Science.gov

Sample records for additionally emerging evidence

  1. Emerging technologies in arthroplasty: additive manufacturing.

    PubMed

    Banerjee, Samik; Kulesha, Gene; Kester, Mark; Mont, Michael A

    2014-06-01

    Additive manufacturing is an industrial technology whereby three-dimensional visual computer models are fabricated into physical components by selectively curing, depositing, or consolidating various materials in consecutive layers. Although initially developed for production of simulated models, the technology has undergone vast improvements and is currently increasingly being used for the production of end-use components in various aerospace, automotive, and biomedical specialties. The ability of this technology to be used for the manufacture of solid-mesh-foam monolithic and coated components of complex geometries previously considered unmanufacturable has attracted the attention of implant manufacturers, bioengineers, and orthopedic surgeons. Currently, there is a paucity of reports describing this fabrication method in the orthopedic literature. Therefore, we aimed to briefly describe this technology, some of the applications in other orthopedic subspecialties, its present use in hip and knee arthroplasty, and concerns with the present form of the technology. As there are few reports of clinical trials presently available, the true benefits of this technology can only be realized when studies evaluating the clinical and radiographic outcomes of cementless implants manufactured with additive manufacturing report durable fixation, less stress shielding, and better implant survivorship. Nevertheless, the authors believe that this technology holds great promise and may potentially change the conventional methods of casting, machining, and tooling for implant manufacturing in the future. PMID:24764230

  2. Emerging technologies in arthroplasty: additive manufacturing.

    PubMed

    Banerjee, Samik; Kulesha, Gene; Kester, Mark; Mont, Michael A

    2014-06-01

    Additive manufacturing is an industrial technology whereby three-dimensional visual computer models are fabricated into physical components by selectively curing, depositing, or consolidating various materials in consecutive layers. Although initially developed for production of simulated models, the technology has undergone vast improvements and is currently increasingly being used for the production of end-use components in various aerospace, automotive, and biomedical specialties. The ability of this technology to be used for the manufacture of solid-mesh-foam monolithic and coated components of complex geometries previously considered unmanufacturable has attracted the attention of implant manufacturers, bioengineers, and orthopedic surgeons. Currently, there is a paucity of reports describing this fabrication method in the orthopedic literature. Therefore, we aimed to briefly describe this technology, some of the applications in other orthopedic subspecialties, its present use in hip and knee arthroplasty, and concerns with the present form of the technology. As there are few reports of clinical trials presently available, the true benefits of this technology can only be realized when studies evaluating the clinical and radiographic outcomes of cementless implants manufactured with additive manufacturing report durable fixation, less stress shielding, and better implant survivorship. Nevertheless, the authors believe that this technology holds great promise and may potentially change the conventional methods of casting, machining, and tooling for implant manufacturing in the future.

  3. Sideline emergencies: an evidence-based approach.

    PubMed

    Fitch, R Warne; Cox, Charles L; Hannah, Gene A; Diamond, Alex B; Gregory, Andrew J M; Wilson, Kristina M

    2011-01-01

    As participation in athletics continues to increase, so too will the occurrence of on-field injuries and medical emergencies. The field of sports medicine continues to advance and many events will have on-site medical staff present. This article reviews the most catastrophic injuries and medical emergencies that are encountered in sports and presents the highest level evidence in regards to on-field approach and management of the athlete.

  4. 14 CFR 121.310 - Additional emergency equipment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... vision along the passenger cabin, to indicate emergency exits beyond and obscured by it, except that if... microlamberts. The colors may be reversed if it increases the emergency illumination of the passenger... fuselage area by contrast in color. The markings must comply with the following: (1) If the reflectance...

  5. The Emergence of Engaged Scholarship: Seven Additional Years of Evolution

    ERIC Educational Resources Information Center

    Giles, Dwight E., Jr.

    2016-01-01

    In this commentary, author Dwight Giles, Jr. reflects on his 2008 article, "Understanding an Emerging Field of Scholarship: Toward a Research Agenda for Engaged, Public Scholarship," reprinted in this 20th anniversary issue of "Journal of Higher Education Outreach and Engagement." In his original article, Giles argued that…

  6. 14 CFR 135.178 - Additional emergency equipment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...; and (iii) On each bulkhead or divider that prevents fore and aft vision along the passenger cabin, to... microlamberts. The colors may be reversed if it increases the emergency illumination of the passenger... from the surrounding fuselage area by contrast in color. The markings must comply with the...

  7. 14 CFR Appendix A to Part 125 - Additional Emergency Equipment

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...; and (iii) On each bulkhead or divider that prevents fore and aft vision along the passenger cabin, to... microlamberts. The colors may be reversed if it increases the emergency illumination of the passenger... fuselage area by contrast in color. The markings must comply with the following: (1) If the reflectance...

  8. Where is the evidence for emergency planning: a scoping review

    PubMed Central

    2012-01-01

    Background Recent terrorist attacks and natural disasters have led to an increased awareness of the importance of emergency planning. However, the extent to which emergency planners can access or use evidence remains unclear. The aim of this study was to identify, analyse and assess the location, source and quality of emergency planning publications in the academic and UK grey literature. Methods We conducted a scoping review, using as data sources for academic literature Embase, Medline, Medline in Process, Psychinfo, Biosis, Science Citation Index, Cinahl, Cochrane library and Clinicaltrials.gov. For grey literature identification we used databases at the Health Protection Agency, NHS Evidence, British Association of Immediate Care Schemes, Emergency Planning College and the Health and Safety Executive, and the websites of UK Department of Health Emergency Planning Division and UK Resilience. Aggregative synthesis was used to analyse papers and documents against a framework based on a modified FEMA Emergency Planning cycle. Results Of 2736 titles identified from the academic literature, 1603 were relevant. 45% were from North America, 27% were commentaries or editorials and 22% were event reports. Of 192 documents from the grey literature, 97 were relevant. 76% of these were event reports. The majority of documents addressed emergency planning and response. Very few documents related to hazard analysis, mitigation or capability assessment. Conclusions Although a large body of literature exists, its validity and generalisability is unclear There is little evidence that this potential evidence base has been exploited through synthesis to inform policy and practice. The type and structure of evidence that would be of most value of emergency planners and policymakers has yet to be identified. PMID:22823960

  9. Health equity in humanitarian emergencies: a role for evidence aid.

    PubMed

    Pottie, Kevin

    2015-02-01

    Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India.

  10. Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework.

    PubMed

    Puranik, Cynthia S; Lonigan, Christopher J

    2014-10-01

    Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

  11. Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

    PubMed Central

    Puranik, Cynthia S.; Lonigan, Christopher J.

    2014-01-01

    Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

  12. Bifurcations of emerging patterns in the presence of additive noise.

    PubMed

    Agez, Gonzague; Clerc, Marcel G; Louvergneaux, Eric; Rojas, René G

    2013-04-01

    A universal description of the effects of additive noise on super- and subcritical spatial bifurcations in one-dimensional systems is theoretically, numerically, and experimentally studied. The probability density of the critical spatial mode amplitude is derived. From this generalized Rayleigh distribution we predict the shape of noisy bifurcations by means of the most probable value of the critical mode amplitude. Comparisons with numerical simulations are in quite good agreement for cubic or quintic amplitude equations accounting for stochastic supercritical bifurcation and for cubic-quintic amplitude equation accounting for stochastic subcritical bifurcation. Experimental results obtained in a one-dimensional Kerr-like slice subjected to optical feedback confirm the analytical expression prediction for the supercritical bifurcation shape.

  13. Contribution of temperament to eating disorder symptoms in emerging adulthood: Additive and interactive effects.

    PubMed

    Burt, Nicole M; Boddy, Lauren E; Bridgett, David J

    2015-08-01

    Temperament characteristics, such as higher negative emotionality (NE) and lower effortful control (EC), are individual difference risk factors for developmental psychopathology. Research has also noted relations between temperament and more specific manifestations of psychopathology, such as eating disorders (EDs). Although work is emerging that indicates that NE and EC may additively contribute to risk for ED symptoms, no studies have considered the interactive effects of NE and EC in relation to ED symptoms. In the current investigation, we hypothesized that (1) low EC would be associated with increased ED symptoms, (2) high NE would be associated with increased ED symptoms, and (3) these temperament traits would interact, such that the relationship between NE and ED symptoms would be strongest in the presence of low EC. After controlling for gender and child trauma history, emerging adults' (N=160) lower EC (i.e., more difficulties with self-regulation) was associated with more ED symptoms. NE did not emerge as a direct predictor of ED symptoms. However, the anticipated interaction of these temperament characteristics on ED symptoms was found. The association between NE and ED symptoms was only significant in the context of low EC. These findings provide evidence that elevated NE may only be a risk factor for the development of eating disorders when individuals also have self-regulation difficulties. The implications of these findings for research and interventions are discussed.

  14. 17 CFR 12.405 - Leave to adduce additional evidence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... evidence. Any time prior to issuance of its final decision pursuant to § 12.406, the Commission may, after... further evidence. The application shall show to the satisfaction of the Commission that the...

  15. [Evidence for emergency treatment of chemical eye burns].

    PubMed

    Laursen, Jonas Vejvad Nørskov; Hjortdal, Jesper Østergaard

    2014-01-01

    The purpose of this article was to review the existing evidence on emergency treatment of chemical eye burns. Clinical studies show that patients receiving prompt eye irrigation after chemical burns had a significantly better clinical outcome. This is further collaborated in animal studies where prompt irrigation with diphoterine or borate buffer significantly lowered pH in the eye after alkali burns. Two of three studies showed that tap water significantly lowered pH as well, but only if it was administered within 60 seconds after exposure. Saline, however, did not cause any significant decrease in pH at all.

  16. 17 CFR 10.107 - Leave to adduce additional evidence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... Any time prior to issuance of the final decision the Commission may, upon its own motion or upon..., reopen the hearing for the reception of further evidence. The application shall show to the...

  17. Ethnographic Evidence of an Emerging Transnational Arts Practice?

    PubMed Central

    Raw, Anni

    2015-01-01

    This article reports new ethnographic research exploring community-based, participatory arts practice in Northern England and Mexico City. Noting the value of an ethnographic approach, the study investigated whether commonalities discovered in practitioners’ approaches are significant enough to constitute a generalisable participatory arts methodology, transcending significant contextual differences, and recognisable across national boundaries. Shared characteristics emerged in practitioners’ modes of engagement with groups, and strategies for catalysing change; clear convergences from which a core methodology in community-based participatory arts for change is distilled. It suggests the opening of liminal spaces in which participants can reflect, rehearsing fresh ways of engaging in transformative dialogues in relation to the world in which they live. This article presents the study findings as a grounded characterisation of ‘participatory arts practice’: a complex but potentially powerful mechanism, in use within numerous community health projects, and evident in diverse settings, despite little or no exchange of ideas between practitioners. PMID:26045637

  18. Toward Achieving Health Equity: Emerging Evidence and Program Practice.

    PubMed

    Dicent Taillepierre, Julio C; Liburd, Leandris; OʼConnor, Ann; Valentine, Jo; Bouye, Karen; McCree, Donna Hubbard; Chapel, Thomas; Hahn, Robert

    2016-01-01

    Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, health equity, and social determinants of health. PMID:26599028

  19. The Fukushima Dai-ichi accident: additional lessons from a radiological emergency assistance mission.

    PubMed

    Becker, Steven M

    2013-11-01

    In response to the March 2011 earthquake-tsunami disaster and the Fukushima Dai-ichi nuclear accident, a special nongovernmental Radiological Emergency Assistance Mission flew to Japan from the United States. Invited by one of Japan's largest hospital and healthcare groups and facilitated by a New York-based international disaster relief organization, the mission included an emergency physician, a health physicist, and a disaster management specialist. During the 10 d mission, team members conducted fieldwork in areas affected by the earthquake, tsunami, and nuclear accident; went to cities and towns in the 20-30 km Emergency Evacuation Preparation Zone around the damaged nuclear plant; visited other communities affected by the nuclear accident; went to evacuation shelters; met with mayors and other local officials; met with central government officials; exchanged observations, experiences, and information with Japanese medical, emergency response, and disaster management colleagues; and provided radiological information and training to more than 1,100 Japanese hospital and healthcare personnel and first responders. The mission produced many insights with potential relevance for radiological/nuclear emergency preparedness and response. The first "lessons learned" were published in December 2011. Since that time, additional broad insights from the mission and mission followup have been identified. Five of these new lessons, which focus primarily on community impacts and responses and public communication issues, are presented and discussed in this article. PMID:24077046

  20. Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

    ERIC Educational Resources Information Center

    Puranik, Cynthia S.; Lonigan, Christopher J.

    2014-01-01

    Researchers and educators use the term "emergent literacy" to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to…

  1. Bariatric emergencies: current evidence and strategies of management

    PubMed Central

    2013-01-01

    Background The demand for bariatric surgery is increasing and the postoperative complications are seen more frequently. The aim of this paper is to review the current outcomes of bariatric surgery emergencies and to formulate a pathway of safe management. Methods The PubMed and Google search for English literatures relevant to emergencies of bariatric surgery was made, 6358 articles were found and 90 papers were selected based on relevance, power of the study, recent papers and laparoscopic workload. The pooled data was collected from these articles that were addressing the complications and emergency treatment of bariatric patients. 830,998 patients were included in this review. Results Bariatric emergencies were increasingly seen in the Accident and Emergency departments, the serious outcomes were reported following complex operations like gastric bypass but also after gastric band and the causes were technical errors, suboptimal evaluation, failure of effective communication with bariatric teams who performed the initial operation, patients factors, and delay in the presentation. The mortality ranged from 0.14%-2.2% and increased for revisional surgery to 6.5% (p = 0.002). Inspite of this, mortality following bariatric surgery is still less than that of control group of obese patients (p = value 0.01). Conclusions Most mortality and catastrophic outcomes following bariatric surgery are preventable. The awareness of bariatric emergencies and its effective management are the gold standards for best outcomes. An algorithm is suggested and needs further evaluation. PMID:24373182

  2. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  3. Emergency contraception review: evidence-based recommendations for clinicians

    PubMed Central

    Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

    2014-01-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. PMID:25254919

  4. Additives

    NASA Technical Reports Server (NTRS)

    Smalheer, C. V.

    1973-01-01

    The chemistry of lubricant additives is discussed to show what the additives are chemically and what functions they perform in the lubrication of various kinds of equipment. Current theories regarding the mode of action of lubricant additives are presented. The additive groups discussed include the following: (1) detergents and dispersants, (2) corrosion inhibitors, (3) antioxidants, (4) viscosity index improvers, (5) pour point depressants, and (6) antifouling agents.

  5. Psychological Benefits of Regular Physical Activity: Evidence from Emerging Adults

    ERIC Educational Resources Information Center

    Cekin, Resul

    2015-01-01

    Emerging adulthood is a transitional stage between late adolescence and young adulthood in life-span development that requires significant changes in people's lives. Therefore, identifying protective factors for this population is crucial. This study investigated the effects of regular physical activity on self-esteem, optimism, and happiness in…

  6. The emergence of consequential thought: evidence from neuroscience.

    PubMed Central

    Baird, Abigail A; Fugelsang, Jonathan A

    2004-01-01

    The ability to think counterfactually about the consequence of one's actions represents one of the hallmarks of the development of complex reasoning skills. The legal system places a great emphasis on this type of reasoning ability as it directly relates to the degree to which individuals may be judged liable for their actions. In the present paper, we review both behavioural and neuroscientific data exploring the role that counterfactual thinking plays in reasoning about the consequences of one's actions, especially as it pertains to the developing mind of the adolescent. On the basis of assimilation of both behavioural and neuroscientific data, we propose a brain-based model that provides a theoretical framework for understanding the emergence of counterfactual reasoning ability in the developing mind. PMID:15590620

  7. Additional evidence for bone technology in the southern African Middle Stone Age.

    PubMed

    d'Errico, Francesco; Henshilwood, Christopher S

    2007-02-01

    Few Middle Stone Age sites have yielded convincing evidence for a complex bone technology, a behavior often associated with the emergence of modern cultures. Here, we review the published evidence for Middle Stone Age bone tools from southern Africa, analyze an additional nine bone artifacts recently recovered from Middle Stone Age levels at Blombos Cave, describe an unpublished bone tool from probable Middle Stone Age levels at Peers Cave, examine a single bone awl found at Blombosch Sands (an open site near Blombos Cave), and reappraise marked bone artifacts and a bone point recovered from Klasies River. To determine the chronological and cultural attribution of these artifacts, document bone-manufacturing techniques associated with the southern African MSA, and discuss the symbolic significance of the markings present on some of these objects we use (1) available contextual information; (2) morphometric comparison of Later Stone Age, Modern San, and purported Middle Stone Age projectile points; (3) analysis of the carbon/nitrogen content of bone tools and faunal remains from Peers and Blombos caves; and (4) microscopic analysis of traces of manufacture and use. Previously undescribed bone artifacts from Blombos Cave include a massive point manufactured on weathered bone, two complete awls and two awl tips manufactured on small-sized mammal and bird bone, a probable projectile point with a tang manufactured by knapping and scraping, a shaft fragment modified by percussion, used as retoucher and bearing a set of incised lines on the middle of the periosteal surface, and two fragments with possible engravings. The point from Peers Cave can be assigned to the Middle Stone Age and bears tiny markings reminiscent of those recorded on projectile points from Blombos and used as marks of ownership on San arrow points. The awl from Blombosch Sands and the bone point from Klasies River can be attributed to the Later Stone Age. Two notched objects from Klasies are

  8. Selecting a process paradigm for an emergent disruptive technology: Evidence from the emerging microsystems technology base

    SciTech Connect

    Smith, J.H.; Walsh, S.T.

    1998-08-01

    Emergent technologies often suffer from a lack of an installed manufacturing base and an obvious dominant manufacturing technique. Firms which base their search for competitive advantage on emergent disruptive technologies must make hard production choices and endure major manufacturing discontinuities. The authors as well as many other firms, are now facing these challenges with the embrace of microsystems technologies. They add to the literature by providing a set of criteria for firms investing in emergent disruptive technologies. Sandia has long been associated as a pioneer in the development of new manufacturing techniques. Microsystems is just the current in a long line of manufacturing technologies that have been considered for mission critical system applications. The authors as well as others, have had to make the hard choice of investing in specific microsystems manufacturing techniques. Important considerations in the technique choice include: the existing internal manufacturing bases, commonality with existing commercial manufacturing infrastructure, current and projected critical performance characteristics, learning curves, the promise to add new but un-thought-of functionally to existing systems, and the anticipated ability to qualify devices built from the technique for mission critical applications.

  9. Sexuality education: emerging trends in evidence and practice.

    PubMed

    Haberland, Nicole; Rogow, Deborah

    2015-01-01

    The International Conference on Population and Development and related resolutions have repeatedly called on governments to provide adolescents and young people with comprehensive sexuality education (CSE). Drawing from these documents, reviews and meta-analyses of program evaluations, and situation analyses, this article summarizes the elements, effectiveness, quality, and country-level coverage of CSE. Throughout, it highlights the matter of a gender and rights perspective in CSE. It presents the policy and evidence-based rationales for emphasizing gender, power, and rights within programs--including citing an analysis finding that such an approach has a greater likelihood of reducing rates of sexually transmitted infections and unintended pregnancy--and notes a recent shift toward this approach. It discusses the logic of an "empowerment approach to CSE" that seeks to empower young people--especially girls and other marginalized young people--to see themselves and others as equal members in their relationships, able to protect their own health, and as individuals capable of engaging as active participants in society.

  10. Periprosthetic joint infection: the algorithmic approach and emerging evidence.

    PubMed

    Parvizi, Javad; Heller, Snir; Berend, Keith R; Della Valle, Craig J; Springer, Bryan D

    2015-01-01

    Periprosthetic joint infections (PJIs) continue to affect patients, result in accelerated mortality, and consume approximately $1 billion of annual healthcare resources. The future of otherwise successful total joint arthroplasties can be jeopardized by PJI. In recent years, the issue of hospital-acquired infections has gained increasing attention in the United States and the rest of the world, and numerous efforts are being made to address this problem. The orthopaedic community continues to partner with societies, professional organizations, and industry to address this challenge. Recently, an international group of more than 300 surgical experts produced a 350-page document that outlines some of the best practices and identifies the evidence gap related to the management of PJIs. The document, using an algorithmic approach, outlines effective strategies for the prevention, diagnosis, and surgical management of PJIs. It is anticipated that the application of this algorithmic approach will lead to a reduction in the incidence of PJIs, will allow clinicians to diagnose PJI effectively and expeditiously, and will improve the outcome of patients affected by PJIs. PMID:25745894

  11. Psychostimulant abuse and neuroinflammation: emerging evidence of their interconnection.

    PubMed

    Clark, Kenneth H; Wiley, Clayton A; Bradberry, Charles W

    2013-02-01

    During the past two decades, there has been a tremendous expansion of knowledge regarding the neurobiological effects of substance abuse and how these effects impact behavior. At the same time, there has been a profound change in our understanding of the way in which the central nervous system responds to noxious stimuli. Most often referred to as the innate immune response (IIR), this defense mechanism is activated by a number of agents (toxic, microbial, ischemic) and has been implicated in the progression of a number of neurodegenerative diseases. We review evidence that psychostimulants of abuse (cocaine, methamphetamine, ecstasy) are associated with activation of the IIR. We first present background on what is currently known about the IIR including some of the cellular elements involved (microglia, astrocytes, vascular endothelial cells), key receptor pathways, and primary inflammatory cytokines (IL-1β, IL-6, TNF-α). We then present a variety of protein and gene expression data taken from animal studies that show increased expression of various components of the IIR following acute or repeated psychostimulant administration. Collectively the data indicate an association of psychostimulant use with IIR activation in the brain even at exposures not traditionally associated with neurotoxicity. Thus, the gradually escalating deleterious effects of psychostimulant use could in part involve neuroinflammatory mechanisms. Finally, we offer one hypothesis of a possible mechanism by which psychostimulants result in IIR activation and discuss the potential therapeutic implications of these findings for treatment of the recovering addict.

  12. Emerging Technologies in the Built Environment: Geographic Information Science (GIS), 3D Printing, and Additive Manufacturing

    SciTech Connect

    New, Joshua Ryan

    2014-01-01

    Abstract 1: Geographic information systems emerged as a computer application in the late 1960s, led in part by projects at ORNL. The concept of a GIS has shifted through time in response to new applications and new technologies, and is now part of a much larger world of geospatial technology. This presentation discusses the relationship of GIS and estimating hourly and seasonal energy consumption profiles in the building sector at spatial scales down to the individual parcel. The method combines annual building energy simulations for city-specific prototypical buildings and commonly available geospatial data in a GIS framework. Abstract 2: This presentation focuses on 3D printing technologies and how they have rapidly evolved over the past couple of years. At a basic level, 3D printing produces physical models quickly and easily from 3D CAD, BIM (Building Information Models), and other digital data. Many AEC firms have adopted 3D printing as part of commercial building design development and project delivery. This presentation includes an overview of 3D printing, discusses its current use in building design, and talks about its future in relation to the HVAC industry. Abstract 3: This presentation discusses additive manufacturing and how it is revolutionizing the design of commercial and residential facilities. Additive manufacturing utilizes a broad range of direct manufacturing technologies, including electron beam melting, ultrasonic, extrusion, and laser metal deposition for rapid prototyping. While there is some overlap with the 3D printing talk, this presentation focuses on the materials aspect of additive manufacturing and also some of the more advanced technologies involved with rapid prototyping. These technologies include design of carbon fiber composites, lightweight metals processing, transient field processing, and more.

  13. CSI: New @ York: development of forensic evidence collection guidelines for the emergency department.

    PubMed

    Eisert, Peter J; Eldredge, Kelli; Hartlaub, Tami; Huggins, Emily; Keirn, Geneva; O'brien, Patti; Rozzi, Heather V; Pugh, Linda C; March, Karen S

    2010-01-01

    Emergency department (ED) nurses care for victims of trauma almost daily. Although preservation of evidence is crucial, the ED is chaotic when a trauma patient arrives and staff members must do everything possible to save the patient's life. However, an integral responsibility of the staff nurse is collection and preservation of forensic evidence. This article provides insight into the process undertaken by a multidisciplinary team to develop a set of evidence-based guidelines for forensic evidence collection. The team compiled evidence from more than 20 articles and consultations with law enforcement officials and forensic experts. This information was used to develop a set of guidelines for forensic evidence collection in the ED or operating room. Staff educational needs presented some challenges. Training was designed to specifically address the roles of three major groups of staff: patient representatives and emergency and trauma nurses. Educational topics included evidence recognition, handling of clothing, gross/trace evidence, documentation, packaging of evidence, and use of the "chain-of-evidence" form. Practice modifications included development of a new "chain-of-evidence" form, a forensic cart in the operating room, and use of a collapsible plastic box for collection of clothing in the ED.

  14. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  15. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  16. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  17. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist...

  18. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist...

  19. Traumatic hand injuries: the emergency clinician's evidence-based approach.

    PubMed

    Andrade, Aaron; Hern, H Gene

    2011-06-01

    At the start of your Saturday afternoon shift, you are not surprised to see that several patients are waiting to be seen for physical injuries. The first patient is a 34-year-old woman who sustained injury to her hand while skiing, 2 hours prior to her arrival. She reports falling with her hand still tethered to the pole's grip, landing on her outstretched right hand. She felt a painful snap in her right thumb, which still hurts, but otherwise she did not sustain any other trauma. Her only complaint currently is pain at the base of the right thumb. The patient is otherwise completely healthy, has no past medical or surgical history, and takes no medications. Upon examination, the affected hand appears to be surprisingly normal except for mild tenderness and swelling over the ulnar aspect of her first metacarpophalangeal joint and mildly decreased strength in her pincher grasp. X-ray reveals no fracture. You wonder if there is additional testing that should be done to evaluate this injury. You move on to a second patient, a 24-year-old man who cut his ring finger knuckle when he punched a wall 2 days ago. Physical examination reveals a small puncture wound over the IV metacarpophalangeal joint with mild swelling, erythema, warmth, and decreased range of motion secondary to pain. X-ray reveals no fracture, but there's something suspicious about this case. A third patient is a 37-year-old industrial worker whose finger contacted the stream of a high-powered grease injector. Physical examination reveals a small puncture wound over the volar proximal interphalangeal joint of his left long finger, mild tenderness to palpation over the area, and slight decreased range of motion secondary to pain. You wonder if the injury is as benign as it looks. PMID:22164514

  20. Traumatic hand injuries: the emergency clinician's evidence-based approach.

    PubMed

    Andrade, Aaron; Hern, H Gene

    2011-06-01

    At the start of your Saturday afternoon shift, you are not surprised to see that several patients are waiting to be seen for physical injuries. The first patient is a 34-year-old woman who sustained injury to her hand while skiing, 2 hours prior to her arrival. She reports falling with her hand still tethered to the pole's grip, landing on her outstretched right hand. She felt a painful snap in her right thumb, which still hurts, but otherwise she did not sustain any other trauma. Her only complaint currently is pain at the base of the right thumb. The patient is otherwise completely healthy, has no past medical or surgical history, and takes no medications. Upon examination, the affected hand appears to be surprisingly normal except for mild tenderness and swelling over the ulnar aspect of her first metacarpophalangeal joint and mildly decreased strength in her pincher grasp. X-ray reveals no fracture. You wonder if there is additional testing that should be done to evaluate this injury. You move on to a second patient, a 24-year-old man who cut his ring finger knuckle when he punched a wall 2 days ago. Physical examination reveals a small puncture wound over the IV metacarpophalangeal joint with mild swelling, erythema, warmth, and decreased range of motion secondary to pain. X-ray reveals no fracture, but there's something suspicious about this case. A third patient is a 37-year-old industrial worker whose finger contacted the stream of a high-powered grease injector. Physical examination reveals a small puncture wound over the volar proximal interphalangeal joint of his left long finger, mild tenderness to palpation over the area, and slight decreased range of motion secondary to pain. You wonder if the injury is as benign as it looks.

  1. Lactic Acid Fermentation, Urea and Lime Addition: Promising Faecal Sludge Sanitizing Methods for Emergency Sanitation.

    PubMed

    Anderson, Catherine; Malambo, Dennis Hanjalika; Perez, Maria Eliette Gonzalez; Nobela, Happiness Ngwanamoseka; de Pooter, Lobke; Spit, Jan; Hooijmans, Christine Maria; de Vossenberg, Jack van; Greya, Wilson; Thole, Bernard; van Lier, Jules B; Brdjanovic, Damir

    2015-10-29

    In this research, three faecal sludge sanitizing methods-lactic acid fermentation, urea treatment and lime treatment-were studied for application in emergency situations. These methods were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi. Hydrated lime was able to reduce the E. coli count in the sludge to below the detectable limit within 1 h applying a pH > 11 (using a dosage from 7% to 17% w/w, depending faecal sludge alkalinity), urea treatment required about 4 days using 2.5% wet weight urea addition, and lactic acid fermentation needed approximately 1 week after being dosed with 10% wet weight molasses (2 g (glucose/fructose)/kg) and 10% wet weight pre-culture (99.8% pasteurised whole milk and 0.02% fermented milk drink containing Lactobacillus casei Shirota). Based on Malawian prices, the cost of sanitizing 1 m³ of faecal sludge was estimated to be €32 for lactic acid fermentation, €20 for urea treatment and €12 for hydrated lime treatment.

  2. Lactic Acid Fermentation, Urea and Lime Addition: Promising Faecal Sludge Sanitizing Methods for Emergency Sanitation

    PubMed Central

    Anderson, Catherine; Malambo, Dennis Hanjalika; Gonzalez Perez, Maria Eliette; Nobela, Happiness Ngwanamoseka; de Pooter, Lobke; Spit, Jan; Hooijmans, Christine Maria; van de Vossenberg, Jack; Greya, Wilson; Thole, Bernard; van Lier, Jules B.; Brdjanovic, Damir

    2015-01-01

    In this research, three faecal sludge sanitizing methods—lactic acid fermentation, urea treatment and lime treatment—were studied for application in emergency situations. These methods were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi. Hydrated lime was able to reduce the E. coli count in the sludge to below the detectable limit within 1 h applying a pH > 11 (using a dosage from 7% to 17% w/w, depending faecal sludge alkalinity), urea treatment required about 4 days using 2.5% wet weight urea addition, and lactic acid fermentation needed approximately 1 week after being dosed with 10% wet weight molasses (2 g (glucose/fructose)/kg) and 10% wet weight pre-culture (99.8% pasteurised whole milk and 0.02% fermented milk drink containing Lactobacillus casei Shirota). Based on Malawian prices, the cost of sanitizing 1 m3 of faecal sludge was estimated to be €32 for lactic acid fermentation, €20 for urea treatment and €12 for hydrated lime treatment. PMID:26528995

  3. Lactic Acid Fermentation, Urea and Lime Addition: Promising Faecal Sludge Sanitizing Methods for Emergency Sanitation.

    PubMed

    Anderson, Catherine; Malambo, Dennis Hanjalika; Perez, Maria Eliette Gonzalez; Nobela, Happiness Ngwanamoseka; de Pooter, Lobke; Spit, Jan; Hooijmans, Christine Maria; de Vossenberg, Jack van; Greya, Wilson; Thole, Bernard; van Lier, Jules B; Brdjanovic, Damir

    2015-11-01

    In this research, three faecal sludge sanitizing methods-lactic acid fermentation, urea treatment and lime treatment-were studied for application in emergency situations. These methods were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi. Hydrated lime was able to reduce the E. coli count in the sludge to below the detectable limit within 1 h applying a pH > 11 (using a dosage from 7% to 17% w/w, depending faecal sludge alkalinity), urea treatment required about 4 days using 2.5% wet weight urea addition, and lactic acid fermentation needed approximately 1 week after being dosed with 10% wet weight molasses (2 g (glucose/fructose)/kg) and 10% wet weight pre-culture (99.8% pasteurised whole milk and 0.02% fermented milk drink containing Lactobacillus casei Shirota). Based on Malawian prices, the cost of sanitizing 1 m³ of faecal sludge was estimated to be €32 for lactic acid fermentation, €20 for urea treatment and €12 for hydrated lime treatment. PMID:26528995

  4. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Charles Street, part of the Emergency Preparedness team at KSC, uses a phone on the specially equipped emergency response vehicle. The vehicle, nicknamed '''The Brute,''' serves as a mobile command center for emergency preparedness staff and other support personnel when needed. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  5. From NELA to EPOCH and beyond: enhancing the evidence base for emergency laparotomy.

    PubMed

    Odor, Peter M; Grocott, Michael P W

    2016-01-01

    Around 35,000 patients undergo emergency laparotomy surgery in the UK each year with an in-hospital 30-day mortality estimated as between 11 and 15 %. The recent publication of the First Patient Report of the National Emergency Laparotomy Audit (NELA) has provided a detailed description of individual hospital performance against national standards of care in emergency laparotomy in England and Wales. Although the standards used for audit purposes in NELA are based upon the best currently available evidence, none of the source data derives from randomised controlled studies. This commentary explores the evidence base for the standards evaluated by NELA and highlights recent and forthcoming studies that may substantially contribute to improving the evidence base in this area, thereby improving patient care and strengthening the validity of the NELA audit standards. PMID:27594991

  6. 77 FR 43481 - Taking Additional Steps to Address the National Emergency With Respect to Somalia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ..., 2012. [FR Doc. 2012-18237 Filed 7-23-12; 11:15 am] Billing code 3295-F2-P ... National Emergency With Respect to Somalia #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal... Emergency With Respect to Somalia By the authority vested in me as President by the Constitution and...

  7. Evidence-based early clinical detection of emerging diseases in food animals and zoonoses: two cases.

    PubMed

    Saegerman, Claude; Humblet, Marie-France; Porter, Sarah Rebecca; Zanella, Gina; Martinelle, Ludovic

    2012-03-01

    If diseases of food-producing animals or zoonoses (re-)emerge, early clinical decision making is of major importance. In this particular condition, it is difficult to apply a classic evidence-based veterinary medicine process, because of a lack of available published data. A method based on the partition of field clinical observations (evidences) could be developed as an interesting alternative approach. The classification and regression tree (CART) analysis was used to improve the early clinical detection in two cases of emerging diseases: bovine spongiform encephalopathy (mad cow disease) and bluetongue due to the serotype 8-virus in cattle. PMID:22374122

  8. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Robert ZiBerna, Roger Scheidt and Charles Street, the Emergency Preparedness team at KSC, practice for an emergency scenario inside the Mobile Command Center, a specially equipped vehicle. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  9. Polymorphism in paracetamol: evidence of additional forms IV and V at high pressure.

    PubMed

    Smith, Spencer J; Bishop, Matthew M; Montgomery, Jeffrey M; Hamilton, Tracy P; Vohra, Yogesh K

    2014-08-01

    The structural phase stability of N-(4-hydroxyphenyl) acetamide (paracetamol) has been studied at ambient temperature up to 23 GPa using Raman spectroscopy. Spectral changes have provided further evidence for a highly kinetically driven Form I → II transition that occurs as a mixed phase from 4.8 to 6.5 GPa, and might complete as early as 7 GPa. Upon further compression to 8.1 GPa, a drastic shift in spectral signature was observed providing the first evidence for a previously undiscovered Form IV of paracetamol. Additional shifts in mode intensities were observed near 11 GPa indicating a potential restructuring of the hydrogen bonding network and/or structural modification to a potentially new Form V. Phase boundaries at 7 and 8 GPa were confirmed under hydrostatic conditions using Raman spectroscopy. Spectral changes indicate that the transition Form IV → V occurs near 11 GPa. Multiple ab initio harmonic frequency calculations at different levels of theory were performed with a B3LYP/6-31G** being used to provide a more robust mode assignment to our experimentally obtained Raman modes. High pressure X-ray diffraction (XRD) was performed up to 21 GPa, which provided further evidence for a highly kinetically driven Form I → II transition in agreement with our Raman measurements. In addition, the XRD provided further evidence for the existence of Form IV near 8 GPa and Form V near 11 GPa with Form V persisting up to 21 GPa.

  10. Reflecting on Learner Assessments and Their Validity in the Presence of Emerging Evidence from Neuroscience

    ERIC Educational Resources Information Center

    Watagodakumbura, Chandana

    2015-01-01

    We can now get purposefully directed in the way we assess our learners in light of the emergence of evidence from the field of neuroscience. Why higher-order learning or abstract concepts need to be the focus in assessment is elaborated using the knowledge of semantic and episodic memories. With most of our learning identified to be implicit, why…

  11. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This new specially equipped vehicle serves as a mobile command center for emergency preparedness staff and other support personnel when needed at KSC or Cape Canaveral Air Force Station. It features a conference room, computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or CCAFS.

  12. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Charles Street, Roger Scheidt and Robert ZiBerna, the Emergency Preparedness team at KSC, sit in the conference room inside the Mobile Command Center, a specially equipped vehicle. Nicknamed '''The Brute,''' it also features computer work stations, mobile telephones and a fax machine. It also can generate power with its onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  13. The new Mobile Command Center at KSC is important addition to emergency preparedness

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This camper-equipped truck known as '''Old Blue''' served as mobile field command center for the Emergency Preparedness team at KSC. It has been replaced with a larger vehicle that includes a conference room, computer work stations, mobile telephones and a fax machine, plus its own onboard generator. Besides being ready to respond in case of emergencies during launches, the vehicle must be ready to help address fires, security threats, chemical spills, terrorist attaches, weather damage or other critical situations that might face KSC or Cape Canaveral Air Force Station.

  14. Additional experimental evidence for a solar influence on nuclear decay rates

    NASA Astrophysics Data System (ADS)

    Jenkins, Jere H.; Herminghuysen, Kevin R.; Blue, Thomas E.; Fischbach, Ephraim; Javorsek, Daniel; Kauffman, Andrew C.; Mundy, Daniel W.; Sturrock, Peter A.; Talnagi, Joseph W.

    2012-09-01

    Additional experimental evidence is presented in support of the recent hypothesis that a possible solar influence could explain fluctuations observed in the measured decay rates of some isotopes. These data were obtained during routine weekly calibrations of an instrument used for radiological safety at The Ohio State University Research Reactor using 36Cl. The detector system used was based on a Geiger-Müller gas detector, which is a robust detector system with very low susceptibility to environmental changes. A clear annual variation is evident in the data, with a maximum relative count rate observed in January/February, and a minimum relative count rate observed in July/August, for seven successive years from July 2005 to June 2011. This annual variation is not likely to have arisen from changes in the detector surroundings, as we show here.

  15. Transition from NICU to Home: Are the Parents Ready to Manage Any Emergency? An Evidence-Based Project.

    PubMed

    Murray, Chantel H; Joseph, Rachel A

    2016-01-01

    Transitioning the care of a previously critically ill infant to home poses many challenges for the parents. Prior to the infant's discharge, the parents undergo rigorous training to continue the care of their infants at home. Even after training, parents may feel overwhelmed by the thought of managing an emergency at home. This evidence-based practice project aims to provide parents with additional hands-on practice of cardiopulmonary resuscitation (CPR) prior to their infant's discharge. Based on this project, a program of teaching CPR regularly is established currently in the NICU at Nemours Alfred I. duPont Hospital for Children. PMID:27194609

  16. Evidence-Based Practice at a Crossroads: The Timely Emergence of Common Elements and Common Factors

    ERIC Educational Resources Information Center

    Barth, Richard P.; Lee, Bethany R.; Lindsey, Michael A.; Collins, Kathryn S.; Strieder, Frederick; Chorpita, Bruce F.; Becker, Kimberly D.; Sparks, Jacqueline A.

    2012-01-01

    Social work is increasingly embracing evidence-based practice (EBP) as a decision-making process that incorporates the best available evidence about effective treatments given client values and preferences, in addition to social worker expertise. Yet, social work practitioners have typically encountered challenges with the application of…

  17. [Evidence-based emergency pathways for patients with acute coronary syndrome].

    PubMed

    Cardo, Stefania; Barone, Anna Patrizia; Agabiti, Nera; Greco, Cesare; Jefferson, Tom; Guasticchi, Gabriella

    2005-11-01

    We present an evidence-based diagnostic and therapeutic pathway for the treatment of subjects with suspected acute elevated ST-segment myocardial infarction (STEMI). The pathway was developed to aid the reorganization of the emergency service (ES) of the Lazio Region of Italy. Pathway development followed several phases: a) setting up of a multidisciplinary panel comprising all professional figures involved in the management of STEMI subjects; b) drafting of a list of important research questions with a particular focus on areas of clinical and organization uncertainty; c) systematic searches for relevant international scientific evidence to answer research questions; d) assessment, synthesis and classification of identified evidence according to the quality of evidence; e) formulation of management recommendations by their strength according to the methods used by the national guidelines program; f) presentation of draft findings and recommendations; g) external peer review of the draft document; h) editing the final version of the document. Our document identifies possible action scenarios (community, emergency room, major accident and emergency departments) and the following critical points: 1) quick diagnosis and individual risk definition; 2) rapid transmission of the electrocardiogram and vital parameters to the ES control center or to the competent coronary care unit (CCU) depending on where the event took place; 3) a direct link between the ES control center and the competent CCU; 4) the structuring of the regional CCU into a Hub & Spoke model; 5) electronic communication of data between ambulance, ES control center and the competent CCU. Our document also defines Hub regional reference centers and local Spoke centers. The pathway details roles and responsibilities of all players in the emergency chain for STEMI sufferers and critical points for the delivery of the pathway: regional programs on early warning, functions of relevant ES personnel and of

  18. Evidence of thermal additivity during short laser pulses in an in vitro retinal model

    NASA Astrophysics Data System (ADS)

    Denton, Michael L.; Tijerina, Amanda J.; Dyer, Phillip N.; Oian, Chad A.; Noojin, Gary D.; Rickman, John M.; Shingledecker, Aurora D.; Clark, Clifton D.; Castellanos, Cherry C.; Thomas, Robert J.; Rockwell, Benjamin A.

    2015-03-01

    Laser damage thresholds were determined for exposure to 2.5-ms 532-nm pulses in an established in vitro retinal model. Single and multiple pulses (10, 100, 1000) were delivered to the cultured cells at three different pulse repetition frequency (PRF) values, and overt damage (membrane breach) was scored 1 hr post laser exposure. Trends in the damage data within and across the PRF range identified significant thermal additivity as PRF was increased, as evidenced by drastically reduced threshold values (< 40% of single-pulse value). Microthermography data that were collected in real time during each exposure also provided evidence of thermal additivity between successive laser pulses. Using thermal profiles simulated at high temporal resolution, damage threshold values were predicted by an in-house computational model. Our simulated ED50 value for a single 2.5-ms pulse was in very good agreement with experimental results, but ED50 predictions for multiple-pulse trains will require more refinement.

  19. Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

    ERIC Educational Resources Information Center

    Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

    2010-01-01

    This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

  20. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    PubMed

    Elliott, Julian H; Turner, Tari; Clavisi, Ornella; Thomas, James; Higgins, Julian P T; Mavergames, Chris; Gruen, Russell L

    2014-02-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

  1. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    PubMed

    Elliott, Julian H; Turner, Tari; Clavisi, Ornella; Thomas, James; Higgins, Julian P T; Mavergames, Chris; Gruen, Russell L

    2014-02-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem. PMID:24558353

  2. A Standardized Method of Preventing and Managing Emergencies within the Context of Evidence-Based Therapy Implementation

    ERIC Educational Resources Information Center

    Urgelles, Jessica; Donohue, Brad; Wilks, Chelsey; Van Hasselt, Vincent B.; Azrin, Nathan H.

    2012-01-01

    Families served within child welfare settings evidence a wide range of emergencies or unexpected crises or circumstances that may lead to danger and make it difficult for them to focus on treatment planning. Mental health treatment providers are often unprepared to effectively manage emergencies during implementation of evidence-based prescribed…

  3. Current and emerging rehabilitation for concussion: a review of the evidence.

    PubMed

    Broglio, Steven P; Collins, Michael W; Williams, Richelle M; Mucha, Anne; Kontos, Anthony P

    2015-04-01

    Concussion is one of the most hotly debated topics in sports medicine today. Research surrounding concussion has experienced significant growth recently, especially in the areas of incidence, assessment, and recovery. However, there is limited research on the most effective rehabilitation approaches for this injury. This review evaluates the current literature for evidence for and against physical and cognitive rest and the emerging areas targeting vestibular, oculomotor, and pharmacologic interventions for the rehabilitation of sport-related concussion.

  4. Targeting carbonic anhydrase to treat diabetic retinopathy: Emerging evidences and encouraging results

    SciTech Connect

    Weiwei, Zhang; Hu, Renming

    2009-12-18

    Diabetic retinopathy (DR) is the leading cause of vision loss among working-age populations in developed countries. Current treatment options are limited to tight glycemic, blood pressure control and destructive laser surgery. Carbonic anhydrases (CAs) are a group of enzymes involving in the rapid conversion of carbon dioxide to bicarbonate and protons. Emerging evidences reveal CA inhibitors hold the promise for the treatment of DR. This article summarizes encouraging results from clinical and animal studies, and reviews the possible mechanisms.

  5. Current and emerging rehabilitation for concussion: A review of the evidence

    PubMed Central

    Broglio, Steven P.; Collins, Michael W.; Williams, Richelle M.; Mucha, Anne; Kontos, Anthony

    2015-01-01

    Concussion is one of the most hotly debated topics in sports medicine today. Research surrounding concussion has experienced significant growth recently especially in the areas of incidence, assessment, and recovery. However, there is limited research on the most effective rehabilitation approaches for this injury. This review evaluates the current literature for evidence for and against physical and cognitive rest and the emerging areas targeting vestibular, oculomotor, and pharamocological interventions for the rehabilitation of sport-related concussion. PMID:25818710

  6. Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence.

    PubMed

    Skypala, Isabel J; Williams, M; Reeves, L; Meyer, R; Venter, C

    2015-01-01

    Although there is considerable literature pertaining to IgE and non IgE-mediated food allergy, there is a paucity of information on non-immune mediated reactions to foods, other than metabolic disorders such as lactose intolerance. Food additives and naturally occurring 'food chemicals' have long been reported as having the potential to provoke symptoms in those who are more sensitive to their effects. Diets low in 'food chemicals' gained prominence in the 1970s and 1980s, and their popularity remains, although the evidence of their efficacy is very limited. This review focuses on the available evidence for the role and likely adverse effects of both added and natural 'food chemicals' including benzoate, sulphite, monosodium glutamate, vaso-active or biogenic amines and salicylate. Studies assessing the efficacy of the restriction of these substances in the diet have mainly been undertaken in adults, but the paper will also touch on the use of such diets in children. The difficulty of reviewing the available evidence is that few of the studies have been controlled and, for many, considerable time has elapsed since their publication. Meanwhile dietary patterns and habits have changed hugely in the interim, so the conclusions may not be relevant for our current dietary norms. The conclusion of the review is that there may be some benefit in the removal of an additive or a group of foods high in natural food chemicals from the diet for a limited period for certain individuals, providing the diagnostic pathway is followed and the foods are reintroduced back into the diet to assess for the efficacy of removal. However diets involving the removal of multiple additives and food chemicals have the very great potential to lead to nutritional deficiency especially in the paediatric population. Any dietary intervention, whether for the purposes of diagnosis or management of food allergy or food intolerance, should be adapted to the individual's dietary habits and a suitably

  7. Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence.

    PubMed

    Skypala, Isabel J; Williams, M; Reeves, L; Meyer, R; Venter, C

    2015-01-01

    Although there is considerable literature pertaining to IgE and non IgE-mediated food allergy, there is a paucity of information on non-immune mediated reactions to foods, other than metabolic disorders such as lactose intolerance. Food additives and naturally occurring 'food chemicals' have long been reported as having the potential to provoke symptoms in those who are more sensitive to their effects. Diets low in 'food chemicals' gained prominence in the 1970s and 1980s, and their popularity remains, although the evidence of their efficacy is very limited. This review focuses on the available evidence for the role and likely adverse effects of both added and natural 'food chemicals' including benzoate, sulphite, monosodium glutamate, vaso-active or biogenic amines and salicylate. Studies assessing the efficacy of the restriction of these substances in the diet have mainly been undertaken in adults, but the paper will also touch on the use of such diets in children. The difficulty of reviewing the available evidence is that few of the studies have been controlled and, for many, considerable time has elapsed since their publication. Meanwhile dietary patterns and habits have changed hugely in the interim, so the conclusions may not be relevant for our current dietary norms. The conclusion of the review is that there may be some benefit in the removal of an additive or a group of foods high in natural food chemicals from the diet for a limited period for certain individuals, providing the diagnostic pathway is followed and the foods are reintroduced back into the diet to assess for the efficacy of removal. However diets involving the removal of multiple additives and food chemicals have the very great potential to lead to nutritional deficiency especially in the paediatric population. Any dietary intervention, whether for the purposes of diagnosis or management of food allergy or food intolerance, should be adapted to the individual's dietary habits and a suitably

  8. Compactional deformation bands in Wingate Sandstone; additional evidence of an impact origin for Upheaval Dome, Utah

    NASA Astrophysics Data System (ADS)

    Okubo, Chris H.; Schultz, Richard A.

    2007-04-01

    Field and microstructural observations from Upheaval Dome, in Canyonlands National Park, Utah, show that inelastic strain of the Wingate Sandstone is localized along compactional deformation bands. These bands are tabular discontinuities (< 0.5 cm thick) that accommodate inelastic shear and compaction of inter-granular volume. Measurements of porosity and grain size from non-deformed samples are used to define a set of capped strength envelopes for the Wingate Sandstone. These strength envelopes reveal that compactional deformation bands require at least ca. 0.7 GPa (and potentially more than 2.3 GPa) of effective mean stress in order to nucleate within this sandstone. We find that the most plausible geologic process capable of generating these required magnitudes of mean stress is a meteoritic impact. Therefore the compactional deformation bands observed within the Wingate Sandstone are additional evidence of an impact event at Upheaval Dome and support a post-Wingate (post-Early Jurassic) age for this impact.

  9. An Additional Baurusuchid from the Cretaceous of Brazil with Evidence of Interspecific Predation among Crocodyliformes

    PubMed Central

    Godoy, Pedro L.; Montefeltro, Felipe C.; Norell, Mark A.; Langer, Max C.

    2014-01-01

    A new Baurusuchidae (Crocodyliformes, Mesoeucrocodylia), Aplestosuchus sordidus, is described based on a nearly complete skeleton collected in deposits of the Adamantina Formation (Bauru Group, Late Cretaceous) of Brazil. The nesting of the new taxon within Baurusuchidae can be ensured based on several exclusive skull features of this clade, such as the quadrate depression, medial approximation of the prefrontals, rostral extension of palatines (not reaching the level of the rostral margin of suborbital fenestrae), cylindrical dorsal portion of palatine bar, ridge on the ectopterygoid-jugal articulation, and supraoccipital with restricted thin transversal exposure in the caudalmost part of the skull roof. A newly proposed phylogeny of Baurusuchidae encompasses A. sordidus and recently described forms, suggesting its sixter-taxon relationship to Baurusuchus albertoi, within Baurusuchinae. Additionally, the remains of a sphagesaurid crocodyliform were preserved in the abdominal cavity of the new baurusuchid. Direct fossil evidence of behavioral interaction among fossil crocodyliforms is rare and mostly restricted to bite marks resulting from predation, as well as possible conspecific male-to-male aggression. This is the first time that a direct and unmistaken evidence of predation between different taxa of this group is recorded as fossils. This discovery confirms that baurusuchids were top predators of their time, with sphagesaurids occupying a lower trophic position, possibly with a more generalist diet. PMID:24809508

  10. Evidence that Additions of Grignard Reagents to Aliphatic Aldehydes Do Not Involve Single-Electron-Transfer Processes.

    PubMed

    Otte, Douglas A L; Woerpel, K A

    2015-08-01

    Addition of allylmagnesium reagents to an aliphatic aldehyde bearing a radical clock gave only addition products and no evidence of ring-opened products that would suggest single-electron-transfer reactions. The analogous Barbier reaction also did not provide evidence for a single-electron-transfer mechanism in the addition step. Other Grignard reagents (methyl-, vinyl-, t-Bu-, and triphenylmethylmagnesium halides) also do not appear to add to an alkyl aldehyde by a single-electron-transfer mechanism. PMID:26214553

  11. Emerging role of phenolic compounds as natural food additives in fish and fish products.

    PubMed

    Maqsood, Sajid; Benjakul, Soottawat; Shahidi, Fereidoon

    2013-01-01

    Chemical and microbiological deteriorations are principal causes of quality loss of fish and fish products during handling, processing, and storage. Development of rancid odor and unpleasant flavor, changes of color and texture as well as lowering nutritional value in fish can be prevented by appropriate use of additives. Due to the potential health hazards of synthetic additives, natural products, especially antioxidants and antimicrobial agents, have been intensively examined as safe alternatives to synthetic compounds. Polyphenols (PP) are the natural antioxidants prevalent in fruits, vegetables, beverages (tea, wine, juices), plants, seaweeds, and some herbs and show antioxidative and antimicrobial activities in different fish and fish products. The use of phenolic compounds also appears to be a good alternative for sulphiting agent for retarding melanosis in crustaceans. Phenolic compounds have also been successfully employed as the processing aid for texture modification of fish mince and surimi. Thus, plant polyphenolic compounds can serve as potential additives for preventing quality deterioration or to retain the quality of fish and fish products.

  12. Evidence for an additional ligand, distinct from B7, for the CTLA-4 receptor.

    PubMed Central

    Razi-Wolf, Z; Galvin, F; Gray, G; Reiser, H

    1993-01-01

    Activation of T lymphocytes requires the recognition of peptide-major histocompatibility complex complexes and costimulatory signals provided by antigen-presenting cells (APCs). The best-characterized costimulatory molecule to date is the B7 antigen, a member of the immunoglobulin family that binds two receptors, CD28 and CTLA-4, expressed on the T-cell surface. Using the anti-mouse B7 (mB7) monoclonal antibody (mAb) 16-10A1, which we recently developed, we found that mB7 is indeed an important costimulatory ligand for the antigen-specific activation of murine T cells by B lymphocytes. Three lines of evidence suggest, however, the existence of at least one additional ligand for the CTLA-4 receptor. First, a soluble fusion protein of human CTLA-4 and the IgG1 Fc region, termed CTLA4Ig, blocks better than the anti-mB7 mAb the allogeneic stimulation of T cells by unfractionated splenic APCs. Second, saturating amounts of anti-mB7 mAb do not significantly block binding of fluorescein isothiocyanate-conjugated CTLA4Ig to activated splenic APCs. Furthermore, CTLA4Ig but not the anti-mB7 mAb reacts with the M12 and M12.C3 cell lines. The identification of an additional ligand for CTLA-4 may have applications to the treatment of autoimmune disease and transplant-associated disorders. PMID:7504299

  13. Evidence for additive polygenic control of pupation height in Drosophila ananassae.

    PubMed

    Singh, B N; Pandey, M B

    1993-01-01

    In order to study the mode of inheritance of pupation height in Drosophila ananassae, two mass culture stocks derived from ecogeographically different localities in India, were used to make a complete set of 16 crosses, which include parentals, F1, backcrosses, and F2. Pupation height defined as the distance a larva pupates over the surface of culture medium was scored in all 16 crosses. The two parental lines showed significant difference in pupation height. The F1 larvae in both reciprocal crosses had intermediate pupation height and there was no difference between two reciprocal crosses as well as between F1 and mid parent value. However, there was greater variance in the F2 generation. These findings provide evidence that the inheritance of pupation height fits a classical additive polygenic model and suggested that there is substantial amount of additive genetic variation in natural populations of D. ananassae. Furthermore, the analysis of reciprocal backcrosses shows significant maternal effect. Progeny with low pupating mothers showed lower pupation height than those with low pupating fathers and progeny with high pupating mothers had higher pupation height than those with high pupating fathers. Since the maternal effect was found only in backcrosses but not in the F1, it is suggested that this maternal effect on pupation height follows the pattern of inheritance of a transient maternal effect.

  14. Emergence of robust gaps in two-dimensional antiferromagnets via additional spin-1/2 probes

    SciTech Connect

    Ferreira, Aires; Lopes, J. Viana; Lopes dos Santos, J. M. B.

    2010-08-15

    We study the capacity of antiferromagnetic lattices of varying geometries to entangle two additional spin-1/2 probes. Analytical modeling of the quantum Monte Carlo data shows the appearance of a robust gap, allowing a description of entanglement in terms of probe-only states, even in cases where the coupling to the probes is larger than the gap of the spin lattice and cannot be treated perturbatively. We find a considerable enhancement of the temperature at which probe entanglement disappears as we vary the geometry of the bus and the coupling to the probes. In particular, the square Heisenberg antiferromagnet exhibits the best thermal robustness of all systems, whereas the three-leg ladder chain shows the best performance in the natural quantum ground state.

  15. Observation of Emerging Photoinitiator Additives in Household Environment and Sewage Sludge in China.

    PubMed

    Liu, Runzeng; Lin, Yongfeng; Hu, Fanbao; Liu, Ruirui; Ruan, Ting; Jiang, Guibin

    2016-01-01

    Photoinitiators (PIs) are widely used additives in industrial polymerization process, the contamination of which through migration into foodstuffs has been subjected to increasing public scrutiny. Nevertheless, little attention has been paid to the PI residue levels and potential exposure pathways from other environmental compartments. In the present study, the occurrence of PI additives with discrete molecular structures, that is, nine benzophenones (BZPs), four thioxanthones (TXs), and eight amine co-initiators (ACIs), was investigated in commercial products, indoor dust and sewage sludge samples. Nine PI compounds were positively detected in ultraviolet curable resins with concentrations of ∑PIs (sum of the detected PIs) up to 2.51 × 10(4) ng/g, and 20 PIs can be found in food contact materials with concentrations of ∑PIs varying from 65.9 to 6.93 × 10(3) ng/g. The wide usage of PIs in commercial products led to the occurrence of 19 PIs in indoor dust, with concentrations of ∑PIs in the range of 245-5.68 × 10(3) ng/g. Meanwhile, all 21 targeted PIs could be identified in the sewage sludge, with concentrations from 67.6 to 2.03 × 10(3) ng/g. Distinct PI composition profiles were observed in different investigated compartments, and BZPs were the dominant homologues in all samples. Most of the target PIs were further identified as class III chemicals by toxic hazard estimation algorithm (Toxtree), which indicates the compounds might be of significant toxicity or have reactive functional groups. PMID:26649800

  16. Monoarticular arthritis update: Current evidence for diagnosis and treatment in the emergency department.

    PubMed

    Genes, Nicholas; Chisolm-Straker, Makini

    2012-05-01

    Monoarticular arthritis presentations in the emergency department are increasing as the population ages and gets heavier. Many etiologies--from trauma to infection to autoimmune-mediated inflammation--are associated with significant disability or early mortality, and their treatments are associated with adverse effects. A systematic approach to evaluating patients with monoarticular arthritic complaints is important for relieving pain, diagnosing systemic illness, and unmasking true arthritis emergencies. Septic arthritis is a rapidly destructive process that can cause significant disability in a matter of hours or days, with relatively high mortality. Other causes of monoarticular arthritis may cause disability in the long term. In all cases, accurate diagnosis and appropriate therapies are crucial for resuming activities and preventing long-term deficits. This review examines the diagnosis and treatment of monoarticular arthritis, with a focus on recent evidence in the diagnosis of septic arthritis and new research on gout therapies. Modalities for pain control and new techniques for imaging are discussed.

  17. Insights and Perspectives on Emerging Inputs to Weight of Evidence Determinations for Food Safety: Workshop Proceedings

    PubMed Central

    Bialk, Heidi; Llewellyn, Craig; Kretser, Alison; Canady, Richard; Lane, Richard; Barach, Jeffrey

    2013-01-01

    This workshop aimed to elucidate the contribution of computational and emerging in vitro methods to the weight of evidence used by risk assessors in food safety assessments. The following issues were discussed: using in silico and high-throughput screening (HTS) data to confirm the safety of approved food ingredients, applying in silico and HTS data in the process of assessing the safety of a new food ingredient, and utilizing in silico and HTS data in communicating the safety of food ingredients while enhancing the public’s trust in the food supply. Perspectives on integrating computational modeling and HTS assays as well as recommendations for optimizing predictive methods for risk assessment were also provided. Given the need to act quickly or proceed cautiously as new data emerge, this workshop also focused on effectively identifying a path forward in communicating in silico and in vitro data. PMID:24296863

  18. ADDITIONAL DEMOGRAPHIC AND CLINICAL EVIDENCES ON THE RELEVANCE OF THE SYSTEMIC THERAPY IN ALCOHOL DEPENDENCE.

    PubMed

    Alexinschi, Ovidiu; Chirita, Roxana; Manuela, Padurariu; Ciobica, Alin; Dobrin, Romeo; Petrariu, F D; Timofte, Daniel; Chirita, Vasile

    2015-01-01

    The modern treatment for alcohol dependence is still problematic, in many cases with the costs exceeding benefits. In these conditions a new management approach was developed lately, known as the systemic therapy. In this way, the crystallization and practical transposition of this new treatment approach is represented by the Clubs of Alcoholics in Treatment. These clubs are in fact a form of psycho-social intervention consisting of multi-family communities in order to maintain long-term abstinence from alcohol and to change their lifestyle and behavior. Thus, in the present paper we were interested in understanding the demographics of this systemic theory and how these aspects are influencing the final results of the therapy, as well as studying/confirming how relevant is this systemic approach on the management of alcohol dependence. Our results presented in this report bring additional evidences for the superiority of the systemic, multi-family approach of alcohol-related problems, as complemented to the standard medicinal therapy. Moreover, the data collected from patients in this study might suggest that patients with a higher educational level and therefore better capacity of understanding the information, with family support, and also with a better occupational insertion, have accepted to follow The Clubs of Alcoholics in Treatment program, with a subsequently better evolution. PMID:26793858

  19. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components

    PubMed Central

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-01-01

    ABSTRACT Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30–70 percentage points within 1–3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women

  20. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components.

    PubMed

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-09-28

    Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30-70 percentage points within 1-3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning

  1. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components.

    PubMed

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-09-28

    Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30-70 percentage points within 1-3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning

  2. Mother's but not father's education predicts general fluid intelligence in emerging adulthood: Behavioral and neuroanatomical evidence.

    PubMed

    Kong, Feng; Chen, Zhencai; Xue, Song; Wang, Xu; Liu, Jia

    2015-11-01

    Lower parental education impairs cognitive abilities of their offspring such as general fluid intelligence dependent on the prefrontal cortex (PFC), but the independent contribution of mother's and father's education is unknown. We used an individual difference approach to test whether mother's and father's education independently affected general fluid intelligence in emerging adulthood at both the behavioral and neural level. Behaviorally, mother's but not father's education accounted for unique variance in general fluid intelligence in emerging adulthood (assessed by the Raven's advanced progressive matrices). Neurally, the whole-brain correlation analysis revealed that the regional gray matter volume (rGMV) in the medial PFC was related to both mother's education and general fluid intelligence but not father's education. Furthermore, after controlling for mother's education, the association between general fluid intelligence and the rGMV in medial PFC was no longer significant, indicating that mother's education plays an important role in influencing the structure of the medial PFC associated with general fluid intelligence. Taken together, our study provides the first behavioral and neural evidence that mother's education is a more important determinant of general cognitive ability in emerging adulthood than father's education.

  3. Plasmodium falciparum field isolates from areas of repeated emergence of drug resistant malaria show no evidence of hypermutator phenotype.

    PubMed

    Brown, Tyler S; Jacob, Christopher G; Silva, Joana C; Takala-Harrison, Shannon; Djimdé, Abdoulaye; Dondorp, Arjen M; Fukuda, Mark; Noedl, Harald; Nyunt, Myaing Myaing; Kyaw, Myat Phone; Mayxay, Mayfong; Hien, Tran Tinh; Plowe, Christopher V; Cummings, Michael P

    2015-03-01

    Multiple transcontinental waves of drug resistance in Plasmodium falciparum have originated in Southeast Asia before spreading westward, first into the rest of Asia and then to sub-Saharan Africa. In vitro studies have suggested that hypermutator P. falciparum parasites may exist in Southeast Asia and that an increased rate of acquisition of new mutations in these parasites may explain the repeated emergence of drug resistance in Southeast Asia. This study is the first to test the hypermutator hypothesis using field isolates. Using genome-wide SNP data from human P. falciparum infections in Southeast Asia and West Africa and a test for relative rate differences we found no evidence of increased relative substitution rates in P. falciparum isolates from Southeast Asia. Instead, we found significantly increased substitution rates in Mali and Bangladesh populations relative to those in populations from Southeast Asia. Additionally we found no association between increased relative substitution rates and parasite clearance following treatment with artemisinin derivatives.

  4. Plasmodium falciparum field isolates from areas of repeated emergence of drug resistant malaria show no evidence of hypermutator phenotype.

    PubMed

    Brown, Tyler S; Jacob, Christopher G; Silva, Joana C; Takala-Harrison, Shannon; Djimdé, Abdoulaye; Dondorp, Arjen M; Fukuda, Mark; Noedl, Harald; Nyunt, Myaing Myaing; Kyaw, Myat Phone; Mayxay, Mayfong; Hien, Tran Tinh; Plowe, Christopher V; Cummings, Michael P

    2015-03-01

    Multiple transcontinental waves of drug resistance in Plasmodium falciparum have originated in Southeast Asia before spreading westward, first into the rest of Asia and then to sub-Saharan Africa. In vitro studies have suggested that hypermutator P. falciparum parasites may exist in Southeast Asia and that an increased rate of acquisition of new mutations in these parasites may explain the repeated emergence of drug resistance in Southeast Asia. This study is the first to test the hypermutator hypothesis using field isolates. Using genome-wide SNP data from human P. falciparum infections in Southeast Asia and West Africa and a test for relative rate differences we found no evidence of increased relative substitution rates in P. falciparum isolates from Southeast Asia. Instead, we found significantly increased substitution rates in Mali and Bangladesh populations relative to those in populations from Southeast Asia. Additionally we found no association between increased relative substitution rates and parasite clearance following treatment with artemisinin derivatives. PMID:25514047

  5. Plasmodium falciparum field isolates from areas of repeated emergence of drug resistant malaria show no evidence of hypermutator phenotype

    PubMed Central

    Brown, Tyler S.; Jacob, Christopher G.; Silva, Joana C.; Takala-Harrison, Shannon; Djimdé, Abdoulaye; Dondorp, Arjen M.; Fukuda, Mark; Noedl, Harald; Nyunt, Myaing Myaing; Kyaw, Myat Phone; Mayxay, Mayfong; Hien, Tran Tinh; Plowe, Christopher V.; Cummings, Michael P.

    2015-01-01

    Multiple transcontinental waves of drug resistance in Plasmodium falciparum have originated in Southeast Asia before spreading westward, first into the rest of Asia and then to sub-Saharan Africa. In vitro studies have suggested that hypermutator P. falciparum parasites may exist in Southeast Asia and that an increased rate of acquisition of new mutations in these parasites may explain the repeated emergence of drug resistance in Southeast Asia. This study is the first to test the hypermutator hypothesis using field isolates. Using genome-wide SNP data from human P. falciparum infections in Southeast Asia and West Africa and a test for relative rate differences we found no evidence of increased relative substitution rates in P. falciparum isolates from Southeast Asia. Instead, we found significantly increased substitution rates in Mali and Bangladesh populations relative to those in populations from Southeast Asia. Additionally we found no association between increased relative substitution rates and parasite clearance following treatment with artemisinin derivatives. PMID:25514047

  6. Relations among Parental Alcoholism, Eating Disorders, and Substance Abuse in Nonclinical College Women: Additional Evidence against the Uniformity Myth.

    ERIC Educational Resources Information Center

    Mintz, Laurie B.; And Others

    1995-01-01

    The relationship of parental alcoholism to eating disorder symptomology and substance abuse in a nonclinical sample of college women was examined. In addition, differences among adult children of alcoholics (ACOAs) related to level of distress concerning parental alcohol use was examined. Results add additional evidence to the notion that not all…

  7. Cenozoic right-lateral slip on the Great Glen Fault, Scotland: Additional Evidence and Possible Causes

    NASA Astrophysics Data System (ADS)

    Le Breton, E.; Cobbold, P. R.; Zanella, A.

    2012-04-01

    The Great Glen Fault (GGF) trends NNE-SSW across all of Northern Scotland, separating two Neoproterozoic supergroups (Moine and Dalradian). The GGF developed as a left-lateral fault during the Caledonian Orogeny (Ordovician to Early Devonian). However, according to previous studies (involving seismic data from the Moray Firth and analyses of Tertiary dyke swarms in NW Scotland), the GGF reactivated right-laterally in the Tertiary. Here we present additional evidence for this later phase, from a study of Jurassic outcrops along the GGF and the nearby Helmsdale Fault. At Eathie and Shandwick, on the NE coast of Scotland, Jurassic strata of marine origin (mostly shale) crop out along the GGF, in contact with Neoproterozoic basement or Devonian Old Red Sandstone. Minor folds and faults in these outcrops indicate post-depositional right-lateral slip, under transpression. In the shale, we have also found bedding-parallel calcite veins ('beef' and 'cone-in-cone'). If these veins provide evidence for overpressure development and maturation of organic matter at significant depth (as they do in other basins), the host sediment must have accumulated deeper offshore in the Moray Firth. Therefore, the Jurassic strata at Eathie and Shandwick must have been subject to Cenozoic exhumation during right-lateral displacement along the GGF. At Helmsdale, according to previous studies, the Jurassic 'Boulder Beds' accumulated during a period of normal faulting on the Helmsdale Fault. There the sedimentary facies are more proximal than those at Eathie and Shandwick and abundant conglomerate contains Devonian clasts but no 'beef'. However we have found steep calcite veins, which cut the entire Jurassic sequence. Their sigmoidal shapes indicate left-lateral slip along the Helmsdale fault zone. Such a motion is compatible with right-lateral displacement on the GGF. Indeed, according to previous studies, folds between the Helmsdale Fault and the GGF may have developed as a result of opposing

  8. Kinks in subducted slabs: Petrological evidence points to additional hindrance to the exhumation of UHP rocks

    NASA Astrophysics Data System (ADS)

    John, T.; Klemd, R.; Scherer, E. E.; Rondenay, S.; Gao, J.

    2012-12-01

    Sudden changes in the dip of subducted oceanic plates have been resolved by seismic imaging [1, 2]. Such kinking often coincides with the seismic disappearance of the low-velocity subducted oceanic crust, i.e., at a depth where eclogitization (dehydration) of the upper oceanic crust is nearly complete and the oceanic crust becomes almost seismically indistinguishable from mantle peridotite. We present petrological evidence for this phenomenon derived from oceanic blueschist- and eclogite-facies rocks from the Chinese Tianshan. The peak-metamorphic conditions of the samples range between 330 and 580°C at 1.5 to 2.3 GPa. Such a wide range of peak conditions for intercalated high- and ultrahigh-pressure rocks has also been reported from other Tianshan localities. These observations suggest that the rocks were derived from different depths within the subduction zone and later juxtaposed during exhumation within the subduction channel. Multi-point Lu-Hf isochrons from four high-pressure rocks yield consistent garnet-growth ages of around ~315 Ma, confirming that the eclogite-facies metamorphism of the Tianshan high-pressure rocks resulted from a single subduction event in the Late Carboniferous. These ages, in conjunction with the ~311 Ma cluster of 40Ar-39Ar and Rb-Sr white mica ages from the same localities imply rapid exhumation. Previously reported peak P-T estimates from UHP metasediments and eclogites all lie on a lower geothermal gradient—and thus on a colder P-T path at the slab-wedge interface—than that defined by the HP eclogites and meta-volcaniclastic rocks studied here. This suggests that the slab-subduction angle steepened sharply at approximately 90 km depth, just between the depths at which the HP and UHP rocks equilibrated. The increase in subduction angle may result from a greater slab pull resulting from eclogitization densification. An additional factor may be an ephemeral weakening of the slab as it undergoes eclogitization reactions [3, 4]. We

  9. Resveratrol, from experimental data to nutritional evidence: the emergence of a new food ingredient.

    PubMed

    Raederstorff, Daniel; Kunz, Iris; Schwager, Joseph

    2013-07-01

    The polyphenol resveratrol is found notably in grapes and in a variety of medicinal plants. Recently, resveratrol has been suggested to have cardioprotective effects and to improve metabolic health by mimicking the effects of calorie restriction. Numerous animal and in vitro studies suggest that resveratrol could improve cardiovascular and metabolic health in humans. In view of this compelling preclinical evidence, several human studies investigating the effects of resveratrol on vascular and metabolic health have been initiated. Collectively, the animal, human epidemiological, and first human intervention studies support a role of resveratrol in vascular and metabolic health. This has led to the introduction of the first supplement and food products containing resveratrol and its emergence as a promising new health ingredient. Thus, supplementation with resveratrol may be included in nutritional and lifestyle programs aiming to reduce the risk of vascular and obesity-related problems.

  10. Ventriculoperitoneal Shunt Complications In Children: An Evidence-Based Approach To Emergency Department Management.

    PubMed

    Bober, Jacqueline; Rochlin, Jonathan; Marneni, Shashidhar

    2016-02-01

    Although much is known about ventriculoperitoneal shunts, there are still large gaps in the literature and no evidence-based guidelines on management. To date, there is no general consensus on workup and treatment, and there are many differing diagnostic and therapeutic strategies for management of complications. Ventriculoperitoneal shunt complications can be separated into 3 categories: mechanical failure, infection, and functional failure. Knowing the basic anatomy of ventriculoperitoneal shunts, the time of shunt placement, and the clinical manifestations suggestive of potential complications can help with the management of patients with ventriculoperitoneal shunts. This review summarizes the literature on complications of ventriculoperitoneal shunts, examines the literature regarding the workup and management of patients with ventriculoperitoneal shunts, and makes recommendations for the management of these patients in the emergency department.

  11. Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department.

    PubMed

    Hildreth, Amy F; Takhar, Sukhjit; Clark, Mark Andrew; Hatten, Benjamin

    2015-09-01

    Pharyngitis is a common presentation, but it can also be associated with life-threatening processes, including sepsis and airway compromise. Other conditions, such as thyroid disease and cardiac disease, may mimic pharyngitis. The emergency clinician must sort through the broad differential for this complaint using a systematic approach that protects against early closure of the diagnosis. This issue reviews the various international guidelines for pharyngitis and notes controversies in diagnostic and treatment strategies, specifically for management of suspected bacterial, viral, and fungal etiology. A management algorithm is presented, with recommendations based on a review of the best available evidence, taking into account patient comfort and outcomes, the need to reduce bacterial resistance, and costs.

  12. Emergency department triage scales and their components: a systematic review of the scientific evidence.

    PubMed

    Farrohknia, Nasim; Castrén, Maaret; Ehrenberg, Anna; Lind, Lars; Oredsson, Sven; Jonsson, Håkan; Asplund, Kjell; Göransson, Katarina E

    2011-01-01

    Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED?2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥ 15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted.We found ED triage scales to be supported, at best, by limited and often insufficient evidence.The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other

  13. Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence

    PubMed Central

    2011-01-01

    Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED? 2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted. We found ED triage scales to be supported, at best, by limited and often insufficient evidence. The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other

  14. Fosfomycin: evaluation of the published evidence on the emergence of antimicrobial resistance in Gram-negative pathogens.

    PubMed

    Karageorgopoulos, Drosos E; Wang, Rui; Yu, Xu-Hong; Falagas, Matthew E

    2012-02-01

    Fosfomycin has attracted renewed interest for the treatment of lower urinary tract and even systemic infections caused by Gram-negative pathogens with resistance to traditionally used agents. The main concern regarding the clinical utility of fosfomycin refers to the potential for the emergence of resistance during therapy. In this review, we evaluate the available published evidence regarding the mechanisms and the frequency of in vitro mutational resistance to fosfomycin in Gram-negative pathogens. We also review data regarding the emergence of resistance in clinical studies of fosfomycin therapy in various infectious syndromes and data from studies that evaluate the evolution of fosfomycin resistance over time. There appears to be discordance between the high frequency of mutational resistance to fosfomycin in vitro and the lower extent of this phenomenon in clinical studies. This discordance could at least partly be attributed to a biological cost associated with common mutations that confer resistance to fosfomycin, including decreased growth rate and low adherence to epithelial cells for the resistant mutants. The development of resistance appears to be more frequent both in vitro and in clinical studies for Pseudomonas aeruginosa in comparison with Escherichia coli, whereas relevant data for other Enterobacteriaceae are relatively scarce. The urinary tract seems to provide a favourable environment for the use of fosfomycin with a low associated likelihood for the emergence of resistance, owing to high drug concentrations and acidic pH. Additional data are needed to further clarify the optimal use of fosfomycin for different infectious syndromes caused by contemporary multidrug-resistant pathogens.

  15. Evidence for the emergence of leg sympathetic vasoconstrictor tone with age in healthy women

    PubMed Central

    Moore, David J.; Barlow, Matthew A.; Gonzales, Joaquin U.; McGowan, Cheri L.; Pawelczyk, James A.; Proctor, David N.

    2015-01-01

    Abstract While muscle sympathetic nerve activity (MSNA) is elevated with advancing age, correlational evidence suggests that, in contrast to men, basal MSNA is not related to resting lower limb hemodynamics in women. However, limited data exists in women that have attempted to directly assess the degree of limb sympathetic vasoconstrictor tone, and whether it is altered with age. To address this issue, we measured changes in femoral artery vascular conductance (FVC) during an acute sympatho‐inhibitory stimulus (−60 mm Hg neck suction, NS) in groups of healthy younger (n = 8, 23 ± 1 years) and older (n = 7, 66 ± 1 years) women. The percent change in FVC in response to NS was significantly augmented in the older (P = 0.006 vs. young) women. Although NS caused no significant change (3 ± 3%, P = 0.33) in FVC in the young women, there was a robust increase in FVC (21 ± 5%, P = 0.003) in the old women. Collectively, these findings provide evidence that in women, leg sympathetic vasoconstrictor tone emerges with age. PMID:25626874

  16. Evidence for the emergence of leg sympathetic vasoconstrictor tone with age in healthy women.

    PubMed

    Moore, David J; Barlow, Matthew A; Gonzales, Joaquin U; McGowan, Cheri L; Pawelczyk, James A; Proctor, David N

    2015-01-01

    While muscle sympathetic nerve activity (MSNA) is elevated with advancing age, correlational evidence suggests that, in contrast to men, basal MSNA is not related to resting lower limb hemodynamics in women. However, limited data exists in women that have attempted to directly assess the degree of limb sympathetic vasoconstrictor tone, and whether it is altered with age. To address this issue, we measured changes in femoral artery vascular conductance (FVC) during an acute sympatho-inhibitory stimulus (-60 mm Hg neck suction, NS) in groups of healthy younger (n = 8, 23 ± 1 years) and older (n = 7, 66 ± 1 years) women. The percent change in FVC in response to NS was significantly augmented in the older (P = 0.006 vs. young) women. Although NS caused no significant change (3 ± 3%, P = 0.33) in FVC in the young women, there was a robust increase in FVC (21 ± 5%, P = 0.003) in the old women. Collectively, these findings provide evidence that in women, leg sympathetic vasoconstrictor tone emerges with age. PMID:25626874

  17. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness.

    PubMed

    Lundgren, Rebecka; Amin, Avni

    2015-01-01

    Intimate partner violence (IPV) and sexual violence (SV) are widespread among adolescents and place them on a lifelong trajectory of violence, either as victims or perpetrators. The aim of this review was to identify effective approaches to prevent adolescent IPV and SV and to identify critical knowledge gaps. The interventions reviewed in this article reflect the global focus on interventions addressing violence perpetrated by men against women in the context of heterosexual relationships. Interventions for girls and boys (10-19 years) were identified through electronic searches for peer-reviewed and gray literature such as reports and research briefs. Studies were excluded if they were published before 1990 or did not disaggregate participants and results by age. Programs were classified as "effective," "emerging," "ineffective," or "unclear" based on the strength of evidence, generalizability of results to developing country settings, and replication beyond the initial pilot. Programs were considered "effective" if they were evaluated with well-designed studies, which controlled for threats to validity through randomization of participants. A review of 142 articles and documents yielded 61 interventions, which aimed to prevent IPV and SV among adolescents. These were categorized as "parenting" (n = 8), "targeted interventions for children and adolescents subjected to maltreatment" (n = 3), "school based" (n = 31; including 10 interventions to prevent sexual assault among university students), "community based" (n = 16), and "economic empowerment" (n = 2). The rigor of the evaluations varies greatly. A good number have relatively weak research designs, short follow-up periods, and low or unreported retention rates. Overall, there is a lack of robust standardized measures for behavioral outcomes. Three promising approaches emerge. First, school-based dating violence interventions show considerable success. However, they have only been implemented in high

  18. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness.

    PubMed

    Lundgren, Rebecka; Amin, Avni

    2015-01-01

    Intimate partner violence (IPV) and sexual violence (SV) are widespread among adolescents and place them on a lifelong trajectory of violence, either as victims or perpetrators. The aim of this review was to identify effective approaches to prevent adolescent IPV and SV and to identify critical knowledge gaps. The interventions reviewed in this article reflect the global focus on interventions addressing violence perpetrated by men against women in the context of heterosexual relationships. Interventions for girls and boys (10-19 years) were identified through electronic searches for peer-reviewed and gray literature such as reports and research briefs. Studies were excluded if they were published before 1990 or did not disaggregate participants and results by age. Programs were classified as "effective," "emerging," "ineffective," or "unclear" based on the strength of evidence, generalizability of results to developing country settings, and replication beyond the initial pilot. Programs were considered "effective" if they were evaluated with well-designed studies, which controlled for threats to validity through randomization of participants. A review of 142 articles and documents yielded 61 interventions, which aimed to prevent IPV and SV among adolescents. These were categorized as "parenting" (n = 8), "targeted interventions for children and adolescents subjected to maltreatment" (n = 3), "school based" (n = 31; including 10 interventions to prevent sexual assault among university students), "community based" (n = 16), and "economic empowerment" (n = 2). The rigor of the evaluations varies greatly. A good number have relatively weak research designs, short follow-up periods, and low or unreported retention rates. Overall, there is a lack of robust standardized measures for behavioral outcomes. Three promising approaches emerge. First, school-based dating violence interventions show considerable success. However, they have only been implemented in high

  19. Evidence for dose-additive effects of a type II pyrethroid mixture. In vitro assessment.

    PubMed

    Romero, A; Ares, I; Ramos, E; Castellano, V; Martínez, M; Martínez-Larrañaga, M R; Anadón, A; Martínez, M A

    2015-04-01

    Despite the widespread use of pyrethroid insecticides that led to common exposure in the population, few studies have been conducted to quantitatively assess dose-additive effects of pyrethroids using a funcional measure involved in the common toxic mode of action. The aim of this study was to evaluate the potency and efficacy of 6 Type II pyretroids (α-cypermethrin, cyfluthrin, λ-cyhalothrin, deltamethrin, cyphenothrin and esfenvalerate) to evoke induction of both nitric oxide and lipid peroxides levels measured as malondialdehyde in three in vitro models (SH-SY5Y, HepG2 and Caco-2 human cells) as well as to test the hypothesis of dose additivity for mixtures of these same 6 pyrethroids. Concentration-responses for 6 pyrethroids were determined as well as the response to mixtures of all 6 pyrethroids. Additivity was tested assuming a dose-additive model. The human neuroblastoma SH-SY5Y cell line was the most sensitive in vitro model. The rank order of potency for cell SH-SY5Y viability MTT assay was deltamethrin>cyphenothrin>λ-cyhalothrin>cyfluthrin>esfenvalerate>α-cypermethrin. When 6 pyrethroids were present in the mixture at an equitoxic mixing ratio, the action on nitric oxide (NO) and lipid peroxides measured as malondialdehyde (MDA) production was consistent with a dose-additive model. The results of the present study are consistent with previous reports of additivity of pyrethroids in vivo e in vitro.

  20. Genomic Evidence for the Emergence and Evolution of Pathogenicity and Niche Preferences in the Genus Campylobacter

    PubMed Central

    Iraola, Gregorio; Pérez, Ruben; Naya, Hugo; Paolicchi, Fernando; Pastor, Eugenia; Valenzuela, Sebastián; Calleros, Lucía; Velilla, Alejandra; Hernández, Martín; Morsella, Claudia

    2014-01-01

    The genus Campylobacter includes some of the most relevant pathogens for human and animal health; the continuous effort in their characterization has also revealed new species putatively involved in different kind of infections. Nowadays, the available genomic data for the genus comprise a wide variety of species with different pathogenic potential and niche preferences. In this work, we contribute to enlarge this available information presenting the first genome for the species Campylobacter sputorum bv. sputorum and use this and the already sequenced organisms to analyze the emergence and evolution of pathogenicity and niche preferences among Campylobacter species. We found that campylobacters can be unequivocally distinguished in established and putative pathogens depending on their repertory of virulence genes, which have been horizontally acquired from other bacteria because the nonpathogenic Campylobacter ancestor emerged, and posteriorly interchanged between some members of the genus. Additionally, we demonstrated the role of both horizontal gene transfers and diversifying evolution in niche preferences, being able to distinguish genetic features associated to the tropism for oral, genital, and gastrointestinal tissues. In particular, we highlight the role of nonsynonymous evolution of disulphide bond proteins, the invasion antigen B (CiaB), and other secreted proteins in the determination of niche preferences. Our results arise from assessing the previously unmet goal of considering the whole available Campylobacter diversity for genome comparisons, unveiling notorious genetic features that could explain particular phenotypes and set the basis for future research in Campylobacter biology. PMID:25193310

  1. Genomic evidence for the emergence and evolution of pathogenicity and niche preferences in the genus Campylobacter.

    PubMed

    Iraola, Gregorio; Pérez, Ruben; Naya, Hugo; Paolicchi, Fernando; Pastor, Eugenia; Valenzuela, Sebastián; Calleros, Lucía; Velilla, Alejandra; Hernández, Martín; Morsella, Claudia

    2014-09-04

    The genus Campylobacter includes some of the most relevant pathogens for human and animal health; the continuous effort in their characterization has also revealed new species putatively involved in different kind of infections. Nowadays, the available genomic data for the genus comprise a wide variety of species with different pathogenic potential and niche preferences. In this work, we contribute to enlarge this available information presenting the first genome for the species Campylobacter sputorum bv. sputorum and use this and the already sequenced organisms to analyze the emergence and evolution of pathogenicity and niche preferences among Campylobacter species. We found that campylobacters can be unequivocally distinguished in established and putative pathogens depending on their repertory of virulence genes, which have been horizontally acquired from other bacteria because the nonpathogenic Campylobacter ancestor emerged, and posteriorly interchanged between some members of the genus. Additionally, we demonstrated the role of both horizontal gene transfers and diversifying evolution in niche preferences, being able to distinguish genetic features associated to the tropism for oral, genital, and gastrointestinal tissues. In particular, we highlight the role of nonsynonymous evolution of disulphide bond proteins, the invasion antigen B (CiaB), and other secreted proteins in the determination of niche preferences. Our results arise from assessing the previously unmet goal of considering the whole available Campylobacter diversity for genome comparisons, unveiling notorious genetic features that could explain particular phenotypes and set the basis for future research in Campylobacter biology.

  2. Evidence That Certain Waste Tank Headspace Vapor Samples Were Contaminated by Semivolatile Polymer Additives

    SciTech Connect

    Huckaby, James L.

    2006-02-09

    Vapor samples collected from the headspaces of the Hanford Site high-level radioactive waste tanks in 1994 and 1995 using the Vapor Sampling System (VSS) were reported to contain trace levels of phthalates, antioxidants, and certain other industrial chemicals that did not have a logical origin in the waste. This report examines the evidence these chemicals were sampling artifacts (contamination) and identifies the chemicals reported as headspace constituents that may instead have been contaminants. Specific recommendations are given regarding the marking of certain chemicals as suspect on the basis they were sampling manifold contaminants.

  3. Emergency planning and mitigation at Vesuvius: A new evidence-based approach

    NASA Astrophysics Data System (ADS)

    Baxter, P. J.; Aspinall, W. P.; Neri, A.; Zuccaro, G.; Spence, R. J. S.; Cioni, R.; Woo, G.

    2008-12-01

    Disasters from explosive volcanic eruptions are infrequent and experience in emergency planning and mitigation for such events remains limited. The need for urgently developing more robust methods for risk assessment and decision making in volcanic crises has become increasingly apparent as world populations continue to expand in areas of active explosive volcanism. Nowhere is this more challenging than at Vesuvius, Italy, with hundreds of thousands of people living on the flanks of one of the most dangerous volcanoes in the world. We describe how a new paradigm, evidence-based volcanology, has been applied in EXPLORIS to contribute to crisis planning and management for when the volcano enters its next state of unrest, as well as in long-term land-use planning. The analytical approach we adopted enumerates and quantifies all the processes and effects of the eruptive hazards of the volcano known to influence risk, a scientific challenge that combines field data on the vulnerability of the built environment and humans in past volcanic disasters with theoretical research on the state of the volcano, and including evidence from the field on previous eruptions as well as numerical simulation modelling of eruptive processes. Formal probabilistic reasoning under uncertainty and a decision analysis approach have provided the basis for the development of an event tree for a future range of eruption types with probability paths and hypothetical casualty outcomes for risk assessment. The most likely future eruption scenarios for emergency planning were derived from the event tree and elaborated upon from the geological and historical record. Modelling the impacts in these scenarios and quantifying the consequences for the circumvesuvian area provide realistic assessments for disaster planning and for showing the potential risk-benefit of mitigation measures, the main one being timely evacuation, but include for consideration protecting buildings against dilute, low dynamic

  4. Additional Validity Evidence and Across-Group Equivalency of the "HOPE Teacher Rating Scale"

    ERIC Educational Resources Information Center

    Peters, Scott J.; Gentry, Marcia

    2013-01-01

    The "HOPE Scale" was developed to identify academic and social components of giftedness and talent in elementary-aged students with particular attention to students from low-income and/or culturally diverse families. Based on previous findings, additional research was conducted on revisions made to the "HOPE Scale". Items were added, and 71…

  5. Priming word order by thematic roles: no evidence for an additional involvement of phrase structure.

    PubMed

    Pappert, Sandra; Pechmann, Thomas

    2014-01-01

    Three experiments are reported that studied the priming of word order in German. Experiment 1 demonstrated priming of the order of case-marked verb arguments. However, order of noun phrases and order of thematic roles were confounded. In Experiment 2, we therefore aimed at disentangling the impact of these two possible factors. By using primes that differed from targets in phrase structure but were parallel with regard to the order of thematic roles, we nevertheless found priming demonstrating the critical impact of thematic roles. Experiment 3 replicated the priming effects from Experiments 1 and 2 within participants and revealed no evidence for a modulation of priming by phrase structure. Consequently, our findings suggest that word order priming crucially depends on the structural outline of thematic roles rather than on the linearization of phrases.

  6. Is the additional greenhouse effect already evident in the current climate?

    PubMed

    Raschke, E

    2001-11-01

    Several greenhouse gases, which are in part or entirely produced by human activities, have accumulated in the atmosphere since approximately the middle of the 19th century. They are assumed to have an additional greenhouse effect causing a further increase of atmospheric temperatures near the ground and a decrease in the layers above approximately 15 km altitude. The currently observed near-surface warming over nearly the entire globe is already considered by a large fraction of our society to be result of this additional greenhouse effect. Complete justification of this assumption is, however, not yet possible, because there are still too many unknowns in our knowledge of participating processes and in our modeling capabilities.

  7. Additive Effects of Repetition and Predictability during Comprehension: Evidence from Event-Related Potentials

    PubMed Central

    Barrios, Shannon; Parker, Dan; Morini, Giovanna; Lau, Ellen

    2014-01-01

    Previous research has shown that neural responses to words during sentence comprehension are sensitive to both lexical repetition and a word’s predictability in context. While previous research has often contrasted the effects of these variables (e.g. by looking at cases in which word repetition violates sentence-level constraints), little is known about how they work in tandem. In the current study we examine how recent exposure to a word and its predictability in context combine to impact lexical semantic processing. We devise a novel paradigm that combines reading comprehension with a recognition memory task, allowing for an orthogonal manipulation of a word’s predictability and its repetition status. Using event-related brain potentials (ERPs), we show that word repetition and predictability have qualitatively similar and additive effects on the N400 amplitude. We propose that prior exposure to a word and predictability impact lexical semantic processing in an additive and independent fashion. PMID:24905459

  8. Emerging evidence for specific neuronal functions of auxiliary calcium channel α2δ subunits

    PubMed Central

    Obermair, Gerald J.

    2015-01-01

    In nerve cells the ubiquitous second messenger calcium regulates a variety of vitally important functions including neurotransmitter release, gene regulation, and neuronal plasticity. The entry of calcium into cells is tightly regulated by voltage-gated calcium channels, which consist of a heteromultimeric complex of a pore forming α1, and the auxiliary β and α2δ subunits. Four genes (Cacna2d1-4) encode for the extracellular membrane-attached α2δ subunits (α2δ-1 to α2δ-4), out of which three isoforms (α2δ-1 to -3) are strongly expressed in the central nervous system. Over the years a wealth of studies has demonstrated the classical role of α2δ subunits in channel trafficking and calcium current modulation. Recent studies in specialized neuronal cell systems propose roles of α2δ subunits beyond the classical view and implicate α2δ subunits as important regulators of synapse formation. These findings are supported by the identification of novel human disease mutations associated with α2δ subunits and by the fact that α2δ subunits are the target of the anti-epileptic and anti-allodynic drugs gabapentin and pregabalin. Here we review the recently emerging evidence for specific as well as redundant neuronal roles of α2δ subunits and discuss the mechanisms for establishing and maintaining specificity. PMID:25504062

  9. Dynamic interplay between histone H3 modifications and protein interpreters: emerging evidence for a "histone language".

    PubMed

    Oliver, Samuel S; Denu, John M

    2011-01-24

    Histone proteins organize DNA into dynamic chromatin structures and regulate processes such as transcription, repair, and replication. Control of chromatin function and structure is mediated in part by reversible post-translational modifications (PTMs) on histones. The most N-terminal region of histone H3 contains a high density of modifiable residues. Here we focus on the dynamic interplay between histone modification states on the H3 N terminus and the binding modules that recognize these states. Specifically, we discuss the effect of auxiliary modifications to H3K4unmod/me3 binding modules (specifically H3R2 methylation, H3T3 phosphorylation, and H3T6 phosphorylation). Emerging evidence suggests that histone PTMs behave less like a strict "code", but more like a "language", which better illustrates the importance of context. Using androgen-receptor-mediated gene activation as an example, we propose a model of how the combinatorial natures of PTMs on the H3 N terminus and the complexes that recognize these epigenetic modifications control gene expression. PMID:21243717

  10. Evidence-based support for the all-hazards approach to emergency preparedness

    PubMed Central

    2012-01-01

    Background During the last decade there has been a need to respond and recover from various types of emergencies including mass casualty events (MCEs), mass toxicological/chemical events (MTEs), and biological events (pandemics and bio-terror agents). Effective emergency preparedness is more likely to be achieved if an all-hazards response plan is adopted. Objectives To investigate if there is a relationship among hospitals' preparedness for various emergency scenarios, and whether components of one emergency scenario correlate with preparedness for other emergency scenarios. Methods Emergency preparedness levels of all acute-care hospitals for MCEs, MTEs, and biological events were evaluated, utilizing a structured evaluation tool based on measurable parameters. Evaluations were made by professional experts in two phases: evaluation of standard operating procedures (SOPs) followed by a site visit. Relationships among total preparedness and different components' scores for various types of emergencies were analyzed. Results Significant relationships were found among preparedness for different emergencies. Standard Operating Procedures (SOPs) for biological events correlated with preparedness for all investigated emergency scenarios. Strong correlations were found between training and drills with preparedness for all investigated emergency scenarios. Conclusions Fundamental critical building blocks such as SOPs, training, and drill programs improve preparedness for different emergencies including MCEs, MTEs, and biological events, more than other building blocks, such as equipment or knowledge of personnel. SOPs are especially important in unfamiliar emergency scenarios. The findings support the adoption of an all-hazards approach to emergency preparedness. PMID:23098065

  11. Determinants of contrast in the signal-key procedure: Evidence against additivity theory.

    PubMed

    Williams, B A; Heyneman, N

    1981-03-01

    Two experiments are reported that challenge the interpretation of previous results with the signal-key procedure, in which the discriminative stimuli are located on a response key different from the key associated with the operant response requirement. Experiment 1 replicated the procedure of Keller (1974), and found that contrast effects on the operant key occurred reliably for only one of four subjects. High rates to the signal key initially occurred for only one subject, but modifications of the procedure produced substantial rates to the signal key for all subjects. In all cases, however, signal-key behavior was greatly reduced by the addition of a changeover delay which prevented reinforcement within 2 seconds of the last peck to the signal key, suggesting that signal-key pecking was maintained primarily by adventitious reinforcement. Experiment 2 modified the signal-key procedure by using three response keys, so that the discriminative stimuli on the signal key controlled different responses during all phases of training. With this modification, reliable contrast effects on the operant key occurred for all subjects, suggesting that the failure to find contrast in previous studies has been due to the confounding of changes in the discrimination requirements with changes in relative rate of reinforcement. The results challenge the additivity theory of contrast, and suggest that "elicited" behavior plays a minor role, if any, in the determination of contrast effects in multiple schedules.

  12. Therapeutic hypothermia in the postresuscitation patient: the development and implementation of an evidence-based protocol for the emergency department.

    PubMed

    Koran, Zeb

    2009-01-01

    Studies have shown that therapeutic hypothermia (TH) improves outcomes in patients who have experienced a cardiac arrest (; ). This article discusses TH and the process used by one emergency department to develop and implement an evidence-based protocol on TH for the postresuscitation patient.

  13. Evidence for an additional uppermost geological unit in the Medusae Fossae Formation, Equatorial Mars

    NASA Astrophysics Data System (ADS)

    Harrison, Samantha; Balme, Matt; Hagermann, Axel

    2013-04-01

    The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal outcrops. The MFF dominates roughly a quarter of the longitudinal extent of the equatorial region of Mars, extending east-west across a distance of ~ 5,500 km between the southern Elysium Planitia and the Tharsis region. The nature of these materials is often referred to as enigmatic, as their exact origin remains unknown. Harrison et al. (Icarus, 2010) presented new observations of outlying occurrences of MFF materials on the southern highlands, atop the dichotomy boundary. They presented two hypotheses to explain these observation: 1) the MFF had a much larger pre-erosional extent than previously thought or 2) these materials had initially been eroded from the main outcrops of the formation, then transported southward by wind and subsequently reworked. A subsequent extension of this work provided evidence for an even larger extent of outlying MFF materials, particularly around and south of the easternmost portions of the MFF. Here we present these new outlier data, together with new textural classification and facies mapping of this region of the MFF. These data show that MFF outlier textures, whilst external to the main MFF outcrops in many places, are also found superposing large areas of the "main" MFF formations. These data support the first of the two working hypotheses presented, but also suggest that these so-called outlying materials represent a previously unmapped, stratigraphically uppermost unit of the Medusae Fossae Formation. We also suggest that, based upon our own morphometric study of yardangs across members and analogue studies by de Silva et al. (Icarus, 2010), these represent a less indurated material than other units of the formation. In the overall context of the origins of the MFF, we find that our data are consistent with the Medusae Fossae materials being a large-scale ignimbrite complex, perhaps with

  14. Geochemical evidence for airborne dust additions to soils in Channel Islands National Park, California

    USGS Publications Warehouse

    Muhs, D.R.; Budahn, J.R.; Johnson, D.L.; Reheis, M.; Beann, J.; Skipp, G.; Fisher, E.; Jones, J.A.

    2008-01-01

    There is an increasing awareness that dust plays important roles in climate change, biogeochemical cycles, nutrient supply to ecosystems, and soil formation. In Channel Islands National Park, California, soils are clay-rich Vertisols or Alfisols and Mollisols with vertic properties. The soils are overlain by silt-rich mantles that contrast sharply with the underlying clay-rich horizons. Silt mantles contain minerals that are rare or absent in the volcanic rocks that dominate these islands. Immobile trace elements (Sc-Th-La and Ta-Nd-Cr) and rare-earth elements show that the basalt and andesite on the islands have a composition intermediate between upper-continental crust and oceanic crust. In contrast, the silt fractions and, to a lesser extent, clay fractions of the silt mantle have compositions closer to average upper-continental crust and very similar to Mojave Desert dust. Island shelves, exposed during the last glacial period, could have provided a source of eolian sediment for the silt mantles, but this is not supported by mineralogical data. We hypothesize that a more likely source for the silt-rich mantles is airborne dust from mainland California and Baja California, either from the Mojave Desert or from the continental shelf during glacial low stands of sea. Although average winds are from the northwest in coastal California, easterly winds occur numerous times of the year when "Santa Ana" conditions prevail, caused by a high-pressure cell centered over the Great Basin. The eolian silt mantles constitute an important medium of plant growth and provide evidence that abundant eolian silt and clay may be delivered to the eastern Pacific Ocean from inland desert sources. ?? 2007 Geological Society of America.

  15. Physician-Assisted Suicide: Considering the Evidence, Existential Distress, and an Emerging Role for Psychiatry.

    PubMed

    Gopal, Abilash A

    2015-06-01

    Physician-assisted suicide (PAS) is one of the most provocative topics facing society today. Given the great responsibility conferred on physicians by recent laws allowing PAS, a careful examination of this subject is warranted by psychiatrists and other specialists who may be consulted during a patient's request for PAS. In this article, recent evidence regarding the implementation of PAS in the United States and The Netherlands is reviewed. Support is found for some concerns about PAS, such as the possibility that mental illness occurs at higher rates in patients requesting PAS, but not for other concerns, such as the fear that PAS will be practiced more frequently on vulnerable populations (the slippery-slope argument). These data and common arguments for and against PAS are discussed with an emphasis on the tension between values, such as maximizing patient autonomy and adhering to professional obligations, as well as the need for additional research that focuses more directly on the patient-centered perspective. Implications of the available evidence are discussed and lead to a consideration of mental anguish in terminally ill patients including aspects of existential distress and an acknowledgment of the importance of tailoring end-of-life care to the distinct set of values and experiences that shape each patient's perspective. The article concludes with a discussion of an expanding role for psychiatrists in evaluating patients who request PAS.

  16. An evidence-based approach to the evaluation and treatment of low back pain in the emergency department.

    PubMed

    Borczuk, Pierre

    2013-07-01

    Low back pain is the most common musculoskeletal complaint that results in a visit to the emergency department, and it is 1 of the top 5 most common complaints in emergency medicine. Estimates of annual healthcare expenditures for low back pain in the United States exceed $90 billion annually, not even taking lost productivity and business costs into account. This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for patients, and help manage healthcare resources and costs. PMID:24044786

  17. No Serological Evidence that Harbour Porpoises Are Additional Hosts of Influenza B Viruses

    PubMed Central

    Bodewes, Rogier; van de Bildt, Marco W. G.; van Elk, Cornelis E.; Bunskoek, Paulien E.; van de Vijver, David A. M. C.; Smits, Saskia L.; Osterhaus, Albert D. M. E.; Kuiken, Thijs

    2014-01-01

    Influenza A and B viruses circulate among humans causing epidemics almost annually. While various hosts for influenza A viruses exist, influenza B viruses have been detected only in humans and seals. However, recurrent infections of seals in Dutch coastal waters with influenza B viruses that are antigenetically distinct from influenza B viruses circulating among humans suggest that influenza B viruses have been introduced into this seal population by another, non-human, host. Harbour porpoises (Phocoena phocoena) are sympatric with seals in these waters and are also occasionally in close contact with humans after stranding and subsequent rehabilitation. In addition, virus attachment studies demonstrated that influenza B viruses can bind to cells of the respiratory tract of these animals. Therefore, we hypothesized that harbour porpoises might be a reservoir of influenza B viruses. In the present study, an unique set of serum samples from 79 harbour porpoises, stranded alive on the Dutch coast between 2003 and 2013, was tested for the presence of antibodies against influenza B viruses by use of the hemagglutination inhibition test and for antibodies against influenza A viruses by use of a competitive influenza A nucleoprotein ELISA. No antibodies were detected against either virus, suggesting that influenza A and B virus infections of harbour porpoises in Dutch coastal waters are not common, which was supported by statistical analysis of the dataset. PMID:24551217

  18. Evidence for an Additional Heat Source in the Warm Ionized Medium of Galaxies.

    PubMed

    Reynolds; Haffner; Tufte

    1999-11-01

    Spatial variations of the [S ii]/Halpha and [N ii]/Halpha line intensity ratios observed in the gaseous halo of the Milky Way and other galaxies are inconsistent with pure photoionization models. They appear to require a supplemental heating mechanism that increases the electron temperature at low densities, ne. This would imply that in addition to photoionization, which has a heating rate per unit volume proportional to n2e, there is another source of heat with a rate per unit volume proportional to a lower power of ne. One possible mechanism is the dissipation of interstellar plasma turbulence, which, according to Minter & Spangler, heats the ionized interstellar medium in the Milky Way at a rate of approximately 1x10-25ne ergs cm-3 s-1. If such a source were present, it would dominate over photoionization heating in regions where ne less, similar0.1 cm-3, producing the observed increases in the [S ii]/Halpha and [N ii]/Halpha intensity ratios at large distances from the galactic midplane as well as accounting for the constancy of [S ii]/[N ii], which is not explained by pure photoionization. Other supplemental heating sources, such as magnetic reconnection, cosmic rays, or photoelectric emission from small grains, could also account for these observations, provided they supply approximately 10-5 ergs s-1 per square centimeter of the Galactic disk to the warm ionized medium.

  19. Molecular-scale evidence of aerosol particle formation via sequential addition of HIO3

    NASA Astrophysics Data System (ADS)

    Sipilä, Mikko; Sarnela, Nina; Jokinen, Tuija; Henschel, Henning; Junninen, Heikki; Kontkanen, Jenni; Richters, Stefanie; Kangasluoma, Juha; Franchin, Alessandro; Peräkylä, Otso; Rissanen, Matti P.; Ehn, Mikael; Vehkamäki, Hanna; Kurten, Theo; Berndt, Torsten; Petäjä, Tuukka; Worsnop, Douglas; Ceburnis, Darius; Kerminen, Veli-Matti; Kulmala, Markku; O'Dowd, Colin

    2016-09-01

    Homogeneous nucleation and subsequent cluster growth leads to the formation of new aerosol particles in the atmosphere. The nucleation of sulfuric acid and organic vapours is thought to be responsible for the formation of new particles over continents, whereas iodine oxide vapours have been implicated in particle formation over coastal regions. The molecular clustering pathways that are involved in atmospheric particle formation have been elucidated in controlled laboratory studies of chemically simple systems, but direct molecular-level observations of nucleation in atmospheric field conditions that involve sulfuric acid, organic or iodine oxide vapours have yet to be reported. Here we present field data from Mace Head, Ireland, and supporting data from northern Greenland and Queen Maud Land, Antarctica, that enable us to identify the molecular steps involved in new particle formation in an iodine-rich, coastal atmospheric environment. We find that the formation and initial growth process is almost exclusively driven by iodine oxoacids and iodine oxide vapours, with average oxygen-to-iodine ratios of 2.4 found in the clusters. On the basis of this high ratio, together with the high concentrations of iodic acid (HIO3) observed, we suggest that cluster formation primarily proceeds by sequential addition of HIO3, followed by intracluster restructuring to I2O5 and recycling of water either in the atmosphere or on dehydration. Our study provides ambient atmospheric molecular-level observations of nucleation, supporting the previously suggested role of iodine-containing species in the formation of new aerosol particles, and identifies the key nucleating compound.

  20. Evidence of an Emerging Disturbance of Earthen Levees Causing Disastrous Floods in Italy

    NASA Astrophysics Data System (ADS)

    Orlandini, S.; Moretti, G.; Albertson, J. D.

    2015-12-01

    A levee failure occurred along the Secchia River, Northern Italy, on January 19, 2014, resulting in flood damage in excess of $500 Million (Figure). In response to this failure, immediate surveillance of other levees in the region led to the identification of a second breach developing on the neighboring Panaro River, where rapid mitigation efforts were successful in averting a full levee failure. The paired breach events that occurred along the Secchia and Panaro Rivers provided an excellent window on an emerging disturbance of levees and related failure mechanism. In the Secchia River, by combining the information content of photographs taken from helicopters in the early stage of breach development and 10-cm resolution aerial photographs taken in 2010 and 2012, animal burrows were found to exist in the precise levee location where the breach originated. In the Panaro River, internal erosion was observed to occur at a location where a crested porcupine den was known to exist and this erosion led to the collapse of the levee top. Evidence collected suggested that it is quite likely that the levee failure of the Secchia River was of a similar mechanism as the observed failure of the Panaro River. Detailed numerical modeling of rainfall, river flow, and variably saturated flow occurring in disturbed levees in response to complex hydroclimatic forcing indicated that the levee failure of the Secchia River may have been triggered by direct river inflow into the den system or collapse of a hypothetical den separated by a 1-m earthen wall from the levee riverside, which saturated during the hydroclimatic event. It is important to bring these processes to the attention of hydrologists and geotechnical engineers as well as to trigger an interdisciplinary discussion on habitat fragmentation and wildlife shifts due to development and climate pressures. These disturbances come together with changes in extreme events to inform the broader concern of risk analysis due to floods.

  1. Dasatinib: the emerging evidence of its potential in the treatment of chronic myeloid leukemia

    PubMed Central

    Haslam, Sonya

    2005-01-01

    Introduction: Current therapy options for chronic myeloid leukemia (CML) include conventional chemotherapy, allogeneic stem cell transplant, interferon-alfa, and imatinib mesylate, which has recently achieved gold standard status. Although the majority of patients initially respond well to treatment with imatinib, wider clinical experience with this drug has resulted in the development of imatinib resistance being increasingly documented. There is therefore an unmet medical need for novel therapies to override imatinib resistance in CML. Aims: This review summarizes the emerging evidence for the potential use of dasatinib in the treatment of imatinib-resistant CML. Disease and treatment: Dasatinib is a novel small molecule that has shown potent antileukemic activity in imatinib-resistant cell lines, malignant marrow cells isolated from patients with imatinib-resistant CML, and in mouse xenograft models of imatinib-resistant CML. Preliminary data from an initial phase I dose escalation trial have been encouraging, indicating that dasatinib is generally well tolerated and produces hematologic and cytogenetic responses in patients with imatinib-resistant CML in all phases of the disease. The maximum tolerated dose (MTD) has not yet been reached, and dose escalation continues to determine the dose range that yields optimal results. Profile: Although dasatinib is still in the early stages of development, the potential impact of this molecule on the treatment of CML could be revolutionary, not only providing a much needed treatment option for patients with imatinib-resistant CML, but also, combined with imatinib, could possibly prove useful in delaying the onset of resistance to treatment. Furthermore, combined with other agents active in CML, dasatinib could have potential utility in purging residual leukemic cells in patients whose disease is controlled by imatinib. PMID:22496672

  2. Populus Responses to Edaphic and Climatic Cues: Emerging Evidence from Systems Biology Research

    SciTech Connect

    Wullschleger, Stan D; Weston, David; Davis, John M

    2009-01-01

    The emergence of Populus as a model system for tree biology continues to be driven by a community of scientists dedicated to developing the resources needed to undertake genetic and functional genomic studies in this genus. As a result, understanding the molecular processes that underpin the growth and development of cottonwood, aspen, and hybrid poplar has steadily increased over the last several decades. Recently, our ability to examine the basic mechanisms whereby trees respond to a changing climate and resource limitations has benefited greatly from the sequencing of the P. trichocarpa genome. This landmark event has laid a solid foundation upon which biologists can now quantify, in breathtaking and unprecedented detail, the diversity of genes, proteins, and metabolites that govern the growth and development of some of the longest living and tallest growing organisms on Earth. Although the challenges likely to be encountered by scientists who work with trees are many, recent literature provides a few examples where a systems approach, one that focuses on integrating transcriptomic, proteomic, and metabolomic analyses, is beginning to provide insights into the molecular-scale response of poplars to their climatic and edaphic environment. In this review, our objectives are to look at evidence from studies that examine the molecular response of poplar to edaphic and climatic cues and highlight instances where two or more omic-scale measurements confirm and hopefully expand our inferences about mechanisms contributing to observed patterns of response. Based on conclusions drawn from these studies, we propose that three requirements will be essential as systems biology in poplar moves to reveal unique insights. These include use of genetically-defined individuals (e.g., pedigrees or transgenics) in studies; incorporation of modeling as a complement to transcriptomic, proteomic and metabolomic data; and inclusion of whole-tree and stand-level phenotypes to place

  3. Experimental Evidence for Dynamic Social Impact: The Emergence of Subcultures in Electronic Groups.

    ERIC Educational Resources Information Center

    Latane, Bibb; Bourgeois, Martin J.

    1996-01-01

    Presents results of experimental tests of Dynamic Social Impact Theory (DSIT) in which participants engaged in discussions over electronic mail. Finds support for the emergence of four group phenomena predicted by DSIT. Shows how, rewarded for being in the majority, individuals' choices resulted in the emergence of four forms of group level…

  4. The relationship between the nucleolus and cancer: Current evidence and emerging paradigms.

    PubMed

    Orsolic, Ines; Jurada, Deana; Pullen, Nick; Oren, Moshe; Eliopoulos, Aristides G; Volarevic, Sinisa

    2016-06-01

    The nucleolus is the most prominent nuclear substructure assigned to produce ribosomes; molecular machines that are responsible for carrying out protein synthesis. To meet the increased demand for proteins during cell growth and proliferation the cell must increase protein synthetic capacity by upregulating ribosome biogenesis. While larger nucleolar size and number have been recognized as hallmark features of many tumor types, recent evidence has suggested that, in addition to overproduction of ribosomes, decreased ribosome biogenesis as well as qualitative changes in this process could also contribute to tumor initiation and cancer progression. Furthermore, the nucleolus has become the focus of intense attention for its involvement in processes that are clearly unrelated to ribosome biogenesis such as sensing and responding to endogenous and exogenous stressors, maintenance of genome stability, regulation of cell-cycle progression, cellular senescence, telomere function, chromatin structure, establishment of nuclear architecture, global regulation of gene expression and biogenesis of multiple ribonucleoprotein particles. The fact that dysregulation of many of these fundamental cellular processes may contribute to the malignant phenotype suggests that normal functioning of the nucleolus safeguards against the development of cancer and indicates its potential as a therapeutic approach. Here we review the recent advances made toward understanding these newly-recognized nucleolar functions and their roles in normal and cancer cells, and discuss possible future research directions.

  5. The relationship between the nucleolus and cancer: Current evidence and emerging paradigms.

    PubMed

    Orsolic, Ines; Jurada, Deana; Pullen, Nick; Oren, Moshe; Eliopoulos, Aristides G; Volarevic, Sinisa

    2016-06-01

    The nucleolus is the most prominent nuclear substructure assigned to produce ribosomes; molecular machines that are responsible for carrying out protein synthesis. To meet the increased demand for proteins during cell growth and proliferation the cell must increase protein synthetic capacity by upregulating ribosome biogenesis. While larger nucleolar size and number have been recognized as hallmark features of many tumor types, recent evidence has suggested that, in addition to overproduction of ribosomes, decreased ribosome biogenesis as well as qualitative changes in this process could also contribute to tumor initiation and cancer progression. Furthermore, the nucleolus has become the focus of intense attention for its involvement in processes that are clearly unrelated to ribosome biogenesis such as sensing and responding to endogenous and exogenous stressors, maintenance of genome stability, regulation of cell-cycle progression, cellular senescence, telomere function, chromatin structure, establishment of nuclear architecture, global regulation of gene expression and biogenesis of multiple ribonucleoprotein particles. The fact that dysregulation of many of these fundamental cellular processes may contribute to the malignant phenotype suggests that normal functioning of the nucleolus safeguards against the development of cancer and indicates its potential as a therapeutic approach. Here we review the recent advances made toward understanding these newly-recognized nucleolar functions and their roles in normal and cancer cells, and discuss possible future research directions. PMID:26721423

  6. Emergence and extinction of Dipterocarpaceae in western India with reference to climate change: Fossil wood evidences

    NASA Astrophysics Data System (ADS)

    Shukla, Anumeha; Mehrotra, R. C.; Guleria, J. S.

    2013-10-01

    Climate has played a crucial role in assigning a different kind of topography to Rajasthan and Gujarat since the Cenozoic time. Evidently, three genera, namely, Dipterocarpus Gaert. f., Hopea Roxb. and Shorea Roxb. of the Dipterocarpaceae are described from the Neogene sediments of western India (Rajasthan and Gujarat). These taxa are marked by their complete absence in the region today. The presence of Dipterocarpaceae in western India has been noticed from the Early Eocene up to the Plio-Pleistocene in deep time. The family is usually a dominant component of the humid tropical and subtropical flora of the Indo-Malayan region and its discovery, along with earlier described fossils from western India indicates existence of ancient tropical rain forests in western India. A change in the climate affected warm and humid conditions occurring there during the Cenozoic resulting in arid to semi-arid climate at present which is responsible for the ultimate extinction of Dipterocarpaceae in the region. In addition, the palaeobiogeography of Dipterocarpaceae is reviewed.

  7. The role of evidence in humanitarian assessment: the Seed System Security Assessment and the Emergency Market Mapping and Analysis.

    PubMed

    Goeldner Byrne, Karri; March, Julie; McGuire, Shawn; Meissner, Laura; Sperling, Louise

    2013-07-01

    This paper reviews advances in the development and use of two evidence-based assessment toolkits: the Seed System Security Assessment (SSSA) and the Emergency Market Mapping and Analysis (EMMA). Both were created in the past five years and have been employed in a range of acute and chronic stress contexts across Africa, Asia, and parts of the Americas, in periods of civil strife, displacement, and drought, as well as following earthquakes, flooding, and political instability. The aims of this paper are threefold: to review advances with regard to each tool; to compare how each toolkit gathers and uses evidence, while considering possibilities for greater complementarity; and to reflect on the nature of 'evidence' used to guide humanitarian response in sudden-onset and chronic crisis situations. A comparison highlights the importance of triangulation and informed analysis for drawing conclusions from imperfect evidence, understanding the limitations of each assessment methodology, and confronting tacit assumptions.

  8. Additional evidence that rosacea pathogenesis may involve demodex: new information from the topical efficacy of ivermectin and praziquantel.

    PubMed

    Abokwidir, Manal; Fleischer, Alan B

    2015-09-01

    Additional evidence that Demodex folliculorum may contribute to the pathogenesis of papulopustular rosacea are new studies of two topical antiparasitic agents. Ivermectin and praziquantel have recently been shown to be effective in decreasing the severity of papulopustular rosacea. These two agents significantly differ in molecular structure, but yield similar antiparasitic mechanisms of action. Higher numbers of Demodex mites are found in the skin of patients with rosacea than in people with normal skin. If Demodex play a role in pathogenesis, then hypersensitivity to the mites, their flora, or their products could explain the observed efficacy of antidemodectic therapy. PMID:26437294

  9. Is ophthalmology evidence based? A clinical audit of the emergency unit of a regional eye hospital

    PubMed Central

    Lai, T Y Y; Wong, V W Y; Leung, G M

    2003-01-01

    Aim: To evaluate the proportion of interventions that are evidence based in the acute care unit of a regional eye hospital. Methods: A prospective clinical audit was carried out at Hong Kong Eye Hospital in July 2002 to investigate the extent to which ophthalmic practices were evidence based. The major diagnosis and intervention provided were identified through chart review. A corresponding literature search using Medline and the Cochrane Library was performed to assess the degree to which each intervention was based on current, best evidence. Each diagnosis intervention pair was accordingly analysed and graded. The level of best, current evidence supporting each intervention was graded and analysed. Results: A total of 274 consecutive consultation episodes were examined. 22 cases were excluded since no diagnosis or intervention was made during the consultation. 108 (42.9%) patient interventions were found to be based on evidence from systematic reviews, meta-analyses, or randomised controlled trials (RCT). Evidence from prospective or retrospective observational studies supported the interventions in 86 (34.1%) patients. In 58 (23.0%) cases, no evidence or opposing evidence was found regarding the intervention. The proportion of evidence based on RCT or systematic reviews was higher for surgical interventions compared with non-surgical interventions (p=0.007). The proportion of interventions based on RCT or systematic reviews was higher for specialist ophthalmologists than trainee ophthalmologists (p=0.021). Conclusion: This study demonstrated that the majority of interventions in the ophthalmic unit were evidence based and comparable to the experience of other specialties. PMID:12642295

  10. Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

    PubMed

    Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors. PMID:26585046

  11. Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

    PubMed

    Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors.

  12. Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: evidence from nationally representative survey data

    PubMed Central

    Frost, Melanie Dawn; Puri, Mahesh; Hinde, Peter Richard Andrew

    2013-01-01

    Objectives To quantify trends in changing sex ratios of births before and after the legalisation of abortion in Nepal. While sex-selective abortion is common in some Asian countries, it is not clear whether the legal status of abortion is associated with the prevalence of sex-selection when sex-selection is illegal. In this context, Nepal provides an interesting case study. Abortion was legalised in 2002 and prior to that, there was no evidence of sex-selective abortion. Changes in the sex ratio at birth since legalisation would suggest an association with legalisation, even though sex-selection is expressly prohibited. Design Analysis of data from four Demographic and Health Surveys, conducted in 1996, 2001, 2006 and 2011. Setting Nepal. Participants 31 842 women aged 15–49. Main outcome measure Conditional sex ratios (CSRs) were calculated, specifically the CSR for second-born children where the first-born was female. This CSR is where the evidence of sex-selective abortion will be most visible. CSRs were looked at over time to assess the impact of legalisation as well as for population sub-groups in order to identify characteristics of women using sex-selection. Results From 2007 to 2010, the CSR for second-order births where the first-born was a girl was found to be 742 girls per 1000 boys (95% CI 599 to 913). Prior to legalisation of abortion (1998–2000), the same CSR was 1021 (906–1150). After legalisation, it dropped most among educated and richer women, especially in urban areas. Just 325 girls were born for every 1000 boys among the richest urban women. Conclusions The fall in CSRs witnessed post-legalisation indicates that sex-selective abortion is becoming more common. This change is very likely driven by both supply and demand factors. Falling fertility has intensified the need to bear a son sooner, while legal abortion services have reduced the costs and risks associated with obtaining an abortion. PMID:23674444

  13. Evidence for the Early Emergence of the Simple View of Reading in a Transparent Orthography

    ERIC Educational Resources Information Center

    Kendeou, Panayiota; Papadopoulos, Timothy C.; Kotzapoulou, Marianna

    2013-01-01

    The main aim of the present study was to empirically test the emergence of the Simple View of Reading (SVR) in a transparent orthography, and specifically in Greek. To do so, we examined whether the constituent components of the SVR could be identified in young, Greek-speaking children even before the beginning of formal reading instruction. Our…

  14. The Dangerous Myth of Emerging Adulthood: An Evidence-Based Critique of a Flawed Developmental Theory

    ERIC Educational Resources Information Center

    Côté, James E.

    2014-01-01

    This article examines the theory of emerging adulthood, introduced into the literature by Arnett (2000), in terms of its methodological and evidential basis, and finds it to be unsubstantiated on numerous grounds. Other, more convincing, formulations of variations in the transition to adulthood are examined. Most flawed academic theories are…

  15. Differences between Girls and Boys in Emerging Language Skills: Evidence from 10 Language Communities

    ERIC Educational Resources Information Center

    Eriksson, Marten; Marschik, Peter B.; Tulviste, Tiia; Almgren, Margareta; Perez Pereira, Miguel; Wehberg, Sonja; Marjanovic-Umek, Ljubica; Gayraud, Frederique; Kovacevic, Melita; Gallego, Carlos

    2012-01-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.08 to 2.06. The results showed that girls are…

  16. Reverse quality management: developing evidence-based best practices in health emergency management.

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  17. Reverse quality management: developing evidence-based best practices in health emergency management.

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359

  18. Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary.

    PubMed

    Mackway-Jones, Kevin C

    2013-07-01

    Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practicing clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again. The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary¹ or placed on the BestBETs website. Each BET has been constructed in the four stages that have been described elsewhere.² The BETs shown here together with those published previously and those currently under construction can be seen at http://www.bestbets.org.³ Three BETs are included in this issue of the journal. Capillary blood gases as an alternative to arterial puncture in diabetic ketoacidosis. Effect of warming local anaesthetics on pain of infiltration. Use of tamsulosin in patients with urinary calculi to increase spontaneous stone passage. PMID:23765766

  19. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies.

    PubMed

    Khan, Habib Hussain; Ahmad, Rubi Binit; Gee, Chan Sok

    2016-01-01

    In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995-2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership), and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies. PMID:27490847

  20. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies

    PubMed Central

    Khan, Habib Hussain; Ahmad, Rubi Binit; Gee, Chan Sok

    2016-01-01

    In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995–2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership), and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies. PMID:27490847

  1. Market Structure, Financial Dependence and Industrial Growth: Evidence from the Banking Industry in Emerging Asian Economies.

    PubMed

    Khan, Habib Hussain; Ahmad, Rubi Binit; Gee, Chan Sok

    2016-01-01

    In this study, we examine the role of market structure for growth in financially dependent industries from 10 emerging Asian economies over the period of 1995-2011. Our approach departs from existing studies in that we apply four alternative measures of market structure based on structural and non-structural approaches and compare their outcomes. Results indicate that higher bank concentration may slow down the growth of financially dependent industries. Bank competition on the other hand, allows financially dependent industries to grow faster. These findings are consistent across a number of sensitivity checks such as alternative measures of financial dependence, institutional factors (including property rights, quality of accounting standards and bank ownership), and endogeneity consideration. In sum, our study suggests that financially dependent industries grow more in more competitive/less concentrated banking systems. Therefore, regulatory authorities need to be careful while pursuing a consolidation policy for banking sector in emerging Asian economies.

  2. Revisiting the Dialogue on the Transition from Coteaching to Inservice Teaching: New Frameworks, Additional Benefits and Emergent Issues

    ERIC Educational Resources Information Center

    Wassell, Beth; LaVan, Sarah Kate

    2009-01-01

    In this rejoinder, we respond to the major points made by Gallo-Fox (this forum), Beers (this forum), Carambo and Stickney (this forum), and Murphy, Carlisle and Beggs (this forum). We focus primarily on the benefits and considerations that stem from employing additional theoretical frameworks for analyzing research in coteaching. We also address…

  3. Emerging Evidence for Instructional Practice: Repeated Viewings of Sign Language Models

    ERIC Educational Resources Information Center

    Beal-Alvarez, Jennifer S.; Huston, Sandra G.

    2014-01-01

    Current initiatives in education, such as No Child Left Behind and the National Common Core Standards movement, call for the use of evidence-based practices, or those instructional practices that are supported by documentation of their effectiveness related to student learning outcomes, including students with special needs. While hearing loss is…

  4. Emerging evidence in infection control: effecting change regarding use of disposable laryngoscope blades.

    PubMed

    Machan, Melissa D; Monaghan, W Patrick; McDonough, John; Hogan, Gerard

    2013-04-01

    The purpose of this evidence-based project was to determine the perceptions of anesthesia providers regarding the use of disposable laryngoscope blades. Frequency of use, ease of use, and complications encountered when using the disposable blade were evaluated before and after an in-service program designed to increase the use of disposable blades. Participants completed an anonymous questionnaire about their knowledge and practice regarding disposable laryngoscope blades. Then they received an investigator-developed article to read about the best and most recent practices regarding disposable laryngoscope blades. The same anonymous questionnaire was completed 3 months later. Inventory of the disposable laryngoscope blades was collected before the project and 1 and 3 months later. After the intervention, 25% of anesthesia providers described performance as their reason for not using the disposable laryngoscope blade, which was down from 60% at the project's start. Inventory showed a 23% increase in use of disposable laryngoscope blades after the intervention, which a single-proportion Z test showed was statistically significant (Z = 2.046, P = .041). This evidence-based project shows that a change in practice was evident after dissemination of the best and most recent clinical evidence regarding laryngoscope blades, which should translate to improved patient outcomes.

  5. The Science of Cocoa Flavanols: Bioavailability, Emerging Evidence, and Proposed Mechanisms12

    PubMed Central

    Blumberg, Jeffrey B.; Ding, Eric L.; Dixon, Richard; Pasinetti, Giulio Maria; Villarreal, Francisco

    2014-01-01

    Over the past 20 y, evidence derived from in vitro experiments, animal models, observational studies, and clinical interventions have suggested that cacao (cocoa) flavonoids act through a variety of mechanisms to modify a number of risk factors associated with chronic conditions, including cardiovascular and neurodegenerative diseases. Recent studies have elucidated the synthesis of flavonoids by plants, making available for research specific flavonoids and their metabolites. The body of evidence suggesting that cocoa flavanols may play a role in reducing the risk of cardiovascular disease has been sufficient to generate several systematic reviews and meta-analyses. Studies are now being directed to identify the molecular pathways underlying the effect of cocoa flavanols, and clinical trials are being planned to test their impact on disease endpoints. PMID:25469389

  6. Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base.

    PubMed

    Comrie-Thomson, Liz; Tokhi, Mariam; Ampt, Frances; Portela, Anayda; Chersich, Matthew; Khanna, Renu; Luchters, Stanley

    2015-01-01

    Men's involvement in the health of women and children is considered an important avenue for addressing gender influences on maternal and newborn health. The impact of male involvement around the time of childbirth on maternal and newborn health outcomes was examined as one part of a systematic review of maternal health intervention studies published between 2000 and 2012. Of 33,888 articles screened, 13 eligible studies relating to male involvement were identified. The interventions documented in these studies comprise an emerging evidence base for male involvement in maternal and newborn health. We conducted a secondary qualitative analysis of the 13 studies, reviewing content that had been systematically extracted. A critical assessment of this extracted content finds important gaps in the evidence base, which are likely to limit how 'male involvement' is understood and implemented in maternal and newborn health policy, programmes and research. Collectively, the studies point to the need for an evidence base that includes studies that clearly articulate and document the gender-transformative potential of involving men. This broader evidence base could support the use of male involvement as a strategy to improve both health and gender equity outcomes.

  7. Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base.

    PubMed

    Comrie-Thomson, Liz; Tokhi, Mariam; Ampt, Frances; Portela, Anayda; Chersich, Matthew; Khanna, Renu; Luchters, Stanley

    2015-01-01

    Men's involvement in the health of women and children is considered an important avenue for addressing gender influences on maternal and newborn health. The impact of male involvement around the time of childbirth on maternal and newborn health outcomes was examined as one part of a systematic review of maternal health intervention studies published between 2000 and 2012. Of 33,888 articles screened, 13 eligible studies relating to male involvement were identified. The interventions documented in these studies comprise an emerging evidence base for male involvement in maternal and newborn health. We conducted a secondary qualitative analysis of the 13 studies, reviewing content that had been systematically extracted. A critical assessment of this extracted content finds important gaps in the evidence base, which are likely to limit how 'male involvement' is understood and implemented in maternal and newborn health policy, programmes and research. Collectively, the studies point to the need for an evidence base that includes studies that clearly articulate and document the gender-transformative potential of involving men. This broader evidence base could support the use of male involvement as a strategy to improve both health and gender equity outcomes. PMID:26159766

  8. Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base

    PubMed Central

    Comrie-Thomson, Liz; Tokhi, Mariam; Ampt, Frances; Portela, Anayda; Chersich, Matthew; Khanna, Renu; Luchters, Stanley

    2015-01-01

    Men's involvement in the health of women and children is considered an important avenue for addressing gender influences on maternal and newborn health. The impact of male involvement around the time of childbirth on maternal and newborn health outcomes was examined as one part of a systematic review of maternal health intervention studies published between 2000 and 2012. Of 33,888 articles screened, 13 eligible studies relating to male involvement were identified. The interventions documented in these studies comprise an emerging evidence base for male involvement in maternal and newborn health. We conducted a secondary qualitative analysis of the 13 studies, reviewing content that had been systematically extracted. A critical assessment of this extracted content finds important gaps in the evidence base, which are likely to limit how ‘male involvement’ is understood and implemented in maternal and newborn health policy, programmes and research. Collectively, the studies point to the need for an evidence base that includes studies that clearly articulate and document the gender-transformative potential of involving men. This broader evidence base could support the use of male involvement as a strategy to improve both health and gender equity outcomes. PMID:26159766

  9. Ultrafast biexciton spectroscopy in semiconductor quantum dots: evidence for early emergence of multiple-exciton generation

    PubMed Central

    Choi, Younghwan; Sim, Sangwan; Lim, Seong Chu; Lee, Young Hee; Choi, Hyunyong

    2013-01-01

    Understanding multiple-exciton generation (MEG) in quantum dots (QDs) requires in-depth measurements of transient exciton dynamics. Because MEG typically faces competing ultrafast energy-loss intra-band relaxation, it is of central importance to investigate the emerging time-scale of the MEG kinetics. Here, we present ultrafast spectroscopic measurements of the MEG in PbS QDs via probing the ground-state biexciton transients. Specifically, we directly compare the biexciton spectra with the single-exciton ones before and after the intra-band relaxation. Early emergence of MEG is evidenced by observing transient Stark shift and quasi-instantaneous linewidth broadening, both of which take place before the intra-band relaxation. Photon-density-dependent study shows that the broadened biexciton linewidth strongly depends on the MEG-induced extra-exciton generation. Long after the intra-band relaxation, the biexciton broadening is small and the single-exciton state filling is dominant. PMID:24220495

  10. The emergence of a novel representation from action: evidence from preschoolers.

    PubMed

    Boncoddo, Rebecca; Dixon, James A; Kelley, Elizabeth

    2010-03-01

    Recent work in embodied cognition has proposed that representations and actions are inextricably linked. The current study examines a developmental account of this relationship. Specifically, we propose that children's actions are foundational for novel representations. Thirty-two preschoolers, aged 3.4 to 5.7 years, were asked to solve a set of simple gear-system problems. Participants' motions and verbalizations were coded to establish the strategies they used. The preschoolers initially solved the problems by simulating the turning and pushing of the gears. Subsequently, most participants discovered a new representation of the problems: the turning direction of the gears alternates. Results show that the number of actions that embodied alternation information, during their simulation of the system, predicted the later emergence of the higher-order representation (i.e. that the gears alternate turning direction). Thus, it appears that the preschoolers discovered a new representation based on their own actions. These results are consistent with the developmental embodiment hypothesis: actions are central to the emergence of new representations.

  11. Additive effects of glyburide and antidepressants in the forced swimming test: evidence for the involvement of potassium channel blockade.

    PubMed

    Guo, W; Todd, K; Bourin, M; Hascoet, M; Kouadio, F

    1996-08-01

    Evidence in the literature suggests that the modulatory effects of antidepressant drugs (ADS) on neuronal excitability, via the inhibition of K+ channels, may be the final common pathway of pharmacological action. Therefore, we tested the hypothesis that combining the ATP-sensitive K+ channel blocker glyburide with a variety of ADS would produce an additive effect and decrease the immobility time of mice in the forced swimming test (FST). Glyburide (GLY, IP, 30 and 50 mg/kg) and subactive doses of ADS were administered 45 and 30 min, respectively, prior to behavioral testing. Results showed that when combined with GLY, ADS whose main pharmacological effect is one of 5-HT uptake blockade (imipramine, amitriptyline, citalopram, paroxetine, fluoxetine, and fluvoxamine) were more effective in decreasing the amount of time mice were immobile, than when these drugs were administered alone. Some noradrenaline uptake inhibiting ADS (desipramine and viloxazine, but not maprotiline) were also significantly more effective in decreasing immobility time when combined with GLY than when administered alone. Pretreatment with GLY was found to have no effect on the dopamine uptake inhibitor bupropion, and out of the atypical ADS tested (trazodone, mianserine and iprindole), only coadministration with iprindole decreased the immobility time. Only the specific MAO-A inhibitor moclobemide was observed to have an antiimmobility effect when combined with GLY. Neither MAO-B specific (RO 16 6491) nor mixed MAO inhibitors (nialamide and pargyline) interacted with GLY to produce antiimmobility effects. These results corroborate and extend our previous report of the ADS enhancing effects of quinine in the same behavioral model, and suggest that the additive effects of quinine and GLY on ADS in FST are a result of K+ channel blockade.

  12. Evidence that climate change has caused 'emergence' of tick-borne diseases in Europe?

    PubMed

    Randolph, Sarah E

    2004-04-01

    Even though tick-borne disease systems are highly susceptible to climatic influences, climate change to date is not necessarily the cause of the marked increased incidence of a variety of tick-borne diseases in many parts of Europe over the past two decades. To test for causality, rather than coincidence, we need to examine whether the right sorts of climate change have occurred at the right time and in the right places to account for the observed heterogeneous temporal and spatial patterns of tick-borne disease 'emergence'. Tick-borne encephalitis (TBE) incidence, for example, showed a 3-fold step increase from 1983 to 1986 in Sweden, doubled in 1993 in the Czech Republic, increased even more dramatically in the same year in Lithuania and Poland, but declined markedly in 1997 in Hungary, Croatia and Slovenia. Within each country, TBE incidence has changed to different degrees in different regions. Because other tick-borne diseases, notably Lyme borreliosis, has commonly 'emerged' in parallel with TBE, we should first examine climate variables predicted to have a general effect on tick abundance, which has indeed increased in the past decade. These include temperature and moisture stress, which have seasonally differential impacts. Monthly mean records for 1960-2000 from the UK Climate Research Unit's interpolated global climate surface reveal that mean spring, spring-autumn and winter temperatures have all increased gradually over the past 40 years, but apparently most sharply in the late 1980s, when moisture stress also increased. These climate data do not reveal any obvious differences between sites where TBE did or did not 'emerge', and in Sweden increases in TBE pre-dated the onset of warmer springs and winters. If recorded climate changes cannot yet satisfactorily explain the temporal and spatial patterns of tick-borne disease change in Europe, the impact of biotic factors, such as increases in deer abundance and changing habitat structure, and of socio

  13. Predictors of victim disclosure in child sexual abuse: Additional evidence from a sample of incarcerated adult sex offenders.

    PubMed

    Leclerc, Benoit; Wortley, Richard

    2015-05-01

    The under-reporting of child sexual abuse by victims is a serious problem that may prolong the suffering of victims and leave perpetrators free to continue offending. Yet empirical evidence indicates that victim disclosure rates are low. In this study, we perform regression analysis with a sample of 369 adult child sexual offenders to examine potential predictors of victim disclosure. Specifically, we extend the range of previously examined potential predictors of victim disclosure and investigate interaction effects in order to better capture under which circumstances victim disclosure is more likely. The current study differs from previous studies in that it examines the impact of victim and offense variables on victim disclosure from the perspective of the offender. In line with previous studies, we found that disclosure increased with the age of the victim and if penetration had occurred. In addition, we found that disclosure increased when the victim came from a non-dysfunctional family and resisted the abuse. The presence of an interaction effect highlighted the impact of the situation on victim disclosure. This effect indicated that as victims get older, they are more likely to disclose the abuse when they are not living with the offender at the time of abuse, but less likely to do so when they are living with the offender at the time of abuse. These findings are discussed in relation to previous studies and the need to facilitate victim disclosure.

  14. An evidence-based approach to the management of hematuria in children in the emergency department.

    PubMed

    Pade, Kathryn H; Liu, Deborah R

    2014-09-01

    Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis). This review will outline the current literature regarding evaluation and management of pediatric patients who present to the emergency department with hematuria. Obtaining a thorough history and the appropriate diagnostic tests will be discussed in depth.

  15. Evidence-Based Point-of-Care Diagnostics: Current Status and Emerging Technologies

    NASA Astrophysics Data System (ADS)

    Chan, Cangel Pui Yee; Mak, Wing Cheung; Cheung, Kwan Yee; Sin, King Keung; Yu, Cheuk Man; Rainer, Timothy H.; Renneberg, Reinhard

    2013-06-01

    Point-of-care (POC) diagnostics brings tests nearer to the site of patient care. The turnaround time is short, and minimal manual interference enables quick clinical management decisions. Growth in POC diagnostics is being continuously fueled by the global burden of cardiovascular and infectious diseases. Early diagnosis and rapid initiation of treatment are crucial in the management of such patients. This review provides the rationale for the use of POC tests in acute coronary syndrome, heart failure, human immunodeficiency virus, and tuberculosis. We also consider emerging technologies that are based on advanced nanomaterials and microfluidics, improved assay sensitivity, miniaturization in device design, reduced costs, and high-throughput multiplex detection, all of which may shape the future development of POC diagnostics.

  16. An evidence-based approach to the management of hematuria in children in the emergency department.

    PubMed

    Pade, Kathryn H; Liu, Deborah R

    2014-09-01

    Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis). This review will outline the current literature regarding evaluation and management of pediatric patients who present to the emergency department with hematuria. Obtaining a thorough history and the appropriate diagnostic tests will be discussed in depth. PMID:25296518

  17. Evidence of Rapidly Warming Rivers in the UK from an Extensive Additive Modelling Study at the National Scale Using R

    NASA Astrophysics Data System (ADS)

    Simpson, G. L.

    2011-12-01

    River water temperature data exhibit non-linear behaviour over the past 50 or so years. Standard techniques for identifying and quantifying trends have centred around the use of linear regression and Mann-Kendall and Thiel-Sen procedures. Observational data from UK rivers suggest that temperatures are far more variable then assumed under these statistical models. In a national-scale assessment of the response of riverine systems to global climatic change, an additive model framework was employed to model patterns in water temperatures from a large database of temporal observational data. Models were developed using R, which allowed for the deployment of cutting-edge additive modelling techniques to describe trends at 2773 sites across England and Wales, UK. At a subset of sites, additive models were used to model long-term trends, trends within seasons and the long-term variation in the seasonal pattern of water temperatures. Changes in water temperature have important consequences for aquatic ecology, with some species being particularly sensitive even to small shifts in temperature during some or all of their lifecycle. While there are many studies reporting increasing regional and global air temperatures, evidence for changes in river water temperature has thus far been site specific and/or from sites heavily influenced by human activities that could themselves lead to warming. Here I present selected results from a national-scale assessment of changing river water temperatures, covering the whole of England and Wales, comprising data from 2,773 locations. Positive trends in water temperature were observed at 86% of sites. At a subset of sites, seasonal trend models were developed, which showed that 90% of locations demonstrated statistically significant increases in water temperature during Autumn and Winter periods. Multivariate smoothers, that allow for within-year and longer-term trend interactions in time, suggest that periods of warmer waters now extend

  18. Araceae from the Early Cretaceous of Portugal: Evidence on the emergence of monocotyledons

    PubMed Central

    Friis, Else Marie; Pedersen, Kaj Raunsgaard; Crane, Peter R.

    2004-01-01

    A new species (Mayoa portugallica genus novum species novum) of highly characteristic inaperturate, striate fossil pollen is described from the Early Cretaceous (Barremian–Aptian) of Torres Vedras in the Western Portuguese Basin. Based on comparison with extant taxa, Mayoa is assigned to the tribe Spathiphylleae (subfamily Monsteroideae) of the extant monocotyledonous family Araceae. Recognition of Araceae in the Early Cretaceous is consistent with the position of this family and other Alismatales as the sister group to all other monocots except Acorus. The early occurrence is also consistent with the position of Spathiphylleae with respect to the bulk of aroid diversity. Mayoa occurs in the earliest fossil floras (from circa 110 to 120 million years ago) that contain angiosperm flowers, carpels, and stamens. The new fossil provides unequivocal evidence of monocots in early angiosperm assemblages that also include a variety of key “magnoliid” lineages (e.g., Chloranthaceae) but only a limited diversity of eudicots. PMID:15546982

  19. Emerging evidence on the role of the Hippo/YAP pathway in liver physiology and cancer.

    PubMed

    Yimlamai, Dean; Fowl, Brendan H; Camargo, Fernando D

    2015-12-01

    The Hippo pathway and its regulatory target, YAP, has recently emerged as an important biochemical signaling pathway that tightly governs epithelial tissue growth. Initially defined in Drosophilia, this pathway has shown remarkable conservation in vertebrate systems with many components of the Hippo/YAP pathway showing biochemical and functional conservation. The liver is particularly sensitive to changes in Hippo/YAP signaling with rapid increases in liver size becoming manifest on the order of days to weeks after perturbation. The first identified direct targets of Hippo/YAP signaling were pro-proliferative and anti-apoptotic gene programs, but recent work has now implicated this pathway in cell fate choice, stem cell maintenance/renewal, epithelial to mesenchymal transition, and oncogenesis. The mechanisms by which Hippo/YAP signaling is changed endogenously are beginning to come to light as well as how this pathway interacts with other signaling pathways, and important details for designing new therapeutic interventions. This review focuses on the known roles for Hippo/YAP signaling in the liver and promising avenues for future study.

  20. Tracking the emergence of the consonant bias in visual-word recognition: evidence with developing readers.

    PubMed

    Soares, Ana Paula; Perea, Manuel; Comesaña, Montserrat

    2014-01-01

    Recent research with skilled adult readers has consistently revealed an advantage of consonants over vowels in visual-word recognition (i.e., the so-called "consonant bias"). Nevertheless, little is known about how early in development the consonant bias emerges. This work aims to address this issue by studying the relative contribution of consonants and vowels at the early stages of visual-word recognition in developing readers (2(nd) and 4(th) Grade children) and skilled adult readers (college students) using a masked priming lexical decision task. Target words starting either with a consonant or a vowel were preceded by a briefly presented masked prime (50 ms) that could be the same as the target (e.g., pirata-PIRATA [pirate-PIRATE]), a consonant-preserving prime (e.g., pureto-PIRATA), a vowel-preserving prime (e.g., gicala-PIRATA), or an unrelated prime (e.g., bocelo -PIRATA). Results revealed significant priming effects for the identity and consonant-preserving conditions in adult readers and 4(th) Grade children, whereas 2(nd) graders only showed priming for the identity condition. In adult readers, the advantage of consonants was observed both for words starting with a consonant or a vowel, while in 4(th) graders this advantage was restricted to words with an initial consonant. Thus, the present findings suggest that a Consonant/Vowel skeleton should be included in future (developmental) models of visual-word recognition and reading.

  1. Evidence of an emerging levee failure mechanism causing disastrous floods in Italy

    NASA Astrophysics Data System (ADS)

    Orlandini, Stefano; Moretti, Giovanni; Albertson, John D.

    2015-10-01

    A levee failure occurred along the Secchia River, Northern Italy, on 19 January 2014, resulting in flood damage in excess of $500 million. In response to this failure, immediate surveillance of other levees in the region led to the identification of a second breach developing on the neighboring Panaro River, where rapid mitigation efforts were successful in averting a full levee failure. The paired breach events that occurred along the Secchia and Panaro Rivers provided an excellent window on an emerging levee failure mechanism. In the Secchia River, by combining the information content of photographs taken from helicopters in the early stage of breach development and 10 cm resolution aerial photographs taken in 2010 and 2012, animal burrows were found to exist in the precise levee location where the breach originated. In the Panaro River, internal erosion was observed to occur at a location where a crested porcupine den was known to exist and this erosion led to the collapse of the levee top. This paper uses detailed numerical modeling of rainfall, river flow, and variably saturated flow in the levee to explore the hydraulic and geotechnical mechanisms that were triggered along the Secchia and Panaro Rivers by activities of burrowing animals leading to levee failures. As habitats become more fragmented and constrained along river corridors, it is possible that this failure mechanism could become more prevalent and, therefore, will demand greater attention in both the design and maintenance of earthen hydraulic structures as well as in wildlife management.

  2. Value-at-risk estimation with wavelet-based extreme value theory: Evidence from emerging markets

    NASA Astrophysics Data System (ADS)

    Cifter, Atilla

    2011-06-01

    This paper introduces wavelet-based extreme value theory (EVT) for univariate value-at-risk estimation. Wavelets and EVT are combined for volatility forecasting to estimate a hybrid model. In the first stage, wavelets are used as a threshold in generalized Pareto distribution, and in the second stage, EVT is applied with a wavelet-based threshold. This new model is applied to two major emerging stock markets: the Istanbul Stock Exchange (ISE) and the Budapest Stock Exchange (BUX). The relative performance of wavelet-based EVT is benchmarked against the Riskmetrics-EWMA, ARMA-GARCH, generalized Pareto distribution, and conditional generalized Pareto distribution models. The empirical results show that the wavelet-based extreme value theory increases predictive performance of financial forecasting according to number of violations and tail-loss tests. The superior forecasting performance of the wavelet-based EVT model is also consistent with Basel II requirements, and this new model can be used by financial institutions as well.

  3. Tracking the Emergence of the Consonant Bias in Visual-Word Recognition: Evidence with Developing Readers

    PubMed Central

    Soares, Ana Paula; Perea, Manuel; Comesaña, Montserrat

    2014-01-01

    Recent research with skilled adult readers has consistently revealed an advantage of consonants over vowels in visual-word recognition (i.e., the so-called “consonant bias”). Nevertheless, little is known about how early in development the consonant bias emerges. This work aims to address this issue by studying the relative contribution of consonants and vowels at the early stages of visual-word recognition in developing readers (2nd and 4th Grade children) and skilled adult readers (college students) using a masked priming lexical decision task. Target words starting either with a consonant or a vowel were preceded by a briefly presented masked prime (50 ms) that could be the same as the target (e.g., pirata-PIRATA [pirate-PIRATE]), a consonant-preserving prime (e.g., pureto-PIRATA), a vowel-preserving prime (e.g., gicala-PIRATA), or an unrelated prime (e.g., bocelo -PIRATA). Results revealed significant priming effects for the identity and consonant-preserving conditions in adult readers and 4th Grade children, whereas 2nd graders only showed priming for the identity condition. In adult readers, the advantage of consonants was observed both for words starting with a consonant or a vowel, while in 4th graders this advantage was restricted to words with an initial consonant. Thus, the present findings suggest that a Consonant/Vowel skeleton should be included in future (developmental) models of visual-word recognition and reading. PMID:24523917

  4. The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

    PubMed Central

    Ruskin, David N.; Masino, Susan A.

    2012-01-01

    A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system. PMID:22470316

  5. Tracking the emergence of the consonant bias in visual-word recognition: evidence with developing readers.

    PubMed

    Soares, Ana Paula; Perea, Manuel; Comesaña, Montserrat

    2014-01-01

    Recent research with skilled adult readers has consistently revealed an advantage of consonants over vowels in visual-word recognition (i.e., the so-called "consonant bias"). Nevertheless, little is known about how early in development the consonant bias emerges. This work aims to address this issue by studying the relative contribution of consonants and vowels at the early stages of visual-word recognition in developing readers (2(nd) and 4(th) Grade children) and skilled adult readers (college students) using a masked priming lexical decision task. Target words starting either with a consonant or a vowel were preceded by a briefly presented masked prime (50 ms) that could be the same as the target (e.g., pirata-PIRATA [pirate-PIRATE]), a consonant-preserving prime (e.g., pureto-PIRATA), a vowel-preserving prime (e.g., gicala-PIRATA), or an unrelated prime (e.g., bocelo -PIRATA). Results revealed significant priming effects for the identity and consonant-preserving conditions in adult readers and 4(th) Grade children, whereas 2(nd) graders only showed priming for the identity condition. In adult readers, the advantage of consonants was observed both for words starting with a consonant or a vowel, while in 4(th) graders this advantage was restricted to words with an initial consonant. Thus, the present findings suggest that a Consonant/Vowel skeleton should be included in future (developmental) models of visual-word recognition and reading. PMID:24523917

  6. I drink for my liver, Doc: emerging evidence that coffee prevents cirrhosis.

    PubMed

    Feld, Jordan J; Lavoie, Élise G; Fausther, Michel; Dranoff, Jonathan A

    2015-01-01

    Evidence demonstrating that regular ingestion of coffee has salutary effects on patients with chronic liver disease is accumulating rapidly. Specifically, it appears that coffee ingestion can slow the progression of liver fibrosis, preventing cirrhosis and hepatocellular carcinoma (HCC). This should excite clinicians and scientists alike, since these observations, if true, would create effective, testable hypotheses that should lead to improved understanding on fibrosis pathogenesis and thus may generate novel pharmacologic treatments of patients with chronic liver disease. This review is designed to examine the relevant clinical and epidemiological data in critical fashion and to examine the putative pharmacological effects of coffee relevant to the pathogenesis of liver fibrosis and cirrhosis. We hope that this will inspire relevant critical analyses, especially among "coffee skeptics". Of note, one major assumption made by this review is that the bulk of the effects of coffee consumption are mediated by caffeine, rather than by other chemical constituents of coffee. Our rationales for this assumption are threefold: first, caffeine's effects on adenosinergic signaling provide testable hypotheses; second, although there are  myriad chemical constituents of coffee, they are present in very low concentrations, and perhaps more importantly, vary greatly between coffee products and production methods (it is important to note that we do not dismiss the "botanical" hypothesis here; rather, we do not emphasize it at present due to the limitations of the studies examined); lastly, some (but not all) observational studies have examined both coffee and non-coffee caffeine consumption and found consistent effects, and when examined, no benefit to decaffeinated coffee has been observed. Further, in the interval since we examined this phenomenon last, further evidence has accumulated supporting caffeine as the effector molecule for coffee's salutary effects. PMID:25977756

  7. I drink for my liver, Doc: emerging evidence that coffee prevents cirrhosis

    PubMed Central

    Feld, Jordan J.; Lavoie, Élise G.; Fausther, Michel; Dranoff, Jonathan A.

    2015-01-01

    Evidence demonstrating that regular ingestion of coffee has salutary effects on patients with chronic liver disease is accumulating rapidly. Specifically, it appears that coffee ingestion can slow the progression of liver fibrosis, preventing cirrhosis and hepatocellular carcinoma (HCC). This should excite clinicians and scientists alike, since these observations, if true, would create effective, testable hypotheses that should lead to improved understanding on fibrosis pathogenesis and thus may generate novel pharmacologic treatments of patients with chronic liver disease. This review is designed to examine the relevant clinical and epidemiological data in critical fashion and to examine the putative pharmacological effects of coffee relevant to the pathogenesis of liver fibrosis and cirrhosis. We hope that this will inspire relevant critical analyses, especially among “coffee skeptics”. Of note, one major assumption made by this review is that the bulk of the effects of coffee consumption are mediated by caffeine, rather than by other chemical constituents of coffee. Our rationales for this assumption are threefold: first, caffeine’s effects on adenosinergic signaling provide testable hypotheses; second, although there are  myriad chemical constituents of coffee, they are present in very low concentrations, and perhaps more importantly, vary greatly between coffee products and production methods (it is important to note that we do not dismiss the “botanical” hypothesis here; rather, we do not emphasize it at present due to the limitations of the studies examined); lastly, some (but not all) observational studies have examined both coffee and non-coffee caffeine consumption and found consistent effects, and when examined, no benefit to decaffeinated coffee has been observed. Further, in the interval since we examined this phenomenon last, further evidence has accumulated supporting caffeine as the effector molecule for coffee’s salutary effects. PMID

  8. Etiology of impaired selective motor control: emerging evidence and its implications for research and treatment in cerebral palsy.

    PubMed

    Cahill-Rowley, Katelyn; Rose, Jessica

    2014-06-01

    Selective motor control (SMC) impairment involves movement patterns dominated by flexor or extensor synergies that interfere with functional movements in children with cerebral palsy (CP). Emerging evidence on neural correlates of impaired SMC has important implications for etiology and for the treatment for children with CP. Early evidence on the microstructure of brain white matter assessed with diffusion tensor imaging in adult patients after stroke suggests that the rubrospinal tract may compensate for injury to the corticospinal tract. Furthermore, the observed changes on diffusion tensor imaging corresponded to the degree of SMC impairment. The rubrospinal tract may provide imperfect compensation in response to corticospinal tract injury, resulting in diminished SMC. Cortical mapping evidence in stroke patients indicates that loss of SMC is also associated with increased overlap of joint representation in the sensorimotor cortices. The severity of SMC impairment can be assessed with the recently developed Selective Control Assessment of the Lower Extremity, a validated observation-based measure designed for children with spastic CP. Recent advances in neuroimaging and assessment of SMC provide an opportunity to better understand the etiology and impact of impaired SMC, which may ultimately guide strategic treatment for children with CP.

  9. New and Emerging Drugs and Targets for Type 2 Diabetes: Reviewing the Evidence

    PubMed Central

    Miller, Brien Rex; Nguyen, Hanh; Hu, Charles Jia-Haur; Lin, Chihyi; Nguyen, Quang T.

    2014-01-01

    BACKGROUND Diabetes is a deadly and costly disease. The number of adults in the United States with newly diagnosed diabetes has nearly tripled from 1980 to 2011. At the current pace, 1 in 3 US adults will have diabetes in their lifetime. Currently, 14 classes of drugs are available to treat type 2 diabetes mellitus, but only 36% of patients with type 2 diabetes achieve glycemic control with the currently available therapies. Therefore, new treatment options are desperately needed. DISCUSSION Despite the availability of many pharmacotherapies, in 2011 an estimated 3.1 million (14.9%) patients with type 2 diabetes still reported not taking medications to treat their diabetes. Patient compliance is a major obstacle facing practicing clinicians on a daily basis. New treatment options are desperately needed, but efficacy and tolerability are no longer the only criteria contributing to the success of a drug. Ease of administration, convenient dosing frequency, being weight control friendly, and having a low risk for hypoglycemia are important factors for the survival of a new drug in the US healthcare system. The present review is focused on important new drugs and drug classes in the pipeline, as well as on recently approved drugs, including sodium glucose cotransporter-2 inhibitors, glucagon-like peptide-1 agents, and new insulin therapies, as well as on the technologic improvements in the delivery and dosing frequency of some of the currently available drugs. CONCLUSIONs In the United States, diabetes can be expected to continue to wreak significant human and financial tolls. The associated complications will continue to climb if they are not controlled and stopped. New therapies for diabetes are clearly needed that will better address these unmet needs. The common threads among the emerging therapies are their convenience of administration and dosing frequency, which are important to the improvement of patient adherence. PMID:25558307

  10. Besifloxacin Ophthalmic Suspension: Emerging Evidence of its Therapeutic Value in Bacterial Conjunctivitis

    PubMed Central

    Khimdas, S.; Visscher, K.L.; Hutnik, C.M.L.

    2011-01-01

    Objective To outline the pharmacodynamics, efficacy and safety of besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis. Quality of Evidence MEDLINE database was searched to review recent pharmacodynamic and clinical studies evaluating besifloxacin and comparing besifloxacin to other topical antibiotics for ophthalmic use. Findings were limited to full-text articles from clinical journals in the English language. Main Message Bacterial resistance is a common source for treatment failure in bacterial conjunctivis. Besifloxacin, a novel fourth generation synthetic fluoroquinolone is likely to show lower resistance rates due to its mechanism of action and its short-term use for ocular infections only (decreased systemic exposure). Besifloxacin displays improved pharmacodynamic properties compared to other commonly used fluoroquinolones and has shown to be efficacious and safe in clinical studies. Conclusion Besifloxacin ophthalmic suspension 0.6% provides safe and efficacious treatment for bacterial conjunctivitis. The factors leading to bacterial resistance are diminished, which allows besifloxacin to be a favorable treatment option. PMID:23861618

  11. The nitrogen legacy: emerging evidence of nitrogen accumulation in anthropogenic landscapes

    NASA Astrophysics Data System (ADS)

    Van Meter, K. J.; Basu, N. B.; Veenstra, J. J.; Burras, C. L.

    2016-03-01

    Watershed and global-scale nitrogen (N) budgets indicate that the majority of the N surplus in anthropogenic landscapes does not reach the coastal oceans. While there is general consensus that this ‘missing’ N either exits the landscape via denitrification or is retained within watersheds as nitrate or organic N, the relative magnitudes of these pools and fluxes are subject to considerable uncertainty. Our study, for the first time, provides direct, large-scale evidence of N accumulation in the root zones of agricultural soils that may account for much of the ‘missing N’ identified in mass balance studies. We analyzed long-term soil data (1957-2010) from 2069 sites throughout the Mississippi River Basin (MRB) to reveal N accumulation in cropland of 25-70 kg ha-1 yr-1, a total of 3.8 ± 1.8 Mt yr-1 at the watershed scale. We then developed a simple modeling framework to capture N depletion and accumulation dynamics under intensive agriculture. Using the model, we show that the observed accumulation of soil organic N (SON) in the MRB over a 30 year period (142 Tg N) would lead to a biogeochemical lag time of 35 years for 99% of legacy SON, even with complete cessation of fertilizer application. By demonstrating that agricultural soils can act as a net N sink, the present work makes a critical contribution towards the closing of watershed N budgets.

  12. Leptospiral Antibodies in Cattle in Alberta and Evidence of an Emerging Serovar

    PubMed Central

    Kingscote, Barbara

    1988-01-01

    Antibodies to Leptospira interrogans serovars hardjo and pomona were present in 8.3% and 0.5% of sera respectively, from adult female cattle in Alberta surveyed in 1984-85. Criterion for a positive serum sample was 50% agglutination at 1/100 dilution in the microscopic agglutination test. A positive herd contained one or more cows with positive serum. Prevalences were calculated on sample sizes that would give 80-95% reliability. Hardjo antibody prevalences and hardjo-positive herd prevalences were 0-53.9% and 0-83.3%, respectively, among 65 municipalities surveyed. Pomona prevalences by comparison were 0-3.4% and 0-11.7% respectively. Hardjo had increased significantly since 1980-82, and antibodies were found throughout the province. Pomona occurred mainly in southeastern Alberta, where it was isolated from cattle, swine and skunks. Hardjo was isolated only from cattle and it was found in many areas. Antibodies to icterohaemorrhagiae were present in 0.4% of sera from parts of Alberta surveyed in 1980; evidence of the presence of leptospires related to this serovar in bovine and porcine urinary tracts was obtained by immunofluorescence. ImagesFigure 3. PMID:17423101

  13. Spectroscopic Evidence for Covalent Binding of Sulfadiazine to Natural Soils via 1,4-nucleophilic addition (Michael Type Addition) studied by Spin Labeling ESR

    NASA Astrophysics Data System (ADS)

    Aleksandrova, Olga

    2015-04-01

    with different polarity. As shown by the spin labeling ESR experiment, molecules modeling SDZ were promptly bound to non-hydrolysable network of soil organic matter only via the aromatic amines that was accompanied by a prompt enlargement of humic particles binding aromatic amines, whereas binding of decomposition products of SDZ to humic acids of soil via the aliphatic amines was not observable. The ESR spectra obviously showed a single-phase process of covalent binding of the aromatic amines. Repeated washouts of labeled soil samples using distil water and ultrafiltration through the membrane of 5000 MWCO PES confirmed irreversible binding of the aromatic amines, and showed that via the aliphatic amines, binding of SDZ or decomposition products of SDZ to soil might also occur but reversibly and only to small soil molecules, which don't enter into the composition of non-hydrolysable part of soil organic matter. SL ESR experiments of different soils at the presence of Laccase highlighted that covalent binding of the aromatic amines to humic particles occurred in the specific hydrophobic areas of soil found as depleted in oxygen. All measured data evidenced that first, SDZ might be decomposed that allowed for measuring the same change of a paramagnetic signal of soil organic matter influenced by both aromatic and aliphatic amines as in the experiment of the interaction of soil with SDZ. Second, a decomposition product of SDZ with the aromatic amine might be bound to non-hydrolysable parts of soil organic matter under specific anaerobic conditions only via 1,4 - nucleophilic addition, Michael-type addition. Gulkowska, A., Thalmann, B., D., Hollender, J., & Krauss, M. (2014). Chemosphere, 107, 366 - 372. Müller, T., Rosendahl, I., Focks, A., Siemens, J., Klasmeier, J., & Matthies. (2013). Environmental Pollution, 172,180 - 185. Nowak, K.M., Miltner, A., Gehre, M., Schaeffer, A., & Kaestner, M. (2011). Environmental Science & Technology 45, 999 - 1006. Weber, E.J., Spidle

  14. Spectroscopic Evidence for Covalent Binding of Sulfadiazine to Natural Soils via 1,4-nucleophilic addition (Michael Type Addition) studied by Spin Labeling ESR

    NASA Astrophysics Data System (ADS)

    Aleksandrova, Olga

    2015-04-01

    with different polarity. As shown by the spin labeling ESR experiment, molecules modeling SDZ were promptly bound to non-hydrolysable network of soil organic matter only via the aromatic amines that was accompanied by a prompt enlargement of humic particles binding aromatic amines, whereas binding of decomposition products of SDZ to humic acids of soil via the aliphatic amines was not observable. The ESR spectra obviously showed a single-phase process of covalent binding of the aromatic amines. Repeated washouts of labeled soil samples using distil water and ultrafiltration through the membrane of 5000 MWCO PES confirmed irreversible binding of the aromatic amines, and showed that via the aliphatic amines, binding of SDZ or decomposition products of SDZ to soil might also occur but reversibly and only to small soil molecules, which don't enter into the composition of non-hydrolysable part of soil organic matter. SL ESR experiments of different soils at the presence of Laccase highlighted that covalent binding of the aromatic amines to humic particles occurred in the specific hydrophobic areas of soil found as depleted in oxygen. All measured data evidenced that first, SDZ might be decomposed that allowed for measuring the same change of a paramagnetic signal of soil organic matter influenced by both aromatic and aliphatic amines as in the experiment of the interaction of soil with SDZ. Second, a decomposition product of SDZ with the aromatic amine might be bound to non-hydrolysable parts of soil organic matter under specific anaerobic conditions only via 1,4 - nucleophilic addition, Michael-type addition. Gulkowska, A., Thalmann, B., D., Hollender, J., & Krauss, M. (2014). Chemosphere, 107, 366 - 372. Müller, T., Rosendahl, I., Focks, A., Siemens, J., Klasmeier, J., & Matthies. (2013). Environmental Pollution, 172,180 - 185. Nowak, K.M., Miltner, A., Gehre, M., Schaeffer, A., & Kaestner, M. (2011). Environmental Science & Technology 45, 999 - 1006. Weber, E.J., Spidle

  15. Fragmentary evidence of great-earthquake subsidence during holocene emergence, Valdivia estuary, South Central Chile

    USGS Publications Warehouse

    Nelson, A.R.; Kashima, K.; Bradley, L.-A.

    2009-01-01

    A reconnaissance of Holocene stratigraphy beneath fringing marshes of the Valdivia estuary, where an M 9.5 earthquake caused 1-2 m of regional coseismic subsidence in 1960, shows only fragmentary evidence of prehistoric coseismic subsidence. In most of the 150 hand-driven cores that were examined, a distinct unconformity separates 0.5-1.5 m of late Holocene tidal and floodplain mud, peat, and sand from underlying middle Holocene subtidal mud and sand. At the Las Coloradas site, where stratigraphy is best preserved, two A horizons of marsh and meadow soils abruptly overlain by sand and mud probably record coseismic subsidence shortly followed by tsunamis. The amount of subsidence during the earthquakes proved difficult to reconstruct with a diatom transfer function because of differences between modern and fossil diatom assemblages. Maximum 14C ages on macrofossils from the two A horizons at the Las Coloradas site of 1.7-1.3 ka and 2.7-1.7 ka allow correlation of the younger horizon with either of two of six 14C-dated A horizons buried by tsunami sand or post-tsunami tidal sand 200 km to the south at Maull??n, and with a lake-wide mass wasting event in Lago Puyehue, 100 km to the southeast. Tidal records of prehistoric coseismic subsidence at Valdivia are scarce because of a sea-level fall of 3-8 m over the past 6000 years, erosion of marsh and meadow soils during subsidence-induced flooding of the estuary, and largely complete land-level recovery during cycles of coseismic subsidence and postseismic uplift.

  16. Thirdhand Tobacco Smoke: Emerging Evidence and Arguments for a Multidisciplinary Research Agenda

    PubMed Central

    Quintana, Penelope J. E.; Destaillats, Hugo; Gundel, Lara A.; Sleiman, Mohamad; Singer, Brett C.; Jacob, Peyton; Benowitz, Neal; Winickoff, Jonathan P.; Rehan, Virender; Talbot, Prue; Schick, Suzaynn; Samet, Jonathan; Wang, Yinsheng; Hang, Bo; Martins-Green, Manuela; Pankow, James F.; Hovell, Melbourne F.

    2011-01-01

    Background: There is broad consensus regarding the health impact of tobacco use and secondhand smoke exposure, yet considerable ambiguity exists about the nature and consequences of thirdhand smoke (THS). Objectives: We introduce definitions of THS and THS exposure and review recent findings about constituents, indoor sorption–desorption dynamics, and transformations of THS; distribution and persistence of THS in residential settings; implications for pathways of exposure; potential clinical significance and health effects; and behavioral and policy issues that affect and are affected by THS. Discussion: Physical and chemical transformations of tobacco smoke pollutants take place over time scales ranging from seconds to months and include the creation of secondary pollutants that in some cases are more toxic (e.g., tobacco-specific nitrosamines). THS persists in real-world residential settings in the air, dust, and surfaces and is associated with elevated levels of nicotine on hands and cotinine in urine of nonsmokers residing in homes previously occupied by smokers. Much still needs to be learned about the chemistry, exposure, toxicology, health risks, and policy implications of THS. Conclusion: The existing evidence on THS provides strong support for pursuing a programmatic research agenda to close gaps in our current understanding of the chemistry, exposure, toxicology, and health effects of THS, as well as its behavioral, economic, and sociocultural considerations and consequences. Such a research agenda is necessary to illuminate the role of THS in existing and future tobacco control efforts to decrease smoking initiation and smoking levels, to increase cessation attempts and sustained cessation, and to reduce the cumulative effects of tobacco use on morbidity and mortality. PMID:21628107

  17. Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications.

    PubMed

    Kanayama, Gen; Brower, Kirk J; Wood, Ruth I; Hudson, James I; Pope, Harrison G

    2010-06-01

    Currently, few users of anabolic-androgenic steroids (AAS) seek substance abuse treatment. But this picture may soon change substantially, because illicit AAS use did not become widespread until the 1980s, and consequently the older members of this AAS-using population - those who initiated AAS as youths in the 1980s - are only now reaching middle age. Members of this group, especially those who have developed AAS dependence, may therefore be entering the age of risk for cardiac and psychoneuroendocrine complications sufficient to motivate them for substance abuse treatment. We suggest that this treatment should address at least three etiologic mechanisms by which AAS dependence might develop. First, individuals with body image disorders such as "muscle dysmorphia" may become dependent on AAS for their anabolic effects; these body image disorders may respond to psychological therapies or pharmacological treatments. Second, AAS suppress the male hypothalamic-pituitary-gonadal axis via their androgenic effects, potentially causing hypogonadism during AAS withdrawal. Men experiencing prolonged dysphoric effects or frank major depression from hypogonadism may desire to resume AAS, thus contributing to AAS dependence. AAS-induced hypogonadism may require treatment with human chorionic gonadotropin or clomiphene to reactivate neuroendocrine function, and may necessitate antidepressant treatments in cases of depression inadequately responsive to endocrine therapies alone. Third, human and animal evidence indicates that AAS also possess hedonic effects, which likely promote dependence via mechanisms shared with classical addictive drugs, especially opioids. Indeed, the opioid antagonist naltrexone blocks AAS dependence in animals. By inference, pharmacological and psychosocial treatments for human opioid dependence might also benefit AAS-dependent individuals.

  18. A broader role for 5ARIs in prostate disease? Existing evidence and emerging benefits.

    PubMed

    Montorsi, Francesco; Alcaraz, Antonio; Desgrandchamps, François; Hammerer, Peter; Schröder, Fritz; Castro, Ramiro

    2009-06-01

    5ARIs are recommended for men who have moderate-to-severe lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) secondary to benign prostatic hyperplasia. Studies have confirmed the utility of combining 5ARIs with alpha-blockers; the MTOPS study showed that risk of overall clinical progression was significantly reduced after 4.5 years with combination therapy (finasteride/doxazosin) in comparison with either monotherapy, while the ongoing CombAT trial (dutasteride/tamsulosin) has for the first time shown benefit in improving symptoms for combination therapy over monotherapies within 12 months of treatment. Data also suggest roles for 5ARIs in prostate cancer. Several studies indicate that treatment with a 5ARI improves the performance of PSA testing for identifying men with prostate cancer, while the PCPT showed a significant reduction in the risk of developing prostate cancer with finasteride. However, widespread use of finasteride in this setting has been tempered by an apparent increase in high-grade disease observed in the study. The ongoing REDUCE study will provide further insight into prostate cancer prevention with 5ARIs. 5ARI-containing regimens may have utility as less aggressive treatment options for patients who only have rising PSA after definitive local therapy, and in patients with disease resistant to androgen deprivation therapy who have PSA progression. Current evidence therefore shows that 5ARIs are effective in treating LUTS/BPE and preventing disease progression, and may also have a role in the prevention of prostate cancer. The overlap between BPE and prostate cancer may allow a more unified approach to managing these conditions, with 5ARIs having a central role. PMID:19267353

  19. Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications.

    PubMed

    Kanayama, Gen; Brower, Kirk J; Wood, Ruth I; Hudson, James I; Pope, Harrison G

    2010-06-01

    Currently, few users of anabolic-androgenic steroids (AAS) seek substance abuse treatment. But this picture may soon change substantially, because illicit AAS use did not become widespread until the 1980s, and consequently the older members of this AAS-using population - those who initiated AAS as youths in the 1980s - are only now reaching middle age. Members of this group, especially those who have developed AAS dependence, may therefore be entering the age of risk for cardiac and psychoneuroendocrine complications sufficient to motivate them for substance abuse treatment. We suggest that this treatment should address at least three etiologic mechanisms by which AAS dependence might develop. First, individuals with body image disorders such as "muscle dysmorphia" may become dependent on AAS for their anabolic effects; these body image disorders may respond to psychological therapies or pharmacological treatments. Second, AAS suppress the male hypothalamic-pituitary-gonadal axis via their androgenic effects, potentially causing hypogonadism during AAS withdrawal. Men experiencing prolonged dysphoric effects or frank major depression from hypogonadism may desire to resume AAS, thus contributing to AAS dependence. AAS-induced hypogonadism may require treatment with human chorionic gonadotropin or clomiphene to reactivate neuroendocrine function, and may necessitate antidepressant treatments in cases of depression inadequately responsive to endocrine therapies alone. Third, human and animal evidence indicates that AAS also possess hedonic effects, which likely promote dependence via mechanisms shared with classical addictive drugs, especially opioids. Indeed, the opioid antagonist naltrexone blocks AAS dependence in animals. By inference, pharmacological and psychosocial treatments for human opioid dependence might also benefit AAS-dependent individuals. PMID:20188494

  20. Evidence of emerging hookah use among university students: a cross-sectional comparison between hookah and cigarette use

    PubMed Central

    2013-01-01

    Background The emergence of hookah is being noted on college campuses and in large U.S. cities and evidence points to an increasing trend for college students. The purpose of this study was to assess hookah use and identify associations with cigarette smoking and demographic factors. Methods An intercept sampling method was used at various locations on a large university campus in the southeastern United States, yielding a high participation rate (52%). A total of 1,203 participants completed a computer-aided survey that assessed the use of tobacco products. The sample characteristics were then weighted to match the University population of students enrolled during the same semester. Bivariate (chi-square and t-test) and multivariate (logistic regression) tests of association were conducted to assess differences between cigarette and hookah users. Results Hookah smoking exceeded cigarette smoking for both ever use (46.4% vs 42.1%) and past year use (28.4% vs 19.6%). Females and males used hookah at similar rates. Hispanic respondents had the highest prevalence of current use of hookah (18.9%) and cigarettes (16.4%). Conclusions As hookah surpasses cigarette use, efforts need to be made to slow the increase in new tobacco products that are attractive to young adults and that pose many of the same health risks as those related to traditional tobacco products. Prevalence of all emerging tobacco products, including hookah, and the relationship with cigarette use needs to be monitored on an ongoing basis. PMID:23560649

  1. On the early emergence of reverse transcription: theoretical basis and experimental evidence

    NASA Technical Reports Server (NTRS)

    Lazcano, A.; Valverde, V.; Hernandez, G.; Gariglio, P.; Fox, G. E.; Oro, J.

    1992-01-01

    Reverse transcriptase (RT) was first discovered as an essential catalyst in the biological cycle of retroviruses. However, in the past years evidence has accumulated showing that RTs are involved in a surprisingly large number of RNA-mediated transpositional events that include both viral and nonviral genetic entities. Although it is probable that some RT-bearing genetic elements like the different types of AIDS viruses and the mammalian LINE family have arisen in recent geological times, the possibility that reverse transcription first took place in the early Archean is supported by (1) the hypothesis that RNA preceded DNA as cellular genetic material; (2) the existence of homologous regions of the subunit tau of the E. coli DNA polymerase III with the simian immunodeficiency virus RT, the hepatitis B virus RT, and the beta' subunit of the E. coli RNA polymerase (McHenry et al. 1988); (3) the presence of several conserved motifs, including a 14-amino-acid segment that consists of an Asp-Asp pair flanked by hydrophobic amino acids, which are found in all RTs and in most cellular and viral RNA polymerases. However, whether extant RTs descend from the primitive polymerase involved in the RNA-to-DNA transition remains unproven. Substrate specificity of the AMV and HIV-1 RTs can be modified in the presence of Mn2+, a cation which allows them to add ribonucleotides to an oligo (dG) primer in a template-dependent reaction. This change in specificity is comparable to that observed under similar conditions in other nucleic acid polymerases. This experimentally induced change in RT substrate specificity may explain previous observations on the misincorporation of ribonucleotides by the Maloney murine sarcoma virus RT in the minus and plus DNA of this retrovirus (Chen and Temin 1980). Our results also suggest that HIV-infected macrophages and T-cell cells may contain mixed polynucleotides containing both ribo- and deoxyribonucleotides. The evolutionary significance of these

  2. The Agoudal (High Atlas Mountains, Morocco) Shattered Limestone: Petrographical and Geochemical Studies and Additional Evidence of Impact

    NASA Astrophysics Data System (ADS)

    El Kerni, H.; Chennaoui Aoudjehane, H.; Marjanac, T.

    2016-08-01

    Agoudal impact structure shattered limestone and breccia are well studied and described using petrographical observations and geochemical analyses, and a new discovery of the magnesiwustite mineral as a further evidence of impact event.

  3. A Review on Prevention and Treatment of Post-Orthodontic White Spot Lesions – Evidence-Based Methods and Emerging Technologies

    PubMed Central

    Bergstrand, Fredrik; Twetman, Svante

    2011-01-01

    Objective: The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances. Material and methods: A search for relevant human clinical trials published in English between 2004 and March 2011 retrieved 25 publications that fulfilled the inclusion criteria. The papers were assessed for prevented fraction and/or absolute risk reduction when possible. Results and conclusions: The findings consolidated the use of topical fluorides in addition to fluoride toothpaste as the best evidence-based way to avoid WSL. The mean prevented fraction based on 6 trials was 42.5% with a range from -4% to 73%. The recent papers provided the strongest support for regular professional applications of fluoride varnish around the bracket base during the course of orthodontic treatment. For the treatment of post-orthodontic WSL, home-care applications of a remineralizing cream, based on casein phosphopeptide-stabilized amorphous calcium phosphate, as adjunct to fluoride toothpaste could be beneficial but the findings were equivocal. For emerging technologies such as sugar alcohols and probiotics, still only studies with surrogate endpoints are available. Thus, further well-designed studies with standardized regimes and endpoints are needed before guidelines on the non-fluoride technologies can be recommended. PMID:21966335

  4. Blowout Jets: Evidence from Hinode/XRT for X-Ray Jets Made by Blowout Eruption of the Emerging Bipole

    NASA Technical Reports Server (NTRS)

    Moore, Ronald L.; Cirtain, Jonathan W.; Sterling, Alphonse C.

    2009-01-01

    Yamauchi et al (2004, ApJ, 605, 511) found that there are two structurally and dynamically distinct types of H macrospicules in polar coronal holes: single-column jet macrospicules and erupting-loop macrospicules. The structure and motion of the single-column jet macrospicules fit the standard Shibata reconnection picture for solar X-ray jets (Shibata et al 1992, PASJ, 44, L173). The form and motion of the erupting-loop macrospicules is reminiscent of the ejective eruption of the sheared-core-field flux rope in the filament-eruption birth of a bubble-type coronal mass ejection (CME). That roughly half of all polar H macrospicules were observed to be erupting-loop macrospicules suggests that there should be a corresponding large class of X-ray jets in which the emerging bipole at the base of the jet undergoes a blowout eruption as in a bubble-type CME, instead of staying closed as in the standard picture for X-ray jets. Along with a cartoon of the standard picture, we present a cartoon depicting the signatures to be expected of a blowout jet in high-resolution coronal X-ray movies such as from Hinode/XRT. From Hinode/XRT movies in polar coronal holes, we show: (1) examples of X-ray jets that fit the standard picture very well, and (2) other examples that do not fit the standard picture but do show signatures appropriate for blowout jets. These signatures are (1) a flare arcade inside the emerging bipole in addition to the flare arcade produced between the emerging bipole and the ambient high-reaching unipolar field by reconnection of these two fields as in the standard picture, and (2) in addition to the jet prong expected from the standard reconnection, a second jet prong or strand, one that could not be produced by the standard reconnection but could be produced by reconnection between the ambient unipolar field and one leg of an erupting core-field flux rope that has blown out the emerging bipole. We therefore infer that these "two pronged" jets are made by

  5. Addition of a Decision Point in Evidence-Based Practice Process Steps to Distinguish EBP, Research and Quality Improvement Methodologies.

    PubMed

    Mick, JoAnn

    2015-06-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741--6787. PMID:25773966

  6. Addition of a Decision Point in Evidence-Based Practice Process Steps to Distinguish EBP, Research and Quality Improvement Methodologies.

    PubMed

    Mick, JoAnn

    2015-06-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741--6787.

  7. A Four-Step and Four-Criteria Approach for Evaluating Evidence of Dose Addition in Chemical Mixture Toxicity

    EPA Science Inventory

    Dose addition is the most frequently-used component-based approach for predicting dose response for a mixture of toxicologically-similar chemicals and for statistical evaluation of whether the mixture response is consistent with dose additivity and therefore predictable from the ...

  8. Evidence for Reduced Drug Susceptibility without Emergence of Major Protease Mutations following Protease Inhibitor Monotherapy Failure in the SARA Trial

    PubMed Central

    Sutherland, Katherine A.; Parry, Chris M.; McCormick, Adele; Kapaata, Anne; Lyagoba, Fred; Kaleebu, Pontiano; Gilks, Charles F.; Goodall, Ruth; Spyer, Moira; Kityo, Cissy; Pillay, Deenan; Gupta, Ravindra K.

    2015-01-01

    Background Major protease mutations are rarely observed following failure with protease inhibitors (PI), and other viral determinants of failure to PI are poorly understood. We therefore characterized Gag-Protease phenotypic susceptibility in subtype A and D viruses circulating in East Africa following viral rebound on PIs. Methods Samples from baseline and treatment failure in patients enrolled in the second line LPV/r trial SARA underwent phenotypic susceptibility testing. Data were expressed as fold-change in susceptibility relative to a LPV-susceptible reference strain. Results We cloned 48 Gag-Protease containing sequences from seven individuals and performed drug resistance phenotyping from pre-PI and treatment failure timepoints in seven patients. For the six patients where major protease inhibitor resistance mutations did not emerge, mean fold-change EC50 to LPV was 4.07 fold (95% CI, 2.08–6.07) at the pre-PI timepoint. Following viral failure the mean fold-change in EC50 to LPV was 4.25 fold (95% CI, 1.39–7.11, p = 0.91). All viruses remained susceptible to DRV. In our assay system, the major PI resistance mutation I84V, which emerged in one individual, conferred a 10.5-fold reduction in LPV susceptibility. One of the six patients exhibited a significant reduction in susceptibility between pre-PI and failure timepoints (from 4.7 fold to 9.6 fold) in the absence of known major mutations in protease, but associated with changes in Gag: V7I, G49D, R69Q, A120D, Q127K, N375S and I462S. Phylogenetic analysis provided evidence of the emergence of genetically distinct viruses at the time of treatment failure, indicating ongoing viral evolution in Gag-protease under PI pressure. Conclusions Here we observe in one patient the development of significantly reduced susceptibility conferred by changes in Gag which may have contributed to treatment failure on a protease inhibitor containing regimen. Further phenotype-genotype studies are required to elucidate genetic

  9. Evidence-Based Communication Practices for Children with Visual Impairments and Additional Disabilities: An Examination of Single-Subject Design Studies

    ERIC Educational Resources Information Center

    Parker, Amy T.; Grimmett, Eric S.; Summers, Sharon

    2008-01-01

    This review examines practices for building effective communication strategies for children with visual impairments, including those with additional disabilities, that have been tested by single-subject design methodology. The authors found 30 studies that met the search criteria and grouped intervention strategies to align any evidence of the…

  10. Dynamic interplay between histone H3 modifications and protein interpreters: emerging evidence for a ‘histone language’

    PubMed Central

    Oliver, Samuel S.; Denu, John M.

    2010-01-01

    Histone proteins organize DNA into dynamic chromatin structures and regulate processes such as transcription, repair and replication. Control of chromatin function and structure is mediated in part by reversible posttranslational modifications (PTMs) on histones. The most N-terminal region of histone H3 contains a high density of modifiable residues. In this review, we focus on the dynamic interplay between histone modification states on the H3 N-terminus and the binding modules that recognize these states. Specifically, we will discuss the effect of auxiliary modifications to H3K4unmod/me3 binding modules (specifically H3R2 methylation, H3T3 phosphorylation and H3T6 phosphorylation). Emerging evidence suggests that histone PTMs behave less like a strict ‘code’, but rather like a ‘language’, which better illustrates the importance of context. Using androgen receptor-mediated gene activation as an example, we propose a model for how the combinatorial nature of PTMs on the H3 N-terminus and the complexes that recognize these epigenetic modifications control gene expression. PMID:21243717

  11. An Empirically Derived Approach to the Latent Structure of the Adult Attachment Interview: Additional Convergent and Discriminant Validity Evidence

    PubMed Central

    Haydon, Katherine C.; Roisman, Glenn I.; Marks, Michael J.; Fraley, R. Chris

    2011-01-01

    Building on studies examining the latent structure of attachment-related individual differences as assessed by the Adult Attachment Interview (AAI) via Principal Components Analysis, the current report further explores the validity of four AAI dimensions reported by Haydon, Roisman, and Burt (in press): dismissing states of mind, preoccupied states of mind, and inferred negative experience with maternal and paternal caregivers. Study 1 reports evidence of distinctive cognitive correlates of dismissing v. preoccupied states of mind with reaction time in an attachment Stroop task and the valence of endorsed self-descriptors, respectively. Study 2 replicates prior meta-analytic findings of generally trivial convergence between state of mind dimensions and self-reported avoidance and anxiety (i.e., Roisman, Holland, et al., 2007). Study 3 contrastively demonstrates moderate empirical overlap between inferred experience—but not state of mind—AAI scales and self-reported avoidance and anxiety when the latter were assessed at the level of specific caregivers. Taken together, these findings add to accumulating evidence that an empirically-driven approach to scaling adults on AAI dimensions (Haydon et al., in press; Roisman et al., 2007) aids in identifying theoretically anticipated and distinctive affective, behavioral, and cognitive correlates of dismissing versus preoccupied states of mind. PMID:21838649

  12. Geochemical and mineralogical evidence for Sahara and Sahel dust additions to Quaternary soils on Lanzarote, eastern Canary Islands, Spain

    USGS Publications Warehouse

    Muhs, D.R.; Budahn, J.; Skipp, G.; Prospero, J.M.; Patterson, D.; Bettis, E. Arthur

    2010-01-01

    Africa is the most important source of dust in the world today, and dust storms are frequent on the nearby Canary Islands. Previous workers have inferred that the Sahara is the most important source of dust to Canary Islands soils, with little contribution from the Sahel region. Soils overlying a late Quaternary basalt flow on Lanzarote, Canary Islands, contain, in addition to volcanic minerals, quartz and mica, exotic to the island's bedrock. Kaolinite in the soils also likely has an exotic origin. Trace-element geochemistry shows that the soils are derived from varying proportions of locally derived basalt and African dust. Major-element geochemistry, clay mineralogy and interpretation of satellite imagery suggest that dust additions to the Canary Islands come not only from the Sahara Desert, but also from the Sahel region. ?? Published 2010. This article is a US Government work and is in the public domain in the USA.

  13. Chemical and particle-size evidence for addition of fine dust to soils of the midwestern United States

    NASA Astrophysics Data System (ADS)

    Mason, Joseph A.; Jacobs, Peter M.

    1998-12-01

    Significant long-term atmospheric dust additions to soils are well documented in many parts of the world, but not in the midwestern United States. We investigated elemental mass fluxes associated with soil development in late Wisconsinan loess in Illinois and Minnesota, using Zr as a stable index element. Positive mass fluxes of Al, Fe, and Ti can most plausibly be explained by additions to these soils of fine far-traveled dust, with higher Al/Zr, Fe/Zr, and Ti/Zr ratios than the coarser locally derived loess. High-resolution particle-size analyses support this explanation. The proposed dust influx will complicate efforts to quantify weathering processes in these soils. Far-traveled dust influx could have occurred simultaneously with the final phase of local loess deposition, and/or later, in the Holocene. Depending on the timing of dust influx, many other soils of the region may have been affected by it.

  14. Evidence for the safety of gum tragacanth (Asiatic Astragalus spp.) and modern criteria for the evaluation of food additives.

    PubMed

    Anderson, D M

    1989-01-01

    Gum tragacanth (GT), affirmed as GRAS within the USA since 1961, was evaluated as 'ADI not specified' by JECFA in 1985. Within the EEC, GT has been permitted temporarily as a food additive (E413), without an ADI, since 1974; a decision regarding its permanent status must be reached before the end of 1988. This review collates the dietary, toxicological, immunological and chemical data available and presents the pre-requisite data concerning the 'Need' and low levels of utilization of GT.

  15. Behavioural response of adult sea lamprey (Petromyzon marinus) to predator and conspecific alarm cues: evidence of additive effects

    USGS Publications Warehouse

    Di Rocco, Richard T.; Imre, Istvan; Johnson, Nicholas; Brown, Grant B

    2015-01-01

    Sea lampreys Petromyzon marinus, an invasive pest in the Upper Great Lakes, avoid odours that represent danger in their habitat. These odours include conspecific alarm cues and predator cues, like 2-phenylethylamine hydrochloride (PEA HCl), which is found in the urine of mammalian predators. Whether conspecific alarm cues and predator cues function additively or synergistically when mixed together is unknown. The objectives of this experimental study were to determine if the avoidance response of sea lamprey to PEA HCl is proportional to the concentration delivered, and if the avoidance response to the combination of a predator cue (PEA HCl) and sea lamprey alarm cue is additive. To accomplish the first objective, groups of ten sea lampreys were placed in an artificial stream channel and presented with stepwise concentrations of PEA HCl ranging from 5 × 10−8 to 5 × 10−10 M and a deionized water control. Sea lampreys exhibited an increase in their avoidance behaviour in response to increasing concentrations of PEA HCl. To accomplish the second objective, sea lampreys were exposed to PEA HCl, conspecific alarm cue and a combination of the two. Sea lampreys responded to the combination of predator cue and conspecific alarm cue in an additive manner.

  16. Protons, Photons, and the Prostate – Is There Emerging Evidence in the Ongoing Discussion on Particle Therapy for the Treatment of Prostate Cancer?

    PubMed Central

    Schiller, Kilian C.; Habl, Gregor; Combs, Stephanie E.

    2016-01-01

    Proton therapy is actively and repeatedly discussed within the framework of particle therapy for the treatment of prostate cancer (PC). The argument in favor of treating the prostate with protons is partly financial: given that small volumes are treated, treatment times are low, resulting in a hypothetical high patient throughput. However, such considerations should not form the basis of medical decision-making. There are also physical and biological arguments which further support the use of particle therapy for PC. The only relevant randomized data currently available is the study by Zietman and colleagues, comparing a high to a low proton boost, resulting in a significant increase in PSA-free survival in the experimental (high dose) arm (1). With modern photon treatments and image-guided radiotherapy (IGRT), equally high doses can be applied with photons and, thus, a randomized trial comparing high-end photons to protons is warranted. For high-linear energy transfer (LET) particles, such as carbon ions, the increase in relative biological effectiveness could potentially convert into an improvement in outcome. Additionally, through the physical differences of protons and carbon ions, the steeper dose gradient with carbon ions and the lack of beam broadening in the carbon beam lead to a superior dose distribution supporting the idea of hypofractionation. Biological and clinical data are emerging, however, has practice-changing evidence already arrived? PMID:26858936

  17. Additional evidence for a dual-strategy model of reasoning: Probabilistic reasoning is more invariant than reasoning about logical validity.

    PubMed

    Markovits, Henry; Brisson, Janie; de Chantal, Pier-Luc

    2015-11-01

    One of the major debates concerning the nature of inferential reasoning is between counterexample-based strategies such as mental model theory and the statistical strategies underlying probabilistic models. The dual-strategy model proposed by Verschueren, Schaeken, and d'Ydewalle (2005a, 2005b) suggests that people might have access to both kinds of strategies. One of the postulates of this approach is that statistical strategies correspond to low-cost, intuitive modes of evaluation, whereas counterexample strategies are higher-cost and more variable in use. We examined this hypothesis by using a deductive-updating paradigm. The results of Study 1 showed that individual differences in strategy use predict different levels of deductive updating on inferences about logical validity. Study 2 demonstrated no such variation when explicitly probabilistic inferences were examined. Study 3 showed that presenting updating problems with probabilistic inferences modified performance on subsequent problems using logical validity, whereas the opposite was not true. These results provide clear evidence that the processes used to make probabilistic inferences are less subject to variation than those used to make inferences of logical validity.

  18. Neotropics provide insights into the emergence of New World monkeys: New dental evidence from the late Oligocene of Peruvian Amazonia.

    PubMed

    Marivaux, Laurent; Adnet, Sylvain; Altamirano-Sierra, Ali J; Boivin, Myriam; Pujos, François; Ramdarshan, Anusha; Salas-Gismondi, Rodolfo; Tejada-Lara, Julia V; Antoine, Pierre-Olivier

    2016-08-01

    Recent field efforts in Peruvian Amazonia (Contamana area, Loreto Department) have resulted in the discovery of a late Oligocene (ca. 26.5 Ma; Chambira Formation) fossil primate-bearing locality (CTA-61). In this paper, we analyze the primate material consisting of two isolated upper molars, the peculiar morphology of which allows us to describe a new medium-sized platyrrhine monkey: Canaanimico amazonensis gen. et sp. nov. In addition to the recent discovery of Perupithecus ucayaliensis, a primitive anthropoid taxon of African affinities from the alleged latest Eocene Santa Rosa locality (Peruvian Amazonia), the discovery of Canaanimico adds to the evidence that primates were well-established in the Amazonian Basin during the Paleogene. Our phylogenetic results based on dental evidence show that none of the early Miocene Patagonian taxa (Homunculus, Carlocebus, Soriacebus, Mazzonicebus, Dolichocebus, Tremacebus, and Chilecebus), the late Oligocene Bolivian Branisella, or the Peruvian Canaanimico, is nested within a crown platyrrhine clade. All these early taxa are closely related and considered here as stem Platyrrhini. Canaanimico is nested within the Patagonian Soriacebinae, and closely related to Soriacebus, thereby extending back the soriacebine lineage to 26.5 Ma. Given the limited dental evidence, it is difficult to assess if Canaanimico was engaged in a form of pitheciine-like seed predation as is observed in Soriacebus and Mazzonicebus, but dental microwear patterns recorded on one upper molar indicate that Canaanimico was possibly a fruit and hard-object eater. If Panamacebus, a recently discovered stem cebine from the early Miocene of Panama, indicates that the crown platyrrhine radiation was already well underway by the earliest Miocene, Canaanimico indicates in turn that the "homunculid" radiation (as a part of the stem radiation) was well underway by the late Oligocene. These new data suggest that the stem radiation likely occurred in the Neotropics

  19. Neotropics provide insights into the emergence of New World monkeys: New dental evidence from the late Oligocene of Peruvian Amazonia.

    PubMed

    Marivaux, Laurent; Adnet, Sylvain; Altamirano-Sierra, Ali J; Boivin, Myriam; Pujos, François; Ramdarshan, Anusha; Salas-Gismondi, Rodolfo; Tejada-Lara, Julia V; Antoine, Pierre-Olivier

    2016-08-01

    Recent field efforts in Peruvian Amazonia (Contamana area, Loreto Department) have resulted in the discovery of a late Oligocene (ca. 26.5 Ma; Chambira Formation) fossil primate-bearing locality (CTA-61). In this paper, we analyze the primate material consisting of two isolated upper molars, the peculiar morphology of which allows us to describe a new medium-sized platyrrhine monkey: Canaanimico amazonensis gen. et sp. nov. In addition to the recent discovery of Perupithecus ucayaliensis, a primitive anthropoid taxon of African affinities from the alleged latest Eocene Santa Rosa locality (Peruvian Amazonia), the discovery of Canaanimico adds to the evidence that primates were well-established in the Amazonian Basin during the Paleogene. Our phylogenetic results based on dental evidence show that none of the early Miocene Patagonian taxa (Homunculus, Carlocebus, Soriacebus, Mazzonicebus, Dolichocebus, Tremacebus, and Chilecebus), the late Oligocene Bolivian Branisella, or the Peruvian Canaanimico, is nested within a crown platyrrhine clade. All these early taxa are closely related and considered here as stem Platyrrhini. Canaanimico is nested within the Patagonian Soriacebinae, and closely related to Soriacebus, thereby extending back the soriacebine lineage to 26.5 Ma. Given the limited dental evidence, it is difficult to assess if Canaanimico was engaged in a form of pitheciine-like seed predation as is observed in Soriacebus and Mazzonicebus, but dental microwear patterns recorded on one upper molar indicate that Canaanimico was possibly a fruit and hard-object eater. If Panamacebus, a recently discovered stem cebine from the early Miocene of Panama, indicates that the crown platyrrhine radiation was already well underway by the earliest Miocene, Canaanimico indicates in turn that the "homunculid" radiation (as a part of the stem radiation) was well underway by the late Oligocene. These new data suggest that the stem radiation likely occurred in the Neotropics

  20. Early Holocene human remains from the Argentinean Pampas: additional evidence for distinctive cranial morphology of early South Americans.

    PubMed

    Pucciarelli, Héctor M; Perez, S Ivan; Politis, Gustavo G

    2010-10-01

    The cranial morphology of Early Holocene American human samples is characterized by a long and narrow cranial vault, whereas more recent samples exhibit a shorter and wider cranial vault. Two hypotheses have been proposed to account for the morphological differences between early and late-American samples: (a) the migratory hypothesis that suggests that the morphological variation between early and late American samples was the result of a variable number of migratory waves; and (b) the local diversification hypothesis, that is, the morphological differences between early and late American samples were mainly generated by local, random (genetic drift), and nonrandom factors (selection and phenotypic plasticity). We present the first craniometric study of three early skulls from the Argentinean Pampas, dated ∼8,000 cal. years BP (Arroyo Seco 2, Chocorí, and La Tigra), and one associated with mega-faunal remains (Fontezuelas skull). In addition, we studied several Late Holocene samples. We show that the skulls from the Argentinean Pampas are morphologically similar to other Early Holocene American skulls (i.e., Lagoa Santa from Brazil, Tequendama, Checua, and Aguazuque from Colombia, Lauricocha from Peru, and early Mexicans) that exhibit long and narrow cranial vaults. These samples differ from the Late Holocene American samples that exhibit a shorter and wider cranial vault. Our results underscore the important differences in cranial morphology between early and late-American samples. However, we emphasize the need for further studies to discuss alternative hypotheses regarding such differences. PMID:20623674

  1. Formula food-reducing diets:A new evidence-based addition to the weight management tool box

    PubMed Central

    Leeds, A R

    2014-01-01

    evidence for improved vitamin D status and maintained bone health in elderly obese people with osteoarthritis but more research is needed. Rapid initial weight loss was feared to be followed by rapid weight regain. However, provided initial weight loss is delivered in parallel with an intense education programme about nutrition, cooking, shopping and lifestyle for long-term maintenance; and where long-term support is provided, subsequent weight maintenance after VLCDs and LCDs has been shown to be possible. A recent literature review identified high-protein diets, obesity drugs and partial use of formula meal replacements as methods which can result in statistically significantly greater weight maintenance after initial weight loss with VLCDs or LCDs. Anxiety about serious adverse side effects seems to be unfounded although users need to be aware of both minor and more serious, though very infrequent, adverse events, such as gallstones and gallbladder disease. PMID:25663817

  2. Goal-directed and transfer-cue-elicited drug-seeking are dissociated by pharmacotherapy: evidence for independent additive controllers.

    PubMed

    Hogarth, Lee

    2012-07-01

    According to contemporary learning theory, drug-seeking behavior reflects the summation of 2 dissociable controllers. Whereas goal-directed drug-seeking is determined by the expected current incentive value of the drug, stimulus-elicited drug-seeking is determined by the expected probability of the drug independently of its current incentive value, and these 2 controllers contribute additively to observed drug-seeking. One applied prediction of this model is that smoking cessation pharmacotherapies selectively attenuate tonic but not cue-elicited craving because they downgrade the expected incentive value of the drug but leave expected probability intact. To test this, the current study examined whether nicotine replacement therapy (NRT) nasal spray would modify goal-directed tobacco choice in a human outcome devaluation procedure, but leave cue-elicited tobacco choice in a Pavlovian to instrumental transfer (PIT) procedure intact. Smokers (N= 96) first underwent concurrent choice training in which 2 responses earned tobacco or chocolate points, respectively. Participants then ingested either NRT nasal spray (1 mg) or chocolate (147 g) to devalue 1 outcome. Concurrent choice was then tested again in extinction to measure goal-directed control of choice, and in a PIT test to measure the extent to which tobacco and chocolate stimuli enhanced choice of the same outcome. It was found that NRT modified tobacco choice in the extinction test but not the extent to which the tobacco stimulus enhanced choice of the tobacco outcome in the PIT test. This dissociation suggests that the propensity to engage in drug-seeking is determined independently by the expected value and probability of the drug, and that pharmacotherapy has partial efficacy because it selectively effects expected drug value.

  3. Goal-directed and transfer-cue-elicited drug-seeking are dissociated by pharmacotherapy: evidence for independent additive controllers.

    PubMed

    Hogarth, Lee

    2012-07-01

    According to contemporary learning theory, drug-seeking behavior reflects the summation of 2 dissociable controllers. Whereas goal-directed drug-seeking is determined by the expected current incentive value of the drug, stimulus-elicited drug-seeking is determined by the expected probability of the drug independently of its current incentive value, and these 2 controllers contribute additively to observed drug-seeking. One applied prediction of this model is that smoking cessation pharmacotherapies selectively attenuate tonic but not cue-elicited craving because they downgrade the expected incentive value of the drug but leave expected probability intact. To test this, the current study examined whether nicotine replacement therapy (NRT) nasal spray would modify goal-directed tobacco choice in a human outcome devaluation procedure, but leave cue-elicited tobacco choice in a Pavlovian to instrumental transfer (PIT) procedure intact. Smokers (N= 96) first underwent concurrent choice training in which 2 responses earned tobacco or chocolate points, respectively. Participants then ingested either NRT nasal spray (1 mg) or chocolate (147 g) to devalue 1 outcome. Concurrent choice was then tested again in extinction to measure goal-directed control of choice, and in a PIT test to measure the extent to which tobacco and chocolate stimuli enhanced choice of the same outcome. It was found that NRT modified tobacco choice in the extinction test but not the extent to which the tobacco stimulus enhanced choice of the tobacco outcome in the PIT test. This dissociation suggests that the propensity to engage in drug-seeking is determined independently by the expected value and probability of the drug, and that pharmacotherapy has partial efficacy because it selectively effects expected drug value. PMID:22823420

  4. 15N electron nuclear double resonance of the primary donor cation radical P+.865 in reaction centers of Rhodopseudomonas sphaeroides: additional evidence for the dimer model.

    PubMed Central

    Lubitz, W; Isaacson, R A; Abresch, E C; Feher, G

    1984-01-01

    Four 15N hyperfine coupling constants, including signs, have been measured by electron nuclear double resonance (ENDOR) and electron nuclear nuclear triple resonance (TRIPLE) for the bacteriochlorophyll a radical cation, BChla+., in vitro and for the light-induced primary donor radical cation, P+.865, in reaction centers of Rhodopseudomonas sphaeroides R-26. A comparison of the data shows that the hyperfine coupling constants have the same sign in both radicals and are, on the average, smaller by a factor of 2 in P+.865. These results provide additional evidence that P+.865 is a bacteriochlorophyll dimer and are in contradiction with the monomer structure of P+.865 recently proposed by O'Malley and Babcock. The reduction factors of the individual 15N couplings, together with the evidence from proton ENDOR data and molecular orbital calculations, indicate a dimer structure in which only two rings (either I and I or III and III) of the bacteriochlorophyll macrocycles overlap. PMID:6096857

  5. Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: a systematic review of qualitative evidence.

    PubMed

    Johnstone, Megan-Jane; Turale, Sue

    2014-03-01

    Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management. PMID:24635901

  6. Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: a systematic review of qualitative evidence.

    PubMed

    Johnstone, Megan-Jane; Turale, Sue

    2014-03-01

    Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management.

  7. Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden.

    PubMed

    Avdic, Daniel

    2016-07-01

    Recent health care consolidation trends raise the important policy question whether improved emergency medical services and enhanced productivity can offset adverse quality effects from decreased access. This paper empirically analyzes how geographical distance from an emergency hospital affects the probability of surviving an acute myocardial infarction (AMI), accounting for health-based spatial sorting and data limitations on out-of-hospital mortality. Exploiting policy-induced variation in hospital distance derived from emergency hospital closures and detailed Swedish mortality data over two decades, results show a drastically decreasing probability of surviving an AMI as residential distance from a hospital increases one year after a closure occurred. The effect disappears in subsequent years, however, suggesting that involved agents quickly adapted to the new environment. PMID:27060525

  8. Effects of additional iron-chelators on Fe(2+)-initiated lipid peroxidation: evidence to support the Fe2+ ... Fe3+ complex as the initiator.

    PubMed

    Tang, L X; Yang, J L; Shen, X

    1997-12-01

    The addition of chelated Fe2+ ions in a liposomal system often results in a short lag period before peroxidation starts. The addition of a second chelator at the end of the lag period results in an inhibition of the lipid peroxidation. The degree of inhibition depends on the stability constants of the chelator in ligating Fe2+ and/or Fe3+. A more striking inhibitory effect was observed for the chelators with higher stability constant for either or both Fe(2+)- and Fe(3+)-complex, but much less inhibition was found for those with lower stability constants for both complexes. Assuming that the "initiator" for iron-dependent lipid peroxidation is formed through the redox process of iron ion and finally emerged at the end of the latent period, the inhibitory effect of the second chelator may be explained as the abstraction of either Fe2+ or Fe3+ from the initiator by an additional free chelator, which results in the decomposition of the initiator. This study supports the hypothesis that a Fe2+ ... Fe3+ complex is responsible for iron-initiated lipid peroxidation. PMID:9397574

  9. Celebrating methodological challenges and changes: reflecting on the emergence and importance of the role of qualitative evidence in Cochrane reviews.

    PubMed

    Hannes, Karin; Booth, Andrew; Harris, Janet; Noyes, Jane

    2013-10-17

    Cochrane systematic reviews have proven to be beneficial for decision making processes, both on a practitioner and a policy level, and there are current initiatives to extend the types of evidence used by them, including qualitative research. In this article we outline the major achievements of the Cochrane Qualitative and Implementation Methods Group. Although the Group has encountered numerous challenges in dealing with the evolution of qualitative evidence synthesis, both outside and within the Cochrane Collaboration, it has successfully responded to the challenges posed in terms of incorporating qualitative evidence in systematic reviews. The Methods Group will continue to advocate for more flexible and inclusive approaches to evidence synthesis in order to meet the exciting challenges and opportunities presented by mixed methods systematic reviews and reviews of complex interventions.

  10. Celebrating methodological challenges and changes: reflecting on the emergence and importance of the role of qualitative evidence in Cochrane reviews

    PubMed Central

    2013-01-01

    Cochrane systematic reviews have proven to be beneficial for decision making processes, both on a practitioner and a policy level, and there are current initiatives to extend the types of evidence used by them, including qualitative research. In this article we outline the major achievements of the Cochrane Qualitative and Implementation Methods Group. Although the Group has encountered numerous challenges in dealing with the evolution of qualitative evidence synthesis, both outside and within the Cochrane Collaboration, it has successfully responded to the challenges posed in terms of incorporating qualitative evidence in systematic reviews. The Methods Group will continue to advocate for more flexible and inclusive approaches to evidence synthesis in order to meet the exciting challenges and opportunities presented by mixed methods systematic reviews and reviews of complex interventions. PMID:24135194

  11. Prosody Signals the Emergence of Intentional Communication in the First Year of Life: Evidence from Catalan-Babbling Infants

    ERIC Educational Resources Information Center

    Esteve-Gibert, Nuria; Prieto, Pilar

    2013-01-01

    There is considerable debate about whether early vocalizations mimic the target language and whether prosody signals emergent intentional communication. A longitudinal corpus of four Catalan-babbling infants was analyzed to investigate whether children use different prosodic patterns to distinguish communicative from investigative vocalizations…

  12. Evidence for the Convergence Model: The Emergence of Highly Pathogenic Avian Influenza (H5N1) in Viet Nam

    PubMed Central

    Saksena, Sumeet; Fox, Jefferson; Epprecht, Michael; Tran, Chinh C.; Nong, Duong H.; Spencer, James H.; Nguyen, Lam; Finucane, Melissa L.; Tran, Vien D.; Wilcox, Bruce A.

    2015-01-01

    Building on a series of ground breaking reviews that first defined and drew attention to emerging infectious diseases (EID), the ‘convergence model’ was proposed to explain the multifactorial causality of disease emergence. The model broadly hypothesizes disease emergence is driven by the co-incidence of genetic, physical environmental, ecological, and social factors. We developed and tested a model of the emergence of highly pathogenic avian influenza (HPAI) H5N1 based on suspected convergence factors that are mainly associated with land-use change. Building on previous geospatial statistical studies that identified natural and human risk factors associated with urbanization, we added new factors to test whether causal mechanisms and pathogenic landscapes could be more specifically identified. Our findings suggest that urbanization spatially combines risk factors to produce particular types of peri-urban landscapes with significantly higher HPAI H5N1 emergence risk. The work highlights that peri-urban areas of Viet Nam have higher levels of chicken densities, duck and geese flock size diversities, and fraction of land under rice or aquaculture than rural and urban areas. We also found that land-use diversity, a surrogate measure for potential mixing of host populations and other factors that likely influence viral transmission, significantly improves the model’s predictability. Similarly, landscapes where intensive and extensive forms of poultry production overlap were found at greater risk. These results support the convergence hypothesis in general and demonstrate the potential to improve EID prevention and control by combing geospatial monitoring of these factors along with pathogen surveillance programs. PMID:26398118

  13. Evidence for the Convergence Model: The Emergence of Highly Pathogenic Avian Influenza (H5N1) in Viet Nam.

    PubMed

    Saksena, Sumeet; Fox, Jefferson; Epprecht, Michael; Tran, Chinh C; Nong, Duong H; Spencer, James H; Nguyen, Lam; Finucane, Melissa L; Tran, Vien D; Wilcox, Bruce A

    2015-01-01

    Building on a series of ground breaking reviews that first defined and drew attention to emerging infectious diseases (EID), the 'convergence model' was proposed to explain the multifactorial causality of disease emergence. The model broadly hypothesizes disease emergence is driven by the co-incidence of genetic, physical environmental, ecological, and social factors. We developed and tested a model of the emergence of highly pathogenic avian influenza (HPAI) H5N1 based on suspected convergence factors that are mainly associated with land-use change. Building on previous geospatial statistical studies that identified natural and human risk factors associated with urbanization, we added new factors to test whether causal mechanisms and pathogenic landscapes could be more specifically identified. Our findings suggest that urbanization spatially combines risk factors to produce particular types of peri-urban landscapes with significantly higher HPAI H5N1 emergence risk. The work highlights that peri-urban areas of Viet Nam have higher levels of chicken densities, duck and geese flock size diversities, and fraction of land under rice or aquaculture than rural and urban areas. We also found that land-use diversity, a surrogate measure for potential mixing of host populations and other factors that likely influence viral transmission, significantly improves the model's predictability. Similarly, landscapes where intensive and extensive forms of poultry production overlap were found at greater risk. These results support the convergence hypothesis in general and demonstrate the potential to improve EID prevention and control by combing geospatial monitoring of these factors along with pathogen surveillance programs. PMID:26398118

  14. Evidence for the formation of an enamine species during aldol and Michael-type addition reactions promiscuously catalyzed by 4-oxalocrotonate tautomerase.

    PubMed

    Poddar, Harshwardhan; Rahimi, Mehran; Geertsema, Edzard M; Thunnissen, Andy-Mark W H; Poelarends, Gerrit J

    2015-03-23

    The enzyme 4-oxalocrotonate tautomerase (4-OT), which has a catalytic N-terminal proline residue (Pro1), can promiscuously catalyze various carbon-carbon bond-forming reactions, including aldol condensation of acetaldehyde with benzaldehyde to yield cinnamaldehyde, and Michael-type addition of acetaldehyde to a wide variety of nitroalkenes to yield valuable γ-nitroaldehydes. To gain insight into how 4-OT catalyzes these unnatural reactions, we carried out exchange studies in D2 O, and X-ray crystallography studies. The former established that H-D exchange within acetaldehyde is catalyzed by 4-OT and that the Pro1 residue is crucial for this activity. The latter showed that Pro1 of 4-OT had reacted with acetaldehyde to give an enamine species. These results provide evidence of the mechanism of the 4-OT-catalyzed aldol and Michael-type addition reactions in which acetaldehyde is activated for nucleophilic addition by Pro1-dependent formation of an enamine intermediate.

  15. Linkage of Type 2 Diabetes on Chromosome 9p24 in Mexican Americans: Additional Evidence from the Veterans Administration Genetic Epidemiology Study (VAGES)

    PubMed Central

    Farook, Vidya S.; Coletta, Dawn K.; Puppala, Sobha; Schneider, Jennifer; Chittoor, Geetha; Hu, Shirley L.; Winnier, Deidre A.; Norton, Luke; Dyer, Thomas D.; Arya, Rector; Cole, Shelley A.; Carless, Melanie; Göring, Harald H.; Almasy, Laura; Mahaney, Michael C.; Comuzzie, Anthony G.; Curran, Joanne E.; Blangero, John; Duggirala, Ravindranath; Lehman, Donna M.; Jenkinson, Christopher P.; DeFronzo, Ralph A.

    2014-01-01

    Objective Type 2 diabetes (T2DM) is a complex metabolic disease and is more prevalent in certain ethnic groups such as the Mexican Americans. The goal of our study was to perform a genome-wide linkage analysis to localize T2DM susceptibility loci in Mexican Americans. Methods We used the phenotypic and genotypic data from 1,122 Mexican American individuals (307 families) who participated in the Veterans Administration Genetic Epidemiology Study (VAGES). Genome-wide linkage analysis was performed, using the variance components approach. Data from two additional Mexican American family studies, the San Antonio Family Heart Study (SAFHS) and the San Antonio Family Diabetes/Gallbladder Study (SAFDGS), were combined with the VAGES data to test for improved linkage evidence. Results After adjusting for covariate effects, T2DM was found to be under significant genetic influences (h2 = 0.62, P = 2.7 × 10−6). The strongest evidence for linkage of T2DM occurred between markers D9S1871 and D9S2169 on chromosome 9p24.2-p24.1 (LOD = 1.8). Given that we previously reported suggestive evidence for linkage of T2DM at this region in SAFDGS also, we found the significant and increased linkage evidence (LOD = 4.3, empirical P = 1.0 × 10−5, genome-wide P = 1.6 × 10−3) for T2DM at the same chromosomal region when we performed genome-wide linkage analysis of the VAGES data combined with SAFHS and SAFDGS data. Conclusion Significant T2DM linkage evidence was found on chromosome 9p24 in Mexican Americans. Importantly, the chromosomal region of interest in this study overlaps with several recent genome-wide association studies (GWASs) involving T2DM related traits. Given its overlap with such findings and our own initial T2DM association findings in the 9p24 chromosomal region, high throughput sequencing of the linked chromosomal region could identify the potential causal T2DM genes. PMID:24060607

  16. Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework

    PubMed Central

    Gushulak, BD; Weekers, J; MacPherson, DW

    2010-01-01

    International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

  17. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. Evidence exists to guide thromboembolic prophylaxis in ambulatory patients with temporary lower limb immobilisation.

    PubMed

    Horner, Dan

    2011-08-01

    A short-cut review was carried out to establish whether patients requiring lower limb immobilisation should have thromboprophylaxis. A total of 148 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is that ambulatory patients with temporary lower leg immobilisation who are over 50, in a rigid cast, non-weight bearing or with a severe injury should be considered as an at risk group for venous thromboembolism (VTE). If there are any other current proven VTE risk factors, patients should be considered as high risk.

  18. Evidence of children's vulnerability to radiation in the context of radiological/nuclear events and considerations for emergency response.

    PubMed

    Lane, Rachel; Reinhardt, Pascale; Thompson, Patsy

    2010-11-01

    International organisations, such as International Atomic Energy Agency, United Nations Scientific Committee on the Effects of Atomic Radiation and World Health Organisation, together with committees of experts such as Biological Effects of Ionising Radiation and Committee on Medical Aspects of Radiation in the Environment, have assessed the effects of radiation on large exposed populations (Chernobyl accident, and Hiroshima/Nagasaki atomic bombings) and on nuclear energy workers and people living near nuclear facilities. Childhood and in utero exposure to moderate and high levels of ionizing radiation, such as those experienced during the atomic bombings of Japan, or from radiotherapy, is an established cause of leukaemia and solid cancer. There is no evidence of increase in solid cancers (excluding thyroid cancer) or leukaemia in the children from Chernobyl, and no evident link between worker's exposure to radiation and leukaemia in their offspring or with the presence of leukaemia clusters around nuclear power plants. It has also not been possible to demonstrate the evidence of radiation hereditary effects in human populations. In accordance with international guidance, Canadian Nuclear Safety Commission recommends optimisation of protection strategies to reduce doses to children. The development of credible radiological/nuclear event scenarios would assist in identifying probable sources of radioactivity and pathways of exposure for children. Such scenarios should then be used to identify protection strategies appropriate for children. PMID:20959331

  19. Evidence for a relationship between emerging magnetic fields, electric currents, and solar flares observed on May 10, 2012

    NASA Astrophysics Data System (ADS)

    Livshits, M. A.; Grigoryeva, I. Yu.; Myshyakov, I. I.; Rudenko, G. V.

    2016-10-01

    Multi-wavelength observations and magnetic-field data for the solar flare of May 10, 2012 (04: 18 UT) are analyzed. A sign change in the line-of-sight magnetic field in the umbra of a small spot has been detected. This is at least partly associated with the emergence of a new magnetic field. A hard X-ray flare was recorded at almost the same time, and a "sunquake" was generated by the impact of the disturbance in the range of energy release on the photosphere. A sigmoid flare was recorded at the beginning of the event, but did not spread, as it usually does, along the polarity inversion (neutral) line. SDO/HMI full vectormagnetic-fieldmeasurements are used to extrapolate the magnetic field of AR 11476 into the corona, and to derive the distribution of vertical currents jz in the photosphere. The relationship between the distribution of currents in the active region and the occurrence of flares is quite complex. The expected "ideal" behavior of the current system before and after the flare (e.g., described by Sharykin and Kosovichev) is observed only in the sigmoid region. The results obtained are compared with observations of two other flares recorded in this active region on the same day, one similar to the discussed flare and the other different. The results confirm that the formation and eruption of large-scale magnetic flux ropes in sigmoid flares is associated with shear motions in the photosphere, the emergence of twisted magnetic tubes, and the subsequent development of the torus instability.

  20. Iron-Sulfur Cluster Biogenesis Chaperones: Evidence for Emergence of Mutational Robustness of a Highly Specific Protein-Protein Interaction.

    PubMed

    Delewski, Wojciech; Paterkiewicz, Bogumiła; Manicki, Mateusz; Schilke, Brenda; Tomiczek, Bartłomiej; Ciesielski, Szymon J; Nierzwicki, Lukasz; Czub, Jacek; Dutkiewicz, Rafal; Craig, Elizabeth A; Marszalek, Jaroslaw

    2016-03-01

    Biogenesis of iron-sulfur clusters (FeS) is a highly conserved process involving Hsp70 and J-protein chaperones. However, Hsp70 specialization differs among species. In most eukaryotes, including Schizosaccharomyces pombe, FeS biogenesis involves interaction between the J-protein Jac1 and the multifunctional Hsp70 Ssc1. But, in Saccharomyces cerevisiae and closely related species, Jac1 interacts with the specialized Hsp70 Ssq1, which emerged through duplication of SSC1. As little is known about how gene duplicates affect the robustness of their protein interaction partners, we analyzed the functional and evolutionary consequences of Ssq1 specialization on the ubiquitous J-protein cochaperone Jac1, by comparing S. cerevisiae and S. pombe. Although deletion of JAC1 is lethal in both species, alanine substitutions within the conserved His-Pro-Asp (HPD) motif, which is critical for Jac1:Hsp70 interaction, have species-specific effects. They are lethal in S. pombe, but not in S. cerevisiae. These in vivo differences correlated with in vitro biochemical measurements. Charged residues present in the J-domain of S. cerevisiae Jac1, but absent in S. pombe Jac1, are important for tolerance of S. cerevisiae Jac1 to HPD alterations. Moreover, Jac1 orthologs from species that encode Ssq1 have a higher sequence divergence. The simplest interpretation of our results is that Ssq1's coevolution with Jac1 resulted in expansion of their binding interface, thus increasing the efficiency of their interaction. Such an expansion could in turn compensate for negative effects of HPD substitutions. Thus, our results support the idea that the robustness of Jac1 emerged as consequence of its highly efficient and specific interaction with Ssq1.

  1. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Hydrotherapy following rotator cuff repair.

    PubMed

    Hay, Laura; Wylie, Katherine

    2011-07-01

    A short cut review was carried out to establish whether hydrotherapy is beneficial in rehabilitation after rotator cuff repair. 27 papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of that best paper are tabulated. It is concluded that while there may be some short term benefit to passive range of movement, further research is needed.

  2. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Weather dependent nasal erythema in reindeer (Rangifer tarandus).

    PubMed

    Teece, Stewart; Foëx, Bernard A

    2007-12-01

    A short cut review was carried out to establish whether nasal erythema in a reindeer might be a useful navigational aid on Christmas Eve. From a search of nine papers, five presented evidence relevant to the question. The author, date and country of publication, "subjects" studied, study type, relevant outcomes, results and study weaknesses of these papers are presented in table 3. The clinical bottom line is that a reindeer with a red nose at rest at the North Pole would not inspire confidence.

  3. Science and evidence of success: two emerging issues in assessment accommodations for students who are deaf or hard of hearing.

    PubMed

    Cawthon, Stephanie W

    2010-01-01

    In the United States, students who are deaf or hard of hearing (SDHH) are required to participate in high-stakes standardized assessments under No Child Left Behind reforms. In 2006-2007, states added science to reading and mathematics as a tested content area. Many SDHH participate in these assessments using testing accommodations, but teachers have few evidence-based resources to draw upon when making accommodations decisions. Two research questions guided this study: (a) What were patterns of SDHH 2006-2007 test accommodations use in state standardized assessments in mathematics, reading, and science? (b) What evidence did teachers use to determine the effectiveness of accommodations for SDHH? A total of 290 participants described their assessment practices with SDHH via an online and paper-and-pencil survey. Extended time, small group, and test directions interpreted were the most frequently used accommodations by SDHH, but there were some different patterns in science for accommodations that included changes to the test items. Teachers reported both student satisfaction and test score validity epistemologies of accommodations' effectiveness. PMID:20147421

  4. Testing the Emergence of New Caledonia: Fig Wasp Mutualism as a Case Study and a Review of Evidence

    PubMed Central

    Cruaud, Astrid; Jabbour-Zahab, Roula; Genson, Gwenaëlle; Ungricht, Stefan; Rasplus, Jean-Yves

    2012-01-01

    While geologists suggest that New Caledonian main island (Grande Terre) was submerged until ca 37 Ma, biologists are struck by the presence of supposedly Gondwanan groups on the island. Among these groups are the Oreosycea fig trees (Ficus, Moraceae) and their Dolichoris pollinators (Hymenoptera, Agaonidae). These partners are distributed in the Paleotropics and Australasia, suggesting that their presence on New Caledonia could result from Gondwanan vicariance. To test this hypothesis, we obtained mitochondrial and nuclear markers (5.3 kb) from 28 species of Dolichoris, used all available sequences for Oreosycea, and conducted phylogenetic and dating analyses with several calibration strategies. All our analyses ruled out a vicariance scenario suggesting instead that New Caledonian colonization by Dolichoris and Oreosycea involved dispersal across islands from Sundaland ca 45.9-32.0 Ma. Our results show that successful long-distance dispersal of obligate mutualists may happen further suggesting that presence of intimate mutualisms on isolated islands should not be used as a priori evidence for vicariance. Comparing our results to a review of all the published age estimates for New Caledonian plant and animal taxa, we showed that support for a vicariant origin of the island biota is still lacking. Finally, as demonstrating a causal relationship between geology and biology requires independent evidence, we argue that a priori assumptions about vicariance or dispersal should not be used to constrain chronograms. This circular reasoning could lead to under or overestimation of age estimates. PMID:22383982

  5. Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy

    PubMed Central

    Aradeon, Susan B; Doctor, Henry V

    2016-01-01

    The Sustainable Development Goal (SDG) maternal mortality target risks being underachieved like its Millennium Development Goal (MDG) predecessor. The MDG skilled birth attendant (SBA) strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER) strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and postimplementation Knowledge, Attitude, and Practice Survey results and qualitative assessments support the CCER theory of change. This theory of change rests on a set of implementation steps that rely on three innovative components: Community Communication, Rapid Imitation Practice, and CCER support

  6. Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy.

    PubMed

    Aradeon, Susan B; Doctor, Henry V

    2016-01-01

    The Sustainable Development Goal (SDG) maternal mortality target risks being underachieved like its Millennium Development Goal (MDG) predecessor. The MDG skilled birth attendant (SBA) strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER) strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and postimplementation Knowledge, Attitude, and Practice Survey results and qualitative assessments support the CCER theory of change. This theory of change rests on a set of implementation steps that rely on three innovative components: Community Communication, Rapid Imitation Practice, and CCER support

  7. Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy.

    PubMed

    Aradeon, Susan B; Doctor, Henry V

    2016-01-01

    The Sustainable Development Goal (SDG) maternal mortality target risks being underachieved like its Millennium Development Goal (MDG) predecessor. The MDG skilled birth attendant (SBA) strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER) strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and postimplementation Knowledge, Attitude, and Practice Survey results and qualitative assessments support the CCER theory of change. This theory of change rests on a set of implementation steps that rely on three innovative components: Community Communication, Rapid Imitation Practice, and CCER support

  8. Additional evidence for morpho-dimensional tooth crown variation in a New Indonesian H. erectus sample from the Sangiran Dome (Central Java).

    PubMed

    Zanolli, Clément

    2013-01-01

    This contribution reports fifteen human fossil dental remains found during the last two decades in the Sangiran Dome area, in Central Java, Indonesia. Among this sample, only one of the specimens had already been briefly described, with the other fourteen remaining unreported. Seven of the fifteen isolated teeth were found in a secured stratigraphic context in the late Lower-early Middle Pleistocene Kabuh Formation. The remaining elements were surface finds which, based on coincidental sources of information, were inferred as coming from the Kabuh Formation. Mainly constituted of permanent molars, but also including one upper incisor and one upper premolar, this dental sample brings additional evidence for a marked degree of size variation and time-related structural reduction in Javanese H. erectus. This is notably expressed by a significant decrease of the mesiodistal diameter, frequently associated to the reduction or even loss of the lower molar distal cusp (hypoconulid) and to a more square occlusal outline. In addition to the hypoconulid reduction or loss, this new sample also exhibits a low frequency of the occlusal Y-groove pattern, with a dominance of the X and, to a lesser extent, of the+patterns. This combination is rare in the Lower and early Middle Pleistocene paleoanthropological record, including in the early Javanese dental assemblage from the Sangiran Dome. On the other hand, similar dental features are found in Chinese H. erectus and in H. heidelbergensis. As a whole, this new record confirms the complex nature of the intermittent exchanges that occurred between continental and insular Southeast Asia through the Pleistocene. PMID:23843996

  9. Additional Evidence for Morpho-Dimensional Tooth Crown Variation in a New Indonesian H. erectus Sample from the Sangiran Dome (Central Java)

    PubMed Central

    Zanolli, Clément

    2013-01-01

    This contribution reports fifteen human fossil dental remains found during the last two decades in the Sangiran Dome area, in Central Java, Indonesia. Among this sample, only one of the specimens had already been briefly described, with the other fourteen remaining unreported. Seven of the fifteen isolated teeth were found in a secured stratigraphic context in the late Lower-early Middle Pleistocene Kabuh Formation. The remaining elements were surface finds which, based on coincidental sources of information, were inferred as coming from the Kabuh Formation. Mainly constituted of permanent molars, but also including one upper incisor and one upper premolar, this dental sample brings additional evidence for a marked degree of size variation and time-related structural reduction in Javanese H. erectus. This is notably expressed by a significant decrease of the mesiodistal diameter, frequently associated to the reduction or even loss of the lower molar distal cusp (hypoconulid) and to a more square occlusal outline. In addition to the hypoconulid reduction or loss, this new sample also exhibits a low frequency of the occlusal Y-groove pattern, with a dominance of the X and, to a lesser extent, of the+patterns. This combination is rare in the Lower and early Middle Pleistocene paleoanthropological record, including in the early Javanese dental assemblage from the Sangiran Dome. On the other hand, similar dental features are found in Chinese H. erectus and in H. heidelbergensis. As a whole, this new record confirms the complex nature of the intermittent exchanges that occurred between continental and insular Southeast Asia through the Pleistocene. PMID:23843996

  10. A.T. Still's Osteopathic Lesion Theory and Evidence-Based Models Supporting the Emerged Concept of Somatic Dysfunction.

    PubMed

    Liem, Torsten

    2016-10-01

    Andrew Taylor Still, MD, DO, coined the original idea of lesion based on the obstruction of flow of body fluids, but primarily referring to bony structures and more precisely to the spine. Throughout the 20th century, this idea was shaped and developed into the concept of somatic dysfunction, a term that is familiar to both US-trained osteopathic physicians and foreign-trained osteopaths and has been an essential cornerstone of osteopathic practice and teaching. The present historical narrative review offers an overview of the evolution of Still's original lesion concept, major evidence-based models of somatic dysfunction that attempt to explain the clinical findings, and a critique of the concept. PMID:27669069

  11. The Emergence of a Phoneme-Sized Unit in L2 Speech Production: Evidence from Japanese-English Bilinguals.

    PubMed

    Nakayama, Mariko; Kinoshita, Sachiko; Verdonschot, Rinus G

    2016-01-01

    Recent research has revealed that the way phonology is constructed during word production differs across languages. Dutch and English native speakers are suggested to incrementally insert phonemes into a metrical frame, whereas Mandarin Chinese speakers use syllables and Japanese speakers use a unit called the mora (often a CV cluster such as "ka" or "ki"). The present study is concerned with the question how bilinguals construct phonology in their L2 when the phonological unit size differs from the unit in their L1. Japanese-English bilinguals of varying proficiency read aloud English words preceded by masked primes that overlapped in just the onset (e.g., bark-BENCH) or the onset plus vowel corresponding to the mora-sized unit (e.g., bell-BENCH). Low-proficient Japanese-English bilinguals showed CV priming but did not show onset priming, indicating that they use their L1 phonological unit when reading L2 English words. In contrast, high-proficient Japanese-English bilinguals showed significant onset priming. The size of the onset priming effect was correlated with the length of time spent in English-speaking countries, which suggests that extensive exposure to L2 phonology may play a key role in the emergence of a language-specific phonological unit in L2 word production.

  12. Evolution and structure of Tomato spotted wilt virus populations: evidence of extensive reassortment and insights into emergence processes.

    PubMed

    Tentchev, Diana; Verdin, Eric; Marchal, Cécile; Jacquet, Monique; Aguilar, Juan M; Moury, Benoît

    2011-04-01

    Tomato spotted wilt virus (TSWV; genus Tospovirus, family Bunyaviridae) genetic diversity was evaluated by sequencing parts of the three RNA genome segments of 224 isolates, mostly from pepper and tomato crops in southern Europe. Eighty-three per cent of the isolates showed consistent clustering into three clades, corresponding to their geographical origin, Spain, France or the USA, for the three RNA segments. In contrast, the remaining 17% of isolates did not belong to the same clade for the three RNA segments and were shown to be reassortants. Among them, eight different reassortment patterns were observed. Further phylogenetic analyses provided insights into the dynamic processes of the worldwide resurgence of TSWV that, since the 1980s, has followed the worldwide dispersal of the western flower thrips (Frankliniella occidentalis) tospovirus vector. For two clades composed essentially of Old World (OW) isolates, tree topology suggested a local re-emergence of indigenous TSWV populations following F. occidentalis introductions, while it could not be excluded that the ancestors of two other OW clades were introduced from North America contemporarily with F. occidentalis. Finally, estimation of the selection intensity that has affected the evolution of the NSs and nucleocapsid proteins encoded by RNA S of TSWV suggests that the former could be involved in the breakdown of resistance conferred by the Tsw gene in pepper.

  13. Ultrafast terahertz spectroscopy study of Kondo insulating thin film SmB6: evidence for an emergent surface state

    NASA Astrophysics Data System (ADS)

    Zhang, Jingdi; Yong, Jie; Takeuchi, Ichiro; Greene, Richard; Averitt, Richard

    We utilize terahertz time domain spectroscopy to investigate thin films of the heavy fermion compound SmB6, a prototype Kondo insulator. Temperature dependent terahertz (THz) conductivity measurements reveal a rapid decrease in the Drude weight and carrier scattering rate at ~T* =20 K, well below the hybridization gap onset temperature (100 K). Moreover, a low-temperature conductivity plateau (below 20K) indicates the emergence of a surface state with an effective electron mass of 0.1me. Conductivity dynamics following optical excitation are also measured and interpreted using Rothwarf-Taylor (R-T) phenomenology, yielding a hybridization gap energy of 17 meV. However, R-T modeling of the conductivity dynamics reveals a deviation from the expected thermally excited quasiparticle density at temperatures below 20K, indicative of another channel opening up in the low energy electrodynamics. Taken together, these results suggest the onset of a surface state well below the crossover temperature (100K) after long-range coherence of the f-electron Kondo lattice is established. JZ and RDA acknowledge support from DOE - Basic Energy Sciences under Grant No. DE-FG02-09ER46643, under which the THz measurements and data analysis were performed. JY, IT and RLG acknowledge support from ONR N00014-13-1-0635 and NSF DMR 1410665.

  14. Category-specificity can emerge from bottom-up visual characteristics: evidence from a modular neural network.

    PubMed

    Gale, Tim M; Laws, Keith R

    2006-08-01

    The role of bottom-up visual processes in category-specific object recognition has been largely unexplored. We examined the role of low-level visual characteristics in category specific recognition using a modular neural network comprising both unsupervised and supervised components. One hundred standardised pictures from ten different categories (five living and five nonliving, including body parts and musical instruments) were presented to a Kohonen self-organising map (SOM) which re-represents the visual stimuli by clustering them within a smaller number of dimensions. The SOM representations were then used to train an attractor network to learn the superordinate category of each item. The ease with which the model acquired the category mappings was investigated with respect to emerging category effects. We found that the superordinates could be separated by very low-level visual factors (as extracted by the SOM). The model also accounted for the well documented atypicality of body parts and musical instrument superordinates. The model has clear relevance to human object recognition since the model was quicker to learn more typical category exemplars and finally the model also accounted for more than 20% of the naming variance in a sample of 57 brain injured subjects. We conclude that purely bottom-up visual characteristics can explain some important features of category-specific phenomena. PMID:16540223

  15. Evolution and structure of Tomato spotted wilt virus populations: evidence of extensive reassortment and insights into emergence processes.

    PubMed

    Tentchev, Diana; Verdin, Eric; Marchal, Cécile; Jacquet, Monique; Aguilar, Juan M; Moury, Benoît

    2011-04-01

    Tomato spotted wilt virus (TSWV; genus Tospovirus, family Bunyaviridae) genetic diversity was evaluated by sequencing parts of the three RNA genome segments of 224 isolates, mostly from pepper and tomato crops in southern Europe. Eighty-three per cent of the isolates showed consistent clustering into three clades, corresponding to their geographical origin, Spain, France or the USA, for the three RNA segments. In contrast, the remaining 17% of isolates did not belong to the same clade for the three RNA segments and were shown to be reassortants. Among them, eight different reassortment patterns were observed. Further phylogenetic analyses provided insights into the dynamic processes of the worldwide resurgence of TSWV that, since the 1980s, has followed the worldwide dispersal of the western flower thrips (Frankliniella occidentalis) tospovirus vector. For two clades composed essentially of Old World (OW) isolates, tree topology suggested a local re-emergence of indigenous TSWV populations following F. occidentalis introductions, while it could not be excluded that the ancestors of two other OW clades were introduced from North America contemporarily with F. occidentalis. Finally, estimation of the selection intensity that has affected the evolution of the NSs and nucleocapsid proteins encoded by RNA S of TSWV suggests that the former could be involved in the breakdown of resistance conferred by the Tsw gene in pepper. PMID:21169211

  16. The Emergence of a Phoneme-Sized Unit in L2 Speech Production: Evidence from Japanese–English Bilinguals

    PubMed Central

    Nakayama, Mariko; Kinoshita, Sachiko; Verdonschot, Rinus G.

    2016-01-01

    Recent research has revealed that the way phonology is constructed during word production differs across languages. Dutch and English native speakers are suggested to incrementally insert phonemes into a metrical frame, whereas Mandarin Chinese speakers use syllables and Japanese speakers use a unit called the mora (often a CV cluster such as “ka” or “ki”). The present study is concerned with the question how bilinguals construct phonology in their L2 when the phonological unit size differs from the unit in their L1. Japanese–English bilinguals of varying proficiency read aloud English words preceded by masked primes that overlapped in just the onset (e.g., bark-BENCH) or the onset plus vowel corresponding to the mora-sized unit (e.g., bell-BENCH). Low-proficient Japanese–English bilinguals showed CV priming but did not show onset priming, indicating that they use their L1 phonological unit when reading L2 English words. In contrast, high-proficient Japanese–English bilinguals showed significant onset priming. The size of the onset priming effect was correlated with the length of time spent in English-speaking countries, which suggests that extensive exposure to L2 phonology may play a key role in the emergence of a language-specific phonological unit in L2 word production. PMID:26941669

  17. Electric transport of a single-crystal iron chalcogenide FeSe superconductor: Evidence of symmetry-breakdown nematicity and additional ultrafast Dirac cone-like carriers

    NASA Astrophysics Data System (ADS)

    Huynh, K. K.; Tanabe, Y.; Urata, T.; Oguro, H.; Heguri, S.; Watanabe, K.; Tanigaki, K.

    2014-10-01

    An SDW antiferromagnetic (SDW-AF) low-temperature phase transition is generally observed and the AF spin fluctuations are considered to play an important role for the superconductivity pairing mechanism in FeAs superconductors. However, a similar magnetic phase transition is not observed in FeSe superconductors, which has caused considerable discussion. We report on the intrinsic electronic states of FeSe as elucidated by electric transport measurements under magnetic fields using a high quality single crystal. A mobility spectrum analysis, an ab initio method that does not make assumptions on the transport parameters in a multicarrier system, provides very important and clear evidence that another hidden order, most likely the symmetry broken from the tetragonal C4 symmetry to the C2 symmetry nematicity associated with the selective d -orbital splitting, exists in the case of superconducting FeSe other than the AF magnetic order spin fluctuations. The intrinsic low-temperature phase in FeSe is in the almost compensated semimetallic states but is additionally accompanied by Dirac cone-like ultrafast electrons ˜104cm2(VS) -1 as minority carriers.

  18. Characteristics and fate of the spermatozoa of Inachus phalangium (Decapoda, Majidae): description of novel sperm structures and evidence for an additional mechanism of sperm competition in Brachyura.

    PubMed

    Rorandelli, Rocco; Paoli, Francesco; Cannicci, Stefano; Mercati, David; Giusti, Fabiola

    2008-03-01

    Various aspects of the reproductive anatomy of the spider crab Inachus phalangium are investigated utilizing light and electron microscopy. Spermatozoal ultrastructure reveals the presence of a glycocalyx in the peripheral region of the periopercular rim, never recorded before in crustacean sperm cells. Sperm cell morphological traits such as semi-lunar acrosome shape, centrally perforate and flat operculum, and absence of a thickened ring, are shared only with Macropodia longirostris, confirming a close phylogenetic relationship of these species and their separation from the other members of the family Majidae. Spermatozoa are transferred to females inside spermatophores of different sizes, but during ejaculate transfer, larger spermatophores might be ruptured by tooth-like structures present on the ejaculatory canal of the male first gonopod, releasing free sperm cells. Such a mechanism could represent the first evidence of a second form of sperm competition in conflict with sperm displacement, the only mechanism of sperm competition known among Brachyura, enabling paternity for both dominant and smaller, non-dominant, males. In addition, we propose several hypotheses concerning the remote and proximal causes of the existence of large seminal receptacles in females of I. phalangium. Among these, genetically diverse progeny, reduction of sexual harassment and phylogenetic retention seem the most plausible, while acquisition of nutrients from seminal fluids, demonstrated in other arthropods, and suggested by previous studies, could be discarded on the basis of the presented data.

  19. Evidence for Emergence of Sex-Determining Gene(s) in a Centromeric Region in Vasconcellea parviflora

    PubMed Central

    Iovene, Marina; Yu, Qingyi; Ming, Ray; Jiang, Jiming

    2015-01-01

    Sex chromosomes have been studied in many plant and animal species. However, few species are suitable as models to study the evolutionary histories of sex chromosomes. We previously demonstrated that papaya (Carica papaya) (2n = 2x = 18), a fruit tree in the family Caricaceae, contains recently emerged but cytologically heteromorphic X/Y chromosomes. We have been intrigued by the possible presence and evolution of sex chromosomes in other dioecious Caricaceae species. We selected a set of 22 bacterial artificial chromosome (BAC) clones that are distributed along the papaya X/Y chromosomes. These BACs were mapped to the meiotic pachytene chromosomes of Vasconcellea parviflora (2n = 2x = 18), a species that diverged from papaya ∼27 million years ago. We demonstrate that V. parviflora contains a pair of heteromorphic X/Y chromosomes that are homologous to the papaya X/Y chromosomes. The comparative mapping results revealed that the male-specific regions of the Y chromosomes (MSYs) probably initiated near the centromere of the Y chromosomes in both species. The two MSYs, however, shared only a small chromosomal domain near the centromere in otherwise rearranged chromosomes. The V. parviflora MSY expanded toward the short arm of the chromosome, whereas the papaya MSY expanded in the opposite direction. Most BACs mapped to papaya MSY were not located in V. parviflora MSY, revealing different DNA compositions in the two MSYs. These results suggest that mutation of gene(s) in the centromeric region may have triggered sex chromosome evolution in these plant species. PMID:25480779

  20. Cardiovascular risk and subclinical hypothyroidism: focus on lipids and new emerging risk factors. What is the evidence?

    PubMed

    Duntas, Leonidas H; Wartofsky, Leonard

    2007-11-01

    Controversy remains as to the risk of cardiovascular disease (CVD) associated with subclinical hypothyroidism (SCH), defined as an increased serum thyrotropin (TSH) concentration with normal free thyroxine and triiodothyronine levels. Substantial evidence indicates altered cholesterol and lipoprotein metabolism in SCH when serum TSH is above 10 mU/L. Observed abnormalities include elevated plasma levels of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C); the altered TC/high-density lipoprotein-cholesterol (HDL-C) and LDL-C/HDL-C ratios suggest a potential accelerated risk for CVD. The influence of SCH on lipids is directly proportional to the degree of TSH elevation and becomes more significant with the progression from SCH to overt disease, thereby accelerating any propensity to atherosclerosis. Although many clinicians may tend to ignore SCH with TSH levels <10, it is apparent that an enhanced CV risk could apply to these individuals, perhaps compounded by insulin resistance and amplified by the copresence of other risk factors such as endothelial dysfunction and elevated C-reactive protein.

  1. Emergence of mammalian species-infectious and -pathogenic avian influenza H6N5 virus with no evidence of adaptation.

    PubMed

    Nam, Jeong-Hyun; Kim, Eun-Ha; Song, Daesub; Choi, Young Ki; Kim, Jeong-Ki; Poo, Haryoung

    2011-12-01

    The migratory waterfowl of the world are considered to be the natural reservoir of influenza A viruses. Of the 16 hemagglutinin subtypes of avian influenza viruses, the H6 subtype is commonly perpetuated in its natural hosts and is of concern due to its potential to be a precursor of highly pathogenic influenza viruses by reassortment. During routine influenza surveillance, we isolated an unconventional H6N5 subtype of avian influenza virus. Experimental infection of mice revealed that this isolate replicated efficiently in the lungs, subsequently spread systemically, and caused lethality. The isolate also productively infected ferrets, with direct evidence of contact transmission, but no disease or transmission was seen in pigs. Although the isolate possessed the conserved receptor-binding site sequences of avian influenza viruses, it exhibited relatively low replication efficiencies in ducks and chickens. Our genetic and molecular analyses of the isolate revealed that its PB1 sequence showed the highest evolutionary relationship to those of highly pathogenic H5N1 avian influenza viruses and that its PA protein had an isoleucine residue at position 97 (a representative virulence marker). Further studies will be required to examine why our isolate has the virologic characteristics of mammalian influenza viruses but the archetypal receptor binding profiles of avian influenza viruses, as well as to determine whether its potential virulence markers (PB1 analogous to those of H5N1 viruses or isoleucine residue at position 97 within PA) could render it highly pathogenic in mice. PMID:21994462

  2. Evidence of genetic drift and reassortment in infectious bursal disease virus and emergence of outbreaks in poultry farms in India.

    PubMed

    Patel, Amrutlal K; Pandey, Vinod C; Pal, Joy K

    2016-06-01

    Recurrent outbreaks of infectious bursal disease (IBD) have become a burning problem to the poultry industry worldwide. Here, we performed genetic analysis of IBD virus (IBDV) field isolates from recent outbreaks in various poultry farms in India. The sequence analysis of IBDV VP2 hypervariable region revealed amino acid pattern similar to that of very virulent (222A, 242I, 253Q, 256I, 272I, 279D, 284A, 294I, 299S and 330S) and intermediate plus virulent (222A, 242I, 253Q, 256I, 272T, 279N, 284A, 294I, 299S and 330S) type whereas analysis of VP1 revealed presence of sequence similar to that of very virulent (61I, 145T) and unique (61I, 141I, 143D, 145S) type in field isolates. Among the eight field isolates, two isolates contained very virulent type VP2 and unique type VP1, three contained intermediate plus virulent type VP2 and unique type VP1 whereas five contained both VP2 and VP1 of very virulent type. The phylogenetic analysis based on VP2 nucleotide sequence showed clustering of all eight isolates close to known very virulent strains whereas based on VP1, five isolates formed unique cluster and three isolates were placed close to very virulent strains. The isolates forming unique VP1 cluster showed highest similarity with classical virulent IBDVs suggesting their possible evolution from segment B of non-very virulent IBDVs. Interestingly, these five isolates were responsible for outbreaks in four different farms located at three different geographic locations in India. These observations indicates genetic reassortment between segment A and segment B from co-infecting IBDV strains leading to emergence of very virulent strains and their widespread prevalence in Indian poultry farms. The presence of 272I and 279D in VP2 protein of five field isolates may explain possible cause of Gumboro intermediate plus vaccine failure in prevention of the outbreaks. However, mortality caused by other three strains which are antigenically similar to VP1 of intermediate plus

  3. A scoping review of the evidence for public health risks of three emerging potentially zoonotic viruses: hepatitis E virus, norovirus, and rotavirus.

    PubMed

    Wilhelm, Barbara; Waddell, Lisa; Greig, Judy; Rajić, Andrijana; Houde, Alain; McEwen, Scott A

    2015-04-01

    Emerging zoonoses are defined as those newly recognized, or increasing in incidence or geographic range. Hepatitis E virus (HEV), norovirus (NoV), and rotavirus (RV), while well known to be transmitted person-person, have also been hypothesized to be emerging zoonoses. Our objective was to investigate their potential public health risks from animal reservoirs. Given the diversity of evidence sources, a scoping review incorporating a mixed methods synthesis approach was used. A broad search was conducted in five electronic databases. Each citation was appraised independently by two reviewers using screening tools designed and tested a priori. Level 1 relevance screening excluded irrelevant citations; level 2 confirmed relevance and categorized. At level 3 screening, data were extracted to support a risk profile. A stakeholder group provided input on study tools and knowledge translation and transfer. Level 1 screening captured 2471 citations, with 1270 advancing to level 2 screening, and 1094 to level 3. We defined criteria for case attribution to zoonosis for each virus. Using these criteria, we identified a small number of zoonotic cases (HEV n=3, NoV=0, RV=40 (zoonoses=3; human-animal re-assortants=37)) categorized as 'likely'. The available evidence suggests the following potential HEV human exposure sources: swine, other domestic animals, wildlife, surface waters, and asymptomatic human shedders. Possible at-risk groups include the immunocompromised and the elderly. Reports of NoV intergenogroup recombinants suggest potential for human-animal recombination. Greatest public health impact for RV zoonoses may be the potential effect of human-animal reassortants on vaccination efficacy. PMID:25681862

  4. Surveillance of endemic foci of tick-borne encephalitis in Finland 1995-2013: evidence of emergence of new foci.

    PubMed

    Tonteri, Elina; Kurkela, Satu; Timonen, Suvi; Manni, Tytti; Vuorinen, Tytti; Kuusi, Markku; Vapalahti, Olli

    2015-01-01

    The geographical risk areas for tick-borne encephalitis (TBE) in Finland remained the same until the beginning of the 21st century, but a considerable geographical expansion has been observed in the past 10 years. In order to support public health measures, the present study describes the number of laboratory-confirmed TBE cases and laboratory tests conducted and the associated trends by hospital district, with a particular emphasis on the suspected geographical risk areas. An additional investigation was conducted on 1,957 clinical serum samples throughout the country taken from patients with neurological symptoms to screen for undiagnosed TBE cases. This study identified new TBE foci in Finland, reflecting the spread of the disease into new areas. Even in the most endemic municipalities, transmission of TBE to humans occurred in very specific and often small foci. The number of antibody tests for TBE virus more than doubled (an increase by 105%) between 2007 and 2013. Analysis of the number of tests also revealed areas in which the awareness of clinicians may be suboptimal at present. However, it appears that underdiagnosis of neuroinvasive TBE is not common.

  5. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    PubMed Central

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  6. Hypertensive emergencies.

    PubMed

    Feitosa-Filho, Gilson Soares; Lopes, Renato Delascio; Poppi, Nilson Tavares; Guimarães, Hélio Penna

    2008-09-01

    Emergencies and hypertensive crises are clinical situations which may represent more than 25% of all medical emergency care. Considering such high prevalence, physicians should be prepared to correctly identify these crises and differentiate between urgent and emergent hypertension. Approximately 3% of all visits to emergency rooms are due to significant elevation of blood pressure. Across the spectrum of blood systemic arterial pressure, hypertensive emergency is the most critical clinical situation, thus requiring special attention and care. Such patients present with high blood pressure and signs of acute specific target organ damage (such as acute myocardial infarction, unstable angina, acute pulmonary edema, eclampsia, and stroke). Key elements of diagnosis and specific treatment for the different presentations of hypertensive emergency will be reviewed in this article. The MedLine and PubMed databases were searched for pertinent abstracts, using the key words "hypertensive crises" and "hypertensive emergencies". Additional references were obtained from review articles. Available English language clinical trials, retrospective studies and review articles were identified, reviewed and summarized in a simple and practical way. The hypertensive crisis is a clinical situation characterized by acute elevation of blood pressure followed by clinical signs and symptoms. These signs and symptoms may be mild (headache, dizziness, tinnitus) or severe (dyspnea, chest pain, coma or death). If the patient presents with mild symptoms, but without acute specific target organ damage, diagnosis is hypertensive urgency. However, if severe signs and symptoms and acute specific target organ damage are present, then the patient is experiencing a hypertensive emergency. Some patients arrive at the emergency rooms with high blood pressure, but without any other sign or symptom. In these cases, they usually are not taking their medications correctly. Therefore, this is not a

  7. Lung Emergencies

    MedlinePlus

    ... Emergencies Cardiac Emergencies Eye Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at ... should be considered an emergency. Symptoms of sudden lung collapse (pneumothorax) Symptoms of a sudden lung collapse ...

  8. Evidence that a late-emerging population of trunk neural crest cells forms the plastron bones in the turtle Trachemys scripta.

    PubMed

    Cebra-Thomas, Judith A; Betters, Erin; Yin, Melinda; Plafkin, Callie; McDow, Kendra; Gilbert, Scott F

    2007-01-01

    The origin of the turtle plastron is not known, but these nine bones have been homologized to the exoskeletal components of the clavicles, the interclavicular bone, and gastralia. Earlier evidence from our laboratory showed that the bone-forming cells of the plastron were positive for HNK-1 and PDGFRalpha, two markers of the skeletogenic neural crest. This study looks at the embryonic origin of these plastron-forming cells. We show that the HNK-1+ cells are also positive for p75 and FoxD3, confirming their neural crest identity, and that they originate from the dorsal neural tube of stage 17 turtle embryos, several days after the original wave of neural crest cells have migrated and differentiated. DiI studies show that these are migratory cells, and they can be observed in the lateral regions of the embryo and can be seen forming intramembranous bone in the ventral (plastron) regions. Before migrating ventrally, these late-emerging neural crest cells reside for over a week in a carapacial staging area above the neural tube and vertebrae. It is speculated that this staging area is where they lose the inability to form skeletal cells. PMID:17501750

  9. Recent advances in emergency life support.

    PubMed

    Dries, David J; Sample, Mary Anne

    2002-03-01

    With additional international input, recent changes in emergency life support are reflected in updated guidelines for Advanced Cardiac Life Support (ACLS) from the American Heart Association and new technology in the arena of vascular access and emergency airway management. These changes will expand nurses' ability to provide advanced levels of care, even in the prehospital situation, and represent a more rigorous evidence-based approach than ever before. As early morbidity and mortality in emergency situations are frequently associated with complications associated with airway management and vascular access, recent development in these areas are reviewed along with evolution in ACLS guidelines. PMID:11818257

  10. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery

    PubMed Central

    2011-01-01

    Background There is no consensus on diagnosis and management of ASBO. Initial conservative management is usually safe, however proper timing for discontinuing non operative treatment is still controversial. Open surgery or laparoscopy are used without standardized indications. Methods A panel of 13 international experts with interest and background in ASBO and peritoneal diseases, participated in a consensus conference during the 1st International Congress of the World Society of Emergency Surgery and 9th Peritoneum and Surgery Society meeting, in Bologna, July 1-3, 2010, for developing evidence-based recommendations for diagnosis and management of ASBO. Whenever was a lack of high-level evidence, the working group formulated guidelines by obtaining consensus. Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT scan signs (free fluid, mesenteric oedema, small bowel faeces sign, devascularized bowel) patients with partial ASBO can be managed safely with NOM and tube decompression (either with long or NG) should be attempted. These patients are good candidates for Water Soluble Contrast Medium (WSCM) with both diagnostic and therapeutic purposes. The appearance of water-soluble contrast in the colon on X-ray within 24 hours from administration predicts resolution. WSCM may be administered either orally or via NGT (50-150 ml) both immediately at admission or after an initial attempt of conservative treatment of 48 hours. The use of WSCM for ASBO is safe and reduces need for surgery, time to resolution and hospital stay. NOM, in absence of signs of strangulation or peritonitis, can be prolonged up to 72 hours. After 72 hours of NOM without resolution surgery is recommended. Patients treated non-operatively have shorter hospital stay, but higher recurrence rate and shorter time to re-admission, although the risk of new surgically treated episodes of ASBO is unchanged. Risk factors for recurrences are age <40 years and

  11. Emerging evidence of signalling roles for PI(3,4)P2 in Class I and II PI3K-regulated pathways.

    PubMed

    Hawkins, Phillip T; Stephens, Len R

    2016-02-01

    There are eight members of the phosphoinositide family of phospholipids in eukaryotes; PI, PI3P, PI4P, PI5P, PI(4,5)P2, PI(3,4)P2, PI(3,5)P2 and PI(3,4,5)P3. Receptor activation of Class I PI3Ks stimulates the phosphorylation of PI(4,5)P2 to form PI(3,4,5)P3. PI(3,4,5)P3 is an important messenger molecule that is part of a complex signalling network controlling cell growth and division. PI(3,4,5)P3 can be dephosphorylated by both 3- and 5-phosphatases, producing PI(4,5)P2 and PI(3,4)P2, respectively. There is now strong evidence that PI(3,4)P2 generated by this route does not merely represent another pathway for removal of PI(3,4,5)P3, but can act as a signalling molecule in its own right, regulating macropinocytosis, fast endophilin-mediated endocytosis (FEME), membrane ruffling, lamellipodia and invadopodia. PI(3,4)P2 can also be synthesized directly from PI4P by Class II PI3Ks and this is important for the maturation of clathrin-coated pits [clathrin-mediated endocytosis (CME)] and signalling in early endosomes. Thus PI(3,4)P2 is emerging as an important signalling molecule involved in the coordination of several specific membrane and cytoskeletal responses. Further, its inappropriate accumulation contributes to pathology caused by mutations in genes encoding enzymes responsible for its degradation, e.g. Inpp4B.

  12. Inhibition of bromodomain and extra-terminal proteins (BET) as a potential therapeutic approach in haematological malignancies: emerging preclinical and clinical evidence

    PubMed Central

    Chaidos, Aristeidis; Caputo, Valentina

    2015-01-01

    Post-translational modifications of the nucleosomal histone proteins orchestrate chromatin organization and gene expression in normal and cancer cells. Among them, the acetylation of N-terminal histone tails represents the fundamental epigenetic mark of open structure chromatin and active gene transcription. The bromodomain and extra-terminal (BET) proteins are epigenetic readers which utilize tandem bromodomains (BRD) modules to recognize and dock themselves on the acetylated lysine tails. The BET proteins act as scaffolds for the recruitment of transcription factors and chromatin organizers required in transcription initiation and elongation. The recent discovery of small molecules capable of blocking their lysine-binding pocket is the first paradigm of successful pharmacological inhibition of epigenetic readers. JQ1 is a prototype benzodiazepine molecule and a specific BET inhibitor with antineoplastic activity both in solid tumours and haematological malignancies. The quinolone I-BET151 and the suitable for clinical development I-BET762 benzodiazepine were introduced in parallel with JQ1 and have also shown potent antitumour activity in preclinical studies. I-BET762 is currently being tested in early phase clinical trials, along with a rapidly growing list of other BET inhibitors. Unlike older epigenetic therapies, the study of BET inhibitors has offered substantial, context-specific, mechanistic insights of their antitumour activity, which will facilitate optimal therapeutic targeting in future. Here, we review the development of this novel class of epigenetic drugs, the biology of BET protein inhibition, the emerging evidence from preclinical work and early phase clinical studies and we discuss their potential role in the treatment of haematological malignancies. PMID:26137204

  13. Coupling between stress coping style and time of emergence from spawning nests in salmonid fishes: evidence from selected rainbow trout strains (Oncorhynchus mykiss).

    PubMed

    Andersson, Madelene Åberg; Khan, Uniza Wahid; Overli, Oyvind; Gjøen, Hans Magnus; Höglund, Erik

    2013-05-27

    Correlations between behavioral and physiological traits, often referred to as stress coping styles, have been demonstrated in numerous animal groups. Such trait variations often cluster in two contrasting styles, with animals characterized as either proactive or reactive. In natural populations of salmonid fishes, emergence from spawning nests, when fry establish a territory and shifts from exogenous to endogenous feeding, is a crucial niche shift with a high selection pressure. The timing of this event is correlated to behavioral and physiological traits such as aggression, boldness/shyness, dominance, and metabolic rate; resembling those of proactive and reactive stress coping styles. In farmed fish populations, however the relation between emergence and stress coping styles seems to be absent, an effect which has been related to lack of selection pressure during emergence. In the present study two rainbow trout strains genetically selected as LR (low-responsive) and HR (high-responsive) trout, characterized with proactive (LR) and reactive (HR) stress coping traits, was used to further investigate the relationship between the time of emergence and stress coping style in salmonid fishes. For this task LR and HR larvae were hatched in mixed batches, and thirty individuals from the earliest and latest 25% of emerging larvae were randomly collected. Thereafter, a line specific genetic marker was used to distinguish the proportion of LR and HR occurring in early and late fractions. The result demonstrates a higher proportion of LR fry in the early fraction in comparison to the HR fry, which emerged at a higher proportion during the late period. Early emerging individuals had larger yolk reserves at emergence, lending further support to a relationship between emergence times, yolk reserves at emergence and stress coping styles in salmonids. Smaller larval bodies in early compared to late emerging individuals suggest that this difference in yolk size reflects

  14. Evidence-Based Design for Project-Based Learning: A Case Study for a 50,000 SF Addition Dedicated to the New Tech Curriculum

    ERIC Educational Resources Information Center

    Moretti, Richard D.; Conte, Philip R.

    2012-01-01

    The Seaford School District, Seaford, Delaware, determined that a component of their "reinvention" of Seaford High School would be the creation of a New Tech Academy, affiliated with the New Tech Network and housed in an addition to that building. The New Tech Network, headquartered in Napa, California, is a rapidly growing association of New Tech…

  15. Acute toxicity of binary-metal mixtures of copper, zinc, and nickel to Pimephales promelas: Evidence of more-than-additive effect.

    PubMed

    Lynch, Natalie R; Hoang, Tham C; O'Brien, Timothy E

    2016-02-01

    Metal mixture toxicity has been studied for decades. However, the results are not consistent, and thus ecological risk assessment and regulation of mixtures has been difficult. The objective of the present study was to use a systematic experimental design to characterize the toxicity of binary-metal mixture of Cu, Zn, and Ni to Pimephales promelas, typically to determine whether the effect of these binary-metal mixtures on P. promelas is more-than-additive. Standard 96-h toxicity tests were conducted with larval P. promelas based on US Environmental and Protection Agency methods to determine metal mixture effects. All experiments were conducted in synthetic moderately hard water with no addition of dissolved organic matter. Three different effect analysis approaches, the MixTox model, the Finney model, and the toxic unit method, were used for comparison. The results indicate that the toxicity of Cu+Zn, Cu+Ni, and Zn+Ni mixtures to P. promelas was more-than-additive. Among the 3 mixtures, the effect of the Cu+Ni mixture was the most profound. The results of the present study are useful for applications to models such as the metal mixture biotic ligand model. More research should be conducted to determine the mechanisms of acute and chronic toxicity of metal mixtures.

  16. Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods.

    PubMed

    Comerford, Kevin B; Pasin, Gonca

    2016-07-23

    Observational studies provide evidence that a higher intake of protein from plant-based foods and certain animal-based foods is associated with a lower risk for type 2 diabetes. However, there are few distinguishable differences between the glucoregulatory qualities of the proteins in plant-based foods, and it is likely their numerous non-protein components (e.g., fibers and phytochemicals) that drive the relationship with type 2 diabetes risk reduction. Conversely, the glucoregulatory qualities of the proteins in animal-based foods are extremely divergent, with a higher intake of certain animal-based protein foods showing negative effects, and others showing neutral or positive effects on type 2 diabetes risk. Among the various types of animal-based protein foods, a higher intake of dairy products (such as milk, yogurt, cheese and whey protein) consistently shows a beneficial relationship with glucose regulation and/or type 2 diabetes risk reduction. Intervention studies provide evidence that dairy proteins have more potent effects on insulin and incretin secretion compared to other commonly consumed animal proteins. In addition to their protein components, such as insulinogenic amino acids and bioactive peptides, dairy products also contain a food matrix rich in calcium, magnesium, potassium, trans-palmitoleic fatty acids, and low-glycemic index sugars-all of which have been shown to have beneficial effects on aspects of glucose control, insulin secretion, insulin sensitivity and/or type 2 diabetes risk. Furthermore, fermentation and fortification of dairy products with probiotics and vitamin D may improve a dairy product's glucoregulatory effects.

  17. Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods.

    PubMed

    Comerford, Kevin B; Pasin, Gonca

    2016-01-01

    Observational studies provide evidence that a higher intake of protein from plant-based foods and certain animal-based foods is associated with a lower risk for type 2 diabetes. However, there are few distinguishable differences between the glucoregulatory qualities of the proteins in plant-based foods, and it is likely their numerous non-protein components (e.g., fibers and phytochemicals) that drive the relationship with type 2 diabetes risk reduction. Conversely, the glucoregulatory qualities of the proteins in animal-based foods are extremely divergent, with a higher intake of certain animal-based protein foods showing negative effects, and others showing neutral or positive effects on type 2 diabetes risk. Among the various types of animal-based protein foods, a higher intake of dairy products (such as milk, yogurt, cheese and whey protein) consistently shows a beneficial relationship with glucose regulation and/or type 2 diabetes risk reduction. Intervention studies provide evidence that dairy proteins have more potent effects on insulin and incretin secretion compared to other commonly consumed animal proteins. In addition to their protein components, such as insulinogenic amino acids and bioactive peptides, dairy products also contain a food matrix rich in calcium, magnesium, potassium, trans-palmitoleic fatty acids, and low-glycemic index sugars-all of which have been shown to have beneficial effects on aspects of glucose control, insulin secretion, insulin sensitivity and/or type 2 diabetes risk. Furthermore, fermentation and fortification of dairy products with probiotics and vitamin D may improve a dairy product's glucoregulatory effects. PMID:27455320

  18. Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods

    PubMed Central

    Comerford, Kevin B.; Pasin, Gonca

    2016-01-01

    Observational studies provide evidence that a higher intake of protein from plant-based foods and certain animal-based foods is associated with a lower risk for type 2 diabetes (T2DM). However, there are few distinguishable differences between the glucoregulatory qualities of the proteins in plant-based foods, and it is likely their numerous non-protein components (e.g., fibers and phytochemicals) that drive the relationship with T2DM risk reduction. Conversely, the glucoregulatory qualities of the proteins in animal-based foods are extremely divergent, with a higher intake of certain animal-based protein foods showing negative effects, and others showing neutral or positive effects on T2DM risk. Among the various types of animal-based protein foods, a higher intake of dairy products (such as milk, yogurt, cheese and whey protein) consistently shows a beneficial relationship with glucose regulation and/or T2DM risk reduction. Intervention studies provide evidence that dairy proteins have more potent effects on insulin and incretin secretion compared to other commonly consumed animal proteins. In addition to their protein components, such as insulinogenic amino acids and bioactive peptides, dairy products also contain a food matrix rich in calcium, magnesium, potassium, trans-palmitoleic fatty acids, and low-glycemic index sugars—all of which have been shown to have beneficial effects on aspects of glucose control, insulin secretion, insulin sensitivity and/or T2DM risk. Furthermore, fermentation and fortification of dairy products with probiotics and vitamin D may improve a dairy product’s glucoregulatory effects. PMID:27455320

  19. Food additives

    PubMed Central

    Spencer, Michael

    1974-01-01

    Food additives are discussed from the food technology point of view. The reasons for their use are summarized: (1) to protect food from chemical and microbiological attack; (2) to even out seasonal supplies; (3) to improve their eating quality; (4) to improve their nutritional value. The various types of food additives are considered, e.g. colours, flavours, emulsifiers, bread and flour additives, preservatives, and nutritional additives. The paper concludes with consideration of those circumstances in which the use of additives is (a) justified and (b) unjustified. PMID:4467857

  20. Alpha-Particle-Induced Complex Chromosome Exchanges Transmitted through Extra-Thymic Lymphopoiesis In Vitro Show Evidence of Emerging Genomic Instability.

    PubMed

    Sumption, Natalia; Goodhead, Dudley T; Anderson, Rhona M

    2015-01-01

    Human exposure to high-linear energy transfer α-particles includes environmental (e.g. radon gas and its decay progeny), medical (e.g. radiopharmaceuticals) and occupational (nuclear industry) sources. The associated health risks of α-particle exposure for lung cancer are well documented however the risk estimates for leukaemia remain uncertain. To further our understanding of α-particle effects in target cells for leukaemogenesis and also to seek general markers of individual exposure to α-particles, this study assessed the transmission of chromosomal damage initially-induced in human haemopoietic stem and progenitor cells after exposure to high-LET α-particles. Cells surviving exposure were differentiated into mature T-cells by extra-thymic T-cell differentiation in vitro. Multiplex fluorescence in situ hybridisation (M-FISH) analysis of naïve T-cell populations showed the occurrence of stable (clonal) complex chromosome aberrations consistent with those that are characteristically induced in spherical cells by the traversal of a single α-particle track. Additionally, complex chromosome exchanges were observed in the progeny of irradiated mature T-cell populations. In addition to this, newly arising de novo chromosome aberrations were detected in cells which possessed clonal markers of α-particle exposure and also in cells which did not show any evidence of previous exposure, suggesting ongoing genomic instability in these populations. Our findings support the usefulness and reliability of employing complex chromosome exchanges as indicators of past or ongoing exposure to high-LET radiation and demonstrate the potential applicability to evaluate health risks associated with α-particle exposure.

  1. Alpha-Particle-Induced Complex Chromosome Exchanges Transmitted through Extra-Thymic Lymphopoiesis In Vitro Show Evidence of Emerging Genomic Instability

    PubMed Central

    Sumption, Natalia; Goodhead, Dudley T.; Anderson, Rhona M.

    2015-01-01

    Human exposure to high-linear energy transfer α-particles includes environmental (e.g. radon gas and its decay progeny), medical (e.g. radiopharmaceuticals) and occupational (nuclear industry) sources. The associated health risks of α-particle exposure for lung cancer are well documented however the risk estimates for leukaemia remain uncertain. To further our understanding of α-particle effects in target cells for leukaemogenesis and also to seek general markers of individual exposure to α-particles, this study assessed the transmission of chromosomal damage initially-induced in human haemopoietic stem and progenitor cells after exposure to high-LET α-particles. Cells surviving exposure were differentiated into mature T-cells by extra-thymic T-cell differentiation in vitro. Multiplex fluorescence in situ hybridisation (M-FISH) analysis of naïve T-cell populations showed the occurrence of stable (clonal) complex chromosome aberrations consistent with those that are characteristically induced in spherical cells by the traversal of a single α-particle track. Additionally, complex chromosome exchanges were observed in the progeny of irradiated mature T-cell populations. In addition to this, newly arising de novo chromosome aberrations were detected in cells which possessed clonal markers of α-particle exposure and also in cells which did not show any evidence of previous exposure, suggesting ongoing genomic instability in these populations. Our findings support the usefulness and reliability of employing complex chromosome exchanges as indicators of past or ongoing exposure to high-LET radiation and demonstrate the potential applicability to evaluate health risks associated with α-particle exposure. PMID:26252014

  2. Sub-meter desiccation crack patterns imaged by Curiosity at Gale Crater on Mars shed additional light on former lakes evident from examined outcrops

    NASA Astrophysics Data System (ADS)

    Hallet, B.; Sletten, R. S.; Mangold, N.; Oehler, D. Z.; Williams, R. M. E.; Bish, D. L.; Heydari, E.; Rubin, D. M.; Rowland, S. K.

    2015-12-01

    Small-scale desiccation crack patterns (mudcrack-like arrays of uniform ~0.1 to 1 m polygonal domains separated by linear or curving cracks in exposed bedding) imaged by Curiosity in Gale Crater, Mars complement a wealth of diverse data obtained from exposures of sedimentary rocks that point to deposition "in fluvial, deltaic, and lacustrine environments" including an "intracrater lake system likely [to have] existed intermittently for thousands to millions of years …"(e.g. Grotzinger et al., 2015, Science, submitted). We interpret these mudcrack-like patterns, found on many of the bedrock exposures imaged by Curiosity, as desiccation cracks that developed either of two ways: 1) at the soft sediment-air interface like common mudcracks, or 2) at or below the sediment-water interface by synaeresis or diastasis (involving differential compaction). In the context of recent studies of terrestrial mudcracks, and cracks formed experimentally in various wet powders as they loose moisture, these desiccation features reflect diverse aspects of the formative environment. If they formed as mudcracks, some of the lakes were shallow enough to permit the recurrent drying and wetting that can lead to the geometric regularity characteristic of several of sets of mudcracks. Moreover, the water likely contained little suspended sediment otherwise the mudcracks would be buried too rapidly for the crack pattern to persist and to mature into regular polygonal patterns. The preservation of these desiccation crack patterns does not require, but does not exclude, deep burial and exhumation. Although invisible from satellite because of their size, a multitude of Mastcam and Navcam images reveals these informative features in considerable detail. These images complement much evidence, mostly from HiRISE data from several regions, suggesting that potential desiccation polygons on larger scales may be more common on the surface of Mars than generally recognized.

  3. Heme oxygenase (HO-1). Evidence for electrophilic oxygen addition to the porphyrin ring in the formation of alpha-meso-hydroxyheme.

    PubMed

    Wilks, A; Torpey, J; Ortiz de Montellano, P R

    1994-11-25

    Previous studies have established that reaction of the rat heme-heme oxygenase complex with H2O2 proceeds normally to give verdoheme, whereas reaction of the complex with meta-chloroperbenzoic acid yields a ferryl (FeIV = O) species and a protein radical but no verdoheme. The heme-heme oxygenase complex is shown here to react regiospecifically with ethyl hydroperoxide to give alpha-meso-ethoxyheme. Formation of this product exactly parallels the formation of alpha-meso-hydroxyheme in the normal reaction supported by cytochrome P450 reductase/NADPH or H2O2. These results rule out a nucleophilic mechanism for the alpha-meso-hydroxylation catalyzed by heme oxygenase and indicate that it involves electrophilic (or possibly radical) addition of the distal oxygen of iron-bound peroxide (FeIII-OOH) to the porphyrin ring.

  4. Characterization of Fluorescent Siderophore-Mediated Iron Uptake in Pseudomonas sp. Strain M114: Evidence for the Existence of an Additional Ferric Siderophore Receptor

    PubMed Central

    Morris, John; O'Sullivan, Daniel J.; Koster, Margot; Leong, John; Weisbeek, Peter J.; O'Gara, Fergal

    1992-01-01

    In Pseudomonas sp. strain M114, the outer membrane receptor for ferric pseudobactin M114 was shown to transport ferric pseudobactins B10 and A225, in addition to its own. The gene encoding this receptor, which was previously cloned on pCUP3, was localized by Tn5 mutagenesis to a region comprising >1.6 kb of M114 DNA. A mutant (strain M114R1) lacking this receptor was then created by a marker exchange technique. Characterization of this mutant by using purified pseudobactin M114 in radiolabeled ferric iron uptake studies confirmed that it was completely unable to utilize this siderophore for acquisition of iron. In addition, it lacked an outer membrane protein band of 89 kDa when subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis. As a result, growth of the mutant was severely restricted under low-iron conditions. However, this phenotype was reversed in the presence of another fluorescent siderophore (pseudobactin MT3A) from Pseudomonas sp. strain MT3A, suggesting the presence of a second receptor in strain M114. Furthermore, wild-type Pseudomonas sp. strain B24 was not able to utilize ferric pseudobactin MT3A, and this phenotype was not reversed upon expression of the M114 receptor encoded on pCUP3. However, a cosmid clone (pMS1047) that enabled strain B24 to utilize ferric pseudobactin MT3A was isolated from an M114 gene bank. Radiolabel transport assays with purified pseudobactin MT3A confirmed this event. Plasmid pMS1047 was shown to encode an outer membrane protein of 81 kDa in strain B24 under iron-limiting conditions; this protein corresponds to a similar protein in strain M114. Images PMID:16348650

  5. Evaluation of an evidence based quality improvement innovation for patients with musculoskeletal low back pain in an accident and emergency setting.

    PubMed

    Potier, Tara; Tims, Emily; Kilbride, Cherry; Rantell, Khadija

    2015-01-01

    We conducted a five stage pilot study which initially consisted of a review of 75 case notes of people attending an emergency department (ED) in an inner London Teaching Hospital with musculoskeletal (MSK) low back pain (LBP). This review highlighted inconsistencies in how they were assessed and managed across and within different staff groups. We found patient documentation was often incomplete and that a biomedical model approach to the management of these patients was common. As a result, four further stages in the project were conducted. Our primary aim was to evaluate the impact of implementing a locally developed quality improvement intervention for the assessment and treatment of MSK LBP in this ED. Secondary aims were to explore the user experience of the new pathway, measured by the patient experience questionnaire (PEQ), and any associated health economic costs of changes in practice. The quality improvement intervention consisted of an evidence based low back pain pathway (EBLBPP), a staff educational program, and a patient education booklet. We undertook a retrospective baseline audit of 100 clinical records of patients was undertaken prior to the instigation of the quality improvement intervention, and four months post implementation. The pre-defined variables of interest were: documentation of the case history, examination, classification of back pain (and if correct), prescribed management and if the documentation was compliant with medico-legal standards. All patients in the study were sent a PEQ to complete and return in a self-addressed envelope. Estimated health costs associated with each patient episode of care were calculated including re-attendance episodes for any people presenting with MSK LBP within a four week period. There was a significant improvement in all areas evaluated post implementation in all groups (simple, referred and simple, referred and serious spinal pathology combined). In particular; screening for red flags (22%) and

  6. Evaluation of an evidence based quality improvement innovation for patients with musculoskeletal low back pain in an accident and emergency setting.

    PubMed

    Potier, Tara; Tims, Emily; Kilbride, Cherry; Rantell, Khadija

    2015-01-01

    We conducted a five stage pilot study which initially consisted of a review of 75 case notes of people attending an emergency department (ED) in an inner London Teaching Hospital with musculoskeletal (MSK) low back pain (LBP). This review highlighted inconsistencies in how they were assessed and managed across and within different staff groups. We found patient documentation was often incomplete and that a biomedical model approach to the management of these patients was common. As a result, four further stages in the project were conducted. Our primary aim was to evaluate the impact of implementing a locally developed quality improvement intervention for the assessment and treatment of MSK LBP in this ED. Secondary aims were to explore the user experience of the new pathway, measured by the patient experience questionnaire (PEQ), and any associated health economic costs of changes in practice. The quality improvement intervention consisted of an evidence based low back pain pathway (EBLBPP), a staff educational program, and a patient education booklet. We undertook a retrospective baseline audit of 100 clinical records of patients was undertaken prior to the instigation of the quality improvement intervention, and four months post implementation. The pre-defined variables of interest were: documentation of the case history, examination, classification of back pain (and if correct), prescribed management and if the documentation was compliant with medico-legal standards. All patients in the study were sent a PEQ to complete and return in a self-addressed envelope. Estimated health costs associated with each patient episode of care were calculated including re-attendance episodes for any people presenting with MSK LBP within a four week period. There was a significant improvement in all areas evaluated post implementation in all groups (simple, referred and simple, referred and serious spinal pathology combined). In particular; screening for red flags (22%) and

  7. Cannabinoid CB1 receptors in the dorsal hippocampus and prelimbic medial prefrontal cortex modulate anxiety-like behavior in rats: additional evidence.

    PubMed

    Lisboa, Sabrina F; Borges, Anna A; Nejo, Priscila; Fassini, Aline; Guimarães, Francisco S; Resstel, Leonardo B

    2015-06-01

    Endocannabinoids (ECBs) such as anandamide (AEA) act by activating cannabinoid type 1 (CB1) or 2 (CB2) receptors. The anxiolytic effect of drugs that facilitate ECB effects is associated with increase in AEA levels in several encephalic areas, including the prefrontal cortex (PFC). Activation of CB1 receptors by CB1 agonists injected directly into these areas is usually anxiolytic. However, depending on the encephalic region being investigated and on the stressful experiences, opposite effects were observed, as reported in the ventral HIP. In addition, contradictory results have been reported after CB1 activation in the dorsal HIP (dHIP). Therefore, in the present paper we have attempted to verify if directly interfering with ECB metabolism/reuptake in the prelimbic (PL) portion of the medial PFC (MPFC) and dHIP would produce different effects in two conceptually distinct animal models: the elevated plus maze (EPM) and the Vogel conflict test (VCT). We observed that drugs which interfere with ECB reuptake/metabolism in both the PL and in the dentate gyrus of the dHIP induced anxiolytic-like effect, in both the EPM and in the VCT via CB1 receptors, suggesting that CB1 signaling in these brain regions modulates defensive responses to both innate and learned threatening stimuli. This data further strengthens previous results indicating modulation of hippocampal and MPFC activity via CB1 by ECBs, which could be therapeutically targeted to treat anxiety disorders.

  8. Ulcer emergencies (image)

    MedlinePlus

    Peptic ulcers may lead to emergency situations. Severe abdominal pain with or without evidence of bleeding may indicate a perforation of the ulcer through the stomach or duodenum. Vomiting of a substance that resembles coffee grounds, ...

  9. Additive genetic variation in resistance traits of an exotic pine species: little evidence for constraints on evolution of resistance against native herbivores

    PubMed Central

    Moreira, X; Zas, R; Sampedro, L

    2013-01-01

    The apparent failure of invasions by alien pines in Europe has been explained by the co-occurrence of native pine congeners supporting herbivores that might easily recognize the new plants as hosts. Previous studies have reported that exotic pines show reduced tolerance and capacity to induce resistance to those native herbivores. We hypothesize that limited genetic variation in resistance to native herbivores and the existence of evolutionary trade-offs between growth and resistance could represent additional potential constraints on the evolution of invasiveness of exotic pines outside their natural range. In this paper, we examined genetic variation for constitutive and induced chemical defences (measured as non-volatile resin in the stem and total phenolics in the needles) and resistance to two major native generalist herbivores of pines in cafeteria bioassays (the phloem-feeder Hylobius abietis and the defoliator Thaumetopoea pityocampa) using half-sib families drawn from a sample of the population of Pinus radiata introduced to Spain in the mid-19th century. We found (i) significant genetic variation, with moderate-to-high narrow-sense heritabilities for both the production of constitutive non-volatile resin and induced total phenolics, and for constitutive resistance against T. pityocampa in bioassays, (ii) no evolutionary trade-offs between plant resistance and growth traits or between the production of different quantitative chemical defences and (iii) a positive genetic correlation between constitutive resistance to the two studied herbivores. Overall, results of our study indicate that the exotic pine P. radiata has limited genetic constraints on the evolution of resistance against herbivores in its introduced range, suggesting that, at least in terms of interactions with these enemies, this pine species has potential to become invasive in the future. PMID:23232833

  10. Evidence for the role of CR1 (CD35), in addition to CR2 (CD21), in facilitating infection of human T cells with opsonized HIV.

    PubMed

    Delibrias, C C; Kazatchkine, M D; Fischer, E

    1993-08-01

    Complement activation by HIV results in the binding of C3 fragments to the gp160 complex and enhanced infection of C3 receptor-bearing target cells. We have studied complement-mediated enhancement of infection of the human CD4-positive T-cell line HPB-ALL which expresses the CR1 (CD35) and CR2 (CD21) receptors for C3. CR1 and CR2 are present on 15% and 40% of normal peripheral blood CD4-positive T lymphocytes respectively. Opsonization of the virus with complement resulted in a 3- to 10-fold enhancement of infection of HPB-ALL cells, as assessed by measuring the release of p24 antigen in culture supernatants throughout the culture period. Blockade of CR2 with cross-linked anti-CR2 monoclonal antibodies decreased infection to the level observed with unopsonized virus. Blocking CR1 reduced complement-mediated infection by 50-80%. Experiments using serum deficient in complement factor I demonstrated that CR1 mediates the interaction between opsonized virus and T cells in addition to its ability to serve as a cofactor for the cleavage of C3b into smaller fragments that interact with CR2. A requirement for CD4 in complement-mediated enhancement of infection was observed with HIV-1 Bru but not with HIV-1 RF. Thus, CR1 and CR2 contribute in an independent and complementary fashion to penetration of opsonized virus into complement receptor-expressing T cells. Involvement of CD4 in infection with opsonized virus depends on the viral strain. PMID:8346417

  11. AS03-adjuvanted H7N1 detergent-split virion vaccine is highly immunogenic in unprimed mice and induces cross-reactive antibodies to emerged H7N9 and additional H7 subtypes.

    PubMed

    Mallett, Corey P; Beaulieu, Edith; Joly, Marie-Hélène; Baras, Benoît; Lu, Xiuhua; Liu, Feng; Levine, Min Z; Katz, Jacqueline M; Innis, Bruce L; Giannini, Sandra L

    2015-07-31

    Avian H7 is one of several influenza A virus subtypes that have the potential to cause pandemics. Herein we describe preclinical results following administration of an investigational H7N1 inactivated detergent-split virion vaccine adjuvanted with the AS03 Adjuvant System. The adjuvanted H7N1 vaccine was highly immunogenic compared to the non-adjuvanted H7N1 vaccine in unprimed mice with less than 100ng of hemagglutinin antigen per dose. In addition, compared to the non-adjuvanted vaccine, the AS03-adjuvanted H7N1 vaccine also induced robust HI and VN antibody responses that cross-reacted with other H7 subtypes, including recently emerged H7N9 virus. These H7 data from the preclinical mouse model add to the existing H5 data to suggest that AS03 adjuvant technology may be generally effective for formulating antigen-sparing detergent-split virion vaccines against intrinsically sub-immunogenic avian influenza A virus subtypes.

  12. Evidence for Emergency Vaccination Having Played a Crucial Role to Control the 1965/66 Foot-and-Mouth Disease Outbreak in Switzerland

    PubMed Central

    Zingg, Dana; Häsler, Stephan; Schuepbach-Regula, Gertraud; Schwermer, Heinzpeter; Dürr, Salome

    2015-01-01

    Foot-and-mouth disease (FMD) is a highly contagious disease that caused several large outbreaks in Europe in the last century. The last important outbreak in Switzerland took place in 1965/66 and affected more than 900 premises and more than 50,000 animals were slaughtered. Large-scale emergency vaccination of the cattle and pig population has been applied to control the epidemic. In recent years, many studies have used infectious disease models to assess the impact of different disease control measures, including models developed for diseases exotic for the specific region of interest. Often, the absence of real outbreak data makes a validation of such models impossible. This study aimed to evaluate whether a spatial, stochastic simulation model (the Davis Animal Disease Simulation model) can predict the course of a Swiss FMD epidemic based on the available historic input data on population structure, contact rates, epidemiology of the virus, and quality of the vaccine. In addition, the potential outcome of the 1965/66 FMD epidemic without application of vaccination was investigated. Comparing the model outcomes to reality, only the largest 10% of the simulated outbreaks approximated the number of animals being culled. However, the simulation model highly overestimated the number of culled premises. While the outbreak duration could not be well reproduced by the model compared to the 1965/66 epidemic, it was able to accurately estimate the size of the area infected. Without application of vaccination, the model predicted a much higher mean number of culled animals than with vaccination, demonstrating that vaccination was likely crucial in disease control for the Swiss FMD outbreak in 1965/66. The study demonstrated the feasibility to analyze historical outbreak data with modern analytical tools. However, it also confirmed that predicted epidemics from a most carefully parameterized model cannot integrate all eventualities of a real epidemic. Therefore, decision

  13. Evidence for Emergency Vaccination Having Played a Crucial Role to Control the 1965/66 Foot-and-Mouth Disease Outbreak in Switzerland.

    PubMed

    Zingg, Dana; Häsler, Stephan; Schuepbach-Regula, Gertraud; Schwermer, Heinzpeter; Dürr, Salome

    2015-01-01

    Foot-and-mouth disease (FMD) is a highly contagious disease that caused several large outbreaks in Europe in the last century. The last important outbreak in Switzerland took place in 1965/66 and affected more than 900 premises and more than 50,000 animals were slaughtered. Large-scale emergency vaccination of the cattle and pig population has been applied to control the epidemic. In recent years, many studies have used infectious disease models to assess the impact of different disease control measures, including models developed for diseases exotic for the specific region of interest. Often, the absence of real outbreak data makes a validation of such models impossible. This study aimed to evaluate whether a spatial, stochastic simulation model (the Davis Animal Disease Simulation model) can predict the course of a Swiss FMD epidemic based on the available historic input data on population structure, contact rates, epidemiology of the virus, and quality of the vaccine. In addition, the potential outcome of the 1965/66 FMD epidemic without application of vaccination was investigated. Comparing the model outcomes to reality, only the largest 10% of the simulated outbreaks approximated the number of animals being culled. However, the simulation model highly overestimated the number of culled premises. While the outbreak duration could not be well reproduced by the model compared to the 1965/66 epidemic, it was able to accurately estimate the size of the area infected. Without application of vaccination, the model predicted a much higher mean number of culled animals than with vaccination, demonstrating that vaccination was likely crucial in disease control for the Swiss FMD outbreak in 1965/66. The study demonstrated the feasibility to analyze historical outbreak data with modern analytical tools. However, it also confirmed that predicted epidemics from a most carefully parameterized model cannot integrate all eventualities of a real epidemic. Therefore, decision

  14. Male emergence schedule and dispersal behaviour are modified by mate availability in heterogeneous landscapes: evidence from the orange-tip butterfly.

    PubMed

    Davies, W James; Saccheri, Ilik J

    2015-01-01

    Protandry (prior emergence of males) in insect populations is usually considered to be the result of natural selection acting directly on eclosion timing. When females are monandrous (mate once), males in high density populations benefit from early emergence in the intense scramble competition for mates. In low density populations, however, scramble competition is reduced or absent, and theoretical models predict that protandry will be less favoured. This raises the question of how males behave in heterogeneous landscapes characterized by high density core populations in a low density continuum. We hypothesized that disadvantaged late emerging males in a core population would disperse to the continuum to find mates. We tested this idea using the protandrous, monandrous, pierid butterfly Anthocharis cardamines (the orange-tip) in a core population in Cheshire, northwest England. Over a six-year period, predicted male fitness (the number of matings a male can expect during his residence time, determined by the daily ratio of virgin females to competing males) consistently declined to <1 in late season. This decline affected a large proportion (∼44%) of males in the population and was strongly associated with decreased male recapture-rates, which we attribute to dispersal to the surrounding continuum. In contrast, reanalysis of mark-release-recapture data from an isolated population in Durham, northeast England, showed that in the absence of a continuum very few males (∼3%) emerged when fitness declined to <1 in late season. Hence the existence of a low density continuum may lead to the evolution of plastic dispersal behaviour in high density core populations, maintaining late emerging males which would otherwise be eliminated by selection. This has important theoretical consequences, since a truncated male emergence curve is a key prediction in game theoretic models of emergence timing which has so far received limited support. Our results have implications for

  15. Mnemonic Vocabulary Instruction: Additional Effectiveness Evidence.

    ERIC Educational Resources Information Center

    Levin, Joel R.; And Others

    1992-01-01

    Four experiments with 132 seventh graders, 162 eighth graders, 75 fourth graders, and 52 third graders compared the mnemonic keyword method with various other vocabulary learning strategies. Mnemonic keyword students outperformed sentence-context and free-study counterparts and generally outperformed others on tests of vocabulary usage. (SLD)

  16. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization

    ERIC Educational Resources Information Center

    Substance Abuse, 2007

    2007-01-01

    Objective: Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience…

  17. Phosphazene additives

    DOEpatents

    Harrup, Mason K; Rollins, Harry W

    2013-11-26

    An additive comprising a phosphazene compound that has at least two reactive functional groups and at least one capping functional group bonded to phosphorus atoms of the phosphazene compound. One of the at least two reactive functional groups is configured to react with cellulose and the other of the at least two reactive functional groups is configured to react with a resin, such as an amine resin of a polycarboxylic acid resin. The at least one capping functional group is selected from the group consisting of a short chain ether group, an alkoxy group, or an aryloxy group. Also disclosed are an additive-resin admixture, a method of treating a wood product, and a wood product.

  18. Potlining Additives

    SciTech Connect

    Rudolf Keller

    2004-08-10

    In this project, a concept to improve the performance of aluminum production cells by introducing potlining additives was examined and tested. Boron oxide was added to cathode blocks, and titanium was dissolved in the metal pool; this resulted in the formation of titanium diboride and caused the molten aluminum to wet the carbonaceous cathode surface. Such wetting reportedly leads to operational improvements and extended cell life. In addition, boron oxide suppresses cyanide formation. This final report presents and discusses the results of this project. Substantial economic benefits for the practical implementation of the technology are projected, especially for modern cells with graphitized blocks. For example, with an energy savings of about 5% and an increase in pot life from 1500 to 2500 days, a cost savings of $ 0.023 per pound of aluminum produced is projected for a 200 kA pot.

  19. Emergency contraception

    MedlinePlus

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing or delaying ...

  20. Chemical Emergency

    MedlinePlus

    ... Emergency App Find our Emergency App in the Apple Store or Google Play Aplicación de Emergencias - ahora ... Lifesaving Blood Get Assistance Types of Emergencies Be Red Cross Ready Mobile Apps Workplaces & Organizations Resources For ...

  1. Emergency Contraception

    MedlinePlus

    ... contraception are available: emergency contraceptive pills and the copper-containing intrauterine device (IUD). Emergency contraceptive pills include ... for emergency use, talk to your doctor. The copper-containing IUD (brand name: Paragard) is a small, ...

  2. Tuberculosis in complex emergencies.

    PubMed

    Coninx, Rudi

    2007-08-01

    This paper describes the key factors and remaining challenges for tuberculosis (TB) control programmes in complex emergencies. A complex emergency is "a humanitarian crisis in a country, region or society where there is total or considerable breakdown of authority resulting from internal or external conflict and which requires an international response that goes beyond the mandate or capacity of any single agency and/or the ongoing United Nations country programme." Some 200 million people are believed to live in countries affected by complex emergencies; almost all of these are developing countries that also bear the main burden of TB. The effects of complex emergencies impact on TB control programmes, interfering with the goals of identifying and curing TB patients and possibly leading to the emergence of MDR-TB. There are many detailed descriptions of aid interventions during complex emergencies; yet TB control programmes are absent from most of these reports. If TB is neglected, it may quickly result in increased morbidity and mortality, as was demonstrated in Bosnia and Herzegovina and in Somalia. TB is a major disease in complex emergencies and requires an appropriate public health response. While there is no manual to cover complex emergencies, the interagency manual for TB control in refugee and displaced populations provides valuable guidance. These programmes contribute to the body of evidence needed to compile such a manual, and should ensure that the experiences of TB control in complex emergencies lead to the establishment of evidence-based programmes. PMID:17768523

  3. Coronary computed tomography angiography for the assessment of acute chest pain in the emergency department: evidence, guidelines, and tips for implementation.

    PubMed

    Ropp, Alan; Lin, Cheng T; White, Charles S

    2015-05-01

    Acute chest pain is an important clinical challenge and a major reason for presentation to the emergency department. Although multiple imaging techniques are available to assess such patients, considerable interest has focused on the use of coronary computed tomography (CT) angiography. Three recent multicenter trials have demonstrated the value of coronary CT angiography (CCTA) to diagnose patients with acute coronary syndrome (ACS) rapidly and accurately. Guidelines developed on the basis of these and other studies suggest that CCTA is optimally used in patients with low to intermediate risk for ACS. A related protocol, the triple rule-out scan, may be valuable if overlapping symptoms occur, particularly between those of ACS and pulmonary embolism. In developing a program to perform CCTA in the emergency room, it is important to work closely with emergency physicians and cardiologists to maximize appropriate use of this technique and to develop appropriate protocols that minimize radiation dose. Ongoing efforts to improve existing capabilities of CCTA include better characterization of coronary plaque and the use of CT fractional flow reserve and perfusion techniques.

  4. Evidence of an increased incidence of day 3 parasitaemia in Suriname: an indicator of the emerging resistance of Plasmodium falciparum to artemether

    PubMed Central

    Vreden, Stephen GS; Jitan, Jeetendra K; Bansie, Rakesh D; Adhin, Malti R

    2013-01-01

    The emerging resistance to artemisinin derivatives that has been reported in South-East Asia led us to assess the efficacy of artemether-lumefantrine as the first line therapy for uncomplicated Plasmodium falciparum infections in Suriname. This drug assessment was performed according to the recommendations of the World Health Organization in 2011. The decreasing number of malaria cases in Suriname, which are currently limited to migrating populations and gold miners, precludes any conclusions on artemether efficacy because adequate numbers of patients with 28-day follow-up data are difficult to obtain. Therefore, a comparison of day 3 parasitaemia in a 2011 study and in a 2005/2006 study was used to detect the emergence of resistance to artemether. The prevalence of day 3 parasitaemia was assessed in a study in 2011 and was compared to that in a study in 2005/2006. The same protocol was used in both studies and artemether-lumefantrine was the study drug. Of 48 evaluable patients in 2011, 15 (31%) still had parasitaemia on day 3 compared to one (2%) out of 45 evaluable patients in 2005/2006. Overall, 11 evaluable patients in the 2011 study who were followed up until day 28 had negative slides and similar findings were obtained in all 38 evaluable patients in the 2005/2006 study. The significantly increased incidence of parasite persistence on day 3 may be an indication of emerging resistance to artemether. PMID:24402149

  5. New Evidence for the Role of Emerging Flux in a Solar Filament's Slow Rise Preceding its CME-Producing Fast Eruption

    NASA Technical Reports Server (NTRS)

    Sterling, Alphonse C.; Harra, Louis K.; Moore, Ronald L.

    2007-01-01

    We observe the eruption of a large-scale (approx.300,000 km) quiet-region solar filament, leading to an Earth-directed "halo" coronal mass ejection (CME). We use coronal imaging data in EUV from the EUV Imaging Telescope (EIT) on the Solar and Heliospheric Observatory (SOHO) satellite, and in soft X-rays (SXRs) from the Soft X-ray Telescope (SXT) on the Yohkoh satellite. We also use spectroscopic data from the Coronal Diagnostic Spectrometer (CDS), magnetic data from the Michelson Doppler Imager (MDI), and white-light coronal data from the Large Angle and Spectrometric Coronagraph Experiment (LASCO), all on SOHO. Initially the filament shows a slow (approx.1 km/s projected against the solar disk) and approximately constant-velocity rise for about 6 hours, before erupting rapidly, reaching a velocity of approx. 8 km/s over the next approx. 25 min. CDS Doppler data show Earth-directed filament velocities ranging from < 20 km/s (the noise limit) during the slow-rise phase, to approx. 100 km/s-1 early in the eruption. Beginning within 10 hours prior to the start of the slow rise, localized new magnetic flux emerged near one end of the filament. Near the start of and during the slow-rise phase, SXR microflaring occurred repeatedly at the flux-emergence site, in conjunction with the development of a fan of SXR illumination of the magnetic arcade over the filament. The SXR microflares, development of the SXR fan, and motion of the slow-rising filament are all consistent with "tether-weakening" reconnection occurring between the newly-emerging flux and the overlying arcade field containing the filament field. The microflares and fan structure are not prominent in EUV, and would not have been detected without the SXR data. Standard "twin dimmings" occur near the location of the filament, and "remote dimmings" and "brightenings" occur further removed from the filament.

  6. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: is ketamine a viable induction agent for the trauma patient with potential brain injury.

    PubMed

    Hughes, Sian

    2011-12-01

    A short cut review was carried out to establish whether ketamine is a viable induction agent in trauma patients with potential brain injuries. 276 papers were found using the reported searches, of which 5 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that there is no evidence to suggest harm with Ketamine use as induction agent for the patient with potential traumatic brain injury. The drug has major advantages in those patients with associated haemodynamic compromise and should potentially be regarded as the agent of choice.

  7. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Immobilisation of stable ankle fractures: plaster cast or functional brace?

    PubMed

    Thackray, Anna J; Taylor, Jonathan

    2013-06-01

    A short-cut review of the literature was carried out to establish whether a functional brace was as good as a traditional plaster of Paris to immobilise a stable ankle fracture in terms of functionality and recovery speed. A total of 260 papers was found using the below outlined search method, of which five were thought to represent the best evidence to answer the specific clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these are shown in table 2. The clinical bottom line is that the limited evidence seems to suggest that a functional brace appears to give more favourable outcomes. Good quality studies involving large populations are, however, needed to delineate a clear answer to this specific question.

  8. Gradual emergence of spontaneous correlated brain activity during fading of general anesthesia in rats: Evidences from fMRI and local field potentials

    PubMed Central

    Bettinardi, Ruggero G.; Tort-Colet, Núria; Ruiz-Mejias, Marcel; Sanchez-Vives, Maria V.; Deco, Gustavo

    2015-01-01

    Intrinsic brain activity is characterized by the presence of highly structured networks of correlated fluctuations between different regions of the brain. Such networks encompass different functions, whose properties are known to be modulated by the ongoing global brain state and are altered in several neurobiological disorders. In the present study, we induced a deep state of anesthesia in rats by means of a ketamine/medetomidine peritoneal injection, and analyzed the time course of the correlation between the brain activity in different areas while anesthesia spontaneously decreased over time. We compared results separately obtained from fMRI and local field potentials (LFPs) under the same anesthesia protocol, finding that while most profound phases of anesthesia can be described by overall sparse connectivity, stereotypical activity and poor functional integration, during lighter states different frequency-specific functional networks emerge, endowing the gradual restoration of structured large-scale activity seen during rest. Noteworthy, our in vivo results show that those areas belonging to the same functional network (the default-mode) exhibited sustained correlated oscillations around 10 Hz throughout the protocol, suggesting the presence of a specific functional backbone that is preserved even during deeper phases of anesthesia. Finally, the overall pattern of results obtained from both imaging and in vivo-recordings suggests that the progressive emergence from deep anesthesia is reflected by a corresponding gradual increase of organized correlated oscillations across the cortex. PMID:25804643

  9. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Antacids and diagnosis in patients with atypical chest pain.

    PubMed

    Teece, Stewart; Crawford, Ian

    2003-03-01

    A short cut review was carried out to establish whether antacids can be used as a diagnostic test in atypical chest pain. Altogether 374 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

  10. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 3: Advantages of ultrasound-assisted lumbar puncture.

    PubMed

    Brousseau, Audrey-Anne; Parent, Marc-Charles

    2016-02-01

    A short cut review was carried out to establish ultrasound can assist. 9 papers were found of which 4 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is that using ultrasound assisted landmarks prior to LP improves success rate and reduces the number of attempts and traumatic taps.

  11. Real-life evidence in evaluating effectiveness of treatment in Haemophilia A with a recombinant FVIII concentrate: a non-interventional study in emerging countries.

    PubMed

    Gouider, E; Rauchensteiner, S; Andreeva, T; Al Zoebie, A; Mehadzic, S; Nefyodova, L; Brunn, M; Tueckmantel, C; Meddeb, B

    2015-05-01

    Some progress has been made regarding availability of recombinant factor VIII concentrates and prophylaxis for haemophilia A in emerging countries, where plasma-derived concentrates were used in the vast majority. Clinical studies to document their introduction and effectiveness are so far not widely available in literature. This non-interventional study evaluates the real-life effectiveness and safety of prophylactic and on-demand treatment with recombinant factor VIII formulated with sucrose (rFVIII-FS) for bleed control and preservation of joints in emerging countries from Eastern Europe, North Africa and Middle East area. One hundred and eighty-six patients from 11 countries were enrolled, mean ± SD age 12.8 ± 12.7 years. At enrolment, majority (79.6%) had severe haemophilia A (<2% IU mL(-1) ), 47.8% had a target joint, 15% had an inhibitor history and one patient was on immune tolerance induction. During the 24-month observation period, 58.1% of the patients were prescribed prophylaxis at every visit, 31.7% were on an on-demand regimen. Patients with severe haemophilia A on prophylaxis (n = 82) had a mean annual rate of treated bleeds of 2.8 ± 4.4, whereas it was 19.1 ± 32.0 for the on-demand group (n = 31), and a mean total Gilbert Score of 9.9 ± 10.3 at baseline and 4.1 ± 6.7 at study end; vs. 15.2 ± 17.3 and 13.7 ± 17.1 for on-demand respectively. The majority of the bleeds (91.1%) were treated with one or two infusions. Four patients without inhibitor history had a first positive inhibitor test during the study. This study demonstrates the effective use of rFVIII-FS in emerging countries and adds to the established safety profile of rFVIII-FS.

  12. [Focal point emergency departments].

    PubMed

    Lange, R; Popp, S; Erbguth, F

    2016-06-01

    The number of patients treated in hospital emergency departments in Germany has risen in recent years to approximately 20 million. This escalation also applies to the increasing numbers of patients presenting with neurological symptoms and diseases, which occur in approximately 20 % of emergency patients. In addition to patients with stroke, inflammatory or degenerative central nervous system (CNS) and peripheral nervous system (PNS) disorders who need urgent treatment, more and more patients with nonspecific complaints or conditions attend emergency departments for elective treatment, not least because timely appointments with specialist neurologists in practices could not be obtained. Neurological expertise and presence in emergency departments at the level of specialist standard are therefore indispensable for providing a professional level of treatment, which also corresponds to current legal requirements. The implementation of a generalist emergency physician in Germany, as introduced in some European countries, would mean a retrograde step for neurological expertise in emergency admission management. The discipline of neurology must work together with other emergency disciplines to improve the financing of emergency departments and provide neurologists working there with a substantive curriculum of further and continuing education in emergency-related aspects of neurology. The discipline of neurology has a responsibility to emergency patients within its range of competencies and must, therefore, strengthen and improve its role in healthcare politics and concerning organizational and personnel aspects of neurological emergencies.

  13. Emergence of a High-Temperature Superconductivity in Hydrogen Cycled pd Compounds as AN Evidence for Superstoihiometric H/d Sites

    NASA Astrophysics Data System (ADS)

    Lipson, Andrei; Castano, Carlos; Miley, George; Lipson, Andrei; Lyakhov, Boris; Mitin, Alexander

    2006-02-01

    Transport and magnetic properties of hydrogen cycled PdHx and Pd/PdO:Hx (x ~ (4/6) × 10-4) nano-composite consisting of a Pd matrix with hydrogen trapped inside dislocation cores have been studied. The results suggest emergence of a high-temperature superconductivity state of a condensed hydrogen phase confined inside deep dislocation cores in the Pd matrix. The possible role of hydrogen/deuterium filled dislocation nano-tubes is discussed. These dislocation cores could be considered as active centers of LENR triggering due to (i) short D-D separation distance (~Bohr radius); (ii) high-local D-loading in the Pd and the corresponding effective lattice compression; (iii) a large optic phonon energy resulting in a most effective lattice-nuclei energy transfer.

  14. Emergency Cardiac Surgery in Patients with Acute Coronary Syndromes: A Review of the Evidence and Perioperative Implications of Medical and Mechanical Therapeutics

    PubMed Central

    Brown, Charles; Joshi, Brijen; Faraday, Nauder; Shah, Ashish; Yuh, David; Rade, Jeffrey J.; Hogue, Charles W.

    2011-01-01

    Patients with acute coronary syndromes who require emergency cardiac surgery present complex management challenges. The early administration of antiplatelet and antithrombotic drugs has improved overall survival for patients with acute myocardial infarction, but to achieve maximal benefit, these drugs are given before coronary anatomy is known and before the decision to perform percutaneous coronary interventions or surgical revascularization has been made. A major bleeding event secondary to these drugs is associated with a high rate of death in medically treated patients with acute coronary syndrome possibly due to subsequent withholding of antiplatelet and antithrombotic therapies that otherwise reduce the rate of death, stroke, or recurrent myocardial infarcation. Whether the added risk of bleeding and blood transfusion in cardiac surgical patients receiving such potent antiplatelet or antithrombotic therapy before surgery specifically for acute coronary syndromes affects long-term mortality has not been clearly established. For patients who do proceed to surgery, strategies to minimize bleeding include stopping the anticoagulation therapy and considering platelet and/or coagulation factor transfusion and possibly rFVIIa administration for refractory bleeding. Mechanical hemodynamic support has emerged as an important option for patients with acute coronary syndromes in cardiogenic shock. For these patients, perioperative considerations include maintaining appropriate anticoagulation, ensuring suitable device flow, and periodically verifying correct device placement. Data supporting the use of these devices are derived from small trials that did not address long-term postoperative outcomes. Future directions of research will seek to optimize the balance between reducing myocardial ischemic risk with antiplatelet and antithrombotics versus the higher rate perioperative bleeding by better risk-stratifying surgical candidates and by assessing the effectiveness of

  15. Emergency cardiac surgery in patients with acute coronary syndromes: a review of the evidence and perioperative implications of medical and mechanical therapeutics.

    PubMed

    Brown, Charles; Joshi, Brijen; Faraday, Nauder; Shah, Ashish; Yuh, David; Rade, Jeffrey J; Hogue, Charles W

    2011-04-01

    Patients with acute coronary syndromes who require emergency cardiac surgery present complex management challenges. The early administration of antiplatelet and antithrombotic drugs has improved overall survival for patients with acute myocardial infarction, but to achieve maximal benefit, these drugs are given before coronary anatomy is known and before the decision to perform percutaneous coronary interventions or surgical revascularization has been made. A major bleeding event secondary to these drugs is associated with a high rate of death in medically treated patients with acute coronary syndrome possibly because of subsequent withholding of antiplatelet and antithrombotic therapies that otherwise reduce the rate of death, stroke, or recurrent myocardial infarction. Whether the added risk of bleeding and blood transfusion in cardiac surgical patients receiving such potent antiplatelet or antithrombotic therapy before surgery specifically for acute coronary syndromes affects long-term mortality has not been clearly established. For patients who do proceed to surgery, strategies to minimize bleeding include stopping the anticoagulation therapy and considering platelet and/or coagulation factor transfusion and possibly recombinant-activated factor VIIa administration for refractory bleeding. Mechanical hemodynamic support has emerged as an important option for patients with acute coronary syndromes in cardiogenic shock. For these patients, perioperative considerations include maintaining appropriate anticoagulation, ensuring suitable device flow, and periodically verifying correct device placement. Data supporting the use of these devices are derived from small trials that did not address long-term postoperative outcomes. Future directions of research will seek to optimize the balance between reducing myocardial ischemic risk with antiplatelet and antithrombotics versus the higher rate perioperative bleeding by better risk stratifying surgical candidates and by

  16. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization

    PubMed Central

    Bernstein, Edward; Bernstein, Judith; Feldman, James; Fernandez, William; Hagan, Melissa; Mitchell, Patricia; Safi, Clara; Woolard, Robert; Mello, Mike; Baird, Janette; Lee, Cristina; Bazargan-Hejazi, Shahrzad; Broderick, Kerry; LaPerrier, Kathryn A.; Kellermann, Arthur; Wald, Marlena M.; Taylor, Robert E.; Walton, Kim; Grant-Ervin, Michelle; Rollinson, Denise; Edwards, David; Chan, Theodore; Davis, Dan; Marshall, Jean Buchanan; Aseltine, Robert; James, Amy; Abu-Hasaballah, Khamis; Schilling, Elizabeth; Baumann, Brigitte M.; Boudreaux, Edwin D.; Maio, Ronald; Cunningham, Rebecca; Murrell, Teresa; Doezema, David; Bauer, Michael J.; Anglin, Deirdre; Eliassen, Adriana; Martin, Marcus; Pines, Jesse; Buchanan, Leslie; Turner, James; D'Onofrio, Gail; Degutis, Linda C.; Owens, Patricia

    2014-01-01

    SUMMARY Objective Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program (www.ed.bmc.org/sbirt). A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term. PMID:18077305

  17. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Alpha blockers v calcium blockers to increase spontaneous passage of renal calculi.

    PubMed

    Stewart, Alexander; Ferguson, Craig

    2013-02-01

    A short cut review was carried out to establish the administration of an alpha-1 receptor antagonist or a calcium channel blocker would facilitate the most rapid and successful expulsion of a stone from a patient with uncomplicated renal colic. 597 articles were found using the reported search, of which five trials were selected as providing the best evidence to answer this question. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that in a patient with an uncomplicated ureteric calculus tamsulosin is more effective than nifedipine in promoting speedy and successful expulsion of the stone.

  18. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 2: Core stability versus conventional exercise for treating non-specific low back pain.

    PubMed

    Davin, John; Callaghan, Michael

    2016-02-01

    A short cut review was carried out to establish whether core stability exercises are better than conventional exercise for treating non-specific low back pain. 6 papers were found of which 4 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is the perception that a core stability rehabilitation programme will improve low back pain has not been proven. PMID:26801491

  19. Emergency Contraception

    MedlinePlus

    f AQ FREQUENTLY ASKED QUESTIONS FAQ114 CONTRACEPTION Emergency Contraception • What is emergency contraception (EC)? • How does EC work? • What are the different types of EC? • What is the most ...

  20. Emergency management of atrial fibrillation

    PubMed Central

    Wakai, A; O'Neill, J

    2003-01-01

    Atrial fibrillation is the most common cardiac arrhythmia managed by emergency and acute general physicians. There is increasing evidence that selected patients with acute atrial fibrillation can be safely managed in the emergency department without the need for hospital admission. Meanwhile, there is significant variation in the current emergency management of acute atrial fibrillation. This review discusses evidence based emergency management of atrial fibrillation. The principles of emergency management of acute atrial fibrillation and the subset of patients who may not need hospital admission are reviewed. Finally, the need for evidence based guidelines before emergency department based clinical pathways for the management of acute atrial fibrillation becomes routine clinical practice is highlighted. PMID:12840118

  1. Childhood Emergencies

    MedlinePlus

    ... Fitness Tracker Save Your Life in the ER? Abdominal Pain Resources Home Safety Checklist ACEP Coloring Book Download the Coloring Book » Emergency Care For You American College of Emergency Phycisians Copyright © American College of Emergency Physicians 2016 Privacy Policy Terms of Use

  2. Emergent Expertise?

    ERIC Educational Resources Information Center

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  3. Parasite Zoonoses and Wildlife: Emerging Issues

    PubMed Central

    Thompson, R.C. Andrew; Kutz, Susan J.; Smith, Andrew

    2009-01-01

    The role of wildlife as important sources, reservoirs and amplifiers of emerging human and domestic livestock pathogens, in addition to well recognized zoonoses of public health significance, has gained considerable attention in recent years. However, there has been little attention given to the transmission and impacts of pathogens of human origin, particularly protozoan, helminth and arthropod parasites, on wildlife. Substantial advances in molecular technologies are greatly improving our ability to follow parasite flow among host species and populations and revealing valuable insights about the interactions between cycles of transmission. Here we present several case studies of parasite emergence, or risk of emergence, in wildlife, as a result of contact with humans or anthropogenic activities. For some of these parasites, there is growing evidence of the serious consequences of infection on wildlife survival, whereas for others, there is a paucity of information about their impact. PMID:19440409

  4. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan

    PubMed Central

    Adam, Izzeldin Fadl; Nakamura, Keiko; Kizuki, Masashi; Al Rifai, Rami; Vanching, Urnaa

    2015-01-01

    Objectives (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Setting Three camps containing 88 984 IDPs in Darfur, Sudan. Participants 640 women aged 15−49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. Interventions IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Primary outcome measures Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). Results The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Conclusions Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health

  5. Emerging Therapies for Scar Prevention

    PubMed Central

    Block, Lisa; Gosain, Ankush; King, Timothy W.

    2015-01-01

    Significance: There are ∼12 million traumatic lacerations treated in the United States emergency rooms each year, 250 million surgical incisions created worldwide every year, and 11 million burns severe enough to warrant medical treatment worldwide. In the United States, over $20 billion dollars per year are spent on the treatment and management of scars. Recent Advances: Investigations into the management of scar therapies over the last decade have advanced our understanding related to the care of cutaneous scars. Scar treatment methods are presented including topical, intralesional, and mechanical therapies in addition to cryotherapy, radiotherapy, and laser therapy. Critical Issues: Current treatment options for scars have significant limitations. This review presents the current and emerging therapies available for scar management and the scientific evidence for scar management is discussed. Future Directions: Based upon our new understanding of scar formation, innovative scar therapies are being developed. Additional research on the basic science of scar formation will lead to additional advances and novel therapies for the treatment of cutaneous scars. PMID:26487979

  6. Defining an emerging disease.

    PubMed

    Moutou, F; Pastoret, P-P

    2015-04-01

    Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future. PMID:26470448

  7. Defining an emerging disease.

    PubMed

    Moutou, F; Pastoret, P-P

    2015-04-01

    Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future.

  8. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Imaging for the diagnosis of pulmonary embolism in pregnant women.

    PubMed

    Bordeleau, Simon

    2013-03-01

    A short-cut review was carried out to establish whether CT pulmonary angiography (CTPA) or ventilation-perfusion (VQ) scanning offer advantages in imaging the pregnant woman with a possible deep vein thrombosis. A total of 80 papers was found using the reported search, of which four represented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is that a ventilation-perfusion (or perfusion) scan should be prioritised if the chest x-ray is normal. In the case of an abnormal chest x-ray, a CT pulmonary angiography scan will be better in finding an alternative diagnosis.

  9. A review of neuroimaging studies of stressor-evoked blood pressure reactivity: Emerging evidence for a brain-body pathway to coronary heart disease risk

    PubMed Central

    Gianaros, Peter J.; Sheu, Lei K.

    2009-01-01

    An individual's tendency to show exaggerated or otherwise dysregulated cardiovascular reactions to acute stressors has long been associated with increased risk for clinical and preclinical endpoints of coronary heart disease (CHD). However, the ‘brain-body’ pathways that link stressor-evoked cardiovascular reactions to CHD risk remain uncertain. This review summarizes emerging neuroimaging research indicating that individual differences in stressor-evoked blood pressure reactivity (a particular form of cardiovascular reactivity) are associated with activation patterns in corticolimbic brain areas that are jointly involved in processing stressors and regulating the cardiovascular system. As supported empirically by activation likelihood estimates derived from a meta-analysis, these corticolimbic areas include divisions of the cingulate cortex, insula, and amygdala—as well as networked cortical and subcortical areas involved in mobilizing hemodynamic and metabolic support for stress-related behavioral responding. Contextually, the research reviewed here illustrates how behavioral medicine and health neuroscience methods can be integrated to help characterize the ‘brain-body’ pathways that mechanistically link stressful experiences with CHD risk. PMID:19410652

  10. Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial

    PubMed Central

    2014-01-01

    Background Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed. Methods/design The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following

  11. DOES BEVERAGE TYPE AND DRINKING CONTEXT MATTER IN AN ALCOHOL-RELATED INJURY? EVIDENCE FROM EMERGENCY DEPARTMENT PATIENTS IN LATIN AMERICA

    PubMed Central

    Andreuccetti, Gabriel; Carvalho, Heraclito B.; Ye, Yu; Bond, Jason; Monteiro, Maristela; Borges, Guilherme; Cherpitel, Cheryl J.

    2014-01-01

    Background Previous studies have already substantiated alcohol’s causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and the drinking context is reported. Methods Emergency department injured patients were interviewed in eight countries from the Latin American and Caribbean (LAC) region. Data on the type of alcoholic beverage, total alcohol volume, and the place where the injury occurred were obtained from patients who reported any alcohol consumption within 6 hours prior to being injured. Patients who did not drink prior to injury were also asked about their typical drinking pattern and the injury place. Differences within- and between-groups were evaluated regarding patients’ typical drinking and drinking before injury. Results Beer was the most prevalent beverage type usually consumed among injured patients across countries, however, patients who drank before injury had a higher typical consumption of spirits than those not drinking prior to injury. The total alcohol volume typically consumed and drinking in public settings were also found to be positively associated with alcohol-related injury. Conclusions A similar beverage-specific association with alcohol-related injury was found across LAC countries, mainly attributed to beer consumption, and spirits drinkers seem to have a greater chance of becoming involved in injury events. Future prevention strategies should inform the public about harms from drinking associated with the context in which drinking takes place. PMID:24556276

  12. Emergency Contraception.

    PubMed

    Batur, Pelin; Kransdorf, Lisa N; Casey, Petra M

    2016-06-01

    Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual assault, yet it remains underused. There are 4 approved EC options in the United States. Although ulipristal acetate requires a provider's prescription, oral levonorgestrel (LNG) is available over the counter for women of all ages. The most effective method of EC is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception. Ulipristal acetate tends to be more efficacious in pregnancy prevention than is LNG, especially when taken later than 72 hours postcoitus. The mechanism of action of oral EC is delay of ovulation, and current evidence reveals that it is ineffective postovulation. Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral LNG EC; therefore, ulipristal acetate or copper intrauterine devices are preferable in this setting. Providers are often unaware of the range of EC options or are unsure of how to counsel patients regarding the access and use of EC. This article critically reviews current EC literature, summarizes recommendations, and provides guidance for counseling women about EC. Useful tips for health care providers are provided, with a focus on special populations, including breast-feeding women and those transitioning to long-term contraception after EC use. When treating women of reproductive age, clinicians should be prepared to counsel them about EC options, provide EC appropriately, and, if needed, refer for EC in a timely manner. PMID:27261868

  13. Short-term retrospective versus prospective memory processing as emergent properties of the mind and brain: human fMRI evidence.

    PubMed

    Mok, L W

    2012-12-13

    demonstrated that short-term retrospection and prospection may emerge without necessarily relying on working memory-specific brain networks. Furthermore, attention may not necessarily be recruited to realize working memory. When cognitive processes are spontaneously experienced, they may be facilitated by the default brain network.

  14. Additive Manufacturing Infrared Inspection

    NASA Technical Reports Server (NTRS)

    Gaddy, Darrell

    2014-01-01

    Additive manufacturing is a rapid prototyping technology that allows parts to be built in a series of thin layers from plastic, ceramics, and metallics. Metallic additive manufacturing is an emerging form of rapid prototyping that allows complex structures to be built using various metallic powders. Significant time and cost savings have also been observed using the metallic additive manufacturing compared with traditional techniques. Development of the metallic additive manufacturing technology has advanced significantly over the last decade, although many of the techniques to inspect parts made from these processes have not advanced significantly or have limitations. Several external geometry inspection techniques exist such as Coordinate Measurement Machines (CMM), Laser Scanners, Structured Light Scanning Systems, or even traditional calipers and gages. All of the aforementioned techniques are limited to external geometry and contours or must use a contact probe to inspect limited internal dimensions. This presentation will document the development of a process for real-time dimensional inspection technique and digital quality record of the additive manufacturing process using Infrared camera imaging and processing techniques.

  15. When the Rule Becomes the Exception. No Evidence of Gene Flow between Two Zerynthia Cryptic Butterflies Suggests the Emergence of a New Model Group

    PubMed Central

    Vovlas, Alessio; Chelazzi, Guido; Bonelli, Simona; Balletto, Emilio; Ciofi, Claudio

    2013-01-01

    There is increasing evidence that most parapatric cryptic/sister taxa are reproductively compatible across their areas of contact. Consequently, the biological species concept, which assumes absence of interbreeding, is becoming a not so effective criterion in evolutionary ecology. Nevertheless, the few parapatric sister taxa showing complete reproductive barriers represent interesting models to study speciation processes and the evolution of reproductive isolation. In this study, we examined contact populations in northwestern Italy of two butterfly species, Zerynthia polyxena and Z. cassandra, characterized by different genitalic morphotypes. We studied levels of divergence among 21 populations distributed from Sicily to France using three genetic markers (the mitochondrial COI and ND1 genes and the nuclear wingless gene) and genitalic geometric morphometrics. Moreover, we performed species distribution modelling to estimate different climatic requirements of Z. polyxena and Z. cassandra. We projected climatic data into glacial maximum scenarios in order to verify if and to which extent glacial cycles could have contributed to speciation processes. Genetic and morphometric analyses identified two main groups. All specimens showed a concordant pattern of diversification, including those individuals sampled in the contact area. Haplotype distribution and climatic models showed that during glacial maxima both species experienced a strong range contraction and presumably remained separated into different microrefugia in southern France, in the Italian Peninsula and on the islands of Elba and Sicily. Long term separation was probably favoured by reduced dispersal ability and high phylopatry, while genitalic diversification probably favoured interbreeding avoidance. Conversely, the aposematic wing pattern remained almost identical. We compared our results with those obtained in other species and concluded that Z. polyxena and Z. cassandra represent a valuable model in

  16. Spain as an emergency air traffic hub during volcanic air fall events? Evidence of past volcanic ash air fall over Europe during the late Pleistocene

    NASA Astrophysics Data System (ADS)

    Hardiman, Mark; Lane, Christine; Blockley, Simon P. E.; Moreno, Ana; Valero-Garcés, Blas; Ortiz, José E.; Torres, Trino; Lowe, John J.; Menzies, Martin A.

    2010-05-01

    Past volcanic eruptions often leave visible ash layers in the geological record, for example in marine or lake sedimentary sequences. Recent developments, however, have shown that non-visible volcanic ash layers are also commonly preserved in sedimentary deposits. These augment the record of past volcanic events by demonstrating that past ash dispersals have been more numerous and widely disseminated in Europe than previously appreciated. The dispersal ‘footprints' of some large late Pleistocene European eruptions are examined here in the light of the recent Eyjafjallajökull eruption. For example, the Vedde Ash which was erupted from Iceland around 12 thousand years ago, delivered distal (and non-visible) glass deposits as far south as Switzerland and as far east as the Ural Mountains in Russia, with an overall European distribution remarkably similar to the dominant tracks of the recent Eyjafjallajökull plumes. The Eyjafjallajökull eruption has demonstrated that relatively small amounts of distal volcanic ash in the atmosphere can seriously disrupt aviation activity, with attendant economic and other consequences. It has raised fundamental questions about the likelihood of larger or more prolonged volcanic activity in the near future, and the possibility of even more serious consequences than those experienced recently. Given that there are several other volcanic centres that could cause such disruption in Europe (e.g. Campania and other volcanic centres in Italy; Aegean volcanoes), a key question is whether there are parts of Europe less prone to ash plumes and which could therefore operate as emergency air traffic hubs during times of ash dispersal. Although not generated to answer this question, the recent geological record might provide a basis for seeking the answer. For example, four palaeo-records covering the time frame of 8 - 40 Ka BP that are geographically distributed across Spain have been examined for non-visible distal ash content. All four have

  17. Importance of Internet Surveillance in Public Health Emergency Control and Prevention: Evidence From a Digital Epidemiologic Study During Avian Influenza A H7N9 Outbreaks

    PubMed Central

    Zhu, Honghong; Jiang, Tao; Wang, Xinyi; Chen, Lei; Jiang, Zhenggang; Zheng, Dawei

    2014-01-01

    Anhui province. We retrieved a total of 32 confirmed rumors spread across 19 provinces/cities in China. In all, 84% (27/32) of rumors were disseminated and transmitted by social media. Conclusions The first 3 days of an epidemic is a critical period for the authorities to take appropriate action through Internet surveillance to prevent and control the epidemic, including preparation of personnel, technology, and other resources; information release; collection of public opinion and reaction; and clarification, prevention, and control of rumors. Internet surveillance can be used as an efficient and economical tool to prevent and control public health emergencies, such as H7N9 outbreaks. PMID:24440770

  18. Emerging infectious disease or evidence of endemicity? A multi-season study of beak and feather disease virus in wild red-crowned parakeets (Cyanoramphus novaezelandiae).

    PubMed

    Jackson, Bethany; Varsani, Arvind; Holyoake, Carly; Jakob-Hoff, Richard; Robertson, Ian; McInnes, Kate; Empson, Raewyn; Gray, Richard; Nakagawa, Kahori; Warren, Kristin

    2015-09-01

    Beak and feather disease virus (BFDV) is a single-stranded DNA virus that is the etiological agent of beak and feather disease in both wild and captive parrots. Given that BFDV is globally recognized as a conservation threat for wild parrots, between 2011-2013, red-crowned parakeets (Cyanoramphus novaezelandiae, n = 229), which are endemic to New Zealand, were captured in mist nets on Tiritiri Matangi Island and Hauturu-o-Toi/Little Barrier Island (LBI), New Zealand, for disease surveillance. Blood and feathers from all birds were tested by PCR for BFDV, and full genomes were recovered and sequenced. A subset of blood samples (n = 96) were tested for antibodies to BFDV by the haemagglutination inhibition (HI) test. A further 238 feather samples were obtained from red-crowned parakeets from three sites in the Wellington region of the North Island, and these were screened for BFDV. The DNA-based prevalence of BFDV infection determined on Tiritiri Matangi Island was 1.09% (CI 95 %, 0.1-3.9%); on Hauturu-o-Toi/LBI, 4.4% (95% CI, 0.5%-15.1%); on Kapiti Island, 3.4% (CI 95%, 1.1-7.8%); at the ZEALANDIA-Karori sanctuary, 1.6% (95% CI, 0-8.4%); and on Matiu-Somes Island, 0% (CI 95%, 0-12.3%). Seroprevalence for BFDV, indicating prior or current exposure, in the Tiritiri Matangi Island population, it was 2% (CI 95%, 0-10.1%), and in the Hauturu-o-Toi/LBI population was 14% (CI 95%, 5.3-27.9%). BFDV-positive birds showed no signs of clinical disease, with the exception of an individual bird obtained opportunistically from Shakespear Regional Park during the study period, which had classical signs of feather loss. Phylogenetic analysis of the 11 full genome sequences recovered from BFDV-positive red-crowned parakeets revealed evidence of ongoing viral flow between red-crowned parakeets and eastern rosellas (Platycercus eximius) in the Hauraki Gulf/Auckland region, with separate but closely related strains from the Wellington region of the North Island. This is the first study

  19. Emergency contraception.

    PubMed

    2012-12-01

    Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives.

  20. Hypertensive Emergencies in the Emergency Department.

    PubMed

    Adebayo, Omoyemi; Rogers, Robert L

    2015-08-01

    Hypertension affects approximately one-third of Americans. An additional 30% are unaware that they harbor the disease. Significantly increased blood pressure constitutes a hypertensive emergency that could lead to end-organ damage. When organs such as the brain, heart, or kidney are affected, an intervention that will lower the blood pressure in several hours is indicated. Several pharmacologic options are available for treatment, with intravenous antihypertensive therapy being the cornerstone, but there is no standard of care. Careful consideration of each patient's specific complaint, history, and physical examination guides the emergency physician through the treatment algorithm.

  1. Vascular emergencies.

    PubMed

    Semashko, D C

    1997-01-01

    This article reviews the initial assessment and emergent management of several common as well as uncommon vascular emergencies. Aortic dissection, aneurysms, and arterial occlusive disease are familiar but challenging clinical entities. Less frequently encountered conditions are also discussed including an aortic enteric fistula, mesenteric venous thrombosis, phlegmasia alba dolens, and subclavian vein thrombosis.

  2. Portable Data Assistants: Potential in Evidence-Based Practice Autism Treatment

    ERIC Educational Resources Information Center

    Dunkel-Jackson, Sarah M.; Dixon, Mark R.; Szekely, Susan

    2012-01-01

    The emerging era of "evidence-based practice" emphasizes that human service agencies need to find effective and efficient means of training staff and implementing systems change based on scientific evidence. Additional advancements in technology use across populations and settings within the field have also served as a catalyst for the development…

  3. The emergence of scalar meanings

    PubMed Central

    Etxeberria, Urtzi; Irurtzun, Aritz

    2015-01-01

    This paper analyzes the emergence of scalar additive meanings. We show that in Basque the same particle ere can obtain both the “simple additive” reading (akin to English too) and the “scalar additive” reading (akin to English even) but we argue that we do not have to distinguish two types of ere. We provide evidence, by means of a production and a perception experiment, that the reading is disambiguated by means of prosody (the placement of nuclear stress), which is a correlate of focus. We argue that the scalarity effect is generated by the combination of two presuppositions (a focus-induced one and a lexical one) and the assertion of the sentence. PMID:25745405

  4. [Emergency departments--2016 update].

    PubMed

    Zimmermann, M; Brokmann, J C; Gräff, I; Kumle, B; Wilke, P; Gries, A

    2016-04-01

    Acute medical care in hospital emergency departments has experienced rapid development in recent years and gained increasing importance not only from a professional medical point of view but also from an economic and health policy perspective. The present article therefore provides an update on the situation of emergency departments in Germany. Care in emergency departments is provided with an increasing tendency to patients of all ages presenting with varying primary symptoms, complaints, illnesses and injury patterns. In the process, patients reach the emergency department by various routes and structural provision. Cross-sectional communication and cooperation, prioritization and organization of emergency management and especially medical staff qualifications increasingly play a decisive role in this process. The range of necessary knowledge and skills far exceeds the scope of prehospital medical emergency care and the working environment differs substantially. In addition to existing structural and economic problems, the latest developments, as well as future proposals for the design of in-hospital emergency medical care in interdisciplinary emergency departments are described.

  5. Parallel inhibition of active force and relaxed fiber stiffness by caldesmon fragments at physiological ionic strength and temperature conditions: additional evidence that weak cross-bridge binding to actin is an essential intermediate for force generation.

    PubMed Central

    Kraft, T; Chalovich, J M; Yu, L C; Brenner, B

    1995-01-01

    Previously we showed that stiffness of relaxed fibers and active force generated in single skinned fibers of rabbit psoas muscle are inhibited in parallel by actin-binding fragments of caldesmon, an actin-associated protein of smooth muscle, under conditions in which a large fraction of cross-bridges is weakly attached to actin (ionic strength of 50 mM and temperature of 5 degrees C). These results suggested that weak cross-bridge attachment to actin is essential for force generation. The present study provides evidence that this is also true for physiological ionic strength (170 mM) at temperatures up to 30 degrees C, suggesting that weak cross-bridge binding to actin is generally required for force generation. In addition, we show that the inhibition of active force is not a result of changes in cross-bridge cycling kinetics but apparently results from selective inhibition of weak cross-bridge binding to actin. Together with our previous biochemical, mechanical, and structural studies, these findings support the proposal that weak cross-bridge attachment to actin is an essential intermediate on the path to force generation and are consistent with the concept that isometric force mainly results from an increase in strain of the attached cross-bridge as a result of a structural change associated with the transition from a weakly bound to a strongly bound actomyosin complex. This mechanism is different from the processes responsible for quick tension recovery that were proposed by Huxley and Simmons (Proposed mechanism of force generation in striated muscle. Nature. 233:533-538.) to represent the elementary mechanism of force generation. Images FIGURE 1 PMID:7647245

  6. Effects of the addition of a resistance training programme to a caloric restriction weight loss intervention on psychosocial factors in overweight and obese post-menopausal women: a Montreal Ottawa New Emerging Team study.

    PubMed

    Messier, Virginie; Rabasa-Lhoret, Rémi; Doucet, Eric; Brochu, Martin; Lavoie, Jean-Marc; Karelis, Antony; Prud'homme, Denis; Strychar, Irene

    2010-01-01

    The aim of this study was to examine the effects of the addition of a resistance training programme to a caloric restriction weight loss intervention on psychosocial profile. The study sample consisted of 137 overweight and obese post-menopausal women. Participants were randomized to a caloric restriction group and caloric restriction + resistance training group. Psychosocial, anthropometric, and metabolic variables were measured before and after the 6-month weight loss intervention. Both groups presented similar weight loss and there were no significant differences between the caloric restriction group and caloric restriction + resistance training group for changes in psychosocial profile. Thereafter, all participants were classified into quintiles based on the amount of weight loss. In all quintiles, women markedly improved body esteem and self-esteem, and decreased hunger and perceived risk for diabetes mellitus (P < 0.05). However, significant increases in dietary restraint were observed in quintiles 2-5 (> or =2.4 % body weight loss), decreases in disinhibition in quintiles 3-5 (> or =4.9 %), increases in self-efficacy in quintiles 3-5 (> or =4.9 %), and increases in health perceptions in quintile 5 (> or =11.1%). The results of this study do not support the hypothesis that the addition of a resistance training programme to a caloric restriction weight loss intervention has additional benefits on psychosocial profile. Overall, the significant improvements in the psychosocial profile observed were mostly accounted for by the degree of weight loss.

  7. Urologic Emergencies.

    PubMed

    Ludvigson, Adam E; Beaule, Lisa T

    2016-06-01

    The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic services, it is usually left to the General Surgeon or Emergency Medicine physician to provide timely care. This article discusses diagnoses that are important to recognize and treatment that is practically meaningful for the non-Urologist to identify and treat. The non-Urology provider, after reading this article, will have a better understanding and a higher comfort level with treating patients with urologic emergencies.

  8. Urologic Emergencies.

    PubMed

    Ludvigson, Adam E; Beaule, Lisa T

    2016-06-01

    The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic services, it is usually left to the General Surgeon or Emergency Medicine physician to provide timely care. This article discusses diagnoses that are important to recognize and treatment that is practically meaningful for the non-Urologist to identify and treat. The non-Urology provider, after reading this article, will have a better understanding and a higher comfort level with treating patients with urologic emergencies. PMID:27261785

  9. Rheumatologic emergencies.

    PubMed

    Gutiérrez-González, Luis Arturo

    2015-12-01

    Rheumatological conditions can sometimes present as emergencies. These can occur due to the disease process or infection; contrary to what many people think, rheumatologic emergencies like a pain, rheumatic crisis, or attack gout do not compromise the patient's life. This article mentioned only true emergencies: catastrophic antiphospholipid syndrome (cAPS), kidney-lung syndrome, central nervous system (CNS) vasculitis, anti-Ro syndrome (neonatal lupus), and macrophage activation syndrome (MAS). The management of above emergencies includes critical care, immunosuppression when indicated, and use of a diagnostic flowchart as well as fast laboratory profile for making decisions. Anticoagulants have to be used in the management of antiphospholipid syndrome. A good understanding of these conditions is of paramount importance for proper management.

  10. Emergency contraception.

    PubMed

    Grimes, David A; Raymond, Elizabeth G

    2002-08-01

    Emergency contraception is used to prevent pregnancy after a coital act not adequately protected by a regular method of contraception. In contrast to early medical abortion, emergency contraception prevents a pregnancy from starting and does not disrupt an established pregnancy. The most commonly used approaches consist of two oral doses of contraceptive steroids. The levonorgestrel-only regimen (levonorgestrel, 0.75 mg, repeated in 12 hours) appears to be more effective and better tolerated than the Yuzpe regimen (ethinyl estradiol, 100 microg, and levonorgestrel, 0.5 mg, repeated in 12 hours). In the largest randomized, controlled trial to date, levonorgestrel prevented about 85% of pregnancies that would have occurred without its use. Hormonal emergency contraception has no known medical contraindications, although it is not indicated for suspected or confirmed pregnancy. However, if hormonal emergency contraception is inadvertently taken in early pregnancy, neither the woman nor the fetus will be harmed. Nausea and vomiting associated with the Yuzpe regimen can be reduced by prophylactic use of meclizine. A strong medical and legal case exists for making hormonal emergency contraception available over the counter, as has happened in countries other than the United States. Easier access to and wider use of emergency contraception could dramatically lower the high rates of unintended pregnancy and induced abortion in the United States. PMID:12160366

  11. Anorectal emergencies.

    PubMed

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  12. Anorectal emergencies.

    PubMed

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.

  13. Anorectal emergencies

    PubMed Central

    Lohsiriwat, Varut

    2016-01-01

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  14. Disentangling the emerging evidence around atypical fractures.

    PubMed

    Abrahamsen, Bo; Clark, Emma M

    2012-06-01

    Atypical femur fractures are rare but a growing concern, as they are more common in patients who use bisphosphonates. The best radiology-based studies have had access to only short-term exposure data, while the studies using prescription databases with substantial long-term data did not have access to radiology reports. The interests of the patients are probably best served by reserving long-term bisphosphonate treatment for patients who are at the highest risk of osteoporotic fractures and considering drug holidays after 5 years in patients at low risk. Recent studies have further strengthened the case for active medical or surgical therapy in patients with incomplete fractures, but patient numbers are small, and randomized controlled trials may not be forthcoming in the immediate future. The recommendations made to establish an international database for such fractures have not yet been followed, and more epidemiologic and pathophysiologic research is needed.

  15. Pressure-induced emergence of unusually high-frequency transverse excitations in a liquid alkali metal: Evidence of two types of collective excitations contributing to the transverse dynamics at high pressures

    SciTech Connect

    Bryk, Taras; Ruocco, G.; Scopigno, T.

    2015-09-14

    Unlike phonons in crystals, the collective excitations in liquids cannot be treated as propagation of harmonic displacements of atoms around stable local energy minima. The viscoelasticity of liquids, reflected in transition from the adiabatic to elastic high-frequency speed of sound and in absence of the long-wavelength transverse excitations, results in dispersions of longitudinal (L) and transverse (T) collective excitations essentially different from the typical phonon ones. Practically, nothing is known about the effect of high pressure on the dispersion of collective excitations in liquids, which causes strong changes in liquid structure. Here dispersions of L and T collective excitations in liquid Li in the range of pressures up to 186 GPa were studied by ab initio simulations. Two methodologies for dispersion calculations were used: direct estimation from the peak positions of the L/T current spectral functions and simulation-based calculations of wavenumber-dependent collective eigenmodes. It is found that at ambient pressure, the longitudinal and transverse dynamics are well separated, while at high pressures, the transverse current spectral functions, density of vibrational states, and dispersions of collective excitations yield evidence of two types of propagating modes that contribute strongly to transverse dynamics. Emergence of the unusually high-frequency transverse modes gives evidence of the breakdown of a regular viscoelastic theory of transverse dynamics, which is based on coupling of a single transverse propagating mode with shear relaxation. The explanation of the observed high-frequency shift above the viscoelastic value is given by the presence of another branch of collective excitations. With the pressure increasing, coupling between the two types of collective excitations is rationalized within a proposed extended viscoelastic model of transverse dynamics.

  16. [Basic emergency].

    PubMed

    Oliveira, Agripino

    2006-01-01

    The increasing demand of health care and lack of its accessibility, in the scope of the National Health Service, are the most determining factors for the use of emergency departments. These facts are reproducible in the town of Espinho in spite of its two emergency consultations working at the same time, open consultation in the primary cares and hospital unit for emergency consultation, twenty meters distant from each other. This study attempt to investigate the reasons why the inhabitants of Espinho choose the institution, based on the opinion survey performed during the first fortnight of July 2002. The purpose of the study was to verify whether the different perception of the illness severity was related to the choice of the institution by the inhabitants of Espinho. In general, the results have shown that the inhabitants of Espinho knew how both consultations work and their choice was a consequence of their expectation at the moment. The patient s self-evaluation of his health condition has proved to be a very important predictor in the choice made. Thus, the open consultation in the primary cares is adjusted to give assistance to the chronic disease, while the emergency unit is prepared for the acute disease. The patients were more pleased with the performance of the emergency unit, which may be used in interventions to improve some aspects of health services and care and concerning the resources of health professionals. PMID:17328842

  17. Emerging pharmacotherapy of tinnitus

    PubMed Central

    Salvi, Richard; Elgoyhen, Ana Belén

    2010-01-01

    Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about one in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Since tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioural treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated to provide replicable long-term reduction of tinnitus impact in the majority of patients, in excess of placebo effects. Accordingly, there are no FDA- or EMEA-approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with its current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variablility in clinical trial methodology. PMID:19712015

  18. Walking boosts your performance in making additions and subtractions

    PubMed Central

    Anelli, Filomena; Lugli, Luisa; Baroni, Giulia; Borghi, Anna M.; Nicoletti, Roberto

    2014-01-01

    Previous research demonstrates that the processing of spatial information and numerical magnitude are strictly interwoven. Recent studies also provide converging evidence that number processing is influenced by body movements. In the present study we further investigate this issue by focusing on whether and how motions experienced with the whole body can influence arithmetical calculations. We asked participants to make additions or subtractions while experiencing leftward and rightward motions. Data revealed the emergence of a congruency effect between the orientation inferred by the type of arithmetical calculations and the type of motions experienced along an horizontal axis. PMID:25566137

  19. Thyroid emergencies.

    PubMed

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  20. Emerging Scholars

    ERIC Educational Resources Information Center

    Anyaso, Hilary Hurd; Rolo, Mark Anthony; Roach, Ronald; Delos, Robin Chen; Branch-Brioso, Karen; Miranda, Maria Eugenia; Seymour, Add, Jr.; Grossman, Wendy; Nealy, Michelle J.; Lum, Lydia

    2009-01-01

    This year's group of "emerging scholars" is a force to be reckoned with. This diverse group of young (under-40) crusaders is pushing the boundaries of research, technology and public policy in ways never imagined and reaching new heights of accomplishments. The Class of 2009 includes a physiologist who devised an artificial pancreas to produce the…

  1. Postmodern Emergence

    ERIC Educational Resources Information Center

    Somerville, Margaret

    2007-01-01

    This paper is a work-in-progress in which the author will begin to articulate the elements of a new methodology that she is calling, for the moment, a methodology of postmodern emergence. She explores this approach through examples from her own research journals that follow her research-in-process and from observing student work-in-progress. She…

  2. Chemical Emergencies

    MedlinePlus

    ... agents such as sarin and VX. Many hazardous chemicals are used in industry - for example, chlorine, ammonia, and benzene. Some can be made from everyday items such as household cleaners. Although there are no guarantees of safety during a chemical emergency, you can take actions to protect yourself. ...

  3. Radiation Emergencies

    MedlinePlus

    ... enough, it can cause premature aging or even death. Although there are no guarantees of safety during a radiation emergency, you can take actions to protect yourself. You should have a disaster plan. Being prepared can help reduce fear, anxiety and losses. If you do experience a ...

  4. Emerging Options for Emergency Contraception

    PubMed Central

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

  5. PFP Emergency Lighting Study

    SciTech Connect

    BUSCH, M.S.

    2000-02-02

    NFPA 101, section 5-9 mandates that, where required by building classification, all designated emergency egress routes be provided with adequate emergency lighting in the event of a normal lighting outage. Emergency lighting is to be arranged so that egress routes are illuminated to an average of 1.0 footcandle with a minimum at any point of 0.1 footcandle, as measured at floor level. These levels are permitted to drop to 60% of their original value over the required 90 minute emergency lighting duration after a power outage. The Plutonium Finishing Plant (PFP) has two designations for battery powered egress lights ''Emergency Lights'' are those battery powered lights required by NFPA 101 to provide lighting along officially designated egress routes in those buildings meeting the correct occupancy requirements. Emergency Lights are maintained on a monthly basis by procedure ZSR-12N-001. ''Backup Lights'' are battery powered lights not required by NFPA, but installed in areas where additional light may be needed. The Backup Light locations were identified by PFP Safety and Engineering based on several factors. (1) General occupancy and type of work in the area. Areas occupied briefly during a shiftly surveillance do not require backup lighting while a room occupied fairly frequently or for significant lengths of time will need one or two Backup lights to provide general illumination of the egress points. (2) Complexity of the egress routes. Office spaces with a standard hallway/room configuration will not require Backup Lights while a large room with several subdivisions or irregularly placed rooms, doors, and equipment will require Backup Lights to make egress safer. (3) Reasonable balance between the safety benefits of additional lighting and the man-hours/exposure required for periodic light maintenance. In some plant areas such as building 236-Z, the additional maintenance time and risk of contamination do not warrant having Backup Lights installed in all rooms

  6. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  7. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  8. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  9. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  10. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  11. [Endocrine emergencies during pregnancy].

    PubMed

    Harbeck, B; Schütt, M; Sayk, F

    2012-03-01

    Endocrine emergencies during pregnancy can become life-threatening for both mother and fetus. In addition to some pregnancy-linked endocrine disorders, several pre-existing forms of endocrinopathy, such as Grave's disease, type 1 diabetes and adrenal insufficiency might deteriorate acutely during pregnancy. Early diagnosis and management are challenging because the classical symptoms are often modified by pregnancy. Laboratory tests are subject to altered physiological ranges and pharmacological options are limited while therapeutic goals are stricter than in the non-pregnant patient. This article focuses on endocrine emergencies complicating pregnancy. PMID:22349529

  12. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    PubMed Central

    Shah, Gulzar H.; Newell, Bobbie; Whitworth, Ruth E.

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. Conclusion: LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection. PMID:27694648

  13. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    PubMed Central

    Shah, Gulzar H.; Newell, Bobbie; Whitworth, Ruth E.

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. Conclusion: LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection.

  14. Emergency cricothyrotomy.

    PubMed

    Hart, Kristopher L; Thompson, Stevan H

    2010-03-01

    Establishment of an unobstructed airway and adequate oxygenation is a basic tenet of life support. Mechanical or anatomic airway obstructions can arise secondary to trauma, pathology, foreign bodies, and infection. The oral and maxillofacial surgeon is uniquely trained to provide surgical and anesthetic care, and must be prepared to provide emergency airway management. This article reviews the indications, contraindications, and techniques of surgical and needle cricothyrotomy. Fortunately, with advances in airway techniques and equipment, emergency cricothyrotomy is not a common procedure. However, in the event that a surgeon has no other means of securing an airway, this procedure may avert a catastrophe. If such a situation does occur, quick and decisive action can best be carried out if there is a thorough understanding of the anatomy and techniques involved.

  15. Emergence delirium.

    PubMed

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-11-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes that there is a need for guidelines concerning diagnosis and treatment of ED. Risk factors should be investigated further in the clinical setting in the future. PMID:24312995

  16. Thyroid Emergencies.

    PubMed

    Leung, Angela M

    2016-01-01

    Myxedema coma and thyroid storm are thyroid emergencies associated with increased mortality. Prompt recognition of these states-which represent the severe, life-threatening conditions of extremely reduced or elevated circulating thyroid hormone concentrations, respectively-is necessary to initiate treatment. Management of myxedema coma and thyroid storm requires both medical and supportive therapies and should be treated in an intensive care unit setting. PMID:27598067

  17. 44 CFR 6.81 - Additional copies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Additional copies. 6.81... HOMELAND SECURITY GENERAL IMPLEMENTATION OF THE PRIVACY ACT OF 1974 Fees § 6.81 Additional copies. A reasonable number of additional copies shall be provided for the applicable fee to a requestor who...

  18. Emerging jets

    NASA Astrophysics Data System (ADS)

    Schwaller, Pedro; Stolarski, Daniel; Weiler, Andreas

    2015-05-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  19. 14 CFR 121.310 - Additional emergency equipment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; and (iii) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power. (2) Each light must be armed or turned on during taxiing... at least 70° of arc at a radius approximately equal to three-fourths of the handle length; and...

  20. 14 CFR 135.178 - Additional emergency equipment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...; (3) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power; (4) Be armed or turned on during taxiing, takeoff, and landing... head twice the width of the shaft, extending along at least 70° of arc at a radius approximately...

  1. 14 CFR 135.178 - Additional emergency equipment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; (3) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power; (4) Be armed or turned on during taxiing, takeoff, and landing... head twice the width of the shaft, extending along at least 70° of arc at a radius approximately...

  2. 14 CFR 135.178 - Additional emergency equipment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; (3) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power; (4) Be armed or turned on during taxiing, takeoff, and landing... head twice the width of the shaft, extending along at least 70° of arc at a radius approximately...

  3. 14 CFR 121.310 - Additional emergency equipment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...; and (iii) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power. (2) Each light must be armed or turned on during taxiing... at least 70° of arc at a radius approximately equal to three-fourths of the handle length; and...

  4. 14 CFR 135.178 - Additional emergency equipment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; (3) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power; (4) Be armed or turned on during taxiing, takeoff, and landing... head twice the width of the shaft, extending along at least 70° of arc at a radius approximately...

  5. 14 CFR Appendix A to Part 125 - Additional Emergency Equipment

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... inadvertent operation of the manual controls; and (iii) When armed or turned on at either station, remain... armed or turned on during taxiing, takeoff, and landing. In showing compliance with this paragraph, a... shaft, extending along at least 70 degrees of arc at a radius approximately equal to 3/4 of the...

  6. 14 CFR Appendix A to Part 125 - Additional Emergency Equipment

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... inadvertent operation of the manual controls; and (iii) When armed or turned on at either station, remain... armed or turned on during taxiing, takeoff, and landing. In showing compliance with this paragraph, a... shaft, extending along at least 70 degrees of arc at a radius approximately equal to 3/4 of the...

  7. 14 CFR 121.310 - Additional emergency equipment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; and (iii) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power. (2) Each light must be armed or turned on during taxiing... at least 70° of arc at a radius approximately equal to three-fourths of the handle length; and...

  8. 14 CFR 121.310 - Additional emergency equipment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; and (iii) When armed or turned on at either station, remain lighted or become lighted upon interruption of the airplane's normal electric power. (2) Each light must be armed or turned on during taxiing... at least 70° of arc at a radius approximately equal to three-fourths of the handle length; and...

  9. 14 CFR Appendix A to Part 125 - Additional Emergency Equipment

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... inadvertent operation of the manual controls; and (iii) When armed or turned on at either station, remain... armed or turned on during taxiing, takeoff, and landing. In showing compliance with this paragraph, a... shaft, extending along at least 70 degrees of arc at a radius approximately equal to 3/4 of the...

  10. 14 CFR Appendix A to Part 125 - Additional Emergency Equipment

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... inadvertent operation of the manual controls; and (iii) When armed or turned on at either station, remain... armed or turned on during taxiing, takeoff, and landing. In showing compliance with this paragraph, a... shaft, extending along at least 70 degrees of arc at a radius approximately equal to 3/4 of the...

  11. Forum outlines top emerging technologies

    NASA Astrophysics Data System (ADS)

    Extance, Andy

    2015-04-01

    Additive manufacturing, next-generation robotics, "sense and avoid" drones that fly themselves, artificial intelligence and "neuromorphic" computing have all made it into the World Economic Forum's top 10 emerging technologies for 2015.

  12. Citizen Science and Emerging Technologies

    EPA Science Inventory

    This session will discuss challenges and opportunities associated with citizen science and how emerging technologies can support citizen science activities. In addition, the session will provide an overview of low-cost environmental monitors and sensors and introduce the Citizen...

  13. Deconstructing "Atypical" Eating Disorders: an Overview of Emerging Eating Disorder Phenotypes.

    PubMed

    Murray, Stuart B; Anderson, Leslie K

    2015-11-01

    Recent changes to the diagnostic framework of eating disorders (ED's) in DSM-5 were introduced to reduce the large preponderance of cases falling within the residual and undifferentiated category. However, current reports continue to illustrate overrepresentation of cases in this residual category, suggesting that clinical reality comprises more diverse ED psychopathology than is accounted for in the current diagnostic spectrum. However, with emerging evidence preliminarily delineating several additional distinct phenotypes, we aim to provide a narrative overview of emerging ED phenotypes which (i) are not currently located as a specific diagnostic category in diagnostic criteria for ED's, (ii) centrally feature ED psychopathology, and (iii) have emerging empirical evidence suggesting the distinct nature of the syndrome. A greater awareness of these emerging phenotypes will likely facilitate accurate diagnostic practice and may also serve to facilitate further empirical efforts.

  14. Psychiatric Emergencies.

    PubMed

    Wheat, Santina; Dschida, Dorothy; Talen, Mary R

    2016-06-01

    Psychiatric emergencies are acute disturbances in thought, behavior, mood, or social relationship that require immediate intervention as defined by the patient, family, or social unit to save the patient and/or others from imminent danger. Ensuring the safety of the patient, surrounding persons, and the medical team is the first step of evaluation. Treatment focuses on stabilization of the patient, then on specific symptoms and ultimately the cause of symptoms. There are important legal considerations, particularly regarding involuntary admissions. It is important to debrief with the patient, surrounding family, and the health care team to ensure a continued therapeutic alliance and the emotional health of all involved. PMID:27262012

  15. Emergency Lighting

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A lighting system originally developed for NASA's Apollo and Skylab manned spacecraft resulted in a industrial spinoff and creation of a whole new company to produce and market the product line. The company is UDEC Corp., Waltham, Mass. UDEC's "Multi-Mode" electronic lighting systems are designed for plant emergency and supplemental use, such as night lighting, "always-on" stairwell lights and illuminated exit signs. Their advantages stem from the qualities demanded for spacecraft installation: extremely high fight output with very low energy drain, compactness, light weight, and high reliability. The Multi-Mode system includes long-life fluorescent lamps operated by electronic circuitry, a sealed battery that needs no maintenance for 10 years, and a solid-state battery charger. A typical emergency installation consists of a master module with battery and an eight watt lamp, together with four remote "Satellight" modules powered by the master's battery. As a night lighting system for maintenance or I security, UDEC fixtures can bypass the battery and 1 operate on normal current at a fraction of the energy 1 demand of conventional night lighting. Industrial customers have realized savings of better than ninety percent with UDEC night lights. UDEC started as a basement industry in 1972 but the company has already sold more than 1,000 lighting systems to building operators.

  16. New technologies emerge.

    PubMed

    Gray, S P

    1997-01-01

    Technology vendors continue to invent new devices, systems and processes to sell to the health care industry. Drugs, instruments and procedures continue to improve and address disease and injury treatment needs. In addition to these direct medical treatment innovations and enhancements, a number of new supporting systems and products have emerged. These support technologies hold significant promise for managers to make day-to-day execution of health care delivery more cost effective and customer friendly.

  17. Self-Identifying Emergency Radio Beacons

    NASA Technical Reports Server (NTRS)

    Friedman, Morton L.

    1987-01-01

    Rescue teams aided by knowledge of vehicle in distress. Similar to conventional emergency transmitters except contains additional timing and modulating circuits. Additions to standard emergency transmitter enable transmitter to send rescuers identifying signal in addition to conventional distress signal created by sweep generator. Data generator contains identifying code.

  18. Earthquakes and emergence

    NASA Astrophysics Data System (ADS)

    Earthquakes and emerging infections may not have a direct cause and effect relationship like tax evasion and jail, but new evidence suggests that there may be a link between the two human health hazards. Various media accounts have cited a massive 1993 earthquake in Maharashtra as a potential catalyst of the recent outbreak of plague in India that has claimed more than 50 lives and alarmed the world. The hypothesis is that the earthquake may have uprooted underground rat populations that carry the fleas infected with the bacterium that causes bubonic plague and can lead to the pneumonic form of the disease that is spread through the air.

  19. Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG) and the MOET (Managing Obstetric Emergencies and Trauma-course) instructions; the Fluxim study

    PubMed Central

    2010-01-01

    Background One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH). Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG) and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma) did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions Methods/Design One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. Discussion This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into the barriers and

  20. Thermodynamics of cercarial development and emergence in trematodes.

    PubMed

    Morley, N J; Lewis, J W

    2013-09-01

    SUMMARY Temperature is an important factor influencing the biology of ectothermic organisms and is intrinsically linked to climate change. Trematodes are potentially susceptible to temperature changes and in order to develop predictive frameworks of their responses to climate change large-scale analyses are needed. The present study, using the Q 10 value, analyses experimental data from the scientific literature on the effects of temperature on cercarial development and emergence across a wide range of temperature in low (⩽35°) and mid-latitude (36-60°) species. Temperature appears to have no significant effect on the rate of development of cercariae within molluscan hosts. Data on cercarial emergence, corrected to incorporate the minimum emergence temperature threshold (METT) and acclimation status, was found to be largely unaffected by temperature over optimum ranges of ≈20 °C (15-25 °C) for mid-latitude species and ≈25 °C (20-30 °C) for low-latitude species. In addition, a decline in emergence rates was shown at higher temperatures. These results are contrary to a previous study on the meta-analysis of cercarial emergence. Some evidence of strain-specific differences and thermostability over a wide temperature range for both cercarial development and emergence was apparent. The significance of these results in furthering our understanding of cercarial biology under natural conditions is discussed.

  1. [Emergency Triage. An Overview].

    PubMed

    Christ, Michael; Bingisser, Roland; Nickel, Christian Hans

    2016-03-01

    In emergency departments, patients present with different severities of diseases and traumatic injuries. However, patients with severe and life-threatening conditions compete for the same resources such as personal and structure. As a general rule, each patient should receive immediate diagnostic and treatment, independent of his or her severity of disease or traumatic injury. However, an unexpected number of patients presenting to the emergency department at the same time may exceed available resources. Thus, waiting times will occur and management of patients may be impeded. As a consequence, patients with diseases or traumatic injuries with a need for time-critical management, have to be detected at the time of presentation. After categorization, patients have to be prioritized and guided to the correct place of treatment ("triage"). Starting in Australia and the United States, nurse-driven triage systems have been introduced in the emergency departments. Aim of triage is to correctly identify at increased risk of death and guide them to rapid and correct treatment. In Germany, two five-level triage systems have been introduced: Manchester Triage System (MTS) and Emergency Severity Index (ESI). We give an overview of these risk assessment tools and discuss pros and cons. In addition, new options such as "team triage" and a combination with "Early Warning Scores" are reported. In summary, nurse-driven triage is an instrument to improve patient safety in emergency medicine. A structured and systematic triage of patients using validated triage assessment tools are recommended from national and international societies of emergency medicine. Therefore, nurse-driven triage is also a must in Germany.

  2. Additive Manufacturing of Hybrid Circuits

    NASA Astrophysics Data System (ADS)

    Sarobol, Pylin; Cook, Adam; Clem, Paul G.; Keicher, David; Hirschfeld, Deidre; Hall, Aaron C.; Bell, Nelson S.

    2016-07-01

    There is a rising interest in developing functional electronics using additively manufactured components. Considerations in materials selection and pathways to forming hybrid circuits and devices must demonstrate useful electronic function; must enable integration; and must complement the complex shape, low cost, high volume, and high functionality of structural but generally electronically passive additively manufactured components. This article reviews several emerging technologies being used in industry and research/development to provide integration advantages of fabricating multilayer hybrid circuits or devices. First, we review a maskless, noncontact, direct write (DW) technology that excels in the deposition of metallic colloid inks for electrical interconnects. Second, we review a complementary technology, aerosol deposition (AD), which excels in the deposition of metallic and ceramic powder as consolidated, thick conformal coatings and is additionally patternable through masking. Finally, we show examples of hybrid circuits/devices integrated beyond 2-D planes, using combinations of DW or AD processes and conventional, established processes.

  3. CT of Gastric Emergencies.

    PubMed

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls.

  4. 46 CFR 308.502 - Additional insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Additional insurance. 308.502 Section 308.502 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance I-Introduction § 308.502 Additional insurance. The assured may place increased value...

  5. 46 CFR 308.502 - Additional insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Additional insurance. 308.502 Section 308.502 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance I-Introduction § 308.502 Additional insurance. The assured may place increased value...

  6. 46 CFR 308.502 - Additional insurance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Additional insurance. 308.502 Section 308.502 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance I-Introduction § 308.502 Additional insurance. The assured may place increased value...

  7. 46 CFR 308.502 - Additional insurance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Additional insurance. 308.502 Section 308.502 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance I-Introduction § 308.502 Additional insurance. The assured may place increased value...

  8. 46 CFR 308.502 - Additional insurance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Additional insurance. 308.502 Section 308.502 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Introduction § 308.502 Additional insurance. The assured may place increased value...

  9. Emerging technologies

    SciTech Connect

    Hodson, C.O.; Williams, D.

    1996-07-01

    Among the emerging technologies for air, hazardous waste and water come new ways of looking at pollution, in both the figurative and quite literal sense. The use of microbes for remediation and pollution control is a component in many of the technologies in this report and is the focus of environmental research at many university and industry labs. Bacteria are the engines driving one featured emissions control technology: the air biofilter. Biofilters are probably more acceptable to most engineers as a soil remediation technology--such as the innovative method described in the hazardous waste section--rather than as means of cleaning off-gases, but in many cases bugs can perform the function inexpensively. The authors give the basics on this available technology. A more experimental application of microbes is being investigated as a potential quantum leap in heavy metals removal technology: bio-engineered, metal consuming plants. The effort to genetically engineer a green remediation tool is detailed in the hazardous waste section.

  10. Emerging technologies

    SciTech Connect

    Lu, Shin-yee

    1993-03-01

    The mission of the Emerging Technologies thrust area at Lawrence Livermore National Laboratory is to help individuals establish technology areas that have national and commercial impact, and are outside the scope of the existing thrust areas. We continue to encourage innovative ideas that bring quality results to existing programs. We also take as our mission the encouragement of investment in new technology areas that are important to the economic competitiveness of this nation. In fiscal year 1992, we have focused on nine projects, summarized in this report: (1) Tire, Accident, Handling, and Roadway Safety; (2) EXTRANSYT: An Expert System for Advanced Traffic Management; (3) Odin: A High-Power, Underwater, Acoustic Transmitter for Surveillance Applications; (4) Passive Seismic Reservoir Monitoring: Signal Processing Innovations; (5) Paste Extrudable Explosive Aft Charge for Multi-Stage Munitions; (6) A Continuum Model for Reinforced Concrete at High Pressures and Strain Rates: Interim Report; (7) Benchmarking of the Criticality Evaluation Code COG; (8) Fast Algorithm for Large-Scale Consensus DNA Sequence Assembly; and (9) Using Electrical Heating to Enhance the Extraction of Volatile Organic Compounds from Soil.

  11. 49 CFR 239.107 - Emergency exits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Emergency exits. 239.107 Section 239.107... exits. For additional requirements related to emergency window exits, see part 223 of this chapter. (a... for scheduled inspection, maintenance, and repair of emergency window and door exits; (2) Test...

  12. Improving emergency department patient flow

    PubMed Central

    Jarvis, Paul Richard Edwin

    2016-01-01

    Emergency departments (ED) face significant challenges in delivering high quality and timely patient care on an ever-present background of increasing patient numbers and limited hospital resources. A mismatch between patient demand and the ED’s capacity to deliver care often leads to poor patient flow and departmental crowding. These are associated with reduction in the quality of the care delivered and poor patient outcomes. A literature review was performed to identify evidence-based strategies to reduce the amount of time patients spend in the ED in order to improve patient flow and reduce crowding in the ED. The use of doctor triage, rapid assessment, streaming and the co-location of a primary care clinician in the ED have all been shown to improve patient flow. In addition, when used effectively point of care testing has been shown to reduce patient time in the ED. Patient flow and departmental crowding can be improved by implementing new patterns of working and introducing new technologies such as point of care testing in the ED.

  13. Acute asthma in emergency room.

    PubMed

    Chugh, Krishan

    2003-03-01

    Acute asthmatic exacerbation is one of the commonest emergencies seen in the pediatric age group. Viral infections are the most important triggers which set up the inflammatory reaction in the bronchial mucosa. GINA 2002 guidelines for assessing the severity and management are very useful for day to day practice. There is evidence to support the view that metered dose inhaler alongwith spaceor with or without mask is as effective as the standard doses of beta-2 agonists given by nebulizer. Ipratrpium bromide adds to the benefits of short acting beta-2 agonists. Systemic steroids should be started early. Early introduction of l/v beta-2 agonists and trial of l/v magnesium sulfate in non-responders have been recently recommended. Intravenous aminophylline can be tried in addition to full dose beta-2 agonists in those who reach the PICU. A close watch on the patient by monitoring clinical parameters, pulse oximeter, arterial blood gases and peak flow rate help in deciding whether there is need to further step up the therapy. Non-conventional measures like ketamine should be tried only under constant monitoring.

  14. High performance addition-type thermoplastics (ATTs) - Evidence for the formation of a Diels-Alder adduct in the reaction of an acetylene-terminated material and a bismaleimide

    NASA Technical Reports Server (NTRS)

    Pater, R. H.; Soucek, M. D.; Chang, A. C.; Partos, R. D.

    1991-01-01

    Recently, the concept and demonstration of a new versatile synthetic reaction for making a large number of high-performance addition-type thermoplastics (ATTs) were reported. The synthesis shows promise for providing polymers having an attractive combination of easy processability, good toughness, respectable high temperature mechanical performance, and excellent thermo-oxidative stability. The new chemistry involves the reaction of an acetylene-terminated material with a bismaleimide or benzoquinone. In order to clarify the reaction mechanism, model compound studies were undertaken in solutions as well as in the solid state. The reaction products were purified by flash chromatography and characterized by conventional analytical techniques including NMR, FT-IR, UV-visible, mass spectroscopy, and high pressure liquid chromatography. The results are presented of the model compound studies which strongly support the formation of a Diels-Alder adduct in the reaction of an acetylene-terminated compound and a bismaleimide or benzoquinone.

  15. Metal Additive Manufacturing: A Review

    NASA Astrophysics Data System (ADS)

    Frazier, William E.

    2014-06-01

    This paper reviews the state-of-the-art of an important, rapidly emerging, manufacturing technology that is alternatively called additive manufacturing (AM), direct digital manufacturing, free form fabrication, or 3D printing, etc. A broad contextual overview of metallic AM is provided. AM has the potential to revolutionize the global parts manufacturing and logistics landscape. It enables distributed manufacturing and the productions of parts-on-demand while offering the potential to reduce cost, energy consumption, and carbon footprint. This paper explores the material science, processes, and business consideration associated with achieving these performance gains. It is concluded that a paradigm shift is required in order to fully exploit AM potential.

  16. Emergency contraception

    PubMed Central

    Langille, Donald B.; Allen, Michael; Whelan, Anne Marie

    2012-01-01

    Abstract Objective To determine the extent to which Nova Scotian FPs prescribe and provide emergency contraceptive pills (ECPs) and to explore their knowledge of and attitudes toward ECPs. Design Survey of Nova Scotian FPs using a modified Dillman method. Setting All regions of Nova Scotia. Participants Family physicians registered with Dalhousie University’s Division of Continuing Medical Education. Main outcome measures Sex differences in the provision of ECPs and knowledge and attitudes about the ECP Plan B. Results Of 913 eligible FPs, 155 (17.0%) participated in the survey. Respondents resembled the sampling frame closely. Most physicians (64.0%) had prescribed ECPs in the previous year (mean number of prescriptions, 4.92); only 12.9% provided ECPs in advance of need. Knowledge about Plan B was quite good, except for knowledge of the time frame for potential effectiveness; only 29.2% of respondents answered that question correctly. Respondents generally supported nonprescription availability of ECPs, but 25.0% of FPs were concerned that this could lead to less use of more effective methods of contraception, and 39.2% believed that it would encourage repeat use. Younger FPs provided ECPs more often than their older colleagues, while female respondents had better knowledge about Plan B. In multivariate analysis being younger than 40 years was marginally associated with prescribing Plan B and with prescribing any form of ECP. Conclusion Most Nova Scotian FPs provided ECPs and had generally good knowledge about and attitudes toward providing such contraception without prescription. However, FPs were poorly informed about the length of time that Plan B can be effective, which could potentially affect use when patients consult several days after unprotected sex. There were some concerns about nonprescription availability of ECPs, which could have implications for recommending it to patients. Rarely were ECPs prescribed for advance use, which might represent a lost

  17. [Ultrasound in the hands of emergency physicians].

    PubMed

    Lukkarinen, Timo; Palomäki, Ari

    2016-01-01

    Emergency ultrasound (US) offers additive value in the diagnosis and treatment of emergency and/or critically ill patients. Emergency Medicine (EM) became a new specialty in Finland in the beginning of 2013. Since then, the training of emergency US has dramatically increased. We discuss the current situation of emergency US as a part of specialist training of EM in Finland and compare it with that in the United States and Canada. Practical indications, limitations and future prospects of emergency US are also presented.

  18. [Ultrasound in the hands of emergency physicians].

    PubMed

    Lukkarinen, Timo; Palomäki, Ari

    2016-01-01

    Emergency ultrasound (US) offers additive value in the diagnosis and treatment of emergency and/or critically ill patients. Emergency Medicine (EM) became a new specialty in Finland in the beginning of 2013. Since then, the training of emergency US has dramatically increased. We discuss the current situation of emergency US as a part of specialist training of EM in Finland and compare it with that in the United States and Canada. Practical indications, limitations and future prospects of emergency US are also presented. PMID:27244935

  19. Emerging and Disruptive Technologies

    PubMed Central

    2016-01-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages.

  20. Emerging and Disruptive Technologies.

    PubMed

    Kricka, Larry J

    2016-08-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages. PMID:27683538

  1. Emerging and Disruptive Technologies.

    PubMed

    Kricka, Larry J

    2016-08-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages.

  2. Emerging and Disruptive Technologies

    PubMed Central

    2016-01-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages. PMID:27683538

  3. Emerging parasitic diseases of sheep.

    PubMed

    Taylor, M A

    2012-09-30

    There have been changes in the emergence and inability to control of a number of sheep parasitic infections over the last decade. This review focuses on the more globally important sheep parasites, whose reported changes in epidemiology, occurrence or failure to control are becoming increasingly evident. One of the main perceived driving forces is climate change, which can have profound effects on parasite epidemiology, especially for those parasitic diseases where weather has a direct effect on the development of free-living stages. The emergence of anthelmintic-resistant strains of parasitic nematodes and the increasing reliance placed on anthelmintics for their control, can exert profound changes on the epidemiology of those nematodes causing parasitic gastroenteritis. As a consequence, the effectiveness of existing control strategies presents a major threat to sheep production in many areas around the world. The incidence of the liver fluke, Fasciola hepatica, is inextricably linked to high rainfall and is particularly prevalent in high rainfall years. Over the last few decades, there have also been increasing reports of other fluke associated diseases, such as dicroceliosis and paramphistomosis, in a number of western European countries, possibly introduced through animal movements, and able to establish with changing climates. External parasite infections, such as myiasis, can cause significant economic loss and presents as a major welfare problem. The range of elevated temperatures predicted by current climate change scenarios, result in an elongated blowfly season with earlier spring emergence and a higher cumulative incidence of fly strike. Additionally, legislative decisions leading to enforced changes in pesticide usage and choices have resulted in increased reports and spread of ectoparasitic infections, particularly mite, lice and tick infestations in sheep. Factors, such as dip disposal and associated environmental concerns, and, perhaps more

  4. Evidence for an additional intracellular site of action of probucol in the prevention of oxidative modification of low density lipoprotein. Use of a new water-soluble probucol derivative.

    PubMed Central

    Parthasarathy, S

    1992-01-01

    Oxidative modification of low density lipoprotein (LDL) renders it more atherogenic. Probucol, a highly nonpolar antioxidant, is transported in lipoproteins, including LDL, and inhibits oxidative modification of LDL in vitro. The ability of probucol to inhibit atherogenesis in the LDL receptor-deficient rabbit has been attributed to its antioxidant effect. We report synthesis of a new water-soluble analogue of probucol that is very effective in preventing cell-induced LDL oxidation. The polar probucol derivative, diglutaryl probucol, is efficiently taken up by endothelial cells and macrophages in culture and is hydrolyzed to release the active antioxidant, probucol. The treated cells, after thorough washing, show a marked decrease in their capacity to oxidize LDL during a subsequent incubation. At high concentrations of the derivative, the cells also released free probucol into the medium. Thus, the effectiveness of probucol in vivo may be related both to its presence in LDL, acting as a nonspecific antioxidant, and to an additional ability to inhibit cell-mediated oxidation of LDL by virtue of its uptake into cells. PMID:1569200

  5. Emergency department coding and billing.

    PubMed

    Edelberg, Caral

    2004-02-01

    ED coding and billing are challenging additions to the responsibilities of emergency physicians. Assurances that each is performed in the most efficient and accurate manner possible is an essential component of today's emergency medicine practice. Minimizing the risk for submitting fraudulent claims is critical, because it assures the efficient and timely billing of all ED services. For the practice to thrive, each is necessary. PMID:15062501

  6. Preschoolers' Emergent Writing at the Computer.

    ERIC Educational Resources Information Center

    Escobedo, Theresa H.; Allen, Margaret

    This study analyzed 131 computer-generated graphics for evidence of emergent writing. Four preschool children created the drawings on a color and a black-and-white computer during eight weekly 1.5 hour sessions. Audio and videotapes were obtained to review procedures, language, and emergent literacy intent. Drawings were categorized independently…

  7. Evolution. When did photosynthesis emerge on Earth?

    PubMed

    De Marais, D J

    2000-09-01

    Life began early in Earth's history, but it was the emergence of photosynthesis that allowed its proliferation across the planet, because it freed life from its sole dependence on abiotic chemical sources of reducing power. Des Marais discusses recent geological and molecular biological evidence, such as the paper by Xiong et al., that photosynthesis emerged at least 2,800 million years ago.

  8. Histone variants: emerging players in cancer biology

    PubMed Central

    Vardabasso, Chiara; Hasson, Dan; Ratnakumar, Kajan; Chung, Chi-Yeh; Duarte, Luis F.

    2014-01-01

    Histone variants are key players in shaping chromatin structure, and, thus, in regulating fundamental cellular processes such as chromosome segregation and gene expression. Emerging evidence points towards a role for histone variants in contributing to tumor progression, and, recently, the first cancer-associated mutation in a histone variant-encoding gene was reported. In addition, genetic alterations of the histone chaperones that specifically regulate chromatin incorporation of histone variants are rapidly being uncovered in numerous cancers. Collectively, these findings implicate histone variants as potential drivers of cancer initiation and/or progression, and, therefore, targeting histone deposition or the chromatin remodeling machinery may be of therapeutic value. Here, we review the mammalian histone variants of the H2A and H3 families in their respective cellular functions, and their involvement in tumor biology. PMID:23652611

  9. 44 CFR 13.6 - Additions and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Additions and exceptions. 13.6 Section 13.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... requirements except in codified regulations published in the Federal Register. (b) Exceptions for classes...

  10. 44 CFR 68.9 - Admissible evidence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9... PROCEDURES § 68.9 Admissible evidence. (a) Legal rules of evidence shall not be in effect at adminstrative hearings. However, only evidence relevant to issues within the scope of review under § 68.8 shall...

  11. EMERGE. Final report

    SciTech Connect

    Vonderhoe, Robert H.

    2002-03-12

    EMERGE had two basic goals: (1) To ensure that the DOE-funded labs at UW-Madison, U of Chicago, and UIUC were connected to the DOE National Labs at the highest available speeds. EMERGE grantees were to work with DOE network engineers to achieve this goal. (2) Establish a testbed for DiffServ networking, develop monitoring, measuring and, visualization tools, develop a grid services package, cooperate with Internet2's Quality DiffServ efforts, and deploy results. For the most part these goals have been achieved, although there were some gaps. By the same token there were also some achievements that came about beyond expectations. The EMERGE testbed was established and extended to Internet2 and, via STAR TAP, to CERN. Additionally, software was developed. Differentiated Services (DiffServ) is a mechanism for supporting network Quality of Service (or QoS) whereby packets that are transmitted by a client program are marked with a priority setting that can be interpreted by the router to effect special treatment of the packet. In particular the marked packets are promoted to a higher priority queue in the router and, as a result, spend a minimum amount of time in the router. Packets that are not marked are attached to a lower priority queue, and in some cases may be dropped when congestion arises.

  12. [Food additives and healthiness].

    PubMed

    Heinonen, Marina

    2014-01-01

    Additives are used for improving food structure or preventing its spoilage, for example. Many substances used as additives are also naturally present in food. The safety of additives is evaluated according to commonly agreed principles. If high concentrations of an additive cause adverse health effects for humans, a limit of acceptable daily intake (ADI) is set for it. An additive is a risk only when ADI is exceeded. The healthiness of food is measured on the basis of nutrient density and scientifically proven effects.

  13. Emergence of Lying in Very Young Children

    ERIC Educational Resources Information Center

    Evans, Angela D.; Lee, Kang

    2013-01-01

    Lying is a pervasive human behavior. Evidence to date suggests that from the age of 42 months onward, children become increasingly capable of telling lies in various social situations. However, there is limited experimental evidence regarding whether very young children will tell lies spontaneously. The present study investigated the emergence of…

  14. Tactical emergency medical support.

    PubMed

    Rinnert, Kathy J; Hall, William L

    2002-11-01

    As increases in criminal activity collide with more aggressive law enforcement postures, there is more contact between police officers and violent felons. Civilian law enforcement special operations teams routinely engage suspects in these violent, dynamic, and complex interdiction activities. Along with these activities comes the substantial and foreseeable risk of death or grievous harm to law officers, bystanders, hostages, or perpetrators. Further, law enforcement agencies who attempt to apprehend dangerous, heavily armed criminals with a special operations team that lacks the expertise to treat the medical consequences that may arise from such a confrontation may be negligent of deliberate indifference. Meanwhile, evidence exists within the military, civilian law enforcement, and medical literature that on-scene TEMS serves to improve mission success and team safety and health, while decreasing morbidity and mortality in the event of an injury or illness suffered during operations. National professional organizations within law enforcement and emergency medicine have identified and support the fundamental need for mission safety and the development of a standard model to train and incorporate TEMS into law enforcement special operations. The overall objective of TEMS is to minimize the potential for injury and illness and to promote optimal medical care from the scene of operations to a definitive care facility. The design, staffing, and implementation of a TEMS program that maximally uses the community resources integrates previously disparate law enforcement, EMS, and emergency medical/trauma center functions to form a new continuum of care [55].

  15. [INVITED] Lasers in additive manufacturing

    NASA Astrophysics Data System (ADS)

    Pinkerton, Andrew J.

    2016-04-01

    Additive manufacturing is a topic of considerable ongoing interest, with forecasts predicting it to have major impact on industry in the future. This paper focusses on the current status and potential future development of the technology, with particular reference to the role of lasers within it. It begins by making clear the types and roles of lasers in the different categories of additive manufacturing. This is followed by concise reviews of the economic benefits and disadvantages of the technology, current state of the market and use of additive manufacturing in different industries. Details of these fields are referenced rather than expanded in detail. The paper continues, focusing on current indicators to the future of additive manufacturing. Barriers to its development, trends and opportunities in major industrial sectors, and wider opportunities for its development are covered. Evidence indicates that additive manufacturing may not become the dominant manufacturing technology in all industries, but represents an excellent opportunity for lasers to increase their influence in manufacturing as a whole.

  16. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: In a penetrating chest wound is a three-sided dressing or a one-way chest seal better at preventing respiratory complications?

    PubMed

    Walthall, Kirsten

    2012-04-01

    A short-cut review was carried out to establish whether the traditional three-sided dressing is better than a one-way chest seal at preventing the respiratory complications from penetrating chest trauma. Only one animal study, two guidelines and two case reports provided published evidence relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is very little evidence, but that the one-way seals may have practical advantages, particularly in the out-of-hospital setting.

  17. A report on the Academic Emergency Medicine 2015 consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization".

    PubMed

    Gunn, Martin L; Marin, Jennifer R; Mills, Angela M; Chong, Suzanne T; Froemming, Adam T; Johnson, Jamlik O; Kumaravel, Manickam; Sodickson, Aaron D

    2016-08-01

    In May 2015, the Academic Emergency Medicine consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization" was held. The goal of the conference was to develop a high-priority research agenda regarding emergency diagnostic imaging on which to base future research. In addition to representatives from the Society of Academic Emergency Medicine, the multidisciplinary conference included members of several radiology organizations: American Society for Emergency Radiology, Radiological Society of North America, the American College of Radiology, and the American Association of Physicists in Medicine. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Through a multistep consensus process, participants developed targeted research questions for future research in six content areas within emergency diagnostic imaging: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use.

  18. Cognitive Effects of Greek Affiliation in College: Additional Evidence

    ERIC Educational Resources Information Center

    Pascarella, Ernest T.; Flowers, Lamont; Whitt, Elizabeth J.

    2009-01-01

    Previous research published in this journal found broad-based negative effects of Greek affiliation on standardized measures of cognitive development after 1 year of college. Following the same sample, and employing essentially the same research design and analytic model, the present study found that the negative effects of Greek affiliation were…

  19. Additional evidence for complex 2-site polarons in CMR manganites.

    NASA Astrophysics Data System (ADS)

    Bridges, Frank; Kurczveil, Geza; Downward, Lisa; Neumeier, John J.

    2007-03-01

    Recently we have proposed a complex 2-site polaron model (which we call a dimeron) that exists for temperatures near and above the ferromagnetic transition temperature, Tc [1]. The dimeron has a hole delocalized over two Mn sites (i.e. a hole and an electron share the two Mn sites) and the two Mn sites have a reduced distortion compared to the remaining Jahn-Teller distorted electron sites. Magnetic clusters just above Tc are likely clusters of these dimeron quasiparticles. The average valance of the two Mn sites in the dimeron is 3.5 and the spin is 7/2. We show that the Mn K-absorption edge is much better described as a sum of a 3.5 valence edge (fraction 2x) plus a 3 valance edge (fraction 1-2x), compared to earlier simulations using x CaMnO3 plus 1-x LaMnO3. We also show that fitting the Mn-O peak to a sum of two experimental Mn-O standards leads to a similar result as in the earlier study - a fraction 2x of lower distorted Mn sites (dimerons) and a fraction 1-2x of more distorted sites with 1 eg electron. Both support the proposed complex - 2-site polaron model.Supported under NSF grant DMR0301971.[1] L. Downward et. al., Phys Rev Lett 95, 106401 (2005).

  20. Eating Disorder Diagnostic Scale: Additional Evidence of Reliability and Validity

    ERIC Educational Resources Information Center

    Stice, Eric; Fisher, Melissa; Martinez, Erin

    2004-01-01

    The authors conducted 4 studies investigating the reliability and validity of the Eating Disorder Diagnostic Scale (HDDS; E. Stice, C. F. Telch, & S. L. Rizvi, 2000), a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa, and binge eating disorder. Study 1 found that the HDDS showed criterion validity with interview-based…

  1. [Pediatric emergencies in the emergency medical service].

    PubMed

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  2. First Record of Drosophila buzzatii (Patterson & Wheeler) (Diptera: Drosophilidae) Emerging from a Non-Cactus Host.

    PubMed

    Fanara, J J; Soto, I M; Lipko, P; Hasson, E

    2016-06-01

    Drosophila buzzatii (Patterson & Wheeler), a typical cactophilic species of the repleta group, is registered for the first time emerging from Melon (Cucumis melo) in western Argentina. The analysis of inversion polymorphism and genetic diversity of mitochondrial cytochrome oxidase subunit I gene (mtCOI) provided additional evidence that corroborated the presence of a high proportion of D. buzzatii among the flies emerged from melon. This finding set the scenario for a broader range of possible hosts and host-related distribution and dispersion for this widespread species. PMID:26960546

  3. Emergency Medical Services

    MedlinePlus

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  4. Recognizing medical emergencies

    MedlinePlus

    Medical emergencies - how to recognize them ... According to the American College of Emergency Physicians, the following are warning signs of a medical emergency: Bleeding that will not stop Breathing problems ( difficulty breathing , shortness of breath ) ...

  5. Emergency Contraception Website

    MedlinePlus

    Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This website is ...

  6. The emergence of physiological genomics.

    PubMed

    Cowley, A W

    1999-01-01

    'Physiological genomics' represents a research paradigm shift emerging to define the functions of tens of thousands of newly discovered genes which are expected to emerge from the sequencing of the human genome and other model organisms. Genomic tools, which will allow a higher efficiency of identification of gene function, are being developed at remarkable speed. This article discusses some of the genomic and bioinformatic tools currently available or under development to provide the infrastructure for mapping and identification of gene function in simple organisms (bacteria, zebrafish, fly, worm) and complex mammalian organisms (mouse and rat). The problems facing the scientific community in the implementation of this functional approach are discussed as it is now evident that new technological and organizational infrastructures are emerging to link genes to overall function of whole organisms.

  7. Pediatric office emergencies.

    PubMed

    Fuchs, Susan

    2013-10-01

    Pediatricians regularly see emergencies in the office, or children that require transfer to an emergency department, or hospitalization. An office self-assessment is the first step in determining how to prepare for an emergency. The use of mock codes and skill drills make office personnel feel less anxious about medical emergencies. Emergency information forms provide valuable, quick information about complex patients for emergency medical services and other physicians caring for patients. Furthermore, disaster planning should be part of an office preparedness plan.

  8. Neurological emergencies: acute stroke

    PubMed Central

    Davenport, R.; Dennis, M.

    2000-01-01

    Stroke causes a vast amount of death and disability throughout the world, yet for many healthcare professionals it remains an area of therapeutic nihilism, and thus uninteresting. This negative perception is shared by the general public, who often have a poor understanding of the early symptoms and significance of a stroke. Yet within the past few years there have been many important developments in the approach to caring for stroke patients, for both the acute management and secondary prevention. After the completion of numerous clinical trials, there is now robust evidence to either support or discredit various interventions. Even more exciting is the prospect of yet more data becoming available in the near future, testing a whole array of treatments, as clinical interest in stroke expands exponentially. In this review an evidence based approach to the management of acute stroke within the first few days is presented, including ischaemic and haemorrhagic events, but not subarachnoid haemorrhage. It is explained why stroke is regarded as a medical emergency, and the importance of a rational, methodic approach to the initial assessment, which is the key to accurate diagnosis and subsequent management, is emphasised. The potential early problems associated with stroke are identified and specific interventions for different stroke types are discussed. The review ends with a brief discussion of the implications that the evolving treatments have for the organisation of modern stroke services.

 PMID:10675208

  9. Psoriasis: classical and emerging comorbidities.

    PubMed

    Oliveira, Maria de Fátima Santos Paim de; Rocha, Bruno de Oliveira; Duarte, Gleison Vieira

    2015-01-01

    Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis.

  10. Psoriasis: classical and emerging comorbidities*

    PubMed Central

    de Oliveira, Maria de Fátima Santos Paim; Rocha, Bruno de Oliveira; Duarte, Gleison Vieira

    2015-01-01

    Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis. PMID:25672294

  11. Additive manufacturing of hybrid circuits

    DOE PAGES

    Bell, Nelson S.; Sarobol, Pylin; Cook, Adam; Clem, Paul G.; Keicher, David M.; Hirschfeld, Deidre; Hall, Aaron Christopher

    2016-03-26

    There is a rising interest in developing functional electronics using additively manufactured components. Considerations in materials selection and pathways to forming hybrid circuits and devices must demonstrate useful electronic function; must enable integration; and must complement the complex shape, low cost, high volume, and high functionality of structural but generally electronically passive additively manufactured components. This article reviews several emerging technologies being used in industry and research/development to provide integration advantages of fabricating multilayer hybrid circuits or devices. First, we review a maskless, noncontact, direct write (DW) technology that excels in the deposition of metallic colloid inks for electrical interconnects.more » Second, we review a complementary technology, aerosol deposition (AD), which excels in the deposition of metallic and ceramic powder as consolidated, thick conformal coatings and is additionally patternable through masking. As a result, we show examples of hybrid circuits/devices integrated beyond 2-D planes, using combinations of DW or AD processes and conventional, established processes.« less

  12. Public Health, Hypertension, and the Emergency Department.

    PubMed

    Brody, Aaron; Janke, Alex; Sharma, Vineet; Levy, Phillip

    2016-06-01

    Hypertension (HTN) is the most common cardiovascular disease worldwide and is associated with severe long-term morbidity when not treated appropriately. Despite this, blood pressure (BP) control remains suboptimal, particularly among underserved populations and those who rely on emergency departments (EDs) as a source of primary care. ED providers encounter patients with severely elevated BP daily, and yet adherence to minimal standards of BP reassessment and referral to outpatient medical care, as recommended by the American College of Emergency Physicians, is limited. Barriers such as provider knowledge deficits, resource constraints, and negative attitudes towards patients who utilize EDs for nonurgent complaints are compounded by perceptions of HTN as a condition that can only be addressed in a primary care setting to contribute to this. Efforts to reduce this gap must go beyond government mandates to address systemic issues including access to care and payment models to encourage health promotion. Additionally, individual physician behavior can be shifted through targeted education, financial incentives, and the accumulation of high-quality evidence to encourage more proactive approaches to the management of uncontrolled HTN in the ED. PMID:27165429

  13. 33 CFR 203.83 - Additional requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

  14. 47 CFR 68.318 - Additional limitations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Conditions for Terminal Equipment Approval § 68.318 Additional... activation. Note to paragraph (b)(1): Emergency alarm dialers and dialers under external computer control are... proceeding to dial another number. (6) Network addressing signals shall be transmitted no earlier than:...

  15. 33 CFR 214.4 - Additional authority.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of clean drinking water, on such terms as he determines to be advisable, to any locality which he finds is confronted with a source of contaminated drinking water causing or likely to cause a... DEFENSE EMERGENCY SUPPLIES OF DRINKING WATER § 214.4 Additional authority. Section 82(2), Pub. L....

  16. 33 CFR 214.4 - Additional authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DEFENSE EMERGENCY SUPPLIES OF DRINKING WATER § 214.4 Additional authority. Section 82(2), Pub. L. 93-251... of clean drinking water, on such terms as he determines to be advisable, to any locality which he finds is confronted with a source of contaminated drinking water causing or likely to cause...

  17. 33 CFR 214.4 - Additional authority.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DEFENSE EMERGENCY SUPPLIES OF DRINKING WATER § 214.4 Additional authority. Section 82(2), Pub. L. 93-251... of clean drinking water, on such terms as he determines to be advisable, to any locality which he finds is confronted with a source of contaminated drinking water causing or likely to cause...

  18. 33 CFR 214.4 - Additional authority.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DEFENSE EMERGENCY SUPPLIES OF DRINKING WATER § 214.4 Additional authority. Section 82(2), Pub. L. 93-251... of clean drinking water, on such terms as he determines to be advisable, to any locality which he finds is confronted with a source of contaminated drinking water causing or likely to cause...

  19. Polyimide processing additives

    NASA Technical Reports Server (NTRS)

    Fletcher, James C. (Inventor); Pratt, J. Richard (Inventor); St.clair, Terry L. (Inventor); Stoakley, Diane M. (Inventor); Burks, Harold D. (Inventor)

    1992-01-01

    A process for preparing polyimides having enhanced melt flow properties is described. The process consists of heating a mixture of a high molecular weight poly-(amic acid) or polyimide with a low molecular weight amic acid or imide additive in the range of 0.05 to 15 percent by weight of additive. The polyimide powders so obtained show improved processability, as evidenced by lower melt viscosity by capillary rheometry. Likewise, films prepared from mixtures of polymers with additives show improved processability with earlier onset of stretching by TMA.

  20. Polyimide processing additives

    NASA Technical Reports Server (NTRS)

    Pratt, J. Richard (Inventor); St.clair, Terry L. (Inventor); Stoakley, Diane M. (Inventor); Burks, Harold D. (Inventor)

    1993-01-01

    A process for preparing polyimides having enhanced melt flow properties is described. The process consists of heating a mixture of a high molecular weight poly-(amic acid) or polyimide with a low molecular weight amic acid or imide additive in the range of 0.05 to 15 percent by weight of the additive. The polyimide powders so obtained show improved processability, as evidenced by lower melt viscosity by capillary rheometry. Likewise, films prepared from mixtures of polymers with additives show improved processability with earlier onset of stretching by TMA.

  1. Additional Types of Neuropathy

    MedlinePlus

    ... A A Listen En Español Additional Types of Neuropathy Charcot's Joint Charcot's Joint, also called neuropathic arthropathy, ... can stop bone destruction and aid healing. Cranial Neuropathy Cranial neuropathy affects the 12 pairs of nerves ...

  2. Food Additives and Hyperkinesis

    ERIC Educational Resources Information Center

    Wender, Ester H.

    1977-01-01

    The hypothesis that food additives are causally associated with hyperkinesis and learning disabilities in children is reviewed, and available data are summarized. Available from: American Medical Association 535 North Dearborn Street Chicago, Illinois 60610. (JG)

  3. Smog control fuel additives

    SciTech Connect

    Lundby, W.

    1993-06-29

    A method is described of controlling, reducing or eliminating, ozone and related smog resulting from photochemical reactions between ozone and automotive or industrial gases comprising the addition of iodine or compounds of iodine to hydrocarbon-base fuels prior to or during combustion in an amount of about 1 part iodine per 240 to 10,000,000 parts fuel, by weight, to be accomplished by: (a) the addition of these inhibitors during or after the refining or manufacturing process of liquid fuels; (b) the production of these inhibitors for addition into fuel tanks, such as automotive or industrial tanks; or (c) the addition of these inhibitors into combustion chambers of equipment utilizing solid fuels for the purpose of reducing ozone.

  4. Overview of Emerging Contaminants and Associated Human Health Effects

    PubMed Central

    Lei, Meng; Zhang, Lun; Lei, Jianjun; Zong, Liang; Li, Jiahui; Wu, Zheng; Wang, Zheng

    2015-01-01

    In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants. PMID:26713315

  5. Overview of Emerging Contaminants and Associated Human Health Effects.

    PubMed

    Lei, Meng; Zhang, Lun; Lei, Jianjun; Zong, Liang; Li, Jiahui; Wu, Zheng; Wang, Zheng

    2015-01-01

    In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants. PMID:26713315

  6. Phenylethynyl Containing Reactive Additives

    NASA Technical Reports Server (NTRS)

    Connell, John W. (Inventor); Smith, Joseph G., Jr. (Inventor); Hergenrother, Paul M. (Inventor)

    2002-01-01

    Phenylethynyl containing reactive additives were prepared from aromatic diamine, containing phenylethvnvl groups and various ratios of phthalic anhydride and 4-phenylethynviphthalic anhydride in glacial acetic acid to form the imide in one step or in N-methyl-2-pvrrolidinone to form the amide acid intermediate. The reactive additives were mixed in various amounts (10% to 90%) with oligomers containing either terminal or pendent phenylethynyl groups (or both) to reduce the melt viscosity and thereby enhance processability. Upon thermal cure, the additives react and become chemically incorporated into the matrix and effect an increase in crosslink density relative to that of the host resin. This resultant increase in crosslink density has advantageous consequences on the cured resin properties such as higher glass transition temperature and higher modulus as compared to that of the host resin.

  7. Emerging chlamydial infections.

    PubMed

    Corsaro, Daniele; Venditti, Danielle

    2004-01-01

    Chlamydiae are important intracellular bacterial pathogens of vertebrates. In the last years, novel members of this group have been discovered: Parachlamydia acanthamoebae and Simkania negevensis seems to be emerging respiratory human pathogens, while Waddlia chondrophila might be a new agent of bovine abortion. Various species have been showed to infect also the herpetofauna and fishes, and some novel chlamydiae are endosymbionts of arthropods. In addition, molecular studies evidenced a huge diversity of chlamydiae from both environmental and clinical samples, most of such a diversity could be formed by novel lineages of chlamydiae. Experimental studies showed that free-living amoebae may support multiplication of various chlamydiae, then could play an important role as reservoir/vector of chlamydial infections. Here we reviewed literature data concerning chlamydial infections, with a particular emphasis on the novely described chlamydial organisms.

  8. Epilepsy emergency rescue training

    PubMed Central

    Shankar, Rohit; Jory, Caryn; ashton, juliet; McLean, Brendan; Walker, Matthew

    2015-01-01

    The NICE audit of epilepsy related deaths revealed that 1200 epilepsy deaths occur every year in the UK, with 42% potentially avoidable.[1] Convulsive status epilepticus (SE) is a life-threatening condition with over 20% mortality rate, especially if early treatment is not initiated.[2] Ten percent of all UK emergency department (ED) admissions are due to epilepsy, usually over represented by cases of SE.[3] Six out of seven epilepsy cases seen in the ED are admitted into medical care.[4] Patients with chronic and/or treatment resistant epilepsy carry a higher risk of premature death. When a seizure lasts for five minutes or more then the patient is at high risk of continuing to SE and this may result in causing brain damage or death.[2] Buccal midazolam is an emergency rescue medication prescribed on a special named patient license to reduce the duration of an epileptic seizure and prevent SE.[2,5] It should be administered by a trained person and is widely used due to its effectiveness and social acceptability. In the UK, epilepsy education and training courses are expected to be conducted by epilepsy professionals in line with the agreed training guidelines of Joint Epilepsy Council (JEC) backed up by evidence from NICE.[6,7] Training should provide an overview of epilepsy to facilitate safe care and appropriate administration of rescue medication for people with epilepsy (PWE) when experiencing a prolonged seizure. The medication is prescribed on specialist advice by the GP or specialists directly. Unfortunately the JEC guidelines are not robust enough to provide assurances of safe care. This problem had a myriad of complexities and an appropriate solution using web based resource was piloted, tested, and applied successfully using quality improvement methodology. PMID:26734339

  9. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: does magnesium prolong the analgaesic effect of bupivacaine in a fascia iliaca nerve block?

    PubMed

    Kilgour, Peter; Oni, Babajide; Ghanayem, Hisham; Tabone, Dianne

    2015-05-01

    A shortcut review was carried out to establish whether routine use of magnesium as an adjunct to bupivacaine fascia iliaca nerve block in femoral neck fracture was effective in prolonging its analgaesic effect. Forty-four papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that while magnesium has the potential to prolong the analgaesic effect of bupivacaine further studies are needed to clarify its exact role and safety profile.

  10. [The situation of emergency psychiatry in Germany].

    PubMed

    Pajonk, F-G B

    2015-09-01

    The impact of psychiatric emergencies for the care of patients in preclinical emergency medicine, in emergency departments and in psychiatric hospitals has been underestimated for a long time. There is still insufficient knowledge and a need for further research. There are, however, sufficient reasons to assume that annually approximately 500,000 patients with a psychiatric emergency receive treatment from a preclinical emergency physician and another 1.5 million in emergency departments in Germany. Further, approximately 500,000 patients are admitted to psychiatric hospitals as an emergency. The most frequent reasons are intoxication, agitation, aggressiveness and suicidal ideation, posing a threat of self-harm to the patient or to other persons and evoking other life-threatening conditions. Emergency psychiatry also plays a role in collective injuries, such as mass disasters, catastrophes and rampage situations. There is some evidence that the number of psychiatric emergencies is increasing. Reasons are, among others, changes in the services provided for inpatient and outpatient treatment, a reduction in stabilizing psychosocial factors and a general increase in the utilization of emergency healthcare services. PMID:26099496

  11. Role of extracellular vesicles in de novo mineralization: an additional novel mechanism of cardiovascular calcification.

    PubMed

    New, Sophie E P; Aikawa, Elena

    2013-08-01

    Extracellular vesicles are membrane micro/nanovesicles secreted by many cell types into the circulation and the extracellular milieu in physiological and pathological conditions. Evidence suggests that extracellular vesicles, known as matrix vesicles, play a role in the mineralization of skeletal tissue, but emerging ultrastructural and in vitro studies have demonstrated their contribution to cardiovascular calcification as well. Cells involved in the progression of cardiovascular calcification release active vesicles capable of nucleating hydroxyapatite on their membranes. This review discusses the role of extracellular vesicles in cardiovascular calcification and elaborates on this additional mechanism of calcification as an alternative pathway to the currently accepted mechanism of biomineralization via osteogenic differentiation.

  12. Multifunctional fuel additives

    SciTech Connect

    Baillargeon, D.J.; Cardis, A.B.; Heck, D.B.

    1991-03-26

    This paper discusses a composition comprising a major amount of a liquid hydrocarbyl fuel and a minor low-temperature flow properties improving amount of an additive product of the reaction of a suitable diol and product of a benzophenone tetracarboxylic dianhydride and a long-chain hydrocarbyl aminoalcohol.

  13. Biobased lubricant additives

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fully biobased lubricants are those formulated using all biobased ingredients, i.e. biobased base oils and biobased additives. Such formulations provide the maximum environmental, safety, and economic benefits expected from a biobased product. Currently, there are a number of biobased base oils that...

  14. 21 CFR 640.27 - Emergency provisions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Emergency provisions. 640.27 Section 640.27 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.27 Emergency provisions. The use...

  15. 49 CFR 211.75 - Evidence.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Evidence. 211.75 Section 211.75 Transportation... TRANSPORTATION RULES OF PRACTICE Interim Procedures for the Review of Emergency Orders § 211.75 Evidence. (a) The Federal Rules of Evidence for United States Courts and Magistrates shall be employed as general...

  16. 49 CFR 211.75 - Evidence.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Evidence. 211.75 Section 211.75 Transportation... TRANSPORTATION RULES OF PRACTICE Interim Procedures for the Review of Emergency Orders § 211.75 Evidence. (a) The Federal Rules of Evidence for United States Courts and Magistrates shall be employed as general...

  17. 49 CFR 211.75 - Evidence.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Evidence. 211.75 Section 211.75 Transportation... TRANSPORTATION RULES OF PRACTICE Interim Procedures for the Review of Emergency Orders § 211.75 Evidence. (a) The Federal Rules of Evidence for United States Courts and Magistrates shall be employed as general...

  18. 49 CFR 211.75 - Evidence.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Evidence. 211.75 Section 211.75 Transportation... TRANSPORTATION RULES OF PRACTICE Interim Procedures for the Review of Emergency Orders § 211.75 Evidence. (a) The Federal Rules of Evidence for United States Courts and Magistrates shall be employed as general...

  19. 49 CFR 211.75 - Evidence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Evidence. 211.75 Section 211.75 Transportation... TRANSPORTATION RULES OF PRACTICE Interim Procedures for the Review of Emergency Orders § 211.75 Evidence. (a) The Federal Rules of Evidence for United States Courts and Magistrates shall be employed as general...

  20. Emerging and re-emerging arboviral diseases in Southeast Asia.

    PubMed

    Dash, A P; Bhatia, Rajesh; Sunyoto, Temmy; Mourya, D T

    2013-01-01

    Arthropod-borne viruses (arboviruses) have become significant public health problems, with the emergence and re-emergence of arboviral diseases nearly worldwide. The most populated Southeast Asia region is particularly vulnerable. The arboviral diseases such as dengue (DEN), Japanese encephalitis (JE), West Nile virus (WNV), chikungunya fever (CHIK), hemorrhagic fevers such as Crimean-Congo hemorrhagic (CCHF) fever, Kyasanur forest disease virus (KFDV), etc. are on the rise and have spread unprecedentedly, causing considerable burden of disease. The emergence/re-emergence of these diseases is associated with complex factors, such as viral recombination and mutation, leading to more virulent and adaptive strains, urbanization and human activities creating more permissive environment for vector-host interaction, and increased air travel and commerce. Climate is a major factor in determining the geographic and temporal distribution of arthropods, the characteristics of arthropod life cycles, the consequent dispersal patterns of associated arboviruses, the evolution of arboviruses; and the efficiency with which they are transmitted from arthropods to vertebrate hosts. The present and future arboviral threats must be mitigated by priority actions such as improving surveillance and outbreak response, establishing collaboration and communication intersectorally, and strengthening the prevention and control programmes along with improving biosafety aspects with regards to highly infectious nature of these arboviral diseases. Evidence from research needs to be generated and priority areas for research defined.

  1. 21 CFR 640.27 - Emergency provisions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.27 Emergency provisions. The use of... must be transfused with the platelets from a specific donor, and (b) the plateletpheresis procedure...

  2. 21 CFR 640.27 - Emergency provisions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.27 Emergency provisions. The use of... must be transfused with the platelets from a specific donor, and (b) the plateletpheresis procedure...

  3. 21 CFR 640.27 - Emergency provisions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.27 Emergency provisions. The use of... must be transfused with the platelets from a specific donor, and (b) the plateletpheresis procedure...

  4. 21 CFR 640.27 - Emergency provisions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.27 Emergency provisions. The use of... must be transfused with the platelets from a specific donor, and (b) the plateletpheresis procedure...

  5. 50 CFR 229.9 - Emergency regulations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... than 180 days or until the end of the applicable commercial fishing season, whichever is earlier... regulations for an additional period of not more than 90 days or until reasons for the emergency...

  6. Supergranular-scale magnetic flux emergence beneath an unstable filament

    NASA Astrophysics Data System (ADS)

    Palacios, J.; Cid, C.; Guerrero, A.; Saiz, E.; Cerrato, Y.

    2015-11-01

    Aims: Here we report evidence of a large solar filament eruption on 2013, September 29. This smooth eruption, which passed without any previous flare, formed after a two-ribbon flare and a coronal mass ejection towards Earth. The coronal mass ejection generated a moderate geomagnetic storm on 2013, October 2 with very serious localized effects. The whole event passed unnoticed to flare-warning systems. Methods: We have conducted multi-wavelength analyses of the Solar Dynamics Observatory through Atmospheric Imaging Assembly (AIA) and Helioseismic and Magnetic Imager (HMI) data. The AIA data on 304, 193, 211, and 94 Å sample the transition region and the corona, respectively, while HMI provides photospheric magnetograms, continuum, and linear polarization data, in addition to the fully inverted data provided by HMI. Results: This flux emergence happened very close to a filament barb that was very active in mass motion, as seen in 304 Å images. The observed flux emergence exhibited hectogauss values. The flux emergence extent appeared just beneath the filament, and the filament rose during the following hours. The emergence acquired a size of 33'' in ~12 h, about ~0.16 km s-1. The rate of signed magnetic flux is around 2 × 1017 Mx min-1 for each polarity. We have also studied the eruption speed, size, and dynamics. The mean velocity of the rising filament during the ~40 min previous to the flare is 115 ± 5 km s-1, and the subsequent acceleration in this period is 0.049 ± 0.001 km s-2. Conclusions: We have observed a supergranular-sized emergence close to a large filament in the boundary of the active region NOAA11850. Filament dynamics and magnetogram results suggest that the magnetic flux emergence takes place in the photospheric level below the filament. Reconnection occurs underneath the filament between the dipped lines that support the filament and the supergranular emergence. The very smooth ascent is probably caused by this emergence and torus instability

  7. Treatment of pediatric migraine in the emergency room.

    PubMed

    Gelfand, Amy A; Goadsby, Peter J

    2012-10-01

    Migraine constitutes a relatively common reason for pediatric emergency room visits. Given the paucity of randomized trials involving pediatric migraineurs in the emergency department setting compared with adults, recommendations for managing these children are largely extrapolated from adult migraine emergency room studies and trials involving outpatient home pediatric migraine therapy. We review current knowledge about pediatric migraineurs presenting at the emergency room and their management, and summarize the best evidence available to guide clinical decision-making.

  8. Review of Spaceflight Dental Emergencies

    NASA Technical Reports Server (NTRS)

    Menon, Anil

    2012-01-01

    All exploration class missions--extending beyond earth's orbit--differ from existing orbital missions by being of longer duration and often not having a means of evacuation. If an exploration mission extends beyond a year, then there will be a greater lapse since the crewmembers last terrestrial dental exams, which routinely occur each year. This increased time since professional dental care could increase the chance of a dental emergency such as intractable pain, dental decay requiring a temporary filling, crown replacement, exposed pulp, abscess, tooth avulsion, or toothache. Additionally, any dental emergency will have to be treated in-flight with available resources and personnel who may not have extensive training in dental care. Thus, dental emergencies are an important risk to assess in preparation for exploration missions.

  9. Vinyl capped addition polyimides

    NASA Technical Reports Server (NTRS)

    Vannucci, Raymond D. (Inventor); Malarik, Diane C. (Inventor); Delvigs, Peter (Inventor)

    1991-01-01

    Polyimide resins (PMR) are generally useful where high strength and temperature capabilities are required (at temperatures up to about 700 F). Polyimide resins are particularly useful in applications such as jet engine compressor components, for example, blades, vanes, air seals, air splitters, and engine casing parts. Aromatic vinyl capped addition polyimides are obtained by reacting a diamine, an ester of tetracarboxylic acid, and an aromatic vinyl compound. Low void materials with improved oxidative stability when exposed to 700 F air may be fabricated as fiber reinforced high molecular weight capped polyimide composites. The aromatic vinyl capped polyimides are provided with a more aromatic nature and are more thermally stable than highly aliphatic, norbornenyl-type end-capped polyimides employed in PMR resins. The substitution of aromatic vinyl end-caps for norbornenyl end-caps in addition polyimides results in polymers with improved oxidative stability.

  10. Tackifier for addition polyimides

    NASA Technical Reports Server (NTRS)

    Butler, J. M.; St.clair, T. L.

    1980-01-01

    A modification to the addition polyimide, LaRC-160, was prepared to improve tack and drape and increase prepeg out-time. The essentially solventless, high viscosity laminating resin is synthesized from low cost liquid monomers. The modified version takes advantage of a reactive, liquid plasticizer which is used in place of solvent and helps solve a major problem of maintaining good prepeg tack and drape, or the ability of the prepeg to adhere to adjacent plies and conform to a desired shape during the lay up process. This alternate solventless approach allows both longer life of the polymer prepeg and the processing of low void laminates. This approach appears to be applicable to all addition polyimide systems.

  11. Emerging concepts in the treatment of myofascial pain: a review of medications, modalities, and needle-based interventions.

    PubMed

    Annaswamy, Thiru Mandyam; De Luigi, Arthur J; O'Neill, Bryan J; Keole, Nandita; Berbrayer, David

    2011-10-01

    Significant developments and changes in the use of interventions and treatments for the management of myofascial pain syndrome have occurred in the past 10 years. These emerging concepts have changed the approach for clinicians who manage these pain disorders. However, wide variations in practice patterns prevail, and no clear consensus exists regarding when and how to use these interventions; in addition, awareness of the evidence basis behind their use is limited. This review examines the most recent advances in the treatment of myofascial pain syndromes. Specifically, the evidence basis of various emerging interventions is reviewed and recommendations for routine clinical practice and their rationale are provided. The purpose of this review is to provide the clinician with a better understanding of emerging concepts in the interventions used for myofascial pain syndromes.

  12. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Is ST elevation in aVR a sure sign of left main coronary artery stenosis?

    PubMed

    Morris, Niall; Body, Richard

    2016-01-01

    A shortcut review was carried out to establish whether ST elevation in aVR accurately identifies acute myocardial infarction caused by left main coronary artery stenosis. 141 unique papers were found in Medline, EMBASE, Cochrane Database of Systematic Reviews, ACP Journal Club and the Database of Abstracts of Reviews of Effects using the reported searches. Of these, 12 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that ST elevation in aVR can identify high-risk patients for early intensive investigation, particularly when found alongside widespread ST depression. It has insufficient utility to identify patients who require immediate revascularisation. PMID:26699191

  13. Electrophilic addition of astatine

    SciTech Connect

    Norseev, Yu.V.; Vasaros, L.; Nhan, D.D.; Huan, N.K.

    1988-03-01

    It has been shown for the first time that astatine is capable of undergoing addition reactions to unsaturated hydrocarbons. A new compound of astatine, viz., ethylene astatohydrin, has been obtained, and its retention numbers of squalane, Apiezon, and tricresyl phosphate have been found. The influence of various factors on the formation of ethylene astatohydrin has been studied. It has been concluded on the basis of the results obtained that the univalent cations of astatine in an acidic medium is protonated hypoastatous acid.

  14. Developing emergency nursing competence.

    PubMed

    Proehl, Jean A

    2002-03-01

    Developing and maintaining the competence emergency nurses need is an important function of emergency clinical nurse specialists (CNS), educators, and other members of the emergency department (ED) leadership team. A thorough orientation is the first and most important step in developing the competence of emergency nurses. After orientation, the challenge is to maintain currency of practice in the face of incessant change such as new medications, new equipment, and new therapies in emergency care. This article focuses on the orientation of emergency nurses. A related article in this issue addresses assessment of competency. PMID:11818264

  15. Functional Generalized Additive Models.

    PubMed

    McLean, Mathew W; Hooker, Giles; Staicu, Ana-Maria; Scheipl, Fabian; Ruppert, David

    2014-01-01

    We introduce the functional generalized additive model (FGAM), a novel regression model for association studies between a scalar response and a functional predictor. We model the link-transformed mean response as the integral with respect to t of F{X(t), t} where F(·,·) is an unknown regression function and X(t) is a functional covariate. Rather than having an additive model in a finite number of principal components as in Müller and Yao (2008), our model incorporates the functional predictor directly and thus our model can be viewed as the natural functional extension of generalized additive models. We estimate F(·,·) using tensor-product B-splines with roughness penalties. A pointwise quantile transformation of the functional predictor is also considered to ensure each tensor-product B-spline has observed data on its support. The methods are evaluated using simulated data and their predictive performance is compared with other competing scalar-on-function regression alternatives. We illustrate the usefulness of our approach through an application to brain tractography, where X(t) is a signal from diffusion tensor imaging at position, t, along a tract in the brain. In one example, the response is disease-status (case or control) and in a second example, it is the score on a cognitive test. R code for performing the simulations and fitting the FGAM can be found in supplemental materials available online.

  16. The virtues of evidence.

    PubMed

    Zarkovich, Erica; Upshur, R E G

    2002-01-01

    Evidence-based medicine has been defined as the conscientious and judicious use of current best evidence in making clinical decisions. This paper will attempt to explicate the terms "conscientious" and "judicious" within the evidence-based medicine definition. It will be argued that "conscientious" and "judicious" represent virtue terms derived from virtue ethics and virtue epistemology. The identification of explicit virtue components in the definition and therefore conception of evidence-based medicine presents an important starting point in the connection between virtue theories and medicine itself. In addition, a unification of virtue theories and evidence-based medicine will illustrate the need for future research in order to combine the fields of virtue-based approaches and clinical practice.

  17. AINTEGUMENTA and the D-type cyclin CYCD3;1 independently contribute to petal size control in Arabidopsis: evidence for organ size compensation being an emergent rather than a determined property

    PubMed Central

    Randall, Ricardo S.; Sornay, Emily; Dewitte, Walter; Murray, James A. H.

    2015-01-01

    Plant lateral aerial organ (LAO) growth is determined by the number and size of cells comprising the organ. Genetic alteration of one parameter is often accompanied by changes in the other, such that the overall effect on final LAO size is minimized, suggested to be caused by an active organ level ‘compensation mechanism’. For example, the aintegumenta (ant) mutant exhibits reduced cell number but increased cell size in LAOs. The ANT transcription factor regulates the duration of the cell division phase of LAO growth, and its ectopic expression is correlated with increased levels of the cell cycle regulator CYCD3;1. This has previously led to the suggestion that ANT regulates CYCD3;1. It is shown here that while ANT is required for normal cell proliferation in petals, CYCD3;1 is not, suggesting that ANT does not regulate CYCD3;1 during petal growth. Moreover CYCD3;1 expression was similar in wild-type and ant-9 flowers. In contrast to the compensatory changes between cell size and number in ant mutants, cycd3;1 mutants show increased petal cell size unaccompanied by changes in cell number, leading to larger organs. However, loss of CYCD3;1 in the ant-9 mutant background leads to a phenotype consistent with compensation mechanisms. These apparently arbitrary examples of compensation are reconciled through a model of LAO growth in which distinct phases of division and cell expansion occupy differing lengths of a defined overall growth window. This leads to the proposal that many observations of ‘compensation mechanisms’ might alternatively be more simply explained as emergent properties of LAO development. PMID:25948704

  18. [Emerging noninfectious diseases].

    PubMed

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  19. Natural Gas Emergencies

    MedlinePlus

    ... by the Cass (ND) and Clay (MN) Emergency Planning Partnerships. Adapted with funding provided by Fargo Cass Public Health through the Cities Readiness Initiative (CRI) English – Natural Gas Emergencies - Last ...

  20. Emergency preparedness and planning

    NASA Technical Reports Server (NTRS)

    Bouvier, Kenneth

    1993-01-01

    Monsanto's emergency response plan in dealing with hazardous materials at their facilities is presented. Topics discussed include the following: CPR training; emergency medial training; incident reports; contractor injuries; hazardous materials transport; evacuation; and other industrial safety concerns.

  1. Advertising emergency department wait times.

    PubMed

    Weiner, Scott G

    2013-03-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

  2. Advertising emergency department wait times.

    PubMed

    Weiner, Scott G

    2013-03-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

  3. Chikungunya: A Potentially Emerging Epidemic?

    PubMed Central

    Thiboutot, Michelle M.; Kannan, Senthil; Kawalekar, Omkar U.; Shedlock, Devon J.; Khan, Amir S.; Sarangan, Gopalsamy; Srikanth, Padma; Weiner, David B.; Muthumani, Karuppiah

    2010-01-01

    Chikungunya virus is a mosquito-borne emerging pathogen that has a major health impact in humans and causes fever disease, headache, rash, nausea, vomiting, myalgia, and arthralgia. Indigenous to tropical Africa, recent large outbreaks have been reported in parts of South East Asia and several of its neighboring islands in 2005–07 and in Europe in 2007. Furthermore, positive cases have been confirmed in the United States in travelers returning from known outbreak areas. Currently, there is no vaccine or antiviral treatment. With the threat of an emerging global pandemic, the peculiar problems associated with the more immediate and seasonal epidemics warrant the development of an effective vaccine. In this review, we summarize the evidence supporting these concepts. PMID:20436958

  4. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  5. Emerging and Re-Emerging Infectious Diseases

    MedlinePlus

    ... Content Marketing Share this: Main Content Area Emerging Infectious Diseases/Pathogens Research Introduction and Goals Despite remarkable advances ... medical research and treatments during the 20th century, infectious diseases remain among the leading causes of death worldwide. ...

  6. Evidence-based guidelines for the management of large hemispheric infarction : a statement for health care professionals from the Neurocritical Care Society and the German Society for Neuro-intensive Care and Emergency Medicine.

    PubMed

    Torbey, Michel T; Bösel, Julian; Rhoney, Denise H; Rincon, Fred; Staykov, Dimitre; Amar, Arun P; Varelas, Panayiotis N; Jüttler, Eric; Olson, DaiWai; Huttner, Hagen B; Zweckberger, Klaus; Sheth, Kevin N; Dohmen, Christian; Brambrink, Ansgar M; Mayer, Stephan A; Zaidat, Osama O; Hacke, Werner; Schwab, Stefan

    2015-02-01

    Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the critical care management of LHI. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. The panel devised a series of clinical questions related to LHI, and assessed the quality of data related to these questions using the Grading of Recommendation Assessment, Development and Evaluation guideline system. They then developed recommendations (denoted as strong or weak) based on the quality of the evidence, as well as the balance of benefits and harms of the studied interventions, the values and preferences of patients, and resource considerations.

  7. Emergency preparedness lessons from Chernobyl

    SciTech Connect

    Martin, J.B.

    1987-09-01

    Emergency preparedness at nuclear power plants in the US has been considerably enhanced since the Three Mile Island accident. The Chernobyl accident has provided valuable data that can be used to evaluate the merit of some of these enhancements and to determine the need for additional improvements. For example, the USSR intervention levels of 25 rem and 75 rem for evacuation are contrasted with US Environmental Protection Agency protective action guides. The manner in which 135,000 persons were evacuated from the 30-km zone around Chernobyl is constrasted with typical US evacuation plans. Meteorological conditions and particulate deposition patterns were studied to infer characteristics of the radioactive plume from Chernobyl. Typical plume monitoring techniques are examined in light of lessons learned by the Soviets about plume behavior. This review has indicated a need for additional improvements in utility and government emergency plans, procedures, equipment, and training. 12 refs., 1 fig., 2 tabs.

  8. Emergency lighting gets 'smarter'.

    PubMed

    Daniels, Alan

    2012-10-01

    Alan Daniels, business development director of emergency lighting specialist, P4, describes the latest trends in, and requirements for, emergency lighting, a vital part of the building services footprint in hospitals and other healthcare premises. He also explains how those responsible for the safe operation of emergency lighting system can ensure they comply with their obligations under the law.

  9. The emergence of parvoviruses of carnivores

    PubMed Central

    Hoelzer, Karin; Parrish, Colin R.

    2010-01-01

    The emergence of canine parvovirus (CPV) represents a well-documented example highlighting the emergence of a new virus through cross-species transmission. CPV emerged in the mid-1970s as a new pathogen of dogs and has since become endemic in the global dog population. Despite widespread vaccination, CPV has remained a widespread disease of dogs, and new genetic and antigenic variants have arisen and sometimes reached high frequency in certain geographic regions or throughout the world. Here we review our understanding of this emergence event and contrast it to what is known about the emergence of a disease in mink caused by mink enteritis virus (MEV). In addition, we summarize the evolution of CPV over the past 30 years in the global dog population, and describe the epidemiology of contemporary parvovirus infections of dogs and cats. CPV represents a valuable model for understanding disease emergence through cross-species transmission, while MEV provides an interesting comparison. PMID:20152105

  10. 44 CFR 61.16 - Probation additional premium.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Probation additional premium... COVERAGE AND RATES § 61.16 Probation additional premium. The additional premium charged pursuant to § 59.24... premium charge is $50.00.”...

  11. Approach to Reptile Emergency Medicine.

    PubMed

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients.

  12. The Threat Index: An Additive Approach.

    ERIC Educational Resources Information Center

    Robinson, Paul J.; Wood, Keith

    1985-01-01

    Examined the effects of actualization and integration on death anxiety in 120 students who completed the Threat Index, Collett-Lester Fear of Death Scale, and Templer Death Anxiety Scale. Results provided clear evidence that actualization and integration have an additive effect on death fear and anxiety. (JAC)

  13. Performance Boosting Additive

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Mainstream Engineering Corporation was awarded Phase I and Phase II contracts from Goddard Space Flight Center's Small Business Innovation Research (SBIR) program in early 1990. With support from the SBIR program, Mainstream Engineering Corporation has developed a unique low cost additive, QwikBoost (TM), that increases the performance of air conditioners, heat pumps, refrigerators, and freezers. Because of the energy and environmental benefits of QwikBoost, Mainstream received the Tibbetts Award at a White House Ceremony on October 16, 1997. QwikBoost was introduced at the 1998 International Air Conditioning, Heating, and Refrigeration Exposition. QwikBoost is packaged in a handy 3-ounce can (pressurized with R-134a) and will be available for automotive air conditioning systems in summer 1998.

  14. Sewage sludge additive

    NASA Technical Reports Server (NTRS)

    Kalvinskas, J. J.; Mueller, W. A.; Ingham, J. D. (Inventor)

    1980-01-01

    The additive is for a raw sewage treatment process of the type where settling tanks are used for the purpose of permitting the suspended matter in the raw sewage to be settled as well as to permit adsorption of the dissolved contaminants in the water of the sewage. The sludge, which settles down to the bottom of the settling tank is extracted, pyrolyzed and activated to form activated carbon and ash which is mixed with the sewage prior to its introduction into the settling tank. The sludge does not provide all of the activated carbon and ash required for adequate treatment of the raw sewage. It is necessary to add carbon to the process and instead of expensive commercial carbon, coal is used to provide the carbon supplement.

  15. Perspectives on Additive Manufacturing

    NASA Astrophysics Data System (ADS)

    Bourell, David L.

    2016-07-01

    Additive manufacturing (AM) has skyrocketed in visibility commercially and in the public sector. This article describes the development of this field from early layered manufacturing approaches of photosculpture, topography, and material deposition. Certain precursors to modern AM processes are also briefly described. The growth of the field over the last 30 years is presented. Included is the standard delineation of AM technologies into seven broad categories. The economics of AM part generation is considered, and the impacts of the economics on application sectors are described. On the basis of current trends, the future outlook will include a convergence of AM fabricators, mass-produced AM fabricators, enabling of topology optimization designs, and specialization in the AM legal arena. Long-term developments with huge impact are organ printing and volume-based printing.

  16. Sarks as additional fermions

    NASA Astrophysics Data System (ADS)

    Agrawal, Jyoti; Frampton, Paul H.; Jack Ng, Y.; Nishino, Hitoshi; Yasuda, Osamu

    1991-03-01

    An extension of the standard model is proposed. The gauge group is SU(2) X ⊗ SU(3) C ⊗ SU(2) S ⊗ U(1) Q, where all gauge symmetries are unbroken. The colour and electric charge are combined with SU(2) S which becomes strongly coupled at approximately 500 GeV and binds preons to form fermionic and vector bound states. The usual quarks and leptons are singlets under SU(2) X but additional fermions, called sarks. transform under it and the electroweak group. The present model explains why no more than three light quark-lepton families can exist. Neutral sark baryons, called narks, are candidates for the cosmological dark matter having the characteristics designed for WIMPS. Further phenomenological implications of sarks are analyzed i including electron-positron annihilation. Z 0 decay, flavor-changing neutral currents. baryon-number non-conservation, sarkonium and the neutron electric dipole moment.

  17. Epilepsy emergencies: diagnosis and management.

    PubMed

    Foreman, Brandon; Hirsch, Lawrence J

    2012-02-01

    Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. PMID:22284053

  18. Who initiates emergency commitments?

    PubMed

    Christy, Annette; Handelsman, Jessica B; Hanson, Ardis; Ochshorn, Ezra

    2010-04-01

    Florida's Mental Health Act was amended in 2005 and 2006 to include licensed mental health counselors and licensed marriage and family therapists, respectively, to the list of professionals authorized to initiate emergency commitments. The present study evaluates the volume of involuntary emergency commitments by type of initiator for a 5 year period. The results indicate that allowing licensed mental health counselors and licensed marriage and family therapist to initiate emergency commitments has not been related to increased numbers of emergency commitments or a higher proportion of emergency commitments being initiated by mental health professionals. Potential policy and fiscal implications, as well as future directions for research, are discussed. PMID:19597746

  19. Color on emergency mapping

    NASA Astrophysics Data System (ADS)

    Jiang, Lili; Qi, Qingwen; Zhang, An

    2007-06-01

    There are so many emergency issues in our daily life. Such as typhoons, tsunamis, earthquake, fires, floods, epidemics, etc. These emergencies made people lose their lives and their belongings. Every day, every hour, even every minute people probably face the emergency, so how to handle it and how to decrease its hurt are the matters people care most. If we can map it exactly before or after the emergencies; it will be helpful to the emergency researchers and people who live in the emergency place. So , through the emergency map, before emergency is occurring we can predict the situation, such as when and where the emergency will be happen; where people can refuge, etc. After disaster, we can also easily assess the lost, discuss the cause and make the lost less. The primary effect of mapping is offering information to the people who care about the emergency and the researcher who want to study it. Mapping allows the viewers to get a spatial sense of hazard. It can also provide the clues to study the relationship of the phenomenon in emergency. Color, as the basic element of the map, it can simplify and clarify the phenomenon. Color can also affects the general perceptibility of the map, and elicits subjective reactions to the map. It is to say, structure, readability, and the reader's psychological reactions can be affected by the use of color.

  20. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

    PubMed Central

    2013-01-01

    Background In 2013 Guidelines on diagnosis and management of ASBO have been revised and updated by the WSES Working Group on ASBO to develop current evidence-based algorithms and focus indications and safety of conservative treatment, timing of surgery and indications for laparoscopy. Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT-scan signs (free fluid, mesenteric edema, small-bowel feces sign, devascularization) patients with partial ASBO can be managed safely with NOM and tube decompression should be attempted. These patients are good candidates for Water-Soluble-Contrast-Medium (WSCM) with both diagnostic and therapeutic purposes. The radiologic appearance of WSCM in the colon within 24 hours from administration predicts resolution. WSCM maybe administered either orally or via NGT both immediately at admission or after failed conservative treatment for 48 hours. The use of WSCM is safe and reduces need for surgery, time to resolution and hospital stay. NOM, in absence of signs of strangulation or peritonitis, can be prolonged up to 72 hours. After 72 hours of NOM without resolution, surgery is recommended. Patients treated non-operatively have shorter hospital stay, but higher recurrence rate and shorter time to re-admission, although the risk of new surgically treated episodes of ASBO is unchanged. Risk factors for recurrences are age <40 years and matted adhesions. WSCM does not decrease recurrence rates or recurrences needing surgery. Open surgery is often used for strangulating ASBO as well as after failed conservative management. In selected patients and with appropriate skills, laparoscopic approach is advisable using open access technique. Access in left upper quadrant or left flank is the safest and only completely obstructing adhesions should be identified and lysed with cold scissors. Laparoscopic adhesiolysis should be attempted preferably if first episode of SBO and/or anticipated single band