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Sample records for achieve long-term control

  1. Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry.

    PubMed

    Pessoa de Magalhães, Roberto J; Vidriales, María-Belén; Paiva, Bruno; Fernandez-Gimenez, Carlos; García-Sanz, Ramón; Mateos, Maria-Victoria; Gutierrez, Norma C; Lecrevisse, Quentin; Blanco, Juan F; Hernández, Jose; de las Heras, Natalia; Martinez-Lopez, Joaquin; Roig, Monica; Costa, Elaine Sobral; Ocio, Enrique M; Perez-Andres, Martin; Maiolino, Angelo; Nucci, Marcio; De La Rubia, Javier; Lahuerta, Juan-Jose; San-Miguel, Jesús F; Orfao, Alberto

    2013-01-01

    Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8(+) T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes

  2. Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry

    PubMed Central

    Pessoa de Magalhães, Roberto J.; Vidriales, María-Belén; Paiva, Bruno; Fernandez-Gimenez, Carlos; García-Sanz, Ramón; Mateos, Maria-Victoria; Gutierrez, Norma C.; Lecrevisse, Quentin; Blanco, Juan F; Hernández, Jose; de las Heras, Natalia; Martinez-Lopez, Joaquin; Roig, Monica; Costa, Elaine Sobral; Ocio, Enrique M.; Perez-Andres, Martin; Maiolino, Angelo; Nucci, Marcio; De La Rubia, Javier; Lahuerta, Juan-Jose; San-Miguel, Jesús F.; Orfao, Alberto

    2013-01-01

    Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8+ T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes

  3. Asthma Medicines: Long-Term Control

    MedlinePlus

    ... Español Text Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic ... and sprinkle forms are available for young children. Long-Acting Beta2-Agonists Medications in the beta 2 - ...

  4. Long-Term Learning, Achievement Tests, and Learner Centered Instruction

    ERIC Educational Resources Information Center

    Salinas, Moises F.; Kane-Johnson, Sarah E.; Vasil-Miller, Melissa A.

    2008-01-01

    The purpose of this study was to examine the effectiveness of achievement tests to measure long-term learning at the higher education level in traditional verses learner-centered classrooms. Volunteer instructors who use comprehensive achievement tests as an important component of their grading system were asked to complete an instrument that…

  5. Long-term control of root growth

    DOEpatents

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin.

  6. Long-term control of root growth

    SciTech Connect

    Burton, F.G.; Cataldo, D.A.; Cline, J.F.; Skiens, W.E.

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin. 7 figs.

  7. Scotopic sensitivity/Irlen syndrome and the use of coloured filters: a long-term placebo controlled and masked study of reading achievement and perception of ability.

    PubMed

    Robinson, G L; Foreman, P J

    1999-08-01

    This study investigated the effects of using coloured filters on reading speed, accuracy, and comprehension as well as on perception of academic ability. A double-masked, placebo-controlled crossover design was used, with subjects being assessed over a period of 20 mo. There were three treatment groups (Placebo filters, Blue filters, and Optimal filters) involving 113 subjects with "reading difficulties", ranging in age from 9.2 yr. to 13.1 yr. and with an average discrepancy between chronological age and reading age of 1.8 yr. The 35 controls (who did not use coloured filters) ranged in age from 9.4 yr. to 12.9 yr., with an average discrepancy between chronological age and reading age of 2.1 yr. The treatment groups increased at a significantly greater rate than the control group in reading accuracy and reading comprehension but not for speed of reading. For self-reported perception of academic ability, two of the three treatment groups showed significantly greater increases than the control group. The larger improvements for treatment groups in reading comprehension may be related to a reduction in print and background distortions allowing attention to be directed to the processing of continuous text rather than to the identification of individual words. A reduction in print distortion, however, may not be sufficient to generate improved word-identification skills without additional remedial support, and this may be indicated by the nonsignificant increase in rate of reading. PMID:10544403

  8. Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma.

    PubMed

    Ducharme, Francine M; Lamontagne, Alexandrine J; Blais, Lucie; Grad, Roland; Lavoie, Kim L; Bacon, Simon L; McKinney, Martha L; Desplats, Eve; Ernst, Pierre

    2016-01-01

    Objective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child and endorsement of enablers to prescribe long-term controllers. Results. With a 56% participation rate, 421 physicians participated. Most (86%) would prescribe a long-term controller (predominantly inhaled corticosteroids, ICS) to the patient in their clinical vignette. Determinants of intention were the recognition of persistent symptoms (OR 2.67), goal of achieving long-term control (OR 5.31), and high comfort level in initiating long-term ICS (OR 2.33). Decision tools, pharmacy reports, reminders, and specific training were strongly endorsed by ≥60% physicians to support optimal management. Physicians strongly endorsed asthma education, lung function testing, specialist opinion, accessible asthma clinic, and paramedical healthcare professionals to guide patients, as enablers to improve patient adherence to and physicians' comfort with long-term ICS. Interpretation. Tools and training to improve physician knowledge, skills, and perception towards long-term ICS and resources that increase patient adherence and physician comfort to facilitate long-term ICS prescription should be considered as targets for implementation. PMID:27445537

  9. Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma

    PubMed Central

    McKinney, Martha L.; Desplats, Eve; Ernst, Pierre

    2016-01-01

    Objective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child and endorsement of enablers to prescribe long-term controllers. Results. With a 56% participation rate, 421 physicians participated. Most (86%) would prescribe a long-term controller (predominantly inhaled corticosteroids, ICS) to the patient in their clinical vignette. Determinants of intention were the recognition of persistent symptoms (OR 2.67), goal of achieving long-term control (OR 5.31), and high comfort level in initiating long-term ICS (OR 2.33). Decision tools, pharmacy reports, reminders, and specific training were strongly endorsed by ≥60% physicians to support optimal management. Physicians strongly endorsed asthma education, lung function testing, specialist opinion, accessible asthma clinic, and paramedical healthcare professionals to guide patients, as enablers to improve patient adherence to and physicians' comfort with long-term ICS. Interpretation. Tools and training to improve physician knowledge, skills, and perception towards long-term ICS and resources that increase patient adherence and physician comfort to facilitate long-term ICS prescription should be considered as targets for implementation. PMID:27445537

  10. [Long-term pediatric opioid based pain control. Case reports].

    PubMed

    Zernikow, B; Schiessl, C; Wamsler, C; Griessinger, N; Sittl, R

    2005-10-01

    Based on 4 case reports we focus on the peculiarities of long-term pediatric opioid based pain control. Case report #1, emphasizing the importance of adequate opioid dosing with reference to body weight, illustrates that with adequate management oral sustained-release opioid therapy is safe even in infants less than one year old. Case report #2 is the first report on the usage of buccal fentanyl citrate for pediatric break-through pain control. Case report #3 focuses on the adverse effects of opioid pain control in an infant with neurological impairment. Case report #4 reports on the successful tumor pain control using transdermal buprenorphine. We conclude that proven therapeutic strategies for opioid pain control as applied in adults may be adopted for the usage on children in pediatrics. However, it is mandatory to take into account both the pharmacokinetic and pharmacodynamic peculiarities of childhood. PMID:16080016

  11. Predicting Long-Term Growth in Students' Mathematics Achievement: The Unique Contributions of Motivation and Cognitive Strategies

    ERIC Educational Resources Information Center

    Murayama, Kou; Pekrun, Reinhard; Lichtenfeld, Stephanie; vom Hofe, Rudolf

    2013-01-01

    This research examined how motivation (perceived control, intrinsic motivation, and extrinsic motivation), cognitive learning strategies (deep and surface strategies), and intelligence jointly predict long-term growth in students' mathematics achievement over 5 years. Using longitudinal data from six annual waves (Grades 5 through 10;…

  12. Long-Term Antecedents and Outcomes of Perceived Control

    PubMed Central

    Infurna, Frank J.; Gerstorf, Denis; Ram, Nilam; Schupp, Jürgen; Wagner, Gert G.

    2012-01-01

    Perceived control plays an important role in shaping development throughout adulthood and old age. Using data from the adult lifespan sample of the national German Socio-Economic Panel (SOEP; N > 10,000, covering 25 years of measurement), we explored long-term antecedents, correlates, and outcomes of perceived control and examined if associations differ with age. Targeting correlates and antecedents of control, findings indicated that higher concurrent levels of social participation, life satisfaction, and self-rated health as well as more positive changes in social participation over the preceding 11 years were each predictive of between-person differences in perceived control. Targeting health outcomes of control, survival analyses revealed that perceived control predicted 14-year hazard rates for disability (n = 996 became disabled) and mortality (n = 1,382 died). The effect for mortality, but not for disability, was independent of socio-demographic and psychosocial factors. Overall, we found very limited support for age-differential associations. Our results provide further impetus to thoroughly examine processes involved in antecedent-consequent relations among perceived control, facets of social life, well-being, and health. PMID:21517184

  13. Long-term litter decomposition controlled by manganese redox cycling

    PubMed Central

    Keiluweit, Marco; Nico, Peter; Harmon, Mark E.; Mao, Jingdong; Pett-Ridge, Jennifer; Kleber, Markus

    2015-01-01

    Litter decomposition is a keystone ecosystem process impacting nutrient cycling and productivity, soil properties, and the terrestrial carbon (C) balance, but the factors regulating decomposition rate are still poorly understood. Traditional models assume that the rate is controlled by litter quality, relying on parameters such as lignin content as predictors. However, a strong correlation has been observed between the manganese (Mn) content of litter and decomposition rates across a variety of forest ecosystems. Here, we show that long-term litter decomposition in forest ecosystems is tightly coupled to Mn redox cycling. Over 7 years of litter decomposition, microbial transformation of litter was paralleled by variations in Mn oxidation state and concentration. A detailed chemical imaging analysis of the litter revealed that fungi recruit and redistribute unreactive Mn2+ provided by fresh plant litter to produce oxidative Mn3+ species at sites of active decay, with Mn eventually accumulating as insoluble Mn3+/4+ oxides. Formation of reactive Mn3+ species coincided with the generation of aromatic oxidation products, providing direct proof of the previously posited role of Mn3+-based oxidizers in the breakdown of litter. Our results suggest that the litter-decomposing machinery at our coniferous forest site depends on the ability of plants and microbes to supply, accumulate, and regenerate short-lived Mn3+ species in the litter layer. This observation indicates that biogeochemical constraints on bioavailability, mobility, and reactivity of Mn in the plant–soil system may have a profound impact on litter decomposition rates. PMID:26372954

  14. Long-term litter decomposition controlled by manganese redox cycling.

    PubMed

    Keiluweit, Marco; Nico, Peter; Harmon, Mark E; Mao, Jingdong; Pett-Ridge, Jennifer; Kleber, Markus

    2015-09-22

    Litter decomposition is a keystone ecosystem process impacting nutrient cycling and productivity, soil properties, and the terrestrial carbon (C) balance, but the factors regulating decomposition rate are still poorly understood. Traditional models assume that the rate is controlled by litter quality, relying on parameters such as lignin content as predictors. However, a strong correlation has been observed between the manganese (Mn) content of litter and decomposition rates across a variety of forest ecosystems. Here, we show that long-term litter decomposition in forest ecosystems is tightly coupled to Mn redox cycling. Over 7 years of litter decomposition, microbial transformation of litter was paralleled by variations in Mn oxidation state and concentration. A detailed chemical imaging analysis of the litter revealed that fungi recruit and redistribute unreactive Mn(2+) provided by fresh plant litter to produce oxidative Mn(3+) species at sites of active decay, with Mn eventually accumulating as insoluble Mn(3+/4+) oxides. Formation of reactive Mn(3+) species coincided with the generation of aromatic oxidation products, providing direct proof of the previously posited role of Mn(3+)-based oxidizers in the breakdown of litter. Our results suggest that the litter-decomposing machinery at our coniferous forest site depends on the ability of plants and microbes to supply, accumulate, and regenerate short-lived Mn(3+) species in the litter layer. This observation indicates that biogeochemical constraints on bioavailability, mobility, and reactivity of Mn in the plant-soil system may have a profound impact on litter decomposition rates. PMID:26372954

  15. Infection Control in the Long Term Care Facility.

    ERIC Educational Resources Information Center

    Morris, Sara

    This booklet is intended to increase the awareness of persons working in long-term care facilities regarding the danger of infectious disease and the ways in which it can be spread. Materials in this booklet include: (1) a brief discussion of historical events in the study of microorganisms; (2) information about how microorganisms cause infection…

  16. Long-term behaviour of timber structures in torrent control

    NASA Astrophysics Data System (ADS)

    Rickli, Christian; Graf, Frank

    2014-05-01

    Timber is widely used for protection measures in torrent control. However, life span of woody constructions such as timber check dams is limited due to fungal decay. However, only sparse scientific information is available on the long-term behaviour of timber structures and the colonisation with decay fungi. Related to this, in practice a controversial discussion has been going on if either Norway Spruce (Picea abies) or Silver Fir (Abies alba) is more enduring and if bark removal increases resistance against fungal decay. In order to going into this matter a series of 15 timber check dams built in 1996 has been monitored. The constructions were alternatively realised with Norway Spruce and Silver Fir, half of them each with remaining and removed bark, respectively. The scientific investigations included the documentation of colonisation with rot fungi and the identification of decayed zones with a simple practical approach as well as based on drilling resistance. Colonisation by decay fungi started three years after construction (e.g. Gloeophyllum sepiarium), detecting two years later first parts with reduced wood resistance. Sixteen years after construction decay was found on all check dams but two. Wood quality was markedly better in watered sections compared to the occasionally dry lateral abutment sections. Taking the whole check dams into consideration, slightly more decay was detected in Norway Spruce compared to logs in Silver Fir and both the practical approach and the drilling resistance measurement yielded in more defects on logs without bark. However, due to limited number of replications and fungal data, it was not possible to statistically verify these results. Statistical analysis was restricted to the drilling resistance data and fruit-bodies of decay fungi of the uppermost log of each check dam. Based on this limited analysis significant differences in the effect on the drilling resistance were found for watered sections and lateral abutments

  17. Automatic lighting controls demonstration: Long-term results

    SciTech Connect

    Rubinstein, F. )

    1991-10-18

    An advanced electronically ballasted lighting control system was installed in a portion of an office building to measure the energy and demand savings. The lighting control system used an integrated lighting control scenario that included daylight following, lumen depreciation correction, and scheduling. The system reduced lighting energy on weekdays by 62% and 51% in the north and south daylit zones, respectively, compared to a reference zone that did not have controls. During the summer, over 75% energy savings were achieved on weekdays in the north daylit zone. Even in the south interior zone, which benefitted lime from daylight, correction strategies and adjustment of the aisleway lights to a low level resulted in energy use of only half that of the reference zone. Although, in general, the savings varied over the year due to changing daylight conditions, the energy reduction achieved with controls could be fit using a simple analytical model. Significant savings also occurred during core operating hours when it is more expensive to supply and use energy. Compared to the usage in the reference zone, energy reductions of 49%, 44%, and 62% were measured in the south daylight, south interior, and north daylight zones, respectively, during core operating hours throughout the year. Lighting energy usage on weekends decreased dramatically in the zones with controls, with the usage in the north daylit zone only 10% that of the reference zone. A simple survey developed to assess occupant response to the lighting control system showed that the occupants were satisfied with the light levels provided.

  18. Preterm Birth, Age at School Entry and Long Term Educational Achievement

    PubMed Central

    Odd, David; Evans, David; Emond, Alan

    2016-01-01

    Objective To investigate if the detrimental impact of year of entering education in preterm infants persists into adolescence. Background Preterm infants are often enrolled in school a year earlier than would be expected if this decision is based on their actual date of birth rather than their due date. Initially these infants appear to do disproportionately worse than those who do not ‘skip’ a year. However, it is unclear if this effect remains as the infants grow, to have an important effect on long term achievements in education. Design A cohort study, drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC). The exposure measurement was gestational age (defined as preterm (<37 weeks gestation) or term (37–42 weeks)). The primary outcome was a low score at the Key Stage 4 (KS4) educational assessment or receiving special educational needs support (both at age 16). We derived conditional regression models matching preterm to term infants on their date of birth (DOB), their expected date of delivery (EDD), or their expected date of delivery and year of school entry. Results After matching for DOB, preterm infants had an increased odds of SEN (OR 1.57 (1.33–1.86)) and the association remained after adjusting for potential confounders (OR 1.39 (1.14–1.68)). The association remained in the analysis matching for EDD (fully adjusted OR 1.43 (1.17–1.74)) but attenuated after restricting to those infants who were enrolled in school in the same year as the control infants (fully adjusted OR 1.21 (0.97–1.52)). There was less evidence for an impact of prematurity on the KS4 score (Matched for DOB; OR 1.10 (0.91 to 1.34), matched for EDD OR 1.17 (0.96 to 1.42) and EDD and same year of schooling, OR 1.00 (0.80 to 1.26)). Conclusions This modifiable effect of going to school a year earlier than predicted by their due date appears to have measurable consequences for ex-preterm infants in adolescence and is likely to limit adulthood opportunities

  19. Alcohol liver disease: A review of current therapeutic approaches to achieve long-term abstinence

    PubMed Central

    García, María Luisa Gutiérrez; Blasco-Algora, Sara; Fernández-Rodríguez, Conrado M

    2015-01-01

    Harmful alcohol drinking may lead to significant damage on any organ or system of the body. Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. In ALD, only alcohol abstinence was associated with a better long-term survival. Therefore, current effective therapeutic strategy should be oriented towards achieving alcohol abstinence or a significant reduction in alcohol consumption. Screening all primary care patients to detect those cases with alcohol abuse has been proposed as population-wide preventive intervention in primary care. It has been suggested that in patients with mild alcohol use disorder the best approach is brief intervention in the primary care setting with the ultimate goal being abstinence, whereas patients with moderate-to-severe alcohol use disorder must be referred to specialized care where detoxification and medical treatment of alcohol dependence must be undertaken. PMID:26229395

  20. Alcohol liver disease: A review of current therapeutic approaches to achieve long-term abstinence.

    PubMed

    García, María Luisa Gutiérrez; Blasco-Algora, Sara; Fernández-Rodríguez, Conrado M

    2015-07-28

    Harmful alcohol drinking may lead to significant damage on any organ or system of the body. Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. In ALD, only alcohol abstinence was associated with a better long-term survival. Therefore, current effective therapeutic strategy should be oriented towards achieving alcohol abstinence or a significant reduction in alcohol consumption. Screening all primary care patients to detect those cases with alcohol abuse has been proposed as population-wide preventive intervention in primary care. It has been suggested that in patients with mild alcohol use disorder the best approach is brief intervention in the primary care setting with the ultimate goal being abstinence, whereas patients with moderate-to-severe alcohol use disorder must be referred to specialized care where detoxification and medical treatment of alcohol dependence must be undertaken. PMID:26229395

  1. Risk Assessment and Control through Countermeasure System Iplementation for Long-term Crew Exposure to Microgravity

    NASA Technical Reports Server (NTRS)

    Gernand, Jeremy M.

    2004-01-01

    Experience with the International Space Station (ISS) program demonstrates the degree to which engineering design and operational solutions must protect crewmembers from health risks due to long-term exposure to the microgravity environment. Risks to safety and health due to degradation in the microgravity environment include crew inability to complete emergency or nominal activities, increased risk of injury, and inability to complete safe return to the ground due to reduced strength or embrittled bones. These risks without controls slowly increase in probability for the length of the mission and become more significant for increasing mission durations. Countermeasures to microgravity include hardware systems that place a crewmember s body under elevated stress to produce an effect similar to daily exposure to gravity. The ISS countermeasure system is predominately composed of customized exercise machines. Historical treatment of microgravity countermeasure systems as medical research experiments unintentionally reduced the foreseen importance and therefore the capability of the systems to function in a long-term operational role. Long-term hazardous effects and steadily increasing operational risks due to non-functional countermeasure equipment require a more rigorous design approach and incorporation of redundancy into seemingly non- mission-critical hardware systems. Variations in the rate of health degradation and responsiveness to countermeasures among the crew population drastically increase the challenge for design requirements development and verification of the appropriate risk control strategy. The long-term nature of the hazards and severe limits on logistical re-supply mass, volume and frequency complicates assessment of hardware availability and verification of an adequate maintenance and sparing plan. Design achievement of medically defined performance requirements by microgravity countermeasure systems and incorporation of adequate failure tolerance

  2. Hepatoblastoma in childhood, long term survival achieved: 2 case reports and literature review

    PubMed Central

    El Asmar, Antoine; El Rassi, Ziad

    2016-01-01

    Introduction Hepatoblastoma is the most common primary liver tumor for children under 5 years of age. It usually presents as an abdominal mass, symptomatic only when large enough to cause mass effect on nearby organs. Symptoms such as early satiety, anorexia, abdominal pain or weight loss are the most common. Diagnosis depends on imaging studies, AFP levels and percutaneous biopsy. Treatment modality is usually surgical with neoadjuvant chemotherapy. Cases In this article, we present 2 cases of hepatoblastoma treated 15 years ago by neoadjuvant chemotherapy and surgery, and are presenting for long term follow-up with complete disease remission. Discussion Complete resection and remission can be achieved as demonstrated below by our 2 cases of hepatoblastoma, especially when performing a true anatomical hepatectomy, along with a neoadjuvant chemotherapy regimen. Although one of the cases did not respond to chemotherapy very well a complete resection was achieved and therefore a disease free survival of 15 years. Conclusion Hepatoblastoma are rare tumors of the pediatric age group. Management depends highly on combined surgical and pediatric oncological knowledge. A complete disease remission can be achieved when both modalities are treatment are optimal. Therefore, hepatoblastoma cases should be referred to specialized centers for management. PMID:26942331

  3. Realising the Real Benefits of Outsourcing: Measurement Excellence and Its Importance in Achieving Long Term Value

    NASA Astrophysics Data System (ADS)

    Oshri, Ilan; Kotlarsky, Julia

    These days firms are, more than ever, pressed to demonstrate returns on their investment in outsourcing. While the initial returns can always be associated with one-off cost cutting, outsourcing arrangements are complex, often involving inter-related high-value activities, which makes the realisation of long-term benefits from outsourcing ever more challenging. Executives in client firms are no longer satisfied with the same level of service delivery through the outsourcing lifecycle. They seek to achieve business transformation and innovation in their present and future services, beyond satisfying service level agreements (SLAs). Clearly the business world is facing a new challenge: an outsourcing delivery system of high-value activities that demonstrates value over time and across business functions. However, despite such expectations, many client firms are in the dark when trying to measure and quantify the return on outsourcing investments: results of this research show that less than half of all CIOs and CFOs (43%) have attempted to calculate the financial impact of outsourcing to their bottom line, indicating that the financial benefits are difficult to quantify (51%).

  4. LONG-TERM EVALUATION OF REGIONAL EROSION CONTROL

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Under legislation passed in 1984, three federal agencies constructed more than $300 million worth of channel erosion control measures in 16 watersheds in northern Mississippi between 1985 and 2003. Most work was completed between 1985 and 1995, and was confined to six larger watersheds. Flows of w...

  5. Motivation, self-determination, and long-term weight control

    PubMed Central

    2012-01-01

    This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation - not only considering the level but also type of motivation - in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change. PMID:22385818

  6. Juxtaposing Math Self-Efficacy and Self-Concept as Predictors of Long-Term Achievement Outcomes

    ERIC Educational Resources Information Center

    Parker, Philip David; Marsh, Herbert W.; Ciarrochi, Joseph; Marshall, Sarah; Abduljabbar, Adel Salah

    2014-01-01

    In this study, we tested the hypothesis that self-efficacy and self-concept reflect different underlying processes and both are critical to understanding long-term achievement outcomes. Although both types of self-belief are well established in educational psychology, research comparing and contrasting their relationship with achievement has been…

  7. A long-term experimental case study of the ecological effectiveness and cost effectiveness of invasive plant management in achieving conservation goals: bitou bush control in booderee national park in eastern australia.

    PubMed

    Lindenmayer, David B; Wood, Jeff; MacGregor, Christopher; Buckley, Yvonne M; Dexter, Nicholas; Fortescue, Martin; Hobbs, Richard J; Catford, Jane A

    2015-01-01

    Invasive plant management is often justified in terms of conservation goals, yet progress is rarely assessed against these broader goals, instead focussing on short-term reductions of the invader as a measure of success. Key questions commonly remain unanswered including whether invader removal reverses invader impacts and whether management itself has negative ecosystem impacts. We addressed these knowledge gaps using a seven year experimental investigation of Bitou Bush, Chrysanthemoides monilifera subsp. rotundata. Our case study took advantage of the realities of applied management interventions for Bitou Bush to assess whether it is a driver or passenger of environmental change, and quantified conservation benefits relative to management costs of different treatment regimes. Among treatments examined, spraying with herbicide followed by burning and subsequent re-spraying (spray-fire-spray) proved the most effective for reducing the number of individuals and cover of Bitou Bush. Other treatment regimes (e.g. fire followed by spraying, or two fires in succession) were less effective or even exacerbated Bitou Bush invasion. The spray-fire-spray regime did not increase susceptibility of treated areas to re-invasion by Bitou Bush or other exotic species. This regime significantly reduced plant species richness and cover, but these effects were short-lived. The spray-fire-spray regime was the most cost-effective approach to controlling a highly invasive species and facilitating restoration of native plant species richness to levels characteristic of uninvaded sites. We provide a decision tree to guide management, where recommended actions depend on the outcome of post-treatment monitoring and performance against objectives. Critical to success is avoiding partial treatments and treatment sequences that may exacerbate invasive species impacts. We also show the value of taking advantage of unplanned events, such as wildfires, to achieve management objectives at

  8. A Long-Term Experimental Case Study of the Ecological Effectiveness and Cost Effectiveness of Invasive Plant Management in Achieving Conservation Goals: Bitou Bush Control in Booderee National Park in Eastern Australia

    PubMed Central

    Lindenmayer, David B.; Wood, Jeff; MacGregor, Christopher; Buckley, Yvonne M.; Dexter, Nicholas; Fortescue, Martin; Hobbs, Richard J.; Catford, Jane A.

    2015-01-01

    Invasive plant management is often justified in terms of conservation goals, yet progress is rarely assessed against these broader goals, instead focussing on short-term reductions of the invader as a measure of success. Key questions commonly remain unanswered including whether invader removal reverses invader impacts and whether management itself has negative ecosystem impacts. We addressed these knowledge gaps using a seven year experimental investigation of Bitou Bush, Chrysanthemoides monilifera subsp. rotundata. Our case study took advantage of the realities of applied management interventions for Bitou Bush to assess whether it is a driver or passenger of environmental change, and quantified conservation benefits relative to management costs of different treatment regimes. Among treatments examined, spraying with herbicide followed by burning and subsequent re-spraying (spray-fire-spray) proved the most effective for reducing the number of individuals and cover of Bitou Bush. Other treatment regimes (e.g. fire followed by spraying, or two fires in succession) were less effective or even exacerbated Bitou Bush invasion. The spray-fire-spray regime did not increase susceptibility of treated areas to re-invasion by Bitou Bush or other exotic species. This regime significantly reduced plant species richness and cover, but these effects were short-lived. The spray-fire-spray regime was the most cost-effective approach to controlling a highly invasive species and facilitating restoration of native plant species richness to levels characteristic of uninvaded sites. We provide a decision tree to guide management, where recommended actions depend on the outcome of post-treatment monitoring and performance against objectives. Critical to success is avoiding partial treatments and treatment sequences that may exacerbate invasive species impacts. We also show the value of taking advantage of unplanned events, such as wildfires, to achieve management objectives at

  9. Learner-Centered Inquiry in Undergraduate Biology: Positive Relationships with Long-Term Student Achievement

    ERIC Educational Resources Information Center

    Derting, Terry L.; Ebert-May, Diane

    2010-01-01

    We determined short- and long-term correlates of a revised introductory biology curriculum on understanding of biology as a process of inquiry and learning of content. In the original curriculum students completed two traditional lecture-based introductory courses. In the revised curriculum students completed two new learner-centered,…

  10. Focusing on Short-Term Achievement Gains Fails to Produce Long-Term Gains

    ERIC Educational Resources Information Center

    Grissmer, David W.; Ober, David R.; Beekman, John A.

    2014-01-01

    The short-term emphasis engendered by No Child Left Behind (NCLB) has focused research predominantly on unraveling the complexities and uncertainties in assessing short-term results, rather than developing methods and assessing results over the longer term. In this paper we focus on estimating long-term gains and address questions important to…

  11. Therapeutic control of plasma concentrations and long-term effect of nortriptyline in recurrent affective disorders.

    PubMed

    Kragh-Sørensen; Hansen, C E; Baastrup, P C; Hvidberg, E F

    1976-07-01

    Based on the evidence that therapeutic plasma concentration range in fact exists for the tricyclic antidepressant drug, Nortriptyline (range 50-150 ng/ml), three different investigations were under taken in order to clarify some clinical pharmacological problems during long-term treatment with this drug. The possible prophlactic effect of the drug in recurrent affective disorders was specially examined in a group of patients with a high risk of episodes in their unipolar manic-depressive disease. The results highly demonstrate the value of monitoring plasma levels in achieving therapeutic control. Depressive relapses during treatment, for months and years, were only related to therapeutic insufficient plasma levels of the drug. PMID:981330

  12. Physically Developed and Exploratory Young Infants Contribute to Their Own Long-Term Academic Achievement

    PubMed Central

    Bornstein, Marc H.; Hahn, Chun-Shin; Suwalsky, Joan T. D.

    2014-01-01

    A developmental cascade defines a longitudinal relation in which one psychological characteristic uniquely affects another psychological characteristic later in time, separately from other intrapersonal and extrapersonal factors. Here, we report results of a large-scale (N = 374), normative, prospective, 14-year longitudinal, multivariate, multisource, controlled study of a developmental cascade from infant motor-exploratory competence at 5 months to adolescent academic achievement at 14 years, through conceptually related and age-appropriate measures of psychometric intelligence at 4 and 10 years and academic achievement at 10 years. This developmental cascade applied equally to girls and boys and was independent of children’s behavioral adjustment and social competence; mothers’ supportive caregiving, verbal intelligence, education, and parenting knowledge; and the material home environment. Infants who were more motorically mature and who explored more actively at 5 months of age achieved higher academic levels as 14-year-olds. PMID:23964000

  13. Achieving high quality long-term care for elderly people: consumers' wishes and providers' responsibilities.

    PubMed

    Morse, R; Jenkinson, D

    1995-01-01

    The organisation of long-term care for older people has major implications for all hospital and community health services. However, even health professionals have a poor understanding of the structure and purpose of long-term care and national professional bodies are still not giving enough attention to the issues involved. In the wider context, care of disabled older people has received little public debate in the UK despite the ethical, social, and financial issues involved and despite the recent major organisational changes in the health service. The past ten years have seen a huge expansion in private residential and nursing homes with a concomitant fall in NHS long-stay beds. Currently, approximately 500,000 elderly people in the UK are living in some form of long-stay care facility, and many other elderly people with multiple disabilities are being supported at home and should also be included under the umbrella of long-term care. Ensuring appropriate, equitable, and high-quality care is a responsibility not only for health and social services but also for society as a whole. This conference, organised jointly by the Royal College of Physicians, the British Geriatrics Society, and Age Concern England, with support from the Department of Health, was a much-needed and welcomed initiative. Over 200 delegates attended, consisting of doctors (geriatricians, psychiatrists, general practitioners), nurses (public and private sector), social services representatives, Department of Health representatives, managers of nursing homes, and members of charities such as Age Concern and the Relatives Association. PMID:7658422

  14. Learner-Centered Inquiry in Undergraduate Biology: Positive Relationships with Long-Term Student Achievement

    PubMed Central

    Ebert-May, Diane

    2010-01-01

    We determined short- and long-term correlates of a revised introductory biology curriculum on understanding of biology as a process of inquiry and learning of content. In the original curriculum students completed two traditional lecture-based introductory courses. In the revised curriculum students completed two new learner-centered, inquiry-based courses. The new courses differed significantly from those of the original curriculum through emphases on critical thinking, collaborative work, and/or inquiry-based activities. Assessments were administered to compare student understanding of the process of biological science and content knowledge in the two curricula. More seniors who completed the revised curriculum had high-level profiles on the Views About Science Survey for Biology compared with seniors who completed the original curriculum. Also as seniors, students who completed the revised curriculum scored higher on the standardized Biology Field Test. Our results showed that an intense inquiry-based learner-centered learning experience early in the biology curriculum was associated with long-term improvements in learning. We propose that students learned to learn science in the new courses which, in turn, influenced their learning in subsequent courses. Studies that determine causal effects of learner-centered inquiry-based approaches, rather than correlative relationships, are needed to test our proposed explanation. PMID:21123693

  15. Rapid, simple, and cost-effective treatments to achieve long-term hydrophilic PDMS surfaces

    NASA Astrophysics Data System (ADS)

    Hemmilä, Samu; Cauich-Rodríguez, Juan V.; Kreutzer, Joose; Kallio, Pasi

    2012-10-01

    This paper describes rapid, simple, and cost-effective treatments for producing biocompatible and long-term hydrophilic polydimethylsiloxane (PDMS) surfaces identified in an experimental study investigating 39 treatments in all. The wetting of the surfaces was monitored during six months. Changes in surface morphology and chemical composition were also analyzed. Some of the treatments are presented here for the first time, while for earlier presented treatments the selection of investigated parameters was wider and the observation period for the surface wetting longer. The PDMS surfaces were modified by surface activation, physisorption, and synthesis of both “grafting to” and “grafting from” polymer brushes. In surface activation, the PDMS sample was exposed to oxygen plasma, with several combinations of exposure time and RF power. In the physisorption and synthesis of polymer brushes, three commercially available and biocompatible chemicals were used: 2-hydroxyethyl methacrylate (HEMA), polyethylene glycol (PEG), and polyvinylpyrrolidone (PVP). Thirty-three of the 39 treatments rendered the PDMS hydrophilic, and in 12 cases the hydrophilicity lasted at least six months. Seven of these long-term hydrophilic coatings supported a contact angle of 30° or less. Three of the long-lasting hydrophilic coatings required only minutes to prepare.

  16. Lyapunov Redesign of Model Reference Adaptive Control System for long term ventilation of lung.

    PubMed

    Woo, J; Rootenberg, J

    1975-01-01

    A lyapunov redesign of Model reference adaptive control system for a long term, automatically regulated, ventilatory system is presented. A fixed resistance-capacitance RC analog lung model is used to generate a desirable (reference response) alveolar pressure. The instantaneous difference in alveolar pressures between the patient and its model is fed to an adaptive controller. The controller is designed to adjust the patient's inflating pressure in such a way as to reduce the instantaneous difference in the alveolar pressures to zero. The adaptive control system described can be implemented provided the patient's alveolar pressure is continuously measurable. Unfortunately, this measurement is impossible to realize; therefore, a method to estimate the continuous alveolar pressure of the patient is to be developed. This estimation is achieved indirectly from the identification process of the patient's respiratory parameter. The same Lyapunov redesign is used in this identification process. Digital simulation of the control of the patient's inflating pressure and the identification process, as well as the simulation of the combined system, were performed. The result has demonstrated the ability of this adaptive system to perform in a fast and stable manner. PMID:1184357

  17. Long-term stability of GOES-8 and -9 attitude control

    NASA Astrophysics Data System (ADS)

    Carr, James L.

    1996-10-01

    An independent audit of the in-orbit behavior of the GOES-8 and GOES-9 satellites has been conducted for the NASA/GSFC. This audit utilized star and landmark observations from the GOES imager to determine long-term histories for spacecraft attitude, orbital position, and instrument internal misalignments. The paper presents results from this audit. Long-term drifts are found in the attitude histories, whereas the misalignment histories are shown to be diurnally stable. The GOES image navigation and registration system is designed to compensate for instrument internal misalignments, and both the diurnally repeatable and drift components of the attitude. Correlations between GOES-8 and GOES-9 long-term roll and pitch drifts implicate the Earth sensor as the origin of these observed drifts. This results clearly demonstrates the enhanced registration stability to be obtained with stellar inertial attitude determination replacing or supplementing Earth sensor control on future GOES missions.

  18. Long-Term Effectiveness of the Response Restriction Method for Establishing Diurnal Bladder Control

    ERIC Educational Resources Information Center

    van Oorsouw, Wietske M. W. J.; Duker, P. C.; Melein, L.; Averink, M.

    2009-01-01

    The long-term effectiveness of the response restriction method for establishing diurnal bladder control was assessed with 48 participants with intellectual disabilities. Intervals of assessment ranged from 28 to 66 months across the individuals following initial baseline. Difference scores in terms of the mean number of toileting accidents per…

  19. Restoring Competitors and Natural Enemies for Long-Term Control of Plant Invaders

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Addressing the underlying causes of rangeland weed invasion is key to long-term, affordable control. Among the most important causes are insufficient competition from native species, often due to disturbance, and a lack of insects and diseases from invasive species’ native ranges. Restoration of slo...

  20. 75 FR 13559 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Long Term...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and... Cytomegalovirus (CMV) Infection, Funding Opportunity Announcement (FOA) IP10-006, Initial Review In accordance... in response to ``Long Term Outcomes of Infants Identified with Congenital CMV Infection, FOA...

  1. Examining the Long-Term Impact of Achievement Loss during the Transition to High School

    ERIC Educational Resources Information Center

    Smith, Joshua S.

    2006-01-01

    Research shows that prior academic achievement is a strong predictor of future academic performance. For some students, the transition from one educational environment to another is associated with academic challenges and achievement loss. This study examined the extent to which achievement loss during the transition from middle school to high…

  2. Long-Term Follow Up of CSRP: Understanding Students' Academic Achievement Post-Treatment

    ERIC Educational Resources Information Center

    Lennon, Jaclyn M.; Li-Grining, Christine; Raver, C. Cybele; Pess, Rachel A.

    2011-01-01

    In this poster presentation, the authors examine the impact of Chicago School Readiness Project (CSRP) on students' academic achievement in elementary school. First, they provide upper- and lower-bound estimates of the impact of CSRP on students' academic achievement, taking into account their subsequent nonrandom selection into higher versus…

  3. Long-Term Exposure to High Altitude Affects Conflict Control in the Conflict-Resolving Stage

    PubMed Central

    Wu, Jianhui; Wang, Baoxi; Guo, Shichun; Luo, Ping; Han, Buxin

    2015-01-01

    The neurocognitive basis of the effect of long-term high altitude exposure on conflict control is unclear. Event related potentials (ERPs) were recorded in a flanker task to investigate the influence of high altitude on conflict control in the high-altitude group (who had lived at high altitude for three years but were born at low altitude) and the low-altitude group (living in low altitude only). Although altitude effect was not significant at the behavioral level, ERPs showed cognitive conflict modulation. The interaction between group and trial type was significant: P3 amplitude was greater in the low-altitude group than in the high-altitude group in the incongruent trial. This result suggests that long-term exposure to high altitude affects conflict control in the conflict-resolving stage, and that attentional resources are decreased to resist the conflict control in the high-altitude group. PMID:26671280

  4. [Immediate and long term post-operative controls of rat uterus anastomoses].

    PubMed

    Gianaroli, L; Livani, M F

    1980-11-15

    The Authors examine the immediate control (passage of methylene blue) and the long term control (hysterography, and biopsies at later stages after the interventions) in the microsurgical anastomoses of a rat uterus. The technique of each single investigation is shown and the results are discussed. Particular attention is given to the histological data which ratifies not only anatomical but also physiological outcomes. The differences among the anastomoses carried out in a single and a double layer are verified. PMID:7011342

  5. Specific Therapy Regimes Could Lead to Long-Term Immunological Control of HIV

    NASA Astrophysics Data System (ADS)

    Wodarz, Dominik; Nowak, Martin A.

    1999-12-01

    We use mathematical models to study the relationship between HIV and the immune system during the natural course of infection and in the context of different antiviral treatment regimes. The models suggest that an efficient cytotoxic T lymphocyte (CTL) memory response is required to control the virus. We define CTL memory as long-term persistence of CTL precursors in the absence of antigen. Infection and depletion of CD4+ T helper cells interfere with CTL memory generation, resulting in persistent viral replication and disease progression. We find that antiviral drug therapy during primary infection can enable the development of CTL memory. In chronically infected patients, specific treatment schedules, either including deliberate drug holidays or antigenic boosts of the immune system, can lead to a re-establishment of CTL memory. Whether such treatment regimes would lead to long-term immunologic control deserves investigation under carefully controlled conditions.

  6. Future Long-term Measurements of Solar Spectral Irradiance Variability: Achievements and Lessons from the SORCE SIM

    NASA Astrophysics Data System (ADS)

    Richard, E. C.; Harder, J. W.; Pilewskie, P.; Woods, T. N.; Lykke, K.; Brown, S.

    2010-12-01

    In order to advance understanding of how natural and anthropogenic process affect Earth’s climate system there is a strong scientific importance of maintaining accurate, long-term records of climate forcing. The continuation of solar spectral irradiance (SSI) measurements are needed to characterize poorly understood wavelength dependent climate processes. A major challenge quantifying the influence of SSI variability relates directly to the radiometric absolute accuracy and long-term precision of the measurements. The strong reliance on radiative transfer modeling for interpretation and quantification of the deposition of solar radiation in the atmosphere makes it imperative that the spectral distribution of radiant energy entering the atmosphere be known to a high degree of absolute accuracy (tied directly to international standards). The Spectral Irradiance Monitor (SIM) is a solar spectral radiometer that continuously monitors the SSI across the wavelength region spanning the ultraviolet, visible and near infrared (200 nm - 2400 nm, a region encompassing 96% of the total solar irradiance). A future SIM instrument is included as part of the Total and Spectral Solar Irradiance Sensor (TSIS) to continue the measurement of SSI, which began with the SOlar Radiation and Climate Experiment (SORCE), launched in 2003. SORCE SIM measurements have now monitored SSI for a sufficiently long time and over a wide range in solar activity to quantify wavelength-dependent variability form the UV to the near IR. The analysis of the SORCE SIM measurements of solar spectral variability have resulted in a number of instrument design refinements central to maintaining the long-term calibration to SI irradiance standards and achieve the necessary measurement precision and long-term reproducibility (0.05-0.01% per year) to meet the needs for establishing a climate record of solar spectral irradiance into the future.

  7. Subcutaneous Adipose Tissue Topography in Long-Term Enterally Fed Children and Healthy Controls.

    PubMed

    Kaimbacher, Petra Silke; Wallner-Liebmann, Sandra Johanna; Dunitz-Scheer, Marguerite; Scheer, Peter Jaron Zwi; Cvirn, Gerhard; Schrabmair, Walter; Schnedl, Wolfgang Johann; Hamlin, Michael John; Tafeit, Erwin

    2015-09-01

    In the context of enteral feeding in children the influence on growth and the question of fat resorption is of great interest. We, therefore, measured the thickness of subcutaneous body fat in a sample of long-term enterally fed toddlers and healthy controls. In 33 long-term enterally fed toddlers (10 girls, 23 boys) and 275 healthy controls (128 girls, 147 boys) subcutaneous body fat was measured by means) of the optical device Lipometer. All participants were divided into three age groups (infants, toddlers and children). The height (p=0. 014, -11.7 cm, -12.5%) and weight (p=0.012, -3.0 kg, -21.9%) of long-term enterally fed female toddlers were significantly lower than healthy controls, while male enterally fed toddlers had lower values in all anthropometric measures compared to healthy controls: height (p=0.003, -8.0 cm, -8.4%), weight (p<0.001, -3.5 kg, -24.8%), BMI (p=0.004, -1.3 BMI), Z-score BMI (p=0.001, -1.2 Z-score BMI), upper arm circumference (p<0.001, -1.6 cm, -10.1%) and waist circumference (p<0.001, -6.2 cm, -12.5%). Tube fed toddlers showed a similar body fat distribution when compared to healthy controls, but demonstrated significantly lower values of anthropometric measurements. The results indicate that long-term enterally fed children have ample fat stores but lack physical development. PMID:26898055

  8. LONG-TERM CRITICALITY CONTROL ISSUES FOR THE MPC (SCPB: N/A)

    SciTech Connect

    D.A. Thomas

    1996-03-19

    This analysis is prepared by the Mined Geologic Disposal System (MGDS) Waste Package Development Department (WPDD) in response to a request received via a QAP-3-12 Design Input Data Request (Reference 5.1) from Waste Acceptance, Storage, & Transportation (WAST) Design (formerly MRSMPC Design). This design analysis is an answer to the Design Input Data Request to provide: Specific requirements for long-term criticality control. The time period for long-term criticality control requirements encompass the time phases of operations (pre-closure), containment (first 1,000 years post-closure), and isolation (the time period beyond the containment phase, at least to 10,000 years post-closure). The purpose and objective of this analysis is to provide specific long-term disposal criticality control requirements for the Multi-Purpose Canister (MPC) Subsystem Design Procurement Specification (DPS), so as to not preclude MPC compatibility with disposal in the MGDS.(References 5.2, 5.3, and 5.4) The response is stated in Section 8 herein and will be available for transmittal as an attachment to a QAP-3-12 Design Input Data Transmittal.

  9. Long term stability of surface EMG pattern classification for prosthetic control.

    PubMed

    Amsüss, Sebastian; Paredes, Liliana P; Rudigkeit, Nina; Graimann, Bernhard; Herrmann, Michael J; Farina, Dario

    2013-01-01

    Long-term functioning of a hand prosthesis is crucial for its acceptance by patients with upper limb deficit. In this study the reliability over days of the performance of pattern classification approaches based on surface electromyography (sEMG) signal for the control of upper limb prostheses was investigated. Recordings of sEMG from the forearm muscles were obtained across five consecutive days from five healthy subjects. It was demonstrated that the classification performance decreased monotonically on average by 4.1% per day. It was also found that the accumulated error was confined to three of the eight movement classes investigated. This contribution gives insight on the long term behavior of pattern classification, which is crucial for commercial viability. PMID:24110514

  10. Interactions between short-term and long-term cardiovascular control mechanisms

    NASA Astrophysics Data System (ADS)

    Hoyer, Dirk; Frank, Birgit; Götze, Christine; Stein, Phyllis K.; Żebrowski, Jan J.; Baranowski, Rafal; Palacios, Manuel; Vallverdú, Montserrat; Caminal, Pere; Bayés de Luna, Anthony; Schmidt, Georg; Schmidt, Hendrik

    2007-03-01

    The cardiovascular system incorporates several controlling mechanisms acting as feedback loops over different time horizons. Because of their complex interrelationships, information-based methods such as autonomic information flow (AIF) functions promise to be useful in identifying normal and pathological behavior. Optimal adjustment between those controllers is necessary for healthy global behavior of the organism. We investigated the question as to whether there are typical relationships between short-term and long-term AIF by means of a meta-analysis of several of our own clinical studies of the mortality of patients with multiple organ dysfunction syndrome, heart failure, idiopathic dilated cardiomyopathy, and the length of stay in hospital after abdominal aorta surgery. We found a fundamental association of increased short-term randomness (decreased AIF) and decreased long-term randomness (increased AIF) due to pathology. A systems theoretic validation of this fundamental type of association was done by an appropriate mathematical model using a dissipative system with two feedback loops over different time horizons. The systematic simulation of an increasing collapse of the short feedback loop confirmed the inverse association between short-term and long-term information flow as a fundamental, system inherent type of readjustment that occurs under pathological conditions.

  11. Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial

    PubMed Central

    Gurnell, Eleanor M.; Hunt, Penelope J.; Curran, Suzanne E.; Conway, Catherine L.; Pullenayegum, Eleanor M.; Huppert, Felicia A.; Compston, Juliet E.; Herbert, Joseph; Chatterjee, V. Krishna K.

    2008-01-01

    Context: Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are the major circulating adrenal steroids and substrates for peripheral sex hormone biosynthesis. In Addison’s disease, glucocorticoid and mineralocorticoid deficiencies require lifelong replacement, but the associated near-total failure of DHEA synthesis is not typically corrected. Objective and Design: In a double-blind trial, we randomized 106 subjects (44 males, 62 females) with Addison’s disease to receive either 50 mg daily of micronized DHEA or placebo orally for 12 months to evaluate its longer-term effects on bone mineral density, body composition, and cognitive function together with well-being and fatigue. Results: Circulating DHEAS and androstenedione rose significantly in both sexes, with testosterone increasing to low normal levels only in females. DHEA reversed ongoing loss of bone mineral density at the femoral neck (P < 0.05) but not at other sites; DHEA enhanced total body (P = 0.02) and truncal (P = 0.017) lean mass significantly with no change in fat mass. At baseline, subscales of psychological well-being in questionnaires (Short Form-36, General Health Questionnaire-30), were significantly worse in Addison’s patients vs. control populations (P < 0.001), and one subscale of SF-36 improved significantly (P = 0.004) after DHEA treatment. There was no significant benefit of DHEA treatment on fatigue or cognitive or sexual function. Supraphysiological DHEAS levels were achieved in some older females who experienced mild androgenic side effects. Conclusion: Although further long-term studies of DHEA therapy, with dosage adjustment, are desirable, our results support some beneficial effects of prolonged DHEA treatment in Addison’s disease. PMID:18000094

  12. Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings

    PubMed Central

    Li, Yu Ting; Wang, Harry H.X.; Liu, Kirin Q.L.; Lee, Gabrielle K.Y.; Chan, Wai Man; Griffiths, Sian M.; Chen, Ruo Ling

    2016-01-01

    Abstract Hypertension is a typical example of long-term disease posing formidable challenges to health care. One goal of antihypertensive therapy is to achieve optimal blood pressure (BP) control and reduce co-occurring chronic conditions (multimorbidity). This study aimed to assess the influence of multimorbidity on medication adherence, and to explore the association between poor BP control and multimorbidity, with implications for hypertension management. A cross-sectional design with multistage sampling was adopted to recruit Chinese hypertensive patients attending general out-patient clinics from 3 geographic regions in Hong Kong. A modified systemic sampling methodology with 1 patient as a sampling unit was used to recruit consecutive samples in each general out-patient clinic. Data were collected by face-to-face interviews using a standardized protocol. Poor BP control was defined as having systolic BP/diastolic BP ≥130/80 mm Hg for those with diabetes or chronic kidney disease; and ≥140/90 mm Hg for others. Medication adherence was assessed by a validated Chinese version of the Morisky Medication Adherence Scale. A simple unweighted enumeration was adopted to measure the combinations of coexisting long-term conditions. Binary logistic regression analysis was conducted with medication adherence and multimorbidity as outcome variables, respectively, after controlling for effects of patient-level covariates. The prevalence of multimorbidity was 47.4% (95% confidence interval [CI] 45.4%–49.4%) among a total of 2445 hypertensive patients. The proportion of subjects having 0, 1, and ≥2 additional long-term conditions was 52.6%, 29.1%, and 18.3%, respectively. The overall rate of poor adherence to medication was 46.6%, whereas the rate of suboptimal BP control was 48.7%. Albeit the influence of multimorbidity on medication adherence was not found to be statistically significant, patients with poorly controlled BP were more likely to have multimorbidity

  13. Assessment of long-term leaching from waste incineration air-pollution-control residues.

    PubMed

    Astrup, T; Mosbaek, H; Christensen, T H

    2006-01-01

    Assessment of long-term leaching from MSWI air-pollution-control (APC) residues is discussed with respect to use in environmental impact assessment, such as life-cycle assessment (LCA). A method was proposed for estimating leaching as a function of the liquid-to-solid (L/S) ratio in a long-term perspective (L/S 5000l/kg). Data for changes in residue pH as a function of L/S was used in combination with pH dependent leaching data to predict leachate concentrations of Al, Ca, Cd, Ba, Mg, Ni, Pb, S, Pb, V and Zn as a function of L/S. Mass balance calculations were used to determine the element fractions leached with respect to L/S. The estimated long-term leaching from a semi-dry residue and a fly ash was compared with short-term leaching determined by batch tests at L/S 10l/kg, both carbonated and non-carbonated versions of the residues were investigated. Generally, very high L/S ratios above 2000l/kg were required to leach 20-30% of the solid contents. However, Ca and S were depleted at L/S 200-900l/kg. The long-term leachate concentrations were found to either remain at the same level as the initial leaching determined by the L/S 10 batch test, or to significantly decrease compared with the initial leaching. Only Al and Zn were found to show higher leachate concentrations at L/S ratios above 3000-5000l/kg. Carbonation generally prolonged the time needed for depletion from the solid residues; however, Ca and S were depleted faster than in the case of non-carbonated residues. This study shows that uncritical use of batch leaching data for assessing the potential leaching is highly problematic, and evaluations of residue disposal should include scenario specific quantification of the long-term leaching. PMID:16488595

  14. Fludarabine, cyclophosphamide, and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia

    PubMed Central

    Thompson, Philip A.; Tam, Constantine S.; O’Brien, Susan M.; Wierda, William G.; Stingo, Francesco; Plunkett, William; Smith, Susan C.; Kantarjian, Hagop M.; Freireich, Emil J.

    2016-01-01

    Accurate identification of patients likely to achieve long-progression-free survival (PFS) after chemoimmunotherapy is essential given the availability of less toxic alternatives, such as ibrutinib. Fludarabine, cyclophosphamide, and rituximab (FCR) achieved a high response rate, but continued relapses were seen in initial reports. We reviewed the original 300 patient phase 2 FCR study to identify long-term disease-free survivors. Minimal residual disease (MRD) was assessed posttreatment by a polymerase chain reaction-based ligase chain reaction assay (sensitivity 0.01%). At the median follow-up of 12.8 years, PFS was 30.9% (median PFS, 6.4 years). The 12.8-year PFS was 53.9% for patients with mutated immunoglobulin heavy chain variable (IGHV) gene (IGHV-M) and 8.7% for patients with unmutated IGHV (IGHV-UM). 50.7% of patients with IGHV-M achieved MRD-negativity posttreatment; of these, PFS was 79.8% at 12.8 years. A plateau was seen on the PFS curve in patients with IGHV-M, with no relapses beyond 10.4 years in 42 patients (total follow-up 105.4 patient-years). On multivariable analysis, IGHV-UM (hazard ratio, 3.37 [2.18-5.21]; P < .001) and del(17p) by conventional karyotyping (hazard ratio, 7.96 [1.02-61.92]; P = .048) were significantly associated with inferior PFS. Fifteen patients with IGHV-M had 4-color MRD flow cytometry (sensitivity 0.01%) performed in peripheral blood, at a median of 12.8 years posttreatment (range, 9.5-14.7). All were MRD-negative. The high rate of very long-term PFS in patients with IGHV-M after FCR argues for the continued use of chemoimmunotherapy in this patient subgroup outside clinical trials; alternative strategies may be preferred in patients with IGHV-UM, to limit long-term toxicity. PMID:26492934

  15. Smart Structures for Vibration Control on Long-Term Space Exploration and Habitation Missions

    NASA Technical Reports Server (NTRS)

    Gattis, Christy B.; Shepard, W. Steve, Jr.

    2004-01-01

    The current vision for space exploration focuses on human missions to the Moon, Mars, and beyond. To support these goals, it is certain that new vehicles and intermediate bases will be developed, whether that means simply re-direction of the ISS as a "mission research facility" or construction of a lunar base. Since these facilities are expected to be constructed from inherently light-weight materials, this work examines some of the potential sources of vibration and noise as well as means for controlling these vibrations. Many of the operating components within these facilities, such as pumps, fans, and motors, will produce vibrations during operation. These vibrations become structure in which they are housed. Resonances can impact acoustic noise levels and noise quality within the environment, possibly affecting crew health and productivity. For long-term missions in particular, it is expected that crew members will spend significant portions of their time restrained in the structure, such as in seats. As a result, the general health and well-being of the crew can be improved by limiting the harmful effects of human exposure to long-term audible and tactile vibration input. Besides the human factor, this work also examines some operational considerations in which vibrations play an important role. Vibrations can impact the environment for science and in-situ manufacturing research within these vehicles. Since a benign vibratory environment is beneficial for most types of science experiments, there is a need for various forms of vibration control. Because the operational characteristics of a vehicle can change during a long-term mission, it is further expected that the characteristics of many of the vibratory excitations will change with time. Consequently, the form of vibration control needed to improve overall habitability and usefulness of the vehicle or element for exploration missions will rely to some degree on the vibration control system's ability to

  16. Major Autonomic Neuroregulatory Pathways Underlying Short- and Long-Term Control of Cardiovascular Function.

    PubMed

    Salman, Ibrahim M

    2016-03-01

    Short-term and long-term blood pressure (BP) regulation and its maintenance at levels adequate to perfuse tissue organs involve an integrated action of multiple neural, cardiovascular, renal, endocrine and local tissue control systems. In the recent year, there has been a growing interest in the understanding of neural pathways key to BP control. For instance, through major advances in studies using both anesthetized and conscious animals, our knowledge of the essential neural mechanisms that subserve the baroreceptor, cardiopulmonary and chemoreceptor reflexes, and those evoked by the activation of stress pathways has dramatically increased. While the importance of these neural pathways in the maintenance of cardiovascular homeostasis is well established, the recognition of the central processing nuclei that integrate various afferent inputs to produce synchronous adjustments of autonomic outflows is still progressively expanding. Based on the literature provided thus far, the present review provides an overview in relation to the important neural determinants of BP control and later offers a concise description of major neuronal pathways that control autonomic outflows to the cardiovascular system in the short and long term. PMID:26838031

  17. An evaluation of controlled permeability formwork for long-term durability of structural concrete elements

    SciTech Connect

    Suryavanshi, A.K.; Swamy, R.N.

    1997-07-01

    The long-term performance of a concrete slab (CPF slab) exposed to chloride ingress and atmospheric carbonation from the surface generated by controlled permeability formwork (CPF) is investigated. The results are compared with a similar slab exposed to long-term chloride ingress and atmospheric carbonation from the cast face (Control slab). Techniques such as X-ray diffraction (XRD) and differential thermal analyses (DTA) were employed to determine the resistance against carbonation while, mercury porosimetry was used for investigating the pore size distribution at the surface of the slabs. Amount of acid soluble chlorides was determined by using Volhard`s method. The CPF employed at the bottom of the mould was not fully effective in its intended purpose of generating a permanent and dense impermeable concrete layer adjacent to it when the design water-cement (w/c) ration of the concrete mix was 0.60. This resulted in an almost similar extent of carbonation at the surface for both CPF and control slabs as shown by XRD and DTA studies. Similarly, there were no significant differences in the amount of chlorides and their depths of penetration for both CPF and control slabs, although the former was marginally superior in chloride penetration resistance at the surface.

  18. Long-Term Effects from Bacterial Meningitis in Childhood and Adolescence on Postural Control

    PubMed Central

    Petersen, Hannes; Patel, Mitesh; Ingason, Einar F.; Einarsson, Einar J.; Haraldsson, Ásgeir; Fransson, Per-Anders

    2014-01-01

    Bacterial meningitis in childhood is associated with cognitive deficiencies, sensorimotor impairments and motor dysfunction later in life. However, the long-term effects on postural control is largely unknown, e.g., whether meningitis subjects as adults fully can utilize visual information and adaptation to enhance stability. Thirty-six subjects (20 women, mean age 19.3 years) treated in childhood or adolescence for bacterial meningitis, and 25 controls (13 women, mean age 25.1 years) performed posturography with eyes open and closed under unperturbed and perturbed standing. The meningitis subjects were screened for subjective vertigo symptoms using a questionnaire, clinically tested with headshake and head thrust test, as well as their hearing was evaluated. Meningitis subjects were significantly more unstable than controls during unperturbed (p≤0.014) and perturbed standing, though while perturbed only with eyes open in anteroposterior direction (p = 0.034) whereas in lateral direction both with eyes open and closed (p<0.001). Meningitis subjects had poorer adaption ability to balance perturbations especially with eyes open, and they frequently reported symptoms of unsteadiness (88% of the subjects) and dizziness (81%), which was found significantly correlated to objectively decreased stability. Out of the 36 subjects only 3 had unilateral hearing impairment. Hence, survivors of childhood bacterial meningitis may suffer long-term disorders affecting postural control, and would greatly benefit if these common late effects became generally known so treatments can be developed and applied. PMID:25405756

  19. A Chronic Respiratory Pasteurella multocida Infection Is Well-Controlled by Long-Term Macrolide Therapy.

    PubMed

    Seki, Masafumi; Sakata, Tomomi; Toyokawa, Masahiro; Nishi, Isao; Tomono, Kazunori

    2016-01-01

    A 57-year-old woman with severe bronchiectasis frequently received antibiotics, including penicillin, for acute exacerbations due to Pasteurella multocida. Although the bacteria showed a decrease in antibiotic susceptibility, her symptoms and X-ray findings became stable, and severe exacerbations were not observed for the last few years after a low-dose erythromycin treatment was started. The development of a respiratory infection with Pasteurella multocida is relatively uncommon, but it can be controlled by immunomodulation which is associated with long-term macrolide therapy. PMID:26831030

  20. Determining the amount of physical activity needed for long-term weight control

    NASA Technical Reports Server (NTRS)

    Wier, L. T.; Ayers, G. W.; Jackson, A. S.; Rossum, A. C.; Poston, W. S.; Foreyt, J. P.

    2001-01-01

    OBJECTIVE: To evaluate prospectively the influence of habitual physical activity on body weight of men and women and to develop a model that defines the role of physical activity on longitudinal weight change. DESIGN AND SETTING: Occupational cohort study conducted for a mean of 5.5 y. SUBJECTS: A total of 496 (341 male and 155 female) NASA/Johnson Space Center employees who completed the 3 month education component of the employee health-related fitness program and remained involved for a minimum of 2 y. MEASUREMENTS: Body weights were measured at baseline (T1) and follow-up (T2), and habitual physical activity was obtained from the mean of multiple ratings of the 11-point (0-10) NASA Activity Scale (NAS) recorded quarterly between T1 and T2. Other measures included age, gender, VO(2 max) obtained from maximal treadmill testing, body mass index (BMI), and body fat percentage. RESULTS: Multiple regression demonstrated that mean NAS, T1 weight, aging and gender all influence long-term T2 weight. T1 age was significant for the men only. Independently, each increase in mean NAS significantly (P<0.01) reduced T2 weight in men (b=-0.91 kg; 95% CI:-1.4 to-0.42 kg) and women (b=-2.14 kg; 95% CI:-2.93 to-1.35 kg). Mean NAS had a greater effect on T2 weight as T1 weight increased, and the relationship was dose-dependent. CONCLUSIONS: Habitual physical activity is a significant source of long-term weight change. The use of self-reported activity level is helpful in predicting long-term weight changes and may be used by health care professionals when counseling patients about the value of physical activity for weight control.

  1. New kind of injection-locked oscillator and its corresponding long-term stability control.

    PubMed

    Hong, Jun; Liu, An; Wang, Xiao-hu; Yao, Sheng-xing; Li, Zu-ling

    2015-09-20

    A new type of opto-electronic hybrid oscillator is proposed for the first time, to the best of our knowledge, and verified by experiments in this paper. Typical electronic oscillator-dielectric resonator oscillator as the first injection source is used to injection lock the first long-fiber loop-based opto-electronic oscillator (OEO); then its output is used to injection lock the second long-fiber opto-electronic oscillator. Using this method, low-phase noise output signal can be obtained. Experiments show that single side-band (SSB) phase noise of a 9.5 GHz oscillation signal at 10 kHz offset frequency decreases from -123 to -135  dBc/Hz after the first injection, then, through the second injection, the SSB phase noise drops down to -146  dBc/Hz. In order to solve the long-term stability problem of the above oscillator, a new stability-control circuit also is designed and verified by experiments. Experiments show that the Allan deviation decreases from 9.0×10(-11) to 2.2×10(-12) during 1 s after the long-term stability-control circuit being used. PMID:26406523

  2. Long-term training modifies the modular structure and organization of walking balance control.

    PubMed

    Sawers, Andrew; Allen, Jessica L; Ting, Lena H

    2015-12-01

    How does long-term training affect the neural control of movements? Here we tested the hypothesis that long-term training leading to skilled motor performance alters muscle coordination during challenging, as well as nominal everyday motor behaviors. Using motor module (a.k.a., muscle synergy) analyses, we identified differences in muscle coordination patterns between professionally trained ballet dancers (experts) and untrained novices that accompanied differences in walking balance proficiency assessed using a challenging beam-walking test. During beam walking, we found that experts recruited more motor modules than novices, suggesting an increase in motor repertoire size. Motor modules in experts had less muscle coactivity and were more consistent than in novices, reflecting greater efficiency in muscle output. Moreover, the pool of motor modules shared between beam and overground walking was larger in experts compared with novices, suggesting greater generalization of motor module function across multiple behaviors. These differences in motor output between experts and novices could not be explained by differences in kinematics, suggesting that they likely reflect differences in the neural control of movement following years of training rather than biomechanical constraints imposed by the activity or musculoskeletal structure and function. Our results suggest that to learn challenging new behaviors, we may take advantage of existing motor modules used for related behaviors and sculpt them to meet the demands of a new behavior. PMID:26467521

  3. FMRP and Ataxin-2 function together in long-term olfactory habituation and neuronal translational control.

    PubMed

    Sudhakaran, Indulekha P; Hillebrand, Jens; Dervan, Adrian; Das, Sudeshna; Holohan, Eimear E; Hülsmeier, Jörn; Sarov, Mihail; Parker, Roy; VijayRaghavan, K; Ramaswami, Mani

    2014-01-01

    Fragile X mental retardation protein (FMRP) and Ataxin-2 (Atx2) are triplet expansion disease- and stress granule-associated proteins implicated in neuronal translational control and microRNA function. We show that Drosophila FMRP (dFMR1) is required for long-term olfactory habituation (LTH), a phenomenon dependent on Atx2-dependent potentiation of inhibitory transmission from local interneurons (LNs) to projection neurons (PNs) in the antennal lobe. dFMR1 is also required for LTH-associated depression of odor-evoked calcium transients in PNs. Strong transdominant genetic interactions among dFMR1, atx2, the deadbox helicase me31B, and argonaute1 (ago1) mutants, as well as coimmunoprecitation of dFMR1 with Atx2, indicate that dFMR1 and Atx2 function together in a microRNA-dependent process necessary for LTH. Consistently, PN or LN knockdown of dFMR1, Atx2, Me31B, or the miRNA-pathway protein GW182 increases expression of a Ca2+/calmodulin-dependent protein kinase II (CaMKII) translational reporter. Moreover, brain immunoprecipitates of dFMR1 and Atx2 proteins include CaMKII mRNA, indicating respective physical interactions with this mRNA. Because CaMKII is necessary for LTH, these data indicate that fragile X mental retardation protein and Atx2 act via at least one common target RNA for memory-associated long-term synaptic plasticity. The observed requirement in LNs and PNs supports an emerging view that both presynaptic and postsynaptic translation are necessary for long-term synaptic plasticity. However, whereas Atx2 is necessary for the integrity of dendritic and somatic Me31B-containing particles, dFmr1 is not. Together, these data indicate that dFmr1 and Atx2 function in long-term but not short-term memory, regulating translation of at least some common presynaptic and postsynaptic target mRNAs in the same cells. PMID:24344294

  4. FMRP and Ataxin-2 function together in long-term olfactory habituation and neuronal translational control

    PubMed Central

    Sudhakaran, Indulekha P.; Hillebrand, Jens; Dervan, Adrian; Das, Sudeshna; Holohan, Eimear E.; Hülsmeier, Jörn; Sarov, Mihail; Parker, Roy; VijayRaghavan, K.; Ramaswami, Mani

    2014-01-01

    Fragile X mental retardation protein (FMRP) and Ataxin-2 (Atx2) are triplet expansion disease- and stress granule-associated proteins implicated in neuronal translational control and microRNA function. We show that Drosophila FMRP (dFMR1) is required for long-term olfactory habituation (LTH), a phenomenon dependent on Atx2-dependent potentiation of inhibitory transmission from local interneurons (LNs) to projection neurons (PNs) in the antennal lobe. dFMR1 is also required for LTH-associated depression of odor-evoked calcium transients in PNs. Strong transdominant genetic interactions among dFMR1, atx2, the deadbox helicase me31B, and argonaute1 (ago1) mutants, as well as coimmunoprecitation of dFMR1 with Atx2, indicate that dFMR1 and Atx2 function together in a microRNA-dependent process necessary for LTH. Consistently, PN or LN knockdown of dFMR1, Atx2, Me31B, or the miRNA-pathway protein GW182 increases expression of a Ca2+/calmodulin-dependent protein kinase II (CaMKII) translational reporter. Moreover, brain immunoprecipitates of dFMR1 and Atx2 proteins include CaMKII mRNA, indicating respective physical interactions with this mRNA. Because CaMKII is necessary for LTH, these data indicate that fragile X mental retardation protein and Atx2 act via at least one common target RNA for memory-associated long-term synaptic plasticity. The observed requirement in LNs and PNs supports an emerging view that both presynaptic and postsynaptic translation are necessary for long-term synaptic plasticity. However, whereas Atx2 is necessary for the integrity of dendritic and somatic Me31B-containing particles, dFmr1 is not. Together, these data indicate that dFmr1 and Atx2 function in long-term but not short-term memory, regulating translation of at least some common presynaptic and postsynaptic target mRNAs in the same cells. PMID:24344294

  5. Long Term Control of Scabies Fifteen Years after an Intensive Treatment Programme

    PubMed Central

    Marks, Michael; Taotao-Wini, Betty; Satorara, Lorraine; Engelman, Daniel; Nasi, Titus; Mabey, David C.; Steer, Andrew C.

    2015-01-01

    Introduction Scabies is a major public health problem in the Pacific and is associated with an increased risk of bacterial skin infections, glomerulonephritis and rheumatic fever. Mass drug administration with ivermectin is a promising strategy for the control of scabies. Mass treatment with ivermectin followed by active case finding was conducted in five communities in the Solomon Islands between 1997 and 2000 and resulted in a significant reduction in the prevalence of both scabies and bacterial skin infections. Methods We conducted a prospective follow-up study of the communities where the original scabies control programme had been undertaken. All residents underwent a standardised examination for the detection of scabies and impetigo. Results Three hundred and thirty eight residents were examined, representing 69% of the total population of the five communities. Only 1 case of scabies was found, in an adult who had recently returned from the mainland. The prevalence of active impetigo was 8.8% overall and 12.4% in children aged 12 years or less. Discussion We found an extremely low prevalence of scabies 15 years after the cessation of a scabies control programme. The prevalence of impetigo had also declined further since the end of the control programme. Our results suggest that a combination of mass treatment with ivermectin and intensive active case finding may result in long term control of scabies. Larger scale studies and integration with other neglected tropical disease control programmes should be priorities for scabies control efforts. PMID:26624616

  6. Short- and Long-Term Sleep Stability in Insomniacs and Healthy Controls

    PubMed Central

    Gaines, Jordan; Vgontzas, Alexandros N.; Fernandez-Mendoza, Julio; Basta, Maria; Pejovic, Slobodanka; He, Fan; Bixler, Edward O.

    2015-01-01

    Study Objectives: Assess the short- and long-term stability of sleep duration in patients with insomnia and normal-sleeping controls. Design: Observational short-term and prospective studies. Setting: Sleep laboratory. Participants: Patients with insomnia (n = 150) and controls (n = 151) were recruited from the local community or sleep disorders clinic. A subsample of 95 men from the Penn State Adult Cohort (PSAC) were followed up 2.6 y after their initial visit. Measurements: Participants underwent a physical examination and 8-h polysomnography (PSG) recording for 3 consecutive nights (controls and insomniacs), or 2 single nights separated by several years (PSAC). Intraclass correlation coefficients (ICCs) assessed the stability of the variables total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO). We also examined persistence of the first-night classification of “short” versus “normal” sleep duration on subsequent nights. Results: Stability of TST, SOL, and WASO based on 1 night were slight to moderate in both patients with insomnia (ICC = 0.37–0.57) and controls (ICC = 0.39–0.59), and became substantial to almost perfect when based on the average of 3 nights (ICC = 0.64–0.81). We observed similar degrees of stability for TST and WASO in the longitudinal sample, with moderate stability based on a single night and substantial stability based on both nights. In examining the persistence of “short” and “normal” sleep duration, 71.4% (controls), 74.7% (patients with insomnia), and 72.6% (longitudinal sample) of participants retained their first-night classifications over subsequent nights. Conclusions: Sleep duration variables, particularly total sleep time based on 3 consecutive nights in both patients with insomnia and controls or two single-night recordings separated by several years, are stable and reflect a person's habitual sleep. Furthermore, a single night in the laboratory may be useful for reliably

  7. Benefits of repeated individual dietary counselling in long-term weight control in women after delivery.

    PubMed

    Jaakkola, Johanna; Isolauri, Erika; Poussa, Tuija; Laitinen, Kirsi

    2015-10-01

    As pregnancy may trigger overweight in women, new means for its prevention are being sought. The aim here was to investigate the effect of individual dietary counselling during and after pregnancy on post-partum weight and waist circumference up to 4 years post-partum. A cohort of women (n = 256) were randomized to receive repeated individual dietary counselling by a nutritionist during and after pregnancy, or as controls not receiving dietary counselling, from the first trimester of pregnancy until 6 months after delivery. Counselling aimed to bring dietary intake into line with recommendations, with particular focus on the increase in the intake of unsaturated fatty acids instead of saturated. Pre-pregnancy weight was taken from welfare clinic records. Weight and waist circumference were measured at 4 years after delivery. The proportion of overweight women increased from 26% prior to pregnancy to 30% at 4 years after delivery among women receiving dietary counselling, as against considerably more, from 32% to 57%, among controls. The prevalence of central adiposity was 31% in women receiving dietary counselling, 64% in controls. Likewise, both the risk of overweight (odds ratio: 0.23, 0.08-0.63, P = 0.005) and central adiposity (odds ratio: 0.18, 0.06-0.52, P = 0.002) were lower in women receiving dietary counselling compared with controls. Repeated dietary counselling initiated in early pregnancy can be beneficial in long-term weight control after delivery. PMID:24521459

  8. A thermal control system for long-term survival of scientific instruments on lunar surface

    NASA Astrophysics Data System (ADS)

    Ogawa, K.; Iijima, Y.; Sakatani, N.; Otake, H.; Tanaka, S.

    2014-03-01

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime -200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a "regolith mound". Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system.

  9. A thermal control system for long-term survival of scientific instruments on lunar surface.

    PubMed

    Ogawa, K; Iijima, Y; Sakatani, N; Otake, H; Tanaka, S

    2014-03-01

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime -200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a "regolith mound". Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system. PMID:24689621

  10. Blood, sweat, tears and success of technology transfer long-term controlled-release of herbicides

    SciTech Connect

    Van Voris, P.; Cataldo, D.A.; Burton, F.G.; Skeins, W.E.

    1988-01-01

    The problems encountered, the technical difficulties that had to be overcome, and the successful transfer of technology related to controlled-release of pesticides is reviewed. Research on control-release of pesticides to date has resulted in products designed to extend bioactivity for periods of several days, months, or at most, several years. However, research supported by the U.S. Department of Energy directed toward solving problems associated with plant-root penetration through caps and liners engineered to minimize leaching or movement of buried nuclear and chemical wastes has resulted in development of a long-term controlled-release herbicide delivery system designed to stop root growth for periods of up to 100 years. Through the unique combination of polymers with a herbicidally active dinitroaniline, a cylindrical pellet was developed that continuously releases a herbicide for a period of up to 100 years. Equilibrium concentration of the herbicide in soil adjacent to the pellet and the bioactive lifetime of the device can be adjusted by changing the size of the pellet; the type of polymer; the type, quality, and quantity of carrier; and/or the concentration and type of dinitroaniline was used.

  11. A thermal control system for long-term survival of scientific instruments on lunar surface

    SciTech Connect

    Ogawa, K.; Iijima, Y.; Tanaka, S.; Sakatani, N.; Otake, H.

    2014-03-15

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime −200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a “regolith mound”. Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system.

  12. A controlled investigation of continuing pain education for long-term care staff

    PubMed Central

    Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

    2013-01-01

    BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

  13. Long-Term Propranolol Use in Severely Burned Pediatric Patients: A Randomized Controlled Study

    PubMed Central

    Herndon, David N.; Rodriguez, Noe A.; Diaz, Eva C.; Hegde, Sachin; Jennings, Kristofer; Mlcak, Ronald P.; Suri, Jaipreet S.; Lee, Jong O.; Williams, Felicia N.; Meyer, Walter; Suman, Oscar E.; Barrow, Robert E.; Jeschke, Marc G.; Finnerty, Celeste C.

    2012-01-01

    Objective To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective randomized single-center controlled study in pediatric patients with large burns. Summary Background Data Severe burns trigger a hypermetabolic response that persists for up to 2 years after burn. Propranolol given for 1 month post burn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods One-hundred seventy nine pediatric patients with >30% total body surface area burns were randomized to receive control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months after burn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjust for non-normality, repeated measures, and regression analyses. P <0.05 was considered significant. Results Long-term propranolol treatment significantly reduced the percent of the predicted heart rate and percent of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions Propranolol treatment for 12 months, following thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients. This study is registered at clinicaltrials.gov, NCT00675714. PMID:22895351

  14. Sand dune patterns on Titan controlled by long-term climate cycles

    NASA Astrophysics Data System (ADS)

    Ewing, Ryan C.; Hayes, Alex G.; Lucas, Antoine

    2015-01-01

    Linear sand dunes cover the equatorial latitudes of Saturn's moon Titan and are shaped by global wind patterns. These dunes are thought to reflect present-day diurnal, tidal and seasonal winds, but climate models have failed to reproduce observed dune morphologies with these wind patterns. Dunes diagnostic of a specific wind or formative timescale have remained elusive. Here we analyse radar imagery from NASA's Cassini spacecraft and identify barchan, star and reoriented dunes in sediment-limited regions of Titan's equatorial dune fields that diverge by 23° on average from the orientation of linear dunes. These morphologies imply shifts in wind direction and sediment availability. Using a numerical model, we estimate that the observed reorientation of dune crests to a change in wind direction would have taken around 3,000 Saturn years (1 Saturn year ~ 29.4 Earth years) or longer--a timescale that exceeds diurnal, seasonal or tidal cycles. We propose that shifts in winds and sediment availability are the product of long-term climate cycles associated with variations in Saturn's orbit. Orbitally controlled landscape evolution--also proposed to explain the distribution of Titan's polar lakes--implies a dune-forming climate on equatorial Titan that is analogous to Earth.

  15. Medium to long term behavior of MR dampers for structural control

    NASA Astrophysics Data System (ADS)

    Caterino, N.; Azmoodeh, B. M.; Occhiuzzi, A.

    2014-10-01

    The medium to long term behavior of a prototype magnetorheological (MR) damper for structural control of earthquake induced vibrations is investigated herein. Unlike some applications for which MR devices experience frequent dynamic loads, seismic dampers might not be used for most of their life, staying dormant for a long period until an earthquake hits the hosting structure. This work aims to evaluate the effectiveness of a MR damper after years of inactivity. A MR device has been tested twice, first in 2008 and then in 2013, after five years of absolute inactivity. The comparison between the results of the two tests is made in terms of force-displacement loops. It is shown that, after a 5-year rest, only part of the first stroke of the damper is characterized by an unexpected response of the damper. After half a stroke, the damper quickly returned to behave like in 2008, even if a slight non-reversible decrease of the reacting force has been recorded. The latter is found to be more evident (5-7%) for larger currents, less visible in the case of zero magnetic field. From the point of view of civil engineering, this decay of performance is definitely acceptable, being largely bounded within the limits of the uncertainties typically involved and taken into account in the structural design. Finally, starting from a literature review, the paper discusses the possible causes of the observed changes in the mechanical response of the damper over time.

  16. Long-term Controlled Drug Release from bi-component Electrospun Fibers

    NASA Astrophysics Data System (ADS)

    Xu, Shanshan; Zhang, Zixin; Xia, Qinghua; Han, Charles

    Multi-drug delivery systems with timed programmed release are hard to be produced due to the complex drug release kinetics which mainly refers to the diffusion of drug molecules from the fiber and the degradation of the carrier. This study focused on the whole life-time story of the long-term drug releasing fibrous systems. Electrospun membrane utilizing FDA approved polymers and broad-spectrum antibiotics showed specific drug release profiles which could be divided into three stages based on the profile slope. With throughout morphology observation, cumulative release amount and releasing duration, releasing kinetics and critical factors were fully discussed during three stages. Through changing the second component, approximately linear drug release profile and a drug release duration about 13 days was prepared, which is perfect for preventing post-operative infection. The addition of this semi-crystalline polymer in turn influenced the fiber swelling and created drug diffusion channels. In conclusion, through adjusting and optimization of the blending component, initial burst release, delayed release for certain duration, and especially the sustained release profile could all be controlled, as well as specific anti-bacterial behavior could be obtained.

  17. Long-term treatment of irritable bowel syndrome: results of a randomized controlled trial.

    PubMed

    Misra, S P; Thorat, V K; Sachdev, G K; Anand, B S

    1989-10-01

    To examine the long-term management of irritable bowel syndrome we conducted a two-part controlled therapeutic trial on 28 patients who had recovered completely after four to six weeks of treatment with ispaghula husk and propantheline. In part I patients were randomly divided into two groups. Group A received a placebo capsule while Group B continued with treatment as before. After six months the response to treatment was assessed according to a scoring system. The overall relapse rate in Group B was 46 per cent compared to 82 per cent in group A. With continued treatment patients in Group B became asymptomatic from the fourth month while patients in Group A continued to deteriorate. In part II, patients who had relapsed whilst on placebo received active treatment. Six of the seven who agreed to continue with the study became asymptomatic within four weeks. However, all the patients who were asymptomatic while on active treatment relapsed on discontinuation and again recovered on reinstitution of active treatment. We conclude that irritable bowel syndrome is a chronic relapsing disorder and that treatment with a combination of ispaghula husk and propantheline is effective, both in relieving symptoms and in the maintenance of remission. PMID:2697886

  18. Control Design Strategies to Enhance Long-Term Aircraft Structural Integrity

    NASA Technical Reports Server (NTRS)

    Newman, Brett A.

    1999-01-01

    Over the operational lifetime of both military and civil aircraft, structural components are exposed to hundreds of thousands of low-stress repetitive load cycles and less frequent but higher-stress transient loads originating from maneuvering flight and atmospheric gusts. Micro-material imperfections in the structure, such as cracks and debonded laminates, expand and grow in this environment, reducing the structural integrity and shortening the life of the airframe. Extreme costs associated with refurbishment of critical load-bearing structural components in a large fleet, or altogether reinventoring the fleet with newer models, indicate alternative solutions for life extension of the airframe structure are highly desirable. Increased levels of operational safety and reliability are also important factors influencing the desirability of such solutions. One area having significant potential for impacting crack growth/fatigue damage reduction and structural life extension is flight control. To modify the airframe response dynamics arising from command inputs and gust disturbances, feedback loops are routinely applied to vehicles. A dexterous flight control system architecture senses key vehicle motions and generates critical forces/moments at multiple points distributed throughout the airframe to elicit the desired motion characteristics. In principle, these same control loops can be utilized to influence the level of exposure to harmful loads during flight on structural components. Project objectives are to investigate and/or assess the leverage control has on reducing fatigue damage and enhancing long-term structural integrity, without degrading attitude control and trajectory guidance performance levels. In particular, efforts have focused on the effects inner loop control parameters and architectures have on fatigue damage rate. To complete this research, an actively controlled flexible aircraft model and a new state space modeling procedure for crack growth

  19. Long-Term Impact of a Community Health Worker Intervention on Diabetes Control in American Samoa

    PubMed Central

    DePue, Judith D.; Dunsiger, Shira; Elsayed, Mohammad; Nu'usolia, Ofeira; McGarvey, Stephen T.

    2015-01-01

    Introduction Diabetes Care in American Samoa (DCAS) was a randomized controlled trial of a 12-month intervention facilitated by community health workers (CHWs) that demonstrated improved HbA1c levels compared with usual care at trial completion. We sought to evaluate the long-term impact of this intervention on diabetes control. Methods We retrospectively collected HbA1c measurements from medical records of DCAS participants (n = 268). The study group received the intervention during the trial, and the control group received the intervention after the trial. We used mixed-effects longitudinal regression models to assess change in HbA1c within each trial arm during 3 time periods: DCAS (12 months of the study group’s intervention), the first year after DCAS (control group’s intervention), and the second year after DCAS. Models were adjusted for baseline characteristics that differed significantly for participants with a low number of HbA1c measurements from those with a high number of HbA1c measurements. Results After adjustment for confounders, the experiment group experienced a decrease in HbA1c of 0.28 units per year (95% confidence interval [CI], −0.64 to 0.07) during DCAS (intervention). HbA1c decreased by 0.88 units per year (95% CI, −1.31 to −0.45) during the year after the intervention. No significant change was observed the following year. HbA1c of the control group did not significantly change during DCAS (usual care) but decreased by 1.31 units per year (95% CI, −1.72 to −0.91) during its intervention. During the year after the control group’s intervention, HbA1c increased by 1.18 units per year (95% CI, 0.42 to 1.93). Conclusion Both groups had initial improvements in glycemic control, but HbA1c later plateaued or increased. These results suggest that time-limited CHW programs improve diabetes control in the short term, but ongoing programs are needed for sustained impact. PMID:26491815

  20. Long-term control of CMV retinitis in a patient with idiopathic CD4+ T lymphocytopenia.

    PubMed

    Yashiro, Shigeko; Fujino, Yujiro; Tachikawa, Natsuo; Inamochi, Kazuya; Oka, Shinichi

    2013-04-01

    Cytomegalovirus (CMV) retinitis with idiopathic CD4(+) T lymphocytopenia (ICL) is rare and difficult to control. We report a first case for long-term control of CMV retinitis with ICL using interleukin-2 (IL-2) therapy and succeeded in discontinuation of anti-CMV therapy. A 49-year-old Japanese woman was diagnosed with ICL based on low CD4(+) count (72/μl), negative for HIV-1 and -2 antibodies, and absence of any defined immunodeficiency diseases or immunosuppressive therapy. PCR test of the aqueous humor in the right eye was suggestive of CMV retinitis. She was treated with systemic ganciclovir, but after several relapses of CMV retinitis, rhegmatogenous retinal detachment appeared in the right eye and she became blind in that eye. Three years later, she developed CMV retinitis in the left eye. Although she received systemic and focal anti-CMV treatments, the retinitis showed no improvement. Finally, retinal detachment occurred, and she underwent vitrectomy. IL-2 was injected to increase CD4(+) counts. Because of hyperpyrexia, blepharedema, central scotoma, and color anomaly, we changed to low-dose IL-2 therapy with no side effects. Finally, we succeeded in increasing the CD4(+) count to more than 200/μl after discontinuation of low-dose IL-2 therapy. CMV retinitis never recurred after discontinuation of anti-CMV therapy, with good visual acuity of 20/20 in the left eye. She developed blindness of the first affected right eye, whereas the visual acuity of the left eye remains excellent more than 12 years after the onset of CMV retinitis through the combined use of anti-CMV therapy, IL-2 therapy, and vitrectomy. PMID:22935818

  1. Long-term cognitive follow-up of Parkinson's disease patients with impulse control disorders.

    PubMed

    Siri, Chiara; Cilia, Roberto; Reali, Elisa; Pozzi, Beatrice; Cereda, Emanuele; Colombo, Aurora; Meucci, Nicoletta; Canesi, Margherita; Zecchinelli, Anna L; Tesei, Silvana; Mariani, Claudio B; Sacilotto, Giorgio; Zini, Michela; Pezzoli, Gianni

    2015-04-15

    This study investigated cognitive functions in Parkinson's disease (PD) patients with impulse control disorders (ICDs) and aimed to identify possible predictors of behavioral outcome. In this longitudinal cohort study, 40 PD outpatients with ICDs and 40 without, were matched for sex, age at PD onset, age and disease duration at cognitive assessment. All patients had two neuropsychological assessments at least 2 years apart (mean, 3.5 years). Multivariate logistic regression analysis was performed to identify predictors of ICDs remission at follow-up. The PD patients with and without ICDs had overall comparable cognitive performance at baseline. When evaluating changes between baseline and follow-up, we found significant group × time interactions in several frontal lobe-related tests, with the ICDs group showing a less pronounced worsening over time. ICDs remission was associated with better performance at baseline in working memory-related tasks, such as digit span (odds ratio [OR] = 2.69 [95% confidence interval (CI), 1.09-6.66]) and attentive matrices (OR=1.19 [95%CI, 1.03-1.37]). ICDs remitters and non-remitters had no remarkable differences in baseline PD-related features and therapy management strategies (including the extent of dopamine agonist dose reduction). In conclusion, ICDs in PD patients are not related to greater cognitive impairment or executive dysfunction, but rather show relatively lower cognitive decline over time. The impaired top-down inhibitory control characterizing ICDs is likely attributable to a drug-induced overstimulation of relatively preserved prefrontal cognitive functions. Full behavioral remission in the long term was predicted by better working memory abilities. © 2015 International Parkinson and Movement Disorder Society. PMID:25757654

  2. Diabetes and cardiovascular disease: Changing the focus from glycemic control to improving the long-term survival

    PubMed Central

    Wang, Cecilia C. Low; Reusch, Jane EB

    2012-01-01

    Diabetes is the fifth leading cause of death worldwide and contributes to leading causes of death, cancer and cardiovascular disease including coronary heart disease, stroke, peripheral vascular disease and other vascular disease. While glycemic management remains a cornerstone of diabetes care, the co-management of hypertension, atherosclerosis, cardiovascular risk reduction and prevention of long-term consequences associated with diabetes are now well recognized as essential to improve long-term survival. Clinical trial evidence substantiates the importance of glycemic control, LDL-cholesterol lowering therapy, blood-pressure lowering, control of albuminuria, and comprehensive approaches targeting multiple risk factors to reduce cardiovascular risk. This article presents a review of the role of diabetes in pathogenesis of atherosclerosis and cardiac dysfunction, recent evidence regarding degree of glycemic control and mortality, and available evidence for a multi-faceted approach to improve long-term outcomes for patients. PMID:23062569

  3. Long-Term Instrumentation, Information, and Control Systems (II&C) Modernization Future Vision and Strategy

    SciTech Connect

    Kenneth Thomas

    2012-02-01

    Life extension beyond 60 years for the U.S operating nuclear fleet requires that instrumentation and control (I&C) systems be upgraded to address aging and reliability concerns. It is impractical for the legacy systems based on 1970's vintage technology operate over this extended time period. Indeed, utilities have successfully engaged in such replacements when dictated by these operational concerns. However, the replacements have been approached in a like-for-like manner, meaning that they do not take advantage of the inherent capabilities of digital technology to improve business functions. And so, the improvement in I&C system performance has not translated to bottom-line performance improvement for the fleet. Therefore, wide-scale modernization of the legacy I&C systems could prove to be cost-prohibitive unless the technology is implemented in a manner to enable significant business innovation as a means of off-setting the cost of upgrades. A Future Vision of a transformed nuclear plant operating model based on an integrated digital environment has been developed as part of the Advanced Instrumentation, Information, and Control (II&C) research pathway, under the Light Water Reactor (LWR) Sustainability Program. This is a research and development program sponsored by the U.S. Department of Energy (DOE), performed in close collaboration with the nuclear utility industry, to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. DOE's program focus is on longer-term and higher-risk/reward research that contributes to the national policy objectives of energy security and environmental security . The Advanced II&C research pathway is being conducted by the Idaho National Laboratory (INL). The Future Vision is based on a digital architecture that encompasses all aspects of plant operations and support, integrating plant systems, plant work processes, and plant workers in a seamless

  4. Long-Term Instrumentation, Information, and Control Systems (II&C) Modernization Future Vision and Strategy

    SciTech Connect

    Kenneth Thomas; Bruce Hallbert

    2013-02-01

    Life extension beyond 60 years for the U.S operating nuclear fleet requires that instrumentation and control (I&C) systems be upgraded to address aging and reliability concerns. It is impractical for the legacy systems based on 1970’s vintage technology operate over this extended time period. Indeed, utilities have successfully engaged in such replacements when dictated by these operational concerns. However, the replacements have been approached in a like-for-like manner, meaning that they do not take advantage of the inherent capabilities of digital technology to improve business functions. And so, the improvement in I&C system performance has not translated to bottom-line performance improvement for the fleet. Therefore, wide-scale modernization of the legacy I&C systems could prove to be cost-prohibitive unless the technology is implemented in a manner to enable significant business innovation as a means of off-setting the cost of upgrades. A Future Vision of a transformed nuclear plant operating model based on an integrated digital environment has been developed as part of the Advanced Instrumentation, Information, and Control (II&C) research pathway, under the Light Water Reactor (LWR) Sustainability Program. This is a research and development program sponsored by the U.S. Department of Energy (DOE), performed in close collaboration with the nuclear utility industry, to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. DOE’s program focus is on longer-term and higher-risk/reward research that contributes to the national policy objectives of energy security and environmental security . The Advanced II&C research pathway is being conducted by the Idaho National Laboratory (INL). The Future Vision is based on a digital architecture that encompasses all aspects of plant operations and support, integrating plant systems, plant work processes, and plant workers in a

  5. A Derivation of the Long-Term Degradation of a Pulsed Atomic Frequency Standard from a Control-Loop Model

    NASA Technical Reports Server (NTRS)

    Greenhall, C. A.

    1996-01-01

    The phase of a frequency standard that uses periodic interrogation and control of a local oscillator (LO) is degraded by a long-term random-walk component induced by downconversion of LO noise into the loop passband. The Dick formula for the noise level of this degradation is derived from an explicit solution of an LO control-loop model.

  6. Defining long-term drivers of pertussis resurgence, and optimal vaccine control strategies.

    PubMed

    Campbell, Patricia Therese; McCaw, James Matthew; McIntyre, Peter; McVernon, Jodie

    2015-10-26

    Pertussis resurgence has been reported from several developed countries with long-standing immunisation programs. Among these, Australia in 2003 discontinued an 18 months (fourth) booster dose in favour of an adolescent (fifth) dose. We developed a model to evaluate determinants of resurgence in Australia and alternative vaccine strategies for mitigation. Novel characteristics of our model included the use of seroepidemiologic data for calibration, and broad investigation of variables relevant to transmission of, and protection against, pertussis. We simulated multiple parameter combinations, retaining those consistent with observed data for subsequent use in predictive models comparing alternative vaccination schedules. Reproducing the early control of pertussis followed by late resurgence observed in Australia required natural immunity to last decades longer than vaccine-acquired immunity, with mean duration exceeding 50 years in almost 90% of simulations. Replacement of the dose at 18 months with an adolescent dose in 2003 resulted in a 40% increase in infections in the age group 18-47 months by 2013. A six dose strategy (2, 4, 6, 18 months, 4 and 15 years) yielded a reduction in infection incidence (pre-school 43%, infants 8%) greater than any alternative strategies considered for timing of five administered doses. Our finding that natural immunity drives long-term trends in pertussis cycles is relevant to a range of pertussis strategies and provides the necessary context in which to consider maternal vaccination. Comparatively short-lived vaccine-acquired immunity requires multiple boosters over the first two decades of life to maximise reduction in infections. PMID:26392008

  7. A Broad Range of Dose Optima Achieve High-level, Long-term Gene Expression After Hydrodynamic Delivery of Sleeping Beauty Transposons Using Hyperactive SB100x Transposase.

    PubMed

    Podetz-Pedersen, Kelly M; Olson, Erik R; Somia, Nikunj V; Russell, Stephen J; McIvor, R Scott

    2016-01-01

    The Sleeping Beauty (SB) transposon system has been shown to enable long-term gene expression by integrating new sequences into host cell chromosomes. We found that the recently reported SB100x hyperactive transposase conferred a surprisingly high level of long-term expression after hydrodynamic delivery of luciferase-encoding reporter transposons in the mouse. We conducted dose-ranging studies to determine the effect of varying the amount of SB100x transposase-encoding plasmid (pCMV-SB100x) at a set dose of luciferase transposon and of varying the amount of transposon-encoding DNA at a set dose of pCMV-SB100x in hydrodynamically injected mice. Animals were immunosuppressed using cyclophosphamide in order to prevent an antiluciferase immune response. At a set dose of transposon DNA (25 µg), we observed a broad range of pCMV-SB100x doses (0.1-2.5 µg) conferring optimal levels of long-term expression (>10(11) photons/second/cm(2)). At a fixed dose of 0.5 μg of pCMV-SB100x, maximal long-term luciferase expression (>10(10) photons/second/cm(2)) was achieved at a transposon dose of 5-125 μg. We also found that in the linear range of transposon doses (100 ng), co-delivering the CMV-SB100x sequence on the same plasmid was less effective in achieving long-term expression than delivery on separate plasmids. These results show marked flexibility in the doses of SB transposon plus pCMV-SB100x that achieve maximal SB-mediated gene transfer efficiency and long-term gene expression after hydrodynamic DNA delivery to mouse liver. PMID:26784638

  8. Attention Problems, Phonological Short-Term Memory, and Visuospatial Short-Term Memory: Differential Effects on Near- and Long-Term Scholastic Achievement

    ERIC Educational Resources Information Center

    Sarver, Dustin E.; Rapport, Mark D.; Kofler, Michael J.; Scanlan, Sean W.; Raiker, Joseph S.; Altro, Thomas A.; Bolden, Jennifer

    2012-01-01

    The current study examined individual differences in children's phonological and visuospatial short-term memory as potential mediators of the relationship among attention problems and near- and long-term scholastic achievement. Nested structural equation models revealed that teacher-reported attention problems were associated negatively with…

  9. Developing Long-Term Computing Skills among Low-Achieving Students via Web-Enabled Problem-Based Learning and Self-Regulated Learning

    ERIC Educational Resources Information Center

    Tsai, Chia-Wen; Lee, Tsang-Hsiung; Shen, Pei-Di

    2013-01-01

    Many private vocational schools in Taiwan have taken to enrolling students with lower levels of academic achievement. The authors re-designed a course and conducted a series of quasi-experiments to develop students' long-term computing skills, and examined the longitudinal effects of web-enabled, problem-based learning (PBL) and…

  10. Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial

    PubMed Central

    Hovi, Sirpa-Liisa; Veerus, Piret; Rahu, Mati; Hemminki, Elina

    2008-01-01

    Background Preventive drugs require long-term trials to show their effectiveness or harms and often a lot of changes occur during post-marketing studies. The purpose of this article is to describe the research process in a long-term randomized controlled trial and discuss the impact and consequences of changes in the research environment. Methods The Estonian Postmenopausal Hormone Therapy trial (EPHT), originally planned to continue for five years, was planned in co-operation with the Women's International Study of Long-Duration Oestrogen after Menopause (WISDOM) in the UK. In addition to health outcomes, EPHT was specifically designed to study the impact of postmenopausal hormone therapy (HT) on health services utilization. Results After EPHT recruited in 1999–2001 the Women's Health Initiative (WHI) in the USA decided to stop the estrogen-progestin trial after a mean of 5.2 years in July 2002 because of increased risk of breast cancer and later in 2004 the estrogen-only trial because HT increased the risk of stroke, decreased the risk of hip fracture, and did not affect coronary heart disease incidence. WISDOM was halted in autumn 2002. These decisions had a major influence on EPHT. Conclusion Changes in Estonian society challenged EPHT to find a balance between the needs of achieving responses to the trial aims with a limited budget and simultaneously maintaining the safety of trial participants. Flexibility was the main key for success. Rapid changes are not limited only to transiting societies but are true also in developed countries and the risk must be included in planning all long-term trials. The role of ethical and data monitoring committees in situations with emerging new data from other studies needs specification. Longer funding for preventive trials and more flexibility in budgeting are mandatory. Who should prove the effectiveness of an (old) drug for a new preventive indication? In preventive drug trials companies may donate drugs but they take a

  11. DEFINITION OF THE LONG-TERM CONTROL EFFICIENCY OF CHEMICAL DUST SUPPRESSANTS APPLIED TO UNPAVED ROADS

    EPA Science Inventory

    The paper presents the methodology and results of a field testing program to quantify the long-term efficiency of chemical dust suppressants applied to industrial unpaved roads. Three generic categories of suppressants were evaluated: water, a water-based petroleum resin, and a w...

  12. Long-Term Retention Explained by a Model of Short-Term Learning in the Adaptive Control of Reaching

    PubMed Central

    Joiner, Wilsaan M.; Smith, Maurice A.

    2008-01-01

    Extensive theoretical, psychophysical, and neurobiological work has focused on the mechanisms by which short-term learning develops into long-term memory. Better understanding of these mechanisms may lead to the ability to improve the efficiency of training procedures. A key phenomenon in the formation of long-term memory is the effect of over learning on retention—discovered by Ebbinghaus in 1885: when the initial training period in a task is prolonged even beyond what is necessary for good immediate recall, long-term retention improves. Although this over learning effect has received considerable attention as a phenomenon in psychology research, the mechanisms governing this process are not well understood, and the ability to predict the benefit conveyed by varying degrees of over learning does not yet exist. Here we studied the relationship between the duration of an initial training period and the amount of retention 24 h later for the adaptation of human reaching arm movements to a novel force environment. We show that in this motor adaptation task, the amount of long-term retention is predicted not by the overall performance level achieved during the training period but rather by the level of a specific component process in a multi-rate model of short-term memory formation. These findings indicate that while multiple learning processes determine the ability to learn a motor adaptation, only one provides a gateway to long-term memory formation. Understanding the dynamics of this key learning process may allow for the rational design of training and rehabilitation paradigms that maximize the long-term benefit of each session. PMID:18784273

  13. Automatic lighting controls demonstration: Long-term results. Final report, July 1991

    SciTech Connect

    Rubinstein, F.

    1991-10-18

    An advanced electronically ballasted lighting control system was installed in a portion of an office building to measure the energy and demand savings. The lighting control system used an integrated lighting control scenario that included daylight following, lumen depreciation correction, and scheduling. The system reduced lighting energy on weekdays by 62% and 51% in the north and south daylit zones, respectively, compared to a reference zone that did not have controls. During the summer, over 75% energy savings were achieved on weekdays in the north daylit zone. Even in the south interior zone, which benefitted lime from daylight, correction strategies and adjustment of the aisleway lights to a low level resulted in energy use of only half that of the reference zone. Although, in general, the savings varied over the year due to changing daylight conditions, the energy reduction achieved with controls could be fit using a simple analytical model. Significant savings also occurred during core operating hours when it is more expensive to supply and use energy. Compared to the usage in the reference zone, energy reductions of 49%, 44%, and 62% were measured in the south daylight, south interior, and north daylight zones, respectively, during core operating hours throughout the year. Lighting energy usage on weekends decreased dramatically in the zones with controls, with the usage in the north daylit zone only 10% that of the reference zone. A simple survey developed to assess occupant response to the lighting control system showed that the occupants were satisfied with the light levels provided.

  14. Long-term survival and T-cell kinetics in relapsed/refractory ALL patients who achieved MRD response after blinatumomab treatment.

    PubMed

    Zugmaier, Gerhard; Gökbuget, Nicola; Klinger, Matthias; Viardot, Andreas; Stelljes, Matthias; Neumann, Svenja; Horst, Heinz-A; Marks, Reinhard; Faul, Christoph; Diedrich, Helmut; Reichle, Albrecht; Brüggemann, Monika; Holland, Chris; Schmidt, Margit; Einsele, Hermann; Bargou, Ralf C; Topp, Max S

    2015-12-10

    This long-term follow-up analysis evaluated overall survival (OS) and relapse-free survival (RFS) in a phase 2 study of the bispecific T-cell engager antibody construct blinatumomab in 36 adults with relapsed/refractory B-precursor acute lymphoblastic leukemia (ALL). In the primary analysis, 25 (69%) patients with relapsed/refractory ALL achieved complete remission with full (CR) or partial (CRh) hematologic recovery of peripheral blood counts within the first 2 cycles. Twenty-five patients (69%) had a minimal residual disease (MRD) response (<10(-4) blasts), including 22 CR/CRh responders, 2 patients with hypocellular bone marrow, and 1 patient with normocellular bone marrow but low peripheral counts. Ten of the 36 patients (28%) were long-term survivors (OS ≥30 months). Median OS was 13.0 months (median follow-up, 32.6 months). MRD response was associated with significantly longer OS (Mantel-Byar P = .009). All 10 long-term survivors had an MRD response. Median RFS was 8.8 months (median follow-up, 28.9 months). A plateau for RFS was reached after ∼18 months. Six of the 10 long-term survivors remained relapse-free, including 4 who received allogeneic stem cell transplantation (allo-SCT) as consolidation for blinatumomab and 2 who received 3 additional cycles of blinatumomab instead of allo-SCT. Three long-term survivors had neurologic events or cytokine release syndrome, resulting in temporary blinatumomab discontinuation; all restarted blinatumomab successfully. Long-term survivors had more pronounced T-cell expansion than patients with OS <30 months. PMID:26480933

  15. Long-term survival and T-cell kinetics in relapsed/refractory ALL patients who achieved MRD response after blinatumomab treatment

    PubMed Central

    Gökbuget, Nicola; Klinger, Matthias; Viardot, Andreas; Stelljes, Matthias; Neumann, Svenja; Horst, Heinz-A.; Marks, Reinhard; Faul, Christoph; Diedrich, Helmut; Reichle, Albrecht; Brüggemann, Monika; Holland, Chris; Schmidt, Margit; Einsele, Hermann; Bargou, Ralf C.; Topp, Max S.

    2015-01-01

    This long-term follow-up analysis evaluated overall survival (OS) and relapse-free survival (RFS) in a phase 2 study of the bispecific T-cell engager antibody construct blinatumomab in 36 adults with relapsed/refractory B-precursor acute lymphoblastic leukemia (ALL). In the primary analysis, 25 (69%) patients with relapsed/refractory ALL achieved complete remission with full (CR) or partial (CRh) hematologic recovery of peripheral blood counts within the first 2 cycles. Twenty-five patients (69%) had a minimal residual disease (MRD) response (<10−4 blasts), including 22 CR/CRh responders, 2 patients with hypocellular bone marrow, and 1 patient with normocellular bone marrow but low peripheral counts. Ten of the 36 patients (28%) were long-term survivors (OS ≥30 months). Median OS was 13.0 months (median follow-up, 32.6 months). MRD response was associated with significantly longer OS (Mantel-Byar P = .009). All 10 long-term survivors had an MRD response. Median RFS was 8.8 months (median follow-up, 28.9 months). A plateau for RFS was reached after ∼18 months. Six of the 10 long-term survivors remained relapse-free, including 4 who received allogeneic stem cell transplantation (allo-SCT) as consolidation for blinatumomab and 2 who received 3 additional cycles of blinatumomab instead of allo-SCT. Three long-term survivors had neurologic events or cytokine release syndrome, resulting in temporary blinatumomab discontinuation; all restarted blinatumomab successfully. Long-term survivors had more pronounced T-cell expansion than patients with OS <30 months. PMID:26480933

  16. LONG-TERM DEMONSTRATION OF SORBENT ENHANCEMENT ADDITIVE TECHNOLOGY FOR MERCURY CONTROL

    SciTech Connect

    Jason D. Laumb; Dennis L. Laudal; Grant E. Dunham; John P. Kay; Christopher L. Martin; Jeffrey S. Thompson; Nicholas B. Lentz; Alexander Azenkeng; Kevin C. Galbreath; Lucinda L. Hamre

    2011-05-27

    Long-term demonstration tests of advanced sorbent enhancement additive (SEA) technologies have been completed at five coal-fired power plants. The targeted removal rate was 90% from baseline conditions at all five stations. The plants included Hawthorn Unit 5, Mill Creek Unit 4, San Miguel Unit 1, Centralia Unit 2, and Hoot Lake Unit 2. The materials tested included powdered activated carbon, treated carbon, scrubber additives, and SEAs. In only one case (San Miguel) was >90% removal not attainable. The reemission of mercury from the scrubber at this facility prevented >90% capture.

  17. Controlling for localised spatio-temporal autocorrelation in long-term air pollution and health studies

    PubMed Central

    Mitchell, Richard

    2014-01-01

    Estimating the long-term health impact of air pollution using an ecological spatio-temporal study design is a challenging task, due to the presence of residual spatio-temporal autocorrelation in the health counts after adjusting for the covariate effects. This autocorrelation is commonly modelled by a set of random effects represented by a Gaussian Markov random field (GMRF) prior distribution, as part of a hierarchical Bayesian model. However, GMRF models typically assume the random effects are globally smooth in space and time, and thus are likely to be collinear to any spatially and temporally smooth covariates such as air pollution. Such collinearity leads to poor estimation performance of the estimated fixed effects, and motivated by this epidemiological problem, this paper proposes new GMRF methodology to allow for localised spatio-temporal smoothing. This means random effects that are either geographically or temporally adjacent are allowed to be autocorrelated or conditionally independent, which allows more flexible autocorrelation structures to be represented. This increased flexibility results in improved fixed effects estimation compared with global smoothing models, which is evidenced by our simulation study. The methodology is then applied to the motivating study investigating the long-term effects of air pollution on respiratory ill health in Greater Glasgow, Scotland between 2007 and 2011. PMID:24648100

  18. Ambient Ozone Control in a Photochemically Active Region: Short-Term Despiking or Long-Term Attainment?

    PubMed

    Ou, Jiamin; Yuan, Zibing; Zheng, Junyu; Huang, Zhijiong; Shao, Min; Li, Zekun; Huang, Xiaobo; Guo, Hai; Louie, Peter K K

    2016-06-01

    China has made significant progress decreasing the ambient concentrations of most air pollutants, but ozone (O3) is an exception. O3 mixing ratios during pollution episodes are far higher than the national standard in the Pearl River Delta (PRD), thus greater evidence-based control efforts are needed for O3 attainment. By using a validated O3 modeling system and the latest regional emission inventory, this study illustrates that control strategies for short-term O3 despiking and long-term attainment in the PRD may be contradictory. VOC-focused controls are more efficient for O3 despiking in urban and industrial areas, but significant NOx emission reductions and a subsequent transition to a NOx-limited regime are required for O3 attainment. By tracking O3 changes along the entire path toward long-term attainment, this study recommends to put a greater focus on NOx emission controls region-wide. Parallel VOC reductions around the Nansha port are necessary in summertime and should be extended to the urban and industrial areas in fall with a flexibility to be strengthened on days forecasted to have elevated O3. Contingent VOC-focused controls on top of regular NOx-focused controls would lay the groundwork for striking a balance between short-term despiking and long-term attainment of O3 concentrations in the PRD. PMID:27135547

  19. Modeling the integration of parasitoid, insecticide, and transgenic insecticidal crop for the long-term control of an insect pest.

    PubMed

    Onstad, David W; Liu, Xiaoxia; Chen, Mao; Roush, Rick; Shelton, Anthony M

    2013-06-01

    The tools of insect pest management include host plant resistance, biological control, and insecticides and how they are integrated will influence the durability of each. We created a detailed model of the population dynamics and population genetics of the diamondback moth, Plutella xylostella L., and its parasitoid, Diadegma insulare (Cresson), to study long-term pest management in broccoli Brassica oleracea L. Given this pest's history of evolving resistance to various toxins, we also evaluated the evolution of resistance to transgenic insecticidal Bt broccoli (expressing Cry1Ac) and two types of insecticides. Simulations demonstrated that parasitism provided the most reliable, long-term control of P. xylostella populations. Use of Bt broccoli with a 10% insecticide-free refuge did not reduce the long-term contribution of parasitism to pest control. Small refuges within Bt broccoli fields can delay evolution of resistance > 30 generations if resistance alleles are rare in the pest population. However, the effectiveness of these refuges can be compromised by insecticide use. Rainfall mortality during the pest's egg and neonate stages significantly influences pest control but especially resistance management. Our model results support the idea that Bt crops and biological control can be integrated in integrated pest management and actually synergistically support each other. However, the planting and maintenance of toxin-free refuges are critical to this integration. PMID:23865173

  20. Short-term and long-term reproducibility of lung tumor position using active breathing control (ABC)

    SciTech Connect

    Koshani, Rojano . E-mail: rkashani@umich.edu; Balter, James M.; Hayman, James A.; Henning, George T.; Herk, Marcel van

    2006-08-01

    Purpose: To evaluate the short-term and long-term reproducibility of lung tumor position for scans acquired using an active breathing control (ABC) device. Methods and Materials: Ten patients with lung cancer were scanned over three sessions during the course of treatment. For each session, two scans were acquired at deep inhale, and one scan each at half of deep inhale and at exhale. Long-term reproducibility was evaluated by comparing the same breathing state scans from two sessions, with setup variation removed by skeletal alignment. Tumor alignment was based on intensity matching of a small volume around the tumor. For short-term reproducibility, the two inhale volumes from the same session were compared. Results: For the short-term reproducibility, the mean and the standard deviation (SD) of the displacement of the center of tumor were 0.0 (1.5) mm in anteroposterior (AP), 0.3 (1.4) mm in superior/inferior (SI), and 0.2 (0.7) mm in right/left (RL) directions. For long-term reproducibility, the mean (SD) were -1.3 (3.1) mm AP, -0.5 (3.8) mm SI, and 0.3 (1.6) mm RL for inhale and -0.2 (2.8) mm AP, 0.2 (2.1) mm SI, and -0.7 (1.1) mm RL for exhale. Conclusion: The ABC device demonstrates very good short-term and long-term reproducibility. Increased long-term variability in position, primarily in the SI and AP directions, indicates the role of tumor-directed localization in combination with breath-held immobilization.

  1. Short- and long-term physiologic and pharmacologic control of blood pressure in pediatric patients

    PubMed Central

    Trachtman, Howard

    2011-01-01

    The incidence of hypertension is rising in the general population. A parallel trend is present in children and adolescents. This reflects more intensive treatment and improved patient survival after a wide range of serious systemic illnesses that can lead to hypertension. In addition, primary or essential hypertension is more prevalent because of the epidemic of obesity and metabolic syndrome in pediatric and adult patients of both genders and in all ethnic groups. As a consequence of the changing demographic pattern of hypertension, more patients are requiring therapy for elevated blood pressure. This review summarizes key aspects of the treatment for hypertension in pediatric patients and the long-term management of this problem, including nonpharmacologic strategies and drug treatment. PMID:21949637

  2. Short- and long-term physiologic and pharmacologic control of blood pressure in pediatric patients.

    PubMed

    Trachtman, Howard

    2011-01-01

    The incidence of hypertension is rising in the general population. A parallel trend is present in children and adolescents. This reflects more intensive treatment and improved patient survival after a wide range of serious systemic illnesses that can lead to hypertension. In addition, primary or essential hypertension is more prevalent because of the epidemic of obesity and metabolic syndrome in pediatric and adult patients of both genders and in all ethnic groups. As a consequence of the changing demographic pattern of hypertension, more patients are requiring therapy for elevated blood pressure. This review summarizes key aspects of the treatment for hypertension in pediatric patients and the long-term management of this problem, including nonpharmacologic strategies and drug treatment. PMID:21949637

  3. Do erosion rates control the long-term carbon isotope mass balance?

    NASA Astrophysics Data System (ADS)

    Shields-Zhou, G. A.

    2014-12-01

    The long-term marine carbon isotope record responds to changes in the proportional burial rates of organic carbon relative to carbonate carbon on a global scale. For this reason, high δ13C values in marine carbonate rocks are normally interpreted to reflect faster rates of organic burial and increased atmospheric oxygenation. Geochemical redox tracers fail to support this paradigm for sustained deviations from the long-term δ13C mean, indicating perhaps that proportionally high organic burial may be associated with lower overall flux rates. Here I propose that ~107-108 year trends in average δ13C, as with seawater 87Sr/86Sr, are driven by changes in the balance between volcanism and denudation (~uplift). In other words, high proportional organic burial may be related to increases in the net CO2 flux (= organic carbon burial + Ca-Mg silicate weathering) relative to the carbonate weathering flux. According to this model, high baseline δ13C values will be associated with periods of heightened volcanic activity and/or diminished tectonic uplift. Conversely, lower baseline δ13C values can be related to times when the global carbon cycle was dominated by carbonate and oxidative weathering due to high rates of physical erosion. Shorter 105-106 year positive δ13C excursions have also been interpreted as the 'smoking gun' to extreme oxygenation events. However, large increases in organic burial are difficult to sustain under steady-state conditions without very high volcanic fluxes, indicating that some of these excursions might be better explained by transient changes to the isotopic composition of carbon sources and sinks.

  4. Approaches for achieving long-term accuracy and precision of δ18O and δ2H for waters analyzed using laser absorption spectrometers.

    PubMed

    Wassenaar, Leonard I; Coplen, Tyler B; Aggarwal, Pradeep K

    2014-01-21

    The measurement of δ(2)H and δ(18)O in water samples by laser absorption spectroscopy (LAS) are adopted increasingly in hydrologic and environmental studies. Although LAS instrumentation is easy to use, its incorporation into laboratory operations is not as easy, owing to extensive offline data manipulation required for outlier detection, derivation and application of algorithms to correct for between-sample memory, correcting for linear and nonlinear instrumental drift, VSMOW-SLAP scale normalization, and in maintaining long-term QA/QC audits. Here we propose a series of standardized water-isotope LAS performance tests and routine sample analysis templates, recommended procedural guidelines, and new data processing software (LIMS for Lasers) that altogether enables new and current LAS users to achieve and sustain long-term δ(2)H and δ(18)O accuracy and precision for these important isotopic assays. PMID:24328223

  5. Short- and long-term control of Vespula pensylvanica in Hawaii by fipronil baiting

    USGS Publications Warehouse

    Hanna, Cause; Foote, David; Kremen, Claire

    2012-01-01

    BACKGROUND: The invasive western yellowjacket wasp, Vespula pensylvanica (Saussure), has significantly impacted the ecological integrity and human welfare of Hawaii. The goals of the present study were (1) to evaluate the immediate and long-term efficacy of a 0.1% fipronil chicken bait on V. pensylvanica populations in Hawaii Volcanoes National Park, (2) to quantify gains in efficacy using the attractant heptyl butyrate in the bait stations and (3) to measure the benefits of this approach for minimizing non-target impacts to other arthropods. RESULTS: The 0.1% fipronil chicken bait reduced the abundance of V. pensylvanica by 95 ± 1.2% during the 3 months following treatment and maintained a population reduction of 60.9 ± 3.1% a year after treatment in the fipronil-treated sites when compared with chicken-only sites. The addition of heptyl butyrate to the bait stations significantly increased V. pensylvanica forager visitation and bait take and significantly reduced the non-target impacts of fipronil baiting. CONCLUSION: In this study, 0.1% fipronil chicken bait with the addition of heptyl butyrate was found to be an extremely effective large-scale management strategy and provided the first evidence of a wasp suppression program impacting Vepsula populations a year after treatment. Copyright © 2011 Society of Chemical Industry

  6. Controlled Adhesion and Growth of Long Term Glial and Neuronal Cultures on Parylene-C

    PubMed Central

    Delivopoulos, Evangelos; Murray, Alan F.

    2011-01-01

    This paper explores the long term development of networks of glia and neurons on patterns of Parylene-C on a SiO2 substrate. We harvested glia and neurons from the Sprague-Dawley (P1–P7) rat hippocampus and utilized an established cell patterning technique in order to investigate cellular migration, over the course of 3 weeks. This work demonstrates that uncontrolled glial mitosis gradually disrupts cellular patterns that are established early during culture. This effect is not attributed to a loss of protein from the Parylene-C surface, as nitrogen levels on the substrate remain stable over 3 weeks. The inclusion of the anti-mitotic cytarabine (Ara-C) in the culture medium moderates glial division and thus, adequately preserves initial glial and neuronal conformity to underlying patterns. Neuronal apoptosis, often associated with the use of Ara-C, is mitigated by the addition of brain derived neurotrophic factor (BDNF). We believe that with the right combination of glial inhibitors and neuronal promoters, the Parylene-C based cell patterning method can generate structured, active neural networks that can be sustained and investigated over extended periods of time. To our knowledge this is the first report on the concurrent application of Ara-C and BDNF on patterned cell cultures. PMID:21966523

  7. Long-term criticality control in radioactive waste disposal facilities using depleted uranium

    SciTech Connect

    Forsberg, C.W.

    1997-02-19

    Plant photosynthesis has created a unique planetary-wide geochemistry - an oxidizing atmosphere with oxidizing surface waters on a planetary body with chemically reducing conditions near or at some distance below the surface. Uranium is four orders of magnitude more soluble under chemically oxidizing conditions than it is under chemically reducing conditions. Thus, uranium tends to leach from surface rock and disposal sites, move with groundwater, and concentrate where chemically reducing conditions appear. Earth`s geochemistry concentrates uranium and can separate uranium from all other elements except oxygen, hydrogen (in water), and silicon (silicates, etc). Fissile isotopes include {sup 235}U, {sup 233}U, and many higher actinides that eventually decay to one of these two uranium isotopes. The potential for nuclear criticality exists if the precipitated uranium from disposal sites has a significant fissile enrichment, mass, and volume. The earth`s geochemistry suggests that isotopic dilution of fissile materials in waste with {sup 238}U is a preferred strategy to prevent long-term nuclear criticality in and beyond the boundaries of waste disposal facilities because the {sup 238}U does not separate from the fissile uranium isotopes. Geological, laboratory, and theoretical data indicate that the potential for nuclear criticality can be minimized by diluting fissile materials with-{sup 238}U to 1 wt % {sup 235}U equivalent.

  8. Long-term controls on ocean phosphorus and oxygen in a global biogeochemical model

    NASA Astrophysics Data System (ADS)

    Palastanga, V.; Slomp, C. P.; Heinze, C.

    2011-09-01

    In this study, we use a biogeochemical ocean general circulation model (HAMOCC), originally developed for the carbon and silicon cycles, and expand it with a description of the sedimentary phosphorus (P) cycle. The model simulates the release of reactive P by aerobic and anaerobic degradation of organic matter in the sediment, as well as formation and burial of Fe-oxide bound P and authigenic Ca-P minerals. We also include pre-anthropogenic inputs of P from atmospheric dust, which is mostly in the form of detrital apatite. Model predicted total P concentrations and rates of reactive P burial for the deep sea agree reasonably well with observations in open ocean and near continental margin sediments. As part of a sensitivity analysis, we assess the long-term response of ocean productivity and deep water oxygenation to increases in the riverine input of P and preferential release of P from sediments. The simulations show that the feedback from preferential P regeneration accelerates the expansion of suboxia (O2 < 25 μM) along continental margins and in the naturally suboxic areas in tropical-subtropical regions on timescales of 10-100 ka. For a case in which maximum P regeneration from sediments is enabled, a large-scale pattern of bottom water suboxia (30% of the total ocean area) develops over the southeastern, tropical and northern Pacific Ocean sectors.

  9. Myeloid Sirtuin 2 Expression Does Not Impact Long-Term Mycobacterium tuberculosis Control

    PubMed Central

    Moreira-Teixeira, Lúcia; Sousa, Jeremy; Torrado, Egídio; Silvestre, Ricardo; Castro, António Gil; Saraiva, Margarida; Pais, Teresa F.

    2015-01-01

    Sirtuins (Sirts) regulate several cellular mechanisms through deacetylation of several transcription factors and enzymes. Recently, Sirt2 was shown to prevent the development of inflammatory processes and its expression favors acute Listeria monocytogenes infection. The impact of this molecule in the context of chronic infections remains unknown. We found that specific Sirt2 deletion in the myeloid lineage transiently increased Mycobacterium tuberculosis load in the lungs and liver of conditional mice. Sirt2 did not affect long-term infection since no significant differences were observed in the bacterial burden at days 60 and 120 post-infection. The initial increase in M. tuberculosis growth was not due to differences in inflammatory cell infiltrates in the lung, myeloid or CD4+ T cells. The transcription levels of IFN-γ, IL-17, TNF, IL-6 and NOS2 were also not affected in the lungs by Sirt2-myeloid specific deletion. Overall, our results demonstrate that Sirt2 expression has a transitory effect in M. tuberculosis infection. Thus, modulation of Sirt2 activity in vivo is not expected to affect chronic infection with M. tuberculosis. PMID:26135889

  10. Balancing regulatory controls and incentives: toward smarter and more transparent oversight in long-term care.

    PubMed

    Miller, Edward Alan; Mor, Vincent

    2008-04-01

    Government oversight of long-term care involves inspections of patients' records, limited observations of patients and care practices, reviews of policies and procedures, and distribution of publicly available information. Although many providers bemoan the stifling consequences of excessive regulation, oversight in this area remains a highly legitimate endeavor for the public, though the public has limited trust in the existing regulatory regime. This distrust stems from many sources, not least of which includes considerable variation, both within and across states, in the way government oversight occurs. Reforming the current regulatory structure requires that we regulate "smarter" and more consistently. This means improving and maximizing use of the data already being collected, but it also means explicitly rationalizing the regulator's responsibility to review performance and apply sanctions when necessary. Oversight should more closely resemble consultancy, with regulators sharing information with providers about how to improve quality. Ideally, there needs to be an iterative process in which state inspectors identify performance problems and the nation's quality improvement organizations then help providers design quality improvement interventions to ameliorate the problems identified. The benefits of a revised regulatory approach are especially apparent in the aftermath of Hurricane Katrina, where more effective oversight would have identified nursing home residents at risk for low-quality care before the disaster occurred while better identifying those in need of evacuation or assistance afterward. PMID:18325900

  11. Macrophage Phenotype Controls Long-Term AKI Outcomes—Kidney Regeneration versus Atrophy

    PubMed Central

    Gröbmayr, Regina; Ryu, Mi; Lorenz, Georg; Hartter, Ingo; Mulay, Shrikant R.; Susanti, Heni Eka; Kobayashi, Koichi S.; Flavell, Richard A.; Anders, Hans-Joachim

    2014-01-01

    The mechanisms that determine full recovery versus subsequent progressive CKD after AKI are largely unknown. Because macrophages regulate inflammation as well as epithelial recovery, we investigated whether macrophage activation influences AKI outcomes. IL-1 receptor–associated kinase-M (IRAK-M) is a macrophage-specific inhibitor of Toll-like receptor (TLR) and IL-1 receptor signaling that prevents polarization toward a proinflammatory phenotype. In postischemic kidneys of wild-type mice, IRAK-M expression increased for 3 weeks after AKI and declined thereafter. However, genetic depletion of IRAK-M did not affect immunopathology and renal dysfunction during early postischemic AKI. Regarding long-term outcomes, wild-type kidneys regenerated completely within 5 weeks after AKI. In contrast, IRAK-M−/− kidneys progressively lost up to two-thirds of their original mass due to tubule loss, leaving atubular glomeruli and interstitial scarring. Moreover, M1 macrophages accumulated in the renal interstitial compartment, coincident with increased expression of proinflammatory cytokines and chemokines. Injection of bacterial CpG DNA induced the same effects in wild-type mice, and TNF-α blockade with etanercept partially prevented renal atrophy in IRAK-M−/− mice. These results suggest that IRAK-M induction during the healing phase of AKI supports the resolution of M1 macrophage– and TNF-α–dependent renal inflammation, allowing structural regeneration and functional recovery of the injured kidney. Conversely, IRAK-M loss-of-function mutations or transient exposure to bacterial DNA may drive persistent inflammatory mononuclear phagocyte infiltrates, which impair kidney regeneration and promote CKD. Overall, these results support a novel role for IRAK-M in the regulation of wound healing and tissue regeneration. PMID:24309188

  12. Nalbuphine Sedation in a Patient with Long Term, High Dose Chemotherapeutically Controlled Psychosis

    PubMed Central

    Kelly, Maureen; Howell, Robert M.

    1985-01-01

    Consideration of which pharmacologic agent to use when a patient requires sedation prior to an oral surgery procedure entails a number of factors, including past medical history, current medications and dose level, duration of administration, pharmacologic interactions, and the dental needs of the patient. The case described in this report illustrates the importance of consideration of these factors in a patient who required sedation prior to oral surgery while taking 800 mg chlorpromazine, 300 mg amantadine hydrochloride, and 900 mg of cimetidine daily. The possible pharmacologic interactions which could occur from concomitantly administering either diazepam or a narcotic in the presence of these agents are numerous and significant. The choice of sedative agent was further complicated by the fact that the patient was prescribed chlorpromazine and amantadine in doses which far exceeded the usual therapeutic levels and had been maintained for an extended period of time, over 8 months. Consequently, any adverse reactions that may have resulted when sedating a patient taking chlorapromazine and amantadine hydrochloride in lower doses for a shorter duration would be more likely to occur with greater speed and severity in a patient receiving such high-dose, long-term therapy. Also, unusual reactions which have not been reported with usual therapeutic dose levels might also occur since these high doses approach toxic levels for some patients. Additionally, a sedative agent had to be used which would not interfere with the antipsychotic effects of chlorpromazine since the patient's psychiatric condition required maintenance of these unusually high therapeutic levels. The following case report gives the rationale and outcome of utilizing nalbuphine for obtunding pain and producing sedation during an oral surgery procedure under such complex therapeutic conditions. PMID:3866505

  13. Nalbuphine sedation in a patient with long-term, high-dose chemotherapeutically controlled psychosis.

    PubMed

    Kelly, M; Howell, R M

    1985-01-01

    Consideration of which pharmacologic agent to use when a patient requires sedation prior to an oral surgery procedure entails a number of factors, including past medical history, current medications and dose level, duration of administration, pharmacologic interactions, and the dental needs of the patient. The case described in this report illustrates the importance of consideration of these factors in a patient who required sedation prior to oral surgery while taking 800 mg chlorpromazine, 300 mg amantadine hydrochloride, and 900 mg of cimetidine daily. The possible pharmacologic interactions which could occur from concomitantly administering either diazepam or a narcotic in the presence of these agents are numerous and significant. The choice of sedative agent was further complicated by the fact that the patient was prescribed chlorpromazine and amantadine in doses which far exceeded the usual therapeutic levels and had been maintained for an extended period of time, over 8 months. Consequently, any adverse reactions that may have resulted when sedating a patient taking chlorapromazine and amantadine hydrochloride in lower doses for a shorter duration would be more likely to occur with greater speed and severity in a patient receiving such high-dose, long-term therapy. Also, unusual reactions which have not been reported with usual therapeutic dose levels might also occur since these high doses approach toxic levels for some patients. Additionally, a sedative agent had to be used which would not interfere with the antipsychotic effects of chlorpromazine since the patient's psychiatric condition required maintenance of these unusually high therapeutic levels. The following case report gives the rationale and outcome of utilizing nalbuphine for obtunding pain and producing sedation during an oral surgery procedure under such complex therapeutic conditions. PMID:3866505

  14. Dissecting Rice Polyamine Metabolism under Controlled Long-Term Drought Stress

    PubMed Central

    Do, Phuc Thi; Degenkolbe, Thomas; Erban, Alexander; Heyer, Arnd G.; Kopka, Joachim; Köhl, Karin I.; Hincha, Dirk K.; Zuther, Ellen

    2013-01-01

    A selection of 21 rice cultivars (Oryza sativa L. ssp. indica and japonica) was characterized under moderate long-term drought stress by comprehensive physiological analyses and determination of the contents of polyamines and selected metabolites directly related to polyamine metabolism. To investigate the potential regulation of polyamine biosynthesis at the transcriptional level, the expression of 21 genes encoding enzymes involved in these pathways were analyzed by qRT-PCR. Analysis of the genomic loci revealed that 11 of these genes were located in drought-related QTL regions, in agreement with a proposed role of polyamine metabolism in rice drought tolerance. The cultivars differed widely in their drought tolerance and parameters such as biomass and photosynthetic quantum yield were significantly affected by drought treatment. Under optimal irrigation free putrescine was the predominant polyamine followed by free spermidine and spermine. When exposed to drought putrescine levels decreased markedly and spermine became predominant in all cultivars. There were no correlations between polyamine contents and drought tolerance. GC-MS analysis revealed drought-induced changes of the levels of ornithine/arginine (substrate), substrates of polyamine synthesis, proline, product of a competing pathway and GABA, a potential degradation product. Gene expression analysis indicated that ADC-dependent polyamine biosynthesis responded much more strongly to drought than the ODC-dependent pathway. Nevertheless the fold change in transcript abundance of ODC1 under drought stress was linearly correlated with the drought tolerance of the cultivars. Combining metabolite and gene expression data, we propose a model of the coordinate adjustment of polyamine biosynthesis for the accumulation of spermine under drought conditions. PMID:23577102

  15. Macrophage phenotype controls long-term AKI outcomes--kidney regeneration versus atrophy.

    PubMed

    Lech, Maciej; Gröbmayr, Regina; Ryu, Mi; Lorenz, Georg; Hartter, Ingo; Mulay, Shrikant R; Susanti, Heni Eka; Kobayashi, Koichi S; Flavell, Richard A; Anders, Hans-Joachim

    2014-02-01

    The mechanisms that determine full recovery versus subsequent progressive CKD after AKI are largely unknown. Because macrophages regulate inflammation as well as epithelial recovery, we investigated whether macrophage activation influences AKI outcomes. IL-1 receptor-associated kinase-M (IRAK-M) is a macrophage-specific inhibitor of Toll-like receptor (TLR) and IL-1 receptor signaling that prevents polarization toward a proinflammatory phenotype. In postischemic kidneys of wild-type mice, IRAK-M expression increased for 3 weeks after AKI and declined thereafter. However, genetic depletion of IRAK-M did not affect immunopathology and renal dysfunction during early postischemic AKI. Regarding long-term outcomes, wild-type kidneys regenerated completely within 5 weeks after AKI. In contrast, IRAK-M(-/-) kidneys progressively lost up to two-thirds of their original mass due to tubule loss, leaving atubular glomeruli and interstitial scarring. Moreover, M1 macrophages accumulated in the renal interstitial compartment, coincident with increased expression of proinflammatory cytokines and chemokines. Injection of bacterial CpG DNA induced the same effects in wild-type mice, and TNF-α blockade with etanercept partially prevented renal atrophy in IRAK-M(-/-) mice. These results suggest that IRAK-M induction during the healing phase of AKI supports the resolution of M1 macrophage- and TNF-α-dependent renal inflammation, allowing structural regeneration and functional recovery of the injured kidney. Conversely, IRAK-M loss-of-function mutations or transient exposure to bacterial DNA may drive persistent inflammatory mononuclear phagocyte infiltrates, which impair kidney regeneration and promote CKD. Overall, these results support a novel role for IRAK-M in the regulation of wound healing and tissue regeneration. PMID:24309188

  16. Immediate and Long-Term Effects of a Cognitive Intervention on Intelligence, Self-Regulation, and Academic Achievement

    ERIC Educational Resources Information Center

    Sanz de Acedo Lizarraga, M. Luisa; Ugarte, M. Dolores; Iriarte, M. Dolores; Sanz de Acedo Baquedano, M. Teresa

    2003-01-01

    The main purpose of this study was to evaluate the effects of a package of activities, known as "Portfolio", on cognitive functioning, self-regulation, and academic achievement. The study was carried out with a group of 40 students from Compulsory Secondary Education (mean age 13 years old) during 120 hours distributed over two school years. A…

  17. Attention Problems and Academic Achievement: Do Persistent and Earlier-Emerging Problems Have More Adverse Long-Term Effects?

    PubMed

    Rabiner, David L; Carrig, Madeline M; Dodge, Kenneth A

    2013-10-18

    This study examined whether the negative association between children's attention difficulties and their academic functioning is largely confined to children whose attention problems persist across early grades and whether it depends on when attention problems emerge in children's schooling. Children from the normative sample of the Fast Track study were classified into four attention problem groups based on the presence versus absence of attention problems in first and second grade. Those with attention problems in both grades showed a decline in reading and math achievement during the K-5 interval relative to children with attention problems in first grade only. Both groups of inattentive first graders also performed worse than comparison children. In contrast, children whose attention problems emerged in second grade did not differ from comparison children on any achievement outcome performed significantly better than inattentive first graders. The implications of these findings are discussed. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24141101

  18. Long-term far-transfer effects of working memory training in children with ADHD: a randomized controlled trial.

    PubMed

    Bigorra, Aitana; Garolera, Maite; Guijarro, Silvina; Hervás, Amaia

    2016-08-01

    ADHD affects working memory (WM) and other executive functions (EFs) and thereby negatively impacts school performance, clinical symptoms and functional impairment. The main aim of this study was to analyse the efficacy of computerized WM training (CWMT) on EF rating scales. A secondary objective was to assess its efficacy on performance-based measures of EF (PBMEF), learning, clinical symptoms and functional impairment. 66 children with combined-type ADHD between 7 and 12 years of age from the Child and Adolescent Psychiatric Unit (Spain) were included in this randomized, double-blind, placebo-controlled, parallel-group clinical trial. The participants were randomized (1:1) to an experimental group (EG) (CWMT) (n = 36) or a control group (CG) (placebo training). Assessments were conducted at baseline (T0), 1-2 weeks (T1), and 6 months post-intervention (T2) with the administration of EF rating scales, PBMEF, measures of academic achievement, and questionnaires regarding clinical symptoms and functional impairment. Participants, parents, teachers and professionals who performed the cognitive assessments were blinded. Adjusted multiple linear regression analysis showed significant improvements in EF scales-parent version, from T1 to T2, on the metacognition index [p = 0.03, d' = -0.78 (95 % CI -1.28 to -0.27)] and on WM (also significant at T2-T0) and plan/organize subscales. Significant improvements were also noted in EF scales-teacher version, from T0 to T1 and T2, on the metacognitive index [p = 0.05, d' = -0.37 (95 % CI -0.86 to 0.12) T1-T0, p = 0.02, d' = -0.81 (95 % CI -1.31 to -0.30) T2-T0] and on the initiate, WM, monitor and shift subscales. There were also significant improvements in PBMEF, ADHD symptoms, and functional impairment. CWMT had a significant impact on ADHD deficits by achieving long-term far-transfer effects. PMID:26669692

  19. Long-Term Aftereffects of Response Inhibition: Memory Retrieval, Task Goals, and Cognitive Control

    ERIC Educational Resources Information Center

    Verbruggen, Frederick; Logan, Gordon D.

    2008-01-01

    Cognitive control theories attribute control to executive processes that adjust and control behavior online. Theories of automaticity attribute control to memory retrieval. In the present study, online adjustments and memory retrieval were examined, and their roles in controlling performance in the stop-signal paradigm were elucidated. There was…

  20. Long-term outcomes of patients with advanced hepatocellular carcinoma who achieved complete remission after sorafenib therapy

    PubMed Central

    2015-01-01

    Background/Aims Sorafenib is currently the sole molecular targeted agent that improves overall survival in advanced hepatocellular carcinoma (HCC). Despite the efficacy of sorafenib, the response rate varies in patients with advanced HCC. We retrospectively analyzed a series of Korean patients with advanced HCC with complete remission (CR) after sorafenib therapy. Methods In total, 523 patients with advanced HCC were treated with sorafenib in 3 large tertiary referral hospitals in Korea. A survey was conducted to collect data on patients who experienced CR after sorafenib monotherapy, and their medical records and follow-up data were analyzed. The tumor response and recurrence rates were assessed by radiologic study, based on modified response evaluation criteria in solid tumors. Results Seven patients with advanced HCC experienced CR after sorafenib therapy. The median time to tumor disappearance and the median disease-free survival time were 3 months and 9 months, respectively. HCC recurrence was identified in three cases (42.9%). Of these, two patients discontinued sorafenib before or after achieving CR and the other patient continued sorafenib after achieving CR. HCC recurred at 3, 10, and 42 months after CR in these three patients. Three patients needed dose reduction for toxicity and adverse events. Conclusions Though CR was achieved after sorafenib therapy in patients with advanced HCC, the recurrence rate was relatively high. Subsequent strategies to reduce a chance of recurrence after sorafenib therapy are required to investigate. PMID:26527250

  1. Classifying Academically At-Risk First Graders into Engagement Types: Association with Long-Term Achievement Trajectories

    PubMed Central

    Hughes, Jan N.; Liew, Jeffrey; Kwok, Oiman

    2008-01-01

    Based on a sample of 480 academically at-risk first graders, we used a cluster analysis involving multimethod assessment (i.e., teacher-report, peer-evaluation, and self-report) of behavioral and psychological engagement to identify subtypes of academic engagement. Four theoretically and practically meaningful clusters were identified and labeled as cooperative (n = 95), resistive (n =96), enthusiastic (n = 188), and disaffected (n = 101). The four types did not differ in IQ measured with the Universal Nonverbal Intelligence Test. The cooperative group consisted of more female and Hispanic students, whereas the resistive group consisted of more male and African American students. The cooperative group was the most popular among peers, followed by the enthusiastic group. The disaffected and resistive groups had more emotional symptoms than the cooperative and enthusiastic groups. Academic engagement types also differed in growth trajectories of academic achievement measured with Woodcock Johnson III Tests of Achievement from second to fourth grade. For reading, the cooperative and enthusiastic groups outperformed the resistive and disaffected groups at the beginning. However, the growth rate was similar across engagement types. For math, the engagement types did not differ at the beginning. However, the cooperative group developed at a faster rate and had higher math achievement by fourth grade than the other types. The findings support the importance of teaching temperament-based regulatory skills and of providing a positive psychological climate for children's academic learning. PMID:19343104

  2. Long-Term Care

    MedlinePlus

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... the Escape (Esc) button on your keyboard.) Most Care Provided at Home Long-term care is provided ...

  3. Long-term Maintenance Treatment of Restless Legs Syndrome With Gabapentin Enacarbil: A Randomized Controlled Study

    PubMed Central

    Bogan, Richard K.; Bornemann, Michel A. Cramer; Kushida, Clete A.; Trân, Pierre V.; Barrett, Ronald W.

    2010-01-01

    OBJECTIVE: To assess maintenance of efficacy and tolerability of gabapentin enacarbil in patients with moderate to severe primary restless legs syndrome (RLS). PATIENTS AND METHODS: This study (conducted April 18, 2006, to November 14, 2007) comprised a 24-week, single-blind (SB) treatment phase (gabapentin enacarbil, 1200 mg) followed by a 12-week randomized, double-blind (DB) phase. Responders from the SB phase (patients with improvements on the International Restless Legs Scale [IRLS] and investigator-rated Clinical Global Impression–Improvement scale at week 24 and stable while taking a gabapentin enacarbil dose of 1200 mg for at least 1 month before randomization) were randomized to gabapentin enacarbil, 1200 mg, or placebo once daily at 5 pm with food. The primary end point was the proportion of patients experiencing relapse (worse scores on the IRLS and investigator-rated Clinical Global Impression of Change scale on 2 consecutive visits at least 1 week apart or withdrawal because of lack of efficacy) during the DB phase. RESULTS: A total of 221 of 327 patients completed the SB phase, 194 (96 in the gabapentin enacarbil group and 98 in the placebo group) were randomized to DB treatment, and 168 (84 in the gabapentin enacarbil group and 84 in the placebo group) completed the DB phase. A significantly smaller proportion of patients treated with gabapentin enacarbil (9/96 [9%]) experienced relapse compared with the placebo-treated patients (22/97 [23%]) (odds ratio, 0.353; 95% confidence interval, 0.2-0.8; P=.02). Somnolence and dizziness were the most common adverse events. One death occurred (unintentional choking during the SB phase) and was judged as being unrelated to the study drug. No clinically relevant changes were observed in laboratory values, in vital signs, or on electrocardiograms. CONCLUSION: Gabapentin enacarbil, 1200 mg, maintained improvements in RLS symptoms compared with placebo and showed long-term tolerability in adults with moderate to

  4. Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings: A Cross-Sectional Analysis.

    PubMed

    Li, Yu Ting; Wang, Harry H X; Liu, Kirin Q L; Lee, Gabrielle K Y; Chan, Wai Man; Griffiths, Sian M; Chen, Ruo Ling

    2016-05-01

    Hypertension is a typical example of long-term disease posing formidable challenges to health care. One goal of antihypertensive therapy is to achieve optimal blood pressure (BP) control and reduce co-occurring chronic conditions (multimorbidity). This study aimed to assess the influence of multimorbidity on medication adherence, and to explore the association between poor BP control and multimorbidity, with implications for hypertension management.A cross-sectional design with multistage sampling was adopted to recruit Chinese hypertensive patients attending general out-patient clinics from 3 geographic regions in Hong Kong. A modified systemic sampling methodology with 1 patient as a sampling unit was used to recruit consecutive samples in each general out-patient clinic. Data were collected by face-to-face interviews using a standardized protocol. Poor BP control was defined as having systolic BP/diastolic BP ≥130/80 mm Hg for those with diabetes or chronic kidney disease; and ≥140/90 mm Hg for others. Medication adherence was assessed by a validated Chinese version of the Morisky Medication Adherence Scale. A simple unweighted enumeration was adopted to measure the combinations of coexisting long-term conditions. Binary logistic regression analysis was conducted with medication adherence and multimorbidity as outcome variables, respectively, after controlling for effects of patient-level covariates.The prevalence of multimorbidity was 47.4% (95% confidence interval [CI] 45.4%-49.4%) among a total of 2445 hypertensive patients. The proportion of subjects having 0, 1, and ≥2 additional long-term conditions was 52.6%, 29.1%, and 18.3%, respectively. The overall rate of poor adherence to medication was 46.6%, whereas the rate of suboptimal BP control was 48.7%. Albeit the influence of multimorbidity on medication adherence was not found to be statistically significant, patients with poorly controlled BP were more likely to have multimorbidity (adjusted

  5. A factor controlling long-term variations of the Siberian water cycles during the past two centuries

    NASA Astrophysics Data System (ADS)

    Oshima, Kazuhiro; Ogata, Koto; Park, Hotaek; Tachibana, Yoshihiro

    2016-04-01

    Among all the rivers flowing into the Arctic Ocean, the three great Siberian rivers; Lena, Yenisei and Ob, are the three largest in terms of discharge (R), and are sources of freshwater, organic matter and heat into the ocean. While long-term variation and trend of the Rs have been examined in a lot of previous studies, causes of the R variations are still unclear. A previous study indicated the negative correlation between the Lena and Ob Rs during the 1980s to mid-1990s and it was affected by an east-west seesaw pattern of atmospheric circulation over Siberia. Our analysis indicated that 15-year running correlations between observed Rs of the Lena and Ob becomes weak after the mid-1990s and it was positive in mid-1950s to 1960s. The similar relationships were seen in precipitation (P) over the two basins. As in the observed Rs, more long-term record of reconstructed Rs of the Lena and Ob based on the tree-ring showed positive, negative and weak correlations in each of the epochs during the past two centuries. Interestingly, the correlations of the reconstructed Rs tend to be distributed on the negative side. These negative correlations were associated with the east-west seesaw pattern, as in the previous study. In addition, the correlations of Ps over eastern and western Siberia in an atmospheric general circulation model (AGCM) control simulation were distributed on more negative side compared to those in the CMIP3 multi-coupled models' simulations. The results of the AGCM and CMIP3 models reveal that the seesaw pattern frequently appears as an atmospheric internal variability over Siberia. Therefore, our results indicated that the east-west seesaw pattern as an atmospheric internal variability is a key factor controlling the long-term variation of water cycles in Siberia region.

  6. Visual thinking networking promotes long-term meaningful learning and achievement for 9th grade earth science students

    NASA Astrophysics Data System (ADS)

    Longo, Palma Joni

    2001-12-01

    An experimental and interview-based design was used to test the efficacy of visual thinking networking (VTN), a new generation of metacognitive learning strategies. Students constructed network diagrams using semantic and figural elements to represent knowledge relationships. The findings indicated the importance of using color in VTN strategies. The use of color promoted the encoding and reconstruction of earth science knowledge in memory and enhanced higher order thinking skills of problem solving. Fifty-six ninth grade earth science students (13--15 years of age) in a suburban school district outside New York City were randomly assigned to three classes with the same instructor. Five major positive findings emerged in the areas of problem solving achievement, organization of knowledge in memory, problem solving strategy dimensionality, conceptual understanding, and gender differences. A multi-covariate analysis was conducted on the pre-post gain scores of the AGI/NSTA Earth Science Examination (Part 1). Students who used the color VTN strategies had a significantly higher mean gain score on the problem solving criterion test items than students who used the black/white VTN (p = .003) and the writing strategies for learning science (p < .001). During a think-out-loud problem solving interview, students who used the color VTN strategies: (1) significantly recalled more earth science knowledge than students who used the black/white VTN (p = .021) and the writing strategies (p < .001); (2) significantly recalled more interrelated earth science knowledge than students who used black/white VTN strategies (p = .048) and the writing strategy (p < .001); (3) significantly used a greater number of action verbs than students who used the writing strategy (p = .033). Students with low abstract reasoning aptitude who used the color VTNs had a significantly higher mean number of conceptually accurate propositions than students who used the black/white VTN (p = .018) and the

  7. 75 FR 37463 - Dispensing of Controlled Substances to Residents at Long Term Care Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-29

    ... stocked with commonly dispensed controlled substances (45 FR 24128, April 9, 1980). These kits are... practitioners with the option of writing prescriptions for controlled substances electronically. 75 FR 16236... steroids, and drugs that are immediate precursors of these classes of substances. The CSA and...

  8. Short and long term impacts of energy variables on transportation controls. Paper 81. 43. 5

    SciTech Connect

    Wada, R.Y.; Petrites, V.; Knudson, W.

    1981-01-01

    The purpose of this paper was to assess the implications of the energy crisis for the planning of transportation controls. Shortages of gasoline had significant effects on urban travel. The use of transportation control is a method to improve air quality. They include parking provision for carpools, transit improvement, mandatory high vehicle occupancy and use of bicycles. 11 refs.

  9. Renewal of the Control System and Reliable Long Term Operation of the LHD Cryogenic System

    NASA Astrophysics Data System (ADS)

    Mito, T.; Iwamoto, A.; Oba, K.; Takami, S.; Moriuchi, S.; Imagawa, S.; Takahata, K.; Yamada, S.; Yanagi, N.; Hamaguchi, S.; Kishida, F.; Nakashima, T.

    The Large Helical Device (LHD) is a heliotron-type fusion plasma experimental machine which consists of a fully superconducting magnet system cooled by a helium refrigerator having a total equivalent cooling capacity of 9.2 kW@4.4 K. Seventeenplasma experimental campaigns have been performed successfully since1997 with high reliability of 99%. However, sixteen years have passed from the beginning of the system operation. Improvements are being implementedto prevent serious failures and to pursue further reliability.The LHD cryogenic control system was designed and developed as an open system utilizing latest control equipment of VME controllers and UNIX workstations at the construction time. Howeverthe generation change of control equipment has been advanced. Down-sizing of control deviceshas beenplanned from VME controllers to compact PCI controllers in order to simplify the system configuration and to improve the system reliability. The new system is composed of compact PCI controller and remote I/O connected with EtherNet/IP. Making the system redundant becomes possible by doubling CPU, LAN, and remote I/O respectively. The smooth renewal of the LHD cryogenic controlsystem and the further improvement of the cryogenic system reliability are reported.

  10. Effects of controlled discontinuation of long-term used antipsychotics on weight and metabolic parameters in individuals with intellectual disability.

    PubMed

    de Kuijper, Gerda; Mulder, Hans; Evenhuis, Heleen; Visser, Frank; Hoekstra, Pieter J

    2013-08-01

    Antipsychotics are frequently prescribed agents in individuals with intellectual disability, often for behavioral symptoms. Efficacy of antipsychotics for this is ambiguous, so discontinuation should be considered. Weight gain and metabolic dysregulation are well-known adverse effects of antipsychotics which increase the risk of the metabolic syndrome. We performed a discontinuation study in 99 adults with intellectual disability, living in residential facilities who used antipsychotics for behavioral symptoms for more than 1 year. The aim of the present study was to investigate the effects of discontinuation of long-term used antipsychotics on weight, body mass index (BMI), and parameters of the metabolic syndrome and to investigate the influence of genetic polymorphisms and medication factors on these outcomes. Discontinuation of antipsychotics led to a mean decrease of 4 cm waist circumference, of 3.5 kg weight, 1.4 kg/m2 BMI, and 7.1 mm Hg systolic blood pressure. In those participants who had not completely discontinued use of antipsychotics we found a decrease in weight and BMI and an increase in fasting glucose. The presence of the C-allele of serotonin 5-hydroxytryptamine receptor polymorphism rs141334 was associated with higher waist circumference and higher plasma levels of triglycerides and lower levels of high-density lipoprotein. Achievement of complete discontinuation predicted a larger decrease in waist circumference and BMI. In conclusion, results of the study show the beneficial effects of discontinuation of long-term used antipsychotics on metabolic outcomes. PMID:23775048

  11. Long-Term Data Reveal Patterns and Controls on Stream Water Chemistry in a Forested Stream: Walker Branch, Tennessee

    SciTech Connect

    Lutz, Brian D; Mulholland, Patrick J; Bernhardt, Emily

    2012-01-01

    We present 20 years of weekly stream water chemistry, hydrology, and climate data for the Walker Branch watershed in eastern Tennessee, USA. Since 1989, the watershed has experienced a similar to 1.08 degrees C increase in mean annual temperature, a similar to 20% decline in precipitation, and a similar to 30% increase in forest evapotranspiration rates. As a result, stream runoff has declined by similar to 34%. We evaluate long-term trends in stream water concentrations and fluxes for nine solutes and use wet deposition data to calculate approximate watershed input-output budgets. Dissolved constituents were classified as geochemical solutes (Ca2+, Mg2+, and SO42-) or nutrients (NH4+, NO3-, soluble reactive phosphorus [SRP], total soluble nitrogen [TSN], total soluble phosphorus [TSP], and dissolved organic carbon [DOC]). Geochemical solutes are predominantly controlled by discharge, and the long-term changes in catchment hydrology have led to significant trends in the concentrations and fluxes of these solutes. Further, the trends in geochemical solute concentrations indicate shifting soil flowpath contributions to streamflow generation through time, with deep groundwater having a greater proportional contribution in recent years. Despite dramatic changes in watershed runoff, there were no trends in inorganic nutrient concentrations (NH4+, NO3-, and SRP). While most nutrients entering the watershed are retained, stream fluxes of nutrient solutes have declined significantly as a result of decreasing runoff. Nutrient concentrations in the stream exhibit large seasonality controlled by in-stream biological uptake. Stream benthic communities are sensitive to hydrologic disturbance, and changes in the frequency or intensity of storm events through time can affect nutrient fluxes. Stream NO3- concentrations are also sensitive to drought, with concentrations decreasing (increasing) if conditions during the three years prior to the time of sampling were drier (wetter

  12. Temperature feedback control for long-term carrier-envelope phase locking

    DOEpatents

    Chang, Zenghu; Yun, Chenxia; Chen, Shouyuan; Wang, He; Chini, Michael

    2012-07-24

    A feedback control module for stabilizing a carrier-envelope phase of an output of a laser oscillator system comprises a first photodetector, a second photodetector, a phase stabilizer, an optical modulator, and a thermal control element. The first photodetector may generate a first feedback signal corresponding to a first portion of a laser beam from an oscillator. The second photodetector may generate a second feedback signal corresponding to a second portion of the laser beam filtered by a low-pass filter. The phase stabilizer may divide the frequency of the first feedback signal by a factor and generate an error signal corresponding to the difference between the frequency-divided first feedback signal and the second feedback signal. The optical modulator may modulate the laser beam within the oscillator corresponding to the error signal. The thermal control unit may change the temperature of the oscillator corresponding to a signal operable to control the optical modulator.

  13. Regional intravascular delivery of AAV-2-F.IX to skeletal muscle achieves long-term correction of hemophilia B in a large animal model.

    PubMed

    Arruda, Valder R; Stedman, Hansell H; Nichols, Timothy C; Haskins, Mark E; Nicholson, Matthew; Herzog, Roland W; Couto, Linda B; High, Katherine A

    2005-05-01

    In earlier work, we showed that adeno-associated virus-mediated delivery of a Factor IX gene to skeletal muscle by direct intramuscular injection resulted in therapeutic levels of circulating Factor IX in mice. However, achievement of target doses in humans proved impractical because of the large number of injections required. We used a novel intravascular delivery technique to achieve successful transduction of extensive areas of skeletal muscle in a large animal with hemophilia. We provide here the first report of long-term (> 3 years, with observation ongoing), robust Factor IX expression (circulating levels of 4%-14%) by muscle-directed gene transfer in a large animal, resulting in essentially complete correction of the bleeding disorder in hemophilic dogs. The results of this translational study establish an experimental basis for clinical studies of this delivery method in humans with hemophilia B. These findings also have immediate relevance for gene transfer in patients with muscular dystrophy. PMID:15479726

  14. Genetic control of Aedes aegypti: data-driven modelling to assess the effect of releasing different life stages and the potential for long-term suppression

    PubMed Central

    2014-01-01

    Background Control of the world’s most important vector-borne viral disease, dengue, is a high priority. A lack of vaccines or effective vector control methods means that novel solutions to disease control are essential. The release of male insects carrying a dominant lethal (RIDL) is one such approach that could be employed to control Aedes aegypti. To maximise the potential of RIDL control, optimum release strategies for transgenic mosquitoes are needed. The use of field data to parameterise models allowing comparisons of the release of different life-stages is presented together with recommendations for effective long-term suppression of a wild Ae. aegypti population. Methods A compartmental, deterministic model was designed and fitted to data from large-scale pupal mark release recapture (MRR) field experiments to determine the dynamics of a pupal release. Pulsed releases of adults, pupae or a combination of the two were simulated. The relative ability of different release methods to suppress a simulated wild population was examined and methods to maintain long-term suppression of a population explored. Results The pupal model produced a good fit to field data from pupal MRR experiments. Simulations using this model indicated that adult-only releases outperform pupal-only or combined releases when releases are frequent. When releases were less frequent pupal-only or combined releases were a more effective method of distributing the insects. The rate at which pupae eclose and emerge from release devices had a large influence on the relative efficacy of pupal releases. The combined release approach allows long-term suppression to be maintained with smaller low-frequency releases than adult- or pupal-only release methods. Conclusions Maximising the public health benefits of RIDL-based vector control will involve optimising all stages of the control programme. The release strategy can profoundly affect the outcome of a control effort. Adult-only, pupal-only and

  15. Evaluating Long-Term Complex Professional Development: Using a Variation of the Cohort Control Design

    ERIC Educational Resources Information Center

    Sample Mcmeeking, Laura B.; Cobb, R. Brian; Basile, Carole

    2010-01-01

    This paper introduces a variation on the post-test only cohort control design and addresses questions concerning both the methodological credibility and the practical utility of employing this design variation in evaluations of large-scale complex professional development programmes in mathematics education. The original design and design…

  16. Long-Term Calorie Restriction Enhances Cellular Quality-Control Processes in Human Skeletal Muscle.

    PubMed

    Yang, Ling; Licastro, Danilo; Cava, Edda; Veronese, Nicola; Spelta, Francesco; Rizza, Wanda; Bertozzi, Beatrice; Villareal, Dennis T; Hotamisligil, Gökhan S; Holloszy, John O; Fontana, Luigi

    2016-01-26

    Calorie restriction (CR) retards aging, acts as a hormetic intervention, and increases serum corticosterone and HSP70 expression in rodents. However, less is known regarding the effects of CR on these factors in humans. Serum cortisol and molecular chaperones and autophagic proteins were measured in the skeletal muscle of subjects on CR diets for 3-15 years and in control volunteers. Serum cortisol was higher in the CR group than in age-matched sedentary and endurance athlete groups (15.6 ± 4.6 ng/dl versus 12.3 ± 3.9 ng/dl and 11.2 ± 2.7 ng/dl, respectively; p ≤ 0.001). HSP70, Grp78, beclin-1, and LC3 mRNA and/or protein levels were higher in the skeletal muscle of the CR group compared to controls. Our data indicate that CR in humans is associated with sustained rises in serum cortisol, reduced inflammation, and increases in key molecular chaperones and autophagic mediators involved in cellular protein quality control and removal of dysfunctional proteins and organelles. PMID:26774472

  17. Long-Term Column Leaching of Phase II Mercury Control Technology By-Products

    SciTech Connect

    Schroeder, K.T.; Cardone, C.R.; White, Fredrick; Rohar, P.C.; Kim, A.G

    2007-07-01

    An NETL research, development and demonstration program under DOE/Fossil Energy Innovations for Existing Plants is directed toward the improvement of the performance and economics of mercury control from coal-fired plants. The current Phase II of the RD&D program emphasizes the evaluation of performance and cost of control technologies through slip-stream and full scale field testing while continuing the development of novel concepts. One of the concerns of the NETL program is the fate of the captured flue gas mercury which is transferred to the condensed phase by-product stream. The stability of mercury and any co-captured elements in the by-products could have a large economic impact if it reduced by-product sales or increasing their disposal costs. As part of a greater characterization effort of Phase II facility baseline and control technology sample pairs, NETL in-house laboratories have performed continuous leaching of a select subset of the available sample pairs using four leachants: water (pH=5.7), dilute sulfuric acid (pH=1.2), dilute acetic acid (pH=2.9), and sodium carbonate (pH=11.1). This report describes results obtained for mercury, arsenic, and selenium during the 5-month leaching experiments.

  18. Controlling Chaos: The Perceptions of Long-Term Crack Cocaine Users in Vancouver, British Columbia, Canada

    PubMed Central

    Kuo, Margot; Bungay, Vicky; Buxton, Jane A.

    2013-01-01

    People who smoke crack cocaine are described as chaotic and more likely to engage in risky sex, polysubstance use and contract infectious diseases. However, little is known about how individuals perceive smoking crack as compared to other forms of cocaine use, especially injection. We explored the lived experience of people who smoke crack cocaine. Six gender-specific focus groups (n = 31) of individuals who currently smoke crack in Vancouver, Canada, were conducted using a semi-structured interview guide. Focus groups were transcribed and analyzed by constant comparative methodology. We applied Rhodes' risk environment to the phenomenological understanding that individuals have regarding how crack has affected their lives. Subjects reported that smoking rather than injecting cocaine allows them to begin “controlling chaos” in their lives. Controlling chaos was self-defined using nontraditional measures such as the ability to maintain day-to-day commitments and housing stability. The phenomenological lens of smoking crack instead of injecting cocaine “to control chaos” contributes a novel perspective to our understanding of the crack-smoking population. This study examines narratives which add to prior reports of the association of crack smoking and increased chaos and suggests that, for some, inhaled crack may represent efforts towards self-directed harm reduction. PMID:24826370

  19. Long-Term Blood Pressure Control Effect of Celiac Plexus Block with Botulinum Toxin

    PubMed Central

    Lee, Sung Hyun; Lim, Dae Hwan; Lee, Ju Ho; Chang, Kiyuk; Koo, Jung Min; Park, Hue Jung

    2016-01-01

    Celiac plexus block (CPB) is one of the main treatment options for patients resistant to conventional antihypertensive drugs. We present a case of resistant hypertension (RHTN) that was treated with CPB using botulinum toxin. An 18-year-old male patient with RHTN, who suffered from persistent hypertension even after combination therapy and a renal denervation procedure, was referred to our pain center for CPB. CPB using botulinum toxin following the use of only local anesthetics resulted in control of systolic blood pressure (BP) at ~150 mmHg for at least three months. PMID:26907344

  20. Long-term effects of chronic khat use: impaired inhibitory control.

    PubMed

    Colzato, Lorenza S; Ruiz, Manuel J; van den Wildenberg, Wery P M; Bajo, Maria Teresa; Hommel, Bernhard

    2010-01-01

    So far no studies have systematically looked into the cognitive consequences of khat use. This study compared the ability to inhibit and execute behavioral responses in adult khat users and khat-free controls, matched in terms of age, race, gender distribution, level of intelligence, alcohol and cannabis consumption. Response inhibition and response execution were measured by a stop-signal paradigm. Results show that users and non-users are comparable in terms of response execution but users need significantly more time to inhibit responses to stop signals than non-users. PMID:21833274

  1. Neural interfaces for upper-limb prosthesis control: opportunities to improve long-term reliability.

    PubMed

    Judy, Jack W

    2012-03-01

    Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system at a scale and rate needed to reliably control modern robotic prostheses over the lifetime of the amputee. The RE-NET program currently encompasses three separate efforts: histology for interface stability over time (HIST), reliable peripheral interfaces (RPIs), and reliable central nervous system (CNS) interfaces (RCIs). PMID:22481748

  2. Prospective analysis of long term control of mild hypertension on cerebral blood flow

    SciTech Connect

    Meyer, J.S.; Rogers, R.L.; Mortel, K.F.

    1985-11-01

    A group of 12 otherwise normal elderly volunteers (mean age = 69.8 years), were detected to have mild hypertension. Cerebral blood flow (CBF) values were measured using 133Xe inhalation method prior to initiating medical treatment and repeated at 6, 12, 24 and 36 months after BP was adequately controlled and restored to normal (below 150/90). Results indicate that CBF values increased markedly during follow-up intervals at 6, 12 and 24 months but not at 36 months. Hypertension is known to be a risk factor for stroke and 4 of the 12 subjects subsequently developed symptoms of cerebrovascular disease (stroke, multi-infarct dementia or transient ischemic attacks) despite control of hypertension. Analyses separating asymptomatic and symptomatic groups indicated that the eight asymptomatic patients continued to maintain increased CBF levels throughout the entire three year interval, whereas the 4 symptomatic patients developed declines in CBF which began, and progressively decreased below the initial pretreatment values, during the second and third years.

  3. Assessing long-term health and cost outcomes of patient-centered medical homes serving adults with poor diabetes control.

    PubMed

    Pagán, José A; Carlson, Erin K

    2013-10-01

    The patient-centered medical home (PCMH) is an integrated primary care delivery model particularly suited for patients with poor diabetes control. Although PCMH models targeting adults with diabetes have shown some early success, little is known about the long-term benefits of medical homes in terms of health and cost outcomes. The performance of a PCMH model in adults with poor diabetes control was assessed using simulated controlled trial data obtained from the Archimedes model of disease progression and health care utilization. Using the Cardio-Metabolic Risk data set, we compared health and cost outcomes over a 20-year period between adults with poor diabetes control (HbA1c >9%) receiving standard care and these same adults receiving care under a PCMH model with a 49% HbA1c intervention improvement rate at a per-beneficiary per-month care management cost of $20 per month. The results suggest that the PCMH model has the potential to not only reduce the proportion of the population with bilateral blindness, foot amputations, and myocardial infarctions-and the mortality rate-but it can also do so in a cost-effective manner ($7898 per quality-adjusted life year). The PCMH model is cost saving for the population 50 to 64 years old and it is particularly cost-effective for men ($883 per quality-adjusted life year). Moreover, these effects are relatively large for adults 30 to 49 years old (lower bilateral blindness and death rates), women (lower foot amputation and death rates), and men (lower bilateral blindness and myocardial infarction rates). The PCMH model has potential long-term benefits to both patients with poor diabetes control as well as health care systems and providers willing to invest in this health care delivery approach. PMID:23799676

  4. Critical role of tissue mast cells in controlling long-term glucose sensor function in vivo.

    PubMed

    Klueh, Ulrike; Kaur, Manjot; Qiao, Yi; Kreutzer, Donald L

    2010-06-01

    Little is known about the specific cells, mediators and mechanisms involved in the loss of glucose sensor function (GSF) in vivo. Since mast cells (MC) are known to be key effector cells in inflammation and wound healing, we hypothesized that MC and their products are major contributors to the skin inflammation and wound healing that controls GSF at sites of sensor implantation. To test this hypothesis we utilized a murine model of continuous glucose monitoring (CGM) in vivo in both normal C57BL/6 mice (mast cell sufficient), as well as mast cell deficient B6.Cg-Kit(W-sh)/HNihrJaeBsmJ (Sash) mice over a 28 day CGM period. As expected, both strains of mice displayed excellent CGM for the first 7 days post sensor implantation (PSI). CGM in the mast cell sufficient C57BL/6 mice was erratic over the remaining 21 days PSI. CGM in the mast cell deficient Sash mice displayed excellent sensor function for the entire 28 day of CGM. Histopathologic evaluation of implantation sites demonstrated that tissue reactions in Sash mice were dramatically less compared to the reactions in normal C57BL/6 mice. Additionally, mast cells were also seen to be consistently associated with the margins of sensor tissue reactions in normal C57BL/6 mice. Finally, direct injection of bone marrow derived mast cells at sites of sensor implantation induced an acute and dramatic loss of sensor function in both C57BL/6 and Sash mice. These results demonstrate the key role of mast cells in controlling glucose sensor function in vivo. PMID:20226521

  5. Short and long-term controls of SOM dynamics in a South African Landscape

    NASA Astrophysics Data System (ADS)

    Khomo, L.; Chadwick, O. A.; Rogers, K.; Trumbore, S.

    2012-04-01

    We used the variations in parent material, climate and topography found in Kruger National Park, South Africa, to investigate the most important factors controlling carbon dynamics in savannah soils. Carbon dynamics were investigated using radiocarbon signatures of carbon in density-separated organic matter and in CO2 respired during incubation of surface soils. Carbon respired in incubations of 0-2cm and 2-8 cm depth intervals had a narrow range of 14C signatures regardless of the parent material, topographic position or climate conditions. The 14C values indicated that the C contributing to decomposition was fixed on average <1 to 5 years previously. Vegetation was apparently linked to these variations. The respired C with highest 14C signature also had the lowest 13C signatures, indicating more C3 (woody) plant influence. The 14C signatures of C in the low-density fraction (<1.7 or 1.9 g cm-3) had a larger range of 14C signatures than respired CO2, again with highest 14C signatures (indicating ages of up to a decade) in C that also had more C3-enriched 13C signatures. Charred material is found in the low density fraction which may explain why its 14C signature differs from that of respired CO2 in these fire-prone landscapes. The age of carbon in the dense fractions was considerably older (up to several thousand radiocarbon years) and strongly related to soil clay content, which in turn reflects a combination of parent material and landscape position. Overall, the age of all organic carbon in these soils was much less than the age of the soil itself, and also less than the age of pedogenic carbonates found in some of the soils. Parent material and landscape position both play a strong role in the storage of carbon across these landscapes over longer timescales. Indirectly, these factors control vegetation patterns, which in turn influence the age of faster cycling carbon in this savannah system.

  6. Separating physical and biological controls on long-term evapotranspiration fluctuations in a tropical deciduous forest subjected to monsoonal rainfall

    NASA Astrophysics Data System (ADS)

    Igarashi, Yasunori; Katul, Gabriel G.; Kumagai, Tomo'omi; Yoshifuji, Natsuko; Sato, Takanori; Tanaka, Nobuaki; Tanaka, Katsunori; Fujinami, Hatsuki; Suzuki, Masakazu; Tantasirin, Chatchai

    2015-07-01

    Evapotranspiration (ET), especially in the mainland of the Indochina Peninsula, can impact and is impacted by the Asian monsoonal (AM) system, thereby prompting interest in its long-term variability. To separate the physical and biological factors controlling ET variability in a tropical deciduous forest under the AM influence, 7 year eddy covariance and ancillary measurements were collected and analyzed. The 7 year mean rainfall (Pr) and ET along with their standard deviations were 1335 ± 256 and 977 ± 108 mm (about 73% of Pr), respectively, suggesting close coupling between these two hydrologic fluxes. However, other physical and biological drivers decouple seasonal and annual variations of ET from Pr. To explore them, a big-leaf model complemented by perturbation analysis was employed. The big-leaf model agreed well with the measured ET at daily to multiyear time scales, lending confidence in its ability to separate biological and physical controls on ET. Using this formulation, both first-order and second-order Taylor series expansions of the total ET derivatives were applied to the big-leaf model and compared with measured changes in ET (dET). Higher-order and joint terms in the second-order expansion were necessary for matching measured and analyzed dET. Vapor pressure deficit (D) was the primary external physical controlling driver of ET. Leaf area index (LAI) and bulk stomatal conductance (gs) were shown to be the main significant biological drivers of the transpiration component of ET. It can be surmised that rainfall variability controls long-term ET through physical (mainly D) and biological (mainly LAI and gs) factors in this ecosystem.

  7. The role of genetic factors and kidney and liver function in glycemic control in type 2 diabetes patients on long-term metformin and sulphonylurea cotreatment.

    PubMed

    Klen, Jasna; Goričar, Katja; Janež, Andrej; Dolžan, Vita

    2014-01-01

    This study investigated the influence of genetic polymorphisms of metformin transporters on long-term glycemic control and lipid status in type 2 diabetes patients in the everyday clinical setting. In total 135 patients treated with combination of metformin and sulphonylurea for at least 6 months were genotyped for SLC22A1 rs628031 and SLC47A1 rs2289669 polymorphisms. Relatively good blood glucose control with median HbA1c 6.9 (6.4-7.6) % was achieved on prescribed metformin dosage of 2550 (2000-2550) mg per day. Only 28 (20.7%) patients experienced mild hypoglycemia events, while no severe hypoglycemia events were observed. Most patients had normal or mildly impaired renal function. Parameters indicating renal function were not correlated with fasting glucose, HbA1c, or lipid parameters. Rs628031 and rs2289669 had minor allele frequencies of 0.385 and 0.355, respectively, and were not associated with HbA1c levels. Rs628031 was marginally associated with risk for hypoglycemia events (P = 0.046; OR = 0.51; 95% CI 0.26-0.99), while significant correlation was observed between rs2289669 and total cholesterol levels (P = 0.018). In conclusion, in patients on long-term metformin and sulphonylurea combination treatment, metformin transporters polymorphisms do not play a major role in glycemic control; however, they may influence lipid status. PMID:25025077

  8. A Case of Uterine Leiomyosarcoma with Long-Term Disease Control by Pazopanib.

    PubMed

    Nagamata, Satoshi; Ebina, Yasuhiko; Yamano, Yumika; Miyamoto, Takeo; Nishijima, Mitsuhiro; Yamada, Hideto

    2016-01-01

    Uterine leiomyosarcoma (ULMS) is an aggressive tumor associated with high rates of progression, recurrence, and mortality. Pazopanib is the only approved molecular targeted drug for advanced soft tissue sarcoma, and it has been proven to prolong progression-free survival relative to placebo. We herein report a case of ULMS with multiple lung metastases treated with pazopanib, which led to sustained disease control for 44 weeks. A 53-year-old woman was referred to our hospital due to massive uterine bleeding from a uterine corpus tumor mass. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed as emergency surgery. The final histopathological diagnosis was uterine leiomyosarcoma, and computed tomography revealed multiple lung metastases. After chemotherapy with 17 cycles of gemcitabine and docetaxel and two cycles of doxorubicin, the lung metastases had increased in size and new lesions had appeared. Pazopanib administration at 800 mg/day was started as third-line therapy. Ten weeks later, the dose of pazopanib was reduced to 600 mg/day because of hepatic impairment and hypertension. However, lung metastases of ULMS were stabilized by pazopanib administration for about 44 weeks without a decline in the patient's quality of life. After 44 weeks of therapy, pazopanib administration was discontinued because of progressive disease and worsening of the patient's respiratory status. Pazopanib is an oral multityrosine kinase inhibitor of vascular endothelial growth factor receptor-1, -2, and -3; platelet-derived growth factor-α and -β; and c-Kit receptor. The role of pazopanib may be clinically significant in the treatment of advanced ULMS. PMID:27578036

  9. Higher cortisol content in hair among long-term unemployed individuals compared to controls.

    PubMed

    Dettenborn, L; Tietze, A; Bruckner, F; Kirschbaum, C

    2010-10-01

    Unemployment and financial strain are chronic stressors that have been shown to be associated with an increase in mean salivary and serum cortisol levels. Hair analysis for cortisol content is a new promising tool by which hair segmental analysis may provide a retrospective calendar of cumulative cortisol exposure over time rather than momentary assessments. Participants of this study were 31 unemployed and 28 employed individuals (46 women). Hair segmental analysis was conducted using 3-cm long segments starting with the scalp-near segment. Due to differing hair length, 52 individuals had values for the second segment and n=33 individuals had values for the third segment. Univariate analysis of variance indicated that unemployed individuals had higher cortisol content in the first (p<0.05, eta(2)=0.071) and second (p<0.05, eta(2)=0.085) hair segment (a total of 6 cm long hair representing the preceding 6 months of collection). Consistent with other data from our laboratory, there was a wash-out effect for the third segment (p<0.05 for segment 3 vs. segment 1 and 2). Unemployed individuals indicated increased levels of perceived stress and impairments in subjective well-being compared to employed individuals. These subjective measures of perceived stress and well-being were unrelated to cortisol content in hair. We conclude that hair analysis for cortisol content may be a valid method to detect differences in cumulative cortisol exposure between chronically stressed individuals and healthy controls. Due to a wash-out effect, retrospective ascertainment of cortisol exposure may be limited to the preceding 6 months of specimen collection. PMID:20471757

  10. Long-Term Stability of Tramadol and Ketamine Solutions for Patient-Controlled Analgesia Delivery

    PubMed Central

    Gu, Junfeng; Qin, Wengang; Chen, Fuchao; Xia, Zhongyuan

    2015-01-01

    Background Subanesthetic doses of ketamine as an adjuvant to tramadol in patient-controlled analgesia (PCA) for postoperative pain have been shown to improve the quality of analgesia. However, there are no such commercially available drug mixtures, and the stability of the combination has rarely been assessed. Material/Methods Admixtures were assessed for periods of up to 14 days at 4°C and 25°C. Three different mixtures of tramadol and ketamine (tramadol 5.0 mg/mL + ketamine 0.5 mg/mL, tramadol 5.0 mg/mL + ketamine 1.0 mg/mL, and tramadol 5.0 mg/mL + ketamine 2.0 mg/mL) were prepared in polyolefin bags by combining these 2 drugs with 0.9% sodium chloride (normal saline [NS]). The chemical stability of the admixtures was evaluated by a validated high-performance liquid chromatography (HPLC) method and by measurement of pH values. Solution appearance and color were assessed by observing the samples against black and white backgrounds. Solutions were considered stable if they maintained 90% of the initial concentration of each drug. Results The percentages of initial concentration of tramadol and ketamine in the various solutions remained above 98% when stored at 4°C or 25°C over the testing period. No changes in color or turbidity were observed in any of the prepared solutions. Throughout this period, pH values remained stable. Conclusions The results indicate that the drug mixtures of tramadol with ketamine in NS for PCA delivery systems were stable for 14 days when stored in polyolefin bags at 4°C or 25°C. PMID:26306476

  11. Ionically Crosslinked Polymer Networks for Underwater Adhesion and Long-Term Controlled Release

    NASA Astrophysics Data System (ADS)

    Lawrence, Patrick G.

    Underwater adhesives have several potential applications in industry as well as in medicine. Much of the recent research in this area has focused on adhesive preparation from biological or custom-designed biomimetic polymers. As a simpler alternative, we have recently shown that ionically crosslinked, gel-like underwater adhesive complexes can be prepared by the mixing of the readily-available and inexpensive polyelectrolyte, poly(allylamine hydrochloride) (PAH), with commonly-used multivalent anions, pyrophosphate (PPi) and tripolyphosphate (TPP). Remarkably, these gel-like complexes adhere to both hydrophilic and hydrophobic substrates under water with tensile adhesive strength considerably greater than that of Scotch Permanent Double Sided Tape (up to ˜400 kPa vs. ˜85 kPa when used as a pressure-sensitive adhesives) and due to the reversible nature of the ionic crosslinks, self-heal when torn. These complexes also exhibit very high storage moduli (greater than 100 kPa), indicative of a very high crosslink density. The high crosslink density allow these gel-like complexes to also entrap and deliver small molecule payloads over multiple-month timescales. Moreover, their formation and rheological/adhesion properties can be controlled using external stimuli (pH and ionic strength). In this thesis we characterize formation and rheological/adhesion properties of gel-like PAH/PPi and PAH/TPP complexes the through the use of dynamic and electrophoretic light scattering, rheology and tensile adhesion tests. We also describe their sensitivity to pH and ionic strength, and explain how the complexes can be dissolved on demand by raising or lowering the ambient pH, and can form spontaneously by increasing the NaCl concentration (which can be used for developing injectable underwater adhesive formulations). Finally, we demonstrate the ability of these adhesives to release small molecule payloads over multiple-month timescales by characterizing their ability to take up and

  12. Agricultural management and environment controls long-term soil nitrous oxide fluxes

    NASA Astrophysics Data System (ADS)

    Gelfand, I.; Shcherbak, I.; Robertson, G. P.

    2013-12-01

    Nitrous oxide (N2O) is an important greenhouse gas with a long atmospheric half-life. Understanding the controls on soil nitrous oxide fluxes is vital for the development of mitigation opportunities and for understanding their climatic impact. The spatial and temporal variability of soil nitrous oxide fluxes, however, makes it difficult to predict such fluxes. We examined the longest available dataset, 22 years of continues measurements, which contains biweekly measurements of soil nitrous oxide emissions together with measurements of an array of environmental and management parameters from eleven ecosystems, including four corn-soybean-wheat rotations under different management (conventional, no-till, biological, and reduced input), one perennial alfalfa system, two tree plantations, three successional systems, and one deciduous forest. This dataset was used to assess the effect of different agricultural and land management practices on soil N2O emissions. Using statistical and correlation analyses, we found that, in general, annual crops emitted 2-3 times more N2O annually than did perennial crops. Among the annual crops, there were no differences in the annual emissions among the cropping systems; the conventional, no-till, reduced input, and biologically managed systems emitted similar amounts of N2O with very different emission patterns. Among the perennial crops, alfalfa emitted 2 times more N2O than did poplar, approximately 1.6 times more than did the coniferous plantation, and ~3 times more than did the unmanaged successional communities and the deciduous forest, which emitted similar amounts. Within the annual crop rotation phases, the wheat phase of the conventionally and no-till-managed rotations emitted approximately twice as much N2O than did the reduced input- and biologically managed systems, largely due to the length of the bare soil fallow. The corn and soybean phases of the conventionally managed rotation emitted between 70 and 100% less N2O than

  13. Long-Term Impact of the World Bank Loan Project for Schistosomiasis Control: A Comparison of the Spatial Distribution of Schistosomiasis Risk in China

    PubMed Central

    Zhang, Zhijie; Zhu, Rong; Ward, Michael P.; Xu, Wanghong; Zhang, Lijuan; Guo, Jiagang; Zhao, Fei; Jiang, Qingwu

    2012-01-01

    Background The World Bank Loan Project (WBLP) for controlling schistosomiasis in China was implemented during 1992–2001. Its short-term impact has been assessed from non-spatial perspective, but its long-term impact remains unclear and a spatial evaluation has not previously been conducted. Here we compared the spatial distribution of schistosomiasis risk using national datasets in the lake and marshland regions from 1999–2001 and 2007–2008 to evaluate the long-term impact of WBLP strategy on China's schistosomiasis burden. Methodology/Principal Findings A hierarchical Poisson regression model was developed in a Bayesian framework with spatially correlated and uncorrelated heterogeneities at the county-level, modeled using a conditional autoregressive prior structure and a spatially unstructured Gaussian distribution, respectively. There were two important findings from this study. The WBLP strategy was found to have a good short-term impact on schistosomiasis control, but its long-term impact was not ideal. It has successfully reduced the morbidity of schistosomiasis to a low level, but can not contribute further to China's schistosomiasis control because of the current low endemic level. A second finding is that the WBLP strategy could not effectively compress the spatial distribution of schistosomiasis risk. To achieve further reductions in schistosomiasis-affected areas, and for sustainable control, focusing on the intermediate host snail should become the next step to interrupt schistosomiasis transmission within the two most affected regions surrounding the Dongting and Poyang Lakes. Furthermore, in the lower reaches of the Yangtze River, the WBLP's morbidity control strategy may need to continue for some time until snails in the upriver provinces have been well controlled. Conclusion It is difficult to further reduce morbidity due to schistosomiasis using a chemotherapy-based control strategy in the lake and marshland regions of China because of the

  14. Long term outcome of Ph+ CML patients achieving complete cytogenetic remission with interferon based therapy moving from interferon to imatinib era.

    PubMed

    Malagola, Michele; Breccia, Massimo; Skert, Cristina; Cancelli, Valeria; Soverini, Simona; Iacobucci, Ilaria; Cattina, Federica; Liberati, Anna Maria; Tiribelli, Mario; Annunziata, Mario; Trabacchi, Elena; De Vivo, Antonio; Castagnetti, Fausto; Martinelli, Giovanni; Fogli, Miriam; Stagno, Fabio; Pica, Gianmatteo; Iurlo, Alessandra; Pregno, Patrizia; Abruzzese, Elisabetta; Pardini, Simonetta; Bocchia, Monica; Russo, Sabina; Pierri, Ivana; Lunghi, Monia; Barulli, Sara; Merante, Serena; Mandelli, Franco; Alimena, Giuliana; Rosti, Gianatonio; Baccarani, Michele; Russo, Domenico

    2014-02-01

    Interferon α (IFNα) prolongs survival of CML patients achieving CCyR and potentially synergizes with TKIs. We report on the molecular status and long term outcome of 121 patients who were treated in Italy between 1986 and 2000 with IFNα based therapy and who obtained CCyR. After a median follow up of 16.5 years, 74 (61%) patients were switched to standard imatinib: 48 (65%) lost the CCyR on IFNα, and 36 (75%) are alive and in CCyR; 26 (35%) were switched to imatinib when they were still in CCyR on IFNα, and all 26 are alive and in CCyR. Forty-seven patients (39%) were never switched to imatinib: 24 (51%) continued and 23 (49%) discontinued IFNα, respectively, and 39/47 (83%) are alive and in CCyR. At last follow-up, the BCR-ABL transcripts level was available in 96/101 living patients (95%) The BCR-ABL:ABL ratio was between 0.1 and 0.01% (MR(3.0) ) in 17%, and less than 0.01% (MR(4.0) ) in 81% of patients. No patient was completely molecular negative (MR(4.5) or MR(5.0) ). The OS at 10 and 20 years is 92 and 84%, respectively. This study confirms that CCyR achieved with IFNα and maintained with or without imatinib or any other therapy significantly correlates with long term survival in CML patients who mostly have MR(4.0) . Complete molecular response (MR(4.5) or MR(5.0) ) seems to be unnecessary for such a long survival. This study further supports development of studies testing the clinical effect of the combinations of TKIs with IFNα. PMID:24122886

  15. Long-term ecological consequences of herbicide treatment to control the invasive grass, Spartina anglica, in an Australian saltmarsh

    NASA Astrophysics Data System (ADS)

    Shimeta, Jeff; Saint, Lynnette; Verspaandonk, Emily R.; Nugegoda, Dayanthi; Howe, Steffan

    2016-07-01

    Invasive plants acting as habitat modifiers in coastal wetlands can have extensive ecological impacts. Control of invasive plants often relies on herbicides, although little is known about subsequent environmental impacts. Studying effects of herbicides on non-target species and long-term cascading consequences may yield insights into the ecology of invasive species by revealing interactions with native species. We conducted a long-term field experiment measuring effects of treating the invasive saltmarsh grass, Spartina anglica, with the herbicide Fusilade Forte®. No changes in sedimentary macrofaunal abundances or species richness, diversity, or assemblages were detected 1-2 months after spraying, despite known toxicity of Fusilade Forte® to fauna. This lack of impact may have been due to low exposure, since the herbicide was taken up primarily by plant leaves, with the small amount that reached the sediment hydrolyzing rapidly. Six months after spraying, however, total macrofauna in treated plots was more than four times more abundant than in unsprayed control plots, due to a fifteen-fold increase in annelids. This population growth correlated with increased sedimentary organic matter in treated plots, likely due to decomposition of dead S. anglica leaves serving as food for annelids. After another year, no differences in macrofauna or organic matter remained between treatments. The indirect effect on annelid populations from herbicide treatment could benefit management efforts by providing greater food resources for wading birds, in addition to improving birds' access to sediments by reducing plant cover. This study shows that an invasive grass can have a significant impact on native fauna through food-web interactions, influenced by herbicide usage.

  16. Recurrence rates in bipolar disorder: Systematic comparison of long-term prospective, naturalistic studies versus randomized controlled trials.

    PubMed

    Vázquez, Gustavo H; Holtzman, Jessica N; Lolich, María; Ketter, Terence A; Baldessarini, Ross J

    2015-10-01

    Bipolar disorder (BD) is a recurrent, lifelong illness with high risks of disability and excess mortality. Despite many treatment options with demonstrated short-term efficacy, evidence concerning long-term treatment effectiveness in BD remains limited and the relative value of naturalistic studies versus randomized, controlled trials (RCTs) in its assessment, uncertain. Systematic computer-searching yielded 10 naturalistic studies and 15 RCTs suitable for analysis of recurrence rates and their association with treatments and selected clinical factors. In naturalistic studies (3904 BD subjects, 53.3% women, 85.8% BD-I, mean onset age 29.1, followed up to 2.1 years), the pooled recurrence rate was 55.2% (26.3%/year). In RCTs (4828 subjects, 50.9% women, 96.0% BD-I, mean onset age 23.1, followed up to 1.9 years), the pooled recurrence rate was 39.3% (21.9%/year) with mood-stabilizing drug-treatment versus 60.6% (31.3%/year) with placebo; drug-versus-placebo outcomes favored antipsychotics over lithium, and disfavor an approved anticonvulsant. Depressive episode-polarity increased from 27.7% at intake to 52.0% at first-recurrence (p<0.0001). Recurrence rate (%/year) did not differ by study-type, was greater with younger onset and rapid-cycling, and paradoxically declined with longer observation. In short, recurrences of major affective episodes up to two years during putative mood-stabilizing treatment of BD patients in prospective, naturalistic studies and RCTs were substantial and similar (26.3 vs. 21.9%/year). Episode-polarity shifted strongly toward depressive first-recurrences. These findings support the value of naturalistic studies to complement long-term RCTs, and add to indications that control of depression in BD remains particularly unsatisfactory. PMID:26238969

  17. Totomatix: a novel automatic set-up to control diurnal, diel and long-term plant nitrate nutrition

    PubMed Central

    Adamowicz, Stéphane; Le Bot, Jacques; Huanosto Magaña, Ruth; Fabre, José

    2012-01-01

    Background Stand-alone nutritional set-ups are useful tools to grow plants at defined nutrient availabilities and to measure nutrient uptake rates continuously, in particular that for nitrate. Their use is essential when the measurements are meant to cover long time periods. These complex systems have, however, important drawbacks, including poor long-term reliability and low precision at high nitrate concentration. This explains why the information dealing with diel dynamics of nitrate uptake rate is scarce and concerns mainly young plants grown at low nitrate concentration. Scope The novel system detailed in this paper has been developed to allow versatile use in growth rooms, greenhouses or open fields at nitrate concentrations ranging from a few micro- to several millimoles per litres. The system controls, at set frequencies, the solution nitrate concentration, pH and volumes. Nitrate concentration is measured by spectral deconvolution of UV spectra. The main advantages of the set-up are its low maintenance (weekly basis), an ability to diagnose interference or erroneous analyses and high precision of nitrate concentration measurements (0·025 % at 3 mm). The paper details the precision of diurnal nitrate uptake rate measurements, which reveals sensitivity to solution volume at low nitrate concentration, whereas at high concentration, it is mostly sensitive to the precision of volume estimates. Conclusions This novel set-up allows us to measure and characterize the dynamics of plant nitrate nutrition at high temporal resolution (minutes to hours) over long-term experiments (up to 1 year). It is reliable and also offers a novel method to regulate up to seven N treatments by adjusting the daily uptake of test plants relative to controls, in variable environments such as open fields and glasshouses. PMID:21985796

  18. Long-term flow/chemistry feedback in a porous medium with heterogenous permeability: Kinetic control of dissolution and precipitation

    SciTech Connect

    Bolton, E.W.; Lasaga, A.C.; Rye, D.M.

    1999-01-01

    The kinetics of dissolution and precipitation is of central importance to understanding the long-term evolution of fluid flows in crustal environments, with implications for problems as diverse as nuclear waste disposal and crustal evolution. The authors examine the dynamics of such evolution for several geologically relevant permeability distributions (models for en-echelon cracks, an isolated sloping fractured zone, and two sloping high-permeability zones that are close enough together to interact). Although the focus is on a simple quartz matrix system, generic features emerge from this study that can aid in the broader goal of understanding the long-term feedback between flow and chemistry, where dissolution and precipitation is under kinetic control. Examples of thermal convection in a porous medium with spatially variable permeability reveal features of central importance to water-rock interaction. After a transient phase, an accelerated rate of change of porosity may be used with care to decrease computational time, as an alternative to the quasi-stationary state approximation (Lichtner, 1988). Kinetic effects produce features not expected by traditional assumptions made on the basis of equilibrium, for example, that cooling fluids are oversaturated and heating fluids are undersaturated with respect to silicic acid equilibrium. Indeed, the authors observe regions of downwelling oversaturated fluid experiencing heating and regions of upwelling, yet cooling, undersaturated fluid. When oscillatory convection is present, the amplitudes of oscillation generally increase with time in near-surface environments, whereas amplitudes tend to decrease over long times near the heated lower boundary. The authors examine the scaling behavior of characteristic length scales, of terms in the solute equation, and of the typical deviation from equilibrium, each as a function of the kinetic rate parameters.

  19. On the need to manage long-term diffuse memory controls of hydrological mass loads and water quality

    NASA Astrophysics Data System (ADS)

    Destouni, G.; Cvetkovic, V.

    2011-12-01

    Water management requires understanding and handling of water quality changes and their cause-effect relations, including the source inputs in and hydrological mass transport through catchments that load tracers, nutrients, pollutants and other anthropogenic and geogenic constituents to downstream waters and ecosystems. Costly abatement is often required to protect water resources and ecosystems from excessive nutrient and pollutant loads, and to maintain and restore good ecological status and vital ecosystem services of water systems. But what controls then the magnitudes and dynamics of the hydrological mass loads to the downstream waters and ecosystems? Erroneous understanding of these controls may undermine and mislead resource demanding water management efforts. To support and improve this understanding we have analyzed data from 15-23 year time series of chloride, commonly used as an effective chemical tracer of water movement, in daily rainfall and runoff of two comparative Swedish catchments. We show that long-term catchment memory in form of diffuse internal subsurface sources that have developed from earlier mass inputs controls current load dynamics. In the chloride tracer example the internal memory sources contribute 75-90% of the total stream load, while contemporary source inputs at the surface contribute only 10-25%, with these ranges being consistently determined from scenario analysis of chloride travel time distributions in both catchment cases. While the loading from contemporary surface inputs is hydrologically controlled and dependent on the variability of transport pathways and travel times through a catchment, the average net mass release rate from internal memory sources depends primarily on mean travel time. For the chloride tracer example the release rate is in the range of 1.3*10E-4 - 4.5*10E-3 g/m2/day in both catchment cases. The present quantification approach provides a relatively simple, testable and general management tool for

  20. LONG-TERM STABILITY OF THE LOCAL GROUND CONTROL NETWORK AT THE CO-LOCATION SITE OF MEDICINA

    NASA Astrophysics Data System (ADS)

    Abbondanza, C.; Sarti, P.; Legrand, J.

    2009-12-01

    ITRF combinations rely on the availability of accurate tie vectors linking reference points of space geodetic techniques. Co-located instruments are assumed to move consistently and no local relative motion is taken into account. Instabilities may degrade the quality of the co-location itself and perturb the result of ITRF combinations. This work aims to determine the stability of the local ground control network at Medicina (Italy) with independent surveying methods. The observatory hosts a co-location between a VLBI telescope and two GPS antennas, MEDI and MSEL. It is located in the Po Plain where thick layers of clays are the prevalent soil characteristics. Hence, provision of long term stability of geodetic monuments is a challenge and monitoring their stability is an issue. MEDI and the VLBI station regularly contribute to the determination of ITRF, while MSEL is part of the EUREF network. A set of five tie vectors observations linking the VLBI and MEDI reference points was acquired between 2001 and 2007. It is our main tool for performing local deformation analysis. Additionally, the GPS time series of MEDI and MSEL were used to cross check and confirm the local instability detected by terrestrial methods. To achieve a rigorous and reliable investigation of the local stability, multi-epoch terrestrial observations were homogeneously processed according to common parameterizations in a consistent reference frame. Similarly, continuous GPS observations from MEDI and MSEL were analysed according to the new EPN reprocessing strategy in order to monitor the short baseline between MEDI and MSEL; to spotlight any change in its length. Both approaches confirm differential motions at the site which can be related to monument instabilities originated by the particularly unfavourable local geological setting and the inapt design of the monuments foundation. The monuments move non homogeneously at rates reaching up to 1.6 mm/year, this value being comparable to intra

  1. Behavioral and electrophysiological auditory processing measures in traumatic brain injury after acoustically controlled auditory training: a long-term study

    PubMed Central

    Figueiredo, Carolina Calsolari; de Andrade, Adriana Neves; Marangoni-Castan, Andréa Tortosa; Gil, Daniela; Suriano, Italo Capraro

    2015-01-01

    ABSTRACT Objective To investigate the long-term efficacy of acoustically controlled auditory training in adults after tarumatic brain injury. Methods A total of six audioogically normal individuals aged between 20 and 37 years were studied. They suffered severe traumatic brain injury with diffuse axional lesion and underwent an acoustically controlled auditory training program approximately one year before. The results obtained in the behavioral and electrophysiological evaluation of auditory processing immediately after acoustically controlled auditory training were compared to reassessment findings, one year later. Results Quantitative analysis of auditory brainsteim response showed increased absolute latency of all waves and interpeak intervals, bilaterraly, when comparing both evaluations. Moreover, increased amplitude of all waves, and the wave V amplitude was statistically significant for the right ear, and wave III for the left ear. As to P3, decreased latency and increased amplitude were found for both ears in reassessment. The previous and current behavioral assessment showed similar results, except for the staggered spondaic words in the left ear and the amount of errors on the dichotic consonant-vowel test. Conclusion The acoustically controlled auditory training was effective in the long run, since better latency and amplitude results were observed in the electrophysiological evaluation, in addition to stability of behavioral measures after one-year training. PMID:26676270

  2. Long-term benefits to the growth of ponderosa pines from controlling southwestern pine tip moth (Lepidoptera: Tortricidae) and weeds.

    PubMed

    Wagner, Michael R; Chen, Zhong

    2004-12-01

    The southwestern pine tip moth, Rhyacionia neomexicana (Dyar) (Lepidoptera: Tortricidae), is a native forest pest that attacks seedlings and saplings of ponderosa pine, Pinus ponderosa Dougl. ex Laws, in the southwestern United States. Repeated attacks can cause severe deformation of host trees and significant long-term growth loss. Alternatively, effective control of R. neomexicana, vegetative competition, or both in young pine plantations may increase survival and growth of trees for many years after treatments are applied. We test the null hypothesis that 4 yr of R. neomexicana and weed control with insecticide, weeding, and insecticide plus weeding would not have any residual effect on survival and growth of trees in ponderosa pine plantation in northern Arizona 14 yr post-treatment, when the trees were 18 yr old. Both insecticide and weeding treatment increased tree growth and reduced the incidence of southwestern pine tip moth damage compared with the control. However, weeding alone also significantly increased tree survival, whereas insecticide alone did not. The insecticide plus weeding treatment had the greatest tree growth and survival, and the lowest rate of tip moth damage. Based on these results, we rejected our null hypothesis and concluded that there were detectable increases in the survival and growth of ponderosa pines 14 yr after treatments applied to control R. neomexicana and weeds. PMID:15666752

  3. The effects of long-term noninvasive ventilation in hypercapnic COPD patients: a randomized controlled pilot study

    PubMed Central

    De Backer, L; Vos, W; Dieriks, B; Daems, D; Verhulst, S; Vinchurkar, S; Ides, K; De Backer, J; Germonpre, P; De Backer, W

    2011-01-01

    Introduction Noninvasive ventilation (NIV) is a well-established treatment for acute-on- chronic respiratory failure in hypercapnic COPD patients. Less is known about the effects of a long-term treatment with NIV in hypercapnic COPD patients and about the factors that may predict response in terms of improved oxygenation and lowered CO2 retention. Methods In this study, we randomized 15 patients to a routine pharmacological treatment (n = 5, age 66 [standard deviation ± 6] years, FEV1 30.5 [±5.1] %pred, PaO2 65 [±6] mmHg, PaCO2 52.4 [±6.0] mmHg) or to a routine treatment and NIV (using the Synchrony BiPAP device [Respironics, Inc, Murrsville, PA]) (n = 10, age 65 [±7] years, FEV1 29.5 [±9.0] %pred, PaO2 59 [±13] mmHg, PaCO2 55.4 [±7.7] mmHg) for 6 months. We looked at arterial blood gasses, lung function parameters and performed a low-dose computed tomography of the thorax, which was later used for segmentation (providing lobe and airway volumes, iVlobe and iVaw) and post-processing with computer methods (providing airway resistance, iRaw) giving overall a functional image of the separate airways and lobes. Results In both groups there was a nonsignificant change in FEV1 (NIV group 29.5 [9.0] to 38.5 [14.6] %pred, control group 30.5 [5.1] to 36.8 [8.7] mmHg). PaCO2 dropped significantly only in the NIV group (NIV: 55.4 [7.7] → 44.5 [4.70], P = 0.0076; control: 52.4 [6.0] → 47.6 [8.2], NS). Patients actively treated with NIV developed a more inhomogeneous redistribution of mass flow than control patients. Subsequent analysis indicated that in NIV-treated patients that improve their blood gases, mass flow was also redistributed towards areas with higher vessel density and less emphysema, indicating that flow was redistributed towards areas with better perfusion. There was a highly significant correlation between the % increase in mass flow towards lobes with a blood vessel density of >9% and the increase in PaO2. Improved ventilation–perfusion match and

  4. Switching between Manual Control and Brain-Computer Interface Using Long Term and Short Term Quality Measures

    PubMed Central

    Kreilinger, Alex; Kaiser, Vera; Breitwieser, Christian; Williamson, John; Neuper, Christa; Müller-Putz, Gernot R.

    2011-01-01

    Assistive devices for persons with limited motor control translate or amplify remaining functions to allow otherwise impossible actions. These assistive devices usually rely on just one type of input signal which can be derived from residual muscle functions or any other kind of biosignal. When only one signal is used, the functionality of the assistive device can be reduced as soon as the quality of the provided signal is impaired. The quality can decrease in case of fatigue, lack of concentration, high noise, spasms, tremors, depending on the type of signal. To overcome this dependency on one input signal, a combination of more inputs should be feasible. This work presents a hybrid Brain-Computer Interface (hBCI) approach where two different input signals (joystick and BCI) were monitored and only one of them was chosen as a control signal at a time. Users could move a car in a game-like feedback application to collect coins and avoid obstacles via either joystick or BCI control. Both control types were constantly monitored with four different long term quality measures to evaluate the current state of the signals. As soon as the quality dropped below a certain threshold, a monitoring system would switch to the other control mode and vice versa. Additionally, short term quality measures were applied to check for strong artifacts that could render voluntary control impossible. These measures were used to prohibit actions carried out during times when highly uncertain signals were recorded. The switching possibility allowed more functionality for the users. Moving the car was still possible even after one control mode was not working any more. The proposed system serves as a basis that shows how BCI can be used as an assistive device, especially in combination with other assistive technology. PMID:22319464

  5. Development of a resource model for infection prevention and control programs in acute, long term, and home care settings: conference proceedings of the Infection Prevention and Control Alliance.

    PubMed

    Morrison, Judith

    2004-02-01

    There is mounting concern about the impact of health care restructuring on the provision of infection prevention services across the health care continuum. In response to this, Health Canada hosted two meetings of Canadian infection control experts to develop a model upon which the resources required to support an effective, integrated infection prevention and control program across the health care continuum could be based. The final models project the IPCP needs as three full time equivalent infection control professionals/500 beds in acute care hospitals and one full time equivalent infection control professional/150-250 beds in long term care facilities. Non human resource requirements are also described for acute, long term, community, and home care settings. PMID:14755227

  6. The Importance of Long-Term Social Research in Enabling Participation and Developing Engagement Strategies for New Dengue Control Technologies

    PubMed Central

    McNaughton, Darlene

    2012-01-01

    Background In recent years, new strategies aimed at reducing the capacity of mosquito vectors to transmit dengue fever have emerged. As with earlier control methods, they will have to be employed in a diverse range of communities across the globe and into the main settings for disease transmission, the homes, businesses and public buildings of residents in dengue-affected areas. However, these strategies are notably different from previous methods and draw on technologies that are not without controversy. Public engagement and authorization are critical to the future success of these programs. Methodology/Principal Findings This paper reports on an Australian case study where long-term social research was used to enable participation and the design of an engagement strategy tailored specifically to the sociopolitical setting of a potential trial release site of Wolbachia-infected Aedes aegytpi mosquitoes. Central themes of the social research, methods used and conclusions drawn are briefly described. Results indicate that different communities are likely to have divergent expectations, concerns and cultural sensibilities with regard to participation, engagement and authorization. Conclusions/Significance The findings show that a range of issues need to be understood and taken into account to enable sensitive, ethical and effective engagement when seeking public support for new dengue control methods. PMID:22953011

  7. User adaptation in long-term, open-loop myoelectric training: implications for EMG pattern recognition in prosthesis control

    NASA Astrophysics Data System (ADS)

    He, Jiayuan; Zhang, Dingguo; Jiang, Ning; Sheng, Xinjun; Farina, Dario; Zhu, Xiangyang

    2015-08-01

    Objective. Recent studies have reported that the classification performance of electromyographic (EMG) signals degrades over time without proper classification retraining. This problem is relevant for the applications of EMG pattern recognition in the control of active prostheses. Approach. In this study we investigated the changes in EMG classification performance over 11 consecutive days in eight able-bodied subjects and two amputees. Main results. It was observed that, when the classifier was trained on data from one day and tested on data from the following day, the classification error decreased exponentially but plateaued after four days for able-bodied subjects and six to nine days for amputees. The between-day performance became gradually closer to the corresponding within-day performance. Significance. These results indicate that the relative changes in EMG signal features over time become progressively smaller when the number of days during which the subjects perform the pre-defined motions are increased. The performance of the motor tasks is thus more consistent over time, resulting in more repeatable EMG patterns, even if the subjects do not have any external feedback on their performance. The learning curves for both able-bodied subjects and subjects with limb deficiencies could be modeled as an exponential function. These results provide important insights into the user adaptation characteristics during practical long-term myoelectric control applications, with implications for the design of an adaptive pattern recognition system.

  8. The effect of physical exercise on orexigenic and anorexigenic peptides and its role on long-term feeding control.

    PubMed

    Benite-Ribeiro, Sandra Aparecida; Putt, David A; Santos, Júlia Matzenbacher

    2016-08-01

    Over the past decades, life-styles changing have led to exacerbated food and caloric intake and a reduction in energy expenditure. Obesity, main outcome of these changes, increases the risk for developing type 2 diabetes, cardiovascular disease and metabolic syndrome, the leading cause of death in adult and middle age population. Body weight and energy homeostasis are maintained via complex interactions between orexigenic and anorexigenic neuropeptides that take place predominantly in the hypothalamus. Overeating may disrupt the mechanisms of feeding control, by decreasing the expression of proopiomelanocortin (POMC) and α-melanocyte stimulating hormone (α-MSH) and increasing orexigenic neuropeptide Y (NPY) and agouti-related peptide (AgRP), which leads to a disturbance in appetite control and energy balance. Studies have shown that regular physical exercise might decrease body-weight, food intake and improve the metabolic profile, however until the currently there is no consensus about its effects on the expression of orexigenic/anorexigenic neuropeptides expression. Therefore, we propose that the type and length of physical exercise affect POMC/αMSH and NPY/AgRP systems differently and plays an important role in feeding behavior. Moreover, based on the present reports, we hypothesize that increased POMC/αMSH overcome NPY/AgRP expression decreasing food intake in long term physical exercise and that results in amelioration of several conditions related to overweight and obesity. PMID:27372853

  9. Long term Glycemic Control Using Polymer Encapsulated, Human Stem-Cell Derived β-cells in Immune Competent mice

    PubMed Central

    Vegas, Arturo J.; Veiseh, Omid; Gürtler, Mads; Millman, Jeffrey R.; Pagliuca, Felicia W.; Bader, Andrew R.; Doloff, Joshua C.; Li, Jie; Chen, Michael; Olejnik, Karsten; Tam, Hok Hei; Jhunjhunwala, Siddharth; Langan, Erin; Aresta-Dasilva, Stephanie; Gandham, Srujan; McGarrigle, James; Bochenek, Matthew A.; Hollister-Lock, Jennifer; Oberholzer, Jose; Greiner, Dale L.; Weir, Gordon C.; Melton, Douglas A.; Langer, Robert; Anderson, Daniel G.

    2016-01-01

    The transplantation of glucose-responsive, insulin-producing cells offers the potential for restoring glycemic control in diabetic patients1. Pancreas transplantation and the infusion of cadaveric islets are currently implemented clinically2, but are limited by the adverse effects of lifetime immunosuppression and the limited supply of donor tissue3. The latter concern may be addressed by recently described glucose responsive mature β-cells derived from human embryonic stem cells; called SC-β, these cells may represent an unlimited human cell source for pancreas replacement therapy4. Strategies to address the immunosuppression concern include immunoisolation of insulin-producing cells with porous biomaterials that function as an immune barrier5,6. However, clinical implementation has been challenging due to host immune responses to implant materials7. Here, we report the first long term glycemic correction of a diabetic, immune-competent animal model with human SC-β cells. SC-β cells were encapsulated with alginate-derivatives capable of mitigating foreign body responses in vivo, and implanted into the intraperitoneal (IP) space of streptozotocin-treated (STZ) C57BL/6J mice. These implants induced glycemic correction until removal at 174 days without any immunosuppression. Human C-peptide concentrations and in vivo glucose responsiveness demonstrate therapeutically relevant glycemic control. Implants retrieved after 174 days contained viable insulin-producing cells. PMID:26808346

  10. Long-term financing needs for HIV control in sub-Saharan Africa in 2015–2050: a modelling study

    PubMed Central

    Atun, Rifat; Chang, Angela Y; Ogbuoji, Osondu; Silva, Sachin; Resch, Stephen; Hontelez, Jan; Bärnighausen, Till

    2016-01-01

    Objectives To estimate the present value of current and future funding needed for HIV treatment and prevention in 9 sub-Saharan African (SSA) countries that account for 70% of HIV burden in Africa under different scenarios of intervention scale-up. To analyse the gaps between current expenditures and funding obligation, and discuss the policy implications of future financing needs. Design We used the Goals module from Spectrum, and applied the most up-to-date cost and coverage data to provide a range of estimates for future financing obligations. The four different scale-up scenarios vary by treatment initiation threshold and service coverage level. We compared the model projections to current domestic and international financial sources available in selected SSA countries. Results In the 9 SSA countries, the estimated resources required for HIV prevention and treatment in 2015–2050 range from US$98 billion to maintain current coverage levels for treatment and prevention with eligibility for treatment initiation at CD4 count of <500/mm3 to US$261 billion if treatment were to be extended to all HIV-positive individuals and prevention scaled up. With the addition of new funding obligations for HIV—which arise implicitly through commitment to achieve higher than current treatment coverage levels—overall financial obligations (sum of debt levels and the present value of the stock of future HIV funding obligations) would rise substantially. Conclusions Investing upfront in scale-up of HIV services to achieve high coverage levels will reduce HIV incidence, prevention and future treatment expenditures by realising long-term preventive effects of ART to reduce HIV transmission. Future obligations are too substantial for most SSA countries to be met from domestic sources alone. New sources of funding, in addition to domestic sources, include innovative financing. Debt sustainability for sustained HIV response is an urgent imperative for affected countries and donors

  11. Long-term fertility control in female cats with GonaCon™, a GnRH immunocontraceptive.

    PubMed

    Levy, Julie K; Friary, John A; Miller, Lowell A; Tucker, Sylvia J; Fagerstone, Kathleen A

    2011-11-01

    The uncontrolled reproduction of free-roaming feral cats contributes to overpopulation and associated concerns regarding their welfare and impact on public health and the environment. Nonsurgical fertility control that could be administered to feral cats in the field would be a powerful tool for cat population control. The objective was to test the efficacy and duration of activity of a single-dose GnRH immunocontraceptive vaccine (GonaCon™) on the fertility of adult female laboratory cats. Vaccinated cats (n = 15) received a single injection of vaccine containing a GnRH-KLH conjugate (200 μg) emulsified in a mycobacterial and oil adjuvant on study Day 0. Sham-treated cats (n = 5) received a single injection containing all vaccine components except the GnRH-KLH conjugate. A breeding trial started on study Day 120. Vaccinated cats had a longer time to conception (median 39.7 mo) compared to sham-treated cats (4.4 mo; P < 0.001). A total of 93% of vaccinated cats remained infertile for the first year following vaccination, whereas 73, 53, and 40% were infertile for 2, 3, and 4 y, respectively. At study termination (5 y after a single GnRH vaccine was administered), four cats (27%) remained infertile. The GnRH antibody titers declined more rapidly in short-term responding cats with < 2 y of infertility (n = 4), compared to long-term responding cats that experienced fertility control for >2 y (n = 11) (P < 0.05). Non-painful but persistent late-onset granulomatous injection site masses appeared 2 y after initial vaccination in five cats. We concluded that GnRH immunocontraception is an ideal candidate for further development for feral cat control. PMID:21835455

  12. Long-term field trial to control the invasive Argentine ant (Hymenoptera: Formicidae) with synthetic trail pheromone.

    PubMed

    Nishisue, K; Sunamura, E; Tanaka, Y; Sakamoto, H; Suzuki, S; Fukumoto, T; Terayama, M; Tatsuki, S

    2010-10-01

    Previous short-term experiments showed that trail following behavior of the Argentine ant, Linepithema humile (Mayr) (Hymenoptera: Formicidae), can be disrupted by a high concentration of synthetic trail pheromone component (Z)-9-hexadecenal. In this study, a long-term field trial was conducted in 100-m2 plots of house gardens in an urban area of Japan to see whether the control effect on Argentine ants can be obtained by permeating synthetic trail pheromone from dispensers. The dispensers were placed in the experimental plots during the ant's active season (April-November) for 2 yr with monthly renewal. To estimate Argentine ant population density, foraging activity of Argentine ants in the study plots was monitored by monthly bait surveys. Throughout the study period, Argentine ant foraging activity was suppressed in the presence of the dispensers, presumably via trail forming inhibition. In contrast, the level of foraging activity was not different between treatment and no-treatment plots when the dispensers were temporarily removed, suggesting that treatment with pheromone dispensers did not suppress Argentine ant density in the treatment plots. Population decline may be expected with larger-scale treatment that covers a significant portion of the ant colony or with improvement in the potency of the disruptant. PMID:21061980

  13. Allogeneic hematopoietic cell transplantation for peripheral T-cell NHL results in long-term disease control

    PubMed Central

    Zain, Jasmine; Palmer, Joycelynne M.; Delioukina, Maria; Thomas, Sandra; Tsai, Ni-Chun; Nademanee, Auayporn; Popplewell, Leslie; Gaal, Karl; Senitzer, David; Kogut, Neil; O'Donnell, Margaret; Forman, Stephen J.

    2012-01-01

    The study analyzed outcomes of a consecutive case series of 37 patients with peripheral T-cell non-Hodgkin lymphoma, from related and unrelated donors, using allogeneic hematopoietic cell transplantation (allo-HCT), between the years 2000 and 2007. All patients were pretreated; the majority had either relapsed or progressive disease (n=25, 68%), 13 had cutaneous histologies (CTCL), and all were ineligible for autologous transplant. Fully ablative conditioning regimens were used in 13 patients while 24 patients underwent reduced intensity conditioning (RIC). At five years the overall survival (OS) and progression-free survival (PFS) probabilities were 52.2% and 46.5%, respectively. At the time of analysis, 9 (24.3%) patients had either relapsed (n=6) or progressed (n=3) post allo-HCT. The cumulative incidences of relapse/progression and non-relapse mortality at 5 years were 24.3% and 28.9%. No statistically significant variables for survival or relapse were discovered by univariate Cox-regression analysis of disease and patient characteristics; differences between CTCL and other histologies were not significant. The median follow-up of 64.0 months (range: 16.4–100.4) indicates a mature data-set with probable cure in the survivors. The relapse/progression curves reached and maintained plateaus after 1 year post-transplant, demonstrating that long-term disease control is possible after allo-HCT in PTCL patients with advanced disease. PMID:21699453

  14. Long-term cardiovascular fitness is associated with auditory attentional control in old adults: neuro-behavioral evidence.

    PubMed

    Getzmann, Stephan; Falkenstein, Michael; Gajewski, Patrick D

    2013-01-01

    It has been shown that healthy aging affects the ability to focus attention on a given task and to ignore distractors. Here, we asked whether long-term physical activity is associated with lower susceptibility to distraction of auditory attention, and how physically active and inactive seniors may differ regarding subcomponents of auditory attention. An auditory duration discrimination task was employed, and involuntary attentional shifts to task-irrelevant rare frequency deviations and subsequent reorientation were studied by analysis of behavioral data and event-related potential measures. The frequency deviations impaired performance more in physically inactive than active seniors. This was accompanied by a stronger frontal positivity (P3a) and increased activation of anterior cingulate cortex, suggesting a stronger involuntary shift of attention towards task-irrelevant stimulus features in inactive compared to active seniors. These results indicate a positive relationship between physical fitness and attentional control in elderly, presumably due to more focused attentional resources and enhanced inhibition of irrelevant stimulus features. PMID:24023949

  15. Wearing shoes increasing dorsiflexion improves short-term but not long-term balance control in young healthy adults.

    PubMed

    Rougier, P R; Lachaume, F; Bourse, J; Rogeon, M; Monti, A; Regueme, S C

    2009-10-16

    Wearing sport shoes inducing ankle dorsiflexion has been shown to alter the biomechanical specificities of the stretched muscles. The possible effect over the short and long term upon the sensorial capacities induced by such stretching has not been addressed yet. Fourteen healthy individuals were involved to assess the proprioceptive repercussion and their effects upon postural control strategies. Postural control and proprioceptive assessment were measured twice: when receiving sport shoes inducing ankle dorsiflexion and 18 days later. Proprioceptive effects were assessed using an ad-hoc device through which the seated and blindfolded subjects were required to reposition their feet in a starting position after the ankles were passively displaced to dorsiflexed and plantarflexed positions. Center-of-gravity horizontal displacements (CG(v)), estimated from center-of-pressure (CP) displacements, and CP-CG(v) displacements were measured through a force platform during upright quiet stance maintenance. The initial session was recorded with the subjects barefoot and wearing the shoes with a set of chocks with 0 degrees (horizontal) and -5 degrees (dorsiflexion) tilting angles. The second session included only barefoot performance in horizontal and dorsiflexion conditions. Dorsiflexion had no immediate effect on the postural control strategies along the anteroposterior axis. In contrast, barefoot or wearing shoes, stability was increased along the mediolateral axis during the dorsiflexion conditions. No ankle proprioceptive or postural change was observed after wearing the shoes for 18 days. Wearing dorsiflexion sport shoes induces short-term effects probably by inducing a backward tilt of the pelvis. A muscular adaptation likely prevents this effect from being prolonged. PMID:19682691

  16. Longitudinal Blood Pressure Control, Long-Term Mortality, and Predictive Utility of Serum Liver Enzymes and Bilirubin in Hypertensive Patients.

    PubMed

    McCallum, Linsay; Panniyammakal, Jeemon; Hastie, Claire E; Hewitt, Jonathan; Patel, Rajan; Jones, Gregory C; Muir, Scott; Walters, Matthew; Sattar, Naveed; Dominiczak, Anna F; Padmanabhan, Sandosh

    2015-07-01

    There is accruing evidence from general population studies that serum bilirubin and liver enzymes affect blood pressure (BP) and cardiovascular risk, but it is unclear whether these have an impact on hypertensive patients in terms of long-term survival or BP control. We analyzed 12 000 treated hypertensive individuals attending a tertiary care clinic followed up for 35 years for association between baseline liver function tests and cause-specific mortality after adjustment for conventional cardiovascular covariates. Generalized estimating equations were used to study the association of liver tests and follow-up BP. The total time at risk was 173 806 person years with median survival 32.3 years. Follow-up systolic BP over 5 years changed by -0.4 (alanine transaminase and bilirubin), +2.1(alkaline phosphatase), +0.9(γ-glutamyl transpeptidase) mm Hg for each standard deviation increase. Serum total bilirubin and alanine transaminase showed a significant negative association with all-cause and cardiovascular mortality, whereas alkaline phosphatase and γ-glutamyl transpeptidase showed a positive association and aspartate transaminase showed a U-shapedassociation. Serum bilirubin showed an incremental improvement of continuous net reclassification improvement by 8% to 26% for 25 year and 35 year cardiovascular mortality, whereas all liver markers together improved continuous net reclassification improvement by 19% to 47% compared with reference model. In hypertensive patients, serum liver enzymes and bilirubin within 4 standard deviations of the mean show independent effects on mortality and BP control. Our findings would support further studies to elucidate the mechanisms by which liver enzymes and bilirubin may exert an effect on BP and cardiovascular risk, but there is little support for using them in risk stratification. PMID:25941342

  17. Mixing-controlled uncertainty in long-term predictions of acid rock drainage from heterogeneous waste-rock piles

    NASA Astrophysics Data System (ADS)

    Pedretti, D.; Beckie, R. D.; Mayer, K. U.

    2015-12-01

    The chemistry of drainage from waste-rock piles at mine sites is difficult to predict because of a number of uncertainties including heterogeneous reactive mineral content, distribution of minerals, weathering rates and physical flow properties. In this presentation, we examine the effects of mixing on drainage chemistry over timescales of 100s of years. We use a 1-D streamtube conceptualization of flow in waste rocks and multicomponent reactive transport modeling. We simplify the reactive system to consist of acid-producing sulfide minerals and acid-neutralizing carbonate minerals and secondary sulfate and iron oxide minerals. We create multiple realizations of waste-rock piles with distinct distributions of reactive minerals along each flow path and examine the uncertainty of drainage geochemistry through time. The limited mixing of streamtubes that is characteristic of the vertical unsaturated flow in many waste-rock piles, allows individual flowpaths to sustain acid or neutral conditions to the base of the pile, where the streamtubes mix. Consequently, mixing and the acidity/alkalinity balance of the streamtube waters, and not the overall acid- and base-producing mineral contents, control the instantaneous discharge chemistry. Our results show that the limited mixing implied by preferential flow and the heterogeneous distribution of mineral contents lead to large uncertainty in drainage chemistry over short and medium time scales. However, over longer timescales when one of either the acid-producing or neutralizing primary phases is depleted, the drainage chemistry becomes less controlled by mixing and in turn less uncertain. A correct understanding of the temporal variability of uncertainty is key to make informed long-term decisions in mining settings regarding the management of waste material.

  18. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    NASA Astrophysics Data System (ADS)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  19. Randomised controlled trial of the effect of long-term selenium supplementation on plasma cholesterol in an elderly Danish population.

    PubMed

    Cold, Frederik; Winther, Kristian H; Pastor-Barriuso, Roberto; Rayman, Margaret P; Guallar, Eliseo; Nybo, Mads; Griffin, Bruce A; Stranges, Saverio; Cold, Søren

    2015-12-14

    Although cross-sectional studies have shown a positive association between Se and cholesterol concentrations, a recent randomised controlled trial in 501 elderly UK individuals of relatively low-Se status found that Se supplementation for 6 months lowered total plasma cholesterol. The Danish PRECISE (PREvention of Cancer by Intervention with Selenium) pilot study (ClinicalTrials.gov ID: NCT01819649) was a 5-year randomised, double-blinded, placebo-controlled trial with four groups (allocation ratio 1:1:1:1). Men and women aged 60-74 years (n 491) were randomised to 100 (n 124), 200 (n 122) or 300 (n 119) μg Se-enriched yeast or matching placebo-yeast tablets (n 126) daily for 5 years. A total of 468 participants continued the study for 6 months and 361 participants, equally distributed across treatment groups, continued for 5 years. Plasma samples were analysed for total and HDL-cholesterol and for total Se concentrations at baseline, 6 months and 5 years. The effect of different doses of Se supplementation on plasma lipid and Se concentrations was estimated by using linear mixed models. Plasma Se concentration increased significantly and dose-dependently in the intervention groups after 6 months and 5 years. Total cholesterol decreased significantly both in the intervention groups and in the placebo group after 6 months and 5 years, with small and nonsignificant differences in changes in plasma concentration of total cholesterol, HDL-cholesterol, non-HDL-cholesterol and total:HDL-cholesterol ratio between intervention and placebo groups. The effect of long-term supplementation with Se on plasma cholesterol concentrations or its sub-fractions did not differ significantly from placebo in this elderly population. PMID:26420334

  20. The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis – a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Exercise training is recommended for non-cystic fibrosis (CF) bronchiectasis, but the long-term effects are unclear. This randomised controlled trial aimed to determine the effects of exercise training and review of airway clearance therapy (ACT) on exercise capacity, health related quality of life (HRQOL) and the incidence of acute exacerbations in people with non-CF bronchiectasis. Methods Participants were randomly allocated to 8 weeks of supervised exercise training and review of ACT, or control. Primary outcomes of exercise capacity and HRQOL (Chronic respiratory disease questionnaire) and secondary outcomes of cough-related QOL (Leicester cough questionnaire) and psychological symptoms (Hospital anxiety and depression scale) were measured at baseline, following completion of the intervention period and at 6 and 12 months follow up. Secondary outcomes of the exacerbation rate and time to first exacerbation were analysed over 12 months. Results Eighty-five participants (mean FEV1 74% predicted; median Modified Medical Research Council Dyspnoea grade of 1 (IQR [1–3]) were included. Exercise training increased the incremental shuttle walk distance (mean difference to control 62 m, 95% CI 24 to 101 m) and the 6-minute walking distance (mean difference to control 41 m, 95% CI 19 to 63 m), but these improvements were not sustained at 6 or 12 months. Exercise training reduced dyspnoea (p = 0.009) and fatigue (p = 0.01) but did not impact on cough-related QOL or mood. Exercise training reduced the frequency of acute exacerbations (median 1[IQR 1–3]) compared to the control group (2[1–3]) over 12 months follow up (p = 0.012), with a longer time to first exacerbation with exercise training of 8 months (95% CI 7 to 9 months) compared to the control group (6 months [95% CI 5 to 7 months], p = 0.047). Conclusions Exercise training in bronchiectasis is associated with short term improvement in exercise capacity, dyspnoea and

  1. Efficacy of phosphorus-32 brachytherapy without external-beam radiation for long-term tumor control in patients with craniopharyngioma.

    PubMed

    Ansari, Shaheryar F; Moore, Reilin J; Boaz, Joel C; Fulkerson, Daniel H

    2016-04-01

    OBJECT Radioactive phosphorus-32 (P32) has been used as brachytherapy for craniopharyngiomas with the hope of providing local control of enlarging tumor cysts. Brachytherapy has commonly been used as an adjunct to the standard treatment of surgery and external-beam radiation (EBR). Historically, multimodal treatment, including EBR, has shown tumor control rates as high as 70% at 10 years after treatment. However, EBR is associated with significant long-term risks, including visual deficits, endocrine dysfunction, and cognitive decline. Theoretically, brachytherapy may provide focused local radiation that controls or shrinks a symptomatic cyst without exposing the patient to the risks of EBR. For this study, the authors reviewed their experiences with craniopharyngioma patients treated with P32 brachytherapy as the primary treatment without EBR. The authors reviewed these patients' records to evaluate whether this strategy effectively controls tumor growth, thus avoiding the need for further surgery or EBR. METHODS The authors performed a retrospective review of pediatric patients treated for craniopharyngioma between 1997 and 2004. This was the time period during which the authors' institution had a relatively high use of P32 for treatment of cystic craniopharyngioma. All patients who had surgery and injection of P32 without EBR were identified. The patient records were analyzed for complications, cyst control, need for further surgery, and need for future EBR. RESULTS Thirty-eight patients were treated for craniopharyngioma during the study period. Nine patients (23.7%) were identified who had surgery (resection or biopsy) with P32 brachytherapy but without initial EBR. These 9 patients represented the study group. For 1 patient (11.1%), there was a complication with the brachytherapy procedure. Five patients (55.5%) required subsequent surgery. Seven patients (77.7%) required subsequent EBR for tumor growth. The mean time between the injection of P32 and

  2. Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study

    PubMed Central

    Fingelkurts, Andrew A.; Fingelkurts, Alexander A.; Bagnato, Sergio; Boccagni, Cristina; Galardi, Giuseppe

    2016-01-01

    Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC patients whose EEGs were registered within 3 months post-injury. The obtained results suggest that EEG recorded at third month after sustaining brain damage, may contain useful information on the long-term outcome of patients in vegetative state: it could discriminate patients who remain in a persistent vegetative state from patients who reach a minimally conscious state or even recover a full consciousness in a long-term perspective (6 years) post-injury. These findings, if confirmed in further studies, may be pivotal for long-term planning of clinical care, rehabilitative programs, medical-legal decisions concerning the patients, and policy makers. PMID:27347266

  3. Brain Changes in Long-Term Zen Meditators Using Proton Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging: A Controlled Study

    PubMed Central

    Fayed, Nicolás; Lopez del Hoyo, Yolanda; Andres, Eva; Serrano-Blanco, Antoni; Bellón, Juan; Aguilar, Keyla; Cebolla, Ausias; Garcia-Campayo, Javier

    2013-01-01

    Introduction This work aimed to determine whether 1H magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are correlated with years of meditation and psychological variables in long-term Zen meditators compared to healthy non-meditator controls. Materials and Methods Design. Controlled, cross-sectional study. Sample. Meditators were recruited from a Zen Buddhist monastery. The control group was recruited from hospital staff. Meditators were administered questionnaires on anxiety, depression, cognitive impairment and mindfulness. 1H-MRS (1.5 T) of the brain was carried out by exploring four areas: both thalami, both hippocampi, the posterior superior parietal lobule (PSPL) and posterior cingulate gyrus. Predefined areas of the brain were measured for diffusivity (ADC) and fractional anisotropy (FA) by MR-DTI. Results Myo-inositol (mI) was increased in the posterior cingulate gyrus and Glutamate (Glu), N-acetyl-aspartate (NAA) and N-acetyl-aspartate/Creatine (NAA/Cr) was reduced in the left thalamus in meditators. We found a significant positive correlation between mI in the posterior cingulate and years of meditation (r = 0.518; p = .019). We also found significant negative correlations between Glu (r = −0.452; p = .045), NAA (r = −0.617; p = .003) and NAA/Cr (r = −0.448; P = .047) in the left thalamus and years of meditation. Meditators showed a lower Apparent Diffusion Coefficient (ADC) in the left posterior parietal white matter than did controls, and the ADC was negatively correlated with years of meditation (r = −0.4850, p = .0066). Conclusions The results are consistent with the view that mI, Glu and NAA are the most important altered metabolites. This study provides evidence of subtle abnormalities in neuronal function in regions of the white matter in meditators. PMID:23536796

  4. Fluoxetine for the Treatment of Childhood Anxiety Disorders: Open-Label, Long-Term Extension to a Controlled Trial

    ERIC Educational Resources Information Center

    Clark, Duncan B.; Birmaher, Boris; Axelson, David; Monk, Kelly; Kalas, Catherine; Ehmann, Mary; Bridge, Jeffrey; Wood, D. Scott; Muthen, Bengt; Brent, David

    2005-01-01

    Objective: To assess the efficacy of fluoxetine for the long-term treatment of children and adolescents with anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Method: Children and adolescents (7-17 years old) with anxiety disorders were studied in open treatment for 1 year after they…

  5. A Controlled Single-Case Treatment of Severe Long-Term Selective Mutism in a Child with Mental Retardation

    ERIC Educational Resources Information Center

    Facon, Bruno; Sahiri, Safia; Riviere, Vinca

    2008-01-01

    The aim of the present study was to demonstrate the efficacy of combining two operant learning procedures--shaping and fading--for treating selective mutism. The participant was a 12-year-old boy with mental retardation presenting a severe long-term selective mutism. The treatment was aimed at increasing the loudness of his vocalizations in an…

  6. Designing a Microfluidic Device with Integrated Ratiometric Oxygen Sensors for the Long-Term Control and Monitoring of Chronic and Cyclic Hypoxia

    PubMed Central

    Grist, Samantha M.; Schmok, Jonathan C.; Liu, Meng-Chi (Andy); Chrostowski, Lukas; Cheung, Karen C.

    2015-01-01

    Control of oxygen over cell cultures in vitro is a topic of considerable interest, as chronic and cyclic hypoxia can alter cell behaviour. Both static and transient hypoxic levels have been found to affect tumour cell behaviour; it is potentially valuable to include these effects in early, in vitro stages of drug screening. A barrier to their inclusion is that rates of transient hypoxia can be a few cycles/hour, which is difficult to reproduce in traditional in vitro cell culture environments due to long diffusion distances from control gases to the cells. We use a gas-permeable three-layer microfluidic device to achieve spatial and temporal oxygen control with biologically-relevant switching times. We measure the oxygen profiles with integrated, ratiometric optical oxygen sensors, demonstrate sensor and system stability over multi-day experiments, and characterize a pre-bleaching process to improve sensor stability. We show, with both finite-element modelling and experimental data, excellent control over the oxygen levels by the device, independent of fluid flow rate and oxygenation for the operating flow regime. We measure equilibration times of approximately 10 min, generate complex, time-varying oxygen profiles, and study the effects of oxygenated media flow rates on the measured oxygen levels. This device could form a useful tool for future long-term studies of cell behaviour under hypoxia. PMID:26287202

  7. Designing a Microfluidic Device with Integrated Ratiometric Oxygen Sensors for the Long-Term Control and Monitoring of Chronic and Cyclic Hypoxia.

    PubMed

    Grist, Samantha M; Schmok, Jonathan C; Liu, Meng-Chi Andy; Chrostowski, Lukas; Cheung, Karen C

    2015-01-01

    Control of oxygen over cell cultures in vitro is a topic of considerable interest, as chronic and cyclic hypoxia can alter cell behaviour. Both static and transient hypoxic levels have been found to affect tumour cell behaviour; it is potentially valuable to include these effects in early, in vitro stages of drug screening. A barrier to their inclusion is that rates of transient hypoxia can be a few cycles/hour, which is difficult to reproduce in traditional in vitro cell culture environments due to long diffusion distances from control gases to the cells. We use a gas-permeable three-layer microfluidic device to achieve spatial and temporal oxygen control with biologically-relevant switching times. We measure the oxygen profiles with integrated, ratiometric optical oxygen sensors, demonstrate sensor and system stability over multi-day experiments, and characterize a pre-bleaching process to improve sensor stability. We show, with both finite-element modelling and experimental data, excellent control over the oxygen levels by the device, independent of fluid flow rate and oxygenation for the operating flow regime. We measure equilibration times of approximately 10 min, generate complex, time-varying oxygen profiles, and study the effects of oxygenated media flow rates on the measured oxygen levels. This device could form a useful tool for future long-term studies of cell behaviour under hypoxia. PMID:26287202

  8. Transport of Black Carbon Across the Terrestrial-Aquatic Interface Following Wildfire: Contributions of Short and Long-term Controls

    NASA Astrophysics Data System (ADS)

    Boot, C. M.; Cotrufo, M. F.; Haddix, M. L.; Schmeer, S.; Kampf, S. K.; Brogan, D. J.; Nelson, P. A.; Rhoades, C.; Ryan, S. E.; Rathburn, S. L.; Hall, E.

    2014-12-01

    Black carbon (BC) is a ubiquitous component of the carbon cycle, yet controls on its landscape-level distribution, including the relative importance of mechanisms for transport across the terrestrial aquatic interface, are relatively unknown. In June 2012, the High Park Fire (HPF) burned 353 km2 of land in the Cache la Poudre (CLP) watershed just northwest of Fort Collins, CO. Following independent efforts of our group to quantify the effects of the HPF on biogeochemical pools and landscape geomorphology, we aimed to synthesize our respective datasets with two main objectives: 1. determine and relate BC content in different parts of the watershed including litter, soils, river bank sediments and dissolved and particulate organic materials in river water, 2. develop a conceptual framework for mechanisms that contribute to BC export from the CLP on short and long-term time scales. Using the benzene polycarboxylic acid (BPCA) method as a molecular proxy for BC concentrations, we found that the majority of BC deposited on the landscape by the HPF was located in the litter, coarse plant fraction of river bank sediments, and DOC, suggesting that BC mobilized on the landscape is transported downstream through the river network. In 2012, following the HPF, the 30-minute rainfall intensity required to mobilize sediment on hillslopes (critical I30) was 3.6 mm/hr, and in summer 2013, the critical I30 increased to 8.1 mm/hr, likely due to vegetation recovery. The low critical I30 in the first season following the fire indicated that BC could have been easily mobilized, even in small storms. Our working conceptual framework is that post fire, there are two phases of BC export from an ecosystem. In the first phase, BC export is primarily driven by transport of particulate material controlled by precipitation intensity and duration, along with the burn severity and slope of the landscape. The second phase of BC export is primarily in the dissolved form, and is driven by climatic

  9. Using Psychodynamic, Cognitive Behavioral, and Control Mastery Prototypes to Predict Change: A New Look at an Old Paradigm for Long-Term Single-Case Research

    ERIC Educational Resources Information Center

    Pole, Nnamdi; Ablon, J. Stuart; O'Connor, Lynn E.

    2008-01-01

    This article illustrates a method of testing models of change in individual long-term psychotherapy cases. A depressed client was treated with 208 sessions of control mastery therapy (CMT), an unmanualized approach that integrates elements of psychodynamic therapy (PDT) and cognitive behavioral therapy (CBT). Panels of experts developed prototypes…

  10. Differential Susceptibility to Early Literacy Intervention in Children with Mild Perinatal Adversities: Short- and Long-Term Effects of a Randomized Control Trial

    ERIC Educational Resources Information Center

    Van der Kooy-Hofland, Verna A. C.; Van der Kooy, Jacoba; Bus, Adriana G.; van IJzendoorn, Marinus H.; Bonsel, Gouke J.

    2012-01-01

    In a randomized control trial, the authors tested whether short- and long-term effects of an early literacy intervention are moderated by mild perinatal adversities in accordance with differential susceptibility theory. One-hundred 5-year-old children (58% male) who scored at or below the 30th percentile on early literacy measures were randomized…

  11. Cost-Effectiveness of a Long-Term Internet-Delivered Worksite Health Promotion Programme on Physical Activity and Nutrition: A Cluster Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Robroek, Suzan J. W.; Polinder, Suzanne; Bredt, Folef J.; Burdorf, Alex

    2012-01-01

    This study aims to evaluate the cost-effectiveness of a long-term workplace health promotion programme on physical activity (PA) and nutrition. In total, 924 participants enrolled in a 2-year cluster randomized controlled trial, with departments (n = 74) within companies (n = 6) as the unit of randomization. The intervention was compared with a…

  12. Ziprasidone in Adolescents with Schizophrenia: Results from a Placebo-Controlled Efficacy and Long-Term Open-Extension Study

    PubMed Central

    Çavuş, Idil; Pappadopulos, Elizabeth; Vanderburg, Douglas G.; Schwartz, Jeffrey H.; Gundapaneni, Balarama K.; DelBello, Melissa P.

    2013-01-01

    Abstract Objective The purpose of this study was to evaluate the short- and long-term efficacy, safety, and tolerability of ziprasidone in adolescents with schizophrenia. Methods Subjects ages 13–17 years with schizophrenia (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM-IV]) were enrolled in a 6 week, randomized, double-blind, placebo-controlled multicenter trial (RCT) followed by a 26 week open-label extension study (OLE). Subjects were randomized in a 2:1 ratio to flexible-dose oral ziprasidone (40–160 mg/day, based on weight) or placebo. Primary end-point was change from baseline in Brief Psychiatric Rating Scale–Anchored (BPRS-A) total score. Safety assessments included adverse events, vital signs, laboratory measures, electrocardiograms, weight and body mass index, and movement disorder ratings. Results Planned interim analysis for the primary end-point in the RCT resulted in early termination of both studies because of futility. In the RCT, 283 subjects received ziprasidone (n=193) or placebo (n=90). In the intent-to-treat analysis population, the least squares mean (SE) BPRS–A score decrease from baseline at week 6 was not significantly different (p=0.15; −14.16 [0.78] for ziprasidone and −12.35 [1.05] for placebo). Per-protocol analysis was significant (p=0.02). In the OLE, 221 subjects entered the OLE and received ziprasidone for a median of 99 days. The mean (SD) change in BPRS-A score from end of RCT to end of OLE (last observation carried forward) was −6.9 (8.9). The most common treatment-emergent adverse events (≥10%) for all causalities during the RCT were somnolence and extrapyramidal disorders, and during OLE was somnolence only. No subjects had Fridericia's corrected QT (QTcF) ≥500 ms in the RCT or OLE phases. One completed suicide occurred during the OLE phase. For RCT and OLE, no clinically significant changes were reported in metabolic indices and laboratory measures

  13. Randomized, Controlled Trial of High-Dose Influenza Vaccine Among Frail Residents of Long-Term Care Facilities

    PubMed Central

    Nace, David A.; Lin, Chyongchiou Jeng; Ross, Ted M.; Saracco, Stacey; Churilla, Roberta M.; Zimmerman, Richard K.

    2015-01-01

    Background. Despite vaccination, residents of long-term-care facilities (LTCFs) remain at high risk of influenza-related morbidity and mortality. More-effective vaccine options for this population are needed. Methods. We conducted a single-blinded, randomized, controlled trial comparing high-dose (HD) to standard-dose (SD) inactivated influenza vaccine (IIV) in 205 frail, elderly residents of LTCFs during the 2011–2012 and 2012–2013 influenza seasons. Hemagglutination inhibition (HI) antibody titers were measured at baseline and 30 and 180 days following vaccination. Results. A total of 187 subjects (91%) completed the study. The mean age was 86.7 years. Geometric mean titers (GMTs) were significantly higher (P < .05) at day 30 for HD recipients, compared with SD recipients, for all comparisons except influenza A(H1N1) during 2012–2013 (the HD formulation was noninferior to the SD formulation for influenza A[H1N1] during 2012–2013). GMTs for HD and SD recipients during 2011–2012 were as follows: influenza A(H1N1), 78 (95% confidence interval [CI], 45–136) and 27 (95% CI, 17–44), respectively; influenza A(H3N2), 26 (95% CI, 17–40) and 10 (95% CI, 7–15), respectively; and influenza B, 26 (95% CI, 19–35) and 14 (95% CI, 11–18), respectively. During 2012–2013, GMTs for HD and SD recipients were as follows: influenza A(H1N1), 46 (95% CI, 33–63) and 50 (95% CI, 37–67); influenza A(H3N2), 23 (95% CI, 18–31) and 14 (95% CI, 11–18), respectively; and influenza B, 26 (95% CI, 21–32) and 17 (95% CI, 14–22), respectively. GMTs were significantly higher at day 180 for HD recipients, compared with SD recipients, for influenza A(H3N2) in both years (P < .001). Conclusions. Among frail, elderly residents of LTCFs, HD influenza vaccine produced superior responses for all strains except influenza A(H1N1) in 2012–2013. Clinical Trials Registration. NCT01654224. PMID:25525051

  14. The long-term control of vegetation and woody debris on channel and flood-plain evolution: insights from a paired catchment study in southeastern Australia

    NASA Astrophysics Data System (ADS)

    Brooks, Andrew P.; Brierley, Gary J.; Millar, Robert G.

    2003-03-01

    pieces and channel width. Consequently, channel recovery will not simply be achieved by reintroducing the pre-existing riparian vegetation and woody debris load. Devising sound management strategies and realistic management targets for the Cann River, or any similarly altered river, requires an understanding of the long-term channel and flood plain evolutionary history, as well as the underlying controls on historical changes.

  15. Nonpharmacological Treatments of Insomnia for Long-Term Painful Conditions: A Systematic Review and Meta-analysis of Patient-Reported Outcomes in Randomized Controlled Trials

    PubMed Central

    Tang, Nicole K.Y.; Lereya, S. Tanya; Boulton, Hayley; Miller, Michelle A.; Wolke, Dieter; Cappuccio, Francesco P.

    2015-01-01

    Study Objectives: Insomnia is a debilitating comorbidity of chronic pain. This study evaluated the effect of nonpharmacological sleep treatments on patient-reported sleep quality, pain, and well-being in people with long-term cancer and non-cancer (e.g., back pain, arthritis, fibromyalgia) pain conditions. Design: We systematically searched Cochrane CENTRAL, MEDLINE, Embase, and PsychINFO for relevant studies. Search period was set to inception of these databases to March 2014. Studies were included if they were: original randomized controlled trials (RCTs); testing a nonpharmacological intervention; that targets sleep; in adults; with painful health conditions; that has a control group; includes a measure of sleep quality; and at least one other health and well-being outcome. Measurement and Findings: Means and standard deviations of sleep quality, pain, fatigue, depression, anxiety, physical and psychological functioning were extracted for the sleep treatment and control groups at baseline, posttreatment and final follow-up. Methodological details concerning the treatment, participants, and study design were abstracted to guide heterogeneity and subgroup analyses. Eleven RCTs involving 1,066 participants (mean age 45–61 years) met the criteria for the meta-analysis. There was no systematic evidence of publication bias. Nonpharmacological sleep treatments in chronic pain patients were associated with a large improvement in sleep quality (standardized mean difference = 0.78, 95% Confidence Interval [0.42, 1.13]; P < 0.001), small reduction in pain (0.18 [0, 0.36] P < 0.05), and moderate improvement in fatigue (0.38 [0.08, 0.69]; P < 0.01) at posttreatment. The effects on sleep quality and fatigue were maintained at follow-up (up to 1 year) when a moderate reduction in depression (0.31, [0.09, 0.53]; P < 0.01) was also observed. Both cancer and non-cancer pain patients benefited from nonpharmacological sleep treatments. Face-to-face treatments achieved better

  16. Snoezelen, structured reminiscence therapy and 10-minutes activation in long term care residents with dementia (WISDE): study protocol of a cluster randomized controlled trial

    PubMed Central

    2010-01-01

    Background People with dementia are often inapproachable due to symptoms of their illness. Therefore nurses should establish relationships with dementia patients via their remaining resources and facilitate communication. In order to achieve this, different targeted non-pharmacological interventions are recommended and practiced. However there is no sufficient evidence about the efficacy of most of these interventions. A number of publications highlight the urgent need for methodological sound studies so that more robust conclusions may be drawn. Methods/Design The trial is designed as a cluster randomized controlled trial with 20 nursing homes in Saxony and Saxony-Anhalt (Germany) as the units of randomization. Nursing homes will be randomly allocated into 4 study groups consisting of 5 clusters and 90 residents: snoezelen, structured reminiscence therapy, 10-minutes activation or unstructured verbal communication (control group). The purpose is to determine whether the interventions are effective to reduce apathy in long-term care residents with dementia (N = 360) as the main outcome measure. Assessments will be done at baseline, 3, 6 and 12 months after beginning of the interventions. Discussion This trial will particularly contribute to the evidence on efficacy of non-pharmacological interventions in dementia care. Trial Registration ClinicalTrials.gov NCT00653731 PMID:20113526

  17. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials.

    PubMed

    Bueno, Nassib Bezerra; de Melo, Ingrid Sofia Vieira; de Oliveira, Suzana Lima; da Rocha Ataide, Terezinha

    2013-10-01

    The role of very-low-carbohydrate ketogenic diets (VLCKD) in the long-term management of obesity is not well established. The present meta-analysis aimed to investigate whether individuals assigned to a VLCKD (i.e. a diet with no more than 50 g carbohydrates/d) achieve better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (LFD; i.e. a restricted-energy diet with less than 30% of energy from fat). Through August 2012, MEDLINE, CENTRAL, ScienceDirect,Scopus, LILACS, SciELO, ClinicalTrials.gov and grey literature databases were searched, using no date or language restrictions, for randomised controlled trials that assigned adults to a VLCKD or a LFD, with 12 months or more of follow-up. The primary outcome was bodyweight. The secondary outcomes were TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), systolic and diastolic blood pressure,glucose, insulin, HbA1c and C-reactive protein levels. A total of thirteen studies met the inclusion/exclusion criteria. In the overall analysis,five outcomes revealed significant results. Individuals assigned to a VLCKD showed decreased body weight (weighted mean difference 20·91 (95% CI 21·65, 20·17) kg, 1415 patients), TAG (weighted mean difference 20·18 (95% CI 20·27, 20·08) mmol/l, 1258 patients)and diastolic blood pressure (weighted mean difference 21·43 (95% CI 22·49, 20·37) mmHg, 1298 patients) while increased HDL-C(weighted mean difference 0·09 (95% CI 0·06, 0·12) mmol/l, 1257 patients) and LDL-C (weighted mean difference 0·12 (95% CI 0·04,0·2) mmol/l, 1255 patients). Individuals assigned to a VLCKD achieve a greater weight loss than those assigned to a LFD in the longterm; hence, a VLCKD may be an alternative tool against obesity. PMID:23651522

  18. Long-term mass transfer and mixing-controlled reactions of a DNAPL plume from persistent residuals

    NASA Astrophysics Data System (ADS)

    Liu, Yuan; Illangasekare, Tissa H.; Kitanidis, Peter K.

    2014-02-01

    Understanding and being able to predict the long-term behavior of DNAPL (i.e., PCE and TCE) residuals after active remediation has ceased have become increasingly important as attention at many sites turns from aggressive remediation to monitored natural attenuation and long-term stewardship. However, plume behavior due to mass loading and reactions during these later phases is less studied as they involve large spatial and temporal scales. We apply both theoretical analysis and pore-scale simulations to investigate mass transfer from DNAPL residuals and subsequent reactions within the generated plume, and, in particular, to show the differences between early- and late-time behaviors of the plume. In the zone of entry of the DNAPL entrapment zone where the concentration boundary layer in the flowing groundwater has not fully developed, the pore-scale simulations confirm the past findings based on laboratory studies that the mass transfer increases as a power-law function of the Peclét number, and is enhanced due to reactions in the plume. Away from the entry zone and further down gradient, the long-term reactions are limited by the available additive and mixing in the porous medium, thereby behave considerably differently from the entry zone. For the reaction between the contaminant and an additive with intrinsic second-order bimolecular kinetics, the late-time reaction demonstrates a first-order decay macroscopically with respect to the mass of the limiting additive, not with respect to that of the contaminant. The late-time decay rate only depends on the intrinsic reaction rate and the solubility of the entrapped DNAPL. At the intermediate time, the additive decays exponentially with the square of time (t2), instead of time (t). Moreover, the intermediate decay rate also depends on the initial conditions, the spatial distribution of DNAPL residuals, and the effective dispersion coefficient.

  19. An updated review of long-term outcomes from randomized controlled trials in approved pharmaceuticals for diabetic macular edema.

    PubMed

    Wang, Jia-Kang; Huang, Tzu-Lun; Su, Pei-Yuan; Chang, Pei-Yao

    2015-12-01

    Diabetic macular edema (DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids (dexamethasone implants and fluocinolone acetonide inserts) and anti-vascular endothelial growth factor (VEGF) (ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome PMID:27215008

  20. Long-term preservation of Anammox bacteria

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Deposit of useful microorganisms in culture collections requires long-term preservation and successful reactivation techniques. The goal of this study was to develop a simple preservation protocol for the long-term storage and reactivation of the anammox biomass. To achieve this, anammox biomass w...

  1. Long-Term Outcome of Cognitive Behavior Therapy for Body Dysmorphic Disorder: A Naturalistic Case Series of 1 to 4 Years After a Controlled Trial.

    PubMed

    Veale, David; Miles, Sarah; Anson, Martin

    2015-11-01

    There is some evidence for the efficacy of cognitive behavior therapy (CBT) for body dysmorphic disorder (BDD) after 1 to 6months but none in the long term. The aim of this study was to follow up the participants in a randomized controlled trial of CBT versus anxiety management to determine whether or not the treatment gains were maintained over time. Thirty of the original 39 participants who had CBT were followed up over 1 to 4years and assessed using a number of clinician and self-report measures, which included the primary outcome measure of the Yale-Brown Obsessive Compulsive Scale modified for BDD. Outcome scores generally maintained over time from end of treatment to long-term follow-up. There was a slight deterioration from n=20 (51.3%) to n=18 (46.2%) who met improvement criteria at long-term follow-up. Eleven (28.2%) were in full remission and 22 (56.4%) were in partial remission. The gains made were generally maintained at long-term follow-up. However, there were a significant number of participants who maintained chronic symptoms after treatment and may need a longer-term or more complex intervention and active medication management. PMID:26520220

  2. Capillarity Effect Controlled Precipitate Growth at the Grain Boundary of Long-Term Aging Al 5083 Alloy

    NASA Astrophysics Data System (ADS)

    Yi, Gaosong; Free, Michael L.; Zhu, Yakun; Derrick, Alexander T.

    2014-10-01

    A model was developed to predict thickness and continuity of β phase (Al3Mg2) formed at grain boundaries of long-term aged Al 5083 alloy. In this model, a variable collector plate mechanism was adopted at the early stage of aging, then, at about 1 month (), the model transitions to a constant collector plate mechanism. Two concentration profiles of Mg, one for a semi-infinite bulk at short diffusion distances and one for a finite slab at long diffusion distances ( of the grain size), were applied to this model for different aging times. Capillarity effects were used to determine the morphology of β phase at the grain boundary. Combining different collector plate mechanisms and Mg concentration profiles, the whole β phase growth process was divided into three stages (short-term Mg concentration profile-variable collector plate, short-term Mg concentration profile-constant collector plate, and long-term Mg concentration profile-constant collector plate). Finally, the model was solved numerically. Experimental results of β phase length and thickness were obtained using transmission electron microscopy (TEM) images of Al 5083 aged at 343 K (70 °C) for different thermal exposure times. Modeling results of β phase thickness and continuity agree well with experimental observations.

  3. Modelling of long-term and short-term mechanisms of arterial pressure control in the cardiovascular system: an object-oriented approach.

    PubMed

    Fernandez de Canete, J; Luque, J; Barbancho, J; Munoz, V

    2014-04-01

    A mathematical model that provides an overall description of both the short- and long-term mechanisms of arterial pressure regulation is presented. Short-term control is exerted through the baroreceptor reflex while renal elimination plays a role in long-term control. Both mechanisms operate in an integrated way over the compartmental model of the cardiovascular system. The whole system was modelled in MODELICA, which uses a hierarchical object-oriented modelling strategy, under the DYMOLA simulation environment. The performance of the controlled system was analysed by simulation in light of the existing hypothesis and validation tests previously performed with physiological data, demonstrating the effectiveness of both regulation mechanisms under physiological and pathological conditions. PMID:24561348

  4. Prediction of successful outcome in a randomised controlled trial of the long-term efficacy of interferon alpha treatment for chronic hepatitis C.

    PubMed

    Vandelli, C; Renzo, F; Braun, H B; Tisminetzky, S; Albrecht, M; De Palma, M; Ranzi, A; Di Marco, G; Stroffolini, T; Baralle, F; Ventura, E; Michel, G

    1999-05-01

    To evaluate the efficacy of a 12-month course of recombinant interferon alpha (IFN-alpha2b), and to assess predictive factors of successful response to IFN therapy in chronic active hepatitis C (HCV CAH), 242 patients with histologically proven HCV CAH were assigned randomly to two groups, one treated with IFN-alpha2b (3 MU three times weekly, intramuscularly), the other untreated. To determine the efficacy of IFN-alpha2b 12 months after therapy, a second liver biopsy was carried out on 100 treated patients and 27 untreated patients. The biochemical, virological, and serological response of patients followed up for at least 50 months after treatment was also evaluated to confirm the efficacy of IFN-alpha2b. The genotypes of infecting HCV, anti-HCV core IgM, and HCV-RNA concentrations were also analysed and the predictors of response determined by univariate and multivariate analyses. Response was defined in terms of the normalisation of aminotransferase activities and the disappearance of HCV-RNA. The overall long-term response was 39.4%. Anti-HCV core IgM levels were significantly lower in long-term responders. Patients with increased levels of IgM anti HCV core (>3.8 sample/cut-off), infected with genotype 1b were nonresponders. Liver histology improved significantly in patients with long-term response. Multivariate analysis identified three independent predictors of the likelihood of long-term response to IFN therapy: age younger than 40 years, basal anti-HCV core IgM levels < or = 3.8, and genotypes other than 1b. These data indicate that the treatment with IFN-alpha2b used in this randomised controlled trial is effective in HCV CAH. Anti-HCV core IgM was the strongest predictor of long-term response in the present study. PMID:10223542

  5. Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training.

    PubMed

    Warschburger, Petra; Kroeller, Katja; Haerting, Johannes; Unverzagt, Susanne; van Egmond-Fröhlich, Andreas

    2016-08-01

    Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances 'obesity-specific' parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7-13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects. PMID:27074374

  6. Soil properties and not inputs control carbon, nitrogen, phosphorus ratios in cropped soils in the long-term

    NASA Astrophysics Data System (ADS)

    Frossard, E.; Buchmann, N.; Bünemann, E. K.; Kiba, D. I.; Lompo, F.; Oberson, A.; Tamburini, F.; Traoré, O. Y. A.

    2015-09-01

    Stoichiometric approaches have been applied to understand the relationship between soil organic matter dynamics and biological nutrient transformations. However, very few studies explicitly considered the effects of agricultural management practices on soil C : N : P ratio. The aim of this study was to assess how different input types and rates would affect the C : N : P molar ratios of bulk soil, organic matter and microbial biomass in cropped soils in the long-term. Thus, we analysed the C, N and P inputs and budgets as well as soil properties in three long-term experiments established on different soil types: the Saria soil fertility trial (Burkina Faso), the Wagga Wagga rotation/stubble management/soil preparation trial (Australia), and the DOK cropping system trial (Switzerland). In each of these trials, there was a large range of C, N and P inputs which had a strong impact on element concentrations in soils. However, although C : N : P ratios of the inputs were highly variable, they had only weak effects on soil C : N : P ratios. At Saria, a positive correlation was found between the N : P ratio of inputs and microbial biomass, while no relation was observed between the nutrient ratios of inputs and soil organic matter. At Wagga Wagga, the C : P ratio of inputs was significantly correlated to total soil C : P, N : P and C : N ratios, but had no impact on the elemental composition of microbial biomass. In the DOK trial, a positive correlation was found between the C budget and the C to organic P ratio in soils, while the nutrient ratios of inputs were not related to those in the microbial biomass. We argue that these responses are due to differences in soil properties among sites. At Saria, the soil is dominated by quartz and some kaolinite, has a coarse texture, a fragile structure and a low nutrient content. Thus, microorganisms feed on inputs (plant residues, manure). In contrast, the soil at Wagga Wagga contains illite and haematite, is richer in clay and

  7. Mirtazapine versus amitriptyline in the long-term treatment of depression: a double-blind placebo-controlled study.

    PubMed

    Montgomery, S A; Reimitz, P E; Zivkov, M

    1998-03-01

    Of 580 patients randomly assigned to short-term, double-blind treatment with either mirtazapine, amitriptyline or placebo, a total of 217 patients clinically judged to be responders subsequently continued on the same medication for up to 2 years in the long-term treatment study (mirtazapine, n = 74; amitriptyline, n = 86 and placebo, n = 57). The efficacy of mirtazapine in relapse prevention was seen in an analysis of the first 20 weeks data. Significantly fewer patients relapsed during treatment with mirtazapine compared with placebo (p < 0.05), and a significantly longer time to relapse was shown on the survival analysis. There was a significant advantage for amitriptyline compared with placebo in the first 20 weeks, with fewer patients relapsing. There was a significant advantage for mirtazapine compared with amitriptyline at 20 weeks seen on the survival analysis (p < 0.05). The significant advantage for mirtazapine compared with placebo was also seen in the prophylactic phase of treatment after 20 weeks. At the endpoint there were significantly more patients in the placebo group with a return of symptoms and significantly fewer showing sustained response. Amitriptyline was better than placebo with fewer patients suffering a recurrence of symptoms, but there was no difference from placebo in the proportion of patients with sustained response. Mirtazapine was well tolerated with a side-effect profile similar to that of placebo. The only adverse event reported significantly more frequently on mirtazapine than on placebo was weight gain. Objectively measured weight gain was more frequent with amitriptyline (22% of patients) compared with mirtazapine (13% of patients). Amitriptyline was associated with significantly more adverse events than either mirtazapine or placebo, in particular sedative and anticholinergic side effects. The efficacy of mirtazapine in reducing the risk of relapse and the recurrence of depression, which on some measures showed an advantage

  8. Long-term P weathering and recent N deposition control contemporary plant-soil C, N, and P

    NASA Astrophysics Data System (ADS)

    Davies, J. A. C.; Tipping, E.; Rowe, E. C.; Boyle, J. F.; Graf Pannatier, E.; Martinsen, V.

    2016-02-01

    Models are needed to understand how plant-soil nutrient stores and fluxes have responded to the last two centuries of widespread anthropogenic nutrient pollution and predict future change. These models need to integrate across carbon, nitrogen, and phosphorus (C, N, and P) cycles and simulate changes over suitable timescales using available driving data. It is also vital that they are constrainable against observed data to provide confidence in their outputs. To date, no models address all of these requirements. To meet this need, a new model, N14CP, is introduced, which is initially applied to Northern Hemisphere temperate and boreal ecosystems over the Holocene. N14CP is parameterized and tested using 88 northern Europe plot-scale studies, providing the most robust test of such a model to date. The model simulates long-term P weathering, based on the assumption of a starting pool of weatherable P (Pweath0, g m-2), which is gradually transformed into organic and sorbed pools. Nitrogen fixation (and consequently primary production) is made dependent on available P. In the absence of knowledge about the spatial variability of Pweath0, N14CP produces good average soil and plant variables but cannot simulate variations among sites. Allowing Pweath0 to vary between sites improves soil C, N, and P results greatly, suggesting that contemporary soil C, N, and P are sensitive to long-term P weathering. Most sites were found to be N limited. Anthropogenic N deposition since 1800 was calculated to have increased plant biomass substantially, in agreement with observations and consequently increased soil carbon pools.

  9. Long-term P weathering and recent N deposition control contemporary plant-soil C, N and P

    NASA Astrophysics Data System (ADS)

    Davies, Jessica; Tipping, Edward; Rowe, Edwin; Boyle, John; Graf Pannatier, Elisabeth; Martinsen, Vegard

    2016-04-01

    Models are needed to understand how plant-soil nutrient stores and fluxes have responded to the last two centuries of widespread anthropogenic nutrient pollution and predict future change. These models need to integrate across carbon, nitrogen and phosphorus (C, N, & P) cycles and simulate changes over suitable timescales using available driving data. It is also vital that they are constrainable against observed data to provide confidence in their outputs. To date, no models address all of these requirements. To meet this need, a new model, N14CP, is introduced, which is initially applied to Northern hemisphere temperate and boreal ecosystems over the Holocene. N14CP is parameterized and tested using 88 northern Europe plot-scale studies, providing the most robust test of such a model to date. The model simulates long-term P weathering, based on the assumption of a starting pool of weatherable P (Pweath0, g m-2), which is gradually transformed into organic and sorbed pools. Nitrogen fixation (and consequently primary production) is made dependent on available P. In the absence of knowledge about the spatial variability of Pweath0, N14CP produces good average soil and plant variables, but cannot simulate variations among sites. Allowing Pweath0 to vary between sites improves soil C, N and P results greatly, suggesting contemporary soil C, N and P are sensitive to long-term P weathering. Most sites were found to be N limited. Anthropogenic N deposition since 1800 was calculated to have increased plant biomass substantially, in agreement with observations, and consequently increased soil carbon pools.

  10. Long-Term Regional Control in the Observed Neck Following Definitive Chemoradiation for Node-Positive Oropharyngeal Squamous Cell Cancer

    PubMed Central

    Goenka, Anuj; Morris, Luc G.T.; Rao, Shyam S.; Wolden, Suzanne L.; Wong, Richard J.; Kraus, Dennis H.; Ohri, Nisha; Setton, Jeremy; Lok, Benjamin H.; Riaz, Nadeem; Mychalczak, Borys R.; Schoder, Heiko; Ganly, Ian; Shah, Jatin P.; Pfister, David G.; Zelefsky, Michael J.; Lee, Nancy Y.

    2015-01-01

    Traditionally, patients treated with chemoradiotherapy for node-positive oropharyngeal squamous cell carcinoma (N+ OPSCC) have undergone a planned neck dissection (ND) after treatment. Recently, negative post-treatment positron-emission tomography (PET)/computed tomography (CT) imaging has been found to have a high negative predictive value for the presence of residual disease in the neck. Here we present the first comprehensive analysis of a large, uniform cohort of N+ OPSCC patients achieving a PET/CT-based complete response (CR) after chemoradiotherapy, and undergoing observation, rather than ND. From 2002 to 2009, 302 patients with N+ OPSCC treated with 70 Gy intensity-modulated radiation therapy and concurrent chemotherapy underwent post-treatment clinical assessment including PET/CT. CR was defined as no evidence of disease on clinical examination and post-treatment PET/CT. ND was reserved for patients with control, 97.7%; 5-year overall survival, 79.8%). The four observed patients experiencing neck recurrence had initial staging of N1 (n=2), N2b (n=1), and N2c (n=1). Three of four were successfully surgically salvaged. There was no association between N stage and rate of neck recurrence (P = 0.74). 52% and 25% of patients undergoing ND had viable tumor in the neck after positive and negative PET/CT, respectively. We conclude that patients achieving CRs after chemoradiation, based on clinical and PET/CT assessment, have a high probability of regional control, with a 2.3% regional failure rate, and may be safely observed without planned ND. PMID:23436584

  11. Soil properties and not inputs control carbon : nitrogen : phosphorus ratios in cropped soils in the long term

    NASA Astrophysics Data System (ADS)

    Frossard, Emmanuel; Buchmann, Nina; Bünemann, Else K.; Kiba, Delwende I.; Lompo, François; Oberson, Astrid; Tamburini, Federica; Traoré, Ouakoltio Y. A.

    2016-02-01

    Stoichiometric approaches have been applied to understand the relationship between soil organic matter dynamics and biological nutrient transformations. However, very few studies have explicitly considered the effects of agricultural management practices on the soil C : N : P ratio. The aim of this study was to assess how different input types and rates would affect the C : N : P molar ratios of bulk soil, organic matter and microbial biomass in cropped soils in the long term. Thus, we analysed the C, N, and P inputs and budgets as well as soil properties in three long-term experiments established on different soil types: the Saria soil fertility trial (Burkina Faso), the Wagga Wagga rotation/stubble management/soil preparation trial (Australia), and the DOK (bio-Dynamic, bio-Organic, and "Konventionell") cropping system trial (Switzerland). In each of these trials, there was a large range of C, N, and P inputs which had a strong impact on element concentrations in soils. However, although C : N : P ratios of the inputs were highly variable, they had only weak effects on soil C : N : P ratios. At Saria, a positive correlation was found between the N : P ratio of inputs and microbial biomass, while no relation was observed between the nutrient ratios of inputs and soil organic matter. At Wagga Wagga, the C : P ratio of inputs was significantly correlated to total soil C : P, N : P, and C : N ratios, but had no impact on the elemental composition of microbial biomass. In the DOK trial, a positive correlation was found between the C budget and the C to organic P ratio in soils, while the nutrient ratios of inputs were not related to those in the microbial biomass. We argue that these responses are due to differences in soil properties among sites. At Saria, the soil is dominated by quartz and some kaolinite, has a coarse texture, a fragile structure, and a low nutrient content. Thus, microorganisms feed on inputs (plant residues, manure). In contrast, the soil at

  12. Long-Term PSA Control with Repeated Stereotactic Body Radiotherapy in a Patient with Oligometastatic Castration-Resistant Prostate Cancer.

    PubMed

    Pasqualetti, Francesco; Cocuzza, Paola; Coraggio, Gabriele; Ferrazza, Patrizia; Derosa, Lisa; Galli, Luca; Pasqualetti, Giuseppe; Locantore, Luisa; Boni, Roberto; Fabrini, Maria G; Erba, Paola A

    2016-01-01

    Prostate cancer (PCa) is one of the most common malignancies and main causes of cancer death in Western countries. In the presence of metastatic disease, systemic treatment remains the main clinical option. However, since the introduction of highly sensitive imaging techniques, a new clinical 'entity' of metastatic patients with a limited number of lesions has been defined: oligometastatic patients. In this patient group, the use of stereotactic body radiotherapy (SBRT) or other local therapies against all active sites of disease revealed by 18F-choline positron emission tomography/computed tomography (PET/CT) could achieve sufficient prostate-specific antigen (PSA) control. However, a clear benefit of this procedure in terms of significant endpoints is yet to be demonstrated. This case report describes our experience with treating a castration-resistant PCa patient with 18F-choline PET/CT-guided SBRT. Because of the occurrence of 5 metachronous lesions over 4 years, the pattern of recurrence was defined by the local multidisciplinary team as oligometastatic disease, and the patient was treated with 5 courses of SBRT which yielded good PSA control. He started systemic therapy with abiraterone acetate almost 5 years after the diagnosis of recurrent PCa. PMID:27160394

  13. Effect of long-term treatment with salmeterol on asthma control: a double blind, randomised crossover study.

    PubMed Central

    Wilding, P.; Clark, M.; Thompson Coon, J.; Lewis, S.; Rushton, L.; Bennett, J.; Oborne, J.; Cooper, S.; Tattersfield, A. E.

    1997-01-01

    OBJECTIVES: To determine the effect of adding salmeterol 50 micrograms twice daily for six months to current treatment in subjects with asthma who control their inhaled corticosteroid dose according to a management plan. DESIGN: A double blind, randomised crossover study. SETTING: Nottingham. SUBJECTS: 101 subjects with mild or moderate asthma taking at least 200 micrograms twice daily of beclomethasone dipropionate or budesonide. INTERVENTIONS: Salmeterol 50 micrograms twice daily and placebo for six months each, with a one month washout. Subjects adjusted inhaled steroid dose according to guidelines. MAIN OUTCOME MEASURE: Reduction in inhaled steroid use, exacerbations of asthma, and use of oral steroids. RESULTS: Data were available for 87 subjects. When compared with placebo salmeterol treatment was associated with a 17% reduction in inhaled steroid use (95% confidence interval 12% to 22%) with no significant difference in the number of subjects who had an exacerbation (placebo 25%, salmeterol 16%) or use of oral steroids. For secondary end points salmeterol treatment was associated with higher morning and evening peak expiratory flow and forced expiratory volume in one second; a reduction in symptoms, bronchodilator use and airway responsiveness to methacholine; and no effect on serum potassium concentration, 24 hour heart rate, or the final forced expiratory volume in one second achieved during a salbutamol dose-response study. CONCLUSIONS: In subjects who adjusted their inhaled steroid treatment according to guidelines the addition of salmeterol 50 micrograms twice daily was associated with a reduction in inhaled steroid use and improved lung function and symptom control. PMID:9167559

  14. Long-term safety evaluation of bimatoprost ophthalmic solution 0.03%: a pooled analysis of six double-masked, randomized, active-controlled clinical trials

    PubMed Central

    Wirta, David; VanDenburgh, Amanda M; Weng, Emily; Whitcup, Scott M; Kurstjens, Sef; Beddingfield, Frederick C

    2011-01-01

    Background: Bimatoprost ophthalmic solution 0.03% was approved in the US for reducing intraoccular pressure (IOP) based on two double-masked, active-controlled clinical trials. Four additional long-term studies (≥12 months) were conducted; however, the aggregate safety profile of the six studies has not been reported. Methods: Adverse events (AEs) were pooled from six double-masked, active-controlled, long-term clinical trials in which subjects received bimatoprost 0.03% once daily (QD) or twice daily (BID) as an eyedrop. AE terms were converted to MedDRA (V.11.0) Preferred Terms and analyzed. Results: In total, 1409 patients received more than one dose of bimatoprost 0.03% QD or BID. Most AEs were mild in severity and reported by 86.7% (QD) and 94.8% (BID) of subjects (≤12 months of treatment). AEs reported through month 12 (aggregate incidence of ≥5%) were conjunctival hyperemia, increased eyelash growth, eye pruritus, periocular skin hyperpigmentation, eye irritation, dry eye, and hypertrichosis. AE onset was generally reported within four months of treatment. The cumulative incidence of common AEs in the QD treatment group at 24–48 months was similar to that measured at 12 months of treatment. Conclusion: Bimatoprost 0.03% has a favorable safety and tolerability profile as characterized by six long-term studies. Common AEs were due to the known pharmacological activity of bimatoprost and reversible with treatment cessation. PMID:21691584

  15. Residents first. A long-term care facility introduces a social model that puts residents in control.

    PubMed

    Boyd, C

    1994-09-01

    Four years ago the leaders at Providence/Mount St. Vincent, Seattle, decided to scrap the traditional medical model of long-term care and create an environment directed by the residents. The traditional system in nursing homes is designed to foster dependence. Our new social model, in contrast, is almost entirely directed by resident preference and need, and it places a high value on human interaction. So far we are having the most success with our assisted living program, which is built into apartment living as part of the rent. All services are available to all residents when they need them. The residents are forming warm relationships with resident assistants, and the flexible, nonmedical help they receive allows them to age in place. The nursing center has been divided into "neighborhoods" of about 20 residents, each with its own staff. A cross-trained, highly capable staff is essential to support resident independence and choice. In one experimental neighborhood, nonmedical tasks that nurses have traditionally done are now being reallocated to resident assistants, who are paid half as much as nurses. The physical heart of every remodeled neighborhood will be a kitchen, as we strive to create a homelike environment. Purposeful activity is replacing therapy in a void. And residents with cognitive impairments are gradually being integrated with more cognitively aware residents. We believe that in the long run, resident-directed care will be less expensive than the medical model. PMID:10136077

  16. High-Density Electromyography and Motor Skill Learning for Robust Long-Term Control of a 7-DoF Robot Arm.

    PubMed

    Ison, Mark; Vujaklija, Ivan; Whitsell, Bryan; Farina, Dario; Artemiadis, Panagiotis

    2016-04-01

    Myoelectric control offers a direct interface between human intent and various robotic applications through recorded muscle activity. Traditional control schemes realize this interface through direct mapping or pattern recognition techniques. The former approach provides reliable control at the expense of functionality, while the latter increases functionality at the expense of long-term reliability. An alternative approach, using concepts of motor learning, provides session-independent simultaneous control, but previously relied on consistent electrode placement over biomechanically independent muscles. This paper extends the functionality and practicality of the motor learning-based approach, using high-density electrode grids and muscle synergy-inspired decomposition to generate control inputs with reduced constraints on electrode placement. The method is demonstrated via real-time simultaneous and proportional control of a 4-DoF myoelectric interface over multiple days. Subjects showed learning trends consistent with typical motor skill learning without requiring any retraining or recalibration between sessions. Moreover, they adjusted to physical constraints of a robot arm after learning the control in a constraint-free virtual interface, demonstrating robust control as they performed precision tasks. The results demonstrate the efficacy of the proposed man-machine interface as a viable alternative to conventional control schemes for myoelectric interfaces designed for long-term use. PMID:25838524

  17. Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis

    PubMed Central

    Ye, Ming; Jacobs, Angela; Khan, Muhammad Naeem; Jaipaul, Joy; Oda, Joanna; Johnson, Marcia; Doroshenko, Alexander

    2016-01-01

    Objectives To evaluate the impact of oseltamivir prophylaxis in the management and control of influenza outbreaks in long-term care facilities in Alberta, Canada. Setting and participants Long-term care facilities where 127 influenza outbreaks were reported to public health authorities in Alberta, Canada, during two influenza seasons from 2013 to 2015. Design and outcome measures Using routinely collected surveillance and administrative data, we examined the association between decision-making time for oseltamivir recommendation as prophylaxis strategy for influenza outbreaks in long-term care facilities (explanatory variable) and the duration of an influenza outbreak, the postprophylaxis risk of influenza-like illness and hospitalisation among residents of long-term care facilities in Alberta (outcome variables) using multivariable linear and Poisson regression models. Results Oseltamivir prophylaxis decision-making time was positively associated with the postintervention duration of an outbreak, with a 1-day delay in making decision on oseltamivir prophylaxis associated with 2.22 (95% CI 1.37 to 3.06) more days of the duration of an outbreak after controlling for potential confounding effect of the number of residents at risk at intervention, outbreak progression time, prevalence of influenza-like illness during outbreak progression, facility location, presence of mixed strain and based on optimal timing of oseltamivir prophylaxis. Although not statistically significant, a 1-day delay in making decision on oseltamivir prophylaxis was associated with a 5% (95% CI −1% to 11%) increase in the postintervention risk of influenza-like illness, and a 6% (95% CI −8% to 22%) increase in the postintervention risk of hospitalisation after controlling for the same potential confounders. Conclusions Our study demonstrated benefits of using oseltamivir prophylaxis to shorten the duration of influenza outbreaks; however, there were no significant differences in the

  18. Hydrodynamic controls on cold-water coral growth in the Gulf of Mexico: Long term in situ seabed lander observations

    NASA Astrophysics Data System (ADS)

    Mienis, Furu; Duineveld, Gerard; Davies, Andrew J.; van Weering, Tjeerd C. E.; Ross, Steve W.; Roberts, Murray; Seim, Harvey E.; Bane, John M.

    2010-05-01

    Cold-water coral reefs and mounds are a common feature on the continental slopes of the North East Atlantic Ocean. On the European continental margin mound structures that are many kilometers long and wide have been discovered, often colonized by a thriving coral community. Similar structures have been found in the West Atlantic on the continental slope between 300-800 m water depth, along the slope from North Carolina to Florida. Presently detailed studies on the environmental constraints in cold-water coral areas are limited to cold-water coral areas in the North East Atlantic. This is the first study showing long term environmental variability in a cold-water coral habitat in the Gulf of Mexico, West Atlantic and the data highlight novel observations of short term environmental variability in a cold-water coral habitat. In the Gulf of Mexico Lophelia pertusa occurrences are scattered and form less dense communities than those situated on the Atlantic margins. The Viosca Knoll (VK826) area is the most extensive cold-water coral area presently known in the Gulf of Mexico, with Lophelia pertusa being the most common coral species. Broadly two characteristic coral habitats can be described on Viosca Knoll. Firstly, a dense coral cover that resembles a biogenic reef and secondly authigenic carbonate blocks with sparse coral coverage. Two benthic landers were deployed for over a year in the vicinity of the corals to measure the local environmental conditions. Both landers measured the current velocity and direction, temperature, salinity, fluorescence, optical backscatter and were equipped with a sediment trap. Furthermore CTD transects were made across the cold-water coral area. Transects showed no fluorescence signal below 150 m water depth and an oxygen minimum zone at the depth of the corals. A prominent intermediate nepheloid layer was present at 300-400 m water depth. Long term deployments of benthic landers of a period over 12 months revealed intra annual

  19. Ecological Controls on Biogeochemical Fluxes in the Western Antarctic Peninsula: Long-Term Observations and Inverse Food Web Model Results

    NASA Astrophysics Data System (ADS)

    Ducklow, H. W.; Sailley, S. F.; Stammerjohn, S. E.; Saba, G. K.; Doney, S. C.

    2014-12-01

    Sea ice in the Western Antarctic Peninsula (WAP) region is both highly variable and rapidly changing. In the Palmer Station region, the ice season duration has decreased by 92 days since 1978. The sea-ice changes affect ocean stratification and freshwater balance; and in turn impact every component of the polar marine ecosystem. Long-term observations from the WAP shelf region show a pattern of chlorophyll (Chl) variability with three to five years of negative Chl anomalies interrupted by one or two years of positive anomalies. Observations and results from an inverse food-web model show that these low and high Chl regimes differed significantly from each other, with high primary productivity and net community production (NCP) associated with the high Chl years and vice-versa. Gross primary production averaged 40 mmolC m-2 d-1 in the low Chl years and 100 mmolC m-2 d-1 in the high Chl years, with 30-40% going to NCP across regimes. Only the food web in the southern region in high Chl years was dominated by large phytoplankton and krill, whereas in in all other cases, foodwebs were dominated by small phytoplankton and microzooplankton. These contrasts were strongest between the northern, low Chl years and southern, high Chl years, consistent with earlier north to south observations of sea ice and ecosystem change along the WAP. The relative importance of major bulk carbon flows did not differ substantially between high and low Chl years. Both the northern/low Chl and southern/high Chl regimes had roughly equal proportions of NCP, although its composition reflected shifts in dominance by large versus small plankton. These results suggest that food webs dominated by smaller phytoplankton and grazers have pathways that funnel production into NCP, and likely, export.

  20. Controlling Factors of Long-Term Trends in Mercury Wet Deposition and Precipitation Concentrations at Huntington Wildlife Forest

    NASA Astrophysics Data System (ADS)

    Ye, Z.; Mao, H.; Driscoll, C. T.

    2015-12-01

    Observations from the Mercury Deposition Network (MDN) at Huntington Wildlife Forest (HWF) suggested that a significant decline (r2 = 0.34, p = 0.03) from 2000 to 2013 in volume weighted mean (VWM) Hg concentrations in precipitation was linked to Hg emission decreases in the United States, especially in the Northeast and Midwest, and yet Hg wet deposition has remained fairly constant over the past two decades. The present study aimed to investigate the climatic, terrestrial, and anthropogenic factors that influenced the decadal pattern in Hg wet deposition in upstate NY. In spring and summer, when Hg wet deposition was the strongest, significant positive correlation (r2 = 0.89, p < 0.0001 in spring; r2 = 0.58, p = 0.002 in summer) of Hg wet deposition with precipitation was found. Increases in precipitation during these seasons could offset the decreasing of Hg concentration in precipitation. Besides, springtime positive correlation (r2 = 0.35, p = 0.02) between precipitation and the North Atlantic Oscillation (NAO) index together with geopotential height and wind speed analysis indicated that large-scale dynamical forcing was likely an important factor influencing the long term trend in springtime Hg wet deposition at HWF. To further quantify the roles of meteorological and anthropogenic factors in Hg wet deposition, the Community Multiscale Air Quality (CMAQ) model was employed using an algorithm depicting state-of-the-art Hg chemistry mechanism and up-to-date Hg emission inventories evaluated with MDN and Atmospheric Mercury Network (AMNet) measurement data. CMAQ simulations with a constant vs. realistic meteorological conditions for multiple warm seasons (including spring and summer) were used to characterize and quantify the impacts of inter-annual variability of precipitation and atmospheric circulation on Hg wet deposition. In addition, contributions to Hg wet deposition from decreases in anthropogenic emissions in NYS and nation-wide were quantified from

  1. Long-term smoking increases the need for acute care among asthma patients: a case control study

    PubMed Central

    2014-01-01

    Background To examine risk factors for asthma patients’ emergency room (ER) visits in a well organized asthma care setting. Methods A random sample of 344 asthma patients from a Pulmonary Clinic of a University Hospital were followed through medical records from 1995 to 2006. All the ER visits due to dyspnea, respiratory infections, chest pain, and discomfort were evaluated. Results The mean age of the study population was 56 years (SD 13 years), 72% being women. 117 (34%) of the patients had had at least one ER visit during the follow-up (mean 0.5 emergency visits per patient year, range 0–7). Asthma exacerbation, lower and upper respiratory infections accounted for the 71% of the ER visits and 77% of the hospitalizations. The patients with ER visits were older, had suffered longer from asthma and more frequently from chronic sinusitis, were more often ex- or current smokers, and had lower lung function parameters compared to the patients without emergency visits. Previous (HR 1.9, CI 1.3-3.1) and current smoking (HR 3.6, CI 1.6-8.2), poor self-reported health related quality of life (HRQoL) (HR 2.5, CI 1.5-4), and poor lung function (FEV1 < 65%, HR 2.2, CI 1.3-3.7) remained independent risk factors for ER visits after adjustment for age and gender. Conclusions Asthma patients who are or have been long-term smokers are more likely to require ER care compared to never smokers. PMID:25030656

  2. Short- and Long-Term Effects of Wholegrain Oat Intake on Weight Management and Glucolipid Metabolism in Overweight Type-2 Diabetics: A Randomized Control Trial.

    PubMed

    Li, Xue; Cai, Xiaxia; Ma, Xiaotao; Jing, Lulu; Gu, Jiaojiao; Bao, Lei; Li, Jun; Xu, Meihong; Zhang, Zhaofeng; Li, Yong

    2016-01-01

    Glycemic control and weight reduction are primary goals for the management of overweight and obese type 2 diabetes mellitus (T2DM). Effective management cannot be achieved without an appropriate diet. Our study aimed to evaluate the short- and long-term effects of oat intake and develop a reasonable dietary plan for overweight T2DM patients. A randomized control trial, registered under ClinicalTrials.gov (Identification code: NCT01495052), was carried out among adult T2DM patients. A subgroup of 298 overweight subjects was selected and received a 30-day centralized intervention and 1-year free-living follow-up. Participants were randomly allocated to one of the following four groups. The usual care group (n = 60) received no intervention; the healthy diet group (n = 79) received a low-fat and high-fiber diet ("healthy diet"); the 50 g-oats group (n = 80) and 100 g-oats group (n = 79) received the "healthy diet" with the same amount of cereals replaced by 50 g and 100 g oats respectively. Anthropometric, blood glycemic and lipid variables were measured. For the 30-day intervention, significant differences in the changes of FPG (fasting plasma glucose), PPG (postprandial plasma glucose), HbA1c (glycosylated hemoglobin), HOMA-IR (homeostasis model assessment of insulin resistance), TC (total cholesterol), TG (total triglycerides), and LDL-c (low-density lipoprotein cholesterol) were observed among the four groups. Compared to the healthy diet group, the 50 g-oats group had a bigger reduction in PPG (mean difference (MD): -1.04 mmol/L; 95% CI: -2.03, -0.05) and TC (MD: -0.24 mmol/L; 95% CI: -0.47, -0.01); the 100 g-oats group had a bigger reduction in PPG (MD: -1.48 mmol/L; 95% CI: -2.57, -0.39), HOMA-IR (MD: -1.77 mU·mol/L²; 95% CI: -3.49, -0.05), TC (MD: -0.33 mmol/L; 95% CI: -0.56, -0.10) and LDL-c (MD: -0.22 mmol/L; 95% CI: -0.41, -0.03). In the 1-year follow-up, greater effects in reducing weight (MD: -0.89 kg; 95% CI: -1.56, -0.22), HbA1c (MD: -0.64%; 95% CI

  3. Protease inhibitor monotherapy for long-term management of HIV infection: a randomised, controlled, open-label, non-inferiority trial

    PubMed Central

    Paton, Nicholas I; Stöhr, Wolfgang; Arenas-Pinto, Alejandro; Fisher, Martin; Williams, Ian; Johnson, Margaret; Orkin, Chloe; Chen, Fabian; Lee, Vincent; Winston, Alan; Gompels, Mark; Fox, Julie; Scott, Karen; Dunn, David T

    2015-01-01

    Summary Background Standard-of-care antiretroviral therapy (ART) uses a combination of drugs deemed essential to minimise treatment failure and drug resistance. Protease inhibitors are potent, with a high genetic barrier to resistance, and have potential use as monotherapy after viral load suppression is achieved with combination treatment. We aimed to assess clinical risks and benefits of protease inhibitor monotherapy in long-term clinical use: in particular, the effect on drug resistance and future treatment options. Methods In this pragmatic, parallel-group, randomised, controlled, open-label, non-inferiority trial, we enrolled adults (≥18 years of age) positive for HIV attending 43 public sector treatment centres in the UK who had suppressed viral load (<50 copies per mL) for at least 24 weeks on combination ART with no change in the previous 12 weeks and a CD4 count of more than 100 cells per μL. Participants were randomly allocated (1:1) to maintain ongoing triple therapy (OT) or to switch to a strategy of physician-selected ritonavir-boosted protease inhibitor monotherapy (PI-mono); we recommended ritonavir (100 mg)-boosted darunavir (800 mg) once daily or ritonavir (100 mg)-boosted lopinavir (400 mg) twice daily, with prompt return to combination treatment if viral load rebounded. All treatments were oral. Randomisation was with permuted blocks of varying size and stratified by centre and baseline ART; we used a computer-generated, sequentially numbered randomisation list. The primary outcome was loss of future drug options, defined as new intermediate-level or high-level resistance to one or more drugs to which the patient's virus was deemed sensitive at trial entry (assessed at 3 years; non-inferiority margin of 10%). We estimated probability of rebound and resistance with Kaplan-Meier analysis. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Number registry, number ISRCTN

  4. Combination of the Pro-Apoptotic TRAIL-Receptor Antibody Mapatumumab With Ionizing Radiation Strongly Increases Long-Term Tumor Control Under Ambient and Hypoxic Conditions

    SciTech Connect

    Marini, Patrizia; Budach, Wilfried; Niyazi, Maximilian; Junginger, Dorothea; Stickl, Stefan; Jendrossek, Verena; Belka, Claus

    2009-09-01

    Purpose: Mapatumumab, an agonistic tumor necrosis factor-related apoptosis inducing ligand-receptor antibody, exerts highly synergistic apoptotic effects in vitro and in short-term growth delay assays when combined with irradiation. Because it remained unclear in how far these effects influence local tumor control, long-term experiments using a colorectal xenograft model were undertaken. Material and Methods: Experiments were performed with irradiation (5 x 3 Gy, d1-5) and mapatumumab (10 mg/kg) in Colo205-xenograft-bearing NMRI (nu/nu) nude mice. Graded top up doses were delivered on the tumor-bearing hind leg under ambient and hypoxic conditions; follow-up was 270 days. Growth delay and local tumor control were end points of the study. Statistical analysis of the experiments included calculation of tumor regrowth and local tumor control. Results: After combined treatment, a pronounced tumor regrowth-delay was observed when compared with irradiation alone. Long-term experiments revealed a highly significant increase in local tumor control for ambient (p = 0.00076) and hypoxic treatment (p = 0.000069). Conclusions: The present data demonstrate for the first time that combination of a pro-apoptotic antibody with irradiation results in evidently reduced tumor regrowth times and subsequently highly increased local tumor control under normoxic and hypoxic conditions in a xenograft mouse model.

  5. Associations Between Long-Term Gang Membership and Informal Social Control Processes, Drug Use, and Delinquent Behavior Among Mexican American Youth.

    PubMed

    Cepeda, Alice; Saint Onge, Jarron M; Nowotny, Kathryn M; Valdez, Avelardo

    2016-10-01

    Research has found that among juveniles weak ties to informal social control entities such as parents, school, and conventional peers increase the probability of the initiation and continuation of deviant behaviors such as drug use and crime. Given the weak ties of formal social control mechanisms in highly disadvantaged communities, informal social control mechanisms are often an important deterrent that reduce or moderate engagement in deviant behaviors among serious and persistent offenders. This analysis examines the association between long-term gang membership and adolescent informal social control processes, drug use, and delinquency. This research is based on data from a study of 160 Mexican American male gang members between the ages of 16 and 20. Findings suggest that among gang members in this context, commonly studied informal control mechanisms such as the family and schools do not function to deter long-term gang membership that is associated with serious criminal and violent behavior and drug use. The implications for future research on desistance or continuation of antisocial behavior across the life course are discussed. PMID:25979430

  6. Almost 50 years of monitoring shows that climate, not forestry, controls long-term organic carbon fluxes in a large boreal watershed.

    PubMed

    Lepistö, Ahti; Futter, Martyn N; Kortelainen, Pirkko

    2014-04-01

    Here, we use a unique long-term data set on total organic carbon (TOC) fluxes, its climatic drivers and effects of land management from a large boreal watershed in northern Finland. TOC and runoff have been monitored at several sites in the Simojoki watershed (3160 km(2) ) since the early 1960s. Annual TOC fluxes have increased significantly together with increased inter-annual variability. Acid deposition in the area has been low and has not significantly influenced losses of TOC. Forest management, including ditching and clear felling, had a minor influence on TOC fluxes - seasonal and long-term patterns in TOC were controlled primarily by changes in soil frost, seasonal precipitation, drought, and runoff. Deeper soil frost led to lower spring TOC concentrations in the river. Summer TOC concentrations were positively correlated with precipitation and soil moisture not temperature. There is some indication that drought conditions led to elevated TOC concentrations and fluxes in subsequent years (1998-2000). A sensitivity analysis of the INCA-C model results showed the importance of landscape position, land-use type, and soil temperature as controls of modeled TOC concentrations. Model predictions were not sensitive to forest management. Our results are contradictory to some earlier plot-scale and small catchment studies that have shown more profound forest management impacts on TOC fluxes. This shows the importance of scale when assessing the mechanisms controlling TOC fluxes and concentrations. The results highlight the value of long-term multiple data sets to better understand ecosystem response to land management, climate change and extremes in northern ecosystems. PMID:24501106

  7. Fire and Long-Term Carbon Accumulation in Boreal Peatlands are Controlled by Interactions Between Climate and Successional Dynamics

    NASA Astrophysics Data System (ADS)

    Camill, P.; Rafert, G.; Barry, A.; Williams, E.; Andreassi, C.; Limmer, J.; Solick, D.

    2008-12-01

    Warming climate has the potential to dramatically alter carbon and fire dynamics in high-latitude systems. Boreal and subarctic peatlands cover 346 million hectares of land surface and store 455 Pg-C, suggesting that changes in these systems can have regional and global-scale impacts on carbon cycling. Soil carbon release is expected to increase with more frequent fires in a warmer world. The dynamics of peatland landscapes, however, will likely involve complex interactions among permafrost thaw, changes in hydrology, and successional development. Understanding landscape-level responses to warming therefore requires integrative approaches that simultaneously examine all of these processes. In this study, we examined long- term changes in plant succession, carbon accumulation, and fire in a landscape located in northern Manitoba, Canada. We recovered 17 replicate permafrost peat cores ranging in depth from 1-4.3 meters (mean = 2.2 m). Using 149 AMS 14C dates, we were able to develop detailed age chronologies for each core. We measured macrofossil abundance to reconstruct the wetland plant community, areal charcoal concentration (mm2cm-3) as a proxy for fire severity, and total carbon and nitrogen. Basal AMS 14C dates indicated that peat accumulation began almost synchronously around 8,000 cal.14C yr BP, with the exception of a few cores resulting from more recent paludification along the wetland margin. Fire severity increased across wetland successional stages, with later successional forested bogs showing greater severity (6.79-11.16 mm2cm-3) than early successional open water, fen, and poor fen communities (0.29-1.82 mm2cm-3). The exception was paludified lowland forests, which exhibited the greatest fire severity during peatland initiation and the death of the overstory (21.68 mm2cm- 3). More severe fires (> 5-10 mm2cm-3) caused peat carbon accumulation rates to decline by half (13.7-24.5 g-Cm-2yr-1) compared to unburned peat (48.9 g-Cm-2yr-1). These two results

  8. Long-Term Effects of Native Hawaiian Students' Early Academic Achievement under the No Child Left Behind Legislation: A Multilevel Cohort Analysis

    ERIC Educational Resources Information Center

    Singh, J. Malkeet

    2011-01-01

    The focus of the No Child Left Behind (NCLB) Legislation is to close the achievement gaps due to disadvantages based on minority status, socio-economic status, special education (SPED) or Limited English Proficiency (LEP). Poverty and culture have been consistently reported to have an impact on academic achievement. However, there have been few…

  9. Achievements of schistosomiasis control in China.

    PubMed

    Yuan, Hongchang; Jiang, Qingwu; Zhao, Genming; He, Na

    2002-01-01

    The control of schistosomiasis has been spectacularly successful in terms of controlling endemicity and severity of the disease during the last 50 years. It can be categorized into two stages. From 1955 through 1980, the transmission-control strategy had been widely and successfully carried out. By the end of 1980, the epidemic of schistosomiasis was successfully circumscribed in certain core regions including areas at the middle and low reaches of the Yangtze River and some mountainous areas in Sichuan and Yunnan provinces, where control of schistosomiasis had been demonstrated to be very difficult to be sustained. Therefore, since 1980, schistosomiasis control in China has been modified to employ a stepwise strategy, based on which morbidity control has been given priorities and if possible transmission control has been pursued. However, since snail-ridden areas remain unchanged so far, reinfections occur frequently. This necessitates a maintenance phase to consolidate the achievements in the control of schistosomiasis. In the mean time, we are challenged with some environmental, social and economical changes in terms of controlling schistosomiasis. Successfully controlling schistosomiasis in China is still a long-term task but will be achieved without doubt along with the economic development and the promotion of living and cultural standard of people. PMID:12426618

  10. Neuropsychological results of long-term therapy with oxiracetam in patients with dementia of Alzheimer type and multi-infarct dementia in comparison with a control group.

    PubMed

    Parnetti, L; Mecocci, P; Petrini, A; Longo, A; Buccolieri, A; Senin, U

    1989-01-01

    The cognitive and behavioral effects of oxiracetam therapy during long-term treatment in patients with dementia of Alzheimer type (DAT) and multi-infarct dementia (MID) were studied in comparison with a historical control group. Twenty DAT/MID outpatients, aged 54-86 years, received oxiracetam (800 mg twice a day) for a period of 6 months. Another 20 DAT/MID outpatients, aged 67-85 years, were selected from our clinical records in order to obtain a control group of patients matched for age, sex, diagnosis, baseline Mini Mental State Examination (MMSE) score and follow-up duration. All the patients were diagnosed as having mild to moderate degrees of dementia as defined by a baseline MMSE score between 14 and 24. The patients of both groups underwent, both at baseline and after 6 months, the following neuropsychological tests: MMSE, Idiopathic Cerebral Dysfunction Scale, Babcock Test, Gibson Spiral, Toulouse-Pieron Test. Statistical analysis of experimental data demonstrated that at baseline the two groups were comparable. At the end of the study period the oxiracetam group scored significantly better on the majority of the tests evaluating memory, attention, orientation, concentration and psychomotricity than the control group, in which a worsening trend was seen on the whole. No side effects were seen during oxiracetam treatment. The present study, showing positive clinical findings after long-term oxiracetam therapy in controlled conditions, confirms that this drug can be a useful pharmacological treatment for mild to moderate degrees of dementia. PMID:2518332

  11. Long-term testing

    NASA Astrophysics Data System (ADS)

    Ferber, M.; Graves, G. A., Jr.

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000-10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  12. Long-term testing

    SciTech Connect

    Ferber, M.; Graves, G.A. Jr.

    1994-12-31

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000--10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  13. The late Silurian-Middle Devonian long-term eustatic cycle as a possible control on the global generic diversity dynamics of bivalves and gastropods

    NASA Astrophysics Data System (ADS)

    Ruban, Dmitry A.

    2013-09-01

    A long-term eustatic cycle (fall and subsequent rise of the global sea level) embraced the late Silurian-Middle Devonian time interval. Potentially, these sea-level changes could drive global biodiversity. The stratigraphic ranges of 204 bivalve genera and 279 gastropod genera included into the famous Sepkoski database allow reconstructing changes in the total diversity and the number of originations and extinctions of these important groups of marine benthic macro- -invertebrates during this interval. None of the recorded parameters coincided with the long-term global sea-level cycle. It cannot be not excluded, however, that the global sea-level changes did not affect the regions favourable for bivalve and gastropod radiation because of regional tectonic mechanisms; neither can it be excluded that the eustatic control persisted together with many other extrinsic and intrinsic controls. Interestingly, the generic diversity of gastropods increased together with a cooling trend, and vice versa. Additionally, the Ludlow, Eifelian, and Givetian biotic crises affected, probably, both fossil groups under study. There was also a coincidence of the relatively high bivalve generic diversity, initial radiation of gastropods and the entire biota, and the diversification of brachiopods with the Early Devonian global sea-level lowstand, and this may be interpreted as evidence of a certain eustatic control on the marine biodiversity.

  14. Alcohol Habits in Patients with Long-Term Musculoskeletal Pain: Comparison with a Matched Control Group from the General Population

    ERIC Educational Resources Information Center

    Thelin Bronner, Kerstin Birgitta; Wennberg, Peter; Kallmen, Hakan; Schult, Marie-Louise Birgitta

    2012-01-01

    This prospective study aimed to describe alcohol habits in patients with chronic pain compared with those in a matched control group from the general Swedish population. In total, 100 consecutive patients enrolled were matched against 100 individuals in a control group on the basis of age and sex. Alcohol habits were measured using the Alcohol Use…

  15. Long-term outcomes of major trauma without head injury in the West of Scotland: pilot case-control study.

    PubMed

    Graham, Colin A; Gordon, Malcolm W G; Roy, Christopher W; Hanlon, Philip W

    2007-02-01

    The aim of this study was to identify the outcomes of survivors of blunt major trauma (without head injury) 2 years or more following injury. The study uses a case-control design, is set in the West of Scotland and includes trauma patients treated in Greater Glasgow NHS Board hospitals. Participants consisted of patients who had sustained major trauma (injury severity score >15) with little or no head injury at least 2 years before assessment, identified from the Scottish Trauma Audit Group database, and age and sex-matched controls nominated by the index case's general practitioner. Nineteen cases and seven controls completed the study from 223 potential cases and 39 potential controls. Participants and non-participants had comparable injury severity score, probability of survival (Ps) and length of stay. American Medical Association impairment scores show survivors were more impaired than controls (25.9 vs 7.4%, P=0.043). No differences were observed in Functional Independence Measure (FIM) or Community Integration Questionnaire (CIQ) scores, although a type II error is possible. Short-form 36 (SF36) Physical Component Summary (PCS) scores of survivors showed no difference compared with controls although survivors' PCS scores were below UK and US means (P=0.008). SF36 Mental Component Summary (MCS) scores of survivors were below those of controls (45.07 vs 56.65, P=0.004) and normal values of the UK population (P=0.036). No differences in work status were noted, but small sample sizes were used. Non-head-injured survivors of major trauma in the West of Scotland have poorer health status (SF36), physically and mentally, than the UK population. They have greater impairment, but have an employment status comparable to that of the controls. The lack of differences in FIM and CIQ scores between survivors and controls may be due to small sample sizes. PMID:17198324

  16. Sociodemographic patterning of long-term diabetes mellitus control following Japan's 3.11 triple disaster: a retrospective cohort study

    PubMed Central

    Leppold, Claire; Tsubokura, Masaharu; Ozaki, Akihiko; Nomura, Shuhei; Shimada, Yuki; Morita, Tomohiro; Tanimoto, Tetsuya; Kami, Masahiro; Kanazawa, Yukio; Oikawa, Tomoyoshi

    2016-01-01

    Objective To assess the sociodemographic patterning of changes in glycaemic control of patients with diabetes affected by the 2011 triple disaster in Japan (earthquake, tsunami and nuclear accident). Methods A retrospective cohort study was undertaken with 404 patients with diabetes at a public hospital in Minamisoma City, Fukushima Prefecture. Glycated haemoglobin (HbA1c) levels were measured in 2010, 2011 and 2012 to capture changes in glycaemic control postdisaster. Age, sex, urban/rural residency, evacuation status and medication use were also assessed. Results There was an overall deterioration in glycaemic control after the disaster, with the mean HbA1c rising from 6.77% in 2010 to 6.90% in 2012 (National Glycohemoglobin Standardization Program, NGSP). Rural residency was associated with a lower likelihood of deteriorating control (OR 0.34, 95% CI 0.13 to 0.84), compared with urban residency. Older age (OR 0.95, 95% CI 0.91 to 0.98) was also slightly protective against increased HbA1c. Evacuation and sex were not significant predictors. Conclusions Patients with diabetes who were affected by Japan's triple disaster experienced a deterioration in their glycaemic control following the disasters. The extent of this deterioration was mediated by sociodemographic factors, with rural residence and older age protective against the effects of the disaster on glycaemic control. These results may be indicative of underlying social determinants of health in rural Japan. PMID:27388360

  17. Motor learning curve and long-term effectiveness of modified constraint-induced movement therapy in children with unilateral cerebral palsy: a randomized controlled trial.

    PubMed

    Geerdink, Yvonne; Aarts, Pauline; Geurts, Alexander C

    2013-03-01

    The goal of this study was to determine the progression of manual dexterity during 6 weeks (54h) (modified) constraint-induced movement therapy ((m)CIMT) followed by 2 weeks (18h) bimanual training (BiT) in children with unilateral spastic cerebral palsy (CP), to establish whether and when a maximal training effect was reached and which factors might influence the motor learning curve. In addition, long-term retention of effects was determined. In a randomized controlled trial of 52 children with CP, aged 2.5-8 years, comparing mCIMT-BiT to conventional therapy, 28 children were allocated to the mCIMT-BiT group. This group was assessed weekly with the Box and Block test. Long-term effectiveness was determined by collecting follow-up data of the primary (Assisting Hand Assessment, ABILHAND-Kids) and secondary (Melbourne, COPM) outcomes at six months and one year after intervention. Fifteen children (53.6%) reached a maximum training effect within the mCIMT period. This group differed from others with respect to age, but not gender, affected side or manual ability. Children younger than five years had a greater chance to reach a maximum score within 6 weeks mCIMT (OR=6.67, 95%CI=1.24-35.71) that stabilized already after four weeks; older children showed a longer progression and tended to decline afterwards. In both age groups, beneficial effects were retained in the long term. The findings suggest that children of 5 years and older might profit from a longer period of mCIMT than 54h to reach their maximum unimanual capacity and to retain this capacity during subsequent bimanual training. PMID:23291509

  18. Factors controlling the long-term temporal and spatial patterns of nitrate-nitrogen export in a dairy farming watershed.

    PubMed

    Jiang, Rui; Wang, Chun-ying; Hatano, Ryusuke; Kuramochi, Kanta; Hayakawa, Atsushi; Woli, Krishna P

    2015-04-01

    It is difficult to investigate the factors that control the riverine nitrate-nitrogen (NO3--N) export in a watershed which gains or losses groundwater. To control the NO3--N contamination in these watersheds, it is necessary to investigate the factors that are related to the export of NO3--N that is only produced by the watershed itself. This study was conducted in the Shibetsu watershed located in eastern Hokkaido, Japan, which gains external groundwater contribution (EXT) and 34% of the annual NO3--N loading occurs through EXT. The riverine NO3--N exports from 1980 to 2009 were simulated by the SWAT model, and the factors controlling the temporal and spatial patterns of NO3--N exports were investigated without considering the EXT. The results show that hydrological events control NO3--N export at the seasonal scale, while the hydrological and biogeochemical processes are likely to control NO3--N export at the annual scale. There was an integrated effect among the land use, topography, and soil type related to denitrification process, that regulated the spatial patterns of NO3--N export. The spatial distribution of NO3--N export from hydrologic response units (HRUs) identified the agricultural areas with surplus N that are vulnerable to nitrate contamination. A new standard for the N fertilizer application rate including manure application should be given to control riverine NO3--N export. This study demonstrates that applying the SWAT model is an appropriate method to determine the temporal and spatial patterns of NO3--N export from the watershed which includes EXT and to identify the crucial pollution areas within a watershed in which the management practices can be improved to more effectively control NO3--N export to water bodies. PMID:25805369

  19. Remediating Organizational Functioning in Children with ADHD: Immediate and Long-Term Effects from a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Abikoff, Howard; Gallagher, Richard; Wells, Karen C.; Murray, Desiree W.; Huang, Lei; Lu, Feihan; Petkova, Eva

    2013-01-01

    Objective: The study compared the efficacy of 2 behavioral interventions to ameliorate organization, time management, and planning (OTMP) difficulties in 3rd- to 5th-grade children with attention-deficit/hyperactivity disorder (ADHD). Method: In a dual-site randomized controlled trial, 158 children were assigned to organizational skills training…

  20. An Interactive Health Communication Application for Supporting Parents Managing Childhood Long-Term Conditions: Outcomes of a Randomized Controlled Feasibility Trial

    PubMed Central

    2014-01-01

    Background Families living with chronic or long-term conditions such as chronic kidney disease (CKD), stages 3-5, face multiple challenges and respond to these challenges in various ways. Some families adapt well while others struggle, and family response to a condition is closely related to outcome. With families and professionals, we developed a novel condition-specific interactive health communication app to improve parents’ management ability—the online parent information and support (OPIS) program. OPIS consists of a comprehensive mix of clinical caregiving and psychosocial information and support. Objective The purpose of this study was to (1) assess feasibility of a future full-scale randomized controlled trial (RCT) of OPIS in terms of recruitment and retention, data collection procedures, and psychometric performance of the study measures in the target population, and (2) investigate trends in change in outcome measures in a small-scale RCT in parents of children with CKD stages 3-5. Methods Parents were recruited from a pediatric nephrology clinic and randomly assigned to one of two treatment groups: usual support for home-based clinical caregiving (control) or usual support plus password-protected access to OPIS for 20 weeks (intervention). Both groups completed study measures at study entry and exit. We assessed feasibility descriptively in terms of recruitment and retention rates overall; assessed recruitment, retention, and uptake of the intervention between groups; and compared family condition management, empowerment to deliver care, and fathers’ involvement between groups. Results We recruited 55 parents of 39 children (42% of eligible families). Of those, about three-quarters of intervention group parents (19/26, 73%) and control group parents (22/29, 76%) were retained through completion of 20-week data collection. The overall retention rate was 41/55 (75%). The 41 parents completing the trial were asked to respond to the same 10

  1. Long-term effects of the Dresden bombing: relationships to control beliefs, religious belief, and personal growth.

    PubMed

    Maercker, Andreas; Herrle, Johannes

    2003-12-01

    Aftereffects of the Dresden bombing of February 1945 on 47 survivors were investigated using a comprehensive framework of trauma sequelae including pathogenetic, salutogenetic, and further mediating or moderating variables. A relatively low rate of PTSD symptomatology was noted. Traumatic exposure was related to current PTSD symptoms and to personal growth, with no systematic relationships between the 2 outcome variables. PTSD symptoms were primarily related to external control, whereas personal growth was primarily associated with internal control. Religious belief in the afterlife moderated effects between exposure and posttraumatic avoidance or personal growth. Furthermore, belonging to particular age groups at traumatization (adolescents, middle-aged adults) was associated with increased posttraumatic intrusions at the time of data collection. PMID:14690356

  2. Exposure–response model for sibutramine and placebo: suggestion for application to long-term weight-control drug development

    PubMed Central

    Han, Seunghoon; Jeon, Sangil; Hong, Taegon; Lee, Jongtae; Bae, Soo Hyeon; Park, Wan-su; Park, Gab-jin; Youn, Sunil; Jang, Doo Yeon; Kim, Kyung-Soo; Yim, Dong-Seok

    2015-01-01

    No wholly successful weight-control drugs have been developed to date, despite the tremendous demand. We present an exposure–response model of sibutramine mesylate that can be applied during clinical development of other weight-control drugs. Additionally, we provide a model-based evaluation of sibutramine efficacy. Data from a double-blind, randomized, placebo-controlled, multicenter study were used (N=120). Subjects in the treatment arm were initially given 8.37 mg sibutramine base daily, and those who lost <2 kg after 4 weeks’ treatment were escalated to 12.55 mg. The duration of treatment was 24 weeks. Drug concentration and body weight were measured predose and at 4 weeks, 8 weeks, and 24 weeks after treatment initiation. Exposure and response to sibutramine, including the placebo effect, were modeled using NONMEM 7.2. An asymptotic model approaching the final body weight was chosen to describe the time course of weight loss. Extent of weight loss was described successfully using a sigmoidal exposure–response relationship of the drug with a constant placebo effect in each individual. The placebo effect was influenced by subjects’ sex and baseline body mass index. Maximal weight loss was predicted to occur around 1 year after treatment initiation. The difference in mean weight loss between the sibutramine (daily 12.55 mg) and placebo groups was predicted to be 4.5% in a simulation of 1 year of treatment, with considerable overlap of prediction intervals. Our exposure–response model, which included the placebo effect, is the first example of a quantitative model that can be used to predict the efficacy of weight-control drugs. Similar approaches can help decision-making during clinical development of novel weight-loss drugs. PMID:26392753

  3. [An expert system for controlling the physical training program of crews on long-term space missions].

    PubMed

    Son'kin, V D; Egorov, A D; Zaĭtseva, V V; Son'kin, V V; Stepantsov, V I

    2003-01-01

    The concept of in-flight expert system for controlling (ESC) the physical training program during extended, including Martian, space missions has been developed based on the literature dedicated to the microgravity countermeasures and a retrospective analysis of effectiveness of the known ESC methods. This concept and the principle of crew autonomy were used as prime assumptions for defining the structure of ESC-based training in long-duration and planetary missions. PMID:14730732

  4. Long-Term Adaptations to Unexpected Surface Perturbations: Postural Control During Stance and Gait in Train Conductors.

    PubMed

    Baumgart, Christian; Hoppe, Matthias Wilhelm; Freiwald, Jürgen

    2016-01-01

    The authors aimed to evaluate the differences in postural control during stance and gait between train conductors and controls. Twenty-one train conductors and 21 office workers performed 6 unilateral and bilateral balance tests on stable and unstable surfaces as well as a gait analysis. In the balance tests, the mean velocity of the center of pressure and unstable surface was measured. In the bilateral balance tests the selected stance width was measured. During gait the length, width, frequency, and velocity of the steps were calculated from the ground reaction forces. Train conductors showed a significantly greater step width during gait (15.4 ± 4.7 vs. 13.0 ± 3.4 cm; p = .035) and stance width during the bilateral stance on the unstable surface (21.0 ± 5.1 vs. 17.8 ± 3.7 cm; p = .026) than the office workers, while no differences were revealed in balance variables. The revealed differences between train conductors and office workers may represent task-specific feedforward control strategies, which increase the base of support and may be helpful to resist unexpected perturbations in trains. PMID:26730891

  5. Long-Term Assessment of Wild Boar Harvesting and Cattle Removal for Bovine Tuberculosis Control in Free Ranging Populations

    PubMed Central

    Mentaberre, Gregorio; Romero, Beatriz; de Juan, Lucía; Navarro-González, Nora; Velarde, Roser; Mateos, Ana; Marco, Ignasi; Olivé-Boix, Xavier; Domínguez, Lucas; Lavín, Santiago; Serrano, Emmanuel

    2014-01-01

    Wild boar is a recognized reservoir of bovine tuberculosis (TB) in the Mediterranean ecosystems, but information is scarce outside of hotspots in southern Spain. We describe the first high-prevalence focus of TB in a non-managed wild boar population in northern Spain and the result of eight years of TB management. Measures implemented for disease control included the control of the local wild boar population through culling and stamping out of a sympatric infected cattle herd. Post-mortem inspection for detection of tuberculosis-like lesions as well as cultures from selected head and cervical lymph nodes was done in 745 wild boar, 355 Iberian ibexes and five cattle between 2004 and 2012. The seasonal prevalence of TB reached 70% amongst adult wild boar and ten different spoligotypes and 13 MIRU-VNTR profiles were detected, although more than half of the isolates were included in the same clonal complex. Only 11% of infected boars had generalized lesions. None of the ibexes were affected, supporting their irrelevance in the epidemiology of TB. An infected cattle herd grazed the zone where 168 of the 197 infected boars were harvested. Cattle removal and wild boar culling together contributed to a decrease in TB prevalence. The need for holistic, sustained over time, intensive and adapted TB control strategies taking into account the multi-host nature of the disease is highlighted. The potential risk for tuberculosis emergence in wildlife scenarios where the risk is assumed to be low should be addressed. PMID:24558435

  6. Sustainability of the Catalytic Activity of a Silica-Titania Composite (STC) for Long-Term Indoor Air Quality Control

    NASA Technical Reports Server (NTRS)

    Coutts, Janelle L.; Levine, Lanfang H.; Richards, Jeffrey T.

    2011-01-01

    TiO2-assisted photocatalytic oxidation (PCO) is an emerging technology for indoor air quality control and is also being evaluated as an alternative trace contaminant control technology for crew habitats in space exploration. Though there exists a vast range of literature on the development of photocatalysts and associated reactor systems, including catalyst performance and performance-influencing factors, the critical question of whether photocatalysts can sustain their initial catalytic activity over an extended period of operation has not been adequately addressed. For a catalyst to effectively serve as an air quality control product, it must be rugged enough to withstand exposure to a multitude of low concentration volatile organic compounds (VOCs) over long periods of time with minimal loss of activity. The objective of this study was to determine the functional lifetime of a promising photocatalyst - the silica-titania composite (STC) from Sol Gel Solutions, LLC in a real-world scenario. A bench-scale STC-packed annular reactor under continuous irradiation by a UV-A fluorescent black-light blue lamp ((lambda)max = 365 nm) was exposed to laboratory air continuously at an apparent contact time of 0.27 sand challenged with a known concentration of ethanol periodically to assess any changes in catalytic activity. Laboratory air was also episodically spiked with halocarbons (e.g., octafluoropropane), organosulfur compounds (e.g., sulfur hexafluoride), and organosilicons (e.g., siloxanes) to simulate accidental releases or leaks of such VOCs. Total organic carbon (TOC) loading and contaminant profiles of the laboratory air were also monitored. Changes in STC photocatalytic performance were evaluated using the ethanol mineralization rate, mineralization efficiency, and oxidation intermediate (acetaldehyde) formation. Results provide insights to any potential catalyst poisoning by trace halocarbons and organosulfur compounds.

  7. Remediating Organizational Functioning in Children with ADHD: Immediate and Long-Term Effects from a Randomized Controlled Trial

    PubMed Central

    Abikoff, Howard; Gallagher, Richard; Wells, Karen C.; Murray, Desiree W.; Huang, Lei; Lu, Feihan; Petkova, Eva

    2012-01-01

    Objective The study compared the efficacy of two behavioral interventions to ameliorate organization, time management and planning (OTMP) difficulties in 3rd–5th grade children with Attention-Deficit/Hyperactivity Disorder (ADHD). Method In a dual-site randomized controlled trial, 158 children were assigned to Organizational Skills Training (OST, N=64); “PATHKO”, a performance-based intervention that precluded skills training (N=61); or a wait-list control (WL, N=33). Treatments were 20 individual clinic-based sessions over 10–12 weeks. OST involved skills building provided primarily to the child. PATHKO trained parents and teachers to reinforce children contingently for meeting end-point target goals. Primary outcomes were the Children’s Organizational Skills Scales (COSS-Parent, COSS-Teacher). Other relevant functional outcomes were assessed. Percentage of participants no longer meeting inclusion criteria for OTMP impairments informed on clinical significance. Assessments occurred at post-treatment, 1-month post-treatment, and twice in the following school year. Results OST was superior to WL on the COSS-P (Cohen’s d = 2.77; p< .0001), COSS-T (d = 1.18; p< .0001), children’s COSS self-ratings, academic performance and proficiency, homework, and family functioning. OST was significantly better than PATHKO only on the COSS-P (d = .63; p< .005). PATHKO was superior to WL on most outcomes, but not in academic proficiency. 60% of OST and PATHKO participants no longer met OTMP inclusion criteria vs. 3% of controls. Significant maintenance effects were found for both treatments. Conclusions Two distinct treatments targeting OTMP problems in children with ADHD generated robust, sustained functional improvements. The interventions show promise of clinical utility in children with ADHD and organizational deficits. PMID:22889336

  8. Long-term ketogenic diet contributes to glycemic control but promotes lipid accumulation and hepatic steatosis in type 2 diabetic mice.

    PubMed

    Zhang, Xiaoyu; Qin, Juliang; Zhao, Yihan; Shi, Jueping; Lan, Rong; Gan, Yunqiu; Ren, Hua; Zhu, Bing; Qian, Min; Du, Bing

    2016-04-01

    The ketogenic diet (KD) has been widely used in weight and glycemic control, although potential side effects of long-term KD treatment have caused persistent concern. In this study, we hypothesized that the KD would ameliorate the progression of diabetes but lead to disruptions in lipid metabolism and hepatic steatosis in a mouse model of diabetes. In type 2 diabetic mouse model, mice were fed a high-fat diet and administered streptozotocin treatment before given the test diets for 8 weeks. Subsequently, ameliorated glucose and insulin tolerance in KD-fed diabetic mice was found, although the body weight of high-fat diet- and KD-fed mice was similar. Interestingly, the weight of adipose tissue in KD mice was greater than in the other groups. The KD diet resulted in higher serum triacylglycerol and cholesterol levels in diabetic mice. Moreover, the KD-fed mice showed greater hepatic lipid accumulation. Mice fed the KD showed significant changes in several key genes such as sterol regulatory element-binding protein, fibroblast growth factor 21, and peroxisome proliferator-activated receptor α, which are all important in metabolism. In summary, KD ameliorates glucose and insulin tolerance in a mouse model of diabetes, but severe hepatic lipid accumulation and hepatic steatosis were observed, which should be considered carefully in the long-term application of KD. PMID:27001280

  9. Continuous-release beads of natural allelochemicals for the long-term control of cyanobacterial growth: Preparation, release dynamics and inhibitory effects.

    PubMed

    Huang, Haomin; Xiao, Xi; Lin, Fang; Grossart, Hans-Peter; Nie, Zeyu; Sun, Lijuan; Xu, Chen; Shi, Jiyan

    2016-05-15

    The effects of allelochemicals on cyanobacterial blooms have been observed for more than 20 years; however, the use of these compounds, usually involving a "direct-added" mode, has clear disadvantages, such as a short activity period or temporarily excessive localized concentration. Here, a simulated-allelopathy mode to facilitate the application of allelochemicals was proposed and tested on Microcystis aeruginosa. The continuous-release beads of 5,4'-dihydroxyflavone (DHF) were constitutive of a polymer matrix and showed a high drug-loading rate (47.18%) and encapsulation efficiency (67.65%) with a theoretical release time of approximately 120 d. Cyanobacterial growth tests showed that the DHF beads had long-term inhibition effects (>30 d), whereas those of "direct-added" DHF to cells lasted a maximum of 10 d. The beads also continuously affected the superoxide dismutase, catalase, and lipid peroxidation of M. aeruginosa. The inhibitory effects of DHF beads on cyanobacterial growth increased as initial cell densities of M. aeruginosa decreased, suggesting that the beads inhibit cyanobacterial activity more effectively in the early bloom phase. Consequently, the anti-cyanobacterial beads represent a novel application mode of allelochemicals with long-term inhibitory effects on cyanobacterial growth. Our study demonstrates that the successful application of allelochemicals offers great potential to control harmful cyanobacterial blooms, especially at the initial stage of development. PMID:26986500

  10. Long-Term Effects of Resistance Exercise Training on Cognition and Brain Volume in Older Women: Results from a Randomized Controlled Trial.

    PubMed

    Best, John R; Chiu, Bryan K; Liang Hsu, Chun; Nagamatsu, Lindsay S; Liu-Ambrose, Teresa

    2015-11-01

    Aerobic exercise training has been shown to attenuate cognitive decline and reduce brain atrophy with advancing age. The extent to which resistance exercise training improves cognition and prevents brain atrophy is less known, and few studies include long-term follow-up cognitive and neuroimaging assessments. We report data from a randomized controlled trial of 155 older women, who engaged in 52 weeks of resistance training (either once- or twice-weekly) or balance-and-toning (twice-weekly). Executive functioning and memory were assessed at baseline, 1-year follow-up (i.e., immediately post-intervention), and 2-year follow-up. A subset underwent structural magnetic resonance imaging scans at those time points. At 2-year follow-up, both frequencies of resistance training promoted executive function compared to balance-and-toning (standardized difference [d]=.31-.48). Additionally, twice-weekly resistance training promoted memory (d=.45), reduced cortical white matter atrophy (d=.45), and increased peak muscle power (d=.27) at 2-year follow-up relative to balance-and-toning. These effects were independent of one another. These findings suggest resistance training may have a long-term impact on cognition and white matter volume in older women. PMID:26581787

  11. Butorphanol and Ketamine Combined in Infusion Solutions for Patient-Controlled Analgesia Administration: A Long-Term Stability Study

    PubMed Central

    Chen, Fuchao; Xiong, Hui; Yang, Jinguo; Fang, Baoxia; Zhu, Jun; Zhou, Benhong

    2015-01-01

    Background Ketamine in subanesthetic dose added to butorphanol has been reported to give superior pain control when used for intravenous patient-controlled analgesia (PCA) after surgery. However, this admixture is not available commercially and stability data applicable to hospital practice are limited. Material/Methods The butorphanol-ketamine admixtures were prepared in polyolefin bags and stored in the dark at 4°C, 25°C, or 37°C for 15 days. The initial concentrations were 50–150 microgram/ml for butorphanol and 1–4 mg/ml for ketamine, respectively. The stabilities were determined by visual inspection, pH measurement, and high-pressure liquid chromatography (HPLC) assay of drug concentrations. Results Over the 15 days, all solutions were clear in appearance, and no color change or precipitation was observed among the three temperatures. The percentages of initial concentration of each drug were over 95% during the study period, and the pH value did not change significantly. Conclusions The results indicate that the drug mixtures of butorphanol and ketamine in 0.9% sodium chloride injection were stable for 15 days when stored in polyolefin bags at 4°C, 25°C, or 37°C. PMID:25896429

  12. Antifouling coating with controllable and sustained silver release for long-term inhibition of infection and encrustation in urinary catheters.

    PubMed

    Wang, Rong; Neoh, Koon Gee; Kang, En-Tang; Tambyah, Paul Anantharajah; Chiong, Edmund

    2015-04-01

    Urinary tract infections constitute a large proportion of nosocomial infections, and the urinary catheter is the most important predisposing factor. Encrustation induced by urease-producing uropathogens like Proteus mirabilis causes further complications. In the present work, a strategy for controllable and sustained release of silver over several weeks has been developed for combating bacterial infection and encrustation in urinary devices. Silver nanoparticles (AgNPs) were first immobilized on polydopamine (PDA) pre-treated silicone catheter surface and this was followed by another PDA coating. The number of AgNP-PDA bilayers could be manipulated to control the amount of silver loaded and its subsequent release. Poly(sulfobetaine methacrylate-co-acrylamide) was then grafted to provide an antifouling outer layer, and to ensure free diffusion of Ag from the surface. The micron-scale combination of an antifouling coating with AgNP-PDA bilayers reduced colonization of the urinary catheter by uropathogens by approximately two orders of magnitude. With one and two AgNP-PDA bilayers, the coated catheter could resist encrustation for 12 and 45 days, respectively, compared with approximately 6 days with the Dover™ silver-coated catheter. Such anti-infective and anti-encrustation catheters can potentially have a large impact on reducing patient morbidity and healthcare expenditure. PMID:24922113

  13. Randomized controlled trial of anterior-chamber intraocular lenses in Nepal: long-term follow-up.

    PubMed Central

    Evans, J. R.; Henning, A.; Pradhan, D.; Foster, A.; Lagnado, R.; Poulson, A.; Johnson, G. J.; Wormald, R. P.

    2000-01-01

    Most of the estimated 20 million people who are blind with cataracts live in rural areas of developing countries, where expert surgical resources are scarce. We have studied the use of multiflex open-loop anterior-chamber intraocular lenses (ACIOL) in high-volume low-cost surgery. Between 1992 and 1995, a total of 2000 people attending Lahan Eye Hospital, Nepal, with bilateral cataracts reducing vision to < or = 6/36 were randomly allocated to receive intracapsular extraction (ICCE) with aphakic spectacles, or ICCE with an ACIOL. We re-examined the cohort (1305/2000, 65%) between November 1996 and April 1997 and report the findings in this article. There were 13 new cases of poor visual outcome (best corrected vision < 6/60) arising after one year: 9 in the ACIOL group and 4 in the control group; odds ratio 2.1 (95% confidence interval, 0.59-9.55). The causes of poor outcome were as follows: ACIOL group--retinal detachment (4 cases), cystoid macular oedema (2), epiretinal membrane (1), age-related macular degeneration (1), and late endophthalmitis (1); control group--retinal detachment (2 cases), late endophthalmitis (1), and primary open-angle glaucoma with age-related macular degeneration (1). In rural areas of developing countries, well-manufactured multiflex open-loop ACIOLs can be implanted safely by experienced ophthalmologists after routine ICCE, avoiding the disadvantages of aphakic spectacle correction. PMID:10812737

  14. Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials

    PubMed Central

    Hu, Yan; Lv, Guohua; Ren, Siying; Johansen, Daniel

    2016-01-01

    Purpose This study aimed to investigate the mid- to long-term outcomes of cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) for the treatment of 1-level or 2-level symptomatic cervical disc disease. Methods Medline, Embase, and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant randomized controlled trials that reported mid- to long-term outcomes (at least 48 months) of CDA versus ACDF. All data were analyzed by Review Manager 5.3 software. The relative risk (RR) and 95% confidence intervals (CIs) were calculated for dichotomous variables. The weighted mean difference (WMD) and 95%CIs were calculated for continuous variables. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used. Results Eight prospective randomized controlled trials (RCTs) were retrieved in this meta-analysis, including 1317 and 1051 patients in CDA and ACDF groups, respectively. Patients after an ACDF had a significantly lower rate of follow-up than that after CDA. Pooled analysis showed patients in CDA group achieved significantly higher rates of overall success, Neck Disability Index (NDI) success, neurological success and significantly lower rates of implant/surgery-related serious adverse events and secondary procedure compared with that in ACDF group. The long-term functional outcomes (NDI, Visual Analog Scale (VAS) neck and arm pain scores, the Short Form 36 Health Survey physical component score (SF-36 PCS)), patient satisfaction and recommendation, and the incidence of superior adjacent segment degeneration also favored patients in CDA group with statistical difference. Regarding inferior adjacent segment degeneration, patients in CDA group had a lower rate without statistical significance. Conclusions This meta-analysis showed that cervical disc arthroplasty was superior over anterior discectomy and fusion for the treatment of symptomatic cervical disc disease in

  15. Long-term fate of glyphosate associated with repeated rodeo applications to control smooth cordgrass (Spartina alterniflora) in Willapa Bay, Washington.

    PubMed

    Kilbride, K M; Paveglio, F L

    2001-02-01

    Cordgrasses (Spartina sp.) are exotic, invasive species that threaten to degrade the intertidal zones of estuaries along the West Coast of North America. Integrated pest management (IPM) strategies primarily focus on the use of aerial and ground applications of Rodeo in conjunction with mowing, but IPM treatments over multiple years usually are necessary to control Spartina. Although information exists regarding the short-term fate and effects to marine biota of a single Rodeo application to control Spartina, little information is available regarding the fate and biotic effects associated with repeated Rodeo applications necessary for control. Consequently, we conducted a 3-year study to assess the short- and long-term fate and potential effects to marine biota associated with repeated applications of Rodeo to control smooth cordgrass in a southwestern Washington estuary. At each of three intertidal locations in Willapa Bay, we established plots on exposed mudflats and along the edge of a Spartina meadow that were hand sprayed with Rodeo (5% solution) and LI-700 (2% solution) during July 1997 and 1998. Glyphosate concentrations in sediment from mudflat plots declined 88% to 96% from 1 day posttreatment in 1997 to 1 year after the second Rodeo applications in 1999. In contrast, glyphosate concentrations in Spartina plots increased 231% to 591% from 1997 to 1999 because Spartina rhizomes likely did not readily metabolize or exude it. Comparison of concentrations from mudflat and Spartina plots with toxicity test values for marine biota indicates that under worst-case conditions short- and long-term detrimental effects to aquatic biota from repeated application of Rodeo for Spartina control would be highly unlikely. PMID:11243319

  16. The long-term effect of minimalist shoes on running performance and injury: design of a randomised controlled trial

    PubMed Central

    Fuller, Joel T; Thewlis, Dominic; Tsiros, Margarita D; Brown, Nicholas A T; Buckley, Jonathan D

    2015-01-01

    Introduction The outcome of the effects of transitioning to minimalist running shoes is a topic of interest for runners and scientists. However, few studies have investigated the longer term effects of running in minimalist shoes. The purpose of this randomised controlled trial (RCT) is to investigate the effects of a 26 week transition to minimalist shoes on running performance and injury risk in trained runners unaccustomed to minimalist footwear. Methods and analysis A randomised parallel intervention design will be used. Seventy-six trained male runners will be recruited. To be eligible, runners must be aged 18–40 years, run with a habitual rearfoot footfall pattern, train with conventional shoes and have no prior experience with minimalist shoes. Runners will complete a standardised transition to either minimalist or control shoes and undergo assessments at baseline, 6 and 26 weeks. 5 km time-trial performance (5TT), running economy, running biomechanics, triceps surae muscle strength and lower limb bone mineral density will be assessed at each time point. Pain and injury will be recorded weekly. Training will be standardised during the first 6 weeks. Primary statistical analysis will compare 5TT between shoe groups at the 6-week time point and injury incidence across the entire 26-week study period. Ethics and dissemination This RCT has been approved by the Human Research Ethics Committee of the University of South Australia. Participants will be required to provide their written informed consent prior to participation in the study. Study findings will be disseminated in the form of journal publications and conference presentations after completion of planned data analysis. Trial registration number This RCT has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000642785). PMID:26297368

  17. Long Term Effect on Professionals’ Knowledge, Practice and Attitudes towards User Involvement Four Years after Implementing an Organisational Development Plan: A Controlled Study

    PubMed Central

    Rise, Marit By; Steinsbekk, Aslak

    2016-01-01

    Background Health service organisations are increasingly implementing user involvement initiatives according to requirements from governments, such as user representation in administrational boards, better information to users, and more involvement of the users during treatment. Professionals are vital in all initiatives to enhance user involvement, and initiatives to increase involvement should influence the professionals’ practice and attitudes. The implementation of a development plan intending to enhance user involvement in a mental health hospital in Central Norway had no effect on the professionals after 16 months. The objective was therefore to investigate the long term effect on the professionals’ knowledge, practice and attitudes towards user involvement after four years. Methods This was a non-randomized controlled study including professionals from three mental health hospitals in Central Norway. A development plan intended to enhance user participation was implemented in one of the hospitals, including establishing a patient education centre and a user office, purchasing of user expertise, appointing contact professionals for next of kin, and improving of the centre’s information and the professional culture. The professionals at two other hospitals constituted the control group. All professionals were invited to answer the Consumer Participation Questionnaire (CPQ) and additional questions, at a four year interval. Results A total of 399 professionals participated (43% response rate). Comparing the changes in the intervention group with the changes in the control group, the results showed that the plan had improved some aspects of the professionals’ knowledge about the user involvement taking place in the hospital. In addition, some parts of the professionals’ practice of providing information to the service users was improved, and the development plan might have raised their awareness about insufficient involvement of next of kin

  18. An Exercise Protocol Designed to control Energy Expenditure and to have a Positive Impact on Maximal Oxygen Consumption for Long-Term Space Missions

    NASA Astrophysics Data System (ADS)

    Matsuo, Tomoaki; Ohkawara, Kazunori; Seino, Satoshi; Shimojo, Nobutake; Yamada, Shin; Ohshima, Hiroshi; Tanaka, Kiyoji; Mukai, Chiaki

    2013-02-01

    Maximal oxygen consumption decreases during spaceflight, and astronauts also experience controversial weight loss. Future space missions require a more efficient exercise program to maintain work efficiency and to control increased energy expenditure (EE). We have been developing two types of original exercise training protocols which are better suited to astronauts’ daily routine exercise during long-term spaceflight: sprint interval training (SIT) and high-intensity interval aerobic training (HIAT). In this study, we compared the total EE, including excess post-exercise energy expenditure (EPEE), induced by our interval cycling protocols with the total EE of a traditional, continuous aerobic training (CAT). In the results, while the EPEEs after the SIT and HIAT were greater than after the CAT, the total EE for an entire exercise/rest session with the CAT was the greatest of our three exercise protocols. The SIT and HIAT would be potential protocols to control energy expenditure for long space missions.

  19. Radiation control coatings installed on federal buildings at Tyndall Air Force Base. Volume 2: Long-term monitoring and modeling

    SciTech Connect

    Petrie, T.W.; Childs, P.W.

    1998-06-01

    The US Department of Energy`s (DOE`s) Federal Energy Management Program (FEMP) supports efforts to reduce energy use and associated expenses in the federal sector. One such effort, the New Technology Demonstration Program (NTDP), seeks to evaluate new energy-saving US technologies and secure their more timely adoption by the US government. Through a partnership with a federal site, the utility serving the site, a manufacturer of an energy-related technology, and other organizations associated with these interests, DOE can evaluate a new technology. The results of the program give federal agency decision makers more hands-on information with which to validate a decision to utilize a new technology in their facilities. This is the second volume of a two-volume report that describes the effects of radiation control coatings installed on federal buildings at Tyndall Air Force Base (AFB) in Florida by ThermShield International. ORNL`s Buildings Technology Center (BTC) was assigned the responsibility for gathering, analyzing, and reporting on the data to describe the effects of the coatings. The first volume described the monitoring plan and its implementation, the results of pre-coating monitoring, the coating installation, results from fresh coatings compared to pre-coating results, and a plan to decommission the monitoring equipment. This second volume updates and completes the presentation of data to compare performance of fresh coatings with weathered coatings.

  20. Microbial carbon recycling - an underestimated process controlling soil carbon dynamics - Part 1: A long-term laboratory incubation experiment

    NASA Astrophysics Data System (ADS)

    Basler, A.; Dippold, M.; Helfrich, M.; Dyckmans, J.

    2015-10-01

    Independent of its chemical structure carbon (C) persists in soil for several decades, controlled by stabilization and recycling. To disentangle the importance of the two factors on the turnover dynamics of soil sugars, an important compound of soil organic matter (SOM), a 3-year incubation experiment was conducted on a silty loam soil under different types of land use (arable land, grassland and forest) by adding 13C-labelled glucose. The compound-specific isotope analysis of soil sugars was used to examine the dynamics of different sugars during incubation. Sugar dynamics were dominated by a pool of high mean residence times (MRT) indicating that recycling plays an important role for sugars. However, this was not substantially affected by soil C content. Six months after label addition the contribution of the label was much higher for microbial biomass than for CO2 production for all examined land use types, corroborating that substrate recycling was very effective within the microbial biomass. Two different patterns of tracer dynamics could be identified for different sugars: while fucose and mannose showed highest label contribution at the beginning of the incubation with a subsequent slow decline, galactose and rhamnose were characterized by slow label incorporation with subsequently constant levels, which indicates that recycling is dominating the dynamics of these sugars. This may correspond to (a) different microbial growing strategies (r and K-strategist) or (b) location within or outside the cell membrane (lipopolysaccharides vs. exopolysaccharides) and thus be subject of different re-use within the microbial food web. Our results show how the microbial community recycles substrate very effectively and that high losses of substrate only occur during initial stages after substrate addition. This study indicates that recycling is one of the major processes explaining the high MRT observed for many SOM fractions and thus is crucial for understanding the

  1. Long-term disease control of a pancreatic neuroendocrine tumor with lanreotide autogel(®): a case report.

    PubMed

    Lybaert, Willem; Van Hul, Erik; Woestenborghs, Heidi

    2014-09-01

    The CLARINET study (ClinicalTrials.gov: NCT00353496) showed that somatostatin analogs are able to stabilize tumor growth in patients with intestinal and pancreatic neuroendocrine tumors (NETs). Here, we present a case of NET originating from the pancreatic tail that was treated with lanreotide Autogel(®). A 60-year-old patient underwent resection of a pancreatic NET with splenectomy and distal pancreatectomy. Four months after surgery, there was an increase in chromogranin A levels, along with a hypercaptating lesion of approximately 3.5 cm at the residual part of the pancreatic corpus. Treatment with 30 mg monthly-administered octreotide long-acting release (LAR) was initiated. After 3 months of treatment, a control CT scan revealed diffuse metastases in the liver, although the patient presented no symptoms and liver tests were normal. Due to difficulties with the administration of octreotide LAR, treatment was switched to lanreotide Autogel(®) 120 mg, administered as monthly deep-subcutaneous injections. Progression-free survival, as shown by 3-monthly CT scans, was obtained for 2 years without the need to increase the lanreotide Autogel(®) dose, and the patient reported no side effects. After these 2 years, deterioration of the patient's clinical status and weight loss were observed, along with increased size of the liver lesions and appearance of peritoneal metastases. Chemotherapy treatment with cisplatinum-etoposide was initiated, while the lanreotide Autogel(®) injections were continued. After three chemotherapy cycles, a rapid decline in the patient's quality of life was noted, and she requested discontinuation of the chemotherapy and lanreotide injections. One month later, the patient died due to clinical progressive disease. PMID:25408662

  2. Long-Term Disease Control of a Pancreatic Neuroendocrine Tumor with Lanreotide Autogel®: A Case Report

    PubMed Central

    Lybaert, Willem; Van Hul, Erik; Woestenborghs, Heidi

    2014-01-01

    The CLARINET study (ClinicalTrials.gov: NCT00353496) showed that somatostatin analogs are able to stabilize tumor growth in patients with intestinal and pancreatic neuroendocrine tumors (NETs). Here, we present a case of NET originating from the pancreatic tail that was treated with lanreotide Autogel®. A 60-year-old patient underwent resection of a pancreatic NET with splenectomy and distal pancreatectomy. Four months after surgery, there was an increase in chromogranin A levels, along with a hypercaptating lesion of approximately 3.5 cm at the residual part of the pancreatic corpus. Treatment with 30 mg monthly-administered octreotide long-acting release (LAR) was initiated. After 3 months of treatment, a control CT scan revealed diffuse metastases in the liver, although the patient presented no symptoms and liver tests were normal. Due to difficulties with the administration of octreotide LAR, treatment was switched to lanreotide Autogel® 120 mg, administered as monthly deep-subcutaneous injections. Progression-free survival, as shown by 3-monthly CT scans, was obtained for 2 years without the need to increase the lanreotide Autogel® dose, and the patient reported no side effects. After these 2 years, deterioration of the patient's clinical status and weight loss were observed, along with increased size of the liver lesions and appearance of peritoneal metastases. Chemotherapy treatment with cisplatinum-etoposide was initiated, while the lanreotide Autogel® injections were continued. After three chemotherapy cycles, a rapid decline in the patient's quality of life was noted, and she requested discontinuation of the chemotherapy and lanreotide injections. One month later, the patient died due to clinical progressive disease. PMID:25408662

  3. Human acellular dermal matrix allograft: A randomized, controlled human trial for the long-term evaluation of patients with extensive burns.

    PubMed

    Li, Xueyong; Meng, Xianghai; Wang, Xiaolin; Li, Yuejun; Li, Wangzhou; Lv, Xiaoxing; Xu, Xiaoli; Lei, Zhanjun; Li, Jinqing

    2015-06-01

    The potential of acellular dermal matrix (ADM) to improve cosmetic and functional outcomes has been demonstrated; however, there have been few clinical comparative studies assessing the long-term morphological, histological and functional changes after ADM placement. This study was designed to retrospectively evaluate the long-term outcomes of the cograft acellular dermal matrix with autologous thin split-thickness skin for the coverage of wounds in extensively burned patients. Thirty burn patients treated with a composite graft of ADM with autologous split-thickness skin from January 2007 to December 2009 were enrolled in this study. Another group of thirty patients who received only an autogenous split-thickness skin implant served as the control. Our study revealed that the collagen in the dermis treated with ADM were ordered, and the proportion of collagen III/I was much higher in the control group than in the ADM group. The basement membrane was prominent and continuous. Meanwhile, the VBSS (Vancouver Burn Skin Score) was used to evaluate skin quality, which shows a significant differences between the two group (P<0.001). Then the functional level was evaluated by the BI (Barthel Index), and the ADM group was much better than the control group (P=0.005). Based on these results, we concluded that the composite graft of ADM with autologous thin split-thickness skin was suitable for repairing the defects in functional areas after a burn. This technique might facilitate wound management with acceptable esthetic outcomes, good functional recovery and less scar hyperplasia at the donor site. PMID:25687834

  4. Long-term evaluation of different strategies of cationic polyelectrolyte dosage to control fouling in a membrane bioreactor treating refinery effluent.

    PubMed

    Alkmim, Aline R; da Costa, Paula R; Moser, Priscila B; França Neta, Luzia S; Santiago, Vânia M J; Cerqueira, Ana C; Amaral, Míriam C S

    2016-04-01

    In this article, the long-term use of cationic polyelectrolyte to improve the sludge filterability and to control membrane fouling in bioreactor membrane while treating refinery effluents have been evaluated in pilot scale. Corrective and preventive cationic polyelectrolyte dosages have been added to the membrane bioreactor (MBR) to evaluate the membrane fouling mitigation in both strategies. The results have confirmed that the use of the Membrane performance enhancer (MPE) increased the sludge filterability and reduced the membrane fouling. During the monitoring period, stress events occurred due to the increase in oil and grease and phenol concentrations in the MBR feeds. The preventive use of cationic polyelectrolyte allowed for a more effective and stable sludge filterability, with lower cationic polyelectrolyte consumption and without decreasing MBR's overall pollutant removal performance. PMID:26508453

  5. Characteristics of solar wind control on Jovian UV auroral activity deciphered by long-term Hisaki EXCEED observations: Evidence of preconditioning of the magnetosphere?

    NASA Astrophysics Data System (ADS)

    Kita, Hajime; Kimura, Tomoki; Tao, Chihiro; Tsuchiya, Fuminori; Misawa, Hiroaki; Sakanoi, Takeshi; Kasaba, Yasumasa; Murakami, Go; Yoshioka, Kazuo; Yamazaki, Atsushi; Yoshikawa, Ichiro; Fujimoto, Masaki

    2016-07-01

    While the Jovian magnetosphere is known to have the internal source for its activity, it is reported to be under the influence of the solar wind as well. Here we report the statistical relationship between the total power of the Jovian ultraviolet aurora and the solar wind properties found from long-term monitoring by the spectrometer EXCEED (Extreme Ultraviolet Spectroscope for Exospheric Dynamics) on board the Hisaki satellite. Superposed epoch analysis indicates that auroral total power increases when an enhanced solar wind dynamic pressure hits the magnetosphere. Furthermore, the auroral total power shows a positive correlation with the duration of a quiescent interval of the solar wind that is present before a rise in the dynamic pressure, more than with the amplitude of dynamic pressure increase. These statistical characteristics define the next step to unveil the physical mechanism of the solar wind control on the Jovian magnetospheric dynamics.

  6. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  7. Long term presence of a single predominant tyrosinase-specific T-cell clone associated with disease control in a patient with metastatic melanoma.

    PubMed

    Ochsenreither, Sebastian; Fusi, Alberto; Busse, Antonia; Letsch, Anne; Haase, Doreen; Thiel, Eckhard; Scheibenbogen, Carmen; Keilholz, Ulrich

    2010-05-15

    In an earlier study, we described a patient who developed an anti-tyrosinase T-cell response leading to long-term tumor control. Here we analyzed this response with regard to T-cell receptor (TCR) Vbeta family usage and clonality in order to further elucidate the nature of the T cell response in this patient. For identification of expanded specific cytotoxic T-cell (CTL) clones, tetramer enrichment of tyrosinase reactive T-cells was followed by comparative quantitative reverse transcribed PCR (qRT PCR) quantification of all TCR Vbeta-families and sequencing of family Vbeta4 elevated in the enriched fraction. The predominant specific clone was quantified by clonotypic qRT PCR in multiple samples from blood, bone marrow, and tumor tissue. FACS analyses with staining of TYR.A2 and TCR Vbeta4 were performed. Epitope specific enrichment revealed an isolated increase of Vbeta-family 4. FACS analysis showed a shift of specific CTLs to Vbeta-family 4 during tumor regression with a maximum of 80% of all TYR.A2 specific cells belonging to this family. Sequencing revealed a single predominant clone against polyclonal background coding for identical CDR3 loops. The predominant clone was highly expressed in bone marrow and tumor tissue, and was detectable in blood over a period of ten years. Considering the results of previous studies showing a specific effector phenotype in blood and a specific memory compartment in bone marrow of this patient, this data implicate the predominant clone featured all attributes of a sufficient CTL response including homing capacity and memory formation resulting in long term clonal persistence and tumor control. PMID:19816942

  8. Fractionated Conformal Radiotherapy for Management of Optic Nerve Sheath Meningiomas: Long-Term Outcomes of Tumor Control and Visual Function at a Single Institution

    SciTech Connect

    Metellus, Philippe; Kapoor, Sumit; Kharkar, Siddharth; Batra, Sachin; Jackson, Juan F.; Kleinberg, Lawrence; Miller, Neil R.; Rigamonti, Daniele

    2011-05-01

    Purpose: To provide the long-term outcomes of patients treated with fractionated conformal radiotherapy (FCRT) for presumed optic nerve sheath meningiomas (ONSMs). Patients and Methods: Between 1995 and 2002, 9 patients with a presumed ONSM were treated with FCRT at our institution. The indications for FCRT were significant visual dysfunction at presentation, progression of visual dysfunction during a period of observation, tumor growth documented by sequential imaging, or a combination of these findings. In 2 patients, FCRT was performed as adjuvant therapy, and in 7, it was the initial and primary treatment. Results: Of the 9 patients, 6 were women and 3 were men, with a mean age of 47 years. All 9 patients had evidence of optic nerve dysfunction in the affected eye, characterized by reduced visual acuity, a visual field defect, and a relative afferent pupillary defect. In addition, 2 patients had proptosis and 1 had diplopia. The mean follow-up period was 98 {+-} 31.7 months (median, 90; range, 61-151). After FCRT, the visual function improved in the 7 patients who had undergone FCRT as the primary treatment. However, 2 patients who were blind in their affected eye at FCRT remained blind. In 4 of the 7 patients with improvement, the improvement was documented within 1-3 months after FCRT. The tumor control rate was 100%. Proptosis and diplopia also regressed in 100% of patients. At 2 years after FCRT, 1 patient had developed radiation retinopathy. Conclusion: The results of our study have shown that FCRT is a safe and effective treatment of ONSMs, affording satisfactory long-term tumor control, good functional outcome, and low treatment morbidity. FCRT should be considered the treatment of choice for patients with presumed ONSMs for whom the treatment has been deemed appropriate.

  9. The short-term and long-term effects of tolvaptan in patients with heart failure: a meta-analysis of randomized controlled trials.

    PubMed

    Xiong, Bo; Huang, Yuwen; Tan, Jie; Yao, Yuanqing; Wang, Chunbin; Qian, Jun; Rong, Shunkang; Deng, Shimin; Cao, Yin; Zou, Yanke; Huang, Jing

    2015-11-01

    A comprehensive evaluation of the benefits of tolvaptan for the management of heart failure (HF) is lacking. The objective of this meta-analysis was to assess the short-term and long-term effects of tolvaptan in patients with HF. Articles were searched from PubMed, MEDLINE and Cochrane Library before March 31, 2015. Randomized controlled trials enrolling adult HF patients and reporting the all-cause mortality, cardiac events, body weight change or changes of serum electrolytes including sodium, potassium and creatinine were included in our meta-analysis. Ten studies covering 5574 patients met the inclusion criteria. Based on the data of meta-analysis, tolvaptan had no impact on the all-cause mortality [relative risk (RR) 0.96; 95 % confidence interval (CI) 0.87-1.06; P = 0.40] and incidence of cardiac events (RR 1.03; 95 % CI 0.96-1.11; P = 0.40) of HF patients. Furthermore, in comparison with control treatments, tolvaptan significantly decreased the body weight [weight mean difference (WMD), -0.87; 95 % CI -1.03 to -0.71; P < 0.001] and statistically increased serum sodium (WMD, 2.58; 95 % CI -1.83 to 3.33; P < 0.001) without any change in serum potassium (WMD, 0.01; 95 % CI -0.03 to 0.05; P = 0.577). However, serum creatinine may be increased slightly by tolvaptan (WMD, 0.05; 95 % CI 0.03-0.07; P < 0.001). This meta-analysis suggests that in HF patients, tolvaptan may not bring long-term benefits, but it effectively improves the volume overload and hyponatremia without obvious increases in serum potassium and creatinine. Hence, tolvaptan is likely to be a promising diuretic for the treatment of HF. PMID:26334632

  10. Long-term effects of pioglitazone on first attack of ischemic cerebrovascular disease in older people with type 2 diabetes: A case-control study in Taiwan.

    PubMed

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2016-08-01

    Long-term studies demonstrating the effect of pioglitazone use on primary prevention of ischemic cerebrovascular disease in older people with type 2 diabetes mellitus are lacking. This study investigated the relationship between pioglitazone use and first attack of ischemic cerebrovascular disease in Taiwan.We conducted a case-control study using the database of the Taiwan National Health Insurance Program. There were 2359 type 2 diabetic subjects aged ≥65 years with newly diagnosed ischemic cerebrovascular disease from 2005 to 2011 as the case group and 4592 sex- and age-matched, randomly selected type 2 diabetic subjects aged ≥65 years without ischemic cerebrovascular disease as the control group. The odds ratio (OR) with 95% confidence interval (CI) of ischemic cerebrovascular disease associated with pioglitazone use was measured by the multivariable unconditional logistic regression model.After adjustment for confounding factors, the multivariable logistic regression analysis disclosed that the adjusted ORs of first attack of ischemic cerebrovascular disease associated with cumulative duration of using pioglitazone were 3.34 for <1 year (95% CI 2.59-4.31), 2.53 for 1 to 2 years (95% CI 1.56-4.10), 2.20 for 2 to 3 years (95% CI 1.05-4.64), and 1.09 for ≥3 years (95% CI 0.55-2.15), respectively.Our findings suggest that pioglitazone use does not have a protective effect on primary prevention for ischemic cerebrovascular disease among older people with type 2 diabetes mellitus during the first 3 years of use. Whether using pioglitazone for >3 years would have primary prevention for ischemic cerebrovascular disease needs a long-term research to prove. PMID:27495077

  11. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  12. KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival.

    PubMed

    Schellenberg, J R; Abdulla, S; Minja, H; Nathan, R; Mukasa, O; Marchant, T; Mponda, H; Kikumbih, N; Lyimo, E; Manchester, T; Tanner, M; Lengeler, C

    1999-01-01

    We present a large-scale social marketing programme of insecticide-treated nets in 2 rural districts in southwestern Tanzania (population 350,000) and describe how the long-term child health and survival impact will be assessed. Formative and market research were conducted in order to understand community perceptions, knowledge, attitudes and practice with respect to the products to be socially marketed. We identified Zuia Mbu (Kiswahili for 'prevent mosquitoes') as a suitable brand name for both treated nets and single-dose insecticide treatment sachets. A mix of public and private sales outlets is used for distribution. In the first stage of a stepped introduction 31 net agents were appointed and trained in 18 villages: 15 were shop owners, 14 were village leaders, 1 was a parish priest and 1 a health worker. For net treatment 37 young people were appointed in the same villages and trained as agents. Further institutions in both districts such as hospitals, development projects and employers were also involved in distribution. Promotion for both products was intense and used a variety of channels. A total of 22,410 nets and 8072 treatments were sold during the first year: 18 months after launching, 46% of 312 families with children aged under 5 years reported that their children were sleeping under treated nets. A strong evaluation component in over 50,000 people allows assessment of the long-term effects of insecticide-treated nets on child health and survival, anaemia in pregnancy, and the costs of the intervention. This evaluation is based on cross-sectional surveys, and case-control and cohort studies. PMID:10492745

  13. Fractionated Conformal Radiotherapy in the Management of Cavernous Sinus Meningiomas: Long-Term Functional Outcome and Tumor Control at a Single Institution

    SciTech Connect

    Metellus, Philippe; Batra, Sachin; Karkar, Siddharth; Kapoor, Sumit; Weiss, Stephanie; Kleinberg, Lawrence; Rigamonti, Danielle

    2010-11-01

    Purpose: To evaluate long-term outcome of cavernous sinus meningioma (CSM) treated with fractionated conformal radiotherapy (FCR). Patients and Methods: Fifty-three patients with CSMs (16 men [30.2%], 37 women [69.8%], aged 53 {+-} 13.0 years [mean {+-} SD]) were treated by FCR. In 28 patients (52.8%) FCR was performed as first-line treatment and in 25 patients (47.2%) as adjuvant treatment. All patients received FCR with a dose of 52.9 {+-} 1.8 Gy in 29.4 {+-} 1.0 fractions over 6 weeks. Dose per fraction was 1.9 {+-} 0.1 Gy. Radiotherapy was delivered stereotactically in 47 cases (88.7%) and conformally in 6 (11.3%) Results: The median follow-up was 6.9 years (range, 3-19 years). According to Sekhar's classification, 19 patients (35.8%) were Grade 1-2, 30 patients (56.6%) were Grade 3-4, and 4 patients (7.6%) were Grade 5. Pretreatment tumor volume was determined in 46 patients, and tumor volume was 12.6 {+-} 8.2 cm{sup 3}. In these patients, the distance between tumor and optic apparatus was 1.62 {+-} 1.2 mm. Actuarial 5- and 10-year progression-free survival rates were 98.1% and 95.8%, respectively. Clinical improvement was observed in 31 patients (58.5%), and 20 patients (37.7%) remained unchanged. Radiologic response was observed in 18 patients (30.2%), and 35 patients (66.0%) showed stable lesions. Two patients (3.8%) showed tumor progression during follow-up. Transient morbidity was observed in 3 patients (5.7%) and permanent morbidity in 1 (1.9%). Conclusion: Fractionated conformal radiotherapy affords satisfactory long-term tumor control and low treatment morbidity.

  14. Long-term Effectiveness of Online Anaphylaxis Education for Pharmacists

    PubMed Central

    Vale, Sandra; Sanfilippo, Frank M; Loh, Richard; Clifford, Rhonda M

    2014-01-01

    Objective. To evaluate the long-term effectiveness of an Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-learning program compared to lectures or no training. Design. A controlled interrupted-time-series study of Australian pharmacists and pharmacy students who completed ASCIA anaphylaxis e-learning or lecture programs was conducted during 2011-2013. Effectiveness was measured using a validated test administered pretraining, posttraining, and 3 and 7 months after training. Assessment. All learning groups performed significantly better on all posttests compared to the pretest, and compared to a control group (p<0.001). The proportion of e-learners achieving the minimum standard for anaphylaxis knowledge improved from 45% at pretest to 87% at 7 months. Conclusion. The ASCIA e-learning program significantly increased anaphylaxis knowledge. The high proportion of participants achieving the minimum standard at 7 months indicates long-term knowledge change. PMID:25258441

  15. Combining Modeling and Monitoring to Produce a New Paradigm of an Integrated Approach to Providing Long-Term Control of Contaminants

    NASA Astrophysics Data System (ADS)

    Fogwell, T. W.

    2009-12-01

    Sir David King, Chief Science Advisor to the British government and Cambridge University Professor, stated in October 2005, "The scientific community is considerably more capable than it has been in the past to assist governments to avoid and reduce risk to their own populations. Prime ministers and presidents ignore the advice from the science community at the peril of their own populations." Some of these greater capabilities can be found in better monitoring techniques applied to better modeling methods. These modeling methods can be combined with the information derived from monitoring data in order to decrease the risk of population exposure to dangerous substances and to promote efficient control or cleanup of the contaminants. An introduction is presented of the types of problems that exist for long-term control of radionuclides at DOE sites. A breakdown of the distributions at specific sites is given, together with the associated difficulties. A paradigm for remediation showing the integration of monitoring with modeling is presented. It is based on a feedback system that allows for the monitoring to act as principal sensors in a control system. The resulting system can be optimized to improve performance. Optimizing monitoring automatically entails linking the monitoring with modeling. If monitoring designs were required to be more efficient, thus requiring optimization, then the monitoring automatically becomes linked to modeling. Records of decision could be written to accommodate revisions in monitoring as better modeling evolves. Currently the establishment of a very prescriptive monitoring program fails to have a mechanism for improving models and improving control of the contaminants. The technical pieces of the required paradigm are already available; they just need to be implemented and applied to solve the long-term control of the contaminants. An integration of the various parts of the system is presented. Each part is described, and examples are

  16. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: A systematic review and meta-analysis.

    PubMed

    Pai, Lee-Wen; Li, Tsai-Chung; Hwu, Yueh-Juen; Chang, Shu-Chuan; Chen, Li-Li; Chang, Pi-Ying

    2016-03-01

    The objective of this study was to systematically review the effectiveness of different types of regular leisure-time physical activities and pooled the effect sizes of those activities on long-term glycemic control in people with type 2 diabetes compared with routine care. This review included randomized controlled trials from 1960 to May 2014. A total of 10 Chinese and English databases were searched, following selection and critical appraisal, 18 randomized controlled trials with 915 participants were included. The standardized mean difference was reported as the summary statistic for the overall effect size in a random effects model. The results indicated yoga was the most effective in lowering glycated haemoglobin A1c (HbA1c) levels. Meta-analysis also revealed that the decrease in HbA1c levels of the subjects who took part in regular leisure-time physical activities was 0.60% more than that of control group participants. A higher frequency of regular leisure-time physical activities was found to be more effective in reducing HbA1c levels. The results of this review provide evidence of the benefits associated with regular leisure-time physical activities compared with routine care for lowering HbA1c levels in people with type 2 diabetes. PMID:26822261

  17. Scotopic sensitivity/Irlen syndrome and the use of coloured filters: a long-term placebo-controlled study of reading strategies using analysis of miscue.

    PubMed

    Robinson, G L; Foreman, P J

    1999-02-01

    This study investigated the long-term effects of using coloured filters on the frequency and type of errors in oral reading. A double-masked, placebo-controlled crossover experimental design was used, with subjects being assessed over a period of 20 months. There were three experimental groups (Placebo tints, Blue tints, and Diagnosed tints) involving 113 subjects with reading difficulties, ranging in age from 9.2 yr. to 13.1 yr. The 35 controls (ranging in age from 9.4 yr. to 12.9 yr.) had reading difficulties but did not require coloured filters. There was a significant improvement for all groups in the accuracy of miscues over the period, although experimental groups over-all did not improve at a significantly different rate than the control group. The failure to find significantly greater improvement for the experimental groups over the control group for the total period, despite subjects' reports of improved print clarity, may be partly related to the lack of effective letter-sound analysis and synthesis skills and to the use of a word-identification strategy of guessing based on partial visual analysis. PMID:10214632

  18. Stapedectomy - long-term report.

    PubMed

    Shea, J J

    1982-01-01

    The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the case of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response. PMID:6897157

  19. HadISD: a quality-controlled global synoptic report database for selected variables at long-term stations from 1973-2011

    NASA Astrophysics Data System (ADS)

    Dunn, R. J. H.; Willett, K. M.; Thorne, P. W.; Woolley, E. V.; Durre, I.; Dai, A.; Parker, D. E.; Vose, R. S.

    2012-10-01

    This paper describes the creation of HadISD: an automatically quality-controlled synoptic resolution dataset of temperature, dewpoint temperature, sea-level pressure, wind speed, wind direction and cloud cover from global weather stations for 1973-2011. The full dataset consists of over 6000 stations, with 3427 long-term stations deemed to have sufficient sampling and quality for climate applications requiring sub-daily resolution. As with other surface datasets, coverage is heavily skewed towards Northern Hemisphere mid-latitudes. The dataset is constructed from a large pre-existing ASCII flatfile data bank that represents over a decade of substantial effort at data retrieval, reformatting and provision. These raw data have had varying levels of quality control applied to them by individual data providers. The work proceeded in several steps: merging stations with multiple reporting identifiers; reformatting to netCDF; quality control; and then filtering to form a final dataset. Particular attention has been paid to maintaining true extreme values where possible within an automated, objective process. Detailed validation has been performed on a subset of global stations and also on UK data using known extreme events to help finalise the QC tests. Further validation was performed on a selection of extreme events world-wide (Hurricane Katrina in 2005, the cold snap in Alaska in 1989 and heat waves in SE Australia in 2009). Some very initial analyses are performed to illustrate some of the types of problems to which the final data could be applied. Although the filtering has removed the poorest station records, no attempt has been made to homogenise the data thus far, due to the complexity of retaining the true distribution of high-resolution data when applying adjustments. Hence non-climatic, time-varying errors may still exist in many of the individual station records and care is needed in inferring long-term trends from these data. This dataset will allow the

  20. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short- and long-term effectiveness

    PubMed Central

    2014-01-01

    mobilisation, and lower incidence of vomiting. Few studies reported long-term outcomes. Conclusions Local anaesthetic infiltration is effective in reducing short-term pain and hospital stay in patients receiving THR and TKR. Studies should assess whether local anaesthetic infiltration can prevent long-term pain. Enhanced pain control with additional analgesia through a catheter should be weighed against a possible infection risk. PMID:24996539

  1. Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response

    PubMed Central

    Simmons, Bryony; Saleem, Jawaad; Heath, Katherine; Cooke, Graham S.; Hill, Andrew

    2015-01-01

    Background. Achievement of a sustained virologic response (SVR) after treatment for Hepatitis C infection is associated with improved outcomes. This meta-analysis aimed to determine the impact of SVR on long-term mortality risk compared with nonresponders in a range of populations. Methods. An electronic search identified all studies assessing all-cause mortality in SVR and non-SVR patients. Eligible articles were stratified into general, cirrhotic, and populations coinfected with human immunodeficiency virus. The adjusted hazard ratio (95% confidence interval [CI]) for mortality in patients achieving SVR vs non-SVR, and pooled estimates for the 5-year mortality in each group were calculated. Results. 31 studies (n = 33 360) were identified as suitable for inclusion. Median follow-up time was 5.4 years (interquartile range, 4.9–7.5) across all studies. The adjusted hazard ratio of mortality for patients achieving SVR vs non-SVR was 0.50 (95% CI, .37–.67) in the general population, 0.26 (95% CI, .18–.74) in the cirrhotic group, and 0.21 (.10–.45) in the coinfected group. The pooled 5-year mortality rates were significantly lower for patients achieving SVR compared with non-SVR in all 3 populations. Conclusions. The results suggest that there is a significant survival benefit of achieving an SVR compared with unsuccessful treatment in a range of populations infected with hepatitis C virus. PMID:25987643

  2. Long term complications of diabetes

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000327.htm Long term complications of diabetes To use the sharing ... sores and infections. If it goes on too long, your toes, foot, or leg may need to ...

  3. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  4. Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS)

    PubMed Central

    Fonagy, Peter; Rost, Felicitas; Carlyle, Jo-anne; McPherson, Susan; Thomas, Rachel; Pasco Fearon, RM; Goldberg, David; Taylor, David

    2015-01-01

    This pragmatic randomized controlled trial tested the effectiveness of long-term psychoanalytic psychotherapy (LTPP) as an adjunct to treatment-as-usual according to UK national guidelines (TAU), compared to TAU alone, in patients with long-standing major depression who had failed at least two different treatments and were considered to have treatment-resistant depression. Patients (N=129) were recruited from primary care and randomly allocated to the two treatment conditions. They were assessed at 6-monthly intervals during the 18 months of treatment and at 24, 30 and 42 months during follow-up. The primary outcome measure was the 17-item version of the Hamilton Depression Rating Scale (HDRS-17), with complete remission defined as a HDRS-17 score ≤8, and partial remission defined as a HDRS-17 score ≤12. Secondary outcome measures included self-reported depression as assessed by the Beck Depression Inventory - II, social functioning as evaluated by the Global Assessment of Functioning, subjective wellbeing as rated by the Clinical Outcomes in Routine Evaluation - Outcome Measure, and satisfaction with general activities as assessed by the Quality of Life Enjoyment and Satisfaction Questionnaire. Complete remission was infrequent in both groups at the end of treatment (9.4% in the LTPP group vs. 6.5% in the control group) as well as at 42-month follow-up (14.9% vs. 4.4%). Partial remission was not significantly more likely in the LTPP than in the control group at the end of treatment (32.1% vs. 23.9%, p=0.37), but significant differences emerged during follow-up (24 months: 38.8% vs. 19.2%, p=0.03; 30 months: 34.7% vs. 12.2%, p=0.008; 42 months: 30.0% vs. 4.4%, p=0.001). Both observer-based and self-reported depression scores showed steeper declines in the LTPP group, alongside greater improvements on measures of social adjustment. These data suggest that LTPP can be useful in improving the long-term outcome of treatment-resistant depression. End

  5. Short- and long-term effects of tactile massage on salivary cortisol concentrations in Parkinson’s disease: a randomised controlled pilot study

    PubMed Central

    2013-01-01

    Background Parkinson’s disease (PD) is a chronic neurodegenerative disorder with limited knowledge about the normal function and effects of non-pharmacological therapies on the hypothalamic-pituitary-adrenal (HPA) axis. The aim of the study was to analyse the basal diurnal and total secretion of salivary cortisol in short- and long-term aspects of tactile massage (TM). Methods Design: Prospective, Controlled and Randomised Multicentre Trial. Setting and interventions: Forty-five women and men, aged 50–79 years, were recruited. Twenty-nine of them were blindly randomised to tactile massage (TM) and 16 of them to the control group, rest to music (RTM). Ten interventions were given during 8 weeks followed by a 26 weeks of follow up. Salivary cortisol was collected at 8 am, 1 pm, 8 pm, and 8 am the next day, on five occasions. With the first and eighth interventions, it was collected immediately before and after intervention. Main outcome measures: The primary aim was to assess and compare cortisol concentrations before and immediately after intervention and also during the follow-up period. The secondary aim was to assess the impact of age, gender, body mass index (BMI), duration and severity of PD, effects of interventional time-point of the day, and levodopa doses on cortisol concentration. Results The median cortisol concentrations for all participants were 16.0, 5.8, 2.8, and 14.0 nmol/L at baseline, later reproduced four times without significant differences. Cortisol concentrations decreased significantly after TM intervention but no change in diurnal salivary cortisol pattern was found. The findings of reduced salivary cortisol concentrations immediately after the interventions are in agreement with previous studies. However, there was no significant difference between the TM and control groups. There were no significant correlations between cortisol concentrations and age, gender, BMI, time-point for intervention, time interval between anti

  6. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    PubMed Central

    2010-01-01

    Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. Results At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. Conclusions The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers. PMID:20470435

  7. Long-term glycemic control using polymer-encapsulated human stem cell-derived beta cells in immune-competent mice.

    PubMed

    Vegas, Arturo J; Veiseh, Omid; Gürtler, Mads; Millman, Jeffrey R; Pagliuca, Felicia W; Bader, Andrew R; Doloff, Joshua C; Li, Jie; Chen, Michael; Olejnik, Karsten; Tam, Hok Hei; Jhunjhunwala, Siddharth; Langan, Erin; Aresta-Dasilva, Stephanie; Gandham, Srujan; McGarrigle, James J; Bochenek, Matthew A; Hollister-Lock, Jennifer; Oberholzer, Jose; Greiner, Dale L; Weir, Gordon C; Melton, Douglas A; Langer, Robert; Anderson, Daniel G

    2016-03-01

    The transplantation of glucose-responsive, insulin-producing cells offers the potential for restoring glycemic control in individuals with diabetes. Pancreas transplantation and the infusion of cadaveric islets are currently implemented clinically, but these approaches are limited by the adverse effects of immunosuppressive therapy over the lifetime of the recipient and the limited supply of donor tissue. The latter concern may be addressed by recently described glucose-responsive mature beta cells that are derived from human embryonic stem cells (referred to as SC-β cells), which may represent an unlimited source of human cells for pancreas replacement therapy. Strategies to address the immunosuppression concerns include immunoisolation of insulin-producing cells with porous biomaterials that function as an immune barrier. However, clinical implementation has been challenging because of host immune responses to the implant materials. Here we report the first long-term glycemic correction of a diabetic, immunocompetent animal model using human SC-β cells. SC-β cells were encapsulated with alginate derivatives capable of mitigating foreign-body responses in vivo and implanted into the intraperitoneal space of C57BL/6J mice treated with streptozotocin, which is an animal model for chemically induced type 1 diabetes. These implants induced glycemic correction without any immunosuppression until their removal at 174 d after implantation. Human C-peptide concentrations and in vivo glucose responsiveness demonstrated therapeutically relevant glycemic control. Implants retrieved after 174 d contained viable insulin-producing cells. PMID:26808346

  8. Long-Term Upregulation of Inflammation and Suppression of Cell Proliferation in the Brain of Adult Rats Exposed to Traumatic Brain Injury Using the Controlled Cortical Impact Model

    PubMed Central

    Acosta, Sandra A.; Tajiri, Naoki; Shinozuka, Kazutaka; Ishikawa, Hiroto; Grimmig, Bethany; Diamond, David; Sanberg, Paul R.; Bickford, Paula C.; Kaneko, Yuji; Borlongan, Cesar V.

    2013-01-01

    The long-term consequences of traumatic brain injury (TBI), specifically the detrimental effects of inflammation on the neurogenic niches, are not very well understood. In the present in vivo study, we examined the prolonged pathological outcomes of experimental TBI in different parts of the rat brain with special emphasis on inflammation and neurogenesis. Sixty days after moderate controlled cortical impact injury, adult Sprague-Dawley male rats were euthanized and brain tissues harvested. Antibodies against the activated microglial marker, OX6, the cell cycle-regulating protein marker, Ki67, and the immature neuronal marker, doublecortin, DCX, were used to estimate microglial activation, cell proliferation, and neuronal differentiation, respectively, in the subventricular zone (SVZ), subgranular zone (SGZ), striatum, thalamus, and cerebral peduncle. Stereology-based analyses revealed significant exacerbation of OX6-positive activated microglial cells in the striatum, thalamus, and cerebral peduncle. In parallel, significant decrements in Ki67-positive proliferating cells in SVZ and SGZ, but only trends of reduced DCX-positive immature neuronal cells in SVZ and SGZ were detected relative to sham control group. These results indicate a progressive deterioration of the TBI brain over time characterized by elevated inflammation and suppressed neurogenesis. Therapeutic intervention at the chronic stage of TBI may confer abrogation of these deleterious cell death processes. PMID:23301065

  9. Long-term modulations of Saturn's auroral radio emissions by the solar wind and seasonal variations controlled by the solar ultraviolet flux

    NASA Astrophysics Data System (ADS)

    Kimura, T.; Lamy, L.; Tao, C.; Badman, S. V.; Kasahara, S.; Cecconi, B.; Zarka, P.; Morioka, A.; Miyoshi, Y.; Maruno, D.; Kasaba, Y.; Fujimoto, M.

    2013-11-01

    Saturn's auroral activities have been suggested to be controlled by the seasonal variations of the polar ionospheric conductivities and atmospheric conditions associated with the solar extreme ultraviolet (EUV) flux. However, they have not yet been explained self-consistently by only the seasonal solar EUV effects. This study investigates the long-term variations of Saturnian Kilometric Radiation (SKR) as a proxy of the auroral activities, which were observed by Cassini's Radio and Plasma Wave Science experiment mostly during the southern summer (DOY (day of year) 001 2004 to DOY 193 2010). We deduced the height distribution of the SKR source region in the Northern (winter) and Southern (summer) Hemispheres from the remote sensing of SKR spectra. The peak spectral density of the southern (summer) SKR was found to be up to 100 times greater than that of the northern (winter) SKR, and the altitude of the peak flux was similar (˜ 0.8 Rs) in the Northern and Southern Hemispheres. The spectral densities in both hemispheres became comparable with each other around equinox in August 2009. These results suggest a stronger SKR source region during the summer than the winter related to the seasonal EUV effect, which is opposite to the trend observed in the Earth's kilometric radiation. A long-term correlation analysis was performed for the SKR, solar EUV flux, and solar wind parameters extrapolated from Earth's orbit by an magnetohydrodynamical simulation focusing on variations on timescales longer than several weeks. We confirmed clear positive correlations between the solar wind dynamic pressure and peak flux density in both the Southern and Northern Hemispheres during the declining phase of the solar cycle. We conclude that the solar wind variations on the timescale of the solar cycle control the SKR source region. In addition, it was also confirmed that the south-to-north ratios of SKR power flux and source altitudes are positively correlated with the solar EUV flux

  10. Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

    PubMed Central

    Saini, M; Dhiman, R; Dada, T; Tandon, R; Vanathi, M

    2015-01-01

    Purpose To evaluate changes in ocular surface and central corneal sub-basal nerve fiber layer (SBNFL) after topical cyclosporin therapy in chronic glaucoma patients on long-term topical antiglaucoma therapy. Methods A prospective comparative study of ocular surface evaluation of chronic glaucoma patients on long-term topical therapy treated concurrently with a topical cyclosporine 0.05% twice daily for 6 months and controls was done. The study parameters evaluated at recruitment and at the 6-month follow-up included details of topical antiglaucoma medications, visual acuity, intraocular pressure, ocular surface evaluation parameters (TBUT, Schirmers I, ocular surface staining scores and ocular surface disease (OSD) index score (OSDI)), central corneal sensation (Cochet Bonnett aesthesiometer), and central confocal microscopy to study the SBNFL density (SBNFLD). Results Thirty-two eyes of 16 patients with chronic glaucoma and 30 eyes of 15 normal subjects as controls were studied. Mean TBUT, pre/post CsA treatment was 8.67±3.01/12.24±1.83 s (P=0.007). Mean conjunctival/corneal staining scores pre/post CsA treatment were 3.38±1.93/1.50±0.718 (P=0.00) /5.19±1.82/1.81±0.78 (P=0.098), respectively. Mean OSDI pre/post CsA treatment scores were 30.63±14.61/14.76±6.06 (P=0.007). Mean corneal sensations scores pre/post CsA treatment were 4.64±0.46/4.94±0.39 (P=0.002). Central corneal SBNFLD pre and post CsA treatment was 8811.35±2985.29/10335.13±4092.064 μm/mm2 (P=0.0001). Conclusions Schirmer's test, ocular surface staining scores, OSDI, corneal sensations, and corneal SBNFLD showed a statistically significant improvement following a 6-month concurrent topical CsA therapy. PMID:25857609

  11. HadISD: a quality controlled global synoptic report database for selected variables at long-term stations from 1973-2010

    NASA Astrophysics Data System (ADS)

    Dunn, R. J. H.; Willett, K. M.; Thorne, P. W.; Woolley, E. V.; Durre, I.; Dai, A.; Parker, D. E.; Vose, R. S.

    2012-05-01

    This paper describes the creation of HadISD; an automatically quality-controlled synoptic resolution dataset of temperature, dewpoint temperature, sea-level pressure, wind speed, wind direction and cloud cover from global weather stations for 1973-2010. The full dataset consists of over 6000 stations, with 3375 long-term stations deemed to have sufficient sampling and quality for climate applications requiring sub-daily resolution. As with other surface datasets, coverage is heavily skewed towards Northern Hemisphere mid-latitudes. The dataset is constructed from a large pre-existing ASCII flatfile data bank that represents over a decade of substantial effort at data retrieval, reformatting and provision. The work proceeded in several steps: merging stations with multiple reporting identifiers; reformatting to netcdf; quality control; and then filtering to form a final dataset. Particular attention has been paid to maintaining true extreme values where possible within an automated objective process. Detailed validation has been performed on a subset of global stations and also on UK data using known extreme events to help finalise the QC tests. Further validation was performed on a selection of extreme events world-wide (Hurricane Katrina in 2005, the cold snap in Alaska in 1989 and heat waves in SE Australia in 2009). Some very initial analyses are performed to illustrate some of the types of problems to which the final data could be applied. Although the filtering has removed the poorest station records, no attempt has been made to homogenise the data thus far, due to the complexity of retaining the true distribution of high-resolution data when applying adjustments. Hence non-climatic, time-varying errors may still exist in many of the individual station records and care is needed in inferring long-term trends from these data. This dataset will allow the study of high frequency variations of temperature, pressure and humidity on a global basis over the last four

  12. Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate: nationwide cohort and nested case-control study

    PubMed Central

    Abrahamsen, Bo; Eiken, Pia; Eastell, Richard

    2016-01-01

    Objectives To determine the skeletal safety and efficacy of long term (≥10 years) alendronate use in patients with osteoporosis. Design Open register based cohort study containing two nested case control studies. Setting Nationwide study of population of Denmark. Participants 61 990 men and women aged 50-94 at the start of treatment, who had not previously taken alendronate, 1996-2007. Interventions Treatment with alendronate. Main outcome measures Incident fracture of the subtrochanteric femur or femoral shaft (ST/FS) or the hip. Non-fracture controls from the cohort were matched to fracture cases by sex, year of birth, and year of initiation of alendronate treatment. Conditional logistic regression models were fitted to calculate odds ratios with and without adjustment for comorbidity and comedications. Sensitivity analyses investigated subsequent treatment with other drugs for osteoporosis. Results 1428 participants sustained a ST/FS (incidence rate 3.4/1000 person years, 95% confidence interval 3.2 to 3.6), and 6784 sustained a hip fracture (16.2/1000 person years, 15.8 to 16.6). The risk of ST/FS was lower with high adherence to treatment with alendronate (medication possession ratio (MPR, a proxy for compliance) >80%) compared with poor adherence (MPR <50%; odds ratio 0.88, 0.77 to 0.99; P=0.05). Multivariable adjustment attenuated this association (adjusted odds ratio 0.88, 0.77 to 1.01; P=0.08). The risk was no higher in long term users (≥10 dose years; 0.70, 0.44 to 1.11; P=0.13) or in current compared with past users (0.91, 0.79 to 1.06; P=0.22). Similarly, MPR >80% was associated with a decreased risk of hip fracture (0.73, 0.68 to 0.78; P<0.001) as was longer term cumulative use for 5-10 dose years (0.74, 0.67 to 0.83; P<0.001) or ≥10 dose years (0.74, 0.56 to 0.97; P=0.03). Conclusions These findings support an acceptable balance between benefit and risk with treatment with alendronate in terms of fracture outcomes, even for over 10

  13. Long-term symptomatic control of Zenker diverticulum by flexible endoscopic mucomyotomy with the hook knife and predisposing factors for clinical recurrence.

    PubMed

    Brueckner, Juliane; Schneider, Annette; Messmann, Helmut; Gölder, Stefan Karl

    2016-06-01

    Objective Flexible endoscopic treatment for Zenker diverticulum (ZD) is well established. Although recurrence of symptoms is relatively frequent, it has hardly been studied. In the present study, we analyse the long-term development of ZD patients' symptoms after successful endoscopic mucomyotomy, as well as interventional safety, sustainability of success, and predisposing factors for clinical recurrence. Methods Forty-six consecutive patients (54% male, mean age 67 years) with symptomatic ZD were treated using a hook knife and soft diverticuloscope. Follow-up interviews at 1 and 6 months inquired about a broad pool of symptoms and the dysphagia score. For further analysis, patients were retrospectively stratified into a 'recurrence' and 'no recurrence' group. Results After 100% initial success, 30% of patients reported recurrence of symptoms after 4.4 months (range 1-40) and were re-treated (mean 1.39 sessions/patient). Though the 'recurrence' group showed a higher dysphagia score and frequency past intervention, endoscopic re-treatment achieved equally good results as in the 'no recurrence' group. Before treatment, 'recurrence' patients had more severe symptoms, such as vomiting (frequency score 2.13 vs. 0.92; p < 0.05), ZD-related insomnia (1.65 vs. 1.08, n.s.), and a higher dysphagia score (2.25 vs. 1.59, n.s.). Also, the 'recurrence' group had larger diverticula, more men, slightly younger age and a longer duration of symptoms. Conclusions Endoscopic treatment of ZD with hook knife and soft diverticuloscope is safe and effective. Despite considerable clinical recurrence, re-treatment achieved a long-lasting freedom of symptoms. Male patients with a high dysphagia score and severe symptoms were more likely to experience recurrence. PMID:26807604

  14. Strategies for evaluating the environment-public health interaction of long-term latency disease: the quandary of the inconclusive case-control study.

    PubMed

    Pleil, Joachim D; Sobus, Jon R; Sheppard, Paul R; Ridenour, Gary; Witten, Mark L

    2012-04-01

    Environmental links to disease are difficult to uncover because environmental exposures are variable in time and space, contaminants occur in complex mixtures, and many diseases have a long time delay between exposure and onset. Furthermore, individuals in a population have different activity patterns (e.g., hobbies, jobs, and interests), and different genetic susceptibilities to disease. As such, there are many potential confounding factors to obscure the reasons that one individual gets sick and another remains healthy. An important method for deducing environmental associations with disease outbreak is the retrospective case-control study wherein the affected and control subject cohorts are studied to see what is different about their previous exposure history. Despite success with infectious diseases (e.g., food poisoning, and flu), case-control studies of cancer clusters rarely have an unambiguous outcome. This is attributed to the complexity of disease progression and the long-term latency between exposure and disease onset. In this article, we consider strategies for investigating cancer clusters and make some observations for improving statistical power through broader non-parametric approaches wherein sub-populations (i.e., whole towns), rather than individuals, are treated as the cases and controls, and the associated cancer rates are treated as the dependent variable. We subsequently present some ecological data for tungsten and cobalt from studies by University of Arizona researchers who document elevated levels of tungsten and cobalt in Fallon, NV. These results serve as candidates for future hybrid ecologic case-control investigations of childhood leukemia clusters. PMID:21382361

  15. Vegetation Control in the Long-term Self-stabilisation of the Liangzhou Oasis of the Upper Shiyang River Watershed of West-central Gansu, NW China

    NASA Astrophysics Data System (ADS)

    Bourque, Charles; Hassan, Quazi

    2010-05-01

    Oases are special ecological systems that naturally oppose the encroachment of deserts by staying moist. Oases provide important habitat refugia for plants, animals, and humans alike. Oases in NW China account for only about 5% of the total land area of the region, but give shelter and feed about 95% of the area's growing population. It has been proposed by many scientists and observers of desertification in NW China that rapid economic development in the area is largely unsustainable and is occurring at the very detriment of the oases. This presentation explores the relationship between vegetation in the Liangzhou Oasis in the Upper Shiyang River Watershed (USRW) of west-central Gansu, China, and within-watershed precipitation, soil water storage, and oasis self-support. Oases along the base of the Qilian Mountains receive a significant portion of their water supply (> 90%) from surface and subsurface flow originating from the Qilian Mountains. Investigation of vegetation control on oasis-water conditions in the USRW is based on an application of a process model of soil-water hydrology. The model is used to simulate long-term soil water content in the Liangzhou Oasis as a function of (i) monthly composites of MODIS images of land surface and mean air temperature, (ii) spatiotemporal calculations of monthly precipitation and relative humidity generated with the assistance of genetic algorithms, and (iii) an 80-m resolution digital elevation model of the area. Modelled removal of vegetation is shown to affect within-watershed precipitation and soil water storage by reducing the exchange of water vapour from the land surface to the air, increasing the air's lifting condensation level by promoting drier air conditions, and causing the high-intensity precipitation band in the Qilian Mountains to weaken and to be displaced upward in the watershed, leading to an overall reduction in soil water in the Liangzhou Oasis. Feedback mechanisms of oasis self-support introduced

  16. Preferential flow paths in paraglacial catchments: first order controls on the long-term stability of 'biodiversity hotspots' in a changing climate

    NASA Astrophysics Data System (ADS)

    Grocott, Michael; Kettridge, Nick; Bradley, Chris; Milner, Alexander

    2016-04-01

    PFPs are a fundamental first order control upon the occurrence of 'biodiversity hotspots' within paraglacial floodplains, and highlights their role as an important conduit for hillslope-floodplain connectivity. Given the expected changes in the hydrological dynamics of paraglacial catchments this research raises questions about the long-term stability of GW-fed streams, and whether the increasing relative importance of groundwater sources (e.g. from colluvium) can sustain flow of GW-fed streams. In addition glacial retreat and associated long-term declines in sediment yields could have negative implications for the development and renewal of PFPs across paraglacial floodplains, which would be detrimental to the persistence of 'biodiversity hotspots'.

  17. Difference of Ecosystem and Hydrological control on Long-term water quality between adjacent subcatchments in a forested catchment in central Japan

    NASA Astrophysics Data System (ADS)

    Katsuyama, M.; Iwasaki, K.; Nagano, R.; Takaki, K.; Tanaka, Y.

    2014-12-01

    We have been monitoring the water quality in the Kiryu Experimental Watershed (KEW; 5.99 ha), Japan, and four subcatchments for more than 20 years. The climate of KEW is warm temperate. The artificially planted Japanese Cypress around 1960 covers whole of the KEW. The geology of KEW is weathered granite. The concentrations of SiO2 and Na, which are mainly supplied from weathering processes, in streamwater were different between the catchments, and the difference was controlled by hydrological conditions in each catchment; in the catchment where shallow groundwater contribution to the streamflow is large, the concentrations were lower. Conversely, in the catchment where deep, bedrock groundwater contribution is large, these concentrations were higher. The K+ concentration which cycles between soil and plants showed clear seasonal variations and the differences between the catchments were small. Considering the long-term trend of streamwater chemistry, the electric conductivity (EC), Cl-, and SO42- concentrations have been gradually decreasing during recent 10 years in all catchments. On the other hand, the NO3- concentration has been commonly increasing in recent 5 years in all catchment. The difference of concentrations between the catchments were depending on the difference of the redox condition caused by soil sediment. One of the subcatchments experienced the disturbance in early 90's and subsequent increase of NO3- concentration, and the residence tine distribution shows the effects of the disturbance is still remaining. Recently, the disturbance is expanding in another subcatchment, and one of the reason of the disturbance is soil erosion. Moreover, the streamwater NO3- concentrations are also gradually increasing even in undisturbed catchments. These facts imply that this 50-year-old unmanaged artificial forest may start degrading, and the biogeochemical cycle may start changing. The long-term dynamics of streamwater chemistry is a good diagnosis tool of the

  18. Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: Controlled before and after study

    PubMed Central

    de Lusignan, Simon; Chan, Tom; Tejerina Arreal, Maria C.; Parry, Glenys; Dent-Brown, Kim; Kendrick, Tony

    2013-01-01

    Background Referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in people with long term conditions (LTCs) is not known. Method Routinely collected primary care, psychological therapy clinic and hospital data were extracted for the registered population of 20 practices (N = 121199). These data were linked using the SAPREL (Secure and Private Record Linkage) method. We linked the 1118 people referred to psychological therapies with 6711 controls, matched for age, gender and practice. We compared utilisation of healthcare resources by people with LTCs, 6 months before and after referral, and conducted a controlled before and after study to compare health utilisation with controls. We made the assumption that collection of a greater number of repeat prescriptions for antidepressants was associated with greater adherence. Results Overall 21.8% of people with an LTC had CMHP vs. 18.8% without (p < 0.001). People with LTCs before referral were more likely to use health care resources (2-tailed t-test p < 0.001). Cases with LTCs showed referral to the psychological therapies clinic was associated with increased antidepressant medication prescribing (mean differences 0.62, p < 0.001) and less use of emergency department than controls (mean difference −0.21, p = 0.003). Conclusions Referral to improved access to psychological therapies (IAPT) services appears of value to people with LTC. It is associated with the issue of a greater number of prescriptions for anti-depressant medicines and less use of emergency services. Further studies are needed to explore bed occupancy and outpatient attendance. PMID:23639304

  19. Imatinib for highly chemoresistant Kaposi sarcoma in a patient with long-term HIV control: a case report and literature review.

    PubMed

    Cao, W; Vyboh, K; Routy, B; Chababi-Atallah, M; Lemire, B; Routy, J P

    2015-10-01

    Kaposi sarcoma (ks) is a vascular tumour caused by oncogenic human herpesvirus type 8; it often occurs with hiv-associated immunosuppression. Numerous cellular signalling pathways are involved in the pathogenesis of ks, among which receptor tyrosine kinases such as the c-Kit and platelet-derived growth factor receptors play an important role. Imatinib mesylate, a tyrosine kinase inhibitor, has resulted in partial regression of ks lesions in one third of treated patients, but its mechanism of action remains unclear. Here, we report the case of a white man with recurrent ks despite well-suppressed hiv infection and multiple chemotherapies who received imatinib and showed a complete and sustained tumour response. To our knowledge, this report is the first showing the value of imatinib in the management of ks in the context of long-lasting hiv control with adequate quantitative CD4 recovery. Our case indicates that imatinib can be a treatment option for highly chemoresistant recurrent ks in patients on long-term antiretroviral therapy. PMID:26628884

  20. Translational control of mGluR-dependent long-term depression and object-place learning by eIF2α

    PubMed Central

    Viana Di Prisco, Gonzalo; Huang, Wei; Buffington, Shelly A; Hsu, Chih-Chun; Bonnen, Penelope E; Placzek, Andon N; Sidrauski, Carmela; Krnjević, Krešimir; Kaufman, Randal J; Walter, Peter; Costa-Mattioli, Mauro

    2015-01-01

    At hippocampal synapses, activation of group I metabotropic glutamate receptors (mGluRs) induces long-term depression (LTD), which requires new protein synthesis. However, the underlying mechanism remains elusive. Here we describe the translational program that underlies mGluR-LTD and identify the translation factor eIF2α as its master effector. Genetically reducing eIF2α phosphorylation, or specifically blocking the translation controlled by eIF2α phosphorylation, prevented mGluR-LTD and the internalization of surface AMPA receptors (AMPARs). Conversely, direct phosphorylation of eIF2α, bypassing mGluR activation, triggered a sustained LTD and removal of surface AMPARs. Combining polysome profiling and RNA sequencing, we identified the mRNAs translationally upregulated during mGluR-LTD. Translation of one of these mRNAs, oligophrenin-1, mediates the LTD induced by eIF2α phosphorylation. Mice deficient in phospho-eIF2α–mediated translation are impaired in object-place learning, a behavioral task that induces hippocampal mGluR-LTD in vivo. Our findings identify a new model of mGluR-LTD, which promises to be of value in the treatment of mGluR-LTD-linked cognitive disorders. PMID:24974795

  1. Imatinib for highly chemoresistant Kaposi sarcoma in a patient with long-term HIV control: a case report and literature review

    PubMed Central

    Cao, W.; Vyboh, K.; Routy, B.; Chababi-Atallah, M.; Lemire, B.; Routy, J.P.

    2015-01-01

    Kaposi sarcoma (ks) is a vascular tumour caused by oncogenic human herpesvirus type 8; it often occurs with hiv-associated immunosuppression. Numerous cellular signalling pathways are involved in the pathogenesis of ks, among which receptor tyrosine kinases such as the c-Kit and platelet-derived growth factor receptors play an important role. Imatinib mesylate, a tyrosine kinase inhibitor, has resulted in partial regression of ks lesions in one third of treated patients, but its mechanism of action remains unclear. Here, we report the case of a white man with recurrent ks despite well-suppressed hiv infection and multiple chemotherapies who received imatinib and showed a complete and sustained tumour response. To our knowledge, this report is the first showing the value of imatinib in the management of ks in the context of long-lasting hiv control with adequate quantitative CD4 recovery. Our case indicates that imatinib can be a treatment option for highly chemoresistant recurrent ks in patients on long-term antiretroviral therapy. PMID:26628884

  2. The 'dark' side of the Greenland Ice Sheet: 2009 updated long term melting trends, remotely controlled boats on supraglacial lakes and cryokonite holes.

    NASA Astrophysics Data System (ADS)

    Tedesco, Marco

    2010-05-01

    In this talk I will report recent results from different projects concerning melting over the Greenland Ice Sheet.

In particular, I will focus on three aspects: first, I will show results updating the long-term melting trends (1979 - 2009) derived with spaceborne satellite data will discuss the 2009 melting season. 
Second, I will present results of an experiment aiming at improving the monitoring of supraglacial lakes from visible and near-infrared satellite data and will present seasonal trends of these surface features. At the beginning of July 2009, we collected lake depth data and satellites-like data to evaluate satellites products used to study supraglacial lakes and improve monitoring techniques. We used a remotely controlled boat equipped with a GPS, fishfinder, spectrometer and microcomputer to collect these data. 
Third, while on the ice sheet, we also collected samples of cryoconite (that dark powdered material responsible for dark holes in the ice). I will report the results of preliminary analysis of this material by using Scanning Electronic Microscopy (SEM, for analyzing the composition) and a spectrometer (to characterize the visible and near-infrared properties). 

The following people contributed to the results here reported: Nick Steiner (CUNY), M. Jenkins (National Geographic), X. Fettweis (University of Liege), Adam Lewinter and James Balog (Extreme Ice Survey), Gina Stovall and Gordon Green (CCNY).
The World Wildlife Foundation (WWF) and Martin Sommerkorn are deeply acknowledged for the financial support provided for the experiment.

  3. The ‘dark’ side of the Greenland Ice Sheet: 2009 updated long term melting trends, remotely controlled boats on supraglacial lakes and cryokonite holes. (Invited)

    NASA Astrophysics Data System (ADS)

    Tedesco, M.

    2009-12-01

    In this talk I will report recent results from different projects concerning melting over the Greenland Ice Sheet. In particular, I will focus on three aspects: first, I will show results updating the long-term melting trends (1979 - 2009) derived with spaceborne satellite data will discuss the 2009 melting season. Second, I will present results of an experiment aiming at improving the monitoring of supraglacial lakes from visible and near-infrared satellite data and will present seasonal trends of these surface features. At the beginning of July 2009, we collected lake depth data and satellites-like data to evaluate satellites products used to study supraglacial lakes and improve monitoring techniques. We used a remotely controlled boat equipped with a GPS, fishfinder, spectrometer and microcomputer to collect these data. Third, while on the ice sheet, we also collected samples of cryoconite (that dark powdered material responsible for dark holes in the ice). I will report the results of preliminary analysis of this material by using Scanning Electronic Microscopy (SEM, for analyzing the composition) and a spectrometer (to characterize the visible and near-infrared properties). The following people contributed to the results of the different projects here reported: Nick Steiner (CUNY), M. Jenkins (National Geographic), X. Fettweis (University of Liege), Adam Lewinter and James Balog (Extreme Ice Survey), Gina Stovall and Gordon Green (CCNY). The World Wildlife Foundation (WWF) and Martin Sommerkorn are deeply acknowledged for the financial support provided for the experiment.

  4. Does Maintenance CBT Contribute to Long-Term Treatment Response of Panic Disorder With or Without Agoraphobia? A Randomized Controlled Clinical Trial

    PubMed Central

    White, Kamila S.; Payne, Laura A.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.; Saksa, John R.; Barlow, David H.

    2012-01-01

    Objective To examine the possibility that maintenance cognitive behavior therapy (M–CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. Method Participants were all patients (N = 379) who first began an open trial of acute-phase CBT. Patients completing and responding to acute-phase treatment were randomized to receive either nine monthly sessions of M-CBT (n = 79) or assessment only (n = 78) and were then followed for an additional 12 months without treatment. Results M–CBT produced significantly lower relapse rates (5.2%) and reduced work and social impairment compared to the assessment only condition (18.4%) at a 21-month follow-up (MFU). Multivariate Cox proportional hazards models showed that residual symptoms of agoraphobia at the end of acute-phase treatment were independently predictive of time to relapse during 21-MFU (HR = 1.15, p < .01). Conclusions M–CBT aimed at reinforcing acute treatment gains to prevent relapse and offset disorder recurrence may improve long-term outcome in PD/A. PMID:23127290

  5. Sustained treatment effect in attention-deficit/hyperactivity disorder: focus on long-term placebo-controlled randomized maintenance withdrawal and open-label studies

    PubMed Central

    Goodman, David W

    2013-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves “well,” and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued long-term ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary. PMID:23576871

  6. Stability, Survival, and Tolerability of an Auditory Osseointegrated Implant for Bone Conduction Hearing: Long-Term Follow-Up of a Randomized Controlled Trial

    PubMed Central

    den Besten, Christine A.; Stalfors, Joacim; Wigren, Stina; Blechert, Johan Ivarsson; Flynn, Mark; Eeg-Olofsson, Måns; Aggarwal, Rohini; Green, Kevin; Nelissen, Rik C.; Mylanus, Emmanuel A. M.; Hol, Myrthe K. S.

    2016-01-01

    Objective: To compare implant stability, survival, and soft tissue reactions for a novel (test) and previous generation (control) percutaneous auditory osseointegrated implant for bone conduction hearing at long-term follow-up of 5 years. Study Design: Single follow-up visit of a previously completed multicenter, randomized, controlled trial. Patients: Fifty-seven of the 77 participants of a completed randomized controlled trial on a new auditory osseointegrated implant underwent a single follow-up visit 5 years after implantation, which comprised implant stability measurements and collection of Holgers scores. Additionally, implant survival was recorded for all 77 patients from the original trial. Results: The test implant showed significantly higher implant stability quotient (ISQ) values compared with the control implant throughout the 5-year follow-up. Mean area under the curve of ISQ high from baseline to 5 years was 71.6 (standard deviation [SD] ±2.0) and 66.7 (SD ±3.4) for the test and control implant, respectively (p < 0.0001). For both implants, the mean ISQ value recorded at 5 years was higher compared with implantation (test group +2.03 [SD ±2.55, within group p < 0.0001] and control group +2.25 [SD ±4.95, within group p = 0.12]). No difference was noticed in increase from baseline between groups (p = 0.64). Furthermore, evaluation of soft tissue reactions continued to show superiority of the test implant. At the 5-year follow-up visit, one patient (2.5%) presented with a Holgers grade 2 in the test group, compared with four patients (23.5%) in the control group (p = 0.048); no patient presented with more severe soft tissue reactions. Excluding explantations, the survival rate was 95.8% for the test group and 95.0% for the control group. The corresponding rates including explantations were 93.9 and 90.0%. Conclusion: The test implant showed superiority in terms of higher mean ISQ values and less adverse soft tissue reactions, both

  7. Long Term Illness and Wages

    ERIC Educational Resources Information Center

    Sandy, Robert; Elliott, Robert R.

    2005-01-01

    Long-term illness (LTI) is a more prevalent workplace risk than fatal accidents but there is virtually no evidence for compensating differentials for a broad measure of LTI. In 1990 almost 3.4 percent of the U.K. adult population suffered from a LTI caused solely by their working conditions. This paper provides the first estimates of compensating…

  8. Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

    PubMed Central

    Moy, Marilyn L; Martinez, Carlos H; Kadri, Reema; Roman, Pia; Holleman, Robert G; Kim, Hyungjin Myra; Nguyen, Huong Q; Cohen, Miriam D; Goodrich, David E; Giardino, Nicholas D

    2016-01-01

    Background Regular physical activity (PA) is recommended for persons with chronic obstructive pulmonary disease (COPD). Interventions that promote PA and sustain long-term adherence to PA are needed. Objective We examined the effects of an Internet-mediated, pedometer-based walking intervention, called Taking Healthy Steps, at 12 months. Methods Veterans with COPD (N=239) were randomized in a 2:1 ratio to the intervention or wait-list control. During the first 4 months, participants in the intervention group were instructed to wear the pedometer every day, upload daily step counts at least once a week, and were provided access to a website with four key components: individualized goal setting, iterative feedback, educational and motivational content, and an online community forum. The subsequent 8-month maintenance phase was the same except that participants no longer received new educational content. Participants randomized to the wait-list control group were instructed to wear the pedometer, but they did not receive step-count goals or instructions to increase PA. The primary outcome was health-related quality of life (HRQL) assessed by the St George’s Respiratory Questionnaire Total Score (SGRQ-TS); the secondary outcome was daily step count. Linear mixed-effect models assessed the effect of intervention over time. One participant was excluded from the analysis because he was an outlier. Within the intervention group, we assessed pedometer adherence and website engagement by examining percent of days with valid step-count data, number of log-ins to the website each month, use of the online community forum, and responses to a structured survey. Results Participants were 93.7% male (223/238) with a mean age of 67 (SD 9) years. At 12 months, there were no significant between-group differences in SGRQ-TS or daily step count. Between-group difference in daily step count was maximal and statistically significant at month 4 (P<.001), but approached zero in months 8

  9. Hyperbaric Oxygen Treatment of Chronic Refractory Radiation Proctitis: A Randomized and Controlled Double-Blind Crossover Trial With Long-Term Follow-Up

    SciTech Connect

    Clarke, Richard E. Tenorio, L. M. Catalina; Hussey, James R.; Toklu, Akin S.; Cone, D. Lindsie; Hinojosa, Jose G.; Desai, Samir P.; Dominguez Parra, Luis; Rodrigues, Sylvia D.; Long, Robert J.; Walker, Margaret B.

    2008-09-01

    Purpose: Cancer patients who undergo radiotherapy remain at life-long risk of radiation-induced injury to normal tissues. We conducted a randomized, controlled, double-blind crossover trial with long-term follow-up to evaluate the effectiveness of hyperbaric oxygen for refractory radiation proctitis. Methods and Materials: Patients with refractory radiation proctitis were randomized to hyperbaric oxygen at 2.0 atmospheres absolute (Group 1) or air at 1.1 atmospheres absolute (Group 2). The sham patients were subsequently crossed to Group 1. All patients were re-evaluated by an investigator who was unaware of the treatment allocation at 3 and 6 months and Years 1-5. The primary outcome measures were the late effects normal tissue-subjective, objective, management, analytic (SOMA-LENT) score and standardized clinical assessment. The secondary outcome was the change in quality of life. Results: Of 226 patients assessed, 150 were entered in the study and 120 were evaluable. After the initial allocation, the mean SOMA-LENT score improved in both groups. For Group 1, the mean was lower (p 0.0150) and the amount of improvement nearly twice as great (5.00 vs. 2.61, p = 0.0019). Similarly, Group 1 had a greater portion of responders per clinical assessment than did Group 2 (88.9% vs. 62.5%, respectively; p 0.0009). Significance improved when the data were analyzed from an intention to treat perspective (p = 0.0006). Group 1 had a better result in the quality of life bowel bother subscale. These differences were abolished after the crossover. Conclusion: Hyperbaric oxygen therapy significantly improved the healing responses in patients with refractory radiation proctitis, generating an absolute risk reduction of 32% (number needed to treat of 3) between the groups after the initial allocation. Other medical management requirements were discontinued, and advanced interventions were largely avoided. Enhanced bowel-specific quality of life resulted.

  10. Mesotherapy with an Intradermal Hyaluronic Acid Formulation for Skin Rejuvenation: An Intrapatient, Placebo-Controlled, Long-Term Trial Using High-Frequency Ultrasound.

    PubMed

    Tedeschi, Aurora; Lacarrubba, Francesco; Micali, Giuseppe

    2015-02-01

    Mesotherapy with hyaluronic acid (HA) is a treatment approach currently used for skin rejuvenation. High-frequency ultrasound (20-100 MHz) is a non-invasive technique that has been used to evaluate age-related dermal changes. The presence and the degree of a typical subepidermal low-echogenic band (SLEB) are photoaging related: the lower the SLEB echogenicity, the higher the photoaging. The aim of this trial was to evaluate, through ultrasound imaging, the long-term effects of microinjections of HA on SLEB echogenicity. Twenty-two women with clinical and ultrasound signs of moderate photoaging were enrolled in the study. Treatment consisted of multiple microinjections of HA salts of biotechnological origin on the dorsum of one hand, once weekly for 4 weeks and, successively, once monthly for 4 months (group A) or 9 months (group B). The dorsum of the other hand of each subject was injected with saline solution and used as a control. In all subjects, high-frequency ultrasound (22 MHz) was performed to evaluate SLEB echogenicity changes during treatment. Eighteen out of 22 patients completed the study. At the end of 4 weeks, an ultrasound increase of dermal echogenicity was observed in 13 subjects (seven of group A and six of group B), which we considered as "responders". In these patients, the Student's t-test showed a significant increase from baseline of SLEB pixel numbers of +24 % (P < 0.01) versus +6 % with placebo. In the same subjects, after an additional 4 months of monthly injections, the mean increase was +18 % (P < 0.05) versus +4 % with placebo. In patients from group B that completed 10 months of treatment, the increase from baseline of SLEB pixel numbers was +18 % (P < 0.05) versus 0 % with placebo. Our study suggests that mesotherapy with HA may effectively improve skin aging and photoaging, as supported by quantifiable ultrasound data showing significant changes in SLEB density over time. PMID:25539986

  11. A Meta-Analysis of Randomized Controlled Trials to Compare Long-Term Outcomes of Nissen and Toupet Fundoplication for Gastroesophageal Reflux Disease

    PubMed Central

    Zhang, Wei; Jiang, Dao-zhen; Qiu, Ming

    2015-01-01

    Aim In recent years, several studies with large sample sizes and recent follow-up data have been published comparing outcomes between laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication. It is now timely to be re-evaluated and synthesized long-term efficacy and adverse events of both total and partial posterior fundoplication. Materials and Methods Electronic searches for RCTs comparing the outcome after laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication were performed in the databases of MEDLINE, EMBASE, and the Cochrane Center Register of Controlled Trials. The data of evaluation in positive and adverse results of laparoscopic Nissen fundoplication and laparoscopic Nissen fundoplication were extracted and compared using meta-analysis. Results 13 RCTs were ultimately identified involving 814 (52.05%) and 750 (47.95%) patients who underwent laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication, respectively. The operative time, perioperative complications, postoperative satisfaction, recurrence, and the rates of medication adoption or re-operation due to recurrence were not significantly different between two groups. The two types of fundoplication both reinforced the anti-reflux barrier and elevated the lower esophageal sphincter pressure. However, rates of adverse results involving dysphasia, gas-bloat syndrome, inability to belch and re-operation due to severe dysphasia were significantly higher after LNF. In the subgroup analysis of wrap length≤2cm, laparoscopic Nissen fundoplication was associated with a significantly higher incidence of postoperative dysphagia. However, in the subgroup wrap length>2cm, the difference was not statistically significant. Conclusion Laparoscopic Toupet fundoplication might be the better surgery approach for gastroesophageal reflux disease with a lower rate of postoperative adverse results and equal effectiveness as Laparoscopic Nissen fundoplication. PMID:26121646

  12. Efficacy of long-term milnacipran treatment in patients meeting different thresholds of clinically relevant pain relief: subgroup analysis of a randomized, double-blind, placebo-controlled withdrawal study

    PubMed Central

    Mease, Philip J; Clauw, Daniel J; Trugman, Joel M; Palmer, Robert H; Wang, Yong

    2014-01-01

    Background Fibromyalgia patients from a long-term, open-label study of milnacipran (50–200 mg/day) were eligible to participate in a 12-week, randomized, placebo-controlled withdrawal study. The withdrawal study evaluated loss of therapeutic response in patients who achieved ≥50% pain improvements after receiving up to 3.25 years of milnacipran. This post-hoc analysis investigated whether patients who met lower thresholds of pain improvement also experienced worsening of fibromyalgia symptoms upon treatment withdrawal. Method Among patients who received milnacipran ≥100 mg/day during the long-term study, three subgroups were identified based on percentage of pain reduction at randomization: ≥50% (protocol-defined “responders”; n=150); ≥30% to <50% (patients with clinically meaningful pain improvement; n=61); and <30% (n=110). Efficacy assessments included the visual analog scale (VAS) for pain, Fibromyalgia Impact Questionnaire-Revised (FIQR), 36-Item Short-Form Health Survey Physical Component Summary (SF-36 PCS), and Beck Depression Inventory (BDI). Results In the ≥30 to <50% subgroup, significant worsening in pain was detected after treatment withdrawal. The difference between placebo and milnacipran in mean VAS score changes for this subgroup (+9.0, P<0.05) was similar to the difference in protocol-defined responders (+9.4, P<0.05). In the <30% subgroup, no worsening in pain was observed in either treatment arm. However, patients in this subgroup experienced significant worsening in FIQR scores after treatment withdrawal (placebo, +6.9; milnacipran, −2.8; P<0.001), as well as worsening in SF-36 PCS and BDI scores. Conclusion Patients who experienced ≥30% to <50% pain reduction with long-term milnacipran had significant worsening of fibromyalgia symptoms after treatment withdrawal. These results suggest that the conventional ≥30% pain responder cutoff may be adequate to demonstrate efficacy in randomized withdrawal studies of fibromyalgia

  13. Long-term Effects of Two Levels of Caloric Restriction on Body Composition, and Diet Satisfaction in CALERIE, a One Year Randomized Controlled Trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is little information on whether the extent of dietary energy restriction in a weight loss program influences long-term weight change. We examined the effects of two levels of caloric restriction (CR) over 12 months on body weight and fat loss, total energy expenditure (TEE), resting metabolic...

  14. Draft Genome Sequence of Pseudomonas sp. Strain 2-92, a Biological Control Strain Isolated from a Field Plot Under Long-Term Mineral Fertilization

    PubMed Central

    Adam, Zaky; Chen, Qing; Lewis, Christopher T.; Lévesque, C. André; Xu, Renlin

    2014-01-01

    Pseudomonas sp. strain 2-92, isolated from a Canadian field plot under long-term mineral fertilization, strongly inhibits the growth of Fusarium graminearum, Rhizoctonia solani, and Gaeumannomyces graminis. Here, we report the draft genome sequence of Pseudomonas sp. strain 2-92. PMID:24407636

  15. Long-term moderate calorie restriction inhibits inflammation without impairing cell-mediated immunity: a randomized controlled trial in non obese humans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Calorie restriction (CR) inhibits inflammation and slows aging in many animal species, but in rodents housed in pathogen-free facilities, CR impairs immunity against certain pathogens. However, little is known about the effects of long-term moderate CR on immune function in humans. In this multi-cen...

  16. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial

    PubMed Central

    de Jager, Jolien; Kooy, Adriaan; Lehert, Philippe; Wulffelé, Michiel G; van der Kolk, Jan; Bets, Daniël; Verburg, Joop; Donker, Ab J M

    2010-01-01

    with vitamin B-12 deficiency; P=0.005 compared with low vitamin B-12) for patients with a normal vitamin B-12 concentration (>220 pmol/l). Conclusions Long term treatment with metformin increases the risk of vitamin B-12 deficiency, which results in raised homocysteine concentrations. Vitamin B-12 deficiency is preventable; therefore, our findings suggest that regular measurement of vitamin B-12 concentrations during long term metformin treatment should be strongly considered. Trial registration Clinicaltrials.gov NCT00375388. PMID:20488910

  17. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials

    PubMed Central

    Dombrowski, S U; Knittle, K; Avenell, A; Araújo-Soares, V

    2014-01-01

    Objective To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. Design Systematic review with meta-analysis. Data sources Medline, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials. Study selection Studies were identified through to January 2014. Randomised trials of interventions to maintain weight loss provided to initially obese adults (aged ≥18) after weight loss of ≥5% body weight with long term (≥12 months) follow-up of weight change (main outcome) were included. Study appraisal and synthesis Potential studies were screened independently and in duplicate; study characteristics and outcomes were extracted. Meta-analyses were conducted to estimate the effects of interventions on weight loss maintenance with the inverse variance method and a random effects model. Results are presented as mean differences in weight change, with 95% confidence intervals. Results 45 trials involving 7788 individuals were included. Behavioural interventions focusing on both food intake and physical activity resulted in an average difference of −1.56 kg (95% confidence interval −2.27 to −0.86 kg; 25 comparisons, 2949 participants) in weight regain compared with controls at 12 months. Orlistat combined with behavioural interventions resulted in a −1.80 kg (−2.54 to −1.06; eight comparisons, 1738 participants) difference compared with placebo at 12 months. All orlistat studies reported higher frequencies of adverse gastrointestinal events in the experimental compared with placebo control groups. A dose-response relation for orlistat treatment was found, with 120 mg doses three times a day leading to greater weight loss maintenance (−2.34 kg, −3.03 to −1.65) compared with 60 mg and 30 mg three times a day (−0.70 kg, 95% confidence interval −1.92 to 0.52), P=0.02. Conclusions Behavioural

  18. Long-term data archiving

    SciTech Connect

    Moore, David Steven

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  19. Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer: A comprehensive systematic review and meta-analysis of randomized control trials.

    PubMed

    Lu, Wei; Gao, Jian; Yang, Jingyun; Zhang, Yijian; Lv, Wenjie; Mu, Jiasheng; Dong, Ping; Liu, Yingbin

    2016-07-01

    The objective of this study was to compare long-term surgical outcomes and complications of laparoscopy-assisted distal gastrectomy (LADG) with open distal gastrectomy (ODG) for the treatment of early gastric cancer (EGC) based on a review of available randomized controlled trials (RCTs) evaluated using the Cochrane methodology.RCTs comparing LADG and ODG were identified by a systematic literature search in PubMed, Cochrane Library, MEDLINE, EMBASE, Scopus, and the China Knowledge Resource Integrated Database, for papers published from January 1, 2003 to July 30, 2015. Meta-analyses were performed to compare the long-term clinical outcomes.Our systematic literature search identified 8 eligible RCTs including 732 patients (374 LADGs and 358 ODGs), with low overall risk of bias. Long-term mortality and relapse rate were comparable for both techniques. The long-term complication rate was 8.47% in LADG groups and 13.62% in the ODG group, indicating that LADG was associated with lower risk for long-term complications (RR = 0.63; 95%CI = 0.39-1.00; P = 0.03).In the treatment of EGC, LADG lowered the rate of long- and short-term complications and promoted earlier recovery, with comparable oncological outcomes to ODG. PMID:27399073

  20. Understanding controls on organic (Uk’37 and TEX86) and inorganic (Mg/Ca) SST proxies: insights from a long term Mozambique Channel sediment trap study

    NASA Astrophysics Data System (ADS)

    Castañeda, I. S.; Fallet, U.; Brummer, G. A.; Sinninghe Damsté, J. S.; Schouten, S.

    2009-12-01

    In 2003, an array of moorings equipped with instruments to measure temperature, salinity and water mass transport was placed across the Mozambique Channel as part of the Long-term Ocean Currents Observation (LOCO) Project. In addition, a sediment trap in the deep channel at 2011 m collected material at 21 day intervals from November 2003 until the present. These sediment trap samples, in combination with in situ and satellite-derived SST measurements, provide a unique opportunity to examine and directly compare organic and inorganic SST proxies. In this study we measured two organic SST proxies, the Uk’37 Index, which is based on the ratio of long-chain di- and triunsaturated ketones produced by haptophyte algae, and the more recently developed TEX86 proxy, which is based on glycerol dialkyl glycerol tetraethers (GDGTs) produced by Marine Group 1 Crenarchaeota. We also analyzed Mg/Ca ratios from two species of surface-dwelling foraminifera, G. ruber and G. trilobus, which provide an inorganic SST proxy. The results obtained up to now show that TEX86-based SST reconstructions capture the mean annual temperature of the study location accurately (mean annual SST is 28.1°C and TEX86 mean annual SST is 28.3°C); however, seasonal variability is not reflected by the TEX86 measurements. In contrast, the Mg/Ca records of G. ruber and G. trilobus, capture the seasonal variability in SST but display a slight offset relative to each other, with G. ruber typically 2 to 3°C warmer than G. trilobus. The Uk’37 Index was nearly always near unity due to the absence of the C37:3 alkenone, showing that this proxy is unable to capture SST at this tropical location. The differences between the organic and inorganic proxies might be due to the different sinking rates and lateral transport effects. To further investigate controls on the TEX86 proxy, we are currently examining intact polar lipids (IPLs) of GDGTs from the most recent year of sediment trap material. IPLs are more

  1. Incidental biasing of attention from visual long-term memory.

    PubMed

    Fan, Judith E; Turk-Browne, Nicholas B

    2016-06-01

    Holding recently experienced information in mind can help us achieve our current goals. However, such immediate and direct forms of guidance from working memory are less helpful over extended delays or when other related information in long-term memory is useful for reaching these goals. Here we show that information that was encoded in the past but is no longer present or relevant to the task also guides attention. We examined this by associating multiple unique features with novel shapes in visual long-term memory (VLTM), and subsequently testing how memories for these objects biased the deployment of attention. In Experiment 1, VLTM for associated features guided visual search for the shapes, even when these features had never been task-relevant. In Experiment 2, associated features captured attention when presented in isolation during a secondary task that was completely unrelated to the shapes. These findings suggest that long-term memory enables a durable and automatic type of memory-based attentional control. (PsycINFO Database Record PMID:26618914

  2. Rethinking Controls on the Long-Term Cenozoic Carbonate Compensation Depth: Case Studies across Late Paleocene - Early Eocene Warming and Late Eocene - Early Oligocene Cooling

    NASA Astrophysics Data System (ADS)

    Greene, S. E.; Ridgwell, A. J.; Schmidt, D. N.; Kirtland Turner, S.; Paelike, H.; Thomas, E.

    2014-12-01

    The carbonate compensation depth (CCD) is the depth below which negligible calcium carbonate is preserved in marine sediments. The long-term position of the CCD is often considered to be a powerful constraint on palaeoclimate and atmospheric CO2 concentration due to the requirement that carbonate burial balance riverine weathering over long timescales. The requirement that weathering and burial be in balance is clear, but it is less certain that burial compensates for changes in weathering via shoaling or deepening of the CCD. Because most carbonate burial occurs well above the CCD , changes in weathering fluxes may be primarily accommodated by increasing or decreasing carbonate burial at shallower depths, i.e., at or near the lysocline, the depth range over which carbonate dissolution markedly increases. Indeed, recent earth system modelling studies have suggested that the position of the CCD is relatively insensitive to changes in atmospheric pCO2. Additionally, studies have questioned the nature and strength of the relationship between the CCD, carbonate saturation state in the water column, and lysocline. To test the relationship between palaeoclimate and the location of the CCD, we reconstructed the global, long-term CCD behaviour across major Cenozoic climate transitions: the late Paleocene - early Eocene long-term warming trend (study interval ~58 to 49 Ma) and the late Eocene - early Oligocene cooling and glaciation (study interval ~38 to 27 Ma). We use Earth system modelling (GENIE) to explore the links between atmospheric pCO2 and the CCD, isolating and teasing apart the roles of total dissolved inorganic carbon, temperature, circulation, and productivity in determining the CCD.

  3. Long-Term Survival and Dialysis Dependency Following Acute Kidney Injury in Intensive Care: Extended Follow-up of a Randomized Controlled Trial

    PubMed Central

    Gallagher, Martin; Cass, Alan; Bellomo, Rinaldo; Finfer, Simon; Gattas, David; Lee, Joanne; Lo, Serigne; McGuinness, Shay; Myburgh, John; Parke, Rachael; Rajbhandari, Dorrilyn

    2014-01-01

    Background The incidence of acute kidney injury (AKI) is increasing globally and it is much more common than end-stage kidney disease. AKI is associated with high mortality and cost of hospitalisation. Studies of treatments to reduce this high mortality have used differing renal replacement therapy (RRT) modalities and have not shown improvement in the short term. The reported long-term outcomes of AKI are variable and the effect of differing RRT modalities upon them is not clear. We used the prolonged follow-up of a large clinical trial to prospectively examine the long-term outcomes and effect of RRT dosing in patients with AKI. Methods and Findings We extended the follow-up of participants in the Randomised Evaluation of Normal vs. Augmented Levels of RRT (RENAL) study from 90 days to 4 years after randomization. Primary and secondary outcomes were mortality and requirement for maintenance dialysis, respectively, assessed in 1,464 (97%) patients at a median of 43.9 months (interquartile range [IQR] 30.0–48.6 months) post randomization. A total of 468/743 (63%) and 444/721 (62%) patients died in the lower and higher intensity groups, respectively (risk ratio [RR] 1.04, 95% CI 0.96–1.12, p = 0.49). Amongst survivors to day 90, 21 of 411 (5.1%) and 23 of 399 (5.8%) in the respective groups were treated with maintenance dialysis (RR 1.12, 95% CI 0.63–2.00, p = 0.69). The prevalence of albuminuria among survivors was 40% and 44%, respectively (p = 0.48). Quality of life was not different between the two treatment groups. The generalizability of these findings to other populations with AKI requires further exploration. Conclusions Patients with AKI requiring RRT in intensive care have high long-term mortality but few require maintenance dialysis. Long-term survivors have a heavy burden of proteinuria. Increased intensity of RRT does not reduce mortality or subsequent treatment with dialysis. Trial registration www.ClinicalTrials.gov NCT00221013

  4. SOME ASPECTS OF THE NATURAL CONTROL OF PLANT PARASITIC NEMATODES IN SOIL UNDER BROAD BEAN VICIA FABA L. CULTIVATED IN CROP ROTATION AND LONG-TERM MONOCULTURE.

    PubMed

    Skwiercz, A T; Damszel, M; Stefanovska, T; Rychcik, B

    2015-01-01

    Observations on population density of plant parasitic nematodes occurring in rhizosphere of broad bean cultivated in the crop rotation and long-term monoculture were performed during 2013-2014. 13 species were observed: Trichodorus primitivus, T. viruliferus, Paratrichodorus pachydermus, Criconema annuliferum, Paratylenchus projectus, Bitylenchus dubius, Merlinius brevidens, Pratylenchus fallax, P. flakkensis, P. neglectus, Heterodera triffolii, H. goettingiana, and Ditylenchus dipsaci. In monoculture plots 70-80% of eggs inside Heterodera cysts were colonized by pathogenic fungi (v.s. 50-62% of cysts from crop rotation). 12-18% of specimens of Pratylenchus species were colonized by the nematode-pathogenic bacteria: Bacillus penetrans. PMID:27145570

  5. Long-term moderate calorie restriction inhibits inflammation without impairing cell-mediated immunity: a randomized controlled trial in non-obese humans

    PubMed Central

    Meydani, Simin N.; Das, Sai K.; Pieper, Carl F.; Lewis, Michael R.; Klein, Sam; Dixit, Vishwa D.; Gupta, Alok K.; Villareal, Dennis T.; Bhapkar, Manjushri; Huang, Megan; Fuss, Paul J.; Roberts, Susan B.; Holloszy, John O.; Fontana, Luigi

    2016-01-01

    Calorie restriction (CR) inhibits inflammation and slows aging in many animal species, but in rodents housed in pathogen-free facilities, CR impairs immunity against certain pathogens. However, little is known about the effects of long-term moderate CR on immune function in humans. In this multi-center, randomized clinical trial to determine CR's effect on inflammation and cell-mediated immunity, 218 healthy non-obese adults (20-50 y), were assigned 25% CR (n=143) or an ad-libitum (AL) diet (n=75), and outcomes tested at baseline, 12, and 24 months of CR. CR induced a 10.4% weight loss over the 2-y period. Relative to AL group, CR reduced circulating inflammatory markers, including total WBC and lymphocyte counts, ICAM-1 and leptin. Serum CRP and TNF-α concentrations were about 40% and 50% lower in CR group, respectively. CR had no effect on the delayed-type hypersensitivity skin response or antibody response to vaccines, nor did it cause difference in clinically significant infections. In conclusion, long-term moderate CR without malnutrition induces a significant and persistent inhibition of inflammation without impairing key in vivo indicators of cell-mediated immunity. Given the established role of these pro-inflammatory molecules in the pathogenesis of multiple chronic diseases, these CR-induced adaptations suggest a shift toward a healthy phenotype. PMID:27410480

  6. Prediction of Long-Term Benefits of Inhaled Steroids by Phenotypic Markers in Moderate-to-Severe COPD: A Randomized Controlled Trial

    PubMed Central

    Snoeck-Stroband, Jiska B.; Lapperre, Therese S.; Sterk, Peter J.; Hiemstra, Pieter S.; Thiadens, Henk A.; Boezen, H. Marike; ten Hacken, Nick H. T.; Kerstjens, Huib A. M.; Postma, Dirkje S.; Timens, Wim; Sont, Jacob K.

    2015-01-01

    Background The decline in lung function can be reduced by long-term inhaled corticosteroid (ICS) treatment in subsets of patients with chronic obstructive pulmonary disease (COPD). We aimed to identify which clinical, physiological and non-invasive inflammatory characteristics predict the benefits of ICS on lung function decline in COPD. Methods Analysis was performed in 50 steroid-naive compliant patients with moderate to severe COPD (postbronchodilator forced expiratory volume in one second (FEV1), 30–80% of predicted, compatible with GOLD stages II-III), age 45–75 years, >10 packyears smoking and without asthma. Patients were treated with fluticasone propionate (500 μg bid) or placebo for 2.5 years. Postbronchodilator FEV1, dyspnea and health status were measured every 3 months; lung volumes, airway hyperresponsiveness (PC20), and induced sputum at 0, 6 and 30 months. A linear mixed effect model was used for analysis of this hypothesis generating study. Results Significant predictors of attenuated FEV1-decline by fluticasone treatment compared to placebo were: fewer packyears smoking, preserved diffusion capacity, limited hyperinflation and lower inflammatory cell counts in induced sputum (p<0.04). Conclusions Long-term benefits of ICS on lung function decline in patients with moderate-to-severe COPD are most pronounced in patients with fewer packyears, and less severe emphysema and inflammation. These data generate novel hypotheses on phenotype-driven therapy in COPD. Trial Registration ClinicalTrials.gov NCT00158847 PMID:26659582

  7. Strategies to retain participants in a long-term HIV prevention randomized controlled trial: lessons from the MINTS-II study.

    PubMed

    Horvath, Keith J; Nygaard, Kate; Danilenko, Gene P; Goknur, Sinan; Oakes, J Michael; Rosser, B R Simon

    2012-02-01

    Achieving satisfactory retention in online HIV prevention trials typically has proven difficult, particularly over extended timeframes. The overall aim of this study was to assess factors associated with retention in the Men's INTernet Study II (MINTS-II), a randomized controlled trial of a sexual risk reduction intervention for men who have sex with men. Participants were recruited via e-mails and banner advertisements in December, 2007 to participate in the MINTS-II Sexpulse intervention and followed over a 12-month period. Retention across the treatment and control arms was 85.2% at 12 months. Factors associated with higher retention included: randomization to the control arm, previous participation in a study by the research team, e-mail and telephone reminders to complete a survey once it was available online, and fewer e-mail contacts between surveys. The results provide evidence that achieving satisfactory retention is possible in online HIV prevention trials, and suggest best practices for maximizing retention. PMID:21538084

  8. Strategies to retain participants in a long-term HIV prevention randomized controlled trial: Lessons from the MINTS-II study

    PubMed Central

    Horvath, Keith J.; Nygaard, Kate; Danilenko, Gene P.; Goknur, Sinan; Oakes, J. Michael; Rosser, B.R. Simon

    2012-01-01

    Achieving satisfactory retention in online HIV prevention trials typically have proved difficult, particularly over extended timeframes. The overall aim of this study was to assess factors associated with retention in the Men’s INTernet Study II (MINTS-II), a randomized controlled trial of a sexual risk reduction intervention for men who have sex with men. Participants were recruited via e-mails and banner advertisements in December, 2007 to participate in the MINTS-II Sexpulse intervention and followed over a 12-month period. Retention across the treatment and control arms was 85.2% at 12 months. Factors associated with higher retention included: randomization to the control arm, previous participation in a study by the research team, e-mail and telephone reminders to complete a survey once it was available to take, and fewer e-mail contacts between surveys. The results provide evidence that achieving satisfactory retention is possible in online HIV prevention trials, and suggest best practices for maximizing retention. PMID:21538084

  9. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  10. Acute, short- and long-term efficacy of oral bevantolol in patients with coronary artery disease: a placebo-controlled, randomized, double-blind study.

    PubMed

    Gimeno, J V; Ferrer, J; Olague, J; Bordes, P; Serra, J; Estruch, G; Mainer, V; Algarra, F J

    1986-09-01

    The efficacy and safety of bevantolol (new cardioselective beta-blocking agent without intrinsic sympathetic activity) were evaluated in chronic stable angina pectoris. Acute effects on heart rate (HR) and pulmonary function (forced expiratory volume in the first second, FEV1, and vital capacity, VC) (double-blind placebo, propranolol, 80 mg, and bevantolol, 150 mg) and the antianginal efficacy during early (double-blind placebo period) and chronic bevantolol therapy (long-term follow-up for 52 weeks) were studied. Bevantolol reduces HR in the same way as propranolol (both p less than 0.01). Pulmonary function is modified significantly only by propranolol (decreasing FEV1, p less than 0.05). Bevantolol reduces antianginal attacks and nitroglycerin consumption (p less than 0.01) and improves exercise tolerance (p less than 0.01) during early and chronic therapy. PMID:3530572

  11. Long-term agroecosystem research in the central Mississippi river basin: hydrogeologic controls and crop management influence on nitrates in loess and fractured glacial till.

    PubMed

    Kitchen, Newell R; Blanchard, Paul E; Lerch, Robert N

    2015-01-01

    Nitrogen from agriculture is known to be a primary source of groundwater NO-N. Research was conducted in a northeastern Missouri watershed to assess the impact of cropping systems on NO-N for a loess and fractured glacial till aquifer underlying claypan soils. Three cropped fields with 10 yr of similar management were each instrumented with 20 to 25 monitoring wells, 3 to 15 m in depth, in 1991 to 1992. Wells were sampled and analyzed for NO-N at least annually from 1991 to 2004. Initial NO-N concentrations were variable, ranging from undetectable to >24 mg L but averaged 7.0 mg L. Groundwater NO-N was significantly higher in Field 3, probably the result of concurrent applications of manure and N fertilizer before 1980. Overall changes in NO-N levels in Fields 1 and 2 were generally small; however, NO-N levels for Field 3 have decreased an average of 0.28 mg L yr. Excessive loading of N into the matrix of the glacial till may have had a long-term impact on NO-N for this field. Despite the presence of dissolved O in the aquifer, evidence of denitrification in some upper-landscape groundwater wells was found. The greatest decreases in NO-N concentration occurred as groundwater moved through an in-field tree line or through a riparian zone. While overall conclusions were complicated by the long-term impact of past management, the capacity of the till to buffer changes, hydrogeologic variability found among wells, and the activity of biological processes, we conclude that cropping practices during this study did not increase glacial till NO-N. PMID:25602321

  12. [Long-term treatment with amiodarone].

    PubMed

    Baedeker, W; Goedel-Meinen, L; Schmidt, G; Hofmann, M; Barthel, P; Blömer, H

    1991-02-01

    The aim of this study was to investigate the efficacy and the side effects of a long-term treatment with amiodarone. We analyzed the data of 41 patients in whom amiodarone therapy had been initiated between 1974 and 1984. Twenty-one patients had dilative cardiomyopathy, 14 patients had chronic myocardial infarction, four patients suffered from WPW syndrome with intermittent atrial fibrillation, one patient had aortic valve surgery, whereas in one patient there was no clinical evidence of a heart disease. All patients had salvos of ventricular extrasystoles, ventricular tachycardia or documented intermittent ventricular fibrillation. There have been seven drop-outs up to the present time. In each patient, the lowest antiarrhythmically effective dose was applied, which was generally higher in patients with low ejection fraction. Effective treatment of the ventricular tachycardia was achieved in 55-92% of patients and did not depend on the duration of treatment. In 10 patients in whom amiodarone therapy had to be stopped for various reasons. Sudden cardiac death was slightly more frequent than in the 24 patients treated with amiodarone, though the difference was not significant. In cases with a history of syncope the prognosis was poor, even with amiodarone therapy. Due to side effects, a dosage reduction or discontinuation of amiodarone treatment became necessary in 14 patients. Amiodarone proved to be an effective drug also for the long-term treatment of ventricular tachycardia, and possibly for the prevention of sudden cardiac death. With the exception of blue skin color, there was no accumulation of side effects, even during long-term treatment of several years. PMID:1711739

  13. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)

    Schmitt, Raymond W.; Brown, Neil L.

    2005-01-01

    Our long-term goal is to establish a reliable system for monitoring surface salinity around the global ocean. Salinity is a strong indicator of the freshwater cycle and has a great influence on upper ocean stratification. Global salinity measurements have potential to improve climate forecasts if an observation system can be developed. This project is developing a new internal field conductivity cell that can be protected from biological fouling for two years. Combined with a temperature sensor, this foul-proof cell can be deployed widely on surface drifters. A reliable in-situ network of surface salinity sensors will be an important adjunct to the salinity sensing satellite AQUARIUS to be deployed by NASA in 2009. A new internal-field conductivity cell has been developed by N Brown, along with new electronics. This sensor system has been combined with a temperature sensor to make a conductivity - temperature (UT) sensor suitable for deployment on drifters. The basic sensor concepts have been proven on a high resolution CTD. A simpler (lower cost) circuit has been built for this application. A protection mechanism for the conductivity cell that includes antifouling protection has also been designed and built. Mr. A.Walsh of our commercial partner E-Paint has designed and delivered time-release formulations of antifoulants for our application. Mr. G. Williams of partner Clearwater Instrumentation advised on power and communication issues and supplied surface drifters for testing.

  14. Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial

    SciTech Connect

    Spiliopoulos, Stavros Katsanos, Konstantinos; Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Kagadis, George C.; Christeas, Nikolaos; Siablis, Dimitris

    2010-10-15

    The purpose of this study was to investigate the immediate and long-term results of cryoplasty versus conventional balloon angioplasty in the femoropopliteal artery of diabetic patients. Fifty diabetic patients (41 men, mean age 68 years) were randomized to cryoplasty (group CRYO; 24 patients with 31 lesions) or conventional balloon angioplasty (group COBA; 26 patients with 34 lesions) of the femoropopliteal artery. Technical success was defined as <30% residual stenosis without any adjunctive stenting. Primary end points included technical success, primary patency, binary in-lesion restenosis (>50%), and freedom from target lesion recanalization. Cox proportional hazards regression analysis was performed to adjust for confounding factors of heterogeneity. In total, 61.3% (19 of 31) in group CRYO and 52.9% (18 of 34) in group COBA were de novo lesions. More than 70% of the lesions were Transatlantic Inter-Society Consensus (TASC) B and C in both groups, and 41.4% of the patients in group CRYO and 38.7% in group COBA suffered from critical limb ischemia. Immediate technical success rate was 58.0% in group CRYO versus 64.0% in group COBA (p = 0.29). According to 3-year Kaplan-Meier estimates, there were no significant differences with regard to patient survival (86.8% in group CRYO vs. 87.0% in group COBA, p = 0.54) and limb salvage (95.8 vs. 92.1% in groups CRYO and COBA, respectively, p = 0.60). There was a nonsignificant trend of increased binary restenosis in group CRYO (hazard ratio [HR] 1.3; 95% CI 0.6-2.6, p = 0.45). Primary patency was significantly lower in group CRYO compared with group COBA (HR 2.2; 95% CI 1.1-4.3, p = 0.02). Significantly more repeat intervention events because of recurrent symptoms were required in group CRYO (HR 2.5; 95% CI 1.2-5.3, p = 0.01). Cryoplasty was associated with lower primary patency and more clinically driven repeat procedures after long-term follow-up compared with conventional balloon angioplasty.

  15. Controlled formation of heterotypic hepatic micro-organoids in anisotropic hydrogel microfibers for long-term preservation of liver-specific functions.

    PubMed

    Yamada, Masumi; Utoh, Rie; Ohashi, Kazuo; Tatsumi, Kohei; Yamato, Masayuki; Okano, Teruo; Seki, Minoru

    2012-11-01

    We have developed a hydrogel-based cell cultivation platform for forming 3D restiform hepatic micro-organoids consisting of primary rat hepatocytes and feeder cells (Swiss 3T3 cells). Sodium alginate solutions containing hepatocytes/3T3 cells were continuously introduced into a microfluidic channel to produce cell-incorporating anisotropic Ba-alginate hydrogel microfibers, where hepatocytes at the center were closely sandwiched by 3T3 cells. Hydrogel fiber-based cultivation under high oxygen tension enabled the formation of heterotypic micro-organoids with a length of up to 1 mm and a diameter of ∼50 μm, mimicking the hepatic cord structures found in the liver, while maintaining a high hepatocyte viability (∼80%) over 30 days. Long-term observation of up to 90 days revealed a significant enhancement of hepatic functions because of heterotypic and homotypic cell-cell interactions, including albumin secretion and urea synthesis as well as expression of hepatocyte-specific genes, compared with conventional monolayer culture and single cultivation in the hydrogel fibers. The encapsulated hepatic constructs were recovered as scaffold-free micro-organoids by enzymatically digesting the hydrogel matrices using alginate lyase. This technique for creating heterotypic micro-organoids with precisely ordered multiple cell types will be useful for the development of a new liver tissue engineering approach and may be applicable to the fabrication of extracorporeal bioartificial liver (BAL) devices and assessment tools for drug development and testing. PMID:22906609

  16. A Cross-model Comparison of Global Long-term Technology Diffusion under a 2°C Climate Change Control Target

    SciTech Connect

    van der Zwaan, Bob; Rosler, Hilke; Kober, Tom; Aboumahboub, Tino; Calvin, Katherine V.; Gernaat, David; Marangoni, Giacomo; McCollum, David

    2013-11-04

    We investigate the long-term global energy technology diffusion patterns required to reach a stringent climate change target with a maximum average atmospheric temperature increase of 2°C. If the anthropogenic temperature increase is to be limited to 2°C, total CO2 emissions have to be reduced massively, so as to reach substantial negative values during the second half of the century. Particularly power sector CO2 emissions should become negative from around 2050 onwards according to most models used for this analysis in order to compensate for GHG emissions in other sectors where abatement is more costly. The annual additional capacity deployment intensity (expressed in GW/yr) for solar and wind energy until 2030 needs to be around that recently observed for coal-based power plants, and will have to be several times higher in the period 2030–2050. Relatively high agreement exists across models in terms of the aggregated low-carbon energy system cost requirements on the supply side until 2050, which amount to about 50 trillion US$.

  17. Long-term effects of gastrectomy in patients with spirometry-defined COPD and patients at risk of COPD: a case-control study

    PubMed Central

    Saito, Hitoshi; Nomura, Koichiro; Abe, Shinji; Motegi, Takashi; Ishii, Takeo; Hattori, Kumiko; Kusunoki, Yuji; Gemma, Akihiko; Kida, Kozui

    2015-01-01

    Objective Comorbidities are characteristic of COPD. However, little is known about the secondary manifestations of COPD in the gastrointestinal tract. Therefore, we aimed to explore the long-term effects of gastrectomy in patients with spirometry-defined COPD or those at risk of COPD. Participants Subjects included 87 patients either with COPD or at risk of COPD (symptomatic) who underwent gastrectomy between December 2003 and October 2013 (group A), and 174 patients either with COPD or at risk of COPD, matched by age (±5 years), sex, and forced expiratory volume in 1 second (FEV1) as percentage of predicted (FEV1% predicted) (±5%) (group B). Methods All patients underwent routine blood chemistry and pulmonary function tests, arterial blood gas analysis, 6-minute walk test (6MWT), high-resolution chest computed tomography scans, and nutritional assessments. Results The mean duration postgastrectomy was 18.3±15.4 years. The mean FEV1 and FEV1% predicted were 2.07±0.76 L and 74.6±24.5%, respectively. Univariate analysis indicated that group A patients had significantly lower body mass index, fat-free mass index, and serum hemoglobin and albumin concentration (all P=0.00), and walked a significantly shorter distance in the 6MWT (P<0.05). Multivariate linear regression analysis for the distance in the 6MWT indicated that increased residual volume (RV) to total lung capacity (TLC) as percentage of predicted (%RV/TLC) alone was an independent and significant predictor of reduced distances in the 6MWT. Conclusion We concluded that nutritional insufficiency in patients with COPD (or those at risk of COPD) who previously underwent gastrectomy might lead to hyperinflation and consequently, decreased exercise capacity. PMID:26604730

  18. OSLER and ODYSSEY LONG TERM: PCSK9 inhibitors on the right track of reducing cardiovascular events

    PubMed Central

    Hassan, Mohamed

    2015-01-01

    Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors have emerged as a novel treatment option in patients with hypercholesterolemia. Evolocumab and alirocumab have achieved consistent and significant (around 60%) reduction in low-density lipoprotein cholesterol (LDL-C) levels when added to statin therapy in short term studies. The Open-Label Study of Long-term Evaluation Against LDL-C (OSLER), and The Long-term Safety and Tolerability of Alirocumab in High Cardiovascular Risk Patients with Hypercholesterolemia Not Adequately Controlled with Their Lipid Modifying Therapy (ODYSSEY LONG TERM) studies are two phase 3, multicentre, randomized, placebo controlled studies that were conducted to evaluate the long term efficacy and safety of evolocumab and alirocumab respectively in reducing lipids and cardiovascular (CV) events. Both studies demonstrated additional 48–53% reduction of CV events when added to statin therapy. Most adverse events occurred with similar frequency in the two groups; however the rate of neurocognitive adverse events was higher with evolocumab and alirocumab than with placebo. These data provide strong support for the notion that lower LDL-C goal is better, and may confirm the role of PCSK9 inhibitors as a new frontier in lipid management. The results of larger long-term outcome studies are still awaited. PMID:26566525

  19. New insights into the evaluation of randomized controlled trials for rare diseases over a long-term research horizon: a simulation study.

    PubMed

    Bayar, Mohamed Amine; Le Teuff, Gwénaël; Michiels, Stefan; Sargent, Daniel J; Le Deley, Marie-Cécile

    2016-08-30

    Large sample sizes are required in randomized clinical trials designed to meet typical one-sided 2.5% α-level and 80% power. This may not be achievable when the disease is rare. We simulated a series of two-arm superiority trials over a 15-year period. The design parameters examined were the α-level and the number of trials conducted over the 15-year period (thus, trial sample size). Different disease severities and accrual rates were considered. The future treatment effect was characterized by its associated hazard rate; different hypotheses of how treatments improve over time were considered. We defined the total survival benefit as the relative difference of the hazard rates at year 15 versus year 0. The optimal design was defined by maximizing the expected total survival benefit, provided that the risk of selecting at year 15 a treatment inferior to the initial control treatment remains below 1%. Compared with two larger trials with typical one-sided 2.5% α-level, performing a series of small trials with relaxed α-levels leads on average to larger survival benefits over a 15-year research horizon, but also to higher risk of selecting a worse treatment at the end of the research period. Under reasonably optimistic assumptions regarding the future treatment effects, optimal designs outperform traditional ones when the disease is severe (baseline median survival ≤ 1 year) and the accrual is ≥100 patients per year, whereas no major improvement is observed in diseases with better prognosis. Trial designs aiming to maximize survival gain over a long research horizon across a series of trials are worth discussing in the context of rare diseases. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27027783

  20. Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: a randomized controlled trial

    PubMed Central

    2011-01-01

    Background The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA), diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD). Methods In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed. Results The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02) and fruit intake (β 1.7, 95%CI 0.6; 2.9) at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2). The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7), but not at 12 months (OR 0.8, 95%CI 0.4; 1.6). Conclusions Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among male construction

  1. Long-Term Effect of Fault-Controlled CO2 Alteration on the Weakening and Strengthening of Reservoir and Seal Lithologies at Crystal Geyser, Green River, Utah

    NASA Astrophysics Data System (ADS)

    Major, J. R.; Eichhubl, P.; Dewers, T. A.

    2014-12-01

    An understanding of the coupled chemical and mechanical properties and behavior of reservoir and seal rocks is critical for assessing both the short and long term security of sequestered CO2. A combined structural diagenesis approach using observations from natural analogs has great advantages for understanding these properties over longer time scales than is possible using laboratory or numerical experiments. Current numerical models evaluating failure of reservoirs and seals during and after CO2 injection in the subsurface are just beginning to account for such coupled processes. Well-characterized field studies of natural analogs such as Crystal Geyser, Utah, are essential for providing realistic input parameters, calibration, and testing of numerical models across a range of spatial and temporal scales. Fracture mechanics testing was performed on a suite of naturally altered and unaltered reservoir and seal rocks exposed at the Crystal Geyser field site. These samples represent end-products of CO2-related alteration over geologic (>103 yr) time scales. Both the double torsion and short rod test methods yield comparable results on the same samples. Tests demonstrate that CO2-related alteration has weakened one reservoir sandstone lithology by approximately 50%, but the subcritical index is not significantly affected. An altered siltstone sample also shows a reduction in fracture toughness values and lowered subcritical index in comparison to unaltered siltstone. In contrast, elevated calcite content in shales due to CO2 alteration has increased fracture toughness. Similarly, fracture toughness was increased in what is otherwise a weak, poorly cemented sandstone unit due to increased calcite cement. Combined, these results demonstrate that CO2-related alteration generally weakens rock to fracturing (i.e. lowers fracture toughness), except in cases where calcite cementation is significantly increased. The natural system at Crystal Geyser demonstrates that water

  2. Long-term controls of soil organic carbon with depth and time: a case study from the Cowlitz River Chronosequence, WA USA

    USGS Publications Warehouse

    Lawrence, Corey R.; Harden, Jennifer W.; Xu, Xiaomei; Schulz, Marjorie S.; Trumbore, Susan E.

    2015-01-01

    Over timescales of soil development (millennia), the capacity of soils to stabilize soil organic carbon (SOC) is linked to soil development through changes in soil mineralogy and other soil properties. In this study, an extensive dataset of soil profile chemistry and mineralogy is compiled from the Cowlitz River Chronosequence (CRC), WA USA. The CRC soils range in age from 0.25 to 1200 kyr, spanning a developmental gradient encompassing clear changes in soil mineralogy, chemistry, and surface area. Comparison of these and other metrics of soil development with SOC properties reveal several relationships that may be diagnostic of the long-term coupling of soil development and C cycling. Specifically, SOC content was significantly correlated with sodium pyrophosphate extractable metals emphasizing the relevance of organo-metal complexes in volcanic soils. The depth distributions of organo-metals and other secondary weathering products, including the kaolin and short-range order (SRO) minerals, support the so-called “binary composition” of volcanic soils. The formation of organo-metal complexes limits the accumulation of secondary minerals in shallow soils, whereas in deep soils with lower SOC content, secondary minerals accumulate. In the CRC soils, secondary minerals formed in deep soils (below 50 cm) including smectite, allophane, Fe-oxides and dominated by the kaolin mineral halloysite. The abundance of halloysite was significantly correlated with bulk soil surface area and 14C content (a proxy for the mean age of SOC), implying enhanced stability of C in deep soils. Allophane, an SRO mineral commonly associated with SOC storage, was not correlated with SOC content or 14C values in CRC soils. We propose conceptual framework to describe these observations based on a general understanding of pedogenesis in volcanic soils, where SOC cycling is coupled with soil development through the formation of and fate of organo-metal or other mobile weathering products

  3. Sleep facilitates long-term face adaptation.

    PubMed

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-10-22

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition. PMID:23986109

  4. Maintaining Engagement in Long-term Interventions with Relational Agents

    PubMed Central

    Bickmore, Timothy; Schulman, Daniel; Yin, Langxuan

    2011-01-01

    We discuss issues in designing virtual humans for applications which require long-term voluntary use, and the problem of maintaining engagement with users over time. Concepts and theories related to engagement from a variety of disciplines are reviewed. We describe a platform for conducting studies into long-term interactions between humans and virtual agents, and present the results of two longitudinal randomized controlled experiments in which the effect of manipulations of agent behavior on user engagement was assessed. PMID:21318052

  5. Long-term solar-terrestrial observations

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

  6. Managing soils for long-term productivity

    PubMed Central

    Syers, J. K.

    1997-01-01

    erosion accentuates the often very low inherent fertility of many soils in the tropics. An integrated approach involving inorganic and organic inputs is required where animal and plant residues are returned, as far as practicable. Chemical fertilizers alone cannot achieve long-term productivity on many soils and organic material inputs are required to maintain soil organic matter levels and crop productivity. A major research effort is required to develop improved strategies for halting and reversing soil degradation if long-term productivity is to be secured.

  7. Comparison of the long-term skeletal stability between a biodegradable and a titanium fixation system following BSSO advancement - a cohort study based on a multicenter randomised controlled trial.

    PubMed

    van Bakelen, N B; Boermans, B D A; Buijs, G J; Jansma, J; Pruim, G J; Hoppenreijs, Th J M; Bergsma, J E; Stegenga, B; Bos, R R M

    2014-10-01

    Biodegradable fixation systems could reduce or eliminate the problems associated with removal of titanium plates. A multicenter randomised controlled trial (RCT) was performed in the Netherlands from December 2006-July 2009, and originally 230 injured and orthognathic patients were included. The patients were randomly assigned to either a titanium control group (KLS Martin) or to a biodegradable test group (Inion CPS). The aim of the present study was to compare the long-term skeletal stability of advancement bilateral sagittal split osteotomies (BSSO) of a biodegradable system and a titanium system. Only patients from the original RCT who were at least 18 years old and who had a BSSO advancement osteotomy were included. Those who had simultaneous Le Fort I osteotomy or genioplasty were excluded. Analysis of skeletal stability was made by digital tracing of lateral cephalograms. Long-term skeletal stability in BSSO advancement did not differ significantly between patients treated with biodegradable plates and screws and those treated with titanium plates and screws. Given the comparable amount of relapse, the general use of Inion CPS in the treatment of BSSO advancement should not be discouraged. On the basis of other properties a total picture of the clinical use can be obtained; the short-term stability, the intraoperative switches, the number of plates removed and cost-effectiveness. Trial registration of original RCT: http://www.controlled-trials.com; ISRCTN 44212338. PMID:25138611

  8. Withdrawal from long-term benzodiazepine treatment.

    PubMed Central

    Petursson, H; Lader, M H

    1981-01-01

    Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety. PMID:6114776

  9. Long-Term Quiescent Fibroblast Cells Transit into Senescence

    PubMed Central

    Marthandan, Shiva; Priebe, Steffen; Hemmerich, Peter; Klement, Karolin; Diekmann, Stephan

    2014-01-01

    Cellular senescence is described to be a consequence of telomere erosion during the replicative life span of primary human cells. Quiescence should therefore not contribute to cellular aging but rather extend lifespan. Here we tested this hypothesis and demonstrate that cultured long-term quiescent human fibroblasts transit into senescence due to similar cellular mechanisms with similar dynamics and with a similar maximum life span as proliferating controls, even under physiological oxygen conditions. Both, long-term quiescent and senescent fibroblasts almost completely fail to undergo apoptosis. The transition of long-term quiescent fibroblasts into senescence is also independent of HES1 which protects short-term quiescent cells from becoming senescent. Most significantly, DNA damage accumulates during senescence as well as during long-term quiescence at physiological oxygen levels. We suggest that telomere-independent, potentially maintenance driven gradual induction of cellular senescence during quiescence is a counterbalance to tumor development. PMID:25531649

  10. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    SciTech Connect

    T. Haney R. VanHorn

    2007-07-31

    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.

  11. LIMS for Lasers 2015 for achieving long-term accuracy and precision of δ2H, δ17O, and δ18O of waters using laser absorption spectrometry

    USGS Publications Warehouse

    Coplen, Tyler B.; Wassenaar, Leonard I

    2015-01-01

    Although laser absorption spectrometry (LAS) instrumentation is easy to use, its incorporation into laboratory operations is not easy, owing to extensive offline manipulation of comma-separated-values files for outlier detection, between-sample memory correction, nonlinearity (δ-variation with water amount) correction, drift correction, normalization to VSMOW-SLAP scales, and difficulty in performing long-term QA/QC audits. METHODS: A Microsoft Access relational-database application, LIMS (Laboratory Information Management System) for Lasers 2015, was developed. It automates LAS data corrections and manages clients, projects, samples, instrument-sample lists, and triple-isotope (δ(17) O, δ(18) O, and δ(2) H values) instrumental data for liquid-water samples. It enables users to (1) graphically evaluate sample injections for variable water yields and high isotope-delta variance; (2) correct for between-sample carryover, instrumental drift, and δ nonlinearity; and (3) normalize final results to VSMOW-SLAP scales. RESULTS: Cost-free LIMS for Lasers 2015 enables users to obtain improved δ(17) O, δ(18) O, and δ(2) H values with liquid-water LAS instruments, even those with under-performing syringes. For example, LAS δ(2) HVSMOW measurements of USGS50 Lake Kyoga (Uganda) water using an under-performing syringe having ±10 % variation in water concentration gave +31.7 ± 1.6 ‰ (2-σ standard deviation), compared with the reference value of +32.8 ± 0.4 ‰, after correction for variation in δ value with water concentration, between-sample memory, and normalization to the VSMOW-SLAP scale. CONCLUSIONS: LIMS for Lasers 2015 enables users to create systematic, well-founded instrument templates, import δ(2) H, δ(17) O, and δ(18) O results, evaluate performance with automatic graphical plots, correct for δ nonlinearity due to variable water concentration, correct for between-sample memory, adjust for drift, perform VSMOW-SLAP normalization, and

  12. METFORMIN: an efficacy, safety and pharmacokinetic study on the short-term and long-term use in obese children and adolescents – study protocol of a randomized controlled study

    PubMed Central

    2014-01-01

    Background The prevalence of childhood obesity and insulin resistance is rising, increasing the risk of diabetes mellitus type 2. To prevent these complications, lifestyle intervention is the corner stone in treatment. However, long-term efficacy of lifestyle intervention is questionable. In addition to lifestyle intervention, pharmacological treatments have been explored. Metformin has been shown to be moderately effective to reduce BMI in obese adolescents with hyperinsulinemia. However, data on pharmacokinetics and long-term efficacy and safety are lacking as well as an evidence-based dosing regimen for this age group. The primary objective of the METFORMIN study is to determine the effect of adding metformin treatment to lifestyle intervention in reducing BMI in obese adolescents with insulin resistance. In addition, the pharmacokinetics of metformin in obese adolescents will be studied. Methods/design The METFORMIN study is a multi-centre prospective study that consists of two 18-month phases: a double-blind randomized placebo-controlled trial (part 1) and an open-label follow-up study (part 2). During part 1, the participants will be given metformin 1,000 mg or placebo twice daily and will be offered a lifestyle intervention programme; 144 participants will be included, 72 in each arm. Primary endpoints are reduction in body mass index, insulin resistance, and percentage body fat. Discussion This study will provide data on short- and long-term efficacy and safety of metformin and on the pharmacokinetics of metformin in obese adolescents. Trial registration ClinicalTrials.gov number NCT01487993; EudraCT nr. 2010-023980-17. Registration date: 06-01-2011 PMID:24899137

  13. Long Term Preservation of Digital Information.

    ERIC Educational Resources Information Center

    Lorie, Raymond A.

    The preservation of digital data for the long term presents a variety of challenges from technical to social and organizational. The technical challenge is to ensure that the information, generated today, can survive long term changes in storage media, devices, and data formats. This paper presents a novel approach to the problem. It distinguishes…

  14. Virtual Models of Long-Term Care

    ERIC Educational Resources Information Center

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  15. Paying for long-term care.

    PubMed Central

    Estes, C L; Bodenheimer, T

    1994-01-01

    Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage. PMID:8128712

  16. Efficacy of a Tailored Tobacco Control Program on Long-Term Use in a Population of U.S. Military Troops

    ERIC Educational Resources Information Center

    Klesges, Robert C.; DeBon, Margaret; Vander Weg, Mark W.; Haddock, C. Keith; Lando, Harry A.; Relyea, George E.; Peterson, Alan L.; Talcott, G. Wayne

    2006-01-01

    The authors evaluated the effect of a brief tailored smoking control intervention delivered during basic military training on tobacco use in a population of military personnel (N = 33,215). Participants were randomized to either a tobacco use intervention (smoking cessation, smokeless tobacco use cessation, or prevention depending on tobacco…

  17. Does Maintenance CBT Contribute to Long-Term Treatment Response of Panic Disorder with or without Agoraphobia? A Randomized Controlled Clinical Trial

    ERIC Educational Resources Information Center

    White, Kamila S.; Payne, Laura A.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.; Saksa, John R.; Barlow, David H.

    2013-01-01

    Objective: We examined the possibility that maintenance cognitive behavior therapy (M-CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. Method: Participants were all patients (N = 379) who…

  18. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    PubMed Central

    Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cataudella, Salvatore; Martini, Nello

    2016-01-01

    Purpose Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Results Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Conclusion Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period

  19. Numerical simulation of gender differences in a long-term microgravity exposure

    NASA Astrophysics Data System (ADS)

    Perez-Poch, Antoni

    The objective of this work is to analyse and simulate gender differences when individuals are exposed to long-term microgravity. Risk probability of a health impairment which may put in jeopardy a long-term mission is also evaluated. Computer simulations are becoming a promising research line of work, as physiological models become more and more sophisticated and reliable. Technological advances in state-of-the-art hardware technology and software allow nowadays for better and more accurate simulations of complex phenomena, such as the response of the human cardiovascular system to long-term exposure to microgravity. Experimental data for long-term missions are difficult to achieve and reproduce, therefore the predictions of computer simulations are of a major importance in this field. Our approach is based on a previous model developed and implemented in our laboratory (NELME: Numerical Evaluation of Long-term Microgravity Effects). The software simulates the behaviour of the cardiovascular system and different human organs, has a modular architecture, and allows to introduce perturbations such as physical exercise or countermeasures. The implementation is based on a complex electricallike model of this control system, using inexpensive software development frameworks, and has been tested and validated with the available experimental data. Gender differences have been implemented for this specific work, as an adjustment of a number of parameters that are included in the model. Women versus men physiological differences have been therefore taken into account, based upon estimations from the physiology bibliography. A number of simulations have been carried out for long-term exposure to microgravity. Gravity varying from Earth-based to zero, and time exposure are the two main variables involved in the construction of results, including responses to patterns of physical aerobical exercise, and also thermal stress simulating an extra-vehicular activity. Results show

  20. Standardized web-based cognitive behavioural therapy of mild to moderate depression: a randomized controlled trial with a long-term follow-up.

    PubMed

    Ruwaard, Jeroen; Schrieken, Bart; Schrijver, Menno; Broeksteeg, Janneke; Dekker, Jack; Vermeulen, Hans; Lange, Alfred

    2009-01-01

    Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-four individuals with chronic, moderate depression participated in a randomized wait-list controlled trial, with an 18-month follow-up (immediate treatment: n = 36, wait-list control: n = 18). Primary outcome measures were the Beck Depression Inventory (BDI-IA) and the Depression scale of the Symptom Checklist-90-Revised (SCL-90-R. DEP). Secondary outcome measures were the Depression Anxiety Stress Scales and the Well-Being Questionnaire. Five participants (9%) dropped out. Intention-to-treat analyses of covariance revealed that participants in the treatment condition improved significantly more than those in the wait-list control condition (.011 < p < .015). With regard to the primary measures, between-group effects (d) were 0.7 for the BDI-IA and 1.1 for the SCL-90-R DEP. Posttest SCL-90- R DEP scores indicated recovery of 49% of the participants in the treatment group compared with 6% in the control group (odds ratio = 14.5; p < .004). On average, the effects were stable up to 18 months (n = 39), although medication was a strong predictor of relapse. The results demonstrate the efficacy of web-CBT for mild to moderate depression and the importance of therapist guidance in psychological interventions. PMID:19221919

  1. Control of radiation and evaporation on temperature variability in a WRF regional climate simulation: comparison with colocated long term ground based observations near Paris

    NASA Astrophysics Data System (ADS)

    Bastin, S.; Chiriaco, M.; Drobinski, P.

    2016-03-01

    The objective of this paper is to understand how large-scale processes, cloud cover and surface fluxes affect the temperature variability over the SIRTA site, near Paris, and in a regional climate simulation performed in the frame of HyMeX/Med-CORDEX programs. This site is located in a climatic transitional area where models usually show strong dispersions despite the significant influence of large scale on interannual variability due to its western location. At seasonal time scale, the temperature is mainly controlled by surface fluxes. In the model, the transition from radiation to soil moisture limited regime occurs earlier than in observations leading to an overestimate of summertime temperature. An overestimate of shortwave radiation (SW), consistent with a lack of low clouds, enhances the soil dryness. A simulation with a wet soil is used to better analyse the relationship between dry soil and clouds but while the wetter soil leads to colder temperature, the cloud cover during daytime is not increased due to the atmospheric stability. At shorter time scales, the control of surface radiation becomes higher. In the simulation, higher temperatures are associated with higher SW. A wet soil mitigates the effect of radiation due to modulation by evaporation. In observations, the variability of clouds and their effect on SW is stronger leading to a nearly constant mean SW when sorted by temperature quantile but a stronger impact of cloud cover on day-to-day temperature variability. Impact of cloud albedo effect on precipitation is also compared.

  2. Simplified continuous simulation model for investigating effects of controlled drainage on long-term soil moisture dynamics with a shallow groundwater table.

    PubMed

    Sun, Huaiwei; Tong, Juxiu; Luo, Wenbing; Wang, Xiugui; Yang, Jinzhong

    2016-08-01

    Accurate modeling of soil water content is required for a reasonable prediction of crop yield and of agrochemical leaching in the field. However, complex mathematical models faced the difficult-to-calibrate parameters and the distinct knowledge between the developers and users. In this study, a deterministic model is presented and is used to investigate the effects of controlled drainage on soil moisture dynamics in a shallow groundwater area. This simplified one-dimensional model is formulated to simulate soil moisture in the field on a daily basis and takes into account only the vertical hydrological processes. A linear assumption is proposed and is used to calculate the capillary rise from the groundwater. The pipe drainage volume is calculated by using a steady-state approximation method and the leakage rate is calculated as a function of soil moisture. The model is successfully calibrated by using field experiment data from four different pipe drainage treatments with several field observations. The model was validated by comparing the simulations with observed soil water content during the experimental seasons. The comparison results demonstrated the robustness and effectiveness of the model in the prediction of average soil moisture values. The input data required to run the model are widely available and can be measured easily in the field. It is observed that controlled drainage results in lower groundwater contribution to the root zone and lower depth of percolation to the groundwater, thus helping in the maintenance of a low level of soil salinity in the root zone. PMID:27126870

  3. Renal histomorphology in dogs with pyometra and control dogs, and long term clinical outcome with respect to signs of kidney disease

    PubMed Central

    Heiene, Reidun; Kristiansen, Veronica; Teige, Jon; Jansen, Johan Høgset

    2007-01-01

    Background Age-related changes in renal histomorphology are described, while the presence of glomerulonephritis in dogs with pyometra is controversial in current literature. Methods Dogs with pyometra were examined retrospectively for evidence of secondary renal damage and persisting renal disease through two retrospective studies. In Study 1, light microscopic lesions of renal tissue were graded and compared in nineteen dogs with pyometra and thirteen age-matched control bitches. In Study 2, forty-one owners of dogs with pyometra were interviewed approximately 8 years after surgery for evidence ofclinical signs of renal failure in order to document causes of death/euthanasia. Results Interstitial inflammation and tubular atrophy were more pronounced in dogs with pyometra than in the control animals. Glomerular lesions classified as glomerular sclerosis were present in both groups. No unequivocal light microscopic features of glomerulonephritis were observed in bitches in any of the groups. Two bitches severely proteinuric at the time of surgery had developed end stage renal disease within 3 years. In five of the bitches polyuria persisted after surgery. Most bitches did not show signs of kidney disease at the time of death/euthanasia. Conclusion Tubulointerstitial inflammation was observed, but glomerular damage beyond age-related changes could not be demonstrated by light microscopy in the dogs with pyometra. However, severe proteinuria after surgery may predispose to development of renal failure. PMID:17480218

  4. Controlled long-term release of small peptide hormones using a new microporous polypropylene polymer: its application for vasopressin in the Brattleboro rat and potential perinatal use

    SciTech Connect

    Kruisbrink, J.; Boer, G.J.

    1984-12-01

    Based on drug release by microporous hollow fibers and the recent introduction of microporous polymers, a new technique was developed for controlled delivery of peptides. Small-diameter microporous polypropylene tubing, lumen-loaded with microgram quantities of vasopressin, and coated with collodion, releases vasopressin after in vitro immersion slowly (1-100 ng/d) and constantly for months. The mechanism of pseudo-zero-order delivery is based on high adsorption of vasopressin, keeping the void volume concentration of dissolved vasopressin constant, which is consequently a constant driving force of outward diffusion. The collodion coating prevents the entry of proteinaceous compounds which would result in rapid desorption of vasopressin. The present delivery module provides a lasting release for other peptides as well (lysine-vasopressin, oxytocin, alpha-melanocyte-stimulating hormone and, to a lesser extent, Met-enkephalin). The microporous polymer-collodion device is biocompatible and, loaded with vasopressin, successfully alleviates the diabetes insipidus of Brattleboro rats deficient for vasopressin. Subcutaneous implantation normalized diuresis for a period of 60 d and constant urine vasopressin excretion is observed. When the commercially available osmotic minipump is too large for implantation, the small size of the present controlled-delivery system allows peptide treatment of young and immature laboratory rats, even if located in utero.

  5. Effects of dynamic controlled atmosphere by respiratory quotient on some quality parameters and volatile profile of 'Royal Gala' apple after long-term storage.

    PubMed

    Both, Vanderlei; Thewes, Fabio Rodrigo; Brackmann, Auri; de Oliveira Anese, Rogerio; de Freitas Ferreira, Daniele; Wagner, Roger

    2017-01-15

    The effects of dynamic controlled atmosphere (DCA) storage based on chlorophyll fluorescence (DCA-CF) and respiratory quotient (DCA-RQ) on the quality and volatile profile of 'Royal Gala' apple were evaluated. DCA storage reduces ACC (1-aminocyclopropane-1-carboxylate) oxidase activity, ethylene production and respiration rate of apples stored for 9months at 1.0°C plus 7days at 20°C, resulting in higher flesh firmness, titratable acidity and lesser physiological disorders, and provided a higher proportion of healthy fruit. Storage in a regular controlled atmosphere gave higher levels of key volatiles (butyl acetate, 2-methylbutyl acetate and hexyl acetate), as compared to fruit stored under DCA-CF, but fruit stored under DCA-RQ 1.5 and RQ 2.0 also showed higher amounts of key volatile compounds, with increment in ethanol and ethyl acetate, but far below the odour threshold. Storage in DCA-CF reduces fruit ester production, especially 2-methylbutyl acetate, which is the most important component of 'Royal Gala' apple flavour. PMID:27542502

  6. A strategy to provide long-term control of weedy rice while mitigating herbicide resistance transgene flow, and its potential use for other crops with related weeds.

    PubMed

    Gressel, Jonathan; Valverde, Bernal E

    2009-07-01

    Transgenic herbicide-resistant rice is needed to control weeds that have evolved herbicide resistance, as well as for the weedy (feral, red) rice problem, which has been exacerbated by shifting to direct seeding throughout the world-firstly in Europe and the Americas, and now in Asia, as well as in parts of Africa. Transplanting had been the major method of weedy rice control. Experience with imidazolinone-resistant rice shows that gene flow to weedy rice is rapid, negating the utility of the technology. Transgenic technologies are available that can contain herbicide resistance within the crop (cleistogamy, male sterility, targeting to chloroplast genome, etc.), but such technologies are leaky. Mitigation technologies tandemly couple (genetically link) the gene of choice (herbicide resistance) with mitigation genes that are neutral or good for the crop, but render hybrids with weedy rice and their offspring unfit to compete. Mitigation genes confer traits such as non-shattering, dwarfism, no secondary dormancy and herbicide sensitivity. It is proposed to use glyphosate and glufosinate resistances separately as genes of choice, and glufosinate, glyphosate and bentazone susceptibilities as mitigating genes, with a six-season rotation where each stage kills transgenic crop volunteers and transgenic crop x weed hybrids from the previous season. PMID:19367567

  7. In-lake measures for phosphorus control: The most feasible and cost-effective solution for long-term management of water quality in urban lakes.

    PubMed

    Huser, Brian J; Futter, Martyn; Lee, Jeff T; Perniel, Mike

    2016-06-15

    Both in-lake and catchment measures designed to reduce phosphorus (P) loading were implemented as part of a 12.3 million USD restoration project for the Minneapolis Chain of lakes in Minnesota (USA). Treatment wetlands, 'in-pipe' measures, and in-lake aluminum sulfate (alum) treatment were applied to restore water quality in the four urban lakes. Different alum dosing methods led to between 4 and 20+ (modeled) years of water quality improvements in these lakes after treatment and only one of the four lakes continues to meet water quality goals approximately 25 years after the project started. Due to limited space and poor performance, reduction of total external loads was low (1-13%) for three lakes. Changes to internal P sediment release rates after application of alum correlated well with epilimnetic total P (TP) concentrations in these lakes, indicating that improvements in water quality were mainly driven by reduced internal loading via in-lake measures. Substantial reductions to external P loading were only achieved at Cedar Lake (49%) via conversion of an existing natural area to a treatment wetland, but even Cedar Lake is no longer meeting management goals. When expressed in terms of dollars spent per unit P removed, in lake alum treatment was on average 50 times more effective than in-catchment measures. The results of this study indicate that substantial external nutrient reductions may not be adequate to sustainably maintain water quality in urban lakes and that continued in-lake management of P accumulated in lake sediment will not only be necessary, but will also be more cost efficient relative to in-catchment measures. PMID:26298078

  8. Long-Term Clinical Outcomes from a Randomized Controlled Trial of Two Implementation Strategies to Promote Collaborative Care Attendance in Community Practices.

    PubMed

    Kilbourne, Amy M; Goodrich, David E; Nord, Kristina M; Van Poppelen, Celeste; Kyle, Julia; Bauer, Mark S; Waxmonsky, Jeanette A; Lai, Zongshan; Kim, Hyungjin M; Eisenberg, Daniel; Thomas, Marshall R

    2015-09-01

    This randomized controlled implementation study compared the effectiveness of a standard versus enhanced version of the replicating effective programs (REP) implementation strategy to improve the uptake of the life goals-collaborative care model (LG-CC) for bipolar disorder. Seven community-based practices (384 patient participants) were randomized to standard (manual/training) or enhanced REP (customized manual/training/facilitation) to promote LG-CC implementation. Participants from enhanced REP sites had no significant changes in primary outcomes (improved quality of life, reduced functioning or mood symptoms) by 24 months. Further research is needed to determine whether implementation strategies can lead to sustained, improved participant outcomes in addition to program uptake. PMID:25315181

  9. Long-term effects of electrodermal biofeedback training on seizure control in patients with drug-resistant epilepsy: two case reports.

    PubMed

    Nagai, Yoko; Trimble, Michael R

    2014-01-01

    We report data from two patients, followed over 3 years after electrodermal biofeedback treatment. Patients were trained three times each week for four weeks to increase their sympathetic arousal using electrodermal biofeedback. This treatment was directed at enabling the patients to change their psychophysiological state as a countermeasure to prevent seizures. Both patients voluntarily kept a record of seizure frequency over the year preceding the treatment and continued to record their seizures for up to 3 years after the termination of biofeedback treatment. Both patients showed a marked reduction in seizure frequency (54.9% and 59.8%) during the month of biofeedback treatment. This improvement was maintained over the subsequent years. We highlight the therapeutic potential of biofeedback interventions that enable patients to volitionally control their state of physiological arousal in the management of drug-resistant epilepsy. PMID:24238895

  10. A randomised controlled study of the long-term effects of exercise training on mortality in elderly people: study protocol for the Generation 100 study

    PubMed Central

    Stensvold, Dorthe; Viken, Hallgeir; Rognmo, Øivind; Skogvoll, Eirik; Steinshamn, Sigurd; Vatten, Lars J; Coombes, Jeff S; Anderssen, Sigmund A; Magnussen, Jon; Ingebrigtsen, Jan Erik; Fiatarone Singh, Maria A; Langhammer, Arnulf; Støylen, Asbjørn; Helbostad, Jorunn L; Wisløff, Ulrik

    2015-01-01

    Introduction Epidemiological studies suggest that exercise has a tremendous preventative effect on morbidity and premature death, but these findings need to be confirmed by randomised trials. Generation 100 is a randomised, controlled study where the primary aim is to evaluate the effects of 5 years of exercise training on mortality in an elderly population. Methods and analysis All men and women born in the years 1936–1942 (n=6966), who were residents of Trondheim, Norway, were invited to participate. Between August 2012 and June 2013, a total of 1567 individuals (790 women) were included and randomised to either 5 years of two weekly sessions of high-intensity training (10 min warm-up followed by 4×4 min intervals at ∼90% of peak heart rate) or, moderate-intensity training (50 min of continuous work at ∼70% of peak heart rate), or to a control group that followed physical activity advice according to national recommendations. Clinical examinations, physical tests and questionnaires will be administered to all participants at baseline, and after 1, 3 and 5 years. Participants will also be followed up by linking to health registries until year 2035. Ethics and dissemination The study has been conducted according to the SPIRIT statement. All participants signed a written consent form, and the study has been approved by the Regional Committee for Medical Research Ethics, Norway. Projects such as this are warranted in the literature, and we expect that data from this study will result in numerous papers published in world-leading clinical journals; we will also present the results at international and national conferences. Trial registration number Clinical trial gov NCT01666340. PMID:25678546

  11. Strengths-based positive psychology interventions: a randomized placebo-controlled online trial on long-term effects for a signature strengths- vs. a lesser strengths-intervention

    PubMed Central

    Proyer, René T.; Gander, Fabian; Wellenzohn, Sara; Ruch, Willibald

    2015-01-01

    Recent years have seen an increasing interest in research in positive psychology interventions. There is broad evidence for their effectiveness in increasing well-being and ameliorating depression. Intentional activities that focus on those character strengths, which are most typical for a person (i.e., signature strengths, SS) and encourage their usage in a new way have been identified as highly effective. The current study aims at comparing an intervention aimed at using SS with one on using individual low scoring (or lesser) strengths in a randomized placebo-controlled trial. A total of 375 adults were randomly assigned to one of the two intervention conditions [i.e., using five signature vs. five lesser strengths (LS) in a new way] or a placebo control condition (i.e., early memories). We measured happiness and depressive symptoms at five time points (i.e., pre- and post-test, 1-, 3-, and 6-months follow-ups) and character strengths at pre-test. The main findings are that (1) there were increases in happiness for up to 3 months and decreases in depressive symptoms in the short term in both intervention conditions; (2) participants found working with strengths equally rewarding (enjoyment and benefit) in both conditions; (3) those participants that reported generally higher levels of strengths benefitted more from working on LS rather than SS and those with comparatively lower levels of strengths tended to benefit more from working on SS; and (4) deviations from an average profile derived from a large sample of German-speakers completing the Values-in-Action Inventory of Strengths were associated with greater benefit from the interventions in the SS-condition. We conclude that working on character strengths is effective for increasing happiness and discuss how these interventions could be tailored to the individual for promoting their effectiveness. PMID:25954221

  12. Numerical Ice-Sheet Modeling of the Long-Term Development of Prydz Bay, Antarctica: Tectonic Controls on Ice-Sheet Dynamics?

    NASA Astrophysics Data System (ADS)

    Taylor, J.; Hambrey, M. J.; Siegert, M. J.; Payne, A. J.

    2002-12-01

    A large quantity of geological data are now available from both offshore and onshore Prydz Bay and the Lambert Graben, East Antarctica, covering the growth and change of the East Antarctic Ice Sheet (EAIS) since early Oligocene time. We have collated much of this information, in order to constrain the rates of deposition of ice-sheet erosional products in this important sector of the EAIS, together with changes in the limits and styles of glaciation. Sedimentological data and indications of past climate from geological archives therefore formed the basis for constructing time-slice snapshots of possible morphological and climatic settings throughout the past 30-35 Ma. All of these data have then been used to constrain, or been tested by, a three-dimensional numerical ice-sheet model, which incorporates grounding-line physics. The primary concern was to assess likely ice-sheet configurations which can be forced to match the geological data, in particular, examining the possible causes of the onset of ice-stream formation in Prydz Bay after the late Miocene epoch. We suggest that tectonically induced changes in the bathymetry of the Lambert Graben and Prydz Bay are one of the major likely causes of changes in ice-sheet dynamics, and thus ice-sheet extent, in this sector of the EAIS. The results of the numerical ice-sheet modeling show clearly that tectonically induced bathymetric changes are sufficient to alter the glacial environment in this region significantly, in particular by controling the grounding and stability of ice within the Lambert Graben and by focusing ice flow from the surrounding area. The history of positive topographic features such as the bounding Prince Charles Mountains are probably not that significant in controlling ice flow, however. Glacial erosion may also have played a role in excavating the Lambert Graben by promoting fast-flowing ice in a positive feedback. We have also assessed possible changes in mass balance regime (climate) and find

  13. An Empirical Study of Long Term Effects of Education.

    ERIC Educational Resources Information Center

    Harnqvist, Kjell

    A large-scale study of Swedish men and women, each of whose intelligence level at age 13 was above the 25th percentile and whose father's education was only at the elementary level, was conducted in order to determine what educational level the participants had achieved and to study long-term effects of schooling. Subjects were sent questionnaires…

  14. Incidental Biasing of Attention from Visual Long-Term Memory

    ERIC Educational Resources Information Center

    Fan, Judith E.; Turk-Browne, Nicholas B.

    2016-01-01

    Holding recently experienced information in mind can help us achieve our current goals. However, such immediate and direct forms of guidance from working memory are less helpful over extended delays or when other related information in long-term memory is useful for reaching these goals. Here we show that information that was encoded in the past…

  15. Transuranic waste: long-term planning

    SciTech Connect

    Young, K.C.

    1985-07-01

    Societal concerns for the safe handling and disposal of toxic waste are behind many of the regulations and the control measures in effect today. Transuranic waste, a specific category of toxic (radioactive) waste, serves as a good example of how regulations and controls impact changes in waste processing - and vice versa. As problems would arise with waste processing, changes would be instituted. These changes improved techniques for handling and disposal of transuranic waste, reduced the risk of breached containment, and were usually linked with regulatory changes. Today, however, we face a greater public awareness of and concern for toxic waste control; thus, we must anticipate potential problems and work on resolving them before they can become real problems. System safety analyses are valuable aids in long-term planning for operations involving transuranic as well as other toxic materials. Examples of specific system safety analytical methods demonstrate how problems can be anticipated and resolution initiated in a timely manner having minimal impacts upon allocation of resource and operational goals. 7 refs., 1 fig.

  16. A LONG-TERM FOLLOW-UP STUDY OF A RANDOMIZED CONTROLLED TRIAL OF MOTHER-INFANT PSYCHOANALYTIC TREATMENT: OUTCOMES ON MOTHERS AND INTERACTIONS.

    PubMed

    Salomonsson, Majlis Winberg; Sorjonen, Kimmo; Salomonsson, Björn

    2015-01-01

    An earlier randomized controlled trial (RCT) compared 80 mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment [mother-infant psychoanalytic therapies (MIP) group], and the other received Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 412 years, the dyads were followed up with assessments of the children's attachment representations, social and emotional development, and global functioning, and the mothers' psychological well-being and representations of the child as well as the mother-child interactions. We gathered data from 66 cases approximately 312 years' posttreatment. All scores involving the mothers had now approached community levels. We found effects on maternal depression in favor of MIP, but no other between-group differences. The MIP treatments seemed to have helped the mothers to recover more quickly on personal well-being, to become more sensitive to their babies' suffering, and to better support and appreciate their children throughout infancy and toddlerhood. If so, this would explain why the MIP children had a better global functioning and were more often "OK" and less often "Troubled" at 412 years. PMID:26551600

  17. Process stability and the recovery control associated with inhibition factors in a UASB-anammox reactor with a long-term operation.

    PubMed

    Niu, Qigui; He, Shilong; Zhang, Yanlong; Ma, Haiyuan; Liu, Yuan; Li, Yu-You

    2016-03-01

    A UASB-anammox reactor was operated for 900 days to study its process stability. The negative effects of free ammonia (FA) and free nitrous acid (FNA) were investigated over three separate inhibitions and recoveries. The IC10, IC50 and IC90 (inhibitory concentration/a 10%, 50% and 90% activity loss) of FNA and FA responding to the NH4(+)-N, NO2(-)-N and TN removal efficiency were evaluated. In the 1st inhibition, the average FNA-IC10 observed was 0.67 μg L(-1) and the FA-IC10 for TN removal was 4.85 mg L(-1). In the 2nd inhibition, an FNA-IC10 of 0.44μ g L(-1) and an FA-IC10 of 3.56 were found. In the 3rd inhibition, however, both the FNA-IC10 and FA-IC10 were found to have increased, with values of 0.50 μg L(-1) and 4.42 mg L(-1), respectively. A clear control region was established for multiple inhibitions and the recoveries, which followed (pH 7.5-8.5, FA below 10mg/100mg NH4(+)-N and an FNA below 0.005 mg/100 mg NO2(-)-N) for the purpose of optimizing the operation conditions of the UASB-anammox reactor. PMID:26722813

  18. WWC Review of the Report "Staying on Track: Testing Higher Achievement's Long-Term Impact on Academic Outcomes and High School Choice." What Works Clearinghouse Single Study Review

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2014

    2014-01-01

    This study of 952 fifth and sixth graders in Washington, DC, and Alexandria, Virginia, found that students who were offered the "Higher Achievement" program had higher test scores in mathematical problem solving and were more likely to be admitted to and attend private competitive high schools. "Higher Achievement" is a…

  19. Exploratory Analyses of the Long-Term Effects of Improving Behavior, Attendance, and Educational Achievement in Grades 1-6 and 8-12. ACT Research Report Series, 2012 (3)

    ERIC Educational Resources Information Center

    Sawyer, Richard; Gibson, Neal

    2012-01-01

    We studied relationships among background characteristics, behavioral infractions, punishments, attendance, and educational achievement, using longitudinal data of students in grades 1-6 and 8-12. We estimated how much hypothesized early improvements in educational achievement or sustained improvements in behavior and attendance might ultimately…

  20. Efficacy of long-term therapy with low doses of omeprazole in the control of gastric acid secretion in Zollinger-Ellison syndrome patients.

    PubMed

    Corleto, V; Annibale, B; D'Ambra, G; Saggioro, A; Ferrua, B; Cassetta, M R; Delle Fave, G

    1993-04-01

    Thirteen patients with Zollinger-Ellison syndrome were investigated: 8 without, and 5 with, previous gastric surgery. After 7-34 months of treatment with famotidine, 8 out of 13 patients were resistant to this drug. Omeprazole 60 mg/day was administered to these 8 patients; after one month, the dose was reduced to 40 mg/day, and after another month to 20 mg/day. Basal acid secretion was inhibited by every dose of omeprazole. The patients were then treated with a low dose (20 mg/day) of omeprazole for a longer period. Periodic clinical and endoscopic assessments, and measurement of basal acid secretion showed the efficacy of this low dose of omeprazole in our Zollinger-Ellison syndrome patients. The drug was discontinued after 12-32 months of omeprazole treatment, and gastric acid recovery was evaluated. Four patients recovered 50% of their 'initial basal acid secretion' after 5 days, while two patients who had been treated with omeprazole for a longer time (30-32 months) recovered only 38 and 40%, respectively, of their 'initial basal acid secretion' at the tenth day. Our results indicate that the omeprazole dosage to be used in the treatment of Zollinger-Ellison syndrome must be chosen principally on the basis of basal acid secretion determination. A low daily dose of omeprazole is able to control acid secretion in Zollinger-Ellison syndrome for a long period (10-30 months). The slow recovery of gastric secretory function demonstrates the prolonged inhibitory effects of omeprazole. PMID:8485270

  1. Long-Term Monitoring of Waterborne Pathogens and Microbial Source Tracking Markers in Paired Agricultural Watersheds under Controlled and Conventional Tile Drainage Management

    PubMed Central

    Wilkes, Graham; Brassard, Julie; Edge, Thomas A.; Gannon, Victor; Gottschall, Natalie; Jokinen, Cassandra C.; Jones, Tineke H.; Khan, Izhar U. H.; Marti, Romain; Sunohara, Mark D.; Topp, Edward

    2014-01-01

    Surface waters from paired agricultural watersheds under controlled tile drainage (CTD) and uncontrolled tile drainage (UCTD) were monitored over 7 years in order to determine if there was an effect of CTD (imposed during the growing season) on occurrences and loadings of bacterial and viral pathogens, coliphages, and microbial source tracking markers. There were significantly lower occurrences of human, ruminant, and livestock (ruminant plus pig) Bacteroidales markers in the CTD watershed in relation to the UCTD watershed. As for pathogens, there were significantly lower occurrences of Salmonella spp. and Arcobacter spp. in the CTD watershed. There were no instances where there were significantly higher quantitative loadings of any microbial target in the CTD watershed, except for F-specific DNA (F-DNA) and F-RNA coliphages, perhaps as a result of fecal inputs from a hobby farm independent of the drainage practice treatments. There was lower loading of the ruminant marker in the CTD watershed in relation to the UCTD system, and results were significant at the level P = 0.06. The odds of Salmonella spp. occurring increased when a ruminant marker was present relative to when the ruminant marker was absent, yet for Arcobacter spp., the odds of this pathogen occurring significantly decreased when a ruminant marker was present relative to when the ruminant marker was absent (but increased when a wildlife marker was present relative to when the wildlife marker was absent). Interestingly, the odds of norovirus GII (associated with human and swine) occurring in water increased significantly when a ruminant marker was present relative to when a ruminant marker was absent. Overall, this study suggests that fecal pollution from tile-drained fields to stream could be reduced by CTD utilization. PMID:24727274

  2. Robotics for Long-Term Monitoring

    SciTech Connect

    Shahin, Sarkis; Duran, Celso

    2002-07-01

    While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

  3. Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Recent studies have shown an important reduction of joint overload during locomotion in elderly women with knee osteoarthritis (OA) after short-term use of minimalist shoes. Our aim is to investigate the chronic effect of inexpensive and minimalist footwear on the clinical and functional aspects of OA and gait biomechanics of elderly women with knee OA. Methods/Design Fifty-six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence) are randomized into blocks and allocated to either the intervention group, which will use flexible, non-heeled shoes— Moleca®—for six months for at least six hours daily, or the control group, which could not use these shoes. Neither group is undergoing physical therapy treatment throughout the intervention period. Moleca® is a women’s double canvas, flexible, flat walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. Both groups will be followed for six months and will be assessed at baseline condition, after three months, and after six months (end of intervention). All the assessments will be performed by a physiotherapist that is blind to the group allocation. The primary outcome is the pain Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score. The secondary outcomes are global WOMAC score; joint stiffness and disability WOMAC scores; knee pain with a visual analogue scale; walking distance in the six-minute walk test; Lequesne score; amount and frequency (number of days) of paracetamol (500 mg) intake over six months; knee adduction moment during gait; global medical assessment score; and global patient auto-assessment score. At baseline, all patients receive a diary to record the hours of daily use of the footwear intervention; every two weeks, the same physiotherapist makes phone calls to all patients in order to verify adherence to treatment. The statistical analysis will be based on intention-to-treat analysis, as well as

  4. Neuroendocrine Humoral and Vascular Components in the Pressor Pathway for Brain Angiotensin II: A New Axis in Long Term Blood Pressure Control

    PubMed Central

    Hamlyn, John M.; Linde, Cristina I.; Gao, Junjie; Huang, Bing S.; Golovina, Vera A.; Blaustein, Mordecai P.; Leenen, Frans H. H.

    2014-01-01

    Central nervous system (CNS) administration of angiotensin II (Ang II) raises blood pressure (BP). The rise in BP reflects increased sympathetic outflow and a slower neuromodulatory pressor mechanism mediated by CNS mineralocorticoid receptors (MR). We investigated the hypothesis that the sustained phase of hypertension is associated also with elevated circulating levels of endogenous ouabain (EO), and chronic stimulation of arterial calcium transport proteins including the sodium-calcium exchanger (NCX1), the type 6 canonical transient receptor potential protein (TRPC6), and the sarcoplasmic reticulum calcium ATPase (SERCA2). Wistar rats received a chronic intra-cerebroventricular infusion of vehicle (C) or Ang II (A, 2.5 ng/min, for 14 days) alone or combined with the MR blocker, eplerenone (A+E, 5 µg/day), or the aldosterone synthase inhibitor, FAD286 (A+F, 25 µg/day). Conscious mean BP increased (P<0.05) in A (123±4 mm Hg) vs all other groups. Blood, pituitary and adrenal samples were taken for EO radioimmunoassay (RIA), and aortas for NCX1, TRPC6 and SERCA2 immunoblotting. Central infusion of Ang II raised plasma EO (0.58±0.08 vs C 0.34±0.07 nM (P<0.05), but not in A + E and A + F groups as confirmed by off-line liquid chromatography (LC)-RIA and LC-multistage mass spectrometry. Two novel isomers of EO were elevated by Ang II; the second less polar isomer increased >50-fold in the A+F group. Central Ang II increased arterial expression of NCX1, TRPC6 and SERCA2 (2.6, 1.75 and 3.7-fold, respectively; P<0.01)) but not when co-infused with E or F. Adrenal and pituitary EO were unchanged. We conclude that brain Ang II activates a CNS-humoral axis involving plasma EO. The elevated EO reprograms peripheral ion transport pathways known to control arterial Na+ and Ca2+ homeostasis; this increases contractility and augments sympathetic effects. The new axis likely contributes to the chronic pressor effect of brain Ang II. PMID:25275393

  5. Laparoscopic bridging vs. anatomic open reconstruction for midline abdominal hernia mesh repair [LABOR]: single-blinded, multicenter, randomized, controlled trial on long-term functional results

    PubMed Central

    2013-01-01

    among treatments (acceptance of the null-hypothesis), then the choice of whether to submit a patient to one intervention will be made on the basis of cost and the surgeon’s experience. Trial registration Current Controlled Trials ISRCTN93729016 PMID:24165473

  6. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial

    PubMed Central

    James, Nicholas D; Sydes, Matthew R; Clarke, Noel W; Mason, Malcolm D; Dearnaley, David P; Spears, Melissa R; Ritchie, Alastair W S; Parker, Christopher C; Russell, J Martin; Attard, Gerhardt; de Bono, Johann; Cross, William; Jones, Rob J; Thalmann, George; Amos, Claire; Matheson, David; Millman, Robin; Alzouebi, Mymoona; Beesley, Sharon; Birtle, Alison J; Brock, Susannah; Cathomas, Richard; Chakraborti, Prabir; Chowdhury, Simon; Cook, Audrey; Elliott, Tony; Gale, Joanna; Gibbs, Stephanie; Graham, John D; Hetherington, John; Hughes, Robert; Laing, Robert; McKinna, Fiona; McLaren, Duncan B; O'Sullivan, Joe M; Parikh, Omi; Peedell, Clive; Protheroe, Andrew; Robinson, Angus J; Srihari, Narayanan; Srinivasan, Rajaguru; Staffurth, John; Sundar, Santhanam; Tolan, Shaun; Tsang, David; Wagstaff, John; Parmar, Mahesh K B

    2016-01-01

    Summary Background Long-term hormone therapy has been the standard of care for advanced prostate cancer since the 1940s. STAMPEDE is a randomised controlled trial using a multiarm, multistage platform design. It recruits men with high-risk, locally advanced, metastatic or recurrent prostate cancer who are starting first-line long-term hormone therapy. We report primary survival results for three research comparisons testing the addition of zoledronic acid, docetaxel, or their combination to standard of care versus standard of care alone. Methods Standard of care was hormone therapy for at least 2 years; radiotherapy was encouraged for men with N0M0 disease to November, 2011, then mandated; radiotherapy was optional for men with node-positive non-metastatic (N+M0) disease. Stratified randomisation (via minimisation) allocated men 2:1:1:1 to standard of care only (SOC-only; control), standard of care plus zoledronic acid (SOC + ZA), standard of care plus docetaxel (SOC + Doc), or standard of care with both zoledronic acid and docetaxel (SOC + ZA + Doc). Zoledronic acid (4 mg) was given for six 3-weekly cycles, then 4-weekly until 2 years, and docetaxel (75 mg/m2) for six 3-weekly cycles with prednisolone 10 mg daily. There was no blinding to treatment allocation. The primary outcome measure was overall survival. Pairwise comparisons of research versus control had 90% power at 2·5% one-sided α for hazard ratio (HR) 0·75, requiring roughly 400 control arm deaths. Statistical analyses were undertaken with standard log-rank-type methods for time-to-event data, with hazard ratios (HRs) and 95% CIs derived from adjusted Cox models. This trial is registered at ClinicalTrials.gov (NCT00268476) and ControlledTrials.com (ISRCTN78818544). Findings 2962 men were randomly assigned to four groups between Oct 5, 2005, and March 31, 2013. Median age was 65 years (IQR 60–71). 1817 (61%) men had M+ disease, 448 (15%) had N+/X M0, and 697 (24%) had N0M0. 165 (6

  7. Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial

    PubMed Central

    2014-01-01

    Background Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving. Objective In this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy@Work, for employees with depressive symptoms who were not on sick leave. Methods A two-arm randomized controlled trial comparing a worker-directed, Web-based, guided self-help intervention to care as usual (CAU) was carried out. We recruited employees from 6 companies via the company’s Intranet and by putting up posters. The inclusion criteria were elevated depressive symptoms as measured by a score ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D) and not being on sick leave. The intervention contained 6 lessons and consisted of problem-solving treatment and cognitive therapy. Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), burnout (Maslach Burnout Inventory, MBI), work performance (Health and Work Performance Questionnaire, HPQ), duration of absenteeism, and anxiety (Hospital Anxiety and Depression Scale, HADS; secondary outcomes), were completed at baseline, posttreatment, and at 6-, and 12-month follow-up. Several subgroup and per-protocol analyses were performed. Results A total of 231 employees were randomized to either the intervention group (n=116) or to CAU (n=115). Completion of assessments varied between 54%-74%. Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time. However, there

  8. Interlaboratory evaluation of Hyalella azteca and Chironomus tentans short-term and long-term sediment toxicity tests

    USGS Publications Warehouse

    Norberg-King, T. J.; Sibley, P.K.; Burton, G.A.; Ingersoll, C.G.; Kemble, N.E.; Ireland, S.; Mount, D.R.; Rowland, C.D.

    2006-01-01

    Methods for assessing the long-term toxicity of sediments to Hyalella azteca and Chironomus tentans can significantly enhance the capacity to assess sublethal effects of contaminated sediments through multiple endpoints. Sublethal tests allow us to begin to understand the relationship between short-term and long-term effects for toxic sediments. We present an interlaboratory evaluation with long-term and 10-d tests using control and contaminated sediments in which we assess whether proposed and existing performance criteria (test acceptability criteria [TAC]) could be achieved. Laboratories became familiar with newly developed, long-term protocols by testing two control sediments in phase 1. In phase 2, the 10-d and long-term tests were examined with several sediments. Laboratories met the TACs, but results varied depending on the test organism, test duration, and endpoints. For the long-term tests in phase 1, 66 to 100% of the laboratories consistently met the TACs for survival, growth, or reproduction using H. azteca, and 70 to 100% of the laboratories met the TACs for survival and growth, emergence, reproduction, and hatchability using C. tentans. In phase 2, fewer laboratories participated in long-term tests: 71 to 88% of the laboratories met the TAC for H. azteca, whereas 50 to 67% met the TAC for C. tentans. In the 10-d tests with H. azteca and C. tentans, 82 and 88% of the laboratories met the TAC for survival, respectively, and 80% met the TAC for C. tentans growth. For the 10-d and long-term tests, laboratories predicted similar toxicity. Overall, the interlaboratory evaluation showed good precision of the methods, appropriate endpoints were incorporated into the test protocols, and tests effectively predicted the toxicity of sediments. ?? 2006 SETAC.

  9. Long-term Use of Opioids for Complex Chronic Pain

    PubMed Central

    Von Korff, Michael R.

    2014-01-01

    Increased opioid prescribing for back pain and other chronic musculoskeletal pain conditions has been accompanied by dramatic increases in prescription opioid addiction and fatal overdose. Opioid-related risks appear to increase with dose. While short-term randomized trials of opioids for chronic pain have found modest analgesic benefits (a one-third reduction in pain intensity on average), the long-term safety and effectiveness of opioids for chronic musculoskeletal pain is unknown. Given the lack of large, long-term randomized trials, recent epidemiologic data suggests the need for caution when considering long-term use of opioids to manage chronic musculoskeletal pain, particularly at higher dosage levels. Principles for achieving more selective and cautious use of opioids for chronic musculoskeletal pain are proposed. PMID:24315147

  10. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  11. Long Term Effects of Food Poisoning

    MedlinePlus

    ... develop chronic arthritis. Brain and nerve damage A Listeria infection can lead to meningitis, an inflammation of ... brain. If a newborn infant is infected with Listeria , long-term consequences may include mental retardation, seizures, ...

  12. Neurological long term consequences of deep diving.

    PubMed Central

    Todnem, K; Nyland, H; Skeidsvoll, H; Svihus, R; Rinck, P; Kambestad, B K; Riise, T; Aarli, J A

    1991-01-01

    Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean age 34.0 (range 22-48) years. The divers reported significantly more symptoms from the nervous system. Concentration difficulties and paraesthesia in feet and hands were common. They had more abnormal neurological findings by neurological examination compatible with dysfunction in the lumbar spinal cord or roots. They also had a larger proportion of abnormal electroencephalograms than the controls. The neurological symptoms and findings were highly significantly correlated with exposure to deep diving (depth included), but even more significantly correlated to air and saturation diving and prevalence of decompression sickness. Visual evoked potentials, brainstem auditory evoked potentials, and magnetic resonance imaging of the brain did not show more abnormal findings in the divers. Four (10%) divers had had episodes of cerebral dysfunction during or after the dives; two had had seizures, one had had transitory cerebral ischaemia and one had had transitory global amnesia. It is concluded that deep diving may have a long term effect on the nervous system of the divers. PMID:2025592

  13. Long-term intraperitoneal insulin delivery.

    PubMed Central

    Pitt, H A; Saudek, C D; Zacur, H A

    1992-01-01

    Over the past 5 years, 21 patients with insulin-dependent diabetes mellitus have been managed at the Johns Hopkins Medical Institutions with variable rate, remotely controlled implanted insulin pumps. To date, nearly 70 patient-years of experience has been gained with intraperitoneal delivery of a new U-400 insulin with a surfactant. All 21 patients are alive after a mean of 39.3 months (range, 10 to 65 months) after insulin pump implantation. Nineteen of the 21 patients remain on intraperitoneal insulin, for a 5-year actuarial system survival of 90%. Glucose control was improved, especially during the first 16 months after pump implantation, without an increased incidence of severe hypoglycemia. Catheter blockage has been a significant problem, occurring in nine of the 21 patients (43%). Catheter occlusion has been successfully managed, however, with laparoscopic repair in seven of 10 attempts or with catheter change in four of five patients. Nevertheless, quality of life and patient acceptance remain excellent. Moreover, pre-existing nephropathy, neuropathy, and retinopathy have been surprisingly stable. With an aggressive policy of catheter change or laparoscopic clearance of catheter blockage, long-term intraperitoneal insulin delivery is now a safe and effective treatment for type I diabetics. PMID:1417197

  14. LONG-TERM MONITORING SENSOR NETWORK

    SciTech Connect

    Stephen P. Farrington; John W. Haas; Neal Van Wyck

    2003-10-16

    Long-term monitoring (LTM) associated with subsurface contamination sites is a key element of Long Term Stewardship and Legacy Management across the Department of Energy (DOE) complex. However, both within the DOE and elsewhere, LTM is an expensive endeavor, often exceeding the costs of the remediation phase of a clean-up project. The primary contributors to LTM costs are associated with labor. Sample collection, storage, preparation, analysis, and reporting can add a significant financial burden to project expense when extended over many years. Development of unattended, in situ monitoring networks capable of providing quantitative data satisfactory to regulatory concerns has the potential to significantly reduce LTM costs. But survival and dependable operation in a difficult environment is a common obstacle to widespread use across the DOE complex or elsewhere. Deploying almost any sensor in the subsurface for extended periods of time will expose it to chemical and microbial degradation. Over the time-scales required for in situ LTM, even the most advanced sensor systems may be rendered useless. Frequent replacement or servicing (cleaning) of sensors is expensive and labor intensive, offsetting most, if not all, of the cost savings realized with unattended, in situ sensors. To enable facile, remote monitoring of contaminants and other subsurface parameters over prolonged periods, Applied Research Associates, Inc has been working to develop an advanced LTM sensor network consisting of three key elements: (1) an anti-fouling sensor chamber that can accommodate a variety of chemical and physical measurement devices based on electrochemical, optical and other techniques; (2) two rapid, cost effective, and gentle means of emplacing sensor packages either at precise locations directly in the subsurface or in pre-existing monitoring wells; and (3) a web browser-based data acquisition and control system (WebDACS) utilizing field-networked microprocessor-controlled smart

  15. Long-Term Course of Borderline Personality Disorder.

    PubMed

    Stone, Michael H

    2016-01-01

    Information concerning the longitudinal course of Borderline Personality Disorder (BPD) derives mainly from (a) long-term (10 to 25 year) retrospective follow-up studies, primarily those conducted during the 1980s/1990s, (b) brief (1 to 3 year) follow-up studies of recent randomized controlled trials (RCTs) of several different treatment approaches, and (c) prospective follow-up studies. The patients contacted in the retrospective studies had been treated mostly by psychoanalytically informed approaches or supportive. Though there was a significant suicide rate of 3 to 9%, about two-thirds of the BPD patients eventually achieved a global assessment score in the 60s or beyond. BPD represents a heterogeneous group of patients, whose outcome is a function of many variables, including personality traits (paranoid and narcissistic conducing to less favorable outcomes), cultural differences, socio-economic level, intelligence level, gender, and age of onset. The RCT studies focused on amelioration of the symptom components of BPD, especially tendencies to self-injury and suicide. The currently favored treatment methods showed in a large percentage of patients, a lessening of these self-destructive behaviors after a year or two of treatment. The time spans were too brief to allow assessment of improvement in key life areas (attainment of self-sufficiency in work, widening of the circle of friends, and success in forming satisfactory intimate partnerships). The prospective studies are based on reassessments at regular intervals of BPD patients and a control group with other personality disorders. Over the past 16 years the BPD patients, compared with controls, were slower to achieve remission, and more apt to show cognitive peculiarities initially-though they showed appreciable improvement over time. The "recovered" BPD patients, compared with the non-recovered patients, showed twice the likelihood of achieving a successful intimate relationship. At 16 years the Mc

  16. ROLE OF CONTROLLABILITY FOR LONG TERM SUSTAINABILITY

    EPA Science Inventory

    Successful implementation of sustainability ideas in ecosystem management requires a basic understanding of the often nonlinear and nonintuitive relationships among different dimensions of sustainability, particularly the system-wide implications of human actions. This basic unde...

  17. Effects of long-term androgen replacement therapy on the physical and mental statuses of aging males with late-onset hypogonadism: a multicenter randomized controlled trial in Japan (EARTH Study).

    PubMed

    Konaka, Hiroyuki; Sugimoto, Kazuhiro; Orikasa, Hideki; Iwamoto, Teruaki; Takamura, Toshinari; Takeda, Yoshiyu; Shigehara, Kazuyoshi; Iijima, Masashi; Koh, Eitetsu; Namiki, Mikio

    2016-01-01

    Androgen replacement therapy (ART) efficacy on late-onset hypogonadism (LOH) has been widely investigated in Western countries; however, it remains controversial whether ART can improve health and prolong active lifestyles. We prospectively assessed long-term ART effects on the physical and mental statuses of aging men with LOH in Japan. The primary endpoint was health-related quality of life assessed by questionnaires. Secondary endpoints included glycemic control, lipid parameters, blood pressure, waist circumference, body composition, muscular strength, International Prostate Symptom Scores (IPSS), International Index of Erectile Function-5 (IIEF-5) scores, and serum prostate-specific antigen levels. Of the 1637 eligible volunteers, 334 patients > 40 years with LOH were randomly assigned to either the ART (n = 169) or control groups (n = 165). Fifty-two weeks after the initial treatment, ART significantly affected the role physical subdomain of the short form-36 health survey (SF-36) scale (P = 0.0318). ART was also associated with significant decreases in waist circumstance (P = 0.002) and serum triglyceride (TG) (P = 0.013) and with significant increases in whole-body and leg muscle mass volumes (P = 0.071 and 0.0108, respectively), serum hemoglobin (P < 0.001), IPSS voiding subscore (P = 0.0418), and the second question on IIEF-5 (P = 0.0049). There was no significant difference between the groups in terms of severe adverse events. In conclusion, in patients with LOH, long-term ART exerted beneficial effects on Role Physical subdomain of the SF-36 scale, serum TG, waist circumstance, muscle mass volume, voiding subscore of IPSS, and the second question of IIEF-5. We hope our study will contribute to the future development of this area. PMID:25761833

  18. Effects of long-term androgen replacement therapy on the physical and mental statuses of aging males with late-onset hypogonadism: a multicenter, randomized controlled trial in Japan (EARTH Study)

    PubMed Central

    Konaka, Hiroyuki; Sugimoto, Kazuhiro; Orikasa, Hideki; Iwamoto, Teruaki; Takamura, Toshinari; Takeda, Yoshiyu; Shigehara, Kazuyoshi; Iijima, Masashi; Koh, Eitetsu; Namiki, Mikio

    2016-01-01

    Androgen replacement therapy (ART) efficacy on late-onset hypogonadism (LOH) has been widely investigated in Western countries; however, it remains controversial whether ART can improve health and prolong active lifestyles. We prospectively assessed long-term ART effects on the physical and mental statuses of aging men with LOH in Japan. The primary endpoint was health-related quality of life assessed by questionnaires. Secondary endpoints included glycemic control, lipid parameters, blood pressure, waist circumference, body composition, muscular strength, International Prostate Symptom Scores (IPSS), International Index of Erectile Function-5 (IIEF-5) scores, and serum prostate-specific antigen levels. Of the 1637 eligible volunteers, 334 patients > 40 years with LOH were randomly assigned to either the ART (n = 169) or control groups (n = 165). Fifty-two weeks after the initial treatment, ART significantly affected the role physical subdomain of the short form-36 health survey (SF-36) scale (P = 0.0318). ART was also associated with significant decreases in waist circumstance (P = 0.002) and serum triglyceride (TG) (P = 0.013) and with significant increases in whole-body and leg muscle mass volumes (P = 0.071 and 0.0108, respectively), serum hemoglobin (P < 0.001), IPSS voiding subscore (P = 0.0418), and the second question on IIEF-5 (P = 0.0049). There was no significant difference between the groups in terms of severe adverse events. In conclusion, in patients with LOH, long-term ART exerted beneficial effects on Role Physical subdomain of the SF-36 scale, serum TG, waist circumstance, muscle mass volume, voiding subscore of IPSS, and the second question of IIEF-5. We hope our study will contribute to the future development of this area. PMID:25761833

  19. The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol

    PubMed Central

    Selkowitz, David M; Kulig, Kornelia; Poppert, Elizabeth M; Flanagan, Sean P; Matthews, Ndidiamaka D; Beneck, George J; Popovich, John M; Lona, Jose R; Yamada, Kimiko A; Burke, Wendy S; Ervin, Carolyn; Powers, Christopher M

    2006-01-01

    be assessed before and after the 12-week post-surgical intervention program. Long-term follow up assessments will occur every six months beginning one year after surgery and ending five years after surgery. Immediate and long-term effects will be assessed using repeated measures multivariate analysis of variance (MANOVA). If significant interactions are found, one-way ANOVAs will be performed followed by post-hoc testing to determine statistically significant pairwise comparisons. Discussion We have presented the rationale and design for a randomized controlled trial evaluating the effectiveness of a treatment regimen for people who have undergone a single-level lumbar microdiscectomy. PMID:16934143

  20. Long-Term Once-Daily Tiotropium Respimat® Is Well Tolerated and Maintains Efficacy over 52 Weeks in Patients with Symptomatic Asthma in Japan: A Randomised, Placebo-Controlled Study

    PubMed Central

    Ohta, Ken; Ichinose, Masakazu; Tohda, Yuji; Engel, Michael; Moroni-Zentgraf, Petra; Kunimitsu, Satoko; Sakamoto, Wataru; Adachi, Mitsuru

    2015-01-01

    Background This study assessed the long-term safety and efficacy of tiotropium Respimat, a long-acting inhaled anticholinergic bronchodilator, in asthma, added on to inhaled corticosteroids (ICS) with or without long-acting β2-agonist (LABA). Methods 285 patients with symptomatic asthma, despite treatment with ICS±LABA, were randomised 2:2:1 to once-daily tiotropium 5 μg, tiotropium 2.5 μg or placebo for 52 weeks (via the Respimat SoftMist inhaler) added on to ICS±LABA, in a double-blind, placebo-controlled, parallel-group study (NCT01340209). Primary objective: to describe the long-term safety profile of tiotropium. Secondary end points included: trough forced expiratory volume in 1 second (FEV1) response; peak expiratory flow rate (PEFR) response; seven-question Asthma Control Questionnaire (ACQ-7) score. Results At Week 52, adverse-event (AE) rates with tiotropium 5 μg, 2.5 μg and placebo were 88.6%, 86.8% and 89.5%, respectively. Commonly reported AEs with tiotropium 5 μg, 2.5 μg and placebo were nasopharyngitis (48.2%, 44.7%, 42.1%), asthma (28.9%, 29.8%, 38.6%), decreased PEFR (15.8%, 7.9%, 21.1%), bronchitis (9.6%, 13.2%, 7.0%), pharyngitis (7.9%, 13.2%, 3.5%) and gastroenteritis (10.5%, 3.5%, 5.3%). In the tiotropium 5 μg, 2.5 μg and placebo groups, 8.8%, 5.3% and 5.3% of patients reported drug-related AEs; 3.5%, 3.5% and 15.8% reported serious AEs. Asthma worsening was the only serious AE reported in more than one patient. At Week 52, adjusted mean trough FEV1 and trough PEFR responses were significantly higher with tiotropium 5 μg (but not 2.5 μg) versus placebo. ACQ-7 responder rates were higher with tiotropium 5 μg and 2.5 μg versus placebo at Week 24. Conclusions The long-term tiotropium Respimat safety profile was comparable with that of placebo Respimat, and associated with mild to moderate, non-serious AEs in patients with symptomatic asthma despite ICS±LABA therapy. Compared with placebo, tiotropium 5 μg, but not 2.5

  1. Long-Term Stewardship Program Science and Technology Requirements

    SciTech Connect

    Joan McDonald

    2002-09-01

    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  2. Short- and long-term (trophic) purinergic signalling.

    PubMed

    Burnstock, Geoffrey

    2016-08-01

    There is long-term (trophic) purinergic signalling involving cell proliferation, differentiation, motility and death in the development and regeneration of most systems of the body, in addition to fast purinergic signalling in neurotransmission, neuromodulation and secretion. It is not always easy to distinguish between short- and long-term signalling. For example, adenosine triphosphate (ATP) can sometimes act as a short-term trigger for long-term trophic events that become evident days or even weeks after the original challenge. Examples of short-term purinergic signalling during sympathetic, parasympathetic and enteric neuromuscular transmission and in synaptic transmission in ganglia and in the central nervous system are described, as well as in neuromodulation and secretion. Long-term trophic signalling is described in the immune/defence system, stratified epithelia in visceral organs and skin, embryological development, bone formation and resorption and in cancer. It is likely that the increase in intracellular Ca(2+) in response to both P2X and P2Y purinoceptor activation participates in many short- and long-term physiological effects.This article is part of the themed issue 'Evolution brings Ca(2+) and ATP together to control life and death'. PMID:27377731

  3. The long-term alteration of borosilicate waste glasses

    SciTech Connect

    Ebert, W.L.; Bates, J.K.; Bradley, C.R.; Buck, E.C.; Dietz, N.L.; Brown, N.R.

    1993-06-01

    Prediction of the long-term durability of glass waste forms under potential disposal conditions is based on a mechanistic model of glass corrosion which has been derived from short-term laboratory tests. The model of glass reaction that has evolved identifies the hydrolysis of an Si-0 bond to release silicic acid as the step which controls the long-term glass reactivity. This reaction step is initially fast under dilute solution conditions, but slows as the silicic acid concentration in solution increases. An increase in the solution concentrations of glass components will occur with progressive glass corrosion, and so the solutions which contact waste glasses over long reaction times will have high concentrations of glass components. Therefore, the glass reactivity is usually expected to decrease with the reaction progress as the contacting solution becomes more concentrated. The corrosion behavior of glasses contacted by highly concentrated solutions must be characterized to assess the long-term glass stability.

  4. A new long-term care manifesto.

    PubMed

    Kane, Robert L

    2015-04-01

    This article argues for a fresh look at how we provide long-term care (LTC) for older persons. Essentially, LTC offers a compensatory service that responds to frailty. Policy debate around LTC centers on costs, but we are paying for something we really don't want. Building societal enthusiasm (or even support) for LTC will require re-inventing and re-branding. LTC has three basic components: personal care, housing, and health care (primarily chronic disease management). They can be delivered in a variety of settings. It is rare to find all three done well simultaneously. Personal care (PC) needs to be both competent and compassionate. Housing must provide at least minimal amenities and foster autonomy; when travel time for PC raises costs dramatically, some form of clustered housing may be needed. Health care must be proactive, aimed at preventing exacerbations of chronic disease and resultant hospitalizations. Enhancing preferences means allowing taking informed risks. Payment incentives should reward both quality of care and quality of life, but positive outcomes must be defined as slowing decline. Paying for services but not for housing under Medicaid would automatically level the playing field between nursing homes (NH) and community-based services. Regulations should achieve greater parity between NH and community care and include both positive and negative feedback. Providing post-acute care should be separate from LTC. Using the tripartite LTC framework, we can create innovative flexible approaches to providing needed services for frail older persons in formats that are both desirable and affordable. Such care will be more socially desirable and hence worth paying for. PMID:26035606

  5. Long-term depot antipsychotics. A risk-benefit assessment.

    PubMed

    Barnes, T R; Curson, D A

    1994-06-01

    The main advantage of depot antipsychotic medication is that it overcomes the problem of covert noncompliance. Patients receiving depot treatment who refuse their injection or fail to receive it for any other reason can be immediately identified and appropriate action taken. In the context of a carefully monitored management programme, depot treatment can have a major impact on compliance and, consequently, the risk of relapse and hospitalisation can be reduced. Another major advantage is that the considerable individual variation in bioavailability and metabolism with oral antipsychotic drugs is markedly reduced with depot treatment. A better correlation between the dose administered and the concentration of medication found in blood or plasma is achieved with depot treatment, and thus, the clinician has greater control over the amount of drug being delivered to the site of activity. A further benefit of depot treatment is the achievement of stable plasma concentrations over long periods, allowing injections to be given every few weeks. However, this also represents a potential disadvantage in that there is a lack of flexibility of administration. Should adverse effects develop, the drug cannot be rapidly withdrawn. Furthermore, adjustment to the optimal dose becomes a long term strategy. The controlled studies of low dose maintenance therapy with depot treatment suggest that it can take months or years for the consequences of dose reduction, in terms of increased risk of relapse, to become manifest. When weighing up the risks and benefits of long term antipsychotic treatment for the individual patient with schizophrenia, the clinician must take into account the nature, severity and frequency of past relapses, and the degree of distress and disability related to any adverse effects. However, the clinical decision to prescribe either a depot or an oral antipsychotic for maintenance treatment will probably rest largely on an assessment of the risk of poor compliance

  6. BIOMONITORING TO ACHIEVE CONTROL OF TOXIC EFFLUENTS

    EPA Science Inventory

    This 48 - page Technology Transfer Report provides a case study of how water quality-based toxicity control procedures can be combined with chemical analyses and biological stream surveys to achieve more effective water pollution control. t describes how regulatory agencies used ...

  7. Long-Term Effects of Neurofeedback Treatment in Autism

    ERIC Educational Resources Information Center

    Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.

    2009-01-01

    Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

  8. The Long-Term Effects of Youth Unemployment

    ERIC Educational Resources Information Center

    Mroz, Thomas A.; Savage, Timothy H.

    2006-01-01

    Using NLSY data, we examine the long-term effects of youth unemployment on later labor market outcomes. Involuntary unemployment may yield suboptimal investments in human capital in the short run. A theoretical model of dynamic human capital investment predicts a rational "catch-up" response. Using semiparametric techniques to control for the…

  9. Long-Term Psychosomatic Effects of Biofeedback vs. Relaxation Training.

    ERIC Educational Resources Information Center

    Nowlis, David P.; Borzone, Ximena C.

    Differences were compared in the short-term and long-term responses of subjects with headache, insomnia, or hypertension to biofeedback training, relaxation, or a combination of both. Headache sufferers, insomniacs, and hypertensives were randomly assigned in equal numbers to biofeedback, relaxation training or a record-keeping control. Over 2…

  10. Long-Term Effects of Peace Workshops in Protracted Conflicts

    ERIC Educational Resources Information Center

    Malhotra, Deepak; Liyanage, Sumanasiri

    2005-01-01

    The current study evaluates the efficacy of an intensive four-day contact intervention (a peace workshop) organized in Sri Lanka and represents an initial step toward understanding the long-term impact of such interventions on attitudes and behaviors in the context of protracted ethnic conflict. Compared with two control groups, the participant…

  11. Long-term Multiwavelength Observations of Polars

    NASA Astrophysics Data System (ADS)

    Santana, Joshua; Mason, Paul A.

    2016-06-01

    Polars are cataclysmic variables with the highest magnetic field strengths (10-250 MG). Matter is accreted after being funneled by the strong magnetic field of the white dwarf. We perform a meta-study of multi-wavelength data of polars. Many polars have been observed in surveys, such as SDSS, 2MASS, ROSAT, just to name a few. Some polars have now been detected by the JVLA, part of an expanding class of radio CVs. A large subset of polars have long-term optical light curves from CRTS and AAVSO. We suggest that the long term light curves of polars display a variety of signature behaviors and may be grouped accordingly. Additional characteristics such a binary period, magnetic field strengths, X-ray properties, and distance estimates are examined in context with long-term observations.

  12. Scenarios for long-term analysis

    SciTech Connect

    Wolbers, Stephen; /Fermilab

    2009-01-01

    Data Preservation and Long-Term Analysis of High Energy Physics (HEP) Experiments data is described and summarized in this talk. The summary covers information presented at the First Workshop on Data Preservation and Long-Term Analysis. Experiments representing e{sup +}e{sup -} collisions (LEP, B Factories and CLEO), ep collisions (H1 and ZEUS), p{bar p} collisions (CDF and D0) and others presented interesting information related to utilizing the large datasets collected over many years at these HEP facilities. Many questions and issues remain to be explored.

  13. Long-Term Use of Benzodiazepines

    PubMed Central

    Potts, Nicholas L.S.; Krishnan, K. Ranga R.

    1992-01-01

    Problems associated with physical dependence and abuse of benzodiazepines by a small percentage of patients have reduced their popularity from the most commonly prescribed psychoactive drug in the 1970s to being prescribed for mainly short periods. Patients who benefit from long-term benzodiazepine use are nearly ignored by the medical community as a whole. This article details what patient population can improve from long-term benzodiazepine therapy, the risks and benefits of treatment, and how to select appropriate candidates. PMID:21229127

  14. Long-term Outcomes after Severe Shock

    PubMed Central

    Pratt, Cristina M.; Hirshberg, Eliotte L.; Jones, Jason P.; Kuttler, Kathryn G.; Lanspa, Michael J.; Wilson, Emily L.; Hopkins, Ramona O.; Brown, Samuel M.

    2014-01-01

    Background Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Methods Seventy-six patients who were alive 90 days after severe shock (received ≥1 mcg/kg/min of norepinephrine equivalent) were eligible for the study. We measured three-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. Results The mean long-term survival was 5.1 years: 82% (62/76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of five years after hospital admission. The patients’ Physical Functioning scores were below US population norms (p<0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full time. Conclusions Early survivors of severe shock had a high three-year survival rate. Patients’ long term physical and psychological outcomes were similar to those reported for cohorts of less severely ill ICU survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term

  15. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study.

    PubMed

    Friedel, Walter E; Matthes, Harald; Bock, Paul R; Zänker, Kurt S

    2009-01-01

    In Europe, patients with colorectal carcinoma (CRC) frequently receive mistletoe extracts to improve quality of life and survival. This study was designed to evaluate supportive treatment with mistletoe extract Iscador (ISC) in nonmetastatic CRC patients under routine clinical conditions and to create well-founded hypotheses for future prospective clinical studies. The design of a multicenter, controlled, retrospective, observational cohort study with parallel groups met the Good Epidemiological Practice rules. Anonymous unselected standardized data from eligible patients with surgically treated stage I-III CRC and adjuvant therapy (AT) or conventional aftercare were included. End points were adjuvant therapy-related adverse reactions (AT-ADRs), symptoms, and disease-free survival (DFS). The results were adjusted for confounder effects. Eight hundred four (429 ISC vs 375 control) CRC patients from 26 centers were observed for a median of 58 versus 51 months; the median ISC therapy lasted 52 months. ISC patients showed fewer AT-ADRs (19% vs 48%, p < .001) and fewer persisting symptoms (p < .001). The DFS hazard ratio of 0.60 (p = .013) suggests a survival benefit in ISC patients versus controls. ISC was well tolerated without life-threatening ADRs, drug interactions, or tumor enhancement. These results suggest a beneficial effect of supportive care ISC therapy within AT protocols and long-term ISC treatment in stage I-III CRC patients, particularly improvement in AT-ADRs and symptoms and possible extension of DFS. PMID:19883529

  16. SULFURIC ACID REMOVAL PROCESS EVALUATION: LONG-TERM RESULTS

    SciTech Connect

    Gary M. Blythe; Richard McMillan

    2002-07-03

    longer-term (approximately 25-day) full-scale tests on two different units. The longer-term tests were conducted to confirm the effectiveness of the sorbents tested over extended operation on two different boilers, and to determine balance-of-plant impacts. The first long-term test was conducted on FirstEnergy's BMP, Unit 3, and the second test was conducted on AEP's Gavin Plant, Unit 1. The Gavin Plant testing provided an opportunity to evaluate the effects of sorbent injected into the furnace on SO{sub 3} formed across an operating SCR reactor. This report presents the results from those long-term tests. The tests determined the effectiveness of injecting commercially available magnesium hydroxide slurry (Gavin Plant) and byproduct magnesium hydroxide slurry (both Gavin Plant and BMP) for sulfuric acid control. The results show that injecting either slurry could achieve up to 70 to 75% overall sulfuric acid removal. At BMP, this overall removal was limited by the need to maintain acceptable electrostatic precipitator (ESP) particulate control performance. At Gavin Plant, the overall sulfuric acid removal was limited because the furnace injected sorbent was less effective at removing SO{sub 3} formed across the SCR system installed on the unit for NOX control than at removing SO{sub 3} formed in the furnace. The long-term tests also determined balance-of-plant impacts from slurry injection during the two tests. These include impacts on boiler back-end temperatures and pressure drops, SCR catalyst properties, ESP performance, removal of other flue gas species, and flue gas opacity. For the most part the balance-of-plant impacts were neutral to positive, although adverse effects on ESP performance became an issue during the BMP test.

  17. Long Term Treatment Concepts and Proactive Therapy for Atopic Eczema

    PubMed Central

    Ehmann, Laura Maximiliane

    2012-01-01

    Atopic eczema, also known as atopic dermatitis, is a frequent, highly pruritic, chronic skin disease, which is typically running in flares. The traditional treatment mainly consists of the reactive application of topical anti-inflammatory agents such as topical corticosteroids and topical calcineurin inhibitors. The short term benefit of this approach is well known, but long term remission between flares is difficult to achieve. Therefore, innovative long-term treatment strategies targeting flare prevention and skin barrier stabilization are needed. We and others have shown that normal looking, non-lesional skin of atopic dermatitis patients is immunobiologially not normal but characterized by an invisible inflammation and barrier defect. This has led to the novel concept of proactive therapy, which is defined as long-term, low-dose intermittent application of anti-inflammatory therapy to the previously affected skin, together with an ongoing emollient treatment of unaffected skin. This review article describes the most important long-term treatment options for atopic dermatitis, which includes emollient therapy, the novel concept of proactive treatment, the different ultraviolet light modalities and a selection of systemic immunosuppressive drugs and biologics. Current trial data, licensed indications, off-label use and relevant side effects of the different treatment modalities are summarized. PMID:22879707

  18. Organomatics and organometrics: Novel platforms for long-term whole-organ culture

    PubMed Central

    Bruinsma, Bote G.; Yarmush, Martin L.; Uygun, Korkut

    2014-01-01

    Organ culture systems are instrumental as experimental whole-organ models of physiology and disease, as well as preservation modalities facilitating organ replacement therapies such as transplantation. Nevertheless, a coordinated system of machine perfusion components and integrated regulatory control has yet to be fully developed to achieve long-term maintenance of organ function ex vivo. Here we outline current strategies for organ culture, or organomatics, and how these systems can be regulated by means of computational algorithms, or organometrics, to achieve the organ culture platforms anticipated in modern-day biomedicine. PMID:25035864

  19. Long-term effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on the peripheral nervous system. Clinical and neurophysiological controlled study on subjects with chloracne from the Seveso area.

    PubMed

    Barbieri, S; Pirovano, C; Scarlato, G; Tarchini, P; Zappa, A; Maranzana, M

    1988-01-01

    This work was set up to investigate the possible presence of peripheral nervous system involvement as a long-term effect of the exposure to dioxin in 152 subjects with chloracne from the Seveso area; 123 age- and sex-matched subjects living in nearby towns with similar environmental pollution formed the control group. The accident in Seveso took place in July, 1976, and this study was carried out from October, 1982, to May, 1983. Although a peripheral neuropathy was not found in any of the subjects, a significant increase of the number of individuals presenting at least two bilateral clinical signs (p less than 0.05) or one abnormal electrophysiological parameter (p less than 0.02) was found in the Seveso group. Principal component analysis did not show any subdivision between these two groups. The Fisher approach to discriminant analysis reveals a clear subdivision between the group of the most exposed subjects and randomly selected subgroups of control subjects. In conclusion, clinical and electrophysiological signs of peripheral nervous system involvement occur with a statistically increased frequency in the Seveso population 6 years after the accident, although a peripheral neuropathy was not evident in any of the chloracne patients using the World Health Organization diagnostic criteria. PMID:2829044

  20. Long Term Care Aide. Course Outline.

    ERIC Educational Resources Information Center

    Wilbee, Judy

    This course outline is intended to assist the instructor in the development of a curriculum for a long-term care aide program by specifying one component of the curriculum--the objectives. These objectives, or competencies expected as outcomes for student performance on completion of the program, describe the capabilities an individual must…

  1. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  2. Long-term fixed income market structure

    NASA Astrophysics Data System (ADS)

    Grilli, Luca

    2004-02-01

    Long-term fixed income market securities present a strong positive correlation in daily returns. By using a metrical approach and considering “modified” time series, I show how it is possible to show a more complex structure which depends strictly on the maturity date.

  3. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  4. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  5. NATIONAL LONG TERM CARE SURVEY (NLTCS)

    EPA Science Inventory

    National Long Term Care Surveys (NLTCS) are surveys of the entire aged population with a particular emphasis on the functionally impaired. Longitudinal study of the health and well-being of elderly Americans. Information about the population of chronically disabled elderly person...

  6. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  7. Long-Term Stability of Social Participation

    ERIC Educational Resources Information Center

    Hyyppa, Markku T.; Maki, Juhani; Alanen, Erkki; Impivaara, Olli; Aromaa, Arpo

    2008-01-01

    The long-term stability of social participation was investigated in a representative urban population of 415 men and 579 women who had taken part in the nationwide Mini-Finland Health Survey in the years 1978-1980 and were re-examined 20 years later. Stability was assessed by means of the following tracking coefficients: kappa, proportion of…

  8. Interaction Effects of Long-Term Air Pollution Exposure and Variants in the GSTP1, GSTT1 and GSTCD Genes on Risk of Acute Myocardial Infarction and Hypertension: A Case-Control Study

    PubMed Central

    Levinsson, Anna; Olin, Anna-Carin; Modig, Lars; Dahgam, Santosh; Björck, Lena; Rosengren, Annika; Nyberg, Fredrik

    2014-01-01

    Introduction Experimental and epidemiological studies have reported associations between air pollution exposure, in particular related to vehicle exhaust, and cardiovascular disease. A potential pathophysiological pathway is pollution-induced pulmonary oxidative stress, with secondary systemic inflammation. Genetic polymorphisms in genes implicated in oxidative stress, such as GSTP1, GSTT1 and GSTCD, may contribute to determining individual susceptibility to air pollution as a promoter of coronary vulnerability. Aims We aimed to investigate effects of long-term traffic-related air pollution exposure, as well as variants in GSTP1, GSTT1 and GSTCD, on risk of acute myocardial infarction (AMI) and hypertension. In addition, we studied whether air pollution effects were modified by the investigated genetic variants. Methods Genotype data at 7 single nucleotide polymorphisms (SNPs) in the GSTP1 gene, and one in each of the GSTT1 and GSTCD genes, as well as air pollution exposure estimates, were available for 119 AMI cases and 1310 randomly selected population controls. Population control individuals with systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or on daily antihypertensive medication were defined as hypertensive (n = 468). Individual air pollution exposure levels were modeled as annual means of NO2 (marker of vehicle exhaust pollutants) using central monitoring data and dispersion models, linking to participants' home addresses. Results Air pollution was significantly associated with risk of AMI: OR 1.78 (95%CI 1.04–3.03) per 10 µg/m3 of long-term NO2 exposure. Three GSTP1 SNPs were significantly associated with hypertension. The effect of air pollution on risk of AMI varied by genotype strata, although the suggested interaction was not significant. We saw no obvious interaction between genetic variants in the GST genes and air pollution exposure for hypertension. Conclusion Air pollution exposure entails an increased risk of AMI

  9. Long-term management of gout: nonpharmacologic and pharmacologic therapies.

    PubMed

    Chaichian, Yashaar; Chohan, Saima; Becker, Michael A

    2014-05-01

    Gout is a common disorder with clinical signs and symptoms resulting from inflammatory responses to monosodium urate crystals deposited in tissues from extracellular fluids saturated for urate. Long-term management of gout focuses on nonpharmacologic and pharmacologic means to achieve and maintain serum urate levels in a subsaturating range. Despite a firm understanding of gout pathophysiology, means to achieve certain diagnosis, and a variety of effective therapies, treatment outcomes remain suboptimal. In this review, available nonpharmacologic and pharmacologic therapies for chronic gout are discussed and a framework is provided for successful achievement and maintenance of goal-range serum urate levels. PMID:24703352

  10. Achieving Long-Term Protection of Water Quality of Grand Lake St. Marys Through Implementation of Conservation Practices and Control of Phosphorus Input from Agricultural Drainage

    EPA Science Inventory

    Grand Lake St. Marys (GLSM), a 13,000 acre lake in northwestern Ohio, is experiencing toxic levels of algal blooms resulting primarily from phosphorus input from agricultural runoff. The algal blooms are so severe that the Ohio Department of Natural Resources advised against any...

  11. The steps that can take us miles: Examining the short-term dynamics of long-term daily goal pursuit.

    PubMed

    Wilkowski, Benjamin M; Ferguson, Elizabeth Louise

    2016-04-01

    Cybernetic models suggest that to achieve one's long-term goals, one must create specific plans, enact these plan, monitor progress toward the goal, and resist temptations. Although many studies have examined these proposals in laboratory settings, few studies have examined such processes in daily life. This was the explicit purpose of the current investigation. Participants identified 4 long-term goals during an orientation session. They then completed a diary protocol in which they reported on these self-regulatory processes. The results were largely consistent with predictions. Of the 20 hypotheses examined, 17 were significant in the expected direction. For example, testing led to the initiation of long-term goal operations, which in turn led to goal progress. Likewise, temptations led to self-control operations, which in turn led to the successful resistance of temptations. The investigation thus suggests that cybernetic principles have broad relevance to understanding goal pursuit in daily life. (PsycINFO Database Record PMID:26913617

  12. The favourable effects of long-term selenium supplementation on regression of cervical tissues and metabolic profiles of patients with cervical intraepithelial neoplasia: a randomised, double-blind, placebo-controlled trial.

    PubMed

    Karamali, Maryam; Nourgostar, Sepideh; Zamani, Ashraf; Vahedpoor, Zahra; Asemi, Zatollah

    2015-12-28

    This study was conducted to assess the effects of long-term Se administration on the regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This randomised, double-blind, placebo-controlled trial was carried out among fifty-eight women diagnosed with CIN1. To diagnose CIN1, we used specific diagnostic procedures of biopsy, pathological diagnosis and colposcopy. Patients were randomly assigned to two groups to receive 200 μg Se supplements as Se yeast (n 28) or placebo (n 28) daily for 6 months. After 6 months of taking Se supplements, a greater percentage of women in the Se group had regressed CIN1 (88·0 v. 56·0 %; P=0·01) compared with those in the placebo group. Long-term Se supplementation, compared with the placebo, resulted in significant decreases in fasting plasma glucose levels (-0·37 (sd 0·32) v. +0·07 (sd 0·63) mmol/l; P=0·002), serum insulin levels (-28·8 (sd 31·2) v. +13·2 (sd 40·2) pmol/l; P<0·001), homeostatic model assessment of insulin resistance values (-1·3 (se 1·3) v. +0·5 (se 1·4); P<0·001) and a significant elevation in quantitative insulin sensitivity check index (+0·03 (sd 0·03) v. -0·01 (sd 0·01); P<0·001). In addition, patients who received Se supplements had significantly decreased serum TAG (-0·14 (sd 0·55) v. +0·15 (sd 0·38) mmol/l; P=0·02) and increased HDL-cholesterol levels (+0·13 (sd 0·21) v. -0·01 (sd 0·15) mmol/l; P=0·003). In addition, compared with the placebo group, there were significant rises in plasma total antioxidant capacity (+186·1 (sd 274·6) v. +42·8 (sd 180·4) mmol/l; P=0·02) and GSH levels (+65·0 (sd 359·8) v. -294·2 (sd 581·8) μmol/l; P=0·007) and a significant decrease in malondialdehyde levels (-1·5 (sd 2·1) v. +0·1 (sd 1·4) μmol/l; P=0·001) among those who took Se supplements. Overall, taking Se supplements among patients with CIN1 led to its regression and had beneficial effects on their metabolic profiles. PMID

  13. Patient-reported improvements in health are maintained 2 years after completing a short course of cognitive behaviour therapy, exercise or both treatments for chronic widespread pain: long-term results from the MUSICIAN randomised controlled trial

    PubMed Central

    Beasley, Marcus; Prescott, Gordon J; Scotland, Graham; McBeth, John; Lovell, Karina; Keeley, Phil; Hannaford, Philip C; Symmons, Deborah P M; MacDonald, Ross I R; Woby, Steve; Macfarlane, Gary J

    2015-01-01

    Objectives The MUSICIAN study has previously shown short-term benefit but only marginal cost-effectiveness for two non-pharmacological interventions for chronic widespread pain (CWP). We wished to determine their long-term effectiveness and cost-effectiveness. Methods A 2×2 factorial randomised controlled trial based in primary care in the UK. People were eligible if they were aged ≥25 years with CWP for which they had consulted their general practitioner. The interventions were a 6-month telephone cognitive behaviour therapy (tCBT) and/or a tailored exercise programme, in comparison to usual care. The primary outcome was patient-reported change in health. Results 884 persons were eligible, 442 were randomised and 81.7% were followed up 24 months post-treatment. In comparison to usual care (positive outcome 12.8%), tCBT (35.4%; OR 3.7 95% CI (1.8 to 8.0)), exercise (29.3%; OR 2.8 95% CI (1.3 to 6.0)) and both interventions (31.2%; OR 3.1 95% CI (1.3 to 6.0)) were significantly more effective. There was only a small decrease in effectiveness over time for individual and combined treatments. Those with more intense/disabling pain, higher distress and those who exhibited passive coping at baseline were more likely to have a positive outcome with tCBT than persons without these characteristics. tCBT was associated with the greatest increase in quality of life and lowest costs. Cost per quality adjusted life year was £3957–£5917 depending on method of analysis. Conclusions A short course of tCBT for people with CWP was effective long-term and was highly cost-effective. Exercise was also effective but delivered positive outcome for fewer patients at greater cost, and there was no advantage for patients receiving both interventions. Trial registration number ISRCTN67013851. PMID:26509056

  14. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    PubMed Central

    2012-01-01

    Background Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL). Whether this is due to their endocrine consequences (hypopituitarism), their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL) in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Methods Consecutive patients (n=101) treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years) with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL)-90, Nottingham Health Profile (NHP), and Psychological Well Being (PGWB) questionnaires. Level of physical activity was assessed using the Baecke questionnaire. Results The median accumulated dose was 1.9 Gy (1.5–2.2 Gy) to the hypothalamus and 2.4 Gy (1.8–3.3 Gy) to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2). The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. Conclusion In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls. PMID:23101561

  15. Long Term Functional Outcomes After Early Childhood Pollicization

    PubMed Central

    Lightdale-Miric, Nina; Mueske, Nicole M.; Lawrence, Emily L.; Loiselle, Jennifer; Berggren, Jamie; Dayanidhi, Sudarshan; Stevanovic, Milan; Valero-Cuevas, Francisco J.; Wren, Tishya A. L.

    2014-01-01

    Study Design Retrospective Cohort Introduction Pollicization creates a thumb from another finger to treat hypoplasia/aplasia. Important outcomes include strength, function, dexterity, and quality of life. Purpose of the Study To evaluate mid- to long-term outcomes and examine predictors of outcome after early childhood pollicization. Methods 8 children who underwent 10 pollicizations (age at surgery ≤ 5 years) were evaluated 3 to 15 years after surgery. Anthropometrics, range of motion, and basic medical history were obtained. Participants completed an upper extremity questionnaire (PODCI) and functional tests including grip and pinch strength, Box and Blocks, 9-hole pegboard, and strength-dexterity (S-D) tests. Results Almost all pollicized hands had poor strength and performed poorly on the traditional functional tests. Six of 10 pollicized hands had normal dexterity scores but were less stable in maintaining a steady-state force. Predictors of poorer outcomes included older age at surgery, reduced metacarpophalangeal and interphalangeal range of motion, and radial absence. Discussion Early childhood pollicization resulted in poor strength and overall function, but normal dexterity was often achieved using altered control strategies. Conclusions Most children will likely obtain adequate dexterity despite weakness after pollicization, but older children and those with the most severe involvement may have poorer outcomes. PMID:25835252

  16. Neuropsychological sequelae of childhood cancer in long-term survivors

    SciTech Connect

    Copeland, D.R.; Fletcher, J.M.; Pfefferbaum-Levine, B.; Jaffe, N.; Ried, H.; Maor, M.

    1985-04-01

    In order to assess the effects of various cancer treatments on neuropsychological functioning, 74 long-term survivors of childhood cancer were examined. A comprehensive battery of tests was administered to two CNS treatment groups (irradiated and nonirradiated leukemia and lymphoma patients) and a control group (solid tumor and Hodgkin disease patients receiving no CNS treatment). The CNS-irradiated group obtained lower scores than the other two groups, with significant differences in visual-motor and fine motor skills, spatial memory, and arithmetic achievement resulting in significant differences in IQ scores (VIQ, PIQ, FSIQ). The results are discussed in relation to: (1) the effects of CNS irradiation on cognitive development; (2) the specificity of these effects; and (3) the relationship of age at diagnosis to treatment effects. It is concluded that although there is a general lowering of scores after CNS irradiation, the effect is most pronounced for nonlanguage skills. Age at diagnosis was less important than the type of treatment, with CNS irradiation reducing performance regardless of when cancer was diagnosed. There were indications that children with any type of cancer diagnosed before age 5 years are more likely to have some cognitive difficulties.

  17. Probabilistic simulation of long term behavior in polymer matrix composites

    NASA Technical Reports Server (NTRS)

    Shah, A. R.; Singhal, S. N.; Murthy, P. L. N.; Chamis, C. C.

    1995-01-01

    A methodology to compute cumulative probability distribution functions (CDF) of fatigue life for different ratios, r of applied stress to the laminate strength based on first ply failure criteria has been developed and demonstrated. Degradation effects due to long term environmental exposure and mechanical cyclic loads are considered in the simulation process. A unified time-stress dependent multi-factor interaction equation model developed at NASA Lewis Research Center has been used to account for the degradation/aging of material properties due to cyclic loads. Fast probability integration method is used to perform probabilistic simulation of uncertainties. Sensitivity of fatigue life reliability to uncertainties in the primitive random variables are computed and their significance in the reliability based design for maximum life is discussed. The results show that the graphite/epoxy (0/+45/90) deg laminate with ply thickness 0.125 in. has 500,000 cycles life for applied stress to laminate strength ratio of 0.6 and a reliability of 0.999. Also, the fatigue life reliability has been found to be most sensitive to the ply thickness and matrix tensile strength. Tighter quality controls must therefore be enforced on ply thickness and matrix strength in order to achieve high reliability of the structure.

  18. A Plea for Long-term Orientation in Organizations

    NASA Astrophysics Data System (ADS)

    Schwaninger, Markus; Ambroz, Kristjan

    2010-11-01

    The stress field between short- and long-term orientations is the epitome of organizational problematics: In many enterprises the latter is dominated by the former. The consequences of a dominant short-term orientation are negative in the best case, but the cases that result in destruction and catastrophe are legion. Few sustainable solutions for the conflict between the short- and long-term perspectives have been developed, and among those concerned many have not sufficiently reflected on this shortfall, or even become aware of it. Frequently, practical constraints obstruct a balance between short- and long-term orientations. The aim of this contribution is to enquire into this dilemma and to find a way of coping with it. Any progress in that direction would help to further the viability of organizations and the quality of life within them. As a pertinent contribution we present the Model of Systemic Control, a framework with a long-term view for the governance of organizations. Even though we are emphasizing the conceptual aspect, our theoretical statement is underpinned by an empirical approach and simulation experiments.

  19. Experiences of the Long Term Stability at SLS

    SciTech Connect

    Wei, F. Q.

    2007-01-19

    The long term stability on the scale from days to a year, besides the short term stability, is one of key performance indicators of a light source. The Swiss Light Source (SLS) was installed and commissioned in 2000. It has successfully worked for more than 5 years without re-alignment of the machine. Hydrostatic Leveling System (HLS) and Horizontal Position System (HPS) have been added at supports of the storage ring (48 girders). They made evidence that the position of SLS Storage Ring (SR) is very stable on the time scale of a day, a week, a month and a year. The evidence for the long term stability is also provided by frequency of the RF cavity. The HLS is a powerful tool. The analysis of the HLS data shows that the vertical displacements, which are adjusted to correct average orbit deviations, of the SLS storage ring foundation and of the girder supports were in the range of 0.15 mm in 2003. The site, the building foundation, the mechanical supports and the temperature control are important pre-conditions to get the good long term stability. The experience gained with the long term stability at SLS is presented.

  20. The long-term costs of career interruptions.

    PubMed

    Ketsche, Patricia G; Branscomb, Lisette

    2003-01-01

    This article is based on a study that analyzed the long-term salary implications of career choices made by healthcare administrators. The study used a cohort of graduates from a single health administration program; these individuals had comparable levels of human capital at the outset of their careers. We estimated the effect of periods of part-time employment and job interruptions--voluntary and involuntary--on long-term salary progression. We also estimated the impact of other career choices, such as membership in a professional organization or the decision to relocate. After controlling for these choices, we estimated the residual effect of gender on salary. We found that voluntary interruptions had a greater effect on long-term salary growth than did involuntary interruptions of the same length or periods of part-time employment. Individuals evaluating options for balancing career and family constraints should understand the long-term cost of choosing a career interruption rather than part-time employment during periods of heightened responsibilities outside the workplace. Healthcare administrators should also be educated about the positive association between professional memberships and career advancement to make informed decisions about participation in such organizations. Surprisingly, after controlling for all choice variables, gender had no measurable effect on long-term salary growth. Half of those who indicated a voluntary interruption for dependent care reasons preferred part-time or flexible-hour work if it had been available. These results suggest that a pool of healthcare administrators might compete for positions if more part-time opportunities were available. PMID:12592867

  1. Long term mortality in burned children

    PubMed Central

    Stamboulian, Daniel; Lede, Roberto

    2015-01-01

    Studies about risk factors for mortality in burn children are scarce and are even less in the follow up of this population across time. Usually, after complete event attendance, children are not follow-up as risk patients, burn injury affects all facets of life. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns. In this editorial we comment the paper of Duke et al. The authors highlight the importance of maintaining a long-term monitoring of children who suffered burns. The importance of this original study is to promote the reconsideration of clinical guides of long-term follow-up of burn patients. PMID:26835375

  2. Long term mortality in burned children.

    PubMed

    Rosanova, María Teresa; Stamboulian, Daniel; Lede, Roberto

    2015-07-01

    Studies about risk factors for mortality in burn children are scarce and are even less in the follow up of this population across time. Usually, after complete event attendance, children are not follow-up as risk patients, burn injury affects all facets of life. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns. In this editorial we comment the paper of Duke et al. The authors highlight the importance of maintaining a long-term monitoring of children who suffered burns. The importance of this original study is to promote the reconsideration of clinical guides of long-term follow-up of burn patients. PMID:26835375

  3. Long-term safety of retinoid therapy.

    PubMed

    Vahlquist, A

    1992-12-01

    The concern about long-term toxicity of oral synthetic retinoids has developed because many patients, especially those with genodermatoses, require lifelong therapy. Several organ systems are at risk, especially the hepatic, skeletal, and cardiovascular systems. Although acute hepatotoxicity is a rare side effect of etretinate and acitretin therapy, prospective studies have not demonstrated chronic liver toxicity. The frequency of bone changes induced by retinoids is difficult to estimate, because this adverse effect is usually asymptomatic and requires x-ray or scintigraphic examination for detection. Atherosclerosis develops in many patients who receive long-term retinoid therapy, but the extent to which the process is aggravated by drug-induced hyperlipidemia is not known. Many patients have now been treated with either etretinate or isotretinoin continuously for as many as 15 years and have not developed any signs of severe chronic toxicity. However, continued intense surveillance is recommended for patients expected to require lifelong therapy. PMID:1460122

  4. [Taiwan long-term care insurance and the evolution of long-term care in Japan].

    PubMed

    Huang, Hui-Wen; Liu, Shu-Hui; Pai, Yu-Chu

    2010-08-01

    The proportion of elderly (65 years of age and older) in Taiwan has exceeded 10% since 2008. With more elderly, the number of patients suffering from dementia and disabilities has also been rapidly increasing. Japan also has been facing increasing demand for long-term care due to an aging society. Prior to 2000, social welfare programs in Japan, working to cope with changing needs, typically provided insufficient services, and geriatric patients were hospitalized unnecessarily, wasting medical resources and causing undue patient hardship. In response, Japan launched its long-term care insurance program in April 2000. Under the program, city, town and village-based organizations should take responsibility for providing care to the elderly in their place of residence. The program significantly improved previous financial shortfalls and long-term care supply and demand has been met by existing social welfare organization resources. In Taiwan, the provision of long-term care by county / city authorities has proven inconsistent, with performance deemed poor after its first decade of long-term care operations. Service was found to be affected by differences in available resources and insufficient long-term care administration. The cultures of Taiwan and Japan are similar. The authors visited the Japan Long-Term Care Insurance Institute in August 2009. Main issues involved in the implementation and evolution of the Japan long-term Care Insurance are reported on in this paper. We hope such may be useful information to those working to develop long-term care programs in Taiwan. PMID:20661859

  5. Long-term orbital lifetime predictions

    NASA Astrophysics Data System (ADS)

    Dreher, P. E.; Lyons, A. T.

    1990-10-01

    Long-term orbital lifetime predictions are analyzed. Predictions were made for three satellites: the Solar Max Mission (SMM), the Long Duration Exposure Facility (LDEF), and the Pegasus Boiler Plate (BP). A technique is discussed for determining an appropriate ballistic coefficient to use in the lifetime prediction. The orbital decay rate should be monitored regularly. Ballistic coefficient updates should be done whenever there is a significant change in the actual decay rate or in the solar activity prediction.

  6. Long-term Variation of AGNs

    NASA Astrophysics Data System (ADS)

    Fan, J. H.; Xie, G. Z.; Adam, G.; Copin, Y.; Lin, R. G.; Bai, J. M.; Quin, Y. P.

    In this paper we will present the long-term variation in the optical and the infrared bands for some selected AGNs. 1. Some new optical data observed by us have been presented for BL Lacertae (1995-1996) and OJ 287 (1994-1995), and new infrared data are presented for OJ 287 (Nov=2E 1995), which corresponds to the second optical peak (Sillanpaa et al. 1996; Takalo et al. 1996) and during last outburst. 2. For objects with long term observations, the Jurkevich's method has been used to analyses the long-term variation period. It is interesting that the reported periods of AGNs are of the similar value of about 10 years: 3C 345 11.4 years (Webb et al. 1988), 3C 120 15 years (Belokon et al. 1987; Hagen-Thorn et al. 1997), ON 231 13.6 years (Liu et al. 1995), OJ 287 12 years (Sillanpaa et al. 1988; Kidger et al. 1992), PKS 0735+178 14 years (Fan et al. 1997), NGC 4151 15 years (Fan et al. 1998a), BL Lacertae 14.0 years (Fan et al. 1998b). Is the mechanism for the long-term variation the same for different AGNs? 3. The DCF method has been adopted to analysis the variation correlation in the optical and infrared bands for BL Lac object OJ 287, the results show that these two bands are strongly correlated, which suggest that the emission mechanism in the two bands is the same. 4. For the optical and infrared bands, the maximum variations are correlated.

  7. Long-term home hemodialysis in children

    PubMed Central

    Borra, Sonia; Kaye, Michael

    1971-01-01

    Experience with chronic hemodialysis as a definitive form of therapy is described for six children aged 11 to 15 years at the onset. Duration on dialysis in the home has been between one and 4½ years. All patients are alive and rehabilitated without serious complications. It is concluded that although transplantation is the most desirable form of treatment for children, long-term hemodialysis is an alternative acceptable second choice. ImagesFIG. 2 PMID:5150193

  8. Long-term consequences of anorexia nervosa.

    PubMed

    Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Katulski, Krzysztof

    2013-07-01

    Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed. PMID:23706279

  9. Titanium for long-term tritium storage

    SciTech Connect

    Heung, L.K.

    1994-12-01

    Due to the reduction of nuclear weapon stockpile, there will be an excess of tritium returned from the field. The excess tritium needs to be stored for future use, which might be several years away. A safe and cost effective means for long term storage of tritium is needed. Storing tritium in a solid metal tritide is preferred to storing tritium as a gas, because a metal tritide can store tritium in a compact form and the stored tritium will not be released until heat is applied to increase its temperature to several hundred degrees centigrade. Storing tritium as a tritide is safer and more cost effective than as a gas. Several candidate metal hydride materials have been evaluated for long term tritium storage. They include uranium, La-Ni-Al alloys, zirconium and titanium. The criteria used include material cost, radioactivity, stability to air, storage capacity, storage pressure, loading and unloading conditions, and helium retention. Titanium has the best combination of properties and is recommended for long term tritium storage.

  10. [Long-term survival after severe trauma].

    PubMed

    Mutschler, W; Mutschler, M; Graw, M; Lefering, R

    2016-07-01

    Long-term survival after severe trauma is rarely addressed in German trauma journals although knowledge of life expectancy and identification of factors contributing to increased mortality are important for lifetime care management, development of service models, and targeting health promotion and prevention interventions. As reliable data in Germany are lacking, we compiled data mainly from the USA and Australia to describe life expectancy, risk factors, and predictors of outcome in patients experiencing traumatic spinal cord injury, traumatic brain injury, and polytrauma. Two years after trauma, life expectancy in all three categories was significantly lower than that of the general population. It depends strongly on severity of disability, age, and gender and is quantifiable. Whereas improvements in medical care have led to a marked decline in short-term mortality, surprisingly long-term survival in severe trauma has not changed over the past 30 years. Therefore, there is need to intensify long-term trauma patient care and to find new strategies to limit primary damage. PMID:27342106

  11. On long-term ozone trends at Hohenpeissenberg

    NASA Technical Reports Server (NTRS)

    Claude, H.; Vandersee, W.; Wege, K.

    1994-01-01

    More than 2000 ozone soundings and a large number of Dobson observations have been performed since 1967 in a unique procedure. The achieved very homogeneous data sets were used to evaluate significant long-term trends both in the troposphere and the stratosphere. The trend amounts to about plus 2 percent per year in the troposphere and to about minus 0.5 percent per year in the stratosphere. Extremely low ozone records obtained during winter 1991/92 are discussed in the light of the long term series. The winter mean of the ozone column is the lowest one of the series. The ozone deficit occurred mainly in the lower stratosphere. One cause may be the Pinatubo cloud. Even compared with the extreme winter mean following the El Chichon eruption the ozone content was lower. Additionally ozone was reduced by dynamical effects due to unusual weather situations.

  12. Fusion energy in context: its fitness for the long term.

    PubMed

    Holdren, J P

    1978-04-14

    Long-term limits to growth in energy will be imposed not by inability to expand supply, but by the rising environmental and social costs of doing so. These costs will therefore be central issues in choosing long-term options. Fusion, like solar energy, is not one possibility but many, some with very attractive environmental characteristics and others perhaps little better in these regards than fission. None of the fusion options will be cheap, and none is likely to be widely available before the year 2010. The most attractive forms of fusion may require greater investments of time and money to achieve, but they are the real reason for wanting fusion at all. PMID:17818794

  13. Physiological, Molecular and Genetic Mechanisms of Long-Term Habituation

    SciTech Connect

    Calin-Jageman, Robert J

    2009-09-12

    Work funded on this grant has explored the mechanisms of long-term habituation, a ubiquitous form of learning that plays a key role in basic cognitive functioning. Specifically, behavioral, physiological, and molecular mechanisms of habituation have been explored using a simple model system, the tail-elicited siphon-withdrawal reflex (T-SWR) in the marine mollusk Aplysia californica. Substantial progress has been made on the first and third aims, providing some fundamental insights into the mechanisms by which memories are stored. We have characterized the physiological correlates of short- and long-term habituation. We found that short-term habituation is accompanied by a robust sensory adaptation, whereas long-term habituation is accompanied by alterations in sensory and interneuron synaptic efficacy. Thus, our data indicates memories can be shifted between different sites in a neural network as they are consolidated from short to long term. At the molecular level, we have accomplished microarray analysis comparing gene expression in both habituated and control ganglia. We have identified a network of putatively regulated transcripts that seems particularly targeted towards synaptic changes (e.g. SNAP25, calmodulin) . We are now beginning additional work to confirm regulation of these transcripts and build a more detailed understanding of the cascade of molecular events leading to the permanent storage of long-term memories. On the third aim, we have fostered a nascent neuroscience program via a variety of successful initiatives. We have funded over 11 undergraduate neuroscience scholars, several of whom have been recognized at national and regional levels for their research. We have also conducted a pioneering summer research program for community college students which is helping enhance access of underrepresented groups to life science careers. Despite minimal progress on the second aim, this project has provided a) novel insight into the network mechanisms by

  14. LONG-TERM STEWARDSHIP AT DOE HANFORD SITE - 12575

    SciTech Connect

    MOREN RJ; GRINDSTAFF KD

    2012-01-11

    The U.S. Department of Energy's (DOE) Hanford Site is located in southeast Washington and consists of 1,518 square kilometers (586 square miles) of land. Established in 1943 as part of the Manhattan Project, Hanford workers produced plutonium for our nation's nuclear defense program until the mid 1980's. Since then, the site has been in cleanup mode that is being accomplished in phases. As we achieve remedial objectives and complete active cleanup, DOE will manage Hanford land under the Long-Term Stewardship (LTS) Program until completion of cleanup and the site becomes ready for transfer to the post cleanup landlord - currently planned for DOE's Office of Legacy Management (LM). We define Hanford's LTS Program in the ''Hanford Long-Term Stewardship Program Plan,'' (DOE/RL-201 0-35)[1], which describes the scope including the relationship between the cleanup projects and the LTS Program. DOE designed the LTS Program to manage and provide surveillance and maintenance (S&M) of institutional controls and associated monitoring of closed waste sites to ensure the protection of human health and the environment. DOE's Richland Operations Office (DOE-RL) and Hanford cleanup and operations contractors collaboratively developed this program over several years. The program's scope also includes 15 key activities that are identified in the DOE Program Plan (DOE/RL-2010-35). The LTS Program will transition 14 land segments through 2016. The combined land mass is approximately 570 square kilometers (220 square miles), with over 1,300 active and inactive waste sites and 3,363 wells. Land segments vary from buffer zone property with no known contamination to cocooned reactor buildings, demolished support facilities, and remediated cribs and trenches. DOE-RL will transition land management responsibilities from cleanup contractors to the Mission Support Contract (MSC), who will then administer the LTS Program for DOE-RL. This process requires an environment of cooperation between

  15. Patient empowerment in long-term conditions: development and preliminary testing of a new measure

    PubMed Central

    2013-01-01

    Background Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. Methods We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. Results Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal

  16. Photodocumentation of long-term lunar surface exposure experiment

    NASA Technical Reports Server (NTRS)

    Hoerz, F.

    1974-01-01

    Preflight photographs of selected Apollo 17 equipment taken for use in determining the effects on various surfaces of long-term exposure to the lunar environment are presented. Photographs of the articles deployed on the lunar surface also are included. The photographic procedure and the coding system used for the photodocumentation are explained. Other documentation measures planned to obtain items for use as controls in projected analyses are discussed.

  17. Long-term-consequence analysis of no action alternative 2

    SciTech Connect

    Buck, J.W.; Bagaasen, L.M.; Staven, L.H.; Serne, R.J.

    1996-07-01

    This report is a supplement to the Waste Isolation Pilot Plant (WIPP) Disposal-Phase Supplemental Environmental Impact Statement. Data and information is described which pertains to estimated impacts from postulated long-term release of radionuclides and hazardous constituents from alpha-bearing wastes stored at major generator/storage sites after loss of institutional control (no action alternative 2). Under this alternative, wastes would remain at the generator sites and not be emplaced at WIPP.

  18. Personalised long-term follow-up of cochlear implant patients using remote care, compared with those on the standard care pathway: study protocol for a feasibility randomised controlled trial

    PubMed Central

    Kitterick, Padraig; DeBold, Lisa; Weal, Mark; Clarke, Nicholas; Newberry, Eva; Aubert, Lisa

    2016-01-01

    Introduction Many resources are required to provide postoperative care to patients who receive a cochlear implant. The implant service commits to lifetime follow-up. The patient commits to regular adjustment and rehabilitation appointments in the first year and annual follow-up appointments thereafter. Offering remote follow-up may result in more stable hearing, reduced patient travel expense, time and disruption, more empowered patients, greater equality in service delivery and more freedom to optimise the allocation of clinic resources. Methods and analysis This will be a two-arm feasibility randomised controlled trial (RCT) involving 60 adults using cochlear implants with at least 6 months device experience in a 6-month clinical trial of remote care. This project will design, implement and evaluate a person-centred long-term follow-up pathway for people using cochlear implants offering a triple approach of remote and self-monitoring, self-adjustment of device and a personalised online support tool for home speech recognition testing, information, self-rehabilitation, advice, equipment training and troubleshooting. The main outcome measure is patient activation. Secondary outcomes are stability and quality of hearing, stability of quality of life, clinic resources, patient and clinician experience, and any adverse events associated with remote care. We will examine the acceptability of remote care to service users and clinicians, the willingness of participants to be randomised, and attrition rates. We will estimate numbers required to plan a fully powered RCT. Ethics and dissemination Ethical approval was received from North West—Greater Manchester South Research Ethics Committee (15/NW/0860) and the University of Southampton Research Governance Office (ERGO 15329). Results Results will be disseminated in the clinical and scientific communities and also to the patient population via peer-reviewed research publications both online and in print, conference and

  19. Informing the design of a randomised controlled trial of an exercise-based programme for long term stroke survivors: lessons from a before-and-after case series study

    PubMed Central

    2013-01-01

    Background To inform the design of a randomised controlled trial (RCT) of an exercise-based programme for long term stroke survivors, we conducted a mixed methods before-and-after case series with assessment at three time points. We evaluated Action for Rehabilitation from Neurological Injury (ARNI), a personalised, functionally-focussed programme. It was delivered through 24 hours of one-to-one training by an Exercise Professional (EP), plus at least 2 hours weekly unsupervised exercise, over 12- 14 weeks. Assessment was by patient-rated questionnaires addressing function, physical activity, confidence, fatigue and health-related quality of life; objective assessment of gait quality and speed; qualitative individual interviews conducted with participants. Data were collected at baseline, 3 months and 6 months. Fidelity and acceptability was assessed by participant interviews, audit of participant and EP records, and observation of training. Findings Four of six enrolled participants completed the exercise programme. Quantitative data demonstrated little change across the sample, but marked changes on some measures for some individuals. Qualitative interviews suggested that small benefits in physical outcomes could be of great psychological significance to participants. Participant-reported fatigue levels commonly increased, and non-completers said they found the programme too demanding. Most key components of the intervention were delivered, but there were several potentially important departures from intervention fidelity. Discussion The study provided data and experience that are helping to inform the design of an RCT of this intervention. It suggested the need for a broader recruitment strategy; indicated areas that could be explored in more depth in the qualitative component of the trial; and highlighted issues that should be addressed to enhance and evaluate fidelity, particularly in the preparation and monitoring of intervention providers. The experience

  20. Medium- to long-term results of a randomized controlled trial to assess the efficacy of arthoscopic-subacromial decompression versus mini-open repair for the treatment of medium-sized rotator cuff tears

    PubMed Central

    Birch, Ann; Temperley, David; Odak, Saurabh; Walton, Michael J; Haines, John F; Trail, Ian

    2015-01-01

    Background We report on the medium- to long-term results of a randomized controlled trial (RCT) aiming to determine whether rotator cuff repair confers any advantage over arthroscopic sub-acromial decompression (ASAD) alone in the management of medium-sized rotator cuff tears. Methods Ethical approval was sought to follow-up patients previously enrolled in a completed and previously published RCT comparing the outcome of ASAD with mini-open cuff repair for the treatment of rotator cuff tear. Forty-two patients were enrolled in the original study, with a mean of 64 years (range 54 years to 77 years). Results Fifteen of the original 17 patients randomized to ASAD alone and 18 of the original 25 patients randomized to cuff repair were available for follow-up. Each patient underwent American Shoulder and Elbow Surgeons (ASES), Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scoring, and clinical and ultrasound examination. Mean duration of follow-up was 7 years (range 5 years to 11 years). There was no statistically significant difference in terms of ASES, DASH and Constant scores at follow-up between the two groups. Some 33% of patients in the cuff-repair group had a proven re-rupture on ultrasound. This patient subgroup had significantly worse Constant scores compared to patients where the repair remained intact. None of the patients from either group developed cuff-tear arthropathy requiring arthroplasty surgery. Conclusions In this medium- to longer-term study, there is no demonstrable significant benefit of cuff repair over decompression alone for the treatment of medium-sized rotator cuff tears, in terms of ASES, DASH and Constant scores for pain, function and strength modules. The presence of cuff tear does not necessitate surgical repair. This conclusion should drive surgical strategies and shared decision-making between patients and surgeons. PMID:27583006

  1. New Nordic Diet versus Average Danish Diet: A Randomized Controlled Trial Revealed Healthy Long-Term Effects of the New Nordic Diet by GC-MS Blood Plasma Metabolomics.

    PubMed

    Khakimov, Bekzod; Poulsen, Sanne Kellebjerg; Savorani, Francesco; Acar, Evrim; Gürdeniz, Gözde; Larsen, Thomas M; Astrup, Arne; Dragsted, Lars O; Engelsen, Søren Balling

    2016-06-01

    A previous study has shown effects of the New Nordic Diet (NND) to stimulate weight loss and lower systolic and diastolic blood pressure in obese Danish women and men in a randomized, controlled dietary intervention study. This work demonstrates long-term metabolic effects of the NND as compared with an Average Danish Diet (ADD) in blood plasma and reveals associations between metabolic changes and health beneficial effects of the NND including weight loss. A total of 145 individuals completed the intervention and blood samples were taken along with clinical examinations before the intervention started (week 0) and after 12 and 26 weeks. The plasma metabolome was measured using GC-MS, and the final metabolite table contained 144 variables. Significant and novel metabolic effects of the diet, resulting weight loss, gender, and intervention study season were revealed using PLS-DA and ASCA. Several metabolites reflecting specific differences in the diets, especially intake of plant foods and seafood, and in energy metabolism related to ketone bodies and gluconeogenesis formed the predominant metabolite pattern discriminating the intervention groups. Among NND subjects, higher levels of vaccenic acid and 3-hydroxybutanoic acid were related to a higher weight loss, while higher concentrations of salicylic, lactic, and N-aspartic acids and 1,5-anhydro-d-sorbitol were related to a lower weight loss. Specific gender and seasonal differences were also observed. The study strongly indicates that healthy diets high in fish, vegetables, fruit, and whole grain facilitated weight loss and improved insulin sensitivity by increasing ketosis and gluconeogenesis in the fasting state. PMID:27146725

  2. A randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of venlafaxine extended release and a long-term extension study for patients with major depressive disorder in Japan

    PubMed Central

    Higuchi, Teruhiko; Kamijima, Kunitoshi; Nakagome, Kazuyuki; Asami, Yuko; Kuribayashi, Kazuhiko; Imaeda, Takayuki

    2016-01-01

    The aim of this study was to assess antidepressant efficacy and safety of venlafaxine extended release in Japanese patients with major depressive disorder (MDD). We carried out a double-blinded, placebo-controlled, randomized study using fixed (75 mg/day) and flexible (75–225 mg/day, most patients attained to 225 mg/day) doses, followed by the long-term, open-labeled, extension study. Outpatients aged at least 20 years diagnosed with MDD were included. The primary efficacy measure was change from baseline in the Hamilton Rating Scale for Depression (HAM-D17) score at week 8; secondary efficacy measures included the Montgomery–Åsberg Depression Rating Scale, the Quick Inventory of Depressive Symptomatology self-report version, HAM-D6, and Clinical Global Impression scales in the double-blinded study. Overall, 538 patients were randomized; significant differences were observed in the primary efficacy variable in the fixed-dose group (−10.76; P=0.031), but not in the flexible-dose (−10.37; P=0.106) group compared with placebo (−9.25). However, the flexible-dose group showed significant efficacy in several secondary measures. Treatment-related adverse events in the treatment period were 51.7 and 67.8% in the fixed-dose and flexible-dose groups, respectively, versus 38.8% with placebo. Throughout the study period, no Japanese-specific adverse events were observed. Thus, venlafaxine extended release was efficacious and safe for MDD treatment in Japan. PMID:26513202

  3. Controlling factors and environmental implications of mercury contamination in urban and agricultural soils under a long-term influence of a chlor-alkali plant in the North-West Portugal

    NASA Astrophysics Data System (ADS)

    Cachada, A.; Rodrigues, S. M.; Mieiro, C.; Ferreira da Silva, E.; Pereira, E.; Duarte, A. C.

    2009-03-01

    This study aims at assessing the extent of total mercury (Hg) contamination in urban and agricultural soils under long-term influence of a chlor-alkali plant, located at about 1 km away from a town centre. Moreover, it aims at identifying the main factors controlling Hg contents’ distribution and associated potential hazards to environment and human health. The median value of total Hg for soil surface layer (0-10 cm) was 0.20 mg/kg (data ranging from 0.050 to 4.5 mg/kg) and for subsurface layer (10-20 cm) 0.18 mg/kg (data ranging from 0.046 to 3.0 mg/kg). The agricultural area showed higher Hg concentrations (ranging from 0.86 to 4.5 mg/kg) than urban area (ranging from 0.05 to 0.61 mg/kg), with some results exceeding target values set by the Dutch guidelines. Mercury concentrations observed in the studied area are more likely to be associated with the influence of the chlor-alkali plant and with the use of historically contaminated sludges and water from a nearby lagoon in agriculture, than to the impacts of urban development. The statistical correlations between Hg concentrations and soil properties suggest that anthropogenic metal sources should influence the spatial distribution more than the geological properties. Although the Hg emissions were drastically reduced 10 years ago, the area under influence of the chlor-alkali plant is still facing potential health and environmental threats arising from soil contamination.

  4. Antimicrobial films containing microparticles for the enhancement of long-term sustained release.

    PubMed

    Bile, Jessica; Bolzinger, Marie-Alexandrine; Valour, Jean-Pierre; Fessi, Hatem; Chevalier, Yves

    2016-05-01

    Coated packagings with thin films containing antimicrobial agents are an alternative technology to ensure the protection of products against microbial contaminations. Indeed, they allow lowering the antimicrobial concentration in the bulk of the product while meeting the safety requirements and the growing consumer demand for low preservative concentrations. Microencapsulation is a suitable way for controlling active agent release and providing a long-term activity. This work aims at combining both technical solutions with coatings containing antimicrobial microparticles for the achievement of long-term sustained release. Polyethylene surfaces were functionalized with microparticles of poly(methyl methacrylate) (PMMA) loaded with phenylethyl alcohol (PEA) as antimicrobial agent by the dip coating process using a polyurethane binder. The release of PEA into water from coated polyethylene surfaces and from PMMA microparticles was investigated to assess the sustained release and its mechanisms. Films with various thicknesses of 400-1000 µm containing antimicrobial microparticles demonstrated unusual long-term release longer than 3 months. The diffusion of the antimicrobial agent through PMMA was the rate limiting step of the sustained release. PEA release increased as the contact area of the protruding microparticles with the external medium increased and the thickness of the film decreased. Such antimicrobial agents encapsulated inside thin coatings are promising with regards to antimicrobial preservation of products along their full shelf-life. PMID:26355722

  5. Long-term EARLINET dust observations

    NASA Astrophysics Data System (ADS)

    Mona, Lucia; Amiridis, Vassilis; Amodeo, Aldo; Binietoglou, Ioannis; D'Amico, Giuseppe; Schwarz, Anja; Papagiannopoulos, Nikolaos; Papayannis, Alexandros; Sicard, Michael; Comeron, Adolfo; Pappalardo, Gelsomina

    2015-04-01

    Systematic observations of Saharan dust events over Europe are performed from May 2000 by EARLINET, the European Aerosol Research LIdar NETwork. EARLINET is a coordinated network of stations that make use of advanced lidar methods for the vertical profiling of aerosols. The backbone of EARLINET network is a common schedule for performing the measurements and the quality assurance of instruments/data. Particular attention is paid to monitoring the Saharan dust intrusions over the European continent. The geographical distribution of the EARLINET stations is particularly appealing for the dust observation, with stations located all around the Mediterranean and in the center of the Mediterranean (Italian stations) where dust intrusions are frequent, and with several stations in the central Europe where dust penetrates occasionally. All aerosol backscatter and extinction profiles related to observations collected during these alerts are grouped in the devoted "Saharan dust" category of the EARLINET database. This category consists of about 4700 files (as of December 2013). Case studies involving several stations around Europe selected from this long-term database have been provided the opportunity to investigate dust modification processes during transport over the continent. More important, the long term EARLINET dust monitoring allows the investigation of the horizontal and vertical extent of dust outbreaks over Europe and the climatological analysis of dust optical intensive and extensive properties at continental scale. This long-term database is also a unique tool for a systematic comparison with dust model outputs and satellite-derived dust products. Because of the relevance for both dust modeling and satellite retrievals improvement, results about desert dust layers extensive properties as a function of season and source regions are investigated and will be presented at the conference. First comparisons with models outputs and CALIPSO dust products will be

  6. Timber beams subjected to long - term loading

    NASA Astrophysics Data System (ADS)

    Sógel, K.

    2010-09-01

    Wood is a significant structural material, which is often used for timber bearing structures. Elements of timber structures must especially satisfy safety requirements, which are expressed by the ultimate limit states in the established standards. The structure must also satisfy the serviceability limit states. Local and global deformations make it impossible for the structure to serve the purpose it was designed for. It is important to take the deflections and their possible increase into account in the design to provide a structure which can be used during the whole period of service. Based on earlier examinations, it is known that a timber element over the course of long-term loading shows creep behavior. The structure of wood is able to adapt to the conditions of the surrounding environment. The properties of wood are especially affected by the relative humidity of the air and then by the type, intensity and duration of the loading. The most important factors affecting the serviceability of timber structures are volume changes caused by humidity and additional deflections caused by the effects of long-term loading. These phenomena emphasize the importance of serviceability limit states for timber structures. The paper deals with a long-term experimental investigation of timber girders that are currently often used. The aim was to obtain the deflection curves and mark the time dependence and the final deflections. The paper will also define the approximations for simulating the time-dependent deflections and obtain the creep coefficients for calculating the final deflections of the girders investigated.

  7. Long-Term Materials Test Program: materials exposure test plan

    SciTech Connect

    1981-12-01

    The Long Term Materials Test Program is designed to identify promising corrosion resistant materials for coal-fired gas turbine applications. Resistance of materials to long term accelerated corrosion will be determined through realistic PFB environmental exposure of candidate turbine materials for up to 14,000 hours. Selected materials also will be evaluated for their ability to withstand the combined erosive and corrosive aspects of the PFB effluent. A pressurized fluidized bed combustor facility has been constructed at the General Electric Coal Utilization Research Laboratory at Malta, New York. The 12-inch diameter combustor will burn high sulfur coal with moderate-to-high chlorine and alkali levels and utilize dolomite as the sulfur sorbent. Hot gas cleanup is achieved using three stages of cyclone separators. Downstream of the cylone separators, a low velocity test section (approx. 30 ft/s) capable of housing 180 pin specimens 1/4'' diameter has been installed to assess the corrosion resistance of the various materials at three different temperatures ranging from 1300 to 1600/sup 0/F. Following the low velocity test section is a high velocity test section consisting of four cascades of airfoil shaped specimens, six specimens per cascade. This high velocity test section is being used to evaluate the combined effects of erosion and corrosion on the degradation of gas turbine materials at gas velocities of 800 to 1400 ft/s. This report summarizes the materials selection and materials exposure test plan for the Long Term Materials Test.

  8. Consensus at last! Long-term results of all randomized controlled trials show that fusion is no better than non-operative care in improving pain and disability in chronic low back pain.

    PubMed

    Mannion, Anne F; Brox, Jens-Ivar; Fairbank, Jeremy C

    2016-05-01

    Commentary On: Hedlund R, Johansson C, Hagg O, Fritzell P, Tullberg T. Swedish Lumbar Spine Study Group. The long-term outcome of lumbar fusion in the Swedish lumbar spine study. Spine J 2016;16:579-87 (in this issue). PMID:27261844

  9. Postsynaptic density-95 mimics and occludes hippocampal long-term potentiation and enhances long-term depression.

    PubMed

    Stein, Valentin; House, David R C; Bredt, David S; Nicoll, Roger A

    2003-07-01

    Previous studies have shown that overexpression of the protein PSD-95 (postsynaptic density-95) selectively enhances AMPA receptor-mediated synaptic responses in hippocampal pyramidal cells. To determine whether this effect is related to synaptic plasticity at these synapses, we examined whether PSD-95 expression mimics long-term potentiation (LTP), and also whether it influences LTP and long-term depression (LTD) in hippocampal slice cultures. Using simultaneous recording from transfected or infected cells and control pyramidal cells, we found that PSD-95, similar to LTP, increases the amplitude and frequency of miniature EPSCs. It also converts silent synapses to functional synapses, as does LTP. In addition, LTP is completely occluded in cells expressing PSD-95, whereas LTD is greatly enhanced. These results suggest that common mechanisms are involved in controlling synaptic AMPA receptors by PSD-95 and synaptic plasticity. PMID:12843250

  10. Long Term Archiving and CCSDS Standards

    NASA Astrophysics Data System (ADS)

    Boucon, Danièle

    This article presents some conceptual and implementation CCSDS -Consultative Committee for Space Data Systemsstandards for long term archiving. It focuses on the most recent one, the Producer Archive Interface Specification (PAIS) standard. This standard, currently available as a draft on the CCSDS web site, will be published by the beginning of 2014. It will enable the Producer to share with the Archive a sufficiently precise and unambiguous formal definition of the Digital Objects to be produced and transferred, by means of a model. It will also enable a precise definition of the packaging of these objects in the form of Submission Information Packages (SIPs), including the order in which they should be transferred.

  11. Long-Term Wind Power Variability

    SciTech Connect

    Wan, Y. H.

    2012-01-01

    The National Renewable Energy Laboratory started collecting wind power data from large commercial wind power plants (WPPs) in southwest Minnesota with dedicated dataloggers and communication links in the spring of 2000. Over the years, additional WPPs in other areas were added to and removed from the data collection effort. The longest data stream of actual wind plant output is more than 10 years. The resulting data have been used to analyze wind power fluctuations, frequency distribution of changes, the effects of spatial diversity, and wind power ancillary services. This report uses the multi-year wind power data to examine long-term wind power variability.

  12. Long-term outcomes in multiple gestations.

    PubMed

    Rand, Larry; Eddleman, Keith A; Stone, Joanne

    2005-06-01

    Children born from a multiple gestation are at increased risk for cerebral palsy, learning disability, and language and neurobehavioral deficits. With the increased incidence of multiple pregnancies and use of assisted reproductive technology (ART), these issues are more commonly affecting parents. Long-term outcomes are a critical part of preconceptual and early pregnancy counseling for parents faced with a multiple gestation or considering ART, and the provider should be well versed on issues surrounding zygosity, gestational age, higher-order multiples, and the effects of options such as multifetal pregnancy reduction. PMID:15922795

  13. Long-Term Solar Irradiance Variability

    NASA Technical Reports Server (NTRS)

    Pap, J. M.

    1996-01-01

    Measurements of the solar energy throughout the solar spectrum and understanding its variability provide important information about the physical processes and structural changes in the solar interior and in the solar atmosphere...The aim of this paper is to discuss the solar-cycle-related long-term changes in solar total and UV irradiances. The spaceborne irradiance observations are compared to ground-based indices of solar magnetic activity, such as the Photometric Sunspot Index, full disk magnetic flux, and the Mt. Wilson Magnetic Plage Strength Index.

  14. Performance considerations in long-term spaceflight

    NASA Technical Reports Server (NTRS)

    Akins, F. R.

    1979-01-01

    Maintenance of skilled performance during extended space flight is of critical importance to both the health and safety of crew members and to the overall success of mission goals. An examination of