, Timothy F.; Jett, James R.

    2007-03-15

    Purpose: The primary goal was to identify the maximum tolerable dose (MTD) of thoracic radiation therapy (TRT) that can be given with chemotherapy and amifostine for patients with limited-stage small-cell lung cancer (LSCLC). Methods and Materials: Treatment began with two cycles of topotecan (1 mg/m{sup 2}) Days 1 to 5 and paclitaxel (175 mg/m{sup 2}) Day 5 (every 3 weeks) given before and after TRT. The TRT began at 6 weeks. The TRT was given in 120 cGy fractions b.i.d. and the dose escalation (from 4,800 cGy, dose level 1, to 6,600 cGy, dose level 4) followed the standard 'cohorts of 3' design. The etoposide (E) (50 mg/day) and cisplatin (C) (3 mg/m{sup 2}) were given i.v. before the morning TRT and amifostine (500 mg/day) was given before the afternoon RT. This was followed by prophylactic cranial irradiation (PCI). The dose-limiting toxicities (DLTs) were defined as Grade {>=}4 hematologic, febrile neutropenia, esophagitis, or other nonhematologic toxicity, Grade {>=}3 dyspnea, or Grade {>=}2 pneumonitis. Results: Fifteen patients were evaluable for the Phase I portion of the trial. No DLTs were seen at dose levels 1 and 2. Two patients on dose level 4 experienced DLTs: 1 patient had a Grade 4 pneumonitis, dyspnea, fatigue, hypokalemia, and anorexia, and 1 patient had a Grade 5 hypoxia attributable to TRT. One of 6 patients on dose level 3 had a DLT, Grade 3 esophagitis. The Grade {>=}3 toxicities seen in at least 10% of patients during TRT were esophagitis (53%), leukopenia (33%), dehydration (20%), neutropenia (13%), and fatigue (13%). The median survival was 14.5 months. Conclusion: The MTD of b.i.d. TRT was 6000 cGy (120 cGy b.i.d.) with EP and amifostine.

  15. A Phase 1 Randomized, Open Label, Rectal Safety, Acceptability, Pharmacokinetic, and Pharmacodynamic Study of Three Formulations of Tenofovir 1% Gel (the CHARM-01 Study)

    PubMed Central

    Mcgowan, Ian; Cranston, Ross D.; Duffill, Kathryn; Siegel, Aaron; Engstrom, Jarret C.; Nikiforov, Alexyi; Jacobson, Cindy; Rehman, Khaja K.; Elliott, Julie; Khanukhova, Elena; Abebe, Kaleab; Mauck, Christine; Spiegel, Hans M. L.; Dezzutti, Charlene S.; Rohan, Lisa C.; Marzinke, Mark A.; Hiruy, Hiwot; Hendrix, Craig W.; Richardson-Harman, Nicola; Anton, Peter A.

    2015-01-01

    Objectives The CHARM-01 study characterized the safety, acceptability, pharmacokinetics (PK), and pharmacodynamics (PD) of three tenofovir (TFV) gels for rectal application. The vaginal formulation (VF) gel was previously used in the CAPRISA 004 and VOICE vaginal microbicide Phase 2B trials and the RMP-02/MTN-006 Phase 1 rectal safety study. The reduced glycerin VF (RGVF) gel was used in the MTN-007 Phase 1 rectal microbicide trial and is currently being evaluated in the MTN-017 Phase 2 rectal microbicide trial. A third rectal specific formulation (RF) gel was also evaluated in the CHARM-01 study. Methods Participants received 4 mL of the three TFV gels in a blinded, crossover design: seven daily doses of RGVF, seven daily doses of RF, and six daily doses of placebo followed by one dose of VF, in a randomized sequence. Safety, acceptability, compartmental PK, and explant PD were monitored throughout the trial. Results All three gels were found to be safe and acceptable. RF and RGVF PK were not significantly different. Median mucosal mononuclear cell (MMC) TFV-DP trended toward higher values for RF compared to RGVF (1136 and 320 fmol/106 cells respectively). Use of each gel in vivo was associated with significant inhibition of ex vivo colorectal tissue HIV infection. There was also a significant negative correlation between the tissue levels of TFV, tissue TFV-DP, MMC TFV-DP, rectal fluid TFV, and explant HIV-1 infection. Conclusions All three formulations were found to be safe and acceptable. However, the safety profile of the VF gel was only based on exposure to one dose whereas participants received seven doses of the RGVF and RF gels. There was a trend towards higher tissue MMC levels of TFV-DP associated with use of the RF gel. Use of all gels was associated with significant inhibition of ex vivo tissue HIV infection. Trial Registration ClinicalTrials.gov NCT01575405 PMID:25942472

  16. RTOG 0913: A Phase 1 Study of Daily Everolimus (RAD001) in Combination With Radiation Therapy and Temozolomide in Patients With Newly Diagnosed Glioblastoma

    SciTech Connect

    Chinnaiyan, Prakash; Won, Minhee; Wen, Patrick Y.; Wendland, Merideth; Dipetrillo, Thomas A.; Corn, Benjamin W.; Mehta, Minesh P.

    2013-08-01

    Purpose: To determine the safety of the mammalian target of rapamycin inhibitor everolimus (RAD001) administered daily with concurrent radiation and temozolomide in newly diagnosed glioblastoma patients. Methods and Materials: Everolimus was administered daily with concurrent radiation (60 Gy in 30 fractions) and temozolomide (75 mg/m{sup 2} per day). Everolimus was escalated from 2.5 mg/d (dose level 1) to 5 mg/d (dose level 2) to 10 mg/d (dose level 3). Adjuvant temozolomide was delivered at 150 to 200 mg/m{sup 2} on days 1 to 5, every 28 days, for up to 12 cycles, with concurrent everolimus at the previously established daily dose of 10 mg/d. Dose escalation continued if a dose level produced dose-limiting toxicities (DLTs) in fewer than 3 of the first 6 evaluable patients. Results: Between October 28, 2010, and July 2, 2012, the Radiation Therapy Oncology Group 0913 protocol initially registered a total of 35 patients, with 25 patients successfully meeting enrollment criteria receiving the drug and evaluable for toxicity. Everolimus was successfully escalated to the predetermined maximum tolerated dose of 10 mg/d. Two of the first 6 eligible patients had a DLT at each dose level. DLTs included gait disturbance, febrile neutropenia, rash, fatigue, thrombocytopenia, hypoxia, ear pain, headache, and mucositis. Other common toxicities were grade 1 or 2 hypercholesterolemia and hypertriglyceridemia. At the time of analysis, there was 1 death reported, which was attributed to tumor progression. Conclusions: Daily oral everolimus (10 mg) combined with both concurrent radiation and temozolomide followed by adjuvant temozolomide is well tolerated, with an acceptable toxicity profile. A randomized phase 2 clinical trial with mandatory correlative biomarker analysis is currently under way, designed to both determine the efficacy of this regimen and identify molecular determinants of response.

  17. Daily Sodium Butyrate Enema for the Prevention of Radiation Proctitis in Prostate Cancer Patients Undergoing Radical Radiation Therapy: Results of a Multicenter Randomized Placebo-Controlled Dose-Finding Phase 2 Study

    SciTech Connect

    Maggio, Angelo; Magli, Alessandro; Rancati, Tiziana; Fiorino, Claudio; Valvo, Francesca; Fellin, Giovanni; Ricardi, Umberto; Munoz, Fernando; Cosentino, Dorian; Cazzaniga, Luigi Franco; Valdagni, Riccardo; Vavassori, Vittorio

    2014-07-01

    Purpose: To evaluate the efficacy of sodium butyrate enemas (NABUREN) in prostate cancer radiation therapy (RT) in reducing the incidence, severity, and duration of acute RT-induced proctitis. Methods and Materials: 166 patients, randomly allocated to 1 of 4 groups (rectal sodium butyrate 1 g, 2 g, or 4 g daily or placebo), were treated with NABUREN during and 2 weeks after RT. The grade of proctitis was registered in a daily diary. The correlation between NABUREN and proctitis was investigated through χ{sup 2} statistics. The toxicity endpoints considered were as follows: total number of days with grade ≥1 proctitis (≥G1); total number of days with grade ≥2 proctitis (≥G2); ≥G1 and ≥G2 proctitis lasting at least 3 and 5 consecutive days starting from week 4 (≥G1+3d, ≥G2+3d); damaging effects of RT on rectal mucosa as measured by endoscopy. The relationship between endpoints and pretreatment morbidities, hormonal therapy, presence of diabetes or hypertension, abdominal surgery, or hemorrhoids was investigated by univariate analysis. Results: The patients were randomly allocated to the 4 arms. No difference in the distribution of comorbidities among the arms was observed (P>.09). The mean ≥G1 and ≥G2 proctitis were 7.8 and 4.9 for placebo and 8.9 and 4.7 for the NABUREN group, respectively. No favorable trend in reduction of incidence, severity, and duration of ≥G1 and ≥G2 proctitis was observed with NABUREN use. In univariate analysis, ≥G1+3d toxicity was found to be related to hemorrhoids (P=.008), and a slight correlation was found between ≥G2 proctitis and hormonal therapy (P=.06). The RT effects on rectal mucosa as based on endoscopic assessment were mainly related to diabetes (P<.01). Endoscopy data at 6 week showed no significant difference between the placebo and butyrate arms. The other investigated endpoints were not correlated with any of the clinical risk factors analyzed. Conclusion: There was no evidence of efficacy

  18. Seasonal Variation in Daily Temperature Ranges.

    NASA Astrophysics Data System (ADS)

    Ruschy, David L.; Baker, Donald G.; Skaggs, Richard H.

    1991-12-01

    Abrupt spring and autumnal changes in the daily temperature range, from low winter values to higher nonwinter values, were noted in the Minneapolis-St. Paul temperature record. Since this feature was even more evident in five rural and small town Minnesota stations, it can be accepted as real.The inverse relationship found between surface albedo and the daily temperature range indicated that the reduced winter temperature range is associated with snow cover. A second factor controlling the temperature range is cloud cover. This led to the conclusion that variation in net solar radiation is the primary factor.A strong statistical relationship between daily temperature range and the three variables considered (solar radiation, albedo, and cloud cover) was limited to the spring and fall. In March-April the statistically significant factors were solar radiation and albedo, while in October-November they were solar radiation and cloud cover. For the October-December period albedo was also statistically important.

  19. Tips for Daily Life

    MedlinePlus

    ... A Share Plus on Google Plus I Have Alzheimer's Disease alz.org | IHaveAlz I Have Alz Homepage Know ... others living with Alzheimer's back to top The Alzheimer's ... living with the disease, share their personal insights about the daily strategies ...

  20. Toothbrushing: Do It Daily.

    ERIC Educational Resources Information Center

    Texas Child Care, 1993

    1993-01-01

    Offers a practical guide for promoting daily toothbrushing in young children. Discusses the importance of proper dental care, explains the causes of tooth decay, describes proper dental care for infants and young children, recommends materials and teaching methods, and discusses visits to the dentist and the benefits of fluoride for dental health.…

  1. Twice-daily and once-daily nedocromil sodium 2% ophthalmic solution for the treatment of seasonal allergic conjunctivitis.

    PubMed

    Alexander, Michael; Allegro, Stacey; Hicks, Angela

    2002-01-01

    In this 8-week open-label, prospective study, 30 patients with grass pollen allergy and ocular itching instilled nedocromil sodium 2% ophthalmic solution twice daily for a 5-day baseline period, followed by once-daily dosing thereafter. Physicians assessed clinical signs after the twice-daily period and after weeks 1 and 3 of the once-daily period; patients rated ocular symptoms daily. Use of specified rescue medication was permitted. Symptom scores for ocular itching, stinging, redness, swelling, burning, tearing, and light sensitivity did not differ significantly between the dosage periods. Scores for erythema, edema, conjunctival injection, and the entire conjunctiva decreased slightly during once-daily administration; discharge scores were unchanged. Of the 20 patients who used rescue medication, only 5 increased their usage by more than two doses per week during the once-daily period. Eighty-three percent of patients were willing to continue the once-daily regimen during the next allergy season. Physicians rated overall control of seasonal allergic conjunctivitis with once-daily administration as "good" or "moderate" in 100% of the patients; 93% of patients applied those ratings themselves. Nedocromil sodium 2% ophthalmic solution instilled once daily maintains control of symptoms in patients who are established on a twice-daily regimen. PMID:12008862

  2. Offer/Acceptance Ratio.

    ERIC Educational Resources Information Center

    Collins, Mimi

    1997-01-01

    Explores how human resource professionals, with above average offer/acceptance ratios, streamline their recruitment efforts. Profiles company strategies with internships, internal promotion, cooperative education programs, and how to get candidates to accept offers. Also discusses how to use the offer/acceptance ratio as a measure of program…

  3. Difference in nephrotoxicity of vancomycin administered once daily and twice daily in rats.

    PubMed

    Konishi, Hiroki; Morita, Yukiko; Mizumura, Miyo; Iga, Ikumi; Nagai, Katsuhito

    2013-10-01

    We compared the degree of nephrotoxicity of vancomycin (VCM) administered once daily and twice daily in rats. VCM was intraperitoneally administered once daily to rats at a dose of 400 mg/kg (VCM-1-treated) or administered at a dose of 200 mg/kg twice daily at 12-hour intervals (VCM-2-treated) for 7 consecutive days. Creatinine clearance was decreased more markedly in VCM-1 rats relative to VCM-2 rats, although there was no significant difference in renal accumulation of VCM between the two groups. Renal superoxide dismutase activity was lower in VCM-1 rats than that in VCM-2 rats. The magnitude of histological change in kidney tissue was in agreement with the degree of alterations in the abovementioned biochemical values. These results suggest that the nephrotoxic effect of once-daily VCM administration is more pronounced than that of the twice-daily treatment. Our findings provide fundamental evidence for the advantage in choosing a divided VCM administration to attenuate nephrotoxicity.

  4. Estimation of effective imaging dose for kilovoltage intratreatment monitoring of the prostate position during cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Ng, J. A.; Booth, J.; Poulsen, P.; Kuncic, Z.; Keall, P. J.

    2013-09-01

    Kilovoltage intratreatment monitoring (KIM) is a novel real-time localization modality where the tumor position is continuously measured during intensity modulated radiation therapy (IMRT) or intensity modulated arc therapy (IMAT) by a kilovoltage (kV) x-ray imager. Adding kV imaging during therapy adds radiation dose. The additional effective dose is quantified for prostate radiotherapy and compared to dose from other localization modalities. The software PCXMC 2.0 was used to calculate the effective dose delivered to a phantom as a function of imager angle and field size for a Varian On-Board Imager. The average angular effective dose was calculated for a field size of 6 cm × 6 cm. The average angular effective dose was used in calculations for different treatment scenarios. Treatment scenarios considered were treatment type and fractionation. For all treatment scenarios, (i.e. conventionally fractionated and stereotactic body radiotherapy (SBRT), IMRT and IMAT), the total KIM dose at 1 Hz ranged from 2-10 mSv. This imaging dose is less than the Navotek radioactive implant dose (64 mSv) and a standard SBRT cone beam computed tomography pretreatment scan dose (22 mSv) over an entire treatment regime. KIM delivers an acceptably low effective dose for daily use as a real-time image-guidance method for prostate radiotherapy.

  5. Neutron dose equivalent meter

    DOEpatents

    Olsher, Richard H.; Hsu, Hsiao-Hua; Casson, William H.; Vasilik, Dennis G.; Kleck, Jeffrey H.; Beverding, Anthony

    1996-01-01

    A neutron dose equivalent detector for measuring neutron dose capable of accurately responding to neutron energies according to published fluence to dose curves. The neutron dose equivalent meter has an inner sphere of polyethylene, with a middle shell overlying the inner sphere, the middle shell comprising RTV.RTM. silicone (organosiloxane) loaded with boron. An outer shell overlies the middle shell and comprises polyethylene loaded with tungsten. The neutron dose equivalent meter defines a channel through the outer shell, the middle shell, and the inner sphere for accepting a neutron counter tube. The outer shell is loaded with tungsten to provide neutron generation, increasing the neutron dose equivalent meter's response sensitivity above 8 MeV.

  6. 12 CFR 250.165 - Bankers' acceptances: definition of participations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the acceptance at the time the BA is presented for payment. H. Rep. No. 97-629, 97th Cong., 2nd Sess. 15 (1982); 128 Cong. Rec. H 4647 (daily ed. July 27, 1982) (remarks by Rep. Barnard): and 128 Cong. Rec. H 8462 (daily ed. October 1, 1982) (remarks by Rep. Barnard). The legislative history...

  7. 12 CFR 250.165 - Bankers' acceptances: definition of participations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the acceptance at the time the BA is presented for payment. H. Rep. No. 97-629, 97th Cong., 2nd Sess. 15 (1982); 128 Cong. Rec. H 4647 (daily ed. July 27, 1982) (remarks by Rep. Barnard): and 128 Cong. Rec. H 8462 (daily ed. October 1, 1982) (remarks by Rep. Barnard). The legislative history...

  8. 12 CFR 250.165 - Bankers' acceptances: definition of participations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the acceptance at the time the BA is presented for payment. H. Rep. No. 97-629, 97th Cong., 2nd Sess. 15 (1982); 128 Cong. Rec. H 4647 (daily ed. July 27, 1982) (remarks by Rep. Barnard): and 128 Cong. Rec. H 8462 (daily ed. October 1, 1982) (remarks by Rep. Barnard). The legislative history...

  9. Pharmacokinetics and pharmacodynamics of boosted once-daily darunavir.

    PubMed

    Kakuda, Thomas N; Brochot, Anne; Tomaka, Frank L; Vangeneugden, Tony; Van De Casteele, Tom; Hoetelmans, Richard M W

    2014-10-01

    The ability to dose antiretroviral agents once daily simplifies the often complex therapeutic regimens required for the successful treatment of HIV infection. Thus, once-daily dosing can lead to improved patient adherence to medication and, consequently, sustained virological suppression and reduction in the risk of emergence of drug resistance. Several trials have evaluated once-daily darunavir/ritonavir in combination with other antiretrovirals (ARTEMIS and ODIN trials) or as monotherapy (MONET, MONOI and PROTEA trials) in HIV-1-infected adults. Data from ARTEMIS and ODIN demonstrate non-inferiority of once-daily darunavir/ritonavir against a comparator and, together with pharmacokinetic data, have established the suitability of once-daily darunavir/ritonavir for treatment-naive and treatment-experienced patients with no darunavir resistance-associated mutations. The findings of ARTEMIS and ODIN have led to recent updates to treatment guidelines, whereby once-daily darunavir/ritonavir, given with other antiretrovirals, is now a preferred treatment option for antiretroviral-naive adult patients and a simplified treatment option for antiretroviral-experienced adults who have no darunavir resistance-associated mutations. Once-daily dosing with darunavir/ritonavir is an option for treatment-naive and for treatment-experienced paediatric patients with no darunavir resistance-associated mutations based on the findings of the DIONE trial and ARIEL substudy. This article reviews the pharmacokinetics, efficacy, safety and tolerability of once-daily boosted darunavir. The feasibility of darunavir/ritonavir monotherapy as a treatment approach for some patients is also discussed. Finally, data on a fixed-dose combination of 800/150 mg of darunavir/cobicistat once daily are presented, showing comparable darunavir bioavailability to that obtained with 800/100 mg of darunavir/ritonavir once daily. PMID:24951533

  10. An automatic dose verification system for adaptive radiotherapy for helical tomotherapy

    NASA Astrophysics Data System (ADS)

    Mo, Xiaohu; Chen, Mingli; Parnell, Donald; Olivera, Gustavo; Galmarini, Daniel; Lu, Weiguo

    2014-03-01

    Purpose: During a typical 5-7 week treatment of external beam radiotherapy, there are potential differences between planned patient's anatomy and positioning, such as patient weight loss, or treatment setup. The discrepancies between planned and delivered doses resulting from these differences could be significant, especially in IMRT where dose distributions tightly conforms to target volumes while avoiding organs-at-risk. We developed an automatic system to monitor delivered dose using daily imaging. Methods: For each treatment, a merged image is generated by registering the daily pre-treatment setup image and planning CT using treatment position information extracted from the Tomotherapy archive. The treatment dose is then computed on this merged image using our in-house convolution-superposition based dose calculator implemented on GPU. The deformation field between merged and planning CT is computed using the Morphon algorithm. The planning structures and treatment doses are subsequently warped for analysis and dose accumulation. All results are saved in DICOM format with private tags and organized in a database. Due to the overwhelming amount of information generated, a customizable tolerance system is used to flag potential treatment errors or significant anatomical changes. A web-based system and a DICOM-RT viewer were developed for reporting and reviewing the results. Results: More than 30 patients were analysed retrospectively. Our in-house dose calculator passed 97% gamma test evaluated with 2% dose difference and 2mm distance-to-agreement compared with Tomotherapy calculated dose, which is considered sufficient for adaptive radiotherapy purposes. Evaluation of the deformable registration through visual inspection showed acceptable and consistent results, except for cases with large or unrealistic deformation. Our automatic flagging system was able to catch significant patient setup errors or anatomical changes. Conclusions: We developed an automatic dose

  11. Acceptability of BCG vaccination.

    PubMed

    Mande, R

    1977-01-01

    The acceptability of BCG vaccination varies a great deal according to the country and to the period when the vaccine is given. The incidence of complications has not always a direct influence on this acceptability, which depends, for a very large part, on the risk of tuberculosis in a given country at a given time.

  12. ATLAS ACCEPTANCE TEST

    SciTech Connect

    Cochrane, J. C. , Jr.; Parker, J. V.; Hinckley, W. B.; Hosack, K. W.; Mills, D.; Parsons, W. M.; Scudder, D. W.; Stokes, J. L.; Tabaka, L. J.; Thompson, M. C.; Wysocki, Frederick Joseph; Campbell, T. N.; Lancaster, D. L.; Tom, C. Y.

    2001-01-01

    The acceptance test program for Atlas, a 23 MJ pulsed power facility for use in the Los Alamos High Energy Density Hydrodynamics program, has been completed. Completion of this program officially releases Atlas from the construction phase and readies it for experiments. Details of the acceptance test program results and of machine capabilities for experiments will be presented.

  13. Effects of Proton Radiation Dose, Dose Rate and Dose Fractionation on Hematopoietic Cells in Mice

    PubMed Central

    Ware, J. H.; Sanzari, J.; Avery, S.; Sayers, C.; Krigsfeld, G.; Nuth, M.; Wan, X. S.; Rusek, A.; Kennedy, A. R.

    2012-01-01

    The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05–0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons. PMID:20726731

  14. Effects of proton radiation dose, dose rate and dose fractionation on hematopoietic cells in mice

    SciTech Connect

    Ware, J.H.; Rusek, A.; Sanzari, J.; Avery, S.; Sayers, C.; Krigsfeld, G.; Nuth, M.; Wan, X.S.; Kennedy, A.R.

    2010-09-01

    The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05-0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons.

  15. Acceptance procedures: Microfilm printer

    NASA Technical Reports Server (NTRS)

    Lockwood, H. E.

    1973-01-01

    Acceptance tests were made for a special order automatic additive color microfilm printer. Tests include film capacity, film transport, resolution, illumination uniformity, exposure range checks, and color cuing considerations.

  16. Dapagliflozin twice daily or once daily: effect on pharmacokinetics and urinary glucose excretion in healthy subjects.

    PubMed

    Tang, W; Reele, S; Hamer-Maansson, J E; Parikh, S; de Bruin, T W A

    2015-04-01

    The primary objective of this single-centre, open-label crossover study (NCT01072578) was to assess the effect of dapagliflozin on the amount of glucose in the blood and urine in healthy volunteers when dapagliflozin was administered once a day (10 mg) versus twice a day (5 mg every 12 h) after 5 days of dosing. At steady state, the AUC(ss)₀₋₂₄ (area under the dapagliflozin curve (0-24 hours) at steady state), C(ss,av) (average concentration at steady state) between dapagliflozin 5 mg twice daily and 10 mg once daily were similar AUC(ss)₀₋₂₄ [5 mg bid, (458.0 (28.7)) and 10 mg qd, (470.0 (28.5))] and C(ss,av) [5 mg bid 18.8 (28.9)) and 10 mg qd, (19.6(28.5))], but minimum and maximum plasma levels of dapagliflozin differed significantly. Percent inhibition of renal glucose reabsorption (%IRGRA) and total urinary glucose excretion over 24 h were similar for both doses. The relationship between the mean dapagliflozin concentration and %IRGRA and the total urinary glucose excreted was well described by a maximum effect model. The results indicate that dapagliflozin may be used for either once daily or twice daily administration.

  17. Quantification of Daily Physical Activity

    NASA Technical Reports Server (NTRS)

    Whalen, Robert; Breit, Greg; Quintana, Jason

    1994-01-01

    The influence of physical activity on the maintenance and adaptation of musculoskeletal tissue is difficult to assess. Cumulative musculoskeletal loading is hard to quantify and the attributes of the daily tissue loading history affecting bone metabolism have not been completely identified. By monitoring the vertical component of the daily ground reaction force (GRFz), we have an indirect measure of cumulative daily lower limb musculoskeletal loading to correlate with bone density and structure. The objective of this research is to develop instrumentation and methods of analysis to quantify activity level in terms of the daily history of ground reaction forces.

  18. Estimating the real world daily usage and cost for exenatide twice daily and liraglutide in Germany, the Netherlands, and the UK based on volumes dispensed by pharmacies

    PubMed Central

    McDonell, Amanda L; Kiiskinen, Urpo; Zammit, Danielle C; Kotchie, Robert W; Thuresson, Per-Olof; Nicolay, Claudia; Haslam, Thomas; Bruinsma, Michiel; Janszen-Van Oosterhout, Anne-Jeanine; Otto, Thorsten

    2015-01-01

    Background Glucagon-like peptide-1 (GLP-1) receptor agonists are indicated for improvement of glycemic control in adults with type 2 diabetes. Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient. The objective of this study was to estimate the average dose usage and real world daily cost of the GLP-1 receptor agonists, exenatide twice daily and liraglutide once daily, in Germany, the Netherlands, and the UK. Methods Administrative databases were used to source the data from longitudinal records of dispensed prescriptions. Data were extracted from the IMS Longitudinal Prescription database which captures details of prescriptions dispensed in pharmacies. Information on the dispensed quantity of each product was used to estimate average daily usage per patient. Daily dose usage was multiplied by the public price per unit to estimate daily cost. Results The dispensed volume in Germany corresponded to a mean dispensed daily dose of 16.81 μg for exenatide twice daily and 1.37 mg for liraglutide (mean daily cost €4.02 and €4.54, respectively). In the Netherlands, average dispensed daily doses of 17.07 μg and 1.49 mg were observed for exenatide twice daily and liraglutide (mean daily cost €3.05 and €3.97, respectively). In the UK, the mean dispensed volume corresponded to a daily usage of 20.49 μg for exenatide twice daily and 1.50 mg for liraglutide (mean daily cost £2.53 and £3.28, respectively). Conclusion Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics. Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK. Such estimates can be used to inform health care decision-makers on the real world usage and cost of medications effective in achieving

  19. Experiential avoidance and well-being: a daily diary analysis.

    PubMed

    Machell, Kyla A; Goodman, Fallon R; Kashdan, Todd B

    2015-01-01

    Experiential avoidance (EA) is a regulatory strategy characterised by efforts to control or avoid unpleasant thoughts, feelings and bodily sensations. Most studies of EA have used trait measures without considering the effects of EA on psychological functioning in naturalistic settings. To address this gap, we used daily diary methodology to examine the influence of EA of anxiety on everyday well-being. For two weeks, 89 participants provided daily reports of EA, positive and negative affect, enjoyment of daily events and meaning in life (MIL). Daily EA predicted higher negative affect, lower positive affect, less enjoyment of daily events (exercising, eating food and listening to music) and less MIL. The effect of EA on positive affect was not accounted for by the amount of negative affect experienced. Our daily measure of EA was a stronger predictor of daily well-being than a traditional trait measure (The Acceptance and Action Questionnaire). Taken together, results offer insights into the adverse effects of EA on daily well-being and suggest that EA is a context-specific regulatory strategy that might be best captured using a state-dependent measure. PMID:24800802

  20. Smaller hospitals accept advertising.

    PubMed

    Mackesy, R

    1988-07-01

    Administrators at small- and medium-sized hospitals gradually have accepted the role of marketing in their organizations, albeit at a much slower rate than larger institutions. This update of a 1983 survey tracks the increasing competitiveness, complexity and specialization of providing health care and of advertising a small hospital's services. PMID:10288550

  1. Students Accepted on Probation.

    ERIC Educational Resources Information Center

    Lorberbaum, Caroline S.

    This report is a justification of the Dalton Junior College admissions policy designed to help students who had had academic and/or social difficulties at other schools. These students were accepted on probation, their problems carefully analyzed, and much effort devoted to those with low academic potential. They received extensive academic and…

  2. Approaches to acceptable risk

    SciTech Connect

    Whipple, C.

    1997-04-30

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.

  3. Why was Relativity Accepted?

    NASA Astrophysics Data System (ADS)

    Brush, S. G.

    Historians of science have published many studies of the reception of Einstein's special and general theories of relativity. Based on a review of these studies, and my own research on the role of the light-bending prediction in the reception of general relativity, I discuss the role of three kinds of reasons for accepting relativity (1) empirical predictions and explanations; (2) social-psychological factors; and (3) aesthetic-mathematical factors. According to the historical studies, acceptance was a three-stage process. First, a few leading scientists adopted the special theory for aesthetic-mathematical reasons. In the second stage, their enthusiastic advocacy persuaded other scientists to work on the theory and apply it to problems currently of interest in atomic physics. The special theory was accepted by many German physicists by 1910 and had begun to attract some interest in other countries. In the third stage, the confirmation of Einstein's light-bending prediction attracted much public attention and forced all physicists to take the general theory of relativity seriously. In addition to light-bending, the explanation of the advance of Mercury's perihelion was considered strong evidence by theoretical physicists. The American astronomers who conducted successful tests of general relativity became defenders of the theory. There is little evidence that relativity was `socially constructed' but its initial acceptance was facilitated by the prestige and resources of its advocates.

  4. Pharmacokinetic properties of single-dose primaquine in Papua New Guinean children: feasibility of abbreviated high-dose regimens for radical cure of vivax malaria.

    PubMed

    Moore, Brioni R; Salman, Sam; Benjamin, John; Page-Sharp, Madhu; Robinson, Leanne J; Waita, Elizabeth; Batty, Kevin T; Siba, Peter; Mueller, Ivo; Davis, Timothy M E; Betuela, Inoni

    2014-01-01

    Since conventional 14-day primaquine (PMQ) radical cure of vivax malaria is associated with poor compliance, and as total dose, not therapy duration, determines efficacy, a preliminary pharmacokinetic study of two doses (0.5 and 1.0 mg/kg of body weight) was conducted in 28 healthy glucose-6-phosphate dehydrogenase-normal Papua New Guinean children, aged 5 to 12 years, to facilitate development of abbreviated high-dose regimens. Dosing was with food and was directly observed, and venous blood samples were drawn during a 168-h postdose period. Detailed safety monitoring was performed for hepatorenal function and hemoglobin and methemoglobin concentrations. Plasma concentrations of PMQ and its metabolite carboxyprimaquine (CPMQ) were determined by liquid chromatography-mass spectrometry and analyzed using population pharmacokinetic methods. The derived models were used in simulations. Both single-dose regimens were well tolerated with no changes in safety parameters. The mean PMQ central volume of distribution and clearance relative to bioavailability (200 liters/70 kg and 24.6 liters/h/70 kg) were within published ranges for adults. The median predicted maximal concentrations (Cmax) for both PMQ and CPMQ after the last dose of a 1.0 mg/kg 7-day PMQ regimen were approximately double those at the end of 14 days of 0.5 mg/kg daily, while a regimen of 1.0 mg/kg twice daily resulted in a 2.38 and 3.33 times higher Cmax for PMQ and CPMQ, respectively. All predicted median Cmax concentrations were within ranges for adult high-dose studies that also showed acceptable safety and tolerability. The present pharmacokinetic data, the first for PMQ in children, show that further studies of abbreviated high-dose regimens are feasible in this age group. PMID:24189254

  5. Evaluation of Radiation Dose and Image Quality for the Varian Cone Beam Computed Tomography System

    SciTech Connect

    Cheng, Harry C.Y.; Wu, Vincent W.C.; Liu, Eva S.F.; Kwong, Dora L.W.

    2011-05-01

    Purpose: To compare the image quality and dosimetry on the Varian cone beam computed tomography (CBCT) system between software Version 1.4.13 and Version 1.4.11 (referred to as 'new' and 'old' protocols, respectively, in the following text). This study investigated organ absorbed dose, total effective dose, and image quality of the CBCT system for the head-and-neck and pelvic regions. Methods and Materials: A calibrated Farmer chamber and two standard cylindrical Perspex CT dosimetry phantoms with diameter of 16 cm (head phantom) and 32 cm (body phantom) were used to measure the weighted cone-beam computed tomography dose index (CBCTDIw) of the Varian CBCT system. The absorbed dose of different organs was measured in a female anthropomorphic phantom with thermoluminescent dosimeters (TLD) and the total effective dose was estimated according to International Commission on Radiological Protection (ICRP) Publication 103. The dose measurement and image quality were studied for head-and-neck and pelvic regions, and comparison was made between the new and old protocols. Results: The values of the new CBCTDIw head-and-neck and pelvic protocols were 36.6 and 29.4 mGy, respectively. The total effective doses from the new head-and-neck and pelvic protocols were 1.7 and 8.2 mSv, respectively. The absorbed doses of lens for the new 200{sup o} and old 360{sup o} head-and-neck protocols were 3.8 and 59.4 mGy, respectively. The additional secondary cancer risk from daily CBCT might be up to 2.8%. Conclusions: The new Varian CBCT provided volumetric information for image guidance with acceptable image quality and lower radiation dose. This imaging tool gave a better standard for patient daily setup verification.

  6. Which metric of ambient ozone to predict daily mortality?

    NASA Astrophysics Data System (ADS)

    Moshammer, Hanns; Hutter, Hans-Peter; Kundi, Michael

    2013-02-01

    It is well known that ozone concentration is associated with daily cause specific mortality. But which ozone metric is the best predictor of the daily variability in mortality? We performed a time series analysis on daily deaths (all causes, respiratory and cardiovascular causes as well as death in elderly 65+) in Vienna for the years 1991-2009. We controlled for seasonal and long term trend, day of the week, temperature and humidity using the same basic model for all pollutant metrics. We found model fit was best for same day variability of ozone concentration (calculated as the difference between daily hourly maximum and minimum) and hourly maximum. Of these the variability displayed a more linear dose-response function. Maximum 8 h moving average and daily mean value performed not so well. Nitrogen dioxide (daily mean) in comparison performed better when previous day values were assessed. Same day ozone and previous day nitrogen dioxide effect estimates did not confound each other. Variability in daily ozone levels or peak ozone levels seem to be a better proxy of a complex reactive secondary pollutant mixture than daily average ozone levels in the Middle European setting. If this finding is confirmed this would have implications for the setting of legally binding limit values.

  7. Acceptability of human risk.

    PubMed Central

    Kasperson, R E

    1983-01-01

    This paper has three objectives: to explore the nature of the problem implicit in the term "risk acceptability," to examine the possible contributions of scientific information to risk standard-setting, and to argue that societal response is best guided by considerations of process rather than formal methods of analysis. Most technological risks are not accepted but are imposed. There is also little reason to expect consensus among individuals on their tolerance of risk. Moreover, debates about risk levels are often at base debates over the adequacy of the institutions which manage the risks. Scientific information can contribute three broad types of analyses to risk-setting deliberations: contextual analysis, equity assessment, and public preference analysis. More effective risk-setting decisions will involve attention to the process used, particularly in regard to the requirements of procedural justice and democratic responsibility. PMID:6418541

  8. SU-E-T-556: Dosimetric Comparison of the Bladder and Rectum Based On Daily CBCT for Prostate IMRT

    SciTech Connect

    Gill, S; Pearson, D; Dalhart, A; Reddy, K; Chen, C

    2014-06-01

    Purpose: With the use of CBCT, delivered dose can be calculated by transferring the planned beams onto the CBCT. Bladder and rectum volumetric doses were calculated and correlated to the daily bladder and rectum fullness. Methods: Patients for this study underwent hypofractionated prostate IMRT to 70 Gy in 28 fractions. Daily CBCT was utilized for image guidance. A clinically acceptable plan was created using a CTV to PTV margin of 5mm. Image fusion was performed to transfer the bladder and rectum contours onto each CBCT. Contours were then edited to match the anatomy of each CBCT. Using the daily treatment isocenter, the planned beams were transferred onto the CBCT and daily and cumulative DVHs calculated. Results: At the time of planning the bladder volume was 470.66cc. The mean, minimum and maximum bladder volume from the 28 CBCTs was 230.57cc, 76.16 cc and 380.8 cc, respectively. Planned bladder V70Gy was 0.98%. Actual bladder V70Gy, as calculated from the CBCTs was 2.46±1.36%. Similarly, planned V60Gy, V50Gy and V40Gy were 2.55%, 4.15% and 6.35% of the total bladder volume. The observed volumes receiving 60Gy, 50Gy and 40Gy were 5.18±2.53%, 4 to 8.21±3.76% and 6 to 12.93±5.60%, respectively. On the planning CT the rectum volume was 41.5cc. The observed mean, minimum and maximum rectum volumes were 58.09cc, 93.52 and 47.50cc. The planned rectum V70Gy was 6.02% while the observed cumulative rectum V70Gy was 13.68±3.39%. Rectum V60Gy, V50Gy and V40Gy changed from 13.61% to 22.5±3.86%, 19.15% to 28.68±4.45 and 25.56% to 34.75±5.15%. Conclusion: Bladder and rectum volumes changes during treatment have an affect on the cumulative dose received by these organs. It was observed that volumetric dose received by bladder decreases as volume of the bladder increases. There is no particular trend observed between volumetric dose and rectal volume.

  9. Prioritization of pesticides based on daily dietary exposure potential as determined from the SHEDS model.

    PubMed

    Melnyk, Lisa Jo; Wang, Zhaohui; Li, Zhilin; Xue, Jianping

    2016-10-01

    A major pathway for exposure to many pesticides is through diet. The objectives were to rank pesticides by comparing their calculated daily dietary exposure as determined by EPA's Stochastic Human Exposure and Dose Simulation (SHEDS) to single pesticides for different age groups to acceptable daily intakes (ADI), characterize pesticide trends in exposures over different time periods, and determine commodities contributing to pesticide exposures. SHEDS was applied, using Pesticide Data Program (PDP) (1991-2011) and pesticide usage data on crops from USDA combined with NHANES dietary consumption data, to generate exposure estimates by age group. ADI data collected from EPA, WHO, and other sources were used to rank pesticides based on relativeness of the dietary exposure potential to ADI by age groups. Sensitivity analysis provided trends in pesticide exposures. Within SHEDS, commodities contributing the majority of pesticides with greatest exposure potential were determined. The results indicated that the highest ranking pesticides were methamidophos and diazinon which exceeded 100% of the ADI. Sensitivity analysis indicated that exposure to methamidophos, diazinon, malathion, ethion and formetanate hydrochloride had a marked decrease from 1991-1999 to 2000-2011. Contributions analysis indicated that apples, mushroom, carrots, and lettuce contributed to diazinon exposure. Beans and pepper contributed to methamidophos exposure. PMID:27497764

  10. Unravelling daily human mobility motifs.

    PubMed

    Schneider, Christian M; Belik, Vitaly; Couronné, Thomas; Smoreda, Zbigniew; González, Marta C

    2013-07-01

    Human mobility is differentiated by time scales. While the mechanism for long time scales has been studied, the underlying mechanism on the daily scale is still unrevealed. Here, we uncover the mechanism responsible for the daily mobility patterns by analysing the temporal and spatial trajectories of thousands of persons as individual networks. Using the concept of motifs from network theory, we find only 17 unique networks are present in daily mobility and they follow simple rules. These networks, called here motifs, are sufficient to capture up to 90 per cent of the population in surveys and mobile phone datasets for different countries. Each individual exhibits a characteristic motif, which seems to be stable over several months. Consequently, daily human mobility can be reproduced by an analytically tractable framework for Markov chains by modelling periods of high-frequency trips followed by periods of lower activity as the key ingredient.

  11. Age and Acceptance of Euthanasia.

    ERIC Educational Resources Information Center

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  12. Single dose NTBC-treatment of hereditary tyrosinemia type I.

    PubMed

    Schlune, A; Thimm, E; Herebian, D; Spiekerkoetter, U

    2012-09-01

    NTBC (2-(2-nitro-4-trifluoromethylbenzoyl)-1,3cyclohexanedione) is the mainstay of treatment in tyrosinemia type 1 (HT 1). The current recommendation is to divide the total daily dose of NTBC into two doses. We monitored the plasma NTBC concentrations in a series of seven patients who were changed from multiple divided doses to a single daily dose of NTBC. Two additional patients were started on a single daily dose of NTBC after the diagnosis of HT 1 was established. In three patients, NTBC kinetics were performed over 6 and 24 hours, respectively. The use of multiple divided doses or a single daily dose did not significantly affect plasma NTBC concentrations or the mean daily dose needed to attain therapeutic plasma NTBC concentrations. Moreover, kinetic studies demonstrated that plasma NTBC concentrations were completely stable over a period of 24 hours with a single dose regimen, as expected given the known NTBC plasma half life of 54 hours. Although these preliminary results need to be confirmed in more patients, our findings show that administration of NTBC in a single daily dose may be as effective as a multiple-dose regimen in reaching therapeutic plasma NTBC concentrations and suppressing succinylacetone formation in patients with HT 1. In fact, single dose treatment may increase patients' compliance with the drug treatment and improve metabolic control.

  13. Baby-Crying Acceptance

    NASA Astrophysics Data System (ADS)

    Martins, Tiago; de Magalhães, Sérgio Tenreiro

    The baby's crying is his most important mean of communication. The crying monitoring performed by devices that have been developed doesn't ensure the complete safety of the child. It is necessary to join, to these technological resources, means of communicating the results to the responsible, which would involve the digital processing of information available from crying. The survey carried out, enabled to understand the level of adoption, in the continental territory of Portugal, of a technology that will be able to do such a digital processing. It was used the TAM as the theoretical referential. The statistical analysis showed that there is a good probability of acceptance of such a system.

  14. High acceptance recoil polarimeter

    SciTech Connect

    The HARP Collaboration

    1992-12-05

    In order to detect neutrons and protons in the 50 to 600 MeV energy range and measure their polarization, an efficient, low-noise, self-calibrating device is being designed. This detector, known as the High Acceptance Recoil Polarimeter (HARP), is based on the recoil principle of proton detection from np[r arrow]n[prime]p[prime] or pp[r arrow]p[prime]p[prime] scattering (detected particles are underlined) which intrinsically yields polarization information on the incoming particle. HARP will be commissioned to carry out experiments in 1994.

  15. Thermoluminescence sensitivity of daily-use materials

    NASA Astrophysics Data System (ADS)

    Correcher, V.; Garcia-Guinea, J.; Rivera, T.

    The thermoluminescence (TL) response of silicon-rich daily-use materials, namely charoite (silicate gemstone), Spanish dental crown, phone chip and Spanish glass has been investigated. All the samples previously characterised by means of X-ray diffraction, electron microscopy associated with energy-dispersion and wavelength-dispersive spectrometry and X-ray fluorescence exhibit a reasonable sensitivity to ionising radiation. The preliminary results, based on their TL properties, allow us to speculate that these materials could be potentially of interest in situations where conventional dosimetric systems are not available. The dose dependence of the 400 nm TL emission of the studied samples displays a very good linearity in the range of 0.1-10 Gy.

  16. Design of landfill daily cells.

    PubMed

    Panagiotakopoulos, D; Dokas, I

    2001-08-01

    The objective of this paper is to study the behaviour of the landfill soil-to-refuse (S/R) ratio when size, geometry and operating parameters of the daily cell vary over realistic ranges. A simple procedure is presented (1) for calculating the cell parameters values which minimise the S/R ratio and (2) for studying the sensitivity of this minimum S/R ratio to variations in cell size, final refuse density, working face length, lift height and cover thickness. In countries where daily soil cover is required, savings in landfill space could be realised following this procedure. The sensitivity of minimum S/R to variations in cell dimensions decreases with cell size. Working face length and lift height affect the S/R ratio significantly. This procedure also offers the engineer an additional tool for comparing one large daily cell with two or more smaller ones, at two different working faces within the same landfill.

  17. Effectiveness of bevantolol in the treatment of hypertension: once-daily versus twice-daily evaluation of home blood pressure measurements.

    PubMed

    Jain, A

    1986-03-01

    Two multicenter, double-blind, placebo-controlled studies were conducted to determine in patients with hypertension the oral dose of bevantolol that would effectively reduce home diastolic blood pressure to less than 95 mm Hg. The two studies differed only in once-daily or twice-daily dose administration. In the 125 patients evaluated, the mean decreases in home diastolic blood pressure were significantly greater in patients receiving 100 to 400 mg/day of bevantolol (8 to 10 mm Hg) than in patients receiving placebo (2 to 3mm Hg) (p less than 0.05). Bevantolol administered once daily or twice daily was equally effective in the management of hypertension and was well tolerated in the doses studied.

  18. SU-E-T-178: Experimental Study of Acceptable Movement Conditions for SBRT Lung Treatments

    SciTech Connect

    Carrasco de Fez, P; Ruiz-Martinez, A; Jornet, N; Eudaldo, T; Latorre-Musoll, A; Ribas, Morales M

    2014-06-01

    Purpose: To experimentally study the acceptable movement conditions for SBRT lung treatments we quantified with film dosimetry the change in dose distributions due to periodic movements of 5 different amplitudes and 4 respiratory gating duty cycles on a SBRT treatment plan. Methods: We planned a SBRT treatment plan for the QUASAR™ (Modus Medical) phantom equipped with the respiratory motion device. We placed a 3 mm water-equivalent sphere simulating a tumour inside the lung-equivalent insert. This sphere is divided in two hemispheres that allow placing films in between. We used radiochromic EBT2™ (Ashland) films. We oriented the lung insert in such a way that sagittal dose distributions could be measured. We applied a sinusoidal movement with 3 s period for 5 different amplitudes of 0(static), 5, 7, 10, 15 and 20 mm without gating. For the 20 mm amplitude we studied the gating technique with 4 duty cycles of 20, 40, 60 and 80% of the respiratory cycle. Each situation was irradiated in a Clinac 2100 linac (Varian) equipped with the RPM™ system. FilmQA Pro™ (Ashland) software together with an Expression 10000XL scanner (EPSON) were used to analyze and compare the measured dose distributions with those planned by the Eclipse™ TPS v. 8.9 (Varian) by means of gamma analysis with 6 criteria: 5%/3mm, 5%/2mm, 5%/1mm, 3%/3mm, 3%/2mm and 2%/2mm (threshold of 10%). Results: Movements with amplitude of less than 7mm do not significantly modified the dosimetry. Gating duty cycles of less than 40% yielded also acceptable results for a 2 cm amplitude movement. Conclusion: To safely perform daily accurate SBRT treatments, movements have to be restricted to 7 mm amplitude (±3.5 mm). Otherwise, a gating strategy should be considered.

  19. Acceptance test procedure for High Pressure Water Jet System

    SciTech Connect

    Crystal, J.B.

    1995-05-30

    The overall objective of the acceptance test is to demonstrate a combined system. This includes associated tools and equipment necessary to perform cleaning in the 105 K East Basin (KE) for achieving optimum reduction in the level of contamination/dose rate on canisters prior to removal from the KE Basin and subsequent packaging for disposal. Acceptance tests shall include necessary hardware to achieve acceptance of the cleaning phase of canisters. This acceptance test procedure will define the acceptance testing criteria of the high pressure water jet cleaning fixture. The focus of this procedure will be to provide guidelines and instructions to control, evaluate and document the acceptance testing for cleaning effectiveness and method(s) of removing the contaminated surface layer from the canister presently identified in KE Basin. Additionally, the desired result of the acceptance test will be to deliver to K Basins a thoroughly tested and proven system for underwater decontamination and dose reduction. This report discusses the acceptance test procedure for the High Pressure Water Jet.

  20. Tractor Operation and Daily Care.

    ERIC Educational Resources Information Center

    Fore, J. M.; And Others

    Written for the tractor operator, the manual describes, with the aid of colored illustrations and diagrams, the tasks involved in the proper operation and daily maintenance of tractors. It offers explanations for the desirability of the various servicing and adjustment operations, as well as guidelines for tractor operation and safety. The…

  1. Digital Daily Cycles of Individuals

    NASA Astrophysics Data System (ADS)

    Aledavood, Talayeh; Lehmann, Sune; Saramäki, Jari

    2015-10-01

    Humans, like almost all animals, are phase-locked to the diurnal cycle. Most of us sleep at night and are active through the day. Because we have evolved to function with this cycle, the circadian rhythm is deeply ingrained and even detectable at the biochemical level. However, within the broader day-night pattern, there are individual differences: e.g., some of us are intrinsically morning-active, while others prefer evenings. In this article, we look at digital daily cycles: circadian patterns of activity viewed through the lens of auto-recorded data of communication and online activity. We begin at the aggregate level, discuss earlier results, and illustrate differences between population-level daily rhythms in different media. Then we move on to the individual level, and show that there is a strong individual-level variation beyond averages: individuals typically have their distinctive daily pattern that persists in time. We conclude by discussing the driving forces behind these signature daily patterns, from personal traits (morningness/eveningness) to variation in activity level and external constraints, and outline possibilities for future research.

  2. Assessment of acceptability and usability of new delivery prototype device for intradermal vaccination in healthy subjects.

    PubMed

    Van Mulder, Timothi J S; Verwulgen, Stijn; Beyers, Koen C L; Scheelen, Linda; Elseviers, Monique M; Van Damme, Pierre; Vankerckhoven, Vanessa

    2014-01-01

    The objectives of this study were to assess the acceptability and usability of a newly developed intradermal prototype device, VAX-ID™, in healthy subjects. In April 2012 an investigational study was conducted in healthy subjects aged 18 to 65 y. To compare injection site and route of administration, subjects were allocated to 4 subgroups, either receiving subsequently 2 intradermal (ID) injections (one in the forearm and one in the deltoid) or an ID (forearm) and an intramuscular (IM) (deltoid) injection. All injections contained saline solution. Acceptability was assessed with a subjects' questionnaire and a daily electronic diary for 5 d. Usability was assessed with a vaccinators' questionnaire and an expert panel. A 10-point Visual Analog Scale was used to score several statements on usability and acceptability. A total of 102 healthy subjects were enrolled in the study (age: 19-63). No statistically significant differences were seen in demographic characteristics between the ID and IM groups. Anxiety before injection, pain during injection and duration of injection were rated significantly lower for ID compared to IM. One day after the injections, redness was reported more often after ID injection in the forearm versus ID in the deltoid; pain at injection site was reported significantly more often after IM vs. ID injection. The new VAX-ID prototype device was found easy to handle, easy to use and safe. The new VAX-ID prototype device was shown to have a high degree of acceptability as well as usability. Further studies with VAX-ID will be conducted using vaccine antigen allowing assessment of immunogenicity and safety. Additionally, these studies will help to further improve VAX-ID in terms of accuracy of delivered dose and feedback to the vaccinator. (NCT01963338).

  3. Daily oral iron supplementation during pregnancy

    PubMed Central

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    ). Although the difference between groups did not reach statistical significance, women who received iron supplements were more likely than controls to report side effects (25.3% versus 9.91%) (RR 2.36; 95% CI 0.96 to 5.82, 11 trials, 4418 women), particularly at doses 60 mg of elemental iron or higher. Women receiving iron were on average more likely to have higher haemoglobin (Hb) concentrations at term and in the postpartum period, but were at increased risk of Hb concentrations greater than 130g/L during pregnancy and at term. Twenty-three studies were conducted in countries that in 2011 had some malaria risk in parts of the country. In some of these countries/territories, malaria is present only in certain areas or up to a particular altitude. Only two of these reported malaria outcomes. There is no evidence that iron supplementation increases placental malaria. For some outcomes heterogeneity was higher than 50%. Authors’ conclusions Prenatal supplementation with daily iron are effective to reduce the risk of low birthweight, and to prevent maternal anaemia and iron deficiency in pregnancy. Associated maternal side effects and particularly high Hb concentrations during pregnancy at currently used doses suggest the need to update recommendations on doses and regimens for routine iron supplementation. PMID:23235616

  4. Randomized, blinded trial of weekend vs daily prednisone in Duchenne muscular dystrophy

    PubMed Central

    Hache, L.P.; Clemens, P.R.; Cnaan, A.; McDonald, C.M.; Viswanathan, V.; Kornberg, A.J.; Bertorini, T.E.; Nevo, Y.; Lotze, T.; Pestronk, A.; Ryan, M.M.; Monasterio, E.; Day, J.W.; Zimmerman, A.; Arrieta, A.; Henricson, E.; Mayhew, J.; Florence, J.; Hu, F.; Connolly, A.M.

    2011-01-01

    Objective: To perform a double-blind, randomized study comparing efficacy and safety of daily and weekend prednisone in boys with Duchenne muscular dystrophy (DMD). Methods: A total of 64 boys with DMD who were between 4 and 10 years of age were randomized at 1 of 12 centers of the Cooperative International Neuromuscular Research Group. Efficacy and safety of 2 prednisone schedules (daily 0.75 mg/kg/day and weekend 10 mg/kg/wk) were evaluated over 12 months. Results: Equivalence was met for weekend and daily dosing of prednisone for the primary outcomes of quantitative muscle testing (QMT) arm score and QMT leg score. Secondary strength scores for QMT elbow flexors also showed equivalence between the 2 treatment groups. Overall side effect profiles of height and weight, bone density, cataract formation, blood pressure, and behavior, analyzed at 12 months, did not differ between weekend and daily dosing of prednisone. Conclusions: Weekend dosing of prednisone is equally beneficial to the standard daily dosing of prednisone. Analysis of side effect profiles demonstrated overall tolerability of both dosing regimens. Classification of evidence: This study provides Class I evidence that weekend prednisone dosing is as safe and effective as daily prednisone in preserving muscle strength and preventing body mass index increases in boys with DMD over a 12-month period. PMID:21753160

  5. Sonic boom acceptability studies

    NASA Astrophysics Data System (ADS)

    Shepherd, Kevin P.; Sullivan, Brenda M.; Leatherwood, Jack D.; McCurdy, David A.

    1992-04-01

    The determination of the magnitude of sonic boom exposure which would be acceptable to the general population requires, as a starting point, a method to assess and compare individual sonic booms. There is no consensus within the scientific and regulatory communities regarding an appropriate sonic boom assessment metric. Loudness, being a fundamental and well-understood attribute of human hearing was chosen as a means of comparing sonic booms of differing shapes and amplitudes. The figure illustrates the basic steps which yield a calculated value of loudness. Based upon the aircraft configuration and its operating conditions, the sonic boom pressure signature which reaches the ground is calculated. This pressure-time history is transformed to the frequency domain and converted into a one-third octave band spectrum. The essence of the loudness method is to account for the frequency response and integration characteristics of the auditory system. The result of the calculation procedure is a numerical description (perceived level, dB) which represents the loudness of the sonic boom waveform.

  6. Sonic boom acceptability studies

    NASA Technical Reports Server (NTRS)

    Shepherd, Kevin P.; Sullivan, Brenda M.; Leatherwood, Jack D.; Mccurdy, David A.

    1992-01-01

    The determination of the magnitude of sonic boom exposure which would be acceptable to the general population requires, as a starting point, a method to assess and compare individual sonic booms. There is no consensus within the scientific and regulatory communities regarding an appropriate sonic boom assessment metric. Loudness, being a fundamental and well-understood attribute of human hearing was chosen as a means of comparing sonic booms of differing shapes and amplitudes. The figure illustrates the basic steps which yield a calculated value of loudness. Based upon the aircraft configuration and its operating conditions, the sonic boom pressure signature which reaches the ground is calculated. This pressure-time history is transformed to the frequency domain and converted into a one-third octave band spectrum. The essence of the loudness method is to account for the frequency response and integration characteristics of the auditory system. The result of the calculation procedure is a numerical description (perceived level, dB) which represents the loudness of the sonic boom waveform.

  7. Dose Reduction Techniques

    SciTech Connect

    WAGGONER, L.O.

    2000-05-16

    As radiation safety specialists, one of the things we are required to do is evaluate tools, equipment, materials and work practices and decide whether the use of these products or work practices will reduce radiation dose or risk to the environment. There is a tendency for many workers that work with radioactive material to accomplish radiological work the same way they have always done it rather than look for new technology or change their work practices. New technology is being developed all the time that can make radiological work easier and result in less radiation dose to the worker or reduce the possibility that contamination will be spread to the environment. As we discuss the various tools and techniques that reduce radiation dose, keep in mind that the radiological controls should be reasonable. We can not always get the dose to zero, so we must try to accomplish the work efficiently and cost-effectively. There are times we may have to accept there is only so much you can do. The goal is to do the smart things that protect the worker but do not hinder him while the task is being accomplished. In addition, we should not demand that large amounts of money be spent for equipment that has marginal value in order to save a few millirem. We have broken the handout into sections that should simplify the presentation. Time, distance, shielding, and source reduction are methods used to reduce dose and are covered in Part I on work execution. We then look at operational considerations, radiological design parameters, and discuss the characteristics of personnel who deal with ALARA. This handout should give you an overview of what it takes to have an effective dose reduction program.

  8. Observability of market daily volatility

    NASA Astrophysics Data System (ADS)

    Petroni, Filippo; Serva, Maurizio

    2016-02-01

    We study the price dynamics of 65 stocks from the Dow Jones Composite Average from 1973 to 2014. We show that it is possible to define a Daily Market Volatility σ(t) which is directly observable from data. This quantity is usually indirectly defined by r(t) = σ(t) ω(t) where the r(t) are the daily returns of the market index and the ω(t) are i.i.d. random variables with vanishing average and unitary variance. The relation r(t) = σ(t) ω(t) alone is unable to give an operative definition of the index volatility, which remains unobservable. On the contrary, we show that using the whole information available in the market, the index volatility can be operatively defined and detected.

  9. Awareness of Daily Life Activities

    NASA Astrophysics Data System (ADS)

    Metaxas, Georgios; Metin, Barbaros; Schneider, Jutta; Markopoulos, Panos; De Ruyter, Boris

    The well-publicized aging of Western societies has prompted a growing interest into technologies that support awareness in cross-generational families. The idea of supporting continual and partly automated flow of information between seniors living alone and their social intimates has been gaining ground among researchers but even among industries. It is anticipated that such an information flow can help bridge geographical distance, discrepant lifestyles, and daily routines, potentially providing peace of mind to both parties and feelings of being connected.

  10. Dose selection for the investigational anticancer agent alisertib (MLN8237): Pharmacokinetics, pharmacodynamics, and exposure-safety relationships.

    PubMed

    Venkatakrishnan, Karthik; Zhou, Xiaofei; Ecsedy, Jeffrey; Mould, Diane R; Liu, Hua; Danaee, Hadi; Fingert, Howard; Kleinfield, Robert; Milton, Ashley

    2015-03-01

    We report population pharmacokinetic, pharmacodynamic, and pharmacokinetic-safety analyses to support phase II/III dose/regimen selection of alisertib, a selective Aurora A kinase (AAK) inhibitor. Phase I studies in adult cancer patients evaluated dosing on Days 1-7 in 21-day cycles or Days 1-21 in 35-day cycles, with corresponding maximum tolerated doses of 50 mg twice daily (BID) and 50 mg QD, respectively. Population pharmacokinetic analyses supported dose- and time-linear pharmacokinetics without identification of clinically meaningful covariates. Exposure-related increases in skin mitotic index and decreases in chromosomal alignment/spindle bipolarity in tumor mitotic cells confirmed AAK inhibition. Exposures in the 7-day schedule at or near 50 mg BID are expected to result in tumor AAK inhibition based on pharmacodynamic assessment in patient tumors. Exposure-safety analyses of data from patients receiving doses of 5-200 mg/day in the 7-day schedule support a low (∼7%) predicted incidence of dose-limiting toxicity at 50 mg BID. Taken together, these analyses support a pharmacologically active and acceptably tolerated dose range of alisertib for future clinical development. PMID:25302940

  11. Daily intakes of naturally occurring radioisotopes in typical Korean foods.

    PubMed

    Choi, Min-Seok; Lin, Xiu-Jing; Lee, Sun Ah; Kim, Wan; Kang, Hee-Dong; Doh, Sih-Hong; Kim, Do-Sung; Lee, Dong-Myung

    2008-08-01

    The concentrations of naturally occurring radioisotopes ((232)Th, (228)Th, (230)Th, (228)Ra, (226)Ra, and (40)K) in typical Korean foods were evaluated. The daily intakes of these radioisotopes were calculated by comparing concentrations in typical Korean foods and the daily consumption rates of these foods. Daily intakes were as follows: (232)Th, 0.00-0.23; (228)Th, 0.00-2.04; (230)Th, 0.00-0.26; (228)Ra, 0.02-2.73; (226)Ra, 0.01-4.37 mBq/day; and (40)K, 0.01-5.71 Bq/day. The total daily intake of the naturally occurring radioisotopes measured in this study from food was 39.46 Bq/day. The total annual internal dose resulting from ingestion of radioisotopes in food was 109.83 muSv/y, and the radioisotope with the highest daily intake was (40)K. These values were same level compiled in other countries.

  12. Randomized, comparative study of the efficacy and safety of artesunate plus amodiaquine, administered as a single daily intake versus two daily intakes in the treatment of uncomplicated falciparum malaria

    PubMed Central

    Ndiaye, Jean Louis A; Faye, Babacar; Diouf, Amadou M; Kuété, Thomas; Cisse, Moustapha; Seck, Papa A; Brasseur, Phillipe; Same-Ekobo, Albert; Lameyre, Valerie; Gaye, Oumar

    2008-01-01

    Background Artesunate plus amodiaquine is a coblistered ACT, given as a single daily intake. It has been suggested that, in view of the number of tablets to be taken (particularly in adults), it may be possible to improve compliance by allowing patients to divide the daily dose. The objectives of this randomized, comparative, open-label, multicentre study, conducted in Senegal and in Cameroon in 2005, was to demonstrate the non-inferiority and to compare the safety of artesunate plus amodiaquine, as a single daily intake versus two daily intakes. Methods A three-day treatment period and 14-day follow-up period was performed in any subject weighting more than 10 kg, presenting with a malaria paroxysm confirmed by parasitaemia ≥ 1,000/μl, after informed consent. Patients were randomly allocated into one of the two regimens, with dosage according to bodyweight range. All products were administered by an authorized person, blinded to both the investigating physician and the biologist. The primary endpoint was an adequate response to treatment on D14 (WHO definition). The two-sided 90% confidence interval of the difference was calculated on intent to treat (ITT) population; the acceptance limit for non-inferiority was 3%. The safety was evaluated by incidence of adverse events. Results Three-hundred and sixteen patients were included in the study. The two patient groups were strictly comparable on D0. The adequate responses to treatment were similar for the two treatment regimens on D14, PCR-corrected (99,4% in the one-daily intake group versus 99,3% in the comparative group). The statistical analyses demonstrated the non-inferiority of administering artesunate/amodiaquine as two intakes. The drug was well tolerated. The main adverse events were gastrointestinal disorders (2.5%) and pruritus (2.5%); safety profiles were similar in the two groups. Conclusion This pilot study confirms the efficacy and good tolerability of artesunate plus amodiaquine, administrated

  13. Daily cycles in coastal dunes

    USGS Publications Warehouse

    Hunter, R.E.; Richmond, B.M.

    1988-01-01

    Daily cycles of summer sea breezes produce distinctive cyclic foreset deposits in dune sands of the Texas and Oregon coasts. In both areas the winds are strong enough to transport sand only during part of the day, reach a peak during the afternoon, and vary little in direction during the period of sand transport. Cyclicity in the foreset deposits is made evident by variations in the type of sedimentary structure, the texture, and the heavy-mineral content of the sand. Some of the cyclic deposits are made up entirely of one basic type of structure, in which the character of the structure varies cyclically; for example, the angle of climb in a climbing-wind-ripple structure may vary cyclically. Other cyclic deposits are characterized by alternations of two or more structural types. Variations in the concentration of fine-grained heavy minerals, which account for the most striking cyclicity, arise mainly because of segregation on wind-rippled depositional surfaces: where the ripples climb at low angles, the coarsegrained light minerals, which accumulate preferentially on ripple crests, tend to be excluded from the local deposit. Daily cyclic deposits are thickest and best developed on small dunes and are least recognizable near the bases of large dunes. ?? 1988.

  14. WAPA Daily Energy Accounting Activities

    1990-10-01

    ISA (Interchange, Scheduling, & Accounting) is the interchange scheduling system used by the DOE Western Area Power Administration to perform energy accounting functions associated with the daily activities of the Watertown Operations Office (WOO). The system's primary role is to provide accounting functions for scheduled energy which is exchanged with other power companies and power operating organizations. The system has a secondary role of providing a historical record of all scheduled interchange transactions. The followingmore » major functions are performed by ISA: scheduled energy accounting for received and delivered energy; generation scheduling accounting for both fossil and hydro-electric power plants; metered energy accounting for received and delivered totals; energy accounting for Direct Current (D.C.) Ties; regulation accounting; automatic generation control set calculations; accounting summaries for Basin, Heartland Consumers Power District, and the Missouri Basin Municipal Power Agency; calculation of estimated generation for the Laramie River Station plant; daily and monthly reports; and dual control areas.« less

  15. Cone penetrometer acceptance test report

    SciTech Connect

    Boechler, G.N.

    1996-09-19

    This Acceptance Test Report (ATR) documents the results of acceptance test procedure WHC-SD-WM-ATR-151. Included in this report is a summary of the tests, the results and issues, the signature and sign- off ATP pages, and a summarized table of the specification vs. ATP section that satisfied the specification.

  16. Intent to Quit among Daily and Non-Daily College Student Smokers

    ERIC Educational Resources Information Center

    Pinsker, E. A.; Berg, C. J.; Nehl, E. J.; Prokhorov, A. V.; Buchanan, T. S.; Ahluwalia, J. S.

    2013-01-01

    Given the high prevalence of young adult smoking, we examined (i) psychosocial factors and substance use among college students representing five smoking patterns and histories [non-smokers, quitters, native non-daily smokers (i.e. never daily smokers), converted non-daily smokers (i.e. former daily smokers) and daily smokers] and (ii) smoking…

  17. Dissolution test acceptance sampling plans.

    PubMed

    Tsong, Y; Hammerstrom, T; Lin, K; Ong, T E

    1995-07-01

    The U.S. Pharmacopeia (USP) general monograph provides a standard for dissolution compliance with the requirements as stated in the individual USP monograph for a tablet or capsule dosage form. The acceptance rules recommended by USP have important roles in the quality control process. The USP rules and their modifications are often used as an industrial lot release sampling plan, where a lot is accepted when the tablets or capsules sampled are accepted as proof of compliance with the requirement. In this paper, the operating characteristics of the USP acceptance rules are reviewed and compared to a selected modification. The operating characteristics curves show that the USP acceptance rules are sensitive to the true mean dissolution and do not reject a lot or batch that has a large percentage of tablets that dissolve with less than the dissolution specification.

  18. Brush border intestinal enzymes after multiple daily fractionation

    SciTech Connect

    Becciolini, A.; Giache, V.; Balzi, M.; Morrone, A.

    1987-03-01

    The modifications in brush border enzyme activity of the epithelial cell of the small intestine were studied after multiple daily fractionation (MDF) of 3 Gy X and 3 Gy X 2 X 2 (12 h split). Disaccharase and dipeptidase activities changed in the same way after irradiation. The results show that both total doses caused the three known phases of increase, decrease, and a return to normal. With MDF, activity at the end of irradiation was similar to or greater than that of controls and remained higher longer than a single dose of 8 Gy. However, the return to normal occurred sooner than after a single dose of 8 Gy. After 11 days, circadian oscillations of brush border enzyme activity appeared similar to those of controls in many segments of the intestine, reaching the highest activity during the night and the lowest in the afternoon.

  19. Is DSM widely accepted by Japanese clinicians?

    PubMed

    Someya, T; Takahashi, M; Takahashi, M

    2001-10-01

    The Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III), a new standardized diagnostic system with multiaxial diagnosis, operational criteria and renewed definitions of mental disorders, was introduced in 1980 and prompted movements to reform conventions in Japanese psychiatry. This review overviews the initial response of Japanese clinicians to accept DSM-III, and its effects on the development of systematic research of psychiatric diagnosis. These new research activities include those on reliability of psychiatric diagnosis, application of various evaluation tools, discussion on the concept of mental disorders, relation of personality disorders with depressive disorders, and Taijin-kyofusho, or culturally distinctive phobia in Japan. A reference database search to survey the latest trend on psychiatric research indicated that the number of papers published by Japanese workers increased sharply after 1987, and DSM apparently greatly influenced their internationalization. Twenty years after the publication of DSM-III, a questionnaire on the use of DSM-IV was set out in 2000 to survey how widely DSM is utilized in clinical practice in Japan. Two hundred and twelve psychiatrists answered the questionnaire, and the results show that DSM has been accepted positively by the younger generation, while the older generation (over 40s) has still less interest in DSM, and DSM is used mainly for research purposes rather than in daily practice.

  20. The pharmacokinetic profile of a novel fixed-dose combination tablet of ibuprofen and paracetamol

    PubMed Central

    2010-01-01

    Background Ibuprofen and paracetamol differ in their mode of action and related therapeutic effects, suggesting that combined administration may offer improved analgesia. Reported here are the results of two studies on the pharmacokinetic properties of a novel ibuprofen (200 mg) and paracetamol (500 mg) fixed-dose combination tablet. Methods Both studies were open-label, randomised studies in healthy volunteers: Study 1 was a four-way crossover, single-dose study; Study 2 was a two-way cross-over, repeat-dose study. Results Pharmacokinetic parameters for ibuprofen and paracetamol were similar for the combination and monotherapy tablets (values falling within the 80% to 125% acceptable bioequivalence range) except for the rate of absorption of paracetamol from the combination (tmax), which was significantly faster compared with monotherapy (median difference 10 minutes; p < 0.05). Mean plasma concentrations of both drugs were higher, earlier, following administration of the combination tablet compared with monotherapy. Mean plasma levels at 10 and 20 minutes were 6.64 μg.mL-1 and 16.81 μg.mL-1, respectively, for ibuprofen from the combination, compared with 0.58 μg.mL-1 and 9.00 μg.mL-1, respectively, for monotherapy. For paracetamol, mean plasma levels at 10 and 20 minutes were 5.43 μg.mL-1 and 14.54 μg.mL-1, respectively, for the combination compared with 0.33 μg.mL-1 and 9.19 μg.mL-1, respectively, for monotherapy. The rate of absorption of both ibuprofen and paracetamol was significantly delayed when the combination tablet was administered in the fed versus fasted state; median delay was 25 minutes for ibuprofen (p > 0.05) and 55 minutes for paracetamol (p < 0.001). The pharmacokinetic parameters were comparable irrespective of whether the combination tablet was given twice or three times daily; systemic exposure was, however, approximately 1.4 times greater for both drugs when given three times daily. Conclusions Administration of ibuprofen and

  1. Contrails reduce daily temperature range.

    PubMed

    Travis, David J; Carleton, Andrew M; Lauritsen, Ryan G

    2002-08-01

    The potential of condensation trails (contrails) from jet aircraft to affect regional-scale surface temperatures has been debated for years, but was difficult to verify until an opportunity arose as a result of the three-day grounding of all commercial aircraft in the United States in the aftermath of the terrorist attacks on 11 September 2001. Here we show that there was an anomalous increase in the average diurnal temperature range (that is, the difference between the daytime maximum and night-time minimum temperatures) for the period 11-14 September 2001. Because persisting contrails can reduce the transfer of both incoming solar and outgoing infrared radiation and so reduce the daily temperature range, we attribute at least a portion of this anomaly to the absence of contrails over this period. PMID:12167846

  2. Contrails reduce daily temperature range.

    PubMed

    Travis, David J; Carleton, Andrew M; Lauritsen, Ryan G

    2002-08-01

    The potential of condensation trails (contrails) from jet aircraft to affect regional-scale surface temperatures has been debated for years, but was difficult to verify until an opportunity arose as a result of the three-day grounding of all commercial aircraft in the United States in the aftermath of the terrorist attacks on 11 September 2001. Here we show that there was an anomalous increase in the average diurnal temperature range (that is, the difference between the daytime maximum and night-time minimum temperatures) for the period 11-14 September 2001. Because persisting contrails can reduce the transfer of both incoming solar and outgoing infrared radiation and so reduce the daily temperature range, we attribute at least a portion of this anomaly to the absence of contrails over this period.

  3. Daily Medicine Record for Your Child

    MedlinePlus

    ... the-Counter Pain Relievers and Fever Reducers Daily Medicine Record for Your Child (English) Share Tweet Linkedin ... Age: ____ 2 years old___ Weight: ___ 30 pounds ___ Daily Medicine Record Child’s name: ___________________ Today’s date: _________________ Age: ____________ Weight: ________________ (pounds) ...

  4. Extending the Technology Acceptance Model: Policy Acceptance Model (PAM)

    NASA Astrophysics Data System (ADS)

    Pierce, Tamra

    There has been extensive research on how new ideas and technologies are accepted in society. This has resulted in the creation of many models that are used to discover and assess the contributing factors. The Technology Acceptance Model (TAM) is one that is a widely accepted model. This model examines people's acceptance of new technologies based on variables that directly correlate to how the end user views the product. This paper introduces the Policy Acceptance Model (PAM), an expansion of TAM, which is designed for the analysis and evaluation of acceptance of new policy implementation. PAM includes the traditional constructs of TAM and adds the variables of age, ethnicity, and family. The model is demonstrated using a survey of people's attitude toward the upcoming healthcare reform in the United States (US) from 72 survey respondents. The aim is that the theory behind this model can be used as a framework that will be applicable to studies looking at the introduction of any new or modified policies.

  5. The Daily Practices of Successful Principals

    ERIC Educational Resources Information Center

    Brock, Barbara L.; Grady, Marilyn L.

    2011-01-01

    While many books outline the attributes of successful school leaders, few describe how those traits manifest in daily practice. "The Daily Practices of Successful Principals" goes beyond the outward picture of excellence and provides a compendium of daily practices used by successful principals in various settings. Written by former administrators…

  6. Acceptability of zinc-fortified, lipid-based nutrient supplements (LNS) prepared for young children in Burkina Faso.

    PubMed

    Hess, Sonja Y; Bado, Lucien; Aaron, Grant J; Ouédraogo, Jean-Bosco; Zeilani, Mamane; Brown, Kenneth H

    2011-10-01

    Micronutrient deficiencies are a public health concern among young children in low-income countries, and novel strategies are needed to improve the nutritional status of children at risk. One promising approach is the use of lipid-based nutrient supplements (LNS), which can be added to complementary food at the time of consumption. The optimal amount of zinc to include in LNS is uncertain, and concerns have been expressed about possible adverse effects of zinc on sensory characteristics of LNS. We conducted a series of acceptability studies of LNS containing either 0 or 10 mg of zinc per daily 20 g LNS dose among Burkinabe children 9-15 months old and their mothers. These acceptability studies included observations of children's consumption, maternal and child sensory reaction to the products using a 5-unit hedonic scale, a triangle test for detection of differences and a review of maternal reports of their child-feeding experiences during a 2-week home-feeding trial. The LNS products were well appreciated by the mothers and children during the sensory trials and the 2-week home-feeding trial. The addition of 10 mg zinc to LNS did not affect the consumed proportion of the offered porridge-LNS-mixture (P = 0.43). Results of the triangle test with mothers confirmed that there was no detectable difference between products containing 0 or 10 mg zinc per 20 g LNS dose. Most importantly, interviews and focus groups following the 2-week home-feeding trial indicated good acceptability of the products by mothers and their children.

  7. A Phase 1 Randomized, Double Blind, Placebo Controlled Rectal Safety and Acceptability Study of Tenofovir 1% Gel (MTN-007)

    PubMed Central

    Mcgowan, Ian; Hoesley, Craig; Cranston, Ross D.; Andrew, Philip; Janocko, Laura; Dai, James Y.; Carballo-Dieguez, Alex; Ayudhya, Ratiya Kunjara Na; Piper, Jeanna; Hladik, Florian; Mayer, Ken

    2013-01-01

    Objective Rectal microbicides are needed to reduce the risk of HIV acquisition associated with unprotected receptive anal intercourse. The MTN-007 study was designed to assess the safety (general and mucosal), adherence, and acceptability of a new reduced glycerin formulation of tenofovir 1% gel. Methods Participants were randomized 1∶1:1∶1 to receive the reduced glycerin formulation of tenofovir 1% gel, a hydroxyethyl cellulose placebo gel, a 2% nonoxynol-9 gel, or no treatment. Each gel was administered as a single dose followed by 7 daily doses. Mucosal safety evaluation included histology, fecal calprotectin, epithelial sloughing, cytokine expression (mRNA and protein), microarrays, flow cytometry of mucosal T cell phenotype, and rectal microflora. Acceptability and adherence were determined by computer-administered questionnaires and interactive telephone response, respectively. Results Sixty-five participants (45 men and 20 women) were recruited into the study. There were no significant differences between the numbers of ≥ Grade 2 adverse events across the arms of the study. Likelihood of future product use (acceptability) was 87% (reduced glycerin formulation of tenofovir 1% gel), 93% (hydroxyethyl cellulose placebo gel), and 63% (nonoxynol-9 gel). Fecal calprotectin, rectal microflora, and epithelial sloughing did not differ by treatment arms during the study. Suggestive evidence of differences was seen in histology, mucosal gene expression, protein expression, and T cell phenotype. These changes were mostly confined to comparisons between the nonoxynol-9 gel and other study arms. Conclusions The reduced glycerin formulation of tenofovir 1% gel was safe and well tolerated rectally and should be advanced to Phase 2 development. Trial Registration ClinicalTrials.gov NCT01232803. PMID:23573238

  8. The haemotoxicity of azathioprine in repeat dose studies in the female CD-1 mouse.

    PubMed

    Molyneux, Gemma; Gibson, Frances M; Chen, Christabelle M; Marway, Harpal K; McKeag, Sean; Mifsud, Charles V J; Pilling, Andrew M; Whayman, Matthew J; Turton, John A

    2008-04-01

    Azathioprine (AZA) is a cytotoxic immunosuppressive drug used in the prevention of rejection in organ transplants and the treatment of auto-immune diseases. However, AZA is haemotoxic causing significant bone marrow depression. The present studies were to characterize the haemotoxicity of AZA in the female CD-1 mouse. In Experiment 1, a dose-ranging study, with AZA gavaged daily for 10 days, clinical evidence of toxicity was evident at 125 mg/kg and above. Experiment 2 was a dose-response study with AZA gavaged daily for 10 days at 40-120 mg/kg. At day 1 after the final dose, AZA induced a dose-related pancytopaenia, reduced femoral marrow cellularity, increases in serum levels of the cytokine fms-like tyrosine kinase 3 ligand, reduction in granulocyte-monocyte colony-forming units and erythroid colonies, and increased bone marrow apoptosis. Histology demonstrated hepatocyte hypertrophy, thymic atrophy, reduced splenic extramedullary haemopoiesis, and reduced cellularity of sternal bone marrow. In Experiment 3, AZA was dosed for 10 days at 100 mg/kg with autopsies at 1, 3, 9, 22, 29, 43 and 57 days postdosing. At 1, 3 and 9 days, haematological parameters reflected changes in Experiment 2. At 22/29 days, many blood parameters were returning towards normal; at 43/57 days, most parameters compared with controls. However, there was some evidence of a persistent (i.e. residual/late-stage) mild reduction in RBC and erythroid progenitor cell counts at day 43/57. We conclude that the CD-1 mouse provides an acceptable model for the haemotoxicity of AZA in man.

  9. L-286 Acceptance Test Record

    SciTech Connect

    HARMON, B.C.

    2000-01-14

    This document provides a detailed account of how the acceptance testing was conducted for Project L-286, ''200E Area Sanitary Water Plant Effluent Stream Reduction''. The testing of the L-286 instrumentation system was conducted under the direct supervision

  10. Accepted scientific research works (abstracts).

    PubMed

    2014-01-01

    These are the 39 accepted abstracts for IAYT's Symposium on Yoga Research (SYR) September 24-24, 2014 at the Kripalu Center for Yoga & Health and published in the Final Program Guide and Abstracts. PMID:25645134

  11. 2013 SYR Accepted Poster Abstracts.

    PubMed

    2013-01-01

    SYR 2013 Accepted Poster abstracts: 1. Benefits of Yoga as a Wellness Practice in a Veterans Affairs (VA) Health Care Setting: If You Build It, Will They Come? 2. Yoga-based Psychotherapy Group With Urban Youth Exposed to Trauma. 3. Embodied Health: The Effects of a Mind�Body Course for Medical Students. 4. Interoceptive Awareness and Vegetable Intake After a Yoga and Stress Management Intervention. 5. Yoga Reduces Performance Anxiety in Adolescent Musicians. 6. Designing and Implementing a Therapeutic Yoga Program for Older Women With Knee Osteoarthritis. 7. Yoga and Life Skills Eating Disorder Prevention Among 5th Grade Females: A Controlled Trial. 8. A Randomized, Controlled Trial Comparing the Impact of Yoga and Physical Education on the Emotional and Behavioral Functioning of Middle School Children. 9. Feasibility of a Multisite, Community based Randomized Study of Yoga and Wellness Education for Women With Breast Cancer Undergoing Chemotherapy. 10. A Delphi Study for the Development of Protocol Guidelines for Yoga Interventions in Mental Health. 11. Impact Investigation of Breathwalk Daily Practice: Canada�India Collaborative Study. 12. Yoga Improves Distress, Fatigue, and Insomnia in Older Veteran Cancer Survivors: Results of a Pilot Study. 13. Assessment of Kundalini Mantra and Meditation as an Adjunctive Treatment With Mental Health Consumers. 14. Kundalini Yoga Therapy Versus Cognitive Behavior Therapy for Generalized Anxiety Disorder and Co-Occurring Mood Disorder. 15. Baseline Differences in Women Versus Men Initiating Yoga Programs to Aid Smoking Cessation: Quitting in Balance Versus QuitStrong. 16. Pranayam Practice: Impact on Focus and Everyday Life of Work and Relationships. 17. Participation in a Tailored Yoga Program is Associated With Improved Physical Health in Persons With Arthritis. 18. Effects of Yoga on Blood Pressure: Systematic Review and Meta-analysis. 19. A Quasi-experimental Trial of a Yoga based Intervention to Reduce Stress and

  12. 2013 SYR Accepted Poster Abstracts.

    PubMed

    2013-01-01

    SYR 2013 Accepted Poster abstracts: 1. Benefits of Yoga as a Wellness Practice in a Veterans Affairs (VA) Health Care Setting: If You Build It, Will They Come? 2. Yoga-based Psychotherapy Group With Urban Youth Exposed to Trauma. 3. Embodied Health: The Effects of a Mind�Body Course for Medical Students. 4. Interoceptive Awareness and Vegetable Intake After a Yoga and Stress Management Intervention. 5. Yoga Reduces Performance Anxiety in Adolescent Musicians. 6. Designing and Implementing a Therapeutic Yoga Program for Older Women With Knee Osteoarthritis. 7. Yoga and Life Skills Eating Disorder Prevention Among 5th Grade Females: A Controlled Trial. 8. A Randomized, Controlled Trial Comparing the Impact of Yoga and Physical Education on the Emotional and Behavioral Functioning of Middle School Children. 9. Feasibility of a Multisite, Community based Randomized Study of Yoga and Wellness Education for Women With Breast Cancer Undergoing Chemotherapy. 10. A Delphi Study for the Development of Protocol Guidelines for Yoga Interventions in Mental Health. 11. Impact Investigation of Breathwalk Daily Practice: Canada�India Collaborative Study. 12. Yoga Improves Distress, Fatigue, and Insomnia in Older Veteran Cancer Survivors: Results of a Pilot Study. 13. Assessment of Kundalini Mantra and Meditation as an Adjunctive Treatment With Mental Health Consumers. 14. Kundalini Yoga Therapy Versus Cognitive Behavior Therapy for Generalized Anxiety Disorder and Co-Occurring Mood Disorder. 15. Baseline Differences in Women Versus Men Initiating Yoga Programs to Aid Smoking Cessation: Quitting in Balance Versus QuitStrong. 16. Pranayam Practice: Impact on Focus and Everyday Life of Work and Relationships. 17. Participation in a Tailored Yoga Program is Associated With Improved Physical Health in Persons With Arthritis. 18. Effects of Yoga on Blood Pressure: Systematic Review and Meta-analysis. 19. A Quasi-experimental Trial of a Yoga based Intervention to Reduce Stress and

  13. Radiation dose implications of digital angiographic systems.

    PubMed

    Hynes, D M; Gershater, R; Edmonds, E W; Rowlands, J A; Baranoski, D; Turow, D G

    1984-08-01

    Digital subtraction angiography (DSA) has been widely accepted and applied. The concentration of iodine in the vessels of interest is low in intravenous DSA. The resultant images can be improved to some extent by increasing the radiation dose. Therefore DSA could become, and possibly could remain, a relatively high-dose procedure. The contributions to dose from the various components of the examination such as fluoroscopy, positioning, test exposures, and final acquisition runs are considered separately. Individual segments of a DSA examination are discussed to show how and where opportunities arise to reduce doses to the lowest levels consistent with satisfactory images. PMID:6377858

  14. Ocular hypotensive efficacy and safety of once daily carteolol alginate

    PubMed Central

    Demailly, P.; Allaire, C.; Trinquand, C.

    2001-01-01

    BACKGROUND/AIM—Carteolol is a β adrenoceptor antagonist used topically to reduce intraocular pressure, typically twice daily. In an effort to provide a once daily dosing regimen, carteolol was formulated with 1% alginic acid. The objective of this study was to evaluate the efficacy and safety of carteolol alginate solution in comparison with standard carteolol solution.
METHODS—This was a double masked, parallel group, multicentre study. Patients with ocular hypertension or open angle glaucoma (n=235) were randomly assigned to receive either carteolol alginate four times daily or standard carteolol solution, twice daily. The masking was maintained through the use of a vehicle in the evening for the alginate group. Patients were evaluated at baseline, 15, 60, and 120 days.
RESULTS—At 0900 (presumed trough) on day 60, mean reductions in intraocular pressure (IOP) from baseline were 6.09 (SD 2.97) and 6.09 (3.18) mm Hg for the standard carteolol and alginate, respectively. At 1100 (presumed peak), mean reductions were 6.51 (2.53) and 6.47 (2.76) mm Hg, respectively. Results were similar at other times (day 15 and day 120). The most common side effect was transient stinging on instillation of drops, which did not differ significantly between groups. There were no differences of note in other ocular or systemic signs or symptoms.
CONCLUSION—The new alginate formulation of carteolol 2% given once daily was as effective as standard carteolol 2% given twice daily with no meaningful differences regarding safety.

 PMID:11466245

  15. Investigation of daily covering material for biocells

    NASA Astrophysics Data System (ADS)

    Bendere, R.; Smigins, R.; Medne, O.; Berzina-Cimdina, L.; Rugele, K.

    2014-02-01

    Bioreactor landfilling, with the acceptance of landfill Directive 1999/31/EC has lost its actuality in European Union; at the same time, this method can still be used for acceleration of biowaste degradation and biogas production. One of the possibilities to reduce the disposal of biowaste is to use biocells for its anaerobic pre-treatment before landfilling. The daily filling up of such a cell requires isolation of the main volume to limit gas emissions, reduce smells, etc. Bioprocesses that are of the utmost importance for biocell treatment are often not taken into account in selection of materials to be used as daily landfill covers. Based on physical, chemical and biological methods the investigations have been carried out into different covering materials offered in the market, with identification of parameters that are the most important for daily covering the biocells. It is found that the materials fitted best this purpose should be of biological origin and consist of small bio-particles with large surface, without the inhibitors of anaerobic processes such as sulphuric compounds. Bioreaktoru pielietošana atkritumu uzglabāšanas sfērā, sakarā ar Direktīvas 1999/31/EC pieņemšanu, ir zaudējusi savu aktualitāti, taču šī metode vēl joprojām var tikt izmantota bioatkritumu noārdīšanai un biogāzes ražošanai. Viena no iespējām kā samazināt bioatkritumu izvietošanu ir biošūnu izmantošana bioatkritumu anaerobai pirmsapstrādei pirms to noglabāšanas. Šūnas piepildīšana ikdienā prasa nepieciešamību izolēt lielāko tās daļu, lai samazinātu gāzes emisiju, smakas, utt. Materiāli, kas ikdienā tiek izmantoti atkritumu pārklāšanai, nepietiekami ietekmē bioprocesus, kas pamatā ir galvenais biošūnas izmantošanas mērķis. Šajā sakarā ir veikta dažādu tirdzniecībā pieejamu pārklājuma materiālu izpēte, pielietojot virkni fizikālo, ķīmisko un bioloģisko metožu, un nosakot svarīgākos parametrus, kas ir b

  16. Waste-acceptance criteria for radioactive waste disposal

    SciTech Connect

    Gilbert, T.L.; Meshkov, N.K.

    1987-02-01

    A method has been developed for establishing waste-acceptance criteria based on quantitative performance factors that characterize the confinement capabilities of a disposal facility for radioactive waste. The method starts from the objective of protecting public health and safety by assuring that disposal of the waste will not result in a radiation dose of any member of the general public, in either the short or long term, in excess of an established basic dose limit. A key aspect of the method is the introduction of a confinement factor that characterizes the overall confinement capability of a particular disposal facility and can be used for quantitative performance assessments as well as for establishing facility-specific waste-acceptance criteria. Confinement factors enable direct and simple conversion of a basic dose limit into waste-acceptance criteria, specified as concentration limits on rationuclides in the waste streams. Waste-acceptance criteria can be represented visually as activity/time plots for various waste streams. These plots show the concentrations of radionuclides in a waste stream as a function of time and permit a visual, quantitative assessment of long-term performance, relative risks from different radionuclides in the waste stream, and contributions from ingrowth. Application of the method to generic facility designs provides a radional basis for a waste classification system. 14 refs.

  17. [Errors in laboratory daily practice].

    PubMed

    Larrose, C; Le Carrer, D

    2007-01-01

    Legislation set by GBEA (Guide de bonne exécution des analyses) requires that, before performing analysis, the laboratory directors have to check both the nature of the samples and the patients identity. The data processing of requisition forms, which identifies key errors, was established in 2000 and in 2002 by the specialized biochemistry laboratory, also with the contribution of the reception centre for biological samples. The laboratories follow a strict criteria of defining acceptability as a starting point for the reception to then check requisition forms and biological samples. All errors are logged into the laboratory database and analysis report are sent to the care unit specifying the problems and the consequences they have on the analysis. The data is then assessed by the laboratory directors to produce monthly or annual statistical reports. This indicates the number of errors, which are then indexed to patient files to reveal the specific problem areas, therefore allowing the laboratory directors to teach the nurses and enable corrective action.

  18. Time to use a dose of Chloroquine as an adjuvant to anti-cancer chemotherapies.

    PubMed

    Pascolo, Steve

    2016-01-15

    Chloroquine, a drug used for over 80 years to treat and prevent malaria and, more recently, to treat autoimmune diseases, is very safe but has a plethora of dose-dependent effects. By increasing pH in acidic compartments it inhibits for example lysosomal enzymes. In the context of cancer, Chloroquine was found to have direct effects on different types of malignancies that could potentiate chemotherapies. For example, the anti-malaria drug may inhibit both the multidrug-resistance pump and autophagy (mechanisms that tumor cells may use to resist chemotherapies), intercalate in DNA and enhance the penetration of chemotherapeutic drugs in cells or solid cancer tissues. However, these activities were mostly demonstrated at high doses of Chloroquine (higher than 10mg/kg or 10mg/l i.e. ca. 31μM). Nevertheless, it was reported that daily uptake of clinically acceptable doses (less than 10mg/kg) of Chloroquine in addition to chemo-radio-therapy increases the survival of glioblastoma patients (Sotelo et al., 2006; Briceno et al., 2007). However, the optimal dose and schedule of this multi-active drug with respect to chemotherapy has never been experimentally determined. The present article reviews the several known direct and indirect effects of different doses of Chloroquine on cancer and how those effects may indicate that a fine tuning of the dose/schedule of Chloroquine administration versus chemotherapy may be critical to obtain an adjuvant effect of Chloroquine in anti-cancer treatments. We anticipate that the appropriate (time and dose) addition of Chloroquine to the standard of care may greatly and safely potentiate current anti-cancer treatments. PMID:26687632

  19. Patrol Officer Daily Noise Exposure.

    PubMed

    Gilbertson, Lynn R; Vosburgh, Donna J H

    2015-01-01

    established by the OSHA or ACGIH occupational exposure levels from the daily occupational tasks that were monitored. PMID:26011417

  20. Daily regulation of hormone profiles.

    PubMed

    Kalsbeek, Andries; Fliers, Eric

    2013-01-01

    The highly coordinated output of the hypothalamic biological clock does not only govern the daily rhythm in sleep/wake (or feeding/fasting) behaviour but also has direct control over many aspects of hormone release. In fact, a significant proportion of our current understanding of the circadian clock has its roots in the study of the intimate connections between the hypothalamic clock and multiple endocrine axes. This chapter will focus on the anatomical connections used by the mammalian biological clock to enforce its endogenous rhythmicity on the rest of the body, using a number of different hormone systems as a representative example. Experimental studies have revealed a highly specialised organisation of the connections between the mammalian circadian clock neurons and neuroendocrine as well as pre-autonomic neurons in the hypothalamus. These complex connections ensure a logical coordination between behavioural, endocrine and metabolic functions that will help the organism adjust to the time of day most efficiently. For example, activation of the orexin system by the hypothalamic biological clock at the start of the active phase not only ensures that we wake up on time but also that our glucose metabolism and cardiovascular system are prepared for this increased activity. Nevertheless, it is very likely that the circadian clock present within the endocrine glands plays a significant role as well, for instance, by altering these glands' sensitivity to specific stimuli throughout the day. In this way the net result of the activity of the hypothalamic and peripheral clocks ensures an optimal endocrine adaptation of the metabolism of the organism to its time-structured environment. PMID:23604480

  1. Adverse effects of exposure to low doses of chlorpyrifos in lactating rats.

    PubMed

    Mansour, Sameeh A; Mossa, Abdel-Tawab H

    2011-04-01

    This study was conducted to shed light on the effect of exposure of lactating rat to chlorpyrifos (CPF). CPF was orally administered to lactating rats at 0.01 mg kg(-1) b.wt. (acceptable daily intake, ADI), 1.00 mg kg(-1) b.wt. (no observed adverse effects level, NOAEL) and 1.35 mg kg(-1) b.wt. (1/100 LD( 50)) from postnatal day 1 (PN1) until day 20 (PN20) after delivery. Results indicated decreases in body weight and increases in relative liver and kidney weights of exposed dams. Significant damage to liver was observed via increased plasma levels of aminotransferases (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)) lactate dehydrogenase (LDH) and γ-glutamyle transferase (γ-GT) in a dose-dependent manner. At two high doses of CPF (1.00 and 1.35 mg kg(-1) b.wt.), the lactating mothers showed significant decrease in the activity of cholinesterase (ChE). Lipid peroxidation was significantly increased, while glutathione s-transferase (GST) and superoxide dismutase (SOD) were significantly decreased compared to control. At high dose of CPF (1.35 mg kg(-1) b.wt.), total protein and uric acid levels were significantly increased. CPF caused dose-related histopathological changes in liver and kidney of the CPF-treated dams.

  2. Clinical Application of High-Dose, Image-Guided Intensity-Modulated Radiotherapy in High-Risk Prostate Cancer

    SciTech Connect

    Bayley, Andrew; Rosewall, Tara; Craig, Tim; Bristow, Rob; Chung, Peter; Gospodarowicz, Mary; Menard, Cynthia; Milosevic, Michael; Warde, Padraig; Catton, Charles

    2010-06-01

    Purpose: To report the feasibility and early toxicity of dose-escalated image-guided IMRT to the pelvic lymph nodes (LN), prostate (P), and seminal vesicles (SV). Methods and Materials: A total of 103 high-risk prostate cancer patients received two-phase, dose-escalated, image-guided IMRT with 3 years of androgen deprivation therapy. Clinical target volumes (CTVs) were delineated using computed tomography/magnetic resonance co-registration and included the prostate, portions of the SV, and the LN. Planning target volume margins (PTV) used were as follows: P (10 mm, 7 mm posteriorly), SV (10 mm), and LN (5 mm). Organs at risk (OaR) were the rectal and bladder walls, femoral heads, and large and small bowel. The IMRT was planned with an intended dose of 55.1 Gy in 29 fractions to all CTVs (Phase 1), with P+SV consecutive boost of 24.7 Gy in 13 fractions. Daily online image guidance was performed using bony landmarks and intraprostatic markers. Feasibility criteria included delivery of intended doses in 80% of patients, 95% of CTV displacements incorporated within PTV during Phase 1, and acute toxicity rate comparable to that of lower-dose pelvic techniques. Results: A total of 91 patients (88%) received the total prescription dose. All patients received at least 72 Gy. In Phase 1, 63 patients (61%) received the intended 55.1 Gy, whereas 87% of patients received at least 50 Gy. Dose reductions were caused by small bowel and rectal wall constraints. All CTVs received the planned dose in >95% of treatment fractions. There were no Radiation Therapy Oncology Group acute toxicities greater than Grade 3, although there were five incidences equivalent to Grade 3 within a median follow-up of 23 months. Conclusion: These results suggest that dose escalation to the PLN+P+SV using IMRT is feasible, with acceptable rates of acute toxicity.

  3. Modifying Students' Classroom Behaviors Using an Electronic Daily Behavior Report Card

    ERIC Educational Resources Information Center

    Williams, Kashunda L.; Noell, George H.; Jones, Beth A.; Gansle, Kristin A.

    2012-01-01

    This study examined the effects of e-mailed daily behavior report cards (DBRC) on students' disruptive classroom behaviors. Additionally, teacher acceptability of e-mailed DBRC as an intervention was assessed. Participants included 46 elementary students (37 males and 9 females), that were assigned to one of three conditions; delayed treatment…

  4. The Daily Heterosexist Experiences Questionnaire: Measuring Minority Stress Among Lesbian, Gay, Bisexual, and Transgender Adults

    PubMed Central

    Balsam, Kimberly F.; Beadnell, Blair; Molina, Yamile

    2013-01-01

    The authors conducted a three-phase, mixed-methods study to develop a self-report measure assessing the unique aspects of minority stress for lesbian, gay, bisexual, and transgender adults. The Daily Heterosexist Experiences Questionnaire has 50 items and nine subscales with acceptable internal reliability, and construct and concurrent validity. Mean sexual orientation and gender differences were found. PMID:24058262

  5. From requirements to acceptance tests

    NASA Technical Reports Server (NTRS)

    Baize, Lionel; Pasquier, Helene

    1993-01-01

    From user requirements definition to accepted software system, the software project management wants to be sure that the system will meet the requirements. For the development of a telecommunication satellites Control Centre, C.N.E.S. has used new rules to make the use of tracing matrix easier. From Requirements to Acceptance Tests, each item of a document must have an identifier. A unique matrix traces the system and allows the tracking of the consequences of a change in the requirements. A tool has been developed, to import documents into a relational data base. Each record of the data base corresponds to an item of a document, the access key is the item identifier. Tracing matrix is also processed, providing automatically links between the different documents. It enables the reading on the same screen of traced items. For example one can read simultaneously the User Requirements items, the corresponding Software Requirements items and the Acceptance Tests.

  6. Dose Escalation of Total Marrow Irradiation With Concurrent Chemotherapy in Patients With Advanced Acute Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation

    SciTech Connect

    Wong, Jeffrey Y.C.; Forman, Stephen; Somlo, George; Liu An; Schultheiss, Timothy; Radany, Eric; Palmer, Joycelynne; Stein, Anthony

    2013-01-01

    Purpose: We have demonstrated that toxicities are acceptable with total marrow irradiation (TMI) at 16 Gy without chemotherapy or TMI at 12 Gy and the reduced intensity regimen of fludarabine/melphalan in patients undergoing hematopoietic cell transplantation (HCT). This article reports results of a study of TMI combined with higher intensity chemotherapy regimens in 2 phase I trials in patients with advanced acute myelogenous leukemia or acute lymphoblastic leukemia (AML/ALL) who would do poorly on standard intent-to-cure HCT regimens. Methods and Materials: Trial 1 consisted of TMI on Days -10 to -6, etoposide (VP16) on Day -5 (60 mg/kg), and cyclophosphamide (CY) on Day -3 (100 mg/kg). TMI dose was 12 (n=3 patients), 13.5 (n=3 patients), and 15 (n=6 patients) Gy at 1.5 Gy twice daily. Trial 2 consisted of busulfan (BU) on Days -12 to -8 (800 {mu}M min), TMI on Days -8 to -4, and VP16 on Day -3 (30 mg/kg). TMI dose was 12 (n=18) and 13.5 (n=2) Gy at 1.5 Gy twice daily. Results: Trial 1 had 12 patients with a median age of 33 years. Six patients had induction failures (IF), and 6 had first relapses (1RL), 9 with leukemia blast involvement of bone marrow ranging from 10%-98%, 5 with circulating blasts (24%-85%), and 2 with chloromas. No dose-limiting toxicities were observed. Eleven patients achieved complete remission at Day 30. With a median follow-up of 14.75 months, 5 patients remained in complete remission from 13.5-37.7 months. Trial 2 had 20 patients with a median age of 41 years. Thirteen patients had IF, and 5 had 1RL, 2 in second relapse, 19 with marrow blasts (3%-100%) and 13 with peripheral blasts (6%-63%). Grade 4 dose-limiting toxicities were seen at 13.5 Gy (stomatitis and hepatotoxicity). Stomatitis was the most frequent toxicity in both trials. Conclusions: TMI dose escalation to 15 Gy is possible when combined with CY/VP16 and is associated with acceptable toxicities and encouraging outcomes. TMI dose escalation is not possible with BU/VP16 due to

  7. ONCE-DAILY VERSUS DIVIDED DOSAGE LITHIUM THERAPY IN ACUTE MANIA

    PubMed Central

    Suresh, K.P.; Prasad, K.M.R.; Mohan, Rajesh; Andrade, Chittaranjan; Ashok, M.V.; Chaturvedi, S.K.; Sreenivas, K.N.

    1995-01-01

    The aim of the study was to compare once-daily with divided dosage lithium treatment in acute mania. In 79 retrospectively studied subjects who met the DSMIII-R criteria for mania, 26 independent and dependent variables were analyzed. The two groups of patients (categorized according to dosage schedule) were broadly comparable with respect to demographic and clinical characteristics. The two groups also did not differ on the outcome measures of lithium efficacy and lithium adverse effects. It is concluded that single dose lithium therapy is clinically comparable with divided dose lithium therapy in acute mania. Possible advantages of switching over to once-daily lithium regimes are discussed. PMID:21743707

  8. Once-Daily Radiation Therapy for Inflammatory Breast Cancer

    SciTech Connect

    Brown, Lindsay; Harmsen, William; Blanchard, Miran; Goetz, Matthew; Jakub, James; Mutter, Robert; Petersen, Ivy; Rooney, Jessica; Stauder, Michael; Yan, Elizabeth; Laack, Nadia

    2014-08-01

    Purpose: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer variant treated with multimodality therapy. A variety of approaches intended to escalate the intensity and efficacy of radiation therapy have been reported, including twice-daily radiation therapy, dose escalation, and aggressive use of bolus. Herein, we examine our outcomes for patients treated with once-daily radiation therapy with aggressive bolus utilization, focusing on treatment technique. Methods and Materials: A retrospective review of patients with nonmetastatic IBC treated from January 1, 2000, through December 31, 2010, was performed. Locoregional control (LRC), disease-free survival (DFS), overall survival (OS) and predictors thereof were assessed. Results: Fifty-two women with IBC were identified, 49 (94%) of whom were treated with neoadjuvant chemotherapy. All underwent mastectomy followed by adjuvant radiation therapy. Radiation was delivered in once-daily fractions of 1.8 to 2.25 Gy (median, 2 Gy). Patients were typically treated with daily 1-cm bolus throughout treatment, and 33 (63%) received a subsequent boost to the mastectomy scar. Five-year Kaplan Meier survival estimates for LRC, DFS, and OS were 81%, 56%, and 64%, respectively. Locoregional recurrence was associated with poorer OS (P<.001; hazard ratio [HR], 4.1). Extracapsular extension was associated with worse LRC (P=.02), DFS (P=.007), and OS (P=.002). Age greater than 50 years was associated with better DFS (P=.03). Pathologic complete response was associated with a trend toward improved LRC (P=.06). Conclusions: Once-daily radiation therapy with aggressive use of bolus for IBC results in outcomes consistent with previous reports using various intensified radiation therapy regimens. LRC remains a challenge despite modern systemic therapy. Extracapsular extension, age ≤50 years, and lack of complete response to chemotherapy appear to be associated with worse outcomes. Novel strategies are needed in IBC

  9. Evaluation of safety and pharmacokinetics of sodium 2,2 dimethylbutyrate, a novel short chain fatty acid derivative, in a phase 1, double-blind, placebo-controlled, single-dose, and repeat-dose studies in healthy volunteers.

    PubMed

    Perrine, Susan P; Wargin, William A; Boosalis, Michael S; Wallis, Wayne J; Case, Sally; Keefer, Jeffrey R; Faller, Douglas V; Welch, William C; Berenson, Ronald J

    2011-08-01

    Pharmacologic induction of fetal globin synthesis is an accepted therapeutic strategy for treatment of the beta hemoglobinopathies and thalassemias, as even small increases in hemoglobin F (HbF) levels reduce clinical severity in sickle cell disease (SCD) and reduce anemia in beta thalassemia. Prior generation short chain fatty acid therapeutics, arginine butyrate (AB), and phenylbutyrate, increased fetal and total hemoglobin levels in patients, but were limited by high doses or intravenous (IV) infusion. A fetal globin-inducing therapeutic with convenient oral dosing would be an advance for these classic molecular diseases. Healthy adult human subjects were treated with a novel short chain fatty acids (SCFA) derivative, sodium 2,2 dimethylbutyrate (SDMB), or placebo, with 1 of 4 single dose levels (2, 5, 10, and 20 mg/kg) or daily doses (5, 10, or 15 mg/kg) over 14 days, and monitored for adverse clinical and laboratory events, drug levels, reticulocytes, and HbF assays. SDMB was well-tolerated with no clinically significant adverse events related to study medication. The terminal half-life ranged from 9 to 15 hours. Increases in mean absolute reticulocytes were observed at all dose levels in the 14-day study. The favorable pharmacokinetics (PK) profiles and safety findings indicate that SDMB warrants further investigation for treatment of anemic subjects with beta hemoglobinopathies.

  10. Imaginary Companions and Peer Acceptance

    ERIC Educational Resources Information Center

    Gleason, Tracy R.

    2004-01-01

    Early research on imaginary companions suggests that children who create them do so to compensate for poor social relationships. Consequently, the peer acceptance of children with imaginary companions was compared to that of their peers. Sociometrics were conducted on 88 preschool-aged children; 11 had invisible companions, 16 had personified…

  11. Acceptance of Others (Number Form).

    ERIC Educational Resources Information Center

    Masters, James R.; Laverty, Grace E.

    As part of the instrumentation to assess the effectiveness of the Schools Without Failure (SWF) program in 10 elementary schools in the New Castle, Pa. School District, the Acceptance of Others (Number Form) was prepared to determine pupil's attitudes toward classmates. Given a list of all class members, pupils are asked to circle a number from 1…

  12. W-025, acceptance test report

    SciTech Connect

    Roscha, V.

    1994-10-04

    This acceptance test report (ATR) has been prepared to establish the results of the field testing conducted on W-025 to demonstrate that the electrical/instrumentation systems functioned as intended by design. This is part of the RMW Land Disposal Facility.

  13. Euthanasia Acceptance: An Attitudinal Inquiry.

    ERIC Educational Resources Information Center

    Klopfer, Fredrick J.; Price, William F.

    The study presented was conducted to examine potential relationships between attitudes regarding the dying process, including acceptance of euthanasia, and other attitudinal or demographic attributes. The data of the survey was comprised of responses given by 331 respondents to a door-to-door interview. Results are discussed in terms of preferred…

  14. Helping Our Children Accept Themselves.

    ERIC Educational Resources Information Center

    Gamble, Mae

    1984-01-01

    Parents of a child with muscular dystrophy recount their reactions to learning of the diagnosis, their gradual acceptance, and their son's resistance, which was gradually lessened when he was provided with more information and treated more normally as a member of the family. (CL)

  15. Acceptance and Commitment Therapy: Introduction

    ERIC Educational Resources Information Center

    Twohig, Michael P.

    2012-01-01

    This is the introductory article to a special series in Cognitive and Behavioral Practice on Acceptance and Commitment Therapy (ACT). Instead of each article herein reviewing the basics of ACT, this article contains that review. This article provides a description of where ACT fits within the larger category of cognitive behavior therapy (CBT):…

  16. Who accepts first aid training?

    PubMed

    Pearn, J; Dawson, B; Leditschke, F; Petrie, G; Nixon, J

    1980-09-01

    The percentage of individuals trained in first aid skills in the general community is inadequate. We report here a study to investigate factors which influence motivation to accept voluntary training in first aid. A group of 700 randomly selected owners of inground swimming pools (a parental high-risk group) was offered a course of formal first aid instruction. Nine per cent attended the offered training course. The time commitment involved in traditional courses (eight training nights spread over four weeks) is not a deterrent, the same percentage accepting such courses as that who accept a course of one night's instruction. Cost is an important deterrent factor, consumer resistance rising over 15 cost units (one cost unit = the price of a loaf of bread). The level of competent first aid training within the community can be raised by (a) keeping to traditional course content, but (b) by ensuring a higher acceptance rate of first aid courses by a new approach to publicity campaigns, to convince prospective students of the real worth of first aid training. Questions concerning who should be taught first aid, and factors influencing motivation, are discussed.

  17. Feasibility, safety, acceptability, and preliminary efficacy of measurement-based care depression treatment for HIV patients in Bamenda, Cameroon.

    PubMed

    Pence, Brian W; Gaynes, Bradley N; Atashili, Julius; O'Donnell, Julie K; Kats, Dmitry; Whetten, Kathryn; Njamnshi, Alfred K; Mbu, Tabenyang; Kefie, Charles; Asanji, Shantal; Ndumbe, Peter

    2014-06-01

    Depression affects 18-30 % of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. We enrolled 55 participants; all started amitriptyline 25-50 mg daily at baseline. By 12 weeks, most remained at 50 mg daily (range 25-125 mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87 % achieved depression remission (PHQ-9 <5) by 12 weeks. Intervention fidelity was high: HIV providers followed MBC recommendations at 96 % of encounters. Most divergences reflected a failure to increase dose when indicated. No serious and few bothersome side effects were reported. Most suicidality (prevalence 62 % at baseline; 8 % at 12 weeks) was either passive or low-risk. Participant satisfaction was high (100 %), and most participants (89 %) indicated willingness to pay for medications if MBC were implemented in routine care. The adapted MBC intervention demonstrated high feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting. PMID:24558099

  18. Techniques for Daily Living: Curriculum Guides.

    ERIC Educational Resources Information Center

    Wooldridge, Lillian; And Others

    Presented are specific guides concerning techniques for daily living which were developed by the child care staff at the Illinois Braille and Sight Saving School. The guides are designed for cottage parents of the children, who may have both visual and other handicaps, and show what daily living skills are necessary and appropriate for the…

  19. Daily Stressors in Primary Education Students

    ERIC Educational Resources Information Center

    Fernández-Baena, F. Javier; Trianes, María V.; Escobar, Milagros; Blanca, María J.; Muñoz, Ángela M.

    2015-01-01

    Daily stress can have a bearing on children's emotional and academic development. This study aimed to assess daily stressors and to determine their prevalence among primary education students, taking into account their gender, academic year, social adaptation, and the school location. A sample of 7,354 Spanish schoolchildren aged between 6…

  20. Daily Spiritual Experiences and Prosocial Behavior

    ERIC Educational Resources Information Center

    Einolf, Christopher J.

    2013-01-01

    This paper examines how the Daily Spiritual Experiences Scale (DSES) relates to range of prosocial behaviors, using a large, nationally representative U.S. data set. It finds that daily spiritual experiences are a statistically and substantively significant predictor of volunteering, charitable giving, and helping individuals one knows personally.…

  1. Daily Oral Language: Is It Effective?

    ERIC Educational Resources Information Center

    Whittingham, Jeff L.

    2007-01-01

    This study examines the Daily Oral Language (DOL) program aimed at helping students learn mechanics of writing through daily editing exercises. This nine-month study sought to determine if DOL improved editing skills and actual writing skills of seventy fourth-grade students. While the results of this study did not statistically demonstrate the…

  2. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day....

  3. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day....

  4. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day....

  5. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day....

  6. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day....

  7. Ketazolam once daily for spasticity: double-blind cross-over study.

    PubMed

    Basmajian, J V; Shankardass, K; Russell, D

    1986-08-01

    This double-blind cross-over study of 14 severely spastic inpatients with chronic multiple sclerosis reveals that once-daily doses of ketazolam, a new drug, are effective in reducing spasticity in a significant proportion of patients without significant side-effects. Added to the similar findings of an earlier double-blind controlled study of divided doses, the results suggest that this special feature of ketazolam provides a unique flexibility that may be exploited in individual cases.

  8. Daily rhythm of nociception in rats.

    PubMed

    Christina, AJM; Merlin, NJ; Vijaya, C; Jayaprakash, S; Murugesh, N

    2004-03-25

    BACKGROUND: Many behavioral and physiological variables exhibit daily rhythmicity. Few investigations of the daily rhythmicity in nociception have been conducted, and conflicting results have been obtained. The present study evaluated the daily rhythmicity in nociception in Wistar rats. METHODS: Nociception was investigated by Eddy's hot plate method, tail immersion method, and tail clip method. The latency between the noxious stimulus and the animal's response was recorded as reaction time. Separate groups of rats were tested in 4-hour intervals for 24 hours. RESULTS: There was clear daily variation in response latency. Reaction time was shortest a few hours before lights-on and longest at the light-dark transition. CONCLUSION: Nociception exhibits robust daily rhythmicity in rats. Sensitivity to pain is highest late in the dark phase of the light-dark cycle and lowest at the light-dark transition.

  9. Daily rhythm of nociception in rats

    PubMed Central

    Christina, AJM; Merlin, NJ; Vijaya, C; Jayaprakash, S; Murugesh, N

    2004-01-01

    Background Many behavioral and physiological variables exhibit daily rhythmicity. Few investigations of the daily rhythmicity in nociception have been conducted, and conflicting results have been obtained. The present study evaluated the daily rhythmicity in nociception in Wistar rats. Methods Nociception was investigated by Eddy's hot plate method, tail immersion method, and tail clip method. The latency between the noxious stimulus and the animal's response was recorded as reaction time. Separate groups of rats were tested in 4-hour intervals for 24 hours. Results There was clear daily variation in response latency. Reaction time was shortest a few hours before lights-on and longest at the light-dark transition. Conclusion Nociception exhibits robust daily rhythmicity in rats. Sensitivity to pain is highest late in the dark phase of the light-dark cycle and lowest at the light-dark transition. PMID:15043763

  10. Accepting the T3D

    SciTech Connect

    Rich, D.O.; Pope, S.C.; DeLapp, J.G.

    1994-10-01

    In April, a 128 PE Cray T3D was installed at Los Alamos National Laboratory`s Advanced Computing Laboratory as part of the DOE`s High-Performance Parallel Processor Program (H4P). In conjunction with CRI, the authors implemented a 30 day acceptance test. The test was constructed in part to help them understand the strengths and weaknesses of the T3D. In this paper, they briefly describe the H4P and its goals. They discuss the design and implementation of the T3D acceptance test and detail issues that arose during the test. They conclude with a set of system requirements that must be addressed as the T3D system evolves.

  11. Sweeteners: consumer acceptance in tea.

    PubMed

    Sprowl, D J; Ehrcke, L A

    1984-09-01

    Sucrose, fructose, aspartame, and saccharin were compared for consumer preference, aftertaste, and cost to determine acceptability of the sweeteners. A 23-member taste panel evaluated tea samples for preference and aftertaste. Mean retail cost of the sweeteners were calculated and adjusted to take sweetening power into consideration. Sucrose was the least expensive and most preferred sweetener. No significant difference in preference for fructose and aspartame was found, but both sweeteners were rated significantly lower than sucrose. Saccharin was the most disliked sweetener. Fructose was the most expensive sweetener and aspartame the next most expensive. Scores for aftertaste followed the same pattern as those for preference. Thus, a strong, unpleasant aftertaste seems to be associated with a dislike for a sweetener. From the results of this study, it seems that there is no completely acceptable low-calorie substitute for sucrose available to consumers.

  12. Resilience in Daily Occupations of Indonesian Mothers of Children With Autism Spectrum Disorder.

    PubMed

    Santoso, Tri Budi; Ito, Yuko; Ohshima, Nobuo; Hidaka, Mikiyo; Bontje, Peter

    2015-01-01

    This qualitative study investigated how resilience functions in the context of daily occupations for mothers of children with autism spectrum disorder (ASD). Fourteen mothers of children with ASD participated in two focus groups that were used to elicit stories of the mothers' resilience in daily occupations. A constant comparative method was used for data analysis. A model of resilience in daily occupations of mothers of children with ASD was developed consisting of four categories: (1) creating and re-creating accepting conditions, (2) finding solutions, (3) striving for balance among daily occupations, and (4) thinking about the child's future. Sources of resilience were found to reside in both the mothers themselves and their social environments. Occupational therapy practitioners can use these findings in developing supportive approaches aimed at mothers, family members, and other people in the lives of children with ASD.

  13. Resilience in Daily Occupations of Indonesian Mothers of Children With Autism Spectrum Disorder.

    PubMed

    Santoso, Tri Budi; Ito, Yuko; Ohshima, Nobuo; Hidaka, Mikiyo; Bontje, Peter

    2015-01-01

    This qualitative study investigated how resilience functions in the context of daily occupations for mothers of children with autism spectrum disorder (ASD). Fourteen mothers of children with ASD participated in two focus groups that were used to elicit stories of the mothers' resilience in daily occupations. A constant comparative method was used for data analysis. A model of resilience in daily occupations of mothers of children with ASD was developed consisting of four categories: (1) creating and re-creating accepting conditions, (2) finding solutions, (3) striving for balance among daily occupations, and (4) thinking about the child's future. Sources of resilience were found to reside in both the mothers themselves and their social environments. Occupational therapy practitioners can use these findings in developing supportive approaches aimed at mothers, family members, and other people in the lives of children with ASD. PMID:26356659

  14. Flurbiprofen interaction with single doses of atenolol and propranolol.

    PubMed Central

    Webster, J; Petrie, J C; McLean, I; Hawksworth, G M

    1984-01-01

    In patients with mild hypertension, flurbiprofen in a dose of 100 mg daily for 7 days attenuated the hypotensive effect of a single dose of propranolol 80 mg but not of atenolol 100 mg. The attenuation was not due to an effect on the pharmacokinetic profile of either propranolol or atenolol. An alternative explanation is required. PMID:6529525

  15. Acceptability of reactors in space

    SciTech Connect

    Buden, D.

    1981-01-01

    Reactors are the key to our future expansion into space. However, there has been some confusion in the public as to whether they are a safe and acceptable technology for use in space. The answer to these questions is explored. The US position is that when reactors are the preferred technical choice, that they can be used safely. In fact, it does not appear that reactors add measurably to the risk associated with the Space Transportation System.

  16. Acceptability of reactors in space

    SciTech Connect

    Buden, D.

    1981-04-01

    Reactors are the key to our future expansion into space. However, there has been some confusion in the public as to whether they are a safe and acceptable technology for use in space. The answer to these questions is explored. The US position is that when reactors are the preferred technical choice, that they can be used safely. In fact, it dies not appear that reactors add measurably to the risk associated with the Space Transportation System.

  17. Adolescent Daily and General Maladjustment: Is There Reactivity to Daily Repeated Measures Methodologies?

    ERIC Educational Resources Information Center

    Nishina, Adrienne

    2012-01-01

    The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or…

  18. 48 CFR 12.402 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Acceptance. 12.402 Section... Acceptance. (a) The acceptance paragraph in 52.212-4 is based upon the assumption that the Government will rely on the contractor's assurances that the commercial item tendered for acceptance conforms to...

  19. Estimating thyroid dose in pediatric CT exams from surface dose measurement

    NASA Astrophysics Data System (ADS)

    Al-Senan, Rani; Mueller, Deborah L.; Hatab, Mustapha R.

    2012-07-01

    The purpose of this study was to investigate the possibility of estimating pediatric thyroid doses from CT using surface neck doses. Optically stimulated luminescence dosimeters were used to measure the neck surface dose of 25 children ranging in ages between one and three years old. The neck circumference for each child was measured. The relationship between obtained surface doses and thyroid dose was studied using acrylic phantoms of various sizes and with holes of different depths. The ratios of hole-to-surface doses were used to convert patients' surface dose to thyroid dose. ImPACT software was utilized to calculate thyroid dose after applying the appropriate age correction factors. A paired t-test was performed to compare thyroid doses from our approach and ImPACT. The ratio of thyroid to surface dose was found to be 1.1. Thyroid doses ranged from 20 to 80 mGy. Comparison showed no statistical significance (p = 0.18). In addition, the average of surface dose variation along the z-axis in helical scans was studied and found to range between 5% (in 10 cm diameter phantom/24 mm collimation/pitch 1.0) and 8% (in 16 cm diameter phantom/12 mm collimation/pitch 0.7). We conclude that surface dose is an acceptable predictor for pediatric thyroid dose from CT. The uncertainty due to surface dose variability may be reduced if narrower collimation is used with a pitch factor close to 1.0. Also, the results did not show any effect of thyroid depth on the measured dose.

  20. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control

    PubMed Central

    Menghi, Enrico; Marcocci, Francesco; Bianchini, David

    2016-01-01

    The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system. PMID:26848962

  1. Warfarin maintenance dose in older patients: higher average dose and wider dose frequency distribution in patients of African ancestry than those of European ancestry.

    PubMed

    Garwood, Candice L; Clemente, Jennifer L; Ibe, George N; Kandula, Vijay A; Curtis, Kristy D; Whittaker, Peter

    2010-06-15

    Studies report that warfarin doses required to maintain therapeutic anticoagulation decrease with age; however, these studies almost exclusively enrolled patients of European ancestry. Consequently, universal application of dosing paradigms based on such evidence may be confounded because ethnicity also influences dose. Therefore, we determined if warfarin dose decreased with age in Americans of African ancestry, if older African and European ancestry patients required different doses, and if their daily dose frequency distributions differed. Our chart review examined 170 patients of African ancestry and 49 patients of European ancestry cared for in our anticoagulation clinic. We calculated the average weekly dose required for each stable, anticoagulated patient to maintain an international normalized ratio of 2.0 to 3.0, determined dose averages for groups <70, 70-79, and >80 years of age and plotted dose as a function of age. The maintenance dose in patients of African ancestry decreased with age (P<0.001). In addition, older patients of African ancestry required higher average weekly doses than patients of European ancestry: 33% higher in the 70- to 79-year-old group (38.2+/-1.9 vs. 28.8+/-1.7 mg; P=0.006) and 52% in the >80-year-old group (33.2+/-1.7 vs. 21.8+/-3.8 mg; P=0.011). Therefore, 43% of older patients of African ancestry required daily doses >5mg and hence would have been under-dosed using current starting-dose guidelines. The dose frequency distribution was wider for older patients of African ancestry compared to those of European ancestry (P<0.01). The higher doses required by older patients of African ancestry indicate that strategies for initiating warfarin therapy based on studies of patients of European ancestry could result in insufficient anticoagulation and thereby potentially increase their thromboembolism risk.

  2. Prioritization of pesticides based on daily dietary exposure potential as determined from the SHEDS model

    EPA Science Inventory

    A major pathway for exposure to many pesticides is through diet. The objectives were to rank pesticides by comparing their calculated daily dietary exposure as determined by EPA's Stochastic Human Exposure and Dose Simulation (SHEDS) to single pesticides for different age groups ...

  3. Effect of once daily and twice daily sustained release theophylline formulations on daytime variation of bronchial hyperresponsiveness in asthmatic patients

    PubMed Central

    Ferrari, M.; Olivieri, M.; Lampronti, G.; Bonazza, L.; Biasin, C.; Nacci, P.; Talamini, G.; Lo, C

    1997-01-01

    BACKGROUND: Previous studies evaluating spirometric values and symptoms have shown that once daily theophylline administered in the evening produces greater stabilisation of the airway function in asthmatic patients than the prototype theophylline given twice a day. The aim of this study was to compare the effects on bronchial responsiveness to methacholine of an ultrasustained release theophylline formulation (Diffumal-24, Malesci, Florence, Italy) administered once a day, a sustained release theophylline formulation (Theo-Dur, Recordati, Milan, Italy) administered twice a day, and placebo. METHODS: The study was performed in 12 adult patients with asthma using a randomised, double blind, three phase, cross-over design. Each phase lasted seven days and was followed or preceded by at least three days of theophylline washout. Diffumal-24 was administered once a day at 20.00 hours whereas Theo-Dur was given twice a day at 08.00 hours and 20.00 hours. In each patient the total daily dose of theophylline was the same during both phases. The dose of the two active preparations was titrated to individual needs before the beginning of the study and then given in divided or once daily doses. At 08.00, 14.00, and 20.00 hours on day 7 of each phase serum theophylline concentrations were measured and spirometric tests (FEV1) and bronchial challenge with methacholine were also performed. RESULTS: When the administration of Diffumal-24 was compared with that of Theo-Dur, a higher serum theophylline concentration of the former was seen in the morning whereas at 20.00 hours the reverse was true. Compared with placebo, at 08.00 hours Diffumal-24 improved FEV1 whereas Theo-Dur did not (difference between treatments 0.29 1, 95% CI 0.12 to 0.45). At 08.00 hours Diffumal-24 decreased bronchial sensitivity to methacholine, expressed as a natural logarithm of PD20, to a greater extent than Theo-Dur (difference between treatments 0.54 log units, 95% CI 0.016 to 1.08). The morning

  4. Effectiveness of daily versus non-daily granulocyte colony-stimulating factors in patients with solid tumours undergoing chemotherapy: a multivariate analysis of data from current practice

    PubMed Central

    Almenar Cubells, D; Bosch Roig, C; Jiménez Orozco, E; Álvarez, R; Cuervo, JM; Díaz Fernández, N; Sánchez Heras, AB; Galán Brotons, A; Giner Marco, V; Codes M De Villena, M

    2013-01-01

    We conducted a multicentre, retrospective, observational study including patients with solid tumours (excluding breast cancer) that received granulocyte colony-stimulating factors (G-CSF) and chemotherapy. We investigated the effectiveness of daily vs. non-daily G-CSFs (pegfilgrastim) adjusting by potential confounders. The study included 391 patients (211 daily G-CSF; 180 pegfilgrastim), from whom 47.3% received primary prophylaxis (PP) (57.8% pegfilgrastim), 26.3% secondary prophylaxis (SP: initiation after cycle 1 and no reactive treatment in any cycle) (51.5% pegfilgrastim) and 26.3% reactive treatment (19.4% pegfilgrastim). Only 42.2% of patients with daily G-CSF and 46.2% with pegfilgrastim initiated prophylaxis within 72 h after chemotherapy, and only 10.5% of patients with daily G-CSF received it for ≥7 days. In the multivariate models, daily G-CSF was associated with higher risk of grade 3-4 neutropenia (G3-4N) vs. pegfilgrastim [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.004–2.97]. Relative to SP, PP protected against G3-4N (OR for SP vs. PP: 6.0, 95%CI: 3.2–11.4) and febrile neutropenia (OR: 3.1, 95%CI: 1.1–8.8), and was associated to less chemotherapy dose delays and reductions (OR for relative dose intensity <85% for SP vs. PP: 3.1, 95%CI: 1.7–5.4) and higher response rate (OR: 2.1, 95%CI: 1.2–3.7). Data suggest that pegfilgrastim, compared with a daily G-CSF, and PP, compared with SP, could be more effective in preventing neutropenia and its related events in the clinical practice. PMID:23331323

  5. Effectiveness of daily versus non-daily granulocyte colony-stimulating factors in patients with solid tumours undergoing chemotherapy: a multivariate analysis of data from current practice.

    PubMed

    Almenar Cubells, D; Bosch Roig, C; Jiménez Orozco, E; Álvarez, R; Cuervo, J M; Díaz Fernández, N; Sánchez Heras, A B; Galán Brotons, A; Giner Marco, V; Codes M De Villena, M

    2013-05-01

    We conducted a multicentre, retrospective, observational study including patients with solid tumours (excluding breast cancer) that received granulocyte colony-stimulating factors (G-CSF) and chemotherapy. We investigated the effectiveness of daily vs. non-daily G-CSFs (pegfilgrastim) adjusting by potential confounders. The study included 391 patients (211 daily G-CSF; 180 pegfilgrastim), from whom 47.3% received primary prophylaxis (PP) (57.8% pegfilgrastim), 26.3% secondary prophylaxis (SP: initiation after cycle 1 and no reactive treatment in any cycle) (51.5% pegfilgrastim) and 26.3% reactive treatment (19.4% pegfilgrastim). Only 42.2% of patients with daily G-CSF and 46.2% with pegfilgrastim initiated prophylaxis within 72 h after chemotherapy, and only 10.5% of patients with daily G-CSF received it for ≥ 7 days. In the multivariate models, daily G-CSF was associated with higher risk of grade 3-4 neutropenia (G3-4N) vs. pegfilgrastim [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.004-2.97]. Relative to SP, PP protected against G3-4N (OR for SP vs. PP: 6.0, 95%CI: 3.2-11.4) and febrile neutropenia (OR: 3.1, 95%CI: 1.1-8.8), and was associated to less chemotherapy dose delays and reductions (OR for relative dose intensity <85% for SP vs. PP: 3.1, 95%CI: 1.7-5.4) and higher response rate (OR: 2.1, 95%CI: 1.2-3.7). Data suggest that pegfilgrastim, compared with a daily G-CSF, and PP, compared with SP, could be more effective in preventing neutropenia and its related events in the clinical practice.

  6. Variations of the radiation dose onboard Mir station.

    PubMed

    Panasyuk, M I; Teltsov, M V; Shumshurov, V I; Tsetlin, V V

    1998-01-01

    Dose variations, associated with the 11-year solar activity cycle, seasonal variations of particle fluxes in the Earth's radiation belts at the station orbit, and solar proton events are studied, using prolonged measurements of radiation doses inside orbital station Mir. Daily averages of radiation doses during the declining phase of the 22nd solar cycle and during transition to the 23rd solar activity cycle reached very large values for astronauts and significantly exceed the values calculated according to existing models.

  7. REL3.0 LPSA DAILY

    Atmospheric Science Data Center

    2016-06-02

    ... Budget (SRB) Release 3.0 Langley Parameterized Shortwave Model Daily Data in Native grid binary format News:  LPSA ... Clouds Radiation Budget Spatial Coverage:  (-90, 90)(-180,180) Spatial Resolution:  ...

  8. AMSR2 Daily Arctic Sea Ice - 2014

    NASA Video Gallery

    In this animation, the daily Arctic sea ice and seasonal land cover change progress through time, from March 21, 2014 through the 3rd of August, 2014. Over the water, Arctic sea ice changes from da...

  9. REL3.0 SW DAILY UTC

    Atmospheric Science Data Center

    2016-10-05

    ... Active Radiation Flux Cloud Fraction Cosine Solar Zenith Angle From Satellite Cosine Solar Zenith Angle From Astronomy ... ISCCP Data Table SSE Renewable Energy Readme Files:  Readme_3.0_sw_daily ...

  10. REL3.0 SW DAILY LOCAL

    Atmospheric Science Data Center

    2016-10-05

    ... Active Radiation Flux Cloud Fraction Cosine Solar Zenith Angle From Satellite Cosine Solar Zenith Angle From Astronomy ... ISCCP Data Table SSE Renewable Energy Readme Files:  Readme_3.0_sw_daily ...

  11. Waste-acceptance criteria for greater-confinement disposal

    SciTech Connect

    Gilbert, T.L.; Meshkov, N.K.

    1986-01-01

    A methodology for establishing waste-acceptance criteria based on quantitative performance factors that characterize the confinement capabilities of a waste-disposal site and facility has been developed. The methodology starts from the basic objective of protecting public health and safety by providing assurance that dispsoal of the waste will not result in a radiation dose to any member of the general public, in either the short or long term, in excess of an established basic dose limit. The method is based on an explicit, straightforward, and quantitative relationship among individual risk, confinement capabilities, and waste characteristics. A key aspect of the methodology is the introduction of a confinement factor that characterizes the overall confinement capability of a particular facility and can be used for quantitative assessments of the performance of different disposal sites and facilities, as well as for establishing site-specific waste-acceptance criteria. Confinement factors are derived by means of site-specific pathway analyses. They make possible a direct and simple conversion of a basic dose limit into waste-acceptance criteria, specified as concentration limits on radionuclides in the waste streams and expressed in quantitative form as a function of parameters that characterize the site, facility design, waste containers, and waste form. Waste-acceptance criteria can be represented visually as activity/time plots for various waste streams. These plots show the concentrations of radionuclides in a waste stream as a function of time and permit a visual, quantitative assessment of long-term performance, relative risks from different radionuclides in the waste stream, and contributions from ingrowth. 13 refs.

  12. [Daily life disability associated with dementia].

    PubMed

    Asada, Takashi

    2013-01-01

    Daily life disability associated with dementia including Alzheimer disease involves a series of difficulties in performing daily tasks. People with this disability have difficulty in being active individually, participating in society, and carrying out daily tasks. Evidence suggests that its causes are lesions in specific areas of the brain. For example, focal lesions appear to be specifically correlated with symptoms of apraxia and agnosia. In general, cognitive decline in the course of dementing illnesses worsens as brain lesions expand. This may be accompanied by the impairment of other organs. However, brain lesions appear to be the overall cause of daily life disability associated with dementia. There are three basic measures that can be taken in response to daily life disability : first, analysis of normal daily life activities ; next, the observation of how the activities of people with dementia deviate from the normal pattern ; and finally, collecting information on caregivers' effective practices to appropriately respond to these deviations. Care for daily life disability associated with dementia should aim to maximize the performance of people with dementia based on their existing abilities. To do this, it is important to recognize disruptions to the normal flow of activity, and understand clues pointing to the causes of these disruptions. In order to examine the daily life disability associated with dementia, we conducted preliminary experiments on the background brain activity. For this purpose, capsaicin derived from red pepper was used to stimulate taste bud receptors on the tongue. During this physiological process, we examined the response within the brain, and observed activity in specific brain regions. For further studies on the background of the disability, we will use fMRI and magnetoencephalography.

  13. Daily Behavior Report Cards with and without Home-Based Consequences: Improving Classroom Behavior in Low Income, African American Children with ADHD

    ERIC Educational Resources Information Center

    Jurbergs, Nichole; Palcic, Jennette L.; Kelley, Mary L.

    2010-01-01

    Daily Behavior Report Cards (DBRC), which typically require teachers to evaluate students' daily behavior and parents to provide contingent consequences, are an effective and acceptable method for improving children's classroom behavior. The current study evaluated whether parent involvement is an essential treatment component or whether teacher…

  14. Issues in carcinogenicity testing: dose selection.

    PubMed

    Haseman, J K

    1985-02-01

    Dose selection in testing chemicals for possible carcinogenicity in rodents continues to be an area of scientific debate. In this paper the definition of "maximum tolerated dose" (MTD) is considered, and the advantages and disadvantages of using MTDs are given. There is no universally accepted definition of an MTD, and as a result, objections to utilizing high doses in carcinogenicity testing may reflect differing definitions of an MTD rather than basic disagreements in dose selection philosophy. Data from 52 National Toxicology Program (NTP) carcinogenicity studies indicate that while dose selection has caused difficulties in certain studies using the gavage route of chemical administration, there is little evidence that this has been a problem in NTP studies using the dietary (feed) route of exposure. These data also indicate that more than two-thirds of the carcinogenic effects detected in feeding studies would have been missed had the high dose been reduced from the estimated MTD to 1/2 MTD. The inherent insensitivity of laboratory animal studies for detecting weak-to-moderate carcinogenic responses also argues against reducing the highest dose level. The addition of a third, lower-dosed group provides for a margin of safety against the possibility of over-estimating the MTD. Primary emphasis should be given to improving procedures for estimating the MTD, particularly for gavage studies. Efforts should also be increased to obtain pharmacokinetic and metabolism data for the test chemical that might be factored into the dose selection and study evaluation processes.

  15. Acceptance and Commitment Therapy as a Treatment for Scrupulosity in Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Dehlin, John P.; Morrison, Kate L.; Twohig, Michael P.

    2013-01-01

    This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the…

  16. For better or worse? Self-esteem and the contingencies of acceptance in marriage.

    PubMed

    Murray, Sandra L; Griffin, Dale W; Rose, Paul; Bellavia, Gina

    2006-07-01

    A longitudinal daily diary study examined the origins and consequences of perceiving a partner's acceptance and love as contingent on professional success. Both members of 154 couples completed a diary for 21 days. Multilevel analyses revealed that low self-esteem men and women felt more accepted and loved by their partner on days when their professional lives were marked by success, and low self-esteem women felt less accepted and loved on days when their professional lives were marked by failure. No such spillover effects between people's professional and relationship lives emerged for people high in chronic selfesteem. A 1-year longitudinal follow-up revealed that people who initially felt less accepted across days reported decreased satisfaction. Men also became especially distressed when their wives felt less accepted initially and (incorrectly) perceived their husbands' regard as contingent.

  17. The frequency distribution of daily global irradiation at Kumasi

    SciTech Connect

    Akuffo, F.O.; Brew-Hammond, A. )

    1993-02-01

    Cumulative frequency distribution curves (CDC) for daily global irradiation on the horizontal produced by Liu and Jordan in 1963 have until recently been considered to have universal validity. Results obtained by Saunier et al. in 1987 and Ideriah and Suleman in 1989 for two tropical locations, Ibadan in Nigeria and Bangkok in Thailand, respectively, have thrown into question the universal validity of the Liu and Jordan generalized CDC. Saunier et al., in particular, showed that their results disagreed with the generalized CDC mainly because of differences in the values of the maximum clearness index (Kmax), as well as the underlying probability density functions. Consequently, they proposed two expressions for determining Kmax and probability densities in tropical locations. This paper presents the results of statistical analysis of daily global irradiation for Kumasi, Ghana, also a tropical location. The results show that the expressions of Saunier et al. provide a better description of the observations than the generalized CDC and, in particular, the empirical equation for Kmax may be valid for Kumasi. Furthermore, the results show that the values of the minimum clearness index (Kmin) for Kumasi are much higher than the generally accepted value of 0.05 for overcast sky conditions. A comparison of the results for Kumasi and Ibadan shows that there is satisfactory agreement when the values of Kmax and Kmin are comparable; in cases where there are discrepancies in the Kmax and Kmin values, the CDC also disagree. 13 refs., 3 figs., 5 tabs.

  18. Associations among Daily Stressors and Salivary Cortisol: Findings from the National Study of Daily Experiences

    PubMed Central

    Stawski, Robert S.; Cichy, Kelly E.; Piazza, Jennifer R.; Almeida, David M.

    2013-01-01

    While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally-occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1,694 adults (Age=57, Range=33–84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30 minutes post-waking, before lunch and before bed, on four consecutive interview days resulting in 5,995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally-occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. PMID:23856186

  19. Model Uncertainty and Bayesian Model Averaged Benchmark Dose Estimation for Continuous Data

    EPA Science Inventory

    The benchmark dose (BMD) approach has gained acceptance as a valuable risk assessment tool, but risk assessors still face significant challenges associated with selecting an appropriate BMD/BMDL estimate from the results of a set of acceptable dose-response models. Current approa...

  20. High-dose mitoxantrone with peripheral blood progenitor cell rescue: toxicity, pharmacokinetics and implications for dosage and schedule.

    PubMed Central

    Ballestrero, A.; Ferrando, F.; Garuti, A.; Basta, P.; Gonella, R.; Esposito, M.; Vannozzi, M. O.; Sorice, G.; Friedman, D.; Puglisi, M.; Brema, F.; Mela, G. S.; Sessarego, M.; Patrone, F.

    1997-01-01

    The optimal use of mitoxantrone (NOV) in the high-dose range requires elucidation of its maximum tolerated dose with peripheral blood progenitor cell (PBPC) support and the time interval needed between drug administration and PBPC reinfusion in order to avoid graft toxicity. The aims of this study were: (1) to verify the feasibility and haematological toxicity of escalating NOV up to 90 mg m(-2) with PBPC support; and (2) to verify the safeness of a short (96 h) interval between NOV administration and PBPC reinfusion. Three cohorts of ten patients with breast cancer (BC) or non-Hodgkin's lymphoma (NHL) received escalating doses of NOV, 60, 75 and 90 mg m(-2) plus melphalan (L-PAM), 140-180 mg m(-2), with PBPC rescue 96 h after NOV. Haematological toxicity was evaluated daily (WHO criteria). NOV plasma pharmacokinetics was also evaluated, as well as NOV cytotoxicity against PBPCs. Haematological recovery was rapid and complete at each NOV dose level without statistically significant differences, and there were no major toxicities. NOV plasma concentrations at the time of PBPC reinfusion were below the toxicity threshold against haemopoietic progenitors. It is concluded that, when adequately supported with PBPCs, NOV can be escalated up to 90 mg m(-2) with acceptable haematological toxicity. PBPCs can be safely reinfused as early as 96 h after NOV administration. PMID:9310249

  1. Absorbed Dose and Dose Equivalent Calculations for Modeling Effective Dose

    NASA Technical Reports Server (NTRS)

    Welton, Andrew; Lee, Kerry

    2010-01-01

    While in orbit, Astronauts are exposed to a much higher dose of ionizing radiation than when on the ground. It is important to model how shielding designs on spacecraft reduce radiation effective dose pre-flight, and determine whether or not a danger to humans is presented. However, in order to calculate effective dose, dose equivalent calculations are needed. Dose equivalent takes into account an absorbed dose of radiation and the biological effectiveness of ionizing radiation. This is important in preventing long-term, stochastic radiation effects in humans spending time in space. Monte carlo simulations run with the particle transport code FLUKA, give absorbed and equivalent dose data for relevant shielding. The shielding geometry used in the dose calculations is a layered slab design, consisting of aluminum, polyethylene, and water. Water is used to simulate the soft tissues that compose the human body. The results obtained will provide information on how the shielding performs with many thicknesses of each material in the slab. This allows them to be directly applicable to modern spacecraft shielding geometries.

  2. Acceptability and factors associated with willingness to receive short messages for improving antiretroviral therapy adherence in China.

    PubMed

    Xiao, Yongkang; Ji, Guoping; Tian, Cuicui; Li, Hui; Biao, Wei; Hu, Zhi

    2014-01-01

    This study aimed to understand the acceptability of short message service (SMS) as a reminder for improving antiretroviral therapy (ART) adherence and determine the factors associated with willingness to accept SMS among people living HIV (PLH) in China. A total of 801 adult patients were recruited in a cross-sectional survey. Factors associated with willingness in unadjusted analyses (α = 0.10) were included in a logistic regression model; 88.4% of the participants owned mobile phones, 49.6% read every short message and 16.2% read only if the phone number was familiar, 79.5% reported daily SMS to remind taking medicine would be helpful, and 68.9% were willing to receive them. In the final model, willingness to accept was positively associated with being young (odds ratio [OR] = 0.32; 95% confidence interval [CI]: 0.11-0.99; p = 0.048), living in the middle or north region (OR = 2.36; 95% CI: 1.24-4.50; p = 0.009, OR = 71.79; 95% CI: 21.53-239.37; p < 0.001, respectively), having primary or "junior or higher" education (OR = 5.80; 95% CI: 2.13-15.86; p = 0.001, OR = 3.20; 95% CI: 1.20-8.58; p = 0.021, respectively), having serious disease condition of stage (OR = 10.01; 95% CI: 2.12-47.30; p = 0.004), being a rural resident (OR = 2.96; 95% CI: 1.72-5.10; p < 0.001), having side effect (OR = 4.74; 95% CI: 1.24-18.03; p = 0.023), and taking a dose two or more hours late in the last 30 days (OR = 2.45; 95% CI: 1.26-4.78; p = 0.009). SMS as a reminder for improving ART adherence is acceptable. The survey results indicate that to be effective, messages need to be more acceptable to elderly patients, urban residents, individuals with earlier stage of HIV disease, and individuals not experiencing side effects. Nonetheless, these results suggest that for a high proportion of PLH in China, reminder messages through mobile phones would be useful for increasing compliance with HIV regimens.

  3. Experimental evaluation of actual delivered dose using mega-voltage cone-beam CT and direct point dose measurement

    SciTech Connect

    Matsubara, Kana; Kohno, Ryosuke; Nishioka, Shie; Shibuya, Toshiyuki; Ariji, Takaki; Akimoto, Tetsuo; Saitoh, Hidetoshi

    2013-07-01

    Radiation therapy in patients is planned by using computed tomography (CT) images acquired before start of the treatment course. Here, tumor shrinkage or weight loss or both, which are common during the treatment course for patients with head-and-neck (H and N) cancer, causes unexpected differences from the plan, as well as dose uncertainty with the daily positional error of patients. For accurate clinical evaluation, it is essential to identify these anatomical changes and daily positional errors, as well as consequent dosimetric changes. To evaluate the actual delivered dose, the authors proposed direct dose measurement and dose calculation with mega-voltage cone-beam CT (MVCBCT). The purpose of the present study was to experimentally evaluate dose calculation by MVCBCT. Furthermore, actual delivered dose was evaluated directly with accurate phantom setup. Because MVCBCT has CT-number variation, even when the analyzed object has a uniform density, a specific and simple CT-number correction method was developed and applied for the H and N site of a RANDO phantom. Dose distributions were calculated with the corrected MVCBCT images of a cylindrical polymethyl methacrylate phantom. Treatment processes from planning to beam delivery were performed for the H and N site of the RANDO phantom. The image-guided radiation therapy procedure was utilized for the phantom setup to improve measurement reliability. The calculated dose in the RANDO phantom was compared to the measured dose obtained by metal-oxide-semiconductor field-effect transistor detectors. In the polymethyl methacrylate phantom, the calculated and measured doses agreed within about +3%. In the RANDO phantom, the dose difference was less than +5%. The calculated dose based on simulation-CT agreed with the measured dose within±3%, even in the region with a high dose gradient. The actual delivered dose was successfully determined by dose calculation with MVCBCT, and the point dose measurement with the image

  4. Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

    SciTech Connect

    Liauw, Stanley L.; Yeh, Alexander M.; Morris, Christopher G.; Olivier, Kenneth R.; Mendenhall, Nancy Price . E-mail: mendenan@shands.ufl.edu

    2006-12-01

    Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size {<=}6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity.

  5. Radiotherapy of advanced laryngeal cancer using three small fractions daily

    SciTech Connect

    Bradley, P.J.; Morgan, D.A. )

    1991-06-01

    Since 1983, the authors have treated advanced (UICC stages 3 and 4) squamous carcinomas of the larynx by primary radiotherapy, using three small fractions a day, 3-4 h interfraction interval, 5 days per week. The early patients received doses per fraction of 1.5 Gy, and a total dose of approximately 70 Gy, given as a split-course over 6 to 7 weeks. While overall tumor control and laryngeal preservation was good, a number of severe late radiation reactions were seen. The schedule was then modified, with a reduction in the fraction size to 1.1 Gy, the total dose to 60 Gy, and the overall time to 4 weeks, with omission of the mid-treatment split. Since 1986, we have treated 26 patients in this way. Acute reactions are brisk, but rapidly healing. Loco-regional control was achieved in 22 patients, only one of whom has relapsed to date, in a solitary node, salvaged by radical neck dissection. Four have died of uncontrolled loco-regional malignancy, and three of intercurrent disease while in clinical remission. No serious late morbidity has been observed in surviving patients, and vocal quality is good in the majority. These results suggest that this hyperfractionated and accelerated radiotherapy schedule may offer an acceptable nonsurgical, voice-preserving treatment for advanced laryngeal carcinoma; it can be used in a normally working radiotherapy department.

  6. MO-G-BRE-04: Automatic Verification of Daily Treatment Deliveries and Generation of Daily Treatment Reports for a MR Image-Guided Treatment Machine

    SciTech Connect

    Yang, D; Li, X; Li, H; Wooten, H; Green, O; Rodriguez, V; Mutic, S

    2014-06-15

    Purpose: Two aims of this work were to develop a method to automatically verify treatment delivery accuracy immediately after patient treatment and to develop a comprehensive daily treatment report to provide all required information for daily MR-IGRT review. Methods: After systematically analyzing the requirements for treatment delivery verification and understanding the available information from a novel MR-IGRT treatment machine, we designed a method to use 1) treatment plan files, 2) delivery log files, and 3) dosimetric calibration information to verify the accuracy and completeness of daily treatment deliveries. The method verifies the correctness of delivered treatment plans and beams, beam segments, and for each segment, the beam-on time and MLC leaf positions. Composite primary fluence maps are calculated from the MLC leaf positions and the beam-on time. Error statistics are calculated on the fluence difference maps between the plan and the delivery. We also designed the daily treatment delivery report by including all required information for MR-IGRT and physics weekly review - the plan and treatment fraction information, dose verification information, daily patient setup screen captures, and the treatment delivery verification results. Results: The parameters in the log files (e.g. MLC positions) were independently verified and deemed accurate and trustable. A computer program was developed to implement the automatic delivery verification and daily report generation. The program was tested and clinically commissioned with sufficient IMRT and 3D treatment delivery data. The final version has been integrated into a commercial MR-IGRT treatment delivery system. Conclusion: A method was developed to automatically verify MR-IGRT treatment deliveries and generate daily treatment reports. Already in clinical use since December 2013, the system is able to facilitate delivery error detection, and expedite physician daily IGRT review and physicist weekly chart

  7. Arctic indigenous women consume greater than acceptable levels of organochlorines.

    PubMed

    Kuhnlein, H V; Receveur, O; Muir, D C; Chan, H M; Soueida, R

    1995-10-01

    Exposure to polychlorinated biphenyls and organochlorine pesticides through traditional food resources was examined for Arctic Indigenous women living in two cultural and environmental areas of the Canadian Arctic--one community representing Baffin Island Inuit in eastern Arctic and two communities representing Sahtú Dene/Métis in western Arctic. Polychlorinated biphenyls, toxaphene, chlorobenzenes, hexachlorocyclohexanes, dichlorodiphenyltrichloroethane, chlordane-related compounds and dieldrin were determined in local food resources as normally prepared and eaten. Quantified dietary recalls taken seasonally reflected normal consumption patterns of these food resources by women in three age groups: 20-40 y, 41-60 y and > or = 61 y. There was wide variation of intake of all organochlorine contaminants in both areas and among age groups for the Sahtú. Fifty percent of the intake recalls collected from the Baffin Inuit exceeded the acceptable daily intake for chlordane-related compounds and toxaphene, and a substantial percentage of the intake records for dieldrin and polychlorinated biphenyls exceeded the acceptable or tolerable daily intake levels. Primary contributing foods to organochlorine contaminants intake for the Baffin Inuit were meat and blubber of ringed seal, blubber of walrus and mattak and blubber of narwal. Important foods contributing organochlorine contaminant to the Sahtú Dene/Métis were caribou, whitefish, inconnu, trout and duck. The superior nutritional benefits and potential health risks of traditional food items are reviewed, as are implications for monitoring organochlorine contaminant contents of food, clinical symptoms and food use. PMID:7562084

  8. Computer acceptance of older adults.

    PubMed

    Nägle, Sibylle; Schmidt, Ludger

    2012-01-01

    Even though computers play a massive role in everyday life of modern societies, older adults, and especially older women, are less likely to use a computer, and they perform fewer activities on it than younger adults. To get a better understanding of the factors affecting older adults' intention towards and usage of computers, the Unified Theory of Acceptance and Usage of Technology (UTAUT) was applied as part of a more extensive study with 52 users and non-users of computers, ranging in age from 50 to 90 years. The model covers various aspects of computer usage in old age via four key constructs, namely performance expectancy, effort expectancy, social influences, and facilitating conditions, as well as the variables gender, age, experience, and voluntariness it. Interestingly, next to performance expectancy, facilitating conditions showed the strongest correlation with use as well as with intention. Effort expectancy showed no significant correlation with the intention of older adults to use a computer.

  9. Benchmark Dose Modeling

    EPA Science Inventory

    Finite doses are employed in experimental toxicology studies. Under the traditional methodology, the point of departure (POD) value for low dose extrapolation is identified as one of these doses. Dose spacing necessarily precludes a more accurate description of the POD value. ...

  10. Simple benchmark for complex dose finding studies.

    PubMed

    Cheung, Ying Kuen

    2014-06-01

    While a general goal of early phase clinical studies is to identify an acceptable dose for further investigation, modern dose finding studies and designs are highly specific to individual clinical settings. In addition, as outcome-adaptive dose finding methods often involve complex algorithms, it is crucial to have diagnostic tools to evaluate the plausibility of a method's simulated performance and the adequacy of the algorithm. In this article, we propose a simple technique that provides an upper limit, or a benchmark, of accuracy for dose finding methods for a given design objective. The proposed benchmark is nonparametric optimal in the sense of O'Quigley et al. (2002, Biostatistics 3, 51-56), and is demonstrated by examples to be a practical accuracy upper bound for model-based dose finding methods. We illustrate the implementation of the technique in the context of phase I trials that consider multiple toxicities and phase I/II trials where dosing decisions are based on both toxicity and efficacy, and apply the benchmark to several clinical examples considered in the literature. By comparing the operating characteristics of a dose finding method to that of the benchmark, we can form quick initial assessments of whether the method is adequately calibrated and evaluate its sensitivity to the dose-outcome relationships.

  11. Treatment of Wilson's disease with zinc XII: dose regimen requirements.

    PubMed

    Brewer, G J; Yuzbasiyan-Gurkan, V; Johnson, V; Dick, R D; Wang, Y

    1993-04-01

    A considerable body of data is now available indicating the efficacy and lack of toxicity of zinc treatment of Wilson's disease. Dose-response studies have shown that regimens of 50 mg of elemental zinc 3 times a day (50 mg x 3), 25 mg x 3, and 50 mg x 2 are effective, but 25 mg x 2 and 50 mg x 1 are not adequately effective. These studies indicate that 75 mg a day is close to the minimally effective dose, but do not address the question of necessary dose frequency. In the current study, the authors have used the minimally effective daily dose, 75 mg, and studied this daily dose in regimens of 25 mg x 3, 37.5 mg x 2, and 75 mg x 1 in treatment of four patients with Wilson's disease. These data have been supplemented with additional data from 11 patients treated with 25 mg 3 times a day and with data from 2 patients treated with 75 mg once a day. Efficacy was evaluated by 10-day copper balance and absorption of orally administered 64copper. The findings indicate that a daily dose of 75 mg must be divided into at least two doses to be effective, and that the 64copper procedure is more sensitive to zinc dose than copper balance.

  12. 48 CFR 2911.103 - Market acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... offered have either achieved commercial market acceptance or been satisfactorily supplied to an agency... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Market acceptance. 2911... DESCRIBING AGENCY NEEDS Selecting And Developing Requirements Documents 2911.103 Market acceptance....

  13. 48 CFR 11.103 - Market acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Market acceptance. 11.103... DESCRIBING AGENCY NEEDS Selecting and Developing Requirements Documents 11.103 Market acceptance. (a) Section... either— (i) Achieved commercial market acceptance; or (ii) Been satisfactorily supplied to an...

  14. 48 CFR 2911.103 - Market acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Market acceptance. 2911... DESCRIBING AGENCY NEEDS Selecting And Developing Requirements Documents 2911.103 Market acceptance. The... offered have either achieved commercial market acceptance or been satisfactorily supplied to an...

  15. Older Adults' Acceptance of Information Technology

    ERIC Educational Resources Information Center

    Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel

    2011-01-01

    This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…

  16. Apollo experience report environmental acceptance testing

    NASA Technical Reports Server (NTRS)

    Laubach, C. H. M.

    1976-01-01

    Environmental acceptance testing was used extensively to screen selected spacecraft hardware for workmanship defects and manufacturing flaws. The minimum acceptance levels and durations and methods for their establishment are described. Component selection and test monitoring, as well as test implementation requirements, are included. Apollo spacecraft environmental acceptance test results are summarized, and recommendations for future programs are presented.

  17. 48 CFR 245.606-3 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Acceptance. 245.606-3..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Reporting, Redistribution, and Disposal of Contractor Inventory 245.606-3 Acceptance. (a) If the schedules are acceptable, the plant clearance...

  18. 46 CFR 28.73 - Accepted organizations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Accepted organizations. 28.73 Section 28.73 Shipping... INDUSTRY VESSELS General Provisions § 28.73 Accepted organizations. An organization desiring to be designated by the Commandant as an accepted organization must request such designation in writing. As...

  19. 46 CFR 28.73 - Accepted organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Accepted organizations. 28.73 Section 28.73 Shipping... INDUSTRY VESSELS General Provisions § 28.73 Accepted organizations. An organization desiring to be designated by the Commandant as an accepted organization must request such designation in writing. As...

  20. 46 CFR 28.73 - Accepted organizations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Accepted organizations. 28.73 Section 28.73 Shipping... INDUSTRY VESSELS General Provisions § 28.73 Accepted organizations. An organization desiring to be designated by the Commandant as an accepted organization must request such designation in writing. As...

  1. 46 CFR 28.73 - Accepted organizations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Accepted organizations. 28.73 Section 28.73 Shipping... INDUSTRY VESSELS General Provisions § 28.73 Accepted organizations. An organization desiring to be designated by the Commandant as an accepted organization must request such designation in writing. As...

  2. 46 CFR 28.73 - Accepted organizations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Accepted organizations. 28.73 Section 28.73 Shipping... INDUSTRY VESSELS General Provisions § 28.73 Accepted organizations. An organization desiring to be designated by the Commandant as an accepted organization must request such designation in writing. As...

  3. New daily persistent headache: an update.

    PubMed

    Rozen, Todd D

    2014-07-01

    New daily persistent headache is a primary headache disorder marked by a unique temporal profile which is daily from onset. For many sufferers this is their first ever headache. Very little is known about the pathogenesis of this condition. It might be a disorder of abnormal glial activation with persistent central nervous system inflammation and it may be a syndrome that occurs in individuals who have a history of cervical hypermobility. At present there is no known specific treatment and many patients go for years to decades without any improvement in their condition despite aggressive therapy. This article will present an up-to-date overview of new daily persistent headache on the topics of clinical presentation, treatment, diagnostic criteria, and presumed pathogenesis. It will also provide some of the authors own treatment suggestions based on recognized triggering events and some suggestions for future clinical trials. PMID:24820732

  4. Daily estimates of soil ingestion in children.

    PubMed Central

    Stanek, E J; Calabrese, E J

    1995-01-01

    Soil ingestion estimates play an important role in risk assessment of contaminated sites, and estimates of soil ingestion in children are of special interest. Current estimates of soil ingestion are trace-element specific and vary widely among elements. Although expressed as daily estimates, the actual estimates have been constructed by averaging soil ingestion over a study period of several days. The wide variability has resulted in uncertainty as to which method of estimation of soil ingestion is best. We developed a methodology for calculating a single estimate of soil ingestion for each subject for each day. Because the daily soil ingestion estimate represents the median estimate of eligible daily trace-element-specific soil ingestion estimates for each child, this median estimate is not trace-element specific. Summary estimates for individuals and weeks are calculated using these daily estimates. Using this methodology, the median daily soil ingestion estimate for 64 children participating in the 1989 Amherst soil ingestion study is 13 mg/day or less for 50% of the children and 138 mg/day or less for 95% of the children. Mean soil ingestion estimates (for up to an 8-day period) were 45 mg/day or less for 50% of the children, whereas 95% of the children reported a mean soil ingestion of 208 mg/day or less. Daily soil ingestion estimates were used subsequently to estimate the mean and variance in soil ingestion for each child and to extrapolate a soil ingestion distribution over a year, assuming that soil ingestion followed a log-normal distribution. Images Figure 1. Figure 2. Figure 3. Figure 4. PMID:7768230

  5. Focus on therapy: hemicrania continua and new daily persistent headache.

    PubMed

    Rossi, Paolo; Tassorelli, Cristina; Allena, Marta; Ferrante, Enrico; Lisotto, Carlo; Nappi, Giuseppe

    2010-06-01

    Hemicrania continua (HC) and new daily-persistent headache (NDPH) represent the only two forms of chronic daily headache in Chap. IV "Other Primary Headaches" of the second edition of the International Classification of Headache Disorders. HC and NDPH are rare and poorly defined from a pathophysiological point of view; as a consequence, their management is largely empirical. Indeed, there is a lack of prospective, controlled trials in this field, and treatment effectiveness is basically inferred from the results of sparse open-label trials, retrospective case series, clinical experience and expert opinions. In this narrative review we have summarised the information collected from an extensive analysis of the literature on the treatment of HC and NDPH in order to provide the best available and up-to-date evidence for the management of these two rare forms of primary headache. Indomethacin is the mainstay of HC management. The reported effective dose of indomethacin ranges from 50 to 300 mg/day. Gabapentin 600-3,600 mg tid, topiramate 100 mg bid, and celecoxib 200-400 mg represent the most interesting alternative choices in the patients who do not tolerate indomethacin or who have contraindications to its use. NDPH is very difficult to treat and it responds poorly only to first-line options used for migraine or tension-type headache.

  6. Periodic CO2 Dosing Strategy for Dunaliella salina Batch Culture.

    PubMed

    Ying, Kezhen; Gilmour, D James; Zimmerman, William B

    2015-01-01

    A periodic CO2 dosing strategy for D. salina 19/30 batch culture is proposed. A model of periodic CO2 dosing including dosing time calculation, dosing interval estimation and final chlorophyll yield prediction was established. In experiments, 5% CO2/95% N2 gas was periodically dosed into D. salina culture. Two different gas dosing flow rates were tested. The corresponding dosing time for each flow rate was estimated via the model (10 min·d-1 for 0.7 L·min-1 and 36 min·d-1 for 0.3 L·min-1). Daily pH measurements showed that the pH of these cultures dosed periodically was always kept between 7.5 and 9.5, which highlights that periodic gas supply can maintain a suitable range of pH for microalgal growth without expensive buffers. Notably the culture dosed for set daily intervals was seen to have similar growth to the culture supplied constantly, but with much higher CO2 capture efficiency (11%-18%) compared to continuous dosing (0.25%). It shows great potential for using periodic gas supply to reduce cost, wasted gas and energy use.

  7. From cellular doses to average lung dose.

    PubMed

    Hofmann, W; Winkler-Heil, R

    2015-11-01

    Sensitive basal and secretory cells receive a wide range of doses in human bronchial and bronchiolar airways. Variations of cellular doses arise from the location of target cells in the bronchial epithelium of a given airway and the asymmetry and variability of airway dimensions of the lung among airways in a given airway generation and among bronchial and bronchiolar airway generations. To derive a single value for the average lung dose which can be related to epidemiologically observed lung cancer risk, appropriate weighting scenarios have to be applied. Potential biological weighting parameters are the relative frequency of target cells, the number of progenitor cells, the contribution of dose enhancement at airway bifurcations, the promotional effect of cigarette smoking and, finally, the application of appropriate regional apportionment factors. Depending on the choice of weighting parameters, detriment-weighted average lung doses can vary by a factor of up to 4 for given radon progeny exposure conditions.

  8. Prophylaxis of migraine: general principles and patient acceptance

    PubMed Central

    D’Amico, Domenico; Tepper, Stewart J

    2008-01-01

    Migraine is a chronic neurological condition with episodic exacerbations. Migraine is highly prevalent, and associated with significant pain, disability, and diminished quality of life. Migraine management is an important health care issue. Migraine management includes avoidance of trigger factors, lifestyle modifications, non-pharmacological therapies, and medications. Pharmacological treatment is traditionally divided into acute or symptomatic treatment, and preventive treatment or prophylaxis. Many migraine patients can be treated using only acute treatment. Patients with severe and/or frequent migraines require long-term preventive therapy. Prophylaxis requires daily administration of anti-migraine compounds with potential adverse events or contraindications, and may also interfere with other concurrent conditions and treatments. These problems may induce patients to reject the idea of a preventive treatment, leading to poor patient adherence. This paper reviews the main factors influencing patient acceptance of anti-migraine prophylaxis, providing practical suggestions to enhance patient willingness to accept pharmacological anti-migraine preventive therapy. We also provide information about the main clinical characteristics of migraine, and their negative consequences. The circumstances warranting prophylaxis in migraine patients as well as the main characteristics of the compounds currently used in migraine prophylaxis will also be briefly discussed, focusing on those aspects which can enhance patient acceptance and adherence. PMID:19337456

  9. Deriving Daily Purpose through Daily Events and Role Fulfillment among Asian American Youth

    ERIC Educational Resources Information Center

    Kiang, Lisa

    2012-01-01

    Establishing life purpose is a key developmental task; however, how it is linked to adolescents' everyday family, school, extracurricular, and leisure experiences remains unclear. Using daily diary data from 180 Asian American ninth and tenth graders (50% ninth; 58% female; 25% first generation), daily purpose was positively related to daily…

  10. Urinary excretion and daily intake rates of diethyl phthalate in the general Canadian population.

    PubMed

    Saravanabhavan, Gurusankar; Walker, Mike; Guay, Mireille; Aylward, Lesa

    2014-12-01

    We have analyzed the trends in the body-weight-adjusted urinary monoethyl phthalate (MEP) concentrations and the diethyl ethyl phthalate (DEP) daily intake estimates in the general Canadian population (aged 6-49 years) using the Canadian Health Measures Survey 2007-2009 dataset. The creatinine correction approach, as well as the urine volume approach in a simple one compartment model were used to calculate the daily urinary MEP excretion rates and DEP intake rates in individual survey participants. Using multiple regression models, we have estimated least square geometric means (LSGMs) of body-weight-adjusted MEP concentration, daily excretion and intake rates among different age groups and sex. We observed that body weight affects the trends in the MEP concentrations significantly among children (aged 6-11 years), adolescents (aged 12-19 years) and adults (aged 20-49 years). The body-weight-adjusted MEP concentrations in children were significantly higher than those in adults. On the other hand the DEP daily intakes in children were significantly lower than those in adults. We did not observe any differences in the DEP daily intake rates between males and females. Although the urinary MEP concentrations are correlated well with DEP daily intake estimates in the overall population, one should be cautious when directly using the urinary concentrations to compare the intake trends in the sub-populations (e.g. children vs. adults) as these trends are governed by additional physiological factors. The DEP daily intake calculated using the creatinine approach and that using the urine volume approach were similar to each other. The estimated geometric mean and 95th percentile of DEP daily intake in the general Canadian population are 2 and 20 μg/kg-bw/day, respectively. These daily intake estimates are significantly lower than the US Environmental Protection Agency's oral reference dose of 800 μg/kg-bw/day. PMID:25217994

  11. Acceptability of GM foods among Pakistani consumers.

    PubMed

    Ali, Akhter; Rahut, Dil Bahadur; Imtiaz, Muhammad

    2016-04-01

    In Pakistan majority of the consumers do not have information about genetically modified (GM) foods. In developing countries particularly in Pakistan few studies have focused on consumers' acceptability about GM foods. Using comprehensive primary dataset collected from 320 consumers in 2013 from Pakistan, this study analyzes the determinants of consumers' acceptability of GM foods. The data was analyzed by employing the bivariate probit model and censored least absolute deviation (CLAD) models. The empirical results indicated that urban consumers are more aware of GM foods compared to rural consumers. The acceptance of GM foods was more among females' consumers as compared to male consumers. In addition, the older consumers were more willing to accept GM food compared to young consumers. The acceptability of GM foods was also higher among wealthier households. Low price is the key factor leading to the acceptability of GM foods. The acceptability of the GM foods also reduces the risks among Pakistani consumers.

  12. Acceptability of GM foods among Pakistani consumers.

    PubMed

    Ali, Akhter; Rahut, Dil Bahadur; Imtiaz, Muhammad

    2016-04-01

    In Pakistan majority of the consumers do not have information about genetically modified (GM) foods. In developing countries particularly in Pakistan few studies have focused on consumers' acceptability about GM foods. Using comprehensive primary dataset collected from 320 consumers in 2013 from Pakistan, this study analyzes the determinants of consumers' acceptability of GM foods. The data was analyzed by employing the bivariate probit model and censored least absolute deviation (CLAD) models. The empirical results indicated that urban consumers are more aware of GM foods compared to rural consumers. The acceptance of GM foods was more among females' consumers as compared to male consumers. In addition, the older consumers were more willing to accept GM food compared to young consumers. The acceptability of GM foods was also higher among wealthier households. Low price is the key factor leading to the acceptability of GM foods. The acceptability of the GM foods also reduces the risks among Pakistani consumers. PMID:27494790

  13. Acceptability of minimally processed and irradiated pineapple and watermelon among Brazilian consumers

    NASA Astrophysics Data System (ADS)

    Martins, Cecília Geraldes; Aragon-Alegro, Lina Casale; Behrens, Jorge Herman; Oliveira Souza, Kátia Leani; Martins Vizeu, Dirceu; Hutzler, Beatriz Weltman; Teresa Destro, Maria; Landgraf, Mariza

    2008-06-01

    This study aimed at evaluating the acceptance of MP watermelon and pineapple exposed to 1.0 and 2.5 kGy compared to non-irradiated samples. No significant differences were observed in liking between irradiated and non-irradiated samples, and also between doses of 1.0 and 2.5 kGy. Significant differences in sourness (pineapple) or sweetness (watermelon) and between intention of purchase of irradiated and non-irradiated fruits were not observed as well. Results showed that MP watermelon and pineapple could be irradiated with doses up to 2.5 kGy without significant changes in acceptability.

  14. Big Ideas behind Daily 5 and CAFE

    ERIC Educational Resources Information Center

    Boushey, Gail; Moser, Joan

    2012-01-01

    The Daily 5 and CAFE were born out of The Sister's research and observations of instructional mentors, their intense desire to be able to deliver highly intentional, focused instruction to small groups and individuals while the rest of the class was engaged in truly authentic reading and writing, and their understanding that a one size fits all…

  15. REL3.0 LPLA DAILY NC

    Atmospheric Science Data Center

    2016-06-02

    ... Budget (SRB) Release 3.0 Langley Parameterized Longwave Model daily Data in 1x1 Degree NetCDF Format News:  LPLA ... Clouds Radiation Budget Spatial Coverage:  (-90, 90)(-180,180) Spatial Resolution:  ...

  16. REL3.0 LPSA DAILY NC

    Atmospheric Science Data Center

    2016-06-02

    ... Budget (SRB) Release 3.0 Langley Parameterized Shortwave Model Daily Data in 1x1 Degree NetCDF Format News:  LPSA ... Clouds Radiation Budget Spatial Coverage:  (-90, 90)(-180,180) Spatial Resolution:  ...

  17. 27 CFR 19.650 - Daily records.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Production of Vinegar by the Vaporizing Process Required Records for Vinegar Plants § 19.650 Daily records. Each manufacturer of vinegar by the vaporizing... proof gallons of distilled spirits used in the manufacture of vinegar; (e) The wine gallons of...

  18. 27 CFR 19.650 - Daily records.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Production of Vinegar by the Vaporizing Process Required Records for Vinegar Plants § 19.650 Daily records. Each manufacturer of vinegar by the vaporizing... proof gallons of distilled spirits used in the manufacture of vinegar; (e) The wine gallons of...

  19. 27 CFR 19.650 - Daily records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Production of Vinegar by the Vaporizing Process Required Records for Vinegar Plants § 19.650 Daily records. Each manufacturer of vinegar by the vaporizing... proof gallons of distilled spirits used in the manufacture of vinegar; (e) The wine gallons of...

  20. 27 CFR 19.650 - Daily records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Production of Vinegar by the Vaporizing Process Required Records for Vinegar Plants § 19.650 Daily records. Each manufacturer of vinegar by the vaporizing... proof gallons of distilled spirits used in the manufacture of vinegar; (e) The wine gallons of...

  1. 27 CFR 19.829 - Daily records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Production of Vinegar by the Vaporizing Process Records § 19.829 Daily records. Each manufacturer of vinegar by the vaporizing process shall keep accurate... spirits used in the manufacture of vinegar; (e) The wine gallons of vinegar produced; and (f) The...

  2. The Case for Daily Physical Education

    ERIC Educational Resources Information Center

    Lynn, Susan

    2007-01-01

    According to a recent study, only 56 percent of high school students participate in physical education, and the percentage of schools requiring physical education has progressively dropped. The goal of providing daily physical education to all K-12 students in the United States presents challenges such as budgetary issues, less time for other…

  3. INTERPOLATING VANCOUVER'S DAILY AMBIENT PM 10 FIELD

    EPA Science Inventory

    In this article we develop a spatial predictive distribution for the ambient space- time response field of daily ambient PM10 in Vancouver, Canada. Observed responses have a consistent temporal pattern from one monitoring site to the next. We exploit this feature of the field b...

  4. Modelling erosion on a daily basis

    NASA Astrophysics Data System (ADS)

    Pikha Shrestha, Dhruba; Jetten, Victor

    2016-04-01

    Effect of soil erosion causing negative impact on ecosystem services and food security is well known. To assess annual erosion rates various empirical models have been extensively used in all the climatic regions. While these models are simple to operate and do not require lot of input data, the effect of extreme rain is not taken into account in the annual estimations. For analysing the effects of extreme rain the event- based models become handy. These models can simulate detail erosional processes including particle detachment, transportation and deposition of sediments during a storm. But they are not applicable for estimating annual erosion rates. Moreover storm event data may not be available everywhere which prohibits their extensive use. In this paper we describe a method by adapting the revised MMF model to assess erosion on daily basis so that the effects of extreme rains are taken into account. We couple it to a simple surface soil moisture balance on a daily basis and include estimation of daily vegetation cover changes. Annual soil loss is calculated by adding daily erosion rates. We compare the obtained results with that obtained from applying the revised MMF model in a case study in the Mamora plateau in northwest Morocco which is affected by severe gully formation. The results show clearly the effects of exceptional rain in erosional processes which cannot be captured in an annual model.

  5. Efficacy and safety of once daily low molecular weight heparin (tinzaparin sodium) in high risk pregnancy.

    PubMed

    Ní Ainle, Fionnuala; Wong, Audris; Appleby, Niamh; Byrne, Brigitte; Regan, Carmen; Hassan, Tayyaba; Milner, Marie; Sullivan, Ann O; White, Barry; O'Donnell, James

    2008-10-01

    Low molecular weight heparin (LMWH) is widely regarded as the anticoagulant treatment of choice for the prevention and treatment of venous thromboembolism during pregnancy. However, previous studies have demonstrated that the pharmacokinetic profiles of LMWH vary significantly with increasing gestation. Consequently, it remains unclear whether LMWH regimens recommended for use in nonpregnant individuals can be safely extrapolated to pregnant women. The aims of this study were to assess the safety and the efficacy of tinzaparin sodium (Innohep) administered only once daily during pregnancy. A systematic retrospective review identified a cohort of 37 high-risk pregnancies which had been managed using tinzaparin 175 IU/kg once daily. In 26 cases, the index pregnancy had been complicated by development of an acute venous thromboembolism (17 deep vein thrombosis and nine pulmonary embolism). For each individual, case notes were examined and data extracted using a predetermined questionnaire. No episodes of recurrent venous thromboembolism were identified amongst this cohort of pregnancies managed using once daily LMWH administration. However, two unusual thrombotic complications were observed, including a parietal infarct in one patient, and a postpartum cerebral venous thrombosis in another. Once daily tinzaparin was well tolerated, with no cases of heparin-induced thrombocytopaenia, symptomatic osteoporosis, or foetal malformations. Tinzaparin dose modification based upon peak anti-Xa levels occurred in 45% of the cases examined. The present study is the largest study to have examined the clinical efficacy of once daily LMWH for use in pregnant women at high risk of venous thromboembolism. Our data support the safety and efficacy of antenatal tinzaparin at a dose of 175 IU/kg. In order to determine whether this once daily regimen provides equivalent (or indeed greater) thromboprophylaxis to twice daily LMWH regimens during pregnancy will require highly powered direct

  6. Nicotine dose-concentration relationship and pregnancy outcomes in rat: Biologic plausibility and implications for future research

    SciTech Connect

    Hussein, Jabeen; Farkas, Svetlana; MacKinnon, Yolanda; Ariano, Robert E.; Sitar, Daniel S.; Hasan, Shabih U. . E-mail: hasans@ucalgary.ca

    2007-01-01

    Cigarette smoke (CS) exposure during pregnancy can lead to profound adverse effects on fetal development. Although CS contains several thousand chemicals, nicotine has been widely used as its surrogate as well as in its own right as a neuroteratogen. The justification for the route and dose of nicotine administration is largely based on inferential data suggesting that nicotine 6 mg/kg/day infused continuously via osmotic mini pumps (OMP) would mimic maternal CS exposure. We provide evidence that 6 mg/kg/day nicotine dose as commonly administered to pregnant rats leads to plasma nicotine concentrations that are 3-10-fold higher than those observed in moderate to heavy smokers and pregnant mothers, respectively. Furthermore, the cumulative daily nicotine dose exceeds by several hundred fold the amount consumed by human heavy smokers. Our study does not support the widely accepted notion that regardless of the nicotine dose, a linear nicotine dose-concentration relationship exists in a steady-state OMP model. We also show that total nicotine clearance increases with advancing pregnancy but no significant change is observed between the 2nd and 3rd trimester. Furthermore, nicotine infusion even at this extremely high dose has little effect on a number of maternal and fetal biologic variables and pregnancy outcome suggesting that CS constituents other than nicotine mediate the fetal growth restriction in infants born to smoking mothers. Our current study has major implications for translational research in developmental toxicology and pharmacotherapy using nicotine replacement treatment as an aid to cessation of cigarette smoking in pregnant mothers.

  7. Acceptance in Romantic Relationships: The Frequency and Acceptability of Partner Behavior Inventory

    ERIC Educational Resources Information Center

    Doss, Brian D.; Christensen, Andrew

    2006-01-01

    Despite the recent emphasis on acceptance in romantic relationships, no validated measure of relationship acceptance presently exists. To fill this gap, the 20-item Frequency and Acceptability of Partner Behavior Inventory (FAPBI; A. Christensen & N. S. Jacobson, 1997) was created to assess separately the acceptability and frequency of both…

  8. Seroconversion status after single dose and double doses of varicella vaccination in children with leukemia.

    PubMed

    Cakir, F Betul; Timur, Cetin; Yoruk, Asim; Cakir, Erkan; Ayhan, Aylin Canbolat

    2012-03-01

    Although varicella is a benign self-limiting disease in healthy children, it can be fatal when it occurs in immunocompromised hosts. Despite that immunosuppressed children are suggested to require 2 doses of vaccine to achieve seroconversion, conflicting results are reported in the literature. The aim of this study was to investigate the seroconversion status and mean antibody titers at first year after single dose and double doses of varicella vaccination in acute lymphoblastic leukemia patients. Patients with leukemia in remission for at least 1 year who were seronegative for varicella-zoster virus immunoglobulin G (IgG) were vaccinated. Titers above the cutoff level (0.65) were accepted as seroconversion. Seventeen patients were vaccinated with single dose whereas 24 patients were vaccinated with double doses. Mean prevaccination antibody titers were 0.56 ± 0.05 in patients with single dose and 0.51 ± 0.08 in patients with double doses (P > .05, Student t test). The mean antibody titers at first year were 0.61 ± 0.05 in patients with single-dose vaccination (P > .05, Wilcoxon signed-rank test) and 1.48 ± 0.04 in patients with double doses (P < .001, Wilcoxon signed-rank test). Seroconversion after single-dose vaccination was achieved in 29% of patients (n = 5/17) and in 75% of patients with double doses (n = 18/24) at first year (P = .004, chi-square test). These results suggest that seroconversion after single-dose vaccination might not persist at first year in malignancy patients. Double doses should be applied in order to provide long-term seroconversion.

  9. Daily Isocenter Correction With Electromagnetic-Based Localization Improves Target Coverage and Rectal Sparing During Prostate Radiotherapy

    SciTech Connect

    Rajendran, Ramji Ramaswamy; Plastaras, John P.; Mick, Rosemarie; McMichael Kohler, Diane; Kassaee, Alireza; Vapiwala, Neha

    2010-03-15

    Purpose: To evaluate dosimetric consequences of daily isocenter correction during prostate cancer radiation therapy using the Calypso 4D localization system. Methods and Materials: Data were analyzed from 28 patients with electromagnetic transponders implanted in their prostates for daily target localization and tracking. Treatment planning isocenters were recorded based on the values of the vertical, longitudinal, and lateral axes. Isocenter location obtained via alignment with skin tattoos was compared with that obtained via the electromagnetic localization system. Daily isocenter shifts, based on the isocenter location differences between the two alignment methods in each spatial axis, were calculated for each patient over their entire course. The mean isocenter shifts were used to determine dosimetric consequences of treatment based on skin tattoo alignments alone. Results: The mean += SD of the percentages of treatment days with shifts beyond += 0.5 cm for vertical, longitudinal and lateral shifts were 62% += 28%, 35% += 26%, and 38% +=21%, respectively. If daily electromagnetic localization was not used, the excess in prescribed dose delivered to 70% of the rectum was 10 Gy and the deficit in prescribed dose delivered to 95% of the planning target volume was 10 Gy. The mean isocenter shift was not associated with the volumes of the prostate, rectum, or bladder, or with patient body mass index. Conclusions: Daily isocenter localization can reduce the treatment dose to the rectum. Correcting for this variability could lead to improved dose delivery, reduced side effects, and potentially improved treatment outcomes.

  10. Once- and twice-daily bevantolol for systemic hypertension using 24-hour ambulatory intraarterial blood pressure recording.

    PubMed

    Al-Khawaja, I M; Caruana, M P; Prince, H; Whittington, J; Raftery, E B

    1986-11-26

    The antihypertensive efficacy of bevantolol, a selective beta 1-adrenoreceptor antagonist, was evaluated in 17 patients with essential hypertension, using continuous ambulatory intraarterial blood pressure (BP) monitoring. The study compared a twice-daily regimen (titrated dose of 200 to 600 mg/day) with the same amount given in a single daily dose. Within-patient comparisons of mean hourly systolic and diastolic BPs and heart rate showed a highly significant effect with twice-daily therapy (p less than 0.001) for all of the 24 hours. Similar significant results were obtained with a single morning dose. There was no difference between the pattern or extent of BP reduction with the 2 regimens. The decrease in BP after bevantolol persisted during the physiologic tests (rest, tilt, isometric and dynamic exercise). Four patients developed minor side effects with the single morning dose, and only 1 patient with the twice-daily regimen. These effects included tiredness, fatigue and dizziness. Unlike pure beta-blocking agents, bevantolol controlled the early morning increase in BP, lending support to the belief that it possesses vasodilatory properties in addition to beta blockade. These results suggest that bevantolol may be useful as first-line therapy in a once-daily dosage for the treatment of essential hypertension.

  11. Daily loss of calcium and sodium from the skin of two healthy men

    PubMed Central

    Carr, T. E. F.; Harrison, G. E.; Nolan, J.

    1973-01-01

    1. The daily losses from the skin of Ca and Na have been measured for two healthy men. The losses included Ca and Na in exfoliated skin cells as well as in insensible perspiration. The daily output of Ca in urine was also measured. 2. In five measurements, the total daily skin loss of Ca ranged from 8·0 to 21·1 mg with mean values of 16·7 and 10·8 mg for the two subjects. The total daily skin loss of Na under the same conditions ranged from 45 to 146 mg with mean values of 97 and 77 mg respectively. 3. The ratio of the daily skin loss to the urinary excretion of Ca was 6·8 and 3·4%. 4. There was no correlation between the daily skin loss of Ca and atmospheric humidity. 5. In the last experiment, the fraction of the total skin loss of Ca due to fluid secretion was assessed by giving an I.V. dose of 47Ca to each subject. The values derived for this fraction were 0·37 and 0·38. PMID:4778144

  12. "Give Us This Day Our Daily Bread."

    ERIC Educational Resources Information Center

    Boucher, Leon

    1979-01-01

    Presents the accomplishments of a two-year old program conducted by three vocational agriculture teachers and two teacher educators in Ohio, which was able to help young adult farmers improve agricultural practices in India. Lists six questions for a vocational agriculture teacher to consider before accepting a foreign position. (LRA)

  13. Effect of irradiation on Brazilian honeys' consistency and their acceptability

    NASA Astrophysics Data System (ADS)

    Matsuda, A. H.; Sabato, S. F.

    2004-09-01

    Contamination of bee products may occur during packing or even during the process of collection. Gamma irradiation was found to decrease the number of bacteria and fungi. However, little information is available on the effects of gamma irradiation on viscosity which is an important property of honey. In this work the viscosity of two varieties of Brazilian honey was measured when they were irradiated at 5 and 10 kGy. The viscosity was measured at four temperatures (25°C, 30°C, 35°C and 40°C) for both samples and compared with control and within the doses. The sensory evaluation was carried on for the parameters color, odor, taste and consistency, using a 9-point hedonic scale. All the data were treated with a statistical tool (Statistica 5.1, StatSoft, 1998). The viscosity was not impaired significantly by gamma irradiation in doses 5 and 10 kGy ( p<0.05). The effect of gamma irradiation on sensorial characteristics (odor, color, taste and consistency) is presented. The taste for Parana type indicated a significant difference among irradiation doses ( p<0.05) but the higher value was for 5 kGy dose, demonstrating the acceptability for this case. The Organic honey presented the taste parameter for 10 kGy, significantly lower than the control mean but it did not differ significantly from the 5 kGy value.

  14. New validated recipes for double-blind placebo-controlled low-dose food challenges.

    PubMed

    Winberg, Anna; Nordström, Lisbeth; Strinnholm, Åsa; Nylander, Annica; Jonsäll, Anette; Rönmark, Eva; West, Christina E

    2013-05-01

    Double-blind placebo-controlled food challenges are considered the most reliable method to diagnose or rule out food allergy. Despite this, there are few validated challenge recipes available. The present study aimed to validate new recipes for low-dose double-blind placebo-controlled food challenges in school children, by investigating whether there were any sensory differences between the active materials containing cow's milk, hen's egg, soy, wheat or cod, and the placebo materials. The challenge materials contained the same hypoallergenic amino acid-based product, with or without added food allergens. The test panels consisted of 275 school children, aged 8-10 and 14-15 yr, respectively, from five Swedish schools. Each participant tested at least one recipe. Standardized blinded triangle tests were performed to investigate whether any sensory differences could be detected between the active and placebo materials. In our final recipes, no significant differences could be detected between the active and placebo materials for any challenge food (p > 0.05). These results remained after stratification for age and gender. The taste of challenge materials was acceptable, and no unfavourable side effects related to test materials were observed. In summary, these new validated recipes for low-dose double-blinded food challenges contain common allergenic foods in childhood; cow's milk, hen's egg, soy, wheat and cod. All test materials contain the same liquid vehicle, which facilitates preparation and dosing. Our validated recipes increase the range of available recipes, and as they are easily prepared and dosed, they may facilitate the use of double-blind placebo-controlled food challenges in daily clinical practice.

  15. SU-E-J-27: Appropriateness Criteria for Deformable Image Registration and Dose Propagation

    SciTech Connect

    Papanikolaou, P; Tuohy, Rachel; Mavroidis, P; Eng, T; Gutierrez, A; Stathakis, S

    2014-06-01

    Purpose: Several commercial software packages have been recently released that allow the user to apply deformable registration algorithms (DRA) for image fusion and dose propagation. Although the idea of anatomically tracking the daily patient dose in the context of adaptive radiotherapy or merely adding the dose from prior treatment to the current one is very intuitive, the accuracy and applicability of such algorithms needs to be investigated as it remains somewhat subjective. In our study, we used true anatomical data where we introduced changes in the density, volume and location of segmented structures to test the DRA for its sensitivity and accuracy. Methods: The CT scan of a prostate patient was selected for this study. The CT images were first segmented to define structure such as the PTV, bladder, rectum, intestines and pelvic bone anatomy. To perform our study, we introduced anatomical changes in the reference patient image set in three different ways: (i) we kept the segmented volumes constant and changed the density of rectum and bladder in increments of 5% (ii) we changed the volume of rectum and bladder in increments of 5% and (iii) we kept the segmented volumes constant but changed their location by moving their COM in increments of 3mm. Using the Velocity software, we evaluated the accuracy of the DRA for each incremental change in all three scenarios. Results: The DRA performs reasonably well when the differential density difference against the background is more than 5%. For the volume change study, the DRA results became unreliable for relative volume changes greater than 10%. Finally for the location study, the DRA performance was acceptable for shifts below 9mm. Conclusion: Site specific and patient specific QA for DRA is an important step to evaluate such algorithms prior to their use for dose propagation.

  16. Depressed Adolescents' Pupillary Response to Peer Acceptance and Rejection: The Role of Rumination.

    PubMed

    Stone, Lindsey B; Silk, Jennifer S; Siegle, Greg J; Lee, Kyung Hwa; Stroud, Laura R; Nelson, Eric E; Dahl, Ronald E; Jones, Neil P

    2016-06-01

    Heightened emotional reactivity to peer feedback is predictive of adolescents' depression risk. Examining variation in emotional reactivity within currently depressed adolescents may identify subgroups that struggle the most with these daily interactions. We tested whether trait rumination, which amplifies emotional reactions, explained variance in depressed adolescents' physiological reactivity to peer feedback, hypothesizing that rumination would be associated with greater pupillary response to peer rejection and diminished response to peer acceptance. Twenty currently depressed adolescents (12-17) completed a virtual peer interaction paradigm where they received fictitious rejection and acceptance feedback. Pupillary response provided a time-sensitive index of physiological arousal. Rumination was associated with greater initial pupil dilation to both peer rejection and acceptance, and diminished late pupillary response to peer acceptance trials only. Results indicate that depressed adolescents high on trait rumination are more reactive to social feedback regardless of valence, but fail to sustain cognitive-affective load on positive feedback. PMID:26271345

  17. Nowcasting daily minimum air and grass temperature

    NASA Astrophysics Data System (ADS)

    Savage, M. J.

    2016-02-01

    Site-specific and accurate prediction of daily minimum air and grass temperatures, made available online several hours before their occurrence, would be of significant benefit to several economic sectors and for planning human activities. Site-specific and reasonably accurate nowcasts of daily minimum temperature several hours before its occurrence, using measured sub-hourly temperatures hours earlier in the morning as model inputs, was investigated. Various temperature models were tested for their ability to accurately nowcast daily minimum temperatures 2 or 4 h before sunrise. Temperature datasets used for the model nowcasts included sub-hourly grass and grass-surface (infrared) temperatures from one location in South Africa and air temperature from four subtropical sites varying in altitude (USA and South Africa) and from one site in central sub-Saharan Africa. Nowcast models used employed either exponential or square root functions to describe the rate of nighttime temperature decrease but inverted so as to determine the minimum temperature. The models were also applied in near real-time using an open web-based system to display the nowcasts. Extrapolation algorithms for the site-specific nowcasts were also implemented in a datalogger in an innovative and mathematically consistent manner. Comparison of model 1 (exponential) nowcasts vs measured daily minima air temperatures yielded root mean square errors (RMSEs) <1 °C for the 2-h ahead nowcasts. Model 2 (also exponential), for which a constant model coefficient ( b = 2.2) was used, was usually slightly less accurate but still with RMSEs <1 °C. Use of model 3 (square root) yielded increased RMSEs for the 2-h ahead comparisons between nowcasted and measured daily minima air temperature, increasing to 1.4 °C for some sites. For all sites for all models, the comparisons for the 4-h ahead air temperature nowcasts generally yielded increased RMSEs, <2.1 °C. Comparisons for all model nowcasts of the daily grass

  18. Meal Replacement Mass Reduction and Integration Acceptability Study

    NASA Technical Reports Server (NTRS)

    Sirmons, T.; Barrett, A.; Richardson, M.; Arias, D.; Schneiderman, J.; Slack, K.; Williams, T.; Douglas, G.

    2017-01-01

    NASA, in planning for long-duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore the team is challenged to reduce the mass of the food system by 10% while maintaining product safety, nutrition, and acceptability. Commercially available products do not meet the nutritional requirements for a full meal replacement in the spaceflight food system, and it is currently unknown if daily meal replacements will impact crew food intake and psychosocial health over time. The purpose of this study was to develop a variety of nutritionally balanced breakfast replacement bars that meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% savings in food mass. To date, six nutrient-dense meal replacement bars (approximately 700 calories per bar) have been developed, using traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). The four highest rated bars were evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact of bars on mood, satiety, digestive discomfort, and satisfaction with food. These factors are currently being analyzed to inform successful implementation strategies where crew maintain adequate food intake. In addition, these bars are currently undergoing shelf-life testing to determine long-term sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that

  19. Consumer acceptance of nutrigenomics-based personalised nutrition.

    PubMed

    Ronteltap, A; van Trijp, J C M; Renes, R J

    2009-01-01

    Nutrigenomics is a new and promising development in nutritional science which aims to understand the fundamental molecular processes affected by foods. Despite general agreement on its promise for better understanding diet-health relationships, less consensus exists among experts on the potential of spin-offs aimed at the consumer such as personalised nutrition. Research into consumer acceptance of such applications is scarce. The present study develops a set of key hypotheses on public acceptance of personalised nutrition and tests these in a representative sample of Dutch consumers. An innovative consumer research methodology is used in which consumers evaluate short films which are systematically varied scenarios for the future of personalised nutrition. Consumer evaluations of these films, which are pre-tested in a pilot study, allow a formal test of how consumer perceptions of personalised nutrition drive consumer acceptance and through which fundamental psychological processes these effects are mediated. Public acceptance is enhanced if consumers can make their genetic profile available free at their own choice, if the actual spin-off products provide a clearly recognisable advantage to the consumer, and are easy to implement into the daily routine. Consumers prefer communication on nutrigenomics and personalised nutrition by expert stakeholders to be univocal and aimed at building support with consumers and their direct environments for this intriguing new development. Additionally, an exploratory segmentation analysis indicated that people have different focal points in their preferences for alternative scenarios of personalised nutrition. The insights obtained from the present study provide guidance for the successful further development of nutrigenomics and its applications.

  20. Extrapolation algorithm to Forecast the Dynamics of Accumulation of the Absorbed Dose at the International Space Station, according to the Radiation Monitoring System Data

    NASA Astrophysics Data System (ADS)

    Lishnevskii, Andrey

    The ISS service module is equipped with the radiation monitoring system (RMS) which provides data for the daily estimation of the radiation environment on board the station. The sensitive elements of the RMS are silicon semiconductor detectors and ionization chambers. The data obtained in quiet radiation environment allowed to determine the contribution to the absorbed radiation dose due to galactic cosmic rays and the Earth’s inner radiation belt. The corresponding analysis was conducted for the 2005-2011 period. As a result empirical relations were obtained allowing to calculate the dose for one crossing of the area of the South Atlantic Anomaly. The initial parameters for the calculation are longitude and altitude on which the ISS trajectory crosses this area. The obtained empirical relations allowed to develop a simple calculation algorithm for the short-term forecasting of the dynamics of accumulation of the radiation dose at the ISS which is based on the assumption that the current level of contribution to the daily dose of galactic cosmic rays and the structure of the Earth’s inner radiation belt at the station flight altitude remains unchanged within a few days. The results of the analysis of the ISS RMS data which was conducted using the developed calculation algorithm for the period from 2005 to 2011 (the period in which solar cycle 23 ended and solar cycle 24 began) showed the possibility to implement a short-term (1-2 days) forecast of the dynamics of accumulation of the dose on board the station with an acceptable error (of no more than 30 percent). Besides, the developed forecast algorithm for the growth phase of the 24th solar cycle (2011-2014) was verified. The algorithm developed for forecasting the radiation environment may be used to process and analyse the current RMS information when providing effective radiation safety for the ISS crew.

  1. Hydroxychloroquine sulphate in the treatment of rheumatoid arthritis: a double blind comparison of two dose regimens.

    PubMed Central

    Pavelka, K; Sen, K P; Pelísková, Z; Vácha, J; Trnavský, K

    1989-01-01

    A controlled, double blind, parallel group, long term study of hydroxychloroquine sulphate in the treatment of rheumatoid arthritis, comparing daily doses of 200 mg and 400 mg, is described. The trial involved 54 patients with moderate disease activity who had not previously received antimalarial drugs. Forty three patients completed the one year treatment. The groups receiving different doses were homogeneous and did not differ in any of the 25 monitored indicators. Both dose regimens were effective, and a significant reduction of disease activity was observed after one year's treatment. Of the nine laboratory and 11 clinical indices of efficacy monitored, no statistically significant differences were reported, but in the group of patients treated with the 400 mg daily dose the number of side effects was three times greater. As there have been no reports of retinopathy with hydroxychloroquine at daily doses of 200 mg the effectiveness of this dose is of practical importance. PMID:2673079

  2. Use of effective dose.

    PubMed

    Harrison, J D; Balonov, M; Martin, C J; Ortiz Lopez, P; Menzel, H-G; Simmonds, J R; Smith-Bindman, R; Wakeford, R

    2016-06-01

    International Commission on Radiological Protection (ICRP) Publication 103 provided a detailed explanation of the purpose and use of effective dose and equivalent dose to individual organs and tissues. Effective dose has proven to be a valuable and robust quantity for use in the implementation of protection principles. However, questions have arisen regarding practical applications, and a Task Group has been set up to consider issues of concern. This paper focusses on two key proposals developed by the Task Group that are under consideration by ICRP: (1) confusion will be avoided if equivalent dose is no longer used as a protection quantity, but regarded as an intermediate step in the calculation of effective dose. It would be more appropriate for limits for the avoidance of deterministic effects to the hands and feet, lens of the eye, and skin, to be set in terms of the quantity, absorbed dose (Gy) rather than equivalent dose (Sv). (2) Effective dose is in widespread use in medical practice as a measure of risk, thereby going beyond its intended purpose. While doses incurred at low levels of exposure may be measured or assessed with reasonable reliability, health effects have not been demonstrated reliably at such levels but are inferred. However, bearing in mind the uncertainties associated with risk projection to low doses or low dose rates, it may be considered reasonable to use effective dose as a rough indicator of possible risk, with the additional consideration of variation in risk with age, sex and population group. PMID:26980800

  3. Use of effective dose.

    PubMed

    Harrison, J D; Balonov, M; Martin, C J; Ortiz Lopez, P; Menzel, H-G; Simmonds, J R; Smith-Bindman, R; Wakeford, R

    2016-06-01

    International Commission on Radiological Protection (ICRP) Publication 103 provided a detailed explanation of the purpose and use of effective dose and equivalent dose to individual organs and tissues. Effective dose has proven to be a valuable and robust quantity for use in the implementation of protection principles. However, questions have arisen regarding practical applications, and a Task Group has been set up to consider issues of concern. This paper focusses on two key proposals developed by the Task Group that are under consideration by ICRP: (1) confusion will be avoided if equivalent dose is no longer used as a protection quantity, but regarded as an intermediate step in the calculation of effective dose. It would be more appropriate for limits for the avoidance of deterministic effects to the hands and feet, lens of the eye, and skin, to be set in terms of the quantity, absorbed dose (Gy) rather than equivalent dose (Sv). (2) Effective dose is in widespread use in medical practice as a measure of risk, thereby going beyond its intended purpose. While doses incurred at low levels of exposure may be measured or assessed with reasonable reliability, health effects have not been demonstrated reliably at such levels but are inferred. However, bearing in mind the uncertainties associated with risk projection to low doses or low dose rates, it may be considered reasonable to use effective dose as a rough indicator of possible risk, with the additional consideration of variation in risk with age, sex and population group.

  4. Treatment acceptability among mexican american parents.

    PubMed

    Borrego, Joaquin; Ibanez, Elizabeth S; Spendlove, Stuart J; Pemberton, Joy R

    2007-09-01

    There is a void in the literature with regard to Hispanic parents' views about common interventions for children with behavior problems. The purpose of this study was to examine the treatment acceptability of child management techniques in a Mexican American sample. Parents' acculturation was also examined to determine if it would account for differences in treatment acceptability. Mexican American parents found response cost, a punishment-based technique, more acceptable than positive reinforcement-based techniques (e.g., differential attention). Results suggest that Mexican American parents' acculturation has little impact on acceptability of child management interventions. No association was found between mothers' acculturation and treatment acceptability. However, more acculturated Mexican American fathers viewed token economy as more acceptable than less acculturated fathers. Results are discussed in the context of clinical work and research with Mexican Americans.

  5. Phase I Study of Daily Irinotecan as a Radiation Sensitizer for Locally Advanced Pancreatic Cancer

    SciTech Connect

    Fouchardiere, Christelle de la; Negrier, Sylvie; Labrosse, Hugues; Martel Lafay, Isabelle; Desseigne, Francoise; Meeus, Pierre; Tavan, David; Petit-Laurent, Fabien; Rivoire, Michel; Perol, David; Carrie, Christian

    2010-06-01

    Purpose: The study aimed to determine the maximum tolerated dose of daily irinotecan given with concomitant radiotherapy in patients with locally advanced adenocarcinoma of the pancreas. Methods and Materials: Between September 2000 and March 2008, 36 patients with histologically proven unresectable pancreas adenocarcinoma were studied prospectively. Irinotecan was administered daily, 1 to 2 h before irradiation. Doses were started at 6 mg/m{sup 2} per day and then escalated by increments of 2 mg/m{sup 2} every 3 patients. Radiotherapy was administered in 2-Gy fractions, 5 fractions per week, up to a total dose of 50 Gy to the tumor volume. Inoperability was confirmed by a surgeon involved in a multidisciplinary team. All images and responses were centrally reviewed by radiologists. Results: Thirty-six patients were enrolled over a period of 8 years through eight dose levels (6 mg/m{sup 2} to 20 mg/m{sup 2} per day). The maximum tolerated dose was determined to be 18 mg/m{sup 2} per day. The dose-limiting toxicities were nausea/vomiting, diarrhea, anorexia, dehydration, and hypokalemia. The median survival time was 12.6 months with a median follow-up of 53.8 months. The median progression-free survival time was 6.5 months, and 4 patients (11.4%) with very good responses could undergo surgery. Conclusions: The maximum tolerated dose of irinotecan is 18 mg/m{sup 2} per day for 5 weeks. Dose-limiting toxicities are mainly gastrointestinal. Even though efficacy was not the aim of this study, the results are very promising, with a median survival time of 12.6 months.

  6. Divergent dose-related effects of gamma-interferon therapy on in vitro antibody-dependent cellular and nonspecific cytotoxicity by human peripheral blood monocytes.

    PubMed

    Weiner, L M; Steplewski, Z; Koprowski, H; Litwin, S; Comis, R L

    1988-02-15

    Twenty-seven patients with advanced gastrointestinal malignancies received recombinant gamma-interferon (rIFN-gamma, Biogen) prior to treatment with the murine monoclonal antibody 17-1A (Centocor), which mediates human monocyte antibody-dependent cellular cytotoxicity (ADCC). rIFN-gamma was used because it enhances human monocyte Fc receptor expression, nonspecific monocyte cytotoxicity (NSMC) and ADCC in vitro. The study was designed to identify a rIFN-gamma dose with acceptable toxicities which enhanced NSMC and ADCC. Patients received one course of therapy consisting of rIFN-gamma by 4-h infusions daily for 4 days at doses ranging from 0.001 to 80.0 X 10(6) units/m2/d, followed by 400 mg of 17-1A on day 5. The maximally tolerated dose of rIFN-gamma in this study was 40 X 10(6) units/d. Significant toxicity was seen at the high (greater than 1 X 10(6) units) but not low (less than or equal to 1 X 10(6) units) dose levels. Monocytes were isolated from patients' peripheral blood at baseline and on Days 3 and 5 for cytotoxicity studies which measured 111-In release from SW1116 cells which bear the target antigen of 17-1A. Low dose rIFN-gamma enhanced NSMC by Day 5 as well as did high dose therapy. ADCC enhancement was seen with low dose therapy (% specific lysis on Day 5 = 23.5 +/- 6.4 SEM versus baseline of 9.6 +/- 3.3, P = 0.03), but not with high dose rIFN-gamma treatment. Total (i.e., NSMC + ADCC) monocyte cytotoxicity was equivalent in the low and high dose treatment groups, although ADCC contributed more to total values in the low dose group. These findings were particularly striking if monocytes were exposed to additional rIFN-gamma in vitro prior to incubation with labeled target cells. We conclude that low dose rIFN-gamma therapy is at least equivalent, and possibly superior to high doses in this setting. Furthermore, low dose therapy, supplemented by ex vivo incubation of purified monocytes with rIFN-gamma, may be an optimal treatment strategy for this

  7. Mindfulness and Cognitive-behavioral Interventions for Chronic Pain: Differential Effects on Daily Pain Reactivity and Stress Reactivity

    PubMed Central

    Davis, Mary C.; Zautra, Alex J.; Wolf, Laurie D.; Tennen, Howard; Yeung, Ellen W.

    2014-01-01

    Objective This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA). Method 143 RA patients were randomized to one of the three treatment conditions. CBT-P targeted pain coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; and E provided information regarding RA pain and its management. At pre- and post-treatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects. Results Multilevel models compared groups in the magnitude of within-person change in daily pain- and stress-reactivity from pre- to post-treatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue, and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E. Conclusions For individuals with RA, M produces the broadest improvements in daily pain- and stress-reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life. PMID:25365778

  8. An introduction to quiet daily geomagnetic fields

    USGS Publications Warehouse

    Campbell, W.H.

    1989-01-01

    On days that are quiet with respect to solar-terrestrial activity phenomena, the geomagnetic field has variations, tens of gamma in size, with major spectral components at about 24, 12, 8, and 6 hr in period. These quiet daily field variations are primarily due to the dynamo currents flowing in the E region of the earth's ionosphere, are driven by the global thermotidal wind systems, and are dependent upon the local tensor conductivity and main geomagnetic field vector. The highlights of the behavior and interpretation of these quiet field changes, from their discovery in 1634 until the present, are discussed as an introduction to the special journal issue on Quiet Daily Geomagnetic Fields. ?? 1989 Birkha??user Verlag.

  9. Heavy metals in common foodstuff: Daily intake

    SciTech Connect

    Tsoumbaris, P.; Tsoukali-Papadopoulou, H. )

    1994-07-01

    Lately, toxic effects of some heavy metals (Pb, Cd) as well as desirable ones of some others (Ni, Mn, Zn) have been a field of thorough investigation. The main way of human body fortification in metals is through foodchain depending on the kind and quantity of the consumed food, according to dietary habits. The purpose of this study is the calculation of metals daily intake through common foodstuff of Greek inhabitants. The calculation is based on results from quantitative analysis of Pb, Cd, Ni, Mn, and Zn in common foodstuff from the market of the city of Thessaloniki. The daily food consumption data is derived from three sources: (a) answers to a questionnaire distributed to families of the city of Thessaloniki, (b) nutrition data provided by the Agricultural Bank of Greece and (c) nutrition data according to international bibliography.

  10. Corticosterone-regulated actions in the rat brain are affected by perinatal exposure to low dose of bisphenol A.

    PubMed

    Poimenova, A; Markaki, E; Rahiotis, C; Kitraki, E

    2010-05-19

    The estrogen-mimicking endocrine disrupter bisphenol A (BPA) which is used in the manufacture of plastic and epoxy resins, is one of the world's most heavily produced synthetic chemicals. BPA is detected in animal tissues, and its bio-accumulation has shown to be higher in the fetus than the mother. Exposure to doses below the daily safe limit has been reported to affect the sexual differentiation of the brain and modify the behavior of the exposed rodent offspring. The aim of the present study was to investigate in the rat the possible organizational effects of low BPA exposure on glucocorticoid-regulated responses. Female breeders were exposed to 40 microg/kg b.w. BPA daily throughout pregnancy and lactation. Plasma corticosterone levels and the two types of hippocampal corticosteroid receptors (GR and MR) were determined in mid-adolescent offspring under basal conditions and following a Y-maze task. BPA treated females had higher corticosterone levels than control females and BPA males and lower GR levels than BPA males, under basal conditions. Following the mildly stressful experience of Y-maze, corticosterone levels were increased in BPA-treated animals of both sexes, compared to the controls. GR levels were also increased in BPA-treated females compared to males. No effect of BPA was observed on MR levels, whereas the Y-maze experience significantly decreased receptors' levels in both female groups. The animals' performance in the task was also evaluated. BPA exposure significantly impaired the spatial recognition memory in both sexes, and modified the behavioural coping in a sex-dependent manner. Female BPA-treated offspring exhibited increased "anxiety-like" behaviour and dramatic loss of exploration attitude during the task, in comparison to males. This study provides for the first time evidence that corticosterone and its actions in the brain are sensitive to the programming effects of BPA at a dose below the currently acceptable daily intake. PMID

  11. Daily Water Use in Nine Cities

    NASA Astrophysics Data System (ADS)

    Maidment, David R.; Miaou, Shaw-Pin

    1986-06-01

    Transfer functions are used to model the short-term response of daily municipal water use to rainfall and air temperature variations. Daily water use data from nine cities are studied, three cities each from Florida, Pennsylvania, and Texas. The dynamic response of water use to rainfall and air temperature is similar across the cities within each State; in addition the responses of the Texas and Florida cities are very similar to one another while the response of the Pennsylvania cities is more sensitive to air temperature and less to rainfall. There is little impact of city size on the response functions. The response of water use to rainfall depends first on the occurrence of rainfall and second on its magnitude. The occurrence of a rainfall more than 0.05 in./day (0.13 cm/day) causes a drop in the seasonal component of water use one day later that averages 38% for the Texas cities, 42% for the Florida cities, and 7% for the Pennsylvania cities. In Austin, Texas, a spatially averaged rainfall series shows a clearer relationship with water use than does rainfall data from a single gage. There is a nonlinear response of water use to air temperature changes with no response for daily maximum air temperatures between 40° and 70°F (4-21°C) an increase in water use with air temperature beyond 70°F; above 85°-90°F (29°-32°C) water use increases 3-5 times more per degree than below that limit in Texas and Florida. The model resulting from these studies can be used for daily water use forecasting and water conservation analysis.

  12. Daily rhythms in plasma levels of homocysteine

    PubMed Central

    Lavie, Lena; Lavie, Peretz

    2004-01-01

    Background There is accumulated evidence that plasma concentration of the sulfur-containing amino-acid homocysteine (Hcy) is a prognostic marker for cardiovascular morbidity and mortality. Both fasting levels of Hcy and post methionine loading levels are used as prognostic markers. The aim of the present study was to investigate the existence of a daily rhythm in plasma Hcy under strictly controlled nutritional and sleep-wake conditions. We also investigated if the time during which methionine loading is performed, i.e., morning or evening, had a different effect on the resultant plasma Hcy concentration. Methods Six healthy men aged 23–26 years participated in 4 experiments. In the first and second experiments, the daily rhythm in Hcy as well as in other amino acids was investigated under a normal or an inverse sleep-wake cycle. In the third and fourth, Hcy concentrations were investigated after a morning and evening methionine loading. To standardize food consumption in the first two experiments, subjects received every 3 hours 150 ml of specially designed low-protein liquid food (Ensure® formula). Results In both the first and second experiments there was a significant daily rhythm in Hcy concentrations with a mid-day nadir and a nocturnal peak. Strikingly different 24-h patterns were observed in methionine, leucine, isoleucine and tyrosine. In all, the 24-h curves revealed a strong influence of both the sleep-wake cycle and the feeding schedule. Methionine loading resulted in increased plasma Hcy levels during both morning and evening experiments, which were not significantly different from each other. Conclusions There is a daily rhythm in plasma concentration of the amino acid Hcy, and this rhythm is independent of sleep-wake and food consumption. In view of the fact that increased Hcy concentrations may be associated with increased cardiovascular risks, these findings may have clinical implications for the health of rotating shift workers. PMID:15347422

  13. The Sub-Daily Distribution of Snowmelt

    NASA Astrophysics Data System (ADS)

    Webb, R.; Gooseff, M. N.; Fassnacht, S. R.

    2015-12-01

    The hydrologic cycle in many mountainous headwaters around the world have snowmelt dominated hydrographs. In addition to water resources for communities and ecosystems, high rates of snowmelt can cause flooding that results in damages to infrastructure. The standard in the United States flood forecasting looks primarily at rainfall estimates but lacks estimates for high rates of snowmelt in regions such as the Southern Rocky Mountains. Recent studies have shown that events such as a 10 year 24 hour snowmelt event is as much as 45% greater than the same recurrence interval rain event. Additionally, this 24 hour snowmelt likely occurs over a much shorter time period due to snowmelt being primarily driven by solar radiation. This study presents and tests a sub-daily temporal distribution of snowmelt. The snowmelt distribution presented herein is tested against hourly data for known daily melt rates from snow telemetry (SNOTEL) stations, and then for conditions when weekly or bi-weekly snow loss is known. It is additionally utilized for modeling a one-dimensional soil profile for infiltration across the soil-snow interface. The intent of this study is to create a less computationally intensive method than the mass energy approach and improve upon the simple degree-day method for the representation of snowmelt at sub-daily time steps. This can be used for streamflow, groundwater recharge, soil moisture distribution, and other land surface modeling efforts. Results of the study display strong agreement with hourly SNOTEL data from Colorado Front Range stations for an assumed 8-hour melt period. Peak flow estimates from snowmelt driven floods could be estimated from long-term datasets to calculate frequency of these flood events. Further application of this sub-daily distribution of snowmelt could be for partially or fully glaciated watersheds with modifications for differences in latitude and/or elevation causing longer or shorter periods of melt per day.

  14. Acceptability of blood and blood substitutes.

    PubMed

    Ferguson, E; Prowse, C; Townsend, E; Spence, A; Hilten, J A van; Lowe, K

    2008-03-01

    Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses.

  15. 7 CFR 932.32 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA Order Regulating Handling Olive Administrative Committee § 932.32 Acceptance. Any person selected by the...

  16. 7 CFR 932.32 - Acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA Order Regulating Handling Olive Administrative Committee § 932.32 Acceptance. Any person selected by the...

  17. 7 CFR 932.32 - Acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA Order Regulating Handling Olive Administrative Committee § 932.32 Acceptance. Any person selected by the...

  18. 7 CFR 932.32 - Acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA Order Regulating Handling Olive Administrative Committee § 932.32 Acceptance. Any person selected by the...

  19. 7 CFR 932.32 - Acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA Order Regulating Handling Olive Administrative Committee § 932.32 Acceptance. Any person selected by the...

  20. 7 CFR 1207.323 - Acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.323 Acceptance. Each...

  1. 7 CFR 1207.323 - Acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.323 Acceptance. Each...

  2. 7 CFR 1207.323 - Acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.323 Acceptance. Each...

  3. 7 CFR 1207.323 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.323 Acceptance. Each...

  4. 7 CFR 1207.323 - Acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.323 Acceptance. Each...

  5. Maintaining remission in ulcerative colitis – role of once daily extended-release mesalamine

    PubMed Central

    Oliveira, Lilliana; Cohen, Russell D

    2011-01-01

    The aminosalicylates (5-ASA; also referred to as mesalamine-based agents) are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC). Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance. PMID:21448448

  6. The Probability Distribution of Daily Streamflow

    NASA Astrophysics Data System (ADS)

    Blum, A.; Vogel, R. M.

    2015-12-01

    Flow duration curves (FDCs) are a graphical illustration of the cumulative distribution of streamflow. Daily streamflows often range over many orders of magnitude, making it extremely challenging to find a probability distribution function (pdf) which can mimic the steady state or period of record FDC (POR-FDC). Median annual FDCs (MA-FDCs) describe the pdf of daily streamflow in a typical year. For POR- and MA-FDCs, Lmoment diagrams, visual assessments of FDCs and Quantile-Quantile probability plot correlation coefficients are used to evaluate goodness of fit (GOF) of candidate probability distributions. FDCs reveal that both four-parameter kappa (KAP) and three-parameter generalized Pareto (GP3) models result in very high GOF for the MA-FDC and a relatively lower GOF for POR-FDCs at over 500 rivers across the coterminous U.S. Physical basin characteristics, such as baseflow index as well as hydroclimatic indices such as the aridity index and the runoff ratio are found to be correlated with one of the shape parameters (kappa) of the KAP and GP3 pdfs. Our work also reveals several important areas for future research including improved parameter estimators for the KAP pdf, as well as increasing our understanding of the conditions which give rise to improved GOF of analytical pdfs to large samples of daily streamflows.

  7. Progress towards daily "swath" solutions from GRACE

    NASA Astrophysics Data System (ADS)

    Save, H.; Bettadpur, S. V.; Sakumura, C.

    2015-12-01

    The GRACE mission has provided invaluable and the only data of its kind that measures the total water column in the Earth System over the past 13 years. The GRACE solutions available from the project have been monthly average solutions. There have been attempts by several groups to produce shorter time-window solutions with different techniques. There is also an experimental quick-look GRACE solution available from CSR that implements a sliding window approach while applying variable daily data weights. All of these GRACE solutions require special handling for data assimilation. This study explores the possibility of generating a true daily GRACE solution by computing a daily "swath" total water storage (TWS) estimate from GRACE using the Tikhonov regularization and high resolution monthly mascon estimation implemented at CSR. This paper discusses the techniques for computing such a solution and discusses the error and uncertainty characterization. We perform comparisons with official RL05 GRACE solutions and with alternate mascon solutions from CSR to understand the impact on the science results. We evaluate these solutions with emphasis on the temporal characteristics of the signal content and validate them against multiple models and in-situ data sets.

  8. Physiological responses to daily light exposure

    PubMed Central

    Yang, Yefeng; Yu, Yonghua; Yang, Bo; Zhou, Hong; Pan, Jinming

    2016-01-01

    Long daylength artificial light exposure associates with disorders, and a potential physiological mechanism has been proposed. However, previous studies have examined no more than three artificial light treatments and limited metabolic parameters, which have been insufficient to demonstrate mechanical responses. Here, comprehensive physiological response curves were established and the physiological mechanism was strengthened. Chicks were illuminated for 12, 14, 16, 18, 20, or 22 h periods each day. A quadratic relationship between abdominal adipose weight (AAW) and light period suggested that long-term or short-term light exposure could decrease the amount of AAW. Quantitative relationships between physiological parameters and daily light period were also established in this study. The relationships between triglycerides (TG), cholesterol (TC), glucose (GLU), phosphorus (P) levels and daily light period could be described by quadratic regression models. TG levels, AAW, and BW positively correlated with each other, suggesting long-term light exposure significantly increased AAW by increasing TG thus resulting in greater BW. A positive correlation between blood triiodothyronine (T3) levels and BW suggested that daily long-term light exposure increased BW by thyroid hormone secretion. Though the molecular pathway remains unknown, these results suggest a comprehensive physiological mechanism through which light exposure affects growth. PMID:27098210

  9. Understanding metropolitan patterns of daily encounters.

    PubMed

    Sun, Lijun; Axhausen, Kay W; Lee, Der-Horng; Huang, Xianfeng

    2013-08-20

    Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters' bounded nature. An individual's encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of "familiar strangers" in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or "structure of co-presence" across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and--particularly--disclosing the impact of human behavior on various diffusion/spreading processes.

  10. Understanding metropolitan patterns of daily encounters.

    PubMed

    Sun, Lijun; Axhausen, Kay W; Lee, Der-Horng; Huang, Xianfeng

    2013-08-20

    Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters' bounded nature. An individual's encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of "familiar strangers" in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or "structure of co-presence" across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and--particularly--disclosing the impact of human behavior on various diffusion/spreading processes. PMID:23918373

  11. Physiological responses to daily light exposure

    NASA Astrophysics Data System (ADS)

    Yang, Yefeng; Yu, Yonghua; Yang, Bo; Zhou, Hong; Pan, Jinming

    2016-04-01

    Long daylength artificial light exposure associates with disorders, and a potential physiological mechanism has been proposed. However, previous studies have examined no more than three artificial light treatments and limited metabolic parameters, which have been insufficient to demonstrate mechanical responses. Here, comprehensive physiological response curves were established and the physiological mechanism was strengthened. Chicks were illuminated for 12, 14, 16, 18, 20, or 22 h periods each day. A quadratic relationship between abdominal adipose weight (AAW) and light period suggested that long-term or short-term light exposure could decrease the amount of AAW. Quantitative relationships between physiological parameters and daily light period were also established in this study. The relationships between triglycerides (TG), cholesterol (TC), glucose (GLU), phosphorus (P) levels and daily light period could be described by quadratic regression models. TG levels, AAW, and BW positively correlated with each other, suggesting long-term light exposure significantly increased AAW by increasing TG thus resulting in greater BW. A positive correlation between blood triiodothyronine (T3) levels and BW suggested that daily long-term light exposure increased BW by thyroid hormone secretion. Though the molecular pathway remains unknown, these results suggest a comprehensive physiological mechanism through which light exposure affects growth.

  12. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method.

    PubMed

    Larson, David B

    2014-10-01

    The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach.

  13. Adaptive fractionation therapy: II. Biological effective dose

    NASA Astrophysics Data System (ADS)

    Chen, Mingli; Lu, Weiguo; Chen, Quan; Ruchala, Kenneth; Olivera, Gustavo

    2008-10-01

    Radiation therapy is fractionized to differentiate the cell killing between the tumor and organ at risk (OAR). Conventionally, fractionation is done by dividing the total dose into equal fraction sizes. However, as the relative positions (configurations) between OAR and the tumor vary from fractions to fractions, intuitively, we want to use a larger fraction size when OAR and the tumor are far apart and a smaller fraction size when OAR and the tumor are close to each other. Adaptive fractionation accounts for variations of configurations between OAR and the tumor. In part I of this series, the adaptation minimizes the OAR (physical) dose and maintains the total tumor (physical) dose. In this work, instead, the adaptation is based on the biological effective dose (BED). Unlike the linear programming approach in part I, we build a fraction size lookup table using mathematical induction. The lookup table essentially describes the fraction size as a function of the remaining tumor BED, the OAR/tumor dose ratio and the remaining number of fractions. The lookup table is calculated by maximizing the expected survival of OAR and preserving the tumor cell kill. Immediately before the treatment of each fraction, the OAR-tumor configuration and thus the dose ratio can be obtained from the daily setup image, and then the fraction size can be determined by the lookup table. Extensive simulations demonstrate the effectiveness of our method compared with the conventional fractionation method.

  14. Pharmacokinetics of Dapsone Administered Daily and Weekly in Human Immunodeficiency Virus-Infected Children

    PubMed Central

    Mirochnick, Mark; Cooper, Ellen; McIntosh, Ken; Xu, Jing; Lindsey, Jane; Jacobus, David; Mofenson, Lynne; Sullivan, John L.; Dankner, Wayne; Frenkel, Lisa M.; Nachman, Sharon; Wara, Diane W.; Johnson, Daniel; Bonagura, Vincent R.; Rathore, Mobeen H.; Cunningham, Coleen K.; McNamara, James

    1999-01-01

    Although dapsone is a commonly used alternative agent for prophylaxis against Pneumocystis carinii pneumonia in children intolerant to trimethoprim-sulfamethoxazole, there are few data that describe dapsone pharmacokinetics in children. We studied dapsone pharmacokinetics in 30 children (median age, 2.8 years; age range, 0.3 to 12 years) receiving a new proprietary liquid preparation by three dosing regimens (1 mg/kg of body weight daily, 2 mg/kg daily, or 4 mg/kg weekly). Dosing of children with 2 mg/kg daily or 4 mg/kg weekly resulted in peak concentrations equivalent to those reached in adults receiving 100-mg tablets daily. For the entire population, the median half-life was 22.2 h (range, 7.1 to 40.3 h), the median oral clearance was 0.0365 liter/kg/h (range, 0.0104 to 0.1021 liter/kg/h), and the median oral apparent volume of distribution was 1.13 liters/kg (range, 0.50 to 2.32 liters/kg). The median dapsone oral clearance was significantly increased in those infants less than 2 years of age compared to the oral clearance in those over 2 years of age (0.0484 versus 0.0278 liter/kg/h; P = 0.011). These data suggest that absorption of this liquid preparation is adequate and that the concentrations in the sera of children receiving 2 mg/kg daily or 4 mg/kg weekly are equivalent to those seen in adults receiving standard dapsone dosing. Dapsone oral clearance appears to be increased in children under 2 years of age. PMID:10543733

  15. In acceptance we trust? Conceptualising acceptance as a viable approach to NGO security management.

    PubMed

    Fast, Larissa A; Freeman, C Faith; O'Neill, Michael; Rowley, Elizabeth

    2013-04-01

    This paper documents current understanding of acceptance as a security management approach and explores issues and challenges non-governmental organisations (NGOs) confront when implementing an acceptance approach to security management. It argues that the failure of organisations to systematise and clearly articulate acceptance as a distinct security management approach and a lack of organisational policies and procedures concerning acceptance hinder its efficacy as a security management approach. The paper identifies key and cross-cutting components of acceptance that are critical to its effective implementation in order to advance a comprehensive and systematic concept of acceptance. The key components of acceptance illustrate how organisational and staff functions affect positively or negatively an organisation's acceptance, and include: an organisation's principles and mission, communications, negotiation, programming, relationships and networks, stakeholder and context analysis, staffing, and image. The paper contends that acceptance is linked not only to good programming, but also to overall organisational management and structures. PMID:23278470

  16. 20 CFR 330.3 - Daily rate of compensation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Daily rate of compensation. 330.3 Section 330... INSURANCE ACT DETERMINATION OF DAILY BENEFIT RATES § 330.3 Daily rate of compensation. (a) Definition. An employee's daily rate of compensation is his or her straight-time rate of pay, including any...

  17. Scientific evaluation of the safety factor for the acceptable daily intake (ADI). Case study: butylated hydroxyanisole (BHA).

    PubMed

    Würtzen, G

    1993-01-01

    The principles of 'data-derived safety factors' are applied to toxicological and biochemical information on butylated hydroxyanisole (BHA). The calculated safety factor for an ADI is, by this method, comparable to the existing internationally recognized safety evaluations. Relevance for humans of forestomach tumours in rodents is discussed. The method provides a basis for organizing data in a way that permits an explicit assessment of its relevance. PMID:8359313

  18. The CNAO dose delivery system for modulated scanning ion beam radiotherapy

    SciTech Connect

    Giordanengo, S.; Marchetto, F.; Garella, M. A.; Donetti, M.; Bourhaleb, F.; Monaco, V.; Hosseini, M. A.; Peroni, C.; Sacchi, R.; Cirio, R.; Ciocca, M.; Mirandola, A.

    2015-01-15

    comparable performances and are presently in use on the CNAO beam lines for clinical activity. Conclusions: The dose delivery system described in this paper is one among the few worldwide existing systems to operate ion beam for modulated scanning radiotherapy. At the time of writing, it has been used to treat more than 350 patients and it has proven to guide and control the therapeutic pencil beams reaching performances well above clinical requirements. In particular, in terms of dose accuracy and stability, daily quality assurance measurements have shown dose deviations always lower than the acceptance threshold of 5% and 2.5%, respectively.

  19. Global daily reference evapotranspiration modeling and evaluation

    USGS Publications Warehouse

    Senay, G.B.; Verdin, J.P.; Lietzow, R.; Melesse, Assefa M.

    2008-01-01

    Accurate and reliable evapotranspiration (ET) datasets are crucial in regional water and energy balance studies. Due to the complex instrumentation requirements, actual ET values are generally estimated from reference ET values by adjustment factors using coefficients for water stress and vegetation conditions, commonly referred to as crop coefficients. Until recently, the modeling of reference ET has been solely based on important weather variables collected from weather stations that are generally located in selected agro-climatic locations. Since 2001, the National Oceanic and Atmospheric Administration's Global Data Assimilation System (GDAS) has been producing six-hourly climate parameter datasets that are used to calculate daily reference ET for the whole globe at 1-degree spatial resolution. The U.S. Geological Survey Center for Earth Resources Observation and Science has been producing daily reference ET (ETo) since 2001, and it has been used on a variety of operational hydrological models for drought and streamflow monitoring all over the world. With the increasing availability of local station-based reference ET estimates, we evaluated the GDAS-based reference ET estimates using data from the California Irrigation Management Information System (CIMIS). Daily CIMIS reference ET estimates from 85 stations were compared with GDAS-based reference ET at different spatial and temporal scales using five-year daily data from 2002 through 2006. Despite the large difference in spatial scale (point vs. ???100 km grid cell) between the two datasets, the correlations between station-based ET and GDAS-ET were very high, exceeding 0.97 on a daily basis to more than 0.99 on time scales of more than 10 days. Both the temporal and spatial correspondences in trend/pattern and magnitudes between the two datasets were satisfactory, suggesting the reliability of using GDAS parameter-based reference ET for regional water and energy balance studies in many parts of the world

  20. Parameterization of daily solar global ultraviolet irradiation.

    PubMed

    Feister, U; Jäkel, E; Gericke, K

    2002-09-01

    Daily values of solar global ultraviolet (UV) B and UVA irradiation as well as erythemal irradiation have been parameterized to be estimated from pyranometer measurements of daily global and diffuse irradiation as well as from atmospheric column ozone. Data recorded at the Meteorological Observatory Potsdam (52 degrees N, 107 m asl) in Germany over the time period 1997-2000 have been used to derive sets of regression coefficients. The validation of the method against independent data sets of measured UV irradiation shows that the parameterization provides a gain of information for UVB, UVA and erythemal irradiation referring to their averages. A comparison between parameterized daily UV irradiation and independent values of UV irradiation measured at a mountain station in southern Germany (Meteorological Observatory Hohenpeissenberg at 48 degrees N, 977 m asl) indicates that the parameterization also holds even under completely different climatic conditions. On a long-term average (1953-2000), parameterized annual UV irradiation values are 15% and 21% higher for UVA and UVB, respectively, at Hohenpeissenberg than they are at Potsdam. Daily global and diffuse irradiation measured at 28 weather stations of the Deutscher Wetterdienst German Radiation Network and grid values of column ozone from the EPTOMS satellite experiment served as inputs to calculate the estimates of the spatial distribution of daily and annual values of UV irradiation across Germany. Using daily values of global and diffuse irradiation recorded at Potsdam since 1937 as well as atmospheric column ozone measured since 1964 at the same site, estimates of daily and annual UV irradiation have been derived for this site over the period from 1937 through 2000, which include the effects of changes in cloudiness, in aerosols and, at least for the period of ozone measurements from 1964 to 2000, in atmospheric ozone. It is shown that the extremely low ozone values observed mainly after the eruption of Mt

  1. Effects of hydrofluoroalkane formulations of ciclesonide 400 µg once daily vs fluticasone 250 µg twice daily on methacholine hyper-responsiveness in mild-to-moderate persistent asthma

    PubMed Central

    Lee, Daniel K C; Haggart, Kay; Currie, Graeme P; Bates, Caroline E; Lipworth, Brian J

    2004-01-01

    Aims There are no data comparing the relative efficacy of hydrofluoroalkane (HFA) formulations of ciclesonide (CIC) and fluticasone propionate (FP) on airway hyper-responsiveness, in mild-to-moderate persistent asthma. We therefore elected to evaluate the comparative efficacy of HFA pressurized metered-dose inhaler formulations of CIC and FP, assessing methacholine challenge, in addition to exhaled nitric oxide, lung function, diary cards and quality of life. Methods Nineteen mild-to-moderate asthmatic patients completed the study per protocol in randomized, double-blind, double-dummy, crossover fashion. Patients were required to stop their usual inhaled corticosteroid therapy for the duration of the study. Pa-tients were commenced instead on salmeterol (SM) 50 µg one puff twice daily + montelukast (ML) 10 mg once daily for 2-week washout periods prior to each randomized treatment, in order to prevent dropouts. Patients received 4 weeks of either CIC 200 µg two puffs once daily (08.00 h) + CIC-placebo (PL) two puffs once daily (20.00 h) + FP-PL two puffs twice daily (08.00 h and 20.00 h), or FP 125 µg two puffs twice daily (08.00 h and 20.00 h) + CIC-PL two puffs twice daily (08.00 h and 20.00 h). SM + ML were withheld for 72 h prior to post-washout visits and CIC or FP was withheld for 24 h prior to study visits. Results There was no significant difference between CIC vs. FP for the primary outcome of methacholine PC20 as doubling dilution (dd) shift from respective baseline; mean difference: 0.4 dd (95% CI −0.4, 1.2). Moreover, there was no difference between treatments for the sequence of CIC first vs FP second; mean difference: 0.2 dd (95% CI −1.3, 1.7) or FP first vs CIC second; mean difference: 0.9 dd (95% CI −0.1, 1.8). There were also no differences for other secondary outcomes between treatments, either respective or irrespective of sequence, as change from baseline. Conclusions There were no differences between 4 weeks of CIC 400 µg once daily

  2. Lack of hypothalamic-pituitary-adrenal axis suppression with once-daily or twice-daily beclomethasone dipropionate aqueous nasal spray administered to patients with allergic rhinitis.

    PubMed

    Brannan, M D; Herron, J M; Reidenberg, P; Affrime, M B

    1995-01-01

    , there were no significant differences in plasma cortisol responses to cosyntropin stimulation between groups of patients with allergic rhinitis treated with either BDP AQ Forte (0.084%) nasal spray 336 micrograms once daily or BDP AQ (0.042%) nasal spray 168 micrograms twice daily compared with the placebo group. These results indicate that the dosing regimens of BDP AQ nasal suspensions used in this study lack systemic effects and are safe and well tolerated.

  3. Clinical Pharmacokinetics of Once-Daily Tacrolimus in Solid-Organ Transplant Patients.

    PubMed

    Staatz, Christine E; Tett, Susan E

    2015-10-01

    Tacrolimus is a pivotal immunosuppressant agent used in solid-organ transplantation. It was originally formulated for oral administration as Prograf(®), a twice-daily immediate-release capsule. In an attempt to improve patient adherence, retain manufacturer market share and/or reduce health care costs, newer once-daily prolonged-release formulations of tacrolimus (Advagraf(®) and Envarsus(®) XR) and various generic versions of Prograf(®) are becoming available. Tacrolimus has a narrow therapeutic index. Small variations in drug exposure due to formulation differences can have a significant impact on patient outcomes. The aim of this review is to critically analyse the published data on the clinical pharmacokinetics of once-daily tacrolimus in solid-organ transplant patients. Forty-three traditional (non-compartmental) and five population pharmacokinetic studies were identified and evaluated. On the basis of the stricter criteria for narrow-therapeutic-index drugs, Prograf(®), Advagraf(®) and Envarsus(®) XR are not bioequivalent [in terms of the area under the concentration-time curve from 0 to 24 h (AUC0-24) or the minimum concentration (C min)]. Patients may require a daily dosage increase if converted from Prograf(®) to Advagraf(®), while a daily dosage reduction appears necessary for conversion from Prograf(®) to Envarsus(®) XR. Prograf(®) itself, or generic immediate-release tacrolimus, can be administered in a once-daily regimen with a lower than double daily dose being reported to give 24-h exposure equivalent to that of a twice-daily regimen. Intense clinical and concentration monitoring is prudent in the first few months after any conversion to once-daily tacrolimus dosing; however, there is no guarantee that therapeutic drug monitoring strategies applicable to one formulation (or twice-daily dosing) will be equally applicable to another. The correlation between the tacrolimus AUC0-24 and C min is variable and not strong for all three

  4. Use of cone-beam computed tomography to characterize daily urinary bladder variations during fractionated radiotherapy for canine bladder cancer.

    PubMed

    Nieset, Jessica R; Harmon, Joseph F; Larue, Susan M

    2011-01-01

    Urinary bladder cancer is difficult to treat accurately with fractionated radiation therapy (RT) due to daily positional changes of the bladder and surrounding soft-tissue structures. We quantified the daily motion experienced by the canine bladder with patients in dorsal vs. sternal vs. lateral recumbency. We also described the dose distribution for three different planning target volume expansions (5, 10, and 15 mm) for each of the three positions to ensure adequate bladder dose and minimize irradiation of nearby healthy tissues. Analysis was based on data from retrospective daily cone-beam computed tomography (CT) (CBCT) images obtained for positioning of canine patients undergoing routine RT. Organs of interest were contoured on each CBCT data set and the images, along with the contours, were registered to the original planning CT. All measurements were made relative to the planning CT and dosimetric data for the organs of interest was determined using a dose volume histogram generated from sample parallel-opposed beam configuration. There was a wide range in bladder position throughout treatment. The least amount of bladder variation and the lowest rectal dose was with dogs in lateral recumbency. It was also determined that a margin of 10 mm would allow for sufficient dose to be delivered to the bladder while minimizing rectal dose.

  5. 12 CFR 250.164 - Bankers' acceptances.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Bankers' acceptances. 250.164 Section 250.164 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM MISCELLANEOUS INTERPRETATIONS Interpretations § 250.164 Bankers' acceptances. (a) Section 207 of the Bank...

  6. 48 CFR 3011.103 - Market acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Market acceptance. 3011.103 Section 3011.103 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND... Developing Requirements Documents 3011.103 Market acceptance. (a) Contracting officers may act on behalf...

  7. 48 CFR 411.103 - Market acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Market acceptance. 411.103... ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Selecting and Developing Requirements Documents 411.103 Market... accordance with FAR 11.103(a), the market acceptability of their items to be offered. (b) The...

  8. 48 CFR 3011.103 - Market acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Market acceptance. 3011.103 Section 3011.103 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND... Developing Requirements Documents 3011.103 Market acceptance. (a) Contracting officers may act on behalf...

  9. 48 CFR 411.103 - Market acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Market acceptance. 411.103... ACQUISITION PLANNING DESCRIBING AGENCY NEEDS Selecting and Developing Requirements Documents 411.103 Market... accordance with FAR 11.103(a), the market acceptability of their items to be offered. (b) The...

  10. 12 CFR 615.5550 - Bankers' acceptances.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FUNDING AND FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Bankers' Acceptances § 615.5550 Bankers' acceptances. Banks... cooperatives' board of directors, under established policies, may delegate this authority to management....

  11. Mindfulness, Acceptance and Catastrophizing in Chronic Pain

    PubMed Central

    de Boer, Maaike J.; Steinhagen, Hannemike E.; Versteegen, Gerbrig J.; Struys, Michel M. R. F.; Sanderman, Robbert

    2014-01-01

    Objectives Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT) suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to examine the influence of mindfulness and general psychological acceptance on pain-related catastrophizing in patients with chronic pain. Methods A cross-sectional survey was conducted, including 87 chronic pain patients from an academic outpatient pain center. Results The results show that general psychological acceptance (measured with the AAQ-II) is a strong predictor of pain-related catastrophizing, independent of gender, age and pain intensity. Mindfulness (measured with the MAAS) did not predict levels of pain-related catastrophizing. Discussion Acceptance of psychological experiences outside of pain itself is related to catastrophizing. Thus, acceptance seems to play a role in the pain experience and should be part of the treatment of chronic pain. The focus of the ACT treatment of chronic pain does not necessarily have to be on acceptance of pain per se, but may be aimed at acceptance of unwanted experiences in general. Mindfulness in the sense of “acting with awareness” is however not related to catastrophizing. Based on our research findings in comparisons with those of other authors, we recommend a broader conceptualization of mindfulness and the use of a multifaceted questionnaire for mindfulness instead of the unidimensional MAAS. PMID:24489915

  12. Consumer acceptance of ginseng food products.

    PubMed

    Chung, Hee Sook; Lee, Young-Chul; Rhee, Young Kyung; Lee, Soo-Yeun

    2011-01-01

    Ginseng has been utilized less in food products than in dietary supplements in the United States. Sensory acceptance of ginseng food products by U.S. consumers has not been reported. The objectives of this study were to: (1) determine the sensory acceptance of commercial ginseng food products and (2) assess influence of the addition of sweeteners to ginseng tea and ginseng extract to chocolate on consumer acceptance. Total of 126 consumers participated in 3 sessions for (1) 7 commercial red ginseng food products, (2) 10 ginseng teas varying in levels of sugar or honey, and (3) 10 ginseng milk or dark chocolates varying in levels of ginseng extract. Ginseng candy with vitamin C and ginseng crunchy white chocolate were the most highly accepted, while sliced ginseng root product was the least accepted among the seven commercial products. Sensory acceptance increased in proportion to the content of sugar and honey in ginseng tea, whereas acceptance decreased with increasing content of ginseng extract in milk and dark chocolates. Findings demonstrate that ginseng food product types with which consumers have been already familiar, such as candy and chocolate, will have potential for success in the U.S. market. Chocolate could be suggested as a food matrix into which ginseng can be incorporated, as containing more bioactive compounds than ginseng tea at a similar acceptance level. Future research may include a descriptive analysis with ginseng-based products to identify the key drivers of liking and disliking for successful new product development.

  13. 36 CFR 251.62 - Acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 251.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.62 Acceptance. Except for an easement, a special use authorization shall become effective... extended by the authorized officer. Refusal of an applicant to sign and accept a special use...

  14. 36 CFR 251.62 - Acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 251.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.62 Acceptance. Except for an easement, a special use authorization shall become effective... extended by the authorized officer. Refusal of an applicant to sign and accept a special use...

  15. 36 CFR 251.62 - Acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 251.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.62 Acceptance. Except for an easement, a special use authorization shall become effective... extended by the authorized officer. Refusal of an applicant to sign and accept a special use...

  16. 36 CFR 251.62 - Acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 251.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.62 Acceptance. Except for an easement, a special use authorization shall become effective... extended by the authorized officer. Refusal of an applicant to sign and accept a special use...

  17. 36 CFR 251.62 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 251.62 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.62 Acceptance. Except for an easement, a special use authorization shall become effective... extended by the authorized officer. Refusal of an applicant to sign and accept a special use...

  18. Improving Acceptance of Automated Counseling Procedures.

    ERIC Educational Resources Information Center

    Johnson, James H.; And Others

    This paper discusses factors that may influence the acceptance of automated counseling procedures by the military. A consensual model of the change process is presented which structures organizational readiness, the change strategy, and acceptance as integrated variables to be considered in a successful installation. A basic introduction to the…

  19. 48 CFR 11.103 - Market acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supported by market research; (4) Include consideration of items supplied satisfactorily under recent or... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Market acceptance. 11.103... DESCRIBING AGENCY NEEDS Selecting and Developing Requirements Documents 11.103 Market acceptance. (a)...

  20. 49 CFR 193.2303 - Construction acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Construction acceptance. 193.2303 Section 193.2303 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Construction § 193.2303 Construction acceptance. No person may place in...

  1. 7 CFR 1205.326 - Acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Acceptance. 1205.326 Section 1205.326 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Cotton Board § 1205.326 Acceptance. Any person selected by the Secretary as...

  2. 7 CFR 1205.326 - Acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Acceptance. 1205.326 Section 1205.326 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Research and Promotion Order Cotton Board § 1205.326 Acceptance. Any person selected by the Secretary as...

  3. 12 CFR 250.164 - Bankers' acceptances.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Bankers' acceptances. 250.164 Section 250.164... reserve requirements under section 7 of the International Banking Act of 1978 (12 U.S.C. 3105). The Board..., Form FR Y-7, are also to be used in the calculation of the acceptance limits applicable to...

  4. 16 CFR 1110.5 - Acceptable certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Acceptable certificates. 1110.5 Section 1110.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CERTIFICATES OF COMPLIANCE § 1110.5 Acceptable certificates. A certificate that is in hard copy or...

  5. Enzyme Reactions and Acceptability of Plant Foods.

    ERIC Educational Resources Information Center

    Palmer, James K.

    1984-01-01

    Provides an overview of enzyme reactions which contribute to the character and acceptability of plant foods. A detailed discussion of polyphenoloxidase is also provided as an example of an enzyme which can markedly affect the character and acceptability of such foods. (JN)

  6. Consumer acceptance of ginseng food products.

    PubMed

    Chung, Hee Sook; Lee, Young-Chul; Rhee, Young Kyung; Lee, Soo-Yeun

    2011-01-01

    Ginseng has been utilized less in food products than in dietary supplements in the United States. Sensory acceptance of ginseng food products by U.S. consumers has not been reported. The objectives of this study were to: (1) determine the sensory acceptance of commercial ginseng food products and (2) assess influence of the addition of sweeteners to ginseng tea and ginseng extract to chocolate on consumer acceptance. Total of 126 consumers participated in 3 sessions for (1) 7 commercial red ginseng food products, (2) 10 ginseng teas varying in levels of sugar or honey, and (3) 10 ginseng milk or dark chocolates varying in levels of ginseng extract. Ginseng candy with vitamin C and ginseng crunchy white chocolate were the most highly accepted, while sliced ginseng root product was the least accepted among the seven commercial products. Sensory acceptance increased in proportion to the content of sugar and honey in ginseng tea, whereas acceptance decreased with increasing content of ginseng extract in milk and dark chocolates. Findings demonstrate that ginseng food product types with which consumers have been already familiar, such as candy and chocolate, will have potential for success in the U.S. market. Chocolate could be suggested as a food matrix into which ginseng can be incorporated, as containing more bioactive compounds than ginseng tea at a similar acceptance level. Future research may include a descriptive analysis with ginseng-based products to identify the key drivers of liking and disliking for successful new product development. PMID:22416723

  7. Heavy Metal, Religiosity, and Suicide Acceptability.

    ERIC Educational Resources Information Center

    Stack, Steven

    1998-01-01

    Reports on data taken from the General Social Survey that found a link between "heavy metal" rock fanship and suicide acceptability. Finds that relationship becomes nonsignificant once level of religiosity is controlled. Heavy metal fans are low in religiosity, which contributes to greater suicide acceptability. (Author/JDM)

  8. Nevada Test Site Waste Acceptance Criteria (NTSWAC)

    SciTech Connect

    NNSA /NSO Waste Management Project

    2008-06-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive (LLW) and LLW Mixed Waste (MW) for disposal.

  9. Radiation dose descriptors: BERT, COD, DAP, and other strange creatures.

    PubMed

    Nickoloff, Edward L; Lu, Zheng Feng; Dutta, Ajoy K; So, James C

    2008-01-01

    Over the years, a number of terms have been used to describe radiation dose. Eight common radiation dose descriptors include background equivalent radiation time (BERT), critical organ dose (COD), surface absorbed dose (SAD), dose area product (DAP), diagnostic acceptable reference level (DARLing), effective dose (ED), fetal absorbed dose (FAD), and total imparted energy (TIE). BERT is compared to the annual natural background radiation (about 3 mSv per year) and is easily understandable for the general public. COD refers to the radiation dose delivered to an individual critical organ. SAD is the radiation dose delivered at the skin surface. DAP is a product of the irradiated surface area multiplied by the radiation dose at the surface. DARLing is usually the radiation level that encompasses 75% (the third quartile) of the data derived from a nationwide or regional survey. DARLings are meant for voluntary guidance. Consistently higher patient doses should be investigated for possible equipment deficiencies or suboptimal protocols. ED is obtained by multiplying the radiation dose delivered to each organ by its weighting factor and then by adding those values to get the sum. It can be used to assess the risk of radiation-induced cancers and serious hereditary effects to future generations, regardless of the procedure being performed, and is the most useful radiation dose descriptor. FAD is the radiation dose delivered to the fetus, and TIE is the sum of the energy imparted to all irradiated tissue. Each of these descriptors is intended to relate radiation dose ultimately to potential biologic effects. To avoid confusion, the key is to avoid using the terms interchangeably. It is important to understand each of the radiation dose descriptors and their derivation in order to correctly evaluate radiation dose and to consult with patients concerned about the risks of radiation.

  10. HOW RELIABLE IS 24 HOUR SERUM LITHIUM LEVEL AFTER A TEST DOSE OF LITHIUM IN PREDICTING OPTIMAL LITHIUM DOSE?

    PubMed Central

    Kuruvilla, K.; Shaji, K.S.

    1989-01-01

    SUMMARY 57% of a group of 35 patients treated with Lithium Carbonate at dosages predicted by the nomogram suggested by Cooper et al (1973) failed to reach therapeutic levels of serum lithium. This finding casts serious doubts on the usefulness of the claim by Cooper et al (1973 & 1976) that 24 hour serum lithium level after a test dose of 600 mg. lithium can predict the daily lithium dose. PMID:21927360

  11. MC2736 Lot 9 daily lot sample failures

    SciTech Connect

    Pike, R.A.

    1991-03-04

    Two Daily Lot Sample (DLS) failures occurred in Lot 9 of the MC2736 battery. The first DLS failed to reach the required voltage. X-rays were carefully reviewed for evidence of any condition which would impact battery performance. It was concluded that Serial No. 4422 failed because of oversized header potting. When the normal stack force used for closure welding was applied, it forced the header potting into the insulation sleeve. As a result, no pressure was applied to the cell stack. Because this condition could be detected on the standard battery x-rays, all x-rays for this lot were reviewed. No other batteries were found which showed any evidence of this problem. The second DLS failure produced no voltage when tested. Upon examination, the primer was found not to have ignited. Extensive investigation failed to determine the cause of the primer failure. The lot was accepted based on performance data from this and previous lots. This primer failure was shown to have no impact on the overall system reliability.

  12. Who accepts responsibility for their transgressions?

    PubMed

    Schumann, Karina; Dweck, Carol S

    2014-12-01

    After committing an offense, transgressors can optimize their chances of reconciling with the victim by accepting responsibility. However, transgressors may be motivated to avoid admitting fault because it can feel threatening to accept blame for harmful behavior. Who, then, is likely to accept responsibility for a transgression? We examined how implicit theories of personality--whether people see personality as malleable (incremental theory) or fixed (entity theory)--influence transgressors' likelihood of accepting responsibility. We argue that incremental theorists may feel less threatened by accepting responsibility because they are more likely to view the situation as an opportunity for them to grow as a person and develop their relationship with the victim. We found support for our predictions across four studies using a combination of real-world and hypothetical offenses, and correlational and experimental methods. These studies therefore identify an important individual difference factor that can lead to more effective responses from transgressors. PMID:25252938

  13. Understanding diversity: the importance of social acceptance.

    PubMed

    Chen, Jacqueline M; Hamilton, David L

    2015-04-01

    Two studies investigated how people define and perceive diversity in the historically majority-group dominated contexts of business and academia. We hypothesized that individuals construe diversity as both the numeric representation of racial minorities and the social acceptance of racial minorities within a group. In Study 1, undergraduates' (especially minorities') perceptions of campus diversity were predicted by perceived social acceptance on a college campus, above and beyond perceived minority representation. Study 2 showed that increases in a company's representation and social acceptance independently led to increases in perceived diversity of the company among Whites. Among non-Whites, representation and social acceptance only increased perceived diversity of the company when both qualities were high. Together these findings demonstrate the importance of both representation and social acceptance to the achievement of diversity in groups and that perceiver race influences the relative importance of these two components of diversity.

  14. Student's music exposure: Full-day personal dose measurements.

    PubMed

    Washnik, Nilesh Jeevandas; Phillips, Susan L; Teglas, Sandra

    2016-01-01

    Previous studies have shown that collegiate level music students are exposed to potentially hazardous sound levels. Compared to professional musicians, collegiate level music students typically do not perform as frequently, but they are exposed to intense sounds during practice and rehearsal sessions. The purpose of the study was to determine the full-day exposure dose including individual practice and ensemble rehearsals for collegiate student musicians. Sixty-seven college students of classical music were recruited representing 17 primary instruments. Of these students, 57 completed 2 days of noise dose measurements using Cirrus doseBadge programed according to the National Institute for Occupational Safety and Health criterion. Sound exposure was measured for 2 days from morning to evening, ranging from 7 to 9 h. Twenty-eight out of 57 (49%) student musicians exceeded a 100% daily noise dose on at least 1 day of the two measurement days. Eleven student musicians (19%) exceeded 100% daily noise dose on both days. Fourteen students exceeded 100% dose during large ensemble rehearsals and eight students exceeded 100% dose during individual practice sessions. Approximately, half of the student musicians exceeded 100% noise dose on a typical college schedule. This finding indicates that a large proportion of collegiate student musicians are at risk of developing noise-induced hearing loss due to hazardous sound levels. Considering the current finding, there is a need to conduct hearing conservation programs in all music schools, and to educate student musicians about the use and importance of hearing protection devices for their hearing.

  15. SU-E-J-36: Combining CBCT Dose Into IMRT Treatment Planning

    SciTech Connect

    Grelewicz, Z; Wiersma, R

    2014-06-01

    Purpose: Cone beam CT (CBCT) is increasingly used in patient setup for IMRT. Daily CBCT may provide effective localization, however, it introduces concern over excessive imaging dose. Previous studies investigated the calculation of excess CBCT dose, however, no study has yet treated this dose as a source of therapeutic radiation, optimized in consideration of PTV and OARs constrains. Here we present a novel combined MV+kV inverse optimization engine to weave the CBCT and MV dose together such that CBCT dose is used for both imaging and therapeutic purposes. This may mitigate some of the excess imaging dose effects of daily CBCT and allow complete evaluation of the CBCT dose prior to treatment. Methods: The EGSnrc Monte Carlo system was used to model a Varian Trilogy CBCT system and 6 MV treatment beam. Using the model, the dose to patient from treatment beam and imaging beam was calculated for ten patients. The standard IMRT objective function was modified to include CBCT dose. Treatment plan optimization using the MOSEK optimization tool was performed retrospectively with and without assuming kV radiation dose from CBCT, assuming one CBCT per fraction. Results: Across ten patients, the CBCT delivered peaks of between .4% and 3.0% of the prescription dose to the PTV, with average CBCT dose to the PTV between .3% and .8%. By including CBCT dose to skin as a constraint during optimization, peak skin dose is reduced by between 1.9% and 7.4%, and average skin dose is reduced by .2% to 3.3%. Conclusions: Pre-treatment CBCT may deliver a substantial amount of radiation dose to the target volume. By considering CBCT dose to skin at the point of treatment planning, it is possible to reduce patient skin dose from current clinical levels, and to provide patient treatment with the improved accuracy that daily CBCT provides.

  16. Sex-specific effects of low-dose gestational estradiol-17β exposure on bone development in porcine offspring.

    PubMed

    Flöter, Veronika L; Galateanu, Gabriela; Fürst, Rainer W; Seidlová-Wuttke, Dana; Wuttke, Wolfgang; Möstl, Erich; Hildebrandt, Thomas B; Ulbrich, Susanne E

    2016-07-29

    Estrogens are important for the bone development and health. Exposure to endocrine disrupting chemicals during the early development has been shown to affect the bone phenotype later in life. Several studies have been performed in rodents, while in larger animals that are important to bridge the gap to humans there is a paucity of data. To this end, the pig as large animal model was used in the present study to assess the influence of gestational estradiol-17β (E2) exposure on the bone development of the prepubertal and adult offspring. Two low doses (0.05 and 10μg E2/kg body weight) referring to the 'acceptable daily intake' (ADI) and the 'no observed effect level' (NOEL) as stated for humans, and a high-dose (1000μg E2/kg body weight), respectively, were fed to the sows every day from insemination until delivery. In the male prepubertal offspring, the ADI dose group had a lower strength strain index (p=0.002) at the proximal tibia compared to controls, which was determined by peripheral quantitative computed tomography. Prepubertal females were not significantly affected. However, there was a higher cortical cross-sectional area (CSA) (p=0.03) and total CSA (p=0.02) at the femur midpoint in the adult female offspring of the NOEL dose group as measured by computed tomography. These effects were independent from plasma hormone concentrations (leptin, IGF1, estrogens), which remained unaltered. Overall, sex-specific effects on bone development and non-monotonic dose responses were observed. These results substantiate the high sensitivity of developing organisms to exogenous estrogens.

  17. Life-Span Exposure to Low Doses of Aspartame Beginning during Prenatal Life Increases Cancer Effects in Rats

    PubMed Central

    Soffritti, Morando; Belpoggi, Fiorella; Tibaldi, Eva; Esposti, Davide Degli; Lauriola, Michelina

    2007-01-01

    Background In a previous study conducted at the Cesare Maltoni Cancer Research Center of the European Ramazzini Foundation (CMCRC/ERF), we demonstrated for the first time that aspartame (APM) is a multipotent carcinogenic agent when various doses are administered with feed to Sprague-Dawley rats from 8 weeks of age throughout the life span. Objective The aim of this second study is to better quantify the carcinogenic risk of APM, beginning treatment during fetal life. Methods We studied groups of 70–95 male and female Sprague-Dawley rats administered APM (2,000, 400, or 0 ppm) with feed from the 12th day of fetal life until natural death. Results Our results show a) a significant dose-related increase of malignant tumor–bearing animals in males (p < 0.01), particularly in the group treated with 2,000 ppm APM (p < 0.01); b) a significant increase in incidence of lymphomas/leukemias in males treated with 2,000 ppm (p < 0.05) and a significant dose-related increase in incidence of lymphomas/leukemias in females (p < 0.01), particularly in the 2,000-ppm group (p < 0.01); and c) a significant dose-related increase in incidence of mammary cancer in females (p < 0.05), particularly in the 2,000-ppm group (p < 0.05). Conclusions The results of this carcinogenicity bioassay confirm and reinforce the first experimental demonstration of APM’s multipotential carcinogenicity at a dose level close to the acceptable daily intake for humans. Furthermore, the study demonstrates that when life-span exposure to APM begins during fetal life, its carcinogenic effects are increased. PMID:17805418

  18. Feasibility and Acceptability of Cell Phone Diaries to Measure HIV Risk Behavior Among Female Sex Workers

    PubMed Central

    Hensel, Devon J.; Fortenberry, J. Dennis; Garfein, Richard S.; Gunn, Jayleen K. L.; Wiehe, Sarah E.

    2015-01-01

    Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group. PMID:24643312

  19. Daily lsa-saf evapotranspiration product

    NASA Astrophysics Data System (ADS)

    Arboleda Rodallega, Alirio; Ghilain, Nicolas; Meulenberghs, Francoise

    2010-05-01

    In the framework of the EUMETSAT's Satellite Application Facility on Land Surface Analysis (LSA-SAF), some models have been implemented in view to characterize continental surfaces by using information obtained from MSG and EPS satellites. In this context a method has been developed in order to monitor the flux of water (Evapotranspiration) between the land surface and the atmosphere. The method is based on a physical approach in which radiative data derived from Meteosat Second Generation (MSG) satellites together with land-cover information are used to constrain a physical model of energy exchange between the soil-vegetation system and the atmosphere. The implemented algorithm provides instantaneous ET estimates over four regions defined in the MSG FOV (the defined regions cover Europe, Africa and the west of south America), with MSG spatial resolution (3km at sub satellite point) and a temporal time step of 30 minutes. The scope of the method is limited to evaporation from terrestrial surfaces rather than from lakes or oceans. The instantaneous product has been validated over different vegetation cover and climatic conditions, providing evidence that the algorithm is able to reproduce ET estimates with accuracy equivalent to the accuracy of ET obtained from observations. In 2009 the instantaneous ET product has been declared pre-operational by EUMETSAT, allowing the product to be disseminated to a larger community of users (http://landsaf.meteo.pt). In some areas like agriculture, hydrology, water management, ecology and climate studies the main concern is not instantaneous but accumulated values over days, months or longer periods. To encompass the need for these community of users, a daily ET product in which daily evapotranspiration is obtained as temporal integration of instantaneous values has been developed. In this contribution we will present the methodology used to obtain instantaneous ET estimates and the procedure applied to derive daily

  20. Detection of daily clouds on Titan.

    PubMed

    Griffith, C A; Hall, J L; Geballe, T R

    2000-10-20

    We have discovered frequent variations in the near-infrared spectrum of Titan, Saturn's largest moon, which are indicative of the daily presence of sparse clouds covering less than 1% of the area of the satellite. The thermodynamics of Titan's atmosphere and the clouds' altitudes suggest that convection governs their evolutions. Their short lives point to the presence of rain. We propose that Titan's atmosphere resembles Earth's, with clouds, rain, and an active weather cycle, driven by latent heat release from the primary condensible species.

  1. Daily Spiritual Experiences and Adolescent Treatment Response

    PubMed Central

    LEE, MATTHEW T.; VETA, PAIGE S.; JOHNSON, BYRON R.; PAGANO, MARIA E.

    2014-01-01

    The purpose of this study is to explore changes in belief orientation during treatment and the impact of increased daily spiritual experiences (DSE) on adolescent treatment response. One-hundred ninety-five adolescents court-referred to a 2-month residential treatment program were assessed at intake and discharge. Forty percent of youth who entered treatment as agnostic or atheist identified themselves as spiritual or religious at discharge. Increased DSE was associated with greater likelihood of abstinence, increased prosocial behaviors, and reduced narcissistic behaviors. Results indicate a shift in DSE that improves youth self-care and care for others that may inform intervention approaches for adolescents with addiction. PMID:25525291

  2. The Gambro system for home daily dialysis.

    PubMed

    Ledebo, Ingrid; Fredin, Richard

    2004-01-01

    Safety and reliability have been the main emphasis when developing our system for home daily dialysis. The AK 95 is part of a comprehensive system of appropriate products consisting additionally of a silent water treatment module, an ultrafilter, and a range of dry disposables for dialysis fluid preparation and disinfection. The dialyzer can be selected from a family of synthetic, biocompatible filters, both low and high flux. To complete the system, a modern data management tool for online or off-line surveillance and multilingual training manuals in both conventional format as well as animated software are available.

  3. Artemether-lumefantrine nanostructured lipid carriers for oral malaria therapy: Enhanced efficacy at reduced dose and dosing frequency.

    PubMed

    Prabhu, Priyanka; Suryavanshi, Shital; Pathak, Sulabha; Sharma, Shobhona; Patravale, Vandana

    2016-09-10

    Artemether-lumefantrine (ARM-LFN) is a World Health Organization (WHO) approved fixed-dose combination having low solubility and poor oral bioavailability. Nanostructured lipid carriers (NLC) were developed to enhance the oral efficacy of this combination using the microemulsion template technique. They were characterized for drug content, entrapment efficiency, size distribution, in vitro release, antimalarial efficacy, and toxicity. The NLC showed sustained drug release. The recommended adult therapeutic dose is 80mg ARM and 480mg LFN (4 tablets) twice a day, which amounts to 160mg ARM and 960mg LFN daily. ARM-LFN NLC given once a day at 1/5 of therapeutic dose (16mg ARM and 96mg LFN) showed complete parasite clearance and 100% survival in Plasmodium berghei-infected mice. 33% of the mice treated with marketed tablets twice a day at the therapeutic dose showed late-stage recrudescence. Thus, NLC showed enhanced efficacy at 1/10 of the daily dose of ARM-LFN. The 10-fold reduced daily dose was formulated in two soft gelatin capsules thus reducing the number of units to be taken at a time by the patient. The capsules showed good stability at room temperature for a year. The NLC were found to be safe in rats. The biocompatible NLC developed using an industrially feasible technique offer a promising solution for oral malaria therapy. PMID:27421912

  4. Kidney injury associated with telavancin dosing regimen in an animal model.

    PubMed

    Tam, Vincent H; Ledesma, Kimberly R; Bowers, Dana R; Zhou, Jian; Truong, Luan D

    2015-05-01

    The elevation of serum creatinine levels is a concern with telavancin therapy. We examined the onset of kidney injury associated with telavancin in an animal model. Urine samples were collected at baseline and daily to determine the concentrations of kidney injury molecule 1 (KIM-1), a marker for early kidney injury. When a clinically relevant exposure of telavancin was given daily to rats, some differences in kidney injury were attributed to the dosing regimen. Further investigations of alternative telavancin dosing regimens are warranted.

  5. Anti-inflamatory dose doxycycline in the treatment of rosacea.

    PubMed

    Del Rosso, James Q

    2009-07-01

    Anti-inflammatory dose doxycycline (ADD), which is the administration of doxycycline 40 mg extended-release capsule once daily, is the only oral therapy approved by the United States Food and Drug Administration (FDA) for treatment of rosacea. ADD once daily has been shown to exhibit anti-inflammatory activity while not demonstrating evidence of antibiotic effects, including with chronic administration. This article summarizes the clinical studies to date on the use of ADD once daily in papulopustular rosacea, including both monotherapy and combination therapy studies. The combination therapy approach of ADD once daily and metronidazole gel 1% once daily has been shown to exhibit a more rapid onset of therapeutic effect than topical therapy alone. ADD once daily has been demonstrated to be effective in adult subjects with moderate to severe rosacea, and exhibits a favorable safety profile coupled with absence of antibiotic selection pressure. Additionally, a much lower incidence of gastrointestinal side effects has been noted with ADD once daily as compared to doxycycline 100 mg once daily.

  6. Reversed Scototaxis during Withdrawal after Daily-Moderate, but Not Weekly-Binge, Administration of Ethanol in Zebrafish

    PubMed Central

    Holcombe, Adam; Howorko, Adam; Powell, Russell A.; Schalomon, Melike; Hamilton, Trevor J.

    2013-01-01

    Alcohol abuse can lead to severe psychological and physiological damage. Little is known, however, about the relative impact of a small, daily dose of alcohol (daily-moderate schedule) versus a large, once per week dose (weekly-binge schedule). In this study, we examined the effect of each of these schedules on behavioural measures of anxiety in zebrafish (Danio rerio). Adult wild-type zebrafish were administered either 0.2% ethanol on a daily-moderate schedule or 1.4% ethanol on a weekly-binge schedule for a period of 21 days, and then tested for scototaxis (preference for darkness) during withdrawal. Compared to a control group with no alcohol exposure, the daily-moderate group spent significantly more time on the light side of the arena (indicative of decreased anxiety) on day two of withdrawal, but not day 9 of withdrawal. The weekly-binge group was not significantly different from the control group on either day of withdrawal and showed no preference for either the light or dark zones. Our results indicate that even a small dose of alcohol on a daily basis can cause significant, though reversible, changes in behaviour. PMID:23675478

  7. Management of insulin therapy in urban diabetes patients is facilitated by use of an intelligent dosing system.

    PubMed

    Cook, Curtiss B; Mann, Linda J; King, Esther C; New, Katina M; Vaughn, Pamela S; Dames, Faye D; Dunbar, Virginia G; Caudle, Jane M; Tsui, Circe; George, Christopher D; McMichael, John P

    2004-06-01

    The Intelligent Dosing System (IDS, Dimensional Dosing Systems, Inc., Wexford, PA) is a software suite that incorporates patient-specific, dose-response data in a mathematical model, and then calculates the new dose of agent needed to achieve the next desired therapeutic goal. We evaluated use of the IDS for titrating insulin therapy. The IDS was placed on handheld platforms and provided to practitioners to use in adjusting total daily insulin dose. Fasting glucose, random glucose, and hemoglobin A1c were used as markers against which insulin could be adjusted. Values of markers expected at the next follow-up visit, as predicted by the model, were compared with levels actually observed. For 264 patients, 334 paired visits were analyzed. Average age was 54 years, diabetes' duration was 10 years, and body mass index was 33.2 kg/m(2); 57% were female, 88% were African American, and 92% had type 2 diabetes. The correlation between IDS suggested and actual prescribed total daily dose was high (r = 0.99), suggesting good acceptability of the IDS by practitioners. Significant decreases in fasting glucose, random glucose, and hemoglobin A1c levels were seen (all P < 0.0001). No significant difference between average expected and observed follow-up fasting glucose values was found (145 vs. 149 mg/dL, P = 0.42), and correlation was high (r = 0.79). Mean observed random glucose value at follow-up was comparable to the IDS predicted level (167 vs. 168 mg/dL, P = 0.97), and correlation was high (r = 0.73). Observed follow-up hemoglobin A1c was higher than the value expected (7.9% vs. 7.4%, P < 0.0055), but correlation was good (r = 0.70). These analyses suggest the IDS is a useful adjunct for decisions regarding insulin therapy even when using a variety of markers of glucose control, and can be used by practitioners to assist in attainment of glycemic goals.

  8. Comparative acceptance of three transdermal nitroglycerin placebo patches.

    PubMed

    Rayment, C M; Kaul, A F; Garfield, J M

    1985-06-01

    Factors that might affect patient acceptance of transdermal drug-delivery system patches were evaluated in healthy volunteers using placebo patches. Placebo transdermal nitroglycerin patches (Transderm-Nitro 5 placebo, Ciba Pharmaceutical Company; Nitro-Dur 10 cm2 placebo, Key Pharmaceuticals; and Nitrodisc 5 placebo, Searle Laboratories) were supplied by the manufacturers. Eighty-two healthy subjects were randomly assigned to begin using one of the three brands of patches. Using a Latin-square crossover design, subjects applied each brand of patch daily for five days and crossed over to the other brands on study days 6 and 11. At the end of each study phase, subjects completed a written questionnaire designed to evaluate their overall acceptance of each brand of patch. A total of 80 subjects completed all three phases of the study. According to forced rank preference, 84% of subjects preferred the Ciba patch to one of the other two brands. Subjects judged the Ciba patch to be the easiest of the three brands to use and reported significantly fewer side effects and skin irritation while using the Ciba patch; they also preferred the size of the Ciba patch and experienced significantly fewer problems with adherence of the Ciba patch. A significant percentage of subjects indicated that they would prefer a transdermal patch over tablets or ointment. Most subjects preferred the Ciba patch over the Key patch or Searle patch. PMID:3925770

  9. Dose Recalculation and the Dose-Guided Radiation Therapy (DGRT) Process Using Megavoltage Cone-Beam CT

    SciTech Connect

    Cheung, Joey Aubry, Jean-Francois; Yom, Sue S.; Gottschalk, Alexander R.; Celi, Juan Carlos; Pouliot, Jean

    2009-06-01

    Purpose: At University of California San Francisco, daily or weekly three-dimensional images of patients in treatment position are acquired for image-guided radiation therapy. These images can be used for calculating the actual dose delivered to the patient during treatment. In this article, we present the process of performing dose recalculation on megavoltage cone-beam computed tomography images and discuss possible strategies for dose-guided radiation therapy (DGRT). Materials and Methods: A dedicated workstation has been developed to incorporate the necessary elements of DGRT. Patient image correction (cupping, missing data artifacts), calibration, completion, recontouring, and dose recalculation are all implemented in the workstation. Tools for dose comparison are also included. Examples of image correction and dose analysis using 6 head-and-neck and 2 prostate patient datasets are presented to show possible tracking of interfraction dosimetric endpoint variation over the course of treatment. Results: Analysis of the head-and-neck datasets shows that interfraction treatment doses vary compared with the planning dose for the organs at risk, with the mean parotid dose and spinal cord D{sub 1} increasing by as much as 52% and 10%, respectively. Variation of the coverage to the target volumes was small, with an average D{sub 5} dose difference of 1%. The prostate patient datasets revealed accurate dose coverage to the targeted prostate and varying interfraction dose distributions to the organs at risk. Conclusions: An effective workflow for the clinical implementation of DGRT has been established. With these techniques in place, future clinical developments in adaptive radiation therapy through daily or weekly dosimetric measurements of treatment day images are possible.

  10. Consumer Acceptance of Dry Dog Food Variations

    PubMed Central

    Donfrancesco, Brizio Di; Koppel, Kadri; Swaney-Stueve, Marianne; Chambers, Edgar

    2014-01-01

    Simple Summary The objectives of this study were to compare the acceptance of different dry dog food products by consumers, determine consumer clusters for acceptance, and identify the characteristics of dog food that drive consumer acceptance. Pet owners evaluated dry dog food samples available in the US market. The results indicated that appearance of the sample, especially the color, influenced pet owner’s overall liking more than the aroma of the product. Abstract The objectives of this study were to compare the acceptance of different dry dog food products by consumers, determine consumer clusters for acceptance, and identify the characteristics of dog food that drive consumer acceptance. Eight dry dog food samples available in the US market were evaluated by pet owners. In this study, consumers evaluated overall liking, aroma, and appearance liking of the products. Consumers were also asked to predict their purchase intent, their dog’s liking, and cost of the samples. The results indicated that appearance of the sample, especially the color, influenced pet owner’s overall liking more than the aroma of the product. Overall liking clusters were not related to income, age, gender, or education, indicating that general consumer demographics do not appear to play a main role in individual consumer acceptance of dog food products. PMID:26480043

  11. Chronic daily headache in the elderly.

    PubMed

    Özge, Aynur

    2013-12-01

    Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (<4 hours) forms of CDH are chronic cluster headache, chronic paroxysmal hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the "aging world" continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body.

  12. Daily Rhythms in Mobile Telephone Communication

    PubMed Central

    Aledavood, Talayeh; López, Eduardo; Roberts, Sam G. B.; Reed-Tsochas, Felix; Moro, Esteban; Dunbar, Robin I. M.; Saramäki, Jari

    2015-01-01

    Circadian rhythms are known to be important drivers of human activity and the recent availability of electronic records of human behaviour has provided fine-grained data of temporal patterns of activity on a large scale. Further, questionnaire studies have identified important individual differences in circadian rhythms, with people broadly categorised into morning-like or evening-like individuals. However, little is known about the social aspects of these circadian rhythms, or how they vary across individuals. In this study we use a unique 18-month dataset that combines mobile phone calls and questionnaire data to examine individual differences in the daily rhythms of mobile phone activity. We demonstrate clear individual differences in daily patterns of phone calls, and show that these individual differences are persistent despite a high degree of turnover in the individuals’ social networks. Further, women’s calls were longer than men’s calls, especially during the evening and at night, and these calls were typically focused on a small number of emotionally intense relationships. These results demonstrate that individual differences in circadian rhythms are not just related to broad patterns of morningness and eveningness, but have a strong social component, in directing phone calls to specific individuals at specific times of day. PMID:26390215

  13. AVERAGE ANNUAL SOLAR UV DOSE OF THE CONTINENTAL US CITIZEN

    EPA Science Inventory

    The average annual solar UV dose of US citizens is not known, but is required for relative risk assessments of skin cancer from UV-emitting devices. We solved this problem using a novel approach. The EPA's "National Human Activity Pattern Survey" recorded the daily ou...

  14. Infused vincristine and adriamycin with high dose methylprednisolone (VAMP) in advanced previously treated multiple myeloma patients.

    PubMed Central

    Forgeson, G. V.; Selby, P.; Lakhani, S.; Zulian, G.; Viner, C.; Maitland, J.; McElwain, T. J.

    1988-01-01

    Forty-five patients with relapsed or refractory multiple myeloma received continuous infusions of vincristine (0.4 mg total dose daily for 4 days) and adriamycin (9 mg m-2 daily for 4 days) with a high dose of methylprednisolone (1 g m-2 i.v. or p.o. daily by 1 h infusion), the VAMP regimen. Sixteen (36%) responded, with a median duration of remission of 11 months and median survival of 20 months. Major toxicities encountered were infective and cardiovascular. Two smaller groups of myeloma patients were treated with high dose methylprednisolone (HDMP) alone, or VAMP plus weekly low dose cyclophosphamide (Cyclo-VAMP). HDMP produced short responses in 25% of patients with less toxicity than VAMP. Cyclo-VAMP was used in a highly selected group of patients who had previously responded to high dose melphalan. It was well tolerated and produced responses in 61% of this group. PMID:3207601

  15. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

    SciTech Connect

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

    2005-07-01

    This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal.

  16. Approaches to acceptable risk: a critical guide

    SciTech Connect

    Fischhoff, B.; Lichtenstein, S.; Slovic, P.; Keeney, R.; Derby, S.

    1980-12-01

    Acceptable-risk decisions are an essential step in the management of technological hazards. In many situations, they constitute the weak (or missing) link in the management process. The absence of an adequate decision-making methodology often produces indecision, inconsistency, and dissatisfaction. The result is neither good for hazard management nor good for society. This report offers a critical analysis of the viability of various approaches as guides to acceptable-risk decisions. This report seeks to define acceptable-risk decisions and to examine some frequently proposed, but inappropriate, solutions. 255 refs., 22 figs., 25 tabs.

  17. Hanford Site Solid Waste Acceptance Criteria

    SciTech Connect

    Not Available

    1993-11-17

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities.

  18. [Doses-related effects of lynestrenol on ovulation (author's transl)].

    PubMed

    Pizarro, M A; Thomas, K; Ferin, J

    1976-01-01

    8 women, aged 22-28, with normal, ovulatory menstrual cycles, volunteered to take different doses of Lynestrenol to determine its effects on Luteineizing Hormone (LH) secretion, and on plasma progesterone levels. Blood samples were taken in the morning and plasma was immediately separated. Results showed that body temperature varied unpredictably during the cycle, and therefore could not be considered a reliable parameter of ovulation. 0.35 mg of Lynestrenol administered daily was enough to suppress ovulation, as evidenced by the absence of LH during midcycle. Although differences exists in individual reactions, administration of Lynestrenol beyond 0.6 mg. daily always suppresses ovulation because of hypothalamo-pituitary inhibition, while doses below 0.5mg. daily can bring about episodic peaks. It is still not clear how Lynestrenol influences gonadotropins, especially LH, while intermittent bleeding seems to be the only sure side effect.

  19. The impact of daily setup variations on head-and-neck intensity-modulated radiation therapy

    SciTech Connect

    Hong, Theodore S.; Tome, Wolfgang A.; Chappell, Richard J.; Chinnaiyan, Prakash; Mehta, Minesh P.; Harari, Paul M. . E-mail: harari@humonc.wisc.edu

    2005-03-01

    Purpose: Intensity-modulated radiation therapy (IMRT) in the treatment of head-and-neck (H and N) cancer provides the opportunity to diminish normal tissue toxicity profiles and thereby enhance patient quality of life. However, highly conformal treatment techniques commonly establish steep dose gradients between tumor and avoidance structures. Daily setup variations can therefore significantly compromise the ultimate precision of idealized H and N IMRT delivery. This study provides a detailed analysis regarding the potential impact of daily setup variations on the overall integrity of H and N IMRT. Methods and materials: A series of 10 patients with advanced H and N cancer were prospectively enrolled in a clinical trial to examine daily H and N radiation setup accuracy. These patients were treated with conventional shrinking field design using three-dimensional treatment planning techniques (not IMRT). Immobilization and alignment were performed using modern H and N practice techniques including conventional thermoplastic masking, baseplate fixation to the treatment couch, three-point laser alignment, and weekly portal film evaluation. After traditional laser alignment, setup accuracy was assessed daily for each patient by measuring 3 Cartesian and 3 angular deviations from the specified isocenter using a high-precision, optically guided patient localization system, which affords submillimeter setup accuracy. These positional errors were then applied to a distinct series of 10 H and N IMRT plans for detailed analysis regarding the impact of daily setup variation (without optical guidance) on the ultimate integrity of IMRT plans over a 30-day treatment course. Dose-volume histogram (DVH), equivalent uniform dose (EUD), mean total dose (mTd), and maximal total dose (MTD) for normal structures were analyzed for IMRT plans with and without incorporation of daily setup variation. Results: Using conventional H and N masking and laser alignment for daily positioning, the

  20. Effects of Positive Peer Reporting (PPR) on Social Acceptance and Negative Behaviors among Peer-Rejected Preschool Children

    ERIC Educational Resources Information Center

    Smith, Shelia M.; Simon, Joan; Bramlett, Ronald K.

    2009-01-01

    Positive peer reporting (PPR) is a peer-mediated intervention that involves teaching and rewarding peers for providing descriptive praise during structured daily sessions. PPR has been used in residential facilities to improve social acceptance, increase prosocial behaviors, and decrease negative interactions of youth identified as peer rejected.…

  1. A Bayesian Semiparametric Model for Radiation Dose-Response Estimation.

    PubMed

    Furukawa, Kyoji; Misumi, Munechika; Cologne, John B; Cullings, Harry M

    2016-06-01

    In evaluating the risk of exposure to health hazards, characterizing the dose-response relationship and estimating acceptable exposure levels are the primary goals. In analyses of health risks associated with exposure to ionizing radiation, while there is a clear agreement that moderate to high radiation doses cause harmful effects in humans, little has been known about the possible biological effects at low doses, for example, below 0.1 Gy, which is the dose range relevant to most radiation exposures of concern today. A conventional approach to radiation dose-response estimation based on simple parametric forms, such as the linear nonthreshold model, can be misleading in evaluating the risk and, in particular, its uncertainty at low doses. As an alternative approach, we consider a Bayesian semiparametric model that has a connected piece-wise-linear dose-response function with prior distributions having an autoregressive structure among the random slope coefficients defined over closely spaced dose categories. With a simulation study and application to analysis of cancer incidence data among Japanese atomic bomb survivors, we show that this approach can produce smooth and flexible dose-response estimation while reasonably handling the risk uncertainty at low doses and elsewhere. With relatively few assumptions and modeling options to be made by the analyst, the method can be particularly useful in assessing risks associated with low-dose radiation exposures. PMID:26581473

  2. Bladder dose-surface maps and urinary toxicity: Robustness with respect to motion in assessing local dose effects.

    PubMed

    Palorini, F; Botti, A; Carillo, V; Gianolini, S; Improta, I; Iotti, C; Rancati, T; Cozzarini, C; Fiorino, C

    2016-03-01

    The purpose of this study was to quantify the impact of inter-fraction modifications of bladder during RT of prostate cancer on bladder dose surface maps (DSM). Eighteen patients treated with daily image-guided Tomotherapy and moderate hypofractionation (70-72.8Gy at 2.5-2.6Gy/fr in 28 fractions and full bladder) were considered. Bladder contours were delineated on co-registered daily Megavoltage CT (MVCT) by a single observer and copied on the planning CT to generate dose-volume/surface histograms (DVH/DSH) and bladder DSMs. Discrepancies between planned and daily absorbed doses were analyzed through the average of individual systematic errors, the population systematic errors and the population random errors for the DVH/DSHs and DSMs. In total, 477 DVH/DSH and 472 DSM were available. DSH and DVH showed small population systematic errors of absolute surfaces (<3.4cm(2)) and volumes (<8.4cm(3)) at the highest doses. The dose to the posterior bladder base assessed on DSMs showed a mean systematic error below 1Gy, with population systematic and random errors within 4 and 3Gy, respectively. The region surrounding this area shows higher mean systematic errors (1-3Gy), population systematic (8-11Gy) and random (5-7Gy) errors. In conclusion, DVH/DSH and DSMs are quite stable with respect to inter-fraction variations in the high-dose region, within about 2cm from bladder base. Larger systematic variations occur in the anterior portion and cranially 2.5-3.5cm from the base. Results suggest that dose predictors related to the high dose area (including the trigone dose) are likely to be sufficiently reliable with respect to the expected variations due to variable bladder filling.

  3. Chinese Nurses' Acceptance of PDA: A Cross-Sectional Survey Using a Technology Acceptance Model.

    PubMed

    Wang, Yanling; Xiao, Qian; Sun, Liu; Wu, Ying

    2016-01-01

    This study explores Chinese nurses' acceptance of PDA, using a questionnaire based on the framework of Technology Acceptance Model (TAM). 357 nurses were involved in the study. The results reveal the scores of the nurses' acceptance of PDA were means 3.18~3.36 in four dimensions. The younger of nurses, the higher nurses' title, the longer previous usage time, the more experienced using PDA, and the more acceptance of PDA. Therefore, the hospital administrators may change strategies to enhance nurses' acceptance of PDA, and promote the wide application of PDA.

  4. Daily mercury intake in fish-eating populations in the Brazilian Amazon.

    PubMed

    Passos, Carlos José Sousa; Da Silva, Delaine Sampaio; Lemire, Mélanie; Fillion, Myriam; Guimarães, Jean Rémy Davée; Lucotte, Marc; Mergler, Donna

    2008-01-01

    Although high levels of fish consumption and bioindicators of mercury exposure have been reported for traditional populations in the Amazon, little is known about their actual daily intake of Hg. Using an ecosystem approach, calculate daily mercury intake in adult fish-eaters, examine the relations between mercury intake and bioindicators of exposure and the factors that influence these relations. A cross-sectional dietary survey on fish and fruit consumption frequency was carried out with 256 persons from six villages of the Tapajós River. Fish portion per meal was determined. Mercury concentration was determined for 1123 local fish specimens. Daily mercury intake (microg/kg/day) was determined for men and women from each village using the average fish-mercury concentration for the fish caught in their fishing zone, the average quantity of fish per meal, fish-species frequency consumption and participants' body weight. Fish-mercury averaged 0.33 microg/g+/-0.33. Daily mercury intake varied between 0 and 11.8 microg/kg/day (mean 0.92 microg/kg/day+/-0.89) and varied by gender and village. Mean blood- and hair-mercury were 58.7+/-36.1 microg/l and 17.9+/-11.5 microg/g, respectively. There was a strong and positive relation between blood-mercury and daily mercury intake, with an inverse relation for fruit intake and schooling; significant variations were observed with immigrant status, and among villages. Hair-mercury was directly associated with daily mercury intake and inversely related to schooling and fruit consumption. Fruit consumption modified the relation between daily mercury intake and blood-mercury levels: for the same daily mercury intake, persons eating more fruit had lower blood-mercury concentrations (ANCOVA Interaction term: F=10.9, P<0.0001). The median difference of the ratio of blood-mercury to daily mercury intake between low and high fruit consumers was 26, representing a 26.3% reduction. These findings reveal high levels of daily mercury intake

  5. Does Once-Daily Raltegravir Have Any Role in the Antiretroviral Treatment?

    PubMed Central

    Gutierrez-Valencia, Alicia; Chacón-Mora, Natalia; Ruiz-Valderas, Rosa; Ben-Marzouk-Hidalgo, Omar J.; Torres-Cornejo, Almudena; Viciana, Pompeyo; Lopez-Cortes, Luis F.

    2015-01-01

    Abstract Administering raltegravir once daily would make adherence to antiretroviral treatment easier, especially if the concomitant drugs are also administered once daily. We report our experience on the use of raltegravir, both once- and twice-daily. Retrospective review of HIV-infected patients on treatment with raltegravir 800 mg once or 400 mg twice a day plus 2 analogs. Patients were classified as group A (subjects switched to raltegravir due to adverse events on a previous regimen or drug–drug interactions) and group B (subjects who restarted antiretroviral treatment after a previous drop-out). The primary clinical endpoint was the percentage of subjects with virological suppression after 96 weeks. Treatment's effectiveness (noncomplete/missing equals failure) was also evaluated. Pharmacokinetic study was performed in unselected patients. Plasma raltegravir concentrations were determined by high-performance liquid chromatography coupled with mass spectrometry. A total of 133 patients were included in the study (74 and 59 on raltegravir once- and twice-daily). There were only 4 virological failures in the entire cohort during the follow-up. Thus, the Kaplan–Meier estimation of efficacy by on-treatment analysis was 96.3% (CI95, 92.8–99.8) at week 96, independently of the dosing regimen and of the raltegravir concentrations. Similar exposures to raltegravir based on AUC0–τ, but higher Cmax and significantly lower Ctrough were observed when raltegravir was given once daily compared with 400 mg twice daily. In fact, 14 out of 56 Ctrough concentrations (25%) from patients taking raltegravir once daily were below the IC95 of wild-type HIV-1 clinical isolates while only 2 samples from patients receiving 400 mg twice a day were below this value, although no relationship between Ctrough and efficacy was found. The main limitations of the study are that the raltegravir dosing regimen was not randomized and more than 50% of the patients were

  6. Evaluation of Safety and Pharmacokinetics of Sodium 2,2 Dimethylbutyrate, a Novel Short Chain Fatty Acid Derivative, in a Phase 1, Double-Blind, Placebo-Controlled, Single- and Repeat-Dose Studies in Healthy Volunteers

    PubMed Central

    Perrine, Susan P.; Wargin, William A.; Boosalis, Michael S.; Wallis, Wayne J.; Case, Sally; Keefer, Jeffrey R.; Faller, Douglas V.; Welch, William C.; Berenson, Ronald J.

    2013-01-01

    Pharmacologic induction of fetal globin synthesis is an accepted therapeutic strategy for treatment of the beta hemoglobinopathies and thalassemias, as even small increases in hemoglobin F (HbF) levels reduce clinical severity in sickle cell disease and reduce anemia in beta thalassemia. Prior generation short chain fatty acid therapeutics, arginine butyrate and phenylbutyrate, increased fetal and total hemoglobin levels in patients, but were limited by high doses or intravenous infusion. A fetal globin-inducing therapeutic with convenient oral dosing would be an advance for these classic molecular diseases. Healthy adult human subjects were treated with a novel SCFA derivative, sodium 2,2 dimethylbutyrate (SDMB), or placebo, with one of four single dose levels (2, 5, 10 and 20 mg/kg) or daily doses (5, 10, or 15 mg/kg) over 14 days, and monitored for adverse clinical and laboratory events, drug levels, reticulocytes, and HbF assays. SDMB was well-tolerated with no clinically significant adverse events related to study medication. The terminal half-life ranged from 9–15 hours. Increases in mean absolute reticulocytes were observed at all dose levels in the 14-day study. The favorable PK profiles and safety findings indicate that SDMB warrants further investigation for treatment of anemic subjects with beta hemoglobinopathies. PMID:21422239

  7. Doses from radiation exposure.

    PubMed

    Menzel, H-G; Harrison, J D

    2012-01-01

    Practical implementation of the International Commission on Radiological Protection's (ICRP) system of protection requires the availability of appropriate methods and data. The work of Committee 2 is concerned with the development of reference data and methods for the assessment of internal and external radiation exposure of workers and members of the public. This involves the development of reference biokinetic and dosimetric models, reference anatomical models of the human body, and reference anatomical and physiological data. Following ICRP's 2007 Recommendations, Committee 2 has focused on the provision of new reference dose coefficients for external and internal exposure. As well as specifying changes to the radiation and tissue weighting factors used in the calculation of protection quantities, the 2007 Recommendations introduced the use of reference anatomical phantoms based on medical imaging data, requiring explicit sex averaging of male and female organ-equivalent doses in the calculation of effective dose. In preparation for the calculation of new dose coefficients, Committee 2 and its task groups have provided updated nuclear decay data (ICRP Publication 107) and adult reference computational phantoms (ICRP Publication 110). New dose coefficients for external exposures of workers are complete (ICRP Publication 116), and work is in progress on a series of reports on internal dose coefficients to workers from inhaled and ingested radionuclides. Reference phantoms for children will also be provided and used in the calculation of dose coefficients for public exposures. Committee 2 also has task groups on exposures to radiation in space and on the use of effective dose.

  8. Competition between novelty and cocaine conditioned reward is sensitive to drug dose and retention interval

    PubMed Central

    Reichel, Carmela M.; Bevins, Rick A.

    2010-01-01

    The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/bne The conditioned rewarding effects of novelty compete with those of cocaine for control over choice behavior using a place-conditioning task. The purpose of the present study was to use multiple doses of cocaine to determine the extent of this competition and to determine whether novelty's impact on cocaine reward was maintained over an abstinence period. In Experiment 1, rats were conditioned with cocaine (7.5, 20, or 30 mg/kg, IP) to prefer one side of an unbiased place conditioning apparatus relative to the other. In a subsequent phase, all rats received alternating daily confinements to the previously cocaine-paired and unpaired sides of the apparatus. During this phase, half the rats had access to a novel object on their initially unpaired side; the remaining rats did not receive objects. The ability of novelty to compete with cocaine in a drug-free and cocaine-challenge test was sensitive to cocaine dose. In Experiment 2, a place preference was established with 10 mg/kg cocaine and testing occurred after 1, 14, or 28 day retention intervals. Findings indicate that choice behaviors mediated by cocaine conditioning are reduced with the passing of time. Taken together, competition between cocaine and novelty conditioned rewards are sensitive to drug dose and retention interval. PMID:20141289

  9. 48 CFR 411.103 - Market acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... acceptance. (a) The head of the contracting activity (HCA) may determine that offerors must demonstrate, in... officer shall place a copy of this determination, signed by the HCA, in the solicitation file....

  10. 48 CFR 411.103 - Market acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... acceptance. (a) The head of the contracting activity (HCA) may determine that offerors must demonstrate, in... officer shall place a copy of this determination, signed by the HCA, in the solicitation file....

  11. 48 CFR 411.103 - Market acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... acceptance. (a) The head of the contracting activity (HCA) may determine that offerors must demonstrate, in... officer shall place a copy of this determination, signed by the HCA, in the solicitation file....

  12. Gas characterization system software acceptance test procedure

    SciTech Connect

    Vo, C.V.

    1996-02-27

    This document details the Software Acceptance Testing of gas characterization systems. The gas characterization systems will be used to monitor the vapor spaces of waste tanks known to contain measurable concentrations of flammable gases.

  13. Nevada Test Site Waste Acceptance Criteria

    SciTech Connect

    U.S. Department of Energy, Nevada Operations Office, Waste Acceptance Criteria

    1999-05-01

    This document provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal; and transuranic and transuranic mixed waste for interim storage at the Nevada Test Site.

  14. Behavioral genetics: scientific and social acceptance.

    PubMed

    Lorenz, David R

    2003-01-01

    Human behavioral genetics can be broadly defined as the attempt to characterize and define the genetic or hereditary basis for human behavior. Examination of the history of these scientific enterprises reveals episodes of controversy, and an apparent distinction between scientific and social acceptance of the genetic nature of such complex behaviors. This essay will review the history and methodology of behavioral genetics research, including a more detailed look at case histories involving behavioral genetic research for aggressive behavior and alcoholism. It includes a discussion of the scientific versus social qualities of the acceptance of behavioral genetics research, as well as the development of a general model for scientific acceptance involving the researchers, the scientific literature, the scientific peer group, the mainstream media, and the public at large. From this model follows a discussion of the means and complications by which behavioral genetics research may be accepted by society, and an analysis of how future studies might be conducted.

  15. 7 CFR 1205.326 - Acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE COTTON RESEARCH AND PROMOTION Cotton Research and Promotion Order Cotton Board § 1205.326 Acceptance. Any person selected by the Secretary as...

  16. 7 CFR 1205.326 - Acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE COTTON RESEARCH AND PROMOTION Cotton Research and Promotion Order Cotton Board § 1205.326 Acceptance. Any person selected by the Secretary as...

  17. 7 CFR 1205.326 - Acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE COTTON RESEARCH AND PROMOTION Cotton Research and Promotion Order Cotton Board § 1205.326 Acceptance. Any person selected by the Secretary as...

  18. What Are Acceptable Limits of Radiation?

    NASA Video Gallery

    Brad Gersey, lead research scientist at the Center for Radiation Engineering and Science for Space Exploration, or CRESSE, at Prairie View A&M University, describes the legal and acceptable limits ...

  19. 78 FR 8189 - Acceptance of Concurrent Jurisdiction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... accepted concurrent legislative jurisdiction from the State of Washington over lands and waters administered by the National Park Service within the boundaries of Lake Roosevelt National Recreation Area. DATES: Effective Date: Concurrent legislative jurisdiction within Lake Roosevelt National...

  20. Integrated Model for E-Learning Acceptance

    NASA Astrophysics Data System (ADS)

    Ramadiani; Rodziah, A.; Hasan, S. M.; Rusli, A.; Noraini, C.

    2016-01-01

    E-learning is not going to work if the system is not used in accordance with user needs. User Interface is very important to encourage using the application. Many theories had discuss about user interface usability evaluation and technology acceptance separately, actually why we do not make it correlation between interface usability evaluation and user acceptance to enhance e-learning process. Therefore, the evaluation model for e-learning interface acceptance is considered important to investigate. The aim of this study is to propose the integrated e-learning user interface acceptance evaluation model. This model was combined some theories of e-learning interface measurement such as, user learning style, usability evaluation, and the user benefit. We formulated in constructive questionnaires which were shared at 125 English Language School (ELS) students. This research statistics used Structural Equation Model using LISREL v8.80 and MANOVA analysis.

  1. Contralateral breast dose from partial breast brachytherapy.

    PubMed

    Robinson, R Cole; Nelson, Christopher L; Bloom, Elizabeth S; Kisling, Kelly D; Mason, Bryan E; Fisher, Gary D; Kirsner, Steven M

    2015-01-01

    The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam-published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single-entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high-dose-rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium-192 as the treatment source. Post-treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI. PMID:26699549

  2. Wavelet and ANN combination model for prediction of daily suspended sediment load in rivers.

    PubMed

    Rajaee, Taher

    2011-07-01

    In this research, a new wavelet artificial neural network (WANN) model was proposed for daily suspended sediment load (SSL) prediction in rivers. In the developed model, wavelet analysis was linked to an artificial neural network (ANN). For this purpose, daily observed time series of river discharge (Q) and SSL in Yadkin River at Yadkin College, NC station in the USA were decomposed to some sub-time series at different levels by wavelet analysis. Then, these sub-time series were imposed to the ANN technique for SSL time series modeling. To evaluate the model accuracy, the proposed model was compared with ANN, multi linear regression (MLR), and conventional sediment rating curve (SRC) models. The comparison of prediction accuracy of the models illustrated that the WANN was the most accurate model in SSL prediction. Results presented that the WANN model could satisfactorily simulate hysteresis phenomenon, acceptably estimate cumulative SSL, and reasonably predict high SSL values.

  3. Acceptance Test Plan for ANSYS Software

    SciTech Connect

    CREA, B.A.

    2000-10-25

    This plan governs the acceptance testing of the ANSYS software (Full Mechanical Release 5.5) for use on Project Word Management Contract (PHMC) computer systems (either UNIX or Microsoft Windows/NT). There are two phases to the acceptance testing covered by this test plan: program execution in accordance with the guidance provided in installation manuals; and ensuring results of the execution are consistent with the expected physical behavior of the system being modeled.

  4. Generalized group chain acceptance sampling plan

    NASA Astrophysics Data System (ADS)

    Zain, Zakiyah; Mughal, Abdur Razzaque; Aziz, Nazrina

    2015-12-01

    In this article, we proposed an acceptance sampling plan based on generalized group chain truncated life test. The decision on acceptance of a submitted lot can be made by using the cumulative information of the immediately preceding samples. The design parameters of the proposed plan such as the minimum number of groups are found to satisfy the desired quality standard. The benefits of this plan include smaller sample size and reduced overall costs.

  5. Plaque growth and removal with daily toothbrushing.

    PubMed

    De la Rosa, M; Zacarias Guerra, J; Johnston, D A; Radike, A W

    1979-12-01

    Dental plaque growth was observed among 180 teenage boys during a 28-day period following prophylaxis. During this period, subjects brushed their teeth under supervision for 2 minutes daily. Plaque levels were measured immediately after brushing and 24 hours after brushing. Both levels increased rapidly during the first 14 days and appeared to be leveled off at 28 days. Less than half of the plaque was removed with one brushing per day leaving about 60% after brushing to promote rapid regrowth. Regrowth rate after brushing on the 28th day was 0.032 plaque units per hour over a 24-hour period. The regrowth rate for the group brushing with dentifrice was 27% lower than for the group brushing without a dentifrice.

  6. Climatology: Contrails reduce daily temperature range

    NASA Astrophysics Data System (ADS)

    Travis, David J.; Carleton, Andrew M.; Lauritsen, Ryan G.

    2002-08-01

    The potential of condensation trails (contrails) from jet aircraft to affect regional-scale surface temperatures has been debated for years, but was difficult to verify until an opportunity arose as a result of the three-day grounding of all commercial aircraft in the United States in the aftermath of the terrorist attacks on 11 September 2001. Here we show that there was an anomalous increase in the average diurnal temperature range (that is, the difference between the daytime maximum and night-time minimum temperatures) for the period 11-14 September 2001. Because persisting contrails can reduce the transfer of both incoming solar and outgoing infrared radiation and so reduce the daily temperature range, we attribute at least a portion of this anomaly to the absence of contrails over this period.

  7. Estimation of daily micronutrient intake of Filipinos.

    PubMed

    Natera, Erlinda; Trinidad, Trinidad; Valdez, Divina; Kawamura, Hisao; Palad, Lorna; Shiraishi, Kunio

    2002-09-01

    The Fourth National Nutrition Survey of the Food and Nutrition Research Institute conducted in 1993 showed an increasing prevalence of micronutrient-related diseases in various age groups. Hence, the daily diet consumed by the average Filipino was examined for its nutrient content. A total of 19 regional diet samples were collected and analyzed for phosphorous, iron, zinc, magnesium, manganese, calcium, potassium, and sodium by using inductively coupled plasma atomic emission spectrometry (ICP-AES). Iodine was determined by inductively coupled plasma mass spectrometry (ICP-MS). Benchmark data for the abovementioned micronutrients showed decreased intake values as compared to the recommended dietary allowance established in 1989. The information will be useful in assessing the existing nutritional status so that appropriate nutrient interventions can possibly be put in place. PMID:12362801

  8. Ozone and daily mortality in Shanghai, China

    SciTech Connect

    Zhang, Y.H.; Huang, W.; London, S.J.; Song, G.X.; Chen, G.H.; Jiang, L.L.; Zhao, N.Q.; Chen, B.H.; Kan, H.D.

    2006-08-15

    Given the changes in types of air pollution from conventional coal combustion to the mixed coal combustion/motor vehicle emissions in China's large cities, it is worthwhile to investigate the acute effect of O{sub 3} on mortality outcomes in the country. We conducted a time-series study to investigate the relation between O{sub 3} and daily mortality in Shanghai using 4 years of daily data (2001-2004). O{sub 3} was found to be significantly associated with total and cardiovascular mortality in the cold season but not in the warm season. In the whole-year analysis, an increase of 10 pg/m{sup 3} of 2-day average O{sub 3} corresponds to 0.45% (95% confidence interval (CI), 0.16-0.73%), 0.53% (95% CI, 0.10-0.96%), and 0.35% (95% CI, -0.40 to 1.09%) increase of total nonaccidental, cardiovascular, and respiratory mortality, respectively. In the cold season, the estimates increased to 1.38% (95% CI , 0.68-2.07%), 1.53% (95% CI, 0.54-2.52%), and 0.95% (95% CI, -0.71 to 2.60%), respectively. In the warm season, we did not observe significant associations for both total and causespecific mortality. The results were generally insensitive to model specifications such as lag structure of O{sub 3} concentrations and degree of freedom for time trend. Multipoflutant models indicate that the effect of O{sub 3} was not confounded by particulate matter {<=} 10 {mu} m in diameter (PM10) or by sulfur dioxide; however, after adding nitrogen dioxide into the model, the association of O{sub 3} with total and cardiovascular mortality became statistically insignificant.

  9. Allergists: Daily Bath OK for Kids with Eczema

    MedlinePlus

    ... medlineplus.gov/news/fullstory_159633.html Allergists: Daily Bath OK for Kids With Eczema The key is ... Although some doctors advise against giving a daily bath to kids with the skin condition eczema, a ...

  10. Verification of factors to estimate daily milk yield from one milking of cows milked twice daily

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this research was to verify factors to predict daily milk yield when milk is sampled once per d for cows milked twice (2x) per d. Milk weights for both milkings were recorded automatically by 30 herds and collected by Dairy Herd Improvement supervisors. Data was split into 2 subsets...

  11. Ruminative self-focus in daily life: associations with daily activities and depressive symptoms.

    PubMed

    Takano, Keisuke; Sakamoto, Shinji; Tanno, Yoshihiko

    2013-08-01

    The present study examined the situations and conditions in which ruminative self-focus is less likely to occur in daily life. Previous researchers have described a mood-brightening effect of depression, where depressed individuals exhibit greater positive emotional reactivity to positive daily events than do nondepressed individuals. To better understand this paradoxical effect, we investigated the moderating role of depression in the relationship between daily activities and ruminative thinking. Forty-one Japanese undergraduates (9 women and 32 men) recorded their thought contents and the type and subjective appraisals of activities that they engaged in 8 times a day for a week at semirandom intervals. Multilevel modeling analyses indicated that subjectively pleasant activities were associated with improved mood states and reduced ruminative thinking. However, some of these associations were moderated by depressive symptoms, suggesting that individuals with higher levels of depression showed a greater reduction of ruminative thinking during pleasant activities. These results imply that daily activities are important for reducing rumination, particularly for individuals with higher levels of depression, and that the brightening effect of depression is evident for cognitive as well as emotional activities. The cognitive basis of this paradoxical effect is discussed. PMID:23527502

  12. Variations in daily quality assurance dosimetry from device levelling, feet position and backscatter material.

    PubMed

    Ceylan, Abdurrahman; Butson, Martin; Cullen, Ashley; Yu, Peter K N; Alnawaf, Hani

    2012-12-01

    Daily quality assurance procedures are an essential part of radiotherapy medical physics. Devices such as the Sun Nuclear, DQA3 are effective tools for analysis of daily dosimetry including flatness, symmetry, energy, field size and central axis radiation dose measurement. The DQA3 can be used on the treatment couch of the linear accelerator or on a dedicated table/bed for superficial and orthovoltage x-ray machines. This device is levelled using its dedicated feet. This work has shown that depending on the quantity of backscatter material behind the DQA3 device, the position of the levelling feet can affect the measured central axis dose by up to 1.8 % (250 kVp and 6 MV) and that the introduction of more backscatter material behind the DQA3 can lead to up to 7.2 % (6 MV) variations in measured central axis dose. In conditions where no backscatter material is present, dose measurements can vary up to 1 %. As such this work has highlighted the need to keep the material behind the DQA3 device constant as well as maintaining the accuracy of the feet position on the device to effectively measure the most accurate daily constancy achievable. Results have also shown that variations in symmetry and energy calculations of up to 1 % can occur if the device is not levelled appropriately. As such, we recommend the position of the levelling feet on the device be as close as possible to the device so that a constant distance is kept between the DQA3 and the treatment couch and thus minimal levelling variations also occur. We would also recommend having no extra backscattering material behind the DQA3 device during use to minimise any variations which might occur from these backscattering effects.

  13. Implications of chronic daily anti-oxidant administration on the inflammatory response to intracortical microelectrodes

    NASA Astrophysics Data System (ADS)

    Potter-Baker, Kelsey A.; Stewart, Wade G.; Tomaszewski, William H.; Wong, Chun T.; Meador, William D.; Ziats, Nicholas P.; Capadona, Jeffrey R.

    2015-08-01

    Objective. Oxidative stress events have been implicated to occur and facilitate multiple failure modes of intracortical microelectrodes. The goal of the present study was to evaluate the ability of a sustained concentration of an anti-oxidant and to reduce oxidative stress-mediated neurodegeneration for the application of intracortical microelectrodes. Approach. Non-functional microelectrodes were implanted into the cortex of male Sprague Dawley rats for up to sixteen weeks. Half of the animals received a daily intraperitoneal injection of the natural anti-oxidant resveratrol, at 30 mg kg-1. The study was designed to investigate the biodistribution of the resveratrol, and the effects on neuroinflammation/neuroprotection following device implantation. Main results. Daily maintenance of a sustained range of resveratrol throughout the implantation period resulted in fewer degenerating neurons in comparison to control animals at both two and sixteen weeks post implantation. Initial and chronic improvements in neuronal viability in resveratrol-dosed animals were correlated with significant reductions in local superoxide anion accumulation around the implanted device at two weeks after implantation. Controls, receiving only saline injections, were also found to have reduced amounts of accumulated superoxide anion locally and less neurodegeneration than controls at sixteen weeks post-implantation. Despite observed benefits, thread-like adhesions were found between the liver and diaphragm in resveratrol-dosed animals. Significance. Overall, our chronic daily anti-oxidant dosing scheme resulted in improvements in neuronal viability surrounding implanted microelectrodes, which could result in improved device performance. However, due to the discovery of thread-like adhesions, further work is still required to optimize a chronic anti-oxidant dosing regime for the application of intracortical microelectrodes.

  14. Implications of Chronic Daily Anti-Oxidant Administration on the Inflammatory Response to Intracortical Microelectrodes

    PubMed Central

    Potter-Baker, Kelsey A.; Stewart, Wade G.; Tomaszewski, William H.; Wong, Chun T.; Meador, William D.; Ziats, Nicholas P.; Capadona, Jeffrey R.

    2015-01-01

    Objective Oxidative stress events have been implicated to occur and facilitate multiple failure modes of intracortical microelectrodes. The goal of the present study was to evaluate the ability of a sustained concentration of an anti-oxidant and to reduce oxidative stress-mediated neurodegeneration for the application of intracortical microelectrodes. Approach Non-functional microelectrodes were implanted into the cortex of male Sprague Dawley rats for up to sixteen weeks. Half of the animals received a daily intraperitoneal injection of the natural anti-oxidant resveratrol, at 30 mg/kg. The study was designed to investigate the biodistribution of the resveratrol, and the effects on neuroinflammation/neuroprotection following device implantation. Main Results Daily maintenance of a sustained range of resveratrol throughout the implantation period resulted in fewer degenerating neurons in comparison to control animals at both two and sixteen weeks post implantation. Initial and chronic improvements in neuronal viability in resveratrol-dosed animals were correlated with significant reductions in local superoxide anion accumulation around the implanted device at two weeks after implantation. Controls, receiving only saline injections, were also found to have reduced amounts of accumulated superoxide anion locally and less neurodegeneration than controls at sixteen weeks post-implantation. Despite observed benefits, thread-like adhesions were found between the liver and diaphragm in resveratrol-dosed animals. Significance Overall, our chronic daily anti-oxidant dosing scheme resulted in improvements in neuronal viability surrounding implanted microelectrodes, which could result in improved device performance. However, due to the discovery of thread-like adhesions, further work is still required to optimize a chronic anti-oxidant dosing regime for the application of intracortical microelectrodes. PMID:26015427

  15. Use of Simulation to Study Nurses Acceptance and Non-Acceptance of Clinical Decision Support Suggestions

    PubMed Central

    Sousa, Vanessa E. C.; Lopez, Karen Dunn; Febretti, Alessandro; Stifter, Janet; Yao, Yingwei; Johnson, Andrew; Wilkie, Diana J.; Keenan, Gail M.

    2015-01-01

    Our long term goal is to ensure nurse clinical decision support (CDS) works as intended before full deployment in clinical practice. As part of a broader effort, this pilot explores factors influencing acceptance/non-acceptance of 8 CDS suggestions displayed through selecting a blinking red button in an electronic health record (EHR) based nursing plan of care software prototype. A diverse sample of 21 nurses participated in this high fidelity clinical simulation experience and completed a questionnaire to assess reasons for accepting/not accepting the CDS suggestions. Of 168 total suggestions displayed during the experiment (8 for each of the 21 nurses), 123 (73.2%) were accepted and 45 (26.8%) were not accepted. The mode number of acceptances by nurses was 7 of 8 with only 2 of 21 nurses accepting all. The main reason for CDS acceptance was the nurse’s belief that the suggestions were good for the patient (n=100%) with other features being secondarily reinforcing. Reasons for non-acceptance were less clear, with under half of the subjects indicating low confidence in the evidence. This study provides preliminary evidence that high quality simulation and targeted questionnaires about specific CDS selections offers a cost effective means for testing before full deployment in clinical practice. PMID:26361268

  16. Technical Basis For Radiological Acceptance Criteria For Uranium At The Y-12 National Security Complex

    SciTech Connect

    Veinot, K. G.

    2009-07-22

    The purpose of this report is to establish radiological acceptance criteria for uranium. Other factors for acceptance not considered include criticality safety concerns, contaminants to the process stream, and impacts to the Safety Basis for the affected facilities. Three types of criteria were developed in this report. They include limits on external penetrating and non-penetrating radiation and on the internal hazard associated with inhalation of the material. These criteria are intended to alleviate the need for any special controls beyond what are normally utilized for worker protection from uranium hazards. Any proposed exceptions would require case-by-case evaluations to determine cost impacts and feasibility. Since Y-12 has set rigorous ALARA goals for worker doses, the external limits are based on assumptions of work time involved in the movement of accepted material plus the desire that external doses normally received are not exceeded, and set so that no special personnel monitoring would be required. Internal hazard controls were established so that dose contributions from non-uranium nuclides would not exceed 10% of that expected from the uranium component. This was performed using a Hazard Index (HI) previously established for work in areas contaminated with non-uranium nuclides. The radiological acceptance criteria for uranium are summarized in Table 1. Note that these limits are based on the assumption that radioactive daughter products have reached equilibrium.

  17. 27 CFR 19.740 - Daily storage records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Daily storage records. 19..., DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Records and Reports Storage Account § 19.740 Daily storage records. (a) General. Proprietors shall maintain daily records in the storage...

  18. 27 CFR 19.736 - Daily production records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Daily production records..., DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Records and Reports Production Account § 19.736 Daily production records. (a) Spirits production. Each proprietor shall maintain daily...

  19. 19 CFR 159.35 - Certified daily rate.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.35 Certified daily rate. The daily buying rate of foreign currency which is determined by the Federal Reserve Bank of New York... 19 Customs Duties 2 2011-04-01 2011-04-01 false Certified daily rate. 159.35 Section...

  20. Racial Differences in Exposure and Reactivity to Daily Family Stressors

    ERIC Educational Resources Information Center

    Cichy, Kelly E.; Stawski, Robert S.; Almeida, David M.

    2012-01-01

    Using data from the National Study of Daily Experiences, the authors examined racial differences in exposure and reactivity to daily stressors involving family members. Respondents included African American and European American adults age 34 to 84 (N = 1,931) who participated in 8 days of daily interviews during which they reported on daily…