Tuberculosis among nonimmigrant visitors to US Military installations.

PubMed

Aaron, Christopher L; Fotinos, Meletios J; West, Kevin B; Goodwin, Donald J; Mancuso, James D

2013-03-01

Nonimmigrant visitors are not required to be evaluated for tuberculosis (TB) before entering the country. Little literature exists describing the challenges of TB control among this demographic. This report reviews the challenges in managing TB in this population on U.S. military installations. Six cases were identified from reportable medical event reports. Information was obtained from public health personnel via phone interviews. Verified cases from 2004 to 2011 were included. Challenges were congruent among locations including: lack of procedures to screen for infection and disease among individuals at time of entry allowing one case to be admitted with acquired immunodeficiency syndrome and another concurrently on treatment for active TB; delays in the diagnosis of active TB as median time from entry to diagnosis was 62 days; and the need to conduct an effective contact investigation as the mean contact index was 77 including 1 secondary case of active TB. These cases emphasize the need for screening for TB in visitors from high-risk countries at time of entry, prompt diagnosis and treatment if found, procedures for evaluation of contacts, and interjurisdictional cooperation in large contact investigations. These challenges are common to nonimmigrants in both military and civilian settings. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Systemic lupus erythematosus and thrombotic thrombocytopenia purpura: a refractory case without lupus activity.

PubMed

Garcia Boyero, Raimundo; Mas Esteve, Eva; Mas Esteve, Maria; Millá Perseguer, M Magdalena; Marco Buades, Josefa; Beltran Fabregat, Juan; Cañigral Ferrando, Guillermo; Belmonte Serrano, Miguel Angel

2013-01-01

The association between systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP) has been infrequently reported. Usually, patients with TTP have more SLE activity and frequent renal involvement. Here we present a case of TTP associated to low-activity SLE. The absence of renal and major organ involvement increased the difficulty in making the initial diagnosis. ADAMTS13 activity in plasma in this patient was very low, as seen in other similar cases. The evolution of the patient was poor, needing plasma exchanges and immunosuppressive therapy, including the use of rituximab. Copyright © 2012 Elsevier España, S.L. All rights reserved.

A Tale of 2 Teachers: A Preschool Physical Activity Intervention Case Study.

PubMed

Howie, Erin K; Brewer, Alisa E; Dowda, Marsha; McIver, Kerry L; Saunders, Ruth P; Pate, Russell R

2016-01-01

Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how 2 teachers successfully adapted and implemented a preschool physical activity intervention. The Study of Health and Activity in Preschool Environments (SHAPES) was a 3-year physical activity intervention. A detailed case study of 2 high-implementing teachers was conducted. Multiple data sources included accelerometry, direct observation, teacher surveys, and intervention staff field notes. Teacher A focused on integrating physical activity into a wide range of activities, including parent and community events. Teacher B focused on high-intensity, structured activities. Both teachers supported the intervention, worked closely with intervention staff, and operated their classroom as an autonomous unit with support from their directors. Teacher A provided an average of 31.5, 78.0, and 67.5 min of physical activity opportunity per day of observation during years 1, 2, and 3. Teacher B provided an average of 2.7, 33.5, and 73.3 minutes of physical activity opportunity per day of observation. Successful implementation of physical activity interventions may look different in different contexts; thus, interventions should allow for flexible implementation. © 2015, American School Health Association.

A Tale of Two Teachers: A Preschool Physical Activity Intervention Case Study

PubMed Central

Howie, Erin K.; Brewer, Alisa E.; Dowda, Marsha; McIver, Kerry L.; Saunders, Ruth P.; Pate, Russell R.

2016-01-01

BACKGROUND Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how two teachers successfully adapted and implemented a preschool physical activity intervention. METHODS The Study of Health and Activity in Preschool Environments (SHAPES) was a three-year physical activity intervention. A detailed case study of two high-implementing teachers was conducted. Multiple data sources included accelerometry, direct observation, teacher surveys and intervention staff field notes. RESULTS Teacher A focused on integrating physical activity into a wide range of activities, including parent and community events. Teacher B focused on high-intensity, structured activities. Both teachers supported the intervention, worked closely with intervention staff, and operated their classroom as an autonomous unit with support from their directors. Teacher A provided an average of 31.5, 78.0 and 67.5 minutes of physical activity opportunity per day of observation during Years 1, 2, and 3. Teacher B provided an average of 2.7, 33.5, and 73.3 minutes of physical activity opportunity per day of observation. CONCLUSION Successful implementation of physical activity interventions may look different in different contexts; thus, interventions should allow for flexible implementation. PMID:26645417

Peace Corps Water/Sanitation Case Studies and Analyses. Appropriate Technologies for Development. Case Study CS-4.

ERIC Educational Resources Information Center

Talbert, Diana E., Comp.

This document provides an overview of Peace Corps water and sanitation activities, five case studies (Thailand, Yemen, Paraguay, Sierra Leone, and Togo), programming guidelines, and training information. Each case study includes: (1) background information on the country's geography, population, and economics; (2) information on the country's…

Case-study experiments in the introductory physics curriculum

NASA Astrophysics Data System (ADS)

Arion, D. N.; Crosby, K. M.; Murphy, E. A.

2000-09-01

Carthage College added inquiry-based case study activities to the traditional introductory physics laboratory. Student teams designed, constructed, and executed their own experiments to study real-world phenomena, through which they gained understanding both of physic principles and methods of physics research. Assessment results and student feedback through teacher evaluations indicate that these activities improved student attitudes about physics as well as their ability to solve physics problems relative to previous course offerings that did not include case study.

Population-based surveillance for bacterial meningitis in China, September 2006-December 2009.

PubMed

Li, Yixing; Yin, Zundong; Shao, Zhujun; Li, Manshi; Liang, Xiaofeng; Sandhu, Hardeep S; Hadler, Stephen C; Li, Junhong; Sun, Yinqi; Li, Jing; Zou, Wenjing; Lin, Mei; Zuo, Shuyan; Mayer, Leonard W; Novak, Ryan T; Zhu, Bingqing; Xu, Li; Luo, Huiming

2014-01-01

During September 2006-December 2009, we conducted active population and sentinel laboratory-based surveillance for bacterial meningitis pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b, in 4 China prefectures. We identified 7,876 acute meningitis and encephalitis syndrome cases, including 6,388 among prefecture residents. A total of 833 resident cases from sentinel hospitals met the World Health Organization case definition for probable bacterial meningitis; 339 of these cases were among children <5 years of age. Laboratory testing confirmed bacterial meningitis in 74 of 3,391 tested cases. The estimated annual incidence (per 100,000 population) of probable bacterial meningitis ranged from 1.84 to 2.93 for the entire population and from 6.95 to 22.30 for children <5 years old. Active surveillance with laboratory confirmation has provided a population-based estimate of the number of probable bacterial meningitis cases in China, but more complete laboratory testing is needed to better define the epidemiology of the disease in this country.

Population-based Surveillance for Bacterial Meningitis in China, September 2006–December 2009

PubMed Central

Li, Yixing; Yin, Zundong; Shao, Zhujun; Li, Manshi; Liang, Xiaofeng; Sandhu, Hardeep S.; Hadler, Stephen C.; Li, Junhong; Sun, Yinqi; Li, Jing; Zou, Wenjing; Lin, Mei; Zuo, Shuyan; Mayer, Leonard W.; Novak, Ryan T.; Zhu, Bingqing; Xu, Li

2014-01-01

During September 2006–December 2009, we conducted active population and sentinel laboratory–based surveillance for bacterial meningitis pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b, in 4 China prefectures. We identified 7,876 acute meningitis and encephalitis syndrome cases, including 6,388 among prefecture residents. A total of 833 resident cases from sentinel hospitals met the World Health Organization case definition for probable bacterial meningitis; 339 of these cases were among children <5 years of age. Laboratory testing confirmed bacterial meningitis in 74 of 3,391 tested cases. The estimated annual incidence (per 100,000 population) of probable bacterial meningitis ranged from 1.84 to 2.93 for the entire population and from 6.95 to 22.30 for children <5 years old. Active surveillance with laboratory confirmation has provided a population-based estimate of the number of probable bacterial meningitis cases in China, but more complete laboratory testing is needed to better define the epidemiology of the disease in this country. PMID:24377388

Assessment Methods for Well Integrity During the Hydraulic Fracturing Cycle, March 11, 2011

EPA Pesticide Factsheets

The focus of this assessment is to concentrate on well integrity during drilling & completion activities associated with running & cementing of production casing operations, completion activities including the HF process & post-frac activities.

28 CFR 42.511 - Reasonable accommodation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... recipient's program or activity depends upon a case-by-case analysis weighing factors that include: (1) The... inconvenience which does not bear on the ability of the handicapped individual to perform the essential duties...

28 CFR 42.511 - Reasonable accommodation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... recipient's program or activity depends upon a case-by-case analysis weighing factors that include: (1) The... inconvenience which does not bear on the ability of the handicapped individual to perform the essential duties...

28 CFR 42.511 - Reasonable accommodation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recipient's program or activity depends upon a case-by-case analysis weighing factors that include: (1) The... inconvenience which does not bear on the ability of the handicapped individual to perform the essential duties...

28 CFR 42.511 - Reasonable accommodation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... recipient's program or activity depends upon a case-by-case analysis weighing factors that include: (1) The... inconvenience which does not bear on the ability of the handicapped individual to perform the essential duties...

Crime and Justice: 10 Activities.

ERIC Educational Resources Information Center

Constitutional Rights Foundation, Los Angeles, CA.

This manual contains learning activities to aid secondary teachers in clarifying and enriching the Scholastic materials "Living Law." The format of the manual includes a brief overview, background information, teacher instructions, and a description of each activity. Case studies, simulations, and role-playing activities are provided. Topics…

Physical activity domains and risk of gastric adenocarcinoma in the MCC-Spain case-control study.

PubMed

Huerta, José M; Chirlaque, María Dolores; Molina, Antonio J; Amiano, Pilar; Martín, Vicente; Fernández-Villa, Tania; Pérez-Gómez, Beatriz; Moreno, Víctor; Burgui, Rosana; Gómez-Acebo, Inés; Ramos-Lora, Manuel; Fernández-Tardón, Guillermo; Peiró, Rosana; Olmedo-Requena, Rocío; Pollán, Marina; Kogevinas, Manolis; Castaño-Vinyals, Gemma; Aragonés, Nuria

2017-01-01

Evidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histology, in the MCC-Spain case-control study. 428 histologically confirmed GAC cases (67% men) including the gastro-esophageal region and 3225 controls were included. Cases were recruited in hospitals from 10 different Spanish regions, whereas population controls were randomly selected within the respective hospitals' catchment areas. A physical activity (PA) questionnaire was used to gather information on household and recreational activities, allowing estimation of PA volume (in metabolic equivalents (MET)-min/week). Participants also reported the intensity of working PA and daily sitting time. Questionnaire data on diet, lifestyles and clinical variables including Helicobacter pylori serology were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. non-cardia), and Lauren classification (intestinal vs. diffuse). Household physical activity (HPA) showed a strong inverse association with GAC, observed for both cardia and non-cardia tumours. Risk of overall gastric cancer was 50% lower risk among participants in the highest HPA category (OR = 0.50, 95%CI: 0.38, 0.66). Recreational physical activity (RPA) was also associated with lower overall GAC risk (OR = 0.68, 95% CI: 0.52, 0.88), particularly at moderate levels of intensity such as walking (OR = 0.61, 95% CI: 0.46, 0.79). The protective effect of RPA was strongest for non-cardia tumours. Sedentary time was not related to GAC risk (p-trend = 0.392), but the potential protective effect of RPA was restricted to non-sedentary participants. Both household and recreational physical activities were independently related to lower GAC risk in the MCC-Spain study.

Physical activity domains and risk of gastric adenocarcinoma in the MCC-Spain case-control study

PubMed Central

Chirlaque, María Dolores; Molina, Antonio J.; Amiano, Pilar; Martín, Vicente; Fernández-Villa, Tania; Pérez-Gómez, Beatriz; Moreno, Víctor; Burgui, Rosana; Gómez-Acebo, Inés; Ramos-Lora, Manuel; Fernández-Tardón, Guillermo; Peiró, Rosana; Olmedo-Requena, Rocío; Pollán, Marina; Kogevinas, Manolis; Castaño-Vinyals, Gemma; Aragonés, Nuria

2017-01-01

Background Evidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histology, in the MCC-Spain case-control study. Methods 428 histologically confirmed GAC cases (67% men) including the gastro-esophageal region and 3225 controls were included. Cases were recruited in hospitals from 10 different Spanish regions, whereas population controls were randomly selected within the respective hospitals' catchment areas. A physical activity (PA) questionnaire was used to gather information on household and recreational activities, allowing estimation of PA volume (in metabolic equivalents (MET)-min/week). Participants also reported the intensity of working PA and daily sitting time. Questionnaire data on diet, lifestyles and clinical variables including Helicobacter pylori serology were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. non-cardia), and Lauren classification (intestinal vs. diffuse). Results Household physical activity (HPA) showed a strong inverse association with GAC, observed for both cardia and non-cardia tumours. Risk of overall gastric cancer was 50% lower risk among participants in the highest HPA category (OR = 0.50, 95%CI: 0.38, 0.66). Recreational physical activity (RPA) was also associated with lower overall GAC risk (OR = 0.68, 95% CI: 0.52, 0.88), particularly at moderate levels of intensity such as walking (OR = 0.61, 95% CI: 0.46, 0.79). The protective effect of RPA was strongest for non-cardia tumours. Sedentary time was not related to GAC risk (p-trend = 0.392), but the potential protective effect of RPA was restricted to non-sedentary participants. Conclusions Both household and recreational physical activities were independently related to lower GAC risk in the MCC-Spain study. PMID:28683070

75 FR 65355 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Project Case Studies of Communities and States Funded under Community Activities under the Communities..., system, and environmental changes. Intensive case studies will be conducted with 24 sites: Six ARRA... Act. The case study sites will be selected to include a mix of State or community characteristics...

Physical activity and cancer risk: dose-response and cancer, all sites and site-specific.

PubMed

Thune, I; Furberg, A S

2001-06-01

The association between physical activity and overall and site-specific cancer risk is elaborated in relation to whether any observed dose-response association between physical activity and cancer can be interpreted in terms of how much physical activity (type, intensity, duration, frequency) is needed to influence site- and gender-specific cancer risk. Observational studies were reviewed that have examined the independent effect of the volume of occupational physical activity (OPA) and/or leisure time physical activity (LPA) on overall and site-specific cancer risk. The evidence of cohort and case-control studies suggests that both leisure time and occupational physical activity protect against overall cancer risk, with a graded dose-response association suggested in both sexes. Confounding effects such as diet, body weight, and parity are often included as a covariate in the analyses, with little influence on the observed associations. A crude graded inverse dose-response association was observed between physical activity and colon cancer in 48 studies including 40,674 colon/colorectal cancer cases for both sexes. A dose-response effect of physical activity on colon cancer risk was especially observed, when participation in activities of at least moderate activity (>4.5 MET) and demonstrated by activities expressed as MET-hours per week. An observed inverse association with a dose-response relationship between physical activity and breast cancer was also identified in the majority of the 41 studies including 108,031 breast cancer cases. The dose-response relationship was in particular observed in case-control studies and supported by observations in cohort studies when participation in activities of at least moderate activity (>4.5 MET) and demonstrated by activities expressed by MET-hours per week. This association between physical activity and breast cancer risk is possibly dependent on age at exposure, age at diagnosis, menopausal status and other effect modifiers, e.g., body mass index. Furthermore, data concerning carcinoma of other cancers (prostate, lung, endometrium, ovary, and testicular cancers) are required. A protective effect of physical activity on site-specific cancer risk with a dose-response association between physical activity and colon and pre- and postmenopausal breast cancer supported by identified biological mechanisms has been observed. The optimal permutation of type, intensity, duration, and frequency of physical activity across the lifespan is unclear, but it is gender, age, and site specific and supports moderate activity (>4.5 MET) more than light activities (<4.5 MET). The complicated nature of the physical activity variable, combined with lack of knowledge regarding possible biological mechanisms operating between physical activity and cancer, warrants further studies including controlled clinical randomized trials.

Test Cases for the Benchmark Active Controls: Spoiler and Control Surface Oscillations and Flutter

NASA Technical Reports Server (NTRS)

Bennett, Robert M.; Scott, Robert C.; Wieseman, Carol D.

2000-01-01

As a portion of the Benchmark Models Program at NASA Langley, a simple generic model was developed for active controls research and was called BACT for Benchmark Active Controls Technology model. This model was based on the previously-tested Benchmark Models rectangular wing with the NACA 0012 airfoil section that was mounted on the Pitch and Plunge Apparatus (PAPA) for flutter testing. The BACT model had an upper surface spoiler, a lower surface spoiler, and a trailing edge control surface for use in flutter suppression and dynamic response excitation. Previous experience with flutter suppression indicated a need for measured control surface aerodynamics for accurate control law design. Three different types of flutter instability boundaries had also been determined for the NACA 0012/PAPA model, a classical flutter boundary, a transonic stall flutter boundary at angle of attack, and a plunge instability near M = 0.9. Therefore an extensive set of steady and control surface oscillation data was generated spanning the range of the three types of instabilities. This information was subsequently used to design control laws to suppress each flutter instability. There have been three tests of the BACT model. The objective of the first test, TDT Test 485, was to generate a data set of steady and unsteady control surface effectiveness data, and to determine the open loop dynamic characteristics of the control systems including the actuators. Unsteady pressures, loads, and transfer functions were measured. The other two tests, TDT Test 502 and TDT Test 5 18, were primarily oriented towards active controls research, but some data supplementary to the first test were obtained. Dynamic response of the flexible system to control surface excitation and open loop flutter characteristics were determined during Test 502. Loads were not measured during the last two tests. During these tests, a database of over 3000 data sets was obtained. A reasonably extensive subset of the data sets from the first two tests have been chosen for Test Cases for computational comparisons concentrating on static conditions and cases with harmonically oscillating control surfaces. Several flutter Test Cases from both tests have also been included. Some aerodynamic comparisons with the BACT data have been made using computational fluid dynamics codes at the Navier-Stokes level (and in the accompanying chapter SC). Some mechanical and active control studies have been presented. In this report several Test Cases are selected to illustrate trends for a variety of different conditions with emphasis on transonic flow effects. Cases for static angles of attack, static trailing-edge and upper-surface spoiler deflections are included for a range of conditions near those for the oscillation cases. Cases for trailing-edge control and upper-surface spoiler oscillations for a range of Mach numbers, angle of attack, and static control deflections are included. Cases for all three types of flutter instability are selected. In addition some cases are included for dynamic response measurements during forced oscillations of the controls on the flexible mount. An overview of the model and tests is given, and the standard formulary for these data is listed. Some sample data and sample results of calculations are presented. Only the static pressures and the first harmonic real and imaginary parts of the pressures are included in the data for the Test Cases, but digitized time histories have been archived. The data for the Test Cases are also available as separate electronic files.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruano-Ravina, Alberto, E-mail: alberto.ruano@usc.es; CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona; García-Lavandeira, José Antonio

We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjustedmore » also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years.« less

The effects of daily bathing on symptoms of patients with bronchial asthma

PubMed Central

Arimoto, Yoshihito; Homma, Chie; Takeoka, Shinjiro; Fukusumi, Munehisa; Mouri, Atsuto; Hamamoto, Yoichiro

2016-01-01

Background The influence of bathing in asthma patients is not yet fully known. Objective We conducted an observational study to investigate changes in symptoms and their degree by bathing in asthmatic patients. Methods A questionnaire focusing on ever experienced bathing-induced symptom changes and their degree, as well as contributing factors, was designed and administered to asthmatic patients in the outpatient department of our institute between January 2012 and November 2013. Results Two hundred fifteen cases were recruited. In 60 cases (27.9%), asthmatic symptoms appeared, including 20 cases of chest discomfort (33.3%), 19 cases of cough (31.7%), and 21 cases of wheezing (35.0%). The triggering factors included vapor inhalation (32 cases, 53.3%), hydrostatic pressure on the thorax due to body immersion in the bathtub (26 cases, 43.3%), and sudden change of air temperature (16 cases, 26.7%). Thirty-eight cases (17.7%) experienced improvement in active asthmatic symptoms by bathing. Vapor inhalation was the most common contributing factor (34 cases, 89.5%), followed by warming of the whole body (13 cases, 34.2%). There was no relationship between asthma severity and the appearance of bathing-induced symptoms or improvement of active asthmatic symptoms by bathing. Conclusion The effects of bathing in asthmatic patients widely differed from patient to patient and their etiology includes several factors. For those who suffer from bathing-induced asthma symptoms, preventive methods, such as premedication with bronchodilators before bathing, should be established. This study is registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan with the registration number UMIN000015641. PMID:27141485

38 CFR 9.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the policy. (g) The term termination of duty means (1) In the case of active duty or active duty for... or her obligation to perform any duty in his or her uniformed service (active duty, or active duty for training or inactive duty training) whether arising from limitations included in a contract of...

38 CFR 9.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the policy. (g) The term termination of duty means (1) In the case of active duty or active duty for... or her obligation to perform any duty in his or her uniformed service (active duty, or active duty for training or inactive duty training) whether arising from limitations included in a contract of...

Public Health Nurses' Activities for Suicide Prevention in Japan.

PubMed

Marutani, Miki; Yamamoto-Mitani, Noriko; Kodama, Shimpei

2016-07-01

Suicide is a major health issue worldwide, including in Japan. Japanese public health nurses (PHNs) play a distinctive role in suicide prevention, although few studies have delineated this role. The purpose of this study was to develop a conceptual framework that elucidates PHNs' activities for suicide prevention. Semi-structured interviews were conducted in 2012-2013 with 15 PHNs who worked in Tokyo metropolitan regions. Data were analyzed qualitatively using grounded theory, and a conceptual framework with seven categories was developed. Three phases that depict the PHNs' suicide prevention activities emerged. Phase I, Pursuing to understand suicide cases, included two categories: tracing back individual suicide cases and raising consciousness among the general public. Phase II, Spreading a web of care, included three categories: knitting a caring network, weaving regular programs into the web, and continuing to be a member of the web. Phase III, Maintaining motivation and commitment, included two categories: legitimatizing suicide prevention and cultivating continued commitment in the community. The activities of suicide prevention by PHNs included a process of developing a caring network that lead to the enhancement of the caring capacity of the community as a whole. © 2016 Wiley Periodicals, Inc.

Development and Formative Evaluation of Multimedia Case Studies for Instructional Design and Technology Students

ERIC Educational Resources Information Center

Sugar, William

2014-01-01

This study describes the development of three case studies that included a combination of multimedia production and instructional design skills within a particular setting. These case studies incorporated real-life incidents from 47 professional instructional designers. These instructional designers described a total of 146 activities involving…

Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood.

PubMed

Cradock, Angie L; Barrett, Jessica L; Kenney, Erica L; Giles, Catherine M; Ward, Zachary J; Long, Michael W; Resch, Stephen C; Pipito, Andrea A; Wei, Emily R; Gortmaker, Steven L

2017-02-01

Participation in recommended levels of physical activity promotes a healthy body weight and reduced chronic disease risk. To inform investment in prevention initiatives, we simulate the national implementation, impact on physical activity and childhood obesity and associated cost-effectiveness (versus the status quo) of six recommended strategies that can be applied throughout childhood to increase physical activity in US school, afterschool and childcare settings. In 2016, the Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) systematic review process identified six interventions for study. A microsimulation model estimated intervention outcomes 2015-2025 including changes in mean MET-hours/day, intervention reach and cost per person, cost per MET-hour change, ten-year net costs to society and cases of childhood obesity prevented. First year reach of the interventions ranged from 90,000 youth attending a Healthy Afterschool Program to 31.3 million youth reached by Active School Day policies. Mean MET-hour/day/person increases ranged from 0.05 MET-hour/day/person for Active PE and Healthy Afterschool to 1.29 MET-hour/day/person for the implementation of New Afterschool Programs. Cost per MET-hour change ranged from cost saving to $3.14. Approximately 2500 to 110,000 cases of children with obesity could be prevented depending on the intervention implemented. All of the six interventions are estimated to increase physical activity levels among children and adolescents in the US population and prevent cases of childhood obesity. Results do not include other impacts of increased physical activity, including cognitive and behavioral effects. Decision-makers can use these methods to inform prioritization of physical activity promotion and obesity prevention on policy agendas. Copyright © 2016. Published by Elsevier Inc.

[Clinical analyses of the diagnosis and treatment of invasive fungal rhinosinusitis: report of 14 cases].

PubMed

Shi, G G; Shi, L; Zhang, Z Y; Wan, Y Z; Li, B; Yu, L; Zhang, E P; Ju, H S; He, M Q; Ji, H Z

2016-08-07

Through the retrospective analysis of the clinical data in 14 cases of invasive fungal rhinosinusitis (IFRS), the clinical characteristics, diagnosis and treatment of this disease were evaluated. Fourteen clinically confirmed cases of IFRS since January 2008 to October 2015 were evaluated.collected, the clinical features, diagnosis, treatment and prognosis were analyzed to obtain a more comprehensive understanding for clinical reference. Fourteen patients were confirmed by pathological examination as IFRS, including 9 cases of aspergillus, 4 cases of mucor, and 1 case of rhinocerebral zygomycosis; including 5 cases of acute IFRS, 9 cases of chronic IFRS. All patients were treated with endoscopic surgery and intravenous antifungal therapy. Nine cases of chronic IFRS (including 1 case of mucor, 7 cases of aspergillus and 1 case of rhinocerebral zygomycosis) were cured, but the vision loss, diplopia or blindness, hard palate perforation remained. Five cases of acute IFRS included 3 cases of mucor and 2 cases of aspergillus. Among the 3 cases of mucor, 2 cases were died and 1 case was cured. Among the 2 cases of aspergillus, 1 patient was cured and the other patient died of electrolyte disorder after discharge from hospital. Patients with IFRS usually have diabetes. After the active surgical cleaning of lesion tissue and the systematic antifungal treatment with adequate dosage, these patients would have a better result. IFRS caused by mucor is ofen dangerous.

Translating Epidemiology into Policy to Prevent Childhood Obesity: The Case for Promoting Physical Activity in School Settings

PubMed Central

Chriqui, Jamie F.; Burgeson, Charlene R.; Fisher, Megan C.; Ness, Roberta B.

2013-01-01

Childhood obesity is a serious public health problem, resulting from energy imbalance (when the intake of energy is greater than the amount of energy expended through physical activity). Numerous health authorities have identified policy interventions as promising strategies for creating population-wide improvements in physical activity. This case study focuses on energy expenditure through physical activity (with a particular emphasis on school-based physical education [PE]). Policy-relevant evidence for promoting physical activity in youth may take numerous forms including epidemiologic data and other supporting evidence (e.g., qualitative data). The implementation and evaluation of school PE interventions leads to a set of lessons related to epidemiology and evidence-based policy. These include the need to: 1) enhance the focus on external validity, 2) develop more policy-relevant evidence based on “natural experiments,” 3) understand that policymaking is political, 4) better articulate the factors that influence policy dissemination, 5) understand the real world constraints when implementing policy in school environments, and 6) build transdisciplinary teams for policy progress. The issues described in this case study provide leverage points for practitioners, policy makers, and researchers as they seek to translate epidemiology to policy. PMID:20470970

Lack of active follow-up of cancer patients in Chennai, India: implications for population-based survival estimates

PubMed Central

Rama, Ranganathan; Shanta, Viswanathan

2008-01-01

Abstract Objective To measure the bias in absolute cancer survival estimates in the absence of active follow-up of cancer patients in developing countries. Methods Included in the study were all incident cases of the 10 most common cancers and corresponding subtypes plus all tobacco-related cancers not ranked among the top 10 that were registered in the population-based cancer registry in Chennai, India, during 1990–1999 and followed through 2001. Registered incident cases were first matched with those in the all-cause mortality database from the vital statistics division of the Corporation of Chennai. Unmatched incident cancer cases were then actively followed up to determine their survival status. Absolute survival was estimated by using an actuarial method and applying different assumptions regarding the survival status (alive/dead) of cases under passive and active follow-up. Findings Before active follow-up, matches between cases ranged from 20% to 66%, depending on the site of the primary tumour. Active follow-up of unmatched incident cases revealed that 15% to 43% had died by the end of the follow-up period, while the survival status of 4% to 38% remained unknown. Before active follow-up of cancer patients, 5-year absolute survival was estimated to be between 22% and 47% higher, than when conventional actuarial assumption methods were applied to cases that were lost to follow-up. The smallest survival estimates were obtained when cases lost to follow-up were excluded from the analysis. Conclusion Under the conditions that prevail in India and other developing countries, active follow-up of cancer patients yields the most reliable estimates of cancer survival rates. Passive case follow-up alone or applying standard methods to estimate survival is likely to result in an upward bias. PMID:18670662

Caspase-6 Activation in Familial Alzheimer Disease Brains Carrying Amyloid Precursor Protein, Presenilin I or Presenilin II Mutations

PubMed Central

Albrecht, Steffen; Bogdanovic, Nenad; Ghetti, Bernardino; Winblad, Bengt; LeBlanc, Andréa C.

2010-01-01

We previously demonstrated the activation of Caspase-6 in the hippocampus and cortex in cases of mild, moderate, severe and very severe Alzheimer disease (AD). To determine whether Caspase-6 is also activated in familial AD, we performed an immunohistochemical analysis of active Caspase-6 and Tau cleaved by Caspase-6 in temporal cortex and hippocampal tissue sections from cases of familial AD. The cases included 5 carrying the amyloid precursor protein K670N, M671L Swedish mutation, 1 carrying the amyloid precursor protein E693G Arctic mutation, 2 each carrying the Presenilin I M146V, F105L, A431E, V261F, Y115C mutations, and 1 with the Presenilin II N141I mutation. Active Caspase-6 immunoreactivity was found in all cases. Caspase-6 immunoreactivity was observed in neuritic plaques or cotton wool plaques in some cases, neuropil threads and neurofibrillary tangles. These results indicate that Caspase-6 is activated in familial forms of AD, as previously observed in sporadic forms. Since sporadic and familial AD cases have similar pathological features, these results support a fundamental role of Caspase-6 in the pathophysiology of both familial and sporadic AD. PMID:19915487

Decisions Based on Science.

ERIC Educational Resources Information Center

Campbell, Vincent; Lofstrom, Jocelyn; Jerome, Brian

This guide makes the case for a decision-making focus in the science curriculum as a response to concern over preparing scientifically literate students. The student activities are organized by guided activities and independent exercises. Themes of the guided activities include xenotransplants, immunizations, household cleaning products, ozone,…

Negative regulators in homeostasis of naïve peripheral T cells.

PubMed

Modiano, Jaime F; Johnson, Lisa D S; Bellgrau, Donald

2008-01-01

It is now apparent that naïve peripheral T cells are a dynamic population where active processes prevent inappropriate activation while supporting survival. The process of thymic education makes naïve peripheral T cells dependent on interactions with self-MHC for survival. However, as these signals can potentially result in inappropriate activation, various non-redundant, intrinsic negative regulatory molecules including Tob, Nfatc2, and Smad3 actively enforce T cell quiescence. Interactions among these pathways are only now coming to light and may include positive or negative crosstalk. In the case of positive crosstalk, self-MHC initiated signals and intrinsic negative regulatory factors may cooperate to dampen T cell activation and sustain peripheral tolerance in a binary fashion (on-off). In the case of negative crosstalk, self-MHC signals may promote survival through partial activation while intrinsic negative regulatory factors act as rheostats to restrain cell cycle entry and prevent T cells from crossing a threshold that would break tolerance.

The Latin American University and R&D.

ERIC Educational Resources Information Center

Vessuri, Hebe, Ed.; And Others

1995-01-01

Includes "Introduction" (Vessuri); "University-Industry Relationships and Periphery Development: The Case of the University of Campinas, Brazil" (Dagnino); "R&D at the Autonomous National University of Mexico" (Chazaro); and "Scientific Activities in Large Institutions of Higher Education: The Case of the…

Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses.

PubMed

Worrell, Mary Claire; Kramer, Michael; Yamin, Aliya; Ray, Susan M; Goswami, Neela D

2017-01-01

Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. Data were abstracted for patients with TB disease diagnosed in 2008-2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses. Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases ( P < .0001 and P < .0001, respectively). Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study and... attended by more than one unit of government. (d) Eligible activities. Activities eligible for technical.... Activities for which costs are ineligible under this section include: (1) In the case of technical assistance...

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study and... attended by more than one unit of government. (d) Eligible activities. Activities eligible for technical.... Activities for which costs are ineligible under this section include: (1) In the case of technical assistance...

Using Photographs as Case Studies to Promote Active Learning in Biology

ERIC Educational Resources Information Center

Krauss, David A.; Salame, Issa I.; Goodwyn, Lauren N.

2010-01-01

If a picture is worth a thousand words, think about how long it takes your students to read a thousand words. Case studies are effective and stimulating ways to teach a variety of subjects, including the biological sciences. In learning the details of a particular case, students develop skills in both deductive and inductive reasoning, hypothesis…

Transition From Peer Review to Peer Learning: Experience in a Radiology Department.

PubMed

Donnelly, Lane F; Dorfman, Scott R; Jones, Jeremy; Bisset, George S

2017-10-18

To describe the process by which a radiology department moved from peer review to peer collaborative improvement (PCI) and review data from the first 16 months of the PCI process. Data from the first 16 months after PCI were reviewed: number of case reviews performed, number of learning opportunities identified, percentage yield of learning opportunities identified, type of learning opportunities identified, and comparison of the previous parameters between case randomly reviewed versus actively pushed (issues actively identified and entered). Changes in actively pushed cases were also assessed as volume per month over the 16 months (run chart). Faculty members were surveyed about their perception of the conversion to PCI. In all, 12,197 cases were peer reviewed, yielding 1,140 learning opportunities (9.34%). The most common types of learning opportunities for all reviewed cases included perception (5.1%) and reporting (1.9%). The yield of learning opportunities from actively pushed cases was 96.3% compared with 3.88% for randomly reviewed cases. The number of actively pushed cases per month increased over the course of the period and established two new confidence intervals. The faculty survey revealed that the faculty perceived the new PCI process as positive, nonpunitive, and focused on improvement. The study demonstrates that a switch to PCI is perceived as nonpunitive and associated with increased radiologist submission of learning opportunities. Active entering of identified learning opportunities had a greater yield and perceived value, compared with random review of cases. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Physical activity in adolescence and abdominal obesity in adulthood: a case-control study among women shift workers.

PubMed

Garcez, Anderson da Silva; Olinto, Maria Teresa Anselmo; Canuto, Raquel; Olinto, Beatriz Anselmo; Pattussi, Marcos Pascoal; Paniz, Vera Maria Vieira

2015-01-01

Physical activity may have a protective effect against abdominal obesity, an important risk factor for cardiometabolic diseases. Thus, the aim of this study was to examine the association between the practice of physical activities in adolescence and abdominal obesity in adulthood among women shift workers in Southern Brazil in 2011. This case-control study included 215 cases (waist circumference greater than or equal to 88 cm) and 326 controls. For both the case and control groups, participation in leisure-time physical activities was most frequent in adolescence and was significantly less in adulthood. After adjusting for potential confounding factors, women who participated in five or more physical activities in adolescence were 50 percent less likely to have abdominal obesity than women who participated in one activity or no physical activities (Odds Ratio = 0.50; 95% confidential interval: 0.27-0.93, p value = .029). Participation in various types of leisure-time physical activities in adolescence may protect against abdominal obesity in adulthood, even if the number of physical activities decreases over time. This finding demonstrated the importance of physical activity as well as the period of life in which these should be encouraged for the prevention of health disorders, such as abdominal obesity.

[Clinical studies on flomoxef in respiratory tract infections].

PubMed

Kanegae, H; Yamada, H; Yamaguchi, T; Kuroki, S; Katoh, O

1987-10-01

Flomoxef (FMOX, 6315-S) is a new oxacephem with a broad spectrum of antimicrobial activity. We used FMOX for treatment of 13 patients with respiratory tract infections including 4 cases of pneumonia, 5 of lung abscess and 4 of exacerbation of the chronic airway diseases. FMOX showed excellent in vitro antimicrobial activities against clinical isolates including 4 strains of Streptococcus pneumoniae, 2 strains of Haemophilus influenzae and each one strain of Escherichia coli and Klebsiella pneumoniae. Clinical responses were excellent in 3 cases, good in 7 and fair or poor in 3. No side effect was observed, but abnormal laboratory findings caused by FMOX administration were found in 2 cases; hypertransaminasemia and eosinophilia. However, neither of them was severe. From the above results, it is considered that FMOX will be useful for treatment of patients with respiratory tract infections.

Analysis of signal transducer and activator of transcription 3 (Stat 3) pathway in multiple myeloma: Stat 3 activation and cyclin D1 dysregulation are mutually exclusive events.

PubMed

Quintanilla-Martinez, Leticia; Kremer, Marcus; Specht, Katja; Calzada-Wack, Julia; Nathrath, Michaela; Schaich, Robert; Höfler, Heinz; Fend, Falko

2003-05-01

The signal transducer and activator of transcription molecules (Stats) play key roles in cytokine-induced signal transduction. Recently, it was proposed that constitutively activated Stat 3 (Stat 3 phosphorylated) contributes to the pathogenesis of multiple myeloma (MM) by preventing apoptosis and inducing proliferation. The study aim was to investigate Stat 3 activation in a series of multiple myeloma (MM) cases and its effect on downstream targets such as the anti-apoptotic proteins Bcl-xL, Mcl-1, and Bcl-2, and the cell-cycle protein cyclin D1. Forty-eight cases of MM were analyzed. Immunohistochemistry was performed on paraffin sections using antibodies against cyclin D1, Bcl-2, Bcl-xL, Mcl-1, p21, Stat 3, and Stat 3 phosphorylated (P). Their specificity was corroborated by Western blot analysis using eight human MM cell lines as control. The proliferation rate was assessed with the antibody MiB1. In addition, the mRNA levels of cyclin D1 and Stat 3 were determined by quantitative real-time reverse transcriptase-polymerase chain reaction of paraffin-embedded microdissected tissue. Three different groups determined by the expression of Stat 3P and cyclin D1 (protein and mRNA) were identified: group 1, Stat 3-activated (23 cases, 48%). All cases revealed nuclear expression of Stat 3P. No elevation of Stat 3 mRNA was identified in any of the cases. Three cases in this group showed intermediate to low cyclin D1 protein and mRNA expression. Group 2 included 15 (31%) cases with cyclin D1 staining and lack of Stat 3P. All cases showed intermediate to high levels of cyclin D1 mRNA expression. Group 3 included 10 (21%) cases with no expression of either cyclin D1 or Stat 3P. High levels of anti-apoptotic proteins Bcl-xL and Mcl-1 were identified in 89% and 100% of all cases, respectively. In contrast to Bcl-xL and Mcl-1, the expression of Bcl-2 showed an inverse correlation with proliferation rate (P: 0.0003). No significant differences were found between the three groups in terms of proliferation rate or expression of anti-apoptotic proteins. However, cyclin D1+ cases were always well differentiated and were more likely to show a lymphoplasmocytoid differentiation (chi-square = 9.55). Overall, constitutive activation of Stat 3 was found in almost half (48%) of the investigated MM cases. However, this does not seem to have a major impact on the expression of anti-apoptotic proteins and proliferation. We showed that cyclin D1 overexpression and Stat 3 activation are, mutually exclusive events in MM (P = 0.0066). The universal expression of Mcl-1, independent of activated Stat 3, suggests that its expression is constitutive and that it might play an important role in the pathogenesis of MM.

[Ethanol and other psychoactive substances in fatal road traffic accidents in the Czech Republic in 2008].

PubMed

Mravcík, Viktor; Zábranský, Tomás; Vorel, Frantisek

2010-01-01

To map the recent prevalence of alcohol and other psychoactive substances in deceased victims of traffic accidents in the Czech Republic. The studied sample consisted of individuals autopsied in the departments of forensic medicine who died during traffic accidents in 2008 and were toxicologically tested for one or more of the following substances: ethanol, volatile substances, cannabis, opiates, stimulants, cocaine, benzodiazepines, and barbiturates. Case definition involved alcohol cases with blood alcohol concentration (BAC) 0.2 g/kg and higher; with cannabis, detections of active THC metabolites only were taken into account; from cases where volatile substances (solvents) were detected we included into the positive cases only those where substances were not produced post mortem or in some physiological or pathological statuses. The sample consisted of 1,040 persons deceased in traffic accidents, of whom 582 (56.0%) were toxicologically tested for one or more of the substances listed above. The sample has been divided into two subsamples--one of 778 (74.8%) active participants of road traffic accidents (pedestrians, bicyclists, and drivers) and other subsample consisting of 262 (25.4%) non-active participants. Ethanol was found in 38.3% of 381 tested and at least one of other psychoactive substances was found in 11.7% of 384 tested active participants--of those, stimulants (mostly methamphetamine) were found most frequently (6.5% of 337 tested), cannabis (5.9% of 203 tested) and benzodiazepines (3.9% of 363 tested active participants). Drivers were positive for ethanol in 29.2% cases, for one or more of other psychoactive substances except ethanol in 12.7% cases, most frequently for stimulants (9.2%) and cannabis (6.2%). Professional drivers were found negative for ethanol and other psychoactive substance except of one case of methamphetamine (6.7%). The study confirms high prevalence of alcohol and other psychoactive substances, especially stimulants (methamphetamine), cannabis and benzodiazepines, among deceased participants of road traffic accidents including drivers in the Czech Republic.

Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru.

PubMed

Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F

2017-04-01

We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

14 CFR § 1203.400 - Specific classifying guidance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and operational information and material, and in some exceptional cases scientific information falling... activities), intelligence sources or methods, or cryptology; (d) Foreign relations or foreign activities of the United States, including confidential sources; (e) Scientific, technological, or economic matters...

Technology Learning Activities: Columbus Sailed the Ocean Blue, the Cellular Connection, Emergency Shelter.

ERIC Educational Resources Information Center

Etchison, Cindy; Deal, Walter F., III

1992-01-01

Presents learning activities such as planning and building a sailboat, manufacturing cellular phone cases, and designing and building emergency shelters. Includes the context, the challenge, resources used, objectives, materials needed, and an evaluation. (JOW)

Implementing Tuberculosis Close-contact Investigation in a Tertiary Hospital in Iran.

PubMed

Shamaei, Masoud; Esmaeili, Shahrbanoo; Marjani, Majid; Tabarsi, Payam

2018-01-01

Close contact investigation is the essential key in tuberculosis (TB) case finding and an effective strategy for TB control program within any society. In this prospective study, 1186 close family contacts of hospitalized TB patients (index) in a referral TB hospital in Tehran-Iran were passively studied. These people were studied to rollout TB infection and disease. Demographic characteristics, clinical and laboratory data of these individuals were reviewed and summarized for analysis. A total of 886 (74.4%) close-family contacts completed their investigation. The index TB patients of these individuals were sputum smear negative for acid-fast bacilli in 137 cases (11.6%) and the rest were smear positive. A total of 610 (68.8%) close-family contact ruled out for TB infection or disease (Group I). A total of 244 cases (27.5%) had latent TB infection (Group II) and active TB (Group III) was confirmed in 32 cases (3.6%). A significant difference was shown for female gender, signs and symptoms, family size, and positive radiological finding between Group I and Group II. The study of index parameter including positive sputum smear/culture did not reveal any significant difference, but positive cavitary lesion significantly more has seen in active TB group ( P = 0.004). This study emphasizes on sign and symptoms and radiological finding in TB contact investigation, where index parameters including positive smear/culture, does not implicate any priority. Although cavitary lesions in index patient have more accompanied by active TB, close contact study should include all of TB indexes. This investigation should include chest radiography for these individuals.

How to include the variability of TMS responses in simulations: a speech mapping case study

NASA Astrophysics Data System (ADS)

De Geeter, N.; Lioumis, P.; Laakso, A.; Crevecoeur, G.; Dupré, L.

2016-11-01

When delivered over a specific cortical site, TMS can temporarily disrupt the ongoing process in that area. This allows mapping of speech-related areas for preoperative evaluation purposes. We numerically explore the observed variability of TMS responses during a speech mapping experiment performed with a neuronavigation system. We selected four cases with very small perturbations in coil position and orientation. In one case (E) a naming error occurred, while in the other cases (NEA, B, C) the subject appointed the images as smoothly as without TMS. A realistic anisotropic head model was constructed of the subject from T1-weighted and diffusion-weighted MRI. The induced electric field distributions were computed, associated to the coil parameters retrieved from the neuronavigation system. Finally, the membrane potentials along relevant white matter fibre tracts, extracted from DTI-based tractography, were computed using a compartmental cable equation. While only minor differences could be noticed between the induced electric field distributions of the four cases, computing the corresponding membrane potentials revealed different subsets of tracts were activated. A single tract was activated for all coil positions. Another tract was only triggered for case E. NEA induced action potentials in 13 tracts, while NEB stimulated 11 tracts and NEC one. The calculated results are certainly sensitive to the coil specifications, demonstrating the observed variability in this study. However, even though a tract connecting Broca’s with Wernicke’s area is only triggered for the error case, further research is needed on other study cases and on refining the neural model with synapses and network connections. Case- and subject-specific modelling that includes both electromagnetic fields and neuronal activity enables demonstration of the variability in TMS experiments and can capture the interaction with complex neural networks.

Translating epidemiology into policy to prevent childhood obesity: the case for promoting physical activity in school settings.

PubMed

Brownson, Ross C; Chriqui, Jamie F; Burgeson, Charlene R; Fisher, Megan C; Ness, Roberta B

2010-06-01

Childhood obesity is a serious public health problem resulting from energy imbalance (when the intake of energy is greater than the amount of energy expended through physical activity). Numerous health authorities have identified policy interventions as promising strategies for creating population-wide improvements in physical activity. This case study focuses on energy expenditure through physical activity (with a particular emphasis on school-based physical education [PE]). Policy-relevant evidence for promoting physical activity in youth may take numerous forms, including epidemiologic data and other supporting evidence (e.g., qualitative data). The implementation and evaluation of school PE interventions leads to a set of lessons related to epidemiology and evidence-based policy. These include the need to: (i) enhance the focus on external validity, (ii) develop more policy-relevant evidence on the basis of "natural experiments," (iii) understand that policy making is political, (iv) better articulate the factors that influence policy dissemination, (v) understand the real-world constraints when implementing policy in school environments, and (vi) build transdisciplinary teams for policy progress. The issues described in this case study provide leverage points for practitioners, policy makers, and researchers as they seek to translate epidemiology to policy. Copyright 2010 Elsevier Inc. All rights reserved.

29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

Code of Federal Regulations, 2010 CFR

2010-07-01

... his machine, or install a new cutting tool. Such activities are an integral part of the principal activity, and are included within such term. (2) In the case of a garment worker in a textile mill, who is...

Return to sports after plate fixation of humeral head fractures 65 cases with minimum 24-month follow-up.

PubMed

Ahrens, Philipp; Martetschläger, Frank; Siebenlist, Sebastian; Attenberger, Johann; Crönlein, Moritz; Biberthaler, Peter; Stöckle, Ulrich; Sandmann, Gunther H

2017-04-26

Humeral head fractures requiring surgical intervention are severe injuries, which might affect the return to sports and daily activities. We hypothesize that athletic patients will be constrained regarding their sporting activities after surgically treated humeral head fractures. Despite a long rehabilitation program physical activities will change and an avoidance of overhead activities will be noticed. Case series with 65 Patients, with a minimum follow-up of 24 months participated in this study. All patients were treated using a locking plate fixation. Their sporting activity was investigated at the time of the injury and re-investigated after an average of 3.83 years. The questionnaire setup included the evaluation of shoulder function, sporting activities, intensity, sport level and frequency evaluation. Level of evidence IV. At the time of injury 61 Patients (94%) were engaged in recreational sporting activities. The number of sporting activities declined from 26 to 23 at the follow-up examination. There was also a decline in sports frequency and duration of sports activities. The majority of patients remains active in their recreational sporting activity at a comparable duration and frequency both pre- and postoperatively. Nevertheless, shoulder centered sport activities including golf, water skiing and martial arts declined or were given up.

The 'Amistad' Case. Lesson Plan.

ERIC Educational Resources Information Center

National Archives and Records Administration, Washington, DC.

Teaching about the Amistad case provides correlations to the National Standards for History, and Civics and Government. An overview of the events of 1839 is given in this lesson plan. Seven student activities include reading and using primary source documents, writing journal articles, viewing the movie "Amistad," and giving…

Integrating Human Factors into Crew Exploration Vehicle (CEV) Design

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina; Baggerman, Susan; Campbell, Paul

2007-01-01

The purpose of this design process is to apply Human Engineering (HE) requirements and guidelines to hardware/software and to provide HE design, analysis and evaluation of crew interfaces. The topics include: 1) Background/Purpose; 2) HE Activities; 3) CASE STUDY: Net Habitable Volume (NHV) Study; 4) CASE STUDY: Human Modeling Approach; 5) CASE STUDY: Human Modeling Results; 6) CASE STUDY: Human Modeling Conclusions; 7) CASE STUDY: Human-in-the-Loop Evaluation Approach; 8) CASE STUDY: Unsuited Evaluation Results; 9) CASE STUDY: Suited Evaluation Results; 10) CASE STUDY: Human-in-the-Loop Evaluation Conclusions; 11) Near-Term Plan; and 12) In Conclusion

Exploring Students' Emotional Responses and Participation in an Online Peer Assessment Activity: A Case Study

ERIC Educational Resources Information Center

Cheng, Kun-Hung; Hou, Huei-Tse; Wu, Sheng-Yi

2014-01-01

In the social interactions among individuals of learning communities, including those individuals engaged in peer assessment activities, emotion may be a key factor in learning. However, research regarding the emotional response of learners in online peer assessment activities is relatively scarce. Detecting learners' emotion when they make…

Magnificent Ground Water Connection. [Sample Activities].

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC.

Water conservation and usage is an important concept in science. This document, geared specifically to New England, provides many activities for protecting and discussing ground water situations. Sample activities for grades K-6 include: (1) All the Water in the World; (2) The Case of the Disappearing Water; (3) Deep Subjects--Wells and Ground…

Child Find Activities under the Individuals with Disabilities Education Act: Recent Case Law

ERIC Educational Resources Information Center

Ennis, Robin Parks; Blanton, Kimberly; Katsiyannis, Antonis

2017-01-01

Since the enactment of the Education for All Handicapped Children Act (IDEA's forerunner) in 1975, an important requirement has been Child Find activities. According to Shapiro and Derrington (2004), Child Find is broadly defined as the entire range of activities, including public awareness, identification, referral, eligibility determination, and…

Using Acid-Base Reagent Problems as a High School Science Research Activity.

ERIC Educational Resources Information Center

Schlenker, Richard M.; Cullen, David; Schlenker, Karl R.

1999-01-01

Describes an open-ended activity in which students try to determine the factors that contribute to an unusual chemical reaction. Uses a case study approach to show students how the presence of chlorine in tap water can interfere with a pH indicator. Includes assessment guidelines and extension activities. (WRM)

Pediatric, Adolescent, and Young Adult Thyroid Carcinoma Harbors Frequent and Diverse Targetable Genomic Alterations, Including Kinase Fusions

PubMed Central

Schrock, Alexa B.; Anderson, Peter M.; Morris, John C.; Heilmann, Andreas M.; Holmes, Oliver; Wang, Kai; Johnson, Adrienne; Waguespack, Steven G.; Ou, Sai‐Hong Ignatius; Khan, Saad; Fung, Kar‐Ming; Stephens, Philip J.; Erlich, Rachel L.; Miller, Vincent A.; Ross, Jeffrey S.; Ali, Siraj M.

2017-01-01

Background. Thyroid carcinoma, which is rare in pediatric patients (age 0–18 years) but more common in adolescent and young adult (AYA) patients (age 15–39 years), carries the potential for morbidity and mortality. Methods. Hybrid‐capture‐based comprehensive genomic profiling (CGP) was performed prospectively on 512 consecutively submitted thyroid carcinomas, including 58 from pediatric and AYA (PAYA) patients, to identify genomic alterations (GAs), including base substitutions, insertions/deletions, copy number alterations, and rearrangements. This PAYA data series includes 41 patients with papillary thyroid carcinoma (PTC), 3 with anaplastic thyroid carcinoma (ATC), and 14 with medullary thyroid carcinoma (MTC). Results. GAs were detected in 93% (54/58) of PAYA cases, with a mean of 1.4 GAs per case. In addition to BRAF V600E mutations, detected in 46% (19/41) of PAYA PTC cases and in 1 of 3 AYA ATC cases, oncogenic fusions involving RET, NTRK1, NTRK3, and ALK were detected in 37% (15/41) of PAYA PTC and 33% (1/3) of AYA ATC cases. Ninety‐three percent (13/14) of MTC patients harbored RET alterations, including 3 novel insertions/deletions in exons 6 and 11. Two of these MTC patients with novel alterations in RET experienced clinical benefit from vandetanib treatment. Conclusion. CGP identified diverse clinically relevant GAs in PAYA patients with thyroid carcinoma, including 83% (34/41) of PTC cases harboring activating kinase mutations or activating kinase rearrangements. These genomic observations and index cases exhibiting clinical benefit from targeted therapy suggest that young patients with advanced thyroid carcinoma can benefit from CGP and rationally matched targeted therapy. Implications for Practice. The detection of diverse clinically relevant genomic alterations in the majority of pediatric, adolescent, and young adult patients with thyroid carcinoma in this study suggests that comprehensive genomic profiling may be beneficial for young patients with papillary, anaplastic, or medullary thyroid carcinoma, particularly for advanced or refractory cases for which clinical trials involving molecularly targeted therapies may be appropriate. PMID:28209747

Contemplating case mix: A primer on case mix classification and management.

PubMed

Costa, Andrew P; Poss, Jeffery W; McKillop, Ian

2015-01-01

Case mix classifications are the frameworks that underlie many healthcare funding schemes, including the so-called activity-based funding. Now more than ever, Canadian healthcare administrators are evaluating case mix-based funding and deciphering how they will influence their organization. Case mix is a topic fraught with technical jargon and largely relegated to government agencies or private industries. This article provides an abridged review of case mix classification as well as its implications for management in healthcare. © 2015 The Canadian College of Health Leaders.

Lipoprotein lipase activity and mass, apolipoprotein C-II mass and polymorphisms of apolipoproteins E and A5 in subjects with prior acute hypertriglyceridaemic pancreatitis

PubMed Central

2009-01-01

Background Severe hypertriglyceridaemia due to chylomicronemia may trigger an acute pancreatitis. However, the basic underlying mechanism is usually not well understood. We decided to analyze some proteins involved in the catabolism of triglyceride-rich lipoproteins in patients with severe hypertriglyceridaemia. Methods Twenty-four survivors of acute hypertriglyceridaemic pancreatitis (cases) and 31 patients with severe hypertriglyceridaemia (controls) were included. Clinical and anthropometrical data, chylomicronaemia, lipoprotein profile, postheparin lipoprotein lipase mass and activity, hepatic lipase activity, apolipoprotein C II and CIII mass, apo E and A5 polymorphisms were assessed. Results Only five cases were found to have LPL mass and activity deficiency, all of them thin and having the first episode in childhood. No cases had apolipoprotein CII deficiency. No significant differences were found between the non-deficient LPL cases and the controls in terms of obesity, diabetes, alcohol consumption, drug therapy, gender distribution, evidence of fasting chylomicronaemia, lipid levels, LPL activity and mass, hepatic lipase activity, CII and CIII mass or apo E polymorphisms. However, the SNP S19W of apo A5 tended to be more prevalent in cases than controls (40% vs. 23%, NS). Conclusion Primary defects in LPL and C-II are rare in survivors of acute hypertriglyceridaemic pancreatitis; lipase activity measurements should be restricted to those having their first episode during chilhood. PMID:19534808

Development of an antimicrobial stewardship-based infectious diseases elective that incorporates human patient simulation technology.

PubMed

Falcione, Bonnie A; Meyer, Susan M

2014-10-15

To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs.

Modeling Technology Integration for Preservice Teachers: A PT3 Case Study

ERIC Educational Resources Information Center

Hall, Leslie

2006-01-01

This case study describes the outcomes of 4 years of professional development funded by a PT3 grant. Participants included general education university faculty members, teacher education faculty members, school administrators, and K-12 teachers. All professional development activities were based on the "National Educational Technology…

28 CFR 541.27 - Protection case-placement in Administrative Detention status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... detention status as a protection case in the following circumstances. (a) Victim of inmate assault or threats. You were the victim of an inmate assault, or are being threatened by other inmates, including... sexual activity. (b) Inmate informant. Your safety is threatened because you provided, or are perceived...

28 CFR 541.27 - Protection case-placement in Administrative Detention status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... detention status as a protection case in the following circumstances. (a) Victim of inmate assault or threats. You were the victim of an inmate assault, or are being threatened by other inmates, including... sexual activity. (b) Inmate informant. Your safety is threatened because you provided, or are perceived...

Gallium-67-citrate uptake in a case of acne vulgaris

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kipper, M.S.; Taylor, A.; Ashburn, W.L.

1981-09-01

A case of increased Ga-67 uptake in a patient with active acne vulgaris is reported. The scan was requested in a search for metastatic testicular carcinoma or bleomycin pulmonary toxicity. Careful clinical evaluation including physical examination was necessary in order to avoid an erroneous scan interpretation.

Using Case Studies to Teach About Global Issues. One Family's Hunger in the United States

ERIC Educational Resources Information Center

Connolly, Gerald E.

1974-01-01

In South Carolina, the children of farmworkers were found to be getting 800 calories of food a day. This case study describes the lifestyle of one of these families and examines problems associated with underemployment and poverty. Study questions and activities are included. (DE)

Enhancing Personal and Family Finance Courses Using Case Studies

ERIC Educational Resources Information Center

Gudmunson, Clinton G.; Zuiker, Virginia Solis; Katras, Mary Jo; Sabri, Mohamad Fazli

2015-01-01

Growing financial concerns among college students and on college campuses suggests urgency in teaching personal finance more effectively. Active learning approaches to teaching, including the use of case studies, problem-based learning, group work, in-class writing, demonstrations, and so forth, may be more appropriate and useful when used to…

Emergency Support Function 15 Standard Operating Procedures

DTIC Science & Technology

2013-08-01

learned from numerous incidents to include the BP oil spill, the Fukushima nuclear incident, Hurricane Sandy and the Boston Marathon attack. Guidance is...Staffing  Operations  Activation  Incident Operations  Case Study - 2013 Boston Marathon Bombing  Case Study - 2011 Fukushima Nuclear Crisis...Quick Summary  Radiological Dispersal Device (RDD)  Improvised Nuclear Device (IND)  Federal Response  Case Studies – 2011 Fukushima Nuclear

Myiasis in pet animals in British Columbia: The potential of forensic entomology for determining duration of possible neglect

PubMed Central

2004-01-01

Abstract Results of a survey of veterinarians in British Columbia included 25 past cases of myiasis and 10 active cases. Most respondents received at least 5 to 10 cases per year, with some as high as 30 per year. This study revealed some advantages and disadvantages of using forensic entomology in living animals. PMID:15646845

Noninvasive brain stimulation treatments for addiction and major depression

PubMed Central

Dunlop, Katharine; Hanlon, Colleen A.

2016-01-01

Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Neuroimaging studies of the functional architecture of the brain suggest common neural substrates underlying MDD and SUDs. Intrinsic brain activity is organized into a set of functional networks, of which two are particularly relevant to psychiatry. The salience network (SN) is crucial for cognitive control and response inhibition, and deficits in SN function are implicated across a wide variety of psychiatric disorders, including MDD and SUDs. The ventromedial network (VMN) corresponds to the classic reward circuit, and pathological VMN activity for drug cues/negative stimuli is seen in SUDs/MDD. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico–striatal–thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control. Inhibition of the VMN also appears promising in preclinical studies for quenching the pathological incentive salience underlying SUDs and MDD. Evolving techniques may further enhance the efficacy of NIBS for MDD and SUD cases that are unresponsive to conventional treatments. PMID:26849183

Unexpected visitor on FDG PET/CT--brown adipose tissue (BAT) in mesentery in a case of retroperitoneal extra-adrenal pheochromocytoma: is the BAT activation secondary to catecholamine-secreting pheochromocytoma?

PubMed

Joshi, Prathamesh Vijay; Lele, Vikram Ramchandra

2012-05-01

Fused positron emission tomography-computed tomography (PET/CT) technology has enabled the determination that nonmalignant fluorodeoxyglucose (FDG) uptake is observed in brown adipose tissue (BAT). FDG uptake in BAT is a known potential source of false-positive interpretations for PET. The typical locations of BAT include neck, supraclavicular area, mediastinum, and paravertebral intercostal spaces. Examples of atypical locations for BAT include posterior neck, left paratracheal area, axillae, perirenal area, and retrocrural area. We report PET/CT findings in a young male patient with malignant retroperitoneal extra-adrenal pheochromocytoma, who demonstrated FDG uptake in BAT at multiple locations including mesenteric BAT. We also propose catecholamine-secreting pheochromocytoma as a possible cause of BAT activation in our case.

Environmental influences on food choice, physical activity and energy balance.

PubMed

Popkin, Barry M; Duffey, Kiyah; Gordon-Larsen, Penny

2005-12-15

In this paper, the environment is defined as the macro- and community-level factors, including physical, legal and policy factors, that influence household and individual decisions. Thus, environment is conceived as the external context in which household and individual decisions are made. This paper reviews the literature on the ways the environment affects diet, physical activity, and obesity. Other key environmental factors discussed include economic, legal, and policy factors. Behind the major changes in diet and physical activity in the US and globally lie large shifts in food production, processing, and distribution systems as well as food shopping and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial reductions in energy expenditure. Many small area studies have linked environmental shifts with diet and activity changes. This paper begins with a review of environmental influences on diet and physical activity, and includes the discussion of two case studies on environmental influences on physical activity in a nationally representative sample of US adolescents. The case studies illustrate the important role of physical activity resources and the inequitable distribution of such activity-related facilities and resources, with high minority, low educated populations at strong disadvantage. Further, the research shows a significant association of such facilities with individual-level health behavior. The inequity in environmental supports for physical activity may underlie health disparities in the US population.

Non-equilibrium Phase Transitions: Activated Random Walks at Criticality

NASA Astrophysics Data System (ADS)

Cabezas, M.; Rolla, L. T.; Sidoravicius, V.

2014-06-01

In this paper we present rigorous results on the critical behavior of the Activated Random Walk model. We conjecture that on a general class of graphs, including , and under general initial conditions, the system at the critical point does not reach an absorbing state. We prove this for the case where the sleep rate is infinite. Moreover, for the one-dimensional asymmetric system, we identify the scaling limit of the flow through the origin at criticality. The case remains largely open, with the exception of the one-dimensional totally-asymmetric case, for which it is known that there is no fixation at criticality.

Identification of a Surrogate Marker for Infection in the African Green Monkey Model of Inhalation Anthrax

DTIC Science & Technology

2008-12-01

as well as condition and clarity of eyes and nose; clinical signs included breathing rate and pattern; natural behavior included peer interaction ...human cases, fatigue and/or mal- aise was a presenting symptom in only 64% of cases (26). While decreased activity and interaction were noted in some...experimental infection with Leishmania leishmania donovani and Leishmania leishmania infantum. Lab. Anim. Sci. 43:37–47. 5. Brachman, P. S. 1980

Electrochemical systems configured to harvest heat energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Seok Woo; Yang, Yuan; Ghasemi, Hadi

Electrochemical systems for harvesting heat energy, and associated electrochemical cells and methods, are generally described. The electrochemical cells can be configured, in certain cases, such that at least a portion of the regeneration of the first electrochemically active material is driven by a change in temperature of the electrochemical cell. The electrochemical cells can be configured to include a first electrochemically active material and a second electrochemically active material, and, in some cases, the absolute value of the difference between the first thermogalvanic coefficient of the first electrochemically active material and the second thermogalvanic coefficient of the second electrochemically activemore » material is at least about 0.5 millivolts/Kelvin.« less

Assessment of the response to cholera outbreaks in two districts in Ghana.

PubMed

Ohene, Sally-Ann; Klenyuie, Wisdom; Sarpeh, Mark

2016-11-02

Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana. We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place. The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate community knowledge about cholera preventive measures. The assessment of the cholera outbreak response in the two districts highlighted strengths in the epidemic control activities. There was however need to strengthen preparedness especially in the area of improving community surveillance and awareness about cholera prevention and the importance of seeking prompt treatment in health facilities in the event of an outbreak.

Dedifferentiated liposarcoma with homologous lipoblastic differentiation: expanding the spectrum to include low-grade tumours.

PubMed

Liau, Jau-Yu; Lee, Jen-Chieh; Wu, Chen-Tu; Kuo, Kuan-Ting; Huang, Hsuan-Ying; Liang, Cher-Wei

2013-04-01

Dedifferentiated liposarcoma (DDLPS) is traditionally defined as a non-lipogenic high-grade sarcoma arising from a well-differentiated liposarcoma that confers metastatic potential. Recently, DDLPSs with lipoblastic differentiation, i.e. morphologically lipogenic DDLPSs, were reported. Because of the lipoblastic differentiation, these tumours caused confusion, and were reported under different names. However, cytogenetic and molecular studies have revealed their DDLPS nature. So far, the cases reported have been high-grade pleomorphic liposarcoma-like tumours. In this study we have collected another series that contains low-grade tumours, and expand the histological spectrum. Eighteen cases of DDLPS with lipoblastic differentiation from various anatomical locations were analysed by routine histology, immunohistochemistry, and MDM2 fluorescence in-situ hybridization. Two main histological patterns were seen: one featured a spindle cell sarcoma containing lipoblasts with variable nuclear pleomorphism, and the other a pleomorphic liposarcoma-like tumour including the epithelioid variant. Two cases showed low nuclear grade and lipogenic activity in the metastatic foci. CDK4, MDM2 and p16(INK) (4a) overexpression was seen in all except one case. MDM2 amplification was found in all 16 cases tested. We have expanded the spectrum of this variant of DDLPS to include low-grade tumours, in which a careful search for increased mitotic activity is essential. Like conventional DDLPS, these tumours are capable of metastasis. © 2012 Blackwell Publishing Ltd.

Sleep EEG of Microcephaly in Zika Outbreak.

PubMed

Kanda, Paulo Afonso Medeiros; Aguiar, Aline de Almeida Xavier; Miranda, Jose Lucivan; Falcao, Alexandre Loverde; Andrade, Claudia Suenia; Reis, Luigi Neves Dos Santos; Almeida, Ellen White R Bacelar; Bello, Yanes Brum; Monfredinho, Arthur; Kanda, Rafael Guimaraes

2018-01-01

Microcephaly (MC), previously considered rare, is now a health emergency of international concern because of the devastating Zika virus pandemic outbreak of 2015. The authors describe the electroencephalogram (EEG) findings in sleep EEG of epileptic children who were born with microcephaly in areas of Brazil with active Zika virus transmission between 2014 and 2017. The authors reviewed EEGs from 23 children. Nine were females (39.2%), and the age distribution varied from 4 to 48 months. MC was associated with mother positive serology to toxoplasmosis (toxo), rubella (rub), herpes, and dengue (1 case); toxo (1 case); chikungunya virus (CHIKV) (1 case); syphilis (1 case); and Zika virus (ZIKV) (10 cases). In addition, 1 case was associated with perinatal hypoxia and causes of 9 cases remain unknown. The main background EEG abnormality was diffuse slowing (10 cases), followed by classic (3 cases) and modified (5 cases) hypsarrhythmia. A distinct EEG pattern was seen in ZIKV (5 cases), toxo (2 cases), and undetermined cause (1 case). It was characterized by runs of frontocentrotemporal 4.5-13 Hz activity (7 cases) or diffuse and bilateral runs of 18-24 Hz (1 case). In ZIKV, this rhythmic activity was associated with hypsarrhythmia or slow background. Further studies are necessary to determine if this association is suggestive of ZIKV infection. The authors believe that EEG should be included in the investigation of all newly diagnosed congenital MC, especially those occurring in areas of autochthonous transmission of ZIKV.

Clinical utility of therapeutic drug monitoring in biological disease modifying anti-rheumatic drug treatment of rheumatic disorders: a systematic narrative review.

PubMed

Van Herwaarden, Noortje; Van Den Bemt, Bart J F; Wientjes, Maike H M; Kramers, Cornelis; Den Broeder, Alfons A

2017-08-01

Biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have improved the treatment outcomes of inflammatory rheumatic diseases including Rheumatoid Arthritis and spondyloarthropathies. Inter-individual variation exists in (maintenance of) response to bDMARDs. Therapeutic Drug Monitoring (TDM) of bDMARDs could potentially help in optimizing treatment for the individual patient. Areas covered: Evidence of clinical utility of TDM in bDMARD treatment is reviewed. Different clinical scenarios will be discussed, including: prediction of response after start of treatment, prediction of response to a next bDMARD in case of treatment failure of the first, prediction of successful dose reduction or discontinuation in case of low disease activity, prediction of response to dose-escalation in case of active disease and prediction of response to bDMARD in case of flare in disease activity. Expert opinion: The limited available evidence does often not report important outcomes for diagnostic studies, such as sensitivity and specificity. In most clinical relevant scenarios, predictive value of serum (anti-) drug levels is absent, therefore the use of TDM of bDMARDs cannot be advocated. Well-designed prospective studies should be done to further investigate the promising scenarios to determine the place of TDM in clinical practice.

Evaluation and Utilization as a Public Health Tool of a National Molecular Epidemiological Tuberculosis Outbreak Database within the United Kingdom from 1997 to 2001

PubMed Central

Drobniewski, F. A.; Gibson, A.; Ruddy, M.; Yates, M. D.

2003-01-01

The aim of this study was to develop a national model and analyze the value of a molecular epidemiological Mycobacterium tuberculosis DNA fingerprint-outbreak database. Incidents were investigated by the United Kingdom PHLS Mycobacterium Reference Unit (MRU) from June 1997 to December 2001, inclusive. A total of 124 incidents involving 972 tuberculosis cases, including 520 patient cultures from referred incidents and 452 patient cultures related to two population studies, were examined by using restriction fragment length polymorphism IS6110 fingerprinting and rapid epidemiological typing. Investigations were divided into the following three categories, reflecting different operational strategies: retrospective passive analysis, retrospective active analysis, and retrospective prospective analysis. The majority of incidents were in the retrospective passive analysis category, i.e., the individual submitting isolates has a suspicion they may be linked. Outbreaks were examined in schools, hospitals, farms, prisons, and public houses, and laboratory cross-contamination events and unusual clinical presentations were investigated. Retrospective active analysis involved a major outbreak centered on a high school. Contact tracing of a teenager with smear-positive pulmonary tuberculosis matched 14 individuals, including members of his class, and another 60 cases were identified in schools clinically and radiologically and by skin testing. Retrospective prospective analysis involved an outbreak of 94 isoniazid-resistant tuberculosis cases in London, United Kingdom, that began after cases were identified at one hospital in January 2000. Contact tracing and comparison with MRU databases indicated that the earliest matched case had occurred in 1995. Subsequently, the MRU changed to an active prospective analysis targeting linked isoniazid-monoresistant isolates for follow up. The patients were multiethnic, born mainly in the United Kingdom, and included professionals, individuals from the music industry, intravenous drug abusers, and prisoners. PMID:12734218

Evaluation and utilization as a public health tool of a national molecular epidemiological tuberculosis outbreak database within the United Kingdom from 1997 to 2001.

PubMed

Drobniewski, F A; Gibson, A; Ruddy, M; Yates, M D

2003-05-01

The aim of this study was to develop a national model and analyze the value of a molecular epidemiological Mycobacterium tuberculosis DNA fingerprint-outbreak database. Incidents were investigated by the United Kingdom PHLS Mycobacterium Reference Unit (MRU) from June 1997 to December 2001, inclusive. A total of 124 incidents involving 972 tuberculosis cases, including 520 patient cultures from referred incidents and 452 patient cultures related to two population studies, were examined by using restriction fragment length polymorphism IS6110 fingerprinting and rapid epidemiological typing. Investigations were divided into the following three categories, reflecting different operational strategies: retrospective passive analysis, retrospective active analysis, and retrospective prospective analysis. The majority of incidents were in the retrospective passive analysis category, i.e., the individual submitting isolates has a suspicion they may be linked. Outbreaks were examined in schools, hospitals, farms, prisons, and public houses, and laboratory cross-contamination events and unusual clinical presentations were investigated. Retrospective active analysis involved a major outbreak centered on a high school. Contact tracing of a teenager with smear-positive pulmonary tuberculosis matched 14 individuals, including members of his class, and another 60 cases were identified in schools clinically and radiologically and by skin testing. Retrospective prospective analysis involved an outbreak of 94 isoniazid-resistant tuberculosis cases in London, United Kingdom, that began after cases were identified at one hospital in January 2000. Contact tracing and comparison with MRU databases indicated that the earliest matched case had occurred in 1995. Subsequently, the MRU changed to an active prospective analysis targeting linked isoniazid-monoresistant isolates for follow up. The patients were multiethnic, born mainly in the United Kingdom, and included professionals, individuals from the music industry, intravenous drug abusers, and prisoners.

Natural Organohalogens: A New Frontier for Medicinal Agents?

ERIC Educational Resources Information Center

Gribble, Gordon W.

2004-01-01

Newly discovered biogenic organo halogens with an emphasis on the biologically active examples from marine organisms, bacteria, terrestrial plants and higher life forms, including humans, are focused. Organohalogen compounds represent a valuable and expanding class of natural products, in many cases boasting exceptional biological activity.

Investigating Aquatic Dead Zones

ERIC Educational Resources Information Center

Testa, Jeremy; Gurbisz, Cassie; Murray, Laura; Gray, William; Bosch, Jennifer; Burrell, Chris; Kemp, Michael

2010-01-01

This article features two engaging high school activities that include current scientific information, data, and authentic case studies. The activities address the physical, biological, and chemical processes that are associated with oxygen-depleted areas, or "dead zones," in aquatic systems. Students can explore these dead zones through both…

Sharing Good Practices: Teenage Girls, Sport, and Physical Activities.

ERIC Educational Resources Information Center

Vescio, Johanna A.; Crosswhite, Janice J.

2002-01-01

Investigated initiatives to increase teenage girls' participation in sport and physical activities, examining good practice case studies from Australia. Surveys of national, state, and regional sporting organizations and various community and school organizations (including culturally diverse girls and girls with disabilities) highlighted three…

Bystander capability to activate speaker function for continuous dispatcher assisted CPR in case of suspected cardiac arrest.

PubMed

Steensberg, Alvilda T; Eriksen, Mette M; Andersen, Lars B; Hendriksen, Ole M; Larsen, Heinrich D; Laier, Gunnar H; Thougaard, Thomas

2017-06-01

The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. In 87days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed. For those asked, "can you activate your mobile phone's speaker function", audio recordings were examined and categorized into groups according to the bystanders capability to activate speaker function on their own initiative, without instructions, or with instructions from the emergency medical dispatcher. Time delay was measured, in seconds, for the bystanders without pre-activated speaker function. 42.0% (58) was able to activate the speaker function without instructions, 2.9% (4) with instructions, 18.1% (25) on own initiative and 37.0% (51) were unable to activate the speaker function. The median time to activate speaker function was 19s and 8s, with and without instructions, respectively. Dispatcher assisted cardiopulmonary resuscitation with activated speaker function, in cases of suspected cardiac arrest, allows for continuous dialogue between the emergency medical dispatcher and the bystander. In this study, we found a 63.0% success rate of activating the speaker function in such situations. Copyright © 2017 Elsevier B.V. All rights reserved.

Parents' Networking Strategies: Participation of Formal and Informal Parent Groups in School Activities and Decisions

ERIC Educational Resources Information Center

Wanat, Carolyn L.

2010-01-01

This case study examined parent groups' involvement in school activities and their participation in decision making. Research questions included the following: (1) What is the nature of parent groups in schools? (2) What activities and issues gain parent groups' attention and participation? (3) How do parent groups communicate concerns about…

[Significance of glucose-6-phosphate isomerase assay in early diagnosis of rheumatoid arthritis].

PubMed

Xu, J; Liu, J; Zhu, L; Zhang, X W; Li, Z G

2016-12-18

To explore the titer of glucose-6-phosphate isomerase (GPI) for early diagnosis of the outpatient with rheumatoid arthritis (RA) in real life, and to analyze its relationship with disease activity. In the study, 1 051 patients with arthritis were collected in the group who had joints tender and swelling, and 90 cases of healthy people as a control group. ELISA method was used to detect the serum level of GPI, and according to clinical features and laboratory test, all the patients including 525 RA patients, the other patients including osteoarthritis (OA), 134 cases of seronegative spine joint disease (SpA), 104 cases of systemic lupus erythematosus (SLE), 31 cases of primary Sjogren syndrome (pSS), 24 cases of gout arthritis (GA), 22 cases of other connective tissue diseases (including polymyalgia rheumatica, dermatomyositis, systemic sclerosis, adult Still disease) and 46 cases of other diseases (including 165 cases of osteoporosis, avascular necrosis of the femoral head, traumatic osteomyelitis, bone and joint disease, juvenile rheumatoid arthritis, tumor). The diagnostic values of GPI were assessed, and the differences between the GPI positive and negative groups of the RA patients in clinical characteristics, disease activity, severity and inflammatory index analyzed. The positive rate of serum GPI in the patients with RA was 55.4%, contrasting to other autoimmune diseases (14.3%) and healthy controls (7.78%)(P<0.001). Compared with the OA and SpA patients, the RA group was increased more significantly, and the difference was statistically significant (P<0.001). The diagnostic value of GPI alone for RA was 0.39 mg/L, the sensitivity was 54.2%, and specificity was 87.3%. The positive rate of GPI in RF negative patients was 36.1%; the positive rate of GPI in anti-CCP antibody negative patients was 34.2%; the positive rate of GPI in RF and anti-CCP antibody negative patients was 24.1%. The level of GPI had positive correlation (P<0.05) with ESR, RF, anti-CCP antibody and HRF-IgG. GPI is sensitive in the patients with RA; GPI positive is important in the diagnosis of RA with anti-CCP antibody and/or RF negative patients. The titer of GPI is related with disease activity of RA.

PLA2G7 genotype, Lp-PLA2 activity and coronary heart disease risk in 10,494 cases and 15,624 controls of European ancestry

PubMed Central

Casas, Juan P.; Ninio, Ewa; Panayiotou, Andrie; Palmen, Jutta; Cooper, Jackie A; Ricketts, Sally L; Sofat, Reecha; Nicolaides, Andrew N; Corsetti, James P; Fowkes, F Gerry R; Tzoulaki, Ioanna; Kumari, Meena; Brunner, Eric J; Kivimaki, Mika; Marmot, Michael G; Hoffmann, Michael M; Winkler, Karl; März, Winfred; Ye, Shu; Stirnadel, Heide A; MBBChir, Kay-Tee Khaw; Humphries, Steve E; Sandhu, Manjinder S; Hingorani, Aroon D; Talmud, Philippa J

2012-01-01

Background Higher Lp-PLA2 activity is associated with increased risk of coronary heart disease (CHD), making Lp-PLA2 a potential therapeutic target. PLA2G7 variants associated with Lp-PLA2 activity could evaluate whether this relationship is causal. Methods and Results A meta-analysis including a total of 12 studies (5 prospective, 4 case-control, 1 case-only and 2 cross-sectional, n=26,118) was undertaken to examine the association of: (i) LpPLA2 activity vs. cardiovascular biomarkers and risk factors and CHD events (two prospective studies; n=4884); ii) PLA2G7 SNPs and Lp-PLA2 activity (3 prospective, 2 case-control, 2 cross-sectional studies; up to n=6094); and iii) PLA2G7 SNPs and angiographic coronary artery disease (2 case-control, 1 case-only study; n=4971 cases) and CHD events (5 prospective, 2 case-control studies; n=5523). Lp-PLA2 activity correlated with several CHD risk markers. Hazard ratio for CHD events top vs. bottom quartile of Lp-PLA2 activity was 1.61 (95%CI: 1.31, 1.99) and 1.17 (95%CI: 0.91, 1.51) after adjustment for baseline traits. Of seven SNPs, rs1051931 (A379V) showed the strongest association with Lp-PLA2 activity, VV subjects having 7.2% higher activity than AAs. Genotype was not associated with risk markers, angiographic coronary disease (OR 1.03 (95%CI 0.80, 1.32), or CHD events (OR 0.98 (95%CI 0.82, 1.17). Conclusions Unlike Lp-PLA2 activity, PLA2G7 variants associated with modest effects on Lp-PLA2 activity were not associated with cardiovascular risk markers, coronary atheroma or CHD. Larger association studies, identification of SNPs with larger effects, or randomised trials of specific Lp-PLA2 inhibitors are needed to confirm/refute a contributory role for Lp-PLA2 in CHD. PMID:20479152

26 CFR 301.6501(c)-1 - Exceptions to general period of limitations on assessment and collection.

Code of Federal Regulations, 2011 CFR

2011-04-01

... taxable event), including, in the case of an equity interest that is not actively traded, the financial and other data used in determining value. Financial data should generally include balance sheets and... of property transferred, including any financial data (for example, balance sheets, etc. with...

26 CFR 301.6501(c)-1 - Exceptions to general period of limitations on assessment and collection.

Code of Federal Regulations, 2010 CFR

2010-04-01

... taxable event), including, in the case of an equity interest that is not actively traded, the financial and other data used in determining value. Financial data should generally include balance sheets and... of property transferred, including any financial data (for example, balance sheets, etc. with...

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

PubMed

Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

75 FR 51077 - Agency Information Collection Activities; Proposed Collection; Comment Request; Information From...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

..., dairy products, game meat, game meat products, animal casings, gelatin, and collagen to the European... animal-derived products (e.g., shell eggs, dairy products, game meat, game meat products, animal casings... this collection of information include U.S. producers of shell eggs, dairy products, game meat, game...

Bioethics Cases and Issues: Enrichment for Social Science, Humanities, and Science Courses.

ERIC Educational Resources Information Center

Guyer, Ruth Levy; Dillon, Mary Lou; Anderson, Linda; Szobota, Lola

2000-01-01

Discusses the use of bioethics and bioethical dilemmas in different subject areas at the high school level by focusing on the case of Baby K. Includes the story of Baby K, classroom activities for U.S. history, 10th and 11th grade ethics, and anatomy and physiology. (CMK)

78 FR 36248 - Appendix B Guidelines for Reviewing Applications for Compensation and Reimbursement of Expenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... recruiting and training. k. Non-working travel: Whether the application includes time billed for non-working... professional's full rate for time spent traveling without actively working on the bankruptcy case or while... $50 million or more in liabilities, aggregated for jointly administered cases. Single asset real...

An Exploratory Multiple Case Study about Using Game-Based Learning in STEM Classrooms

ERIC Educational Resources Information Center

Vu, Phu; Feinstein, Sheryl

2017-01-01

This exploratory multiple case study attempted to examine whether game-based learning activities had any impacts on students' academic performances and behaviors, and what perceptions the teachers had toward implementing games into their classrooms. Data used in this study included 101 students' pre and post-test scores, and four structured…

Mission US and Historical Empathy: A Qualitative Case Study of Sixth-Grade Students' Experiences

ERIC Educational Resources Information Center

Maxlow, James Richard

2015-01-01

This study investigated the potential development and use of historical empathy in sixth-grade students while using the colonial-era historical education game "Mission US" and its associated learning activities. A collective case study was developed to describe and interpret students' experiences. The gathered data included the students'…

It System Integration: Global Medical Acquisition of Health Tech Case Study

ERIC Educational Resources Information Center

Russo, Mark; White, Bruce

2013-01-01

Mergers and Acquisitions are just part of life in business. For example, in the health care technology field in 2012, Veritas Capital Partners acquired Thomson Reuters' Healthcare. Other major active acquisition companies included: Medical Transcription Billing, T-System Technologies and Sharecare. In this case study, a larger health technology…

Socio-Cultural Factors in Second Language Learning: A Case Study of Adventurous Adult Language Learners

ERIC Educational Resources Information Center

Ozfidan, Burhan; Machtmes, Krisanna L.; Demir, Husamettin

2014-01-01

Sociocultural theories consider language learning as a social practice examines students as active participants in the construction of learning processes. This study investigates sociocultural theories' central concepts, which includes peer interaction and feedback, private speech, and self-efficacy. The present study is a case study of twenty…

Including the Consumer and Environment in Occupational Therapy Treatment Planning.

ERIC Educational Resources Information Center

Brown, Catana; Bowen, Robin E.

1998-01-01

Occupational therapists (n=29) completed treatment plans based on case study data. Analysis indicated they often identified goals not addressed by the consumer/client. They significantly selected more simulated than real activities and more activities designed to change the person rather than the environment. (SK)

Variations on an Historical Case Study

ERIC Educational Resources Information Center

Field, Patrick

2006-01-01

The National Inquiry Standard for Science Education Preparation requires science teachers to introduce students to scientific inquiry to solve problems by various methods, including active learning in a collaborative environment. In order for science teachers to comply with this inquiry standard, activities must be designed for students to…

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

PubMed

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

PubMed Central

du Breuil, Anne L.; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses. PMID:27800207

Contact Tracing Activities during the Ebola Virus Disease Epidemic in Kindia and Faranah, Guinea, 2014

PubMed Central

Taylor, Melanie M.; Dee, Jacob; Hakim, Avi; Cantey, Paul; Lim, Travis; Bah, Hawa; Camara, Sékou Mohamed; Ndongmo, Clement B.; Togba, Mory; Touré, Leonie Yvonne; Bilivogui, Pepe; Sylla, Mohammed; Kinzer, Michael; Coronado, Fátima; Tongren, Jon Eric; Swaminathan, Mahesh; Mandigny, Lise; Diallo, Boubacar; Seyler, Thomas; Rondy, Marc; Rodier, Guénaël; Perea, William A.; Dahl, Benjamin

2015-01-01

The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20–December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic. PMID:26488116

Contact Tracing Activities during the Ebola Virus Disease Epidemic in Kindia and Faranah, Guinea, 2014.

PubMed

Dixon, Meredith G; Taylor, Melanie M; Dee, Jacob; Hakim, Avi; Cantey, Paul; Lim, Travis; Bah, Hawa; Camara, Sékou Mohamed; Ndongmo, Clement B; Togba, Mory; Touré, Leonie Yvonne; Bilivogui, Pepe; Sylla, Mohammed; Kinzer, Michael; Coronado, Fátima; Tongren, Jon Eric; Swaminathan, Mahesh; Mandigny, Lise; Diallo, Boubacar; Seyler, Thomas; Rondy, Marc; Rodier, Guénaël; Perea, William A; Dahl, Benjamin

2015-11-01

The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20-December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.

Piloting a programme tool to evaluate malaria case investigation and reactive case detection activities: results from 3 settings in the Asia Pacific.

PubMed

Cotter, Chris; Sudathip, Prayuth; Herdiana, Herdiana; Cao, Yuanyuan; Liu, Yaobao; Luo, Alex; Ranasinghe, Neil; Bennett, Adam; Cao, Jun; Gosling, Roly D

2017-08-22

Case investigation and reactive case detection (RACD) activities are widely-used in low transmission settings to determine the suspected origin of infection and identify and treat malaria infections nearby to the index patient household. Case investigation and RACD activities are time and resource intensive, include methodologies that vary across eliminating settings, and have no standardized metrics or tools available to monitor and evaluate them. In response to this gap, a simple programme tool was developed for monitoring and evaluating (M&E) RACD activities and piloted by national malaria programmes. During the development phase, four modules of the RACD M&E tool were created to assess and evaluate key case investigation and RACD activities and costs. A pilot phase was then carried out by programme implementers between 2013 and 2015, during which malaria surveillance teams in three different settings (China, Indonesia, Thailand) piloted the tool over a period of 3 months each. This study describes summary results of the pilots and feasibility and impact of the tool on programmes. All three study areas implemented the RACD M&E tool modules, and pilot users reported the tool and evaluation process were helpful to identify gaps in RACD programme activities. In the 45 health facilities evaluated, 71.8% (97/135; min 35.3-max 100.0%) of the proper notification and reporting forms and 20.0% (27/135; min 0.0-max 100.0%) of standard operating procedures (SOPs) were available to support malaria elimination activities. The tool highlighted gaps in reporting key data indicators on the completeness for malaria case reporting (98.8%; min 93.3-max 100.0%), case investigations (65.6%; min 61.8-max 78.4%) and RACD activities (70.0%; min 64.7-max 100.0%). Evaluation of the SOPs showed that knowledge and practices of malaria personnel varied within and between study areas. Average monthly costs for conducting case investigation and RACD activities showed variation between study areas (min USD $844.80-max USD $2038.00) for the malaria personnel, commodities, services and other costs required to carry out the activities. The RACD M&E tool was implemented in the three pilot areas, identifying key gaps that led to impacts on programme decision making. Study findings support the need for routine M&E of malaria case reporting, case investigation and RACD activities. Scale-up of the RACD M&E tool in malaria-eliminating settings will contribute to improved programme performance to the high level that is required to reach elimination.

Observation of acoustic-gravity waves in the upper atmosphere during severe storm activity

NASA Technical Reports Server (NTRS)

Hung, R. J.

1975-01-01

A nine-element continuum wave spectrum, high-frequency, Doppler sounder array has been used to detect upper atmospheric wave-like disturbances during periods with severe weather activity, particularly severe thunderstorms and tornadoes. Five events of severe weather activity, including extreme tornado outbreak of April 3, 1974, were chosen for the present study. The analysis of Doppler records shows that both infrasonic waves and gravity waves were excited when severe storms appeared in the north Alabama area. Primarily, in the case of tornado activity, S-shaped Doppler fluctuations or Doppler fold-backs are observed, while quasi-sinusoidal fluctuations are more common in the case of thunderstorm activity. A criterion for the production of Doppler fold-backs is derived and compared with possible tornado conditions.

Scapulothoracic muscle activity and recruitment timing in patients with shoulder impingement symptoms and glenohumeral instability.

PubMed

Struyf, Filip; Cagnie, Barbara; Cools, Ann; Baert, Isabel; Brempt, Jolien Van; Struyf, Pieter; Meeus, Mira

2014-04-01

Various studies have investigated scapulothoracic muscle activity and recruitment patterns in relation to shoulder complaints in different populations, but a consensus review is lacking. To systematically review the state of the art regarding scapulothoracic muscle activity and recruitment timing in subjects with shoulder pain compared to pain free controls. Systematic review. The search for relevant articles was performed in Pubmed and Web of Science, including Web of Knowledge, using key words related to shoulder pain, scapulothoracic muscle activity or recruitment timing. Articles were included till November 2012. Case-control studies concerning the scapulothoracic region and muscle recruitment using electromyography (EMG) were included. Articles regarding rotator cuff muscles or neck-shoulder pathologies or studies handling a treatment outcome, were excluded. The methodological quality of the articles was assessed using appropriate risk of bias criteria for case-control studies. A total of 12 articles were included in the systematic review, containing patients with Shoulder Impingement Syndrome (SIS) or glenohumeral instability. In patients with SIS 3 out of 6 articles showed increased upper trapezius muscle (UT) activity, 3 out of 5 studies showed decreased lower trapezius muscle (LT) activity and 3 out of 5 articles showed decreased serratus anterior muscle (SA) activity. Patients with glenohumeral instability showed contradictory results on scapulothoracic muscle activity patterns. In both SIS and glenohumeral instability patients, no consensus was found on muscle recruitment timing. Patients with SIS and glenohumeral instability display numerous variations in scapulothoracic muscle activity compared to healthy controls. In the SIS-group, the LT and SA muscle activity is decreased. In addition, the UT muscle activity is increased among the SIS patients, whereas no clear change is seen among patients with glenohumeral instability. Although the scapulothoracic muscle activity changed, no consensus could be made regarding muscle recruitment timing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bioterrorism and Biocrimes: The Illicit Use of Biological Agents Since 1900

DTIC Science & Technology

2001-02-01

to white supremacist groups, including the Aryan Nation and the Christian Identity movement, he 5 involve allegations of covert state activities ...toxin to poison livestock in what is now Kenya. The full extent of these activities is not known. Polish Resistance: Multiple reports suggest that...thorough reporting of Aum’s biological warfare activities . See page 47 for additional details. Table 1: Confirmed cases of illicit biological agent activity

Thermal activation of dislocations in large scale obstacle bypass

NASA Astrophysics Data System (ADS)

Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; Martinez, Enrique

2017-08-01

Dislocation dynamics simulations have been used extensively to predict hardening caused by dislocation-obstacle interactions, including irradiation defect hardening in the athermal case. Incorporating the role of thermal energy on these interactions is possible with a framework provided by harmonic transition state theory (HTST) enabling direct access to thermally activated reaction rates using the Arrhenius equation, including rates of dislocation-obstacle bypass processes. Moving beyond unit dislocation-defect reactions to a representative environment containing a large number of defects requires coarse-graining the activation energy barriers of a population of obstacles into an effective energy barrier that accurately represents the large scale collective process. The work presented here investigates the relationship between unit dislocation-defect bypass processes and the distribution of activation energy barriers calculated for ensemble bypass processes. A significant difference between these cases is observed, which is attributed to the inherent cooperative nature of dislocation bypass processes. In addition to the dislocation-defect interaction, the morphology of the dislocation segments pinned to the defects play an important role on the activation energies for bypass. A phenomenological model for activation energy stress dependence is shown to describe well the effect of a distribution of activation energies, and a probabilistic activation energy model incorporating the stress distribution in a material is presented.

Who Wants To Be an IPM Super Sleuth? Integrated Pest Management Educational Activities & Resources for Kids of All Ages.

ERIC Educational Resources Information Center

Walejko, Gina K.; Colon, Joseph L.

This guide presents games and activities on integrated pest management (IPM) for home targeting grades 1-7. The activities and games use a problem-solving approach based on pest knowledge to develop an understanding of pest management. Three cases are presented: (1) "Inspection is the Key to IPM Success" includes two…

[Presence of inhibitors of activated partial thromboplastin time (TTPA). Clinical repercussion in obstetric patients].

PubMed

Bustos, H H; Huber, R; Baptista, H; Izquierdo, H; Sánchez Contreras, J

1992-01-01

Partial thromboplastin time, activated with kaolin (TTPA) is a qualitative test used to find defects of some factor of intrinsic via of coagulation or to rule out the presence of some circulating inhibitor. The lupus anticoagulant (LA) is part of a group of several auto-antibody with pathogenic potential in several branches of medicine, mainly rheumatology, hematology and gyneco-obstetrics. In this last area the LA has been associated with different obstetrical repercussions. The purpose of this study was to determine the main obstetrical events associated with patients with circulating anticoagulants identified by TTPA with kaolin. Ninety six patients were included in cases-control study. Group I (n = 48) cases and Group II (n = 48) controls, were selected from the same population and information source. The cases were included when presenting prolongation of more than 4 seconds of TTPA activated with kaolin regarding a control with lack of correction with normal plasma. A registration sheet for data captation, was designed specially for this study. The comparability of both groups was established, as there were no differences (significant) among the variable considered as basal. The group of cases presented with a greater frequency of habitual abortion, neonatal death and thrombotic phenomena. This relationship of autoimmunological pictures with recurrent fetal loss and thromboembolic incidents has been consistently described in literature. To this respect, several immunological abnormalities. Including positive anticardiolipin antibodies and VDRL falsely positive. The incidence, in this country of these entities, is unknown. These observations show the need of a methodologic superation.(ABSTRACT TRUNCATED AT 250 WORDS)

Teaching Strategy: Using the Civil Law Poster.

ERIC Educational Resources Information Center

Update on Law-Related Education, 1997

1997-01-01

Presents a series of instructional activities to be used in conjunction with a poster that identifies types of cases and processes associated with civil law. Includes procedures for the instructional activities, objectives, a poster, and student handouts using tables and graphs to illustrate current facts about tort law. (MJP)

Experiential Learning through a Physical Activity Program for Children with Disabilities

ERIC Educational Resources Information Center

Richards, K. Andrew R.; Eberline, Andrew D.; Padaruth, Sookhenlall; Templin, Thomas J.

2015-01-01

Service-learning has become a popular pedagogical tool to promote academic and civic learning. One form of service-learning provides physical activity for underrepresented community groups, including children with disabilities. Using experiential learning theory, the purpose of this descriptive case study was to evaluate college students'…

Student Activity Guide for "Business in an Information Economy."

ERIC Educational Resources Information Center

Graf, David; And Others

The 20 chapters of this student activity guide provide study guides (key terms and concepts reviews), projects, cases for analyses, and self-assessment exercises for business and career education classes. Topics covered include the following: business winners (entrepreneurship); growth of the U.S. economy, the basics of economics, comparing…

Experiential Learning and Learning Environments: The Case of Active Listening Skills

ERIC Educational Resources Information Center

Huerta-Wong, Juan Enrique; Schoech, Richard

2010-01-01

Social work education research frequently has suggested an interaction between teaching techniques and learning environments. However, this interaction has never been tested. This study compared virtual and face-to-face learning environments and included active listening concepts to test whether the effectiveness of learning environments depends…

Teaching Case: A Systems Analysis Role-Play Exercise and Assignment

ERIC Educational Resources Information Center

Mitri, Michel; Cole, Carey; Atkins, Laura

2017-01-01

This paper presents a role-play exercise and assignment that provides an active learning experience related to the system investigation phase of an SDLC. Whether using waterfall or agile approaches, the first SDLC step usually involves system investigation activities, including problem identification, feasibility study, cost-benefit analysis, and…

The New School-Based Learning (SBL) to Work-Based Learning (WBL) Transition Module: A Practical Implementation in the Technical and Vocational Education (TVE) System in Bahrain

NASA Astrophysics Data System (ADS)

Alseddiqi, M.; Mishra, R.; Pislaru, C.

2012-05-01

This paper diagnoses the implementation of a new engineering course entitled 'school-based learning (SBL) to work-based learning (WBL) transition module' in the Bahrain Technical and Vocational Education (TVE) learning environment. The module was designed to incorporate an innovative education and training approach with a variety of learning activities that are included in various learning case studies. Each case study was based on with learning objectives coupled with desired learning outcomes. The TVE students should meet the desired outcomes after the completion of the learning activities and assessments. To help with the implementation phase of the new module, the authors developed guidelines for each case study. The guidelines incorporated learning activities to be delivered in an integrated learning environment. The skills to be transferred were related to cognitive, affective, and technical proficiencies. The guidelines included structured instructions to help students during the learning process. In addition, technology was introduced to improve learning effectiveness and flexibility. The guidelines include learning indicators for each learning activity and were based on their interrelation with competencies to be achieved with respect to modern industrial requirements. Each learning indicator was then correlated against the type of learning environment, teaching and learning styles, examples of mode of delivery, and assessment strategy. Also, the learning activities were supported by technological features such as discussion forums for social perception and engagement and immediate feedback exercises for self-motivation. Through the developed module, TVE teachers can effectively manage the teaching and learning process as well as the assessment strategy to satisfy students' individual requirements and enable them to meet workplace requirements.

77 FR 54355 - Amendments to Commodity Pool Operator and Commodity Trading Advisor Regulations Resulting From...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... forex transaction, offset), exercised, expired (including, in the case of a retail forex transaction... activity (including retail forex and swap transactions) expected to be engaged in by the offered pool. (h...) Any costs or fees included in the spread between bid and asked prices for retail forex or, if known...

Durability of aneurysm treatments in patients with active Behcet's disease.

PubMed

Elsharawy, Mohamed A; Elsaid, Aymen; Al-Dhafery, Bander; Alghnimi, Ibrahim; Almabyouq, Fatimah

2016-10-01

Aneurysms in Behcet's disease are rare, serious, and recurrent. To achieve durable treatment, patients should receive immunosuppressive therapy before intervention to induce remission. We present early and long-term results of emergency cases of active Behcet's disease, which did not permit waiting for suppressive treatment. The study was undertaken on all cases admitted to the vascular unit, King Fahd Hospital of University for aneurysm treatment in patients with active Behcet's disease over about 10 years. All patients had exclusion of the aneurysm either by open surgery or endovascular intervention. Morbidities and mortality were recorded within the hospital admission and on the follow-up. During the study period, three cases were included. All interventions were successful and lifesaving. However, two cases, treated with surgical interposition grafts, were blocked in the intermediate term follow-up (2-12 months) and one case, treated with endovascular treatment, complicated with pseudoaneurysm at femoral puncture site after six months. Although early results were good, intermediate ones were not satisfactory because of progressive graft thrombosis and formation of new aneurysms. Awareness of these rare cases help for early identification and proper immunosuppressive before emergency vascular intervention is warranted. © The Author(s) 2015.

Current Trends in Microform Use by Secondary Schools: Four Case Studies.

ERIC Educational Resources Information Center

Lee, Thomas Graham

The case study section of this booklet discusses a number of current microform programs in secondary schools. The remainder of the booklet presents an overview of microform activity, including comments on the history of secondary school microform utilization and an up-to-date listing of microform selection aids. The amount of information available…

The Arts: A Competitive Advantage for California.

ERIC Educational Resources Information Center

KPMG Peat Marwick, Washington, DC. Policy Economic Group.

This 1993 study attempts to define the size and scope of state-wide economic activity generated by the arts in California. The analysis is based on data from surveys of nonprofit arts organization and five case studies. The case studies, which provided context for the core research, include examinations of: (1) artists in Los Angeles County; (2)…

Conflicts in Chemistry: The Case of Plastics, a Role-Playing Game for High School Chemistry Students

ERIC Educational Resources Information Center

Cook, Deborah H.

2014-01-01

Conflicts in Chemistry: The Case of Plastics, an innovative role-playing activity for high school students, was developed by the Chemical Heritage Foundation to promote increased public understanding of chemistry. The pilot program included three high school teachers and their students at three different schools and documented implementation and…

The Effect of Gender on Perception of Case Studies and Performance

ERIC Educational Resources Information Center

Murray, Marlene

2016-01-01

The case study method of teaching uses real-world narratives to teach concepts and content. This method of teaching encourages active learning, which has been shown to have a positive effect on student performance in many disciplines including science. Although more females than males pursue a postsecondary degree, more males than females pursue…

Teaching the Universal Declaration of Human Rights in a U.S. Government Course.

ERIC Educational Resources Information Center

Rosen, Philip

1990-01-01

Discusses the United Nations Universal Declaration of Human Rights as a vehicle for learning democratic and humanistic values. Provides goals for instruction about the Declaration. Compares the Declaration to U.S. Supreme Court cases and congressional acts, and suggests classroom activities using it. Includes an appendix on Supreme Court cases and…

E-Mentoring for New Principals: A Case Study of a Mentoring Program

ERIC Educational Resources Information Center

Russo, Erin D.

2013-01-01

This descriptive case study includes both new principals and their mentor principals engaged in e-mentoring activities. This study examines the components of a school district's mentoring program in order to make sense of e-mentoring technology. The literature review highlights mentoring practices in education, and also draws upon e-mentoring…

[Use of hospital discharge records to estimate the incidence of malignant mesotheliomas].

PubMed

Stura, Antonella; Gangemi, Manuela; Mirabelli, Dario

2007-01-01

cancer registries usually adopt strategies for active case finding. Interest in using administrative sources of data is rising to assess the usefullness of Hospital discharge records (HDR) to supplement the traditional methods of case finding of the malignant mesothelioma (MM) Registry of the Piedmont Region. HDRs have been used since 1996. We assessed the number of cases identified only through HDRs and their influence on MM incidence. cases identified through HDRs were about 10% of those with histologic confirmation of the diagnosis, 34% of those with cytologic confirmation, and 72% of those without morphologic examination. Cases diagnosed in hospitals located outside the region would have been easily (50%) missed. The age-standardised (standard: Italian pop. at the 1981 census) incidence rate of pleural MM increases from 2.2 to 2.7 per 100,000 per year among men, and from 1.1 to 1.2 among women, when including all cases identified from HDRs, irrespective of their diagnostic confirmation. Peritoneal MM incidence estimates are unaffected. Overall without access to the hospital discharge files, 179 cases out of 954 would not have been registered between 1996 and 2001. In the same calendar period 59 cases identified by means of active search by the Registry have not been found in the hospital discharge files. HDRs are useful in addition, but not in substitution, to active search of MM cases.

Development of an Antimicrobial Stewardship-based Infectious Diseases Elective that Incorporates Human Patient Simulation Technology

PubMed Central

Meyer, Susan M.

2014-01-01

Objective. To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. Design. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Assessment. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. Conclusion. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs. PMID:25386016

Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

PubMed

Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L

2015-10-01

To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Neutrophil CD64 expression, procalcitonin and presepsin are useful to differentiate infections from flares in SLE patients with SIRS.

PubMed

Echeverri, A; Naranjo-Escobar, J; Posso-Osorio, I; Aguirre-Valencia, D; Zambrano, D; Castaño, G L; Martínez, J D; Cañas, C A; Tobón, G J

2018-06-01

Background/Objective Differentiating systemic lupus erythematosus (SLE) activity from infections in febrile patients is difficult because of similar initial clinical presentation. The aim of this study is to evaluate the usefulness of a number of biomarkers for differentiating infections from activity in SLE patients admitted with systemic inflammatory response (SIRS). Methods Patients with SLE and SIRS admitted to the emergency room were included in this study. Measurements of different markers including procalcitonin, neutrophil CD64 expression and presepsin, were performed. Infection was considered present when positive cultures and/or polymerase chain reaction were obtained. Sensitivity and specificity were calculated for all biomarkers. Results Twenty-seven patients were admitted, 23 women (82.5%), mean age 33.2 years. An infectious disease was confirmed in 12 cases. Markers for SLE activity including anti-DNA titers by IIF ( p = 0.041) and enzyme-linked immunosorbent assay ( p = 0.009) were used for differentiating SLE flares from infection. On the contrary, increased procalcitonin ( p = 0.047), neutrophil CD64 expression by flow cytometry ( p = 0.037) and presepsin ( p = 0.037) levels were observed in infected SLE patients. Conclusions High neutrophil CD64 expression, presepsin and procalcitonin levels are useful to differentiate infections from activity in SLE patients. In most cases, a positive bioscore that includes these three markers demonstrate the presence of an infectious disease.

Is long-term physical activity safe for older adults with knee pain?: a systematic review.

PubMed

Quicke, J G; Foster, N E; Thomas, M J; Holden, M A

2015-09-01

To determine whether long-term physical activity is safe for older adults with knee pain. A comprehensive systematic review and narrative synthesis of existing literature was conducted using multiple electronic databases from inception until May 2013. Two reviewers independently screened, checked data extraction and carried out quality assessment. Inclusion criteria for study designs were randomised controlled trials (RCTs), prospective cohort studies or case control studies, which included adults of mean age over 45 years old with knee pain or osteoarthritis (OA), undertaking physical activity over at least 3 months and which measured a safety related outcome (adverse events, pain, physical functioning, structural OA imaging progression or progression to total knee replacement (TKR)). Of the 8614 unique references identified, 49 studies were included in the review, comprising 48 RCTs and one case control study. RCTs varied in quality and included an array of low impact therapeutic exercise interventions of varying cardiovascular intensity. There was no evidence of serious adverse events, increases in pain, decreases in physical function, progression of structural OA on imaging or increased TKR at group level. The case control study concluded that increasing levels of regular physical activity was associated with lower risk of progression to TKR. Long-term therapeutic exercise lasting 3 to 30 months is safe for most older adults with knee pain. This evidence supports current clinical guideline recommendations. However, most studies investigated selected, consenting older adults carrying out low impact therapeutic exercise which may affect result generalizability. PROSPERO 2014:CRD42014006913. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Retrospective multicenter evaluation of the "fly-catching syndrome" in 24 dogs: EEG, BAER, MRI, CSF findings and response to antiepileptic and antidepressant treatment.

PubMed

Wrzosek, Marcin; Płonek, Marta; Nicpoń, Józef; Cizinauskas, Sigitas; Pakozdy, Akos

2015-12-01

The fly-catching syndrome (FCS) is a rare canine condition of sudden, occasional, or constant episodes of biting the air. It may be accompanied by jumping, licking, and swallowing. The etiology of FCS is unknown and controversial. Various explanations for its occurrence have included epileptoid disorders such as visual cortex epileptiform disturbances and simple and complex partial seizures as well as compulsive disorders, hallucinatory behavior, and stereotypy. A retrospective multicenter analysis of 24 dogs with clinical symptoms of FCS is presented. Clinical signs at the time of presentation, the mean age at onset of the disease, the response to treatment, and the clinical outcome were recorded and analyzed in all patients. All dogs underwent clinical, neurological, and otoscopic examinations. Complete blood cell counts (CBCs) and serum chemistry panels were obtained from each dog. Diagnostic testing included MRI and EEG examinations in 21 cases, BAER in 19 cases, and CSF analysis in 20 cases. The EEG revealed spike activity in 8 (38%) of the 21 cases, 7 of which had activity in the occipital lobes. The brainstem auditory evoked response (BAER) revealed three cases of bilateral deafness. The MRI revealed six cases of Chiari malformation (CM), one case of syringohydromyelia (SM), and one case of a falx cerebri meningioma. The dogs were divided into groups according to their treatment protocol. Group A included dogs treated with phenobarbital (PB), and group B consisted of dogs treated with fluoxetine (FLX). Thirty-six percent of the dogs in group A responded to PB, while 100% of the dogs in group B responded to FLX. The results suggest that FCS is more responsive to FLX than PB. However, the etiology of this behavior remains unclear in most cases. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Progress toward poliomyelitis eradication - Pakistan, January 2012-September 2013.

PubMed

2013-11-22

Pakistan is one of three countries where transmission of indigenous wild poliovirus (WPV) has never been interrupted. This report describes polio eradication activities and progress in Pakistan during January 2012-September 2013 and updates previous reports. During 2012, 58 WPV cases were reported in selected areas, compared with 198 cases throughout the country in 2011; 52 WPV cases were reported during January-September 2013, compared with 54 cases during the same period in 2012. Of the 110 WPV cases reported since January 2012, 92 cases (84%) occurred in the conflict-affected Federally Administered Tribal Areas (FATA) and in security-compromised Khyber Pakhtunkhwa (KP) Province. WPV type 3 (WPV3) was isolated from only three persons with polio in a single district in 2012; the most recent case occurred in April 2012. During August 2012-September 2013, 52 circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were detected, including 30 cases (58%) identified in FATA during January-September 2013. Approximately 350,000 children in certain districts of FATA have not received polio vaccine during supplementary immunization activities (SIAs) conducted since mid-2012 because local authorities have banned polio vaccination. In some other areas of Pakistan, SIAs have been compromised by attacks targeting polio workers that started in mid-2012. Further efforts to reach children in conflict-affected and security-compromised areas, including vaccinating at transit points and conducting additional short-interval-additional-dose (SIAD) SIAs as areas become accessible, will be necessary to prevent reintroduction of WPV into other areas of Pakistan and other parts of the world.

Uncompacted myelin lamellae in peripheral nerve biopsy.

PubMed

Vital, Claude; Vital, Anne; Bouillot, Sandrine; Favereaux, Alexandre; Lagueny, Alain; Ferrer, Xavier; Brechenmacher, Christiane; Petry, Klaus G

2003-01-01

Since 1979, the authors have studied 49 peripheral nerve biopsies presenting uncompacted myelin lamellae (UML). Based on the ultrastructural pattern of UML they propose a 3-category classification. The first category includes cases displaying regular UML, which was observed in 43 cases; it was more frequent in 9 cases with polyneuropathy organomegaly endocrinopathy m-protein skin changes (POEMS) syndrome as well as in 1 case of Charcot-Marie-Tooth 1B with a novel point mutation in the P0 gene. The second category consists of cases showing irregular UML, observed in 4 cases with IgM monoclonal gammopathy and anti-myelin-associated glycoprotein (MAG) activity. This group included 1 benign case and 3 B-cell malignant lymphomas. The third category is complex UML, which was present in 2 unrelated patients with an Arg 98 His missense mutation in the P0 protein gene. Irregular and complex UML are respectively related to MAG and P0, which play a crucial role in myelin lamellae compaction and adhesion.

Naval Medical Research and Development News. Volume 8, Issue 7, July 2016

DTIC Science & Technology

2016-07-01

potent, broad-spectrum activity against microbial infections. AMPs display various antibacterial action mechanisms including membrane permeabilization...optimize the operational health and readiness of the nation’s armed forces. In proximity to more than 95,000 active duty service members, world-class...asymptomatic cases that go undetected by current surveillance activities . A recent collaboration between Navy Medicine researchers and partners in

Getting to the Bottom of L2 Listening Instruction: Making a Case for Bottom-Up Activities

ERIC Educational Resources Information Center

Siegel, Joseph; Siegel, Aki

2015-01-01

This paper argues for the incorporation of bottom-up activities for English as a foreign language (EFL) listening. It discusses theoretical concepts and pedagogic options for addressing bottom-up aural processing in the EFL classroom as well as how and why teachers may wish to include such activities in lessons. This discussion is augmented by a…

Electronic Publishing and Document Delivery; A Case Study of Commercial Information Services on the Internet.

ERIC Educational Resources Information Center

Abbott, Anthony

1992-01-01

Discusses the electronic publishing activities of Meckler Publishing on the Internet, including a publications catalog, an electronic journal, and tables of contents databases. Broader issues of commercial network publishing are also addressed, including changes in the research process, changes in publishing, bibliographic control,…

Subarachnoid Haemorrhage and Sports

PubMed Central

Sousa Nanji, Liliana; Melo, Teresa P.; Canhão, Patrícia; Fonseca, Ana Catarina; Ferro, José Manuel

2015-01-01

Background Some cases of subarachnoid haemorrhage (SAH) have been associated with vigorous physical activity, including sports. Our research aimed to describe the association between SAH and sports and to identify the types of sports that were more frequently found as precipitating factors in a tertiary single-centre SAH register. Methods We retrieved information from a prospectively collected SAH registry and reviewed discharge notes of acute SAH patients admitted to the Stroke Unit of Hospital de Santa Maria, Lisbon, between 1995 and 2014. Results Out of 738 patients included in the analysis, 424 (57.5%) cases of SAH were preceded by physical activity. Nine cases (1.2%) were associated with sports, namely running (2 cases), aerobics (2 cases), cycling, body balance, dance, surf and windsurf. Patients with SAH while practicing sports were younger than controls (average age 43.1 vs. 57.0 years; p = 0.007). In 1 patient, there was a report of trauma to the neck. Patients in the sports group only had Hunt and Hess scale grades 1 (11.1%) or 2 (88.9%) at admission, while patients in the control group had a wider distribution in severity. Conclusions Our findings indicate that SAH precipitated by sports is not very frequent and is uncommonly related to trauma. Patients who suffered SAH associated with sports were younger and apparently had a milder clinical presentation. PMID:26648972

Subarachnoid Haemorrhage and Sports.

PubMed

Sousa Nanji, Liliana; Melo, Teresa P; Canhão, Patrícia; Fonseca, Ana Catarina; Ferro, José Manuel

2015-01-01

Some cases of subarachnoid haemorrhage (SAH) have been associated with vigorous physical activity, including sports. Our research aimed to describe the association between SAH and sports and to identify the types of sports that were more frequently found as precipitating factors in a tertiary single-centre SAH register. We retrieved information from a prospectively collected SAH registry and reviewed discharge notes of acute SAH patients admitted to the Stroke Unit of Hospital de Santa Maria, Lisbon, between 1995 and 2014. Out of 738 patients included in the analysis, 424 (57.5%) cases of SAH were preceded by physical activity. Nine cases (1.2%) were associated with sports, namely running (2 cases), aerobics (2 cases), cycling, body balance, dance, surf and windsurf. Patients with SAH while practicing sports were younger than controls (average age 43.1 vs. 57.0 years; p = 0.007). In 1 patient, there was a report of trauma to the neck. Patients in the sports group only had Hunt and Hess scale grades 1 (11.1%) or 2 (88.9%) at admission, while patients in the control group had a wider distribution in severity. Our findings indicate that SAH precipitated by sports is not very frequent and is uncommonly related to trauma. Patients who suffered SAH associated with sports were younger and apparently had a milder clinical presentation.

Applying economic evaluation to public health interventions: the case of interventions to promote physical activity.

PubMed

Trueman, Paul; Anokye, Nana Kwame

2013-03-01

This paper explores the application of alternative approaches to economic evaluation of public health interventions, using a worked example of exercise referral schemes (ERSs). Cost-utility (CUA) and cost-consequence analyses (CCA) were used to assess the cost-effectiveness of ERSs. For the CUA, evidence was synthesized using a decision analytic model that adopts a lifetime horizon and NHS/Personal Social Services perspective. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). CCA was conducted from a partial-societal perspective, including health and non-healthcare costs and benefits. Outcomes were reported in natural units, such as cases of strokes or CHD avoided. Compared with usual care, the incremental cost per QALY of ERS is £20 876. Based on a cohort of 100 000 individuals, CCA estimates cost of ERS at £22 million to the healthcare provider and £12 million to participants. The benefits of ERS include additional 3900 people becoming physically active, 51 cases of CHD avoided, 16 cases of stroke avoided, 86 cases of diabetes avoided and a gain of ∼800 QALYs. CCA might provide greater transparency than CUA in reporting the outcomes of public health interventions and have greater resonance with stakeholders involved in commissioning these interventions.

Daring to Marry: Marriage Equality Activism After Proposition 8 as Challenge to the Assimilationist/Radical Binary in Queer Studies.

PubMed

Weber, Shannon

2015-01-01

I analyze three case studies of marriage equality activism and marriage equality-based groups after the passage of Proposition 8 in California. Evaluating the JoinTheImpact protests of 2008, the LGBTQ rights group GetEQUAL, and the group One Struggle One Fight, I argue that these groups revise queer theoretical arguments about marriage equality activism as by definition assimilationist, homonormative, and single-issue. In contrast to such claims, the cases studied here provide a snapshot of heterogeneous, intersectional, and coalition-based social justice work in which creative methods of protest, including direct action and flash mobs, are deployed in militant ways for marriage rights and beyond.

Henry's law constants of polyols

NASA Astrophysics Data System (ADS)

Compernolle, S.; Müller, J.-F.

2014-12-01

Henry's law constants (HLC) are derived for several polyols bearing between 2 and 6 hydroxyl groups, based on literature data for water activity, vapour pressure and/or solubility. While deriving HLC and depending on the case, also infinite dilution activity coefficients (IDACs), solid state vapour pressures or activity coefficient ratios are obtained as intermediate results. An error analysis on the intermediate quantities and the obtained HLC is included. For most compounds, these are the first values reported, while others compare favourably with literature data in most cases. Using these values and those from a previous work (Compernolle and Müller, 2014), an assessment is made on the partitioning of polyols, diacids and hydroxy acids to droplet and aqueous aerosol.

The active engagement model of applied ethics as a structure for ethical reflection in the context of course-based service learning.

PubMed

Nesbit, Kathryn C; Jensen, Gail M; Delany, Clare

2018-01-01

The purpose of this case report is to explore the active engagement model as a tool to illuminate the ethical reflections of student physical therapists in the context of service learning in a developing country. The study participants were a convenience sample of six students. The study design is a case report using a phenomenological perspective. Data were collected from students' narrative writing and semi-structured interviews. The steps of the active engagement model provided the structural framework for student responses. The analysis process included open coding, selective coding, and member checking. Results showed the emergence of two main themes: 1) gathering rich detail and 2) developing independent moral identity. Students' descriptions of their relationships were detailed and included explanations about the complexities of the sociocultural context. Independent and deliberate agency was evident by the students' preparedness to be collaborative, to raise ethical questions, to identify ethically important aspects of their practice and to describe their professional roles. The students noted that the use of the model increased their engagement in the ethical decision-making process and their recognition of ethical questions. This case report illustrates attributes of the active engagement model which have implications for teaching ethical reflection: scaffolding for ethical reflection, use of narrative for reflection, reflection in action, and illumination of relevant themes. Each of these attributes leads to the development of meaningful ethical reflection. The attributes of this model shown by this case report have potential applications to teaching ethical reflection.

Active Collaborative Learning through Remote Tutoring

ERIC Educational Resources Information Center

Gehret, Austin U.; Elliot, Lisa B.; MacDonald, Jonathan H. C.

2017-01-01

An exploratory case study approach was used to describe remote tutoring in biochemistry and general chemistry with students who are deaf or hard of hearing (D/HH). Data collected for analysis were based on the observations of the participant tutor. The research questions guiding this study included (1) How is active learning accomplished in…

An Economic Course for Elementary School Teachers. Second Revised Edition.

ERIC Educational Resources Information Center

Lovell, Hugh; Harter, Charlotte

This handbook is intended to help economic educators develop teacher training courses for demonstrating to classroom teachers how to teach economics to children, grades 1-9. Teachers enrolled in the course carry out their own pupil activities which teach economic ideas. These activities include problem solving, case studies, skits, making posters,…

Workload and time management in central cancer registries: baseline data and implication for registry staffing.

PubMed

Chapman, Susan A; Mulvihill, Linda; Herrera, Carolina

2012-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions,together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey.Results indicate that registries faced reductions in budgeted staffing from 2008-2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing,case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however,estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines.

Workload and Time Management in Central Cancer Registries: Baseline Data and Implication for Registry Staffing

PubMed Central

Chapman, Susan A.; Mulvihill, Linda; Herrera, Carolina

2015-01-01

The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions, together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey. Results indicate that registries faced reductions in budgeted staffing from 2008–2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing, case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however, estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines. PMID:23493024

Pilot surveillance for childhood encephalitis in Australia using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network.

PubMed

Britton, P N; Dale, R C; Elliott, E; Festa, M; Macartney, K; Booy, R; Jones, C A

2016-07-01

We aimed to assess the performance of active surveillance for hospitalized childhood encephalitis in New South Wales (NSW) using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network to inform methodology for the nationwide Australian childhood encephalitis (ACE) study. We piloted active surveillance for suspected encephalitis from May to December 2013 at the Children's Hospital at Westmead, Sydney, NSW. Cases were ascertained using four screening methods: weekday nurse screening of admission records (PAEDS), cerebrospinal fluid (CSF) microscopy records, magnetic resonance imaging (MRI) reports, and pharmacy dispensing records. Comprehensive clinical data were prospectively collected on consented participants and subsequently reviewed by an expert panel. Cases were categorized as confirmed encephalitis or 'not encephalitis'; encephalitis cases were sub-categorized as infectious, immune-mediated or unknown. We performed an ICD-10 diagnostic code audit of hospitalizations for the pilot period. We compared case ascertainment in the four screening methods and with the ICD code audit. Forty-eight cases of suspected encephalitis were identified by one or more methods. PAEDS was the most efficient mechanism (yield 34%), followed by MRI, CSF, and pharmacy audits (yield 14%, 12%, and 7% respectively). Twenty-five cases met the criteria for confirmed encephalitis. PAEDS was the most sensitive of the mechanisms for confirmed encephalitis (92%) with a positive predictive value (PPV) of 72%. The ICD audit was moderately sensitive (64%) but poorly specific (Sp 9%, PPV 14%). Of the 25 confirmed encephalitis cases, 19 (76%) were sub-categorized as infectious, three (12%) were immune-mediated, and three (12%) were 'unknown'. We identified encephalitis cases associated with two infectious disease outbreaks (enterovirus 71, parechovirus 3). PAEDS is an efficient, sensitive and accurate surveillance mechanism for detecting cases of childhood encephalitis including those associated with emerging infectious diseases. Active surveillance significantly increases the ascertainment of encephalitis cases compared with passive approaches.

Expression of retinoblastoma gene product (pRb) in mantle cell lymphomas. Correlation with cyclin D1 (PRAD1/CCND1) mRNA levels and proliferative activity.

PubMed Central

Jares, P.; Campo, E.; Pinyol, M.; Bosch, F.; Miquel, R.; Fernandez, P. L.; Sanchez-Beato, M.; Soler, F.; Perez-Losada, A.; Nayach, I.; Mallofré, C.; Piris, M. A.; Montserrat, E.; Cardesa, A.

1996-01-01

Mantle cell lymphomas (MCLs) are molecularly characterized by bcl-1 rearrangement and constant cyclin D1 (PRAD-1/CCND1) gene overexpression. Cyclin D1 is a G1 cyclin that participates in the control of the cell cycle progression by interacting with the retinoblastoma gene product (pRb). Inactivation of the Rb tumor suppressor gene has been implicated in the development of different types of human tumors including some high grade non-Hodgkin's lymphomas. To determine the role of the retinoblastoma gene in the pathogenesis of MCLs and its possible interaction with cyclin D1, pRb expression was examined in 23 MCLs including 17 typical and 6 blastic variants by immunohistochemistry and Western blot. Rb gene structure was studied in 13 cases by Southern blot. Cytogenetic analysis was performed in 5 cases. The results were compared with the cyclin D1 mRNA levels examined by Northern analysis, and the proliferative activity of the tumors was measured by Ki-67 growth fraction and flow cytometry. pRb was expressed in all MCLs. The expression varied from case to case (mean, 14.1% of positive cells; range, 1.3 to 42%) with a significant correlation with the proliferative activity of the tumors (mitotic index r = 0.85; Ki-67 r = 0.7; S phase = 0.73). Blastic variants showed higher numbers of pRb-positive cells (mean, 29%) than the typical cases (10%; P < 0.005) by immunohistochemistry and, concordantly, higher levels of expression by Western blot. In addition, the blastic cases also had an increased expression of the phosphorylated protein. No alterations in Rb gene structure were observed by Southern blot analysis. Cyclin D1 mRNA levels were independent of pRb expression and the proliferative activity of the tumors. These findings suggest that pRb in MCLs is normally regulated in relation to the proliferative activity of the tumors. Cyclin D1 overexpression may play a role in the maintenance of cell proliferation by overcoming the suppressive growth control of pRb. Images Figure 1 Figure 2 Figure 4 PMID:8623927

Indicators of sustainable capacity building for health research: analysis of four African case studies.

PubMed

Bates, Imelda; Taegtmeyer, Miriam; Squire, S Bertel; Ansong, Daniel; Nhlema-Simwaka, Bertha; Baba, Amuda; Theobald, Sally

2011-03-28

Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable. Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. By mapping the capacity building activities in each case study onto a framework previously used for evaluating health research capacity in Ghana, we were able to identify activities that were common to all projects. We used these activities to derive indicators which could be used in other projects to monitor progress towards building sustainable research capacity. Indicators of sustainable capacity building increased in complexity as projects matured and included- early engagement of stakeholders; explicit plans for scale up; strategies for influencing policies; quality assessments (awareness and experiential stages)- improved resources; institutionalisation of activities; innovation (expansion stage)- funding for core activities secured; management and decision-making led by southern partners (consolidation stage).Projects became sustainable after a median of 66 months. The main challenges to achieving sustainability were high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development. Our indicators of sustainable capacity building need to be tested prospectively in a variety of projects to assess their usefulness. For each project the evidence required to show that indicators have been achieved should evolve with the project and they should be determined prospectively in collaboration with stakeholders.

Health promotion in local churches in Victoria: an exploratory study.

PubMed

Ayton, Darshini; Manderson, Lenore; Smith, Ben J; Carey, Gemma

2016-11-01

Church-based health promotion has increasingly gained attention in strategies to address health disparities. In Australia, we have limited understanding of the role of local churches in health promotion and without this, how they might be involved in meaningful partnerships to tackle public health challenges. The objective of this qualitative study was to explore how churches are involved in health promotion in the state of Victoria. The research involved in-depth interviews with ministers from 30 churches in urban and rural Victoria, and case studies with 10 of these churches to enable further exploration. These case studies, conducted in 2010, included interviews with church staff, focus groups with volunteers, participant observation and document analysis. Analysis was iterative, utilising open, axial and thematic coding. Three different expressions of church - traditional, new modern and emerging - were identified and found to differentiate the levels and types of health promotion activity. Case studies illustrate the different expressions of how church mission influences health promotion activity. The traditional churches were involved particularly in disease screening and health education activities with their own, predominantly older congregation members. The new modern churches tended to have the material and human resources to be harnessed in health promotion activities involving congregation members and others. Emerging churches, in contrast, engaged in broad health-promoting activities, including disease prevention, lifestyle activities and socio-ecological approaches at a community level. These research findings highlight the opportunities and challenges of engaging with local churches in health promotion efforts and public health programmes to address health inequities. © 2015 John Wiley & Sons Ltd.

[Maternal and fetal outcome in Mexican women with rheumatoid arthritis].

PubMed

Saavedra, Miguel A; Sánchez, Antonio; Bustamante, Reyna; Miranda-Hernández, Dafhne; Soliz-Antezana, Jimena; Cruz-Domínguez, Pilar; Morales, Sara; Jara, Luis J

2015-01-01

To report our experience in maternal-fetal outcome in women with RA in a national medical referral center. A retrospective analysis of the records of pregnant women with rheumatoid arthritis attending at a Pregnancy and Autoimmune Rheumatic Diseases Clinic was performed. Maternal-fetal outcomes such as disease activity, preclampsia/eclampsia, rate of live births, abortions, stillbirths, preterm birth, weeks of gestation, birth weight, congenital malformations and use of anti-rheumatic drugs were studied. We included 73 pregnancies in 72 patients. Disease activity was documented in 47.2% of patients during pregnancy and/or postpartum and 87.7% of patients received some antirheumatic drug. Preclampsia developed in 8.2% of cases. The live birth rate was 98.6%, with preterm delivery in 15.9% and low weight at term in 17.6% of cases. Cesarean section was performed in 77.1% of cases. The disease activity was not associated with a higher percentage of maternal-fetal complications. Our study showed that most patients do not experience significant activity of RA during pregnancy, fetal outcome is satisfactory and disease activity did not appear to influence significantly the obstetric outcome.

Decision support systems and the healthcare strategic planning process: a case study.

PubMed

Lundquist, D L; Norris, R M

1991-01-01

The repertoire of applications that comprises health-care decision support systems (DSS) includes analyses of clinical, financial, and operational activities. As a whole, these applications facilitate developing comprehensive and interrelated business and medical models that support the complex decisions required to successfully manage today's health-care organizations. Kennestone Regional Health Care System's use of DSS to facilitate strategic planning has precipitated marked changes in the organization's method of determining capital allocations. This case study discusses Kennestone's use of DSS in the strategic planning process, including profiles of key DSS modeling components.

Aeromechanical Evaluation of Smart-Twisting Active Rotor

NASA Technical Reports Server (NTRS)

Lim, Joon W.; Boyd, D. Douglas, Jr.; Hoffman, Frauke; van der Wall, Berend G.; Kim, Do-Hyung; Jung, Sung N.; You, Young H.; Tanabe, Yasutada; Bailly, Joelle; Lienard, Caroline;

Control of a community outbreak of hepatitis A in an area of low endemicity, Wales, 2016.

PubMed

Vaz, J; Floyd, C; Mason, B; Shankar, A G; Lewis, H

2017-10-03

Incidence of hepatitis A in Wales is low (average of 0.48/100,000 inhabitants from 2004-2015). We describe a community outbreak of hepatitis A involving 3 schools (primary and secondary) in South Wales between March and June 2016 and reflect on the adequacy of the control measures used. Anyone in South Wales epidemiologically linked to a serological and/or RNA positive confirmed case of hepatitis A during the 15-50 d before onset of symptoms (diarrhea, vomiting, fever, nausea, AND jaundice, or jaundice-associated symptom) was defined as a case. Case identification was based on laboratory or GP suspicion notification, changing to active surveillance toward the end. As per national guidance, household contacts were identified and offered immunisation while in schools vaccination followed evidence of transmission. We went beyond guidance by vaccinating street play mates and in secondary schools. Mass vaccination uptake was calculated. There were 17 cases, mostly in children under 16 y of age. All cases had an epidemiological link to either a school or a household case (except primary) and no travel history. Street playing was the only epidemiological link between 2 cases in different schools. A total of 139 household contacts were identified. All schools, including secondary one, had a transmission event preceding mass vaccination (overall uptake 85%, reaching 1,574 individuals) and no tertiary cases emerged after the campaigns. We recommend extending guidance to include actions taken that helped curb this outbreak: 1) vaccinating in secondary school and 2) broadening the household contact definition. Based on our learning we further suggest 3) vaccinating upon identification of a single case who attended school while infectious regardless of source and 4) active case finding by serologically testing contacts.

The Proof Is in the PR: Five Case Studies Offer Conclusive Evidence of the Value of Strategic Communications.

ERIC Educational Resources Information Center

Schreiber, William

1993-01-01

Five case studies illustrate the value of strategic communications in school and college public relations (PR). Central issues include public scrutiny of a controversial faculty hiring policy; internal communication during retrenchment; a local education/job fair; animal rights activism; and winning public approval for a long-range campus plan.…

31 CFR 560.545 - Democracy and human rights in Iran and academic and cultural exchange programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... States or located in the United States to engage in the following projects or activities in or related to Iran that are designed to directly benefit the Iranian people: (1) Projects, including conferences and... may be issued on a case-by-case basis to authorize U.S. persons to engage in the following projects or...

31 CFR 560.545 - Democracy and human rights in Iran and academic and cultural exchange programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... States or located in the United States to engage in the following projects or activities in or related to Iran that are designed to directly benefit the Iranian people: (1) Projects, including conferences and... may be issued on a case-by-case basis to authorize U.S. persons to engage in the following projects or...

Impact of Active Teaching Methods Implemented on Therapeutic Chemistry Module: Performance and Impressions of First-Year Pharmacy Students

ERIC Educational Resources Information Center

Derfoufi, Sanae; Benmoussa, Adnane; El Harti, Jaouad; Ramli, Youssef; Taoufik, Jamal; Chaouir, Souad

2015-01-01

This study investigates the positive impact of the Case Method implemented during a 4- hours tutorial in "therapeutic chemistry module." We view the Case Method as one particular approach within the broader spectrum of problem based or inquiry based learning approaches. Sixty students were included in data analysis. A pre-test and…

Azelaic acid in the treatment of acne in adult females: case reports.

PubMed

Vargas-Diez, E; Hofmann, M A; Bravo, B; Malgazhdarova, G; Katkhanova, O A; Yutskovskaya, Y

2014-01-01

Acne, one of the most common skin problems in dermatological practice, is a condition that affects not only adolescents but also adults. While approximately 80% of cases occurring in adulthood are persistent from teenage years, around 20% are described as 'late-onset' disease, appearing for the first time in adulthood. The disease can be triggered by hormonal changes (including a change from one contraceptive to another), or it can be induced by certain nonhormonal medications, emotional stress, and various underlying diseases such as polycystic ovary syndrome. In many cases acne becomes a chronic skin condition with undulating activity, including improvement and relapse phases, and is often experienced as a major psychological burden. It is, therefore, even more important to provide an effective as well as a safe and tolerable treatment. The spectrum of topical acne treatments has expanded substantially in recent years and various topical medications are available, ranging from azelaic acid, antibiotics, retinoids and benzoyl peroxide to several fixed combinations of these active compounds. The following case collection illustrates how 15% azelaic acid gel, as a well-established monotherapy, can be successfully employed to treat mild-to-moderate forms of adult female acne. © 2013 S. Karger AG, Basel.

Spinal accessory nerve injury: A potentially missed cause of a painful, droopy shoulder.

PubMed

Macaluso, Steven; Ross, Douglas C; Doherty, Timothy J; Doherty, Christopher D; Miller, Thomas A

2016-11-21

Spinal accessory nerve (SAN) injury can be an overlooked cause of scapular winging and shoulder dysfunction. The most common etiology is iatrogenic injury following surgical procedures at the posterior triangle of the neck. We present three cases of isolated injury to the SAN following trauma. To improve detection of SAN injuries through highlighting the clinical presentation, diagnosis and treatment via three cases in which the injuries were initially missed. Clinical case series and narrative review. Three (3) patients were evaluated by history, physical exam and electrodiagnostic study (EMG). Clinical symptoms included, a painful, droopy shoulder and difficulties with overhead activities. Clinical signs included the observation of scapular winging, and focal atrophy of the trapezius and in some cases the sternocleidomastoid (SCM). Novel clinical signs such as the active elevation lag sign and triangle sign were also helpful clinically to highlight the SAN as the site of pathology. EMG revealed denervation and reduced motor unit recruitment in the trapezius and SCM. Early detection of SAN injuries can be improved through appropriate clinical suspicion, a detailed history and careful physical exam. EMG testing can help guide prognosis, direct conservative and surgical treatment, and reduce patient morbidity.

Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009–2010

PubMed Central

Kutty, Preeta Krishnan; Lawler, Jacqueline; Rausch-Phung, Elizabeth; Ortega-Sanchez, Ismael R; Goodell, Stephen; Schulte, Cynthia; Pollock, Lynn; Valure, Barbara; Hudson, Jean; Gallagher, Kathleen; Blog, Debra

2014-01-01

Studies assessing the economic burden of a mumps outbreak in a highly vaccinated population are limited. The Orange County Health Department (OCHD), New York State Department of Health (NYS DOH), and the Centers for Disease Control and Prevention conducted a mumps investigation in an affected village with a highly vaccinated population. To understand the epidemiology, standardized mumps case definition and active surveillance were used to identify mumps cases. In addition, an economic assessment of a combined outbreak investigation and third dose measles-mumps-rubella (MMR) vaccine intervention conducted by OCHD and NYS DOH was performed; estimated by retrospectively evaluating public health response-related activities including use of a third dose of MMR vaccine. From September 24, 2009, through June 15, 2010, 790 mumps cases were reported—64% were male and highest attack rate was among 11–17 year age group (99.1 cases per 1000 individuals). Of the 658 cases with known vaccination history, 83.6% had documentation of 2 doses of mumps containing vaccine. No deaths were reported. The 2 major exposure settings were schools (71.8%) and households (22.5%). Approximately 7736 h of public health personnel time were expended with the total approximate cost of US $463 000, including US $34 392 for MMR vaccine—the estimated cost per household was US $827. Mumps continues to be endemic in many parts of the world, resulting in importations into the United States. Large mumps outbreaks similar to this in highly vaccinated populations may require considerable investigation and control activities. PMID:24633360

Epidemiology and the economic assessment of a mumps outbreak in a highly vaccinated population, Orange County, New York, 2009-2010.

PubMed

Kutty, Preeta Krishnan; Lawler, Jacqueline; Rausch-Phung, Elizabeth; Ortega-Sanchez, Ismael R; Goodell, Stephen; Schulte, Cynthia; Pollock, Lynn; Valure, Barbara; Hudson, Jean; Gallagher, Kathleen; Blog, Debra

2014-01-01

Studies assessing the economic burden of a mumps outbreak in a highly vaccinated population are limited. The Orange County Health Department (OCHD), New York State Department of Health (NYS DOH), and the Centers for Disease Control and Prevention conducted a mumps investigation in an affected village with a highly vaccinated population. To understand the epidemiology, standardized mumps case definition and active surveillance were used to identify mumps cases. In addition, an economic assessment of a combined outbreak investigation and third dose measles-mumps-rubella (MMR) vaccine intervention conducted by OCHD and NYS DOH was performed; estimated by retrospectively evaluating public health response-related activities including use of a third dose of MMR vaccine. From September 24, 2009, through June 15, 2010, 790 mumps cases were reported-64% were male and highest attack rate was among 11-17 year age group (99.1 cases per 1000 individuals). Of the 658 cases with known vaccination history, 83.6% had documentation of 2 doses of mumps containing vaccine. No deaths were reported. The 2 major exposure settings were schools (71.8%) and households (22.5%). Approximately 7736 h of public health personnel time were expended with the total approximate cost of US $463,000, including US $34,392 for MMR vaccine-the estimated cost per household was US $827. Mumps continues to be endemic in many parts of the world, resulting in importations into the United States. Large mumps outbreaks similar to this in highly vaccinated populations may require considerable investigation and control activities.

Progress toward poliomyelitis eradication--Nigeria, January 2008-July 2009.

PubMed

2009-10-23

Although wild poliovirus (WPV) cases in Nigeria decreased from 1,129 in 2006 to 285 in 2007, Nigeria had the world's highest polio burden in 2008, with 798 (48%) of 1,651 WPV cases reported globally, including 721 (74%) of 976 WPV type 1 (WPV1) cases. This report provides an update on progress toward polio eradication in Nigeria during 2008-2009 and activities planned to interrupt transmission. During 2008-2009, Nigeria was the source for WPV1 transmission to 11 countries and WPV type 3 (WPV3) transmission to four countries. In addition, transmission of circulating type 2 vaccine-derived poliovirus (cVDPV2) has been ongoing since 2005. WPV1 cases decreased 87%, from 574 during January-July 2008 to 73 for the same period in 2009. However, WPV3 cases rose approximately six-fold, from 51 during January-July 2008 to 303 during the same period in 2009, partly because of the increased emphasis on controlling WPV1. The decline in the proportion of children who have never received oral poliovirus vaccine (OPV) in the highest- incidence northern states, from 31% in 2006 to 11% in the first half of 2009 indicates progress toward eradication. During 2008-2009, activities to accelerate polio eradication included use of mobile teams to vaccinate children not at home during supplemental immunization activities (SIAs), and efforts to increase political oversight and the engagement of community leaders. Sustained support of traditional, religious, and political leaders and improved implementation of SIAs will be needed to interrupt WPV and cVDPV2 transmission.

Experimental Studies of Low-Pressure Turbine Flows and Flow Control. Streamwise Pressure Profiles and Velocity Profiles

NASA Technical Reports Server (NTRS)

Volino, Ralph

2012-01-01

This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies.This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies. The folders in this supplement contain processed data in ASCII format. Streamwise pressure profiles and velocity profiles are included. The velocity profiles were acquired using single sensor and cross sensor hot-wire probes which were traversed from the wall to the freestream at various streamwise locations. In some of the flow control cases (3D Trips and Jets) profiles were acquired at multiple spanwise locations.

Modeling complexity in pathologist workload measurement: the Automatable Activity-Based Approach to Complexity Unit Scoring (AABACUS).

PubMed

Cheung, Carol C; Torlakovic, Emina E; Chow, Hung; Snover, Dale C; Asa, Sylvia L

2015-03-01

Pathologists provide diagnoses relevant to the disease state of the patient and identify specific tissue characteristics relevant to response to therapy and prognosis. As personalized medicine evolves, there is a trend for increased demand of tissue-derived parameters. Pathologists perform increasingly complex analyses on the same 'cases'. Traditional methods of workload assessment and reimbursement, based on number of cases sometimes with a modifier (eg, the relative value unit (RVU) system used in the United States), often grossly underestimate the amount of work needed for complex cases and may overvalue simple, small biopsy cases. We describe a new approach to pathologist workload measurement that aligns with this new practice paradigm. Our multisite institution with geographically diverse partner institutions has developed the Automatable Activity-Based Approach to Complexity Unit Scoring (AABACUS) model that captures pathologists' clinical activities from parameters documented in departmental laboratory information systems (LISs). The model's algorithm includes: 'capture', 'export', 'identify', 'count', 'score', 'attribute', 'filter', and 'assess filtered results'. Captured data include specimen acquisition, handling, analysis, and reporting activities. Activities were counted and complexity units (CUs) generated using a complexity factor for each activity. CUs were compared between institutions, practice groups, and practice types and evaluated over a 5-year period (2008-2012). The annual load of a clinical service pathologist, irrespective of subspecialty, was ∼40,000 CUs using relative benchmarking. The model detected changing practice patterns and was appropriate for monitoring clinical workload for anatomical pathology, neuropathology, and hematopathology in academic and community settings, and encompassing subspecialty and generalist practices. AABACUS is objective, can be integrated with an LIS and automated, is reproducible, backwards compatible, and future adaptable. It can be applied as a robust decision support tool for the assessment of overall and targeted staffing needs as well as utilization analyses for resource allocation.

Global Review of Induced and Triggered Earthquakes

NASA Astrophysics Data System (ADS)

Foulger, G. R.; Wilson, M.; Gluyas, J.; Julian, B. R.; Davies, R. J.

2016-12-01

Natural processes associated with very small incremental stress changes can modulate the spatial and temporal occurrence of earthquakes. These processes include tectonic stress changes, the migration of fluids in the crust, Earth tides, surface ice and snow loading, heavy rain, atmospheric pressure, sediment unloading and groundwater loss. It is thus unsurprising that large anthropogenic projects which may induce stress changes of a similar size also modulate seismicity. As human development accelerates and industrial projects become larger in scale and more numerous, the number of such cases is increasing. That mining and water-reservoir impoundment can induce earthquakes has been accepted for several decades. Now, concern is growing about earthquakes induced by activities such as hydraulic fracturing for shale-gas extraction and waste-water disposal via injection into boreholes. As hydrocarbon reservoirs enter their tertiary phases of production, seismicity may also increase there. The full extent of human activities thought to induce earthquakes is, however, much wider than generally appreciated. We have assembled as near complete a catalog as possible of cases of earthquakes postulated to have been induced by human activity. Our database contains a total of 705 cases and is probably the largest compilation made to date. We include all cases where reasonable arguments have been made for anthropogenic induction, even where these have been challenged in later publications. Our database presents the results of our search but leaves judgment about the merits of individual cases to the user. We divide anthropogenic earthquake-induction processes into: a) Surface operations, b) Extraction of mass from the subsurface, c) Introduction of mass into the subsurface, and d) Explosions. Each of these categories is divided into sub-categories. In some cases, categorization of a particular case is tentative because more than one anthropogenic activity may have preceded or been ongoing at the time of the relevant earthquakes, e.g., oil production and brine injections. We present a first analysis of the data in our database and comment on some related issues with which scientists are currently grappling. Figure: Induced or triggered seismicity world-wide in Mollweide projection, centered on the Greenwich meridian.

Physician Surveys to Assess Customary Care in Medical Malpractice Cases

PubMed Central

Hartz, Arthur; Lucas, Joshua; Cramm, Timothy; Green, Michael; Bentler, Suzanne; Ely, John; Wolfe, Steven; James, Paul

2002-01-01

OBJECTIVE Physician experts hired and prepared by the litigants provide most information on standard of care for medical malpractice cases. Since this information may not be objective or accurate, we examined the feasibility and potential value of surveying community physicians to assess standard of care. DESIGN Seven physician surveys of mutually exclusive groups of randomly selected physicians. SETTING Iowa. PARTICIPANTS Community and academic primary care physicians and relevant specialists. INTERVENTIONS Included in each survey was a case vignette of a primary care malpractice case and key quotes from medical experts on each side of the case. Surveyed physicians were asked whether the patient should have been referred to a specialist for additional evaluation. The 7 case vignettes included 3 closed medical malpractice cases, 3 modifications of these cases, and 1 active case. MEASUREMENTS AND MAIN RESULTS Sixty-three percent of 350 community primary care physicians and 51% of 216 community specialists completed the questionnaire. For 3 closed cases, 47%, 78%, and 88% of primary care physician respondents reported that they would have made a different referral decision than the defendant. Referral percentages were minimally affected by modifying patient outcome but substantially changed by modifying patient presentation. Most physicians, even those whose referral decisions were unusual, assumed that other physicians would make similar referral decisions. For each case, at least 65% of the primary care physicians disagreed with the testimony of one of the expert witnesses. In the active case, the response rate was high (71%), and the respondents did not withhold criticism of the defendant doctor. CONCLUSIONS Randomly selected peer physicians are willing to participate in surveys of medical malpractice cases. The surveys can be used to construct the distribution of physician self-reported practice relevant to a particular malpractice case. This distribution may provide more information about customary practice or standard of care than the opinion of a single physician expert. PMID:12133145

Public Health Practice of Population-Based Birth Defects Surveillance Programs in the United States.

PubMed

Mai, Cara T; Kirby, Russell S; Correa, Adolfo; Rosenberg, Deborah; Petros, Michael; Fagen, Michael C

2016-01-01

Birth defects remain a leading cause of infant mortality in the United States and contribute substantially to health care costs and lifelong disabilities. State population-based surveillance systems have been established to monitor birth defects, yet no recent systematic examination of their efforts in the United States has been conducted. To understand the current population-based birth defects surveillance practices in the United States. The National Birth Defects Prevention Network conducted a survey of US population-based birth defects activities that included questions about operational status, case ascertainment methodology, program infrastructure, data collection and utilization, as well as priorities and challenges for surveillance programs. Birth defects contacts in the United States, including District of Columbia and Puerto Rico, received the survey via e-mail; follow-up reminders via e-mails and telephone were used to ensure a 100% response rate. Forty-three states perform population-based surveillance for birth defects, covering approximately 80% of the live births in the United States. Seventeen primarily use an active case-finding approach and 26 use a passive case-finding approach. These programs all monitor major structural malformations; however, passive case-finding programs more often monitor a broader list of conditions, including developmental conditions and newborn screening conditions. Active case-finding programs more often use clinical reviewers, cover broader pregnancy outcomes, and collect more extensive information, such as family history. More than half of the programs (24 of 43) reported an ability to conduct follow-up studies of children with birth defects. The breadth and depth of information collected at a population level by birth defects surveillance programs in the United States serve as an important data source to guide public health action. Collaborative efforts at the state and national levels can help harmonize data collection and increase utility of birth defects programs.

Thrombocytopaenia and neutropaenia associated with daptomycin USE.

PubMed

Leyra, Fernando; Perez-Chuliá, Nuria; Jofré, Cristina; Suarez-Gonzalo, Luis; Del Ser, Natalia Peña; Moreno, Isidro

2016-10-01

Daptomycin is a lipopeptide antibiotic active against gram-positive bacteria indicated for the treatment of complicated skin and skin structure infections and Staphylococcus aureus bloodstream infections, including endocarditis. Thrombocytopaenia, but not neutropaenia, is described as a possible or probable adverse effect in the product information. Up to now, two case reports of daptomycin-induced thrombocytopaenia have been published and a single case of neutropaenia associated with prolonged daptomycin use. We report a case of simultaneous thrombocytopaenia and neutropaenia associated with prolonged daptomycin use for a culture-negative endocarditis.

Maintaining the Background Dust Opacity During Northern Hemisphere Summer Mars Using Wind Stress Based Dust Lifting

NASA Astrophysics Data System (ADS)

Jha, V.; Kahre, M. A.

2017-12-01

The Mars atmosphere has low levels of dust during Northern Hemisphere (NH) spring and summer (the non-dusty season) and increased levels during NH autumn and winter (the dusty season). In the absence of regional or global storms, dust devils and local storms maintain a background minimum dust loading during the non-dusty season. While observational surveys and Global Climate Model (GCM) studies suggest that dust devils are likely to be major contributors to the background haze during NH spring and summer, a complete understanding of the relative contribution of dust devils and local dust storms has not yet been achieved. We present preliminary results from an investigation that focuses on the effects of radiatively active water ice clouds on dust lifting processes during these seasons. Water ice clouds are known to affect atmospheric temperatures directly by absorption and emission of thermal infrared radiation and indirectly through dynamical feedbacks. Our goal is to understand how clouds affect the contribution by local (wind stress) dust storms to the background dust haze during NH spring and summer. The primary tool for this work is the NASA Ames Mars GCM, which contains physical parameterizations for a fully interactive dust cycle. Three simulations that included wind stress dust lifting were executed for a period of 5 Martian years: a case that included no cloud formation, a case that included radiatively inert cloud formation and a case that included radiatively active cloud (RAC) formation. Results show that when radiatively active clouds are included, the clouds in the aphelion cloud belt radiatively heat the atmosphere aloft in the tropics (Figure 1). This heating produces a stronger overturning circulation, which in turn produces an enhanced low-level flow in the Hadley cell return branch. The stronger low-level flow drives higher surface stresses and increased dust lifting in those locations. We examine how realistic these simulated results are by comparing the spatial pattern of predicted wind stress lifting with a catalog of observed local storms. Better agreement is achieved in the radiatively active cloud case. These results suggest that wind stress lifting may contribute more to maintaining the background dust haze during NH spring and summer than what previous studies have shown.

Broad Detection of Alterations Predicted to Confer Lack of Benefit From EGFR Antibodies or Sensitivity to Targeted Therapy in Advanced Colorectal Cancer.

PubMed

Rankin, Andrew; Klempner, Samuel J; Erlich, Rachel; Sun, James X; Grothey, Axel; Fakih, Marwan; George, Thomas J; Lee, Jeeyun; Ross, Jeffrey S; Stephens, Philip J; Miller, Vincent A; Ali, Siraj M; Schrock, Alexa B

2016-09-28

A KRAS mutation represented the first genomic biomarker to predict lack of benefit from anti-epidermal growth factor receptor (EGFR) antibody therapy in advanced colorectal cancer (CRC). Expanded RAS testing has further refined the treatment approach, but understanding of genomic alterations underlying primary and acquired resistance is limited and further study is needed. We prospectively analyzed 4,422 clinical samples from patients with advanced CRC, using hybrid-capture based comprehensive genomic profiling (CGP) at the request of the individual treating physicians. Comparison with prior molecular testing results, when available, was performed to assess concordance. We identified a RAS/RAF pathway mutation or amplification in 62% of cases, including samples harboring KRAS mutations outside of the codon 12/13 hotspot region in 6.4% of cases. Among cases with KRAS non-codon 12/13 alterations for which prior test results were available, 79 of 90 (88%) were not identified by focused testing. Of 1,644 RAS/RAF wild-type cases analyzed by CGP, 31% harbored a genomic alteration (GA) associated with resistance to anti-EGFR therapy in advanced CRC including mutations in PIK3CA, PTEN, EGFR, and ERBB2. We also identified other targetable GA, including novel kinase fusions, receptor tyrosine kinase amplification, activating point mutations, as well as microsatellite instability. Extended genomic profiling reliably detects alterations associated with lack of benefit to anti-EGFR therapy in advanced CRC, while simultaneously identifying alterations potentially important in guiding treatment. The use of CGP during the course of clinical care allows for the refined selection of appropriate targeted therapies and clinical trials, increasing the chance of clinical benefit and avoiding therapeutic futility. Comprehensive genomic profiling (CGP) detects diverse genomic alterations associated with lack of benefit to anti-epidermal growth factor receptor therapy in advanced colorectal cancer (CRC), as well as targetable alterations in many other genes. This includes detection of a broad spectrum of activating KRAS alterations frequently missed by focused molecular hotspot testing, as well as other RAS/RAF pathway alterations, mutations shown to disrupt antibody binding, RTK activating point mutations, amplifications, and rearrangements, and activating alterations in downstream effectors including PI3K and MEK1. The use of CGP in clinical practice is critical to guide appropriate selection of targeted therapies for patients with advanced CRC. ©AlphaMed Press.

Conservative care of De Quervain's tenosynovitis/ tendinopathy in a warehouse worker and recreational cyclist: a case report.

PubMed

Howell, Emily R

2012-06-01

This case study was conducted to evaluate the conservative management of a patient presenting with right sided wrist and thumb pain diagnosed as De Quervain's tenosynovitis/tendinopathy. A 49-year-old female warehouse worker and recreational cyclist with right-sided De Quervain's tenosynovitis/tendinopathy that began after a long-distance cycling trip. Treatment included ultrasound, soft tissue and myofascial release therapy, tool assisted fascial stripping or "guasha", acupuncture, mobilizations and kinesiology taping. Home advice included icing, rest, wrist bracing, elevation and eccentric rehabilitation exercises. The positive outcome was a complete resolution of the patient's complaint. This case demonstrates how De Quervain's disease is a challenging condition to treat with conservative methods and can be aggravated with new exacerbating factors as treatment continues. In this case, the addition of the active care (including eccentric exercises and self-care) helped to reinforce the passive care given in the office and accelerate the recovery.

Single-Case Experimental Designs to Evaluate Novel Technology-Based Health Interventions

PubMed Central

Cassidy, Rachel N; Raiff, Bethany R

2013-01-01

Technology-based interventions to promote health are expanding rapidly. Assessing the preliminary efficacy of these interventions can be achieved by employing single-case experiments (sometimes referred to as n-of-1 studies). Although single-case experiments are often misunderstood, they offer excellent solutions to address the challenges associated with testing new technology-based interventions. This paper provides an introduction to single-case techniques and highlights advances in developing and evaluating single-case experiments, which help ensure that treatment outcomes are reliable, replicable, and generalizable. These advances include quality control standards, heuristics to guide visual analysis of time-series data, effect size calculations, and statistical analyses. They also include experimental designs to isolate the active elements in a treatment package and to assess the mechanisms of behavior change. The paper concludes with a discussion of issues related to the generality of findings derived from single-case research and how generality can be established through replication and through analysis of behavioral mechanisms. PMID:23399668

Perioperative Care Coordination Measurement: A Tool to Support Care Integration of Pediatric Surgical Patients.

PubMed

Ferrari, Lynne R; Ziniel, Sonja I; Antonelli, Richard C

2016-03-01

The relationship of care coordination activities and outcomes to resource utilization and personnel costs has been evaluated for a number of pediatric medical home practices. One of the first tools designed to evaluate the activities and outcomes for pediatric care coordination is the Care Coordination Measurement Tool (CCMT). It has become widely used as an instrument for health care providers in both primary and subspecialty care settings. This tool enables the user to stratify patients based on acuity and complexity while documenting the activities and outcomes of care coordination. We tested the feasibility of adapting the CCMT to a pediatric surgical population at Boston Children's Hospital. The tool was used to assess the preoperative care coordination activities. Care coordination activities were tracked during the interval from the date the patient was scheduled for a surgical or interventional procedure through the day of the procedure. A care coordination encounter was defined as any task, whether face to face or not, supporting the development or implementation of a plan of care. Data were collected to enable analysis of 5675 care coordination encounters supporting the care provided to 3406 individual surgical cases (patients). The outcomes of care coordination, as documented by the preoperative nursing staff, included the elaboration of the care plan through patient-focused communication among specialist, facilities, perioperative team, and primary care physicians in 80.5% of cases. The average time spent on care coordination activities increased incrementally by 30 minutes with each additional care coordination encounter for a surgical case. Surgical cases with 1 care coordination encounter took an average of 35.7 minutes of preoperative care coordination, whereas those with ≥4 care coordination encounters reported an average of 121.6 minutes. We successfully adapted and implemented the CCMT for a pediatric surgical population and measured nonface-to-face, nonbillable encounters performed by perioperative nursing staff. The care coordination activities integrated into the preoperative process include elaboration of care plans and identification and remediation of discrepancies. Capturing the activities and outcomes of care coordination for preoperative care provides a framework for quality improvement and enables documentation of the value of nonface-to-face perioperative nursing encounters that comprise care coordination.

Acute Erycibe henryi Prain ("Ting Kung Teng") poisoning.

PubMed

Huang, Hsien-Hao; Yen, David Hung-Tsang; Wu, Ming-Ling; Deng, Jou-Fang; Huang, Chun-I; Lee, Chen-Hsen

2006-01-01

Erycibe henryi Prain ("Ting Kung Teng"), a species of Convolvulaceae, has been used in Chinese medicine to relieve pain involving the musculoskeletal system, such as arthritis, sciatica, and traumatic tissue swelling. E. henryi can be mistaken for another herbal plant, Tripterygium wilfordii Hook F, used to treat gouty arthritis. We report here three cases of E. henryi poisoning. All three cases presented with vomiting, diarrhea, salivation, diaphoresis, lacrimation, and rhinorrhea; two patients also had miosis, hypothermia, bradycardia, hypotension, and ventricular tachyarrhythmias. Laboratory abnormalities included leucocytosis, hyperglycemia, hyperamylasemia, hypocalcemia, and transiently elevated liver enzymes, creatinine and creatinine phosphokinase. The active constituents of E. henryi include several tropane alkaloids, which exhibit cholinergic activities. Gastrointestinal disturbances and ventricular tachyarrhythmias may occur with ingestion of either E. henryi or T. wilfordii, but the cholinergic symptoms can help to differentiate them.

How we treat chronic active Epstein-Barr virus infection.

PubMed

Sawada, Akihisa; Inoue, Masami; Kawa, Keisei

2017-04-01

Chronic active Epstein-Barr virus infection (CAEBV) is a prototype of the EBV-associated T- or NK-cell lymphoproliferative diseases, which also include hypersensitivity to mosquito bites and severe-type hydroavacciniforme. The manifestations of CAEBV are often self-limiting with minimum supportive care or only prednisolone and cyclosporine A with or without etoposide. However, allogeneic hematopoietic stem cell transplantation (HSCT) is the only cure, without which patients with CAEBV die within several years. A severe hypercytokinemia and hemophagocytic syndrome, which may occur suddenly, often results in a fatal clinical course. At out institute, we have established a 3-step strategy, including allogeneic HSCT, for the treatment of CAEBV. Seventy-nine patients with CAEBV and related diseases have been treated to date. The 3-year overall survival rate (3y-OS) is currently 87.3 ± 4.2% after planned allogeneic HSCT. However, 3y-OS in patients with uncontrolled active disease is only 16.7 ± 10.8%. To maximize survival rates with minimized late sequelae, we recommend earlier initiation and completion of the 3-step treatment without watchful waiting. We present six illustrative and difficult cases (including severe hypercytokinemia or emergent HSCT) and discuss them together with 73 residual cases.

Effect of using an audience response system on learning environment, motivation and long-term retention, during case-discussions in a large group of undergraduate veterinary clinical pharmacology students.

PubMed

Doucet, Michèle; Vrins, André; Harvey, Denis

2009-12-01

Teaching methods that provide an opportunity for individual engagement and focussed feedback are required to create an active learning environment for case-based teaching in large groups. A prospective observational controlled study was conducted to evaluate whether the use of an audience response system (ARS) would promote an active learning environment during case-based discussions in large groups, have an impact on student motivation and improve long-term retention. Group A (N = 83) participated in large group case discussions where student participation was voluntary, while for group B (N = 86) an ARS was used. Data collection methods included student and teacher surveys, student focus group interviews, independent observations and 1-year post-course testing. Results indicated that the use of an ARS provided an active learning environment during case-based discussions in large groups by favouring engagement, observation and critical reflection and by increasing student and teacher motivation. Although final exam results were significantly improved in group B, long-term retention was not significantly different between groups. It was concluded that ARS use significantly improved the learning experience associated with case-based discussions in a large group of undergraduate students.

How Do I Manage? An Introduction to Management. Supplementary Material and Workbook.

ERIC Educational Resources Information Center

North West Regional Management Centre, Chorley (England).

This book contains supplementary material for a British self-study course in management designed as an introduction to the course for the Certificate in Management Studies. The materials in this book are learning activities referenced to various topics in the course materials. The nine activities include a case study of a production supervision…

Study Service: A Tool of Innovation in Higher Education. Papers on Higher Education, No. 6.

ERIC Educational Resources Information Center

Monal, Isabel; And Others

Case studies of study service activities (activities that adapt higher education more closely to the community) are examined. The document describes 21 such studies, one from each of 21 countries, undertaken by college students in the community. Background information is included on the origin, conditions, and need for study service in higher…

Recovery from severe novel coronavirus infection.

PubMed

Albarrak, Ali M; Stephens, Gwen M; Hewson, Roger; Memish, Ziad A

2012-12-01

We describe the third confirmed case of novel coronavirus infection in a resident of the Arabian Peninsula. Our patient presented, as did 2 prior cases, with severe pneumonia and renal dysfunction requiring intensive care support including assisted ventilation. However, unlike the earlier cases, and despite underlying chronic disease and a single kidney, he survived his infection and has been discharged home. The Ministry of Health continues active surveillance for additional cases. As this case report goes to press, 2 additional confirmed cases have been identified in Riyadh, Saudi Arabia. Contact investigations are in progress. Future work will focus not only on the origin of the virus and mechanisms of transmission, but also the host factors that influence pathogenesis and prognosis.

The hippocampus and memory of verbal and pictorial material.

PubMed

Papanicolaou, Andrew C; Simos, Panagiotis G; Castillo, Eduardo M; Breier, Joshua I; Katz, Jeffrey S; Wright, Anthony A

2002-01-01

Recognition of words and kaleidoscope pictures showed a double dissociation of left and right hippocampal activity using magnetic source imaging (MSI). MSI has advantages over alternative imaging techniques that measure hemodynamic changes for identifying regional changes in brain activity in real time and on an individual subject basis without the need for image subtraction. In this study, lists of words or kaleidoscope pictures were presented for memorization followed by tests of list items and foils during which brain activity was recorded. There was greater activation in the left than the right hippocampus with abstract nouns (e.g., relief) and greater activation in the right than the left hippocampus with kaleidoscope pictures. This dissociation was evident on a case by case basis. This study demonstrates the specialization of the two medial temporal lobe (MTL) regions, including the hippocampi, for mnemonic processing of verbal and pictorial items that are difficult to encode verbally.

Hanford Site Environmental Safety and Health Fiscal Year 2001 Budget-Risk management summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

REEP, I.E.

1999-05-12

The Hanford Site Environment, Safety and Health (ES&H) Budget-Risk Management Summary report is prepared to support the annual request to sites in the U.S. Department of Energy (DOE) Complex by DOE, Headquarters. The request requires sites to provide supplementary crosscutting information related to ES&H activities and the ES&H resources that support these activities. The report includes the following: (1) A summary status of fiscal year (FY) 1999 ES&H performance and ES&H execution commitments; (2)Status and plans of Hanford Site Office of Environmental Management (EM) cleanup activities; (3) Safety and health (S&H) risk management issues and compliance vulnerabilities of FY 2001more » Target Case and Below Target Case funding of EM cleanup activities; (4) S&H resource planning and crosscutting information for FY 1999 to 2001; and (5) Description of indirect-funded S&H activities.« less

Expression and Mutational Analysis of c-kit in Ovarian Surface Epithelial Tumors

PubMed Central

Lee, Myung-Hoon; Park, Tae-In; Bae, Han-Ik

2006-01-01

Coexpression of Kit ligand and c-kit has been reported in some gynecologic tumors. To determine whether imatinib mesylate is useful in ovarian epithelial tumors, we performed immunohistochemical and mutational analysis. The cases consisted of 33 cases, which included 13 serous cystadenocarcinomas, 1 borderline serous tumor, 8 mucinous cystadenocarcinomas, 6 borderline mucinous tumors and 5 clear cell carcinomas. Five cases of serous cystadenoma and 5 cases of mucinous cystadenoma were also included. In the immunohistochemical study, 3 cases (3/6, 50%) of borderline mucinous cystic tumor and two cases (2/8, 25%) of mucinous cystadenocarcinoma show positive staining for KIT protein. Only one case (1/13, 7.7%) of serous cystadenocarcinoma had positive staining. On mutational analysis, no mutation was identified at exon 11. However, two cases of borderline mucinous tumors and one case of mucinous cystadenocarcinoma had mutations at exon 17. In these cases, the immunohistochemistry also shows focal positive staining at epithelial component. Although, KIT protein expression showed higher incidence in mucinous tumors than serous tumors, they lack KIT-activating mutations in exon 11. Thus, ovarian surface epithelial tumors are unlikely to respond to imatinib mesylate. PMID:16479070

A Status of NASA Rotorcraft Research

DTIC Science & Technology

2009-09-01

approximate threefold range in the values of CP. It has been found useful in many cases to include additional independent variables and group...and improved rotorcraft. These needs include better analysis and better data. Many plans proposed for NASA rotorcraft research are discussed here, to...a successful active noise- control system include : obtaining a clean reference signal with minimal phase jitter; achieving a global reduction of

mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

PubMed

Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A

2017-07-01

This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P < .0001) and more likely to receive recombinant tissue plasminogen activator (20% versus 12%, P < .0001) than those with ED activation. After adjustment, cases with EMS activation had shorter DTC (6.1 minutes shorter, 95% CI [-10.3, -2]) and DTN (12.8 minutes shorter, 95% CI [-21, -4.6]) and were more likely to meet goal DTN (OR 1.83, 95% CI [1.1, 3]). Cases between 1200 and 1800 had longer DTC (7.7 minutes longer, 95% CI [2.4, 13]) and DTN (21.1 minutes longer, 95% CI [9.3, 33]), and reduced rate of goal DTN (OR .3, 95% CI [.15, .61]) compared to those between 0000 and 0600. Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Indoor air pollution from secondhand tobacco smoke, solid fuels, and kerosene in homes with active tuberculosis disease in South Africa.

PubMed

Elf, Jessica L; Eke, Onyinyechi; Rakgokong, Modiehi; Variava, Ebrahim; Baliram, Yudesh; Motlhaoleng, Katlego; Lebina, Limakatso; Shapiro, Adrienne E; Breysse, Patrick N; Golub, Jonathan E; Martinson, Neil

2017-11-13

Secondhand tobacco smoke (SHS), use of solid fuels, and kerosene may play an important role in perpetuating the tuberculosis (TB) epidemic. The purpose of this study was to explore the prevalence of household air pollution (HAP) from these sources in homes of someone with TB in a high HIV-prevalence setting. A convenience sample of homes and household members participating in an ongoing active case-finding study in Matlosana district townships surrounding Klerksdorp, South Africa were included. We found a high prevalence of air pollution from SHS, solid fuels, and kerosene among individuals in homes with a case of prevalent active TB disease in Klerksdorp, South Africa. Adults in 40% of homes reported a daily smoker in the home, and 70% of homes had detectable air nicotine. In homes with a history of previous TB (prior to but not including the index case) as compared to those without previous TB, both SHS (83% vs. 65%, respectively) and solid/kerosene fuel use for more than 1 h/day (27% vs. 21%, respectively) were more prevalent. Larger studies are needed to estimate the risk of TB from these types of air pollution in HIV infected individuals and settings with high HIV prevalence.

Identifying coagulopathies in the pathophysiology of cold stress syndrome in the Florida manatee Trichechus manatus latirostris.

PubMed

Barratclough, Ashley; Conner, Bobbi J; Brooks, Marjory B; Pontes Stablein, Alyssa; Gerlach, Trevor J; Reep, Roger L; Ball, Ray L; Floyd, Ruth Francis

2017-08-09

Cold stress syndrome (CSS) in the Florida manatee Trichechus manatus latirostris has been defined as morbidity and mortality resulting from prolonged exposure to water temperatures <20°C. The pathophysiology is described as multifactorial, involving nutritional, immunological and metabolic disturbances; however, the exact mechanisms are unknown. We hypothesized that thromboembolic complications contribute to the pathophysiology of CSS in addition to the previously described factors. During the winter of 2014-2015, 10 Florida manatees with clinical signs of CSS were presented to Lowry Park Zoo, Tampa, FL, USA. Thromboelastography (TEG) and coagulation panels were performed at admission. In addition, coagulation panel data from 23 retrospective CSS cases were included in the analyses. There were numerous differences between mean values of TEG and coagulation parameters for healthy manatees and those for CSS cases. Among TEG parameters, reaction time (R), clot formation time (K) and percentage of clot lysed after 30 min (LY30) values were significantly different (p < 0.05) between the 2 groups. CSS cases also had significantly higher mean D-dimer concentration and coagulation factor XI activity, prolonged mean activated partial thromboplastin time (aPTT) and significantly decreased mean antithrombin activity. These combined abnormalities include clinicopathologic criteria of disseminated intravascular coagulation, indicating an increased risk of thromboembolic disease associated with manatee CSS.

Role of More Active Identification of Brain-Dead Cases in Increasing Organ Donation.

PubMed

Sadegh Beigee, Farahnaz; Mohsenzadeh, Mojtaba; Shahryari, Shagin; Mojtabaee, Meysam

2017-02-01

Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases. Since March 2015, our newly established protocol for active detection of brain-dead cases includes the following changes: (1) instead of calling high-volume intensive care units 3 times per week, we switched to calling every day in the morning; (2) instead of calling low-volume intensive care units 1 time per week, we switched to calling 3 times per week; (3) we included intensive care units (cardiac and general), neurosurgery, and emergency departments, as well as nursing supervisor offices, in our call and visit lists; and (4) we increased visits to wards by our trained staff as inspectors. From March 2015 to March 2016, the number of reported suspected brain-dead cases has increased from 224 to 460 per year, with proven brain death increasing from 180 to 306 cases. The actual number of donors has also increased, from 116 to 165 donations (53% increase) over 1 year. More proactive strategies have had significant effects on brain-dead detection, resulting in significantly increased donor pools and organ donations. In countries with low cooperation of hospital staff, more proactive engagement in detecting brain-dead cases is a good solution to prevent loss of potential organ donors, with a final result of decreasing wait list mortality.

Quantifying the influence of previously burned areas on suppression effectiveness and avoided exposure: A case study of the Las Conchas Fire

Treesearch

Matthew P. Thompson; Patrick Freeborn; Jon D. Rieck; Dave Calkin; Julie W. Gilbertson-Day; Mark A. Cochrane; Michael S. Hand

2016-01-01

We present a case study of the Las Conchas Fire (2011) to explore the role of previously burned areas (wildfires and prescribed fires) on suppression effectiveness and avoided exposure. Methodological innovations include characterisation of the joint dynamics of fire growth and suppression activities, development of a fire line effectiveness framework, and...

Curriculum Adaptation in Special Schools for Students with Intellectual Disabilities (SID): A Case Study of Project Learning in One SID School in Hong Kong

ERIC Educational Resources Information Center

Zhang, Jia-Wei; Wong, Lam; Chan, Tak-Hang; Chiu, Chi-Shing

2014-01-01

Using a qualitative case study approach, the authors analyzed the curriculum adaptation process for one project learning activity in School K, which is a SID school in the context of school-university collaboration. Multiple sources of data were collected for triangulation, including interviews, documents and observations. Curriculum adaptation…

The Entrepreneurial University: A Case Study of the University of New Mexico in a Competitive Research Environment, 1972-1978.

ERIC Educational Resources Information Center

Bjork, Lars G.

Factors affecting the emergence of the University of New Mexico as a research institution in a period of increased competition for research support are discussed. The case study covers the period of 1972-1978 and focuses on the development of the Office of the Vice President for Research and its entrepreneurial activities, including its increased…

Diagnostic problems in case of twin pregnancies: US vs. MRI study.

PubMed

Bekiesinska-Figatowska, Monika; Herman-Sucharska, Izabela; Romaniuk-Doroszewska, Anna; Jaczynska, Renata; Furmanek, Mariusz; Bragoszewska, Hanna

2013-09-01

To present an experience with twin pregnancies underlining the impact of magnetic resonance imaging (MRI) on diagnosis and management. There were 17 cases of twin pregnancies: nine monochorionic [including four monochorionic diamniotic and five monochorionic monoamniotic (conjoined twins)] and eight dichorionic. The MRI examinations were performed between 19 and 39 weeks of gestational age in two centers using 1.5 T scanners (GE Signa Excite and GE Signa HDxt; GE Healthcare, Waukesha, WI, USA), always after ultrasound (US). In the first period of our activity, SSFSE sequence in T2-weighted images (SSFSE/T2WI) was the main diagnostic tool supported by TSE or GRE T1-weighted images (T1WI). After upgrading the scanners, diffusion-weighted imaging (DWI), steady-state free precession (FIESTA), and echoplanar GRE imaging (EPIGRE) became available. In 11 cases (64.7%), MRI was superior to US and supplied additional information, including two cases in which pathology of the second twin suspected on US was ruled out on the basis of MRI. In six cases (35.3%) MRI confirmed US diagnosis and brought no new data. MRI offers more detailed assessment of fetal pathology in cases of twin pregnancies, including conjoined twins, in which sonographic evaluation is more difficult than in single cases.

Documentation of Measles Elimination in Iran: Evidences from 2012 to 2014.

PubMed

Karami, Manoochehr; Zahraei, Seyed Mohsen; Sabouri, Azam; Soltanshahi, Rambod; Biderafsh, Azam; Piri, Naser; Lee, Jong-Koo

2017-08-05

Documentation of achieving the goal of measles elimination to justify to international organizations including the WHO is a priority for public health authorities. This study aimed to address the status of Iran in the achievement of the measles elimination goal from 2012-2014. A descriptive study METHODS: Data on the measles outbreaks were extracted from the national notifiable measles surveillance system in Iran from 2012 to 2014. The required documents regarding the achievement of measles elimination, including Effective Reproduction Number (R) and the distribution of outbreak size, was addressed. The R was calculated using the proportion of imported cases as 1 - P, where P is equal to the proportion of cases that were imported. The distribution of the measles outbreaks size was described using descriptive statistics to show their magnitudes. The proportion of large outbreaks with more than 10 cases was considered as a proxy of the R value. The total number of measles cases was 232 cases (including 186 outbreak related cases) in 2012 and 142 cases in 2014, including108 outbreak related cases. The distribution of the measles outbreak size of occurred outbreaks from that period indicated that there were 37 outbreaks with three or more than three cases. The R value in 2012 was 0.87 and the corresponding value for 2014 was 0.76. According to the magnitude of effective reproduction number and distribution of outbreaks' size, measles has been eliminated in Iran. However, it is necessary to consider the potential endemic activity of measles because of no authorized immigration.

The cost of resident scholarly activity and its effect on resident clinical experience.

PubMed

Schott, Nicholas J; Emerick, Trent D; Metro, David G; Sakai, Tetsuro

2013-11-01

Scholarly activity is an important aspect of the academic training of future anesthesiologists. However, residents' scholarly activity may reduce training caseloads and increase departmental costs. We conducted this study within a large academic anesthesiology residency program with data from the 4 graduating classes of 2009 through 2012. Scholarly activity included peer-reviewed manuscripts, case reports, poster presentations at conferences, book chapters, or any other publications. It was not distinguished whether a resident was the principal investigator or a coinvestigator on a project. The following data were collected on each resident: months spent on a resident research rotation, number of scholarly projects completed, number of research conferences attended, and Accreditation Council for Graduate Medical Education case entries. Comparison was made between residents electing a resident research rotation with those who did not for (1) scholarly projects, (2) research conference attendance, and (3) Accreditation Council for Graduate Medical Education case numbers. Cost to the department for extra clinical coverage during residents' time spent on research activities was calculated using an estimated average cost of $675 ± $176 (mean ± SD) per day with local certified registered nurse anesthetist pay scales. Sixty-eight residents were included in the analyses. Twenty-four residents (35.3%) completed resident research rotations with an average duration of 3.7 months. Residents who elected resident research rotations completed more scholarly projects (5 projects [4-6]: median [25%-75% interquartile range] vs 2 [0-3]; P < 0.0001), attended more research conferences (2 conferences [2-4] vs 1 [0-2]; P < 0.0001), but experienced fewer cases (980 cases [886-1333] vs 1182 [930-1420]; P ≤ 0.002) compared with those who did not elect resident research rotations. The estimated average cost to the department per resident who elected a resident research rotation was $13,500 ± $9724 per month. The average resident time length away from duty for conference attendance was 3.2 ± 0.2 days, with an average cost to the department of $2160 ± $565. The average annual departmental expense for resident conference travel was an additional $1424 ± $133 per resident, as calculated from reimbursement data. Together, the estimated departmental cost for resident scholarly activity during the residency training period was $27,467 ± $20,153 per resident. Residents' scholarly activities require significant departmental financial support. Residents who elected to spend months conducting research completed significantly more scholarly projects but experienced fewer clinical cases.

Transient physical and psychosocial activities increase the risk of nonpersistent and persistent low back pain: a case-crossover study with 12 months follow-up.

PubMed

Machado, Gustavo C; Ferreira, Paulo H; Maher, Chris G; Latimer, Jane; Steffens, Daniel; Koes, Bart W; Li, Qiang; Ferreira, Manuela L

2016-12-01

A previous study has shown that transient physical and psychosocial activities increased the risk of developing low back pain. However, the link between these factors in triggering nonpersistent or persistent episodes remains unclear. We aimed to investigate the association of transient exposures to physical and psychosocial activities with the development of nonpersistent or persistent low back pain. This was a case-crossover study with 12 months follow-up. We included 999 consecutive participants seeking care for a sudden onset of low back pain. Development of low back pain was the outcome measure. At baseline, participants reported transient exposures to 12 predefined activities over the 4 days preceding pain onset. After 12 months, participants were asked whether they had recovered and the date of recovery. Exposures in the 2-hour period preceding pain onset (case window) were compared with the 2-hour period, 24 hours before pain onset (control window) in a case-crossover design for all participants. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI), and interaction analyses were used to compare estimates of nonpersistent (i.e., <6 weeks duration) and persistent cases. This study received funding from Australia's National Health and Medical Research Council (APP1003608). There were 832 participants (83%) who completed the 12 months follow-up successfully. Of these, 430 participants had nonpersistent low back pain (<6 weeks duration), whereas 352 reported persistent symptoms (≥6 weeks duration). Exposure to several transient activities, such as manual tasks involving heavy loads, awkward postures, live people or animals, moderate or vigorous physical activity, and being fatigued or tired during a task or activity, significantly increased the risk of both nonpersistent and persistent low back pain, with ORs ranging from 2.9 to 11.7. Overall, the risk of developing a persistent or a nonpersistent episode of low back pain associated with the included physical factors did not differ significantly. Our results revealed that previously identified triggers contribute equally to the development of both nonpersistent and persistent low back pain. Future prevention strategies should focus on controlling exposure to these triggers as they have the potential to decrease the burden associated with both acute and chronic low back pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Moral reasoning and decisions in dilemmas of neonatal care.

PubMed

Candee, D; Sheehan, T J; Cook, C D; Husted, S D; Bargen, M

1982-10-01

The relationship between levels of moral reasoning and decisions in dilemmas of neonatal care was investigated in a sample of 452 pediatricians. Subjects included residents, faculty members, and practitioners recruited from a variety of university-affiliated and community hospitals. It was hypothesized that physicians whose moral reasoning was more fully developed would less actively treat particular cases. Such cases might include those where a patient's family requested such a limit (designated "negative family attitude") or the quality of life likely to be led after therapy was so low as to preclude even a minimal degree of human activity or social interaction (designated "unsalvageable prognosis"). The hypothesis was tested through the use of two questionnaires. The first questionnaire, devised by Crane, assessed the physician's reported degree of activism in treating six cases of infants born with severe defects. The structure of moral reasoning was measured by a second questionnaire, Rest's Defining Issue Test. Subjects were scored by the degree to which they use universal, ethical principles in resolving a series of moral dilemmas. Results of the absolute level of activism (Table 1) showed that among both residents and postresidents, the degree to which cases are actively treated depends, for salvageable patients, on the type of damage and on the possibility for research. Results involving moral reasoning showed a different pattern among residents and postresidents. Among residents, a significant correlation exists between principled reasoning and the absence of active treatment (r = - 0.41, Form A; r = - 0.23, Form B). As predicted, such correlations were strongest for cases of negative family attitude or of unsalvageable prognosis. The pattern of correlations among postresidents showed either no relationship to moral reasoning or the reverse of the residency pattern (r = -0.08, Form A; r = 0.30, Form B). The influence of the type of institution a resident operates within was assessed by analysis of variance. Inasmuch as moral reasoning and institutional type both had significant main effects (Form A), their magnitude differed. Institutional type accounted for 43% of the variation in mean activism scores whereas moral reasoning accounted for only 4%; however, because one could, a priori, expect institutional norms and customs to be powerful determinants of behavior, any additional, identifiable influence deserves attention. The structure of individuals' moral reasoning seems to be such an influence.

[Impact of current approaches to laboratory screening of donated blood and its components on hepatitis B virus infection in patients with blood system diseases].

PubMed

Ignatova, E N; Tupoleva, T A; Ovchinnikova, E N; Romanova, T Yu; Yaroslavtseva, N G; Filatov, F P; Troitskaya, V V; Kuzmina, L A; Parovichnikova, E N; Gaponova, T V; Savchenko, V G

To evaluate the detection rate of markers for hepatitis B virus (HBV) in the blood samples taken from patients with blood system diseases, by applying the current approaches to examining donated blood and its components for markers of viral infections. The investigation included blood samples from patients with blood system diseases (n=364) and donors (n=5,011). The results of laboratory screening of donated blood samples (n=13,081) were retrospectively analyzed. Commercial kits of reagents were used for immunochemical assay and polymerase chain reaction. Patients with blood system diseases were recorded to have markers of active HBV infection in 12.6% of cases, anti-HBc in 31.3%, and anti-HBs in 37.6%. A retrospective analysis of the results of screening donated blood samples showed the presence of markers for active HBV infection in 0.28% of cases. A prospective examination of blood donors revealed markers of HBV infection in 4.83% of cases, including those of active forms in 0.54% and anti-HBc in 4.79%. The markers of active HBV infection in donors were only anti-HBc IgM in 0.42% of cases. The blood samples from donors with an anti-HBs titer of >200 mIU/ml contained anti-HBc IgM in 10.5%. In the last 5-7 years, the detection rate of markers of HBV infection in the blood samples of patients with blood system diseases have remained at a high level. Screening for decreed markers fails to identify people with inapparent infections among the donors. Even high anti-HBs concentrations in the donated blood may be a risk for HBV transmission by transfusion to a recipient.

Physical activity and risk of cancers of the colon and rectum: an Italian case-control study

PubMed Central

Tavani, A; Braga, C; Vecchia, C La; Conti, E; Filiberti, R; Montella, M; Amadori, D; Russo, A; Franceschi, S

1999-01-01

We investigated the relationships between risk of colon and rectal cancers and physical activity in both sexes at different ages by a case-control study conducted between 1991 and 1996 in six Italian centres. Cases were 1225 patients (688 men, 537 women) below the age of 75 with colon cancer and the controls included 4154 patients (2073 men, 2081 women) admitted to hospital for acute, non-neoplastic conditions. We also analysed 722 cases of rectal cancer. Compared with the lowest level of occupational physical activity at 30–39 years old the odds ratios (OR) for the highest level were 0.64 (95% confidence interval, CI 0.44–0.93) in men and 0.49 (95% CI 0.33–0.72) in women. The inverse association in both sexes was similar at 15–19 and 50–59 years old. No association was found in either sex for leisure-time physical activity. For both sexes the inverse relationship between occupational physical activity at 30–39 years old and colon cancer risk was not significantly heterogeneous across strata of selected covariates, and for ascending, transverse, descending and sigmoid colon. Rectal cancer risk was not associated with any measure of physical activity (OR = 1.32 for men and 0.88 for women for the highest level of occupational physical activity at 30–39 years old compared with the lowest). This study confirms that occupational physical activity is protective against colon, but not against rectal cancer. © 1999 Cancer Research Campaign PMID:10206313

Progress toward measles control - African region, 2001-2008.

PubMed

2009-09-25

In 2001, the countries of the World Health Organization (WHO) African Region (AFR) became part of a global initiative with a goal of reducing the number of measles deaths by 50% by 2005, compared with 1999. Recommended strategies for measles mortality reduction included 1) increasing routine coverage for the first dose of measles-containing vaccine (MCV1) for all children, 2) providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), 3) improving measles case management, and 4) establishing case-based surveillance with laboratory confirmation of all suspected measles cases. Before introduction of MCV throughout AFR, approximately 1 million measles cases had been reported each year in the early 1980s. After strengthening measles-control activities, annual reported cases declined to an estimated 300,000- -580,000 during the 1990s. This report summarizes the progress made during 2001- -2008 toward improving measles control in AFR. During 2001- -2008 estimated MCV1 coverage increased from 57% to 73%, SIAs vaccinated approximately 398 million children, and reported measles cases decreased by 93%, from 492,116 in 2001 to 32,278 in 2008. By 2005, global measles deaths had decreased by 60%, and the AFR goal had been achieved; AFR adopted a new goal to reduce deaths by 90%, compared with 2000, and that goal was achieved in 2006. However, inaccuracies in reported vaccination coverage exist, surveillance is suboptimal, and measles outbreaks continue to occur in AFR countries. Further progress in measles control will require full implementation of recommended strategies, including validation of vaccination coverage.

Human surveillance for West Nile virus infection in Ontario in 2000

PubMed Central

Ford-Jones, E. Lee; Fearon, Margaret; Leber, Chuck; Dwight, Prabo; Myszak, Moira; Cole, Beverly; Greene, Pam Baker; Artes, Sheila; McGeer, Allison; D'Cunha, Colin; Naus, Monika

2002-01-01

Background The first reports of West Nile virus (WNV) infection in the United States in 1999 prompted Ontario to establish a surveillance protocol to monitor for the possible spread of the virus into the province. Surveillance components included evaluation of dead birds, sentinel chickens, mosquito pools and human disease. We report the results of human surveillance in 2000. Methods Between July 1 and Oct. 31, 2000, an active surveillance program was undertaken in which designated site coordinators in sentinel hospitals identified patients who met the suspect case definition (fever and fluctuating level of consciousness [encephalopathy], with or without muscle weakness). During the same period, following province-wide distribution of educational material, all other patients tested for WNV antibodies were identified through review of provincial laboratory reports (laboratory-based enhanced passive surveillance). Results Of the 60 hospitals contacted, 59 agreed to participate in the active surveillance program; 52 provided information on a regular (weekly) basis, and 7 submitted fewer than 8 reports. Thirty-six (61%) of the sentinel sites reported suspect cases. In total, 188 patients were tested (130 identified through active surveillance and 58 through enhanced passive surveillance). Patients identified through active surveillance were more likely than those identified through passive surveillance to meet the suspect case definition (43% [n = 56] v. 7% [n = 4]), to be admitted to hospital (75% [n = 99] v. 16% [n = 9]), to have a longer hospital stay (mean 25 v. 3 days), to have had a second (convalescent) serum sample collected (37% [n = 48] v. 31% [n = 18]), to have had a cerebrospinal fluid (CSF) sample banked (56% [n = 73] v. 14% [n = 8]) and to have had a discharge diagnosis reported (79% [n = 103] v. 28% [n = 16]). Of the 60 patients (32%) who met the suspect case definition, 34 (57% [31 active, 3 passive]) had a discharge diagnosis of encephalitis. Of these, 17 (50% [15 active, 2 passive]) had paired serum samples collected, and 18 (51% [all active]) had a CSF sample banked. The reported causal agents were herpes simplex virus (n = 8), varicella virus (n = 2), Powassan virus (n = 1), echovirus 30 (n = 1) and group B Streptococcus (n = 1); the cause was unknown in 18 cases. One patient died of encephalitis. The remaining 26 patients who met the suspect case definition were ultimately found to have nonencephalitic infections, vascular events or alcohol- or drug-related illness. The 128 (68%) tested for WNV who did not meet the suspect case definition included 9 patients ultimately discharged with a diagnosis of encephalitis. No cases of WNV infection were identified. Interpretation Only one-third of the tested patients met the suspect case definition of encephalopathy on admission, and nearly half of them were later found to have another diagnosis; others did not meet the case definition but were later discharged with a diagnosis of encephalitis. This affirms that identification of acute encephalitis on the basis of symptoms at the time of admission is often impossible. PMID:11800244

Activated Charcoal Does Not Reduce Duration of Phenytoin Toxicity in Hospitalized Patients.

PubMed

Cumpston, Kirk; Stromberg, Paul; Wills, Brandon K; Rose, S Rutherfoord

2016-01-01

Phenytoin toxicity frequently results in a prolonged inpatient admission. Several publications avow multidose activated charcoal (MDAC) will enhance the elimination of phenytoin. However, these claims are not consistent, and the mechanism of enhanced eliminaiton is unproven. The aim of this investigation is to compare the time to reach a clinical composite end point in phenytoin overdose patients treated with no activated charcoal (NoAC), single-dose activated charcoal (SDAC), and MDAC. This was a retrospective study using electronic poison center data. Patients treated in a health care facility with phenytoin concentrations >20 mg/L were included. Patients were grouped by use of SDAC, MDAC, and NoAC. The primary end points were either time to resolution of symptoms, hospital discharge, or the case was closed by a toxicologist. After applying inclusion and exclusion criteria, 132 cases were included for analysis. There were 88 NoAC, 13 SDAC, and 31 MDAC cases. The groups were similar in symptomatology, age, and chronicity of expsoure. Mean peak phenytoin concentrations (SD) were 42 mg/L (12), 41 mg/L (11), and 42 mg/L (11) for NoAC, SDAC, and MDAC, respectively. Mean time to reach the study end point was 39 hours [95% confidence interval (CI), 31-48], 52 hours (95% CI, 36-68), and 60 hours (95% CI, 45-75) for NoAC, SDAC, and MDAC, respectively. The groups appeared similar with respect to peak phenytoin concentrations and prevalence of signs and symptoms. In this observational series, the use of activated charcoal was associated with increased time to reach the composite end point of clinical improvement.

Defense Horizons. A New Military Framework for NATO. May 2005, Number 48

DTIC Science & Technology

2005-05-01

seem to ask too much of the European allies. This is not the case. The entire framework includes only about 10 percent of Europe’s active military...Europeans, creating these forces and capabilities is a viable proposition because they require commitment of only 10 percent of their active military...security challenges, from defeating radical Islamic terrorism to controlling Iran’s nuclear activities to building a free Iraq to achieving an Israeli

Controlling congenital and paediatric chagas disease through a community health approach with active surveillance and promotion of paediatric awareness.

PubMed

Soriano-Arandes, Antoni; Basile, Luca; Ouaarab, Hakima; Clavería, Isabel; Gómez i Prat, Jordi; Cabezos, Juan; Ciruela, Pilar; Albajar-Viñas, Pedro; Jané, Mireia

2014-11-21

Chagas disease (CD) is endemic in countries of continental Latin America. Congenital transmission is a major concern worldwide. In 2010, the Public Health Agency of Catalonia (ASPCAT) launched a screening protocol for Trypanosoma cruzi infection in pregnant women and their newborns. In 2012, ASPCAT detected appropriate follow-up of pregnant women but incomplete information about their offspring. The PROSICS community health team carried out active surveillance and community health action in target populations. These activities included active case searches, group awareness workshops and visualization campaigns as well as investigation of all lost children born from pregnant women with CD and their families. Overall, 42/179 (23.5%) cases were included in the study: 35/42 (83.3%) children were born in Hospitalet de Llobregat (Catalonia, Spain); 4/42 (16.7%) were born in Latin America; two were miscarried and one was stillborn. The mean age of pregnant women was 31.3 years (SD 5.52; range: 21-44): 90.5% were Bolivian, of whom 74% were diagnosed with CD during pregnancy. Of the 35 newborns, 31 were recovered by community health action; 12/31 were correctly controlled at Hospitalet de Llobregat and 19/31 were controlled at a primary health centre. Of these 19 (73.7%) cases, 14 were not tested for CD by family paediatricians and were recovered by the PROSICS community health team. Finally, two (6.9%) of the 29 newborns tested with serology were positive. It is essential to implement active surveillance, education and information activities at paediatric primary care and community levels to avoid the loss of CD-infected mothers and their newborns. Training sessions addressed to paediatricians and other involved health professionals would consolidate surveillance and care reference circuits, improving the control of congenital CD.

Extending the range of differential diagnosis of chronic traumatic encephalopathy of the boxer: Insights from a case report

PubMed Central

Caixeta, Leonardo; Dangoni, Iron; de Sousa, Rafael Dias; Soares, Pedro Paulo Dias; Mendonça, Andreia Costa Rabelo

2018-01-01

ABSTRACT Sports activities associated with repetitive cranial trauma have become a fad and are popular in gyms and even among children. It is important to consistently characterize the consequences of such sports activities in order to better advise society on the real risks to the central nervous system. We present the case of a former boxer reporting cognitive and behavioral symptoms that began six years after his retirement as a boxer, evolving progressively with parkinsonian and cerebellar features suggestive of probable chronic traumatic encephalopathy (CTE). Using our case as a paradigm, we extended the range of differential diagnosis of CTE, including corticobasal degeneration, multiple system atrophy, vitamin B12 deficiency, neurosyphilis, frontotemporal dementia and Alzheimer’s disease. PMID:29682240

Travel-related leptospirosis: a series of 15 imported cases.

PubMed

van de Werve, Charlotte; Perignon, Alice; Jauréguiberry, Stéphane; Bricaire, François; Bourhy, Pascal; Caumes, Eric

2013-01-01

Leptospirosis belongs to the spectrum of travel-related infections. We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100. Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered. Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis. © 2013 International Society of Travel Medicine.

[Clinical characteristics of human recombination activating gene 1 mutations in 8 immunodeficiency patients with diverse phenotypes].

PubMed

Yu, G; Wang, W J; Liu, D R; Tao, Z F; Hui, X Y; Hou, J; Sun, J Q; Wang, X C

2018-03-02

Objective: To investigate the clinical characteristics of 8 immunodeficiency cases caused by human recombination activating gene 1 (RAG1) mutations, and to explore the relationship among genotypes, clinical manifestations and immunophenotypes. Methods: Clinical data were collected and analyzed from patients with RAG1 mutations who visited the Department of Clinical Immunology, Children's Hospital of Fudan University between October 2013 and June 2017. The data included clinical manifestations, immunophenotypes and genotypes. Results: A total of 8 patients were diagnosed with RAG1 deficiency (6 boys and 2 girls). The minimum age of onset was 2 months, and the maximum age was 4 months. The minimum age of diagnosis was 2 months, and the maximum age was 13 years. Four patients had a family history of infant death due to severe infections. Two cases were born to the same consanguineous parents. All cases had recurrent infections, including involvement of respiratory tract (8 cases), digestive tract (6 cases), urinary tract (1 case), and central nervous system (1 case). The pathogens of infection included bacteria, viruses and fungi. Rotavirus was found in 3 cases, cytomegalovirus (CMV) in 5 cases, bacillus Calmette-Guérin adverse reaction in 2 cases (1 of whom had a positive acid-fast smear from lymph node puncture fluid), fungal infection in 3 cases. One case had multiple nodular space-occupying lesions in lungs and abdominal cavity complicated with multiple bone destruction. The peripheral blood lymphocyte counts of all patients ranged between 0.1 ×10(9)/L and 3.3×10(9)/L (median, 0.65×10(9)/L). Eosinophilia was found in 3 cases (range, (0.48-1.69) ×10(9)/L). The patients were classified according to immunophenotype as severe combined immunodeficiency phenotype (4 cases), leaky severe combined immunodeficiency (2 cases), Omenn syndrome (1 case) and combined immunodeficiency (1 case) . Decreased serum IgG levels were found in 3 cases, increased serum IgM levels in 3 cases, increased serum IgE levels in 5 cases. RAG1 homozygous mutations were detected in 5 cases and RAG1 compound heterozygous mutations in 3 cases. Two novel mutations and six previously reported mutations were identified. Three cases were successfully treated with hematopoietic stem cell transplantation. Four cases died due to infections, and the 13 year-old patient was still under follow-up in the outpatient clinic. Conclusions: Different RAG1 gene mutations can lead to diverse clinical presentations and immune phenotypes. Clinicians should pay attention to the family history of infant death with severe infection. In that situation, immunological evaluation and gene detection should be performed as early as possible.

Genomic analyses identify recurrent MEF2D fusions in acute lymphoblastic leukaemia

PubMed Central

Gu, Zhaohui; Churchman, Michelle; Roberts, Kathryn; Li, Yongjin; Liu, Yu; Harvey, Richard C.; McCastlain, Kelly; Reshmi, Shalini C.; Payne-Turner, Debbie; Iacobucci, Ilaria; Shao, Ying; Chen, I-Ming; Valentine, Marcus; Pei, Deqing; Mungall, Karen L.; Mungall, Andrew J.; Ma, Yussanne; Moore, Richard; Marra, Marco; Stonerock, Eileen; Gastier-Foster, Julie M.; Devidas, Meenakshi; Dai, Yunfeng; Wood, Brent; Borowitz, Michael; Larsen, Eric E.; Maloney, Kelly; Mattano Jr, Leonard A.; Angiolillo, Anne; Salzer, Wanda L.; Burke, Michael J.; Gianni, Francesca; Spinelli, Orietta; Radich, Jerald P.; Minden, Mark D.; Moorman, Anthony V.; Patel, Bella; Fielding, Adele K.; Rowe, Jacob M.; Luger, Selina M.; Bhatia, Ravi; Aldoss, Ibrahim; Forman, Stephen J.; Kohlschmidt, Jessica; Mrózek, Krzysztof; Marcucci, Guido; Bloomfield, Clara D.; Stock, Wendy; Kornblau, Steven; Kantarjian, Hagop M.; Konopleva, Marina; Paietta, Elisabeth; Willman, Cheryl L.; L. Loh, Mignon; P. Hunger, Stephen; Mullighan, Charles G.

2016-01-01

Chromosomal rearrangements are initiating events in acute lymphoblastic leukaemia (ALL). Here using RNA sequencing of 560 ALL cases, we identify rearrangements between MEF2D (myocyte enhancer factor 2D) and five genes (BCL9, CSF1R, DAZAP1, HNRNPUL1 and SS18) in 22 B progenitor ALL (B-ALL) cases with a distinct gene expression profile, the most common of which is MEF2D-BCL9. Examination of an extended cohort of 1,164 B-ALL cases identified 30 cases with MEF2D rearrangements, which include an additional fusion partner, FOXJ2; thus, MEF2D-rearranged cases comprise 5.3% of cases lacking recurring alterations. MEF2D-rearranged ALL is characterized by a distinct immunophenotype, DNA copy number alterations at the rearrangement sites, older diagnosis age and poor outcome. The rearrangements result in enhanced MEF2D transcriptional activity, lymphoid transformation, activation of HDAC9 expression and sensitive to histone deacetylase inhibitor treatment. Thus, MEF2D-rearranged ALL represents a distinct form of high-risk leukaemia, for which new therapeutic approaches should be considered. PMID:27824051

Surgical Orthodontic Treatment for Open Bite in Noonan Syndrome Patient: A Case Report.

PubMed

Kawakami, Masayoshi; Yamamoto, Kazuhiko; Shimomura, Tadahiro; Kirita, Tadaaki

2016-03-01

Noonan syndrome, characterized by short stature, facial anomalies, and congenital heart defects, may also be associated with hematopoietic disorders. Craniofacial anomalies in affected patients include hypertelorism and severe open bite associated with masticatory dysfunction. We treated a Noonan syndrome patient with a skeletal open bite. Surgical orthodontic treatment including two-jaw surgery established a good occlusal relationship after correction of severe anemia. Both upper and lower incisors were moved to upright positions, while clockwise rotation of the palatal plane and decreased mandibular plane angle were accomplished. Lower masticatory activity may affect posttreatment occlusion in such cases.

Toward a generation free of tuberculosis: TB disease and infection in individuals of college age in the United States.

PubMed

Shah, N S; Flood-Bryzman, A; Jeffries, C; Scott, J

2018-01-01

To assess the magnitude of active TB disease and latent TB infection (LTBI) in young adults of college age. Individuals who were aged 18-24 years in 2011 were used as a proxy for college students. Active TB cases reported to the 2011 US National TB Surveillance System (NTSS) were included. LTBI prevalence was calculated from the 2011-2012 National Health and Nutrition Examination Survey. The 2011 American Community Survey was used to calculate population denominators. Analyses were stratified by nativity. Active TB disease incidence among persons aged 18-24 years was 2.82/100,000, 18.8/100,000 among foreign-born individuals and 0.9/100,000 among US-born individuals. In 2011, 878 TB cases were reported; 629 (71.6%) were foreign-born. LTBI prevalence among persons of 18-24 years was 2.5%: 8.7% and 1.3% among foreign-born and US-born, respectively. Active screening and treatment programs for foreign-born young adults could identify TB cases earlier and provide an opportunity for prevention efforts.

Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction: The INTERHEART Study.

PubMed

Smyth, Andrew; O'Donnell, Martin; Lamelas, Pablo; Teo, Koon; Rangarajan, Sumathy; Yusuf, Salim

2016-10-11

Physical exertion, anger, and emotional upset are reported to trigger acute myocardial infarction (AMI). In the INTERHEART study, we explored the triggering association of acute physical activity and anger or emotional upset with AMI to quantify the importance of these potential triggers in a large, international population. INTERHEART was a case-control study of first AMI in 52 countries. In this analysis, we included only cases of AMI and used a case-crossover approach to estimate odds ratios for AMI occurring within 1 hour of triggers. Of 12 461 cases of AMI 13.6% (n=1650) engaged in physical activity and 14.4% (n=1752) were angry or emotionally upset in the case period (1 hour before symptom onset). Physical activity in the case period was associated with increased odds of AMI (odds ratio, 2.31; 99% confidence interval [CI], 1.96-2.72) with a population-attributable risk of 7.7% (99% CI, 6.3-8.8). Anger or emotional upset in the case period was associated with an increased odds of AMI (odds ratio, 2.44; 99% CI, 2.06-2.89) with a population-attributable risk of 8.5% (99% CI, 7.0-9.6). There was no effect modification by geographical region, prior cardiovascular disease, cardiovascular risk factor burden, cardiovascular prevention medications, or time of day or day of onset of AMI. Both physical activity and anger or emotional upset in the case period were associated with a further increase in the odds of AMI (odds ratio, 3.05; 99% CI, 2.29-4.07; P for interaction <0.001). Physical exertion and anger or emotional upset are triggers associated with first AMI in all regions of the world, in men and women, and in all age groups, with no significant effect modifiers. © 2016 American Heart Association, Inc.

78 FR 24161 - Takes of Marine Mammals Incidental to Specified Activities; Navy Training Conducted at the Silver...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... one provided here. Comments sent via email, including all attachments, must not exceed a 10-megabyte... due to their light weight, low magnetic signature (in cases of mines sensitive to magnetic fields... underwater detonation training events include one or two detonations. Table 2-1 in the Navy's LOA application...

Neisseria meningitidis and Streptococcus pneumoniae as leading causes of pediatric bacterial meningitis in nine Mexican hospitals following 3 years of active surveillance.

PubMed

Chacon-Cruz, Enrique; Martinez-Longoria, Cesar Adrian; Llausas-Magana, Eduardo; Luevanos-Velazquez, Antonio; Vazquez-Narvaez, Jorge Alejandro; Beltran, Sandra; Limon-Rojas, Ana Elena; Urtiz-Jeronimo, Fernando; Castaneda-Narvaez, Jose Luis; Otero-Mendoza, Francisco; Aguilar-Del Real, Fernando; Rodriguez-Chagoyan, Jesus; Rivas-Landeros, Rosa Maria; Volker-Soberanes, Maria Luisa; Hinojosa-Robles, Rosa Maria; Arzate-Barbosa, Patricia; Aviles-Benitez, Laura Karina; Elenes-Zamora, Fernando Ivan; Becka, Chandra M; Ruttimann, Ricardo

2016-01-01

Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals. From January 2010 to February 2013, we conducted a three years of active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspected case, and microbiological studies confirmed/ruled out all potentially bacterial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diagnostic tests), and both pneumococcal serotyping and meningococcal serogrouping by using standard methods. Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup C was predominant. Streptococcus pneumoniae followed Neisseria meningitides, but was uniformly distributed throughout the country. Serotype 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants). Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures - negative but presumably bacterial meningitis cases.

Expanding the Boundaries of Museum Studies: Popular Education through Engagement with Hidden Histories of Organising and Activism

ERIC Educational Resources Information Center

Toth, Emese R.; Guttman, Sandy; Kimura, Andie; Quinn, Therese

2016-01-01

This article shares a descriptive case study of a popular education project entitled Alternative Tours UIC (ALTourUIC) that took place during a graduate course in the Museum and Exhibition Studies Programme at University of Illinois at Chicago. The educational activities created by the students included a map locating historically rich areas of…

An Epistemological Analysis of the Evolution of Didactical Activities in Teaching-Learning Sequences: The Case of Fluids. Special Issue

ERIC Educational Resources Information Center

Psillos, D.; Tselfes, Vassilis; Kariotoglou, Petros

2004-01-01

In the present paper we propose a theoretical framework for an epistemological modelling of teaching-learning (didactical) activities, which draws on recent studies of scientific practice. We present and analyse the framework, which includes three categories: namely, Cosmos-Evidence-Ideas (CEI). We also apply this framework in order to model a…

On "Stepping Back and Letting Go": The Role of Control in the Success or Failure of Social Studies Simulations

ERIC Educational Resources Information Center

Wright-Maley, Cory

2015-01-01

This comparative case study presents one key challenge that 2 experienced teachers faced when using simulations: control. Simulations are activities that place high demands on teachers, including the ability to anticipate pitfalls in advance, act in multiple capacities, shape the direction of the activity without unduly interfering, and to be…

Historical Research and Research in Higher Education: Reflections and Recommendations from a Self-Study

ERIC Educational Resources Information Center

Haigh, Neil

2012-01-01

When we conceptualize and undertake new research projects, a number of the associated activities require us to take on the role of an historian: there is historical research to do. Those activities include determining whether there is a compelling case for embarking on the project in the light of previous research, making design decisions that…

Case Study Evaluating Just-In-Time Teaching and Peer Instruction Using Clickers in a Quantum Mechanics Course

ERIC Educational Resources Information Center

Sayer, Ryan; Marshman, Emily; Singh, Chandralekha

2016-01-01

Just-in-Time Teaching (JiTT) is an instructional strategy involving feedback from students on prelecture activities in order to design in-class activities to build on the continuing feedback from students. We investigate the effectiveness of a JiTT approach, which included in-class concept tests using clickers in an upper-division quantum…

"I Am a Starbucks Worker … My Life No Longer Belongs to Me:" The Performance of Estrangement as a Learning Tool

ERIC Educational Resources Information Center

Keenan, John; Evans, Adrienne

2014-01-01

In this paper, we explore the use of "estrangement" autoethnography as a means to encourage student autonomy and enhance learning. We include a case study of a structured activity requiring estrangement in consumer spaces to challenge student perspectives of normal environments. Our students welcomed the activity as one which changed…

Analyzing the Social Knowledge Construction Behavioral Patterns of an Online Synchronous Collaborative Discussion Instructional Activity Using an Instant Messaging Tool: A Case Study

ERIC Educational Resources Information Center

Hou, Huei-Tse; Wu, Sheng-Yi

2011-01-01

Online discussions have been widely utilized as an educational activity, and much research has been conducted on the process and behaviors involved in asynchronous discussions. However, research on behavioral patterns in learners' synchronous discussions, including the process of social knowledge construction and project coordination is limited.…

Recreating the Arsenal of Venice: Using Experiential Activities to Teach the History of Management

ERIC Educational Resources Information Center

Stovall, Steven Austin

2010-01-01

In works by Van Fleet and Wren and by Smith, a strong case is made for including a greater emphasis on the historical aspects of management in undergraduate introductory-level management courses. This article builds on these two works by providing specific experiential activities to assist instructors who wish to offer more depth to their…

Skype-Based English Activities: A Case for Compelling Input? Correlational Changes before and after Skype Exchanges

ERIC Educational Resources Information Center

Ockert, David

2015-01-01

This paper reports the results of a small, longitudinal study involving a group of Japanese elementary school students (N = 29) involved in exploratory research using foreign language activities, including two Skype exchanges between these students and students in Australia. The purpose of the research was to test for the impact of a series of…

Activities and Strategies for the Inclusion of a K-12 Educational Component in Digitization Grant Projects of Academic Libraries

ERIC Educational Resources Information Center

Teel, Linda

2010-01-01

This article seeks to explore and discuss activities and strategies for including a K-12 educational component in digitization grant projects in academic libraries. The article is based on cases studying the K-12 educational component of the three following grants awarded to East Carolina University Joyner Library by North Carolina Exploring…

Invasive listeriosis in the Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009: further targeted prevention needed for higher-risk groups.

PubMed

Silk, Benjamin J; Date, Kashmira A; Jackson, Kelly A; Pouillot, Régis; Holt, Kristin G; Graves, Lewis M; Ong, Kanyin L; Hurd, Sharon; Meyer, Rebecca; Marcus, Ruthanne; Shiferaw, Beletshachew; Norton, Dawn M; Medus, Carlota; Zansky, Shelley M; Cronquist, Alicia B; Henao, Olga L; Jones, Timothy F; Vugia, Duc J; Farley, Monica M; Mahon, Barbara E

2012-06-01

Listeriosis can cause severe disease, especially in fetuses, neonates, older adults, and persons with certain immunocompromising and chronic conditions. We summarize US population-based surveillance data for invasive listeriosis from 2004 through 2009. We analyzed Foodborne Diseases Active Surveillance Network (FoodNet) data for patients with Listeria monocytogenes isolated from normally sterile sites. We describe the epidemiology of listeriosis, estimate overall and specific incidence rates, and compare pregnancy-associated and nonpregnancy-associated listeriosis by age and ethnicity. A total of 762 listeriosis cases were identified during the 6-year reporting period, including 126 pregnancy-associated cases (17%), 234 nonpregnancy-associated cases(31%) in patients aged <65 years, and 400 nonpregnancy-associated cases (53%) in patients aged ≥ 65 years. Eighteen percent of all cases were fatal. Meningitis was diagnosed in 44% of neonates. For 2004-2009, the overall annual incidence of listeriosis varied from 0.25 to 0.32 cases per 100,000 population. Among Hispanic women, the crude incidence of pregnancy-associated listeriosis increased from 5.09 to 12.37 cases per 100,000 for the periods of 2004-2006 and 2007-2009, respectively; among non-Hispanic women, pregnancy-associated listeriosis increased from 1.74 to 2.80 cases per 100,000 for the same periods. Incidence rates of nonpregnancy-associated listeriosis in patients aged ≥ 65 years were 4-5 times greater than overall rates annually. Overall listeriosis incidence did not change significantly from 2004 through 2009. Further targeted prevention is needed, including food safety education and messaging (eg, avoiding Mexican-style cheese during pregnancy). Effective prevention among pregnant women, especially Hispanics, and older adults would substantially affect overall rates.

Histological and immunohistochemical characteristics of undifferentiated small round cell sarcomas associated with CIC-DUX4 and BCOR-CCNB3 fusion genes.

PubMed

Yamada, Yuichi; Kuda, Masaaki; Kohashi, Kenichi; Yamamoto, Hidetaka; Takemoto, Junkichi; Ishii, Takeaki; Iura, Kunio; Maekawa, Akira; Bekki, Hirofumi; Ito, Takamichi; Otsuka, Hiroshi; Kuroda, Makoto; Honda, Yumi; Sumiyoshi, Shinji; Inoue, Takeshi; Kinoshita, Naoe; Nishida, Atsushi; Yamashita, Kyoko; Ito, Ichiro; Komune, Shizuo; Taguchi, Tomoaki; Iwamoto, Yukihide; Oda, Yoshinao

2017-04-01

CIC-DUX4 and BCOR-CCNB3 fusion-gene-associated small round cell sarcomas account for a proportion of pediatric small round cell sarcomas, but their pathological features have not been sufficiently clarified. We reviewed a large number of soft tissue tumors registered at our institution, retrieved the cases of unclassified tumors with a small round cell component, and subjected them to histopathological, immunohistochemical, and gene profile analysis. We reviewed 164 cases of unclassified tumors with a small round cell component and analyzed them by RT-PCR and FISH. Tumors positive for a specific fusion-gene were also subjected to histopathological and immunohistochemical examinations. We identified 16 cases of BCOR-CCNB3/CIC-associated (CIC-DUX4 or CIC gene rearrangement-positive) sarcomas. These included seven BCOR-CCNB3 sarcomas and nine CIC-associated sarcomas. Heterogeneous elements included a myxoid spindle cell component in three BCOR-CCNB3 sarcomas and an epithelioid cell component in two CIC-associated sarcomas (one CIC-DUX4-positive and one CIC-DUX4-negative sarcomas). Mitotic activity was low in both heterogeneous components. By immunohistochemistry, in seven BCOR-CCNB3 sarcomas expression of EMA was positive in two cases, of p63 in three, of CD56 in six, of TLE1 in seven, of NKX2.2 in two, of CCNB3 in seven, and of BCOR in six cases (one case could not be tested for BCOR). In nine cases of CIC-associated sarcoma, CD56 was expressed in five, alpha-smooth muscle actin in one, ERG in three, and CD99, WT1 and TLE1 each in eight cases. Both sarcoma types showed not only a small round cell component, but also a myxoid/epithelioid component with low mitotic activity.

Successful Control of Ebola Virus Disease: Analysis of Service Based Data from Rural Sierra Leone

PubMed Central

Lokuge, Kamalini; Caleo, Grazia; Greig, Jane; Duncombe, Jennifer; McWilliam, Nicholas; Squire, James; Lamin, Manjo; Veltus, Emily; Wolz, Anja; Kobinger, Gary; de la Vega, Marc-Antoine; Gbabai, Osman; Nabieu, Sao; Lamin, Mohammed; Kremer, Ronald; Danis, Kostas; Banks, Emily; Glass, Kathryn

2016-01-01

Introduction The scale and geographical distribution of the current outbreak in West Africa raised doubts as to the effectiveness of established methods of control. Ebola Virus Disease (EVD) was first detected in Sierra Leone in May 2014 in Kailahun district. Despite high case numbers elsewhere in the country, transmission was eliminated in the district by December 2014. We describe interventions underpinning successful EVD control in Kailahun and implications for EVD control in other areas. Methods Internal service data and published reports from response agencies were analysed to describe the structure and type of response activities, EVD case numbers and epidemic characteristics. This included daily national situation reports and District-level data and reports of the Sierra Leone Ministry of Health and Sanitation, and Médecins Sans Frontières (MSF) patient data and internal epidemiological reports. We used EVD case definitions provided by the World Health Organisation over the course of the outbreak. Characteristics assessed included level of response activities and epidemiological features such as reported exposure (funeral-related or not), time interval between onset of illness and admission to the EVD Management Centre (EMC), work-related exposures (health worker or not) and mortality. We compared these characteristics between two time periods—June to July (the early period of response), and August to December (when coverage and quality of response had improved). A stochastic model was used to predict case numbers per generation with different numbers of beds and a varying percentage of community cases detected. Results There were 652 probable/confirmed EVD cases from June-December 2014 in Kailahun. An EMC providing patient care opened in June. By August 2014 an integrated detection, treatment, and prevention strategy was in place across the district catchment zone. From June-July to August-December 2014 surveillance and contact tracing staff increased from 1.0 to 8.8 per confirmed EVD case, EMC capacity increased from 32 to 100 beds, the number of burial teams doubled, and health promotion activities increased in coverage. These improvements in response were associated with the following changes between the same periods: the proportion of confirmed/probable cases admitted to the EMC increased from 35% to 83% (χ2 p-value<0·001), the proportion of confirmed patients admitted to the EMC <3 days of symptom onset increased from 19% to 37% (χ2 p-value <0·001), and reported funeral contact in those admitted decreased from 33% to 16% (χ2 p-value <0·001). Mathematical modelling confirmed the importance of both patient management capacity and surveillance and contact tracing for EVD control. Discussion Our findings demonstrate that control of EVD can be achieved using established interventions based on identification and appropriate management of those who are at risk of and develop EVD, including in the context of ongoing transmission in surrounding regions. Key attributes in achieving control were sufficient patient care capacity (including admission to specialist facilities of suspect and probable cases for assessment), integrated with adequate staffing and resourcing of community-based case detection and prevention activities. The response structure and coverage targets we present are of value in informing effective control in current and future EVD outbreaks. PMID:26959413

Successful Control of Ebola Virus Disease: Analysis of Service Based Data from Rural Sierra Leone.

PubMed

Lokuge, Kamalini; Caleo, Grazia; Greig, Jane; Duncombe, Jennifer; McWilliam, Nicholas; Squire, James; Lamin, Manjo; Veltus, Emily; Wolz, Anja; Kobinger, Gary; de la Vega, Marc-Antoine; Gbabai, Osman; Nabieu, Sao; Lamin, Mohammed; Kremer, Ronald; Danis, Kostas; Banks, Emily; Glass, Kathryn

2016-03-01

The scale and geographical distribution of the current outbreak in West Africa raised doubts as to the effectiveness of established methods of control. Ebola Virus Disease (EVD) was first detected in Sierra Leone in May 2014 in Kailahun district. Despite high case numbers elsewhere in the country, transmission was eliminated in the district by December 2014. We describe interventions underpinning successful EVD control in Kailahun and implications for EVD control in other areas. Internal service data and published reports from response agencies were analysed to describe the structure and type of response activities, EVD case numbers and epidemic characteristics. This included daily national situation reports and District-level data and reports of the Sierra Leone Ministry of Health and Sanitation, and Médecins Sans Frontières (MSF) patient data and internal epidemiological reports. We used EVD case definitions provided by the World Health Organisation over the course of the outbreak. Characteristics assessed included level of response activities and epidemiological features such as reported exposure (funeral-related or not), time interval between onset of illness and admission to the EVD Management Centre (EMC), work-related exposures (health worker or not) and mortality. We compared these characteristics between two time periods--June to July (the early period of response), and August to December (when coverage and quality of response had improved). A stochastic model was used to predict case numbers per generation with different numbers of beds and a varying percentage of community cases detected. There were 652 probable/confirmed EVD cases from June-December 2014 in Kailahun. An EMC providing patient care opened in June. By August 2014 an integrated detection, treatment, and prevention strategy was in place across the district catchment zone. From June-July to August-December 2014 surveillance and contact tracing staff increased from 1.0 to 8.8 per confirmed EVD case, EMC capacity increased from 32 to 100 beds, the number of burial teams doubled, and health promotion activities increased in coverage. These improvements in response were associated with the following changes between the same periods: the proportion of confirmed/probable cases admitted to the EMC increased from 35% to 83% (χ(2) p-value<0·001), the proportion of confirmed patients admitted to the EMC <3 days of symptom onset increased from 19% to 37% (χ(2) p-value <0·001), and reported funeral contact in those admitted decreased from 33% to 16% (χ(2) p-value <0·001). Mathematical modelling confirmed the importance of both patient management capacity and surveillance and contact tracing for EVD control. Our findings demonstrate that control of EVD can be achieved using established interventions based on identification and appropriate management of those who are at risk of and develop EVD, including in the context of ongoing transmission in surrounding regions. Key attributes in achieving control were sufficient patient care capacity (including admission to specialist facilities of suspect and probable cases for assessment), integrated with adequate staffing and resourcing of community-based case detection and prevention activities. The response structure and coverage targets we present are of value in informing effective control in current and future EVD outbreaks.

Enhanced Monitored Natural Recovery (EMNR) Case Studies Review

DTIC Science & Technology

2009-05-01

tubificid worms, and gastropods . Although recolonization includes a significant percentage of deposit feeding organisms, their activity does not appear...Cleanup at Navy Facilities: Adaptive Site Management Committee on Environmental Remediation at Naval Facilities.” National Research Council

Look Out! It's Poison Ivy!

ERIC Educational Resources Information Center

Darlington, Elizabeth, Day

1986-01-01

Provides background information on poison ivy and offers suggestions for instructional activities. Includes illustrations of the varieties of poison ivy leaf forms and poison ivy look-alikes. Highlights interesting facts and cases associated with poison ivy and its relatives. (ML)

[Single-port laparoscopic cholecystectomy: advantages and disadvantages].

PubMed

Alekberzade, A V; Lipnitsky, E M; Krylov, N N; Sundukov, I V; Badalov, D A

2016-01-01

To analyze the outcomes of single-port laparoscopic cholecystectomy. Early and long-term postoperative period has been analyzed in 240 patients who underwent laparoscopic cholecystectomy (LCE) including 120 cases of single-port technique and 120 cases of four-port technique. Both groups were compared in surgical time, pain syndrome severity (visual analog scale), need for analgesics, postoperative complications, hospital-stay, daily activity recovery and return to physical work, patients' satisfaction of surgical results and their aesthetic effect. It was revealed that single-port LCE is associated with lower severity of postoperative pain, quick recovery of daily activity and return to physical work, high satisfaction of surgical results and their aesthetic effect compared with four-port LCE. Disadvantages of single-port LCE include longer duration of surgery, high incidence of postoperative umbilical hernia. However hernia was predominantly observed during the period of surgical technique development. Further studies to standardize, evaluate the safety and benefits of single-port LCE are necessary.

Conceptual modeling for identification of worst case conditions in environmental risk assessment of nanomaterials using nZVI and C60 as case studies.

PubMed

Grieger, Khara D; Hansen, Steffen F; Sørensen, Peter B; Baun, Anders

2011-09-01

Conducting environmental risk assessment of engineered nanomaterials has been an extremely challenging endeavor thus far. Moreover, recent findings from the nano-risk scientific community indicate that it is unlikely that many of these challenges will be easily resolved in the near future, especially given the vast variety and complexity of nanomaterials and their applications. As an approach to help optimize environmental risk assessments of nanomaterials, we apply the Worst-Case Definition (WCD) model to identify best estimates for worst-case conditions of environmental risks of two case studies which use engineered nanoparticles, namely nZVI in soil and groundwater remediation and C(60) in an engine oil lubricant. Results generated from this analysis may ultimately help prioritize research areas for environmental risk assessments of nZVI and C(60) in these applications as well as demonstrate the use of worst-case conditions to optimize future research efforts for other nanomaterials. Through the application of the WCD model, we find that the most probable worst-case conditions for both case studies include i) active uptake mechanisms, ii) accumulation in organisms, iii) ecotoxicological response mechanisms such as reactive oxygen species (ROS) production and cell membrane damage or disruption, iv) surface properties of nZVI and C(60), and v) acute exposure tolerance of organisms. Additional estimates of worst-case conditions for C(60) also include the physical location of C(60) in the environment from surface run-off, cellular exposure routes for heterotrophic organisms, and the presence of light to amplify adverse effects. Based on results of this analysis, we recommend the prioritization of research for the selected applications within the following areas: organism active uptake ability of nZVI and C(60) and ecotoxicological response end-points and response mechanisms including ROS production and cell membrane damage, full nanomaterial characterization taking into account detailed information on nanomaterial surface properties, and investigations of dose-response relationships for a variety of organisms. Copyright © 2011 Elsevier B.V. All rights reserved.

Characteristics of phase-correcting fresnel zone plates and elliptical waveguides

NASA Astrophysics Data System (ADS)

Wiltse, James C.

1994-02-01

The primary area of activity has been concentrated on the investigations relating to Fresnel zone plate antennas. A secondary effort has dealt with the characteristics of propagation in waveguides of elliptical cross section. In both cases, applications at microwave and millimeter-wavelengths have been emphasized. Thorough literature searches were conducted, and the results are given in Appendices A and B. The zone plate work has dealt with both transmission and reflection types, and has included considering the off-axis-fed cases. In the latter case, the plate may consist of elliptical zones, rather than the usual circular configuration. In general, the characteristics studied include far-field patterns, focal region fields, off-axis performance, bandwidth, and aberrations. In the case of propagation in elliptical waveguides, the attenuation and modal properties were studied for enclosed metal waveguides, coaxial transmission lines, and various surface waveguides.

Treating the insomniac patient - General measures and psychological and pharmacological treatment

NASA Technical Reports Server (NTRS)

Kales, A.; Bixler, E. O.; Kales, J. D.

1975-01-01

The general preliminary measures for treating insomnia include moderate physical exercise several hours before bedtime, and the relaxation of complex mental activity before bedtime. A case history concerning a woman with marital troubles is offered as evidence that insomnia may be caused by deeply rooted psychological and situational problems. Another case history illustrates how prior pharmacological treatment may complicate the process of clinically evaluating an insomniac.

Progressive hemifacial atrophy (Parry-Romberg syndrome). Case report.

PubMed

Mazzeo, N; Fisher, J G; Mayer, M H; Mathieu, G P

1995-01-01

Progressive hemifacial atrophy (Parry-Romberg syndrome) is a slowly progressing facial atrophy of subcutaneous fat and the wasting of associated skin, cartilage, and bone. This disorder includes an active progressive phase (2 to 10 years) followed by a burning out of the atrophic process with subsequent stability. This article presents a review of the literature and a case report with unique dental involvement as a result of this disease process.

The association between urban tree cover and gun assault: A case-control and case-crossover study

Treesearch

Michelle C. Kondo; Eugenia C. South; Charles C. Branas; Therese S. Richmond; Douglas J. Wiebe

2017-01-01

Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems–assisted interviews with boys andmen aged 10–24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot...

From the School Newsroom to the Courtroom. Lessons on the Hazelwood Case and Free Expression Policy Making in the Public Schools.

ERIC Educational Resources Information Center

Rosenblum, Warren; And Others

The purpose of this lesson packet is to raise issues about student rights of free expression in public schools. Included are preparatory reading material and two classroom simulation activities. The lessons are based on the U.S. Supreme Court case of Hazelwood v. Kuhlmeier, in which a Missouri high school principal and school district were sued by…

Measures to restore metallurgical mine wasteland using ecological restoration technologies: A case study at Longnan Rare Earth Mine

NASA Astrophysics Data System (ADS)

Rao, Yunzhang; Gu, Ruizhi; Guo, Ruikai; Zhang, Xueyan

2017-01-01

Whereas mining activities produce the raw materials that are crucial to economic growth, such activities leave extensive scarring on the land, contributing to the waste of valuable land resources and upsetting the ecological environment. The aim of this study is therefore to investigate various ecological technologies to restore metallurgical mine wastelands. These technologies include measures such as soil amelioration, vegetation restoration, different vegetation planting patterns, and engineering technologies. The Longnan Rare Earth Mine in the Jiangxi Province of China is used as the case study. The ecological restoration process provides a favourable reference for the restoration of a metallurgical mine wasteland.

Retinal pigmentary changes in chronic uveitis mimicking retinitis pigmentosa.

PubMed

Sevgi, D Damla; Davoudi, Samaneh; Comander, Jason; Sobrin, Lucia

2017-09-01

To present retinal pigmentary changes mimicking retinitis pigmentosa (RP) as a finding of advanced uveitis. We retrospectively reviewed charts of patients without a family history of inherited retinal degenerations who presented with retinal pigment changes and signs of past or present intraocular inflammation. Comprehensive eye examination including best-corrected visual acuity, slit-lamp examination and dilated fundus examination was performed on all patients in addition to color fundus photography, optical coherence tomography, fluorescein angiography (FA), and full-field electroretinogram testing. We identified five patients with ages ranging from 33 to 66 years, who presented with RP-like retinal pigmentary changes which were eventually attributed to longstanding uveitis. The changes were bilateral in three cases and unilateral in two cases. Four of five cases presented with active inflammation, and the remaining case showed evidence of active intraocular inflammation during follow-up. This study highlights the overlapping features of advanced uveitis and RP including the extensive pigmentary changes. Careful review of possible past uveitis history, detailed examination of signs of past or present inflammation and ancillary testing, with FA often being most helpful, are required for the correct diagnosis. This is important, because intervention can prevent further damage if the cause of the pigmentary changes is destructive inflammation.

Medical and drug risk factors associated with neuroblastoma: a case-control study.

PubMed

Kramer, S; Ward, E; Meadows, A T; Malone, K E

1987-05-01

A matched case-control study of prenatal risk factors for neuroblastoma was conducted, including 104 cases diagnosed over the period 1970-79 in the Greater Delaware Valley. Significantly elevated odds ratios (ORs) were associated with maternal use of a neurally active drug during pregnancy (OR = 2.83), sex hormone exposure 3 months prior to or during pregnancy (OR = 2.25), frequent alcohol consumption during pregnancy (OR = 9.0), and maternal use of diuretic drugs during pregnancy (OR = 5.75). Significantly more case mothers than control mothers reported use of hair coloring products during pregnancy (OR = 3.0). No association was found between cigarette smoking, coffee consumption, or medical irradiation and case-control status.

[Associations of sedentary behavior and physical activity with dyslipidemia].

PubMed

Zhou, J; Zhou, Q; Wang, D P; Zhang, T; Wang, H J; Song, Y; He, H Z; Wang, M; Wang, P Y; Liu, A P

2017-06-18

To analyze associations of sedentary behavior and physical activity with dyslipidemia among residents in Wuhai city. Data about social demographic characteristics, life style, health status and other covariate required for analysis in this study was obtained from a cross-sectional study on a total of 11 497 18-79 years old residents in Wuhai City by questionnaire, body mea-surement and laboratory examination. In this study, sedentary behavior and physical activity were evaluated using international physical activity questionnaire long version (IPAQ). IPAQ is widely used all over the world, and its reliability and validity have been tested in Chinese population. 2016 Chinese Guideline for the Management of Dyslipidemia in Adults was used to define dyslipidemia in this study. According to IPAQ scoring protocol, 124 participants were excluded as a result of reporting more than 960 min of physical activity per day. 50.58% of 11 373 participants included in the analysis reported more than 4 hours of sedentary behavior per day in this study, thus 49.42% participants reported no more than 4 hours of sedentary behavior per day; the proportions of these 11 373 participants who reached Low level physical activity, Moderate level physical activity and high level physical activity were 23.43%, 37.29% and 39.28% respectively; and the detection ratios of new cases and prevalent cases of dyslipidemia in Wuhai City were 20.46% and 16.13% respectively. After controlling for confounders in this study, we found out that sedentary behavior increased the risk of new cases of dyslipidemia in women (OR=1.17, 95% CI: 1.00-1.36), and increased the risk of prevalent cases of dyslipidemia in both men (OR=1.21, 95% CI: 1.02-1.44) and women (OR=1.24, 95% CI: 1.04-1.48); as for association of physical activity with dyslipidemia, association was found between high level physical activity and prevalent cases of dyslipidemia in men in this study (OR=0.78, 95% CI: 0.62-0.98), suggested that high level physical activity may help to reduce the risk of prevalent cases of dyslipidemia in men. Our results from this cross-sectional study in Wuhai City suggested that sedentary behavior increased the risk of dyslipidemia; by contrast, physical activity may help to reduce the risk of dyslipidemia.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis.

PubMed

Sayed, Shahin; Lester, Susan C; Wilson, Michael; Berney, Daniel; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela; Guarner, Jeannette

2017-01-01

Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45-90 min to complete.Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging.New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers' feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis

PubMed Central

Wilson, Michael; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela

2017-01-01

Background Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. Objectives We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Methods Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Results Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45–90 min to complete. Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging. New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers’ feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Conclusion Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice. PMID:29147646

International Cooperation at NASA

NASA Astrophysics Data System (ADS)

Tawney, Timothy; Feldstein, Karen

International cooperation is a cornerstone principle of NASA’s activities, especially within the activities of the Science Mission Directorate. Nearly two thirds of the flight missions in which NASA leads or participates involve international cooperation. Numerous ground based activities also rely on international cooperation, whether because of unique expertise, unique geography, or the need for a global response. Going forward, in an era of tighter budgets and a more integrated global perspective, NASA and the rest of the space agencies around the world will be forced to work more closely together, in a broader array of activities than ever before, in order to be able to afford to push the boundaries of space exploration. The goal of this presentation is to provide an overview of NASA’s current international science cooperative activities. It will include a discussion of why NASA conducts international cooperation and look at the mechanisms through which international cooperation can occur at NASA, including peer-to-peer development of relationships. It will also discuss some of the limiting factors of international cooperation, such as export control, and ways in which to manage those constraints. Finally, the presentation would look at some of the present examples where NASA is working to increase international cooperation and improve coordination. Case studies will be used to demonstrate these mechanisms and concepts. For example, NASA continues to participate in international coordination groups such as the International Mars Exploration Working Group (IMEWG) and International Space Exploration Coordination Group (ISECG), but is expanding into new areas as well. NASA is one of the leaders in expanding and improving international coordination in the area of Near-Earth Object detection, characterization, and mitigation. Having participated in the first meetings of such groups as the International Asteroid Warning Network (IAWN) and Space Missions Planning Advisory Group (SMPAG), NASA is placing an ever greater emphasis on sharing information among members and working to avoid duplication of effort for the betterment of all humanity. International cooperation at NASA takes many forms. In some cases NASA leads, while in other cases it follows the lead of our many international partners, all in the name of obtaining the best science. In many cases, truly stellar partnerships emerge. In a few cases, the partnership is ended before it can flourish. But in all cases, the partners are learning to work more closely together so that in the future, our partnerships will yield ever better results.

Low Speed and High Speed Correlation of SMART Active Flap Rotor Loads

NASA Technical Reports Server (NTRS)

Kottapalli, Sesi B. R.

2010-01-01

Measured, open loop and closed loop data from the SMART rotor test in the NASA Ames 40- by 80- Foot Wind Tunnel are compared with CAMRAD II calculations. One open loop high-speed case and four closed loop cases are considered. The closed loop cases include three high-speed cases and one low-speed case. Two of these high-speed cases include a 2 deg flap deflection at 5P case and a test maximum-airspeed case. This study follows a recent, open loop correlation effort that used a simple correction factor for the airfoil pitching moment Mach number. Compared to the earlier effort, the current open loop study considers more fundamental corrections based on advancing blade aerodynamic conditions. The airfoil tables themselves have been studied. Selected modifications to the HH-06 section flap airfoil pitching moment table are implemented. For the closed loop condition, the effect of the flap actuator is modeled by increased flap hinge stiffness. Overall, the open loop correlation is reasonable, thus confirming the basic correctness of the current semi-empirical modifications; the closed loop correlation is also reasonable considering that the current flap model is a first generation model. Detailed correlation results are given in the paper.

Psychodrama and Moviemaking in a Death Education Course to Work Through a Case of Suicide Among High School Students in Italy.

PubMed

Testoni, Ines; Ronconi, Lucia; Palazzo, Lorenza; Galgani, Michele; Stizzi, Antonio; Kirk, Kate

2018-01-01

This study describes the psychological effects of an experience of death education (DE) used to explore a case of suicide in an Italian high school. DE activities included philosophical and religious perspectives of the relationships between death and the meaning of life, a visit to a local hospice, and psychodrama activities, which culminated in the production of short movies. The intervention involved 268 high school students (138 in the experimental group). Pre-test and post-test measures assessed ontological representations of death, death anxiety, alexithymia, and meaning in life. Results confirmed that, in the experimental group, death anxiety was significantly reduced as much as the representation of death as annihilation and alexithymia, while a sense of spirituality and the meaning of life were more enhanced, compared to the No DE group. These improvements in the positive meaning of life and the reduction of anxiety confirmed that it is possible to manage trauma and grief at school with death education interventions that include religious discussion, psychodrama and movie making activities.

Ebola virus disease in a humanitarian aid worker - New York City, October 2014.

PubMed

Yacisin, Kari; Balter, Sharon; Fine, Annie; Weiss, Don; Ackelsberg, Joel; Prezant, David; Wilson, Ross; Starr, David; Rakeman, Jennifer; Raphael, Marisa; Quinn, Celia; Toprani, Amita; Clark, Nancy; Link, Nathan; Daskalakis, Demetre; Maybank, Aletha; Layton, Marcelle; Varma, Jay K

2015-04-03

In late October 2014, Ebola virus disease (Ebola) was diagnosed in a humanitarian aid worker who recently returned from West Africa to New York City (NYC). The NYC Department of Health and Mental Hygiene (DOHMH) actively monitored three close contacts of the patient and 114 health care personnel. No secondary cases of Ebola were detected. In collaboration with local and state partners, DOHMH had developed protocols to respond to such an event beginning in July 2014. These protocols included safely transporting a person at the first report of symptoms to a local hospital prepared to treat a patient with Ebola, laboratory testing for Ebola, and monitoring of contacts. In response to this single case of Ebola, initial health care worker active monitoring protocols needed modification to improve clarity about what types of exposure should be monitored. The response costs were high in both human resources and money: DOHMH alone spent $4.3 million. However, preparedness activities that include planning and practice in effectively monitoring the health of workers involved in Ebola patient care can help prevent transmission of Ebola.

Psychodrama and Moviemaking in a Death Education Course to Work Through a Case of Suicide Among High School Students in Italy

PubMed Central

Testoni, Ines; Ronconi, Lucia; Palazzo, Lorenza; Galgani, Michele; Stizzi, Antonio; Kirk, Kate

2018-01-01

This study describes the psychological effects of an experience of death education (DE) used to explore a case of suicide in an Italian high school. DE activities included philosophical and religious perspectives of the relationships between death and the meaning of life, a visit to a local hospice, and psychodrama activities, which culminated in the production of short movies. The intervention involved 268 high school students (138 in the experimental group). Pre-test and post-test measures assessed ontological representations of death, death anxiety, alexithymia, and meaning in life. Results confirmed that, in the experimental group, death anxiety was significantly reduced as much as the representation of death as annihilation and alexithymia, while a sense of spirituality and the meaning of life were more enhanced, compared to the No DE group. These improvements in the positive meaning of life and the reduction of anxiety confirmed that it is possible to manage trauma and grief at school with death education interventions that include religious discussion, psychodrama and movie making activities. PMID:29692745

Pervasive refusal syndrome. Three German cases provide further illustration.

PubMed

Jans, Thomas; Ball, Juliane; Preiss, Maike; Haberhausen, Michael; Warnke, Andreas; Renner, Tobias J

2011-09-01

Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

Sexual Activity as a Risk Factor for the Spontaneous Rupture of Cerebral Aneurysms.

PubMed

Blanke-Roeser, Constantin; Matschke, Jakob; Püschel, Klaus

2016-06-01

Subarachnoid hemorrhages from ruptured cerebral aneurysms have a high clinical relevance and often lead to death. Approximately 2% to 5% of the people worldwide, even of younger age, are said to have aneurysms at cerebral arteries. In many cases, they remain clinically unapparent for decades. However, there are numerous risk factors for the rupture of an aneurysm, including temporary raises of the blood pressure. Such changes of the blood pressure can be induced even by several everyday behaviors. For example, any sort of sexual activities may cause extensive raises of the blood pressure because of several physical and psychological factors. The term "sexual activity" covers sexual intercourse as well as masturbation. In this article, the remarkable case of a 24-year-old woman with a ruptured cerebral aneurysm in the context of masturbation is presented. It is discussed with respect to the possible pathophysiological effects of sexual activity on cerebral aneurysms.

Intraoperative non-record-keeping usage of anesthesia information management system workstations and associated hemodynamic variability and aberrancies.

PubMed

Wax, David B; Lin, Hung-Mo; Reich, David L

2012-12-01

Anesthesia information management system workstations in the anesthesia workspace that allow usage of non-record-keeping applications could lead to distraction from patient care. We evaluated whether non-record-keeping usage of the computer workstation was associated with hemodynamic variability and aberrancies. Auditing data were collected on eight anesthesia information management system workstations and linked to their corresponding electronic anesthesia records to identify which application was active at any given time during the case. For each case, the periods spent using the anesthesia information management system record-keeping module were separated from those spent using non-record-keeping applications. The variability of heart rate and blood pressure were also calculated, as were the incidence of hypotension, hypertension, and tachycardia. Analysis was performed to identify whether non-record-keeping activity was a significant predictor of these hemodynamic outcomes. Data were analyzed for 1,061 cases performed by 171 clinicians. Median (interquartile range) non-record-keeping activity time was 14 (1, 38) min, representing 16 (3, 33)% of a median 80 (39, 143) min of procedure time. Variables associated with greater non-record-keeping activity included attending anesthesiologists working unassisted, longer case duration, lower American Society of Anesthesiologists status, and general anesthesia. Overall, there was no independent association between non-record-keeping workstation use and hemodynamic variability or aberrancies during anesthesia either between cases or within cases. Anesthesia providers spent sizable portions of case time performing non-record-keeping applications on anesthesia information management system workstations. This use, however, was not independently associated with greater hemodynamic variability or aberrancies in patients during maintenance of general anesthesia for predominantly general surgical and gynecologic procedures.

Meta-analysis of expression and function of neprilysin in Alzheimer's disease.

PubMed

Zhang, Huifeng; Liu, Dan; Wang, Yixing; Huang, Huanhuan; Zhao, Yujia; Zhou, Hui

2017-09-14

Neprilysin (NEP) is one of the most important Aβ-degrading enzymes, and its expression and activity in Alzheimer's brain have been widely reported, but the results remain debatable. Thus, the meta-analysis was performed to elucidate the role of NEP in Alzheimer's disease (AD). The relevant case-control or cohort studies were retrieved according to our inclusion/exclusion criteria. Six studies with 123 controls and 141 AD cases, seven studies with 102 controls and 90 AD cases, and four studies with 93 controls and 132 AD cases were included in meta-analysis of NEP's protein, mRNA, and enzyme activity respectively. We conducted Meta regression to detect the sources of heterogeneity and further performed cumulative meta-analysis or subgroup analysis. Our meta-analysis revealed a significantly lower level of NEP mRNA (SMD=-0.44, 95%CI: -0.87, -0.00, p=0.049) in AD cases than in non-AD cases, and such pattern was not altered over time in the cumulative meta-analysis. However, the decrease of NEP protein (SMD=-0.18, 95%CI: -0.62, 0.25) and enzyme activity (SMD=-0.35, 95%CI: -1.03, 0.32) in AD cases did not pass the significance check, while the cumulative meta-analysis by average age showed the pooled effect became insignificant as adding the studies with younger subjects, which indicates that the protein expression and enzyme activity of NEP in the cortex are affected by age. Therefore, the present meta-analysis suggests the need of further investigation of roles of NEP in AD pathogenesis and treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Atropa belladonna intoxication: a case report.

PubMed

Berdai, Mohamed Adnane; Labib, Smael; Chetouani, Khadija; Harandou, Mustapha

2012-01-01

Atropa belladonna is a poisonous plant also called deadly nightshade. Its roots, leaves and fruits contain alkaloids: atropine, hyocyamine and scopolamine. The risk of poisoning in children is important because of possible confusion with other berries. Atropa belladonna acute intoxication is a severe condition, it's should be considered in the presence of anti-cholinergic toxidrome, the differential diagnosis include other plants or psychoactive drugs containing atropine. The treatment is mainly symptomatic including gastrointestinal decontamination with activated charcoal. In severe cases, physostigmine can be used as an antidote. We report the case of 11 year old girl with Atropa belladonna poisoning which was administrated in a therapeutic purpose as a remedy to jaundice. The child presented essentially a central anti-cholinergic syndrome. She was admitted in the intensive care unit, the progression was favorable with symptomatic treatment.

A Rare Case Report of Immobility-Induced Hypercalcemia in an Infant.

PubMed

Vyas, Neha; Kaminski, Beth; MacLeish, Sarah

2016-04-01

Immobility-induced hypercalcemia is a rare cause of hypercalcemia in children, and to our knowledge it has never been reported in an infant. Infants and children are in a state of high bone turnover. Therefore, they are prone to the imbalance of osteoblastic and osteoclastic activity that occurs with prolonged immobilization, leading to hypercalcemia. Here we present the case of an infant with hypercalcemia who presented with fatigue, irritability, and failure to thrive after prolonged immobilization. Therapeutic interventions were conservative and included hydration and increased mobility leading to complete resolution. This case highlights the importance of including this rare entity in a differential diagnosis of hypercalcemia as well as screening postsurgical patients with prolonged immobility for hypercalcemia. Copyright © 2016 by the American Academy of Pediatrics.

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013

PubMed Central

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

Introduction During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Methods Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. Results A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Discussion Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases. PMID:27757248

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013.

PubMed

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Musto, Jennie; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases.

FIELD-DRIVEN APPROACHES TO SUBSURFACE CONTAMINANT TRANSPORT MODELING.

EPA Science Inventory

Observations from field sites provide a means for prioritizing research activities. In the case of petroleum releases, observations may include spiking of concentration distributions that may be related to water table fluctuation, co-location of contaminant plumes with geochemi...

Assessing dietary and lifestyle risk factors and their associations with disease comorbidities among patients with schizophrenia: A case-control study from Bahrain.

PubMed

Jahrami, Haitham Ali; Faris, Mo'ez Al-Islam Ezzat; Saif, Zahraa Qassim; Hammad, Laila Habib

2017-08-01

Acquired dietary habits and lifestyle behaviors of patients with schizophrenia may affect their life expectancy, disease complications and prognosis. The objectives of the current study were to assess the dietary habits and other lifestyle behaviors for Bahraini patients with schizophrenia, and to determine their associations with different medical comorbidities. A case-control study was conducted during the period of March to December 2016. A sample of 120 cases were recruited from the Psychiatric Hospital, Bahrain and age-sex-matched with 120 controls. Controls were recruited from primary health centres, and were free from serious mental illness. Dietary habits and lifestyle behaviors including smoking, alcohol intake and physical activity were assessed using a questionnaire. All medical records were reviewed retrospectively. Logistic regression analysis was used to identify dietary and lifestyle risk factors that are associated with one or more disease comorbidities. Cases had higher prevalence of smoking and alcohol intake, excessive dietary intake, and decreased physical activity (all P<0.05) compared with controls. Cases appeared to be at higher risk for developing chronic medical conditions such as obesity, type 2 diabetes, hypertension, cardiovascular disease, and musculoskeletal disorders. Cases were three times more likely to have up to three or more medical comorbidities compared with controls. Excessive dietary intake and decreased physical activity were identified as the main risk factors. Excessive caloric intake and decreased physical activity represent the main dietary and lifestyle risk factors associated with comorbidities among patients with schizophrenia in Bahrain. Copyright © 2017 Elsevier B.V. All rights reserved.

Progressing the state of knowledge on the human influence on hydrological droughts through case studies

NASA Astrophysics Data System (ADS)

Rangecroft, Sally; Van Loon, Anne; Bosman, Marianne; Wanders, Niko; Di Baldassarre, Giuliano; AghaKouchak, Amir

2017-04-01

Human activities can have a large influence on changes in the hydrological system and hydrological extremes, more than climate variability and climate change in some cases. However, there are currently only a limited number of studies which aim to quantify the human impact on hydrological droughts. Here we present a synthesis study of existing and new results that aims to summarize and quantify the anthropogenic impact on hydrological drought from case studies and observations. By combining a large number of case studies, we allow conclusions to be drawn about the effects of different human activities. This work suggests ways forward to increase our understanding on how human activities are influencing drought characteristics; invaluable information for water resource management and adaptation. During this project, the impact of different human activities (e.g. water abstraction, reservoir building, urbanisation, etc) on drought frequency, duration and deficit has been calculated in a consistent manner, allowing for an improved understanding to how they have impacted droughts. This consistent methodology is a necessary element for this comparative hydrology exercise, yet we use one which is flexible and applicable to different case study set ups and data availability. The methodology used here depends on available observation data, with three possible approaches: i) paired catchment approach; ii) upstream-downstream comparison; iii) observation modelling framework. The synthesised results of the existing and new case studies cover a number of human activities, hydro-climatic and socio-economic contexts. In particular, we remove the climate dependency in the results by using case studies from multiple climatic regions, including UK, Italy, US, Australia, Mexico and Chile. For groundwater abstraction, it is clear across all the relevant case studies that abstraction activities worsen drought events. This is especially prominent in the deficit volumes, with nearly all results showing at least a 50% increase in deficit compared to the natural situation due to the human activity. However, for the reservoir case studies we find mixed results with some catchments showing drought alleviation and others demonstrating an aggravation of drought. These results show us that the impact of reservoirs on droughts downstream is dependent on reservoir management and purpose. From the urbanised case studies we find urbanisation to be a more difficult human activity to quantify and analyse. Mixed results indicate possible conflicting processes occurring due to urbanisation, and the need for further case studies and discussions. This is the first step towards quantifying the human influence on drought on the global scale using catchment scale observation-based studies, which will provide important information for global scale modellers, water managers and drought policy makers.

West Nile Virus and Other Nationally Notifiable Arboviral Diseases - United States, 2016.

PubMed

Burakoff, Alexis; Lehman, Jennifer; Fischer, Marc; Staples, J Erin; Lindsey, Nicole P

2018-01-12

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the continental United States (1,2). Other arboviruses, including La Crosse, Powassan, Jamestown Canyon, St. Louis encephalitis, and eastern equine encephalitis viruses, cause sporadic cases of disease and occasional outbreaks. This report summarizes surveillance data reported to CDC for 2016 for nationally notifiable arboviruses. It excludes dengue, chikungunya, and Zika viruses, as these are primarily nondomestic viruses typically acquired through travel. Forty-seven states and the District of Columbia (DC) reported 2,240 cases of domestic arboviral disease, including 2,150 (96%) WNV disease cases. Of the WNV disease cases, 1,310 (61%) were classified as neuroinvasive disease (e.g., meningitis, encephalitis, acute flaccid paralysis), for a national incidence of 0.41 cases per 100,000 population. After WNV, the most frequently reported arboviruses were La Crosse (35 cases), Powassan (22), and Jamestown Canyon (15) viruses. Because arboviral diseases continue to cause serious illness, maintaining surveillance is important to direct prevention activities.

The Burden of Cholera in Uganda

PubMed Central

Bwire, Godfrey; Malimbo, Mugagga; Maskery, Brian; Kim, Young Eun; Mogasale, Vittal; Levin, Ann

2013-01-01

Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations prior to introducing the vaccine. PMID:24340106

Promoting active transportation as a partnership between urban planning and public health: the columbus healthy places program.

PubMed

Green, Christine Godward; Klein, Elizabeth G

2011-01-01

Active transportation has been considered as one method to address the American obesity epidemic. To address obesity prevention through built-environment change, the local public health department in Columbus, Ohio, established the Columbus Healthy Places (CHP) program to formally promote active transportation in numerous aspects of community design for the city. In this article, we present a case study of the CHP program and discuss the review of city development rezoning applications as a successful strategy to link public health to urban planning. Prior to the CHP review, 7% of development applications in Columbus included active transportation components; in 2009, 64% of development applications adopted active transportation components specifically recommended by the CHP review. Active transportation recommendations generally included adding bike racks, widening or adding sidewalks, and providing sidewalk connectivity. Recommendations and lessons learned from CHP are provided.

Promoting Active Transportation as a Partnership Between Urban Planning and Public Health: The Columbus Healthy Places Program

PubMed Central

Green, Christine Godward; Klein, Elizabeth G.

2011-01-01

Active transportation has been considered as one method to address the American obesity epidemic. To address obesity prevention through built-environment change, the local public health department in Columbus, Ohio, established the Columbus Healthy Places (CHP) program to formally promote active transportation in numerous aspects of community design for the city. In this article, we present a case study of the CHP program and discuss the review of city development rezoning applications as a successful strategy to link public health to urban planning. Prior to the CHP review, 7% of development applications in Columbus included active transportation components; in 2009, 64% of development applications adopted active transportation components specifically recommended by the CHP review. Active transportation recommendations generally included adding bike racks, widening or adding sidewalks, and providing sidewalk connectivity. Recommendations and lessons learned from CHP are provided. PMID:21563711

Physical activity in individuals with haemophilia and experience with recombinant factor VIII Fc fusion protein and recombinant factor IX Fc fusion protein for the treatment of active patients: a literature review and case reports.

PubMed

Wang, Michael; Álvarez-Román, María Teresa; Chowdary, Pratima; Quon, Doris V; Schafer, Kim

2016-10-01

The World Federation of Hemophilia and the National Hemophilia Foundation encourage people with haemophilia (PWH) to participate in routine physical activity. The benefits of physical activity for PWH include improvements in joint, bone, and muscle health. Accordingly, a number of studies suggest that levels of physical activity among PWH are similar to those of their healthy peers, especially among individuals who began prophylaxis at an early age (≤3 years). Importantly, several studies found either no increased risk or only a transient increase in risk of bleeding with more intensive physical activity compared with less intensive physical activity. Data on optimal prophylaxis regimens for PWH who participate in physical/sporting activities; however, remain sparse. Long-acting recombinant factor VIII Fc fusion protein (rFVIIIFc) and recombinant factor IX Fc fusion protein (rFIXFc) demonstrated efficacy for the prevention and treatment of bleeding episodes in Phase 3 clinical trials of participants with haemophilia A and B, respectively, with most individuals able to maintain or increase their physical activities. This manuscript reviews the current literature that describes physical activity in PWH. Additionally, case studies are presented to provide supplemental information to clinicians illustrating the use of rFVIIIFc and rFIXFc in physically active patients with haemophilia A and B, respectively. These case reports demonstrate that it is possible for patients to be physically active and maintain good control of their haemophilia with extended interval prophylactic dosing using rFVIIIFc or rFIXFc.

Physical activity in individuals with haemophilia and experience with recombinant factor VIII Fc fusion protein and recombinant factor IX Fc fusion protein for the treatment of active patients: a literature review and case reports

PubMed Central

Wang, Michael; Álvarez-Román, María Teresa; Chowdary, Pratima; Quon, Doris V.; Schafer, Kim

2016-01-01

The World Federation of Hemophilia and the National Hemophilia Foundation encourage people with haemophilia (PWH) to participate in routine physical activity. The benefits of physical activity for PWH include improvements in joint, bone, and muscle health. Accordingly, a number of studies suggest that levels of physical activity among PWH are similar to those of their healthy peers, especially among individuals who began prophylaxis at an early age (≤3 years). Importantly, several studies found either no increased risk or only a transient increase in risk of bleeding with more intensive physical activity compared with less intensive physical activity. Data on optimal prophylaxis regimens for PWH who participate in physical/sporting activities; however, remain sparse. Long-acting recombinant factor VIII Fc fusion protein (rFVIIIFc) and recombinant factor IX Fc fusion protein (rFIXFc) demonstrated efficacy for the prevention and treatment of bleeding episodes in Phase 3 clinical trials of participants with haemophilia A and B, respectively, with most individuals able to maintain or increase their physical activities. This manuscript reviews the current literature that describes physical activity in PWH. Additionally, case studies are presented to provide supplemental information to clinicians illustrating the use of rFVIIIFc and rFIXFc in physically active patients with haemophilia A and B, respectively. These case reports demonstrate that it is possible for patients to be physically active and maintain good control of their haemophilia with extended interval prophylactic dosing using rFVIIIFc or rFIXFc. PMID:27116081

Physical activity in middle-aged women and hip fracture risk: the UFO study.

PubMed

Englund, U; Nordström, P; Nilsson, J; Bucht, G; Björnstig, U; Hallmans, G; Svensson, O; Pettersson, U

2011-02-01

In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women. In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture. The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years. Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05-0.53 for walking and OR 0.19; 95% CI; 0.08-0.46, OR 0.17, 95% CI; 0.05-0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women. An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

75 FR 28475 - Airworthiness Directives; Airbus Model A330-200 and -300 Series Airplanes, and Model A340-300...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... unsafe condition as: In the door 2 area, the hat-racks are supplied with a basic wire harness which includes ``Oxygen Masks'' activation. In case of a monument installation, the respective non-used hat- rack... door 2 area, the hat-racks are supplied with a basic wire harness which includes ``Oxygen Masks...

Career Education: Learning with a Purpose. Secondary Guide-Vol. 1. Art, English, Industrial Arts, Physical Education, Science, Field Trips and Guest Speakers.

ERIC Educational Resources Information Center

Atkinson, Marilyn; And Others

The guide offers a compilation of teacher developed career education materials which may be integrated with secondary level curriculum and, in some cases, complete unit or course outlines are included. Suggested activities and ideas are presented for the following five subject areas and their related units: art, English (activity suggestions for…

Flashlight™ Cost Analysis Handbook: Modeling Resource Use in Teaching and Learning with Technology. Version 2.0

ERIC Educational Resources Information Center

Ehrmann, Stephen C.; Milam, John H., Jr.

2003-01-01

This volume describes for educators how to create simple models of the full costs of educational innovations, including the costs for time devoted to the activity, space needed for the activity, etc. Examples come from educational uses of technology in higher education in the United States and China. Real case studies illustrate the method in use:…

[PERIOPERATIVE ANALGESIA INFLUENCE ON MOTHER REHABILITATION PERIOD AFTER CESAREAN SECTION].

PubMed

Sedykh, S V

2015-01-01

Early breast-feeding is a standard of perinatal care currently. After cesarean section it can be possible in case of early mother activation (verticalization). Assessment of perioperative analgesia influence on activation timing was the aim of our research. We included 120 parturient women. It was proved, that local analgesia using in postoperative period promotes early mother verticaliration, and optimal breast-feeding starting.

Adult cases of mitochondrial DNA depletion due to TK2 defect: an expanding spectrum.

PubMed

Béhin, A; Jardel, C; Claeys, K G; Fagart, J; Louha, M; Romero, N B; Laforêt, P; Eymard, B; Lombès, A

2012-02-28

In this study we aim to demonstrate the occurrence of adult forms of TK2 mutations causing progressive mitochondrial myopathy with significant muscle mitochondrial DNA (mtDNA) depletion. Patients' investigations included serum creatine kinase, blood lactate, electromyographic, echocardiographic, and functional respiratory analyses as well as TK2 gene sequencing and TK2 activity measurement. Mitochondrial activities and mtDNA were analyzed in the patients' muscle biopsy. The 3 adult patients with TK2 mutations presented with slowly progressive myopathy compatible with a fairly normal life during decades. Apart from its much slower progression, these patients' phenotype closely resembled that of pediatric cases including early onset, absence of CNS symptoms, generalized muscle weakness predominating on axial and proximal muscles but affecting facial, ocular, and respiratory muscles, typical mitochondrial myopathy with a mosaic pattern of COX-negative and ragged-red fibers, combined mtDNA-dependent respiratory complexes deficiency and mtDNA depletion. In accordance with the disease's relatively slow progression, the residual mtDNA content was higher than that observed in pediatric cases. That difference was not explained by the type of the TK2 mutations or by the residual TK2 activity. TK2 mutations can cause mitochondrial myopathy with a slow progression. Comparison of patients with similar mutations but different disease progression might address potential mechanisms of mtDNA maintenance modulation.

What Is Case Management? A Scoping and Mapping Review

PubMed Central

Millington, Michael; Salvador-Carulla, Luis

2016-01-01

The description of case management in research and clinical practice is highly variable which impedes quality analysis, policy and planning. Case management makes a unique contribution towards the integration of health care, social services and other sector services and supports for people with complex health conditions. There are multiple components and variations of case management depending on the context and client population. This paper aims to scope and map case management in the literature to identify how case management is described in the literature for key complex health conditions (e.g., brain injury, diabetes, mental health, spinal cord injury). Following literature searches in multiple databases, grey literature and exclusion by health condition, community-based and adequate description, there were 661 potential papers for data extraction. Data from 79 papers (1988–2013) were analysed to the point of saturation (no new information) and mapped to the model, components and activities. The results included 22 definitions, five models, with 69 activities or tasks of case managers mapped to 17 key components (interventions). The results confirm the significant terminological variance in case management which produces role confusion, ambiguity and hinders comparability across different health conditions and contexts. There is an urgent need for an internationally agreed taxonomy for the coordination, navigation and management of care. PMID:28413368

Forecasting landslide activations by means of GA-SAKe. An example of application to three case studies in Calabria (Southern Italy)

NASA Astrophysics Data System (ADS)

Iovine, Giulio G. R.; De Rango, Alessio; Gariano, Stefano L.; Terranova, Oreste G.

2016-04-01

GA-SAKe - the Genetic-Algorithm based release of the hydrological model SAKe (Self Adaptive Kernel) - allows to forecast the timing of activation of landslides [1, 2], based on dates of landslide activations and rainfall series. The model can be applied to either single or set of similar landslides in a homogeneous context. Calibration of the model is performed through Genetic-Algorithm, and provides families of optimal, discretized solutions (kernels) that maximize the fitness function. The mobility functions are obtained through convolution of the optimal kernels with rain series. The shape of the kernel, including its base time, is related to magnitude of the landslide and hydro-geological complexity of the slope. Once validated, the model can be applied to estimate the timing of future landslide activations in the same study area, by employing measured or forecasted rainfall. GA-SAKe is here employed to analyse the historical activations of three rock slides in Calabria (Southern Italy), threatening villages and main infrastructures. In particular: 1) the Acri-Serra di Buda case, developed within a Sackung, involving weathered crystalline and metamorphic rocks; for this case study, 6 dates of activation are available; 2) the San Fili-Uncino case, developed in clay and conglomerate overlaying gneiss and biotitic schist; for this case study, 7 dates of activation are available [2]; 3) the San Benedetto Ullano-San Rocco case, developed in weathered metamorphic rocks; for this case study, 3 dates of activation are available [1, 3, 4, 5]. The obtained results are quite promising, given the high performance of the model against slope movements characterized by numerous historical activations. Obtained results, in terms of shape and base time of the kernels, are compared by taking into account types and sizes of the considered case studies, and involved rock types. References [1] Terranova O.G., Iaquinta P., Gariano S.L., Greco R. & Iovine G. (2013) In: Landslide Science and Practice, Margottini, Canuti, Sassa (Eds.), Vol. 3, pp.73-79. [2] Terranova O.G., Gariano S.L., Iaquinta P. & Iovine G.G.R. (2015). Geosci. Model Dev., 8, 1955-1978. [3] Iovine G., Iaquinta P. & Terranova O. (2009). In Anderssen, Braddock & Newham (Eds.), Proc. 18th World IMACS Congr. and MODSIM09 Int. Congr. on Modelling and Simulation, pp. 2686-2693. [4] Iovine G., Lollino P., Gariano S.L. & Terranova O.G. (2010). NHESS, 10, 2341-2354. [5] Capparelli G., Iaquinta P., Iovine G., Terranova O.G. & Versace P. (2012). Natural Hazards, 61(1), pp.247-256.

Tracking and responding to an outbreak of tuberculosis using MIRU-VNTR genotyping and whole genome sequencing as epidemiological tools.

PubMed

Black, Anne T; Hamblion, Esther L; Buttivant, Helen; Anderson, Sarah R; Stone, Madeline; Casali, Nicola; Drobniewski, Francis; Nwoguh, Francisca; Marshall, Ben G; Booth, Linda

2017-07-05

We describe an outbreak that contributed to a near doubling of the incidence of tuberculosis in Southampton, UK. We examine the importance of 24 locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) genotyping in its identification and management and the role of whole genome sequencing (WGS) in tracing the spread of the strain. Outbreak cases were defined as those diagnosed between January and December 2011 with indistinguishable 24 locus-MIRU-VNTR genotypes or, cases linked epidemiologically. A cluster questionnaire was administered by TB nurses to identify contacts and social settings. Overall, 25 patients fulfilled the case definition. No cases with this MIRU-VNTR genotype had been detected in the UK previously. Connections were found between all cases through household contacts or social venues including a football club, Internet cafe and barber's shop. Public health actions included extended contact tracing, venue screening and TB awareness-raising. The outbreak resulted in a high rate of transmission and high incidence of clinical disease among contacts. This outbreak illustrates the value of combining active case-finding with prospective MIRU-VNTR genotyping to identify settings to undertake public health action. In addition WGS revealed that the VNTR-defined cluster was a single outbreak and that active TB transmission not reactivation was responsible for this outbreak in non-UK born individuals. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Brucellosis as a neglected disease in a neglected population: a seroepidemiological study of migratory nomads in the Fars province of Iran.

PubMed

Honarvar, B; Moghadami, M; Lankarani, K B; Davarpanah, M A; Ataolahi, M; Farbod, A; Eskandari, E; Panahi, M; Ghorbani, A; Zahiri, Z; Tabrizi, R; Pourjafar, M; Heidari, S M M

2017-02-01

This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results. For the 536 participants, the female (316, 59%) to male (220, 41%) ratio was 1·4 and the participants' mean age was 32·4 ± 18·9 (range 1-96) years. Of all participants, 325 (60·6%) showed clinical symptoms; in symptomatic participants, the Rose Bengal plate test was positive in 33 (6·1%) cases, the SAT was positive in 18 (3·3%) cases, and the 2-ME test was positive in 30 (5·5%) cases. Positive SAT and 2-ME results were seen in 18 (3·3%) cases, but a negative SAT and a positive CWT were found in 36 (6·7%) cases. As a result, active brucellosis was detected in 54 cases, indicating a prevalence of 10% (95% confidence interval 8-12). In conclusion, we determined that brucellosis is a prevalent yet neglected disease in this nomadic population. Brucellosis control is not possible as long as these high-risk populations remain neglected.

Experimental Studies of Low-Pressure Turbine Flows and Flow Control

NASA Technical Reports Server (NTRS)

Volino, Ralph J.

2012-01-01

This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies.

Physics in Argentina: The Case of Nanoscience and Nanotecnology

NASA Astrophysics Data System (ADS)

Balseiro, Carlos A.

2013-03-01

Since the creation of the Ministry of Science and Technology in 2008 the science budget has increased and new programs have been launch. After a brief introduction describing general aspects, including the structure of the Ministry and the role of the National Research Council, I will focus on the case of nanoscience and nanotechnology in our country: The main actors and their activities, new programs and facilities, international cooperation and technology oriented projects.

Pseudomonas mendocina native valve infective endocarditis: a case report.

PubMed

Rapsinski, Glenn J; Makadia, Jina; Bhanot, Nitin; Min, Zaw

2016-10-04

Gram-negative microorganisms are uncommon pathogens responsible for infective endocarditis. Pseudomonas mendocina, a Gram-negative water-borne and soil-borne bacterium, was first reported to cause human infection in 1992. Since then, it has rarely been reported as a human pathogen in the literature. We describe the first case of native valve infective endocarditis due to P. mendocina in the USA. A 57-year-old white man presented with bilateral large leg ulcers, fever, and marked leukocytosis. His past medical history included gout and chronic alcohol use. P. mendocina was isolated from his blood cultures. A comprehensive review of P. mendocina infection in the literature was performed. A total of eight cases of P. mendocina infection were reported in the literature. More than two-thirds of the cases of P. mendocina septicemia were associated with native valve infective endocarditis. Thus, an echocardiogram was performed and demonstrated mitral valve endocarditis with mild mitral insufficiency. His leg wounds were debrided and were probably the source of P. mendocina bacteremia. Unlike Pseudomonas aeruginosa, P. mendocina is susceptible to third-generation cephalosporins. Our patient received a 6-week course of antimicrobial therapy with a favorable clinical outcome. Our reported case and literature review illuminates a rare bacterial cause of infective endocarditis secondary to P. mendocina pathogen. Native cardiac valves were affected in all reported cases of infective endocarditis, and a majority of affected heart valves were left-sided. The antibiotics active against P. mendocina are different from those that are active against P. aeruginosa, and they notably include third-generation cephalosporins. The outcome of all reported cases of P. mendocina was favorable and no mortality was described.

The organization of HIV and other health activities within urban religious congregations.

PubMed

Palar, Kartika; Mendel, Peter; Derose, Kathryn Pitkin

2013-10-01

Most religious congregations in the USA are involved with some type of social service activity, including health activities. However, relatively few formally engage with people with HIV, and many have reported barriers to introducing HIV prevention activities. We conducted a qualitative case study of HIV involvement among 14 urban congregations in Los Angeles County in 2007. In-depth qualitative interviews of lay leaders and clergy were analyzed for themes related to HIV and other health activities, including types of health issues addressed, types of activities conducted, how activities were organized, and the relationship between HIV and other health activities. We identified three primary models representing how congregations organized HIV and other health activities: (1) embedded (n = 7), where HIV activities were contained within other health activities; (2) parallel (n = 5), where HIV and other health activities occurred side by side and were organizationally distinct; (3) overlap (n = 2), where HIV and non-HIV health efforts were conducted by distinct groups, but shared some members and organization. We discuss implications of each model for initiating and sustaining HIV activities within urban congregations over time.

New drugs and regimens for treatment of TB

PubMed Central

Leibert, Eric; Rom, William N

2013-01-01

Tools for effective TB control have been available for years. Case finding, active medications, case management and directly observed therapy are the foundations for the management of TB. The current TB epidemic, centered in resource-limited settings is fueled by the HIV-1 epidemic. Lack of ability to diagnose and treat drug-resistant TB has led to development of more extensive patterns of resistance. Among the currently available drugs, there is reason to hope that rifamycins paired with fluoroquinolones will lead to shorter treatment regimens for drug-susceptible TB. As the result of novel public-private collaborations and investments of resources, new drugs are being developed. These include TMC207, already shown to have activity early in the treatment of multidrug-resistant TB and others that are likely to be active against persistor organisms, and have the prospect to dramatically shorten treatment courses for active and latent TB. Given that these drugs have novel mechanisms of action, combinations have the prospect to be highly active even against multidrug-resistant organisms. PMID:20586565

Intentional intra-arterial injection of midazolam in a patient with status epilepticus in the Intensive Care Unit

PubMed Central

Ali, Muhammad Asghar; Yahya, Muhammad

2017-01-01

Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered. We present a case where midazolam was intentionally injected intra-arterially to abort seizure activity in a patient with status epilepticus in the Intensive Care Unit. PMID:29033730

"Everyone should be able to choose how they get around": how Topeka, Kansas, passed a complete streets resolution.

PubMed

Dodson, Elizabeth A; Langston, Marvin; Cardick, Lauren C; Johnson, Nancy; Clayton, Paula; Brownson, Ross C

2014-02-20

Regular physical activity can help prevent chronic diseases, yet only half of US adults meet national physical activity guidelines. One barrier to physical activity is a lack of safe places to be active, such as bike paths and sidewalks. Complete Streets, streets designed to enable safe access for all users, can help provide safe places for activity. This community case study presents results from interviews with residents and policymakers of Topeka, Kansas, who played an integral role in the passage of a Complete Streets resolution in 2009. It describes community engagement processes used to include stakeholders, assess existing roads and sidewalks, and communicate with the public and decision-makers. Key informant interviews were conducted with city council members and members of Heartland Healthy Neighborhoods in Topeka to learn how they introduced a Complete Streets resolution and the steps they took to ensure its successful passage in the City Council. Interviews were recorded, transcribed, and analyzed by using focused-coding qualitative analysis. Results included lessons learned from the process of passing the Complete Streets resolution and advice from participants for other communities interested in creating Complete Streets in their communities. Lessons learned can apply to other communities pursuing Complete Streets. Examples include clearly defining Complete Streets; educating the public, advocates, and decision-makers about Complete Streets and how this program enhances a community; building a strong and diverse network of supporters; and using stories and examples from other communities with Complete Streets to build a convincing case.

“Everyone Should Be Able to Choose How They Get Around”: How Topeka, Kansas, Passed a Complete Streets Resolution

PubMed Central

Langston, Marvin; Cardick, Lauren C.; Johnson, Nancy; Clayton, Paula; Brownson, Ross C.

2014-01-01

Background Regular physical activity can help prevent chronic diseases, yet only half of US adults meet national physical activity guidelines. One barrier to physical activity is a lack of safe places to be active, such as bike paths and sidewalks. Complete Streets, streets designed to enable safe access for all users, can help provide safe places for activity. Community Context This community case study presents results from interviews with residents and policymakers of Topeka, Kansas, who played an integral role in the passage of a Complete Streets resolution in 2009. It describes community engagement processes used to include stakeholders, assess existing roads and sidewalks, and communicate with the public and decision-makers. Methods Key informant interviews were conducted with city council members and members of Heartland Healthy Neighborhoods in Topeka to learn how they introduced a Complete Streets resolution and the steps they took to ensure its successful passage in the City Council. Interviews were recorded, transcribed, and analyzed by using focused-coding qualitative analysis. Outcome Results included lessons learned from the process of passing the Complete Streets resolution and advice from participants for other communities interested in creating Complete Streets in their communities. Interpretation Lessons learned can apply to other communities pursuing Complete Streets. Examples include clearly defining Complete Streets; educating the public, advocates, and decision-makers about Complete Streets and how this program enhances a community; building a strong and diverse network of supporters; and using stories and examples from other communities with Complete Streets to build a convincing case. PMID:24556251

Calibration of the Total and Static Pressure Transducers in the DSTO Transonic Wind Tunnel

DTIC Science & Technology

2010-08-01

handled by the ActiveX control MSCOMM32.OCX which is not part of the Microsoft Windows operating system. It is, however, included as part of the...implemented new measures to register ActiveX controls in its Windows suite of operating systems, which has made the above file obsolete and it could no...longer be used if the Windows operating system were updated. If this is the case, then the new version of ActiveX control files can be installed using

Design Your Own Budget: A Case Study Based on the 1988 Budget.

ERIC Educational Resources Information Center

Williams, Paul

1992-01-01

Presents a classroom activity in which students work in groups to develop a national budget. Requires students to consider economic factors such as inflation, unemployment, and taxation. Includes charts and a national budget work sheet. (CFR)

Virtual patient care: an interprofessional education approach for physician assistant, physical therapy and occupational therapy students.

PubMed

Shoemaker, Michael J; Platko, Christina M; Cleghorn, Susan M; Booth, Andrew

2014-07-01

The purpose of this retrospective qualitative case report is to describe how a case-based, virtual patient interprofessional education (IPE) simulation activity was utilized to achieve physician assistant (PA), physical therapy (PT) and occupational therapy (OT) student IPE learning outcomes. Following completion of a virtual patient case, 30 PA, 46 PT and 24 OT students were required to develop a comprehensive, written treatment plan and respond to reflective questions. A qualitative analysis of the submitted written assignment was used to determine whether IPE learning objectives were met. Student responses revealed three themes that supported the learning objectives of the IPE experience: benefits of collaborative care, role clarification and relevance of the IPE experience for future practice. A case-based, IPE simulation activity for physician assistant and rehabilitation students using a computerized virtual patient software program effectively facilitated achievement of the IPE learning objectives, including development of greater student awareness of other professions and ways in which collaborative patient care can be provided.

[Morphological and functional characteristics of lymphocytes of mothers of children with Down syndrome].

PubMed

Novikov, V D; Valova, T A; Iasakova, N T; Belan, I B

2000-01-01

Nuclear chromatine of peripheral blood lymphocytes was studied in 13 women with children suffering from Down's syndrome using optic structural computer analysis. In 12 cases significant increase of nuclear roundness coefficient was determined. Deformation coefficient was determined for heterochromatine structures in 8 cases. Integral optic density of nuclear chromatine was significantly decreased in 12 women. This indicates the reduction of felgen-positive material due to deficiency of its compact fraction (in 11 cases). The activity of lymphocyte cytoplasmic lactate, alpha-glycerophosphate and succinate dehydrogenases (SDG) was studied morphocytochemically in 5 women who had children with the disease. High activity of mitochondrial SDG was determined in all cases which probably indicates disorders in lymphocyte energy state. This is one of the reasons for retention of risk pregnancy. Further research in this area may serve as a base for complete cytoanalysis in order to distinguish risk groups among women including primagravida for consequent determination of embryonal karyotype.

3-D Hybrid Kinetic Modeling of the Interaction Between the Solar Wind and Lunar-like Exospheric Pickup Ions in Case of Oblique/ Quasi-Parallel/Parallel Upstream Magnetic Field

NASA Technical Reports Server (NTRS)

Lipatov, A. S.; Farrell, W. M.; Cooper, J. F.; Sittler, E. C., Jr.; Hartle, R. E.

2015-01-01

The interactions between the solar wind and Moon-sized objects are determined by a set of the solar wind parameters and plasma environment of the space objects. The orientation of upstream magnetic field is one of the key factors which determines the formation and structure of bow shock wave/Mach cone or Alfven wing near the obstacle. The study of effects of the direction of the upstream magnetic field on lunar-like plasma environment is the main subject of our investigation in this paper. Photoionization, electron-impact ionization and charge exchange are included in our hybrid model. The computational model includes the self-consistent dynamics of the light (hydrogen (+), helium (+)) and heavy (sodium (+)) pickup ions. The lunar interior is considered as a weakly conducting body. Our previous 2013 lunar work, as reported in this journal, found formation of a triple structure of the Mach cone near the Moon in the case of perpendicular upstream magnetic field. Further advances in modeling now reveal the presence of strong wave activity in the upstream solar wind and plasma wake in the cases of quasiparallel and parallel upstream magnetic fields. However, little wave activity is found for the opposite case with a perpendicular upstream magnetic field. The modeling does not show a formation of the Mach cone in the case of theta(Sub B,U) approximately equal to 0 degrees.

MANAGING UNCERTAINTIES ASSOCIATED WITH RADIOACTIVE WASTE DISPOSAL: TASK GROUP 4 OF THE IAEA PRISM PROJECT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seitz, R.

2011-03-02

It is widely recognized that the results of safety assessment calculations provide an important contribution to the safety arguments for a disposal facility, but cannot in themselves adequately demonstrate the safety of the disposal system. The safety assessment and a broader range of arguments and activities need to be considered holistically to justify radioactive waste disposal at any particular site. Many programs are therefore moving towards the production of what has become known as a Safety Case, which includes all of the different activities that are conducted to demonstrate the safety of a disposal concept. Recognizing the growing interest inmore » the concept of a Safety Case, the International Atomic Energy Agency (IAEA) is undertaking an intercomparison and harmonization project called PRISM (Practical Illustration and use of the Safety Case Concept in the Management of Near-surface Disposal). The PRISM project is organized into four Task Groups that address key aspects of the Safety Case concept: Task Group 1 - Understanding the Safety Case; Task Group 2 - Disposal facility design; Task Group 3 - Managing waste acceptance; and Task Group 4 - Managing uncertainty. This paper addresses the work of Task Group 4, which is investigating approaches for managing the uncertainties associated with near-surface disposal of radioactive waste and their consideration in the context of the Safety Case. Emphasis is placed on identifying a wide variety of approaches that can and have been used to manage different types of uncertainties, especially non-quantitative approaches that have not received as much attention in previous IAEA projects. This paper includes discussions of the current results of work on the task on managing uncertainty, including: the different circumstances being considered, the sources/types of uncertainties being addressed and some initial proposals for approaches that can be used to manage different types of uncertainties.« less

Static and Dynamic Aeroelastic Tailoring With Variable Camber Control

NASA Technical Reports Server (NTRS)

Stanford, Bret K.

2016-01-01

This paper examines the use of a Variable Camber Continuous Trailing Edge Flap (VCCTEF) system for aeroservoelastic optimization of a transport wingbox. The quasisteady and unsteady motions of the flap system are utilized as design variables, along with patch-level structural variables, towards minimizing wingbox weight via maneuver load alleviation and active flutter suppression. The resulting system is, in general, very successful at removing structural weight in a feasible manner. Limitations to this success are imposed by including load cases where the VCCTEF system is not active (open-loop) in the optimization process, and also by including actuator operating cost constraints.

Neisseria meningitidis and Streptococcus pneumoniae as leading causes of pediatric bacterial meningitis in nine Mexican hospitals following 3 years of active surveillance

PubMed Central

Chacon-Cruz, Enrique; Martinez-Longoria, Cesar Adrian; Llausas-Magana, Eduardo; Luevanos-Velazquez, Antonio; Vazquez-Narvaez, Jorge Alejandro; Beltran, Sandra; Limon-Rojas, Ana Elena; Urtiz-Jeronimo, Fernando; Castaneda-Narvaez, Jose Luis; Otero-Mendoza, Francisco; Aguilar-Del Real, Fernando; Rodriguez-Chagoyan, Jesus; Rivas-Landeros, Rosa Maria; Volker-Soberanes, Maria Luisa; Hinojosa-Robles, Rosa Maria; Arzate-Barbosa, Patricia; Aviles-Benitez, Laura Karina; Elenes-Zamora, Fernando Ivan; Becka, Chandra M.; Ruttimann, Ricardo

2016-01-01

Objectives: Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals. Methods: From January 2010 to February 2013, we conducted a three years of active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspected case, and microbiological studies confirmed/ruled out all potentially bacterial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diagnostic tests), and both pneumococcal serotyping and meningococcal serogrouping by using standard methods. Results: Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup C was predominant. Streptococcus pneumoniae followed Neisseria meningitides, but was uniformly distributed throughout the country. Serotype 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants). Conclusions: Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures – negative but presumably bacterial meningitis cases. PMID:27551428

Three cases of pulmonary thromboembolism and extensive prayer (invocation) activity as a new possible risk factor.

PubMed

Eom, Minseob; Lim, Sung-Chul; Shin Kim, Youn

2009-06-01

Pulmonary thromboembolism (PTE) is caused when thrombi are detached from the deep vein of the lower leg. In the field of forensic medicine, it is a well-known cause of sudden death. It has been reported that risk factors for PTE include surgery, trauma, extensive bed rest, and malignant neoplasm, among others; in addition, long-haul air travel is associated with a slightly increased risk for PTE, though such cases are rare. Recently, PTE had been reported in association with different conditions, such as ethrombosis, seated immobility thromboembolism, driving for long periods, and after traveling. The authors performed autopsies on 3 patients who died suddenly after 3 to 4 days of prayer in a prayer center or hermitage. It was confirmed that all deaths were caused by thrombi that had developed in the deep vein, obstructing the pulmonary artery. It was concluded that during repeated praying activities over an extensive time period, the kneeling position might have caused PTE. It is also possible that dehydration due to fasting may affect the formation of thrombi. According to the literature, PTE cases developed in association with prayer activity and position have not been reported to date, and so PTE caused by prayer activity is thought to be a new type of PTE developed in association with a certain life style. Therefore, people should be advised that a position involving a long period of immobilization, including long periods of prayer, could raise the risk of PTE. In addition, social policies to prevent the development of this kind of PTE are needed.

Challenges of Implementing a Communication-and-Resolution Program Where Multiple Organizations Must Cooperate.

PubMed

Mello, Michelle M; Armstrong, Sarah J; Greenberg, Yelena; McCotter, Patricia I; Gallagher, Thomas H

2016-12-01

To implement a communication-and-resolution program (CRP) in a setting in which liability insurers and health care facilities must collaborate to resolve incidents involving a facility and separately insured clinicians. Six hospitals and clinics and a liability insurer in Washington State. Sites designed and implemented CRPs and contributed information about cases and operational challenges over 20 months. Data were qualitatively analyzed. Data from interviews with personnel responsible for CRP implementation were triangulated with data on program cases collected by sites and notes recorded during meetings with sites and among project team members. Sites experienced small victories in resolving particular cases and streamlining some working relationships, but they were unable to successfully implement a collaborative CRP. Barriers included the insurer's distance from the point of care, passive rather than active support from top leaders, coordinating across departments and organizations, workload, nonparticipation by some physicians, and overcoming distrust. Operating CRPs where multiple organizations must collaborate can be highly challenging. Success likely requires several preconditions, including preexisting trust among organizations, active leadership engagement, physicians' commitment to participate, mechanisms for quickly transmitting information to insurers, tolerance for missteps, and clear protocols for joint investigations and resolutions. © Health Research and Educational Trust.

Enhancing communication by using the Coordinated Care Classification System.

PubMed

O'Neal, P V; Kozeny, D K; Garland, P P; Gaunt, S M; Gordon, S C

1998-07-01

Because of the changes in our healthcare system, some clinical nurse specialists (CNSs) are having to expand their traditional roles of clinician, educator, consultant, leader, and researcher to include case management activities. The CNSs at Promina Gwinnett Health System in Lawrenceville, Georgia, have combined CNS and case manager activities and have adopted the title "CNS/Outcomes Coordinator." The CNS/Outcomes Coordinator is responsible for coordinating patient care, promoting team collaboration, and facilitating communication. To inform the healthcare team of the CNS/Outcomes Coordinator's patient responsibilities, the CNS/Outcomes Coordinators developed a Coordinated Care Classification System. This article describes how coordinating patient care, promoting team collaboration, and facilitating communication can be enhanced by the use of a classification system.

Tectonically Induced Anomalies Without Large Earthquake Occurrences

NASA Astrophysics Data System (ADS)

Shi, Zheming; Wang, Guangcai; Liu, Chenglong; Che, Yongtai

2017-06-01

In this study, we documented a case involving large-scale macroscopic anomalies in the Xichang area, southwestern Sichuan Province, China, from May to June of 2002, after which no major earthquake occurred. During our field survey in 2002, we found that the timing of the high-frequency occurrence of groundwater anomalies was in good agreement with those of animal anomalies. Spatially, the groundwater and animal anomalies were distributed along the Anninghe-Zemuhe fault zone. Furthermore, the groundwater level was elevated in the northwest part of the Zemuhe fault and depressed in the southeast part of the Zemuhe fault zone, with a border somewhere between Puge and Ningnan Counties. Combined with microscopic groundwater, geodetic and seismic activity data, we infer that the anomalies in the Xichang area were the result of increasing tectonic activity in the Sichuan-Yunnan block. In addition, groundwater data may be used as a good indicator of tectonic activity. This case tells us that there is no direct relationship between an earthquake and these anomalies. In most cases, the vast majority of the anomalies, including microscopic and macroscopic anomalies, are caused by tectonic activity. That is, these anomalies could occur under the effects of tectonic activity, but they do not necessarily relate to the occurrence of earthquakes.

Stellar Obliquity and Magnetic Activity of Planet-hosting Stars and Eclipsing Binaries Based on Transit Chord Correlation

NASA Astrophysics Data System (ADS)

Dai, Fei; Winn, Joshua N.; Berta-Thompson, Zachory; Sanchis-Ojeda, Roberto; Albrecht, Simon

2018-04-01

The light curve of an eclipsing system shows anomalies whenever the eclipsing body passes in front of active regions on the eclipsed star. In some cases, the pattern of anomalies can be used to determine the obliquity Ψ of the eclipsed star. Here we present a method for detecting and analyzing these patterns, based on a statistical test for correlations between the anomalies observed in a sequence of eclipses. Compared to previous methods, ours makes fewer assumptions and is easier to automate. We apply it to a sample of 64 stars with transiting planets and 24 eclipsing binaries for which precise space-based data are available, and for which there was either some indication of flux anomalies or a previously reported obliquity measurement. We were able to determine obliquities for 10 stars with hot Jupiters. In particular we found Ψ ≲ 10° for Kepler-45, which is only the second M dwarf with a measured obliquity. The other eight cases are G and K stars with low obliquities. Among the eclipsing binaries, we were able to determine obliquities in eight cases, all of which are consistent with zero. Our results also reveal some common patterns of stellar activity for magnetically active G and K stars, including persistently active longitudes.

Study of the Anti-Staphylococcal Potential of Honeys Produced in Northern Poland.

PubMed

Grecka, Katarzyna; Kuś, Piotr M; Worobo, Randy W; Szweda, Piotr

2018-01-28

The antimicrobial activity of 144 samples of honeys including 95 products from apiaries located in Northern Poland was evaluated. The antibacterial activity of those natural products, their thermal stability, and activity in the presence of catalase was investigated by microdilution assays in titration plates. The MTT assay was performed for the determination of anti-biofilm activity. Spectrophotometric assays were used for the determination of antioxidant potential, total phenolic content, and ability to generate hydrogen peroxide. Some of the investigated honeys exhibited surprisingly high antimicrobial, especially anti-staphylococcal, potential, with Minimal Inhibitory Concentration (MIC) values of only 1.56% ( v/v ). Much higher resistance was observed in the case of staphylococci growing as biofilms. Lower concentrations of the product, up to 12.5% ( v/v ) stimulated its growth and effective eradication of biofilm required concentration of at least 25% ( v/v ). Hydrogen peroxide has been identified as a crucial contributor to the antimicrobial activity of honeys supplied by Polish beekeepers. However, some of the results suggest that phytochemicals, especially polyphenols, play an important role depending on botanical source (both positive, e.g., in the case of buckwheat honeys as well as negative, e.g., in the case of some rapeseed honeys) in their antimicrobial potential.

Air travel by individuals with active tuberculosis: reporting patterns and epidemiologic characteristics, Canada 2006-2008.

PubMed

Scholten, Derek; Saunders, Andrea; Dawson, Kathryn; Wong, Thomas; Ellis, Edward

2010-03-01

Investigations related to tuberculosis (TB) cases on airline flights have received increased attention in recent years. In Canada, reports of air travel by individuals with active TB are sent to the Public Health Agency of Canada (PHAC) for public health risk assessment and contact follow-up. A descriptive analysis was conducted to examine reporting patterns over time. Reports of air travel by individuals with active TB received by PHAC between January 2006 and December 2008 were reviewed. Descriptive analyses were performed on variables related to reporting patterns, characteristics and actions taken. The number of reports increased each year with 18, 35 and 51 reports received in 2006, 2007 and 2008, respectively. Of the 104 total cases, most were male (63%) and born outside of Canada (87%). Ninety-eight cases (97%) met the criteria for infectiousness and a contact investigation was initiated for 136 flights. Reports of air travel by individuals with active TB have been increasing annually in Canada in recent years. Outcomes of the subsequent contact investigations, including passenger follow-up results and evidence of TB transmission, is necessary to further evaluate the effectiveness of the Canadian guidelines.

[Application of anterior percutaneous screw fixation in treatment of odontoid process fractures in aged people].

PubMed

Luo, Peng; Dou, Hai-cheng; Ni, Wen-fei; Huang, Qi-shan; Wang, Xiang-yang; Xu, Hua-zi; Chi, Yong-long

2011-03-01

To explore the efficacy of anterior percutaneous screw fixation in the treatment of odontoid process fractures in aged people. From February 2001 to April 2009, 15 elderly patients with odontoid fracture were treated with anterior percutaneous screw fixation,including 13 males and 2 females; the average age was 69.3 years (ranged, 60 to 86 years). According to Anderson classification, there were 10 patients with type II fractures (type II A in 7 cases, type II B in 3 cases, based on Eysel and Roosen classification), 4 patients with shallow type III fractures, 1 patient with deep type III fractures. Thirteen patients were fresh fractures, 2 patients were obsolete fractures. All patients had varying degrees of neck or shoulder pain, and limit activity of neck. There were 4 patients with neural symptoms including 2 grade D and 2 grade C according to Frankel classification. All the patients were followed up and were assessed by radiology. Clinical examination included neck activity, neurological function and the degree of neck pain. Radiology examinations including anteroposterior, lateral, open mouth position and flexion-extension radiographs of cervical vertebra were performed. After surgery, all patients were followed up,and the duration ranged from 6 to 60 months (averaged 31.3 months). Two patients died of other diseases during the follow-up period (18 and 22 months after surgery respectively). All patients got satisfactory results, and all screws were in good position. As the screw was too long, esophagus was compressed by screw tail in one case. One case showed fibrous union, 12 cases had achieved solid bony union, 2 cases showed nonunion without clinical symptoms. The rotation of neck in 3 cases was mildly limited,the neck function of the remaining patients were normal. Four patients with symptoms nerve injuries improved after operation (Frankel E in 3 cases, Frankel D in 1 case). The symptom of neck pain had a significant improvement after surgery (P < 0.001). The VAS score decreased from preoperative (6.07 +/- 1.44) (4 to 8 scores),to postoperative (1.13 +/- 0.92) (0 to 3 scores). And there were no severe postoperative complications. The anterior percutaneous screw fixation is less traumatic than conventional approaches for aged people in dealing with odontoid process fractures. Most patients will achieve satisfactory clinical results, as long as the general conditions of them are comprehensively assess. However, this procedure should not be used in patients with comminuted odontoid fractures or severe osteoporosis.

Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards

PubMed Central

Bocian, Ewa; Grzybowska, Wanda; Tyski, Stefan

2014-01-01

Background The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields. Material/Methods This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers’ description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012. Results Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards. Conclusions Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty). PMID:24755666

Molecular analyses of 6 different types of uterine smooth muscle tumors: Emphasis in atypical leiomyoma.

PubMed

Zhang, Qing; Ubago, Julianne; Li, Li; Guo, Haiyang; Liu, Yugang; Qiang, Wenan; Kim, J Julie; Kong, Beihua; Wei, Jian-Jun

2014-10-15

Uterine smooth muscle tumors (USMTs) constitute a group of histologic, genetic, and clinical heterogeneous tumors that include at least 6 major histologically defined tumor types: leiomyoma (ULM), mitotically active leiomyoma (MALM), cellular leiomyoma (CLM), atypical leiomyoma (ALM), uncertain malignant potential (STUMP), and leiomyosarcoma (LMS). Apart from ULM and LMS, the nature of these variants is not well defined. A total of 167 cases of different USMT variants were collected, reviewed, and diagnostically confirmed based on the World Health Organization and Stanford schemes. These included 38 cases of LMS, 18 cases of STUMP, 42 cases of ALM, 22 cases of CLM, 7 cases of MALM, and 40 cases of ULM. Molecular analysis included selected microRNAs (miRNAs), oncogenes, and tumor suppressors that are highly relevant to USMT. Overall, 49% (17/35) of LMS cases and 7% (1/14) of STUMP cases died due to their USMT, but no deaths were attributed to ALM. miRNA profiling revealed that ALM and LMS shared similar miRNA signatures. P53 mutations and PTEN deletions were significantly higher in LMS, ALM, and STUMP compared with other USMT variants (P < .01). In contrast, MED12 mutations were extremely common in ULM and MALM (> 74%) but were significantly less common (< 15%) in CLM, ALM, STUMP, and LMS (P < .01). Six types of USMT have different gene mutation fingerprints. ALM shares many molecular alterations with LMS. Our findings suggest that ALM may be a precursor lesion of LMS or have similar genetic changes during its early stage. © 2014 American Cancer Society.

Engineered Fc variant antibodies with enhanced ability to recruit complement and mediate effector functions

PubMed Central

Moore, Gregory L; Chen, Hsing; Karki, Sher

2010-01-01

Engineering the antibody Fc region to enhance the cytotoxic activity of therapeutic antibodies is currently an active area of investigation. The contribution of complement to the mechanism of action of some antibodies that target cancers and pathogens makes a compelling case for its optimization. Here we describe the generation of a series of Fc variants with enhanced ability to recruit complement. Variants enhanced the cytotoxic potency of an anti-CD20 antibody up to 23-fold against tumor cells in CDC assays, and demonstrated a correlated increase in C1q binding affinity. Complementenhancing substitutions combined additively, and in one case synergistically, with substitutions previously engineered for improved binding to Fc gamma receptors. The engineered combinations provided a range of effector function activities, including simultaneously enhanced CDC, ADCC, and phagocytosis. Variants were also effective at boosting the effector function of antibodies targeting the antigens CD40 and CD19, in the former case enhancing CDC over 600-fold, and in the latter case imparting complement-mediated activity onto an IgG1 antibody that was otherwise incapable of it. This work expands the toolkit of modifications for generating monoclonal antibodies with improved therapeutic potential and enables the exploration of optimized synergy between Fc gamma receptors and complement pathways for the destruction of tumors and infectious pathogens. PMID:20150767

Toward a Generation Free of Tuberculosis: TB Disease and Infection in Individuals of College Age in the United States

ERIC Educational Resources Information Center

Shah, N. S.; Flood-Bryzman, A.; Jeffries, C.; Scott, J.

2018-01-01

Objectives: To assess the magnitude of active TB disease and latent TB infection (LTBI) in young adults of college age. Participants: Individuals who were aged 18-24 years in 2011 were used as a proxy for college students. Methods: Active TB cases reported to the 2011 US National TB Surveillance System (NTSS) were included. LTBI prevalence was…

Pupils' Perceptions of and Experiences in Team Invasion Games: A Case Study of a Scottish Secondary School and Its Three Feeder Primary Schools

ERIC Educational Resources Information Center

Gray, Shirley; Sproule, John; Wang, C. K. John

2008-01-01

It has been claimed that young children in schools in Scotland cannot relate to the activities that are taught in the more "traditional" PE curriculum, activities that predominately include team invasion games (TIG) such as basketball, soccer and hockey (Scottish Executive, 2004). However, one of the issues with this claim is that it…

Non-Governmental Organization and Prison Support Services in Nigeria: A Case Study of the Justice, Development and Peace Commission.

ERIC Educational Resources Information Center

Imhabekhai, Clement I.

2002-01-01

Examines government activities in Nigeria in relation to prison support services, including health, counseling, training, legal aid, and library services. Recommends public agency networking with nongovernmental organizations to provide needed services. (JOW)

Uncertainties in biological responses that influence hazard and risk approaches to the regulation of endocrine active substances

EPA Science Inventory

Endocrine Disrupting Substances (EDSs) may have certain biological effects including delayed effects, multigenerational effects, and non-monotonic dose response relationships (NMDRs) that require careful consideration when determining environmental hazards. The case studies evalu...

42 CFR 440.169 - Case management services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... access to needed medical, social, educational, and other services, in accordance with § 441.18 of this... for any medical, educational, social, or other services. These assessment activities include the... documentation. (iii) Gathering information from other sources, such as family members, medical providers, social...

Marketing of Group Counseling Services.

ERIC Educational Resources Information Center

Wilson, F. Robert; And Others

1987-01-01

Provides social marketing guidelines for attracting members of appropriate target groups and encouraging their participation in group activities. Includes examination of the personal and social framework of the group counselor, elements of social marketing theory, a case study illustrating difficulties encountered by novice group counselors in…

7 CFR 275.12 - Review of active cases.

Code of Federal Regulations, 2010 CFR

2010-01-01

... completed through casefile review and collateral contact. The field investigation will include interviews.... (1) Personal interviews. Personal interviews shall be conducted in a manner that respects the rights, privacy, and dignity of the participants. Prior to conducting the personal interview, the reviewer shall...

SETAC: Uncertainties in biological responses that influence hazard or risk approaches to the regulation of endocrine active substances

EPA Science Inventory

Endocrine Disrupting Substances (EDSs) may have certain biological effects including delayed effects, multigenerational effects, and non-monotonic dose response relationships (NMDRs) that require careful consideration when determining environmental hazards. The case studies evalu...

42 CFR 440.169 - Case management services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... access to needed medical, social, educational, and other services, in accordance with § 441.18 of this... for any medical, educational, social, or other services. These assessment activities include the... documentation. (iii) Gathering information from other sources, such as family members, medical providers, social...

Implementation and evaluation of a community-based interprofessional learning activity.

PubMed

Luebbers, Ellen L; Dolansky, Mary A; Vehovec, Anton; Petty, Gayle

2017-01-01

Implementation of large-scale, meaningful interprofessional learning activities for pre-licensure students has significant barriers and requires novel approaches to ensure success. To accomplish this goal, faculty at Case Western Reserve University, Ohio, USA, used the Ottawa Model of Research Use (OMRU) framework to create, improve, and sustain a community-based interprofessional learning activity for large numbers of medical students (N = 177) and nursing students (N = 154). The model guided the process and included identification of context-specific barriers and facilitators, continual monitoring and improvement using data, and evaluation of student learning outcomes as well as programme outcomes. First year Case Western Reserve University medical students and undergraduate nursing students participated in team-structured prevention screening clinics in the Cleveland Metropolitan Public School District. Identification of barriers and facilitators assisted with overcoming logistic and scheduling issues, large class size, differing ages and skill levels of students and creating sustainability. Continual monitoring led to three distinct phases of improvement and resulted in the creation of an authentic team structure, role clarification, and relevance for students. Evaluation of student learning included both qualitative and quantitative methods, resulting in statistically significant findings and qualitative themes of learner outcomes. The OMRU implementation model provided a useful framework for successful implementation resulting in a sustainable interprofessional learning activity.

Tinea genitalis: a new entity of sexually transmitted infection? Case series and review of the literature

PubMed Central

Luchsinger, Isabelle; Bosshard, Philipp Peter; Kasper, Romano Silvio; Reinhardt, Dominic; Lautenschlager, Stephan

2015-01-01

Objective Investigation on recent cases of tinea genitalis after travelling to South East Asia. Methods Patients with tinea in the genital region, which emerged after sex in South East Asia, underwent further assessment including microscopy, cultures and DNA analyses. Results The case series includes seven patients. In six patients, Trichophyton interdigitale (former Trichophyton mentagrophytes) was detected. Three patients suffered from a severe inflammatory reaction of the soft tissue and two of them needed hospitalisation due to severe pain. In four patients, cicatrising healing was noticed. Five patients were declared incapacitated for work. Conclusions Sexual activity should be considered as a potentially important and previously underappreciated means of transmission of T. interdigitale. To avoid irreversible scarring alopecia, prompt initiation of antifungal treatment is essential and adequate isolation and identification of the pathogen is mandatory. PMID:26071391

Clinicopathological study of severe chronic active Epstein-Barr virus infection that developed in association with lymphoproliferative disorder and/or hemophagocytic syndrome.

PubMed

Ohshima, K; Suzumiya, J; Sugihara, M; Nagafuchi, S; Ohga, S; Kikuchi, M

1998-12-01

Chronic active Epstein-Barr virus (CAEBV) infection has been previously reported to be sometimes associated with an aggressive clinical course. However, the role of EBV in the CAEBV is not well clarified. A retrospective study was performed on nine adult and five child patients (eight males and six females). Histologically, at first admission, the presence of neoplastic lesions could not be confirmed. The lymph nodes in half of all cases revealed paracortical hyperplasia with transformed lymphocytes (hyperplastic type). Half of the cases showed non-suppurative necrosis and an increased number of histiocytes with phagocytosis (histiocytic type). Activated histiocytes with lymphokine positivity were frequently detected in the histiocytic type. In the phenotypical study, 10 of the examined 11 cases showed increased numbers of natural killer (NK) cells and/or CD8-positive T lymphocytes. In situ hybridization (ISH) showed EBV-infected lymphoid cells, but the number of EBV-infected cells varied. Double-labeling immunochemistry/ISH demonstrated EBV-infected T cells, including NK cells, but not B cells. In addition, three cases showed a monoclonal dissemination of EBV terminal repetitive sequence (TR), and two cases showed oligoclonal dissemination. From those findings, monoclonal, oligoclonal and polyclonal populations of EBV-infected T or NK cells were considered to be present in CAEBV states. During the clinical course, 12 of the 14 cases died within 5 years. Six cases died from EBV-associated hematopoietic tumors (histiocytic tumor, T cell lymphoma, B cell lymphoma, plasmacytoma, and NK cell leukemia); one from non-EBV-associated acute myelogenous leukemia, and five due to hemophagocytic syndrome. The examined EBV-associated hematopoietic tumors showed monoclonal EBV terminal repetitive sequences. There is a possibility that the monoclonal dissemination of EBV-infected cells develops from oligoclonal or polyclonal EBV-infected cells. And active histiocytes with lymphokine positivity were frequently detected in the cases with histologically histiocytic type. These findings seem to be related with the causes of death due to hemophagocytic syndrome.

Preliminary report: outbreak of Legionnaires disease in a hotel in Calp, Spain, update on 22 February 2012.

PubMed

Vanaclocha, H; Guiral, S; Morera, V; Calatayud, M A; Castellanos, M; Moya, V; Jerez, G; Gonzalez, F

2012-02-23

Research is ongoing on eighteen cases of Legionellosis, including four deaths, identified among tourists and employees in a hotel in Calp, Spain. Cases occurred during a period of two months, indicating the possibility of a point-source transmission at the hotel. An environmental investigation identified several positive samples in the hotel, which as a precautionary measure, was closed until requested improvements were made. Surveillance measures currently remain active.

The Case of the Great Space Exploration: An Educator Guide with Activities in Mathematics, Science, and Technology. The NASA SCI Files. EG-2004-09-12-LARC

ERIC Educational Resources Information Center

Ricles, Shannon; Jaramillo, Becky; Fargo, Michelle

2004-01-01

In this companion to the "NASA SCI Files" episode "The Case of the Great Space Exploration," the tree house detectives learn about NASA's new vision for exploring space. In four segments aimed at grades 3-5, students learn about a variety of aspects of space exploration. Each segment of the guide includes an overview, a set of objectives,…

[Invasive meningococcal disease--management and treatment].

PubMed

Garlicki, Aleksander; Bociqga-Jasik, Monika; Kalinowska-Nowak, Anna

2008-01-01

Invasive meningococcal disease is life threatening disease and in fulminant cases mortality rate may be as high as 70%. Rapid introduction of treatment and monitoring on intensive care unit is crucial for prognosis. The understanding of patomechanism responsible for sepsis development allow to introduce supportive treatment including glicocorticoids and recombinant human activated protein C. Very important is suitable prophylaxis among risk groups with, additional considering vaccination in the case of infection caused by A, C, Y, W-135 serogroups.

Rich context information for just-in-time adaptive intervention promoting physical activity.

PubMed

Cruciani, F; Nugent, C; Cleland, I; McCullagh, P

2017-07-01

Sedentary lifestyle and inadequate levels of physical activity represent two serious health risk factors. Nevertheless, within developed countries, 60% of people aged over 60 are deemed to be sedentary. Consequently, interest in behavior change to promote physical activity is increasing. In particular, the role of emerging mobile apps to facilitate behavior change has shown promising results. Smart technologies can help in providing rich context information including an objective assessment of the level of physical activity and information on the emotional and physiological state of the person. Collectively, this can be used to develop innovative persuasive solutions for adaptive behavior change. Such solutions offer potential in reducing levels of sedentary behavior. This work presents a study exploring new ways of employing smart technologies to facilitate behavior change. It is achieved by means of (i) developing a knowledge base on sedentary behaviors and recommended physical activity guidelines, and (ii) a context model able to combine information on physical activity, location, and a user's diary to develop a context-aware virtual coach with the ability to select the most appropriate behavior change strategy on a case by case basis.

STS-114: Engine Cut-Off Sensors Are a No-Go: Teaching Notes for NASA Case Study

NASA Technical Reports Server (NTRS)

Ransom, Khadijah S.; Johnson, Grace K.

2013-01-01

This case study format is intended to simulate the experience of facing the same difficult challenges and making the same critical decisions as managers, engineers, and scientists in the Space Shuttle Program. It has been designed for use in the classroom setting to help students develop skills related to decision-making. Students will read about the engine cut-off sensor anomaly which created challenges during the STS-114 mission and have the opportunity to make decisions as lead NASA engineers and Mission Management Team members. Included within this document are three case study presentation options - class discussion, group activity, and open-ended research. Please read the full case prior to in-class presentation to allow ample time for students' analysis and reflection, as well as to prepare additional questions. activities or exercises, material selection, etc. Depending upon the setting of your presentation and the number of participants, please choose at least one presentation format beforehand and plan accordingly. You may expect the following learning objectives by using the proposed formats. Learning Objectives: To enable students to experience the responsibilities of NASA management, engineers, and analysis; to discover possible procedures for investigating system anomalies; to become familiar with the liquid hydrogen low level engine cut-off sensor, including its function, connecting components, and location within the Space Shuttle; and to encourage critical analysis and stimulating discussion of Space Shuttle mission challenges.

Sulphur-Containing Heterocycles as Antimycobacterial Agents: Recent Advances in Thiophene and Thiadiazole Derivatives.

PubMed

Krátký, Martin; Vinsova, Jarmila

2016-01-01

The global tuberculosis epidemic and emergence of drug resistance call for intensive research on new antimycobacterial agents. Recent development is focused mainly on heterocyclic molecules. In many cases, introduction of sulphur has improved antimicrobial activity; many drugs feature a sulphur heterocycle. Thiophene derivatives and thiadiazoles including derived ortho-condensed heterocycles have been found to have a wide range of biological activities. This review highlights the recent progress in the field with a focus on whole-cell antimycobacterial activity of the agents as well as targeting of enzymes from Mycobacterium tuberculosis. Some of the compounds have exhibited high activity with submicromolar minimum inhibitory concentrations including activity against drug-resistant strains and/or IC50 values for a range of enzymes as their targets (InhA, dehydroquinase, Pks13, carbonic anhydrases, DprE1). Mechanisms of action, toxicity, and structure-activity relationships are also discussed. Several compounds have exhibited promising in vitro and in vivo activities and safety profiles, thus constituting novel, promising leads.

Itraconazole-resistant Candida auris with phospholipase, proteinase and hemolysin activity from a case of vulvovaginitis.

PubMed

Kumar, Dharmendra; Banerjee, Tuhina; Pratap, Chandra Bhan; Tilak, Ragini

2015-04-15

Since the emergence of pathogenic non-albicans Candida species, a number of new isolates have been added to the list. One such unusual species is Candida auris (C. auris), recently isolated and studied in few reports. In this study, a case of vulvovaginitis caused by Candida auris incidentally identified by molecular methods using internal transcribed spacer polymerase chain reaction (ITS PCR) is described. Antifungal susceptibility testing revealed the isolate to be resistant to itraconazole (MIC ≥ 2 µg/ml) and expressed important virulence factors including phospholipase, proteinase and hemolysin activity. The patient was successfully treated with oral fluconazole and did not have any invasive fungemia. Very few cases of this emerging pathogen have been reported. However, its isolation from clinical specimens reveals the significance of non-albicans candida species over C. albicans and the diversity of Candida spp causing infections.

A case of atypical progressive outer retinal necrosis after highly active antiretroviral therapy.

PubMed

Woo, Se Joon; Yu, Hyeong Gon; Chung, Hum

2004-06-01

This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients.

Abacus in the brain: a longitudinal functional MRI study of a skilled abacus user with a right hemispheric lesion.

PubMed

Tanaka, Satoshi; Seki, Keiko; Hanakawa, Takashi; Harada, Madoka; Sugawara, Sho K; Sadato, Norihiro; Watanabe, Katsumi; Honda, Manabu

2012-01-01

The abacus, a traditional physical calculation device, is still widely used in Asian countries. Previous behavioral work has shown that skilled abacus users perform rapid and precise mental arithmetic by manipulating a mental representation of an abacus, which is based on visual imagery. However, its neurophysiological basis remains unclear. Here, we report the case of a patient who was a good abacus user, but transiently lost her "mental abacus" and superior arithmetic performance after a stroke owing to a right hemispheric lesion including the dorsal premotor cortex (PMd) and inferior parietal lobule (IPL). Functional magnetic resonance imaging experiments were conducted 6 and 13 months after her stroke. In the mental calculation task, her brain activity was shifted from the language-related areas, including Broca's area and the left dorsolateral prefrontal and IPLs, to the visuospatial-related brain areas including the left superior parietal lobule (SPL), according to the recovery of her arithmetic abilities. In the digit memory task, activities in the bilateral SPL, and right visual association cortex were also observed after recovery. The shift of brain activities was consistent with her subjective report that she was able to shift the calculation strategy from linguistic to visuospatial as her mental abacus became stable again. In a behavioral experiment using an interference paradigm, a visual presentation of an abacus picture, but not a human face picture, interfered with the performance of her digit memory, confirming her use of the mental abacus after recovery. This is the first case report on the impairment of the mental abacus by a brain lesion and on recovery-related brain activity. We named this rare case "abacus-based acalculia." Together with previous neuroimaging studies, the present result suggests an important role for the PMd and parietal cortex in the superior arithmetic ability of abacus users.

The running athlete: stress fractures, osteitis pubis, and snapping hips.

PubMed

Henning, P Troy

2014-03-01

Pelvic stress fractures, osteitis pubis, and snapping hip syndrome account for a portion of the overuse injuries that can occur in the running athlete. PUBMED SEARCHES WERE PERFORMED FOR EACH ENTITY USING THE FOLLOWING KEYWORDS: snapping hip syndrome, coxa sultans, pelvic stress fracture, and osteitis pubis from 2008 to 2013. Topic reviews, case reports, case series, and randomized trials were included for review. Clinical review. Level 4. Collectively, 188 articles were identified. Of these, 58 were included in this review. Based on the available evidence, the majority of these overuse injuries can be managed non-operatively. Primary treatment should include removal from offending activity, normalizing regional muscle strength/length imbalances and nutritional deficiencies, and mitigating training errors through proper education of the athlete and training staff. C.

ESIP's Emerging Provenance and Context Content Standard Use Cases: Developing Examples and Models for Data Stewardship

NASA Astrophysics Data System (ADS)

Ramdeen, S.; Hills, D. J.

2013-12-01

Earth science data collections range from individual researchers' private collections to large-scale data warehouses, from computer-generated data to field or lab based observations. These collections require stewardship. Fundamentally, stewardship ensures long term preservation and the provision of access to the user community. In particular, stewardship includes capturing appropriate metadata and documentation--and thus the context of the data's creation and any changes they underwent over time --to enable data reuse. But scientists and science data managers must translate these ideas into practice. How does one balance the needs of current and (projected) future stakeholders? In 2011, the Data Stewardship Committee (DSC) of the Federation of Earth Science Information Partners (ESIP) began developing the Provenance and Context Content Standard (PCCS). As an emerging standard, PCCS provides a framework for 'what' must be captured or preserved as opposed to describing only 'how' it should be done. Originally based on the experiences of NASA and NOAA researchers within ESIP, the standard currently provides data managers with content items aligned to eight key categories. While the categories and content items are based on data life cycles of remote sensing missions, they can be generalized to cover a broader set of activities, for example, preservation of physical objects. These categories will include the information needed to ensure the long-term understandability and usability of earth science data products. In addition to the PCCS, the DSC is developing a series of use cases based on the perspectives of the data archiver, data user, and the data consumer that will connect theory and practice. These cases will act as specifications for developing PCCS-based systems. They will also provide for examination of the categories and content items covered in the PCCS to determine if any additions are needed to cover the various use cases, and also provide rationale and indicate priorities for preservation. Though the use cases currently focus on two areas, 'creating' a data set and 'using' a data set, the use cases will eventually cover the full data lifecycle. Currently developing a template to be used in future use case creation, the DSC is also preparing and testing more use case scenarios. This presentation will introduce the ESIP use cases based on the PCCS. It will at once expand stakeholder participation and show the application of these materials beyond the ESIP community in which they were developed. More information about the ESIP use case activities can be found on the DSC wiki - http://wiki.esipfed.org/index.php/Preservation_Use_Case_Activity.

Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014.

PubMed

Munk, Niki; Shue, Sarah; Freeland, Emilee; Ralston, Rick; Boulanger, Karen T

2016-09-01

Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting specifications outlined by the TMB-adapted CARE guidelines could improve the impact and usability of TMB case reports in research, education, and practice.

Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014†

PubMed Central

Munk, Niki; Shue, Sarah; Freeland, Emilee; Ralston, Rick; Boulanger, Karen T.

2016-01-01

Introduction Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. Methods 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. Results Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. Conclusion The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting specifications outlined by the TMB-adapted CARE guidelines could improve the impact and usability of TMB case reports in research, education, and practice. PMID:27648108

Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011.

PubMed

Kalaycioglu, H; Korukluoglu, G; Ozkul, A; Oncul, O; Tosun, S; Karabay, O; Gozalan, A; Uyar, Y; Caglayık, D Y; Atasoylu, G; Altas, A B; Yolbakan, S; Ozden, T N; Bayrakdar, F; Sezak, N; Pelıtlı, T S; Kurtcebe, Z O; Aydın, E; Ertek, M

2012-05-24

In 2010, 47 human cases of West Nile virus (WNV)infection, including 12 laboratory-confirmed and 35 probable cases, were identified in Turkey. These were the first cases detected during routine surveillance.The patients were from 15 provinces, mainly located in the western part of the country. Incidence was 0.19/100,000 with a maximum of 1.39 in Sakarya province.Forty of the total 47 cases showed neuroinvasive manifestation. Median age was 58 years with a range of four to 86. Ten of the patients died. Enhanced surveillance in humans and animals and mosquito control measures were implemented. The WNV infections were included in the national notifiable diseases list as of April 2011. In 2011, three probable and two confirmed cases of WNV infection were diagnosed in provinces where infections had been detected in the previous year, supporting a lower activity than 2010. However,detection of WNV infections in humans in 2010 and 2011 consecutively, may indicate that WNV has become endemic in the western part of Turkey. Field epidemiological studies were undertaken to understand more about the nature of infection in Turkey.

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants

PubMed Central

Klátyik, Szandra; Bohus, Péter; Darvas, Béla; Székács, András

2017-01-01

Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU), and the occurrence of veterinary drug (VD) and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually) initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively), and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively). Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants) and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects between the active ingredients and their additives in formulated products; moreover, toxicity has been evidenced for various additives. Therefore, toxicological evaluation of surfactants and other additives is essential for proper environmental risk assessment of formulations used in agriculture including animal husbandry and plant protection. PMID:28929103

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants.

PubMed

Klátyik, Szandra; Bohus, Péter; Darvas, Béla; Székács, András

2017-01-01

Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU), and the occurrence of veterinary drug (VD) and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually) initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively), and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively). Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants) and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects between the active ingredients and their additives in formulated products; moreover, toxicity has been evidenced for various additives. Therefore, toxicological evaluation of surfactants and other additives is essential for proper environmental risk assessment of formulations used in agriculture including animal husbandry and plant protection.

Creative Activities in Music--A Genome-Wide Linkage Analysis.

PubMed

Oikkonen, Jaana; Kuusi, Tuire; Peltonen, Petri; Raijas, Pirre; Ukkola-Vuoti, Liisa; Karma, Kai; Onkamo, Päivi; Järvelä, Irma

2016-01-01

Creative activities in music represent a complex cognitive function of the human brain, whose biological basis is largely unknown. In order to elucidate the biological background of creative activities in music we performed genome-wide linkage and linkage disequilibrium (LD) scans in musically experienced individuals characterised for self-reported composing, arranging and non-music related creativity. The participants consisted of 474 individuals from 79 families, and 103 sporadic individuals. We found promising evidence for linkage at 16p12.1-q12.1 for arranging (LOD 2.75, 120 cases), 4q22.1 for composing (LOD 2.15, 103 cases) and Xp11.23 for non-music related creativity (LOD 2.50, 259 cases). Surprisingly, statistically significant evidence for linkage was found for the opposite phenotype of creative activity in music (neither composing nor arranging; NCNA) at 18q21 (LOD 3.09, 149 cases), which contains cadherin genes like CDH7 and CDH19. The locus at 4q22.1 overlaps the previously identified region of musical aptitude, music perception and performance giving further support for this region as a candidate region for broad range of music-related traits. The other regions at 18q21 and 16p12.1-q12.1 are also adjacent to the previously identified loci with musical aptitude. Pathway analysis of the genes suggestively associated with composing suggested an overrepresentation of the cerebellar long-term depression pathway (LTD), which is a cellular model for synaptic plasticity. The LTD also includes cadherins and AMPA receptors, whose component GSG1L was linked to arranging. These results suggest that molecular pathways linked to memory and learning via LTD affect music-related creative behaviour. Musical creativity is a complex phenotype where a common background with musicality and intelligence has been proposed. Here, we implicate genetic regions affecting music-related creative behaviour, which also include genes with neuropsychiatric associations. We also propose a common genetic background for music-related creative behaviour and musical abilities at chromosome 4.

Central nervous system infection by Listeria monocytogenes in patients with systemic lupus erythematosus: analysis of 26 cases, including the report of a new case.

PubMed

Horta-Baas, Gabriel; Guerrero-Soto, Omar; Barile-Fabris, Leonor

2013-01-01

Infections in patients with systemic lupus erythematosus cause significant morbidity. Infection due to Listeria monocytogenes (LM) is considered an opportunistic disease, and has been published on rare occasions in patients with SLE. To review the presentation of listeria infections in the central nervous system (CNS) in SLE patients. We conducted a literature review, selecting cases with central nervous system infection and confirmation of LM infection through culture. Twenty six cases are described. The most common presentation was meningitis, with meningoencephalitis and brain abscesses being less frequent. The predisposing factors are: use of glucocorticoids, immunosuppressants, renal replacement therapy and the activity flares. CNS infection by listeria is rare and sometimes fatal. The atypical presentation may lead to a delay in diagnosis and appropriate treatment. L. monocytogenes should be included in the differential diagnosis of patients with SLE with neurological manifestations. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Masticatory Muscle Sleep Background EMG Activity is Elevated in Myofascial TMD Patients

PubMed Central

Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Wigren, Pia E.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

2013-01-01

Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n=124) with a demographically matched control group without TMD (n=46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artifacts were removed. Results indicated that median background EMG during these non SB-event periods was significantly higher (p<.01) for women with myofascial TMD (median=3.31 μV and mean=4.98 μV) than for control women (median=2.83 μV and mean=3.88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0–10 numerical scale) on post sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. PMID:24237356

Strengthening Acute Flaccid Paralysis Surveillance through the Village Polio Volunteers Program in Somalia.

PubMed

Mbaeyi, Chukwuma; Mohamed, Abdinoor; Owino, Brian Ogola; Mengistu, Kumlachew F; Ehrhardt, Derek; Elsayed, Eltayeb Ahmed

2018-03-02

Surveillance for cases of acute flaccid paralysis (AFP) is a key strategy adopted for the eradication of polio. Detection of poliovirus circulation is often predicated on the ability to identify AFP cases and test their stool specimens for poliovirus infection in a timely manner. The Village Polio Volunteers (VPV) program was established in 2013 in a bid to strengthen polio eradication activities in Somalia, including AFP surveillance, given the country's vulnerability to polio outbreaks. To assess the impact of the VPV program on AFP surveillance, we determined case counts, case-reporting sources, and non-polio AFP rates in the years before and after program introduction, i.e., 2011-2016. We also compared the stool adequacy and timeliness of cases reported by VPVs to those reported by other sources. In the years following program introduction, VPVs accounted for a high proportion of AFP cases reported in Somalia. AFP case counts rose from 148 cases in 2012, the year before program introduction, to 279 cases in 2015, during which VPVs accounted for 40% of reported cases. Further, the non-polio AFP rate improved from 2.8 cases in 2012 to 4.8 cases per 100,000 persons <15 years by 2015. Stool adequacy rates have been consistently high and AFP cases have been detected in a timelier manner since the program was introduced. Given the impact of the VPV program on improving AFP surveillance indicators in Somalia, similar community-based programs could play a crucial role in enhancing surveillance activities in countries with limited healthcare infrastructure.

A case of reactive arthritis in a Ranger Indoctrination Program (RIP) student.

PubMed

Hart, Robert S; Detro, John F

2009-01-01

Musculoskeletal complaints comprise the majority of cases encountered by military physicians when evaluating young active duty Soldier-athletes. This is a case of reactive arthritis in a 19-year-old active duty Soldier-athlete whose failure to improve with conservative therapy initiated further investigation. When evaluating what appear to be routine overuse injuries, it is important to actively include other potential causes of musculoskeletal complaints in the differential diagnosis. Further investigation of disease in patients whose symptoms and complaints do not improve with routine conservative care is paramount. Reactive arthritis, though self-limiting in two-thirds of those affected, can become a chronic disabling disease affecting as many as 40 out of 100 patients. Current theories suggest the persistent presence of non-culturable bacteria and bacterial antigens residing in the joint synovia as the etiology of the disease state. There is no curative therapy for reactive arthritis and management is focused on the treatment of symptoms with non-steroidal anti-inflammatory drugs (NSAIDs), immunomodulator therapy, and antibiotics if an infectious source is suspected.

EFFECT OF STRUCTURED PHYSICAL ACTIVITY ON SLEEP-WAKE BEHAVIORS IN SEDENTARY ELDERS WITH MOBILITY LIMITATIONS

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; King, Abby C.; Kritchevsky, Stephen B.; Liu, Christine K.; Myers, Valerie H.; Nadkarni, Neelesh K.; Pahor, Marco; Spring, Bonnie J.; Gill, Thomas M.

2016-01-01

OBJECTIVE To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elders with mobility limitations. DESIGN Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors pre-specified as a tertiary outcome over a planned intervention period ranging between 24 and 30 months. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, aged 70–89 years, who were initially sedentary with a Short Physical Performance Battery score <10. MEASUREMENTS Sleep-wake behaviors were evaluated by the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (> 5 defined poor sleep quality) — administered at baseline and subsequently at 6, 18, and 30 months. RESULTS The randomized groups were similar on baseline demographic variables, including mean age (79 years) and sex (67% female). Relative to health education, structured physical activity significantly reduced the likelihood of having poor sleep quality (adjusted odds ratios [adjOR] for PSQI >5 of 0.80 [0.68, 0.94]), including a reduction in new cases (adjOR for PSQI >5 of 0.70 [0.54, 0.89]) but not in resolution of prevalent cases (adjOR for PSQI ≤5 of 1.13 [0.90, 1.43]). No significant intervention effects were observed for ISI or ESS. CONCLUSION Structured physical activity reduced the likelihood of developing poor sleep quality (PSQI >5) over the intervention period, when compared with health education, but had no effect on prevalent cases of poor sleep quality, or on sleep-wake behaviors evaluated by the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated by the PSQI. PMID:26115386

Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations.

PubMed

Vaz Fragoso, Carlos A; Miller, Michael E; King, Abby C; Kritchevsky, Stephen B; Liu, Christine K; Myers, Valerie H; Nadkarni, Neelesh K; Pahor, Marco; Spring, Bonnie J; Gill, Thomas M

2015-07-01

To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations. Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months. Lifestyle Interventions and Independence for Elders Study. Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635). Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months. The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS. Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Improved Operating Room Efficiency via Constraint Management: Experience of a Tertiary-Care Academic Medical Center.

PubMed

Kimbrough, Charles W; McMasters, Kelly M; Canary, Jeff; Jackson, Lisa; Farah, Ian; Boswell, Mark V; Kim, Daniel; Scoggins, Charles R

2015-07-01

Suboptimal operating room (OR) efficiency is a universal complaint among surgeons. Nonetheless, maximizing efficiency is critical to institutional success. Here, we report improvement achieved from low-cost, low-technology measures instituted within a tertiary-care academic medical center/Level I trauma center. Improvements in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, were instituted in March 2012. A retrospective review of prospectively maintained OR case data was performed to evaluate time periods before and after program implementation, as well as to assess trends over time. Operating room performance metrics were compared using Mann-Whitney and chi-squared tests. Changes over time were analyzed using linear regression. Data including all surgical cases were available for a 36-month period; 10 months (6,581 cases) before program implementation and 26 months afterward (17,574 cases). Dramatic improvement was seen in first-case on-time starts, which increased from 39.3% to 83.8% (p < 0.0001). Additionally, the percent utilization of available OR time demonstrated a steady increase (p < 0.001). After an initial lag, case volume also improved, evident by an increase observed in the 12-month rolling average of cases per month (p < 0.001). The increase in case volume occurred during peak OR time (7 am to 5 pm), and did not result from adding cases after hours (5 pm to 11 pm). After many years of what seemed an insoluble problem, simple changes fostering collaboration among services, including active management of the OR schedule and transparent data, have resulted in substantial improvement in OR efficiency and case volume. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

[Physician versus 'off-label" ordinance].

PubMed

Kordus, Katarzyna; Spiewak, Radosław

2015-01-01

Polish physicians are obliged by legislation to prescribe drugs authorized for the sale in the Republic of Poland, based on registration documentation, including the Summaries of Product Characteristics (SPC). So called 'off label' treatment occurs in case of the conflict between prescription and information contained in the SPC, which may be considered as a 'medical experiment'. In case of adverse drug reactions, such classification excludes the responsibility of the marketing authorization holders, and damages are not covered by obligatory third party insurance, which can pose financial and legal consequences to the doctor. Deviations from SPC-compliant prescription may include a different way of drug administration, drug administration compliant with the indications yet in patients for whom there is no specified drug dosage, or in case of an indication not contained in the SPC. Medicinal products with equivalent active component, form and dose can have different registration indications in the SPC, and the actively promoted dispensation of less expensive substitutes by the pharmacists may, against doctor's will, result in the use that is non-compliant with registration of the substitute drug. Pharmacotherapy of 'orphan diseases', for which there are no registered medicinal products, also becomes an essential issue as it forces doctors into 'off-label' prescriptions. Moreover, the reimbursement of drugs in most cases is limited to medicinal products that are prescribed according to the registration indications. The pleas by medical professionals to make ordination and reimbursement of drugs depend on active pharmaceutical ingredient and evidence of efficacy, as well as to introduce Evidence Based Medicine (EBM) standards for the treatment of diseases, did not receive proper attention from the governing bodies. Therefore, a fundamental question remains unanswered as to what should be the principal gauge for physicians' therapeutic decision: the ethics, conscience, recent scientific evidence or legal and administrative regulations?

Paediatric Active Enhanced Disease Surveillance inaugural annual report, 2014.

PubMed

Zurynski, Yvonne A; McRae, Jocelynne E; Quinn, Helen E; Wood, Nicholas J; Macartney, Kristine K

2016-09-30

The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment of selected uncommon vaccine preventable diseases and potential adverse events following immunisation (AEFI). PAEDS enhances other Australian surveillance systems by providing prospective detailed clinical and laboratory data for the same child. Specialist surveillance nurses screen hospital admissions, emergency department records, laboratory and other data, to prospectively identify hospitalised children aged under 15 years in 5 paediatric tertiary referral hospitals in New South Wales, Victoria, South Australia, Western Australia and Queensland. Standardised protocols and case definitions are used across all sites. Conditions under surveillance include vaccine preventable diseases: acute flaccid paralysis, varicella, pandemic and seasonal influenza and pertussis, and potential AEFIs: febrile seizures and intussusception. PAEDS also conducts surveillance for acute childhood encephalitis. Since August 2007, PAEDS has recruited a total of 6,227 hospitalised cases in total, for all conditions. From January to December 2014, there were 1,220 cases recruited across all conditions. Key outcomes include: enhanced acute flaccid paralysis surveillance to reach World Health Organization targets; supporting varicella and influenza vaccination in children; confirmation of a known low risk of febrile seizures following the 1st dose of measles-mumps-rubella vaccine but no increased risk of febrile seizures after measles-mumps-rubella-varicella vaccine, and a slightly increased risk of developing intussusception 1-7 days after rotavirus vaccination in infants aged less than 3 months. Acute childhood encephalitis data facilitated rapid investigation and response to the enterovirus 71 outbreak in 2013-2014. PAEDS provides unique policy-relevant data. This is the first of planned PAEDS annual reports to Communicable Diseases Intelligence.

Biochemical Predictors of Low Bone Mineral Density and Fracture Susceptibility in Maltese Postmenopausal Women.

PubMed

Formosa, Melissa M; Xuereb-Anastasi, Angela

2016-01-01

Osteoporosis and fractures are complex conditions influenced by an interplay of genetic and environmental factors. The aim of the study was to investigate three biochemical parameters including total serum calcium, total serum alkaline phosphatase (sALP) and albumin in relation to bone mineral density (BMD) at the lumbar spine and femoral neck (FN), and with all-type of low-trauma fractures in Maltese postmenopausal women. Levels were also correlated with age and physical activity. A case-control study of 1045 women was performed. Women who suffered a fracture were classified as cases whereas women without a fracture history were included as controls subdivided into normal, osteopenic, or osteoporotic according to their BMD measurements. Blood specimens were collected following good standard practice and testing was performed by spectrophotometry. Calcium and sALP levels were weakly correlated with FN BMD levels (calcium: r = -0.111, p = 0.002; sALP: r = 0.089, p = 0.013). Fracture cases had the lowest serum levels of calcium, sALP and albumin relative to all other control groups, which decreased with increasing age, possibly increasing fracture risk. Biochemical levels were lowest in women who sustained a hip fracture and more than one fracture. Biochemical parameters decreased with reduced physical activity; however, this was most evident for fracture cases. Reduced physical activity was associated with lower BMD levels at the hip, and to a lower extent at the spine. In conclusion, results suggest that levels of serum calcium and albumin could be indicative of fracture risk, whereas calcium levels and to lower extent sALP levels could be indicators of hip BMD.

Avoidable Antibiotic Exposure for Uncomplicated Skin and Soft Tissue Infections in the Ambulatory Care Setting

PubMed Central

Hurley, Hermione J.; Knepper, Bryan C.; Price, Connie S.; Mehler, Philip S.; Burman, William J.; Jenkins, Timothy C.

2014-01-01

Background Uncomplicated skin and soft tissue infections are among the most frequent indications for outpatient antibiotics. A detailed understanding of current prescribing practices is necessary to optimize antibiotic use for these conditions. Methods This was a retrospective cohort study of children and adults treated in the ambulatory care setting for uncomplicated cellulitis, wound infection, or cutaneous abscess between March 1, 2010 and February 28, 2011. We assessed the frequency of avoidable antibiotic exposure, defined as: use of antibiotics with broad gram-negative activity, combination antibiotic therapy, or treatment for 10 or more days. Total antibiotic-days prescribed for the cohort were compared to antibiotic-days in four hypothetical short-course (5 – 7 days), single-antibiotic treatment models consistent with national guidelines. Results 364 cases were included for analysis (155 cellulitis, 41 wound infection, and 168 abscess). Antibiotics active against methicillin-resistant Staphylococcus aureus were prescribed in 61% of cases of cellulitis. Of 139 cases of abscess where drainage was performed, antibiotics were prescribed in 80% for a median of 10 (interquartile range 7 – 10) days. Of 292 total cases where complete prescribing data were available, avoidable antibiotic exposure occurred in 46%. This included use of antibiotics with broad gram-negative activity in 4%, combination therapy in 12%, and treatment for 10 or more days in 42%. Use of the short-course, single-antibiotic treatment strategies would have reduced prescribed antibiotic-days by 19 – 55%. Conclusions Nearly half of uncomplicated skin infections involved avoidable antibiotic exposure. Antibiotic use could be reduced through treatment approaches utilizing short courses of a single antibiotic. PMID:24262724

A Case Study of the United States Navy’s Enterprise Resource Planning System

DTIC Science & Technology

2006-06-01

incarnations, MRP-II added the capabilities of shop-floor management and distribution management activities. Later versions included the ability to manage ... finances , human resources, engineering, and project management. Enterprise Resource Planning systems were then developed as an integrated system

Empowering Infants through Responsive and Intentional Play Activities

ERIC Educational Resources Information Center

Shin, Minsun; Partyka, Thomas

2017-01-01

This qualitative case study explored how an infant teacher provided meaningful learning experiences for infants through play and the teacher's educational rationale behind these experiences. Findings were based on multiple sources of data, including classroom observations (natural observation and videotaped observation) for approximately 12 weeks…

An Ounce of Prevention: Sexual Harassment Education.

ERIC Educational Resources Information Center

Limback, E. Rebecca; Bland, Zinna

1995-01-01

To prevent sexual harassment, schools should have a written policy and should educate students about it. Suggested teaching activities include using current court cases, examining and refining school policy, roleplaying on video, inviting speakers, and using an "Is This Sexual Harassment?" questionnaire describing various behaviors. (SK)

7 CFR 275.12 - Review of active cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... investigation will include interviews with the head of household, spouse, or authorized representative; contact... Form FNS-380. (1) Personal interviews. Personal interviews shall be conducted in a manner that respects the rights, privacy, and dignity of the participants. Prior to conducting the personal interview, the...

The effect of continuing professional development on public complaints: a case-control study.

PubMed

Wenghofer, Elizabeth F; Campbell, Craig; Marlow, Bernard; Kam, Sophia M; Carter, Lorraine; McCauley, William

2015-03-01

This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise programme impact on physician performance at the population level. © 2015 John Wiley & Sons Ltd.

GATA2 Deficiency and Epstein-Barr Virus Disease.

PubMed

Cohen, Jeffrey I

2017-01-01

GATA2 is a transcription factor that binds to the promoter of hematopoietic genes. Mutations in one copy of the gene are associated with haploinsufficiency and reduced levels of protein. This results in reduced numbers of several cell types important for immune surveillance including dendritic cells, monocytes, CD4, and NK cells, as well as impaired NK cell function. Recently, GATA2 has been associated with several different presentations of severe Epstein-Barr virus (EBV) disease including primary infection requiring repeated hospitalizations, chronic active EBV disease, EBV-associated hydroa vacciniforme with hemophagocytosis, and EBV-positive smooth muscle tumors. EBV was found predominantly in B cells in each of the cases in which it was studied, unlike most cases of chronic active EBV disease in which the virus is usually present in T or NK cells. The variety of EBV-associated diseases seen in patients with GATA2 deficiency suggest that additional forms of severe EBV disease may be found in patients with GATA2 deficiency in the future.

Changes in chlamydia control activities in Europe between 2007 and 2012: a cross-national survey

PubMed Central

Sfetcu, Otilia; van der Sande, Marianne A.; Andersen, Berit; Herrmann, Björn; Ward, Helen; Götz, Hannelore M.; Uusküla, Anneli; Woodhall, Sarah C.; Redmond, Shelagh M.; Amato-Gauci, Andrew J.; Low, Nicola; van Bergen, Jan E.

2016-01-01

Background: In 2012, the levels of chlamydia control activities including primary prevention, effective case management with partner management and surveillance were assessed in 2012 across countries in the European Union and European Economic Area (EU/EEA), on initiative of the European Centre for Disease Control (ECDC) survey, and the findings were compared with those from a similar survey in 2007. Methods: Experts in the 30 EU/EEA countries were invited to respond to an online questionnaire; 28 countries responded, of which 25 participated in both the 2007 and 2012 surveys. Analyses focused on 13 indicators of chlamydia prevention and control activities; countries were assigned to one of five categories of chlamydia control. Results: In 2012, more countries than in 2007 reported availability of national chlamydia case management guidelines (80% vs. 68%), opportunistic chlamydia testing (68% vs. 44%) and consistent use of nucleic acid amplification tests (64% vs. 36%). The number of countries reporting having a national sexually transmitted infection control strategy or a surveillance system for chlamydia did not change notably. In 2012, most countries (18/25, 72%) had implemented primary prevention activities and case management guidelines addressing partner management, compared with 44% (11/25) of countries in 2007. Conclusion: Overall, chlamydia control activities in EU/EEA countries strengthened between 2007 and 2012. Several countries still need to develop essential chlamydia control activities, whereas others may strengthen implementation and monitoring of existing activities. PMID:26498953

Effect of Active Case Finding on Prevalence and Transmission of Pulmonary Tuberculosis in Dhaka Central Jail, Bangladesh

PubMed Central

Banu, Sayera; Rahman, Md. Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md. Siddiqur Rahman; Rahman, Md. Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D.

2015-01-01

Background Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. Methods The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). Results A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as ‘modern’ and 100 (30%) strains as ‘ancestral’. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Conclusions Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh. PMID:25933377

Effect of active case finding on prevalence and transmission of pulmonary tuberculosis in Dhaka Central Jail, Bangladesh.

PubMed

Banu, Sayera; Rahman, Md Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md Siddiqur Rahman; Rahman, Md Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D

2015-01-01

Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as 'modern' and 100 (30%) strains as 'ancestral'. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh.

Donor-Derived West Nile Virus Infection in Solid Organ Transplant Recipients: Report of Four Additional Cases and Review of Clinical, Diagnostic, and Therapeutic Features

PubMed Central

Winston, Drew J.; Vikram, Holenarasipur R.; Rabe, Ingrid B.; Dhillon, Gundeep; Mulligan, David; Hong, Johnny C.; Busuttil, Ronald W.; Nowicki, Marek J.; Mone, Thomas; Civen, Rachel; Tecle, Selam A.; Trivedi, Kavita K.; Hocevar, Susan N.

2017-01-01

We describe four solid-organ transplant recipients with donor-derived West Nile virus (WNV) infection (encephalitis 3, asymptomatic 1) from a common donor residing in a region of increased WNV activity. All four transplant recipients had molecular evidence of WNV infection in their serum and/or cerebrospinal fluid (CSF) by reverse transcription polymerase chain reaction (RT-PCR) testing. Serum from the organ donor was positive for WNV IgM but negative for WNV RNA, whereas his lymph node and spleen tissues tested positive for WNV by RT-PCR. Combination therapy included intravenous immunoglobulin (4 cases), interferon (3 cases), fresh frozen plasma with WNV IgG (2 cases), and ribavirin (1 case). Two of the four transplant recipients survived. Review of the 20 published cases of organ-derived WNV infection found that this infection is associated with a high incidence of neuroinvasive disease (70%) and severe morbidity and mortality (30%). Median time to onset of symptomatic WNV infection was 13 days after transplantation (range 5–37 days). Initial unexplained fever unresponsive to antibiotic therapy followed by rapid onset of neurologic deficits was the most common clinical presentation. Confirmation of infection was made by testing serum and CSF for both WNV RNA by RT-PCR and WNV IgM by serological assays. Treatment usually included supportive care, reduction of immunosuppression, and frequent intravenous immunoglobulin. The often negative results for WNV by current RT-PCR and serological assays and the absence of clinical signs of acute infection in donors contribute to the sporadic occurrence of donor-derived WNV infection. Potential organ donors should be assessed for unexplained fever and neurological symptoms, particularly if they reside in areas of increased WNV activity. PMID:24827763

Donor-derived West Nile virus infection in solid organ transplant recipients: report of four additional cases and review of clinical, diagnostic, and therapeutic features.

PubMed

Winston, Drew J; Vikram, Holenarasipur R; Rabe, Ingrid B; Dhillon, Gundeep; Mulligan, David; Hong, Johnny C; Busuttil, Ronald W; Nowicki, Marek J; Mone, Thomas; Civen, Rachel; Tecle, Selam A; Trivedi, Kavita K; Hocevar, Susan N

2014-05-15

We describe four solid-organ transplant recipients with donor-derived West Nile virus (WNV) infection (encephalitis 3, asymptomatic 1) from a common donor residing in a region of increased WNV activity. All four transplant recipients had molecular evidence of WNV infection in their serum and/or cerebrospinal fluid (CSF) by reverse transcription polymerase chain reaction (RT-PCR) testing. Serum from the organ donor was positive for WNV IgM but negative for WNV RNA, whereas his lymph node and spleen tissues tested positive for WNV by RT-PCR. Combination therapy included intravenous immunoglobulin (4 cases), interferon (3 cases), fresh frozen plasma with WNV IgG (2 cases), and ribavirin (1 case). Two of the four transplant recipients survived.Review of the 20 published cases of organ-derived WNV infection found that this infection is associated with a high incidence of neuroinvasive disease (70%) and severe morbidity and mortality (30%). Median time to onset of symptomatic WNV infection was 13 days after transplantation (range 5-37 days). Initial unexplained fever unresponsive to antibiotic therapy followed by rapid onset of neurologic deficits was the most common clinical presentation. Confirmation of infection was made by testing serum and CSF for both WNV RNA by RT-PCR and WNV IgM by serological assays. Treatment usually included supportive care, reduction of immunosuppression, and frequent intravenous immunoglobulin. The often negative results for WNV by current RT-PCR and serological assays and the absence of clinical signs of acute infection in donors contribute to the sporadic occurrence of donor-derived WNV infection. Potential organ donors should be assessed for unexplained fever and neurological symptoms, particularly if they reside in areas of increased WNV activity.

Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia.

PubMed

Al Zahrani, Mohammed H; Omar, Abdiasiis I; Abdoon, Abdelmohsin M O; Ibrahim, Ali Adam; Alhogail, Abdullah; Elmubarak, Mohamed; Elamin, Yousif Eldirdiry; AlHelal, Mohammed A; Alshahrani, Ali M; Abdelgader, Tarig M; Saeed, Ibrahim; El Gamri, Tageddin B; Alattas, Mohammed S; Dahlan, Abdu A; Assiri, Abdullah M; Maina, Joseph; Li, Xiao Hong; Snow, Robert W

2018-06-26

Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen. Malaria program activity reports, case data, and ancillary information have been assembled from national health information systems, archives, and other related sources. Information was analyzed as a semi-quantitative time series, between 2000 and 2017, to provide a plausibility framework to understand the possible contributions of factors related to control activities, conflict, economic development, migration, and climate. The malaria recession in the Yemeni border regions of Saudi Arabia is a likely consequence of multiple, coincidental factors, including scaled elimination activities, cross-border vector control, periods of low rainfall, and economic development. The temporal alignment of many of these factors suggests that economic development may have changed the receptivity to the extent that it mitigated against surges in vulnerability posed by imported malaria from its endemic neighbor Yemen. In many border areas of the world, malaria is likely to be sustained through a complex congruence of factors, including poverty, conflict, and migration.

42 CFR 431.978 - Eligibility sampling plan and procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., for example, by making adjustments to the plan when necessary due to fluctuations in the universe. (2... active and negative universes; or (ii) If the active case universe or negative case universe of Medicaid... active cases and negative cases, respectively. (iii) If the active case universe or negative case...

42 CFR 431.978 - Eligibility sampling plan and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., for example, by making adjustments to the plan when necessary due to fluctuations in the universe. (2... active and negative universes; or (ii) If the active case universe or negative case universe of Medicaid... active cases and negative cases, respectively. (iii) If the active case universe or negative case...

42 CFR 431.978 - Eligibility sampling plan and procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., for example, by making adjustments to the plan when necessary due to fluctuations in the universe. (2... active and negative universes; or (ii) If the active case universe or negative case universe of Medicaid... active cases and negative cases, respectively. (iii) If the active case universe or negative case...

42 CFR 431.978 - Eligibility sampling plan and procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., for example, by making adjustments to the plan when necessary due to fluctuations in the universe. (2... active and negative universes; or (ii) If the active case universe or negative case universe of Medicaid... active cases and negative cases, respectively. (iii) If the active case universe or negative case...

42 CFR 431.978 - Eligibility sampling plan and procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., for example, by making adjustments to the plan when necessary due to fluctuations in the universe. (2... active and negative universes; or (ii) If the active case universe or negative case universe of Medicaid... active cases and negative cases, respectively. (iii) If the active case universe or negative case...

Medicolegal Issues in Traumatic Brain Injury.

PubMed

Zasler, Nathan D; Bigler, Erin

2017-05-01

The role of the physiatrist in provision of medicolegal expert testimony in cases involving traumatic brain injury is challenging and complex. This article provides an overview of how such work should be conducted from a practical perspective including discussion of ethical, legal, medical, and business aspects of such activities. Additionally, pointers are provided with regards to how information including preinjury, injury, and postinjury (including neuroimaging and neuropsychological data) should be considered and integrated into medicolegal opinions and testimony. Copyright © 2016 Elsevier Inc. All rights reserved.

Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning Strike.

PubMed

Scantling, Dane; Frank, Brian; Pontell, Mathew E; Medinilla, Sandra

2016-09-01

Only limited clinical scenarios are grounds for induction of therapeutic hypothermia. Its use in traumatic cardiac arrests, including those from lightning strikes, is not well studied. Nonshockable cardiac arrest rhythms have only recently been included in resuscitation guidelines. We report a case of full neurological recovery with therapeutic hypothermia after a lightning-induced pulseless electrical activity cardiac arrest in an 18-year-old woman. We also review the important pathophysiology of lightning-induced cardiac arrest and neurologic sequelae, elaborate upon the mechanism of therapeutic hypothermia, and add case-based evidence in favor of the use of targeted temperature management in lightning-induced cardiac arrest. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Active and passive surveillance of yellow fever vaccine 17D or 17DD-associated serious adverse events: systematic review.

PubMed

Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler

2011-06-20

To identify the rate of serious adverse events attributable to yellow fever vaccination with 17D and 17DD strains reported in active and passive surveillance data. We conducted a systematic review of published literature on adverse events associated with yellow fever. We searched 9 electronic databases for peer reviewed and grey literature in all languages. There were no restrictions on date of publication. Reference lists of key studies were also reviewed to identify additional studies. We identified 66 relevant studies: 24 used active, 17 a combination of passive and active (15 of which were pharmacovigilance databases), and 25 passive surveillance. ACTIVE SURVEILLANCE: A total of 2,660,929 patients in general populations were followed for adverse events after vaccination, heavily weighted (97.7%) by one large Brazilian study. There were no observed cases of viscerotropic or neurotropic disease, one of anaphylaxis and 26 cases of urticaria (hypersensitivity). We also identified four studies of infants and children (n=2199), four studies of women (n=1334), and one study of 174 HIV+, and no serious adverse events were observed. PHARMACOVIGILANCE DATABASES: 10 of the 15 databases contributed data to this review, with 107,621,154 patients, heavily weighted (94%) by the Brazilian database. The estimates for Australia were low at 0/210,656 for "severe neurological disease" and 1/210,656 for YEL-AVD, and also low for Brazil with 9 hypersensitivity events, 0.23 anaphylactic shock events, 0.84 neurologic syndrome events and 0.19 viscerotropic events cases/million doses. The five analyses of partly overlapping periods for the US VAERS database provided an estimate of 6.6 YEL-AVD and YEL-AND cases per million, and estimates between 11.1 and 15.6 of overall "serious adverse events" per million. The estimates for the UK were higher at 34 "serious adverse events" and also for Switzerland with 14.6 "neurologic events" and 40 "serious events not neurological"/million doses. PASSIVE SURVEILLANCE: Six studies of campaigns in general populations included 94,500,528 individuals, very heavily weighted (99%) by the Brazilian data, and providing an estimate of 0.51 serious AEFIs/million doses. Five retrospective reviews of hospital or clinic records included 60,698 individuals, and no serious AEFIs were proven. The data are heavily weighted (96%) by the data from the Hospital for Tropical Diseases, London. Two studies included 35,723 children, four studies included 138 pregnant women, six studies included 191 HIV+ patients, and there was one review of patients who were HIV+, and no serious AEFIs were proven. The databases in each country used different definitions, protocols, surveillance mechanisms for the initial identification and reporting of cases, and strategies for the clinical and laboratory follow up of cases. The pharmacovigilance databases provide three sets of estimates: a low estimate from the Brazilian and Australian data, a medium estimate from the US VAERS data, and a higher estimate from the UK and Swiss data. The estimates from the active surveillance data are lower (and strongly influenced by the Brazilian data) and the estimates from the passive surveillance studies are also lower (strongly influenced by the London Hospital for Tropical Diseases data from the early 1950s). Sophisticated pathology, histopathology and tests such as PCR amplicon sequencing are needed to prove that serious adverse events were actually caused by the yellow fever vaccine, and the availability of such diagnostic capability is strongly biased towards recent reports from developed countries. Despite these variations in the estimation of serious harm, overall the 17D and 17DD yellow fever vaccine has proven to be a very safe vaccine and is highly effective against an illness with high potential mortality rates. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ten-Year Incidence of Sport and Recreation Injuries Resulting in Major Trauma or Death in Victoria, Australia, 2005-2015.

PubMed

Ekegren, Christina L; Beck, Ben; Simpson, Pamela M; Gabbe, Belinda J

2018-03-01

Sports injuries that result in major trauma or death are associated with significant health care burden and societal costs. An understanding of changes in injury trends, and their drivers, is needed to implement policy aimed at risk reduction and injury prevention. To date, population-level reporting has not been available regarding trends in serious sport and recreation injuries anywhere in Australia over such an extended period, nor have any studies of this length captured comprehensive, long-term data on all sports-related major trauma internationally. To describe the incidence of sport and active recreation injuries resulting in major trauma or death over a 10-year period (July 2005 to June 2015) in the state of Victoria, Australia. Descriptive epidemiological study. All sport and active recreation-related major trauma cases and deaths in Victoria, Australia, over a 10-year period were extracted from the population-level Victorian State Trauma Registry and the National Coroners Information System. Poisson regression analysis was used to examine trends in the incidence of sport and active recreation-related major trauma and death. The 10-year study period entailed 2847 nonfatal major trauma cases and 614 deaths (including 96 in-hospital deaths). The highest frequencies of major trauma cases and deaths were in cycling, motor sports, and equestrian activities. The participation-adjusted major trauma and death rate was 12.2 per 100,000 participants per year over the study period. An 8% increase was noted in the rate of nonfatal major trauma (incident rate ratio [IRR], 1.08; 95% CI, 1.06-1.10; P < .001) and a 7% decrease in the death rate (IRR, 0.93; 95% CI, 0.90-0.97; P < .001). Significant increases were found in the rates of major trauma (including deaths) in equestrian activities, motor sports, and cycling. The death rate from sport and active recreation decreased by more than half over the course of 10 years in Victoria, while the rate of nonfatal major trauma almost doubled. This increase is largely attributable to equestrian activities, motor sports, and cycling. Study findings highlight the need to prioritize investments in the prevention of trauma in these activities.

Malaria elimination in Haiti by the year 2020: an achievable goal?

PubMed

Boncy, Paul Jacques; Adrien, Paul; Lemoine, Jean Frantz; Existe, Alexandre; Henry, Patricia Jean; Raccurt, Christian; Brasseur, Philippe; Fenelon, Natael; Dame, John B; Okech, Bernard A; Kaljee, Linda; Baxa, Dwayne; Prieur, Eric; El Badry, Maha A; Tagliamonte, Massimiliano S; Mulligan, Connie J; Carter, Tamar E; Beau de Rochars, V Madsen; Lutz, Chelsea; Parke, Dana M; Zervos, Marcus J

2015-06-05

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d'Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on "Elimination Strategies for Malaria in Haiti" on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of malaria in Haiti will require collaborative multidisciplinary approaches, sound strategic planning, and strong ownership of strategies by the Haiti Ministère de la Santé Publique et de la Population.

Health Risks to Ecological Workers on Contaminated Sites - the Department of Energy as a Case Study

PubMed Central

Burger, Joanna; Gochfeld, Michael

2016-01-01

Background At most contaminated sites the risk to workers focuses on those ‘hazardous waste workers’ directly exposed to chemicals or radionuclides, and to the elaborate approaches implemented to protecting their health and safety. Ecological workers generally are not considered. Objectives To explore the risks to the health and safety of ecological workers on sites with potential chemical and radiological exposures before, during or after remediation of contamination. To use the U.S. Department of Energy as a case study, and to develop concepts that apply generally to sites contaminated with hazardous or nuclear wastes, Methods Develop categories of ecological workers, describe their usual jobs, and provide information on the kinds of risks they face. Ecological activities include continued surveillance and monitoring work on any sites with residual contamination, subject to institutional controls and engineered barriers following closure as well as the restoration. Results The categories of ecological workers and their tasks include 1) Ecological characterization, mapping and monitoring, 2) biodiversity studies, 2) Contaminant fate and transport, 3) On-going industrial activities 4) Remediation activities (environmental management), 5) Environmental restoration, 6) Post-cleanup surveillance and monitoring, and 7) Post-closure future site activities. There are a set of functional activities that can occur with different frequencies and intensities, including visual inspection, collecting biological samples, collecting media physical samples, collecting biological debris, restoration planting, and maintaining ecosystems. Conclusions Ecological workers face different exposures and risks than other environmental cleanup workers. Many of their tasks mimic shift work with long hours leading to fatigue, and they are exposed to biological as well as chemical/radiological hazards. DOE and other entities need to examine the risks to ecological workers on site with an eye to risk reduction. PMID:27668128

Integrated method of teaching in Web Quest activity and its impact on undergraduate students' cognition and learning behaviors: a future trend in medical education.

PubMed

Badiyepeymaie Jahromi, Zohreh; Mosalanejad, Leili

2015-01-14

Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students' learning behaviors. In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according to Web Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient's treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet.Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. In view of Web Quest's positive impacts on students' learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended.

Integrated Method of Teaching in Web Quest Activity and Its Impact on Undergraduate Students’ Cognition and Learning Behaviors: A Future Trend in Medical Education

PubMed Central

Jahromi, Zohreh Badiyepeymaie; Mosalanejad, Leili

2015-01-01

Introduction: Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students’ learning behaviors. Materials and Methods: In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according toWeb Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient’s treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet. Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. Results: The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. Conclusions: In view of Web Quest’s positive impacts on students’ learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended. PMID:25946931

What Do We Need To Live on Planet Earth? A Case Study of Traditional Rural Life in East Africa. A Curriculum Unit for History and Social Studies, Grades 2-4.

ERIC Educational Resources Information Center

Murphey, Carol; Wallace, Kendra R.

The unit focuses on the lifestyles of two social groups in East Africa: the traditional nomadic Masai and the traditional agrarian Kikuyu. The activities engage students in an exploration of the dynamic interactions between these people and the animals that share the same land. Activities include: (1) "Houses"; (2) "Elephants";…

A phase II study of sorafenib in recurrent and/or metastatic salivary gland carcinomas: Translational analyses and clinical impact.

PubMed

Locati, L D; Perrone, F; Cortelazzi, B; Bergamini, C; Bossi, P; Civelli, E; Morosi, C; Lo Vullo, S; Imbimbo, M; Quattrone, P; Dagrada, G P; Granata, R; Resteghini, C; Mirabile, A; Alfieri, S; Orlandi, E; Mariani, L; Saibene, G; Pilotti, S; Licitra, L

2016-12-01

Pre-clinical and clinical evidence suggests a rationale for the use of anti-angiogenic agents, including sorafenib, in recurrent and/or metastatic salivary gland carcinomas (RMSGCs). This study evaluates the activity of sorafenib in patients with RMSGCs and also investigates whether the activity of sorafenib could be related to its main tailored targets (i.e. BRAF, vascular endothelial growth factor receptor 2 [VEGFR2], platelet-derived growth factor receptor α [PDGFRα] and β, RET, KIT). Patients received sorafenib at 400 mg BID. The primary end-point was response rate (RR) including complete response or partial response (PR); secondary end-points included RR according to Choi criteria, disease control rate (DCR), overall survival (OS), and progression-free survival (PFS). Thirty-seven patients (19 adenoid cystic cancers, ACC) were enrolled. Six PRs were recorded. RR was 16% (95% confidence interval [CI]: 6-32; 11% in ACC and 22% in non-ACC). Choi criteria could be applied in 30 out of 37 cases with a RR of 50% (95% CI: 31-69%); DCR was 76% (95% CI: 59-88%). Incidence of ≥G3 adverse events was 29.7%. Median PFS and OS for the entire population were 5.9 months and 23.4 months, respectively. Median PFS and OS were 8.9 and 26.4 months for ACC versus 4.2 and 12.3 months for non-ACC patients. All the cases showed expression of PDGFRβ in the stroma and VEGFR2 in endothelial cells; PDGFRα positivity was found in the stroma of four (27%) cases. All except for two cases showed no PDGFRβ, VEGFR2 and PDGFRα expression in the tumour cells. KIT expression was restricted to ACC and a weak RET expression was limited to one adenocarcinoma, not otherwise specified (NOS). No BRAF mutation was found. No correlation was observed between the sorafenib activity and the expression of its markers although all six responders (two ACC, one adenocarcinoma, NOS, one salivary duct cancer [SDC], one high-grade mucoepidermoid [HG-MEC] and one poorly-differentiated cancer) are enriched in the stromal component showing a PDGFRβ immunodecoration. In ACCs, immunohistochemistry revealed MYB protein expression in 15/16 cases (94%) and the MYB-NFIB fusion oncogene was observed in 9/14 (64%). Sorafenib is the first anti-angiogenic agent to demonstrate activity in RMSGC patients, particularly in some histotypes such as HG-MEC, SDC and adenocarcinoma, NOS. The PDGFRβ-positive rich stromal component characterising these histotypes and the lack of correlation between the activity of sorafenib and its targets suggests anti-angiogenic effect as the prevalent mechanism of action of sorafenib in SGCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Future Contracting for Availability

DTIC Science & Technology

2016-04-30

including Tornado and Harrier fast jets, and logistics activities related to aerial refueling. These cases outline the benefits achieved on these...platforms—including savings in the billions of pounds. Tornado and Harrier Aircraft Under the Tornado and Harrier programs, the Royal Air Force paid...owned K-707 and KDC-10 to refuel British Royal Air Force (RAF) GR-4A Tornadoes and Canadian Air Force CF-18s during training operations. Over the

A Safety Case Approach for Deep Geologic Disposal of DOE HLW and DOE SNF in Bedded Salt - 13350

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sevougian, S. David; MacKinnon, Robert J.; Leigh, Christi D.

2013-07-01

The primary objective of this study is to investigate the feasibility and utility of developing a defensible safety case for disposal of United States Department of Energy (U.S. DOE) high-level waste (HLW) and DOE spent nuclear fuel (SNF) in a conceptual deep geologic repository that is assumed to be located in a bedded salt formation of the Delaware Basin [1]. A safety case is a formal compilation of evidence, analyses, and arguments that substantiate and demonstrate the safety of a proposed or conceptual repository. We conclude that a strong initial safety case for potential licensing can be readily compiled bymore » capitalizing on the extensive technical basis that exists from prior work on the Waste Isolation Pilot Plant (WIPP), other U.S. repository development programs, and the work published through international efforts in salt repository programs such as in Germany. The potential benefits of developing a safety case include leveraging previous investments in WIPP to reduce future new repository costs, enhancing the ability to effectively plan for a repository and its licensing, and possibly expediting a schedule for a repository. A safety case will provide the necessary structure for organizing and synthesizing existing salt repository science and identifying any issues and gaps pertaining to safe disposal of DOE HLW and DOE SNF in bedded salt. The safety case synthesis will help DOE to plan its future R and D activities for investigating salt disposal using a risk-informed approach that prioritizes test activities that include laboratory, field, and underground investigations. It should be emphasized that the DOE has not made any decisions regarding the disposition of DOE HLW and DOE SNF. Furthermore, the safety case discussed herein is not intended to either site a repository in the Delaware Basin or preclude siting in other media at other locations. Rather, this study simply presents an approach for accelerated development of a safety case for a potential DOE HLW and DOE SNF repository using the currently available technical basis for bedded salt. This approach includes a summary of the regulatory environment relevant to disposal of DOE HLW and DOE SNF in a deep geologic repository, the key elements of a safety case, the evolution of the safety case through the successive phases of repository development and licensing, and the existing technical basis that could be used to substantiate the safety of a geologic repository if it were to be sited in the Delaware Basin. We also discuss the potential role of an underground research laboratory (URL). (authors)« less

Physical activity and its effects on reproduction.

PubMed

Redman, Leanne M

2006-05-01

The reproductive system is tightly coupled with energy balance, and thereby changes in the status of energy balance through changes in physical activity can impact on the reproductive system. In light of the new physical activity for health recommendations, it is therefore important to understand the inherent effects, both positive and negative, of physical activity on the reproductive system. At both extremes of the energy spectrum, disorders of chronic energy excess and energy deficiency are characterized by a wide range of reproductive disorders, including menstrual irregularity, anovulation, polycystic ovarian syndrome, and infertility in women, and erectile dysfunction and altered spermatogenesis in men. Although laboratory research indicates that individuals may be able to prevent or reverse reproductive disruptions, either by increasing energy expenditure in cases of energy excess or by dietary reform in cases of energy deficits, there is an acute need for applied research to confirm this idea and to identify mechanisms by which the availability of energy per se regulates reproductive function in humans.

Modulating reproductive activity in stallions: a review.

PubMed

Stout, T A E

2005-10-01

Situations in which suppression or stimulation of reproductive activity in stallions has been attempted, or is desired, include resolution of the equine arteritis virus 'shedding' state, induction of testicular descent in inguinal cryptorchids, and the improvement of sperm production capacity and/or semen quality in sub-fertile stallions. However, the most common reason for wanting to modulate reproductive activity in a stallion is to alter the expression of sexual behaviour. In the case of intact stallions used for competitive or recreational purposes, the overt expression of sexual or aggressive behaviour can be distracting for both animal and owner and, in some cases, dangerous to all concerned. By the same token, a breeding stallion that displays little interest in mounting a mare/phantom, or is slow to achieve erection and/or ejaculation, can be extremely frustrating. This paper reviews the major pharmacological agents reported to usefully modify reproductive activity in stallions, and outlines their pros and cons when compared to training, management or surgical alternatives.

[Introduction of active learning and student readership in teaching by the pharmaceutical faculty].

PubMed

Sekiguchi, Masaki; Yamato, Ippei; Kato, Tetsuta; Torigoe, Kojyun

2005-07-01

We have introduced improvements and new approaches into our teaching methods by exploiting 4 active learning methods for pharmacy students of first year. The 4 teaching methods for each lesson or take home assignment are follows: 1) problem-based learning (clinical case) including a student presentation of the clinical case, 2) schematic drawings of the human organs, one drawing done in 15-20 min during the week following a lecture and a second drawing done with reference to a professional textbook, 3) learning of professional themes in take home assignments, and 4) short test in order to confirm the understanding of technical terms by using paper or computer. These improvements and new methods provide active approaches for pharmacy students (as opposed to passive memorization of words and image study). In combination, they have proven to be useful as a learning method to acquire expert knowledge and to convert from passive learning approach to active learning approach of pharmacy students in the classroom.

Asymmetrical brain activity induced by voluntary spatial attention depends on the visual hemifield: a functional near-infrared spectroscopy study.

PubMed

Harasawa, Masamitsu; Shioiri, Satoshi

2011-04-01

The effect of the visual hemifield to which spatial attention was oriented on the activities of the posterior parietal and occipital visual cortices was examined using functional near-infrared spectroscopy in order to investigate the neural substrates of voluntary visuospatial attention. Our brain imaging data support the theory put forth in a previous psychophysical study, namely, the attentional resources for the left and right visual hemifields are distinct. Increasing the attentional load asymmetrically increased the brain activity. Increase in attentional load produced a greater increase in brain activity in the case of the left visual hemifield than in the case of the right visual hemifield. This asymmetry was observed in all the examined brain areas, including the right and left occipital and parietal cortices. These results suggest the existence of asymmetrical inhibitory interactions between the hemispheres and the presence of an extensive inhibitory network. Copyright © 2011 Elsevier Inc. All rights reserved.

The Many Faces of Meningococcal Disease: A Case Series and Review of Presentations and Treatment Options

DTIC Science & Technology

2004-01-01

United States. Classic findings include headache, fevers , and a petechial rash that begins on the lower extremities with a predilection for areas of...cough and sore throat, but no headache or fevers . He reported to the medical clinic at 9:00 a.m., 6 hours after the rash began. He was in acute...meningitidis septicemia (meningococcemia). Case 2 A 22-year-old active-duty female developed fevers , headaches, confusion, and a rash on her

Health impact assessment in multinationals: A case study of the Royal Dutch/Shell Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Birley, Martin

2005-10-15

Health impact assessment is part of the risk management process of multinational corporations/companies. Sexually transmitted infections, including HIV/AIDS, and the 'paradox of plenty' are used as examples of the challenges they face. The 'business case' for impact assessment is explained. The policies, procedures, standards, and activities used by Shell to manage such risks are described. An approach to capacity building and competency development is presented that applies to both company staff and external contractors.

THE COMMAND OF THE TREND: SOCIAL MEDIA AS A WEAPON IN THE INFORMATION AGE

DTIC Science & Technology

2017-06-01

and a bot network) based on the analysis within this case study . Table 3. ISIS Case Study Analysis Propaganda Narratives 1. ISIS is strong...get started with an interview and included me in a cyber think-tank for the study of ISIS activity on social media. Additionally, I am still... study demonstrates how social media is a tool for modern warfare in the information age. The report builds on analysis of three distinct topics

Validation of Student and Parent Reported Data on the Basic Grant Application Form, 1978-79 Comprehensive Validation Guide. Procedural Manual for: Validation of Cases Referred by Institutions; Validation of Cases Referred by the Office of Education; Recovery of Overpayments.

ERIC Educational Resources Information Center

Smith, Karen; And Others

Procedures for validating data reported by students and parents on an application for Basic Educational Opportunity Grants were developed in 1978 for the U.S. Office of Education (OE). Validation activities include: validation of flagged Student Eligibility Reports (SERs) for students whose schools are part of the Alternate Disbursement System;…

The Prachanda Path and Oglaigh na hEireann: A Comparative Case Study of the Insurgencies in Nepal and Northern Ireland

DTIC Science & Technology

2008-05-22

Prior to the 1980s, politicians aligned with the PIRA conducted an activity called “ abstentionism ,” which meant that they participated in elections... The Prachanda Path and Óglaigh na hÉireann: A Comparative Case Study of the Insurgencies in Nepal and Northern Ireland A Monograph by MAJOR...burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing

CD8+ T Lymphocyte Expansion, Proliferation and Activation in Dengue Fever

PubMed Central

de Matos, Andréia Manso; Carvalho, Karina Inacio; Rosa, Daniela Santoro; Villas-Boas, Lucy Santos; da Silva, Wanessa Cardoso; Rodrigues, Célia Luiza de Lima; Oliveira, Olímpia Massae Nakasone Peel Furtado; Levi, José Eduardo; Araújo, Evaldo Stanislau Affonso; Pannuti, Claudio Sergio; Luna, Expedito José Albuquerque; Kallas, Esper George

2015-01-01

Dengue fever induces a robust immune response, including massive T cell activation. The level of T cell activation may, however, be associated with more severe disease. In this study, we explored the level of CD8+ T lymphocyte activation in the first six days after onset of symptoms during a DENV2 outbreak in early 2010 on the coast of São Paulo State, Brazil. Using flow cytometry we detected a progressive increase in the percentage of CD8+ T cells in 74 dengue fever cases. Peripheral blood mononuclear cells from 30 cases were thawed and evaluated using expanded phenotyping. The expansion of the CD8+ T cells was coupled with increased Ki67 expression. Cell activation was observed later in the course of disease, as determined by the expression of the activation markers CD38 and HLA-DR. This increased CD8+ T lymphocyte activation was observed in all memory subsets, but was more pronounced in the effector memory subset, as defined by higher CD38 expression. Our results show that most CD8+ T cell subsets are expanded during DENV2 infection and that the effector memory subset is the predominantly affected sub population. PMID:25675375

The potential of virtual reality-based training to enhance the functional autonomy of Alzheimer's disease patients in cooking activities: A single case study.

PubMed

Foloppe, Déborah A; Richard, Paul; Yamaguchi, Takehiko; Etcharry-Bouyx, Frédérique; Allain, Philippe

2018-07-01

Impairments in performing activities of daily living occur early in the course of Alzheimer's disease (AD). There is a great need to develop non-pharmacological therapeutic interventions likely to reduce dependency in everyday activities in AD patients. This study investigated whether it was possible to increase autonomy in these patients in cooking activities using interventions based on errorless learning, vanishing-cue, and virtual reality techniques. We recruited a 79-year-old woman who met NINCDS-ADRDA criteria for probable AD. She was trained in four cooking tasks for four days per task, one hour per day, in virtual and in real conditions. Outcome measures included subjective data concerning the therapeutic intervention and the experience of virtual reality, repeated assessments of training activities, neuropsychological scores, and self-esteem and quality of life measures. The results indicated that our patient could relearn some cooking activities using virtual reality techniques. Transfer to real life was also observed. Improvement of the task performance remained stable over time. This case report supports the value of a non-immersive virtual kitchen to help people with AD to relearn cooking activities.

Using model based systems engineering for the development of the Large Synoptic Survey Telescope's operational plan

NASA Astrophysics Data System (ADS)

Selvy, Brian M.; Claver, Charles; Willman, Beth; Petravick, Don; Johnson, Margaret; Reil, Kevin; Marshall, Stuart; Thomas, Sandrine; Lotz, Paul; Schumacher, German; Lim, Kian-Tat; Jenness, Tim; Jacoby, Suzanne; Emmons, Ben; Axelrod, Tim

2016-08-01

We† provide an overview of the Model Based Systems Engineering (MBSE) language, tool, and methodology being used in our development of the Operational Plan for Large Synoptic Survey Telescope (LSST) operations. LSST's Systems Engineering (SE) team is using a model-based approach to operational plan development to: 1) capture the topdown stakeholders' needs and functional allocations defining the scope, required tasks, and personnel needed for operations, and 2) capture the bottom-up operations and maintenance activities required to conduct the LSST survey across its distributed operations sites for the full ten year survey duration. To accomplish these complimentary goals and ensure that they result in self-consistent results, we have developed a holistic approach using the Sparx Enterprise Architect modeling tool and Systems Modeling Language (SysML). This approach utilizes SysML Use Cases, Actors, associated relationships, and Activity Diagrams to document and refine all of the major operations and maintenance activities that will be required to successfully operate the observatory and meet stakeholder expectations. We have developed several customized extensions of the SysML language including the creation of a custom stereotyped Use Case element with unique tagged values, as well as unique association connectors and Actor stereotypes. We demonstrate this customized MBSE methodology enables us to define: 1) the rolls each human Actor must take on to successfully carry out the activities associated with the Use Cases; 2) the skills each Actor must possess; 3) the functional allocation of all required stakeholder activities and Use Cases to organizational entities tasked with carrying them out; and 4) the organization structure required to successfully execute the operational survey. Our approach allows for continual refinement utilizing the systems engineering spiral method to expose finer levels of detail as necessary. For example, the bottom-up, Use Case-driven approach will be deployed in the future to develop the detailed work procedures required to successfully execute each operational activity.

Redox-dependent transcriptional regulation.

PubMed

Liu, Hongjun; Colavitti, Renata; Rovira, Ilsa I; Finkel, Toren

2005-11-11

Reactive oxygen species contribute to the pathogenesis of a number of disparate disorders including tissue inflammation, heart failure, hypertension, and atherosclerosis. In response to oxidative stress, cells activate expression of a number of genes, including those required for the detoxification of reactive molecules as well as for the repair and maintenance of cellular homeostasis. In many cases, these induced genes are regulated by transcription factors whose structure, subcellular localization, or affinity for DNA is directly or indirectly regulated by the level of oxidative stress. This review summarizes the recent progress on how cellular redox status can regulate transcription-factor activity and the implications of this regulation for cardiovascular disease.

Serum and tissue angiotensin-converting enzyme in patients with alopecia areata.

PubMed

Fahim, Shabnam; Montazer, Fatemeh; Tohidinik, Hamid Reza; Naraghi, Zahra Safaei; Abedini, Robabeh; Nasimi, Maryam; Ghandi, Narges

2018-03-27

Alopecia areata is an immune-dependent disorder characterized by the interaction of T-lymphocytes with follicular antigens. Recent studies have shown the existence of a local renin-angiotensin system in the skin, where angiotensin-converting enzyme (ACE) plays a role in autoimmunity and inflammation. The objective of this study was to evaluate serum and tissue ACE activity in patients with alopecia areata. This case-control study was conducted on patients with alopecia areata and healthy controls. Serum and tissue ACE activity were assessed and compared between the two groups. Twenty-five alopecia areata patients (60% male, mean age 32.1 ± 9.9 years) and 24 controls (50% male, mean age 37.4 ± 8.8 years) were included. Mean serum ACE activity was 52.1 ± 9 U/L in cases and 55.3 ± 14.7 U/L in controls (P = 0.37). Tissue ACE activity was significantly lower in cases in all parts of the skin i.e. epidermis (P = 0.016), follicular epithelium (P = 0.004), and endothelium (P = 0.037). Among cases, serum ACE activity was significantly higher in patients with more severe disease (P = 0.030), nonpatchy alopecia areata (alopecia universalis; ophiasis, patchy and ophiasis, diffuse) (P = 0.029), and with nail involvement (P = 0.027). The sample size was too small to draw definite conclusions. Further, most of the patients had only mild or moderate alopecia areata. Unlike in some other inflammatory diseases, the tissue level of ACE seems to be significantly lower in alopecia areata compared to normal controls. Serum ACE was significantly higher in patients with more severe disease.

[Effects of agricultural activities and transgenic crops on agricultural biodiversity].

PubMed

Zhang, Xi-Tao; Luo, Hong-Bing; Li, Jun-Sheng; Huang, Hai; Liu, Yong-Bo

2014-09-01

Agricultural biodiversity is a key part of the ecosystem biodiversity, but it receives little concern. The monoculture, environmental pollution and habitat fragmentation caused by agricultural activities have threatened agricultural biodiversity over the past 50 years. To optimize agricultural management measures for crop production and environmental protection, we reviewed the effects of agricultural activities, including cultivation patterns, plastic mulching, chemical additions and the cultivation of transgenic crops, on agricultural biodiversity. The results showed that chemical pesticides and fertilizers had the most serious influence and the effects of transgenic crops varied with other factors like the specific transgene inserted in crops. The environmental risk of transgenic crops should be assessed widely through case-by-case methods, particularly its potential impacts on agricultural biodiversity. It is important to consider the protection of agricultural biodiversity before taking certain agricultural practices, which could improve agricultural production and simultaneously reduce the environmental impacts.

Benefits assessment of active control technology and related cockpit technology for rotorcraft

NASA Technical Reports Server (NTRS)

Hampton, B. J.

1982-01-01

Two main-rotor active control concepts, one incorporating multicyclic actuators located just below the swashplate, and the other providing for the actuators and power supplies to be located in the rotating frame are considered. Each design concept is integrated with cockpit controllers and displays appropriate to the actuation concept in each case. The benefits of applying the defined ACT/RCT concepts to rotorcraft are quantified by comparison to the baseline model 412 helicopter. These benefits include, in the case of one active control concept; (1) up to 91% reduction in 4/rev hub shears; (2) a flight safety failure rate of 1.96 x 10 to the 8th power failures per flight-hour; (3) rotating controls/rotor hub drag reduction of 40%; (4) a 9% reduction in control system weight; and (5) vibratory deicing. The related cockpit concept reduces pilot workload for critical mission segments as much as 178% visual and 25% manual.

Effect of conglutinin on phagocytic activity of bovine granulocytes.

PubMed

Dec, M; Wernicki, A; Puchalski, A; Urban-Chmiel, R; Radej, S

2012-01-01

In the present study we investigated the effect of bovine conglutinin on the phagocytic activity of leukocytes. We measured both the chemotactic activity of conglutinin and its effect on the internalization of zymosan particles and E. coli by granulocytes. We also assessed the binding of conglutinin to various microorganisms isolated from clinical cases in cattle. We showed that conglutinin binds strongly to the surface of yeast cells and to mannan-rich zymosan particles, while weak binding was observed in the case of the bacterial strains tested, including those whose O antigen is composed of mannan. Conglutinin (1-10 microg/ml) neither acts as a chemotactic factor for peripheral blood leukocytes nor affects ingestion of E. coli by granulocytes. However, as flow cytometry based assay showed, conglutinin (0.1-1 microg/ml) increased ingestion of zymosan expressed as mean fluorescence intensity (MFI) of positive cells.

A modeled economic analysis of a digital tele-ophthalmology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy.

PubMed

Whited, John D; Datta, Santanu K; Aiello, Lloyd M; Aiello, Lloyd P; Cavallerano, Jerry D; Conlin, Paul R; Horton, Mark B; Vigersky, Robert A; Poropatich, Ronald K; Challa, Pratap; Darkins, Adam W; Bursell, Sven-Erik

2005-12-01

The objective of this study was to compare, using a 12-month time frame, the cost-effectiveness of a non-mydriatic digital tele-ophthalmology system (Joslin Vision Network) versus traditional clinic-based ophthalmoscopy examinations with pupil dilation to detect proliferative diabetic retinopathy and its consequences. Decision analysis techniques, including Monte Carlo simulation, were used to model the use of the Joslin Vision Network versus conventional clinic-based ophthalmoscopy among the entire diabetic populations served by the Indian Health Service, the Department of Veterans Affairs, and the active duty Department of Defense. The economic perspective analyzed was that of each federal agency. Data sources for costs and outcomes included the published literature, epidemiologic data, administrative data, market prices, and expert opinion. Outcome measures included the number of true positive cases of proliferative diabetic retinopathy detected, the number of patients treated with panretinal laser photocoagulation, and the number of cases of severe vision loss averted. In the base-case analyses, the Joslin Vision Network was the dominant strategy in all but two of the nine modeled scenarios, meaning that it was both less costly and more effective. In the active duty Department of Defense population, the Joslin Vision Network would be more effective but cost an extra 1,618 dollars per additional patient treated with panretinal laser photo-coagulation and an additional 13,748 dollars per severe vision loss event averted. Based on our economic model, the Joslin Vision Network has the potential to be more effective than clinic-based ophthalmoscopy for detecting proliferative diabetic retinopathy and averting cases of severe vision loss, and may do so at lower cost.

Defining the performance gap: Conducting a self-assessment

NASA Technical Reports Server (NTRS)

Braymer, Susan A.; Stoner, David L.; Powell, William C.

1992-01-01

This paper presents two different approaches to performing self-assessments of continuous improvement activities. Case Study 1 describes the activities performed by JSC to assess the implementation of continuous improvement efforts at the NASA Center. The JSC approach included surveys administered to randomly selected NASA personnel and personal interviews with NASA and contractor management personnel. Case Study 2 describes the continuous improvement survey performed by the JSC Safety, Reliability, and Quality Assurance (SR&QA) organization. This survey consisted of a short questionnaire (50 questions) administered to all NASA and contractor SR&QA personnel. The questionnaire is based on the eight categories of the President's Award for Quality and Productivity Improvement. It is designed to objectively determine placement on the TQ benchmark and identify a roadmap for improvement.

Learning Across Cultures: Intercultural Communication and International Educational Exchange.

ERIC Educational Resources Information Center

Althen, Gary, Ed.; And Others

Aspects of intercultural educational activity, research on learning, and implications for educational interchange, and case studies of the application of ideas from the intercultural communication field to work in international educational interchange are addressed in nine papers. Contents include: "Dynamics of Cross-cultural Adjustment: from…

Practical Project Management for Education and Training.

ERIC Educational Resources Information Center

Lockitt, Bill

This booklet provides a succinct guide to effective management procedures, including whether and how to take on projects, estimation of costs prior to project bids, project management tools, case studies, and practical exercises for staff development activities. Chapter 1 investigates why institutions take on projects, issues involved, benefits…

Freedom of Religion and the Public Schools.

ERIC Educational Resources Information Center

Williams, Mary Louise

1991-01-01

Presents activities for teaching high school students about the freedom of religion. Includes student handouts that explain basic constitutional principles and summarize leading U.S. Supreme Court cases concerning religious liberty. Encourages teachers to invite students to speculate on the future relationship of religion and public education. (SG)

75 FR 28098 - Agency Information Collection Activities: Notice of Request for Extension of Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... studying crashes using case-control methods including the Grand Rapids study, (Borkenstein, R.F., Crowther... Federal holidays. SUPPLEMENTARY INFORMATION: Title: Motorcycle Crash Causation Study and Pilot Motorcycle Crash Causes and Outcomes Study. OMB Control #: 2125-0619. Background: Motorcycle injuries and...

School Safety and Congress. Teaching Strategy.

ERIC Educational Resources Information Center

Kopecky, Frank

1995-01-01

Presents a lesson plan that examines the effects of Supreme Court decisions on state/federal relations using the issue of school safety. Student handouts discuss the constitutionality of the Gun Free School Zones Act as it relates to a specific criminal case. Activities include several structured discussions. (MJP)

78 FR 37785 - Foreign-Trade Zone (FTZ) 196-Fort Worth, Texas; Notification of Proposed Production Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... carrying cases, wrist straps, screws, power supplies, nickel/ cadmium batteries, lithium/ion batteries, other batteries, antenna assemblies, audio flex assemblies, bridge flex assemblies, interplex assembly... components and materials sourced from abroad include: labels, battery adhesives, decals, Kevlar protective...

An Introduction to Research and the Computer: A Self-Instructional Package.

ERIC Educational Resources Information Center

Vasu, Ellen Storey; Palmer, Richard I.

This self-instructional package includes learning objectives, definitions, exercises, and feedback for learning some basic concepts and skills involved in using computers for analyzing data and understanding basic research terminology. Learning activities are divided into four sections: research and research hypotheses; variables, cases, and…

Mini epidemic of isoniazide resistant TB in rural TN: a need for supervised preventive therapy.

PubMed

Mehta, Jay; Keith, Rob; Al Hasan, Muhannad; Ryland, Byrd; Roy, Thomas

2009-08-01

With the resurgence of tuberculosis (TB) in the late 1980s, multi-drug-resistant TB (MDR-TB) also became a serious challenge to the TB control programs across the United States (US). While the incidence of TB resumed a downward trend in the mid 1900s, drug-resistant TB continues to be a national and international problem. We reviewed the public health data of drug-resistant TB cases (1996-2002) in Greene County, TN, with a detailed analysis of their contact investigation. Our study included demographic data of age, sex, race, human immunodeficiency virus (HIV) status and other known risk factors for drug-resistant TB. Contact investigation of two patients with isoniazide-resistant active pulmonary TB led to the discovery of two additional cases of active pulmonary tuberculosis, one of them being a 14-month-old child. All four of the patients were U.S. born, had negative HIV tests, and lacked other risk factors for drug-resistant TB. In all four cases, the Mycobacterium tuberculosis isolates were resistant to isoniazide, three were streptomycin resistant, and was ethambutol resistant. A total of 65 close contacts were identified, 11 of whom had a positive purified protein derivative (PPD) skin test indicating latent TB infection. Based on the American Thoracic Society's recommendations, the contacts with a positive PPD were prescribed rifampin for chemo-prevention rather than INH. However, one active case was detected from this infected contact who had failed to comply with chemo-preventive therapy. The second active case was a child who developed active pulmonary TB before chemoprevention could be initiated. Drug culture profile and DNA analysis (RFLP) confirmed the same source for TB transmission. The 11/65 (16.5 percent) infection rate among the contact was comparable to the state average (p < 0.05), but the case rate of 4/65 (6.15 percent) was high. In two out of four active cases, who were family members of the known cases, active infection could have been prevented. High prevalence of drug-resistant TB in rural areas without any known risk factors and failure of prevention are crucial findings of our study. Clinicians practicing in a rural setting should be aware of occasional mini-outbreaks of drug-resistant TB. Supervised therapy for rifampin chemo-prophylaxis and other standard public health measures successfully controlled this mini-epidemic. Awareness of drug resistance in family clusters and an urgent need for prompt chemo-preventive measures are important in implementing successful TB control programs.

Tuberculosis active case finding in Cambodia: a pragmatic, cost-effectiveness comparison of three implementation models.

PubMed

James, Richard; Khim, Keovathanak; Boudarene, Lydia; Yoong, Joanne; Phalla, Chea; Saint, Saly; Koeut, Pichenda; Mao, Tan Eang; Coker, Richard; Khan, Mishal Sameer

2017-08-22

Globally, almost 40% of tuberculosis (TB) patients remain undiagnosed, and those that are diagnosed often experience prolonged delays before initiating correct treatment, leading to ongoing transmission. While there is a push for active case finding (ACF) to improve early detection and treatment of TB, there is extremely limited evidence about the relative cost-effectiveness of different ACF implementation models. Cambodia presents a unique opportunity for addressing this gap in evidence as ACF has been implemented using different models, but no comparisons have been conducted. The objective of our study is to contribute to knowledge and methodology on comparing cost-effectiveness of alternative ACF implementation models from the health service perspective, using programmatic data, in order to inform national policy and practice. We retrospectively compared three distinct ACF implementation models - door to door symptom screening in urban slums, checking contacts of TB patients, and door to door symptom screening focusing on rural populations aged above 55 - in terms of the number of new bacteriologically-positive pulmonary TB cases diagnosed and the cost of implementation assuming activities are conducted by the national TB program of Cambodia. We calculated the cost per additional case detected using the alternative ACF models. Our analysis, which is the first of its kind for TB, revealed that the ACF model based on door to door screening in poor urban areas of Phnom Penh was the most cost-effective (249 USD per case detected, 737 cases diagnosed), followed by the model based on testing contacts of TB patients (308 USD per case detected, 807 cases diagnosed), and symptomatic screening of older rural populations (316 USD per case detected, 397 cases diagnosed). Our study provides new evidence on the relative effectiveness and economics of three implementation models for enhanced TB case finding, in line with calls for data from 'routine conditions' to be included in disease control program strategic planning. Such cost-effectiveness comparisons are essential to inform resource allocation decisions of national policy makers in resource constraint settings. We applied a novel, pragmatic methodological approach, which was designed to provide results that are directly relevant to policy makers, costing the interventions from Cambodia's national TB program's perspective and using case finding data from implementation activities, rather than experimental settings.

Long-term symptomatic, functional, and work outcomes of carpal tunnel syndrome among construction workers.

PubMed

Evanoff, Bradley; Gardner, Bethany T; Strickland, Jaime R; Buckner-Petty, Skye; Franzblau, Alfred; Dale, Ann Marie

2016-05-01

The long-term outcomes of carpal tunnel syndrome (CTS) including symptoms, functional status, work disability, and economic impact are unknown. We conducted a retrospective study of 234 active construction workers with medical claims for CTS and 249 workers without CTS claims; non-cases were matched on age, trade, and insurance eligibility. We conducted telephone interviews with cases and non-cases and collected administrative data on work hours. Compared to non-cases, CTS cases were more likely to report recurrent hand symptoms, decreased work productivity/quality, decreased performance of physical work demands, and greater functional limitations. Surgical cases showed larger improvements on multiple outcomes than non-surgical cases. Minimal differences in paid work hours were seen between cases and non-cases in the years preceding and following CTS claims. Persistent symptoms and functional impairments were present several years after CTS diagnosis. Long-term functional limitations shown by this and other studies indicate the need for improved prevention and treatment. © 2016 Wiley Periodicals, Inc.

Environmental surveillance during an outbreak of tularaemia in hares, the Netherlands, 2015

PubMed Central

Janse, Ingmar; Maas, Miriam; Rijks, Jolianne M; Koene, Miriam; van der Plaats, Rozemarijn QJ; Engelsma, Marc; van der Tas, Peter; Braks, Marieta; Stroo, Arjan; Notermans, Daan W; de Vries, Maaike C; Reubsaet, Frans; Fanoy, Ewout; Swaan, Corien; Kik, Marja JL; IJzer, Jooske; Jaarsma, Ryanne I; van Wieren, Sip; de Roda-Husman, Ana Maria; van Passel, Mark; Roest, Hendrik-Jan; van der Giessen, Joke

2017-01-01

Tularaemia, a disease caused by the bacterium Francisella tularensis, is a re-emerging zoonosis in the Netherlands. After sporadic human and hare cases occurred in the period 2011 to 2014, a cluster of F. tularensis-infected hares was recognised in a region in the north of the Netherlands from February to May 2015. No human cases were identified, including after active case finding. Presence of F. tularensis was investigated in potential reservoirs and transmission routes, including common voles, arthropod vectors and surface waters. F. tularensis was not detected in common voles, mosquito larvae or adults, tabanids or ticks. However, the bacterium was detected in water and sediment samples collected in a limited geographical area where infected hares had also been found. These results demonstrate that water monitoring could provide valuable information regarding F. tularensis spread and persistence, and should be used in addition to disease surveillance in wildlife. PMID:28877846

Spectral properties of all-active InP-based microring resonator devices

NASA Astrophysics Data System (ADS)

Kapsalis, A.; Alexandropoulos, D.; Mikroulis, S.; Simos, H.; Stamataki, I.; Syvridis, D.; Hamacher, M.; Troppenz, U.; Heidrich, H.

2006-02-01

Microring resonators are excellent candidates for very large scale photonic integration due to their compactness, and fabrication simplicity. Moreover a wide range of all-optical signal processing functions can be realized due to the resonance effect. Possible applications include filtering, add/drop of optical beams and power switching, as well as more complex procedures including multiplexing, wavelength conversion, and logic operations. All-active ring components based in InGaAsP/InP are possible candidates for laser sources, lossless filters, wavelength converters, etc. Our work is based on measurement, characterization and proposal of possible exploitation of such devices in a variety of applications. We investigate the spectral characteristics of multi-quantum well InGaAsP(λ=1.55μm)/InP microring structures of various ring diameters and different configurations including racetracks with one or two bus waveguides and MMI couplers. The latter configuration has recently exhibited the possibility to obtain tunable active filters as well as tunable laser sources based on all-active ring-bus-coupler structures. In the case of tunable lasers single mode operation has been achieved by obtaining sufficiently high side mode suppression ratio. The tuning capability is attributed to a coupled cavities effect, resembling the case of multi-section DBR lasers. However, in contrast to the latter, the fabrication of microring resonators is considered an easier task, due to a single step growth procedure, although further investigation must be carried out in order to achieve wide range tunability. Detailed mappings of achievable wavelengths are produced for a wide range of injection current values.

Progress toward poliomyelitis eradication --- Nigeria, January 2010-June 2011.

PubMed

2011-08-12

The Global Polio Eradication Initiative (GPEI) was launched by the World Health Assembly in 1988. By 2006, transmission of indigenous wild poliovirus (WPV) was interrupted in all countries except Nigeria, Afghanistan, Pakistan, and India. Among the 36 states and Federal Capital Territory of Nigeria, WPV transmission has persisted in eight northern states considered at high risk; in addition, four other northern states have been considered at high risk for WPV transmission. In these 12 high-risk states, type 2 circulating vaccine-derived poliovirus (cVDPV2) transmission also was observed during 2005-2011. This report updates GPEI progress in Nigeria during January 2010--June 2011 and describes activities required to interrupt transmission. In Nigeria, confirmed WPV cases decreased 95%, from 388 in 2009 to 21 in 2010; cVDPV2 cases decreased 82%, from 154 in 2009 to 27 in 2010. However, as of July 26, 2011, Nigeria had reported 24 WPV cases (including one WPV/cVDPV2 coinfection) and 11 cVDPV2 cases during January-June 2011, compared with six WPV cases and 10 cVDPV2 cases during January-June 2010. Despite substantial progress, immunization activities and surveillance sensitivity will need to be enhanced further to interrupt WPV transmission in Nigeria by the end of 2011.

Lobomycosis: a therapeutic challenge*

PubMed Central

Araújo, Marcelo Grossi; Cirilo, Nathalie Silva; dos Santos, Soraya Neves Marques Barbosa; Aguilar, Claudemir Roberto; Guedes, Antonio Carlos Martins

2018-01-01

Lobomycosis or lacaziosis is a chronic granulomatous fungal infection caused by Lacazia loboi. Most cases are restricted to tropical regions. Transmission is believed to occur through traumatic inoculation in the skin, mainly in exposed areas. It is characterized by keloid-like nodules. There are only a few hundred cases reported. The differential diagnoses include many skin conditions, and treatment is difficult. The reported case, initially diagnosed as keloid, proved to be refractory to surgical treatment alone. It was subsequently approached with extensive surgery, cryotherapy every three months and a combination of itraconazole and clofazimine for two years. No signs of clinical and histopathological activity were detected during follow-up. PMID:29723380

Mining Claim Activity on Federal Land in the United States

USGS Publications Warehouse

Causey, J. Douglas

2007-01-01

Several statistical compilations of mining claim activity on Federal land derived from the Bureau of Land Management's LR2000 database have previously been published by the U.S Geological Survey (USGS). The work in the 1990s did not include Arkansas or Florida. None of the previous reports included Alaska because it is stored in a separate database (Alaska Land Information System) and is in a different format. This report includes data for all states for which there are Federal mining claim records, beginning in 1976 and continuing to the present. The intent is to update the spatial and statistical data associated with this report on an annual basis, beginning with 2005 data. The statistics compiled from the databases are counts of the number of active mining claims in a section of land each year from 1976 to the present for all states within the United States. Claim statistics are subset by lode and placer types, as well as a dataset summarizing all claims including mill site and tunnel site claims. One table presents data by case type, case status, and number of claims in a section. This report includes a spatial database for each state in which mining claims were recorded, except North Dakota, which only has had two claims. A field is present that allows the statistical data to be joined to the spatial databases so that spatial displays and analysis can be done by using appropriate geographic information system (GIS) software. The data show how mining claim activity has changed in intensity, space, and time. Variations can be examined on a state, as well as a national level. The data are tied to a section of land, approximately 640 acres, which allows it to be used at regional, as well as local scale. The data only pertain to Federal land and mineral estate that was open to mining claim location at the time the claims were staked.

Triple Achilles Tendon Rupture: Case Report.

PubMed

Saxena, Amol; Hofer, Deann

We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Study of tethered satellite active attitude control

NASA Technical Reports Server (NTRS)

Colombo, G.

1982-01-01

Existing software was adapted for the study of tethered subsatellite rotational dynamics, an analytic solution for a stable configuration of a tethered subsatellite was developed, the analytic and numerical integrator (computer) solutions for this "test case' was compared in a two mass tether model program (DUMBEL), the existing multiple mass tether model (SKYHOOK) was modified to include subsatellite rotational dynamics, the analytic "test case,' was verified, and the use of the SKYHOOK rotational dynamics capability with a computer run showing the effect of a single off axis thruster on the behavior of the subsatellite was demonstrated. Subroutines for specific attitude control systems are developed and applied to the study of the behavior of the tethered subsatellite under realistic on orbit conditions. The effect of all tether "inputs,' including pendular oscillations, air drag, and electrodynamic interactions, on the dynamic behavior of the tether are included.

The Running Athlete

PubMed Central

Henning, P. Troy

2014-01-01

Context: Pelvic stress fractures, osteitis pubis, and snapping hip syndrome account for a portion of the overuse injuries that can occur in the running athlete. Evidence Acquisition: PubMed searches were performed for each entity using the following keywords: snapping hip syndrome, coxa sultans, pelvic stress fracture, and osteitis pubis from 2008 to 2013. Topic reviews, case reports, case series, and randomized trials were included for review. Study Design: Clinical review. Level of Evidence: Level 4. Results: Collectively, 188 articles were identified. Of these, 58 were included in this review. Conclusion: Based on the available evidence, the majority of these overuse injuries can be managed non-operatively. Primary treatment should include removal from offending activity, normalizing regional muscle strength/length imbalances and nutritional deficiencies, and mitigating training errors through proper education of the athlete and training staff. Strength of Recommendation Taxonomy: C PMID:24587861

Preventive home care of frail older people: a review of recent case management studies.

PubMed

Hallberg, Ingalill Rahm; Kristensson, Jimmie

2004-09-01

Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal caregiver's strain and satisfaction.

Delamination Assessment Tool for Spacecraft Composite Structures

NASA Astrophysics Data System (ADS)

Portela, Pedro; Preller, Fabian; Wittke, Henrik; Sinnema, Gerben; Camanho, Pedro; Turon, Albert

2012-07-01

Fortunately only few cases are known where failure of spacecraft structures due to undetected damage has resulted in a loss of spacecraft and launcher mission. However, several problems related to damage tolerance and in particular delamination of composite materials have been encountered during structure development of various ESA projects and qualification testing. To avoid such costly failures during development, launch or service of spacecraft, launcher and reusable launch vehicles structures a comprehensive damage tolerance verification approach is needed. In 2009, the European Space Agency (ESA) initiated an activity called “Delamination Assessment Tool” which is led by the Portuguese company HPS Lda and includes academic and industrial partners. The goal of this study is the development of a comprehensive damage tolerance verification approach for launcher and reusable launch vehicles (RLV) structures, addressing analytical and numerical methodologies, material-, subcomponent- and component testing, as well as non-destructive inspection. The study includes a comprehensive review of current industrial damage tolerance practice resulting from ECSS and NASA standards, the development of new Best Practice Guidelines for analysis, test and inspection methods and the validation of these with a real industrial case study. The paper describes the main findings of this activity so far and presents a first iteration of a Damage Tolerance Verification Approach, which includes the introduction of novel analytical and numerical tools at an industrial level. This new approach is being put to the test using real industrial case studies provided by the industrial partners, MT Aerospace, RUAG Space and INVENT GmbH

Assessing Hepatitis C Burden and Treatment Effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC): Design and Characteristics of Linked and Unlinked Participants

PubMed Central

Janjua, Naveed Zafar; Kuo, Margot; Chong, Mei; Yu, Amanda; Alvarez, Maria; Cook, Darrel; Armour, Rosemary; Aiken, Ciaran; Li, Karen; Mussavi Rizi, Seyed Ali; Woods, Ryan; Godfrey, David; Wong, Jason; Gilbert, Mark; Tyndall, Mark W.; Krajden, Mel

2016-01-01

Background The British Columbia (BC) Hepatitis Testers Cohort (BC-HTC) was established to assess and monitor hepatitis C (HCV) epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals. Methods The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV), HIV or active tuberculosis (TB) in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992) of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals. Results Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54%) were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90–100%). Conclusion Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV. PMID:26954020

Assessing Hepatitis C Burden and Treatment Effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC): Design and Characteristics of Linked and Unlinked Participants.

PubMed

Janjua, Naveed Zafar; Kuo, Margot; Chong, Mei; Yu, Amanda; Alvarez, Maria; Cook, Darrel; Armour, Rosemary; Aiken, Ciaran; Li, Karen; Mussavi Rizi, Seyed Ali; Woods, Ryan; Godfrey, David; Wong, Jason; Gilbert, Mark; Tyndall, Mark W; Krajden, Mel

2016-01-01

The British Columbia (BC) Hepatitis Testers Cohort (BC-HTC) was established to assess and monitor hepatitis C (HCV) epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals. The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV), HIV or active tuberculosis (TB) in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992) of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals. Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54%) were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90-100%). Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV.

Gastrointestinal histoplasmosis in the acquired immunodeficiency syndrome: report of 18 cases and literature review.

PubMed

Assi, Maha; McKinsey, David S; Driks, Michael R; O'Connor, Mary C; Bonacini, Maurizio; Graham, Bruce; Manian, Farrin

2006-07-01

No large case series of gastrointestinal histoplasmosis (GIH) in patients with AIDS has been published. We report 18 cases and review 34 published cases in the medical literature. We did a retrospective chart review from patients seen in our medical practices between 1989 and 2004. Most of our patients were men who had sex with men and who were not receiving highly active antiretroviral therapy. Median CD4 count was 34/muL. The most common presenting symptoms were diarrhea, fever, abdominal pain, and weight loss. The most commonly involved site was the colon or cecum. Biopsies revealed visible Histoplasma capsulatum organisms in 89%. Cultures from any site were positive in 76.9%. Four patients died from GIH. Gastrointestinal histoplasmosis occurs in severely immunocompromised patients with AIDS not receiving highly active antiretroviral therapy. Typical manifestations include diarrhea, fever, abdominal pain, and weight loss. Diagnosis is confirmed by blood or gastrointestinal tissue culture. Improvements in antiretroviral and antifungal therapies appear to have reduced the incidence of GIH and may improve the prognosis of this disease.

Risk factors for pneumonic and ulceroglandular tularaemia in Finland: a population-based case-control study.

PubMed

Rossow, H; Ollgren, J; Klemets, P; Pietarinen, I; Saikku, J; Pekkanen, E; Nikkari, S; Syrjälä, H; Kuusi, M; Nuorti, J P

2014-10-01

Few population-based data are available on factors associated with pneumonic and ulceroglandular type B tularaemia. We conducted a case-control study during a large epidemic in 2000. Laboratory-confirmed case patients were identified through active surveillance and matched control subjects (age, sex, residency) from the national population information system. Data were collected using a self-administered questionnaire. A conditional logistic regression model addressing missing data with Bayesian full-likelihood modelling included 227 case patients and 415 control subjects; reported mosquito bites [adjusted odds ratio (aOR) 9·2, 95% confidence interval (CI) 4·4-22, population-attributable risk (PAR) 82%] and farming activities (aOR 4·3, 95% CI 2·5-7·2, PAR 32%) were independently associated with ulceroglandular tularaemia, whereas exposure to hay dust (aOR 6·6, 95% CI 1·9-25·4, PAR 48%) was associated with pneumonic tularaemia. Although the bulk of tularaemia type B disease burden is attributable to mosquito bites, risk factors for ulceroglandular and pneumonic forms of tularaemia are different, enabling targeting of prevention efforts accordingly.

Time delay between cardiac and brain activity during sleep transitions

NASA Astrophysics Data System (ADS)

Long, Xi; Arends, Johan B.; Aarts, Ronald M.; Haakma, Reinder; Fonseca, Pedro; Rolink, Jérôme

2015-04-01

Human sleep consists of wake, rapid-eye-movement (REM) sleep, and non-REM (NREM) sleep that includes light and deep sleep stages. This work investigated the time delay between changes of cardiac and brain activity for sleep transitions. Here, the brain activity was quantified by electroencephalographic (EEG) mean frequency and the cardiac parameters included heart rate, standard deviation of heartbeat intervals, and their low- and high-frequency spectral powers. Using a cross-correlation analysis, we found that the cardiac variations during wake-sleep and NREM sleep transitions preceded the EEG changes by 1-3 min but this was not the case for REM sleep transitions. These important findings can be further used to predict the onset and ending of some sleep stages in an early manner.

THE USE OF TRIGGER POINT DRY NEEDLING AND INTRAMUSCULAR ELECTRICAL STIMULATION FOR A SUBJECT WITH CHRONIC LOW BACK PAIN: A CASE REPORT

PubMed Central

2013-01-01

Study Design: Case Report. Background and Purpose: Myofascial trigger points (MTrPs) are widely accepted by clinicians and researchers as a primary source of regional neuromusculoskeletal pain. Trigger point dry needling (TrP‐DN) is an invasive procedure that involves stimulation of MTrPs using an monofilament needle. The purpose of this case report is to report the outcomes of TrP‐DN and intramuscular electrical stimulation (IES) as a primary treatment intervention in a subject with chronic low back pain. Case Description: The subject was a 30‐year‐old female, active duty military, who was referred to physical therapy for low back and right posterolateral hip pain. She noticed symptoms after suffering a lumbar flexion injury while picking up a barbell during weight training. Physical examination demonstrated findings that supported the diagnosis of lumbar segmental instability with a right hip stability dysfunction. Objective findings included a multi‐segmental flexion movement pattern dysfunction and MTrPs in the right gluteus maximus and gluteus medius muscles with deep palpation. The subject was treated with TrP‐DN and IES for a total of two visits. Bilateral L3 and L5 multifidus and right gluteus maximus and medius muscles were treated, along with implementing a home exercise program consisting of core stability exercises. Outcomes: The subject reported no existing pain and disability on the Numerical Pain Rating Scale and Oswestry Disability Questionnaire and a large perceived change in recovery on the Global Rating of Change at final follow‐up. Physical examination was normal, demonstrating no observed impairments or functional limitations, including normal multi‐segmental flexion and no MTrPs with deep palpation. Discussion: The subject was able to return to full military active duty without any physical limitations and resumed pre‐injury activity levels, including the ability to resume all activities without pain. There is much promise regarding the use of TrP‐DN with IES intervention for the treatment of lumbar and/or hip stability dysfunction. Future research is recommended to determine if TrP‐DN intervention, with and without IES, is effective for other body regions and long‐term subject outcomes. Level of Evidence: Level 4. PMID:23593553

Occupational and leisure time physical activity and the risk of nonfatal acute myocardial infarction in Italy.

PubMed

Altieri, Andrea; Tavani, Alessandra; Gallus, Silvano; La Vecchia, Carlo

2004-08-01

Physical activity has long been related to a reduced risk of coronary heart disease (CHD), including acute myocardial infarction (AMI). However, the quantitative estimates of the possible protective role of physical activity appear to vary across studies and populations. A case-control study conducted in Italy between 1995 and 1999, including 507 incident cases below 79 years (378 men, 129 women) with a first episode of AMI, and 478 controls (297 men, 181 women) admitted to hospitals for acute conditions. Compared with the lowest level of occupational physical activity, the multivariate odds ratios (OR) of AMI for the highest level were 0.61 (95% confidence interval [CI], 0.38-0.97) at age 15 to 19 years, 0.57 (95% CI, 0.34-0.95) at age 30 to 39 years, and 0.51 (95% CI, 0.29-0.90) at age 50 to 59 years. The corresponding values for leisure time activity were 0.54 (95% CI, 0.38-0.77), 0.86 (95% CI, 0.57-1.30), and 1.00 (95% CI, 0.57-1.74), respectively. The association was consistent across strata of age, sex, education, smoking, and other selected covariates. The attributable risk for low occupational exercise at age 30 to 39 years was over 10%, indicating the scope for further intervention on this modifiable risk factor in this Italian population, particularly in consideration of the public health importance of CHD.

Noncanonical spike-related BOLD responses in focal epilepsy

PubMed Central

Lemieux, Louis; Laufs, Helmut; Carmichael, David; Paul, Joseph Suresh; Walker, Matthew C; Duncan, John S

2008-01-01

Till now, most studies of the Blood Oxygen Level-Dependent (BOLD) response to interictal epileptic discharges (IED) have assumed that its time course matches closely to that of brief physiological stimuli, commonly called the canonical event-related haemodynamic response function (canonical HRF). Analyses based on that assumption have produced significant response patterns that are generally concordant with prior electroclinical data. In this work, we used a more flexible model of the event-related response, a Fourier basis set, to investigate the presence of other responses in relation to individual IED in 30 experiments in patients with focal epilepsy. We found significant responses that had a noncanonical time course in 37% of cases, compared with 40% for the conventional, canonical HRF-based approach. In two cases, the Fourier analysis suggested activations where the conventional model did not. The noncanonical activations were almost always remote from the presumed generator of epileptiform activity. In the majority of cases with noncanonical responses, the noncanonical responses in single-voxel clusters were suggestive of artifacts. We did not find evidence for IED-related noncanonical HRFs arising from areas of pathology, suggesting that the BOLD response to IED is primarily canonical. Noncanonical responses may represent a number of phenomena, including artefacts and propagated epileptiform activity. Hum Brain Mapp 2008. © 2007 Wiley-Liss, Inc. PMID:17510926

Volcano-tectonic earthquakes: A new tool for estimating intrusive volumes and forecasting eruptions

USGS Publications Warehouse

White, Randall A.; McCausland, Wendy

2016-01-01

Notable cases in which distal VT events preceded eruptions at long-dormant volcanoes include: Nevado del Ruiz (1984–1985), Pinatubo (1991), Unzen (1989–1995), Soufriere Hills (1995), Shishaldin (1989–1999), Tacana' (1985–1986), Pacaya (1980–1984), Rabaul (1994), and Cotopaxi (2001). Additional cases are recognized at frequently active volcanoes including Popocateptl (2001–2003) and Mauna Loa (1984). We present four case studies (Pinatubo, Soufriere Hills, Unzen, and Tacana') in which we demonstrate the above mentioned VT characteristics prior to eruptions. Using regional data recorded by NEIC, we recognized in near-real time that a huge distal VT swarm was occurring, deduced that a proportionately huge magmatic intrusion was taking place beneath the long dormant Sulu Range, New Britain Island, Papua New Guinea, that it was likely to lead to eruptive activity, and warned Rabaul Volcano Observatory days before a phreatic eruption occurred. This confirms the value of this technique for eruption forecasting. We also present a counter-example where we deduced that a VT swarm at Volcan Cosiguina, Nicaragua, indicated a small intrusion, insufficient to reach the surface and erupt. Finally, we discuss limitations of the method and propose a mechanism by which this distal VT seismicity is triggered by magmatic intrusion.

Triggers for an episode of sudden onset low back pain: study protocol

PubMed Central

2012-01-01

Background Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated with acute exposure to a range of common physical and psychological factors. Methods/design This study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain) will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window). Discussion The completion of this study will provide the first-research based estimates of the increase in risk of a sudden episode of acute low back pain associated with transient exposure to a range of common factors thought to trigger low back pain. PMID:22273001

[Neurofeedback in the Treatment of Anorexia Nervosa: a Case Report].

PubMed

Lackner, N; Unterrainer, H F; Skliris, D; Wood, G; Dunitz-Scheer, M; Wallner-Liebmann, S J; Scheer, P J Z; Neuper, C

2016-02-01

Anorexia nervosa has been related to alterations in brain activity in terms of hyperactive EEG patterns. This case report illustrates the principles and results of a five-week neurofeedback treatment in a 29-year-old woman suffering from anorexia nervosa. A neurofeedback protocol to enhance alpha activity (8 - 12 Hz) was developed and conducted additionally to the standardized treatment for eating disorders in training sessions twice a week. Pre- and post-test measurements included resting state EEG measurements and a psychological test battery. The results show improvements from pre- to post-test in eating disorder psychopathology including psychological wellbeing, emotional competence, and eating behavior traits. In addition, a decrease in theta power (4 - 7 Hz), a well-known trait marker of anorexia nervosa, was measured. However, our data should be interpreted with caution because this is a single case study. Nevertheless, this report documents the practicability and method of neurofeedback as treatment adjunct in eating disorders from the clinical perspective. Although the use of neurofeedback in the treatment of anorexia nervosa is recommended in literature, empirical studies are still lacking. Randomized controlled trials to evaluate short- and long-term effects of neurofeedback are needed. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical usefulness of 99mTc-EDDA/HYNIC-TOC scintigraphy in oncological diagnostics: a pilot study.

PubMed

Plachcinska, Anna; Mikolajczak, Renata; Maecke, Helmut; Mlodkowska, Ewa; Kunert-Radek, Jolanta; Michalski, Andrzej; Rzeszutek, Katarzyna; Kozak, Jozek; Kusmierek, Jacek

2004-04-01

The clinical usefulness of a new 99mTc-labeled somatostatin analogue has been studied from the standpoint of oncological diagnostics. The group of patients studied included 40 individuals with diagnosed malignant neoplasms (32 primary and 8 metastatic). Among the primary tumors were 7 pituitary adenomas (5 hormonally active and 2 inactive), 1 liposarcoma, 2 carcinoids, 1 breast carcinoma, and 21 cases of lung cancer (2 small cell and 19 non-small cell) were represented. The metastatic tumors consisted of: 3 malignant melanomas, 1 pheochromocytoma, 1 prostatic cancer, 1 leiomyosarcoma, 1 pancreatic carcinoma ectopically secreting ACTH, and 1 carcinoid of the thymus. The radiopharmaceutical, 99mTc-EDDA/HYNIC-octreotide, was i.v. administered at the activity of 740-925 MBq. The imaging was comprized of a whole-body scan and single photon emission computed tomography. Positive scintigrams were obtained in 4 of 5 hormonally active pituitary adenomas, in 1 of 2 cases of carcinoid, in liposarcoma, breast cancer, and all cases of small cell (SCLC) and non-small cell lung cancer (NSCLC). The neoplastic metastases were visualized in 2 of 3 cases of melanoma and in patients with pheochromocytoma, pancreatic carcinoma secreting ACTH, and thymic carcinoid. Scintigrams were negative in both hormonally inactive pituitary adenomas, in one case of metastatic malignant melanoma, leiomyosarcoma, and in cases of metastasis from the prostatic carcinomas. The results of this pilot study indicated that 99mTc-EDDA/HYNIC-TOC is a potentially useful radiopharmaceutical for the imaging of a wide range of primary and metastatic tumors. More detailed indications for the clinical usefulness of the new tracer for the imaging of selected tumor types require studies on much larger groups of patients. Special attention should be paid to the successful imaging of all cases of NSCLC.

Dynamic Assessment or Schema Theory: The Case of Listening Comprehension

ERIC Educational Resources Information Center

Farangi, Mohamad Reza; Kheradmand Saadi, Zahra

2017-01-01

Not only is listening considered as an active skill nowadays, but also different approaches are suggested to incorporate it effectively into language classrooms. Our purpose, here, is to compare two approaches claiming to be effective in enhancing EFL learners' listening capabilities including schema theory and dynamic assessment. Through a…

77 FR 38637 - Announcement of the Award of Single-Source Cooperative Agreement to Rubicon Programs, Inc., in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

...-Prisoner Reentry activities to promote responsible fatherhood, family reunification, and economic stability... economic stability. The project will implement a program that includes comprehensive case management to... eliminate barriers to social and economic self-sufficiency for individuals preparing to reenter their...

Open Access Research via Collaborative Educational Blogging: A Case Study from Library & Information Science

ERIC Educational Resources Information Center

Rebmann, Kristen Radsliff; Clark, Camden Bernard

2017-01-01

This article charts the development of activities for online graduate students in library and information science. Project goals include helping students develop competencies in understanding open access publishing, synthesizing research in the field, and engaging in scholarly communication via collaborative educational blogging. Using a design…

75 FR 14630 - Agency Information Collection Activities: Proposed Collection; Comments Requested

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-26

... on a recurring basis. In the SCPS data collection program, felony defendants are tracked for up to 1 year with data collected on a variety of felony case processing characteristics. These include the... convicted, sentencing data are collected. The SCPS 2009 project also involves collecting aggregate...

76 FR 5401 - Bureau of Justice Statistics; Agency Information Collection Activities: Proposed Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... collected will include the types of criminal cases appealed to state intermediate appellate courts and... notice of information collection under review: Survey of State Court Criminal Appeals, 2010. The... submission of responses. Overview of This Information (1) Type of information collection: New data collection...

76 FR 18581 - Agency Information Collection Activities: Proposed Collection; Comments Requested

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... collected will include the types of criminal cases appealed to state intermediate appellate courts and... collection: Survey of State Court Criminal Appeals, 2010. The Department of Justice, Office of Justice... electronic submission of responses. Overview of This Information (1) Type of information collection: New data...

Mediating Factors in Literacy Instruction: How Novice Elementary Teachers Navigate New Teaching Contexts

ERIC Educational Resources Information Center

Scales, Roya Qualls; Wolsey, Thomas DeVere; Young, Janet; Smetana, Linda; Grisham, Dana L.; Lenski, Susan; Dobler, Elizabeth; Yoder, Karen Kreider; Chambers, Sandra A.

2017-01-01

This longitudinal study, framed by activity theory, examines what seven novice teachers' talk and actions reveal about their literacy teaching practices then delves into mediating influences of the teaching context. Utilizing collective, multi-case methods, data sources included interviews, observations, and artifacts. Findings indicate novices…

Middle School Physical Education Teachers' Perspectives on Overweight Students

ERIC Educational Resources Information Center

Doolittle, Sarah A.; Rukavina, Paul B.; Li, Weidong; Manson, Mara; Beale, Angela

2016-01-01

Using the Social Ecological Constraints model, a qualitative multiple case study design was used to explore experienced and committed middle school physical education teachers' perspectives on overweight and obese students (OWS), and how and why they acted to include OWS in physical education and physical activity opportunities in their school…

LSS systems planning and performance program

NASA Technical Reports Server (NTRS)

Mckenna, Victoria Jones; Dendy, Michael J.; Naumann, Charles B.; Rice, Sally A.; Weathers, John M.

1993-01-01

This report describes, using viewgraphs, the Marshall Space Flight Center's Large Space Structures Ground Test Facilities located in building 4619. Major topics include the Active Control Evaluation of Systems (ACES) Laboratory; the Control-Structures Interaction/Controls, Astrophysics, and Structures Experiment in Space (CSI/CASES); Advanced Development Facility; and the ACES Guest Investigator Program.

20 CFR 1002.5 - What definitions apply to USERRA?

Code of Federal Regulations, 2011 CFR

2011-04-01

...-related responsibilities, except in the case that such entity has been delegated functions that are purely... appointee upon activation of the National Disaster Medical System (NDMS) or as a participant in an... employer, including the composition, structure, and functions of the work force of such employer; the...

Executive Development: Meeting the Needs of Top Teams and Boards.

ERIC Educational Resources Information Center

Jackson, Sheila; Farndale, Elaine; Kakabadse, Andrew

2003-01-01

A literature review and six case studies examined the roles and responsibilities of the chief executive officers and board chairs, the capabilities required for success, and related executive development activity. Findings include the importance of focusing executive development on capability enhancement to ensure that it supports organizational…

Case Studies from Russia, a Session of a NATO Conference on Defense Conversion.

DTIC Science & Technology

1996-10-29

84101 USA Oleg Diyankov Russian Federal Nuclear Center Donald Hislop P.O. Box 245 Shezhinsk Department of Sociology, University of Chelyabinsk Region...database on the major aggregates related to European defense activity including statistics from 1980 to 1993 on defense budget, equipment purchases, R/D

Expanded Outreach at Clemson University. A Case Study.

ERIC Educational Resources Information Center

Bennett, A. Wayne

This paper summarizes recent strategic planning activities at Clemson University, focusing on outreach and extended education goals at the university. Specific benchmarks for outreach and extended education include: (1) by May 1994, each department will develop an operational definition of its public service mission, an action plan to integrate…

ACHP | Federal Emergency Management Agency Historic Preservation Program

Science.gov Websites

developing agreements to improve and expedite Section 106 compliance for disaster recovery activities. The developing the PPA, FEMA conducted outreach to stakeholders, including holding listening sessions with the protocols. In either case, FEMA will continue to be responsible for conducting consultation with Indian

What a Book Editor Does All Day.

ERIC Educational Resources Information Center

Allen, Patricia

1982-01-01

Describes the major tasks that an editor for a commercial publishing house, in this case a children's book publisher, performs on a day-to-day basis, including manuscript selection, working with authors and illustrators in completing a book, scheduling books for publication, and managing economic and production activities. (JL)

22 CFR 171.11 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... those costs the Department incurs in searching for, duplicating, and, in the case of commercial requests...) Representative of the news media means any person actively gathering news for an entity that is organized and... events or that would be of current interest to the public. News media include television or radio...

A Cross-Case Analysis of Three Native Science Field Centers

ERIC Educational Resources Information Center

Augare, Helen J.; Davíd-Chavez, Dominique M.; Groenke, Frederick I.; Little Plume-Weatherwax, Melissa; Lone Fight, Lisa; Meier, Gene; Quiver-Gaddie, Helene; Returns From Scout, Elvin; Sachatello-Sawyer, Bonnie; St. Pierre, Nate; Valdez, Shelly; Wippert, Rachel

2017-01-01

Native Science Field Centers (NSFCs) were created to engage youth and adults in environmental science activities through the integration of traditional Native ways of knowing (understanding about the natural world based on centuries of observation including philosophy, worldview, cosmology, and belief systems of Indigenous peoples), Native…

Transfer of Learning across Courses in an MBA Curriculum: A Managerial Finance Case Study

ERIC Educational Resources Information Center

Stretcher, Robert; Hynes, Geraldine E.; Maniam, Bala

2010-01-01

Business degree programs typically include a variety of required courses targeting analytical skills, general knowledge, and communication competencies. Integration of these learning outcomes is crucial for students' effective professional activities, yet little is known about cross-disciplinary transfer of specific knowledge, skills, and…

Designing and Delivering Cross-Cultural Instruction.

ERIC Educational Resources Information Center

Ben-Yoseph, Miriam

A course on management in a cross-cultural environment was designed to address dilemmas and opportunities that individuals might encounter in work or study. The course attracted students with a broad variety of backgrounds. A main textbook was supplemented with readings, guest lectures, and a variety of class activities including case studies,…

The Gatekeeping Impulse and Professor X: An Exploration

ERIC Educational Resources Information Center

Sonnenmoser, Richard

2009-01-01

College and university instructors who assess student writing, including but not limited to teachers of first-year composition, sometimes keep the gate. Gatekeeping by writing instructors is an activity directly related to grading practices and, in many cases, to grading practices which emphasize formal, mechanical, usually sentence-level choices…

Interprofessional Collaboration 1996 Resource Guide: A Resource Guide of Learning Activities.

ERIC Educational Resources Information Center

Hanley, Mary Stone; And Others

The Training for Interprofessional Collaboration Project (TIC) is a joint effort of five professional schools of the University of Washington and various community sites and agencies to provide preservice (graduate level) and inservice training in teacher and interprofessional collaboration. The guide includes bibliographies, case studies,…

Bank Community Development Corporations.

ERIC Educational Resources Information Center

Illinois State Dept. of Commerce and Community Affairs, Springfield.

This handbook provides a brief overview of bank and bank holding company community development corporations (CDCs), the types of activities for which they can be used, the legal requirements in establishing such an entity, and how they are organized and operated. Case studies, including studies of the Shorebank Corporation of Chicago, the First…

Democracy, Citizenship and School Improvement: What Can One School Tell Us?

ERIC Educational Resources Information Center

Flecknoe, Mervyn

2002-01-01

Case study of English primary school that instituted several democratic procedures involving pupils and staff in leadership activities. Findings suggest that Hargraves's capital theory of school effectiveness and improvement and Furman and Starratt's theories of the democratic community require a student dimension. Includes discussion of…

Testing and Risk Assessment of Chemicals that Impact Highly Adaptive Biological Systems: The Case of Endocrine Systems

EPA Science Inventory

Animals have evolved a variety of mechanisms for responding to toxic chemicals of both natural and anthropogenic origin. Well-known examples include activation of cellular repair pathways and induction of metabolizing enzymes. From a governmental regulatory perspective, these a...

Laptop Computers in the Elementary Classroom: Authentic Instruction with At-Risk Students

ERIC Educational Resources Information Center

Kemker, Kate; Barron, Ann E.; Harmes, J. Christine

2007-01-01

This case study investigated the integration of laptop computers into an elementary classroom in a low socioeconomic status (SES) school. Specifically, the research examined classroom management techniques and aspects of authentic learning relative to the student projects and activities. A mixed methods approach included classroom observations,…

Using Social Science to Improve Children's Television: An NBC Case Study.

ERIC Educational Resources Information Center

Stipp, Horst; And Others

1987-01-01

Describes the evolution and activities of the Social Science Advisory Panel at NBC (National Broadcasting Company) that brings knowledge about children and television to the production of Saturday morning children's television programs. Highlights include self-regulatory aspects of the panel, issues confronted such as violence and stereotyping,…

The Road to Oxbridge: Schools and Elite University Choices

ERIC Educational Resources Information Center

Donnelly, Michael

2014-01-01

This paper explores hidden messages sent out by schools about Oxbridge, using Basil Bernstein's concepts of classification and framing. Research in three case-study schools captured these messages from their everyday practices and processes, including their events and activities, sorting mechanisms, interactions and resources. Whilst all of the…

Excellence in Teaching End-of-Life Care. A New Multimedia Toolkit for Nurse Educators.

ERIC Educational Resources Information Center

Wilkie, Diana J.; Judge, Kay M.; Wells, Marjorie J.; Berkley, Ila Meredith

2001-01-01

Describes a multimedia toolkit for teaching palliative care in nursing, which contains modules on end-of-life topics: comfort, connections, ethics, grief, impact, and well-being. Other contents include myths, definitions, pre- and postassessments, teaching materials, case studies, learning activities, and resources. (SK)

Field Safety Notes in Product Problems of Medical Devices for Use in Pulmonology.

PubMed

Hannig, Jürgen; Siekmeier, Rüdiger

2015-01-01

The current European system for medical devices is governed by three EC directives: the Medical Device Directive 93/42/EEC, the In-Vitro Diagnostic Directive 98/79/EC and the Active Implantable Medical Device Directive 90/385/EEC and regulates marketing and post-market surveillance of medical devices in the European Economic Area. In cases of incidents and field safety corrective actions (FSCA) manufacturers have to inform the responsible Competent Authority, which is the Federal Institute for Drugs and Medical Devices (BfArM) and the public by field safety notices (FSN). In this study we analyzed FSN of medical devices exclusively serving for diagnostics or treatment in pulmonology (e.g. nebulizers, oxygen concentrators, pulse oximeters, lung function analyzers, and non-active devices for treatment). FSCA and FSN publicized by BfArM in 2005-2013 were analyzed in respect to the MEDDEV 2.12-1 rev 8. In total 41 FSCA were publicized for the included products. German and English FSN were found in 36/35 cases, respectively. FSN were clearly characterized as FSN in 22/20 cases and declaration of the type of action was found in 27/26 cases, respectively. Product names were provided in all cases. Lot numbers or other information for product characterization were available in 7/8 and 26/24 cases, respectively. Detailed information regarding FSCA and product malfunction were found in 27/33 and 36/35 cases, respectively. Information on product related risks with previous use of the affected product was provided in 24/23 cases. In 34/34 cases manufacturers provided information to mitigate product related risks. Requests to pass FSN to persons needing awareness were found in 10/14 cases. Contact data were provided in 30/30 cases. Confirmation that the Competent Authority was informed was found in 12/14 cases and in 19/18 cases a customer confirmation was included. The obtained data suggest that there is an increasing annual number of FSCA and most FSN fulfill the criteria of MEDDEV 2.12-1 rev 8. However, there are differences between German and English FSN, e.g. regarding the distribution to persons needing awareness, missing statement that the Competent Authority was informed and missing customer confirmation. Due to the importance of FSN for reduction of product related risks in FSCA type and content of FSN should be further improved.

Nipah Virus Infection Outbreak with Nosocomial and Corpse-to-Human Transmission, Bangladesh

PubMed Central

Hossain, M. Jahangir; Gurley, Emily S.; Ameen, Kazi M.H.; Parveen, Shahana; Islam, M. Saiful; Faruque, Labib I.; Podder, Goutam; Banu, Sultana S.; Lo, Michael K.; Rollin, Pierre E.; Rota, Paul A.; Daszak, Peter; Rahman, Mahmudur; Luby, Stephen P.

2013-01-01

Active Nipah virus encephalitis surveillance identified an encephalitis cluster and sporadic cases in Faridpur, Bangladesh, in January 2010. We identified 16 case-patients; 14 of these patients died. For 1 case-patient, the only known exposure was hugging a deceased patient with a probable case, while another case-patient’s exposure involved preparing the same corpse for burial by removing oral secretions and anogenital excreta with a cloth and bare hands. Among 7 persons with confirmed sporadic cases, 6 died, including a physician who had physically examined encephalitis patients without gloves or a mask. Nipah virus–infected patients were more likely than community-based controls to report drinking raw date palm sap and to have had physical contact with an encephalitis patient (29% vs. 4%, matched odds ratio undefined). Efforts to prevent transmission should focus on reducing caregivers’ exposure to infected patients’ bodily secretions during care and traditional burial practices. PMID:23347678

Draugen HSE-case - occupational health risk management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glas, J.J.P.; Kjaer, E.

1996-12-31

The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to workmore » environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.« less

Thrombolysis with intravenous recombinant tissue plasminogen activator during early postpartum period: a review of the literature.

PubMed

Akazawa, Munetoshi; Nishida, Makoto

2017-05-01

Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery. Blood transfusion was necessary in all cases except for one (12/13; 92%). In seven cases (7/13; 54%), a large amount of blood was required for transfusion. Subsequent laparotomy to control bleeding was required in five cases (5/13; 38%), including three cases of hysterectomy and two cases of hematoma removal, all of which involved cesarean delivery. In cases of transvaginal delivery, there was no report of laparotomy. The occurrence of severe bleeding was high in relation to cesarean section, compared with vaginal deliveries. Using rt-PA in relation to cesarean section might be worth avoiding. However, the paucity of data in the literature makes it difficult to assess the ultimate outcomes and safety of this treatment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Purity-activity relationships of natural products: the case of anti-TB active ursolic acid.

PubMed

Jaki, Birgit U; Franzblau, Scott G; Chadwick, Lucas R; Lankin, David C; Zhang, Fangqiu; Wang, Yuehong; Pauli, Guido F

2008-10-01

The present study explores the variability of biological responses from the perspective of sample purity and introduces the concept of purity-activity relationships (PARs) in natural product research. The abundant plant triterpene ursolic acid (1) was selected as an exemplary natural product due to the overwhelming number yet inconsistent nature of its approximate 120 reported biological activities, which include anti-TB potential. Nine different samples of ursolic acid with purity certifications were obtained, and their purity was independently assessed by means of quantitative 1H NMR (qHNMR). Biological evaluation consisted of determining MICs against two strains of virulent Mycobacterium tuberculosis and IC50 values in Vero cells. Ab initio structure elucidation provided unequivocal structural confirmation and included an extensive 1H NMR spin system analysis, determination of nearly all J couplings and the complete NOE pattern, and led to the revision of earlier reports. As a net result, a sigmoid PAR profile of 1 was obtained, demonstrating the inverse correlation of purity and anti-TB bioactivity. The results imply that synergistic effects of 1 and its varying impurities are the likely cause of previously reported antimycobacterial potential. Generating PARs is a powerful extension of the routinely performed quantitative correlation of structure and activity ([Q]SAR). Advanced by the use of primary analytical methods such as qHNMR, PARs enable the elucidation of cases like 1 when increasing purity voids biological activity. This underlines the potential of PARs as a tool in drug discovery and synergy research and accentuates the need to routinely combine biological testing with purity assessment.

China’s Foreign Aid and Government-Sponsored Investment Activities: Scale, Content, Destinations, and Implications

DTIC Science & Technology

2013-01-01

Ecuador , Brazil, Chile, and Venezuela. Before 2005, many of the regional programs focused on infrastructure, including power plants...prior academic work on China’s pro- grams have focused on Africa and include Davies et al. and Brautigam. Both these provide detailed case studies...Chinese engage- ment there is concentrated on four resource-rich countries: Venezuela, Brazil, Argentina, and Ecuador . 26 China’s Foreign Aid and

Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients.

PubMed

Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Wigren, P E; Klausner, J J; Krieger, A C; Lavigne, G J

2013-12-01

Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P < 0·01) for women with myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. © 2013 John Wiley & Sons Ltd.

Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border.

PubMed

Lutterloh, Emily; Likaka, Andrew; Sejvar, James; Manda, Robert; Naiene, Jeremias; Monroe, Stephan S; Khaila, Tadala; Chilima, Benson; Mallewa, Macpherson; Kampondeni, Sam D; Lowther, Sara A; Capewell, Linda; Date, Kashmira; Townes, David; Redwood, Yanique; Schier, Joshua G; Nygren, Benjamin; Tippett Barr, Beth; Demby, Austin; Phiri, Abel; Lungu, Rudia; Kaphiyo, James; Humphrys, Michael; Talkington, Deborah; Joyce, Kevin; Stockman, Lauren J; Armstrong, Gregory L; Mintz, Eric

2012-04-01

Salmonella enterica serovar Typhi causes an estimated 22 million cases of typhoid fever and 216 000 deaths annually worldwide. We investigated an outbreak of unexplained febrile illnesses with neurologic findings, determined to be typhoid fever, along the Malawi-Mozambique border. The investigation included active surveillance, interviews, examinations of ill and convalescent persons, medical chart reviews, and laboratory testing. Classification as a suspected case required fever and ≥1 other finding (eg, headache or abdominal pain); a probable case required fever and a positive rapid immunoglobulin M antibody test for typhoid (TUBEX TF); a confirmed case required isolation of Salmonella Typhi from blood or stool. Isolates underwent antimicrobial susceptibility testing and subtyping by pulsed-field gel electrophoresis (PFGE). We identified 303 cases from 18 villages with onset during March-November 2009; 214 were suspected, 43 were probable, and 46 were confirmed cases. Forty patients presented with focal neurologic abnormalities, including a constellation of upper motor neuron signs (n = 19), ataxia (n = 22), and parkinsonism (n = 8). Eleven patients died. All 42 isolates tested were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; 4 were also resistant to nalidixic acid. Thirty-five of 42 isolates were indistinguishable by PFGE. The unusual neurologic manifestations posed a diagnostic challenge that was resolved through rapid typhoid antibody testing in the field and subsequent blood culture confirmation in the Malawi national reference laboratory. Extending laboratory diagnostic capacity, including blood culture, to populations at risk for typhoid fever in Africa will improve outbreak detection, response, and clinical treatment.

Recreational injuries in Washington state national parks.

PubMed

Stephens, Bradford D; Diekema, Douglas S; Klein, Eileen J

2005-01-01

The objectives of this study were to identify the number and types of recreational injuries sustained by visitors to Mount Rainier National Park and Olympic National Park in Washington State and to compare the nature of injuries sustained by children compared with adults. We retrospectively reviewed case incident reports obtained by rangers in Mount Rainer National Park and Olympic National Park between 1997 and 2001. Data collected included victim age, gender, date of injury, activity preinjury, type of injury, and mechanism of injury. There were 535 cases of recreational wilderness injuries (including 19 total deaths), yielding a rate of 22.4 injuries per million visits. The mean age of injury victims was 34 years. Males were more likely to sustain injury than were females (59% vs 41%). Most injuries occurred during summer months between noon and 6:00 PM, and 90% occurred during daylight hours. The most common preinjury activities included hiking (55%), winter sports (15%), and mountaineering (12%), and the most common types of injuries included sprains, strains and soft tissue injuries (28%), fractures or dislocations (26%), and lacerations (15%). A total of 121 (23%) of the injuries occurred in children (<18 years of age). There were 19 deaths in the 2 national parks (18 men, 1 woman); all victims were adults. Hiking (58%) and mountaineering (26%) were the most common activities at the time of death. Mechanism of death included falls (37%), medical (eg, myocardial infarction) (21%), drowning (5%), and suicide (5%). The most common type of injury was soft tissue injury, and injuries occurred most commonly while hiking, during daylight hours, and in the summer. Preinjury activities and types of injuries were different in children compared with adults. Knowledge of how and when injuries occur in national parks can assist in determining what resources are needed to help provide a safer environment for park visitors. This study may also aid prevention strategies in the national parks, guide training of rangers, aid in the preparation of first aid kits, and further the education of people who participate in wilderness activities.

[An activity-friendly environment: that's also the doctor's business].

PubMed

de Jong, N B; Hoyng, J E A; Takken, T

2017-01-01

Achieving and maintaining sufficient levels of physical activity is important for the health of the Dutch population. However, the vast majority of the Dutch population - including children - does not comply with the current physical activity guideline. This is the case despite excellent infrastructure which allows safe movement and facilitates walking or cycling to school or work. Perhaps the layout of our living environment is unattractive for movement. It may possibly be unchallenging for young people or too much concrete for adults. In this article we discuss the role of the physical environment on physical activity and ultimately our health. Ways in which the environment could influence the levels of physical activity of the population are also considered.

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

PubMed Central

2014-01-01

Background Malaria in pregnancy remains a major health problem. Placental malaria infection may cause pathophysiological changes in pregnancy and result in morphological changes to placental villi. Quantitative histomorphological image analysis of placental biopsies was performed to compare placental villous architecture between active or treated placental malaria cases and controls. Methods A total of 67 placentas were studied from three clinical groups: control patients who did not have malaria (n = 27), active (n = 14) and treated (n=26) malaria cases, including both Plasmodium falciparum and Plasmodium vivax infections. Image analysis of histological placental sections was performed using ImageJ software to measure the number and size (area) of terminal villi, perimeter measurement per villus and total perimeter per unit area, and number of capillaries per villus (vascularity). Histological features of placental malaria were scored and these results were correlated with malaria status and clinical outcomes. Results Villous size correlated with vascularity (p <0.0001) but was inversely correlated with observed villi per unit area, (p = 0.0001). Significantly greater villous area and vascularity was observed in UK controls. Indices of histological malaria infection were significantly greater in active versus treated malaria cases. Active placental malaria cases showed significantly smaller villous area (p <0.0084), vascularity (p <0.0139) and perimeter (p <0.0006) than treated malaria cases or controls, but significantly more villi per unit area (p <0.0001). Villous size in treated malaria cases was significantly larger than active placental malaria cases (p <0.001) and similar to controls. There was a significant relationship between villous number and anaemia at the time of infection (p <0.0034), but not placental weight, birth weight or gestational age at delivery. No differences were found between histology or villous morphology comparing infections with P. falciparum or P. vivax. Conclusions These results imply that villous size, perimeter and vascularity are acutely decreased during active placental malaria, decreasing the surface area available for gas exchange per villus. However the increased number of villi per unit area offsets this change and persists after treatment. Histopathological and villous architectural changes may be reversed by early detection and appropriate anti-malarial treatment. PMID:24386908

[Clinical characteristics of 4 cases of scleritis associated with systemic lupus erythematosus].

PubMed

Wang, L; Yang, Y; Jia, Y; Miao, H; Zhou, Y S; Zhang, X Y

2016-12-18

Episcleritis and scleritis are relatively rare ocular diseases, which are commonly associated with rheumatic diseases including systemic lupus erythematosus (SLE). To investigate clinical and laboratory features of SLE-associated episcleritis and scleritis, we now report 4 cases of inpatients who were diagnosed with episcleritis or scleritis secondary to SLE from September 2005 to July 2016 in the Department of Rheumatology and Immunology in Peking University People's Hospital. Demographic, clinical and laboratory characteristics were summarized together with the treatment regimen and the prognosis; the literature was reviewed. There were 3 female and 1 male patients. The average age was (49.0±23.8) years and the mean duration of SLE at the onset of episcleritis or scleritis was (2.1±1.4) years. In addition to the eye involvement, the patients had mucocutaneous manifestations, serositis, lupus nephritis and interstitial pneumonia simultaneously; in the past, 1 patient experienced arthritis, 2 presented Raynaud's phenomenon, and 2 had hematologic involvement. All the patients had antinuclear antibody (ANA) of high titer. The anti double-stranded DNA (ds-DNA) antibody titers were increased in 2 patients. Three patients had positive anti-nucleosome antibody (ANuA) while the other 1 patient did not test it. The complement levels were decreased in 3 patients. The systemic lupus erythematosus disease activity index (SLEDAI) scores were more than 4 points in all the patients (ranging from 7-16), suggesting active disease. Ocular symptoms included pain, redness of the eye and tears. Ophthalmic examinations revealed 3 cases of episcleritis and 1 case of scleritis. Among the 4 patients, 2 patients experienced ocular complications including decrease in vision and uveitis. All the patients were treated with systemic corticosteroids combined with hydroxycloroquine; 3 patients were treated with immunosuppressants (cyclophosphamide in 2 patients and leflunomide in 1 patient). All of the 4 patients received topical steroid and 1 patient received periocular injection of triamcinolone acetonide; 1 patient received topical nonsteroidal anti-inflammatory drug (NSAID).No recurrence of episcleritis or scleritis was observed during the follow-ups. As a conclusion, scleritis and episcleritis, although uncommon, may occur in patients with autoimmune rheumatic diseases including SLE. The occurrence of episcleritis and scleritis may suggest active disease of SLE. Ocular complications need to be aware of in the patients. Prompt diagnosis and treatment was associated with good visual outcomes in the follow-ups.

[Epidemiological aspects of Ebola virus disease in Guinea (december 2013-april 2016)].

PubMed

Migliani, R; Keïta, S; Diallo, B; Mesfin, S; Perea, W; Dahl, B; Rodier, G

2016-10-01

Ebola Zaire species variant Makona between its emergence in December 2013 and April 2016, resulted in an epidemic of Guinea importance and unprecedented gravity with 3814 reported cases of which 3358 were confirmed (88.0%) and 2544 were died (66.7%). The epidemic has evolved in phases: a silent phase without identification of all fatal cases until February 2014; a first outbreak from March 2014, when the alarm is raised and the virus detected, which lasted until July 2014; a second increase, which was the most intense, from August 2014 to January 2015 focused primarily on the forest Guinea; and a final increase from February 2015 centered on lower Guinea and the capital Conakry. Adapting strategies in 2015 (initiative "Zero Ebola in 60 days" active case search and suspicious deaths and awareness of active prefectures, microbanding the last affected communities and raking around these localities) and ring vaccination of contacts around confirmed cases has allowed to gradually control the main outbreak in October 2015. But a survivor was originally resurgence in forest areas between March and April 2016 with 10 cases including 8 deaths. The epidemic has particularly affected the forest Guinea region (44% and 48% of Guinean cases and deaths), elderly women (≥ 50 years), and health professionals (211 cases including 115 deaths); however, almost one-third of the patients (32.6%) was not provided supportive care in the Ebola centers. The epidemic is currently marked by the resurgence of small foci, from excreting subjects cured of the virus who have been controlled so far successfully. The survivors are the subject of special attention. It is necessary to learn lessons from the response to better prepare for the future, to improve knowledge about the natural history of the Ebola virus disease, and to rethink communication in this regard with the public and its leaders.

Adolescent testicular microlithiasis: A case-based, multinational survey of clinical management practices.

PubMed

Brodie, Katie E; Saltzman, Amanda F; Cost, Nicholas G

2018-04-01

Testicular microlithiasis (TM) is a condition characterized by calcium deposits within the testis, usually detected incidentally during ultrasonography of the scrotum. TM has been associated with the presence of, and possibly the development of, testicular malignancy. Our aim was to document international clinical management practices for TM and to analyze what factors and perception of risk influence conservative versus active management and follow-up. European Society for Paediatric Urology (ESPU) and Society for Pediatric Urology (SPU) members were invited to complete an online case-based survey of clinical management practices of TM. Eight cases had a single variable changed each time (classic versus limited TM, unilateral versus bilateral, prior cryptorchidism versus no cryptorchidism) to ascertain the provider's perception of risk. The respondents completed multiple choice questions on initial management, follow-up plan, length and interval of follow-up. Multivariate logistic regression was performed to determine factors associated with decisions on management and follow-up. There were 265 respondents to the survey from 35 countries (Table). Median time in practice was 13 years. Factors that were significantly associated with more aggressive initial management (more than counseling on self-examination) included: not yet in independent practice, low volume TM cases per year, those practicing pediatric and adult urology, classic appearance of TM and cryptorchidism. Factors that were significantly associated with urologist follow-up and active investigation included: European practitioners, low TM case volume per year, those practicing both pediatric urology and pediatric surgery, classic TM appearance and a case history of cryptorchidism. Interval and length of follow-up was wide-ranging, with most respondents favoring annual follow-up. Management of TM varies and a mix of surgeon and case factors significantly influences management strategies. This baseline understanding of the lack of systematic management suggests the need for the development of consensus guidelines and prospective study. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

The contribution of human agricultural activities to increasing evapotranspiration is significantly greater than climate change effect over Heihe agricultural region.

PubMed

Zou, Minzhong; Niu, Jun; Kang, Shaozhong; Li, Xiaolin; Lu, Hongna

2017-08-18

Evapotranspiration (ET) is a major component linking the water, energy, and carbon cycles. Understanding changes in ET and the relative contribution rates of human activity and of climate change at the basin scale is important for sound water resources management. In this study, changes in ET in the Heihe agricultural region in northwest China during 1984-2014 were examined using remotely-sensed ET data with the Soil and Water Assessment Tool (SWAT). Correlation analysis identified the dominant factors that influence change in ET per unit area and those that influence change in total ET. Factor analysis identified the relative contribution rates of the dominant factors in each case. The results show that human activity, which includes factors for agronomy and irrigation, and climate change, including factors for precipitation and relative humidity, both contribute to increases in ET per unit area at rates of 60.93% and 28.01%, respectively. Human activity, including the same factors, and climate change, including factors for relative humidity and wind speed, contribute to increases in total ET at rates of 53.86% and 35.68%, respectively. Overall, in the Heihe agricultural region, the contribution of human agricultural activities to increased ET was significantly greater than that of climate change.

Direct Medical Costs Attributable to Cancer-Associated Venous Thromboembolism: A Population-Based Longitudinal Study.

PubMed

Cohoon, Kevin P; Ransom, Jeanine E; Leibson, Cynthia L; Ashrani, Aneel A; Petterson, Tanya M; Long, Kirsten Hall; Bailey, Kent R; Heit, John A

2016-09-01

The purpose of this study is to estimate medical costs attributable to venous thromboembolism among patients with active cancer. In a population-based cohort study, we used Rochester Epidemiology Project (REP) resources to identify all Olmsted County, Minn. residents with incident venous thromboembolism and active cancer over the 18-year period, 1988-2005 (n = 374). One Olmsted County resident with active cancer without venous thromboembolism was matched to each case on age, sex, cancer diagnosis date, and duration of prior medical history. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs from 1 year prior to index (venous thromboembolism event date or control-matched date) to the earliest of death, emigration from Olmsted County, or December 31, 2011, with censoring on the shortest follow-up to ensure a similar follow-up duration for each case-control pair. We used generalized linear modeling to predict costs for cases and controls and bootstrapping methods to assess uncertainty and significance of mean adjusted cost differences. Outpatient drug costs were not included in our estimates. Adjusted mean predicted costs were 1.9-fold higher for cases ($49,351) than for controls ($26,529) (P < .001) from index to up to 5 years post index. Cost differences between cases and controls were greatest within the first 3 months (mean difference = $13,504) and remained significantly higher from 3 months to 5 years post index (mean difference = $12,939). Venous thromboembolism-attributable costs among patients with active cancer contribute a substantial economic burden and are highest from index to 3 months, but may persist for up to 5 years. Copyright © 2016 Elsevier Inc. All rights reserved.

Passive smoking and risk of pulmonary tuberculosis in children immediately following infection. A case-control study.

PubMed

Altet, M N; Alcaide, J; Plans, P; Taberner, J L; Saltó, E; Folguera, L I; Salleras, L

1996-12-01

Passive smoking-related respiratory disorders in children. To assess the effect of passive smoking on the development of active pulmonary tuberculosis (PTB) in children immediately following infection by Mycobacterium tuberculosis within the family. An unmatched case-control study in which 93 contacts who became cases (active PTB diagnosed) and 95 contacts who did not became cases (tuberculin-positive children without evidence of active disease) were included. All were household contacts of a new case of pulmonary bacillary tuberculosis. Smoking habits were investigated by a questionnaire. Urinary cotinine was analysed. Odds Ratio (OR) was adjusted for age and socio-economic status using multiple logistic regression analysis. Passive smoking was a risk factor for PTB (OR: 5.29; 95% confidence interval (CI): 2.33-12.82; P < 0.00005). The adjusted OR was 5.39 (95% CI: 2.44-11.91; P < 0.00001). The risk increased when contacts were passive smokers both at home and outside the home within the family (OR: 6.35; 95% CI: 3.20, 12.72; P < 0.00001). Contacts 0-4 and 5-9 years old showed a significantly higher risk than those aged > or = 10. There was a dose-response relationship between the risk of developing active PTB immediately following infection and the number of cigarettes smoked daily by the household adults (P < 0.001). Mean (SD) urinary continine detectable concentrations (ng/ml) were different between disease contacts (119.46 [68.61]) and non diseased contacts (91.87 [73.10]). The difference was statistically significant (P < 0.001). Passive exposure to tobacco smoke in children was associated with an increased risk of developing pulmonary tuberculosis immediately following infection. This is an association of great concern requiring health education programmes and antitobacco medical advice.

Table tennis dystonia.

PubMed

Le Floch, Anne; Vidailhet, Marie; Flamand-Rouvière, Constance; Grabli, David; Mayer, Jean-Michel; Gonce, Michel; Broussolle, Emmanuel; Roze, Emmanuel

2010-02-15

Focal task-specific dystonia (FTSD) occurs exclusively during a specific activity that usually involves a highly skilled movement. Classical FTSD dystonias include writer's cramp and musician's dystonia. Few cases of sport-related dystonia have been reported. We describe the first four cases of FTSD related to table tennis (TT), two involving professional international competitors. We also systematically analyzed the literature for reports of sport-related dystonia including detailed clinical descriptions. We collected a total of 13 cases of sport-related dystonia, including our four TT players. Before onset, all the patients had trained for many years, for a large number of hours per week. Practice time had frequently increased significantly in the year preceding onset. As TT is characterized by highly skilled hand/forearm movements acquired through repetitive exercises, it may carry a higher risk of FTSD than other sports. Intensive training may result in maladaptive responses and overwhelm homeostatic mechanisms that regulate cortical plasticity in vulnerable individuals. Our findings support the importance of environmental risk factors in sport-related FTSD, as also suggested in classical FTSD, and have important implications for clinical practice. (c) 2010 Movement Disorder Society.

Odontogenic carcinoma with dentinoid: a new odontogenic carcinoma.

PubMed

Mosqueda-Taylor, Adalberto; Neville, Brad W; Tatemoto, Yukihiro; Ogawa, Ikuko; Takata, Takashi

2014-12-01

Dentinoid is an integral part of some odontogenic tumors. This article describes the clinico-pathological features of three cases of odontogenic carcinomas with dentinoid (OCD). A comparison of these with previously reported cases of dentinoid-producing epithelial odontogenic tumors allowed us to identify another six cases that may be considered as examples of OCD. Six cases occurred in the mandible and three in the maxilla, all developing behind the canines. There was no sex predilection (five men and four women; age range 14-61 years, mean 38.1). Pain or discomfort was mentioned in five cases, four of which showed tooth resorption. All cases appeared initially as well-defined radiolucencies, five of which showed variable amounts of calcified material. Recurrences were recorded in three instances, but no evidence of metastasis has been found. Seven cases were composed predominantly or entirely of clear cells, usually with minimal cellular atypia and variable mitotic activity; however, in all cases there was evidence of tumor infiltration into adjacent tissues, including the presence of perineural invasion in two tumors. Those cases in which no reference was made to the presence of clear cells exhibited evident mitotic activity and cellular pleomorphism. The epithelium in OCD does not produce buds or enamel organ-like structures such as those found in ameloblastic fibro-dentinoma and this tumor does not contain a mesenchyme-like connective tissue resembling dental papilla as observed in several mixed odontogenic tumors. Based on the existing data and the present series of cases, OCD appears to represent a distinct entity.

Keratoconus in Civil Aviation Pilots in a Report of Six Cases.

PubMed

Rebello, Albert; Rodrigues, Bênesson; Pereira, Marcos

2017-06-01

Keratoconus is a progressive noninflammatory ectatic corneal dystrophy, characterized by corneal thinning and increased curvature with central or paracentral tapered protrusion. Such changes in corneal morphology induce irregular astigmatism and myopia, resulting in visual acuity impairment. This report assesses cases in which keratoconus is not an absolute disabling condition for civil aviation pilots. Six cases of keratoconus in active pilots are presented. This report includes cases which were treated with crosslinking therapy and even corneal transplantation. In such cases, the civil aviation medical authority considered four aspects in the medical assessment: best corrected visual acuity, condition stability, risk of sudden incapacitation, and pilot category. Six civil pilots with ages between 19 and 45 yr of age presented with keratoconus in different stages. Using the Snellen scale, best corrected visual acuity (BCVA) was measured in 12 eyes, all of them having equal or better than 20/30 (20/20, N = 9; 20/25, N = 2; 20/30, N = 1). All of them are currently fit for aviation activity and have been given an aviation medical certificate with limitation of use of corrective lenses by the Brazilian Civil Aviation Authority (ANAC in Portuguese). Among these cases, there is a pilot who had undergone treatment with crosslinking therapy and another that had undergone corneal transplantation. These cases demonstrate that keratoconus is not always a disabling condition for civil aviation pilots. Nevertheless, it has to be analyzed on a case-by-case basis.Rebello A, Rodrigues B, Pereira M. Keratoconus in civil aviation pilots in a report of six cases. Aerosp Med Hum Perform. 2017; 88(6):574-578.

INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE.

PubMed

Işikay, Sedat; Hizli, Şamil; Çoşkun, Serkan; Yilmaz, Kutluhan

2015-12-01

Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. A total of 175 children with the diagnosis of celiac disease (study group) and 99 age- and sex-matched healthy children as controls (control group) were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3%) of newly diagnosed and in 2 (1.5%) of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0%) of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively). We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients, clinicians should be aware of this association and be alert about any neurological symptoms.

Economic instruments for population diet and physical activity behaviour change: a systematic scoping review.

PubMed

Shemilt, Ian; Hollands, Gareth J; Marteau, Theresa M; Nakamura, Ryota; Jebb, Susan A; Kelly, Michael P; Suhrcke, Marc; Ogilvie, David

2013-01-01

Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people's actual behavioural responses using study designs capable of generating reliable causal inferences regarding intervention effects. Policy implementation needs to be carefully aligned with evaluation planning and design.

ASSOCIATION BETWEEN THE VITREOMACULAR INTERFACE AND OPTICAL COHERENCE TOMOGRAPHY CHARACTERISTICS IN WET AGE-RELATED MACULAR DEGENERATION.

PubMed

Ashraf, Mohammed; Souka, Ahmed; Adelman, Ron A

2017-09-01

To study the effect of the vitreomacular interface on various wet age-related macular degeneration (AMD) characteristics including the size and type of choroidal neovascularization (CNV), choroidal thickness, and activity of the CNV. This was a retrospective observational cross-sectional study. The study included 43 patients (51 eyes) with treatment-naive age-related macular degeneration. Twenty-six patients with wet AMD in one eye and dry AMD in the other eye were included in a paired-eye analysis. Patients underwent optical coherence tomography examination using Heidelberg Spectralis (spectral domain optical coherence tomography) at presentation to determine the type of CNV and the vitreomacular status. In addition, various parameters were measured including the choroidal thickness and horizontal width and vertical height measurements of the CNV. There was no correlation between the height, width, activity or type of the CNV, and the presence or absence of vitreomacular adhesion. The mean choroidal thickness (using enhanced depth imaging) in cases with vitreomacular adhesion was 272.57 μm compared with 197.32 μm in cases with no vitreomacular adhesion, a statistically significant difference (P = 0.003). In the paired-eye study (21 patients), there was no significant difference between the eyes with wet AMD and dry AMD with regard to vitreomacular status or the choroidal thickness. In a subgroup analysis, patients with Type 1 CNV had a significantly higher percentage of vitreomacular adhesion compared with the other eye with dry AMD (P = 0.034). In conclusion, the vitreomacular interface does seem to be associated with an increased choroidal thickness in cases of wet AMD. Furthermore, the association between the vitreomacular interface and wet AMD is more significant for Type 1 CNV.

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

Applications of active adaptive noise control to jet engines

NASA Technical Reports Server (NTRS)

Shoureshi, Rahmat; Brackney, Larry

1993-01-01

During phase 2 research on the application of active noise control to jet engines, the development of multiple-input/multiple-output (MIMO) active adaptive noise control algorithms and acoustic/controls models for turbofan engines were considered. Specific goals for this research phase included: (1) implementation of a MIMO adaptive minimum variance active noise controller; and (2) turbofan engine model development. A minimum variance control law for adaptive active noise control has been developed, simulated, and implemented for single-input/single-output (SISO) systems. Since acoustic systems tend to be distributed, multiple sensors, and actuators are more appropriate. As such, the SISO minimum variance controller was extended to the MIMO case. Simulation and experimental results are presented. A state-space model of a simplified gas turbine engine is developed using the bond graph technique. The model retains important system behavior, yet is of low enough order to be useful for controller design. Expansion of the model to include multiple stages and spools is also discussed.

Vital Signs: Health Care–Associated Legionnaires’ Disease Surveillance Data from 20 States and a Large Metropolitan Area — United States, 2015

PubMed Central

Barskey, Albert E.; Shah, Priti P.; Schrag, Stephanie; Whitney, Cynthia G.; Arduino, Matthew J.; Reddy, Sujan C.; Kunz, Jasen M.; Hunter, Candis M.; Raphael, Brian H.; Cooley, Laura A.

2017-01-01

Background Legionnaires’ disease, a severe pneumonia, is typically acquired through inhalation of aerosolized water containing Legionella bacteria. Legionella can grow in the complex water systems of buildings, including health care facilities. Effective water management programs could prevent the growth of Legionella in building water systems. Methods Using national surveillance data, Legionnaires’ disease cases were characterized from the 21 jurisdictions (20 U.S. states and one large metropolitan area) that reported exposure information for ≥90% of 2015 Legionella infections. An assessment of whether cases were health care–associated was completed; definite health care association was defined as hospitalization or long-term care facility residence for the entire 10 days preceding symptom onset, and possible association was defined as any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other Legionnaires’ disease cases were considered unrelated to health care. Results A total of 2,809 confirmed Legionnaires’ disease cases were reported from the 21 jurisdictions, including 85 (3%) definite and 468 (17%) possible health care–associated cases. Among the 21 jurisdictions, 16 (76%) reported 1–21 definite health care–associated cases per jurisdiction. Among definite health care–associated cases, the majority (75, 88%) occurred in persons aged ≥60 years, and exposures occurred at 72 facilities (15 hospitals and 57 long-term care facilities). The case fatality rate was 25% for definite and 10% for possible health care–associated Legionnaires’ disease. Conclusions and Implications for Public Health Practice Exposure to Legionella from health care facility water systems can result in Legionnaires’ disease. The high case fatality rate of health care–associated Legionnaires’ disease highlights the importance of case prevention and response activities, including implementation of effective water management programs and timely case identification. PMID:28594788

An SEU resistant 256K SOI SRAM

NASA Astrophysics Data System (ADS)

Hite, L. R.; Lu, H.; Houston, T. W.; Hurta, D. S.; Bailey, W. E.

1992-12-01

A novel SEU (single event upset) resistant SRAM (static random access memory) cell has been implemented in a 256K SOI (silicon on insulator) SRAM that has attractive performance characteristics over the military temperature range of -55 to +125 C. These include worst-case access time of 40 ns with an active power of only 150 mW at 25 MHz, and a worst-case minimum WRITE pulse width of 20 ns. Measured SEU performance gives an Adams 10 percent worst-case error rate of 3.4 x 10 exp -11 errors/bit-day using the CRUP code with a conservative first-upset LET threshold. Modeling does show that higher bipolar gain than that measured on a sample from the SRAM lot would produce a lower error rate. Measurements show the worst-case supply voltage for SEU to be 5.5 V. Analysis has shown this to be primarily caused by the drain voltage dependence of the beta of the SOI parasitic bipolar transistor. Based on this, SEU experiments with SOI devices should include measurements as a function of supply voltage, rather than the traditional 4.5 V, to determine the worst-case condition.

The cleanroom case study in the Software Engineering Laboratory: Project description and early analysis

NASA Technical Reports Server (NTRS)

Green, Scott; Kouchakdjian, Ara; Basili, Victor; Weidow, David

1990-01-01

This case study analyzes the application of the cleanroom software development methodology to the development of production software at the NASA/Goddard Space Flight Center. The cleanroom methodology emphasizes human discipline in program verification to produce reliable software products that are right the first time. Preliminary analysis of the cleanroom case study shows that the method can be applied successfully in the FDD environment and may increase staff productivity and product quality. Compared to typical Software Engineering Laboratory (SEL) activities, there is evidence of lower failure rates, a more complete and consistent set of inline code documentation, a different distribution of phase effort activity, and a different growth profile in terms of lines of code developed. The major goals of the study were to: (1) assess the process used in the SEL cleanroom model with respect to team structure, team activities, and effort distribution; (2) analyze the products of the SEL cleanroom model and determine the impact on measures of interest, including reliability, productivity, overall life-cycle cost, and software quality; and (3) analyze the residual products in the application of the SEL cleanroom model, such as fault distribution, error characteristics, system growth, and computer usage.

Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

PubMed

Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

2016-06-16

In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts. This article is copyright of The Authors, 2016.