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Sample records for address grave acts

  1. 77 FR 23196 - Native American Graves Protection and Repatriation Act Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... Office of the Secretary 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection and Repatriation... Secretary of the Interior (Secretary) is responsible for implementation of the Native American Graves... implementing the Native American ] Graves Protection and Repatriation Act for purposes of factual accuracy...

  2. 48 CFR 352.242-72 - Native American Graves Protection and Repatriation Act.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Native American Graves... and Clauses 352.242-72 Native American Graves Protection and Repatriation Act. As prescribed in 342.302(c)(4), the Contracting Officer shall insert the following clause: Native American...

  3. 76 FR 39007 - Native American Graves Protection and Repatriation Act Regulations- Definition of “Indian Tribe”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD98 Native American Graves Protection... regulations implementing the Native American Graves Protection and Repatriation Act (NAGPRA) removes the... implementation of the Native American Graves Protection and Repatriation Act, including the issuance...

  4. 48 CFR 352.242-72 - Native American Graves Protection and Repatriation Act.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Native American Graves Protection and Repatriation Act. 352.242-72 Section 352.242-72 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of...

  5. Repatriation in the United States: The Current State of the Native American Graves Protection and Repatriation Act

    ERIC Educational Resources Information Center

    Daehnke, Jon; Lonetree, Amy

    2011-01-01

    Repatriation in the United States today is synonymous with the passage of the Native American Graves Protection and Repatriation Act (NAGPRA). Although repatriations of Native American ancestral remains and cultural objects certainly occurred--and continue to occur--outside of the purview of NAGPRA, this law remains the centerpiece of repatriation…

  6. 75 FR 12377 - Native American Graves Protection and Repatriation Act Regulations-Disposition of Culturally...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... first rules to implement the Act on December 4, 1995 (43 CFR part 10, 60 FR 62158). --We published rules for assessing civil penalties under the Act on April 3, 2003 (43 CFR 10.12, 68 FR 16354). --We....13, 72 FR 13189). --We are publishing this rule today. --We are developing additional rules to...

  7. Balancing Act: Addressing Culture and Gender in ESL Classrooms

    ERIC Educational Resources Information Center

    Johnson, Michelle A.; Chang, Debbie

    2012-01-01

    ESL educators find themselves teaching a diverse group of students in today's classroom. This study investigated how ESL instructors address diversity in their teaching. The literature review revealed research on the experiences of teachers using culturally responsive teaching strategies. Using qualitative research methods, this study explores the…

  8. Grave Markers.

    ERIC Educational Resources Information Center

    DeMuro, Ted

    1985-01-01

    Junior high school students studied the cultural uses, symbolic meanings, and general physical forms of tombs and tombstones and then used basic slab building techniques to construct large clay grave markers. (RM)

  9. [Graves' ophthalmopathy].

    PubMed

    Eckstein, A; Dekowski, D; Führer-Sakel, D; Berchner-Pfannschmidt, U; Esser, J

    2016-04-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.

  10. Determination of grave disability.

    PubMed

    Wilbert, D E; Jorstad, V; Loren, J D; Wirrer, B

    1976-01-01

    There is a historical dilemma concerning the civil rights of psychiatric patients who are believed to need a protected status because of incompetency. California's Lanterman-Petris-Short Act provides a mechanism for putting the patient under the care of a conservator if the patient is unable to provide for his own personal needs of food, clothing, and shelter. If successful, this legislation will likely be the model for the country. Fifty-one patients for whom the clinical staff desired to initiate conservatorship proceedings were given a test consisting of behavioral tasks specifically designed to be appropriate to the legal definition of grave disability. The natural groupings were: chronic organic brain syndrome, chronic schizophrenia, and other. We found that the grave disability of the organic brain syndrome patients was fairly predictable from their mental status examination, while the grave disability of the chronic schizophrenic patients was unpredictable from their mental status examination and required the application of the behavioral test for an appropriate determination of their ability to perform the functions specified in the law: The Lanterman-Petris-Short Act to provide for personal needs of food, clothing, and shelter. When the method or the proceedings were applied to patients of other diagnostic categories, they were found to be inappropriate. At this writing, our method of evaluation is being recognized and requested by public and legal agencies in our area. It has been used as evidence in court. The procedure is clear, relevant, and easily taught to new workers. The results, given in plain English and in essay form, are readily understood by physician, social worker, judge, and jury alike. We began our study with vexation, ambiguous criteria, and a chronic medical and legal problem; we conclude with a practical and relevant answer.

  11. Addressing environmental justice under the National Environment Policy Act at Sandia National Laboratories/New Mexico

    SciTech Connect

    Cohen, T.M.; Bleakly, D.R.

    1997-04-01

    Under Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, the Department of Energy (DOE) and Sandia National Laboratories New Mexico (SNL) are required to identify and address, as appropriate, disproportionately high, adverse human health or environmental effects of their activities on minority and low-income populations. The National Environmental Policy Act (NEPA) also requires that environmental justice issues be identified and addressed. This presents a challenge for SNL because it is located in a culturally diverse area. Successfully addressing potential impacts is contingent upon accurately identifying them through objective analysis of demographic information. However, an effective public participation process, which is necessarily subjective, is also needed to understand the subtle nuances of diverse populations that can contribute to a potential impact, yet are not always accounted for in a strict demographic profile. Typically, there is little or no coordination between these two disparate processes. This report proposes a five-step method for reconciling these processes and uses a hypothetical case study to illustrate the method. A demographic analysis and community profile of the population within 50 miles of SNL were developed to support the environmental justice analysis process and enhance SNL`s NEPA and public involvement programs. This report focuses on developing a methodology for identifying potentially impacted populations. Environmental justice issues related to worker exposures associated with SNL activities will be addressed in a separate report.

  12. The role of Violence Against Women Act in addressing intimate partner violence: a public health issue.

    PubMed

    Modi, Monica N; Palmer, Sheallah; Armstrong, Alicia

    2014-03-01

    Intimate partner violence (IPV) is defined as violence committed by a current or former boyfriend or girlfriend, spouse or ex-spouse. Each year, 1.3 to 5.3 million women in the United States experience IPV. The large number of individuals affected, the enormous healthcare costs, and the need for a multidisciplinary approach make IPV an important healthcare issue. The Violence Against Women Act (VAWA) addresses domestic violence, dating violence, sexual assault, and stalking. It emphasizes development of coordinated community care among law enforcement, prosecutors, victim services, and attorneys. VAWA was not reauthorized in 2012 because it lacked bipartisan support. VAWA 2013 contains much needed new provisions for Native Americans; lesbian, gay, bisexual, transgender, gay, and queer (LGBTQ) individuals; and victims of human trafficking but does not address the large amount of intimate partner violence in America's immigrant population. There are important remaining issues regarding intimate partner violence that need to be addressed by future legislation. This review examines the role of legislation and addresses proposals for helping victims of IPV. PMID:24299159

  13. The Role of Violence Against Women Act in Addressing Intimate Partner Violence: A Public Health Issue

    PubMed Central

    Modi, Monica N.; Palmer, Sheallah

    2014-01-01

    Abstract Intimate partner violence (IPV) is defined as violence committed by a current or former boyfriend or girlfriend, spouse or ex-spouse. Each year, 1.3 to 5.3 million women in the United States experience IPV. The large number of individuals affected, the enormous healthcare costs, and the need for a multidisciplinary approach make IPV an important healthcare issue. The Violence Against Women Act (VAWA) addresses domestic violence, dating violence, sexual assault, and stalking. It emphasizes development of coordinated community care among law enforcement, prosecutors, victim services, and attorneys. VAWA was not reauthorized in 2012 because it lacked bipartisan support. VAWA 2013 contains much needed new provisions for Native Americans; lesbian, gay, bisexual, transgender, gay, and queer (LGBTQ) individuals; and victims of human trafficking but does not address the large amount of intimate partner violence in America's immigrant population. There are important remaining issues regarding intimate partner violence that need to be addressed by future legislation. This review examines the role of legislation and addresses proposals for helping victims of IPV. PMID:24299159

  14. 78 FR 21410 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves...

  15. Graves disease (image)

    MedlinePlus

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

  16. State of the Research and Literature Address: ACT with Children, Adolescents and Parents

    ERIC Educational Resources Information Center

    Murrell, Amy R.; Scherbarth, Andrew J.

    2011-01-01

    Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) has been found effective in treating a wide number of psychological conditions affecting adults. To date, however, little research has been done on the use of ACT with youth and parents. Few efforts have been made at summarizing the literature that does exist. This article,…

  17. State of the Research & Literature Address: ACT with Children, Adolescents and Parents

    ERIC Educational Resources Information Center

    Murrell, Amy R.; Scherbarth, Andrew J.

    2006-01-01

    Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) has been found effective in treating a wide number of psychological conditions affecting adults. To date, however, little research has been done on the use of ACT with youth and parents. Few efforts have been made at summarizing the literature that does exist. This article,…

  18. 2012 CCCC Chair's Address: Stories Take Place--A Performance in One Act

    ERIC Educational Resources Information Center

    Powell, Malea

    2012-01-01

    This is a written version of the address that Malea Powell gave at the Conference on College Composition and Communication (CCCC) Convention in St. Louis, Missouri, on Thursday, March 22, 2012. This address is a collection of stories. According to her, stories take place. Stories practice place into space. Stories produce habitable spaces. She…

  19. Modeling Graves' Orbitopathy in Experimental Graves' Disease.

    PubMed

    Banga, J P; Moshkelgosha, S; Berchner-Pfannschmidt, U; Eckstein, A

    2015-09-01

    Graves' orbitopathy (GO), also known as thyroid eye disease is an inflammatory disease of the orbital tissue of the eye that arises as a consequence of autoimmune thyroid disease. The central feature of the disease is the production of antibodies to the thyrotropin hormone receptor (TSHR) that modulate the function of the receptor leading to autoimmune hyperthyroidism and GO. Over the years, all viable preclinical models of Graves' disease have been incomplete and singularly failed to progress in the treatment of orbital complications. A new mouse model of GO based upon immunogenic presentation of human TSHR A-subunit plasmid by close field electroporation is shown to lead to induction of prolonged functional antibodies to TSHR resulting in chronic disease with subsequent progression to GO. The stable preclinical GO model exhibited pathologies reminiscent of human disease characterized by orbital remodeling by inflammation and adipogenesis. Inflammatory lesions characterized by CD3+ T cells and macrophages were localized in the orbital muscle tissue. This was accompanied by extensive adipogenesis of orbital fat in some immune animals. Surprisingly, other signs of orbital involvement were reminiscent of eyelid inflammation involving chemosis, with dilated and congested orbital blood vessels. More recently, the model is replicated in the author's independent laboratories. The pre-clinical model will provide the basis to study the pathogenic and regulatory roles of immune T and B cells and their subpopulations to understand the initiation, pathophysiology, and progression of GO.

  20. Don Graves Remembered

    ERIC Educational Resources Information Center

    Romano, Tom

    2011-01-01

    Don Graves died Tuesday, September 28, 2010. In the early 1980s, Don blew open the door to teaching children to write. His qualitative research and subsequent 26 books transformed the teaching of writing in elementary schools. He showed how much could be learned by the simple, powerful strategy of sitting beside children and asking them about…

  1. Prevention of Graves' ophthalmopathy.

    PubMed

    Bartalena, Luigi

    2012-06-01

    Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. PMID:22632372

  2. Infrared thermographic detection of buried grave sites

    NASA Astrophysics Data System (ADS)

    Weil, Gary J.; Graf, Richard J.

    1992-04-01

    Since time began, people have been born and people have died. For a variety of reasons grave sites have had to be located and investigated. These reasons have included legal, criminal, religious, construction and even simple curiosity problems. Destructive testing methods such as shovels and backhoes, have traditionally been used to determine grave site locations in fields, under pavements, and behind hidden locations. These existing techniques are slow, inconvenient, dirty, destructive, visually obtrusive, irritating to relatives, explosive to the media and expensive. A new, nondestructive, non-contact technique, infrared thermography has been developed to address these problems. This paper will describe how infrared thermography works and will be illustrated by several case histories.

  3. Graves Opthalmopathy and Psychoendocrinopathies

    PubMed Central

    Ghanem, Asaad A.; Amr, Mostafa A.; Araafa, Lamiaa F.

    2010-01-01

    Purpose: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO). Design: A prospective, controlled, University Hospital based study Subjects and Methods: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup. Psychiatric changes were assessed with the Middlesex Hospital Questionnaire (MHQ). Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone (TSH) concentrations, TSH receptor antibody (TRAb) activity and anti-thyroglobulin particle agglutination (TGPA) and antithyroid microsomal particle agglutination (MCPA). Results: The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group (P<0.0001). The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group (P<0.05). The scale scores of depression and phobia showed a positive correlation with scores of anxiety (P<0.0001). The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria (P<0.0001). Conclusion: The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO. PMID:20616926

  4. 76 FR 12132 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... the Interior, as required by law, in order to effect the agreed-upon disposition of Native...

  5. 77 FR 7180 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves Protection... of Native American human remains determined to be culturally unidentifiable; presentations by...

  6. 76 FR 69282 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-08

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... effect the agreed-upon disposition of Native American human remains determined to be...

  7. 75 FR 9429 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of three meetings of the Native American Graves... agreement, of Native American human remains determined to be culturally unidentifiable; and presentations...

  8. The pathogenesis of Graves' disease.

    PubMed

    Gossage, A A; Munro, D S

    1985-05-01

    The abnormally increased thyroid activity that is characteristic of Graves' disease is caused by immunoglobulins which specifically interact with the thyroid cell and stimulate it. Increases and decreases in thyroid activity in Graves' disease can be clearly related to rise and fall of these immunoglobulin-mediated activities. The level of immunoglobulin stimulatory activity can be used for prediction of the likelihood of neonatal Graves' disease and of recurrence of disease after cessation of treatment with antithyroid drugs. Investigation of patients with Graves' disease and their families has led to identification of particular human leukocyte antigens and genetically linked markers on immunoglobulins which both appear to incur increased susceptibility to certain autoimmune diseases. Differences in immune function, when compared with control populations, have been found in patients with these genetically linked markers. Protection against autoimmune disease is maintained by purposeful inhibition of any self-directed activity within each function of the immune system and by the controlling interaction of other immune functions. No single deficiency of immune function can be selected as giving the major risk of autoimmune disease, but rather a sum of relative defects resulting in an increased risk. In some patients with Graves' disease the self-protection mechanisms regain sufficient control of the immune functions to reduce the activity of the autoimmune disease, and the patient may achieve clinical remission. Often, however, there is evidence that abnormal immune activity directed against thyroid tissue has persisted with liability to recurrence of the Graves' disease.

  9. Digging your own grave: OSL signatures in experimental graves.

    PubMed

    Kemp, Justine; Pietsch, Timothy J; Olley, Jon

    2014-11-01

    Excavation of mock graves in sediments of aeolian and fluvial origin were conducted to test the bleaching efficiency of grave digging in materials that commonly host ancient burials in Australia. Grave-size pits were dug into Pleistocene aeolian sediments at Willandra Lakes and younger fluvial sediments on the Lachlan River, backfilled, and re-excavated. Samples for optical dating were taken from sediment infilling the mock graves and from the adjacent, undisturbed substrate, and analysed using the single aliquot-regenerative dose (SAR) protocol applied to single quartz grains. The resulting equivalent dose (De) distributions revealed that ≤1% of grains had been fully zeroed in both settings, and an additional 1-6% of poorly bleached grains were apparent in the fluvial sediments. Insufficient and heterogeneous bleaching of sediments during excavation and backfilling produced a decrease in the central dose of between 3 and 6 Gy, and an increase in over-dispersion values of between 5 and 10%. These differences were insufficient to clearly distinguish the disturbance event from the effects of bioturbation, biological mixing, or other sources of De variation. The use of the Minimum Age Model substantially over-estimated the burial age (zero years) in both depositional environments, with the degree of over-estimation increasing with the age of the host sediments. These results suggest that optically stimulated luminescence (OSL) techniques will not produce accurate ages for grave infill in a number of forensic and archaeological settings. Further study of the bleaching susceptibility of grains within grave infills, as well as the effectiveness of grave-digging as a bleaching mechanism is required. In other archaeological and geomorphological applications of OSL dating we recommend routine checks on the effective zeroing of sediments in modern equivalent situations. PMID:24953668

  10. [Orbital decompression for Graves' ophthalmopathy].

    PubMed

    Boulétreau, P; Breton, P; Freidel, M

    2005-04-01

    Graves' ophthalmopathy is a complex orbital condition with a controversial pathogenesis. It is the clinical expression of a discordance between the inextensible orbit and hypertrophic muscular and fatty elements within the orbit responding to immunological stimulation. The relationship between the orbital and its content can be improved by surgical expansion which increases the useful volume of the orbit. This procedure can be combined with lipectomy to decrease the volume of the orbital contents. We briefly recall the history of surgical decompression techniques and present our experience with Graves' ophthalmopathy patients.

  11. Euthyroid Graves' ophthalmopathy with negative autoantibodies.

    PubMed Central

    Cakir, Mehtap

    2005-01-01

    Graves' disease is an autoimmune-based hyperthyroidism in which a number of different antibodies directed against thyroid tissue plays a role. Graves' ophthalmopathy is thought to be a consequence of this autoimmune basis and occurs in some patients with Graves' disease. On occasional cases, the disease may present only with ophthalmopathy without hyperthyroidism. A 32-year-old woman with euthyroid Graves' ophthalmopathy and negative thyroid autoantibodies, including TSH receptor antibody, is presented here. Images Figure 1 Figure 2 PMID:16334503

  12. The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act.

    PubMed

    Long, Sharon K; Kenney, Genevieve M; Zuckerman, Stephen; Goin, Dana E; Wissoker, Douglas; Blavin, Fredric; Blumberg, Linda J; Clemans-Cope, Lisa; Holahan, John; Hempstead, Katherine

    2014-01-01

    The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts. This raises concerns about some people's ability to evaluate trade-offs when choosing health insurance plans. Assisting people as they attempt to enroll in health coverage will require targeted education efforts and staff to support those with low health insurance literacy.

  13. Adding to Our Practice Toolkit: Using the ACTS Script to Address Stigmatizing Peer Behaviors in the Context of Maternal Substance Use.

    PubMed

    Marcellus, Lenora; Poag, Elizabeth

    2016-01-01

    Infants with neonatal abstinence syndrome (NAS) are a growing population in the NICU setting, and nurses report that caring for families can be challenging. Women who are pregnant and newly parenting who use drugs and alcohol typically face significant negative attitudes, judgment, and stigma within their communities and from providers when they access health care. When nurses witness biased behavior or communication from their peers, they may feel distressed and unprepared to address the situation. Using script guides or structured communication frameworks (e.g., SBAR) is one helpful strategy for rehearsing actions and responses. The ACTS script was developed specifically to address peer attitudes and stigma in relation to substance use during pregnancy. PMID:27636698

  14. Antepartal nursing management of Grave's disease.

    PubMed

    Karacic, B

    1986-01-01

    The signs and symptoms of Grave's disease may be difficult to distinguish from the normal thyroid changes that occur in pregnancy. A brief review of thyroid physiology, thyroid changes during pregnancy, the effect of Grave's disease during pregnancy on the woman and fetus, and an assessment tool for use during the antepartal period is presented. Recommendations of specific areas of need seen in the pregnant Grave's patient during the antepartal period are also outlined. PMID:3635591

  15. Antiphospholipid antibody syndrome complicated by Grave's disease.

    PubMed

    Takahashi, Ayumi; Tamura, Atsushi; Ishikawa, Osamu

    2002-12-01

    The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity. PMID:12532043

  16. 78 FR 16295 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-14

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native...

  17. 77 FR 74874 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American...

  18. Radiation therapy for Graves' disease

    SciTech Connect

    Brennan, M.W.; Leone, C.R. Jr.; Janaki, L.

    1983-08-01

    We used radiation therapy (a total of 2,000 rads) to treat 14 patients (three men and 11 women, ranging in age from 27 to 72 years) with Graves' disease. Three of these patients had refused to take corticosteroids and the other 11 had failed to respond to them, had experienced side effects, or had other contraindications to their use. After follow-up periods ranging from six months to three years, soft-tissue inflammation was reduced in 13 of the 14 patients. All but two patients showed a decrease in proptosis of 1 to 3 mm. Myopathy showed the least improvement. Although we noted transient eyelid erythema, there were no permanent sequelae and none of the patients has had a recurrence of the inflammation.

  19. Current treatment of Graves' disease

    SciTech Connect

    Harada, T.; Shimaoka, K.; Mimura, T.; Ito, K.

    1987-04-01

    In this review we have described the rationale for the appropriate treatment of patients with Graves' disease. Because the etiology of this disorder remains obscure, its management remains controversial. Since antithyroid drugs and radioiodine became readily available in the early 1950s, they have been widely used for the treatment of thyrotoxicosis, and the number of cases treated surgically has markedly decreased. However, almost four decades of experience have disclosed an unexpectedly high incidence of delayed hypothyroidism after radioiodine treatment and a low remission rate after antithyroid therapy. As a result, surgery is again being advocated as the treatment of choice. The three modalities of treatment have different advantages and disadvantages, and selection of treatment is of importance. In principle, we believe that for most patients a subtotal thyroidectomy should be performed after the patient has been rendered euthyroid by antithyroid drugs. We attempt to leave a thyroid remnant of 6 to 8 gm.36 references.

  20. The National Historic Preservation Act is Not Your Problem, But How You are Addressing it for Your CERCLA Project May Be - 12344

    SciTech Connect

    Cusick, Lesley T.

    2012-07-01

    The 1995 Environmental Protection Agency (EPA) and U.S. Department of Energy (DOE) joint 'Policy on Decommissioning of Department of Energy Facilities Under CERCLA was developed so that decommissioning could occur in a manner that ensures protection of worker and public health and the environment, that is consistent with Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), that provides for stakeholder involvement, and that achieves risk reduction without unnecessary delay'. The source of the 'unnecessary delays' the joint policy intended to avert could be attributed to numerous factors such as obtaining permits, conducting administrative activities, or implementing regulatory processes that could yield, among other things, differing preferred alternatives. Why, you might ask, more than fifteen years later, does DOE continue to struggle through CERCLA projects with unnecessary delays? From problem identification, to determination of nature and extent, to alternative analysis and ultimately remedy selection and implementation, reaching a compliant and effective clean-up end-point can be a process that seems to mimic geologic timescales. The source of these delays is often the failure to use all of the tools the CERCLA process offers. As one example, renewed commitment to follow the CERCLA process to address the regulatory reviews pursuant to the National Historic Preservation Act (NHPA) is called for. Project managers implementing CERCLA actions in any agency, not only DOE, do not need to be apprehensive about using the CERCLA process for NHPA review but should welcome it. It is critical that methods are used that address substantive NHPA requirements clearly and consistently, and that they are shared and communicated as frequently as needed to interested and questioning stakeholders. (author)

  1. [Differential diagnosis of Graves' orbitopathy. Case report].

    PubMed

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  2. [Differential diagnosis of Graves' orbitopathy. Case report].

    PubMed

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures. PMID:26876268

  3. Medical Treatment of Graves' Orbitopathy.

    PubMed

    Salvi, M; Campi, I

    2015-09-01

    The medical treatment of Graves' orbitopathy (GO) is usually reserved to moderate to severe disease. Steroids have been widely employed and possess anti-inflammatory activity, but about 20-30% of patients are not responsive and about 20% present with disease recurrence. Immunosuppressive therapy alternative to corticosteroids may target the different antigens involved in pathogenic mechanisms of GO. Some have already been employed in clinical studies and showed interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the TSH receptor and the IGF-1 receptor on the fibroblasts, inflammatory cytokines, B and T cells. Most promising results are obtained by interacting with the PIK3/mTORC1 signaling cascades for adipogenesis and the anti-IGF-1R with the monoclonal antibody teprotumumab. A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials. Clinical practice will greatly benefit from the use of disease modifying agents in GO, as compared to steroids, currently standard treatment for GO. Among these, rituximab may be useful, especially in patients resistant to steroid or with contraindications to steroids. However, larger randomized controlled trials are needed for definitive data on the potential disease-modifying role of rituximab in GO. Direct targeting of the orbital fibroblast via immunosuppression or nonimmunosuppressive drugs is emerging as a promising alternative. PMID:26361263

  4. Testimony of Patricia Whitefoot, President National Indian Education Association, before the Education and Labor Subcommittee on Early Childhood, Elementary and Secondary Education on the Elementary and Secondary Education Act Reauthorization: Addressing the Needs of Diverse Students

    ERIC Educational Resources Information Center

    Whitefoot, Patricia

    2010-01-01

    In this testimony, Patricia Whitefoot talks on behalf of the National Indian Education Association with regard to the Elementary and Secondary Education Act Reauthorization and addressing the needs of diverse students. Native education has made significant strides since NIEA's founding. Native education, however, still faces enormous challenges,…

  5. Bilateral carpal tunnel syndrome in Graves' disease.

    PubMed

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  6. Finding the Heartbeat: Applying Donald Graves's Approaches and Theories

    ERIC Educational Resources Information Center

    Koshewa, Allen

    2011-01-01

    Donald Graves's early professional books inspired Koshewa to look more deeply into student writing during the 1980s, and to value all phases of the writing process. Graves's perspective on uncovering and celebrating voice elevated Koshewa's writing instruction to a new plane. In this article, he writes about the impact that Donald Graves's work…

  7. For Consideration in Reauthorizing the "No Child Left Behind Act"... Promoting a Systematic Focus on Learning Supports to Address Barriers to Learning and Teaching. A Center Policy Brief

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2006

    2006-01-01

    Anticipating Congressional hearings related to reauthorizing NCLB, this policy analysis report focuses on how learning supports can be enhanced in the reauthorized law. The intent is to enhance effectiveness in addressing the factors that interfere with a great many students succeeding at school. The emphasis is on fully integrating the…

  8. Severe eyelid oedema in Graves' ophthalmopathy.

    PubMed

    Anagnostis, Panagiotis; Adamidou, Fotini; Poulasouchidou, Maria; Karras, Spyridon

    2013-07-13

    We report a case of severe eyelid oedema due to Graves' ophthalmopathy (GO). The aim was to present a case report and review of the literature about eyelid oedema due to GO. The case report includes a history of patient data and literature review. The patient was offered intravenous methylprednisolone and gave consent. A dosage of 500 mg intravenous methylprednisolone once weekly for 6 weeks, followed by 250 mg intravenous methylprednisolone once weekly for 6 weeks, with a total treatment period of 12 weeks was given. Up to day, minor improvement has been observed. Severe eyelid oedema due to GO is a rare manifestation of Graves' disease. In cases of active and moderate-to-severe disease, treatment with intravenous glucorticoids is recommended alone or with orbital radiotherapy, followed by rehabilitative surgery.

  9. THERAPY OF ENDOCRINE DISEASE: Endocrine dilemma: management of Graves' orbitopathy.

    PubMed

    Campi, Irene; Vannucchi, Guia; Salvi, Mario

    2016-09-01

    Management of Graves' orbitopathy (GO) must be based on the correct assessment of activity and severity of the disease. Activity is usually assessed with the Clinical Activity Score, whereas severity is classified according to a European Group On Graves' Orbitopathy (EUGOGO) consensus statement as mild, moderate-to-severe, and sight-threatening. Myopathic and chronic congestive forms are uncommon clinical presentations of GO. Restoration and maintenance of stable euthyroidism are recommended in the presence of GO.In moderate-to-severe disease, steroids have been widely employed and have shown to possess an anti-inflammatory activity, but about 20-30% of patients are not responsive and present recurrence. Some novel immunosuppressors have already been employed in clinical studies and have shown interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the thyroid-stimulating hormone and the insulin-like growth factor 1 receptor on the fibroblasts, inflammatory cytokines, B and T cells, and the PIK3/mTORC1 signaling cascades for adipogenesis. A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials.As the main goal of treatment is the well-being of the patient, the therapeutic strategy should be addressed to better suit the patient needs, more than improving one or more biological parameters. The increasing availability of new therapies will expand the therapeutic options for GO patients and allow the clinician to really personalize the treatment to better suit the patients' personal needs. PMID:27032693

  10. Addressing Concerns.

    ERIC Educational Resources Information Center

    Cronin, Greg; Helmig, Mary; Kaplan, Bill; Kosch, Sharon

    2002-01-01

    Four camp directors discuss how the September 11 tragedy and current world events will affect their camps. They describe how they are addressing safety concerns, working with parents, cooperating with outside agencies, hiring and screening international staff, and revising emergency plans. Camps must continue to offer community and support to…

  11. Graves' disease. Manifestations and therapeutic options

    SciTech Connect

    McFarland, K.F.; Saleeby, G.

    1988-03-01

    Graves' disease is the most common cause of hyperthyroidism. Clinical features include thyroid enlargement, eye signs, tachycardia, heat intolerance, emotional lability, weight loss, and hyperkinesis. Three modes of therapy are available. The preferences of the patient and physician are usually prime considerations in devising the therapeutic plan. Radioactive iodine is the most frequently used and safest method of treatment for adults. Antithyroid drugs are preferred for children and pregnant women. Surgery is usually reserved for patients in whom the other forms of treatment are not acceptable. Considerable patient education during the decision-making process enhances the success of the therapeutic plan.

  12. Human health and the environment can't wait for reform: current opportunities for the federal government and states to address chemical risks under the Toxic Substances Control Act.

    PubMed

    Trevisan, Lauren

    2011-01-01

    Expressing its concern about growing rates of cancer and other diseases, coupled with the lack of data about the effect of the thousands of chemicals used in U.S. society, in 1976 Congress enacted the Toxic Substances Control Act (TSCA). Congress intended for TSCA to shed new light on chemical risks and provide the U.S. Environmental Protection Agency (EPA) with a set of tools to address those risks and protect human health and the environment. In the years since TSCA's passage, the procedural hurdles and the difficult-to-meet legal standards built into the statute, along with a court decision rejecting EPA's use of its authority to ban dangerous chemicals, have impeded EPA's ability to regulate chemical use and manufacture. This Comment argues that both the EPA and state governments have the authority to act now to address the risks posed by dangerous chemicals. By utilizing certain sections of the statute in new and aggressive ways, EPA can effectively address chemical risks. Further, this Comment argues that TSCA's preemption provision affords states leeway to continue to regulate the use of chemicals within their borders. Though reform of TSCA is necessary, EPA and states can effectively protect against chemical risks in the near-term by using the full extent of their authority under the current law.

  13. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

    Though President Barack Obama has rarely made healthcare references in his State of the Union addresses, health policy experts are hoping he changes that strategy this year. "The question is: Will he say anything? You would hope that he would, given that that was the major issue he started his presidency with," says Dr. James Weinstein, left, of the Dartmouth-Hitchcock health system. PMID:23487896

  14. [Graves’ orbitopathy in pediatrics].

    PubMed

    Mendoza F, Carolina; Lacourt R, Patricia

    2015-08-01

    Graves’ orbitopathy (GO) is rare in pediatric patients, however is the most common extrathyroid manifestation of Graves’ disease (GD), being present in 30-67% of patients. GO is an autoimmune inflammatory disorder involving orbital connective and fatty tissues as well as the extraocular muscles. In children, GO is less common and less severe than in adults. The most common symptoms are upper eyelid retraction, conjunctival injection, and proptosis and periorbital edema. Severe complications include dysthyroid optic neuropathy, corneal ulceration and eyeball subluxation. The diagnosis is established by clinical, laboratory and imaging findings. There are no management guidelines for GO in children but adult recommendations include the assessment of clinical activity and its severity, to implement the best treatment. Supportive therapies are intended to relieve symptoms and prevent corneal damage in mild cases. Tobacco exposure should also be avoided. The first line of treatment is systemic administration of corticosteroids in active and severe cases. Other options as somatostatin use and retrobulbar radiation have not been used in children, therefore their use is not recommended. PMID:26436933

  15. Graves Disease Is Associated With Endometriosis

    PubMed Central

    Yuk, Jin-Sung; Park, Eun-Ju; Seo, Yong-Soo; Kim, Hee Jin; Kwon, Seon-Young; Park, Won I.

    2016-01-01

    Abstract The aim of this cross-sectional study was to compare the prevalence of thyroid diseases between women with and without endometriosis. We established the endometriosis group according to diagnosis codes, surgery codes, and gonadotropin-releasing hormone agonist codes using the Korean Health Insurance Review and Assessment Service—National Inpatients Sample (HIRA-NIS) from 2009 to 2011. Four controls were randomly matched to each endometriosis case. Thyroid disease cases were selected using the thyroid disease diagnosis code (E0X). Among the 1,843,451 women sampled, 5615 had endometriosis; 22,460 controls were matched to the endometriosis cases. After adjustment for age and sampling year, Graves disease was associated with endometriosis (odds ratio [OR]: 2.52; 95% CI: 1.30–4.88; P < 0.01), while hypothyroidism was not (OR: 1.17; 95% CI: 0.90–1.52; P = 0.25). Autoimmune hypothyroidism was also not associated with endometriosis (OR: 1.61; 95% CI: 0.88–2.94; P = 0.12). This study revealed an association between Graves disease and endometriosis. PMID:26962803

  16. 75 FR 65030 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for two members of the Native American Graves Protection and Repatriation Review Committee....

  17. YARD NO. 3 BASINS (GRAVING DOCKS), VIEW TO EASTNORTHEAST AT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    YARD NO. 3 BASINS (GRAVING DOCKS), VIEW TO EAST-NORTHEAST AT THE SOUTH END OF THE CRANEWAY AND GALLERY BETWEEN BASINS NO. 1 AND 2, LOOKING ACROSS SOUTH END OF BASIN NO. 1 (THE WESTERN-MOST BASIN) - Rosie the Riveter National Historical Park, Graving Docks, Shipyard No. 3, Richmond, Contra Costa County, CA

  18. Donald Graves in Australia--"Children Want to Write ..."

    ERIC Educational Resources Information Center

    Walshe, R. D., Ed.

    The articles in this collection are intended to present a detailed picture of the work of Donald Graves and his associates at the Writing Process Laboratory (WPL) of the University of New Hampshire. The introduction provides an overview of the work of Graves and examines his views of beginning writing, writing conferences, revision, audience, and…

  19. Current insights into animal models of Graves' disease and orbitopathy.

    PubMed

    Wiesweg, B; Johnson, K T M; Eckstein, A K; Berchner-Pfannschmidt, U

    2013-08-01

    Graves' disease (GD) is a systemic autoimmune disease that is characterized by hyperthyroidism, orbitopathy and in rare cases dermopathy. Graves' orbitopathy (GO) is an inflammatory disease of eye and orbit which occurs in about 30-60% of patients. Hyperthyroidism occurs due to the presence of stimulating TSHR-autoantibodies (TRAbs) leading to increased serum levels of thyroid hormones. Attempts to induce Graves' disease in mice by immunization against the hTSHR or its variants have resulted in production of TRAbs that stimulate thyroid follicular cells to increase thyroid hormone secretion. Graves' like orbital changes, such as inflammation, adipogenesis and muscle fibrosis are more difficult to induce. In this review we summarize different methods used to induce murine Graves'-like disease and their impact on murine orbits.

  20. Orbital decompression for Graves' orbitopathy in England

    PubMed Central

    Perros, P; Chandler, T; Dayan, C M; Dickinson, A J; Foley, P; Hickey, J; MacEwen, C J; Lazarus, J H; McLaren, J; Rose, G E; Uddin, J M; Vaidya, B

    2012-01-01

    Aims The purpose of this study was to obtain data on orbital decompression procedures performed in England, classed by hospital and locality, to evaluate regional variation in care. Methods Data on orbital decompression taking place in England over a 2-year period between 2007 and 2009 were derived from CHKS Ltd and analysed by the hospital and primary care trust. Results and conclusions In all, 44% of these operations took place in hospitals with an annual workload of 10 or fewer procedures. Analysis of the same data by primary care trust suggests an almost 30-fold variance in the rates of decompression performed per unit population. Expertise available to patients with Graves' orbitopathy and rates of referral for specialist care in England appears to vary significantly by geographic location. These data, along with other outcome measures, will provide a baseline by which progress can be judged. PMID:22157920

  1. Predictive Factors of Development of Graves' Ophthalmopathy for Patients with Juvenile Graves' Disease

    PubMed Central

    Verkauskiene, Rasa; Jasinskas, Vytautas; Jankauskiene, Jurate

    2016-01-01

    Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO. PMID:27413373

  2. Predictive Factors of Development of Graves' Ophthalmopathy for Patients with Juvenile Graves' Disease.

    PubMed

    Jarusaitiene, Dalia; Verkauskiene, Rasa; Jasinskas, Vytautas; Jankauskiene, Jurate

    2016-01-01

    Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002-2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4-29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.

  3. Inaugural address

    NASA Astrophysics Data System (ADS)

    Joshi, P. S.

    2014-03-01

    From jets to cosmos to cosmic censorship P S Joshi Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, India E-mail: psj@tifr.res.in 1. Introduction At the outset, I should like to acknowledge that part of the title above, which tries to capture the main flavour of this meeting, and has been borrowed from one of the plenary talks at the conference. When we set out to make the programme for the conference, we thought of beginning with observations on the Universe, but then we certainly wanted to go further and address deeper questions, which were at the very foundations of our inquiry, and understanding on the nature and structure of the Universe. I believe, we succeeded to a good extent, and it is all here for you in the form of these Conference Proceedings, which have been aptly titled as 'Vishwa Mimansa', which could be possibly translated as 'Analysis of the Universe'! It is my great pleasure and privilege to welcome you all to the ICGC-2011 meeting at Goa. The International Conference on Gravitation and Cosmology (ICGC) series of meetings are being organized by the Indian Association for General Relativity and Gravitation (IAGRG), and the first such meeting was planned and conducted in Goa in 1987, with subsequent meetings taking place at a duration of about four years at various locations in India. So, it was thought appropriate to return to Goa to celebrate the 25 years of the ICGC meetings. The recollections from that first meeting have been recorded elsewhere here in these Proceedings. The research and teaching on gravitation and cosmology was initiated quite early in India, by V V Narlikar at the Banares Hindu University, and by N R Sen in Kolkata in the 1930s. In course of time, this activity grew and gained momentum, and in early 1969, at the felicitation held for the 60 years of V V Narlikar at a conference in Ahmedabad, P C Vaidya proposed the formation of the IAGRG society, with V V Narlikar being the first President. This

  4. Opening Address

    NASA Astrophysics Data System (ADS)

    Yamada, T.

    2014-12-01

    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  5. Convocation address.

    PubMed

    Ghatowar, P S

    1993-07-01

    The Union Deputy Minister of Health and Family Welfare in India addressed the 35th convocation of the International Institute for Population Sciences in Bombay in 1993. Officials in developing countries have been concerned about population growth for more than 30 years and have instituted policies to reduce population growth. In the 1960s, population growth in developing countries was around 2.5%, but today it is about 2%. Despite this decline, the world will have 1 billion more individuals by the year 2001. 95% of these new people will be born in developing countries. India's population size is so great that India does not have the time to wait for development to reduce population growth. Population needs to be viewed as an integrated part of overall development, since it is linked to poverty, illiteracy, environmental damage, gender issues, and reproductive health. Despite a large population size, India has made some important advancements in health and family planning. For example, India has reduced population growth (to 2.14% annually between 1981-1991), infant mortality, and its birth rate. It has increased the contraceptive use rate and life expectancy. Its southern states have been more successful at achieving demographic goals than have the northern states. India needs to implement efforts to improve living conditions, to change attitudes and perceptions about small families and contraception, and to promote family planning acceptance earlier among young couples. Improvement of living conditions is especially important in India, since almost 33% of the people live in poverty. India needs to invest in nutrition, health, and education. The mass media and nongovernmental organizations need to create population awareness and demand for family planning services. Improvement in women's status accelerates fertility decline, as has happened in Kerala State. The government needs to facilitate generation of jobs. Community participation is needed for India to achieve

  6. Welcome Address

    NASA Astrophysics Data System (ADS)

    Kiku, H.

    2014-12-01

    Ladies and Gentlemen, It is an honor for me to present my welcome address in the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3), as the president of Kanto Gakuin University. Particularly to those from abroad more than 17 countries, I am very grateful for your participation after long long trips from your home to Yokohama. On the behalf of the Kanto Gakuin University, we certainly welcome your visit to our university and stay in Yokohama. First I would like to introduce Kanto Gakuin University briefly. Kanto Gakuin University, which is called KGU, traces its roots back to the Yokohama Baptist Seminary founded in 1884 in Yamate, Yokohama. The seminary's founder was Albert Arnold Bennett, alumnus of Brown University, who came to Japan from the United States to establish a theological seminary for cultivating and training Japanese missionaries. Now KGU is a major member of the Kanto Gakuin School Corporation, which is composed of two kindergartens, two primary schools, two junior high schools, two senior high schools as well as KGU. In this university, we have eight faculties with graduate school including Humanities, Economics, Law, Sciences and Engineering, Architecture and Environmental Design, Human and Environmental Studies, Nursing, and Law School. Over eleven thousands students are currently learning in our university. By the way, my major is the geotechnical engineering, and I belong to the faculty of Sciences and Engineering in my university. Prof. T. Yamada, here, is my colleague in the same faculty. I know that the nuclear physics is one of the most active academic fields in the world. In fact, about half of the participants, namely, more than 50 scientists, come from abroad in this conference. Moreover, I know that the nuclear physics is related to not only the other fundamental physics such as the elementary particle physics and astrophysics but also chemistry, medical sciences, medical cares, and radiation metrology

  7. Confessions of a Wannabe (American Folklore Society Presidential Invited Plenary Address, October 2009).

    PubMed

    Welsch, Roger

    2011-01-01

    This paper is a written rendering of a plenary address delivered at the 2009 Annual Meeting of the American Folklore Society. Drawing on materials from his forthcoming book Confessions of a Wannabe, the author provides a personal account of the deeply emotional sense of responsibility, obligation, and reciprocity involved in long-term ethnographic research among Native American communities, particularly the Omaha and Pawnee tribes of Nebraska. The author details the ways in which personal relations with the people and communities he has observed have shaped his personal and professional life, and he calls into question the ideal of purportedly neutral or distanced ethnography. Details are provided of the author's experiences in converting his farm into an appropriate reburial site for repatriated Pawnee remains recovered under the aegis of the Native American Graves Repatriation and Protection Act (NAGPRA). PMID:21280353

  8. Graves disease with ophthalmopathy following radiotherapy for Hodgkin's disease

    SciTech Connect

    Jacobson, D.R.; Fleming, B.J.

    1984-12-01

    The number of patients achieving long-term survival following neck irradiation for Hodgkin's disease and other malignancies is increasing. Paralleling this increase in survivors is the development of late complications of the therapy itself. Eleven patients have previously been reported who developed Graves ophthalmopathy 18 months to seven years after receiving neck radiotherapy for nonthyroidal malignancies. The seven patients who had HLA typing were all HLA-B8 negative, despite the reported association of the HLA-B8 antigen with Graves disease. A patient who is HLA-B8 positive who developed Graves ophthalmopathy and hyperthyroidism nine years after receiving mantle radiotherapy for Hodgkin's disease is reported. It is recommended that Graves disease be included among the thyroid diseases that receive consideration during follow-up of patients who have received mantle radiotherapy.

  9. 1. OVERVIEW WITH WILLIAM MORRIS GRAVE MONUMENT, THE INSCRIPTION ON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. OVERVIEW WITH WILLIAM MORRIS GRAVE MONUMENT, THE INSCRIPTION ON WHICH READS: 'GOD'S FINGER TOUCHED HIM AND HE SLEPT.' - Pratt Mines, Fraternal Cemetery, Crest of Sheridan Road, Irish Hill, Birmingham, Jefferson County, AL

  10. Successful treatment of Graves disease in pregnancy with Lugol's iodine.

    PubMed

    Jamieson, A; Semple, C G

    2000-02-01

    We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention. PMID:10765530

  11. Development of Graves' disease following radiation therapy in Hodgkin's disease

    SciTech Connect

    Loeffler, J.S.; Tarbell, N.J.; Garber, J.R.; Mauch, P.

    1988-01-01

    Radiation-related thyroid dysfunction is a common occurrence in patients with Hodgkin's disease treated with mantle field radiation. Although chemical and clinical hypothyroidism are most commonly seen, Graves' disease has also been described. We have examined the records of 437 surgically staged patients who received mantle field irradiation between April 1969 and December 1980 to ascertain the frequency of manifestations of Graves' disease. Within this group, seven patients developed hyperthyroidism accompanied by ophthalmic findings typical of those seen in Graves' disease. The actuarial risk of developing Graves' disease at 10 years following mantle irradiation for Hodgkin's disease was 3.3% in female patients and 1% in male patients in this study. The observed/expected ratios were 5.9 and 5.1 for female and male patients, respectively. This observed risk significantly exceeded that seen in the general population.

  12. Delineation of graves using electrical resistivity tomography

    NASA Astrophysics Data System (ADS)

    Nero, Callistus; Aning, Akwasi Acheampong; Danuor, Sylvester K.; Noye, Reginald M.

    2016-03-01

    A suspected old royal cemetery has been surveyed at the Kwame Nkrumah University of Science and Technology (KNUST) campus, Kumasi, Ghana using Electrical Resistivity Tomography (ERT) with the objective of detecting graves in order to make informed decisions with regard to the future use of the area. The survey was conducted on a 10,000 m2 area. Continuous Vertical Electrical Sounding (CVES) was combined with the roll along technique for 51 profiles with 1 m probe separation separated by 2 m. Inverted data results indicated wide resistivity variations ranging between 9.34 Ωm and 600 Ωm in the near surface. Such heterogeneity suggests a disturbance of the soil at this level. Both high (≥ 600 Ωm) and low resistivity (≤ 74.7 Ωm) anomalies, relative to background levels, were identified within the first 4 m of the subsurface. These were suspected to be burial tombs because of their rectangular geometries and resistivity contrasts. The results were validated with forward numerical modeling results. The study area is therefore an old cemetery and should be preserved as a cultural heritage site.

  13. Fly Ash: From Cradle to Grave

    USGS Publications Warehouse

    Ellis, Margaret S.; Affolter, Ronald H.

    2007-01-01

    The Energy Resources Program of the U.S. Geological Survey promotes and supports coal research to improve the understanding of the coal endowment of the United States. This results in geologically based, non-biased energy information products for policy and decision makers, land and resource managers, other federal and state agencies, the domestic energy industry, foreign governments, nongovernmental groups, academia, and other scientists. A more integrated approach to our coal quality work involves what we call a 'cradle to grave' approach. These types of studies focus not on just one aspect of the coal but rather on how or where different quality parameters form and (or) occur and what happens to them through the mining, production, transport, utilization and waste disposal process. An extensive suite of coal quality analyses, mineralogical, petrology, and leaching investigations are determined on samples taken from the different phases of the coal utilization process. This report consists of a tutorial that was given on June 10, 2007 at the 32nd International Technical Conference on Coal Utilization & Fuel Systems, The Power of Coal, Clearwater Coal Conference in Clearwater, Florida, USA. This tutorial covers how these studies are conducted and the importance of providing improved, comprehensive, science-based data sets for policy and decision makers.

  14. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    PubMed

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility.

  15. Hyperparathyroidism after radioactive iodine therapy for Graves disease

    SciTech Connect

    Esselstyn, C.B. Jr.; Schumacher, O.P.; Eversman, J.; Sheeler, L.; Levy, W.J.

    1982-11-01

    The association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been documented in recent years. This also has been demonstrated experimentally in animals. Despite the numbers of patients with Graves disease who have been treated with radioactive iodine, there are no reports in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves disease. This report describes the operative and pathologic findings in four patients with hyperparathyroidism. These patients had previously been treated with radioactive iodine for Graves disease. The pathologic findings at surgery included in three cases a single enlarged hyperplastic gland consistent with a parathyroid adenoma. One patient had hyperplasia of all four glands. The two largest glands and halves of the two remaining glands were removed. In a long-term follow-up of children and adolescents treated with radioactive iodine for Graves disease, Levy and Schumacher found calcium elevations in 10 of 159 patients. The increased incidence of hyperparathyroidism following radioactive iodine treatment for Graves disease in children and adolescents would seem several times higher than normal. Whether adults who have radioactive iodine treatment for Graves disease have a similar increase incidence is not known. Meanwhile it would seem reasonable to suggest that patients whose hyperthyroidism is treated with radioactive iodine should have their serum calcium levels determined at 5-year intervals.

  16. Preclinical models of Graves' disease and associated secondary complications.

    PubMed

    Moshkelgosha, Sajad; So, Po-Wah; Diaz-Cano, Salvador; Banga, J Paul

    2015-01-01

    Autoimmune thyroid disease is the most common organ-specific autoimmune disorder which consists of two opposing clinical syndromes, Hashimoto's thyroiditis and Graves' (hyperthyroidism) disease. Graves' disease is characterized by goiter, hyperthyroidism, and the orbital complication known as Graves' orbitopathy (GO), or thyroid eye disease. The hyperthyroidism in Graves' disease is caused by stimulation of function of thyrotropin hormone receptor (TSHR), resulting from the production of agonist antibodies to the receptor. A variety of induced mouse models of Graves' disease have been developed over the past two decades, with some reproducible models leading to high disease incidence of autoimmune hyperthyroidism. However, none of the models show any signs of the orbital manifestation of GO. We have recently developed an experimental mouse model of GO induced by immunization of the plasmid encoded ligand binding domain of human TSHR cDNA by close field electroporation that recapitulates the orbital pathology in GO. As in human GO patients, immune mice with hyperthyroid or hypothyroid disease induced by anti-TSHR antibodies exhibited orbital pathology and chemosis, characterized by inflammation of orbital muscles and extensive adipogenesis leading to expansion of the orbital retrobulbar space. Magnetic resonance imaging of the head region in immune mice showed a significant expansion of the orbital space, concurrent with proptosis. This review discusses the different strategies for developing mouse models in Graves' disease, with a particular focus on GO. Furthermore, it outlines how this new model will facilitate molecular investigations into pathophysiology of the orbital disease and evaluation of new therapeutic interventions.

  17. Increased risk of Graves' disease after pregnancy.

    PubMed

    Benhaim Rochester, Dana; Davies, Terry F

    2005-11-01

    The improvement in autoimmune thyroid disease during pregnancy and the subsequent exacerbation postpartum is secondary to immune system changes necessary to a normal pregnancy. Prior studies have shown that a clinically significant number of women develop Graves' disease (GD) in the postpartum period. The aim of this study was to examine the risk of post pregnancy GD and define patient characteristics that may impact the diagnosis and treatment strategies for this group. We performed a retrospective review of 152 consecutive women, aged 18-39 years when diagnosed with GD, to examine the relation between disease diagnosis and prior pregnancy. Differences in patient characteristics and treatment outcomes of women were analyzed. New York City population data were used to estimate a relative risk for the development of postpartum GD. We found that in parous women, 45% were diagnosed with GD in the postpartum period and 55% had an onset in subsequent years. No significant differences were noted in patient characteristics or treatment outcomes. We found that the risk of women developing post pregnancy GD was greatest in the older patients (35-39 years), with 56% developing GD compared to 42% of nulliparous women. These data, therefore, suggest an increased risk for older women. We were able to calculate the increase in estimated relative risk for postpartum disease by using control population data. The risk maximized at 5.6 for the age group 35-39 years when compared to the control population. These data support earlier studies that showed that a clinically significant number of women develop GD after childbirth compared to nulliparous women and extends this risk for many years. The mechanism of this long-standing increased susceptibility requires further delineation.

  18. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    PubMed

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M

    1988-04-01

    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  19. Human T lymphotropic virus type 1 uveitis after Graves' disease.

    PubMed Central

    Yamaguchi, K; Mochizuki, M; Watanabe, T; Yoshimura, K; Shirao, M; Araki, S; Miyata, N; Mori, S; Kiyokawa, T; Takatsuki, K

    1994-01-01

    A distinct clinical entity of uveitis associated with human T lymphotropic virus type 1 (HTLV-I) has been reported previously. During the period between January 1989 and April 1992, 93 patients were observed with HTLV-I uveitis and a significant correlation was found between Graves' disease and HTLV-I uveitis. Sixteen of the 93 patients with HTLV-I uveitis (17.2%) had a previous history of Graves' disease. Fifteen patients were female (15/60, 25.0%) and one was male (1/33, 3.0%). Interestingly, uveitis occurred after the onset of Graves' disease in all cases. On the other hand, none of 222 patients with idiopathic uveitis who were seronegative to HTLV-I had a history of Graves' disease. Although the mechanisms by which HTLV-I causes the correlation between uveitis and Graves' disease are unknown, the present data suggest that immune mediated or autoimmune mechanisms are involved in HTLV-I uveitis. Images PMID:8148330

  20. [Radioiodine versus surgery in the treatment of Graves' hyperthyroidism].

    PubMed

    Jukić, Tomislav; Stanicić, Josip; Petric, Vlado; Kusić, Zvonko

    2010-01-01

    The most common etiologic cause of thyrotoxicosis in children and adults is autoimmune Graves' (Basedow's) disease. Antithyroid medications, surgery and radioactive iodine have been used in the treatment of Graves' hyperthyroidism for more than six decades. The use of antithyroid drugs is the most common therapeutic approach. However, long-term remission with antithyroid drugs can be expected in 20-50% of adults and 20-30% of children. The methods for definitive treatment of Graves' hyperthyroidism are iodine-131 (radioiodine) and surgery. Both treatment modalities have benefits and risks and the decision is made according to the age, patient preference and the presence of other co-morbidities, individual characteristics of patients and the availability of certain treatment modality. Radioiodine is simple, safe, effective and economic procedure for definitive treatment of Graves' hyperthyroidism. It is administered ambulatory and can be given to the patient in thyrotoxicosis. Due to many benefits, radioiodine is preferred in most of the adult patients with Graves' hyperthyroidism while only small proportion of patients is sent to surgery. Radioiodine is especially the treatment of choice in elderly patients and patients with heart disease. In these patients radioiodine is indicated immediately after reaching euthyroidism with antithyroid drugs. Surgery is mainly indicated in younger patients, in the case of patient preference or in special indications. Clear indications for surgical treatment of Graves' hyperthyroidism are: suspected or confirmed malignancy, coexisting pathology that demands surgical treatment, pregnancy and breastfeeding, large goiter (> 80 grams) or goiter with symptoms and signs of compression, severe toxic side effects of antithyroid medications, requirement for immediate control of disease, age younger than 5 years and active ophtalmopathy. The risk of surgical treatment is negatively correlated with the surgeon's experience and nowadays

  1. Graves' Disease Pharmacotherapy in Women of Reproductive Age.

    PubMed

    Prunty, Jeremy J; Heise, Crystal D; Chaffin, David G

    2016-01-01

    Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence

  2. Current perspectives on the role of orbital fibroblasts in the pathogenesis of Graves' ophthalmopathy.

    PubMed

    Dik, Willem A; Virakul, Sita; van Steensel, Leendert

    2016-01-01

    Graves' ophthalmopathy (GO) is an extra-thyroidal complication of Graves' disease (GD; Graves' hyperthyroidism) characterized by orbital tissue inflammation, expansion, remodeling and fibrosis. Although the initiating trigger of GO is still indistinct, excessive orbital fibroblast activity is at the heart of its pathogenesis. Orbital fibroblasts are activated by cellular interactions with immune cells and the soluble factors they secrete. Orbital fibroblasts, especially from GO patients, express the thyrotropin receptor (TSH-receptor; TSHR), and activation of the orbital fibroblast population by stimulatory autoantibodies directed against the TSHR may provide an important link between GD and GO. Furthermore, stimulatory autoantibodies directed against the insulin-like growth factor-1 receptor have been proposed to contribute to orbital fibroblast activation in GO. Activated orbital fibroblasts produce inflammatory mediators thereby contributing to the orbital inflammatory process in GO. Moreover, orbital fibroblasts exhibit robust proliferative activity and extracellular matrix (especially hyaluronan) synthesizing capacity and can differentiate into adipocytes and myofibroblasts with disease progression, thereby contributing to tissue expansion/remodeling and fibrosis in GO. Orbital fibroblasts, especially those from GO patients, exhibit a hyper-responsive phenotype when compared to fibroblasts from other anatomical regions, which may further contribute to GO pathogenesis. Fibrocytes have been identified as additional source of orbital fibroblasts in GO, where they may contribute to orbital tissue inflammation, adipogenesis and remodeling/fibrosis. This review addresses our current view on the role that orbital fibroblasts fulfill in GO pathogenesis and both established as well as less established not fully crystallized concepts that need future studies will be discussed.

  3. 77 FR 12875 - Proposed Information Collection; Native American Graves Protection and Repatriation Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-02

    ... National Park Service Proposed Information Collection; Native American Graves Protection and Repatriation... Number ``1024- 0144, Native American Graves Protection and Repatriation Regulations'' in the subject line... entire ICR package free of charge. SUPPLEMENTARY INFORMATION: I. Abstract The Native American...

  4. 77 FR 65407 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Notice of Nomination Solicitation... American Graves Protection and Repatriation Review Committee, National NAGPRA Program, National...

  5. 75 FR 13140 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination... Repatriation Review Committee; Notice of Nomination Solicitation. The National Park Service is soliciting nominations for one member of the Native American Graves Protection and Repatriation Review Committee....

  6. Premature twins of a mother with Graves' disease with discordant thyroid function: a case report.

    PubMed

    O'Connor, M J; Paget-Brown, A O; Clarke, W L

    2007-06-01

    Thyroid dysfunction is recognized in the newborns of mothers affected by Graves' disease during pregnancy. We describe the development of concurrent hyperthyroidism and hypothyroidism in the twin infants of a mother with Graves' disease diagnosed during pregnancy.

  7. [The treatment of Graves' disease: current views and controversies].

    PubMed

    Orgiazzi, Jacques

    2011-12-01

    One of the more prevalent among the organ-specific autoimmune diseases, Graves' disease share their chronic evolution and lack of immunomodulatory treatment. Treatment strategy has to consider as opposite options as medical conservatory or ablative approach which requires much expertise and attention to patients' wish. Whatever treatment option, it is mandatory to prevent any risk of iatrogenic hypothyroidism, especially a rise of TSH above normal limit. The long-lasting benefit-risk ratio of treatment options is of primordial importance in this usually benign but enduring disease. Occurrence of Graves' orbitopathy, a significant complication, requires a special multidisciplinary management; the same is true in the case of a current or planned pregnancy. Overall quality-of-life is often markedly affected by Graves' disease; this should not be overlooked. Smoking increases relapse risk after a course of antithyroid drug; it also increases the risk and severity of Graves' orbitopathy. Patients must be made aware of these deleterious effects and encouraged to quit smoking.

  8. 1. OVERVIEW, LOOKING WEST, TOMBSTONES, STATUES AND GRAVE PLOTS OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. OVERVIEW, LOOKING WEST, TOMBSTONES, STATUES AND GRAVE PLOTS OF THE DUCHOCK, MOSKO, BENKO AND OTHER FAMILIES OF THIS FORMER COAL MINING AREA SETTLED BY CZECH AND SLAVIC MINERS IN THE 1880S AND 1890S - St. Michael's Cemetery, Brookside Road, Brookside, Jefferson County, AL

  9. Time-lapse geophysical investigations over a simulated urban clandestine grave.

    PubMed

    Pringle, Jamie K; Jervis, John; Cassella, John P; Cassidy, Nigel J

    2008-11-01

    A simulated clandestine shallow grave was created within a heterogeneous, made-ground, urban environment where a clothed, plastic resin, human skeleton, animal products, and physiological saline were placed in anatomically correct positions and re-covered to ground level. A series of repeat (time-lapse), near-surface geophysical surveys were undertaken: (1) prior to burial (to act as control), (2) 1 month, and (3) 3 months post-burial. A range of different geophysical techniques was employed including: bulk ground resistivity and conductivity, fluxgate gradiometry and high-frequency ground penetrating radar (GPR), soil magnetic susceptibility, electrical resistivity tomography (ERT), and self potential (SP). Bulk ground resistivity and SP proved optimal for initial grave location whilst ERT profiles and GPR horizontal "time-slices" showed the best spatial resolutions. Research suggests that in complex urban made-ground environments, initial resistivity surveys be collected before GPR and ERT follow-up surveys are collected over the identified geophysical anomalies. PMID:18808369

  10. The possible etiological role of psychological disturbances in Graves' disease.

    PubMed

    Harsch, I; Paschke, R; Usadel, K H

    1992-01-01

    In the discussion of possible factors in the etiology of Graves' disease, stress has always played a major role. We investigated the possible influence of present depression (depressivity scale DS) and anxiety (State Trait Angstinventar STAI X1) on peripheral lymphocyte subpopulations in 10 patients with Graves' disease. The tests were done in hyperthyroidism and after 2-4 months in stable euthyroidism. Parallel to the psychometric testing, peripheral lymphocyte subpopulations were investigated. Elevated anxiety as a constant personality trait was investigated with the State Trait Angstinventar STAI X2 in 19 hyperthyroid patients with Graves' disease. 5 of the 10 patients had a pathological T4:T8 ratio and very high raw values for present anxiety (mean = 53,8; STAI X1), as well as a a high percentile for depression (median 93,1; DS). The other 5 patients with a normal T4:T8 ratio had much lower values for anxiety (mean = 37,8; STAI X1) and depression (median 78,4; DS). In those patients, the T4:T8 ratio remained normal in stable euthyroidism, while the values for anxiety and depression decreased. This also happened in the patients with a formerly pathologic T4:T8 ratio. However, the pathologic T4:T8 ratio persisted in those patients. The STAI X2 percentage ranking for the 19 hyperthyroid patients was 76,5. The value for healthy people is 55,5. Therefore a significantly elevated anxiety--representing a constantly elevated internal psychological stress--seems to be present in patients with Graves' disease. Since psychological stress is known to influence the immune system, such a constant personality trait could be a predisposing factor for Graves' disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    PubMed

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C

    2015-09-01

    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  12. Hazardous materials management using a Cradle-to-Grave Tracking and Information System (CGTIS)

    SciTech Connect

    Kjeldgaard, E.; Fish, J.; Campbell, D.; Freshour, N.; Hammond, B.; Bray, O.; Hollingsworth, M.

    1995-03-01

    Hazardous materials management includes interactions among materials, personnel, facilities, hazards, and processes of various groups within a DOE site`s environmental, safety & health (ES&H) and line organizations. Although each group is charged with addressing a particular aspect of these properties and interactions, the information it requires must be gathered into a coherent set of common data for accurate and consistent hazardous material management and regulatory reporting. It is these common data requirements which the Cradle-to-Grave Tracking and Information System (CGTIS) is designed to satisfy. CGTIS collects information at the point at which a process begins or a material enters a facility, and maintains that information, for hazards management and regulatory reporting, throughout the entire life-cycle by providing direct on-line links to a site`s multitude of data bases to bring information together into one common data model.

  13. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    SciTech Connect

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  14. Drug-induced graves disease from CTLA-4 receptor suppression.

    PubMed

    Borodic, Gary; Hinkle, David M; Cia, Yihong

    2011-01-01

    Monoclonal antibody, ipilimumab, useful for treatment of metastatic melanoma, blocks CTLA-4 mediated T-cell suppression and can also cause a Graves ophthalmopathy like syndrome. Epidemiologic study has linked variant polymorphisms of CTLA-4 receptor gene to the presence of thyroid eye disease. The combination of these observations suggests CTLA-4 mediated T-cell functions are important to the pathogenesis of thyroid-associated eye disease. PMID:21242854

  15. Immunization with thyroglobulin induces Graves'-like disease in mice

    PubMed Central

    Endo, Toyoshi; Kobayashi, Tetsuro

    2009-01-01

    We immunized AKR/N mice with bovine thyroglobulin (Tg) once every 2 weeks and monitored their time-dependent changes in 125I uptake activity in the thyroid glands. After 3 months, anti-Tg antibody was positive in all sera from the immunized mice. Serum free tri-iodothyronine (T3) and free thyroxine (T4) levels in the immunized mice (n=6) were significantly higher than those in the saline injected (control) mice (n=6). Neck counts as well as scintigraphy of the thyroid glands revealed that iodide uptake activity of the immunized mice was not suppressed, but was instead higher than that of the control mice. Two of the six immunized mice showed extremely high iodide uptake activity. The thyroid glands of these two mice were diffusely enlarged and the height of the epithelial cells was also increased. In addition, two mice with high iodide uptake activity produced a high titer of thyroid-stimulating antibody. Additional experiments showed that 4 out of 11 AKR/N mice and 3 out of 10 C57BL6 mice immunized with Tg had high serum free T3/free T4 levels, high 125I uptake activity of the thyroid, and positive thyroid-stimulating antibody activity. Diffuse goiter, thyrotoxicosis, high iodide uptake activity, and positive thyroid-stimulating antibody are the characteristics of Graves' disease. Thus, these mice exhibit the symptoms of Graves' disease. These results suggest that immunization with Tg induces Graves'-like disease in mice and that our methods will provide a new animal model of Graves' disease. PMID:19491147

  16. Immunization with thyroglobulin induces Graves'-like disease in mice.

    PubMed

    Endo, Toyoshi; Kobayashi, Tetsuro

    2009-08-01

    We immunized AKR/N mice with bovine thyroglobulin (Tg) once every 2 weeks and monitored their time-dependent changes in (125)I uptake activity in the thyroid glands. After 3 months, anti-Tg antibody was positive in all sera from the immunized mice. Serum free tri-iodothyronine (T(3)) and free thyroxine (T(4)) levels in the immunized mice (n=6) were significantly higher than those in the saline injected (control) mice (n=6). Neck counts as well as scintigraphy of the thyroid glands revealed that iodide uptake activity of the immunized mice was not suppressed, but was instead higher than that of the control mice. Two of the six immunized mice showed extremely high iodide uptake activity. The thyroid glands of these two mice were diffusely enlarged and the height of the epithelial cells was also increased. In addition, two mice with high iodide uptake activity produced a high titer of thyroid-stimulating antibody. Additional experiments showed that 4 out of 11 AKR/N mice and 3 out of 10 C57BL6 mice immunized with Tg had high serum free T(3)/free T(4) levels, high (125)I uptake activity of the thyroid, and positive thyroid-stimulating antibody activity. Diffuse goiter, thyrotoxicosis, high iodide uptake activity, and positive thyroid-stimulating antibody are the characteristics of Graves' disease. Thus, these mice exhibit the symptoms of Graves' disease. These results suggest that immunization with Tg induces Graves'-like disease in mice and that our methods will provide a new animal model of Graves' disease. PMID:19491147

  17. Drug-induced graves disease from CTLA-4 receptor suppression.

    PubMed

    Borodic, Gary; Hinkle, David M; Cia, Yihong

    2011-01-01

    Monoclonal antibody, ipilimumab, useful for treatment of metastatic melanoma, blocks CTLA-4 mediated T-cell suppression and can also cause a Graves ophthalmopathy like syndrome. Epidemiologic study has linked variant polymorphisms of CTLA-4 receptor gene to the presence of thyroid eye disease. The combination of these observations suggests CTLA-4 mediated T-cell functions are important to the pathogenesis of thyroid-associated eye disease.

  18. Graves' disease in a dialysis dependent chronic renal failure patient

    PubMed Central

    Nair, C. G.; Jacob, P.; Menon, R.; Babu, M. J. C.

    2014-01-01

    Thyroid hormone level may be altered in chronic renal failure patients. Low levels of thyroxine protect the body from excess protein loss by minimizing catabolism. Hyperthyroidism is rarely encountered in end-stage dialysis dependent patients. Less than 10 well-documented cases of Graves' disease (GD) are reported in literature so far. We report a case of GD in a patient on dialysis. PMID:25484538

  19. Americans with Disabilities Act.

    ERIC Educational Resources Information Center

    Updating School Board Policies, 1992

    1992-01-01

    Addressed to school board members, this article attempts to summarize requirements of the Americans with Disabilities Act (ADA) and its implications for school districts. It warns against hasty purchase of private compliance assistance; then provides an overview of each of the Act's five Titles which address employment practices, activities…

  20. [Keynote address: Climate change

    SciTech Connect

    Forrister, D.

    1994-12-31

    Broadly speaking, the climate issue is moving from talk to action both in the United States and internationally. While few nations have adopted strict controls or stiff new taxes, a number of them are developing action plans that are making clear their intention to ramp up activity between now and the year 2000... and beyond. There are sensible, economically efficient strategies to be undertaken in the near term that offer the possibility, in many countries, to avoid more draconian measures. These strategies are by-and-large the same measures that the National Academy of Sciences recommended in a 1991 report called, Policy Implications of Greenhouse Warming. The author thinks the Academy`s most important policy contribution was how it recommended the nations act in the face of uncertain science and high risks--that cost effective measures are adopted as cheap insurance... just as nations insure against other high risk, low certainty possibilities, like catastrophic health insurance, auto insurance, and fire insurance. This insurance theme is still right. First, the author addresses how the international climate change negotiations are beginning to produce insurance measures. Next, the author will discuss some of the key issues to watch in those negotiations that relate to longer-term insurance. And finally, the author will report on progress in the United States on the climate insurance plan--The President`s Climate Action Plan.

  1. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    SciTech Connect

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  2. Recommended Changes to the No Child Left Behind Act to Address Workforce Issues. Submitted to the House Subcommittee on Higher Education, Lifelong Learning, and Competitiveness of the Committee on Education and Labor

    ERIC Educational Resources Information Center

    Harris, Linda; Tsoi-A-Fatt, Rhonda

    2007-01-01

    This paper presents Center for Law and Social Policy's (CLASP's) recommendations on how No Child Left Behind (NCLB) could better address the workforce challenges faced by this country. CLASP is a nonprofit organization engaged in research, analysis, technical assistance, and advocacy on a range of issues affecting low-income families. The…

  3. The Role of Special Education Administrators in Addressing Contextual Factors When Implementing Comprehensive School Reform in Response to the Mandate of the No Child Left behind Act of 2001 (P.L. 107-110)

    ERIC Educational Resources Information Center

    Darensbourg, Kennith Houston

    2011-01-01

    This study is designed to identify the effective implementation practices that special education administrators enact to alleviate the negative and enforce the positive effects of contextual factors when implementing comprehensive school reform. Two research questions were designed to address this issue. Research Question One sought to identify…

  4. Grave's Disease and Primary Biliary Cirrhosis-An Unusual and Challenging Association.

    PubMed

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2014-03-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  5. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    PubMed Central

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  6. Thyroid carcinoma in patients with Graves' disease: an institutional experience.

    PubMed

    Wei, Shuanzeng; Baloch, Zubair W; LiVolsi, Virginia A

    2015-03-01

    Graves' disease (GD) is an autoimmune disorder characterized by diffuse hyperplasia and excessive production of thyroid hormone. The association between thyroid carcinoma and GD is controversial. The prevalence of thyroid carcinoma was investigated in patients with GD who underwent thyroidectomy for thyroid nodular lesions or GD from 1994 to 2013 at our institution. Three hundred and forty-seven patients were placed into two groups: Graves' disease with nodular lesions group (group GN) included 85 patients who had thyroidectomy for nodular lesion, and Graves' disease group (group G) included 262 patients who had thyroidectomy for hyperthyroidism. There were 59 patients with thyroid carcinomas in the 85 patients (69 %) of group GN, including 3 follicular carcinomas (5 %), 1 poorly differentiated carcinoma (2 %), and 55 papillary thyroid carcinomas (93 %). Among the 55 papillary thyroid carcinomas, 19 cases were papillary thyroid microcarcinomas (34 %); and 5 cases of tall cell variant (9 %) were identified. There were 8 cases with lymph node metastasis (14 %), 6 cases with lymphovascular invasion (10 %), and 12 cases with extrathyroidal invasion (20 %). In addition, 24 carcinomas showed multiple foci of tumor (41 %). In contrast, 51 patients (19 %) of 262 patients in group G had carcinoma, including 2 follicular carcinomas (4 %) and 49 papillary thyroid carcinomas (96 %). In the 49 cases of papillary thyroid carcinomas, 47 cases were microcarcinomas (96 %); and 2 cases of tall cell variant (4 %) were found. There were no lymph node metastasis or lymphovascular and extrathyroidal invasion, but 11 cases (22 %) demonstrated multiple carcinoma foci. In conclusion, thyroid nodular lesions in patients with GD should raise a high suspicion of carcinoma, and these lesions are frequently clinically significant tumors. Incidental thyroid carcinomas in patients with GD are not uncommon, but most of them are low-risk papillary thyroid microcarcinoma without lymph node

  7. Detection of single graves by airborne hyperspectral imaging.

    PubMed

    Leblanc, G; Kalacska, M; Soffer, R

    2014-12-01

    Airborne hyperspectral imaging (HSI) was assessed as a potential tool to locate single grave sites. While airborne HSI has shown to be useful to locate mass graves, it is expected the location of single graves would be an order of magnitude more difficult due to the smaller size and reduced mass of the targets. Two clearings were evaluated (through a blind test) as potential sites for containing at least one set of buried remains. At no time prior to submitting the locations of the potential burial sites from the HSI were the actual locations of the sites released or shared with anyone from the analysis team. The two HSI sensors onboard the aircraft span the range of 408-2524nm. A range of indicators that exploit the narrow spectral and spatial resolutions of the two complimentary HSI sensors onboard the aircraft were calculated. Based on the co-occurrence of anomalous pixels within the expected range of the indicators three potential areas conforming to our underlying assumptions of the expected spectral responses (and spatial area) were determined. After submission of the predicted burial locations it was revealed that two of the targets were located within GPS error (10m) of the true burial locations. Furthermore, due to the history of the TPOF site for burial work, investigation of the third target is being considered in the near future. The results clearly demonstrate promise for hyperspectral imaging to aid in the detection of buried remains, however further work is required before these results can justifiably be used in routine scenarios. PMID:25447169

  8. Detection of single graves by airborne hyperspectral imaging.

    PubMed

    Leblanc, G; Kalacska, M; Soffer, R

    2014-12-01

    Airborne hyperspectral imaging (HSI) was assessed as a potential tool to locate single grave sites. While airborne HSI has shown to be useful to locate mass graves, it is expected the location of single graves would be an order of magnitude more difficult due to the smaller size and reduced mass of the targets. Two clearings were evaluated (through a blind test) as potential sites for containing at least one set of buried remains. At no time prior to submitting the locations of the potential burial sites from the HSI were the actual locations of the sites released or shared with anyone from the analysis team. The two HSI sensors onboard the aircraft span the range of 408-2524nm. A range of indicators that exploit the narrow spectral and spatial resolutions of the two complimentary HSI sensors onboard the aircraft were calculated. Based on the co-occurrence of anomalous pixels within the expected range of the indicators three potential areas conforming to our underlying assumptions of the expected spectral responses (and spatial area) were determined. After submission of the predicted burial locations it was revealed that two of the targets were located within GPS error (10m) of the true burial locations. Furthermore, due to the history of the TPOF site for burial work, investigation of the third target is being considered in the near future. The results clearly demonstrate promise for hyperspectral imaging to aid in the detection of buried remains, however further work is required before these results can justifiably be used in routine scenarios.

  9. Investigation of clandestine graves resulting from human rights abuses.

    PubMed

    Vanezis, P

    1999-12-01

    The role of the forensic scientist in the investigation of clandestine graves resulting from human rights abuses is discussed. Individuals buried in such circumstances have perished following abuse by persons in authority or by other political factions. Such persons have been classed by the abusers as dissidents or political opponents, or have been killed simply for belonging to a particular racial or religious grouping. Guidelines for investigation and the general approach by the scientist are suggested and examples of exhumations are cited in which the author has had personal involvement. These include exhumations carried out in the former Yugoslavia, Rwanda and Chile.

  10. Neonatal Cholestasis Caused by Undiagnosed Maternal Graves' Disease

    PubMed Central

    Jensen, M. Kyle; Adams, Christa J.; Book, Linda S.

    2014-01-01

    Neonatal cholestasis results from a variety of etiologies, including anatomic, infectious, and metabolic abnormalities. Hyperthyroidism, in contrast to hypothyroidism, is infrequently associated with neonatal cholestasis. Newborn screening is an important tool to detect newborn metabolic disorders, including thyroid dysfunction. However, one must exercise caution when interpreting these reports; typically only high thyroid stimulating hormone (TSH) levels are flagged as abnormal, while low or undetectable levels may not be. We present a unique case of cholestasis in a hyperthyroid neonate of an untreated, undiagnosed mother with Graves' disease; the infant's metabolic screen was not flagged as abnormal. PMID:26157908

  11. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management.

    PubMed

    Barrio-Barrio, Jesús; Sabater, Alfonso L; Bonet-Farriol, Elvira; Velázquez-Villoria, Álvaro; Galofré, Juan C

    2015-01-01

    Graves' ophthalmopathy (GO) is an autoimmune inflammatory disorder associated with thyroid disease which affects ocular and orbital tissues. GO follows a biphasic course in which an initial active phase of progression is followed by a subsequent partial regression and a static inactive phase. Although the majority of GO patients have a mild, self-limiting, and nonprogressive ocular involvement, about 3-7% of GO patients exhibit a severe sight-threatening form of the disease due to corneal exposure or compressive optic neuropathy. An appropriate assessment of both severity and activity of the disease warrants an adequate treatment. The VISA (vision, inflammation, strabismus, and appearance), and the European Group of Graves' Orbitopathy (EUGOGO) classifications are the two widely used grading systems conceived to assess the activity and severity of GO and guide the therapeutic decision making. A critical analysis of classification, assessment, and management systems is reported. A simplified "GO activity assessment checklist" for routine clinical practice is proposed. Current treatments are reviewed and management guidelines according to the severity and activity of the disease are provided. New treatment modalities such as specific monoclonal antibodies, TSH-R antagonists, and other immunomodulatory agents show a promising outcome for GO patients.

  12. Imaging studies for diagnosing Graves' orbitopathy and dysthyroid optic neuropathy

    PubMed Central

    Gonçalves, Allan C. Pieroni; Gebrim, Eloísa M. M. S.; Monteiro, Mário L. R.

    2012-01-01

    Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies, such as computed tomography, magnetic resonance imaging, ultrasound and color Doppler imaging, play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss. In this paper, we review the imaging modalities that aid in the diagnosis and management of Graves' orbitopathy, with special emphasis on the diagnosis of optic nerve dysfunction in this condition. PMID:23184212

  13. Cradle to grave design of polymers for packaging

    SciTech Connect

    Narayan, R.

    1993-12-31

    Today`s polymeric materials are designed with little consideration for their ultimate disposability or recyclability. This has resulted in mounting worldwide concerns over the environmental consequences of such materials when they enter the waste stream after their intended uses. Of particular concern are polymers used in single use, disposable packaging applications. In the U.S., about 30% of synthetic polymers, totaling 16.5 billion pounds annually is used for packaging applications. Therefore, there is an urgent need to redesign and engineer new polymers that have the needed performance characteristics of the plastics, but can be transformed in appropriate waste disposal infrastructures to products that are compatible with the environment or recycled to the same or other products -- a {open_quotes}cradle to grave{close_quotes} design concept for materials. A {open_quotes}Cradle to Grave{close_quotes} design, use and disposal of new biodegradable polymers used in fast-food packaging will be presented. Integration of the biodegradable materials production with waste disposal infrastructures, specifically composting, will be discussed.

  14. Is Recombinant Human TSH a Trigger for Graves' Orbitopathy?

    PubMed Central

    Daumerie, C.; Boschi, A.; Perros, P.

    2012-01-01

    The pathogenesis of Graves' orbitopathy (GO) remains unknown. The hypothesis of a causal relationship between autoimmunity against the TSH receptor (TSHR) and GO is supported by clinical studies. Radioiodine treatment is associated with worsening or new onset of GO, possibly via antigen shedding or by inducing hypothyroidism. The coexistence of thyroid cancer with Graves' disease (GD) and GO is rare. Here we report 3 cases of reactivation of GO in patients who underwent treatment with recombinant human TSH (rhTSH) and radioiodine ablation. In each case, a thyroidectomy was performed to treat the GD, and an incidental thyroid cancer was discovered. In all 3 cases, reactivation of GO was observed 3–6 weeks after administration of rhTSH, despite maintaining euthyroidism, which was unaccompanied by a rise in serum TSHR antibodies after radioiodine and despite steroids in 1 of the 3 patients. These observations suggest that binding of either TSH or TSHR antibodies to the TSHR, independently of thyroid status, may be causally related to deterioration of GO. Clinicians should be aware of a possible association between rhTSH administration and reactivation of GO, which should be taken into account before prescribing rhTSH in patients with GO. Prophylactic steroids may need to be considered for patients at high risk of exacerbation of GO. PMID:24783004

  15. Is Recombinant Human TSH a Trigger for Graves' Orbitopathy?

    PubMed

    Daumerie, C; Boschi, A; Perros, P

    2012-07-01

    The pathogenesis of Graves' orbitopathy (GO) remains unknown. The hypothesis of a causal relationship between autoimmunity against the TSH receptor (TSHR) and GO is supported by clinical studies. Radioiodine treatment is associated with worsening or new onset of GO, possibly via antigen shedding or by inducing hypothyroidism. The coexistence of thyroid cancer with Graves' disease (GD) and GO is rare. Here we report 3 cases of reactivation of GO in patients who underwent treatment with recombinant human TSH (rhTSH) and radioiodine ablation. In each case, a thyroidectomy was performed to treat the GD, and an incidental thyroid cancer was discovered. In all 3 cases, reactivation of GO was observed 3-6 weeks after administration of rhTSH, despite maintaining euthyroidism, which was unaccompanied by a rise in serum TSHR antibodies after radioiodine and despite steroids in 1 of the 3 patients. These observations suggest that binding of either TSH or TSHR antibodies to the TSHR, independently of thyroid status, may be causally related to deterioration of GO. Clinicians should be aware of a possible association between rhTSH administration and reactivation of GO, which should be taken into account before prescribing rhTSH in patients with GO. Prophylactic steroids may need to be considered for patients at high risk of exacerbation of GO. PMID:24783004

  16. Radioiodine-induced hypothyroidism in Graves' disease: factors associated

    SciTech Connect

    Cunnien, A.J.; Hay, I.D.; Gorman, C.A.; Offord, K.P.; Scanlon, P.W.

    1982-11-01

    A retrospective analysis was done of the records of 454 patients who received their first /sup 131/I treatment for Graves' disease during six periods covering 1951 to 1978. In the earliest group, 3% of patients were hypothyroid 3 mo after /sup 131/I use, and 40% were hypothyroid at 1 yr. In the most recent group, 36% of patients were hypothyroid at 3 mo and 91% were myxedematous at 1 yr. Although no obvious trends were noted, whether in the number of patients pretreated with thionamide drugs, in the mean 24-hr /sup 131/I uptake, or in the calculated dose of /sup 131/I (muCi/estimated gram of thyroid tissue) during the years of the study, the initial mean dose of /sup 131/I administered increased from 8.1 mCi in the earliest group to 13.8 mCi in the latest group. Concurrently, estimates of gland size increased from a mean of 26 g in the first group to 43 g in the last. If, in patients with Graves' disease, the thyroid gland size did not truly increase during the years of the study, the increasing occurrence of early hypothyroidism seen after /sup 131/I use may reflect the conscious or unconscious decision to use larger doses of /sup 131/I calculated on the basis of inflated estimates of thyroid gland weight.

  17. Cytokines, Graves' Disease, and Thyroid-Associated Ophthalmopathy

    PubMed Central

    Khadavi, Nicole; Smith, Terry J.

    2008-01-01

    Graves' disease, an autoimmune process associated with thyroid dysfunction, can also manifest as remodeling of orbital connective tissue. Affected tissues exhibit immune responses that appear to be orchestrated by resident cells and those recruited from the bone marrow through their expression and release of cytokines and surface display of cytokine receptors. Cytokines are small molecules produced by many types of cells, including those of the “professional” immune system. Aberrant cytokine expression appears to play an important role in the pathogenesis of many human diseases, including thyroid autoimmunity. The skewed pattern of cytokine expression in the thyroid, including the T helper cell bias, may condition the response to apoptotic signals and determine the characteristics of an autoimmune reaction. Furthermore, chemoattractant cytokines, including IL16, RANTES, and CXCL10, elaborated by resident cells in the thyroid and orbit may provoke mononuclear cell infiltration. Other cytokines may drive cell activation and tissue remodeling. Thus cytokines and the signaling pathways they activate represent attractive therapeutic targets. Interruption of these might alter the natural course of Graves' disease and its orbital manifestations. PMID:18713026

  18. Cytokines, Graves' disease, and thyroid-associated ophthalmopathy.

    PubMed

    Gianoukakis, Andrew G; Khadavi, Nicole; Smith, Terry J

    2008-09-01

    Graves' disease, an autoimmune process associated with thyroid dysfunction, can also manifest as remodeling of orbital connective tissue. Affected tissues exhibit immune responses that appear to be orchestrated by resident cells and those recruited from the bone marrow through their expression and release of cytokines and surface display of cytokine receptors. Cytokines are small molecules produced by many types of cells, including those of the "professional" immune system. Aberrant cytokine expression appears to play an important role in the pathogenesis of many human diseases, including thyroid autoimmunity. The skewed pattern of cytokine expression in the thyroid, including the T helper cell bias, may condition the response to apoptotic signals and determine the characteristics of an autoimmune reaction. Furthermore, chemoattractant cytokines, including IL16, RANTES, and CXCL10, elaborated by resident cells in the thyroid and orbit may provoke mononuclear cell infiltration. Other cytokines may drive cell activation and tissue remodeling. Thus cytokines and the signaling pathways they activate represent attractive therapeutic targets. Interruption of these might alter the natural course of Graves' disease and its orbital manifestations. PMID:18713026

  19. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

    PubMed Central

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J.; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M.; Adamidou, Fotini; Anagnostis, Panagiotis; Ayvaz, Goksun; Azzolini, Claudio; Boschi, Antonella; Bournaud, Claire; Clarke, Lucy; Currò, Nicola; Daumerie, Chantal; Dayan, Colin; Fuhrer, Dagmar; Konuk, Onur; Marinò, Michele; Morris, Daniel; Nardi, Marco; Pearce, Simon; Pitz, Susanne; Rudovsky, Gottfried; Vannucchi, Guia; Vardanian, Christine; von Arx, Georg

    2016-01-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment. PMID:27099835

  20. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy.

    PubMed

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M

    2016-03-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment. PMID:27099835

  1. 78 FR 27078 - Native American Graves Protection and Repatriation Act Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... (Department) published the initial rules to implement NAGPRA in 1995 (60 FR 62158, December 4, 1995), which... concerning: Civil penalties (68 FR 16354, April 3, 2003); Future applicability (72 FR 13189, March 21, 2007); and Disposition of culturally unidentifiable human remains (75 FR 12378, March 15, 2010). Since...

  2. Radioiodine thyroid ablation in graves' hyperthyroidism: merits and pitfalls.

    PubMed

    Nwatsock, J F; Taieb, D; Tessonnier, L; Mancini, J; Dong-A-Zok, F; Mundler, O

    2012-01-01

    Ablative approaches using radioiodine are increasingly proposed for the treatment of Graves' disease (GD) but their ophthalmologic and biological autoimmune responses remain controversial and data concerning clinical and biochemical outcomes are limited. The aim of this study was to evaluate thyroid function, TSH-receptor antibodies (TRAb) and Graves' ophthalmopathy (GO) occurrence after radioiodine thyroid ablation in GD. We reviewed 162 patients treated for GD by iodine-131 ((131)I) with doses ranging from 370 to 740 MBq, adjusted to thyroid uptake and sex, over a 6-year period in a tertiary referral center. Collected data were compared for outcomes, including effectiveness of radioiodine therapy (RIT) as primary endpoint, evolution of TRAb, and occurrence of GO as secondary endpoints. The success rate was 88.3% within the first 6 months after the treatment. The RIT failure was increased in the presence of goiter (adjusted odds ratio = 4.1, 95% confidence interval 1.4-12.0, P = 0.010). The TRAb values regressed with time (r = -0.147; P = 0.042) and patients with a favorable outcome had a lower TRAb value (6.5 ± 16.4 U/L) than those with treatment failure (23.7 ± 24.2 U/L, P < 0.001). At the final status, 48.1% of patients achieved normalization of serum TRAb. GO occurred for the first time in 5 patients (3.7%) who were successfully cured for hyperthyroidism but developed early and prolonged period of hypothyroidism in the context of antithyroid drugs (ATD) intolerance (P = 0.003) and high TRAb level (P = 0.012). On the basis the results of this study we conclude that ablative RIT is effective in eradicating Graves' hyperthyroidism but may be accompanied by GO occurrence, particularly in patients with early hypothyroidism and high pretreatment TRAb and/or ATD intolerance. In these patients, we recommend an early introduction of LT4 to reduce the duration and the degree of the radioiodine-induced hypothyroidism. PMID:22942775

  3. Monitoring controlled graves representing common burial scenarios with ground penetrating radar

    NASA Astrophysics Data System (ADS)

    Schultz, John J.; Martin, Michael M.

    2012-08-01

    Implementing controlled geophysical research is imperative to understand the variables affecting detection of clandestine graves during real-life forensic searches. This study focused on monitoring two empty control graves (shallow and deep) and six burials containing a small pig carcass (Sus scrofa) representing different burial forensic scenarios: a shallow buried naked carcass, a deep buried naked carcass, a deep buried carcass covered by a layer of rocks, a deep buried carcass covered by a layer of lime, a deep buried carcass wrapped in an impermeable tarpaulin and a deep buried carcass wrapped in a cotton blanket. Multi-frequency, ground penetrating radar (GPR) data were collected monthly over a 12-month monitoring period. The research site was a cleared field within a wooded area in a humid subtropical environment, and the soil consisted of a Spodosol, a common soil type in Florida. This study compared 2D GPR reflection profiles and horizontal time slices obtained with both 250 and 500 MHz dominant frequency antennae to determine the utility of both antennae for grave detection in this environment over time. Overall, a combination of both antennae frequencies provided optimal detection of the targets. Better images were noted for deep graves, compared to shallow graves. The 250 MHz antenna provided better images for detecting deep graves, as less non-target anomalies were produced with lower radar frequencies. The 250 MHz antenna also provided better images detecting the disturbed ground. Conversely, the 500 MHz antenna provided better images when detecting the shallow pig grave. The graves that contained a pig carcass with associated grave items provided the best results, particularly the carcass covered with rocks and the carcass wrapped in a tarpaulin. Finally, during periods of increased soil moisture levels, there was increased detection of graves that was most likely related to conductive decompositional fluid from the carcasses.

  4. Variable addressability imaging systems

    NASA Astrophysics Data System (ADS)

    Kubala, Kenneth Scott

    The use of variable addressability for creating an optimum human-machine interface is investigated. Current wide field optical systems present more information to the human visual system than it has the capacity to perceive. The axial resolution, and/or the field of view can be increased by minimizing the difference between what the eye can perceive and what the system presents. The variable addressability function was developed through the use of a human factors experiment that characterized the position of the eye during the simulated use of a binocular system. Applying the variable addressability function to a conventional optical design required the development of a new metric for evaluating the expected performance of the variable addressability system. The new metric couples psycho-visual data and traditional optical data in order to specify the required performance of the variable addressability system. A non-linear mapping of the pixels is required in order to have the system work most efficiently with the human visual system, while also compensating for eye motion. The non-linear mapping function, which is the backbone of the variable addressability technique, can be created using optical distortion. The lens and system design is demonstrated in two different spectral bands. One of the designs was fabricated, tested, and assembled into a prototype. Through a second human factors study aimed at measuring performance, the variable addressability prototype was directly compared to a uniform addressability prototype, quantifying the difference in performance for the two prototypes. The human factors results showed that the variable addressability prototype provided better resolution 13% of the time throughout the experiment, but was 15% slower in use than the uniform addressability prototype.

  5. Management plan and delivery of care in Graves' ophthalmopathy patients.

    PubMed

    Yang, Morgan; Perros, Petros

    2012-06-01

    Most patients with Graves' orbitopathy have mild disease that requires no or minimal intervention. For the minority of patients with moderate or severe disease, multiple medical and surgical treatments may be required at different stages. It is crucial that such patients are monitored closely and treatments applied with care in the right sequence. Medical treatments should be used as early as possible and only during the active phase of the disease. Rehabilitative surgery is indicated in the inactive phase of the disease and should follow the sequence: surgical decompression followed by eye muscle surgery, followed by lid surgery. Delivery of care in a coordinated fashion that makes use of best available expertise is important and best implemented through a Combined Thyroid Eye clinic. PMID:22632367

  6. [The necklace from the 660 grave in Megara Iblea].

    PubMed

    Verger, Stéphane

    2011-01-01

    The article analyzes the 660 grave in Megara Iblea, a Greek colony in Sicily, in which a woman has been buried. On her breast a magnificent neckless was found, made of amulets recalling the travel of the sun during the summer solstice. Some objects allude to solar cults (a cock; round pendants), others seem to came from Gallia and Macedonia (summer far West and East), others recall archeological contexts such as tombs in Marvinci, in the Vardar Valley, and allude to relations with female practices of medicine and magic and to female roles characterized by extraordinary powers, due to being descendants of the Sun god. These solar symbols, joint with the discovery of many little objects, typical of children burials, allow to hypotize a relation with the cult of Mater Matuta and seem to point out a difficult or anomalous pregnancy or birth. PMID:21941988

  7. Association between Polymorphisms in the TSHR Gene and Graves' Orbitopathy

    PubMed Central

    Jurecka-Lubieniecka, Beata; Ploski, Rafal; Kula, Dorota; Szymanski, Konrad; Bednarczuk, Tomasz; Ambroziak, Urszula; Hasse-Lazar, Kornelia; Hyla-Klekot, Lidia; Tukiendorf, Andrzej; Kolosza, Zofia; Jarzab, Barbara

    2014-01-01

    Background Graves' orbitopathy (GO) as well as Graves' disease (GD) hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR). GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age), for whom environmental effects had less time to influence outcomes than in adults. Methods 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2). Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4) and lymphoid protein tyrosine phosphatase (PTPN22). Results The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. Conclusions Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients. PMID:25061884

  8. Total thyroidectomy as primary definitive treatment for Graves' hyperthyroidism.

    PubMed

    Snyder, Samuel; Govednik, Cara; Lairmore, Terry; Jiang, Da-Shu; Song, Juhee

    2013-12-01

    The objective of this study was to compare the results of total thyroidectomy (TT) for hyperthyroidism secondary to Graves' disease (GD) with TT for other benign thyroid diseases to determine if TT should be considered more often as first-line therapy for GD. Seven hundred eighty patients underwent TT for benign disease: 203 for GD, 56 for other hyperthyroidisms, and 521 for other benign diseases from March 1, 2003, to December 31, 2009. The perioperative results of these three groups were compared for demographics, blood loss, operative time, complications, and hospitalization. There were no significant differences among the three groups except the patients with GD were more likely to be younger (42 vs 56 vs 57 years; P < 0.001), have more blood loss (154 vs 99 vs 110 mL; P = 0.05), and were more likely to develop permanent hypoparathyroidism (1.0 vs 1.8 vs 0%; P = 0.03) when compared with other causes of hyperthyroidism and other benign thyroid diseases. Permanent recurrent laryngeal nerve injury did not occur in the GD group (0 vs 0 vs 0.4% nerves at risk; P = 0.69) with transient recurrent laryngeal nerve injury occurring in 1.7 versus 2.7 versus 3.1 per cent nerves at risk (P = 0.35). The lack of a euthyroid state preoperatively had no influence on surgical outcomes or complications. Eighty percent of the TTs for GD were done as same-day outpatient procedures. TT offers a safe, low-risk, and rapid cure for GD to justifiably be considered as a reasonable first-line therapy in selected patients with Graves' hyperthyroidism. PMID:24351357

  9. Thyroid-stimulating antibody (TSAb) of Graves' disease.

    PubMed

    Zakarija, M; McKenzie, J M

    The current knowledge of thyroid-stimulating antibody (TSAb) and its significance in Graves' disease is reviewed under 4 headings. 1) Methods of assay; these are categorized as thyroid-stimulation or thyrotropin-receptor-modulation type methods. The latter are convenient but non-specific and the former are inconvenient but specific. The use of guinea pig fat cell membranes as a source of receptor for thyrotropin may improve the specificity of the thyrotropin-binding inhibition (TBI) system. 2) Immunochemistry of TSAb; evidence for the restricted heterogeneity, or oligoclonality, of the antibody as it occurs in some sera, viz. selected for the very high titer, includes a relatively constant pI on isoelectric focussing, restriction to IgG1 and having only lambda or k as the light chain. 3) Are antibodies other than TSAb pathogenic in hyperthyroidism? data are provided indicating the presence in one serum of an antibody that inhibits the action of TSAb in vitro. Clinically this novel antibody caused delayed onset of neonatal hyperthyroidism in 2 children. The prevalence of the antibody and its general clinical significance are unknown, but ways of testing for its presence are reviewed. 4) Clinical significance of the assay of TSAb; TSAb occurs in at least 90% of patients but should not be necessary for the diagnosis of Graves' disease. Its persistence at the end of a course of antithyroid drugs predicates relapse; a high level on first diagnosis may forecast such persistence and be an indication for ablative therapy for hyperthyroidism. A high level of TSAb in the third trimester of pregnancy is a reliable index of neonatal hyperthyroidism. It should be recognized that there is a marked tendency for TSAb values to fall throughout the course of pregnancy.

  10. Graves' Patient with Thymic Expression of Thyrotropin Receptors and Dynamic Changes in Thymic Hyperplasia Proportional to Graves' Disease Activity

    PubMed Central

    Song, Young Shin; Won, Jae-Kyung; Kim, Mi Jeong; Lee, Ji Hyun; Kim, Dong-Wan; Chung, June-Key; Park, Do Joon

    2016-01-01

    Thymic hyperplasia is frequently observed in Graves' disease. However, detectable massive enlargement of the thymus is rare, and the mechanism of its formation has remained elusive. This case showed dynamic changes in thymic hyperplasia on serial computed tomography images consistent with changes in serum thyrotropin receptor (TSH-R) antibodies and thyroid hormone levels. Furthermore, the patient's thymic tissues underwent immunohistochemical staining for TSH-R, which demonstrated the presence of thymic TSH-R. The correlation between serum TSH-R antibody levels and thymic hyperplasia sizes and the presence of TSH-R in her thymus suggest that TSH-R antibodies could have a pathogenic role in thymic hyperplasia. PMID:26996584

  11. Addressivity in cogenerative dialogues

    NASA Astrophysics Data System (ADS)

    Hsu, Pei-Ling

    2014-03-01

    Ashraf Shady's paper provides a first-hand reflection on how a foreign teacher used cogens as culturally adaptive pedagogy to address cultural misalignments with students. In this paper, Shady drew on several cogen sessions to showcase his journey of using different forms of cogens with his students. To improve the quality of cogens, one strategy he used was to adjust the number of participants in cogens. As a result, some cogens worked and others did not. During the course of reading his paper, I was impressed by his creative and flexible use of cogens and at the same time was intrigued by the question of why some cogens work and not others. In searching for an answer, I found that Mikhail Bakhtin's dialogism, especially the concept of addressivity, provides a comprehensive framework to address this question. In this commentary, I reanalyze the cogen episodes described in Shady's paper in the light of dialogism. My analysis suggests that addressivity plays an important role in mediating the success of cogens. Cogens with high addressivity function as internally persuasive discourse that allows diverse consciousnesses to coexist and so likely affords productive dialogues. The implications of addressivity in teaching and learning are further discussed.

  12. Nitrous oxide, methane and carbon dioxide dynamics from experimental pig graves.

    PubMed

    Dalva, M; Moore, T R; Kalacska, M; Leblanc, G; Costopoulos, A

    2015-02-01

    Twelve pig carcasses were buried in single, shallow and deep (30 and 90 cm, respectively) graves at an experimental site near Ottawa, Ontario, Canada, with three shallow and three deep wrapped in black plastic garbage bags. An additional six carcasses were left at the surface to decompose, three of which were bagged. Six reference pits without remains were also dug. The objective of this three-year study was to examine the biogeochemistry and utility of nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) in grave detection and whether grave depth or cadaver condition (bagged versus bare) affected soil pore air concentrations and emission of the three gases. Graves showed significantly higher (α=0.05) concentrations and surface fluxes of N2O and CO2 than reference pits, but there was no difference in CH4 between graves and reference pits. While CH4 decreased with depth in the soil profiles, N2O and CO2 showed a large increase compared to reference pits. Shallow graves showed significantly higher emissions and pore air concentrations of N2O and CO2 than deep graves, as did bare versus bagged carcasses.

  13. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    PubMed Central

    Žarković, Miloš

    2012-01-01

    Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs) are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS). Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1) involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo. PMID:22175033

  14. Nitrous oxide, methane and carbon dioxide dynamics from experimental pig graves.

    PubMed

    Dalva, M; Moore, T R; Kalacska, M; Leblanc, G; Costopoulos, A

    2015-02-01

    Twelve pig carcasses were buried in single, shallow and deep (30 and 90 cm, respectively) graves at an experimental site near Ottawa, Ontario, Canada, with three shallow and three deep wrapped in black plastic garbage bags. An additional six carcasses were left at the surface to decompose, three of which were bagged. Six reference pits without remains were also dug. The objective of this three-year study was to examine the biogeochemistry and utility of nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) in grave detection and whether grave depth or cadaver condition (bagged versus bare) affected soil pore air concentrations and emission of the three gases. Graves showed significantly higher (α=0.05) concentrations and surface fluxes of N2O and CO2 than reference pits, but there was no difference in CH4 between graves and reference pits. While CH4 decreased with depth in the soil profiles, N2O and CO2 showed a large increase compared to reference pits. Shallow graves showed significantly higher emissions and pore air concentrations of N2O and CO2 than deep graves, as did bare versus bagged carcasses. PMID:25544693

  15. Experiments to Detect Clandestine Graves from Interpreted High Resolution Geophysical Anomalies

    NASA Astrophysics Data System (ADS)

    Molina, C. M.; Hernandez, O.; Pringle, J.

    2013-05-01

    This project refers to the search for clandestine sites where possibly missing people have been buried based on interpreted near surface high resolution geophysical anomalies. Nowadays, there are thousands of missing people around the world that could have been tortured and killed and buried in clandestine graves. This is a huge problem for their families and governments that are responsible to warranty the human rights for everybody. These people need to be found and the related crime cases need to be resolved. This work proposes to construct a series of graves where all the conditions of the grave, human remains and related objects are known. It is expected to detect contrasting physical properties of soil to identify the known human remains and objects. The proposed geophysical methods will include electrical tomography, magnetic and ground penetrating radar, among others. Two geographical sites will be selected to located and build standard graves with contrasting weather, soil, vegetation, geographic and geologic conditions. Forward and inverse modeling will be applied to locate and enhance the geophysical response of the known graves and to validate the methodology. As a result, an integrated geophysical program will be provided to support the search for clandestine graves helping to find missing people that have been illegally buried. Optionally, the methodology will be tested to search for real clandestine graves.

  16. Mapping anthropogenic fill with GPR for unmarked grave detection: a case study from a possible location of Mokare's grave, Albany, Western Australia

    NASA Astrophysics Data System (ADS)

    Bladon, Paul; Moffat, Ian; Guilfoyle, David; Beale, Alice; Milani, Jennifer

    2011-11-01

    Geophysical techniques are a commonly used, non-invasive method for the location of unmarked graves. Contrary to popular perception, most studies rely not on directly imaging skeletal material but instead on locating the subsurface disturbance created by grave digging. This approach is effective only when sufficient contrast exists between detectable properties (such as structure, mineralogy or porosity) of the grave fill and the surrounding sediment. Resolving these features can be particularly problematic in disturbed areas where other anthropogenic fill is in place, as it is often complex in character and lacks a natural stratigraphy. In many cultural heritage projects, it is often more important to ensure that burials are not disturbed rather than to specifically locate them. Under these circumstances, ground penetrating radar (GPR) can be used to locate modern anthropogenic fill. This may show which areas of the site are younger than the targeted graves and therefore of no archaeological interest. This approach is trialled on a site thought to contain the grave of Mokare, a significant historical figure in the colonial settlement of the Albany area in Western Australia. The delineation of a package of modern fill in the shallow subsurface in the context of the probable history of earthworks on the site demonstrates that Mokare is not buried in the surveyed location. This approach, applied to suitable sites, could contribute to culturally sensitive non-invasive investigation of burial sites in other locations.

  17. Radioiodine treatment of Graves' disease. An assessment of its potential risks

    SciTech Connect

    Graham, G.D.; Burman, K.D.

    1986-12-01

    Concern about the side effects of radiation exposure has deterred physicians from using radioiodine treatment for Graves' disease, although the efficacy and safety of this treatment have been established in the 35 years since its introduction. In that time, no significant side effects have been discovered. We believe iodine-131 should be considered the treatment of choice in most patients with Graves' disease. This article reviews the current understanding of the risks in radioiodine treatment of Graves' disease, including the risks for teratogenicity, genetic damage, carcinogenesis, and cellular dysfunction.

  18. Addressing Employer Services.

    ERIC Educational Resources Information Center

    Perspective: Essays and Reviews of Issues in Employment Security and Employment and Training Programs, 1986

    1986-01-01

    This volume of an annual journal contains 21 articles focusing on the many services that state Employment Security (ES) agencies are providing to improve outreach to employers who pay for the programs through the dedicated revenues of the Federal Unemployment Tax Act and state benefit taxes and to improve their own staff ability to deliver…

  19. Addressing Social Issues.

    ERIC Educational Resources Information Center

    Schoebel, Susan

    1991-01-01

    Maintains that advertising can help people become more aware of social responsibilities. Describes a successful nationwide newspaper advertising competition for college students in which ads address social issues such as literacy, drugs, teen suicide, and teen pregnancy. Notes how the ads have helped grassroots programs throughout the United…

  20. Addressing Sexual Harassment

    ERIC Educational Resources Information Center

    Young, Ellie L.; Ashbaker, Betty Y.

    2008-01-01

    This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

  1. 77 FR 65406 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Notice of nomination solicitation... Protection and Repatriation Review Committee, National NAGPRA Program, National Park Service, 1201 Eye...

  2. VIEW OF FLAT GRAVE MARKERS AL0NG SAINT MIHIEL AVENUE, WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW OF FLAT GRAVE MARKERS AL0NG SAINT MIHIEL AVENUE, WITH UPRIGHT MARKERS IN BACKGROUND. VIEW TO NORTHWEST. - Los Angeles National Cemetery, 950 South Sepulveda Boulevard, Los Angeles, Los Angeles County, CA

  3. Dilated cardiomyopathy with Graves disease in a young child.

    PubMed

    Choi, Yu Jung; Jang, Jun Ho; Park, So Hyun; Oh, Jin-Hee; Koh, Dae Kyun

    2016-06-01

    Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP. PMID:27462586

  4. Dilated cardiomyopathy with Graves disease in a young child

    PubMed Central

    Choi, Yu Jung; Jang, Jun Ho; Oh, Jin-Hee; Koh, Dae Kyun

    2016-01-01

    Graves disease (GD) can lead to complications such as cardiac arrhythmia and heart failure. Although dilated cardiomyopathy (DCMP) has been occasionally reported in adults with GD, it is rare in children. We present the case of a 32-month-old boy with DCMP due to GD. He presented with irritability, vomiting, and diarrhea. He also had a history of weight loss over the past few months. On physical examination, he had tachycardia without fever, a mild diffuse goiter, and hepatomegaly. The chest radiograph showed cardiomegaly with pulmonary edema, while the echocardiography revealed a dilated left ventricle with an ejection fraction (EF) of 28%. The thyroid function test (TFT) showed elevated serum T3 and decreased thyroid stimulating hormone (TSH) levels. The TSH receptor autoantibody titer was elevated. He was diagnosed with DCMP with GD; treatment with methylprednisolone, diuretics, inotropics, and methimazole was initiated. The EF improved after the TFT normalized. At follow-up several months later, although the TFT results again showed evidence of hyperthyroidism, his EF had not deteriorated. His cardiac function continues to remain normal 1.5 months after treatment was started, although he still has elevated T3 and high TSH receptor antibody titer levels due to poor compliance with drug therapy. To summarize, we report a young child with GD-induced DCMP who recovered completely with medical therapy and, even though the hyperthyroidism recurred several months later, there was no relapse of the DCMP. PMID:27462586

  5. Odontological identification of human remains from mass graves in Croatia.

    PubMed

    Brkic, H; Strinovic, D; Kubat, M; Petrovecki, V

    2000-01-01

    This paper reports the results and methods of dental identification of 1000 human remains exhumed from mass graves in Croatia up to July 1998. Personal identification of the victims was performed at the Department of Forensic Medicine and Criminology at the School of Medicine in Zagreb. A forensic odontologist participated in the identification process by carrying out the dental identification. A total of 824 victims were positively identified, while 176 victims remained unidentified. Dental identification based on available dental antemortem data was achieved in 25% of the cases. Dental identification based on dental charts was achieved in 35%, on x-rays in 15%, on photographs of teeth in 22%, on interviews in 18%, and on confirmation by odontologists in 10% of the cases. Teeth, in combination with anthropological parameters, age, sex and height, as well as other specific characteristics such as tattoos, personal identification cards, clothes, jewellery and DNA, were helpful for identification of 64% of the victims, but the significance for the identification was not dominant. Only in 11% of the cases was identification achieved by other relevant means and teeth not used at all. Identification procedures in Croatia will continue until another 1700 people who are still missing or kept as prisoners of war since the aggression on Croatia in 1991 are found and/or identified. PMID:11197622

  6. A case of autoimmune hepatitis combined with Graves' disease.

    PubMed

    Jhee, Jong Hyun; Kim, Hyun Ju; Kang, Wonseok; Kim, Sewha; Kim, Do Young

    2015-01-01

    A 25-year-old woman presented with jaundice, palpitation, and weight loss of 5 kg during a period of 2 weeks. Laboratory tests showed elevated levels of liver enzymes (AST 1,282 IU/L, ALT 1,119 IU/L) and total bilirubin (6.4 mg/dL); negative for hepatitis virus infection; elevated serum levels of triiodothyronine (T3, 3.60 ng/dL), free thyroxine (fT4, 3.82 ng/dL), and lowered serum level of thyroid stimulating hormone (TSH, <0.025 μIU/mL); and positive for thyroid stimulating antibody and anti-mitochondrial antibody (AMA). The liver biopsy findings were consistent with autoimmune hepatitis (AIH). Accordingly, oral steroid therapy was started with 60 mg of prednisolone under the impression of AIH associated with Graves' disease. After a week of steroid therapy, the clinical manifestation showed significant improvement, with normalization of both liver and thyroid functions. Diagnosis of the liver condition of patients who present with hyperthyroidism and liver dysfunction is important, so that appropriate therapy can be promptly initiated. PMID:25603854

  7. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    PubMed

    Messina, G; Viceconti, N; Trinti, B

    1997-11-01

    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  8. Cradle-to-Grave Logistic Technologies for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Broyan, James L.; Ewert, Michael K.; Shull, Sarah

    2013-01-01

    Human exploration missions under study are very limited by the launch mass capacity of exiting and planned vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Consequently, crew item logistical mass is typically competing with vehicle systems for mass allocation. NASA is Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing four logistics technologies guided by a systems engineering cradle-to-grave approach to enable used crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion supply gases. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as the mission duration increases. This paper provides a description, benefits, and challenges of the four technologies under development and a status of progress at the mid ]point of the three year AES project.

  9. An unusual presenting symptom of graves' disease: myalgia.

    PubMed

    Papanikolaou, N; Perros, P

    2013-01-01

    A 50-year-old female patient presented with severe myalgia involving her proximal muscles for 3-4 weeks. She also reported mild thyrotoxic symptoms over the same time period. Examination revealed mild thyrotoxicosis, a moderate diffuse goiter and no eye signs. The clinical picture was dominated by muscle pain and tenderness involving mainly her proximal arms and legs, her calves and her fingers, requiring opiate analgesia. Muscle power and tendon reflexes were normal. Laboratory evaluation revealed undetectable serum thyroid stimulating hormone (TSH) with raised FT4, FT3 and positive TSH receptor antibodies. Treatment with carbimazole was started. Additional laboratory investigations were negative (inflammatory markers, creatine kinase and antibodies to antinuclear antibodies, gastric parietal cell, smooth muscle, mitochondrial, dsDNA, centromere, extractable nuclear antigen (ENA) ribonucleoprotein, ENA Sm, ENA Ro, ENA Anti-La, ENA Scl70, ENA Jo-1, anti-CCP and rheumatoid factor). Further assessment in the rheumatology clinic confirmed there was no small joint tenderness or loss of range of movement of her limbs, but widespread and profound muscle tenderness of the common extensors of the forearms, biceps, trapezius, calves and thighs. She was treated symptomatically with analgesic medication and continued on carbimazole. A month later she was euthyroid and her myalgia had resolved. Hyperthyroidism has a profound effect on skeletal muscle and often leads to myopathy. Severe myalgia in association with Graves' disease is rare and resolves with the restoration of euthyroidism. PMID:24783030

  10. [Management of Graves' disease and hypothyroidism in pregnancy].

    PubMed

    Momotani, Naoko; Iwama, Saika

    2012-11-01

    In the treatment of pregnant patients with Graves' disease, propylthiouracil is preferred over methimazole in early pregnancy because of a possible teratogenicity of methimazole. Methimazole is preferable to propylthiouracil in other time of pregnancy on the basis of severe liver dysfunction occasionally caused by propylthiouracil. Fetal hypothyroidism can be avoided when maternal free T4 levels are maintained at or above the upper normal limit for non-pregnant subjects. However, maternal free T4 should be kept normal for pregnant reference range when pregnancy complications develop. Fetal hypothyroidism in this setting will not affect the infant's development as long as mothers are euthyroid and the infants recover from hypothyroid state within a short time after birth. In hypothyroid women, 1-T4 dose often needs to be increased in pregnancy. Maternal T4 deficiency in early pregnancy has been suggested to affect normal brain development in the offspring. However, it has recently been shown in iodine rich area that no adverse effect on neuropsychological development was seen irrespective of the severity of maternal T4 deficiency. Insufficient iodine intake in the mother can cause low T4 in pregnancy and also inadequate production of T4 in breast-fed infants when sufficient T4 is essential for normal brain development.

  11. Clinical efficacy of Yingliu treatment for Graves disease

    PubMed Central

    Yang, Hua; Bi, Xiaojuan; Tang, Hong; Zeng, Juanhua; Cong, Yilei; Wu, Tengfei; Chen, Qiuye

    2015-01-01

    Objective: To observe the clinical efficacy and safety of the traditional Chinese medicine (TCM) mixture Yingliu combined with methimazole medication for the treatment of Graves disease (GD). Method: In a randomized, paralleled control study, 92 GD patients were randomized into a Yingliu mixture treatment and a control treatment group, both receiving methimazole. Both treatments lasted for 12 weeks and outcome parameter were thyroid function, thyroid autoantibodies, TCM symptome scores and safety indicators. Results: The clinical efficiency of the Yingliu mixture-methimazole combination was 92.5% vs. 82.5% (P < 0.05) of the solely methimazole medication group. After 12 weeks treatments the Yingliu mixture in combination with methimazole improved free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) receptor antibody (TRAb) and thyroglobulin antibody (TGAb) values significantly more than methimazole alone and TCM symptome scores were significant lower after 12 week treatment in the Yingliu mixture- methimazole group (P < 0.05). The thyroid enlargement (21 vs. 10, P < 0.05), fatigue (39 vs. 30, P < 0.01) and dry mouth symptoms (37 vs. 29, P < 0.05) were superior improved in the Yingliu than in the control medication group, respectively. There was no significant difference regarding safety evaluations between both treatment groups (P = 0.499). Conclusion: Yingliu mixture as combined medication with methimazole can significantly improve the outcome of a solely methimazole application for GD treatments. PMID:26131218

  12. Optimal iodine-131 dose for eliminating hyperthyroidism in Graves' disease

    SciTech Connect

    Nordyke, R.A.; Gilbert, F.I. Jr. )

    1991-03-01

    Since hypothyroidism is commonplace after treatment of Graves' disease with radioiodine, the goal should be cure of hyperthyroidism rather than avoidance of hypothyroidism. To find the optimal dose to accomplish cure, we treated 605 patients with stepwise increasing doses of 3, 4, 5, 6, 8, and 10 mCi, analyzing the relationship of dose, age, sex, gland weight, and thyroidal uptake to cure. Estimates of cure at doses above 10 mCi were made from the literature. Cure was directly related to dose between 5 and 10 mCi. There was no significant relationship between cure and age (chi-square, p = 0.74), sex (chi-square, p = 0.12), and 24-hr uptake if over 30% (chi-square for slope, p greater than 0.10). Cure and gland weight had an inverse relationship (chi-square for slope, 0.01 less than p less than 0.02). We concluded that the optimal 131I dose for curing hyperthyroidism is approximated by starting with 10 mCi and increasing it for unusually large glands or for special patient circumstances.

  13. Prenatal diagnosis and management of fetal goiter caused by maternal Grave's disease.

    PubMed

    Hadi, H A; Strickland, D

    1995-07-01

    We present a case of maternal Grave's disease associated with fetal goitrous hyperthyroidism. Fetal goiter was diagnosed by ultrasound and diagnosis of fetal hyperthyroidism was established by umbilical blood sampling. Fetus was successfully treated by increasing maternal propylthiouracil dosage. Fetal thyroid status was normal at birth. Role of sonography and umbilical blood sampling in management of fetal goiter complicated with maternal Grave's disease is discussed. PMID:7575824

  14. Working to Address Treaty Enforcement Rapidly for Texas Act

    THOMAS, 113th Congress

    Sen. Cornyn, John [R-TX

    2013-06-10

    06/10/2013 Read twice and referred to the Committee on Foreign Relations. (text of measure as introduced: CR S4060) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    PubMed

    Wartofsky, L

    1997-04-01

    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

  16. Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy

    PubMed Central

    Yang, Yeoree; Hwang, Seawon; Kim, Minji; Lim, Yejee; Kim, Min-Hee; Lee, Sohee; Kang, Moo-Il; Cha, Bong-Yun

    2015-01-01

    The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies. PMID:26394731

  17. Holographic content addressable storage

    NASA Astrophysics Data System (ADS)

    Chao, Tien-Hsin; Lu, Thomas; Reyes, George

    2015-03-01

    We have developed a Holographic Content Addressable Storage (HCAS) architecture. The HCAS systems consists of a DMD (Digital Micromirror Array) as the input Spatial Light Modulator (SLM), a CMOS (Complementary Metal-oxide Semiconductor) sensor as the output photodetector and a photorefractive crystal as the recording media. The HCAS system is capable of performing optical correlation of an input image/feature against massive reference data set stored in the holographic memory. Detailed system analysis will be reported in this paper.

  18. Lithium as an Alternative Option in Graves Thyrotoxicosis

    PubMed Central

    Prakash, Ishita; Nylen, Eric Sixtus; Sen, Sabyasachi

    2015-01-01

    A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was >6.99 ng/dL (0.7–1.8); FT3 was 18 pg/mL (3–5); TSI was 658% (0–139). Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis. PMID:26425375

  19. Predicting relapse following medical therapy for Graves' disease

    SciTech Connect

    McKillop, J.H.; Wilson, R.; Pearson, D.W.; Cuthbert, G.F.; Jenkins, C.; Caine, S.; Thomson, J.A.

    1984-01-01

    In 40 patients with Graves' disease (35 female, 5 male; mean age at presentation = 38 yrs) the authors examined the ability of thyroidal /sup 99m/Tc uptake and serum thyroid stimulating immunoglobins (TSI) to identify patients who would relapse after a course of medical therapy. Serum TSI and 20 minute thyroidal /sup 99m/Tc uptake were estimated every 3 months during a 12 month course of carbimazole and tri iodothyronine. TSI levels were estimated by inhibition of receptor binding and expressed as an index (normal value <25). 17 patients (Group 1) remained biochemically euthyroid for at least 1 year after cessation of therapy. 23 (Group II) developed recurrent thyrotoxicosis. Thyroid hormone level did not differ between Groups I and II at presentation. /sup 99m/Tc uptake did not differ significantly in the two groups at presentation and overlap of values persisted throughout therapy. 3 patients had undetectable TSI levels at presentation and throughout follow-up. In the remaining 37, TSI levels at presentation were significantly higher in Group II and all 7 patients with initial values >80 relapsed. After 12 months therapy a TSI level of >25 was present in 1 Group I patient and 16 Group II patients who had detectable TSI at presentation. /sup 99m/Tc uptake was a poor predictor of relapse of thyrotoxicosis. A very high TSI level at presentation (>80) was associated with relapse. An abnormal TSI on completion of 12 months medical therapy had a sensitivity of 86% and a specificity of 94% for prediction of relapse of thyrotoxicosis in the subsequent year.

  20. Prognostic factors in the radiotherapy of Graves' ophthalmopathy

    SciTech Connect

    Petersen, I.A.; Kriss, J.P.; McDougall, I.R.; Donaldson, S.S. )

    1990-08-01

    Between April 1968 and February 1988, 311 patients with symptomatic and progressive Graves' ophthalmopathy were treated with megavoltage orbital radiotherapy. The patients were divided into three groups: I treated with 20 Gy/2 weeks; II treated with 30 Gy/3 weeks, and III received 20 Gy/2 weeks. The degree of eye involvement was evaluated numerically before and after therapy for each of five parameters: soft tissue signs, proptosis, eye muscle impairment, corneal involvement, and sight loss. Pre-treatment and current thyroid diagnosis and status were also noted. To evaluate the effects of radiotherapy alone, follow-up was terminated at the time any eye surgery was done; for those not treated surgically the minimum follow-up was 12 months. Because there were significant demographic differences between the patient groups, the results of each group were analyzed separately. A stepwise linear regression analysis was performed to determine if there were any significant variables affecting outcome. Based on these data formulae were derived which enable outcome to be predicted in any patient. Before therapy more than 90% of patients in all groups had soft tissue and eye muscle involvement, whereas 65-75% had proptosis and about half 50% had some degree of sight loss. Radiotherapy arrested progression of ophthalmic parameters in all but 1-6% of the patients. Objective and symptomatic improvement was noted for all parameters assessed, but there was marked individual variability. The best responses were noted for soft tissue, corneal involvement, and sight loss; however over half the patients had some improvement in eye muscle function and proptosis. Factors which resulted in less favorable outcome included male gender, advanced age, need for concurrent therapy for hyperthyroidism, and no history of hyperthyroidism. No complications have been observed.

  1. Thyrotropin Receptor Epitope and Human Leukocyte Antigen in Graves' Disease.

    PubMed

    Inaba, Hidefumi; De Groot, Leslie J; Akamizu, Takashi

    2016-01-01

    Graves' disease (GD) is an organ-specific autoimmune disease, and thyrotropin (TSH) receptor (TSHR) is a major autoantigen in this condition. Since the extracellular domain of human TSHR (TSHR-ECD) is shed into the circulation, TSHR-ECD is a preferentially immunogenic portion of TSHR. Both genetic factors and environmental factors contribute to development of GD. Inheritance of human leukocyte antigen (HLA) genes, especially HLA-DR3, is associated with GD. TSHR-ECD protein is endocytosed into antigen-presenting cells (APCs), and processed to TSHR-ECD peptides. These peptide epitopes bind to HLA-class II molecules, and subsequently the complex of HLA-class II and TSHR-ECD epitope is presented to CD4+ T cells. The activated CD4+ T cells secrete cytokines/chemokines that stimulate B-cells to produce TSAb, and in turn hyperthyroidism occurs. Numerous studies have been done to identify T- and B-cell epitopes in TSHR-ECD, including (1) in silico, (2) in vitro, (3) in vivo, and (4) clinical experiments. Murine models of GD and HLA-transgenic mice have played a pivotal role in elucidating the immunological mechanisms. To date, linear or conformational epitopes of TSHR-ECD, as well as the molecular structure of the epitope-binding groove in HLA-DR, were reported to be related to the pathogenesis in GD. Dysfunction of central tolerance in the thymus, or in peripheral tolerance, such as regulatory T cells, could allow development of GD. Novel treatments using TSHR antagonists or mutated TSHR peptides have been reported to be effective. We review and update the role of immunogenic TSHR epitopes and HLA in GD, and offer perspectives on TSHR epitope specific treatments. PMID:27602020

  2. Spontaneous Improvement of Untreated Mild Graves' Ophthalmopathy: Rundle's Curve Revisited

    PubMed Central

    Menconi, Francesca; Profilo, Maria Antonietta; Leo, Marenza; Sisti, Eleonora; Altea, Maria Antonietta; Rocchi, Roberto; Latrofa, Francesco; Nardi, Marco; Vitti, Paolo; Marcocci, Claudio

    2014-01-01

    Background: According to Rundle's curve, Graves' ophthalmopathy (GO) worsens during an initial phase up to a peak of maximum severity, then improves and reaches a static plateau, with the activity curve preceding the severity curve by a few months. To our knowledge, no studies have tried to replicate Rundle's curve, and very few have investigated the natural history of GO. Here, we studied GO natural history retrospectively and tried to identify factors that may affect it. Methods: A total of 65 patients with untreated GO underwent an eye assessment after a median of seven months after the appearance of GO and then after a median of 40 months. The primary endpoints were the variation of the single GO features and of the NOSPECS score, as well as the overall outcome of GO. The secondary endpoint was the influence of several variables (age, sex, smoking, GO and thyroid disease duration, thyroid treatment, thyroid status, thyroid volume, anti-TSH receptor autoantibodies) on the outcome of GO. Results: The majority of patients had mild, minimally active GO, and only five had a Clinical Activity Score (CAS) >3. There was a significant reduction of CAS (p<0.0001) and NOSPECS (p=0.01) between the first and last observation, with a timing pattern resembling Rundle's curve. This difference was confirmed even when patients with a CAS >3 at first observation were excluded. At the last observation, 50.8% of patients had improved, 33.8% had remained stable, and 15.4% had worsened moderately or substantially. The overall outcome of GO was not affected by any of the variables under examination. Conclusions: In confirmation of Rundle's observations, untreated GO improves spontaneously with time in the majority of patients, with an activity peak between 13 and 24 months, which may have implications in determining the proper timing of GO treatments. PMID:23980907

  3. Current trends in the management of Graves' disease

    SciTech Connect

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. )

    1990-06-01

    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  4. Bioreactors Addressing Diabetes Mellitus

    PubMed Central

    Minteer, Danielle M.; Gerlach, Jorg C.

    2014-01-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies. PMID:25160666

  5. Bioreactors addressing diabetes mellitus.

    PubMed

    Minteer, Danielle M; Gerlach, Jorg C; Marra, Kacey G

    2014-11-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies.

  6. Content addressable memory project

    NASA Technical Reports Server (NTRS)

    Hall, J. Storrs; Levy, Saul; Smith, Donald E.; Miyake, Keith M.

    1992-01-01

    A parameterized version of the tree processor was designed and tested (by simulation). The leaf processor design is 90 percent complete. We expect to complete and test a combination of tree and leaf cell designs in the next period. Work is proceeding on algorithms for the computer aided manufacturing (CAM), and once the design is complete we will begin simulating algorithms for large problems. The following topics are covered: (1) the practical implementation of content addressable memory; (2) design of a LEAF cell for the Rutgers CAM architecture; (3) a circuit design tool user's manual; and (4) design and analysis of efficient hierarchical interconnection networks.

  7. Prise en charge des traumatismes graves du rein

    PubMed Central

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  8. Addressing Environmental Health Inequalities

    PubMed Central

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), “Addressing Environmental Health Inequalities—Proceedings from the ISEE Conference 2015”, we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  9. Addressing Environmental Health Inequalities.

    PubMed

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), "Addressing Environmental Health Inequalities-Proceedings from the ISEE Conference 2015", we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  10. The Nurse Reinvestment Act revisited.

    PubMed

    Luther, Ann P

    2007-01-01

    The United States is in the midst of a widely recognized critical nursing shortage. In 2002 the "Nurse Reinvestment Act" was passed with overwhelming bipartisan support in an effort to address this serious public health threat. The Act is due for reauthorization of funding in 2007. This paper provides a brief overview of the programs contained within the Act and describes practical ways in which members of the nursing community can take action to insure renewed support for the Act. PMID:17691598

  11. Genetic associations of the thyroid stimulating hormone receptor gene with Graves diseases and Graves ophthalmopathy: A meta-analysis

    PubMed Central

    Xiong, Haibo; Wu, Mingxing; Yi, Hong; Wang, Xiuqing; Wang, Qian; Nadirshina, Sophia; Zhou, Xiyuan; Liu, Xueqin

    2016-01-01

    Graves’ disease (GD) is a common thyroid disease, and Graves ophthalmopathy(GO) is the most common extra-thyroidal manifestation of GD. Genetic associations of the thyroid stimulating hormone receptor (TSHR) gene with GD and GO have been studied in different population groups for a long time. We aimed to obtain a more precise estimation of the effects of TSHR single nucleotide polymorphisms (SNPs) on GD/GO using a meta-analysis. Publications were searched on Pub Med and EMBASE up to December 30, 2015. Eight studies involving three SNPs (rs179247, rs12101255, and rs2268458), which included 4790 cases and 5350 controls, met the selection criteria. The pooled odds ratios (OR) and the 95% confidence intervals (CI) were estimated. SNPs rs179247 (dominant model [GG + GA vs. AA]: OR = 0.66, 95%CI: 0.61–0.73, P = 0.000, I2 = 0%) and rs12101255 (dominant model [TT + TC vs. CC]: OR = 1.67, 95%CI: 1.53–1.83, P = 0.000, I2 = 0%) were significantly associated with GD in all of the genetic models. TSHR rs12101255 and rs2268458 polymorphisms had no association between GO and GD (GD without GO). The results indicate that rs179247 and rs12101255 are likely to be genetic biomarkers for GD. Further studies with different population groups and larger sample sizes are needed to confirm the genetic associations of the TSHR gene with GD/GO. PMID:27456991

  12. Content addressable memory project

    NASA Technical Reports Server (NTRS)

    Hall, Josh; Levy, Saul; Smith, D.; Wei, S.; Miyake, K.; Murdocca, M.

    1991-01-01

    The progress on the Rutgers CAM (Content Addressable Memory) Project is described. The overall design of the system is completed at the architectural level and described. The machine is composed of two kinds of cells: (1) the CAM cells which include both memory and processor, and support local processing within each cell; and (2) the tree cells, which have smaller instruction set, and provide global processing over the CAM cells. A parameterized design of the basic CAM cell is completed. Progress was made on the final specification of the CPS. The machine architecture was driven by the design of algorithms whose requirements are reflected in the resulted instruction set(s). A few of these algorithms are described.

  13. Bax: Addressed to kill.

    PubMed

    Renault, Thibaud T; Manon, Stéphen

    2011-09-01

    The pro-apoptototic protein Bax (Bcl-2 Associated protein X) plays a central role in the mitochondria-dependent apoptotic pathway. In healthy mammalian cells, Bax is essentially cytosolic and inactive. Following a death signal, the protein is translocated to the outer mitochondrial membrane, where it promotes a permeabilization that favors the release of different apoptogenic factors, such as cytochrome c. The regulation of Bax translocation is associated to conformational changes that are under the control of different factors. The evidences showing the involvement of different Bax domains in its mitochondrial localization are presented. The interactions between Bax and its different partners are described in relation to their ability to promote (or prevent) Bax conformational changes leading to mitochondrial addressing and to the acquisition of the capacity to permeabilize the outer mitochondrial membrane. PMID:21641962

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

  15. Triiodothyronine, Thyroxine, and Iodine in Purified Thyroglobulin from Patients with Graves' Disease

    PubMed Central

    Izumi, M.; Larsen, P. Reed

    1977-01-01

    Previous studies have suggested that there is an overproduction of triiodothyronine (T3) relative to thyroxine (T4) in patients with thyrotoxicosis associated with Graves' disease. To evaluate whether or not an increased ratio of T3 to T4 in thyroidal secretion could be contributing to this relative T3 hyperproduction, T3, T4, and iodine were measured in thyroglobulin (Tg) from controls and patients with Graves' disease who had been treated either with propranolol only or with antithyroid drugs plus iodide before surgery. To avoid possible artifacts associated with pulse labeling and chromatography, T3 and T4 were determined by radioimmunoassay of Pronase hydrolysates of purified Tg. Results of analyses of Tg from six control patients and seven with Graves' disease, not receiving thiourea drugs or iodide, showed that the iodine content of Graves' disease Tg was not different from normal. Both contained 3.4 residues of T4/molecule Tg, but there was 0.39±0.08 (mean±SD) residue of T3/molecule Tg in Graves' Tg as opposed to 0.23±0.07 residue T3 molecule Tg in controls matched for iodine content (P < 0.01). This difference resulted in a significantly lower T4/T3 molar ratio (9±2) in Graves' Tg as opposed to control (15±2, P < 0.001). In Tg from patients with treated Graves' disease, iodine, T3, and T4 were reduced, but the reduction in the latter was more substantial, resulting in a T4/T3 molar ratio of 3.4±1. Fractionation of Tg from all groups by RbCl density gradient ultracentrifugation indicated that at physiological levels of Tg iodination, the molar ratio of T3/Tg was consistently higher in Graves' disease. The specific mechanism for this difference is not known, but it is not due to iodine deficiency. If T3 and T4 are secreted in this altered ratio in patients with Graves' disease, the magnitude of the difference could explain the relative T3 hyperproduction which is characteristic of this state. PMID:577211

  16. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland.

    PubMed

    Smith, D M; Dutta, S; Ahmed, F; Thaha, M A

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The "Scottish automated follow-up register" (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ (2) test and ANOVA using SPSS v15.0. A p value of < 0.05 was considered significant. Results. Altogether, 3737 patients were diagnosed with Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p < 0.001). The dose of RAI has increased (p < 0.001) and there has been a reduction in recurrence rate with higher dose of RAI. Surgical intervention rates decreased from 55.3% to 12.3% (p < 0.001) over time. Conclusions. Analysis of a large dataset of patients with Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates. PMID:27313946

  17. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland

    PubMed Central

    Smith, D. M.; Dutta, S.; Ahmed, F.; Thaha, M. A.

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The “Scottish automated follow-up register” (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ2 test and ANOVA using SPSS v15.0. A p value of < 0.05 was considered significant. Results. Altogether, 3737 patients were diagnosed with Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p < 0.001). The dose of RAI has increased (p < 0.001) and there has been a reduction in recurrence rate with higher dose of RAI. Surgical intervention rates decreased from 55.3% to 12.3% (p < 0.001) over time. Conclusions. Analysis of a large dataset of patients with Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates. PMID:27313946

  18. Addressing the municipal market

    SciTech Connect

    Mullin, R.

    1993-05-12

    Most municipalities employ simple, fairly inexpensive water treatment regimes, which is why some large industrial treatment firms stay away from the municipal market, despite rapid growth in the sector. Of the $625 million/year spent for US wastewater treatment, 46% is for municipalities, up 14.5% from 1987. Waste treatment in general grew by 12% in that period, according to Kline Co. (Fairfield, NJ). Some of the challenges facing municipalities in the Clean Water Act reauthorization bills are metals-contaminated sediments and storm water containment and treatment. Bill Tullos, business manager for chlor-alkali at Elf Atochem North America, does not foresee a phaseout of chlorine-based products used as disinfectant in drinking water treatment by municipalities, or as a wastewater treatment in municipal and industrial use. [open quotes]Alternatives are not as effective and are more expensive,[close quotes] says Tullos. [open quotes]There was some promise with ozone, but unfortunately it tends to tear apart your corrosion and scale inhibitors. Chlorine also provides residual protection from contamination all along the water line system.[close quotes] Tullos adds that the formation of tetrahydromethane-one of the problems of using chlorine-based products-can be avoided by screening out the hydrocarbons first and then adding chlorine.

  19. Improving America's Schools Act

    NASA Technical Reports Server (NTRS)

    Cradler, John; Bridgforth, Elizabeth

    1995-01-01

    The Improving America's Schools ACT (IASA) emphasizes coherent systemic education reform, with Goals 2000 setting common standards for IASA and the recently authorized School-to-Work Program. IASA addresses the need to raise academic achievement, increase opportunities to learn, improve professional development, increase community involvement, utilize instructional applications of technology, and improve assessment, and allow more local flexibility in the use of funds.

  20. A study of human leukocyte D locus related antigens in Graves' disease.

    PubMed

    Farid, N R; Sampson, L; Noel, E P; Barnard, J M; Mandeville, R; Larsen, B; Marshall, W H; Carter, N D

    1979-01-01

    An association between Graves' disease and the human leukocyte antigen (HLA) system has previously been reported. The disease was more strongly associated with the HLA D locus antigen Dw3 than with HLA B8. Products of the HLA D locus are determined by the interaction of test cells with standard typing lymphocytes, a technically difficult procedure. Recently, it has been possible to type serologically for D locus related (DRw) specificities on peripheral bone marrow-derived (B) lymphocytes. Blood B lymphocytes from 50 unrelated controls and 41 patients with Graves' disease were typed for seven HLA DRw specificities. 28 patients with Graves' disease (68%) were positive for DRw3, in contrast to 14 controls (28%); whereas only 21 patients (50%) were HLA B8 positive, compared with 13 (26%) controls. Thus, positivity for DRw3 afforded a relative risk for Graves' disease of 5.5, whereas that for HLA B8 amounted to 3.0. Additionally, a family with multiple cases of Graves' disease in which the disease was previously shown to be inherited with the haplotype, was linked to DRw2, which suggests that the susceptibility to the disease was inherited in association with that antigen. Two HLA B/glyoxalase recombination events were observed in this family; in both instances HLA DRw followed HLA B. This study thus demonstrates that the disease susceptibility gene for Graves' disease is in strong linkage disequilibrium with DRw3; however, it may be associated with other DRw specificities and inherited within family units in association with them.

  1. South Carolina's Educator Improvement Act: Portent of the Super School Board?

    ERIC Educational Resources Information Center

    McDaniel, Thomas R.

    1981-01-01

    South Carolina's Educator Improvement Act provides for a "cradle-to-grave" system of training, certification, employment, and evaluation of teachers. The author fears this type of legislation is the precursor of a nationwide shift in the locus of policy making. (Author/WD)

  2. Addressing psychiatric comorbidity.

    PubMed

    Woody, G E; McLellan, A T; O'Brien, C P; Luborsky, L

    1991-01-01

    Research studies indicate that addressing psychiatric comorbidity can improve treatment for selected groups of substance-abusing patients. However, the chances for implementing the necessary techniques on a large scale are compromised by the absence of professional input and guidance within programs. This is especially true in public programs, which treat some of the most disadvantaged, disturbed, and socially destructive individuals in the entire mental health system. One starting point for upgrading the level of knowledge and training of staff members who work in this large treatment system could be to develop a better and more authoritative information dissemination network. Such a system exists in medicine; physicians are expected to read appropriate journals and to guide their treatment decisions using the data contained in the journals. Standards of practice and methods for modifying current practice are within the tradition of reading new facts, studying old ones, and comparing treatment outcome under different conditions with what is actually being done. No such general system of information-gathering or -sharing exists, particularly in public treatment programs. One of the most flagrant examples of this "educational shortfall" can be found among those methadone programs that adamantly insist on prescribing no more than 30 to 35 mg/day for all patients, in spite of the overwhelming evidence that these dose levels generally are inadequate. In some cases, program directors are unaware of studies that have shown the relationship between dose and outcome. In other cases, they are aware of the studies but do not modify their practices accordingly. This example of inadequate dosing is offered as an example of one situation that could be improved by adherence to a system of authoritative and systematic information dissemination. Many issues in substance abuse treatment do not lend themselves to information dissemination as readily as that of methadone dosing

  3. Ocular Changes and Approaches of Ophthalmopathy in Basedow – Graves- Parry- Flajani Disease

    PubMed Central

    SARACI, George; TRETA, Anamaria

    2011-01-01

    ABSTRACT Basedow-Graves disease is an autoimmune condition with multiple local and systemic aspects. Among these, oculopathy has a major impact on patient's life from both functional and esthetic point of view. Basedow-Graves oculopathy requires an appropriate positive and differential diagnosis using clinical and imagistic approaches. Treatment is always required in moderate or severe forms and it begins with simple general points and continues with medical and surgical therapies. Current article stresses upon the most characteristic clinical signs of thyroidian ophthalmopathy and the required current therapeutic approaches. PMID:22205899

  4. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    PubMed

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice. PMID:27319009

  5. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    PubMed

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

  6. Isolated Adrenocorticotropin Deficiency Concomitant with Graves' Disease: A Case Report and Literature Review.

    PubMed

    Ohara, Nobumasa; Kaneko, Masanori; Kuriyama, Hideyuki; Sato, Kazuhiro; Katakami, Hideki; Oki, Yutaka; Kaneko, Kenzo; Kamoi, Kyuzi

    2016-01-01

    A 73-year-old Japanese woman with untreated Graves' hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves' disease, especially in older patients. PMID:27629962

  7. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    SciTech Connect

    Eckel, R.H.; Green, W.L.

    1980-04-11

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  8. 27 CFR 5.36 - Name and address.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...”, “manufactured by”, or “produced by” (whichever may be appropriate to the act of rectification involved) followed... the place where the bottling, distilling or rectification operation occurred, if the address where...

  9. THE ROLE OF RISK ASSESSMENT IN ADDRESSING HAZARDOUS WASTE ISSUES

    EPA Science Inventory

    Risk assessment plays many important roles in addressing hazardous waste issues. In addition to providing a scientific framework and common health metric to evaluate risks. Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or "Superfund") risk assessm...

  10. ACT: Acting Out Central Theme.

    ERIC Educational Resources Information Center

    Kise, Joan Duff

    1982-01-01

    The author describes ACT (Acting Out Central Theme), a method for dealing with psychomotor, cognitive, and affective domains in slow readers. The ACT approach involves three sessions which focus on discussion of a theme such as friendship, presentaton of the theme as a skit, and assignment of topics to individual students. (SW)

  11. "Why Didn't I Know about This Book When I Started?": In Memory of Donald Graves and Arthur Applebee

    ERIC Educational Resources Information Center

    Petrosky, Anthony; Mihalakis, Vivian

    2016-01-01

    This essay explores Donald Graves' groundbreaking research of the 1980s. We show how Graves' approach to the teaching of writing built on his sensitive appreciation of the ways children actually engage in the composing process when they are given the opportunity to produce writing that is meaningful to them. However, the issue for us is not simply…

  12. Nurse Reinvestment Act. Public Law.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC.

    This document contains the text of the Nurse Reinvestment Act, which amends the Public Health Service Act to address the increasing shortage of registered nurses by instituting a series of policies to improve nurse recruitment and nurse retention. Title I details two initiatives to boost recruitment of nurses. The first initiative includes the…

  13. T-cell prolymphocytic leukaemia (T-PLL): a rare disease with a grave prognosis.

    PubMed

    Vivekanandarajah, Abhirami; Atallah, Jean Paul; Gupta, Shilpi

    2013-05-02

    T-cell prolymphocytic leukaemia (T-PLL) is an extremely uncommon haematological malignancy that has an aggressive course and a grave prognosis. We describe a patient who presented with lymphocytosis, scalp erythema, ascites and splenomegaly and was diagnosed with T-PLL. He was treated with alemtuzumab with a good response and was referred for allogeneic stem cell transplantation.

  14. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    ERIC Educational Resources Information Center

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  15. Multiple Fractures in Patient with Graves' Disease Accompanied by Isolated Hypogonadotropic Hypogonadism.

    PubMed

    Yi, Hyon-Seung; Kim, Ji Min; Ju, Sang Hyeon; Lee, Younghak; Kim, Hyun Jin; Kim, Koon Soon

    2016-02-01

    Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to deficiency of sex steroid hormone. Graves' disease is also an important cause of secondary osteoporosis. However, IHH does not preclude the development of primary hyperthyroidism caused by Graves' disease, leading to more severe osteoporosis rapidly. Here, we describe the first case of 35-year-old Asian female patient with IHH accompanied by Graves' disease and osteoporosis-induced multiple fractures. Endocrine laboratory findings revealed preserved anterior pituitary functions except for secretion of gonadotropins and showed primary hyperthyroidism with positive autoantibodies. Sella magnetic resonance imaging showed slightly small sized pituitary gland without mass lesion. Dual energy X-ray absorptiometry revealed severe osteoporosis in lumbar spine and femur neck of the patient. Plain film radiography of the pelvis and shoulder revealed a displaced and nondisplaced fracture, respectively. After surgical fixation with screws for the femoral fracture, the patient was treated with antithyroid medication, calcium, and vitamin D until now and has been recovering fairly well. We report a patient of IHH with Graves' disease and multiple fractures that is a first case in Korea. PMID:26981520

  16. Tinea corporis overlying the thyroid gland after radioiodine (131I) treatment of Graves' disease

    SciTech Connect

    Moreno, A.J.; Hartshorne, M.F.; Yedinak, M.A.; Crooks, L.A.; Fox, B.J.

    1986-04-01

    A case of tinea corporis involving the skin overlying the thyroid gland is described in a 36-year-old man who had received radioiodine treatment for Graves' disease. The dermatophytosis mimicked a delayed roentgen erythema. Radiation to the dermis may have locally altered the cell-mediated immunity and predisposed this patient to the dermatophytosis.

  17. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  18. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  19. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  20. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  1. 38 CFR 38.631 - Graves marked with a private headstone or marker.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... private headstone or marker. 38.631 Section 38.631 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... marked with a private headstone or marker. (a) VA will furnish an appropriate Government headstone or marker for the grave of a decedent described in paragraph (b) of this section, but only if the...

  2. Addressing Barriers to Learning. Volume 11, Number 2. Spring 2006

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2006

    2006-01-01

    This issue of the quarterly newsletter of the Center for Mental Health in Schools includes the following features and regular segments: (1) Concerns = Opportunities: Addressing Student Disengagement, Acting Out, and Dropouts by Moving in New Directions; (2) Info Sheet: Costs of Not Addressing Barriers to Learning; and (3) Current Status of Mental…

  3. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    PubMed Central

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  4. Juggling Act

    ERIC Educational Resources Information Center

    Rudalevige, Andrew

    2009-01-01

    Two education bills from George W. Bush's first term are long overdue for reauthorization. One, of course, is the No Child Left Behind Act (NCLB), passed in late 2001. The other is the Education Sciences Reform Act (ESRA), which in November 2002 replaced the Office of Educational Research and Improvement (OERI) with a new Institute of Education…

  5. Anti-CD38 autoimmunity in patients with chronic autoimmune thyroiditis or Graves' disease

    PubMed Central

    Antonelli, A; Fallahi, P; Nesti, C; Pupilli, C; Marchetti, P; Takasawa, S; Okamoto, H; Ferrannini, E

    2001-01-01

    Autoantibodies directed against human CD38 (an enzyme catalysing the interconversion of NAD+ and cyclic ADP-ribose) have been demonstrated recently in patients with type 2 diabetes. We tested 220 consecutive Caucasian patients with autoimmune chronic thyroiditis, 104 patients with Graves' disease, 220 subjects from the general population (control I) and 78 healthy control subjects not affected by thyroid autoimmune disorders (control II) for the presence of anti-CD38 autoimmunity. Using Western blot analysis and optical densitometry, a specific band corresponding to human recombinant CD38 was identified in the serum of several subjects. By defining anti-CD38 positivity as a standardized optical reading >3 s.d. higher than the mean value of control I, 10·4% of patients with thyroiditis and 7·7% of Graves' patients were anti-CD38 positive (P = 0·0009 versus 1·8% of control I). Similarly, 13·1% of patients with thyroiditis and 10·5% of Graves' patients had a standardized optical reading >3 s.d. higher than the mean value of the subjects not affected by thyroid autoimmune disorders (P = 0·002 versus 1·2% of control II). Anti-CD38 autoimmunity did not differ between euthyroid, hyperthyroid or hypothyroid patients or between patients with or without thyroid hypoechogenicity. Anti-CD38 autoantibodies were associated with higher levels of circulating antithyroid-peroxidase antibodies (P = 0·03) and they were more frequent in Graves' patients with ophthalmopathy (P < 0·05). Anti-CD38 autoantibodies are a new autoimmune marker in chronic autoimmune thyroiditis and Graves' disease. The specific role of CD38 and its autoantibodies in the modulation of thyroid cell function or growth remains to be investigated. PMID:11737057

  6. Freedom of Information Act

    USGS Publications Warehouse

    Newman, D.J.

    2012-01-01

    The Freedom of Information Act( FOIA), 5 U.S.C.§ 552, as amended, generally provides that any person has a right to request access to Federal agency records. The USGS proactively promotes information disclosure as inherent to its mission of providing objective science to inform decisionmakers and the general public. USGS scientists disseminate up-to-date and historical scientific data that are critical to addressing national and global priorities.

  7. ACT Test

    MedlinePlus

    ... this page helpful? Also known as: ACT; Activated Coagulation Time Formal name: Activated Clotting Time Related tests: ... in the blood called platelets and proteins called coagulation factors are activated in a sequence of steps ...

  8. Acting Atoms.

    ERIC Educational Resources Information Center

    Farin, Susan Archie

    1997-01-01

    Describes a fun game in which students act as electrons, protons, and neutrons. This activity is designed to help students develop a concrete understanding of the abstract concept of atomic structure. (DKM)

  9. 2015 ASHG Awards and Addresses

    PubMed Central

    2016-01-01

    Each year at the annual meeting of The American Society of Human Genetics (ASHG), addresses are given in honor of The Society and a number of award winners. A summary of each of these is given below. On the following pages, we have printed the presidential address and the addresses for the William Allan Award, the Curt Stern Award, and the Victor A. McKusick Leadership Award. Webcasts of these addresses, as well as those of many other presentations, can be found at http://www.ashg.org.

  10. Therapeutic use of mini-scleral lenses in a patient with Graves' ophthalmopathy.

    PubMed

    Harthan, Jennifer S

    2014-01-01

    Patients with Graves' ophthalmopathy can be very challenging to manage secondary to the complex nature of their disease presentation. Patients may present with a variety of ocular findings including: lid retraction, periorbital and lid swelling, chemosis, conjunctival hyperemia, proptosis, optic neuropathy, restrictive myopathy, exposure keratopathy and/or keratoconjunctivitis sicca. Mini-scleral and scleral lens designs have been important in the management of irregular and regular corneas, and in the therapy of ocular surface diseases. We present here the case of a 48-year-old Caucasian male who had been diagnosed with Graves' ophthalmopathy 13 years earlier. With significant ocular surface staining and over ten diopters of astigmatism, the patient had never been able to wear contact lenses comfortably. After being fit with the Mini-Scleral Design™ lenses, his vision improved to 20/25 OU, his ocular surface improved, and overall quality of vision increased.

  11. GO-QOL--disease-specific quality of life questionnaire in Graves' orbitopathy.

    PubMed

    Sawicka-Gutaj, Nadia; Bednarczuk, Tomasz; Daroszewski, Jacek; Waligórska-Stachura, Joanna; Miśkiewicz, Piotr; Sowiński, Jerzy; Bolanowski, Marek; Ruchała, Marek

    2015-01-01

    The main goal of therapy for Graves' orbitopathy (GO) is to restore visual function and to improve quality of life (QOL); therefore, the idea of self-assessment of eye changes by the patient has been developed. We developed a validated Polish version of the GO-QOL questionnaire (GO-QOLpl). As an original version we used the English version of GO-QOL, which consists of 15 questions summarised in two subscales. GO-QOLpl was translated and validated in accordance with standard principles for translation of patient-reported outcomes (PRO). GO-QOLpl is a linguistically validated version of the original GO-QOL questionnaire, which is recommended by the European Group of Graves' Orbitopathy (EUGOGO). We strongly support the use of GO-QOLpl for the assessment of QOL among Polish patients with GO in clinical practice.

  12. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention

    PubMed Central

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-01-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome. PMID:24403961

  13. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.

    PubMed

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-07-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

  14. Psychological problems in the family members of gravely traumatised patients admitted into an intensive care unit.

    PubMed

    Pérez-San Gregorio, M A; Blanco-Picabia, A; Murillo-Cabezas, F; Domínguez-Roldán, J M; Sánchez, B; Núñez-Roldán, A

    1992-01-01

    The aim of these studies was the analysis of the psychological repercussions on the closest members of families of 76 gravely traumatised patients admitted into the Intensive Care Unit (ICU) of the Hospital Universitario de Rehabilitación y Traumatología "Virgen del Rocio", Sevilla (Spain). An investigation based on social information and the Clinical Analysis Questionnaire was used. The sample of family members was composed of 42 women and 34 men, with an average age of 41.3 years (SD +/- 12.8). Results showed that (a) more than 50% of the family members of gravely traumatised patients admitted into an ICU showed symptoms of depression, (b) the women scored more points in hypochondria, suicidal depression, anxious depression, low-energy depression, guilt-resentment, apathy-withdrawal, paranoia, schizophrenia, psychasthenia and psychological disadjustment, and (c) in general terms, the psychological characteristics of the families were far from the norm of the control group.

  15. Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine.

    PubMed

    Ahmed, Zulfiqar; Mai, Christine L; Elder, Badrea; Rodriguez, Samuel; Yaster, Myron

    2014-04-01

    Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today's society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling.

  16. A case of Mayer-Rokitansky-Küster-Hauser syndrome presenting as Graves disease.

    PubMed

    Lim, Ye-Jee; Sohn, Tae-Seo; Kang, Seung-Hun; Chang, Kyung-Yoon; Kim, Bo-Kyung; Kim, Yeon-Ji; Ha, Won-Chul; Oh, Su-Jin; Son, Hyun-Shik

    2012-01-01

    The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by aplasia of the uterus and the upper part of the vagina in an XX individual with normal development of secondary sexual characteristics. Individuals with this syndrome may also present with renal and skeletal abnormalities. We report a case of a 16-year-old girl presenting with thyrotoxicosis and primary amenorrhea. After being diagnosed with Graves disease, this patient was placed on antithyroid medication. Although her thyroid function normalized, she did not start to menstruate. Therefore, we assessed her primary amenorrhea and diagnosed the patient with MRKH syndrome through pelvic imaging. To our knowledge, an association between Graves disease and MRKH syndrome has not yet been reported. PMID:23329766

  17. Correlation of stress with outcome of radioiodine therapy for Graves disease

    SciTech Connect

    Stewart, T.; Rochon, J.; Lenfestey, R.; Wise, P.

    1985-06-01

    Between November 1965 and December 1983, 293 patients were treated for Graves disease using /sup 131/I. All patients were asked to identify a stressful event antedating the onset of overt clinical symptoms. Eighty-one patients were able to do this (27.6%). Two hundred forty-four patients received a single treatment, 49 required two or more treatments. Patients with stress initiating the symptoms of Graves disease became hypothyroid earlier, 50% at 12 mo compared with 36 mo for the nonstress group. At 10 yr 5% of the stress group remained euthyroid compared with 17% nonstress. The authors conclude that stress in the 12 mo or less before the onset of clinical symptoms potentiates the development of hypothyroidism induced by a standard dose of radioiodine.

  18. Radiotherapy for Graves' disease. The possible role of low-dose radiotherapy.

    PubMed

    Arenas, Meritxell; Sabater, Sebastià; Jiménez, Pedro Lara; Rovirosa, Àngels; Biete, Albert; Linares, Victoria; Belles, Montse; Panés, Julià

    2016-01-01

    Immunomodulatory effects of low-dose radiotherapy (LD-RT) have been used for the treatment of several benign diseases, including arthrodegenerative and inflammatory pathologies. Graves' disease is an autoimmune disease and radiotherapy (RT) is a therapeutic option for ocular complications. The dose recommended in the clinical practice is 20 Gy (2 Gy/day). We hypothesized that lower doses (<10 Gy total dose, <1 Gy/day) could results in higher efficacy if we achieved anti-inflammatory and immunomodulatory effects of LD-RT. We review current evidence on the effects of RT in the treatment of Graves' disease and the possible use of LD-RT treatment strategy. PMID:27601953

  19. Effect of Selenium Supplementation on Recurrent Hyperthyroidism Caused by Graves' Disease: A Prospective Pilot Study.

    PubMed

    Wang, L; Wang, B; Chen, S R; Hou, X; Wang, X F; Zhao, S H; Song, J Q; Wang, Y G

    2016-09-01

    The effect of selenium supplementation on recurrent hyperthyroidism caused by Graves' disease is unclear. Our study aimed to assess the efficacy of selenium supplementation therapy on recurrent Graves' disease. Forty-one patients with recurrent Graves' disease were enrolled in this study. All patients received the routine treatment using methimazole (MMI), while patients allocated to the selenium group received additional selenium therapy for 6 months. The influence of selenium supplementation on the concentrations of thyroid stimulating hormone (TSH), anti-TSH-receptor antibodies (TRAb), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed. The remission rate was also compared between 2 groups. There was no obvious difference in the demographic data and the levels of serum FT4, FT3, TSH, and TRAb between the 2 groups at baseline. Both FT4 and FT3 decreased more at 2 months in the selenium group than the controls, while the TSH level increased more in patients receiving selenium supplementation (p<0.05). The TRAb level was significantly lower in patients receiving selenium supplementation (2.4 IU/l vs. 5.6 IU/l, p=0.04). The percentages of patients with normal TRAb level at 6 months was also significantly higher in the selenium group (19.0 vs. 0%, p=0.016). Kaplan-Meier survival curve showed patients receiving selenium supplementation had a significantly higher rate of remission than controls (Log-rank test p=0.008). In conclusion, selenium supplementation can enhance the effect of antithyroid drugs in patients with recurrent Graves' disease. Randomized trials with large number of participants are needed to validate the finding above. PMID:27392116

  20. The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

    PubMed

    Papapetrou, Peter D

    2015-01-01

    According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

  1. Socioeconomic Disparities in the Presentation and Treatment of Graves' Disease and Thyroid Eye Disease.

    PubMed

    Vargason, Caroline W; Chelnis, James G; Barahimi, Behin I; Mawn, Louise A

    2016-01-01

    Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.

  2. Both interleukin-23A polymorphism and serum interlukin-23 expression are associated with Graves' disease risk.

    PubMed

    Jia, Huiying; Tao, Feng; Liu, Changqin; Guo, Ting; Zhu, Wei; Wang, Shu; Cui, Bin; Ning, Guang

    2015-03-01

    Two independent Chinese cohorts were used to study the genetic association between the interleukin-23A (IL-23A) gene polymorphism (rs11171806) and susceptibility to Graves' disease (GD). The initial Shanghai cohort consisted of 712 unrelated patients with GD and 705 healthy control subjects, and the replication cohort from Xiamen Island included 433 patients with GD and 410 healthy control subjects. The serum concentration of IL-23 in GD patients was measured significantly higher than in health controls. Moreover in the subgroup analysis, higher concentrations of IL-23 were identified in patients of older age (⩾40 years) and female gender. We also performed an association study with the IL-23 gene polymorphism rs11171806 in both cohorts, in Shanghai cohorts, the frequencies of rs11171806 alleles were strongly different between Graves' disease patients (G 95.7% and A 4.3%) and healthy controls (G 97.7% and A 2.3%) (P=2.6×10(-3), OR=1.93 (95% CI: 1.25-2.97)), and in Xiamen cohorts, the proportion of individuals carrying the A allele of rs11171806 was the same significantly higher in Graves' disease patients than in controls [Graves' disease vs. control, 4.8% vs. 4.3%, OR=2.15 (95% CI: 1.23-3.79), P(allele)=6.3×10(-3)]. The distribution of rs11171806 genotype was also investigated in subgroups according to the age and gender. All of these findings suggested that IL-23 may play an important role in the development of GD, and the IL-23A gene is a genetic risk marker for GD in Han Chinese population.

  3. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    PubMed

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay

    2015-04-01

    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted.

  4. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    PubMed

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay

    2015-04-01

    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted. PMID:25824071

  5. 40 CFR 700.17 - Addresses for the Office of Pollution Prevention and Toxics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Addresses for the Office of Pollution... (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Addresses § 700.17 Addresses for the Office of Pollution... non-docket materials—(1) United States Postal Service mailing address. Office of Pollution...

  6. 40 CFR 700.17 - Addresses for the Office of Pollution Prevention and Toxics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Addresses for the Office of Pollution... (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Addresses § 700.17 Addresses for the Office of Pollution... non-docket materials—(1) United States Postal Service mailing address. Office of Pollution...

  7. Randomized double-blind trial of prednisone versus radiotherapy in Graves' ophthalmopathy

    SciTech Connect

    Prummel, M.F.; Mourits, M.; Blank, L.; Berghout, A.; Koornneef, L.; Wiersinga, W.M. )

    1993-10-16

    Corticosteriods are usually given for management of Graves' ophthalmopathy, but they have many and serious side-effects. By comparison, retrobulbar irradiation is well tolerated, although its efficacy has been evaluated only in uncontrolled studies. Therefore, the authors did a double-blind randomized trial, in which 28 patients with moderately severe Graves' ophthalmopathy were treated with a 3-month course of oral prednisone and sham irradiation, and 28 received retrobulbar irradiation (20 Gy) and placebo capsules. Therapeutic outcome, assessed twenty-four weeks after the start of treatment, was determined by the change in the highest NOSPECS class. A successful outcome was observed in 14 prednisone-treated and in 13 irradiated patients. Responders to treatment (but not nonresponders) in both groups showed improvements in total and subjective eye score and a decrease in eye-muscle volume. Response to either treatment was due largely to changes in soft-tissue involvement and eye-muscle motility. Radiotherapy and oral prednisone appear to be equally effective as initial treatment in patients with moderately severe Graves' ophthalmopathy. In view of its better tolerability, radiotherapy should be considered the treatment of first choice.

  8. Radiotherapy in the treatment of Graves ophthalmopathy—to do it or not?

    PubMed Central

    2009-01-01

    To the objective of this study is to evaluate the role and toxicity of radiotherapy in the treatment of Graves ophthalmopathy. In the years 2000–2003, 121 patients with malignant exophthalmos were treated with radiotherapy of the retrobulbar area to the total dose of 20 Gy in ten fractions with a 6 MeV photon beam. The treatment was performed by the team of the Clinic of Oncology of the Jagiellonian University Medical College in Cracow. The radiotherapy was preceded by intravenous steroid therapy: methylprednisolone acetate administered at the dose of 2 g/week for four consecutive weeks. The highest efficacy, expressed as improvement of all ocular symptoms, was observed for the combined treatment. Female and non-diabetic patients responded positively to the combined treatment. Radiotherapy combined with steroid therapy in the treatment of Graves ophthalmopathy seems to be an effective treatment for strictly defined indications. In the treatment of Graves–Basedow disease, radiotherapy is a well-tolerated treatment modality. Diabetes is a factor that worsens prognosis in Graves ophthalmopathy and female sex is a favourable factor for this condition. PMID:20835395

  9. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    NASA Astrophysics Data System (ADS)

    Jervis, John R.; Pringle, Jamie K.

    2014-09-01

    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  10. [A case of membranous nephropathy with ANCA-associated necrotizing glomerulonephritis during oral administration of PTU for Graves' disease].

    PubMed

    Fujii, Takayuki; Kawamata, Toyotaka; Ueda, Shiro; Akikusa, Bunshiro; Hasegawa, Shigeru; Tsukahara, Tsunemichi; Iesato, Kenji; Ogawa, Makoto; Saisho, Hiromitsu

    2003-01-01

    We experienced a coincidental case of two types of glomerulopathy associated with Graves' disease. A 64-year-old man, who had been treated with propylthiouracil(PTU) for Graves' disease for 15 years, was admitted to our hospital for macroscopic hematuria and rapidly progressive deterioration of renal function. Although his thyroid function had been within the normal range during treatment, the level of thyrotropin receptor antibody(TRAb) gradually increased from a year before admission. Serological tests revealed that he was positive for myeloperoxidase-antineutrophil cytoplasmic antibody(MPO-ANCA). The renal biopsy specimen showed necrotizing and crescentic glomerulonephritis(GN) superimposed on membranous nephropathy(MN). This is a rare case of MN complicated with ANCA associated crescentic GN in a Graves' disease patient. Association of these two renal alterations was not clearly defined. MN involved with Graves' disease also has been rarely reported. Some reports demonstrated deposition of thyroglobulin and other thyroid related antigens in the glomeruli. In the present case, long-term impairment of Graves' disease and elevation of TRAb might have been responsible for the formation and deposition of thyroid-associated immune complex in the glomeruli. As for crescentic GN, PTU might have induced ANCA-associated GN independently of MN. This case is instructive for considering the relation between Graves' disease and renal injury.

  11. Addressing adolescent pregnancy with legislation.

    PubMed

    Montgomery, Tiffany M; Folken, Lori; Seitz, Melody A

    2014-01-01

    Adolescent pregnancy is a concern among many women's health practitioners. While it is practical and appropriate to work to prevent adolescent pregnancy by educating adolescents in health care clinics, schools and adolescent-friendly community-based organizations, suggesting and supporting legislative efforts to reduce adolescent pregnancy can help address the issue on an even larger scale. This article aims to help nurses better understand current legislation that addresses adolescent pregnancy, and to encourage support of future adolescent pregnancy prevention legislation. PMID:25145716

  12. Addressing adolescent pregnancy with legislation.

    PubMed

    Montgomery, Tiffany M; Folken, Lori; Seitz, Melody A

    2014-01-01

    Adolescent pregnancy is a concern among many women's health practitioners. While it is practical and appropriate to work to prevent adolescent pregnancy by educating adolescents in health care clinics, schools and adolescent-friendly community-based organizations, suggesting and supporting legislative efforts to reduce adolescent pregnancy can help address the issue on an even larger scale. This article aims to help nurses better understand current legislation that addresses adolescent pregnancy, and to encourage support of future adolescent pregnancy prevention legislation.

  13. 43 CFR Appendix B to Part 2 - Internet Addresses

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Regulations (43 CFR, Part 2, Subparts A and B): http://www.doi.gov/foia/foiaregs.html 7. DOI FOIA Policy and... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Internet Addresses B Appendix B to Part 2... INFORMATION ACT Pt. 2, App. B Appendix B to Part 2—Internet Addresses 1. Department of the Interior (DOI)...

  14. 43 CFR Appendix B to Part 2 - Internet Addresses

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Regulations (43 CFR, Part 2, Subparts A and B): http://www.doi.gov/foia/foiaregs.html 7. DOI FOIA Policy and... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Internet Addresses B Appendix B to Part 2... INFORMATION ACT Pt. 2, App. B Appendix B to Part 2—Internet Addresses 1. Department of the Interior (DOI)...

  15. Addressing problems of employee performance.

    PubMed

    McConnell, Charles R

    2011-01-01

    Employee performance problems are essentially of 2 kinds: those that are motivational in origin and those resulting from skill deficiencies. Both kinds of problems are the province of the department manager. Performance problems differ from problems of conduct in that traditional disciplinary processes ordinarily do not apply. Rather, performance problems are addressed through educational and remedial processes. The manager has a basic responsibility in ensuring that everything reasonable is done to help each employee succeed. There are a number of steps the manager can take to address employee performance problems.

  16. Addressing Discrimination in School Matters!

    ERIC Educational Resources Information Center

    Sullivan, Amanda L.

    2009-01-01

    Every student has the right to an education free from discrimination that provides high-quality, equitable opportunities to learn. Unfortunately, sometimes individuals or systems may act in ways that violate this right. Discrimination occurs when people are treated unequally or less favorably than others because of some real or perceived…

  17. Acting to let someone die.

    PubMed

    McGee, Andrew

    2015-02-01

    This paper examines the recent prominent view in medical ethics that withdrawing life-sustaining treatment (LST) is an act of killing. I trace this view to the rejection of the traditional claim that withdrawing LST is an omission rather than an act. Although that traditional claim is not as problematic as this recent prominent view suggests, my main claim is that even if we accepted that withdrawing LST should be classified as an act rather than as an omission, it could still be classified as letting die rather than killing. Even though omissions are contrasted with acts, letting die need not be, for one can let die by means of acts. The remainder of the paper is devoted to establishing this claim and addresses certain objections to it.

  18. Addressing Phonological Questions with Ultrasound

    ERIC Educational Resources Information Center

    Davidson, Lisa

    2005-01-01

    Ultrasound can be used to address unresolved questions in phonological theory. To date, some studies have shown that results from ultrasound imaging can shed light on how differences in phonological elements are implemented. Phenomena that have been investigated include transitional schwa, vowel coalescence, and transparent vowels. A study of…

  19. Every Other Day. Keynote Address.

    ERIC Educational Resources Information Center

    Tiller, Tom

    Schools need to be reoriented and restructured so that what is taught and learned, and the way in which it is taught and learned, are better integrated with young people's real-world experiences. Many indicators suggest that the meaningful aspects of school have been lost in the encounter with modern times. The title of this address--"Every Other…

  20. State of the Lab Address

    SciTech Connect

    King, Alex

    2010-01-01

    In his third-annual State of the Lab address, Ames Laboratory Director Alex King called the past year one of "quiet but strong progress" and called for Ames Laboratory to continue to build on its strengths while responding to changing expectations for energy research.

  1. State of the Lab Address

    ScienceCinema

    King, Alex

    2016-07-12

    In his third-annual State of the Lab address, Ames Laboratory Director Alex King called the past year one of "quiet but strong progress" and called for Ames Laboratory to continue to build on its strengths while responding to changing expectations for energy research.

  2. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    SciTech Connect

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. )

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  3. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    PubMed

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing

    2012-01-01

    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P < 0.05). There were neither significant difference of the O/OC ratio in 13 GO patients between pre- and post-treatment periods, nor significant difference in the 9 (9/11) patients before and after three months. Orbital (99m)Tc-TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  4. Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults

    PubMed Central

    Dominguez, Paulette N.; Jimeno, Cecilia A.; Obaldo, Jerry M.; Ogbac, Ruben V.

    2016-01-01

    Background Radioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease. Methods A hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those randomized to fixed activity received either low fixed activity at 9.9 mCi for thyroid gland size <40 g or high fixed activity at 14.9 mCi for thyroid gland size 40 to 80 g, and those grouped to calculated activity received 160 µCi/g of thyroid tissue adjusted for 24 hours radioiodine uptake. Thyroid function tests (free thyroxine [T4] and thyroid stimulating hormone [TSH]) were monitored at 10, 16, and 24 weeks after radioactive iodine therapy. The primary outcome, treatment failure was defined as persistently elevated free T4 and low TSH. Results Of the 122 patients randomized, 56 in the fixed dose group and 56 in the calculated dose group completed the follow-up. At the end of 6 months, the percentage of treatment failure was 37.50% in the calculated dose group versus 19.64% in the fixed dose group with a relative risk of 0.53 (95% confidence interval, 0.28 to 0.98) favoring the fixed dose group. Conclusion Fixed dose radioiodine has a significantly lower incidence of persistent hyperthyroidism at 6 months post-radioactive therapy. PMID:26996425

  5. Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

    SciTech Connect

    Chen, J.J.; Ladenson, P.W.

    1986-07-01

    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or /sup 131/I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among the 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. The low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism.

  6. Réactions immunoallergiques graves aux antibacillaires: à propos de 10 cas

    PubMed Central

    Alami, Sabah El Machichi; Hammi, Sanae; Bourkadi, Jamal Eddine

    2014-01-01

    L'hypersensibilité aux antituberculeux est l'un des effets secondaires imprévisibles qui apparait chez 4 à 5 % de la population exposée et s’élève à 25% chez les sujets VIH positifs. Dans notre étude parmi 39 patients ayant présenté des réactions immunoallergiques, 10 avaient des formes graves. Le délai moyen d'apparition des signes était de 23 jours. Les réactions immunoallergiques observées étaient 5 cas de toxidermie généralisée fébrile, un cas de Dress syndrome, un cas de neutropénie, un cas de pancitopénie et 2 cas de thrombopénie. Tous nos patients avaient bien évolué cliniquement et bactériologiquement après l'adoption d'un régime thérapeutique excluant le ou les médicaments incriminés. En pratique, si l'effet indésirable imputé à un antituberculeux est grave, il est impératif de l'arrêter, de traiter l'incident et d'associer une autre molécule chez certains cas. Notre étude a montré une fréquence significative des complications graves probablement sous-estimée, surtout dans les pays fortement touchés par l'infection HIV.

  7. Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease.

    PubMed

    Miyake, Teruki; Matsuura, Bunzo; Furukawa, Shinya; Todo, Yasuhiko; Yamamoto, Shin; Yoshida, Osamu; Imai, Yusuke; Watanabe, Takao; Yamamoto, Yasunori; Hirooka, Masashi; Tokumoto, Yoshio; Kumagi, Teru; Abe, Masanori; Seike, Hirotaka; Miyauchi, Shozo; Hiasa, Yoichi

    2016-01-01

    3,5,3'-triiodo-L-thyronine regulates the glucose metabolism, lipid metabolism, and hepatic steatosis. Several groups have shown the relationships between hypothyroidism and nonalcoholic fatty liver and hypothyroidism and nonalcoholic steatohepatitis (NASH). However, the effect of hyperthyroidism on NASH has not yet been investigated. We herein report effects of thyroid hormone on the pathological condition of NASH in a patient with NASH complicated by Graves' disease. In our case, the liver enzyme level improved with the increasing thyroid hormone level; however, the liver enzyme level was aggravated with the improving thyroid hormone level. Therefore, hyperthyroidism may improve the pathological condition of NASH. PMID:27477408

  8. Progressive bilateral ophthalmoparesis--a case of simultaneous autoimmunity: balancing Graves' ophthalmoparesis and ocular myasthenia.

    PubMed

    Canepa, Carlo; Venu, Maya

    2016-01-04

    A 44-year-old woman with no medical history presented with a 1-year history of horizontal diplopia, bilateral exophthalmos and progressive asymmetrical ophthalmoparesis, with no pupillary dysfunction or ptosis. Within 3 months of her initial presentation, she noticed paresis of right eye abduction, followed after 1 month with paresis of left eye abduction. Initial investigations revealed positive antiperoxidase antibodies for Graves' disease and positive AChR for myasthenia gravis. MRI of the brain showed increased intensity in bilateral inferior rectus muscles and CT of the chest showed thymic hyperplasia. Treatment with carbimazole and pyridostigmine was started, with complete resolution after 1 month.

  9. Peritonitis secondary to ruptured splenic abscess: a grave complication of typhoid fever.

    PubMed

    George, Peter; Ahmed, Ashfaq; Maroli, Roshan; Tauro, Leo Francis

    2012-12-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever. PMID:23199723

  10. Walter Miles, Pop Warner, B. C. Graves, and the psychology of football.

    PubMed

    Baugh, Frank G; Benjamin, Ludy T

    2006-01-01

    In 1926-1927, a graduate student, B. C. Graves, working with Stanford University psychologist Walter Miles and legendary football coach Pop Warner, conducted an investigation of variations in signal calling as they affected the charging times of football players. The study was one of two that involved Miles and the ingenious multiple chronograph that he had invented to time the reactions of seven players simultaneously. These studies represented a brief digression in the career of Miles, who certainly was no sport psychologist. They tell of an interesting collaboration between scientist and coaches that produced one of the richest studies in sport psychology in the first half of the twentieth century.

  11. Unusual locations of localized myxedema in Graves disease. Report of three cases

    SciTech Connect

    Noppakun, N.; Bancheun, K.; Chandraprasert, S.

    1986-01-01

    Three patients with Graves disease had very unusual locations of localized myxedema. One patient had localized myxedema on the pretibial and shoulder areas after sodium iodide I 131 therapy. The second patient had localized myxedema on his neck, shoulders, and upper part of the back as well as on the pretibial area. The third patient had localized myxedema on the pinnae, also following sodium iodide I 131 therapy. After surgical removal followed by intralesional triamcinolone acetonide injections, the first patient's lesions recurred. The lesions in the second case did not respond to topical steroid cream. The third patient had a partial response to intralesional steroid injections.

  12. Graves' Disease

    MedlinePlus

    ... our online catalog. ​ Additional Links Hashimoto's Disease Hyperthyroidism Hypothyroidism Pregnancy & Thyroid Disease Thyroid Tests Find a Specialist ... everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make ...

  13. Graves disease

    MedlinePlus

    ... in men (possible) Problems concentrating Fatigue Frequent bowel movements Hair loss Heat intolerance and increased sweating Increased appetite , despite having weight loss Irregular menstrual periods in women Muscle weakness of the hips and shoulders Moodiness, ...

  14. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    PubMed

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

  15. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    PubMed

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease. PMID:27609732

  16. Analysis of HLA-DQB and HLA-DPB alleles in Graves' disease by oligonucleotide probing of enzymatically amplified DNA.

    PubMed

    Weetman, A P; Zhang, L; Webb, S; Shine, B

    1990-07-01

    We have tested the possible association of HLA-DQB and HLA-DPB alleles with Graves' thyrotoxicosis, with or without severe ophthalmopathy, by polymerase chain amplification of genomic DNA and allele-specific oligonucleotide probing. There was no significantly abnormal distribution of DQB alleles compared to 50 control subjects except for a reduced prevalence of DQw 3.1 in the Graves' patients with severe ophthalmopathy (X2 = 6.23, P less than 0.02). HLA-DPB 2.1/8 was found in only 1 of 40 of these patients compared with 15 of the controls (X2 = 11.49, P less than 0.001). Ten of 48 patients with Graves' disease but without clinically significant eye involvement were HLA-DPB 2.1/8 positive, not significantly different from controls, but significantly different from the ophthalmopathy group (X2 = 6.70, P less than 0.01). The other DPB alleles in both groups of Graves' disease patients were the same as controls. These results suggest that HLA-DPB 2.1/8 may confer a protective effect in Graves' disease with respect to ophthalmopathy. PMID:2401099

  17. Student Perceptions of Using Games to Address Science Literacy

    ERIC Educational Resources Information Center

    Keller, Cara M.

    2012-01-01

    The purpose of this qualitative evaluative case study was to gain insight into how students perceived the efficacy of using games to address their science literacy concerns. Scientists in the United States are concerned with the lack of science literacy. The No Child Left Behind Act of 2001 requires proficiency in reading, mathematics, language…

  18. Workforce Investment Act: Labor has Made Progress in Addressing Areas of Concern, but More Focus Needed on Understanding What Works and What Doesn't. Testimony Before the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness, Committee on Education and Labor, House of Representatives. GAO-09-396T

    ERIC Educational Resources Information Center

    Scott, George A.

    2009-01-01

    Since the Workforce Investment Act's (WIA) enactment in 1998, GAO has issued numerous reports that included recommendations regarding many aspects of WIA. These aspects include performance measures and accountability, funding formulas and spending, one-stop centers, and training, as well as services provided to specific populations, such as…

  19. [Perioperative treatment for the urgent orbital decompression surgery in a 30-weeks pregnant woman with Graves' orbitopathy].

    PubMed

    Guerrero-Domínguez, R; López-Herrera-Rodríguez, D; Domínguez-Blanco, A; Medina-de Moya, I; Sánchez-Carrillo, F

    2014-01-01

    Thyroid ophthalmopathy is a rare extra-thyroid complication usually associated with Graves' disease. This disease can occur in the euthyroid pregnant patient. Graves' orbitopathy is characterized by eyelid retraction, proptosis, extraocular muscle dysfunction, and periorbital edema. In some cases an emergency surgical repair may be required to avoid irreversible vision loss. We present the case of a 35-year-old woman in her 30th gestational week, who suffered from Graves' ophthalmopathy, severe exophthalmia, and visual acuity decrease. Following consultations among anesthesiologists, ophthalmologists, maxillofacial surgeons, endocrinologists, obstetricians and the patient, it was decided to perform a surgical orbital wall decompression. The anesthetic and perioperative implications associated with gestational age and the considerations for this surgical procedure, and how to avoid increasing intraocular pressure are discussed. PMID:23835254

  20. Prolonged suppressed thyroid-stimulating hormone levels in hyperthyroidism in a neonate born to a mother with Graves' disease.

    PubMed

    Hojo, M; Momotani, N; Ikeda, N; Ueda, A; Uno, K; Ishikita, T; Ishiguro, A; Shimbo, T

    1998-10-01

    We report here a case of neonatal hyperthyroidism born to a mother, whose pregnancy was complicated by poorly controlled Graves' disease. The patient demonstrated exophthalmos and marked goiter at birth, indicating the existence of thyrotoxicosis in utero. The mother's Graves' disease was well controlled in the third trimester, resulting in a slightly lower level of free thyroxine (FT4) in the umbilical cord blood serum; however, thyroid-stimulating hormone (TSH) was undetectable. Thyroid-stimulating hormone remained undetectable for 2 months, while FT4 levels varied in the course. This case suggests that severe and prolonged thyrotoxicosis in utero, due to poor control of pregnancy with Graves' disease, might induce unresponsiveness of the hypothalamo-pituitary system in the newborn.

  1. Celiac Disease in a Predisposed Subject (HLA-DQ2.5) with Coexisting Graves' Disease.

    PubMed

    Hwang, In Kyoung; Kim, Seon Hye; Lee, Unjoo; Chin, Sang Ouk; Rhee, Sang Youl; Oh, Seungjoon; Woo, Jeong Taek; Kim, Sung Woon; Kim, Young Seol; Chon, Suk

    2015-03-27

    Celiac disease is an intestinal autoimmune disorder, triggered by ingestion of a gluten-containing diet in genetically susceptible individuals. The genetic predisposition is related to human leukocyte antigen (HLA) class II genes, especially HLA-DQ2-positive patients. The prevalence of celiac disease has been estimated to be ~1% in Europe and the USA, but it is rarer and/or underdiagnosed in Asia. We report a case of celiac disease in a predisposed patient, with a HLA-DQ2 heterodimer, and Graves' disease that was treated successfully with a gluten-free diet. A 47-year-old woman complained of persistent chronic diarrhea and weight loss over a 9 month period. Results of all serological tests and stool exams were negative. However, the patient was found to carry the HLA DQ2 heterodimer. Symptoms improved after a gluten-free diet was initiated. The patient has been followed and has suffered no recurrence of symptoms while on the gluten-free diet. An overall diagnosis of celiac disease was made in a genetically predisposed patient (HLA-DQ2 heterodimer) with Graves' disease.

  2. Clinical efficacy of combined rituximab treatment in a woman with severe Graves' ophthalmopathy

    PubMed Central

    Liu, Xiaomei; Guo, Hui; Liu, Juan; Shi, Bingyin

    2016-01-01

    The present study reports the case of a female Chinese patient with Graves' disease (GD) and severe Graves' ophthalmopathy (GO) in its active phase, who was treated with propylthiouracil and oral prednisolone for 2 months at a local hospital. However, a lack of improvement in symptoms meant that the patient was transferred to the First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China), whereupon the patient received high-dose intravenous methylprednisolone pulse therapy, although with limited efficacy. Subsequently, rituximab (RTX; anti-CD20 monoclonal antibody) combined with orbital irradiation treatment was initiated. The patient responded positively to the combined treatment; the clinical symptoms and enlargement of the extraocular muscles were ameliorated, and there were marked decreases in the clinical activity and NOSPECS grading scores. Furthermore, the serum levels of anti-thyrotropin receptor antibodies (TRAb) were markedly decreased at 2 months following RTX therapy. The patient was maintained in a euthyroid state by treatment with methimazole during and following RTX therapy. It was concluded that RTX treatment may attenuate severe GO by depleting lymphocytes, and may promote the recovery of GD by reducing the serum levels of TRAb. PMID:27446325

  3. The relationship between serum adipocytokines and Graves' ophthalmopathy: A hospital-based study.

    PubMed

    Kim, Bo-Yeon; Mok, Ji-Oh; Kang, Sung-Koo; Jang, Sun-Young; Jung, Chan-Hee; Kim, Chul-Hee

    2016-05-31

    Adipocytokines are thought to be associated with inflammatory disorders and autoimmune diseases. However, limited information is available on the relationship between serum adipocytokine levels, Graves' disease (GD), and Graves' ophthalmopathy (GO). The present study examined the relationship between serum adipocytokine levels and GD and GO. A total of 80 patients with GD participated in this study. The medical records of patients were reviewed retrospectively. GO activity was assessed using the clinical activity score (CAS). GO severity was assessed by the modified NOSPECS classification and included soft tissue involvement, proptosis, and extraocular muscle involvement. Serum adiponectin, leptin, resistin, and retinol-binding protein 4 (RBP-4) levels were measured using commercially available enzyme-linked immunosorbent assays. The prevalence of GO was 36.3%. Serum adiponectin, leptin, and resistin levels were significantly higher in patients with GO than in those without GO. The CAS was positively correlated with serum adiponectin and leptin levels. The total eye score was positively correlated with serum adiponectin, leptin, resistin, and RBP-4 levels. A multivariate analysis revealed that serum leptin and resistin levels were associated with the presence of GO after adjusting for clinical factors. Free thyroxine was negatively correlated with serum leptin level. These results suggest that adipocytokines, such as leptin and resistin, may play a role in inflammatory and autoimmune processes of GD and GO. Future studies with larger numbers of patients are required to establish relationships between serum adipocytokines levels and GO and ascertain the role of adipocytokines in GD and GO.

  4. Post-radioiodine De Novo Onset Graves' Ophthalmopathy: Case Reports and a Review of the Literature.

    PubMed

    Batra, Ruchika; Krishnasamy, Senthil Kumar; Buch, Harit; Sandramouli, Soupramanien

    2015-05-01

    New-onset Graves' ophthalmopathy (GO) following radioiodine treatment (RAI) and worsening of existing GO are well-described in the endocrinology literature. These phenomena are recognized by ophthalmologists, yet poorly documented in the ophthalmology literature. Two male patients, aged 43 and 62 years, respectively, with Graves' disease without GO, received RAI. Four months later, one patient developed acute GO with unilateral reduction in visual acuity, conjunctival chemosis, lagophthalmos, bilateral severely restricted ocular motility, and lid retraction. High-dose intravenous steroids, followed by oral steroids, led to a dramatic clinical improvement. The second patient received a second dose of RAI for persistent hyperthyroidism and subsequently developed acute GO-comprising restricted ocular motility, peri-orbital swelling, and conjunctival chemosis. Symptoms gradually resolved on continued carbimazole treatment. Neither patient received pre-RAI prophylactic glucocorticoids, as currently they are only recommended for patients with pre-existing GO or multiple risk factors. We discuss the limitations of using this risk-based approach in preventing new-onset GO following RAI therapy.

  5. DNA Identification of Skeletal Remains from World War II Mass Graves Uncovered in Slovenia

    PubMed Central

    Marjanović, Damir; Durmić-Pašić, Adaleta; Bakal, Narcisa; Haverić, Sanin; Kalamujić, Belma; Kovačević, Lejla; Ramić, Jasmin; Pojskić, Naris; Škaro, Vedrana; Projić, Petar; Bajrović, Kasim; Hadžiselimović, Rifat; Drobnič, Katja; Huffine, Ed; Davoren, Jon; Primorac, Dragan

    2007-01-01

    Aim To present the joint effort of three institutions in the identification of human remains from the World War II found in two mass graves in the area of Škofja Loka, Slovenia. Methods The remains of 27 individuals were found in two small and closely located mass graves. The DNA was isolated from bone and teeth samples using either standard phenol/chloroform alcohol extraction or optimized Qiagen DNA extraction procedure. Some recovered samples required the employment of additional DNA purification methods, such as N-buthanol treatment. QuantifilerTM Human DNA Quantification Kit was used for DNA quantification. PowerPlex 16 kit was used to simultaneously amplify 15 short tandem repeat (STR) loci. Matching probabilities were estimated using the DNA View program. Results Out of all processed samples, 15 remains were fully profiled at all 15 STR loci. The other 12 profiles were partial. The least successful profile included 13 loci. Also, 69 referent samples (buccal swabs) from potential living relatives were collected and profiled. Comparison of victims' profile against referent samples database resulted in 4 strong matches. In addition, 5 other profiles were matched to certain referent samples with lower probability. Conclusion Our results show that more than 6 decades after the end of the World War II, DNA analysis may significantly contribute to the identification of the remains from that period. Additional analysis of Y-STRs and mitochondrial DNA (mtDNA) markers will be performed in the second phase of the identification project. PMID:17696306

  6. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

    SciTech Connect

    Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria; Souhami, Luis; Gois Manso, Paulo; Souza Dias, Rodrigo; Comodo Segreto, Helena Regina; Araujo Segreto, Roberto

    2012-03-01

    Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.

  7. Associations of CTLA4 Gene Polymorphisms with Graves' Ophthalmopathy: A Meta-Analysis.

    PubMed

    Du, Pengfei; Ma, Xiaojie; Wang, Changjiang

    2014-01-01

    Many studies have established that T-lymphocyte antigen-4 (CTLA4) is a susceptible gene for Graves' disease (GD). Also many studies showed the association between the CTLA4 exon-1 49A/G polymorphism and the risk of developing Graves' ophthalmopathy (GO) in GD patients. But those results were inconsistent. In recent years many new studies were published which helped to shed light on the relationship of CTLA4 SNP49 with GO. So we performed the meta-analysis to explore the association between the SNP49 and GO susceptibility in GD patients. Studies up to February 29, 2012, were searched by using PubMed. The odds ratio was used to evaluate the strength of the association. Altogether 12 case-control studies involving 2,505 participants were included in the meta-analysis. Results showed that the G allele was related to the increased risk of GO compared with the A allele under allelic genetic model (OR = 1.14, 95% CI: 1.14-1.72, P = 0.001) in European subgroup. No publication bias was detected. Our results showed that the SNP49 polymorphism of CTLA4 gene was related to increased risk of GO.

  8. Human spumaretrovirus-related sequences in the DNA of leukocytes from patients with Graves disease.

    PubMed Central

    Lagaye, S; Vexiau, P; Morozov, V; Guénebaut-Claudet, V; Tobaly-Tapiero, J; Canivet, M; Cathelineau, G; Périès, J; Emanoil-Ravier, R

    1992-01-01

    Viruses, and more particularly retroviruses, have been postulated to play a role in the pathogenesis of autoimmune diseases. In a search for spumaretrovirus infection markers, we screened a group of 29 patients with Graves disease and a representative healthy population (23 subjects) as a control. Southern blot hybridization under stringent conditions, of patients' DNA extracted from peripheral blood lymphocytes, with a spumaretrovirus-specific genomic probe derived from the human spumaretrovirus (HSRV) prototype, gave a positive signal in 10 cases. Moreover, by PCR, HSRV-related sequences were detected in the DNA of 19 patients (66%). Positive DNA samples in Southern blots were also positive in PCR for all regions tested (gag, bel1, bel2, long terminal repeat). Amplified (gag and bel2) products were cloned and sequenced; they showed high homology with HSRV. On the other hand, all 23 control subjects were negative by both procedures. Sera from both populations were examined for the presence of antibodies reactive with antigens of the spumaretrovirus family. These sera were negative by several immunodetection techniques: ELISA, indirect immunofluorescence, serum neutralization, and Western blotting. These results strongly suggest the existence of an association between Graves disease and the presence of HSRV-related infection markers. Images PMID:1332028

  9. Use of antihistamines after serious allergic reaction to methimazole in pediatric Graves' disease.

    PubMed

    Toderian, Amy B; Lawson, Margaret L

    2014-05-01

    Antithyroid drugs are usually considered first-line therapy for management of pediatric Graves' disease because they avoid permanent hypothyroidism, provide a chance for remission, and are less invasive than the alternatives of thyroidectomy or radioactive iodine. Methimazole (MMI) is the only antithyroid drug recommended in pediatrics due to the risk of propylthiouracil-induced liver toxicity. Allergic reactions with MMI occur in up to 10% of patients and, when mild, can be managed with concurrent antihistamine therapy. Guidelines recommend discontinuation of MMI with serious allergic reactions. We present the case of an adolescent girl with Graves' disease and a serious allergic reaction after starting MMI whose family refused radioactive iodine and was reluctant to proceed to surgery. Antihistamine therapy was successfully used to allow continued treatment with MMI. This case demonstrates extension of management guidelines for minor cutaneous allergic reactions to MMI, through the use of antihistamines for a serious allergic reaction, allowing us to continue MMI and provide treatment consistent with the family's preferences and values.

  10. [Particular evolution of the thyroid state in Grave's disease: two cases].

    PubMed

    Cherif, Lotfi; Ben Abdallah, Néjib; Khairi, Karima; Hadj Ali, Inçaf; Turki, Sami; Ben Maïz, Hédi

    2003-09-01

    We report two cases of Grave's disease (GD) caracterized by the succession of hypothyroid and hyperthyroid states. Case 1: A 32 years old woman, has presented initially a typical GD with hyperthyroidism. Grave's ophtalmopathy and homogenous goiter. Four months later, she presented a spontaneous hypothyroidism necessiting treatment with thyroxine and a severe myasthenia gravis. More later (6 months), she experienced symptoms of hyperthyroidism after thymectomy. The level of anti-thyrotropin-receptor antibodies (TSab) was very high (141 UI/I, NV < 10). Case 2: A 29 years old woman has been treated by thyroxine (150 microg/day) for a primary hypothyroidism. Ten months later, she presented symptoms of hyperthyroidism even after stoppage of thyroxine. TSH value was decreased (TSH < 0.05 microU/ml) and FT4 level was raised (FT4 = 25.5 pmol/l). The thyroid antibodies were positive. We discuss, after review of the litterature, the physiopathological mecanisms of these changes in the thyroid state, particularly the role of the blocking and stimulating anti-thyrotropin-receptor antibodies.

  11. The gravimeter "B-grave" for the in-situ surface gravity measurements of an asteroid

    NASA Astrophysics Data System (ADS)

    van Ruymbeke, Michel; karatekin, ozgur; rasson, jean; wielant, françois; dumont, Phillipe; Ritter, Birgit; zhu, Ping

    2016-04-01

    In the context of the preliminary study phase for the CubeSats supporting ESA's Asteroid Impact Mission (AIM) to the Didymos, we investigate a miniaturized gravimeter as part of the geophysical instrument package for the Asteroid Geophysical Explorer (AGEX). AGEX intends to land a CubeSat on the secondary object in the Didymos system, Didymoon in order to characterize the asteroid surface and internal structure A 3D compact gravimeter is developed at the Royal Observatory of Belgium. Its design allows to meter a weak 50 μm/sec² gravity field corresponding to 5 ppm of Earth gravity in a harsh environment. A system with three components mounted in an orthogonal geometry allows obtaining the gravity field in amplitude and in angular position without any requirement of levelling. B-GRAVES will use a in-situ calibration and multi-parameter approach for validation of the measurements. A laboratory simulation is induced with centrifugal forces applied to the pendulum set-up in a vertical position to reject the Earth gravity field. Signal treatment and uncertainties are discussed keeping in mind questions of thermal and vibration influence. The B-GRAVES can serve as a novel and robust instrument for future lander and rover missions .

  12. Rapid resolution of fetal goiter associated with maternal Grave's disease: a case report.

    PubMed

    Friedland, D R; Rothschild, M A

    2000-08-11

    The incidence of abnormal fetal thyroid function with maternal Grave's disease is about 2-12%. The development of larger fetal goiters can complicate labor and precipitate life-threatening airway obstruction at delivery. A case is presented of a large stable goiter confirmed by sonography, which unexpectedly resolved by the time of parturition. A 3 x 6 cm fetal goiter was detected at 34 weeks gestation in a mother treated with propylthiouracil for Grave's disease. A repeat sonogram at 36 weeks showed no change in goiter size. Umbilical blood sampling showed the fetus to be markedly hyperthyroid. Planned Cesarean section took place 11 days after the final sonogram. A multi-disciplinary operative team was present including the Otolaryngology service with equipment for emergency intubation, bronchoscopy and tracheotomy. Upon delivery, the infant had no evidence of goiter and no airway compromise. Fetal goiter is a rare entity, and recent advances in the field of maternal-fetal medicine have enabled intra-uterine diagnosis and treatment of such conditions. A review of published case reports demonstrates two trends in treated fetuses: preterm progressive resolution of the goiter, or delivery with gross evidence of goiter. This reported case is unique, as a persistent goiter resolved completely in less than 2 weeks. Otolaryngologic response to and management of potential congenital airway compromise is discussed. PMID:10960698

  13. Transient Hypothyroidism after Radioiodine for Graves' Disease: Challenges in Interpreting Thyroid Function Tests.

    PubMed

    Sheehan, Michael T; Doi, Suhail A R

    2016-03-01

    Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves' disease will help in the timely management of patients. PMID:26864507

  14. Radioiodine-induced hypothyroidism in Graves' disease: factors associated with the increasing incidence

    SciTech Connect

    Cunnien, A.J.; Hy, I.D.; Gorman, C.A.; Offord, K.P.; Scanlon, P.W.

    1982-11-01

    A retrospective analysis was done of the records of 454 patients who received their first I-131 treatment for Graves' disease during six periods covering 1951 to 1978. In the earliest group, 3% of patients were hypothyroid 3 mo after I-131 use, and 40% were hypothyroid at 1 yr. In the most recent group, 36% of patients were hypothyroid at 3 mo and 91% were myxedematous at 1 yr. Although no obvious trends were noted, whether in the number of patients pretreated with thionamide drugs, in the mean 24-hr I-131 uptake, or in the calculated dose of I-131 (..mu..Ci/estimated gram of thyroid tissue) during the years of the study, the initial mean dose of I-131 administered increased from 8.1 mCi in the earliest group to 13.8 mCi in the latest group. Concurrently, estimates of gland size increased from a mean of 26 g in the first group to 43 g in the last. If, in patients with Graves' disease, the thyroid gland size did not truly increase during the years of the study, the increasing occurrence of early hypothyroidism seen after I-131 use may reflect the conscious or unconscious decision to use larger doses of I-131 calculated on the basis of inflated estimates of thyroid gland weight.

  15. Addressing Passive Smoking in Children

    PubMed Central

    Hutchinson, Sasha G.; Kuijlaars, Jennifer S.; Mesters, Ilse; Muris, Jean W. M.; van Schayck, Constant P.; Dompeling, Edward; Feron, Frans J. M.

    2014-01-01

    Background A significant number of parents are unaware or unconvinced of the health consequences of passive smoking (PS) in children. Physicians could increase parental awareness by giving personal advice. Aim To evaluate the current practices of three Dutch health professions (paediatricians, youth health care physicians, and family physicians) regarding parental counselling for passive smoking (PS) in children. Methods All physicians (n = 720) representing the three health professions in Limburg, the Netherlands, received an invitation to complete a self-administered electronic questionnaire including questions on their: sex, work experience, personal smoking habits, counselling practices and education regarding PS in children. Results The response rate was 34%. One tenth (11%) of the responding physicians always addressed PS in children, 32% often, 54% occasionally and 4% reported to never attend to it. The three health professions appeared comparable regarding their frequency of parental counselling for PS in children. Addressing PS was more likely when children had respiratory problems. Lack of time was the most frequently mentioned barrier, being very and somewhat applicable for respectively 14% and 43% of the physicians. One fourth of the responders had received postgraduate education about PS. Additionally, 49% of the responders who did not have any education about PS were interested in receiving it. Conclusions Physicians working in the paediatric field in Limburg, the Netherlands, could more frequently address PS in children with parents. Lack of time appeared to be the most mentioned barrier and physicians were more likely to counsel parents for PS in children with respiratory complaints/diseases. Finally, a need for more education on parental counselling for PS was expressed. PMID:24809443

  16. Addressing inequities in healthy eating.

    PubMed

    Friel, Sharon; Hattersley, Libby; Ford, Laura; O'Rourke, Kerryn

    2015-09-01

    What, when, where and how much people eat is influenced by a complex mix of factors at societal, community and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social and cultural pathways that cause social stratification and influence the quality of conditions in which people live their lives. These factors are the social determinants of inequities in healthy eating. This paper provides an overview of the current evidence base for addressing these determinants and for the promotion of equity in healthy eating. PMID:26420812

  17. Identifying and Addressing Vaccine Hesitancy

    PubMed Central

    Kestenbaum, Lori A.; Feemster, Kristen A.

    2015-01-01

    In the 20th century, the introduction of multiple vaccines significantly reduced childhood morbidity, mortality, and disease outbreaks. Despite, and perhaps because of, their public health impact, an increasing number of parents and patients are choosing to delay or refuse vaccines. These individuals are described as vaccine hesitant. This phenomenon has developed due to the confluence of multiple social, cultural, political and personal factors. As immunization programs continue to expand, understanding and addressing vaccine hesitancy will be crucial to their successful implementation. This review explores the history of vaccine hesitancy, its causes, and suggested approaches for reducing hesitancy and strengthening vaccine acceptance. PMID:25875982

  18. Nanoscale content-addressable memory

    NASA Technical Reports Server (NTRS)

    Davis, Bryan (Inventor); Principe, Jose C. (Inventor); Fortes, Jose (Inventor)

    2009-01-01

    A combined content addressable memory device and memory interface is provided. The combined device and interface includes one or more one molecular wire crossbar memories having spaced-apart key nanowires, spaced-apart value nanowires adjacent to the key nanowires, and configurable switches between the key nanowires and the value nanowires. The combination further includes a key microwire-nanowire grid (key MNG) electrically connected to the spaced-apart key nanowires, and a value microwire-nanowire grid (value MNG) electrically connected to the spaced-apart value nanowires. A key or value MNGs selects multiple nanowires for a given key or value.

  19. Addressing the workforce pipeline challenge

    SciTech Connect

    Leonard Bond; Kevin Kostelnik; Richard Holman

    2006-11-01

    A secure and affordable energy supply is essential for achieving U.S. national security, in continuing U.S. prosperity and in laying the foundations to enable future economic growth. To meet this goal the next generation energy workforce in the U.S., in particular those needed to support instrumentation, controls and advanced operations and maintenance, is a critical element. The workforce is aging and a new workforce pipeline, to support both current generation and new build has yet to be established. The paper reviews the challenges and some actions being taken to address this need.

  20. Act resilient.

    PubMed

    Joseph, Genie; Bice-Stephens, Wynona

    2014-01-01

    Attendees have reported changing from being fearful to serene, from listless to energized, from disengaged to connected, and becoming markedly less anxious in a few weeks. Anecdotally, self-reported stress levels have been reduced by over 50% after just one class. Attendees learn not to be afraid of their feelings by working with emotions in a playful manner. When a person can act angry, but separate himself from his personal story, the emotional energy exists in a separate form that is not attached to specific events, and can be more easily dealt with and neutralized. Attendees are taught to "take out the emotional trash" through expressive comedy. They become less intimated by their own emotional intensity and triggers as they learn how even metaphorical buckets of anger, shame, guilt and hurt can be emotionally emptied. The added benefit is that this is accomplished without the disclosure of personal information of the requirement to reexperience past pain which can trigger its own cascade of stress. PMID:24706248

  1. Environmental Politics and the Endangered Species Act.

    ERIC Educational Resources Information Center

    Sahr, David

    2000-01-01

    Explores the controversial issue of the Endangered Species Act (ESA) discussing the Act and the scope of the extinction problem. Reviews the arguments for and against the ESA, addresses the tactics that have been used in the political struggle over the ESA, and highlights the future of the ESA. Includes teaching activities. (CMK)

  2. Addressing viral resistance through vaccines

    PubMed Central

    Laughlin, Catherine; Schleif, Amanda; Heilman, Carole A

    2015-01-01

    Antimicrobial resistance is a serious healthcare concern affecting millions of people around the world. Antiviral resistance has been viewed as a lesser threat than antibiotic resistance, but it is important to consider approaches to address this growing issue. While vaccination is a logical strategy, and has been shown to be successful many times over, next generation viral vaccines with a specific goal of curbing antiviral resistance will need to clear several hurdles including vaccine design, evaluation and implementation. This article suggests that a new model of vaccination may need to be considered: rather than focusing on public health, this model would primarily target sectors of the population who are at high risk for complications from certain infections. PMID:26604979

  3. Changing concepts: the presidential address.

    PubMed

    Weed, J C

    1974-09-01

    A discussion of conceptual change in areas related to fertility and medicine is presented in an address by the president of the American Fertility Society. Advances in technological research and medicine, particularly in steroids and reporductive physiology, have been the most readily acceptable changes. Cesarean section and surgical sterilization have also become increasingly accepted. Newer developments such as sperm banks, artificial insemination, and ovum transfer have created profound ethical, moral, and medical issued in human engineering research and evolutionary theory. The legalization of abortion has brought moral, ethical, and legal problems for many members of the medical profession. It is urged that the Society promote education of the people in reproductive function, sexual activity, and parental obligation while being acutely aware of the problems in influencing or altering human reproduction.

  4. Addressing Failures in Exascale Computing

    SciTech Connect

    Snir, Marc; Wisniewski, Robert; Abraham, Jacob; Adve, Sarita; Bagchi, Saurabh; Balaji, Pavan; Belak, J.; Bose, Pradip; Cappello, Franck; Carlson, Bill; Chien, Andrew; Coteus, Paul; DeBardeleben, Nathan; Diniz, Pedro; Engelmann, Christian; Erez, Mattan; Fazzari, Saverio; Geist, Al; Gupta, Rinku; Johnson, Fred; Krishnamoorthy, Sriram; Leyffer, Sven; Liberty, Dean; Mitra, Subhasish; Munson, Todd; Schreiber, Rob; Stearley, Jon; Van Hensbergen, Eric

    2014-01-01

    We present here a report produced by a workshop on Addressing failures in exascale computing' held in Park City, Utah, 4-11 August 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system, discuss existing knowledge on resilience across the various hardware and software layers of an exascale system, and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia, and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  5. Addressing failures in exascale computing

    SciTech Connect

    Snir, Marc; Wisniewski, Robert W.; Abraham, Jacob A.; Adve, Sarita; Bagchi, Saurabh; Balaji, Pavan; Belak, Jim; Bose, Pradip; Cappello, Franck; Carlson, William; Chien, Andrew A.; Coteus, Paul; Debardeleben, Nathan A.; Diniz, Pedro; Engelmann, Christian; Erez, Mattan; Saverio, Fazzari; Geist, Al; Gupta, Rinku; Johnson, Fred; Krishnamoorthy, Sriram; Leyffer, Sven; Liberty, Dean; Mitra, Subhasish; Munson, Todd; Schreiber, Robert; Stearly, Jon; Van Hensbergen, Eric

    2014-05-01

    We present here a report produced by a workshop on “Addressing Failures in Exascale Computing” held in Park City, Utah, August 4–11, 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system; discuss existing knowledge on resilience across the various hardware and software layers of an exascale system; and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia; and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  6. Light addressable photoelectrochemical cyanide sensor

    SciTech Connect

    Licht, S.; Myung, N.; Sun, Y.

    1996-03-15

    A sensor is demonstrated that is capable of spatial discrimination of cyanide with use of only a single stationary sensing element. Different spatial regions of the sensing element are light activated to reveal the solution cyanide concentration only at the point of illumination. In this light addressable photoelectrochemical (LAP) sensor the sensing element consists of an n-CdSe electrode immersed in solution, with the open-circuit potential determined under illumination. In alkaline ferro-ferri-cyanide solution, the open-circuit photopotential is highly responsive to cyanide, with a linear response of (120 mV) log [KCN]. LAP detection with a spatial resolution of {+-}1 mm for cyanide detection is demonstrated. The response is almost linear for 0.001-0.100 m cyanide with a resolution of 5 mV. 38 refs., 7 figs., 1 tab.

  7. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt, Morocco, 11-12,000 BP): the case of Grave XII.

    PubMed

    Belcastro, Maria Giovanna; Condemi, Silvana; Mariotti, Valentina

    2010-06-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12000 BP), excavated by Roche in the 1950s, contains 28 multiple graves. The funerary practices of the Taforalt population have been the focus of a previous work (Mariotti et al., 2009). In the absence of the excavation records of the necropolis, these funerary practices were investigated through the analysis of the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cut marks). Previous research has drawn particular attention to Grave XII (containing three male adults and two juveniles), where many intentionally modified specimens were identified. The present study focused specifically on the human remains recovered from Grave XII. Analysis of these remains has provided evidence of interventions, such as dismemberment and defleshing of the cadaver, and the use of ochre to colour the bones. Furthermore, the presence of lesions on two skulls suggests the possibility of intentional killing and cannibalism among the Taforalt population. This study further supports our previous impression of the complex and diversified funerary practices, characterising the social life of the Iberomaurusian population of Taforalt.

  8. L'Attitude Chirurgicale dans les Brulures Electriques Graves par Haut Voltage: À Propos de Deux Cas

    PubMed Central

    Moussaoui, A.; Fejjal, N.; Achbouk, A.; Tourabi, K.; Ribag, Y.; Bakkali, H.; Ababou, K.; Ihrai, H.

    2008-01-01

    Summary Devant une brûlure électrique grave, deux attitudes chirurgicales se distinguent: 1. une attitude conservatrice; 2. une attitude d'amputation. A la lumière de deux observations, les Auteurs discutent les avantages et les difficultés de la mise en oeuvre de chaque attitude. PMID:21991118

  9. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt, Morocco, 11-12,000 BP): the case of Grave XII.

    PubMed

    Belcastro, Maria Giovanna; Condemi, Silvana; Mariotti, Valentina

    2010-06-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12000 BP), excavated by Roche in the 1950s, contains 28 multiple graves. The funerary practices of the Taforalt population have been the focus of a previous work (Mariotti et al., 2009). In the absence of the excavation records of the necropolis, these funerary practices were investigated through the analysis of the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cut marks). Previous research has drawn particular attention to Grave XII (containing three male adults and two juveniles), where many intentionally modified specimens were identified. The present study focused specifically on the human remains recovered from Grave XII. Analysis of these remains has provided evidence of interventions, such as dismemberment and defleshing of the cadaver, and the use of ochre to colour the bones. Furthermore, the presence of lesions on two skulls suggests the possibility of intentional killing and cannibalism among the Taforalt population. This study further supports our previous impression of the complex and diversified funerary practices, characterising the social life of the Iberomaurusian population of Taforalt. PMID:20471665

  10. A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis

    PubMed Central

    2010-01-01

    A 56-year-old woman with Graves' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved. PMID:20731531

  11. Graves Disease Induced by Radioiodine Therapy for Toxic Nodular Goiter: A Case Report.

    PubMed

    Yürekli, Yakup; Cengiz, Arzu; Güney, Engin

    2015-10-01

    Graves' disease (GD) may be observed as an infrequent adverse effect after radioiodine therapy (RAIT) for toxic thyroid adenoma (TA) and toxic multi nodular goiter (MNG). We present a case of a 55-year-old male with a toxic nodule who was treated with RAI. After therapy, the patient's serum free triiodothyronine (fT3) and free thyroxine (fT4) levels gradually increased. Antithyroid peroxidase (TPOAb), antithyroglobulin (TgAb) and TSH-receptor antibodies (TRAb) were also positive. Thyroid scintigraphy revealed diffuse intense uptake after four months of RAIT. Radiation-induced GD should be considered in patients with aggravated hyperthyroidism 3-4 months after therapy. PMID:27529890

  12. Recurrent Thyrotoxicosis due to Both Graves' Disease and Hashimoto's Thyroiditis in the Same Three Patients

    PubMed Central

    Schaffer, Ashley; Puthenpura, Vidya

    2016-01-01

    Hashimoto's thyroiditis (HT) and Graves' disease (GD) are the 2 most common autoimmune disease processes affecting the thyroid gland. The relationship between the two is complex and not clearly understood. It has been theorized that HT and GD are 2 separate disease processes due to unique genetic differences demonstrated by genome studies. On the other hand, based on occurrence of both HT and GD in monozygotic twins and within the same family, they have been regarded to represent 2 ends of the same spectrum. This case report describes 3 patients who presented with thyrotoxicosis due to both GD and HT. The initial presentation was thyrotoxicosis due to GD treated with antithyroid medication followed by temporary resolution. They all subsequently experienced recurrence of thyrotoxicosis in the form of Hashitoxicosis due to HT, and then eventually all developed thyrotoxicosis due to GD, requiring radioablation therapy. PMID:27340576

  13. TL, OSL and C-14 dating results of the sediments and bricks from mummified nuns' grave.

    PubMed

    Tudela, Diego R G; Tatumi, Sonia H; Yee, Márcio; Brito, Silvio L M; Morais, José L; Morais, Daisy de; Piedade, Silvia C; Munita, Casimiro S P; Hazenfratz, Roberto

    2012-06-01

    This paper presents the results of TL and OSL dating of soil and fragments of bricks from a grave, which was occupied by two mummified nuns, found at "Luz" Monastery, located in the state of São Paulo, Brazil. The TL and OSL ages were compared to C-14 dating ones obtained from bone collagens of the mummies. The majority of the ages is related to the eighteenth century. The gamma-ray spectroscopy was used to evaluate natural radioisotope concentrations in the samples, and by using these concentrations the annual dose rates, from 3.0 to 5.3 Gy/kyr, were obtained. Neutron activation analysis was performed and the radioisotope contents results are in agreement with those obtained by gamma-ray spectroscopy. The contents of U, Th and Ce elements were higher than those found in usual sediments.

  14. Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran.

    PubMed

    Razavi, M E; Abotoraby, R B; Kakhki, R D; Ghanavati, S Z; Layegh, P; Taghavi, M; Rajabian, M T

    2008-01-01

    This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients (n = 68) presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 (SD 14.0) years, range 15 to 71 years. The most common complaints were foreign body sensation (54.0%) and puffy eyelids (48.4%). The most common apparent abnormality was lid retraction in 64.2% of patients (bilateral in 95.3% of cases). The patients had a mean modified Werner's NO SPECS classification score of 3.00 (SD 1.46). The score was significantly higher in males than females [3.58 (SD 1.44) versus 2.63 (SD 1.35)] and was positively correlated with age.

  15. Purification and crystallisation of the autoantigen thyroid peroxidase from human Graves' thyroid tissue.

    PubMed

    Gardas, A; Sohi, M K; Sutton, B J; McGregor, A M; Banga, J P

    1997-05-19

    Milligram quantities of the human membrane autoantigen thyroid peroxidase (TPO) have been purified to a high degree of homogeneity by a combination of detergent solubilisation, monoclonal antibody affinity, and ion exchange chromatography, from pooled Graves' disease thyroid glands. The purified TPO of greater than 90% purity was enzymatically active as judged by its ability to oxidise guaiacol. Crystals of TPO have been grown from solutions of the protein solubilised in sodium deoxycholate, in the presence of ammonium sulphate. The crystals exhibited birefringence under polarised light, indicative of molecular order. Crystallisation of this large, membrane autoantigen represents the first step in delineating the complete three-dimensional structure of a human autoantigen involved in destructive thyroiditis.

  16. Rhabdomyolysis Induced by Nonstrenuous Exercise in a Patient with Graves' Disease

    PubMed Central

    Summachiwakij, Sarawut

    2014-01-01

    Hyperthyroidism can result in several musculoskeletal conditions such as thyrotoxic periodic paralysis, thyrotoxic myopathy, and thyroid ophthalmopathy. Rhabdomyolysis has been rarely reported to be associated with hyperthyroidism. We describe a 33-year-old man who presented with bilateral thigh pain and dark brown urine after regular squatting. He had a past medical history of hyperthyroidism but stopped taking it 2 months prior to admission. He was found to have rhabdomyolysis, myoglobinuria, and thyrotoxicosis. Presence of thyroid-stimulating immunoglobulins (TSI) and high radioiodine uptake confirmed a diagnosis of Graves' disease. He received aggressive fluid resuscitation and sodium bicarbonate intravenously along with monitoring fluid and electrolyte. Methimazole was also resumed. The patient responded to treatment and rhabdomyolysis gradually resolved. Therefore, nonstrenuous exercise can potentially induce rhabdomyolysis in patients with hyperthyroidism. Although hyperthyroidism is not widely recognized as a cause of rhabdomyolysis, it should be considered in the differential diagnosis of rhabdomyolysis. PMID:24716006

  17. PTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.

    PubMed

    Hardy, Olga T; Smolinski, Kara N; Yan, Albert C; Grimberg, Adda

    2006-01-01

    Palpable purpura is a concerning clinical finding in pediatric patients and can have many causes, including infectious and autoimmune processes. A rare cause, drug-induced vasculitis, may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. We report a girl with Turner syndrome and Graves' disease who presented with palpable purpuric lesions. The diagnosis of propylthiouracil (PTU)-associated vasculitis was made by observation of consistent clinical features, the detection of elevated ANA and ANCA in the blood, and the observed clinical resolution of symptoms following withdrawal of PTU. Subsequent treatment of persistent hyperthyroidism with radioablation did not result in an exacerbation of the vasculitis, a complication described in prior case reports.

  18. Delayed Diagnosis of Graves' Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency.

    PubMed

    Naik, Dukhabandhu; Jebasingh, K Felix; Thomas, Nihal

    2016-04-01

    Adrenal crisis is a potential life threatening complication. The common causes of adrenal crisis are infections, surgical stress and abrupt cessation of steroid medications. Endocrine causes like Graves' disease with thyrotoxicosis is one of the less common causes of an adrenal crisis. We report a 42-year-old female who presented with recurrent episodes of adrenal crisis due to delayed diagnosis of thyrotoxicosis. She was initially treated with Carbimazole followed by Radio-iodine ablation and currently she is euthyroid. Her adrenal insufficiency was initially treated with hydrocortisone during the time of adrenal crisis followed by Prednisolone 5 mg once daily in the morning along with fludrocortisone 50 mcg once daily. This case highlights the need for high index of suspicion and less common causes like thyrotoxicosis should be ruled out in patients with adrenal crisis.

  19. Graves' Disease Mechanisms: The Role of Stimulating, Blocking, and Cleavage Region TSH Receptor Antibodies

    PubMed Central

    Morshed, S. A.; Davies, T. F.

    2016-01-01

    The immunologic processes involved in Graves' disease (GD) have one unique characteristic – the autoantibodies to the TSH receptor (TSHR) – which have both linear and conformational epitopes. Three types of TSHR antibodies (stimulating, blocking, and cleavage) with different functional capabilities have been described in GD patients, which induce different signaling effects varying from thyroid cell proliferation to thyroid cell death. The establishment of animal models of GD by TSHR antibody transfer or by immunization with TSHR antigen has confirmed its pathogenic role and, therefore, GD is the result of a breakdown in TSHR tolerance. Here we review some of the characteristics of TSHR antibodies with a special emphasis on new developments in our understanding of what were previously called “neutral” antibodies and which we now characterize as autoantibodies to the “cleavage” region of the TSHR ectodomain. PMID:26361259

  20. Fieldpath Lunar Meteorite Graves Nunataks 06157, a Magnesian Piece of the Lunar Highlands Crust

    NASA Technical Reports Server (NTRS)

    Zeigler, Ryan A.; Korotev, R. L.; Korotev, R. L.

    2012-01-01

    To date, 49 feldspathic lunar meteorites (FLMs) have been recovered, likely representing a minimum of 35 different sample locations in the lunar highlands. The compositional variability among FLMs far exceeds the variability observed among highland samples in the Apollo and Luna sample suites. Here we will discuss in detail one of the compositional end members of the FLM suite, Graves Nunataks (GRA) 06157, which was collected by the 2006-2007 ANSMET field team. At 0.79 g, GRA 06157 is the smallest lunar meteorite so far recovered. Despite its small size, its highly feldspathic and highly magnesian composition are intriguing. Although preliminary bulk compositions have been reported, thus far no petrographic descriptions are in the literature. Here we expand upon the bulk compositional data, including major-element compositions, and provide a detailed petrographic description of GRA 06157.

  1. Role of genetic and non-genetic factors in the etiology of Graves' disease.

    PubMed

    Marinò, M; Latrofa, F; Menconi, F; Chiovato, L; Vitti, P

    2015-03-01

    In spite of the advancements in understanding the pathogenic mechanisms of Graves' disease (GD), its ultimate cause remains elusive. The majority of investigators agree that GD is likely a multifactorial disease, due to a complex interplay of genetic and non-genetic factors that lead to the loss of immune tolerance to thyroid antigens and to the initiation of a sustained autoimmune reaction. Twin and family studies support a role of genetic factors, among which the HLA complex, CD40, CTLA-4, PTPN22, FCRL3, thyroglobulin, and the TSH receptor may be involved. Among non-genetic factors, iodine, infections, psychological stress, gender, smoking, thyroid damage, vitamin D, selenium, immune modulating agents, and periods of immune reconstitution may contribute the development of the diseases. Here we review in detail the respective role of genetic and non-genetic factors in the etiology of GD, taking advantage of the great bulk of data generated especially over the past 30 years.

  2. Antioxidant supplementation and serum lipids in patients with Graves' disease: effect on LDL-cholesterol.

    PubMed

    Vrca, Vesna Bačić; Mayer, Ljiljana; Skreb, Franjo; Rahelić, Dario; Marušić, Srećko

    2012-03-01

    The effect of supplementation with a fixed combination of antioxidants (beta-carotene, selenium, vitamins C and E) on serum lipids was monitored in patients with newly detected Graves' disease. Measurements were made prior to the commencement of therapy and after 30 and 60 days. Patients were randomized into two groups. Test group comprised patients who received antioxidant supplementation in addition to methimazole, while patients treated with methimazole only were in the control group. The concentration of total and HDL-cholesterol increased significantly in test and control groups (p < 0.05) but these groups did not differ significantly. Concentration of LDL-cholesterol increased significantly in the test group only (p < 0.005) and was significantly different from the control group 60 days after the commencement of therapy (p < 0.005). Significant increase in the LDL-cholesterol concentration in the test group requires further investigations.

  3. Painful acute radiation thyroiditis induced by 131I treatment of Graves' disease.

    PubMed

    Shah, Kinjal K; Tarasova, Valentina; Davidian, Michael; Anderson, Robert J

    2015-01-01

    A 44-year-old woman, chronic smoker with Graves' disease was treated with radioactive iodine ablation (RAI). One week after the treatment, she presented with severe pain in the anterior neck with radiation to the angle of the jaw associated with fatigue, tremor and odynophagia. Physical examination demonstrated an asymmetric and exquisitely tender thyroid gland. There was no laboratory evidence of thyrotoxicosis. Acute radiation thyroiditis was diagnosed. Non-steroidal anti-inflammatory drugs and hydrocodone-acetaminophen started initially were ineffective for pain control. Prednisone provided relief and was continued for 1 month with a tapering dose. Symptoms completely resolved after 1 month at which time the thyroid remained diffusely enlarged and non-tender. Three months following RAI ablation she developed hypothyroid symptoms. Levothyroxine was initiated. The patient has remained asymptomatic on continued follow-up care. PMID:25576511

  4. A predictive mathematical model for the calculation of the final mass of Graves' disease thyroids treated with 131I

    NASA Astrophysics Data System (ADS)

    Traino, Antonio C.; Di Martino, Fabio; Grosso, Mariano; Monzani, Fabio; Dardano, Angela; Caraccio, Nadia; Mariani, Giuliano; Lazzeri, Mauro

    2005-05-01

    Substantial reductions in thyroid volume (up to 70-80%) after radioiodine therapy of Graves' hyperthyroidism are common and have been reported in the literature. A relationship between thyroid volume reduction and outcome of 131I therapy of Graves' disease has been reported by some authors. This important result could be used to decide individually the optimal radioiodine activity A0 (MBq) to administer to the patient, but a predictive model relating the change in gland volume to A0 is required. Recently, a mathematical model of thyroid mass reduction during the clearance phase (30-35 days) after 131I administration to patients with Graves' disease has been published and used as the basis for prescribing the therapeutic thyroid absorbed dose. It is well known that the thyroid volume reduction goes on until 1 year after therapy. In this paper, a mathematical model to predict the final mass of Graves' diseased thyroids submitted to 131I therapy is presented. This model represents a tentative explanation of what occurs macroscopically after the end of the clearance phase of radioiodine in the gland (the so-called second-order effects). It is shown that the final thyroid mass depends on its basal mass, on the radiation dose absorbed by the gland and on a constant value α typical of thyroid tissue. α has been evaluated based on a set of measurements made in 15 reference patients affected by Graves' disease and submitted to 131I therapy. A predictive equation for the calculation of the final mass of thyroid is presented. It is based on macroscopic parameters measurable after a diagnostic 131I capsule administration (0.37-1.85 MBq), before giving the therapy. The final mass calculated using this equation is compared to the final mass of thyroid measured 1 year after therapy administration in 22 Graves' diseased patients. The final masses calculated and measured 1 year after therapy are in fairly good agreement (R = 0.81). The possibility, for the physician, to decide a

  5. Analysis of T cell subsets in Graves' disease: alterations associated with carbimazole.

    PubMed Central

    Ludgate, M E; McGregor, A M; Weetman, A P; Ratanachaiyavong, S; Lazarus, J H; Hall, R; Middleton, G W

    1984-01-01

    Conflicting data on subpopulations of peripheral blood lymphocytes in patients with autoimmune disease largely reflect variations in methods of study. An investigation was therefore conducted aimed at avoiding this difficulty. Serial samples of peripheral blood mononuclear cells from 42 patients with hyperthyroid Graves' disease were collected at monthly intervals before, during, and for 12 months after a six month course of carbimazole. Samples were stored in liquid nitrogen until completion of the study, when they were thawed and all samples from each patient analysed within the same assay using mouse monoclonal antibodies to human cell subsets and a fluorescence activated cell sorter. Proportions of cytotoxic/suppressor (OKT8) positive cells before treatment (mean 17.4 (SEM 0.8)%) were significantly lower (p less than 0.001) than those in normal controls (29.8 (1.9)%; n = 10) and returned to normal by the end of treatment. In contrast, the proportions of activated T cells (OKIa-OKM1) were significantly raised before treatment as compared with normal (14.4 (0.6)% versus 4.6 (0.8)%; p less than 0.001) and fell to normal by the end of treatment. Proportions of OKT3 and OKT4 positive T cells remained unchanged throughout treatment and in the succeeding 12 months. In patients who relapsed after treatment there was a rise in the proportion of activated T cells and a fall in OKT8 positive T cells, which returned towards normal with retreatment. The explanation for the alterations in numbers of circulating T cells remains to be determined but they may provide a means for predicting more accurately the outcome of Graves' disease after treatment with carbimazole. Images p530-a PMID:6421364

  6. Non-invasive management of fetal goiter during maternal treatment of hyperthyroidism in Grave's disease.

    PubMed

    Lembet, Arda; Eroglu, Derya; Kinik, Sibel Tulgar; Gurakan, Berkan; Kuscu, Esra

    2005-01-01

    There is an increased risk of fetal goiter in patients who have a history of Grave's disease and undergo propylthiouracil (PTU) treatment during pregnancy. In this report, we describe a case of a fetal goiter detected by antenatal ultrasound at the 26th week of gestation in a mother treated with PTU for Grave's disease. A 32 x 38 x 20 mm fetal goiter was detected, each lobe measured 30 x 18 x 18 mm and estimated volume was 10 cm3. Subsequently, fetal thyroid function was assessed by umbilical fetal blood sampling. Cord blood showed elevated serum TSH (40.2 mU/l) and normal concentrations of free T4 (9.5 pmol/l) and free T3 (2.6 pmol/l). There were no other ultrasonographic signs of fetal hypothyroidism. Based on the above findings, the mother's PTU dosage was reduced to 50 mg daily from a total of 150 mg and weekly ultrasonographic examinations were performed. Six weeks after the initial ultrasound, a complete regression of the fetal goiter was noted. At the 34th week of gestation, the patient was delivered due to intrauterine growth restriction and oligohydramnios and gave birth to a male, weighing 1,920 g. The newborn thyroid was not palpable and thyroid ultrasonography was normal. Cord blood TSH was normal (8.4 mU/l) and free T4 was within lower normal limit (9.03 pmol/l). Ten days later, newborn thyroid function was normal and the baby did well afterwards. In conclusion, after the evaluation of fetal thyroid status, selected cases with fetal goiter can be initially managed without intrauterine treatment. PMID:15980635

  7. Adjuvant Treatment of Graves' Disease with Diclofenac: Safety, Effects on Ophthalmopathy and Antibody Concentrations

    PubMed Central

    Lantz, Mikael; Calissendorff, Jan; Träisk, Frank; Tallstedt, Leif; Planck, Tereza; Törring, Ove; Hallengren, Bengt; Åsman, Peter

    2016-01-01

    Background Orbital morphological changes are often present in patients with Graves' disease (GD) already at diagnosis, and cyclooxygenase type 2 (COX-2) is overexpressed in active Graves' ophthalmopathy (GO). Objective To investigate if adjuvant treatment of GD with the COX inhibitor and peroxisome proliferator-activated receptor-γ (PPAR-γ) antagonist diclofenac decreases the development of ophthalmopathy and if laboratory parameters are affected. Methods This is a multicenter trial where 61 subjects were randomized to methimazole (block and replace with l-thyroxine) either with or without diclofenac 50 mg 1 × 2 for 12 months. The primary end point development of GO after 24 months was evaluated. Smoking habits were registered and the thyroid parameters TSH, free T4, free T3, TSH receptor antibodies (TRAb) and anti-TPO were followed. Safety parameters (kidney, liver and blood) and adverse events were regularly registered. Results GO developed in 11% (n = 3) of the patients treated with diclofenac and in 21% (n = 6) of the controls (p = 0.273). The adverse event profile was acceptable without any severe events related to diclofenac. Both TRAb and anti-TPO concentrations decreased during treatment with methimazole, but the anti-TPO concentrations were lower in patients treated with diclofenac after 15 months (p = 0.031). The TRAb concentrations were not significantly changed between groups. Smokers had higher concentrations of TRAb than nonsmokers both at diagnosis of GD (p = 0.048) and after 15 months (p = 0.042). Conclusions Treatment with diclofenac had no significant influence on development of GO. Diclofenac reduces anti-TPO concentrations and seems to be safe to use in GD patients. PMID:27099839

  8. The drugs stop here: a public health framework to address the drug shortage crisis.

    PubMed

    Hoffman, Sharona

    2012-01-01

    Drug shortages are emerging as a major public health threat. Grave concern has been expressed by the medical community and government officials, and the crisis has been highlighted in recent media stories. Nevertheless, little has been written to date in the legal literature about the drug shortage crisis, and this timely article begins to fill this gap. It provides a thorough analysis of the origins and implications of the drug shortage problem and formulates a multi-layered approach to addressing it. The article argues that drug shortages result from a combination of market failures and regulatory constraints. It proposes a blend of legislative, regulatory, and private-sector interventions that should deter undesirable conduct on the part of manufacturers and provide appropriate incentives to combat the drug shortage phenomenon.

  9. Addressing neurological disorders with neuromodulation.

    PubMed

    Oluigbo, Chima O; Rezai, Ali R

    2011-07-01

    Neurological disorders are becoming increasingly common in developed countries as a result of the aging population. In spite of medications, these disorders can result in progressive loss of function as well as chronic physical, cognitive, and emotional disability that ultimately places enormous emotional and economic on the patient, caretakers, and the society in general. Neuromodulation is emerging as a therapeutic option in these patients. Neuromodulation is a field, which involves implantable devices that allow for the reversible adjustable application of electrical, chemical, or biological agents to the central or peripheral nervous system with the objective of altering its functioning with the objective of achieving a therapeutic or clinically beneficial effect. It is a rapidly evolving field that brings together many different specialties in the fields of medicine, materials science, computer science and technology, biomedical, and neural engineering as well as the surgical or interventional specialties. It has multiple current and emerging indications, and an enormous potential for growth. The main challenges before it are in the need for effective collaboration between engineers, basic scientists, and clinicians to develop innovations that address specific problems resulting in new devices and clinical applications. PMID:21193369

  10. A region addresses patient safety.

    PubMed

    Feinstein, Karen Wolk; Grunden, Naida; Harrison, Edward I

    2002-06-01

    The Pittsburgh Regional Healthcare Initiative (PRHI) is a coalition of 35 hospitals, 4 major insurers, more than 30 major and small-business health care purchasers, dozens of corporate and civic leaders, organized labor, and partnerships with state and federal government all working together to deliver perfect patient care throughout Southwestern Pennsylvania. PRHI believes that in pursuing perfection, many of the challenges facing today's health care delivery system (eg, waste and error in the delivery of care, rising costs, frustration and shortage among clinicians and workers, financial distress, overcapacity, and lack of access to care) will be addressed. PRHI has identified patient safety (nosocomial infections and medication errors) and 5 clinical areas (obstetrics, orthopedic surgery, cardiac surgery, depression, and diabetes) as ideal starting points. In each of these areas of work, PRHI partners have assembled multifacility/multidisciplinary groups charged with defining perfection, establishing region-wide reporting systems, and devising and implementing recommended improvement strategies and interventions. Many design and conceptual elements of the PRHI strategy are adapted from the Toyota Production System and its Pittsburgh derivative, the Alcoa Business System. PRHI is in the proof-of-concept phase of development. PMID:12032502

  11. Addressing neurological disorders with neuromodulation.

    PubMed

    Oluigbo, Chima O; Rezai, Ali R

    2011-07-01

    Neurological disorders are becoming increasingly common in developed countries as a result of the aging population. In spite of medications, these disorders can result in progressive loss of function as well as chronic physical, cognitive, and emotional disability that ultimately places enormous emotional and economic on the patient, caretakers, and the society in general. Neuromodulation is emerging as a therapeutic option in these patients. Neuromodulation is a field, which involves implantable devices that allow for the reversible adjustable application of electrical, chemical, or biological agents to the central or peripheral nervous system with the objective of altering its functioning with the objective of achieving a therapeutic or clinically beneficial effect. It is a rapidly evolving field that brings together many different specialties in the fields of medicine, materials science, computer science and technology, biomedical, and neural engineering as well as the surgical or interventional specialties. It has multiple current and emerging indications, and an enormous potential for growth. The main challenges before it are in the need for effective collaboration between engineers, basic scientists, and clinicians to develop innovations that address specific problems resulting in new devices and clinical applications.

  12. Gender: addressing a critical focus.

    PubMed

    Thornton, L; Wegner, M N

    1995-01-01

    The definition of gender was addressed at the Fourth World Conference on Women (Beijing, China). After extensive debate, the definition developed by the UN Population Fund in 1995 was adopted: "a set of qualities and behaviors expected from a female or male by society." The sustainability of family planning (FP) programs depends on acknowledgment of the role gender plays in contraceptive decision-making and use. For example, programs must consider the fact that women in many cultures do not make FP decisions without the consent of their spouse. AVSC is examining providers' gender-based ideas about clients and the effects of these views on the quality of reproductive health services. Questions such as how service providers can encourage joint responsibility for contraception without requiring spousal consent or how they can make men feel comfortable about using a male method in a society where FP is considered a woman's issue are being discussed. Also relevant is how service providers can discuss sexual matters openly with female clients in cultures that do not allow women to enjoy their sexuality. Another concern is the potential for physical violence to a client as a result of the provision of FP services. PMID:12294397

  13. Usefulness of Measuring Thyroid Stimulating Antibody at the Time of Antithyroid Drug Withdrawal for Predicting Relapse of Graves Disease

    PubMed Central

    Kwon, Hyemi; Jang, Eun Kyung; Kim, Mijin; Park, Suyeon; Jeon, Min Ji; Kim, Tae Yong; Ryu, Jin-Sook; Shong, Young Kee; Kim, Won Bae

    2016-01-01

    Background Hyperthyroidism relapse in Graves disease after antithyroid drug (ATD) withdrawal is common; however, measuring the thyrotropin receptor antibody (TRAb) at ATD withdrawal in order to predict outcomes is controversial. This study compared measurement of thyroid stimulatory antibody (TSAb) and thyrotropin-binding inhibitory immunoglobulin (TBII) at ATD withdrawal to predict relapse. Methods This retrospective study enrolled patients with Graves disease who were treated with ATDs and whose serum thyroid-stimulating hormone levels were normal after receiving low-dose ATDs. ATD therapy was stopped irrespective of TRAb positivity after an additional 6 months of receiving the minimum dose of ATD therapy. Patients were followed using thyroid function tests and TSAb (TSAb group; n=35) or TBII (TBII group; n=39) every 3 to 6 months for 2 years after ATD withdrawal. Results Twenty-eight patients (38%) relapsed for a median follow-up of 21 months, and there were no differences in baseline clinical characteristics between groups. In the TSAb group, relapse was more common in patients with positive TSAb at ATD withdrawal (67%) than patients with negative TSAb (17%; P=0.007). Relapse-free survival was shorter in TSAb-positive patients. In the TBII group, there were no differences in the relapse rate and relapse-free survivals according to TBII positivity. For predicting Graves disease relapse, the sensitivity and specificity of TSAb were 63% and 83%, respectively, whereas those of TBII were 28% and 65%. Conclusion TSAb at ATD withdrawal can predict the relapse of Graves hyperthyroidism, but TBII cannot. Measuring TSAb at ATD withdrawal can assist with clinical decisions making for patients with Graves disease. PMID:27118279

  14. Earliest floral grave lining from 13,700–11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel

    PubMed Central

    Nadel, Dani; Danin, Avinoam; Power, Robert C.; Rosen, Arlene M.; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R.; Barzilai, Omry; Boaretto, Elisabetta

    2013-01-01

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700–11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000–11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene. PMID:23818584

  15. Earliest floral grave lining from 13,700-11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel.

    PubMed

    Nadel, Dani; Danin, Avinoam; Power, Robert C; Rosen, Arlene M; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R; Barzilai, Omry; Boaretto, Elisabetta

    2013-07-16

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700-11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000-11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene.

  16. The Voting Rights Act--An Historical Perspective

    ERIC Educational Resources Information Center

    Rustin, Bayard; And Others

    1975-01-01

    This address to the morning session of the Southern Policy Conference on the Voting Rights Act of 1965 puts the Act in an historical perspective in which its importance is clearly perceived; also includes is a discussion of the address by Nicholas Katzenbach, Vernon Jordan, James P. Turner, and George H. Esser, persons who either were involved in…

  17. The Civil Rights Act and the Weight of History

    ERIC Educational Resources Information Center

    Wiley, Terrence G.

    2015-01-01

    This article briefly reviews the contributions to this volume and revisits the original focus of the Civil Rights Act (CRA). It considers how much progress has been made in addressing the original concerns regarding ethnic and racial discrimination that the act was intended to address and the intersection of language issues with them. The article…

  18. Pediatric medical devices: a look at significant US legislation to address unmet needs.

    PubMed

    Samuels-Reid, Joy H; Blake, Erica D

    2014-03-01

    There are many barriers to the availability of medical devices intended for the pediatric population causing healthcare providers to use creative measures to address pediatric unmet device needs. The USA has taken significant legislative measures to spur medical device development and address the unmet needs in all pediatric subpopulations. For example, the Medical Device User Fee and Modernization Act of 2002 amended the Federal Food Drug and Cosmetic Act by adding new provisions intended to promote the development of safe and effective pediatric devices, and to protect the pediatric population during clinical trials. In 2004, the Medical Devices Technical Corrections Act was added to address potential difficulties in bringing pediatric devices to the market. Further, the Pediatric Medical Device Safety and Improvement Act of 2007 and the Food and Drug Administration Amendments Act of 2007 provided the FDA significant new responsibilities and authorities regarding pediatric use.

  19. 77 FR 36231 - Americans With Disabilities Act (ADA) and Architectural Barriers Act (ABA) Accessibility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-18

    ...The Architectural and Transportation Barriers Compliance Board (Access Board) proposes to amend the Americans with Disabilities Act (ADA) and Architectural Barriers Act (ABA) Accessibility Guidelines to specifically address emergency transportable housing units that are provided by the Federal Emergency Management Agency or other entities on a temporary site in response to an emergency need......

  20. Determining thyroid {sup 131}I effective half-life for the treatment planning of Graves' disease

    SciTech Connect

    Willegaignon, Jose; Sapienza, Marcelo T.; Barberio Coura Filho, George; Buchpiguel, Carlos A.; Traino, Antonio C.

    2013-02-15

    Purpose: Thyroid {sup 131}I effective half-life (T{sub eff}) is an essential parameter in patient therapy when accurate radiation dose is desirable for producing an intended therapeutic outcome. Multiple {sup 131}I uptake measurements and resources from patients themselves and from nuclear medicine facilities are requisites for determining T{sub eff}, these being limiting factors when implementing the treatment planning of Graves' disease (GD) in radionuclide therapy. With the aim of optimizing this process, this study presents a practical, propitious, and accurate method of determining T{sub eff} for dosimetric purposes. Methods: A total of 50 patients with GD were included in this prospective study. Thyroidal {sup 131}I uptake was measured at 2-h, 6-h, 24-h, 48-h, 96-h, and 220-h postradioiodine administration. T{sub eff} was calculated by considering sets of two measured points (24-48-h, 24-96-h, and 24-220-h), sets of three (24-48-96-h, 24-48-220-h, and 24-96-220-h), and sets of four (24-48-96-220-h). Results: When considering all the measured points, the representative T{sub eff} for all the patients was 6.95 ({+-}0.81) days, whereas when using such sets of points as (24-220-h), (24-96-220-h), and (24-48-220-h), this was 6.85 ({+-}0.81), 6.90 ({+-}0.81), and 6.95 ({+-}0.81) days, respectively. According to the mean deviations 2.2 ({+-}2.4)%, 2.1 ({+-}2.0)%, and 0.04 ({+-}0.09)% found in T{sub eff}, calculated based on all the measured points in time, and with methods using the (24-220-h), (24-48-220-h), and (24-96-220-h) sets, respectively, no meaningful statistical difference was noted among the three methods (p > 0.500, t test). Conclusions: T{sub eff} obtained from only two thyroid {sup 131}I uptakes measured at 24-h and 220-h, besides proving to be sufficient, accurate enough, and easily applicable, attributes additional major cost-benefits for patients, and facilitates the application of the method for dosimetric purposes in the treatment planning of

  1. ESSA, Equity of Opportunity, and Addressing Barriers to Learning. Research for School Improvement and Transformation. Policy Brief

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2016

    2016-01-01

    The "Every Student Succeeds Act" (ESSA) recognizes that significant numbers of students require supports to successfully meet challenging state academic standards. This brief (1) analyzes the act to assess how it addresses the nature and scope of supports to address barriers to learning and re-engage disconnected students and (2)…

  2. Funerary practices of the Iberomaurusian population of Taforalt (Tafoughalt; Morocco, 11-12,000BP): new hypotheses based on a grave by grave skeletal inventory and evidence of deliberate human modification of the remains.

    PubMed

    Mariotti, Valentina; Bonfiglioli, Benedetta; Facchini, Fiiorenzo; Condemi, Silvana; Belcastro, Maria Giovanna

    2009-04-01

    The Iberomaurusian necropolis of Taforalt (Morocco, 11-12,000BP), excavated by Roche in the 1950s, contains 28 multiple graves. The osteological collection has been the focus of many anthropological studies and has been used as a comparative sample for other paleoanthropological investigations. The presence of particular sepulchral structures and the use of ochre testify to complex funerary practices, which have not been adequately investigated thus far. Unfortunately, neither the excavation records nor detailed descriptions of the graves are available today. The aim of this study is to investigate the funerary practices of the population based on examination of the human osteological collection (Institut de Paléontologie Humaine, Paris). The bones of adolescents and adults were inventoried to analyse the contents of each grave and the distribution of intentionally modified specimens (ochre-dyeing, cutmarks). The minimum number of individuals was also calculated. The results suggest that the necropolis is a group of primary and secondary burials, even within the same "grave," of about 40 adolescents and adults. The previous estimate of 86 individuals by Ferembach in 1962 appears to be an overestimation. The presence of red ochre and cutmarks on some bones suggests various rituals, which denote a certain profundity of thinking about life and death. It is possible that the Taforalt cave was a special, perhaps sacred, place where particular rituals were celebrated or where more occasional social or religious events took place. Comparison with other Iberomaurusian and Capsian sites provides evidence of cultural continuity in North Africa for a long period of time. The present study demonstrates that re-examination of human osteological collections deriving from ancient excavations, for which a lack of adequate documentation of the context of the specimens is fairly common, can also provide information about aspects like funerary practices, which are usually

  3. 77 FR 11383 - Change of Address and Electronic Submission of FOIA Requests

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... address and to permit Freedom of Information Act (FOIA) requests via electronic mail and facsimile. DATES... requests by electronic mail and facsimile. Regulatory Flexibility Act I certify that this regulation will... letter and the envelope. (2) By electronic mail at FOIAREQUEST@tsp.gov . The subject must include...

  4. Automated Discovery of Speech Act Categories in Educational Games

    ERIC Educational Resources Information Center

    Rus, Vasile; Moldovan, Cristian; Niraula, Nobal; Graesser, Arthur C.

    2012-01-01

    In this paper we address the important task of automated discovery of speech act categories in dialogue-based, multi-party educational games. Speech acts are important in dialogue-based educational systems because they help infer the student speaker's intentions (the task of speech act classification) which in turn is crucial to providing adequate…

  5. Americans with Disabilities Act as Amended: Principles and Practice

    ERIC Educational Resources Information Center

    Bowman, Lorenzo

    2011-01-01

    This article provides an overview of the Americans with Disabilities Act (ADA) and the 2008 amendments to the act (ADAAA) as well as Section 504 of the Rehabilitation Act of 1973. The article describes the major sections of the ADA, addresses the changes brought about to the ADA and Section 504 as a result of the ADAAA, reviews the outcome of…

  6. Estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese patients with Graves׳ disease.

    PubMed

    Suzuki, Yoshitake; Matsushita, Kazuyuki; Seimiya, Masanori; Yoshida, Toshihiko; Sawabe, Yuji; Ogawa, Makoto; Nomura, Fumio

    2015-12-01

    Glomerular filtration rate (eGFR) by serum creatinine (eGFRCr) or standardized cystatin C (eGFRCysC) were estimated in Japanese patients with Graves׳ disease (GD) of different sex. Clinical samples were collected from patients with GD with normal renal function to accurately validate eGFRCr and eGFRCysC levels and evaluate how hyperthyroidism affects renal function. Levels of eGFRCr and eGFRCysC showed clinical usefulness in successfully treated euthyroid patients with GD regardless of sex. The article includes detailed experimental methods and data used in our analysis. The data relates to the "Paradoxical effect of thyroid function on the estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese Graves' disease patients" (Suzuki et al., 2015) [1].

  7. 16 CFR 681.2 - Duties of card issuers regarding changes of address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of card issuers regarding changes of address. 681.2 Section 681.2 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT IDENTITY THEFT RULES § 681.2 Duties of card issuers regarding changes of address. (a) Scope. This...

  8. 75 FR 67453 - Identity Theft Red Flags and Address Discrepancies Under the Fair and Accurate Credit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... Office of Thrift Supervision Identity Theft Red Flags and Address Discrepancies Under the Fair and...: Identity Theft Red Flags and Address Discrepancies under the Fair and Accurate Credit Transactions Act of... issue jointly guidelines for financial institutions and creditors regarding identity theft with...

  9. 45 CFR 1184.8 - How can I address concerns regarding my request?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false How can I address concerns regarding my request... FREEDOM OF INFORMATION ACT § 1184.8 How can I address concerns regarding my request? (a) FOIA Public..., MD 20740-6001, Email: ogis@nara.gov, Phone: (301) 837-1996, Fax: (301) 837-0348. This information...

  10. 16 CFR 681.2 - Duties of card issuers regarding changes of address.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Duties of card issuers regarding changes of address. 681.2 Section 681.2 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT IDENTITY THEFT RULES § 681.2 Duties of card issuers regarding changes of address. (a) Scope. This...

  11. 16 CFR 681.2 - Duties of card issuers regarding changes of address.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duties of card issuers regarding changes of address. 681.2 Section 681.2 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT IDENTITY THEFT RULES § 681.2 Duties of card issuers regarding changes of address. (a) Scope. This...

  12. 16 CFR 681.2 - Duties of card issuers regarding changes of address.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Duties of card issuers regarding changes of address. 681.2 Section 681.2 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT IDENTITY THEFT RULES § 681.2 Duties of card issuers regarding changes of address. (a) Scope. This...

  13. 16 CFR 681.2 - Duties of card issuers regarding changes of address.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Duties of card issuers regarding changes of address. 681.2 Section 681.2 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT IDENTITY THEFT RULES § 681.2 Duties of card issuers regarding changes of address. (a) Scope. This...

  14. Cigarette Smoke Extract-Induced Oxidative Stress and Fibrosis-Related Genes Expression in Orbital Fibroblasts from Patients with Graves' Ophthalmopathy

    PubMed Central

    Kau, Hui-Chuan; Wu, Shi-Bei; Tsai, Chieh-Chih; Liu, Catherine Jui-Ling; Wei, Yau-Huei

    2016-01-01

    Cigarette smoking is the most important risk factor for the development or deterioration of Graves' ophthalmopathy. Smoke-induced increased generation of reactive oxygen species may be involved. However, it remains to be clarified how orbital fibroblasts are affected by cigarette smoking. Our study demonstrated that Graves' orbital fibroblasts have exaggerated response to cigarette smoke extract challenge along with increased oxidative stress, fibrosis-related genes expression, especially connective tissue growth factor, and intracellular levels of transforming growth factor-β1 and interleukin-1β. The findings obtained in this study provide some clues for the impact of cigarette smoking on Graves' ophthalmopathy and offer a theoretical basis for the potential and rational use of antioxidants in treating Graves' ophthalmopathy. PMID:27340508

  15. Semblance analysis to assess GPR data from a five-year forensic study of simulated clandestine graves

    NASA Astrophysics Data System (ADS)

    Booth, Adam D.; Pringle, Jamie K.

    2016-02-01

    Ground penetrating radar (GPR) surveys have proven useful for locating clandestine graves in a number of forensic searches. There has been extensive research into the geophysical monitoring of simulated clandestine graves in different burial scenarios and ground conditions. Whilst these studies have been used to suggest optimum dominant radar frequencies, the data themselves have not been quantitatively analysed to-date. This study uses a common-offset configuration of semblance analysis, both to characterise velocity trends from GPR diffraction hyperbolae and, since the magnitude of a semblance response is proportional to signal-to-noise ratio, to quantify the strength of a forensic GPR response. 2D GPR profiles were acquired over a simulated clandestine burial, with a wrapped-pig cadaver monitored at three-month intervals between 2008 and 2013 with GPR antennas of three different centre-frequencies (110, 225 and 450 MHz). The GPR response to the cadaver was a strong diffraction hyperbola. Results show, in contrast to resistivity surveys, that semblance analysis have little sensitivity to changes attributable to decomposition, and only a subtle influence from seasonality: velocity increases (0.01-0.02 m/ns) were observed in summer, associated with a decrease (5-10%) in peak semblance magnitude, SM, and potentially in the reflectivity of the cadaver. The lowest-frequency antennas consistently gave the highest signal-to-noise ratio although the grave was nonetheless detectable by all frequencies trialled. These observations suggest that forensic GPR surveys could be undertaken with little seasonal hindrance. Whilst GPR analysis cannot currently provide a quantitative diagnostic proxy for time-since-burial, the consistency of responses suggests that graves will remain detectable beyond the five years shown here.

  16. The Accuracy of the Osteological Sexing of Cremated Human Remains: A Test Based on Grave Goods from East Lithuanian Barrows.

    PubMed

    Kurila, Laurynas

    2015-12-01

    The accuracy of the sex determination of cremated human remains is one of the vital parameters for archaeologists and skeletal anthropologists dealing with cremations. Few studies have so far aimed at testing it. In the present paper, the accuracy of the sexing techniques was assessed by paralleling biological sex (identified morphologically) to gender (presumed on the basis of the grave goods which accompanied the deceased). A collection of cremated bones from East Lithuanian barrows (c. fourth/fifth--eleventh/twelfth centuries AD) was employed. The fragmentary nature and poor state of the bones generally represents cremains from similar archaeological contexts. The database inevitably underwent several stages of filtration. Out of 364 cremations with a minimum of 445 individuals, only 157 were sexed single adult burials, of which only 81 had "gender-related" grave goods. The relationship of artefact type to gender was defined statistically, revising the results in line with the chronological and typological differences and the probable symbolism of the grave goods. Sex and gender coincided in 56 cases (69.14%), but a considerable distance between the results for both sexes was observed. Biological females displayed a fairly high match level, i.e. 35 out of the 41 (85.37%) individuals osteologically identified as females had been given "feminine" items. The burials of biological males, on the other hand, yielded a surprisingly low match rate, i.e. only 21 out of 40 (52.50%). This disparity suggests a possible misinterpretation of grave goods as gender markers, rather than (only?) erroneous sexing. It is thus argued that for females, the mean value for the accuracy of sexing is 85.5%. In most cases, such precision is entirely satisfactory for the analysis of a poorly-preserved osteological material. For males, however, the accuracy is likely to fall somewhere in the range between 52.5 and 85.5%, with the applied methodology so far failing to contribute to higher

  17. Iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a concurrent diagnosis of primary hyperaldosteronism

    PubMed Central

    Snell, L; Morris, D V

    2015-01-01

    Summary Myxoedema madness was first described as a consequence of severe hypothyroidism in 1949. Most cases were secondary to long-standing untreated primary hypothyroidism. We present the first reported case of iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a second concurrent diagnosis of primary hyperaldosteronism. A 29-year-old woman presented with severe hypothyroidism, a 1-week history of psychotic behaviour and paranoid delusions 3 months after treatment with radioactive iodine ablation for Graves' disease. Her psychiatric symptoms abated with levothyroxine replacement. She was concurrently found to be hypertensive and hypokalemic. Primary hyperaldosteronism from bilateral adrenal hyperplasia was diagnosed. This case report serves as a reminder that myxoedema madness can be a complication of acute hypothyroidism following radioactive iodine ablation of Graves' disease and that primary hyperaldosteronism may be associated with autoimmune hyperthyroidism. Learning points Psychosis (myxoedema madness) can present as a neuropsychiatric manifestation of acute hypothyroidism following radioactive iodine ablation of Graves' disease.Primary hyperaldosteronism may be caused by idiopathic bilateral adrenal hyperplasia even in the presence of an adrenal adenoma seen on imaging.Adrenal vein sampling is a useful tool for differentiating between a unilateral aldosterone-producing adenoma, which is managed surgically, and an idiopathic bilateral adrenal hyperplasia, which is managed medically.The management of autoimmune hyperthyroidism, iatrogenic hypothyroidism and primary hyperaldosteronism from bilateral idiopathic adrenal hyperplasia in patients planning pregnancy includes delaying pregnancy 6 months following radioactive iodine treatment and until patient is euthyroid for 3 months, using amiloride as opposed to spironolactone, controlling blood pressure with agents safe in pregnancy such as nifedipine and avoiding

  18. The Accuracy of the Osteological Sexing of Cremated Human Remains: A Test Based on Grave Goods from East Lithuanian Barrows.

    PubMed

    Kurila, Laurynas

    2015-12-01

    The accuracy of the sex determination of cremated human remains is one of the vital parameters for archaeologists and skeletal anthropologists dealing with cremations. Few studies have so far aimed at testing it. In the present paper, the accuracy of the sexing techniques was assessed by paralleling biological sex (identified morphologically) to gender (presumed on the basis of the grave goods which accompanied the deceased). A collection of cremated bones from East Lithuanian barrows (c. fourth/fifth--eleventh/twelfth centuries AD) was employed. The fragmentary nature and poor state of the bones generally represents cremains from similar archaeological contexts. The database inevitably underwent several stages of filtration. Out of 364 cremations with a minimum of 445 individuals, only 157 were sexed single adult burials, of which only 81 had "gender-related" grave goods. The relationship of artefact type to gender was defined statistically, revising the results in line with the chronological and typological differences and the probable symbolism of the grave goods. Sex and gender coincided in 56 cases (69.14%), but a considerable distance between the results for both sexes was observed. Biological females displayed a fairly high match level, i.e. 35 out of the 41 (85.37%) individuals osteologically identified as females had been given "feminine" items. The burials of biological males, on the other hand, yielded a surprisingly low match rate, i.e. only 21 out of 40 (52.50%). This disparity suggests a possible misinterpretation of grave goods as gender markers, rather than (only?) erroneous sexing. It is thus argued that for females, the mean value for the accuracy of sexing is 85.5%. In most cases, such precision is entirely satisfactory for the analysis of a poorly-preserved osteological material. For males, however, the accuracy is likely to fall somewhere in the range between 52.5 and 85.5%, with the applied methodology so far failing to contribute to higher

  19. CCCC Chair's Address: Representing Ourselves, 2008

    ERIC Educational Resources Information Center

    Glenn, Cheryl

    2008-01-01

    This article presents the text of the author's address at the fifty-ninth annual convention of the Conference on College Composition and Communication (CCCC) in March 2008. In her address, the author picks up strands of previous Chairs' addresses and weaves them through the fabric of her remarks. What she hopes will give sheen to the fabric is her…

  20. 32 CFR 516.7 - Mailing addresses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Mailing addresses. 516.7 Section 516.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION General § 516.7 Mailing addresses. Mailing addresses for organizations referenced...

  1. 47 CFR 13.10 - Licensee address.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Licensee address. 13.10 Section 13.10 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS General § 13.10 Licensee address. In accordance with § 1.923 of this chapter all applications must specify an address where...

  2. 75 FR 49813 - Change of Address

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ... COMMISSION 11 CFR Parts 9405, 9407, 9409, 9410, 9420, and 9428 Change of Address AGENCY: United States... Assistance Commission (EAC) is amending its regulations to reflect a change of address for its headquarters. This technical amendment is a nomenclature change that updates and corrects the address for...

  3. 77 FR 48429 - Commission Address Change

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-14

    ... HEALTH REVIEW COMMISSION 29 CFR Parts 2700, 2701, 2702, 2704, 2705, 2706 Commission Address Change AGENCY... to inform the public of the address change. DATES: This final rule will take effect on August 27... because the amendments are of a minor and administrative nature dealing with only a change in address....

  4. 47 CFR 97.23 - Mailing address.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Mailing address. 97.23 Section 97.23 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO... name and mailing address. The mailing address must be in an area where the amateur service is...

  5. 47 CFR 97.23 - Mailing address.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Mailing address. 97.23 Section 97.23 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO... name and mailing address. The mailing address must be in an area where the amateur service is...

  6. 47 CFR 97.23 - Mailing address.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Mailing address. 97.23 Section 97.23 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO... name and mailing address. The mailing address must be in an area where the amateur service is...

  7. 47 CFR 97.23 - Mailing address.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Mailing address. 97.23 Section 97.23 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO... name and mailing address. The mailing address must be in an area where the amateur service is...

  8. 47 CFR 97.23 - Mailing address.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Mailing address. 97.23 Section 97.23 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO... name and mailing address. The mailing address must be in an area where the amateur service is...

  9. Geophysical monitoring of simulated graves with resistivity, magnetic susceptibility, conductivity and GPR in Colombia, South America.

    PubMed

    Molina, Carlos Martin; Pringle, Jamie K; Saumett, Miguel; Evans, Gethin T

    2016-04-01

    In most Latin American countries there are significant numbers of both missing people and forced disappearances, ∼71,000 Colombia alone. Successful detection of buried human remains by forensic search teams can be difficult in varying terrain and climates. Three clandestine burials were simulated at two different depths commonly encountered in Latin America. In order to gain critical knowledge of optimum geophysical detection techniques, burials were monitored using: ground penetrating radar, magnetic susceptibility, bulk ground conductivity and electrical resistivity up to twenty-two months post-burial. Radar survey results showed good detection of modern 1/2 clothed pig cadavers throughout the survey period on 2D profiles, with the 250MHz antennae judged optimal. Both skeletonised and decapitated and burnt human remains were poorly imaged on 2D profiles with loss in signal continuity observed throughout the survey period. Horizontal radar time slices showed good anomalies observed over targets, but these decreased in amplitude over the post-burial time. These were judged due to detecting disturbed grave soil rather than just the buried targets. Magnetic susceptibility and electrical resistivity were successful at target detection in contrast to bulk ground conductivity surveys which were unsuccessful. Deeper burials were all harder to image than shallower ones. Forensic geophysical surveys should be undertaken at suspected burial sites. PMID:26921813

  10. [A study on observation of bone metabolism in middle-aged and senile female Graves' disease].

    PubMed

    Zhu, L Q; Liu, Y H; Zhou, Y B

    1996-08-01

    Sixty-nine cases of middle aged and senile female Graves' desease (GD) patients suffered from abnormal bone metabolism have been studied. They were divided randomly into group A and B, treated separately with antithyroid drugs (Tapazol and inderal, etc.) in group A, and added with Chinese herbal medicine for tonifying Kidney and promoting blood circulation in group B. Before treatment, patients of both groups showed obvious higher blood calcium (Ca) 24-hour urinary Ca, phosphorus (P) and serum clcitonin (CT) levels than that in normal subjects. These patients' serum Ca, moreover, had a parallel relationship with serum T3 levels (r = 0.6142, P < 0.01) and the serum Ca also a paralleled with serum CT levels (r = 0.5714, P < 0.05). After six months of treatment, the serum Ca, 24-hour urinary Ca, P and blood CT values were all reduced in various degree. The decrease of these bone metabolic parameters were more significant in group B than that in group A. PMID:9387746

  11. Synthetic gene network restoring endogenous pituitary-thyroid feedback control in experimental Graves' disease.

    PubMed

    Saxena, Pratik; Charpin-El Hamri, Ghislaine; Folcher, Marc; Zulewski, Henryk; Fussenegger, Martin

    2016-02-01

    Graves' disease is an autoimmune disorder that causes hyperthyroidism because of autoantibodies that bind to the thyroid-stimulating hormone receptor (TSHR) on the thyroid gland, triggering thyroid hormone release. The physiological control of thyroid hormone homeostasis by the feedback loops involving the hypothalamus-pituitary-thyroid axis is disrupted by these stimulating autoantibodies. To reset the endogenous thyrotrophic feedback control, we designed a synthetic mammalian gene circuit that maintains thyroid hormone homeostasis by monitoring thyroid hormone levels and coordinating the expression of a thyroid-stimulating hormone receptor antagonist (TSHAntag), which competitively inhibits the binding of thyroid-stimulating hormone or the human autoantibody to TSHR. This synthetic control device consists of a synthetic thyroid-sensing receptor (TSR), a yeast Gal4 protein/human thyroid receptor-α fusion, which reversibly triggers expression of the TSHAntag gene from TSR-dependent promoters. In hyperthyroid mice, this synthetic circuit sensed pathological thyroid hormone levels and restored the thyrotrophic feedback control of the hypothalamus-pituitary-thyroid axis to euthyroid hormone levels. Therapeutic plug and play gene circuits that restore physiological feedback control in metabolic disorders foster advanced gene- and cell-based therapies.

  12. T cell responses to synthetic TSH receptor peptides in Graves' disease.

    PubMed Central

    Tandon, N; Freeman, M A; Weetman, A P

    1992-01-01

    Twenty-eight peptides, representing the entire extracellular domain of the TSH receptor, were synthesised to investigate which parts of this autoantigen may be targets for the T cell response in Graves' disease (GD). T cells from 11 of 21 controls and 26 of 36 newly diagnosed GD patients proliferated in response to one or more peptides with a stimulation index (SI) of greater than 2.0 (chi 2 = 2.31, P greater than 0.1). The response of patients and controls to any of the individual peptides was also not statistically different. However, individual patients gave high SIs with certain peptides to which controls either gave an absent or very weak response. HLA-DR3 was not associated with any particular response to TSHR peptides. Three out of seven GD patients whose T cells were evaluated before and after treatment showed a response of this kind only early in the course of their disease. Intrathyroidal T cells from four GD patients did not give a consistent proliferative response to pools of five peptides, and depleting peripheral blood T cells of their CD8+ population did not affect the proliferative response. These results indicate that the T cell response to the TSH receptor in GD does not seem to be directed against any one particular epitope on the peptides we have tested which cover the extracellular domain. PMID:1516261

  13. Disease activity in Graves' ophthalmopathy: diagnosis with orbital MR imaging and correlation with clinical score.

    PubMed

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-10-01

    In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone.

  14. Educational interventions targeted at minors in situations of grave social vulnerability and their families

    NASA Astrophysics Data System (ADS)

    de La Caba Collado, Mariangeles; Bartau Rojas, Isabel

    2010-10-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The design, intervention and assessment process of this study was carried out in two phases over a period of a year and a half. For both phases, three different groups—of men/fathers, women/mothers and children—were established. Study variables (parenting skills and children's personal and social development) were evaluated before and after the intervention in every group, as well as during the entire process. The results, taking into account the improvements reported by all the participants (social workers, group monitors, fathers, mothers, children) show that inter-professional involvement and coordination at all phases of the intervention is vital in order to achieve small but significant improvements.

  15. Early Medieval Muslim Graves in France: First Archaeological, Anthropological and Palaeogenomic Evidence

    PubMed Central

    Pemonge, Marie-Hélène; Hubert, Christophe; Groppi, Alexis; Houix, Bertrand; Deguilloux, Marie-France; Breuil, Jean-Yves

    2016-01-01

    The rapid Arab-Islamic conquest during the early Middle Ages led to major political and cultural changes in the Mediterranean world. Although the early medieval Muslim presence in the Iberian Peninsula is now well documented, based in the evaluation of archeological and historical sources, the Muslim expansion in the area north of the Pyrenees has only been documented so far through textual sources or rare archaeological data. Our study provides the first archaeo-anthropological testimony of the Muslim establishment in South of France through the multidisciplinary analysis of three graves excavated at Nimes. First, we argue in favor of burials that followed Islamic rites and then note the presence of a community practicing Muslim traditions in Nimes. Second, the radiometric dates obtained from all three human skeletons (between the 7th and the 9th centuries AD) echo historical sources documenting an early Muslim presence in southern Gaul (i.e., the first half of 8th century AD). Finally, palaeogenomic analyses conducted on the human remains provide arguments in favor of a North African ancestry of the three individuals, at least considering the paternal lineages. Given all of these data, we propose that the skeletons from the Nimes burials belonged to Berbers integrated into the Umayyad army during the Arab expansion in North Africa. Our discovery not only discusses the first anthropological and genetic data concerning the Muslim occupation of the Visigothic territory of Septimania but also highlights the complexity of the relationship between the two communities during this period. PMID:26910855

  16. Disease Activity in Graves' Ophthalmopathy: Diagnosis with Orbital MR Imaging and Correlation with Clinical Score

    PubMed Central

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-01-01

    Summary In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone. PMID:24199816

  17. Le Point sur la Pharmacologie des Agents Anesthesiques Chez le Brule Grave

    PubMed Central

    Siah, S.; Ababou, K.; Benziane, H.; El Jaoudi; Bensghir, M.; Bakali, H.; El Wali, A.; Ihrai, I.; Drissi, N.K.

    2008-01-01

    Summary La pharmacologie des agents anesthésiques chez le brûlé est variable et imprévisible. Dans les premières 48 h, il y a une hypovolémie avec chute du débit cardiaque et des fuites plasmatiques. Après 48 h, il y a une hypervolémie avec augmentation du débit cardiaque, hypermétabolisme et la clearance des médicaments est augmentée. Parmi les facteurs de déséquilibre, on retrouve les variations des protéines plasmatiques. Deux protéines sont importantes chez le brûlé grave : l'albumine et l'alpha 1- glycoprotéine. Leur taux varie beaucoup au cours de l'évolution de la brûlure. Les agents anesthésiques dont la liaison avec ces deux protéines est prédominante verront leur pharmacocinétique modifiée. L'anesthésiste-réanimateur du service des brûlés va maîtriser ces notions pharmacologiques pour utiliser à bon escient les agents anesthésiques. PMID:21991108

  18. Synthetic gene network restoring endogenous pituitary-thyroid feedback control in experimental Graves' disease.

    PubMed

    Saxena, Pratik; Charpin-El Hamri, Ghislaine; Folcher, Marc; Zulewski, Henryk; Fussenegger, Martin

    2016-02-01

    Graves' disease is an autoimmune disorder that causes hyperthyroidism because of autoantibodies that bind to the thyroid-stimulating hormone receptor (TSHR) on the thyroid gland, triggering thyroid hormone release. The physiological control of thyroid hormone homeostasis by the feedback loops involving the hypothalamus-pituitary-thyroid axis is disrupted by these stimulating autoantibodies. To reset the endogenous thyrotrophic feedback control, we designed a synthetic mammalian gene circuit that maintains thyroid hormone homeostasis by monitoring thyroid hormone levels and coordinating the expression of a thyroid-stimulating hormone receptor antagonist (TSHAntag), which competitively inhibits the binding of thyroid-stimulating hormone or the human autoantibody to TSHR. This synthetic control device consists of a synthetic thyroid-sensing receptor (TSR), a yeast Gal4 protein/human thyroid receptor-α fusion, which reversibly triggers expression of the TSHAntag gene from TSR-dependent promoters. In hyperthyroid mice, this synthetic circuit sensed pathological thyroid hormone levels and restored the thyrotrophic feedback control of the hypothalamus-pituitary-thyroid axis to euthyroid hormone levels. Therapeutic plug and play gene circuits that restore physiological feedback control in metabolic disorders foster advanced gene- and cell-based therapies. PMID:26787873

  19. Analyses to help identify individuals from a historical mass grave in Kassel, Germany.

    PubMed

    v Grumbkow, Philipp; Zipp, Anna; Grosskopf, Birgit; Fueldner, Kai; Hummel, Susanne

    2012-01-01

    In 2008, the skeletal remains of more than 60 human individuals were found in a mass grave on the grounds of the University of Kassel, Germany. There was no evidence helping to identify them or throwing light on the cause of their death. Mainly due to 14C age determination and initial hints on age and sex distribution, historians hypothesized that they had been soldiers of Napoleon's army who died in an epidemic in the winter of 1813/14. To test this assumption, morphological and molecular analyses were carried out on a sample. The morphological analyses comprised an age and sex determination as well as a macro- and micro-morphological inspection for pathological deviations after the commingled bones had been assembled as individuals. The molecular investigations aimed to identify the geographic origin of the remains. For this, mitochondrial and Y-chromosomal haplotypings were carried out. The results point to a group of mainly young men, some of them suffering from systemic inflammation of the periosteum. Others revealed severe aberrations in bone microstructure. The greatest similarities revealed by Y-haplogroup and -haplotype distribution were to populations that live in what are now the Benelux countries. All aspects support the thesis that these were soldiers of the Napoleonic army. PMID:22338792

  20. The diagnostic criteria of Graves' disease and especially the thyrotropin receptor antibody; our own experience.

    PubMed

    Paunkovic, Nebojsa; Paunkovic, Jane

    2007-01-01

    It is generally accepted that the thyrotropin receptor antibody (TRAb) has a stimulating activity and is the major pathogenic factor in Graves' disease (GD). In spite of that, TRAb is not routinely examined in clinical practice. The aim of this article is to briefly review the subject and suggest protocols for the diagnosis, treatment and follow-up of patients with GD based on our own studies and referring especially to TRAb. Clinical symptoms and signs and thyroid hormones may have poor sensitivity or specificity, especially in cases of endocrine ophthalmopathy and subclinical hyperthyroidism. In these cases the TRAb test is 98% sensitive and specific with a diagnostic accuracy of almost 99%. By this test it is possible to differentiate between autoimmune and other forms of thyrotoxicosis such as autonomous hyperthyroidism, destructive thyroiditis, iodine induced hyperthyroidism etc. Antithyroid drugs decrease serum TRAb levels and also induce immune remission. If after treatment TRAb remains increased as in about 30%of our cases, patients will relapse. In pregnant women with GD the follow-up of serum TRAb levels is also important as predictive of immune thyroid disease in the newborn. Data presented in this article confirm that the determination of serum TRAb levels in some rare hyperthyroid disorders, such as associated autoimmune and autonomous forms and in epidemiological studies, is also justified.

  1. Autoantibody against diiodinated tyrosine-gastrin in a patient with Graves' disease

    SciTech Connect

    Noguchi, M.; Adachi, H.; Aoki, E.; Iida, Y.; Kasagi, K.; Endo, K.; Konishi, J.; Torizuka, K.

    1987-01-01

    We describe autoantibodies against iodinated gastrin in a patient with Graves' disease. Values for serum gastrin differed in this case, depending on which of two different radioimmunoassay (RIA) kits was used. RIA with the dextran-coated charcoal method for separation of free tracer gastrin gave a value less than 9.5 pmol/L, whereas the value by a RIA kit by the double-antibody method was 318 pmol/L. The patient's serum contained a binding protein for /sup 125/I-labeled gastrin, as detected by Sephadex G-200 column chromatography. The IgG fraction was responsible for the ability of serum to bind /sup 125/I-labeled gastrin. Interestingly, of the two possible forms of iodinated gastrins, monoiodinated (MIT) and diiodinated (DIT) tyrosine-/sup 125/I-labeled gastrin, only the latter bound to patient's IgG. Furthermore, DIT-gastrin, but not gastrin or MIT-gastrin, inhibited the binding of DIT-/sup 125/I-labeled gastrin. The patient's serum evidently contains autoantibodies against DIT-gastrin that interfere with RIA of gastrin.

  2. Early Medieval Muslim Graves in France: First Archaeological, Anthropological and Palaeogenomic Evidence.

    PubMed

    Gleize, Yves; Mendisco, Fanny; Pemonge, Marie-Hélène; Hubert, Christophe; Groppi, Alexis; Houix, Bertrand; Deguilloux, Marie-France; Breuil, Jean-Yves

    2016-01-01

    The rapid Arab-Islamic conquest during the early Middle Ages led to major political and cultural changes in the Mediterranean world. Although the early medieval Muslim presence in the Iberian Peninsula is now well documented, based in the evaluation of archeological and historical sources, the Muslim expansion in the area north of the Pyrenees has only been documented so far through textual sources or rare archaeological data. Our study provides the first archaeo-anthropological testimony of the Muslim establishment in South of France through the multidisciplinary analysis of three graves excavated at Nimes. First, we argue in favor of burials that followed Islamic rites and then note the presence of a community practicing Muslim traditions in Nimes. Second, the radiometric dates obtained from all three human skeletons (between the 7th and the 9th centuries AD) echo historical sources documenting an early Muslim presence in southern Gaul (i.e., the first half of 8th century AD). Finally, palaeogenomic analyses conducted on the human remains provide arguments in favor of a North African ancestry of the three individuals, at least considering the paternal lineages. Given all of these data, we propose that the skeletons from the Nimes burials belonged to Berbers integrated into the Umayyad army during the Arab expansion in North Africa. Our discovery not only discusses the first anthropological and genetic data concerning the Muslim occupation of the Visigothic territory of Septimania but also highlights the complexity of the relationship between the two communities during this period. PMID:26910855

  3. White goddess--the unspeakable name. An inquiry into Robert Graves' King Jesus.

    PubMed

    Nakano, N

    1984-03-01

    Robert Graves is a poet-mythographer, well-known in the U. K. and the U. S. A., but not in Japan despite his huge amount of poetic, mythographical, prose and critical works. Furthermore, even in the U. S. A. and the U. K., some people have been shunning him politely as a versatile iconoclast possessed of the White Goddess. In fact, it is not difficult to imagine that when King Jesus, a life story of Christ, was published, people were shocked at his extraordinary mythographical Christology derived from his enthusiasm towards the White Goddess Cult. In Christ he discovered the fragments of maternal doctrine as a new concept in opposition to the Apollonian theory of Judaism, but they seemed to be quite incomplete in the author's eyes lacking in something most essential in life, recognition of love and hatred discipline. This paper is an inquiry into how the author developed his own hermaneutics of Christ through his wide and thorough scholarship on mythology, history, the Bible and Celtic poetry.

  4. Preliminary results of sequential monitoring of simulated clandestine graves in Colombia, South America, using ground penetrating radar and botany.

    PubMed

    Molina, Carlos Martin; Pringle, Jamie K; Saumett, Miguel; Hernández, Orlando

    2015-03-01

    In most Latin American countries there are significant numbers of missing people and forced disappearances, 68,000 alone currently in Colombia. Successful detection of shallow buried human remains by forensic search teams is difficult in varying terrain and climates. This research has created three simulated clandestine burial styles at two different depths commonly encountered in Latin America to gain knowledge of optimum forensic geophysics detection techniques. Repeated monitoring of the graves post-burial was undertaken by ground penetrating radar. Radar survey 2D profile results show reasonable detection of ½ clothed pig cadavers up to 19 weeks of burial, with decreasing confidence after this time. Simulated burials using skeletonized human remains were not able to be imaged after 19 weeks of burial, with beheaded and burnt human remains not being able to be detected throughout the survey period. Horizontal radar time slices showed good early results up to 19 weeks of burial as more area was covered and bi-directional surveys were collected, but these decreased in amplitude over time. Deeper burials were all harder to image than shallower ones. Analysis of excavated soil found soil moisture content almost double compared to those reported from temperate climate studies. Vegetation variations over the simulated graves were also noted which would provide promising indicators for grave detection.

  5. Accelerating adaptation of natural resource management to address climate change.

    PubMed

    Cross, Molly S; McCarthy, Patrick D; Garfin, Gregg; Gori, David; Enquist, Carolyn A F

    2013-02-01

    Natural resource managers are seeking tools to help them address current and future effects of climate change. We present a model for collaborative planning aimed at identifying ways to adapt management actions to address the effects of climate change in landscapes that cross public and private jurisdictional boundaries. The Southwest Climate Change Initiative (SWCCI) piloted the Adaptation for Conservation Targets (ACT) planning approach at workshops in 4 southwestern U.S. landscapes. This planning approach successfully increased participants' self-reported capacity to address climate change by providing them with a better understanding of potential effects and guiding the identification of solutions. The workshops fostered cross-jurisdictional and multidisciplinary dialogue on climate change through active participation of scientists and managers in assessing climate change effects, discussing the implications of those effects for determining management goals and activities, and cultivating opportunities for regional coordination on adaptation of management plans. Facilitated application of the ACT framework advanced group discussions beyond assessing effects to devising options to mitigate the effects of climate change on specific species, ecological functions, and ecosystems. Participants addressed uncertainty about future conditions by considering more than one climate-change scenario. They outlined opportunities and identified next steps for implementing several actions, and local partnerships have begun implementing actions and conducting additional planning. Continued investment in adaptation of management plans and actions to address the effects of climate change in the southwestern United States and extension of the approaches used in this project to additional landscapes are needed if biological diversity and ecosystem services are to be maintained in a rapidly changing world.

  6. The Efficacy of Radiation Therapy in the Treatment of Graves' Orbitopathy

    SciTech Connect

    Matthiesen, Chance; Thompson, J. Spencer; Thompson, David; Farris, Bradley; Wilkes, Byron; Ahmad, Salahuddin; Herman, Terence; Bogardus, Carl

    2012-01-01

    Purpose: To review our institutional outcomes of patients treated with radiation therapy (RT) for Graves' orbitopathy (GO), assess the role of orbital reirradiation, and identify prognostic factors of complete response (CR). Methods and Materials: This is a retrospective review of 211 patients who presented with a diagnosis of GO and received RT between January 2000-2010. RT dose was 20 Gy in 10 fractions. Patient median age was 51 years (range, 15-84 years), median follow-up was 11 months (range, 1-88 months). Patient symptoms included any combination of proptosis (90.9%), extraocular muscle dysfunction (78.9%), soft tissue signs (68.4%), and diplopia (58.4%). Corticosteroids were used as first-line therapy in 20.6% of patients. Among those who achieved either CR or partial response (PR), prognostic factors were evaluated. Results: Stabilization of disease without recurrence was clinically achieved overall in 202 patients (96.7%). At the completion of RT, 176 patients (84.2%) reported a symptomatic improvement of pretreatment symptoms. CR of GO symptoms was achieved using multiple treatment modalities, including RT by 93 patients (44.5%), of which 32 patients received RT only. Corticosteroids were discontinued in 97.8% of patients who received them as initial therapy. Surgical intervention following radiotherapy was required for 144 (68.9%) of all patients. Fourteen patients received orbital reirradiation for persistent or recurrent symptoms. Five of these achieved a CR, and the other nine achieved disease stabilization but retained persistent ocular symptoms. Long-term side effects of RT included dry eyes (12%). Of the prognostic factors we investigated, only gender predicted CR, which was less common in men (33.9%) than in women (49.7%) p = 0.0471. Conclusions: Orbital radiation for GO is an established treatment modality for patients. Orbital reirradiation is beneficial for patients who do not respond to initial RT or experience symptom recurrence without an

  7. Characterization of Regulatory B Cells in Graves' Disease and Hashimoto's Thyroiditis.

    PubMed

    Kristensen, Birte; Hegedüs, Laszlo; Lundy, Steven K; Brimnes, Marie K; Smith, Terry J; Nielsen, Claus H

    2015-01-01

    A hallmark of regulatory B cells is IL-10 production, hence their designation as IL-10+ B cells. Little is known about the ability of self-antigens to induce IL-10+ B cells in Graves' disease (GD), Hashimoto's thyroiditis (HT), or other autoimmune disease. Here we pulsed purified B cells from 12 HT patients, 12 GD patients, and 12 healthy donors with the thyroid self-antigen, thyroglobulin (TG) and added the B cells back to the remaining peripheral blood mononuclear cells (PBMCs). This procedure induced IL-10+ B-cell differentiation in GD. A similar tendency was observed in healthy donors, but not in cells from patients with HT. In GD, B cells primed with TG induced IL-10-producing CD4+ T cells. To assess the maximal frequency of inducible IL-10+ B cells in the three donor groups PBMCs were stimulated with PMA/ionomycin. The resulting IL-10+ B-cell frequency was similar in the three groups and correlated with free T3 levels in GD patients. IL-10+ B cells from both patient groups displayed CD25 or TIM-1 more frequently than did those from healthy donors. B-cell expression of two surface marker combinations previously associated with regulatory B-cell functions, CD24hiCD38hi and CD27+CD43+, did not differ between patients and healthy donors. In conclusion, our findings indicate that autoimmune thyroiditis is not associated with reduced frequency of IL-10+ B cells. These results do not rule out regulatory B-cell dysfunction, however. The observed phenotypic differences between IL-10+ B cells from patients and healthy donors are discussed.

  8. Thyroglobulin Autoantibodies Are Associated with Refractoriness to Antithyroid Drug Treatment for Graves' Disease.

    PubMed

    Katahira, Masahito; Ogata, Hidetada

    2016-01-01

    Objective The recurrence rate associated with antithyroid drug (ATD) treatment for Graves' disease (GD) is high compared with that for radioiodine therapy or surgery. It is important to identify patients in whom remission is unlikely, so that they are not given treatment that is destined to fail. The objective of this study was thus to evaluate factors influencing the prognosis of GD patients treated with ATDs. Patients One hundred and sixty-one patients were divided into two groups: 100 patients who could not discontinue ATDs for eight years or more (refractory group) and 61 patients who achieved remission within eight years after starting ATD treatment (nonrefractory group). The groups were compared in terms of age, thyroid function and thyroid-related autoantibodies at diagnosis, and the durations to the recovery of thyroid function and thyroid-related autoantibodies. Results The baseline levels of free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating antibodies (TSAbs) and thyroid-stimulating hormone (TSH) receptor antibodies (TRAbs) were high, and the age at diagnosis and the baseline level of thyroglobulin autoantibodies (TgAbs) were low in the refractory group compared with those in the nonrefractory group. The durations to the recovery of TSH, free T4, TRAb and TSAb levels were longer in the refractory group than in the nonrefractory group. No significant difference was observed with regard to thyroid peroxidase autoantibodies. Conclusion We compared the clinical features of these two groups in order to identify factors influencing the prognosis of GD patients treated with ATDs. A low baseline level of TgAbs is associated with the refractoriness of GD to ATD treatment. PMID:27301499

  9. Gene Map of the HLA Region, Graves' Disease and Hashimoto Thyroiditis, and Hematopoietic Stem Cell Transplantation.

    PubMed

    Sasazuki, Takehiko; Inoko, Hidetoshi; Morishima, Satoko; Morishima, Yasuo

    2016-01-01

    The human leukocyte antigen (HLA) genomic region spanning about 4 Mb is the most gene dense and the polymorphic stretches in the human genome. A total of the 269 loci were identified, including 145 protein coding genes mostly important for immunity and 50 noncoding RNAs (ncRNAs). Biological function of these ncRNAs remains unknown, becoming hot spot in the studies of HLA-associated diseases. The genomic diversity analysis in the HLA region facilitated by next-generation sequencing will pave the way to molecular understanding of linkage disequilibrium structure, population diversity, histocompatibility in transplantation, and associations with autoimmune diseases. The 4-digit DNA genotyping of HLA for six HLA loci, HLA-A through DP, in the patients with Graves' disease (GD) and Hashimoto thyroiditis (HT) identified six susceptible and three resistant HLA alleles. Their epistatic interactions in controlling the development of these diseases are shown. Four susceptible and one resistant HLA alleles are shared by GD and HT. Two HLA alleles associated with GD or HT control the titers of autoantibodies to thyroid antigens. All these observations led us to propose a new model for the development of GD and HT. Hematopoietic stem cell transplantation from unrelated donor (UR-HSCT) provides a natural experiment to elucidate the role of allogenic HLA molecules in immune response. Large cohort studies using HLA allele and clinical outcome data have elucidated that (1) HLA locus, allele, and haplotype mismatches between donor and patient, (2) specific amino acid substitution at specific positions of HLA molecules, and (3) ethnic background are all responsible for the immunological events related to UR-HSCT including acute graft-versus-host disease (GVHD), chronic GVHD, graft-versus-leukemia (GvL) effect, and graft failure.

  10. Novel Duplicate Address Detection with Hash Function

    PubMed Central

    Song, GuangJia; Ji, ZhenZhou

    2016-01-01

    Duplicate address detection (DAD) is an important component of the address resolution protocol (ARP) and the neighbor discovery protocol (NDP). DAD determines whether an IP address is in conflict with other nodes. In traditional DAD, the target address to be detected is broadcast through the network, which provides convenience for malicious nodes to attack. A malicious node can send a spoofing reply to prevent the address configuration of a normal node, and thus, a denial-of-service attack is launched. This study proposes a hash method to hide the target address in DAD, which prevents an attack node from launching destination attacks. If the address of a normal node is identical to the detection address, then its hash value should be the same as the “Hash_64” field in the neighboring solicitation message. Consequently, DAD can be successfully completed. This process is called DAD-h. Simulation results indicate that address configuration using DAD-h has a considerably higher success rate when under attack compared with traditional DAD. Comparative analysis shows that DAD-h does not require third-party devices and considerable computing resources; it also provides a lightweight security resolution. PMID:26991901

  11. Novel Duplicate Address Detection with Hash Function.

    PubMed

    Song, GuangJia; Ji, ZhenZhou

    2016-01-01

    Duplicate address detection (DAD) is an important component of the address resolution protocol (ARP) and the neighbor discovery protocol (NDP). DAD determines whether an IP address is in conflict with other nodes. In traditional DAD, the target address to be detected is broadcast through the network, which provides convenience for malicious nodes to attack. A malicious node can send a spoofing reply to prevent the address configuration of a normal node, and thus, a denial-of-service attack is launched. This study proposes a hash method to hide the target address in DAD, which prevents an attack node from launching destination attacks. If the address of a normal node is identical to the detection address, then its hash value should be the same as the "Hash_64" field in the neighboring solicitation message. Consequently, DAD can be successfully completed. This process is called DAD-h. Simulation results indicate that address configuration using DAD-h has a considerably higher success rate when under attack compared with traditional DAD. Comparative analysis shows that DAD-h does not require third-party devices and considerable computing resources; it also provides a lightweight security resolution.

  12. Novel Duplicate Address Detection with Hash Function.

    PubMed

    Song, GuangJia; Ji, ZhenZhou

    2016-01-01

    Duplicate address detection (DAD) is an important component of the address resolution protocol (ARP) and the neighbor discovery protocol (NDP). DAD determines whether an IP address is in conflict with other nodes. In traditional DAD, the target address to be detected is broadcast through the network, which provides convenience for malicious nodes to attack. A malicious node can send a spoofing reply to prevent the address configuration of a normal node, and thus, a denial-of-service attack is launched. This study proposes a hash method to hide the target address in DAD, which prevents an attack node from launching destination attacks. If the address of a normal node is identical to the detection address, then its hash value should be the same as the "Hash_64" field in the neighboring solicitation message. Consequently, DAD can be successfully completed. This process is called DAD-h. Simulation results indicate that address configuration using DAD-h has a considerably higher success rate when under attack compared with traditional DAD. Comparative analysis shows that DAD-h does not require third-party devices and considerable computing resources; it also provides a lightweight security resolution. PMID:26991901

  13. New Congress to Address Familiar Agenda.

    ERIC Educational Resources Information Center

    Penning, Nick

    1991-01-01

    Congressional education committees will soon reconsider education laws about to expire. The most controversial task is reauthorizing the preschool grants program under the Education of the Handicapped Act. These committees will also restructure the Higher Education Act and the Office of Educational Research and consider a Children's Investment…

  14. Exploring primary care activities in ACT teams.

    PubMed

    Vanderlip, Erik R; Williams, Nancy A; Fiedorowicz, Jess G; Katon, Wayne

    2014-05-01

    People with serious mental illness often receive inadequate primary and preventive care services. Federal healthcare reform endorses team-based care that provides high quality primary and preventive care to at risk populations. Assertive community treatment (ACT) teams offer a proven, standardized treatment approach effective in improving mental health outcomes for the seriously mentally ill. Much is known about the effectiveness of ACT teams in improving mental health outcomes, but the degree to which medical care needs are addressed is not established. The purpose of this study was to explore the extent to which ACT teams address the physical health of the population they serve. ACT team leaders were invited to complete an anonymous, web-based survey to explore attitudes and activities involving the primary care needs of their clients. Information was collected regarding the use of health screening tools, physical health assessments, provision of medical care and collaboration with primary care systems. Data was analyzed from 127 team leaders across the country, of which 55 completed the entire survey. Nearly every ACT team leader believed ACT teams have a role in identifying and managing the medical co-morbidities of their clientele. ACT teams report participation in many primary care activities. ACT teams are providing a substantial amount of primary and preventive services to their population. The survey suggests standardization of physical health identification, management or referral processes within ACT teams may result in improved quality of medical care. ACT teams are in a unique position to improve physical health care by virtue of having medically trained staff and frequent, close contact with their clients.

  15. Public Address Systems. Specifications - Installation - Operation.

    ERIC Educational Resources Information Center

    Palmer, Fred M.

    Provisions for public address in new construction of campus buildings (specifications, installations, and operation of public address systems), are discussed in non-technical terms. Consideration is given to microphones, amplifiers, loudspeakers and the placement and operation of various different combinations. (FS)

  16. Addressing Standards and Assessments on the IEP.

    ERIC Educational Resources Information Center

    Thompson, Sandra J.; Thurlow, Martha L.; Esler, Amy; Whetstone, Patti J.

    2001-01-01

    A study that examined state Individualized Education Program (IEP) forms found that out of the 41 with IEP forms, only 5 specifically addressed educational standards on their forms. Thirty-one states addressed the general curriculum on their IEP forms and 30 states listed three or more options for assessment participation. (Contains nine…

  17. History Forum Addresses Creation/Evolution Controversy.

    ERIC Educational Resources Information Center

    Schweinsberg, John

    1997-01-01

    A series of programs entitled Creationism and Evolution: The History of a Controversy was presented at the University of Alabama in Huntsville. The controversy was addressed from an historical and sociological, rather than a scientific perspective. Speakers addressed the evolution of scientific creationism, ancient texts versus sedimentary rocks…

  18. 16 CFR 1000.4 - Commission address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Commission address. 1000.4 Section 1000.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION ORGANIZATION AND FUNCTIONS § 1000.4 Commission address. The principal Offices of the Commission are at 4330 East West...

  19. 10 CFR 218.34 - Addresses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Addresses. 218.34 Section 218.34 Energy DEPARTMENT OF ENERGY OIL STANDBY MANDATORY INTERNATIONAL OIL ALLOCATION Procedures § 218.34 Addresses. All..., Economic Regulatory Administration, Department of Energy, 2000 M Street, NW., Washington, DC 20461, and...

  20. 40 CFR 374.6 - Addresses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Addresses. 374.6 Section 374.6... COMMUNITY RIGHT-TO-KNOW PROGRAMS PRIOR NOTICE OF CITIZEN SUITS § 374.6 Addresses. Administrator, U.S.... Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, IL 60604. Regional Administrator, Region...

  1. 10 CFR 218.34 - Addresses.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Addresses. 218.34 Section 218.34 Energy DEPARTMENT OF ENERGY OIL STANDBY MANDATORY INTERNATIONAL OIL ALLOCATION Procedures § 218.34 Addresses. All correspondence, petitions, and any information required by this part shall be submitted to: Administrator, Economic Regulatory Administration, Department...

  2. 34 CFR 674.44 - Address searches.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Address searches. 674.44 Section 674.44 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence § 674.44 Address searches. (a) If...

  3. 34 CFR 674.44 - Address searches.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Address searches. 674.44 Section 674.44 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence § 674.44 Address searches. (a) If...

  4. 34 CFR 674.44 - Address searches.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false Address searches. 674.44 Section 674.44 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence § 674.44 Address searches. (a) If...

  5. 34 CFR 674.44 - Address searches.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false Address searches. 674.44 Section 674.44 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence § 674.44 Address searches. (a) If...

  6. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  7. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  8. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  9. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  10. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  11. 34 CFR 674.44 - Address searches.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Address searches. 674.44 Section 674.44 Education..., DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Due Diligence § 674.44 Address searches. (a) If mail... institutional offices; (2) Reviews of telephone directories or inquiries of information operators in the...

  12. Forms of Address in Chilean Spanish

    ERIC Educational Resources Information Center

    Bishop, Kelley; Michnowicz, Jim

    2010-01-01

    The present investigation examines possible social and linguistic factors that influence forms of address used in Chilean Spanish with various interlocutors. A characteristic of the Spanish of Chile is the use of a variety of forms of address for the second person singular, "tu", "vos", and "usted", with corresponding verb conjugations (Lipski…

  13. 37 CFR 251.1 - Official addresses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ARBITRATION ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE... Copyright Arbitration Royalty Panels (CARPs) must be addressed as follows: (a) If hand delivered by a... through the U.S. Postal Service, use the following address: Copyright Arbitration Royalty Panel, P.O....

  14. Image compression using address-vector quantization

    NASA Astrophysics Data System (ADS)

    Nasrabadi, Nasser M.; Feng, Yushu

    1990-12-01

    A novel vector quantization scheme, the address-vector quantizer (A-VQ), is proposed which exploits the interblock correlation by encoding a group of blocks together using an address-codebook (AC). The AC is a set of address-codevectors (ACVs), each representing a combination of addresses or indices. Each element of the ACV is an address of an entry in the LBG-codebook, representing a vector-quantized block. The AC consists of an active (addressable) region and an inactive (nonaddressable) region. During encoding the ACVs in the AC are reordered adaptively to bring the most probable ACVs into the active region. When encoding an ACV, the active region is checked, and if such an address combination exists, its index is transmitted to the receiver. Otherwise, the address of each block is transmitted individually. The SNR of the images encoded by the A-VQ method is the same as that of a memoryless vector quantizer, but the bit rate is by a factor of approximately two.

  15. Recovery Act Milestones

    ScienceCinema

    Rogers, Matt

    2016-07-12

    Every 100 days, the Department of Energy is held accountable for a progress report on the American Recovery and Reinvestment Act. Update at 200 days, hosted by Matt Rogers, Senior Advisor to Secretary Steven Chu for Recovery Act Implementation.

  16. Recovery Act Milestones

    SciTech Connect

    Rogers, Matt

    2009-01-01

    Every 100 days, the Department of Energy is held accountable for a progress report on the American Recovery and Reinvestment Act. Update at 200 days, hosted by Matt Rogers, Senior Advisor to Secretary Steven Chu for Recovery Act Implementation.

  17. ACTS data center

    NASA Technical Reports Server (NTRS)

    Syed, Ali; Vogel, Wolfhard J.

    1993-01-01

    Viewgraphs on ACTS Data Center status report are included. Topics covered include: ACTS Data Center Functions; data flow overview; PPD flow; RAW data flow; data compression; PPD distribution; RAW Data Archival; PPD Audit; and data analysis.

  18. The dermatology acting internship.

    PubMed

    Stephens, John B; Raimer, Sharon S; Wagner, Richard F

    2011-07-15

    Acting internships are an important component of modern day medical school curriculum. Several specialties outside of internal medicine now offer acting internship experiences to fourth year medical students. We have found that a dermatology acting internship is a valuable experience for fourth year medical students who are interested in pursuing a residency in dermatology. Our experience with the dermatology acting internship over the 2010-2011 academic year is described.

  19. Evaluation of TSH receptor antibody by 'natural in vivo human assay' in neonates born to mothers with Graves' disease.

    PubMed

    Tamaki, H; Amino, N; Iwatani, Y; Tachi, J; Kimura, M; Mitsuda, N; Ichihara, K; Tanizawa, O; Miyai, K

    1989-05-01

    Neonatal thyrotoxicosis induced by transferred TSH receptor antibody (TRAb) is the ideal human in-vivo experimental system for the evaluation of TRAb. The clinical significance of circulating TRAb in Graves' disease was evaluated by this 'natural in-vivo human assay'. TRAb activity in vitro was measured by radioreceptor assay (thyrotrophin-binding inhibitor immunoglobulin, TBII) and sensitive cAMP accumulation assay using FRTL-5 cells (thyroid-stimulating antibody, TSAb). Further, the binding-stimulation index (B-S index) was newly introduced, which was the most useful indicator for prediction of neonatal thyrotoxicosis, calculated as the product of TBII and TSAb (Tamaki et al., 1988a). Maternal serum TRAb indices showed highly significant correlations with the serum free T4 index (FT4I) and free T3 index (FT3I) in neonates (5-10 days after birth) born to 20 mothers with Graves' disease who had positive TBII and/or TSAb (FT4I: r = 0.825 for TBII, r = 0.908 for TSAb, r = 0.944 for the B-S index, P less than 0.001; FT3I: r = 0.622 for TBII, P less than 0.01, r = 0.812 for TSAb, r = 0.791 for the B-S index, P less than 0.001; n = 20). In contrast, in 57 untreated adult patients with hyperthyroid Graves' disease, the FT4I and FT3I levels were not correlated with any of the TRAb indices. The linear regression relationship between the B-S index and FT4I found in neonates was applied to values in adult patients with Graves' disease, and the patients were divided into three groups on the basis of the 95% confidence limit: high, normal, and low responders of thyroid hormone (FT4I) secretion to the B-S index. FT4I and the ratio of FT4I to the B-S index were highest and the TRAb indices were lowest in the high responders, while FT4I and the FT4I/B-S index ratio were lowest and the TRAb indices were highest in the low responders. The FT4I/B-S index ratio was inversely correlated with the titres of antithyroid microsomal antibody in all the adult patients with untreated Graves

  20. 75 FR 67145 - Sunshine Act: Public Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-01

    ... CORPORATION Sunshine Act: Public Hearing TIME AND DATE: 2 p.m., Wednesday, November 24, 2010. PLACE: Offices...: Hearing open to the Public at 2 p.m. PURPOSE: Public Hearing in conjunction with each meeting of OPIC's... the Corporation. pROCEDURES: Individuals wishing to address the hearing orally must provide...

  1. Indian Child Welfare Act Proceedings. Final rule.

    PubMed

    2016-06-14

    This final rule adds a new subpart to the Department of the Interior's (Department) regulations implementing the Indian Child Welfare Act (ICWA), to improve ICWA implementation. The final rule addresses requirements for State courts in ensuring implementation of ICWA in Indian child-welfare proceedings and requirements for States to maintain records under ICWA.

  2. Forgetting ACT UP

    ERIC Educational Resources Information Center

    Juhasz, Alexandra

    2012-01-01

    When ACT UP is remembered as the pinnacle of postmodern activism, other forms and forums of activism that were taking place during that time--practices that were linked, related, just modern, in dialogue or even opposition to ACT UP's "confrontational activism"--are forgotten. In its time, ACT UP was embedded in New York City, and a larger world,…

  3. Thyroid storm associated with Graves' disease covered by diabetic ketoacidosis: A case report

    PubMed Central

    2011-01-01

    Background Thyroid storm is a condition in which multiple organ dysfunction results from failure of the compensatory mechanisms of the body owing to excessive thyroid hormone activity induced by some factors in patients with thyrotoxicosis. While diabetic ketoacidosis (DKA) is an important trigger for thyroid storm, simultaneous development of DKA and thyroid storm is rare. Case presentation A 59-year-old woman with no history of either diabetes mellitus or thyroid disease presented to our hospital because of developing nausea, vomiting and diarrhea for 2 days. Physical examination showed mild disturbance of consciousness, fever, and tachycardia. There were no other signs of thyrotoxicosis. Laboratory studies revealed elevation of random blood glucose and glycosylated hemoglobin, strongly positive of urine acetone, and metabolic acidosis. Since DKA was diagnosed, we initiated the patient on treatment with administration of insulin and adequate fluid replacement. Although the hyperglycemia and acidosis were immediately relieved, the disturbance of consciousness and tachycardia remained persistent. Levels of FT3 and FT4 were extremely high and TSH was below the detectable limit. TRAb was positive. The thyroid storm score of Burch & Wartofsky was 75/140, and the thyroid storm diagnostic criteria of the Japan Thyroid Association were satisfied. Oral administration of thiamazole, potassium iodide and propranolol resulted in immediate relief of the tachycardia. Discussion We encountered a case of thyroid storm associated with Graves' disease covered by DKA. Thyroid storm and DKA are both potentially fatal, and the prognosis varies depending on whether or not these conditions are detected and treated sufficiently early. The thyroid storm diagnostic criteria prepared in 2008 by the Japan Thyroid Association are very simple as compared to the Burch & Wartofsky scoring system for thyroid storm. The Japanese criteria may be useful in the diagnosis of this condition since they

  4. Methylprednisolone Pulse Treatment of Graves' Ophthalmopathy Is Not Associated with Secondary Adrenocortical Insufficiency

    PubMed Central

    Jespersen, Sofie; Nygaard, Birte; Kristensen, Lars Østergaard

    2015-01-01

    Objective Graves' ophthalmopathy (GO) is an inflammatory disease in the orbital region. The first-line medical treatment is glucocorticoids. An important potential side effect of glucocorticoid treatment is suppression of the hypothalamic-pituitary-adrenal (HPA) axis with impairment of endogenous cortisol production, implicating symptoms of adrenocortical insufficiency, especially in the period after cessation of therapy with possible risks in cases of intercurrent illness. The aim of this study was to evaluate HPA axis function before and after methylprednisolone pulse treatment of GO. Study Design HPA axis function was evaluated by measurements of plasma ACTH and an ACTH stimulation test with plasma cortisol measurements at 0 and 30 min after an intravenous bolus of synthetic ACTH (Synacthen® 250 µg). This was done in 12 patients with GO before and at cessation of methylprednisolone pulse treatment (500 mg i.v. per week for 6 weeks followed by 250 mg i.v. per week for an additional 6 weeks). Results All patients included fulfilled the criteria of intact HPA axis function before and at cessation of methylprednisolone pulse treatment. Data are given as medians (with ranges). Before glucocorticoid treatment basal plasma cortisol was 290 nM (196-579) and 786 nM (612-1,050) after ACTH stimulation. At cessation of therapy the corresponding values were 309 nM (88-718) and 852 nM (524-1,011), respectively. Thus, all patients passed a 30-min stimulated plasma cortisol of 500 nM. Before treatment plasma ACTH was 4.2 pmol/l (4-16) and at cessation of therapy the corresponding value was 4.8 pmol/l (2-9; p = 0.27). Conclusion Transient suppression of the HPA axis with secondary adrenocortical insufficiency does not seem to be a common phenomenon after intravenous methylprednisolone pulse therapy for GO. Therefore, routine precautions are not necessary. However, our results do not exclude that transient secondary adrenocortical insufficiency might occur occasionally. PMID

  5. Vaccinating Your Preteen: Addressing Common Concerns

    MedlinePlus

    ... when they will be needed. What is the cost of these vaccines? I’m not sure if ... Act (ACA) requires insurance companies to cover the cost of all recommended vaccines, which include those for ...

  6. Student Perceptions of Using Games to Address Science Literacy

    NASA Astrophysics Data System (ADS)

    Keller, Cara M.

    The purpose of this qualitative evaluative case study was to gain insight into how students perceived the efficacy of using games to address their science literacy concerns. Scientists in the United States are concerned with the lack of science literacy. The No Child Left Behind Act of 2001 requires proficiency in reading, mathematics, language arts, and science by the completion of the 2013--2014 school year. The high school participating in this study received substandard test scores on both the 2009 state graduation test and the science portion of the ACT test. The research question included understanding how students perceive the use of games in addressing their science literacy needs. The data from the student journals, field notes, and transcribed class discussions were analyzed using a 6 step method that included coding the data into main themes. The triangulated data were used to both gain insight into student perspective and inform game development. Constructivist theories formed the conceptual framework of the study. The findings of the study suggested that games may prove a valuable tool in science literacy attainment. The study indicated that games were perceived by the students to be effective tools in meeting their learning needs. Implications for positive social change included providing students, educators, and administrators with game resources that can be used to meet the science learning needs of struggling students, thereby improving science scores on high stakes tests.

  7. Immunoglobulins from Graves' disease patients interact with different sites on TSH receptor/LH-CG receptor chimeras than either TSH or immunoglobulins from idiopathic myxedema patients.

    PubMed

    Tahara, K; Ban, T; Minegishi, T; Kohn, L D

    1991-08-30

    To examine the identity of binding sites for thyrotropin (TSH) and thyroid stimulating antibodies (TSAbs) associated with Graves' disease, we constructed eight human TSH receptor/rat LH-CG receptor chimeras. Substitution of amino acid residues 8-165 of the TSH receptor with the corresponding LH-CG receptor segment (Mc1 + 2) results in a chimera which retains high affinity TSH binding and the cAMP response to TSH but loses both the cAMP response to Graves' IgG and Graves' IgG inhibition of TSH binding. Two of three IgGs from idiopathic myxedema patients which contain thyroid stimulation blocking antibodies (TSBAbs) still, however, react with this chimera. Chimeras which substitute residues 90-165 (Mc2) and 261-370 (Mc4) retain the ability to interact with TSH, Graves' IgG, and idiopathic myxedema IgG. The data thus suggest that residues 8-165 contain an epitope specific for TSAbs and that TSH receptor determinants important for the activities of TSAbs and TSH are not identical. Further, binding sites for TSBAbs in idiopathic myxedema may be different from receptor binding sites for both Graves' IgG TSAb as well as TSH and may be different in individual patients.

  8. 45 CFR 1226.10 - Hatch Act restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... employee thereof. (2) Acting as an officer of a primary meeting or caucus, addressing, making motions... caucuses. (3) Organizing or conducting a political meeting or rally on any political matter. (4)...

  9. 45 CFR 1226.10 - Hatch Act restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... employee thereof. (2) Acting as an officer of a primary meeting or caucus, addressing, making motions... caucuses. (3) Organizing or conducting a political meeting or rally on any political matter. (4)...

  10. 45 CFR 1226.10 - Hatch Act restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... employee thereof. (2) Acting as an officer of a primary meeting or caucus, addressing, making motions... caucuses. (3) Organizing or conducting a political meeting or rally on any political matter. (4)...

  11. 45 CFR 1226.10 - Hatch Act restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... employee thereof. (2) Acting as an officer of a primary meeting or caucus, addressing, making motions... caucuses. (3) Organizing or conducting a political meeting or rally on any political matter. (4)...

  12. 45 CFR 1226.10 - Hatch Act restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... employee thereof. (2) Acting as an officer of a primary meeting or caucus, addressing, making motions... caucuses. (3) Organizing or conducting a political meeting or rally on any political matter. (4)...

  13. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815...

  14. 40 CFR 98.9 - Addresses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... submitted to the following address: (a) For U.S. mail. Director, Climate Change Division, 1200 Pennsylvania Ave., NW., Mail Code: 6207J, Washington, DC 20460. (b) For package deliveries. Director,...

  15. 40 CFR 98.9 - Addresses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... submitted to the following address: (a) For U.S. mail. Director, Climate Change Division, 1200 Pennsylvania Ave., NW., Mail Code: 6207J, Washington, DC 20460. (b) For package deliveries. Director,...

  16. Addressing Your Child's Weight at the Doctor

    MedlinePlus

    ... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

  17. Addressing Transition Issues in Languages Education.

    ERIC Educational Resources Information Center

    Steigler-Peters, Susi; Moran, Wendy; Piccioli, Maria Teresa; Chesterton, Paul

    2003-01-01

    Focuses on what has been learned from the implementation and evaluation of the Australian Language and Continuity Initiative (LCI) in relation to addressing transition issues in language education. (Author/VWL)

  18. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815...

  19. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815...

  20. 7 CFR 1730.3 - RUS addresses.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE General § 1730.3 RUS addresses. (a) Persons wishing to obtain... assigned RUS General Field Representative (GFR) or such other office as designated by RUS....

  1. 7 CFR 1730.3 - RUS addresses.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE General § 1730.3 RUS addresses. (a) Persons wishing to obtain... assigned RUS General Field Representative (GFR) or such other office as designated by RUS....

  2. 7 CFR 1730.3 - RUS addresses.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE General § 1730.3 RUS addresses. (a) Persons wishing to obtain... assigned RUS General Field Representative (GFR) or such other office as designated by RUS....

  3. 7 CFR 1730.3 - RUS addresses.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE General § 1730.3 RUS addresses. (a) Persons wishing to obtain... assigned RUS General Field Representative (GFR) or such other office as designated by RUS....

  4. 7 CFR 1730.3 - RUS addresses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE General § 1730.3 RUS addresses. (a) Persons wishing to obtain... assigned RUS General Field Representative (GFR) or such other office as designated by RUS....

  5. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815...

  6. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815...

  7. Optical Addressing And Clocking Of RAM's

    NASA Technical Reports Server (NTRS)

    Johnston, Alan R.; Nixon, Robert H.; Bergman, Larry A.; Esener, Sadik

    1989-01-01

    Proposed random-access-memory (RAM) addressing system, in which memory linked optically to read/write logic circuits, greatly increases computer operating speed. System - comprises addressing circuits including numerous lasers as signal sources, numerous optical gates including optical detectors associated with memory cells, and holographic element to direct light signals to desired memory-cell locations - applied to high-capacity digital systems, supercomputers, and complex microcircuits.

  8. 75 FR 75969 - Publication of State Plan Pursuant to the Help America Vote Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... Rico, and the U.S. Virgin Islands. 69 FR 14002. HAVA anticipated that states, territories and the... Empowerment Act (MOVE Act) and address changes in the respective budgets to account for the use of Fiscal...

  9. 75 FR 76893 - Publication of State Plan Pursuant to the Help America Vote Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    ... Rico, and the U.S. Virgin Islands. 69 FR 14002. HAVA anticipated that states, territories and the... provide for compliance with the Military and Overseas Voter Empowerment Act (MOVE Act) and address...

  10. 76 FR 58007 - Privacy Act of 1974; Report of a New System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... requirements of the Privacy Act of 1974, CMS is establishing a new system of records to support its shared... of the Patient Protection and Affordable Care Act (PPACA), amending the Social Security Act (the Act... of Records Notice (SORN) addresses a new system which HHS is establishing to support CMS...

  11. 45 CFR Appendix A to Part 2507 - Freedom of Information Act Request Letter (Sample)

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Freedom of Information Act Request Letter (Sample... INFORMATION ACT Pt. 2507, App. A Appendix A to Part 2507—Freedom of Information Act Request Letter (Sample) Freedom of Information Act Officer Name of Agency Address of Agency City, State, Zip Code Re: Freedom...

  12. Origin of primary PGM assemblage in сhromitite from a mantle tectonite at Harold's Grave (Shetland Ophiolite Complex, Scotland)

    NASA Astrophysics Data System (ADS)

    Badanina, Inna Yu.; Malitch, Kreshimir N.; Lord, Richard A.; Meisel, Thomas C.

    2013-12-01

    In this paper we present textural and mineral chemistry data for a PGM inclusion assemblage and whole-rock platinum-group element (PGE) concentrations of chromitite from Harold's Grave, which occurrs in a dunite pod in a mantle tectonite at Unst in the Shetland Ophiolite Complex (SOC), Scotland. The study utilized a number of analytical techniques, including acid digestion and isotope dilution (ID) ICP-MS, hydroseparation and electron microprobe analysis. The chromitite contains a pronounced enrichment of refractory PGE (IPGE: Os, Ir and Ru) over less refractory PGE (PPGE: Rh, Pt and Pd), typical of mantle hosted `ophiolitic' chromitites. A `primary' magmatic PGM assemblage is represented by euhedrally shaped (up to 60 μm in size) single and composite inclusions in chromite. Polyphase PGM grains are dominated by laurite and osmian iridium, with subordinate laurite + osmian iridium + iridian osmium and rare laurite + Ir-Rh alloy + Rh-rich sulphide (possibly prassoite). The compositional variability of associated laurite and Os-rich alloys at Harold's Grave fit the predicted compositions of experiment W-1200-0.37 of Andrews and Brenan (Can Mineral 40: 1705-1716, 2002) providing unequivocal information on conditions of their genesis, with the upper thermal stability of laurite in equilibrium with Os-rich alloys estimated at 1200-1250 °C and f(S2) of 10-0.39-10-0.07.

  13. The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves' Disease.

    PubMed

    English, Collette; Casey, Ruth; Bell, Marcia; Bergin, Diane; Murphy, Joseph

    2016-01-01

    The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. Volume, vascularity, echogenicity and echotexture of the glands were noted. The presence of nodules and lymph nodes was also documented. The mean volumes of the right lobe were 2.4 mL ± 2.9 SD (0.6-14) and the left lobe were 1.8 mL ± 1.9 SD (0.4-9.1), with a mean total volume of 4.2 mL ± 4.7 SD (1.3-19.1). Of those who had a pre-treatment ultrasound (23%), the percentage reduction in volume was 87% (p < 0.05); 93% of the glands were hypovascular, with the remaining 7% showing normal vascularity. The glands were hyperechoic and of coarse echotexture. Overall, the sonographic features of the post-RIT gland included a significantly reduced mean total volume of 4.2 mL, hypovascularity, coarse echotexture and hyperechogenicity.

  14. Methimazole, but not betamethasone, prevents 131I treatment-induced rises in thyrotropin receptor autoantibodies in hyperthyroid Graves' disease

    SciTech Connect

    Gamstedt, A.; Wadman, B.; Karlsson, A.

    1986-04-01

    The effects of methimazole or betamethasone therapy on the TSH receptor antibody response to radioiodine therapy were compared in a prospective randomized study of 60 patients with hyperthyroidism due to Graves' disease. The patients were followed for 1 yr after treatment with 131I. Twenty-three patients received 131I alone, 17 were treated with methimazole for 2 months before and 3 months after 131I therapy, and 20 patients were treated with betamethasone for 3 weeks before and 4 weeks after 131I therapy. 131I induced a transient rise in the mean serum level of TSH receptor autoantibodies, measured as TSH binding inhibitory immunoglobulin (TBII), but in patients receiving methimazole treatment, no such rise occurred. In the betamethasone-treated patients, TBII increased similarly to that in patients treated with 131I alone. In addition, in patients given betamethasone, there was an early decrease in total serum immunoglobulin G, which persisted throughout the follow-up period. In the other 2 groups, no changes in total immunoglobulin G were found. The results demonstrate that in hyperthyroid Graves' disease, TBII production is influenced by therapy. Methimazole abolished the 131I-induced increase in TBII, whereas betamethasone did not have such an inhibitory effect.

  15. Noble gases and halogens in Graves Nunataks 06129: The complex thermal history of a felsic asteroid crust

    NASA Astrophysics Data System (ADS)

    Claydon, Jennifer L.; Crowther, Sarah A.; Fernandes, Vera A.; Gilmour, Jamie D.

    2015-06-01

    The meteorite Graves Nunataks 06128/06129 is a rare example of felsic asteroidal crust. Knowledge of its history can help shed light on the evolution processes of planetesimals. The noble gases can be used to constrain both the chronology of meteorites and the processes that result in movements of volatile elements on asteroidal bodies. We have examined the I-Xe and Ar-Ar systems of the plagioclase-rich achondrite, Graves Nunataks 06129 by high-resolution laser step-heating of irradiated samples. Iodine and 129Xe∗ are both present but are released at different temperatures and do not show a correlation, therefore the I-Xe system in GRA 06129 has no chronological significance. We propose that radiogenic 129Xe∗ was lost from primary phases and parentless 129Xe∗ was later introduced into the rock by interaction with a fluid sourced from a reservoir that evolved with a high I/Xe ratio. This could have been the same halogen-rich fluid that induced the conversion of merrillite and pyroxene into chlorapatite. Inherited 40Ar (i.e. not generated by in situ decay of 40K) is also present in one of three fragments studied here and may have been introduced at the same time as parentless 129Xe∗.

  16. The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves' Disease.

    PubMed

    English, Collette; Casey, Ruth; Bell, Marcia; Bergin, Diane; Murphy, Joseph

    2016-01-01

    The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. Volume, vascularity, echogenicity and echotexture of the glands were noted. The presence of nodules and lymph nodes was also documented. The mean volumes of the right lobe were 2.4 mL ± 2.9 SD (0.6-14) and the left lobe were 1.8 mL ± 1.9 SD (0.4-9.1), with a mean total volume of 4.2 mL ± 4.7 SD (1.3-19.1). Of those who had a pre-treatment ultrasound (23%), the percentage reduction in volume was 87% (p < 0.05); 93% of the glands were hypovascular, with the remaining 7% showing normal vascularity. The glands were hyperechoic and of coarse echotexture. Overall, the sonographic features of the post-RIT gland included a significantly reduced mean total volume of 4.2 mL, hypovascularity, coarse echotexture and hyperechogenicity. PMID:26603660

  17. Immunization of mice with a newly identified thyroid-stimulating hormone receptor splice variant induces Graves'-like disease.

    PubMed

    Endo, Toyoshi; Kobayashi, Teturo

    2013-06-01

    We have cloned a thyroid-stimulating hormone receptor (TSHR) cDNA from mouse thyroid glands. The sequence of this cDNA indicated that it encoded a 739 amino acid TSHR splice variant that lacked exon 5 (TSHR739). In thyroid gland samples from adult mice, the amount of TSHR739 mRNA was about 10% of the amount of full-length TSHR (TSHR764) mRNA. A eCFP-tagged TSHR739 integrated into plasma membrane, but lacked TSH binding activity and it did not produce cAMP in response to TSH. However, thyroid-stimulating antibodies from patients with Graves' disease stimulated cAMP production in HEK293 cells that expressed TSHR739. Quantitative PCR revealed that TSHR739 transcript levels were low in the fetal mouse thyroid samples, but TSHR739 transcript levels increased after birth and as the mice grew. We used plasmid injection combined with electroporation into skeletal muscles to immunize BALB/c mice with TSHR739, TSHR764,, or control plasmid; TSHR739 caused goiters, high (125)I uptake activity, thyrotoxicosis, and production of thyroid-stimulating antibodies, but TSHR764, or control did not. These results indicated that immunization with an autologous TSHR antigen, TSHR739, induced Graves'-like disease in mice, and that TSHR739 is a candidate autoantigen in autoimmune thyroid disease. PMID:23538203

  18. Isotopic composition and identification of the origins of individuals buried in a Neolithic collective grave at Bronocice (southern Poland).

    PubMed

    Szostek, K; Haduch, E; Stepańczak, B; Kruk, J; Szczepanek, A; Pawlyta, J; Głąb, H; Milisauskas, S

    2014-04-01

    The oxygen present in a human organism comes from numerous sources, but the major factor that causes variation in the isotopic composition of this element in a tissue is available drinking water. The isotopic ratio of oxygen in an organism's tissue, including that found in bones and teeth, reflects the isotopic oxygen composition typical for the area where a given individual developed and lived. Of particular interest with regard to this issue were a series of skeletons from the multiple grave discovered at the Funnel Beaker-Baden settlement at Bronocice (southern Poland). The question therefore arose whether the specimens buried in this grave were part of the local community. The oxygen isotope level was established using apatite isolated from bones or teeth. A femur and root dentine samples taken from permanent teeth were subjected to oxygen isotope analysis. The oxygen isotope level of the site was established on the basis of local water precipitation and measurements taken from the oxygen isotope concentration in apatite samples isolated from the bones of animals co-occurring with the studied human group. It has been found that the oxygen isotope levels in the bones and dentine of almost all the analysed specimens from the excavated site at Bronocice were within the established range for the area's environment, providing evidence for their local origin. Thus, it can be assumed that the analysed group inhabiting the macrosettlement at Bronocice during the Funnel Beaker phase of the Baden culture was most probably of local origin.

  19. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Managing owner designation; address; requirement to... Required for Vessel Documentation § 67.113 Managing owner designation; address; requirement to report change of address. The owner of each vessel must designate a managing owner on the Application...

  20. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Managing owner designation; address; requirement to... Required for Vessel Documentation § 67.113 Managing owner designation; address; requirement to report change of address. The owner of each vessel must designate a managing owner on the Application...

  1. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Managing owner designation; address; requirement to... Required for Vessel Documentation § 67.113 Managing owner designation; address; requirement to report change of address. The owner of each vessel must designate a managing owner on the Application...

  2. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Managing owner designation; address; requirement to... Required for Vessel Documentation § 67.113 Managing owner designation; address; requirement to report change of address. The owner of each vessel must designate a managing owner on the Application...

  3. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Managing owner designation; address; requirement to... Required for Vessel Documentation § 67.113 Managing owner designation; address; requirement to report change of address. The owner of each vessel must designate a managing owner on the Application...

  4. Climate change in China and China's policies and actions for addressing climate change

    NASA Astrophysics Data System (ADS)

    Qin, D.; Huang, J.; Luo, Y.

    2010-12-01

    Since the first assessment report (FAR) of Inter-Governmental Panel on Climate Change (IPCC) in 1990, the international scientific community has made substantial progresses in climate change sciences. Changes in components of climate system, including the atmosphere, oceans and cryosphere, indicate that global warming is unequivocal. Instrumental records demonstrate that the global mean temperature has a significant increasing trend during the 20th century and in the latest 50 years the warming become faster. In the meantime, the global sea level has a strong increasing trend, as well as the snow coverage of Northern Hemisphere showed an obvious downward trend. Moreover, the global warming plays a key role in significantly affecting the climate system and social-economy on both global and regional scales, such as sea level rise, melting of mountain glaciers and ice sheets, desertification, deforestation, increase of weather extremes (typhoon, hurricane and rainstorm) and so on. The state of the art understanding of IPCC Fourth Assessment Report (AR4) was most of the observed increase in global average temperatures since the mid-20th century is very likely due to the observed increase in the concentrations of anthropogenic greenhouse gases. Climate change issues, as a grave challenge to the sustainable development of the human society, have received ever greater attention from the international community. Deeply cognizant of the complexity and extensive influence of these issues and fully aware of the arduousness and urgency of the task of addressing climate change, the Chinese government is determined to address climate change in the process of pursuing sustainable development. The facts of climate change in China and its impacts, and China’s policies and actions for addressing climate change are introduced in this paper.

  5. Increased microRNA-155 and decreased microRNA-146a may promote ocular inflammation and proliferation in Graves' ophthalmopathy.

    PubMed

    Li, Kaijun; Du, Yi; Jiang, Ben-Li; He, Jian-Feng

    2014-04-18

    Graves' ophthalmopathy is an inflammatory autoimmune disease of the orbit, characterized by inflammation and proliferation of the orbital tissue caused by CD4+T cells and orbital fibroblasts. Despite recent substantial findings regarding its cellular and molecular foundations, the pathogenesis of Graves' ophthalmopathy remains unclear. Accumulating data suggest that microRNAs play important roles in the pathophysiology of autoimmunity and proliferation. Specifically, microRNA-155 (miR-155) can promote autoimmune inflammation by enhancing inflammatory T cell development. In contrast to miR-155, microRNA-146a (miR-146a) can inhibit the immune response by suppressing T cell activation. Furthermore, miR-155 and miR-146a are involved in cell proliferation, differentiation, and many other life processes. Thus, miR-155 and miR-146a, with opposite impacts on inflammatory responses carried out by T lymphocytes, appear to have multiple targets in the pathogenesis of Graves' ophthalmopathy. Our previous work showed that the expression of miR-146a was significantly decreased in peripheral blood mononuclear cells from Graves' ophthalmopathy patients compared with normal subjects. Accordingly, we proposed that the expression of miR-155 increased and the expression of miR-146a decreased in the target cells (CD4+T cells and orbital fibroblasts), thus promoting ocular inflammation and proliferation in Graves' ophthalmopathy. The proposed hypothesis warrants further investigation of the function of the differentially expressed microRNAs, which may shed new light on the pathogenesis of Graves' ophthalmopathy and lead to new strategies for its management.

  6. Act II of the Sunshine Act.

    PubMed

    Pham-Kanter, Genevieve

    2014-11-01

    To coincide with the introduction in the United States of the Sunshine Act, Genevieve Pham-Kanter discusses what we need to look for to fight hidden bias and deliberate or unconscious corruption. Please see later in the article for the Editors' Summary.

  7. The significant increase in incidence of Graves' disease in eastern Serbia during the civil war in the former Yugoslavia (1992 to 1995).

    PubMed

    Paunkovic, N; Paunkovic, J; Pavlovic, O; Paunovic, Z

    1998-01-01

    The incidence of Graves' disease for the last 25 years in eastern Serbia (Yugoslavia), Timok Region is reported. Registration of all Graves' disease patients was conducted in the Endocrinology-Thyroid Unit of Nuclear Medicine Service, Medical Center Zajecar. Timok Region has a population of 315,000 people in seven counties. From 1971 to 1980 an average of 16 new patients per year were registered; from 1981 to 1990 an average of 33 patients per year were registered; in 1995 the number reached 100, and in 1996 there were 148 newly registered patients. Some of the possible factors influencing this significant annual increase of autoimmune hyperthyroidism are discussed.

  8. Effects of Prostaglandin F2α on Adipocyte Biology Relevant to Graves' Orbitopathy

    PubMed Central

    Draman, Mohd Shazli; Grennan-Jones, Fiona; Zhang, Lei; Taylor, Peter N; Tun, Tommy Kyaw; McDermott, John; Moriarty, Paul; Morris, Daniel; Lane, Carol; Sreenan, Seamus; Dayan, Colin

    2013-01-01

    Background: In Graves' orbitopathy (GO), increased proliferation, excess adipogenesis, and hyaluronan overproduction produce GO exophthalmos. Enophthalmos occurs in some glaucoma patients treated with Bimatoprost (prostaglandin F2α, PGF2α) eye drops. We hypothesized that enophthalmos is secondary to reductions in orbital tissue proliferation, adipogenesis, and/or increased lipolysis. We aimed to determine which of these is affected by PGF2α by using the 3T3-L1 murine preadipocyte cell line and primary human orbital fibroblasts (OFs) from GO patients (n=5) and non-GO (n=5). Methods: 3T3-L1 cells and orbital OFs were cultured alone or with PGF2α (all experiments used 10−8 to 10−6 M) and counted on days 1/2/3 or 5, respectively; cell cycle analysis (flow cytometry) was applied. Adipogenesis (in the presence/absence of PGF2α) was evaluated (day 7 or 15 for 3T3-L1 and primary cells, respectively) morphologically by Oil Red O staining and quantitative polymerase chain reaction measurement of adipogenesis markers (glycerol-3-phosphate dehydrogenase and lipoprotein lipase, respectively). For lipolysis, in vitro–differentiated 3T3-L1 or mature orbital adipocytes were incubated with norepinephrine and PGF2α and free glycerol was assayed. Appropriate statistical tests were applied. Results: The population doubling time of 3T3-L1 was 27.3±1.4 hours—significantly increased by dimethyl sulfoxide 0.02% to 44.6±4.8 hours (p=0.007) and further significantly increased (p=0.049 compared with dimethyl sulfoxide) by 10−8 M PGF2α to 93.6±19.0 hours, indicating reduced proliferation, which was caused by prolongation of G2/M. GO OFs proliferated significantly more rapidly than non-GO (population doubling time 5.36±0.34 or 6.63±0.35 days, respectively, p=0.035), but the proliferation of both was significantly reduced (dose dependent from 10−8 M) by PGF2α, again with prolongation of G2/M. Adipogenesis in 3T3-L1 cells was minimally affected by PGF2α when assessed

  9. Could the eucrite Graves Nunataks 98098 be Vesta's equivalent to Lunar KREEP?

    NASA Astrophysics Data System (ADS)

    Sarafian, A. R.; Marschall, H.; Nielsen, S.

    2013-12-01

    Basaltic eucrites, members of the HED achondrite clan, are thought to derive from the asteroid 4-Vesta [1]. Most eucrites show little compositional and petrographic variability, thus anomalous eucrite could provide key insights into differentiation processes that operated on Vesta. The eucrite Graves Nunataks (GRA) 98098 is an unbrecciated eucrite with cross cutting white tabular veins consisting of mainly equigranular tridymite and euhedral plagioclase with some pyroxene [2]. In addition, GRA has the second highest modal (volume) abundance of apatite in a eucrite studied thus far. The apatite is associated with the veins [2]. The GRA bulk rock composition is enriched in incompatible elements with concentrations ca. 3-5 times higher than in most basaltic eucrites [3]. Additionally, GRA has 10-20 times more Cl than any other analyzed eucritic apatite [2]. Here we measured the trace-element concentrations of plagioclase and pyroxene by laser ablation ICP-MS and the D/H ratio of the apatites by SIMS. In the domains of GRA cut by veins, the trace elements in plagioclase and pyroxene show an up to 15x enrichment in incompatible elements compared to other basaltic eucrites [4]. Here we report the first D/H measurement of any magmatic material from Vesta. The D/H of apatite in GRA is relatively light compared to vSMOW. Based on the high abundance of incompatible elements in GRA and the high Cl content found in apatites, Sarafian et al. [2] suggested that GRA could be akin to Lunar KREEP (lunar rocks enriched in K, REEs and P). With the additional evidence of enriched incompatible elements in plagioclase and pyroxene and the similarity in D/H compared to KREEP, it is likely that GRA was infiltrated by a late-stage melt enriched in incompatible elements, similar to Lunar KREEP. Further study is needed to determine if this late-stage melt formed in a similar manner as KREEP. 1. Consolmango, G.J. and M.J. Drake, Composition and evolution of the eucrite parent body: Evidence

  10. The Uniform Alcoholism and Intoxication Treatment Act: Law Enforcement Guidelines.

    ERIC Educational Resources Information Center

    International Association of Chiefs of Police, Inc., Washington, DC.

    This text has been prepared in an effort to explain what the Uniform Act contains, intends to do, and cannot do. It also examines mehtods by which the Act can be implemented as well as the manner in which implementation can be accomplished most effectively. Working within the parameters of the overall alcohol problem, it also addresses the major…

  11. Dealing with the Clean Water Act pending reauthorization

    SciTech Connect

    Mathews, S.

    1994-09-01

    This report addresses probable changes in the Clean Water Act that may affect federal facilities such as those under the DOE. These changes will be included in a reauthorization of the act. The author draws upon the 1992 National Water Quality Inventory Report to Congress as a source to identify changes in the focus of the reauthorized act on non-point source issues, watershed management, new enforcement mechanisms and an assortment of smaller issues that will have indirect effects on federal facilities.

  12. 25 CFR 700.33 - Act (The Act).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Act (The Act). 700.33 Section 700.33 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.33 Act (The Act). (a) The Act. The Act is Pub. L. 93-531, (88...

  13. 25 CFR 700.33 - Act (The Act).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Act (The Act). 700.33 Section 700.33 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.33 Act (The Act). (a) The Act. The Act is Pub. L. 93-531, (88...

  14. 25 CFR 700.33 - Act (The Act).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Act (The Act). 700.33 Section 700.33 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.33 Act (The Act). (a) The Act. The Act is Pub. L. 93-531, (88...

  15. 25 CFR 700.33 - Act (The Act).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Act (The Act). 700.33 Section 700.33 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.33 Act (The Act). (a) The Act. The Act is Pub. L. 93-531, (88...

  16. Dare to Care/Dare to Act: Racism and Education.

    ERIC Educational Resources Information Center

    Leeper, Robert R., Ed.

    This booklet presents the text of the addresses by three speakers at the Annual Conference of the Association for Supervision and Curriculum Development, March 6-10, 1971, in St. Louis, Missouri. The first address, "Dare to Care/Dare to Act" by Price M. Cobbs, M.D., deals with the symptoms, the virulence, and the infectious nature of racism. He…

  17. Cheaper Adjoints by Reversing Address Computations

    DOE PAGES

    Hascoët, L.; Utke, J.; Naumann, U.

    2008-01-01

    The reverse mode of automatic differentiation is widely used in science and engineering. A severe bottleneck for the performance of the reverse mode, however, is the necessity to recover certain intermediate values of the program in reverse order. Among these values are computed addresses, which traditionally are recovered through forward recomputation and storage in memory. We propose an alternative approach for recovery that uses inverse computation based on dependency information. Address storage constitutes a significant portion of the overall storage requirements. An example illustrates substantial gains that the proposed approach yields, and we show use cases in practical applications.

  18. Shared address collectives using counter mechanisms

    SciTech Connect

    Blocksome, Michael; Dozsa, Gabor; Gooding, Thomas M; Heidelberger, Philip; Kumar, Sameer; Mamidala, Amith R; Miller, Douglas

    2014-02-18

    A shared address space on a compute node stores data received from a network and data to transmit to the network. The shared address space includes an application buffer that can be directly operated upon by a plurality of processes, for instance, running on different cores on the compute node. A shared counter is used for one or more of signaling arrival of the data across the plurality of processes running on the compute node, signaling completion of an operation performed by one or more of the plurality of processes, obtaining reservation slots by one or more of the plurality of processes, or combinations thereof.

  19. ACT and College Success

    ERIC Educational Resources Information Center

    Bleyaert, Barbara

    2010-01-01

    What is the relationship between ACT scores and success in college? For decades, admissions policies in colleges and universities across the country have required applicants to submit scores from a college entrance exam, most typically the ACT (American College Testing) or SAT (Scholastic Aptitude Test). This requirement suggests that high school…

  20. The Clean Water Act

    SciTech Connect

    Piatt, J.

    1995-12-31

    The Federal Water Pollution Control Act, commonly called the Clean Water Act (CWA), was adopted on 18 October 1972. Since then it has been amended 18 times, the last amendments were adopted on 4 February 1987. As established, its objective is: to restore and maintain the chemical, physical, and biological integrity of the Nation`s waters. And has, as an interim goal: water quality which provides for the protection and propagation of fish, shellfish, and wildlife and provides for recreation in and on the water. It should be noted that Congress established as the Act`s ultimate goal: the discharge of pollutants into the navigable waters be eliminated. The Act set out to meet this lofty objective and goal through the development and implementation of controls on the point source discharges and the nonpoint source release of pollutants. The regulation of point and nonpoint sources as well as future requirements are discussed.

  1. 40 CFR 80.174 - Addresses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FUELS AND FUEL ADDITIVES Detergent Gasoline § 80.174 Addresses. (a) The detergent additive sample..., 2565 Plymouth Road, Ann Arbor, Michigan 48105. (b) Other detergent registration and certification data, and certain other information which may be specified in this subpart, shall be sent to:...

  2. Transition through Teamwork: Professionals Address Student Access

    ERIC Educational Resources Information Center

    Bube, Sue Ann; Carrothers, Carol; Johnson, Cinda

    2016-01-01

    Prior to 2013, there was no collaboration around the transition services for deaf and hard of hearing students in Washington State. Washington had numerous agencies providing excellent support, but those agencies were not working together. It was not until January 29, 2013, when pepnet 2 hosted the Building State Capacity to Address Critical…

  3. Address Systems in "The Plum Plum Pickers"

    ERIC Educational Resources Information Center

    Geuder, Patricia A.

    1975-01-01

    The address systems in Raymond Barrio's "The Plum Plum Pickers" imply sociolinguistic differences between the Chicano and the Anglo characters. The kinds of sociolinguistic situations, the number of dyadic patterns, and the quantity of the dyadic patterns strongly suggest the differences. (Author)

  4. Preservice Educators' Confidence in Addressing Sexuality Education

    ERIC Educational Resources Information Center

    Wyatt, Tammy Jordan

    2009-01-01

    This study examined 328 preservice educators' level of confidence in addressing four sexuality education domains and 21 sexuality education topics. Significant differences in confidence levels across the four domains were found for gender, academic major, sexuality education philosophy, and sexuality education knowledge. Preservice educators…

  5. 50 CFR 228.8 - Mailing address.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 11 2013-10-01 2013-10-01 false Mailing address. 228.8 Section 228.8 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION... the Presiding Officer, c/o Assistant Administrator, National Marine Fisheries Service, 1315...

  6. 50 CFR 228.8 - Mailing address.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Mailing address. 228.8 Section 228.8 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION... the Presiding Officer, c/o Assistant Administrator, National Marine Fisheries Service, 1315...

  7. Autocheck: Addressing the Problem of Rural Transportation.

    ERIC Educational Resources Information Center

    Payne, Guy A.

    This paper describes a project implemented by a social worker from the Glynn County School District in rural Georgia to address transportation problems experienced by students and their families. The project aims to assist families who are unable to keep appointments or attend other important events due to unreliable transportation. A county needs…

  8. 40 CFR 80.174 - Addresses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Addresses. 80.174 Section 80.174 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF... Services Division, U.S. Environmental Protection Agency, National Vehicle and Fuel Emissions...

  9. Addressing Student Debt in the Classroom

    ERIC Educational Resources Information Center

    Perkins, David; Johnston, Tim; Lytle, Rick

    2016-01-01

    Student debt is a national concern. The authors address debt in the classroom to enhance students' understanding of the consequences of debt and the need for caution when financing their education. However, student feedback indicates this understanding has a delayed effect on borrowing behavior and underscores the importance of making difficult…

  10. Opening Address of Chairman Michael Pertschuk.

    ERIC Educational Resources Information Center

    Pertschuk, Michael

    Presented to a symposium sponsored by the Federal Trade Commission (FTC) to consider some of the issues involved in the continuing growth of a few large companies in the field of communication, this address cites statements of concern, made by the Supreme Court and by some periodicals, that excessive concentrations of power threaten First…

  11. How Sociology Texts Address Gun Control

    ERIC Educational Resources Information Center

    Tonso, William R.

    2004-01-01

    William R. Tonso has chosen an issue that he knows something about to examine how sociology textbooks address controversy. Appealing for gun control is fashionable, but it is at odds with a fondness that ordinary Americans have for their firearms--one that is supported by a growing body of research on deterrence to crime. There are two sides to…

  12. Registering Names and Addresses for Information Technology.

    ERIC Educational Resources Information Center

    Knapp, Arthur A.

    The identification of administrative authorities and the development of associated procedures for registering and accessing names and addresses of communications data systems are considered in this paper. It is noted that, for data communications systems using standards based on the Open Systems Interconnection (OSI) Reference Model specified by…

  13. Addressing Issues Related to Technology and Engineering

    ERIC Educational Resources Information Center

    Technology Teacher, 2008

    2008-01-01

    This article presents an interview with Michael Hacker and David Burghardt, codirectors of Hoftra University's Center for Technological Literacy. Hacker and Burghardt address issues related to technology and engineering. They argue that teachers need to be aware of the problems kids are facing, and how to present these problems in an engaging…

  14. Latitude and Longitude. AIR Presidential Address.

    ERIC Educational Resources Information Center

    Chaffee, Ellen Earle

    This speech addresses the problem of higher education's response to the forces of change and argues for a reinventing of higher education rather than repeatedly amending core teaching and research activities to fit new social and economic situations. Three higher education organizational dynamics (recruitment, budgeting, and handling outside…

  15. Federal Offices That Address Women's Issues.

    ERIC Educational Resources Information Center

    Weber, Patricia A.; And Others

    This directory contains a listing of federal offices that address women's issues. Among the departments and agencies included are: the executive branch and the executive agencies departments of agriculture, commerce, defense (Air Force, Army, Coast Guard, Marine Corps, National Guard and Navy), education, health and human services, housing and…

  16. Problem Solvers: Solutions--The Inaugural Address

    ERIC Educational Resources Information Center

    Dause, Emily

    2014-01-01

    Fourth graders in Miss Dause's and Mrs. Hicks's mathematics classes at South Mountain Elementary School in Dillsburg, Pennsylvania, worked with the data from the Inauagural Address problem that was previously published published in the February 2013 issue of "Teaching Children Mathematics". This activity allowed students to…

  17. State of the District Address, 1982.

    ERIC Educational Resources Information Center

    Koltai, Leslie

    This address by the Chancellor of the Los Angeles Community College District (LACCD) discusses recent and long-term changes in the district's programs, educational quality, and financial standing, and suggests means for future improvements. First, the paper highlights the district's achievements in improving transfer education and developing new…

  18. 40 CFR 65.14 - Addresses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Addresses. 65.14 Section 65.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONSOLIDATED... Department of Health and Environment, Bureau of Air Quality and Radiation Control, Forbes Field,...

  19. Addressing South Africa's Engineering Skills Gaps

    ERIC Educational Resources Information Center

    Hall, Jonathan; Sandelands, Eric

    2009-01-01

    Purpose: This paper aims to provide a case study of how engineering skills gaps are being addressed by Murray & Roberts in South Africa. Design/methodology/approach: The paper focuses on skills challenges in South Africa from a reflective practitioner perspective, exploring a case example from an industry leader. Findings: The paper explores how…

  20. 76 FR 80903 - Mandatory Declassification Review Addresses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... of the Secretary Mandatory Declassification Review Addresses AGENCY: Department of Defense. ACTION... Declassification Review requests may be sent. This notice benefits the public in advising them where to send such requests for declassification review. FOR FURTHER INFORMATION CONTACT: Mr. Robert Storer, (571)...

  1. Native Women at Risk: Addressing Cancer Prevention.

    ERIC Educational Resources Information Center

    Thiemann, Kay M. B.

    1994-01-01

    Discusses outcomes of a conference that brought together representatives from Indian tribes, state health departments, the Indian Health Service, the Mayo Clinic, and the American Cancer Society, to address the high rate of cervical cancer among American Indian women. Describes barriers to health care and plans to promote cancer screening among…

  2. 21 CFR 600.2 - Mailing addresses.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Mailing addresses. 600.2 Section 600.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS... Health, 21 Wilson Dr., rm. 107, Bethesda, MD 20892-6780. (d) Vaccine Adverse Event Reporting...

  3. Rational Rhymes for Addressing Common Childhood Issues

    ERIC Educational Resources Information Center

    Warren, Jeffrey M.

    2011-01-01

    Music-based interventions are valuable tools counselors can use when working with children. Specific types of music-based interventions, such as songs or rhymes, can be especially pertinent in addressing the thoughts, feelings, and behaviors of children. Rational-emotive behavior therapy (REBT) provides a therapeutic framework that encourages…

  4. Violence Goes to School. Keynote Address.

    ERIC Educational Resources Information Center

    Levin, Jack

    1998-01-01

    Increased juvenile violence in schools has led to suggested solutions that are politically expedient but fail to address what makes violence so appealing. Instead of school uniforms, conflict resolution programs, or media rating systems, a grass roots approach of alternative programs, parental involvement, and youth support systems could repair…

  5. ALI (Autonomous Lunar Investigator): Revolutionary Approach to Exploring the Moon with Addressable Reconfigurable Technology

    NASA Technical Reports Server (NTRS)

    Clark, P. E.; Curtis, S. A.; Rilee, M. L.; Floyd, S. R.

    2005-01-01

    Addressable Reconfigurable Technology (ART) based structures: Mission Concepts based on Addressable Reconfigurable Technology (ART), originally studied for future ANTS (Autonomous Nanotechnology Swarm) Space Architectures, are now being developed as rovers for nearer term use in lunar and planetary surface exploration. The architecture is based on the reconfigurable tetrahedron as a building block. Tetrahedra are combined to form space-filling networks, shaped for the required function. Basic structural components are highly modular, addressable arrays of robust nodes (tetrahedral apices) from which highly reconfigurable struts (tetrahedral edges), acting as supports or tethers, are efficiently reversibly deployed/stowed, transforming and reshaping the structures as required.

  6. Mapping virtual addresses to different physical addresses for value disambiguation for thread memory access requests

    DOEpatents

    Gala, Alan; Ohmacht, Martin

    2014-09-02

    A multiprocessor system includes nodes. Each node includes a data path that includes a core, a TLB, and a first level cache implementing disambiguation. The system also includes at least one second level cache and a main memory. For thread memory access requests, the core uses an address associated with an instruction format of the core. The first level cache uses an address format related to the size of the main memory plus an offset corresponding to hardware thread meta data. The second level cache uses a physical main memory address plus software thread meta data to store the memory access request. The second level cache accesses the main memory using the physical address with neither the offset nor the thread meta data after resolving speculation. In short, this system includes mapping of a virtual address to a different physical addresses for value disambiguation for different threads.

  7. 25 CFR 224.102 - Must a tribe establish a comment or hearing process for addressing environmental concerns?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... addressing environmental concerns? 224.102 Section 224.102 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF... or hearing process for addressing environmental concerns? Yes. The Act (25 U.S.C. 3504(e)(2)(C)(iii... establish an environmental review process under a TERA that: (a) Ensures that the public is notified...

  8. Mössbauer study of the warrior figures of pottery in the grave site of the first Chinese emperor (221 B.C.)

    NASA Astrophysics Data System (ADS)

    Zhongtian, Sun; Xianjia, Pan; Guangyong, Qin; Guoqiao, Jin; Zhongyi, Yuan

    1988-12-01

    Mossbauer spectroscopy measurements at both room and liquid nitrogen temperature of potsherd samples of terracotta figures of warriors and horses excavated from within the pit at the grave site of the First Emperor (221 B.C.), lead us to conclude that the No. 4 potsherd sample was fired at a temperature of 980±50°C in a reducing atmosphere.

  9. Anti-Ku antibody-positive scleroderma-dermatomyositis overlap syndrome developing Graves' disease and immune thrombocytopenic purpura.

    PubMed

    Kamei, Nozomu; Yamane, Kiminori; Yamashita, Yasuyo; Nakanishi, Shuhei; Watanabe, Hiroshi; Fujikawa, Rumi; Hiyama, Keiko; Ishioka, Shinichi; Mendoza, Ciro; Kohno, Nobuoki

    2002-12-01

    Graves' disease (GD) has been reported to be frequently complicated with other autoimmune diseases. However, it is rarely complicated with scleroderma-polymyositis overlap syndrome. Recently, we encountered a 35-year-old woman who developed GD and immune thrombocytopenic purpura during follow-up observation of scleroderma-dermatomyositis overlap syndrome. Platelet counts recovered after high-dose gamma-globulin therapy and bolus methylprednisolone therapy. The present case is the first report of a combination of scleroderma, dermatomyositis, GD, and immune thrombocytopenic purpura. The patient was anti-Ku antibody-positive and had relatively low natural killer T cell counts, both of which might contribute to the complication of multiple autoimmune diseases.

  10. Unusual presentation of Warthin variant of Papillary thyroid carcinoma with lymph nodal metastases in a patient of Graves' disease.

    PubMed

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga; Arun, B R

    2015-01-01

    Warthin-like Papillary thyroid carcinoma (WPTC) is a rare variant of papillary carcinoma of thyroid, PTC which derives its name by closely resembling Warthin's tumor of salivary gland. Hallmark histological feature of this variant is papillary folding lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. It is thought to be one of those differentiated thyroid cancers with favorable prognosis. We report a case of Graves' disease with a cold nodule harboring WPTC with initial presentation of lymph nodal metastases. It is important to identify this peculiar variant of PTC as 5 to 10% of them undergo dedifferentiation and 30% have the lymph nodal metastases and extra thyroidal extension.

  11. 3 CFR - Establishing Policies for Addressing Domestic Violence in the Federal Workforce

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Violence in the Federal Workforce Presidential Documents Other Presidential Documents Memorandum of April 18, 2012 Establishing Policies for Addressing Domestic Violence in the Federal Workforce Memorandum... initial passage of the Violence Against Women Act in 1994 (Public Law 103-322), domestic violence...

  12. 17 CFR 230.154 - Delivery of prospectuses to investors at the same address.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Delivery of prospectuses to investors at the same address. 230.154 Section 230.154 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION GENERAL RULES AND REGULATIONS, SECURITIES ACT OF 1933 General § 230.154 Delivery of prospectuses to investors at the...

  13. 76 FR 70878 - Revitalizing Base Closure Communities and Addressing Impacts of Realignment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... of the Secretary 32 CFR Part 174 RIN 0790-AI67 Revitalizing Base Closure Communities and Addressing... Fiscal Year 2010, Public Law 111-84, amended the Defense Base Closure and Realignment Act of 1990 to... (LRA) for purposes of job generation on a military installation closed or realigned under a...

  14. 25 CFR 224.136 - How will the Director's report address a tribe's noncompliance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... DETERMINATION ACT Periodic Reviews Noncompliance § 224.136 How will the Director's report address a tribe's... notice of violation of Federal law or the terms of a TERA. (a) If the Director determines that the tribe has not complied with Federal law or the terms of a TERA, the Director's written report must include...

  15. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... policies and procedures. (i) Comparing the information in the consumer report provided by the consumer... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duties of users of consumer reports... CREDIT REPORTING ACT DUTIES OF USERS OF CONSUMER REPORTS REGARDING ADDRESS DISCREPANCIES § 641.1...

  16. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... policies and procedures. (i) Comparing the information in the consumer report provided by the consumer... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of users of consumer reports... CREDIT REPORTING ACT DUTIES OF USERS OF CONSUMER REPORTS REGARDING ADDRESS DISCREPANCIES § 641.1...

  17. 25 CFR 224.136 - How will the Director's report address a tribe's noncompliance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... DETERMINATION ACT Periodic Reviews Noncompliance § 224.136 How will the Director's report address a tribe's... notice of violation of Federal law or the terms of a TERA. (a) If the Director determines that the tribe has not complied with Federal law or the terms of a TERA, the Director's written report must include...

  18. 25 CFR 224.136 - How will the Director's report address a tribe's noncompliance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DETERMINATION ACT Periodic Reviews Noncompliance § 224.136 How will the Director's report address a tribe's... notice of violation of Federal law or the terms of a TERA. (a) If the Director determines that the tribe has not complied with Federal law or the terms of a TERA, the Director's written report must include...

  19. 25 CFR 224.136 - How will the Director's report address a tribe's noncompliance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DETERMINATION ACT Periodic Reviews Noncompliance § 224.136 How will the Director's report address a tribe's... notice of violation of Federal law or the terms of a TERA. (a) If the Director determines that the tribe has not complied with Federal law or the terms of a TERA, the Director's written report must include...

  20. A genomic point mutation in the extracellular domain of the thyrotropin receptor in patients with Graves` ophthalmopathy

    SciTech Connect

    Bahn, R.S.; Dutton, C.M.; Heufelder, A.E.; Sarkar, G. |

    1994-02-01

    Orbital and pretibial fibroblasts are targets of autoimmune attack in Graves` ophthalmopathy (GO) and pretibial dermopathy (PTD). The fibroblast autoantigen involved in these peripheral manifestations of Graves` disease and the reason for the association of GO and PTD with hyperthyroidism are unknown. RNA encoding the full-length extracellular domain of the TSH receptor has been demonstrated in orbital and dermal fibroblasts from patients with GO and normal subjects, suggesting a possible antigenic link between fibroblasts and thyrocytes. RNA was isolated from cultured orbital, pretibial, and abdominal fibroblasts obtained from patients with severe GO (n = 22) and normal subjects (n = 5). RNA was reverse transcribed, and the resulting cDNA was amplified by the polymerase chain reaction, using primers spanning overlapping regions of the entire extracellular domain of the TSH receptor. Nucleotide sequence analysis showed an A for C substitution in the first position of codon 52 in 2 of the patients, both of whom had GO, PTD, and acropachy. Genomic DNA isolated from the 2 affected patients, and not from an additional 12 normal subjects, revealed the codon 52 mutation by direct sequencing and AciI restriction enzyme digestions. In conclusion, the authors have demonstrated the presence of a genomic point mutation, leading to a threonine for proline amino acid shift in the predicted peptide, in the extracellular domain of the TSH receptor in two patients with severe GO, PTD, acropachy, and high thyroid-stimulating immunoglobulin levels. RNA encoding this mutant product was demonstrated in the fibroblasts of these patients. They suggest that the TSH receptor may be an important fibroblast autoantigen in GO and PTD, and that this mutant form of the receptor may have unique immunogenic properties. 28 refs., 3 figs., 2 tabs.